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Popular Science Monthly/Volume 5/July 1874/The Genesis of Woman

THE GENESIS OF WOMAN.
By ELY VAN DE WARKER, M. D.

IN the construction of a piece of delicate mechanism there are two crises. Through some fault in its construction it may not permit movement in any part; and, each part being perfect, yet, through some defect in the arrangement, it may be capable of motion, but unable to fulfill the purpose for which it was designed. The first is an error of structure, the last an error of function.

If in the construction of the machine these sources of failure were avoided, it would perform its appointed office, until interrupted by an accident, or the natural wear of the parts entails both errors of structure and function.

At birth in the human animal sex is as distinct as at any after-period of life. Birth merely marks a stage of development, and not a change in design. Fœtal life to the perfection of the sexual design embraces simply a process of construction. This is the period in which the crises occur. By arrest of development, through imperfection in the structure of subsidiary parts, the perfection of function may never be reached. This would result from an error of structure. Structural perfection may be attained; but, through some defect in the mutual dependence of the parts, the perfection of sexual design may never be reached. This would result from functional error. The woman who has reached the stature and years which mark completion of structure, but in whom certain organs, vital to the attainment of sexual perfection, remain in an embryonic condition, or one who has reached anatomical perfection, but through defect of function may never gain that expression of sexual perfection called perfect ovulation, may be, in every other respect, physically a perfect woman, but has given a total defeat to the purpose for which she was designed. Both these errors are incidents in the genesis of woman. A fault of sexual function does not spring into existence the moment sexual life is to be crowned by ovulation. This imperfect function is a result, not a process. It antedates the commencement of ovarian life. It may be occult in the years of childhood, it may be antenatal, or even an error of ancestry. I believe it exists with the force of a law, that the conditions which result in ovarian irregularity are operative before and not during the establishment of that function. This office, like any other of the body, is exposed to the accidents of disease; but I think it may be proved that when irregularity of this function is the result of concurrent causes it is purely an accident—the exception which confirms the rule.

Young women become an object of parental or medical solicitude at a period when it will have but little influence on the perfection or imperfection of their sexual life. By the keenness of the vision directed to this period of woman's genesis, they are blinded to all the years of formative childhood. Perfect function is an expression for perfect organs. Women do not reach the inception of ovarian life with organs in an infantile condition. During the years of childhood structural evolution goes on, and ends in the climax of function. It naturally follows, that during the period of structural development are sown the seeds of ovarian ill-health. For instance: given, a child with no inherited taint, reared as she ought to be, mentally, bodily, and hygienically, and who escapes the accidents incident to growth, and some time, between the years of thirteen and eighteen, she becomes functionally perfect, without trouble and without hazard, be she at the boarding-school, at college, or at home in the whirl of fashion.

As this subject is having a practical bearing upon the usefulness and higher education of young women at what is commonly regarded the critical period of their development, I deem it in the interest of a more perfect understanding of the matter, that it be studied in the light of recent physiology. It is apparent from the above, that instead of confining the critical period of woman's development to the establishment of ovarian function, I believe that the true crisis is confined to the formative years of childhood.

In stating my idea of the genesis of woman sexually, it will be necessary for me to keep in view the usually accepted belief, and to apply reasonable objections, based upon admitted physiological data, to the value assigned to puberty. It is at this period, when young women are entering upon their higher education, that it is claimed they are physically and mentally disabled from pursuing the same studies, in the same manner, and in the same institutions, with young men; and that their time and study must be arranged solely with reference to ovarian function. This is the latest medical opinion upon this question. The answer to this comes from a class of society, from men and women engaged in teaching the sexes, either separately or together. The answer is a flat denial, and has almost a flavor of poetic justice. It is couching the lance in defense of woman against the grave charge of periodicity. It is a matter to be regretted that those who have answered this content themselves with facts which have simply a negative value. It is evident that if ever a generally accepted opinion upon this question is to be reached, it is attainable only by giving a just value, physiologically and hygienically, to the puberic age.

The position of writers upon the diseases of women, on this subject, is unfortunate, and one badly calculated to conserve public health. They comparatively ignore the formative years of childhood, or if referred to at all it is so incidentally that the interest turns upon the year of puberty. Dr. E. J. Tilt, of London, traces the diseases of ovulation to ovaritis, acute, subacute, and chronic. In his chain of cause and effect he speaks of those only which lie at the very threshold of diseased action. Tracing back these morbid acts to their remote causes, he says a few words of those which we have all heard so much about—late hours and suppers, idle and luxurious habits, improper dress and exciting literature. I have no disposition to deny these conditions their just value in the cause of ovaritis. I acknowledge the importance of the diseases which he describes in the production of ovarian derangement. But, he speaks of the woman and ignores the child; the accidents of completion are all, and the accidents of formation nothing. There are causes of ovarian derangement other than those which are given by Dr. Tilt. Inflammation is not the only error of structure which may so result. There are conditions which must be assigned to the formative years of life. Relative excess or deficiency is one, and nervous action, radiating from the central or ganglionic systems, exerts a potent and unmeasured power for weal or woe upon ovarian periodicity. Dr. Tilt is not alone in assigning undue importance to the accidents of puberty. Dr. Meigs has had great influence upon the forming of opinion in this country, and his influence has been the more deeply felt from his having clothed with the graces of rhetoric some stern pathological facts. In describing the advent of puberty he has indulged in a sort of physiological antithesis. The child-life of woman is the material which is suddenly transformed into a being clothed in beauty, veiled in modesty, pulsating with charming passion and the divine consciousness of possible maternity. This is what the doctor says: "The earliest years of her life are occupied then in bringing her up to that point of perfect development of her alimentary, respiratory, innervative, and circulatory life, that may fit her for exerting the great reproductive force" ("Diseases of Women," p. 373); and "the transverse and antero-posterior diameters of the pelvis have suddenly and visibly increased" (p. 375); and "it seems as if the forces which had been employed to perfect the beautiful machine, by arranging and completing the quantitative synthesis of its organism, were now occupied, in a sort of paroxysmal intensity, with adorning it with all its graces and attractions, and setting upon it the seal of perfection" (p. 376); and, lastly, "this occurs between fourteen and fifteen years of age" (p. 372). This is certainly leaving a good many physiological facts unnoticed for the sake of dramatic unity. Leaving out the manner, the above is about the substance of what has been written by gynæcological writers upon this period of woman's life. Anatomical writers are also guilty of coming to hasty conclusions upon what ought to be regarded matters of fact rather than of opinion. Mr. Gray, in his "Anatomy," says, that "about puberty the pelvis in both sexes presents the general characters of the adult male pelvis, but after puberty it acquires the sexual characters peculiar to it in adult life" ("Anatomy, Descriptive and Surgical," p. 158).

In my first quotation, alimentation, respiration, innervation, and circulation, are spoken of, but no word of the development of sex, the very thing our author is writing about. Now, the normal evolutions of Nature, either physically or psychologically, are never paroxysmal. If the forces which direct development find expression in paroxysm, it constitutes disease and not health. It is almost impossible to conceive of a woman who is developed from a child in one year; and yet, this sudden transformation is generally regarded as a fact in the genesis of woman. In regard to the sudden increase of the pelvic diameters, I cannot but consider it as an "event viewed unequally," as the late Prof. Czermak said. I am not aware of the existence of any measurements of the pelves of children approaching puberic life which give the least color of evidence to this assertion. On the contrary, it is opposed to the common order of growth in plants and animals. The transverse and antero-posterior diameters of the cavity of the pelvis in the two sexes differ about one inch, roughly stated. If this difference is objected to as too great, there is still an admitted difference which would render such an increase of bone formation as a sudden development impossible. The opinion of Mr. Gray, that pelvic development is a post-puberic phenomenon, makes it necessary to explain some very absurd conclusions which legitimately follow. Such a condition would ascribe functions, which are the most perfect expressions for high structural development, to infantile organs. If there are those who still insist that Mr. Gray is right, they must admit the violation of a physiological law: that the organs within the pelvis have outgrown the capacity of the cavity containing them; that there exist adult organs in an infantile pelvis. Such a state of things in a healthy animal is impossible, if we accept the evidence of universal experience. The cavities of the cranium, the thorax, and the pelvis, have a steady and relatively equal development. In the accepted description of the sudden onset of ovarian life, and the equally rapid anatomical accommodation of the osseous and soft parts, mental changes are described as present which are as profound and important as those attending pelvic development. But it has never been thought necessary to describe any increase in cranial capacity to accommodate these objective mental phenomena. Even a new mental attribute is believed to be developed (Meigs), that of modesty, and it is therefore as reasonable to expect, to a limited extent, cranial as well as pelvic increase. Stated in this way—and it is a fair statement—it does not seem possible to accept Mr. Gray's opinion as an anatomical fact. Women do not necessarily cease to develop because of the establishment of the ovarian function. As a rule, women will increase in stature until the twenty-fifth year. It is an equable growth, a cementing, a binding together, and final completion. I regard this fact as evidence of the steady and gradual structural and functional evolution existent during the formative years of childhood, and prolonged into the childbearing era. Were changes of structure really as rapid at this period, it would imply vital depression, just as we see it in plants and animals taking on rapid growth, and just as we see impaired mental and bodily energy follow sudden and excessive exercise of any organ in a member of the human family. Yet at puberty the opposite occurs. Women are never so hopeful, buoyant, and strong, as at the beginning of healthy ovulation.

Analogy furnishes strong arguments in favor of the early and gradual preparation of the system generally for the ovarian function. Mammary enlargement antedates functional activity by months in cases of gestation. Here is a comparatively simple act, that of glandular secretion, preceded by elaborate structural preparation. In the sexual cycle of organs the mammæ act a subordinate part; yet in this region, in the two sexes during childhood, the first sexual characteristics may be detected in the well-developed. This is an interesting and most significant fact, and one that renders it highly improbable that pelvic enlargement is postponed to the puberic age, and coincides with many other facts which show that sexual evolution is a simultaneous movement toward completion by all the organs involved.

The commencement of the ovarian function is not the only crisis through which woman has to pass. There are two dentitions, each of which is a critical period. It is, I think, safe to say that the diseases incident to dentition destroy more human lives three to one than the diseases of ovarian function. Dentition is a process preceded by elaborate anatomical preparation, and furnishes the strongest analogous proof of gradual and persistent sexual development. Teeth which appear at the fifth to the sixth months of life, are preceded by anatomical changes begun as early as the sixth week of fœtal life. Teeth which are to make their appearance at the fifth to the ninth years of life are in a preparatory state at the seventh month after birth; and teeth which make their eruption between the seventeenth and twenty-first years are in a recognizable state of growth at the sixth year of age. Here is a most elaborate preparation for function, a slow and ceaseless building up, with—in a state of health—no paroxysmal outbreak, either in the growth or completion of function. It is equally true that the organs within the pelvis which characterize sex can be traced to a fœtal origin, and, during the months of infancy and years of childhood, they exhibit the same process of structural evolution. Paroxysm in the process of dentition is a disease, and it is equally a morbid act in the development of sexual maturity. Ovulation does not induce a greater change in the system and habits than does dentition. This may appear at the first glance to be an unwarranted assertion. But observe the change in the life and habits of the little human animal at the eruption of the deciduous teeth. After subsisting upon a single article of diet it becomes omnivorous: from entire dependence upon others, it has reached a certain amount of independence, which entails a change in the mental character of the child. It instinctively exercises its new function of prehension, and is as prone to bite as a woman is to love.

And here let me recall what I said at the opening of this paper upon errors of structure. This process of dentition will illustrate it, and render its application to the diseases of ovarian function apparent. It is during the formative process of dentition that the function may be perverted, the shape and growth retarded. During this slow development it is at the mercy of faulty nutrition and hygiene. Perfect nutrition and ceaseless care are necessary to avert the dangers of dentition. The effort to ward off these disasters would be useless which confined itself to the completion of the act, to the neglect of the formative process. And yet this is the manner in which the sexual completion of woman is treated. How much we hear of the woman, and how little of the child!

Mental changes are described as taking place as suddenly as those of the body. There are of course some subjective mental impressions which may be traced to the new ovarian function—the sense of completion, and the new relation it establishes with others, and the consciousness that half a lifetime will be under the dominion of a strange periodicity, a mystery to herself. Aside from these there are no newly-developed mental attributes which may be traced to sex. Any thing new in mental vigor which may present itself at this period of life is more clearly explained by the general maturity of mind and body than by the action of a special function, and the state of remote organs.

It has been believed until recently that the removal of the ovaries, by operation or disease, would unsex the woman; that the features would become thin and masculine, the voice harsh, and even a beard develop. This is now known to be a wrong belief. It is true that the removal of these organs has been over-estimated; is it not possible that the commencement of their functional activity has been given undue importance in their reflex effect upon mind and body? This is answered by the fact that so gradual is the growth of mind, and the expanding of the intellectual limits, that the closest observer will not detect the dividing line between childhood and womanhood. Look back, if you will, at the young woman who has grown up under your daily notice, and point out the period of her life—be it one of months or a year—in which sex has become, objectively, a part of brain-fibre. For myself it is impossible to perceive the era of this change, so gradually are the various stages of development merged into each other.

A few words about the function itself concerning which so much is being said. The periodic presence is regarded as an expression of ovarian activity alone. This is in a great measure true; but it is not all the truth. Facts which have been coming to the light in the last few years show that forces not of ovarian origin are engaged in determining the function and its periodical character. Women from whom both ovaria have been removed have lived on with this function in lull force, identical, as to quantity and time, to the function previous to the removal (Peaslee, "Ovarian Tumors," p. 527). Cases have occurred in which the ovaria have never passed out of the rudimentary state, and yet the general character of these women is decidedly feminine, "and never reminds us of viragos" (Klob, "Pathological Anatomy of the Female Pelvic Organs," p. 14). So far as external sexual traits are concerned, such a woman differs in no manner from one who is functionally perfect. The natural inference is, that forces, other than those which spring from the ovaria and their function, are capable of directing development, and that there is a certain amount of sex, that of the general configuration of the body especially, which develops independently of ovarian stimulus.

We may also gain a knowledge, inferentially, of the establishment of ovulation by observing the manner of cessation of this function. Its decline and extinction is a slow and gradual process. This period has a mean duration of nearly three years (Tilt, "Change of Life," p. 65). There are also anatomical changes, which, if taken into account, would greatly extend this time. The gradual decline of the ovarian function is a type of its equally gradual inception. It is a reasonable inference that, whatever takes time in throwing down, also requires time in the building up. So far as the importance of the change of life and the beginning of ovulation are concerned, the latter greatly exceeds the former—I am speaking of the two phenomena as physiological acts—and yet we see the former always attended by anatomical preparation, and by a functional activity so slowly diminished, that even the subject herself is unconscious of the crisis through which she is passing. I have already alluded to the fact that paroxysm, or rapidity in the establishment of a function, is an evidence of disease, and not the healthy way Nature has of doing this work.

In an article of this kind many facts which have a direct bearing upon this question cannot be mentioned in detail. Such a fact is the early vice of a peculiar nature to which very young children become addicted. The impulse to this is generally ascribed to emotions which result from ovarian stimulus; but, on the contrary, the tendency to vice exists long anterior to the development of this function. I can only state the fact that the presence of the passions antedates the appearance of ovulation by months and years; thus, the interest mutually excited in children of opposite sex is not confined to nubile years. In support of this I can appeal to the common experience of adults.

The conclusions at which I arrive are briefly these:

That sex, structurally and functionally, from infancy to puberty, is in a state of slow and progressive evolution.

That the time occupied in the establishment of ovulation is not the true crisis in the development of woman.

That undue value has been given to simple ovarian growth and function as a factor in the development of womanly mental and structural peculiarities.

That in a state of health the inception of the ovarian function is never paroxysmal, or sudden.

That perfect structural development is followed by perfect function, and that the reverse of this is true; and, lastly—

That early diseased ovulation is mainly the result of physical, moral, and hygienic faults of the true crisis of woman—that of formative childhood—rather than of the period of puberty.

With these facts before us, is it not legitimate to assume that the puberic period in woman's life has been over-estimated in its direct influence upon her health at that and subsequent periods? Instead of curtailing her opportunities for work and study, by throwing around her restraints, and, as it were, creating a disability out of a natural function, transfer the attention and anxiety now lavished upon her, to a period when all that makes woman in the best and noblest sense is in a process of elaboration; for it is during this time of rapid structural change that the future good or bad health of the woman is determined. Let healthy ovulation be the natural outcome of a healthy childhood, and the function will obey its law of periodicity year by year, and all this time the young woman is as able to sustain uninterrupted physical and intellectual work as the young man. I do not wish to be understood as saying that at puberty, or at any other period of woman's life, the laws of health may be violated with impunity, but that a law of health is no more binding upon the young woman than upon the young man; that really there is no such thing as one law for women, and another for men. But the law of the woman is not the law of the child. The woman must follow those laws of health which keep her healthy; the child must be trained to obey those which will insure health in the woman. If I am right in tracing ovarian functional derangement mainly to the structural crisis, it is evident that the child must be an object of careful attention. It is not my purpose to mention the causes which will vitiate the development of the child. I desire to direct attention to this period as one full of danger to the future woman. Lest I be accused of ascribing too many of the disasters to which the functional health of women is liable to the period of childhood, I will say that women, and all the functions peculiar to their sex, are liable to the accidents of disease at any time; but, if we accept the evidence of the intelligent people who have the opportunity of observing large numbers of young women in schools and colleges, the early period of sexual function is not so liable to disease as when women are called upon to perform some of the higher duties of their being later in life. Neither is it my object to prejudice in any way the discussion of the co-education of the sexes. I think society is not prepared to discuss that question now. It is being worked out in the best possible manner, that of actual experiment. But, my aim has been to fix, if possible, the actual value of the puberic age of woman as a crisis, so that there may be no fictitious bar to her progress to either a higher education, or to her training for any of the skilled labors suited to her strength.