THE NERVOUS HOUSEWIFE

BY

ABRAHAM MYERSON, M. D. 

BOSTON

LITTLE, BROWN, AND COMPANY

1920

Published November, 1920

Norwood Press

Set up and electrotyped by J. S. Cushing Co. 

Norwood, Mass. , U. S. A. 

CONTENTS

 CHAPTER PAGE I INTRODUCTORY 1 II THE NATURE OF "NERVOUSNESS" 17 III TYPES OF HOUSEWIFE PREDISPOSED TO NERVOUSNESS 46 IV THE HOUSEWORK AND THE HOME AS FACTORS IN THE NEUROSIS 74 V REACTION TO THE DISAGREEABLE 91 VI POVERTY AND ITS PSYCHICAL RESULTS 116 VII THE HOUSEWIFE AND HER HUSBAND 126 VIII THE HOUSEWIFE AND HER HOUSEHOLD CONFLICTS 141 IX THE SYMPTOMS AS WEAPONS AGAINST THE HUSBAND 160 X HISTORIES OF SOME SEVERE CASES 168 XI OTHER TYPICAL CASES 199 XII TREATMENT OF THE INDIVIDUAL CASES 231 XIII THE FUTURE OF WOMAN, THE HOME, AND MARRIAGE 244 INDEX 269

CHAPTER I

INTRODUCTORY

How old is the problem of the Nervous Housewife?

Did the semi-mythical Cave Man (who is perhaps only a pseudo-scientificcreation) on his return from a prehistoric hunt find his leafy spouseall in tears over her staglocythic house-cleaning, or the conduct of theyoungest cave child? Did she complain of her back, did she have aheadache every time they disagreed, did she fuss and fret until he losthis patience and dashed madly out to the Cave Man's Refuge?

We cannot tell; we only know that all humor aside, and without referenceto the past, the Nervous Housewife is surely a phenomenon of thepresent-day American home. In greater or less degree she is in everyman's home; nor is she alone the rich Housewife with too little to do, for though riches do not protect, poverty predisposes, and the poorHousewife is far more frequently the victim of this disease ofoccupation. Every practicing physician, every hospital clinic, finds hera problem, evoking pity, concern, exasperation, and despair. She goesfrom specialist to specialist, --orthopedic surgeon, gynecologist, X-rayman, neurologist. By the time she has completed a course of treatmentshe has tasted all the drugs in the pharmacopeia, wears plates on herfeet, spectacles on her nose, has had her teeth tinkered with, and herinsides straightened; has had a course in hydrotherapeutics, electrotherapeutics, osteopathy, and Christian Science!

Such is an extreme case; the minor cases pass through life burdened withpains and aches of the body and soul. And one of the commonest andsaddest of transformations is the change of the gay, laughing younggirl, radiant with love and all aglow at the thought of union with herman, into the housewife of a decade, --complaining, fatigued, anddisillusioned. Bound to her husband by the ties the years and thechildren have brought, there is a wall of misunderstanding between them. 

"Men don't understand, " cries she. "Women are unreasonable, " says he. 

What are the causes of the change? Did the housewife of a pastgeneration go through the same stage? Ask any man you meet and he willtell you his mother is or was more enduring than his wife. "She borethree times as many children; she did all her own housework; she bakedmore, cooked more, sewed more; she got up at five o'clock in the morningand went to bed at ten at night; she never went out, never had avacation, did not know the meaning of manicure, pedicure, coiffure. Shewas contented, never extravagant, and rarely sick. "

So the average man will say, and then: "Those were the good old days ofsimple living, gone like the dodo!" To-day, --well, it reminds me of ajoke I heard. One man meets another and says: 'By the way, I heard thatyour wife was the champion athlete at college. ' 'Ah, yes, ' said thehusband; 'now she is too weak to wash the dishes. '

Is the average man's impression the correct one? Or are we dealing withthe incorrigible disposition of man to glorify the past? To the majorityof people their youth was an era of stronger, braver men, morewholesome, beautiful women. People were better, times were more natural, and there is a grim satisfaction in predicting that the "world is goingto the dogs. " "The good old days" has been the cry of man from the veryearliest times. 

Yet read what a contemporary of the housewife of three quarters of acentury ago says, --the wisest, wittiest, sanest doctor of the day, Oliver Wendell Holmes. The genial autocrat of the breakfast tableobserves: "Talk about military duty! What is that to the warfare of amarried maid of all work, with the title of mistress and an Americanfemale constitution which collapses just in the middle third of life, comes out vulcanized India rubber, if it happens to live through theperiod when health and strength are most wanted?"

And then, if one looks in the advertisements of half a century ago, onefinds the nostrum dealer loudly proclaiming his capacity to cure whatis evidently the Nervous Housewife. In America at least she has alwaysexisted, perhaps in lesser numbers than at present. And one remembers ina dim sort of way that the married woman of olden days was altogetherfaded at thirty-five, that she entered on middle life at a time when atleast many of our women of to-day still think themselves young. 

It becomes interesting and necessary at this point to trace theevolution of the home, because this is to trace the evolution of ourhousewife. We are apt to think of the home as originating in a sort ofcave, where the little unit--the Man, the Woman, and the Children--dweltin isolation, ever on the watch against marauders, either animal orhuman. In this cave the woman was the chattel of man; he had seized herby force and ruled by force. 

Perhaps there was such a stage, but much more likely the home was acommunal residence, where the man-herd, the group, the clan, the Familyin the larger sense dwelt. Only a large group would be safe, and thestrong social instinct, the herd feeling, was the basis of the home. Here the men and women dwelt in a promiscuity that through the ageswent through an evolution which finally became the father-controlledmonogamy of to-day. Here the women lived; here they span, sewed, built;here they started the arts, the handicrafts, and the religions. And fromhere the men went forth to fish and hunt and fight, grim males to whom amaiden was a thing to court and a wife a thing to enslave. 

Just how the home became more and more segregated and the family lifemore individualized is not in the province of this book to detail. Thisis certain: that the home was not only a place where man and womanmated, where their children were born and reared, where food wasprepared and cooked, and where shelter from the elements was obtained;it was also the first great workshop, where all the manifold industrieshad their inception and early development. The housewife was then notonly mother, wife, cook, and nurse; she was the spinner, the weaver, thetanner, the dyer, the brewer, the druggist. 

Even in the high civilization of the Jews this wide scope of thehousewife prevailed. Read what the wisest, perhaps because mostmarried, of men says:

 She seeketh wool and flax, And worketh willingly with her hands. She is like the merchant ships; She bringeth her food from afar. She considereth a field, and buyeth it. With the fruit of her hands she planteth a vineyard. She girdeth her loins with strength, And maketh strong her arms. She perceiveth that her merchandise is good. Her lamp goeth not out by night. She layeth her hands to the distaff And her hands hold the spindle. 

 * * * * *

 She is not afraid of the snow for her household: For all her household are clothed with scarlet. She maketh for herself coverlets, She maketh linen garments and selleth them, And delivereth girdles unto the merchants. 

No wonder "her children rise up and call her blessed" and it is somewhatcondescending of her husband when he "praiseth her. " All we learn of himis that he "is known in the gates when he sitteth among the elders ofthe land. " With a wife like her, this was all he had to do. 

This combination of industrialism and domesticity continued untilgradually men stepped into the field of work, perhaps as a result oftheir wives' example, and became farmers on a larger scale, merchants ofa wider scope, artisans, handicraftsmen, guild members of a moredeveloped technique. Woman started these things in the home or near it;man, through his restless energy, specialized and thus developed anintenser civilization. But even up till the nineteenth century womancarried on all her occupations at the home, which still continued to beworkshop and hearth. 

Then man invented the machine, harnessed steam, wired electricity, andthere was born the Factory, the specialized house of industry, in whichthere works no artisan, only factory hands. The home could not competewith this man's monster, into which flowed one river of raw material andout of which poured another of finished products. But not only did thefactory dye, weave, spin, tan, etc. ; it also invaded the innermostsphere of woman's work. For her loaf of bread it turned out thousands, until finally she is beginning to give up baking; for her hit-or-missjellies, preserves, jams, it invented scientific canning with absolutemethods, handy forms, tempting flavors. And canning did not stop there;meats, soups, vegetables, fruits are now placed in the hands of thehousewife "Ready to Serve, " until the cynical now state, "Woman is nolonger a cook, she is a can opener. " With all the talk in this moderntime of women invading man's field, it is just to remark that man hasstepped into woman's work and carried off a huge part of it to his owncreation, the factory. 

Thus it has come to pass that in our day the housewife does but littledyeing, spinning, weaving, is no longer a handicraftsman, and inaddition is turning over a large part of her food preparation andcooking to the factory. 

But the factory is not content with thus disarranging the ancient schemeof things by invading the housewife's province; it has dragged a largenumber of women, yearly increasing in number and proportion, intoindustry. Thus it has made this condition of affairs: that it takes theyoung girl from the home for the few years that intervene before hermarriage. She is thus initiated into wage-earning before she becomes aman's wife, the housewife. 

This industrial period of a girl's life is important psychologically, for it profoundly influences her reaction to her status and work ashomekeeper. 

Of even greater importance to our study than the influence of thefactory is the rise of what is known as feminism. Of all the livingcreatures in the world the female of the human species has been the mostdowntrodden, for to every wretched class of man there was a stillinferior, more wretched group, their wives. She was a slave to theslaves, a dependent of the abjectly poor. When men passed through thestage where woman's life might be taken at a whim, she remained acreature without rights of the wider kind. Men debated whether she had asoul, made cynical proverbs about her, called her the "weaker vessel, "and debarred her from political and economic equality, classing her upto this very moment in rights with the idiot, the imbecile, and thecriminal. Worse than this, they gave her a spurious homage, created alop-sided chivalry, and caused her to accept as her ideal goal ofwomanhood the achievement of beauty and the entrance into wifehood. After they tied her hand and foot with restrictions and belittlingideals, they capped the climax by calling her weak and petty by natureand even got her to believe it!

It is not my intention to trace the rise of feminism. Brave women arosefrom age to age to glorify the world and their sex, and men here andthere championed them. Man started to emancipate himself from slavery, and noble ideals of the equality of mankind first were whispered, thenshouted as battle cries, and finally chiseled with enduring letters intothe foundations of States. "But if all this was good for men, why notfor women--why should they be fettered by illiteracy, pettiness, dependence; why should they be voiceless in the state and world?" Soasked the feminists. The factory called for women as labor; they becamethe clerks, the teachers, the typists, the nurses. Medicine and the lawopened their doors, at least in part. And now we are on the verge ofuniversal suffrage, with women entering into the affairs of the world, theoretically at least the equals of man. 

But with the entrance of woman into many varied professions andoccupations, with a wider access to experience and knowledge, arosewhat may be called the era of the "individualization of woman. " For ifany group of people are kept under more or less uniform conditions inearly life, if one goal is held out as the only legitimate aim and end, in a word, if their training and purposes are made alike, they becomealike and individuality never develops. With individuality comesrebellion at old-established conditions, dissatisfaction, discontent, and especially if the old ideal still remains in force. This new type ofwoman is not so well fitted for the old type of marriage as herpredecessors. There arises a group of consequences based psychologicallyon this, a fact which we shall find of great importance later on. 

Women still regard marriage as their chief goal in life, still enterhomes, still bear children, and take their husband's name. But havingbecome more individualized they demand more definite individualtreatment and rebel more at what they consider an infringement of theirrights as human beings. Also, and unfortunately, they still wish theright to be whimsical, they continue to reserve for themselves theweapons of tears, reproaches, and unreasonable demands. This hasbrought about the divorce evil. 

Briefly the "divorce" evil arises first from the rebellion of womanagainst marital drunkenness, unfaithfulness, neglect, brutality that aformer generation of wives tolerated and even expected. Second, itarises from a conflict between the institution of marriage which stillcarries with it the chattel idea--that woman is property--and ageneration of women that does not accept this. Third, it arises from theill-balanced demands of women to be treated as equals and also asirresponsible, petty, and indulged tyrants. Men are unable to adjustthemselves to the shattering of the romantic ideal, and the homedisintegrates. Though divorce is the top of the crest of maritalunhappiness, it really represents only the extreme cases, and behind itis a huge body of quarreling and divided homes. 

We shall later see that our Nervous Housewife has symptoms and pains andaches and changes in mood and feeling that are born of the conflict thatis in part pictured by divorce. _Divorce is a manifestation of thediscontent of women, and so is the nervousness of the housewife. _

There arises as a result of this individualization of woman, as aresult of increasing physiological knowledge, the hugely important factof restricted child bearing. The woman will no longer bear childrenindiscriminately, --and the large family is soon to be a thing of thepast in America and in all the civilized world. The-woman-that-knows-howshrinks from the long nine months of pregnancy, the agony of the birth, and the weary restricted months of nursing. Had the woman of a past timeknown how, she too would have refused to bear. In this the housewife ofto-day is seconded by her husband, for where he has sympathy for hiswife he prefers to let her decide the number of children, and also he isimpressed by the high cost of rearing them. 

One gets cynical about the influence of church, patriotism, and presswhen one sees how the housewife has disregarded these influences. Forall the religions preach that race suicide is a sin, all the statesmenpoint out that only decadent nations restrict families, and all ornearly all the press thunder against it. It is even against the law fora physician or other person to instruct in the methods of birthrestriction, and yet--the birth rate steadily drops. An immigrant motherhas six, eight, or ten children and her daughter has one, two, or three, very rarely more, and often enough none. This is true even of racesclose to religious teaching, such as the Irish Catholic and the Jew. 

One can well be cynical of the power of religion and teaching and lawwhen one finds that even the families of ministers, rabbis, editors, andlawmakers, all of whom stand publicly for natural birth, have shown agreat reduction in their size, that has taken place in a singlegeneration. 

Is the modern woman more susceptible to the effects of pregnancy, --lessresistant to the strain of childbearing and childbirth? It is a quitegeneral impression amongst obstetricians that this is a fact and alsothat fewer women are able to nurse their babies. If so, these phenomenaare of the highest importance to the race and likewise to the problem ofthe new housewife. For we shall learn that the lowering of energy isboth a cause and symptom of her neuroses. 

If then we summarize what has been thus far outlined, we find twocurrents in the evolution of the housewife. _First_, she has yielded alarge part of her work to the factory, practically all of that part ofit which is industrial and a considerable portion of the foodpreparation. 

_Second_, there has been a rise in the dignity and position of woman inthe past one hundred and fifty years which has had many results. She hasconsiderably widened the scope of her experience with life through workin the factory, in the office, in the schoolhouse, and in theprofessions. This has changed her attitude toward her originaloccupation of housewife and is a psychological fact of great importance. She has become more industrial and individualized, and as a result hasdeclined to live in unsatisfactory relations with man, so that divorcehas become more frequent. In part this is also caused by her inabilityto give up petty irresponsibility while claiming equality. Finally, thedeclining birth rate is still further evidence of her individualizationand is in a sense her denial of mere femaleness and an affirmation offreedom. 

CHAPTER II

THE NATURE OF "NERVOUSNESS"

Preliminary to our discussion of the nervousness of the housewife wemust take up without great regard to details the subject of nervousnessin general. 

Nervousness, like many another word of common speech, has no placewhatever in medicine. Indeed, no term indicating an abnormal conditionis so loosely used as this one. 

People say a man is nervous when they mean he is subject to attacks ofanger, an emotional state. Likewise he is nervous when he is a victim offear, a state literally the opposite of the first. Or, if he isrestless, is given to little tricks like pulling at his hair, or bitinghis nails, he is nervous. The mother excuses her spoiled child on theground of his nervousness, and I have seen a thoroughly bad boy whobranded his baby sister with a heated spoon called "nervous. " A"nervous breakdown" is a familiar verbal disguise for one or other ofthe sinister faces of insanity itself. 

It should be made clear that what we are dealing with in the nervoushousewife is not a special form of nervous disorder. It conforms to thegeneral types found in single women and also in men. It differs in theintensity of symptoms, in the way they group themselves, and in thecauses. 

Physicians use the term psychoneuroses to include a group of nervousdisorders of so-called functional nature. That is to say, there is noalteration that can be found in the brain, the spinal cord, or any partof the nervous system. In this, these conditions differ from suchdiseases as locomotor ataxia, tumor of the brain, cerebral hemorrhage, etc. , because there are marked changes in the structure in the lattertroubles. One might compare the psychoneuroses to a watch which neededoiling or cleaning, or merely a winding up, --as against one in which avital part was broken. 

The most important of the psychoneuroses, in so far as the housewife isconcerned, is the condition called neurasthenia, although two otherdiseases, psychasthenia and hysteria, are of importance. 

It is interesting that neurasthenia is considered by many physicians asa disease of modern times. Indeed, it was first described in 1869 by theeminent neurologist Beard, who thought it was entirely caused by thestress and strain of American life. That not only America, but everypart of the whole civilized world has its neurasthenia is now anaccepted fact. Knowing what we do of its causes we infer that it isprobably as old as mankind; but there exists no reasonable doubt thatmodern life, with its hurry, its tensions, its widespread and everpresent excitement, has increased the proportion of people involved. 

Particularly the increase in the size and number of the cities, ascompared with the country, is a great factor in the spread ofneurasthenia. Then, too, the introduction of so-called time-saving, _i. E. _ distance-annihilating instruments, such as the telephone, telegraph, railroad, etc. , have acted not so much to save time as toincrease the number of things done, seen, and heard. The busy man withhis telephone close at hand may be saving time on each transaction, butby enormously increasing the number of his transactions he is not saving_himself_. 

The keynote of neurasthenia is _increased liability to fatigue_. Thetired feeling that comes on with a minimum of exertion, worse on arisingthan on going to bed, is its distinguishing mark. Sleep, which shouldremove the fatigue of the day, does not; the victim takes half of hisday to get going; and at night, when he should have the deliciousdrowsiness of bedtime, he is wide-awake and disinclined to go to bed orsleep. This fatigue enters into all functions of the mind and body. Fatigue of mind brings about lack of concentration, an inattention; andthis brings about an inefficiency that worries the patient beyond wordsas portending a mental breakdown. Fatigue of purpose brings alistlessness of effort, a shirking of the strenuous, the moredistressing because the victim is often enough an idealist withover-lofty purposes. Fatigue of mood is marked by depression of a mildkind, a liability to worry, an unenthusiasm for those one loves or forthe things formerly held dearest. And finally the fatigue is oftenmarked by a lack of control over the emotional expression, so that angerblazes forth more easily over trifles, and the tears come upon even aslight vexation. _To be neurasthenic is to magnify the pins and pricksof life into calamities, and to be the victim of an abnormal state thatis neither health nor disease. _

The more purely physical symptoms constitute almost everythingimaginable. 

1. Pains and aches of all kinds stand out prominently; headache, backache, pains in the shoulders and arms, pains in the feet and legs, pains that flit here and there, dull weary pains, disagreeable feelingsrather than true pains. These pains are frequently related todisagreeable experiences and thoughts, but it is probable that fatigueplays the principal part in evoking them. 

2. Changes in the appetite, in the condition of the stomach and bowels, are prominent. Loss of appetite is complained of, or more often acapricious appetite, vanishing quickly, or else too easily satisfied. The capriciousness of appetite is undoubtedly emotional, fordisagreeable emotions, such as worry, fear, vexation, have long beenknown as the chief enemies of appetite. 

With this change of appetite goes a host of disorders manifested by"belching", "sour stomach", "logy feelings", etc. What is back of theselay terms is that the tone, movement, and secreting activity of thestomach is impaired in neurasthenia. When we consider later on thenature of emotion, we shall find these changes to be part of thedisorder of emotion. 

3. So, too, there is constipation. In how far the constipation isprimary and in how far it is secondary is a question. At any rate, onceit is established, it interferes with all the functions of the organismby its interference with the mood. 

The following story of Voltaire bluntly illustrates a fact of widespreadknowledge. Voltaire and an Englishman, after an intimate philosophicaldiscussion, decided that the aches and pains of life outnumbered theagreeable sensations, and that to live was to endure unhappiness. Therefore, they decided that jointly they would commit suicide and namedthe time and the place. On the day appointed the Englishman appearedwith a revolver ready to blow out his brains, but no Voltaire was to beseen. He looked high and low and then went to the sage's home. There hefound him seated before a table groaning with the good things of lifeand reading a naughty novel with an expression of utmost enjoyment. Saidthe Englishman to Voltaire, "This was the day upon which we were tocommit suicide. " "Ah, yes, " said Voltaire, "so we were, but to-day mybowels moved well. "

4. The disturbed sleep, either as insomnia or an unrestful, dream-disturbed slumber, is a distressing symptom. For we look to thebed as a refuge from our troubles, as a sanctuary wherein is rebuildedour strength. We may link work and sleep as the two complementaryfunctions necessary for happiness. If sleep is disturbed, so is work, and with that our purposes are threatened. So disturbed sleep has notonly its bodily effects but has its marked results on our happiness. 

5. Fundamental in the symptoms of neurasthenia is fear. This fear takestwo main forms. First, the worry over the life situation in general, that is to say, fear concerning business; fear concerning the healthand prosperity of the household; fear that magnifies anything that haseven the faintest possibility of being direful into something that isalmost sure to happen and be disastrous. This constant worry over thepossibilities of the future is both a cause of neurasthenia and asymptom, in that once a neurasthenic state is established, the liabilityto worry becomes greatly increased. 

Second, there is a special form of worry called by the old authorshypochondriacism, which essentially is fear about one's own health. Thehypochondriac magnifies every flutter of his heart into heart disease, every stitch in his side into pleurisy, every cough into tuberculosis, every pain in the abdomen into cancer of the stomach, every headacheinto the possibility of brain tumor or insanity. He turns his gazeinward upon himself, and by so doing becomes aware of a host ofsensations that otherwise stream along unnoticed. Our vision was meantfor the environment, for the world in which we live, since the bodilyprocesses go on best unnoticed. The little fugitive pains and aches; thelittle changes in respiration; the rumblings and movements of thegastro-intestinal tract have no essential meaning in the majority ofcases, but once they are watched with apprehension and anxiety, theymultiply extraordinarily in number and intensity. One of the cardinalgroups of symptoms in a neurasthenic is this fear of serious bodilydisease for which he seeks examination and advice constantly. Naturallyenough, he becomes the choicest prey for the charlatan, the faker, orperhaps ranks second to the victim of venereal or sexual disease. Thefaker usually assures him that he has the disorders he fears and thenproceeds to cure him by his own expensive and marvelous course oftreatment. 

What has been sketched here is merely the outside of neurasthenia. Backof it as causative are matters we shall deal with in detail later on inrelation to the housewife, --matters like innate temperament, badtraining, liability to worry, wounded pride, failure, desire forsympathy, monotony of life, boredom, unhappiness, pessimism of outlook, over-æsthetic tastes, unfulfilled and thwarted desires, secret jealousy, passions and longings, fear of death, sex problems and difficulties anddoubt; matters like recent illness, childbirth, poverty, overwork, wrong sex habits, lack of fresh air, etc. 

Fundamentally neurasthenia is a deënergization. By this is meant thateither there is an actual reduction in the energy of the body (as aftera sickness, pregnancy, etc. ) or else something impedes the discharge ofenergy. This latter is usually an emotional matter, or arises from somethought, some life situation of a depressing kind. 

It is necessary and important that we consider these two aspects of oursubject a little closer, not so much as regards the housewife, but overthe wider field of the human being. 

The human being, like every living thing, is an instrument for thebuilding up and discharge of energy. He takes in food, the food isdigested (made over into certain substances) and these are built up intothe tissues, --and then their energy is discharged as heat and as motion. The heat is the body temperature, the motion is the movement of thehuman body in all the marvelous variety of which it is capable. In otherwords, the discharge of energy is the play of our childhood and of ourlater years; it is the skill and strength of our arms, the cleverness ofour hands, the fleetness of our feet, the joyous vigor of ourlove-making, the embrace; it is the noble purpose, the long, hard-foughtbattles of any kind. It is all that is summed up in desire, purpose, andachievement. 

Now all these things may be impeded by actual reduction of energy, as intuberculosis, cancer, or in the lassitude of convalescence. In additionthere are emotions, feelings, thoughts that energize, --that create vigorand strength of body and mind. Joy rouses the spirit; one dances, laughs, sings, shouts; or the more quiet type of person takes up workwith zeal and renewed energy. Hope brings with it an eagerness for thebattle, a zest for work. The glow of pride that comes with praise is astimulus of great power and enlarges the scope of the personality. Thefeeling that comes with successful effort, with rewarded effort, is anew birth of purpose and will. And whatever arouses the fighting spirit, which in the last analysis is based on anger, achieves the same end. 

There are _deënergizing emotions and experiences_ as well, things thatsuddenly rob the victim of strength and purpose. Fear of a certain typeis one of these things, as when one's knees knock together, the limbsbecome as it were without the control of the will, the heart flutters, and the voice is hoarse and weak. Fear of sickness, fear of death, either for one's self or some beloved one, may completely deënergize thestrongest man. Then there is hope deferred, and disappointment, thefrustration of desire and purpose, helplessness before insult andinjustice, blame merited or unmerited, the feeling of failure andinevitable disaster. There is the unhappy life situation, --the mistakenmarriage, the disillusionment of betrayed love, the dashing of parentalpride. The profoundest deënergization of life may come from a failure ofinterest in one's work, a boredom due to monotony, a dropping out ofenthusiasm from the mere failure of new stimuli, as occurs withloneliness. Any or all of these factors may bring about a neurasthenic, deënergized state with lowering of the functions of mind and body. Weshall discover how this comes about farther on. 

What part does a subconscious personality take in all this and infurther symptoms? Is there a subconsciousness, and what is it?

In answer, the majority of modern psychologists and psychopathologistsaffirm the existence of a subconscious personality. One needs onlymention James, Janet, Ribot, McDougall, Freud, Prince, out of a host ofwriters. Whether they are right or not, or whether we now deal with anew fashion in mental science, this can be affirmed--that every humanbeing is a pot boiling with desires, passions, lusts, wishes, purposes, ideas, and emotions, some of which he clearly recognizes and clearlyadmits, and some of which he does not clearly recognize and which hewould deny. 

These desires, passions, purposes, etc. , are not in harmony one withanother; they are often irreconcilable and one has to be smothered forthe sake of the other. Thus a sex feeling that is not legitimate, anillicit forbidden love has to be conquered for the sake of the purposeto be religious or good, or the desire to be respected. So one maystruggle against a hatred for a person whom one should love, --a husband, a wife, an invalid parent, or child whose care is a burden, and onerefuses to recognize that there is such a struggle. So one may seek tosuppress jealousy, envy of the nearest and dearest; soul-stirring, forbidden passions; secret revolt against morality and law which may(and often do) rage in the most puritanical breast. 

In the theory of the subconscious these undesired thoughts, feelings, passions, wishes, are repressed and pushed into the innermost recessesof the being, out of the light of the conscious personality, butnevertheless acting on the personality, distorting it, wearying it. 

However this may be, there is struggle, conflict in every human breastand especially difficult and undecided struggles in the case of theneurasthenic. Literally, secretly or otherwise, he is a house dividedagainst himself, deënergized by fear, disgust, revolt, and conflict. 

And the housewife we are trying to understand is particularly such acreature, with a host of deënergizing influences playing on her, buffeting her. Our aim will be to analyze these influences and todiscover how they work. 

I have stated that in medical practice two other types aredescribed, --psychasthenia and hysteria. These are not so definitelyrelated to the happenings of life as to the inborn disposition of thepatient. Nor are they quite so common in the housewife as theneurasthenic, deënergized state. However, they are usually of moreserious nature, and as such merit a description. 

By the term psychasthenia is understood a group of conditions in whichthe bodily symptoms, such as fatigue, sleeplessness, loss of appetite, etc. , are either not so marked as in neurasthenia, or else areovershadowed by other, more distinctly mental symptoms. 

These mental symptoms are of three main types. There is a tendency torecurring fears, --fears of open places, fears of closed places, fear ofleaving home, of being alone, fear of eating or sleeping, fear of dirt, so that the victim is impelled continually to wash the hands, fear ofdisease--especially such as syphilis--and a host of other fears, all ofwhich are recognized as unreasonable, against which the victim strugglesbut vainly. Sometimes the fear is nameless, vague, undifferentiated, andcomes on like a cloud with rapid heartbeat, faint feelings, and a senseof impending death. Sometimes the fear is related to something that hasactually happened, as, fear of anything hot after a sunstroke; or fearof any vehicle after an automobile accident. 

There is also a tendency to obsessive ideas and doubts; that is, ideasand doubts that persist in coming against the will of the patient, suchas the obscene word or phrase that continually obtrudes itself on achaste woman, or the doubt whether one has shut the door or properlyturned off the gas. Of course, everybody has such obsessions and doubtsoccasionally, but to be psychasthenic about it is to have themcontinually and to have them obtrude themselves into every action. Inextreme psychasthenia the difficulty of "making up the mind", ofdeciding, becomes so great that a person may suffer agonies of internaldebate about crossing the street, putting on his clothes, eating hismeals, doing his work, about every detail of his coming, going, doing, and thinking. A restless anxiety results, a fear of insanity, aninefficiency, and an incapacity for sustained effort that results in thename that is often applied, --"anxiety neurosis. "

Third, there is a group of impulsions and habits. Citing a few absurdimpulsions: a person feels compelled to step over every crack, to touchthe posts along his journey, to take the stairs three steps at a time. The habits range from the queer desire to bite one's nails to the quickthat is so common in children and which persists in the psychasthenicadult, to the odd grimaces and facial contortions, blinking eyes andcracking joints of the inveterate _ticquer_. Against some of these habitspasms, comparable to severe stammering, all measures are in vain, forthere seems to be a queer pleasure in these acts against which the willof the patient is powerless. 

Especially do the first two described types of trouble followexhaustion, acute illness, sudden fright, and long painful ordeal. Theground is prepared for these conditions, _e. G. _ by the strain of longattendance on a sick husband or child. Then, suddenly one day, comes aqueer fear or a faint dizzy feeling which awakens great alarm, isbrooded upon, wondered at, and its return feared. This fearfulexpectation really makes the return inevitable, and then the diseasestarts. If the patient would seek competent advice at this stage, recovery would usually be prompt. Instead, there is a long unsuccessfulstruggle, with each defeat tending to make the fear or anxiety orobsession habitual. Sometimes, perhaps in most cases, and in all casesaccording to Freud and his followers, there is a long-hidden series ofcauses behind the symptoms; subconscious sexual conflicts andrepressions, etc. It may be stated here that the present author is notat all a Freudian and believes that the causes of these forms ofnervousness are simpler, more related to the big obvious factors inlife, than to the curiously complicated and bizarrely sexual Freudianfactors. People get tired, disgusted, apprehensive; they hate where theyshould love; love where they should hate; are jealous unreasonably; arebored, tortured by monotony; have their hopes, purposes, and desiresfrustrated and blocked; fear death and old age, however brave a facethey may wear; want happiness and achievement, and some break, one wayor another, according to their emotional and intellectual resistance. These and other causes are the great factors of the conditions we havebeen considering. 

Of all the forms of nervousness proper, the psychoneuroses, hysteria isprobably the one having its source mainly in the character of thepatient. That is to say, outward happenings play a part which issecondary to the personality defect. Hysteria is one of the oldest ofdiseases and has probably played a very important rôle in the history ofman. Unquestionably many of the religions have depended upon hysteria, for it is in this field that "miracle cures" occur. All founders ofreligions have based part of their claim on the belief of others intheir healing power. Nothing is so spectacular as when the hystericalblind see, the hysterical dumb talk, the hysterical cripple throws awayhis crutches and walks. In every age and in every country, in everyfaith, there have been the equivalents of Lourdes and St. Anne deBeaupré. 

In hysteria four important groups of symptoms occur in the housewife aswell as in her single sisters and brothers. 

There is first of all an emotional instability, with a tendency toprolonged and freakish manifestations, --the well-known hysterics withlaughing, crying, etc. Fundamental in the personality of the hystericsis this instability, this emotionality, which is however secondary toan egotistic, easily wounded nature, craving sympathy and respect andoften unable legitimately to earn them. 

A group of symptoms that seem hard to explain are the so-calledparalyses. These paralyses may affect almost any part, may come in amoment and go as suddenly, or last for years. They may concern arm, leg, face, hands, feet, speech, etc. They seem very severe, but are due toworry, to misdirected ideas and emotions and not at all to injury to thenervous system. They are manifestations of what the neurologists call"dissociations of the personality. " That is, conflicts of emotions, ideas, and purposes of the type previously described have occurred, anda paralysis has resulted. These paralyses yield remarkably to anyenergizing influence like good fortune, the compelling personality of aphysician or clergyman or healer (the miracle cure), or a seriousdanger. The latter is exemplified in the cases now and then reported ofpeople who have not been out of bed for years, but are aroused by threatof some danger, like a fire, reach safety, and thereafter are well. 

Similar in type to the paralyses are losses of sensation in variousparts of the body, --losses so complete that one may thrust a needle deepinto the flesh without pain to the patient. In the days of witch-huntingthe witch-hunters would test the women suspected with a pin, and if theyfound places where pain was not felt, considered they had proof ofwitchcraft or diabolic possession, so that many a hysteric was hanged ordrowned. The history of man is full of psychopathic characters andhappenings; insane men have changed the course of human events by theirideas and delusions, and on the other hand society has continuallymistaken the insane and the nervously afflicted for criminals orwretches deserving severest punishment. 

Especially striking in hysteria are the curious changes in consciousnessthat take place. These range from what seem to be fainting spells tolong trances lasting perhaps for months, in which animation isapparently suspended and the body seems on the brink of death. In oldendays the Delphian oracles were people who had the power voluntarily ofthrowing themselves into these hysteric states and their vaguestatements were taken to be heaven-inspired. To-day, their descendantsin hysteria are the crystal gazers, the mediums, the automatic writersthat by a mixture of hysteria and faking deceive the simple andcredulous. 

For, in the last analysis, all hysterics are deceivers both ofthemselves and of others. Their symptoms, real enough at bottom, aretheatrical and designed for effect. As I shall later show, they areweapons, used to gain an end, which is the whim or will of the patient. 

In order to clinch our understanding of the above conditions we must nowconsider in more detail certain phases of emotion. 

Fear curdles the blood, anger floods the body with passion, sorrowflexes the proud head to earth and stifles the heartbeat; joy opens thefloodgates of strength, and hope lifts up the head and braces man'ssoul. 

Man is said to be a rational being, but his thought is directed mainlyagainst the problems of nature, much more rarely against _his own_problems. It is for emotion that we live, for emotion in the wide senseof pleasure and pride. What guides us in our conduct is desire, anddesire in the last analysis is based on the instincts and the alliedemotions, --hunger, sex, property, competition, coöperation. Theintelligence guides the instincts and governs the emotions, but in thecase of the vast majority of mankind is swept out of the field when anygreat decision is to be made. 

We are accustomed to thinking of emotion as a thing purelypsychical, --purely of the mind, despite the fact that all the greatdescriptions and all the homely sayings portray it as bodily. "My heartthumped like a steam engine, " or "I could not catch my breath"; "a coldchill played up and down my back"; "I swallowed hard, because my mouthwas so dry I could not speak. " And the Bible repeatedly says of the manstricken by fear, "His bowels turned to water, " with a graphic forceonly equaled by its truth. 

William James, nearly simultaneously with Lange, pointed out thatemotion cannot be separated from its physical concomitants and maintainits identity. That is, if we separate in our minds the weak, chillyfeeling, the dry mouth, the racing heart, the sharp, harsh breathing, and the tension of the muscles getting ready for flight from the feelingof fear, nothing tangible is left. Similarly with sorrow or joy oranger. Take the latter emotion; imagine yourself angry, --immediately thejaw becomes set and the lips draw back in a semi-snarl, the fists clenchand the muscles tighten, while the head and body are thrust forward inwhat is, as Darwin pointed out, the preparation for pouncing on the foe. Even if you mimic anger without any especial reason, there steals overyou a feeling not unlike anger. 

In a famous paragraph James essentially states that instead of cryingbecause we are sorry, it is fully as likely that we are sorry because wecry. So with every emotion; we are afraid because we run away, and happybecause we dance and shout. In other words he reversed the order ofthings as the everyday person would see it; makes primary and offundamental importance the physical response rather than the feelingitself. 

This has been widely disagreed with, and is not at all an acceptabletheory in its entirety. Yet modern physiology has shown that emotion islargely a physical matter, largely a thing of blood vessels, heartbeat, lungs, glands, and digestive organs. This physical foundation of emotionis a very important matter in our study of the housewife as of everyother living person. For it is especially in the emotional disturbancethat the origin of much of nervousness is to be found, and that on whatmay be called the physical basis of emotion. 

What can emotion produce that is pathological, detrimental towell-being? We may start with the grossest, simplest manifestations. Itmay entirely upset digestion, as in the vomiting of disgust andexcitement. Or, in lesser measure, it may completely destroy theappetite, as occurs when a disturbing emotion arises at mealtime. Thisis probably brought about by the checking of the gastric secretions. (Cannon's work; Pavlow's work. )

It may check the secretion of milk in the nursing mother, or it maychange the quality of the milk so that it almost poisons the infant. Itmay cause the bladder and bowels to be evacuated, or it may preventtheir evacuation. 

It may so change the supply of blood in the body as to leave the headwithout sufficient quantity and thus bring about a fainting spell;_i. E. _ may absolutely deprive the victim of consciousness. In lesserdegree it causes the blush, a visible manifestation of emotion oftenvery distressing. 

It may completely abolish sex power in the male, or it may bring aboutsex manifestations which the victim would almost rather die than show. 

It may completely deënergize so that neither interest, enthusiasm, orpower remains. This is a familiar effect of sorrow but occurs in lesserdegree with the form of fear called worry. 

The fact is that emotion is an intense bodily response to a situationwhich when perceived is the state of feeling. This intense bodilyresponse, involving the very minutest tissues of the body, may increasethe available energy, may help the bodily functioning, may stimulate the"psychical" processes, but also it may deënergize to an extraordinarydegree, it may interfere with every function, including thought andaction. It may surely produce acute illness, and it may, though rarely, produce death. 

Moreover, it is extraordinarily contagious. Every one knows how a heartylaugh spreads, and how quick the response to a smile. Indeed, emotionhas probably for one of its main functions the producing of an effecton some one else, and all the world uses emotion for this purpose. Angeris used to produce fear, sorrow to evoke sympathy, fear is to bringabout relenting, a smile and laughter, friendliness, except where onesmiles or laughs _at_ some one, and then its design is to bring sorrow, anger, or pain. The leader maintains a hopeful, joyous demeanor so thathis followers may also be joyous or hopeful and thus be energized totheir best. Morale is the state of emotion of a group; it is raised whenjoyous, energizing emotions are set working in the group and is loweredwhen pessimistic deënergizing emotions become dominant. A city or anation becomes energized with good news and success and deënergized whenthe battle seems lost. 

The spread of emotion from person to person by sympathetic feeling orthe reverse (as when we get depressed because our enemy is happy) is asocial fact of incalculable importance. The problem of the nervoushousewife is a problem of society because she gives her mood over to herfamily or else intensely dissatisfies its members so that the home tiesare greatly weakened. 

This spread of emotion was happily portrayed by a motion picture Irecently saw. Old Grouchy Moneybags, wealthy beyond measure andafflicted with gout, is seated at his breakfast table. In the next room, seen with the all-seeing eye of the movie, the butler makes love to thevery willing maid. In the kitchen the fat cook is feeding the everhungry butcher's boy with gingerbread and cake, and on the back stepsthe household cat is purring gently in contentment. Happiness is thepredominant note. 

Then Old Moneybags savagely rings the bell. Enters the butler, obsequious and solicitous. "The coffee is bad, the toast is vile, everything is wrong. You are a _deleted deleted deleted deleted_rascal. " Exit the butler, outwardly humble, inwardly a raging flood ofanger, and he meets the maid, who archly invites his attentions. Shegets them, only they are in the form of an angry shove and an oath. White with indignation, she stamps her foot and runs into the kitchen, bursting into tears. The cook, solicitous, receives a slap in the face, and as the maid bounces out, the cook, seeking a victim, grabs away thegingerbread from the butcher's boy. And that still hungry juvenileslams the door as he leaves and kicks the slumbering cat off the backdoorstep. 

Unfortunately the film did not show what the outraged cat did. Possiblyit started a devastation that reached back into Moneybags' career; atany rate the unusual little picture (which later went on to the usualhappy ending) showed how emotion spreads through the world, just asdisease does. The infection that starts in the hovel finally strikesdown the rich man's child, enthroned in the palace. The mood engenderedby the humiliation of poverty or cruelty or any injustice finally shakesa king off his throne. 

So when we trace the deënergizing emotions of the housewife, we aretracing factors that affect her husband, his work, and Society at large;we trace the things that mold her children, and thus we follow her mood, her emotion, into the future, into history. 

CHAPTER III

TYPES OF HOUSEWIFE PREDISPOSED TO NERVOUSNESS

There are three main factors in the production of the nervousness of thehousewife, and they weave and interweave in a very complex way toproduce a variety of results. All the things of life, no matter howsimple in appearance, are a complex combination of action and reaction. Our housewife's symptoms are no exception, whether they are mainlypains, aches, and fatigue, or the deeply motivated doubt or feeling ofunreality. 

The nature of the housewife, the conditions of her life, and herrelations to her husband are these three factors. All enter into eachcase, though in some only one may be emphasized as of importance. Thereare cases where the nature of the woman is mainly the essential cause, others where it is the conditions of her life, and still others wherethe husband stands out as the source of her symptoms. 

We are now to consider the nature of the housewife as our first factor. We may preamble this by saying that a woman essentially normal in onerelationship in life may be abnormal in some other, may be thetraditional square peg in the round hole. Moreover, we are to insist onthe essential and increasing individuality of women, which is to a largeextent a recent phenomenon. The cynical commonplace is "All women arealike"--and then follows the specific accusation--"in fickleness", "inextravagance", "in unreasonableness", in this trick or that. The chiefeffort of conservatism is to make them alike, to fit each one for thesame life by the same training in habits, knowledge, abilities, andideals. 

Talk about Prussianism! The great Prussianism, with its ideal ofuniformity, serviceability, and servility, has been the masculine idealof woman's life. Man was to be diversified as life itself, was to tasteall its experiences, but woman had her sphere, which belied allmathematics by being a narrow groove. 

The nineteenth century changed all that, --or started the change whichis going on with extraordinary rapidity in the twentieth. There are allkinds of women, at least potentially. It may be true that womantends less to vary than man, that she follows a conservativemiddle-of-the-road biologically, while man spreads out, but no one canbe sure of this until woman's early training to some extent resemblesman's. 

1. From the very start woman is trained to vanity. Every mother loves todoll up her girl baby, and the child is admired for her dress andappearance. Now it is an essential quality of the normal human beingthat he accepts as an ideal the quality most admired. To the youngchild, the girl, the young woman, the important thing is Looks, Looks, Looks! The first question asked about a woman is, "Is she pretty?" Thepretty girls, the ones most courted, the ones surest on the whole to getmarried and to become housewives are usually spoiled by indulgence, petting, admiration, and this for a quality not at all related to strongcharacter, and therefore vanity of a trivial kind results. 

2. Moreover, woman is trained to emotionality. It may be that she is bynature more emotional than man, but again this can only be known whenshe has been trained to repress emotional response as a man is trained. If a boy cries or shows fear, he is scolded, and training of one kind oranother is instituted to bring about moral and mental hardihood. But ifa girl cries, she is consoled by some means and taught that tears arepotent weapons, a fact she uses with extraordinary effect later on, especially in dealing with men. If she shows fear, she is protected, sheltered, and given a sort of indulged inferiority. 

3. The romantic ideal is constantly held before her in the privatecounsel of her mother, in the books she reads, in the plays shewitnesses, in all the allurements of art. She is to await the lover, thehero; he will take her off with him to dwell in love and happinessforever. All stories, or most of them, end before the heroine developsthe neurosis of the housewife. In fact, literature is the worst possiblepreparation for married life, excepting perhaps the _courtship_. Thislatter emphasizes a distorted chivalry that makes of woman a petty thingon a pedestal, out of touch with reality; it is an exciting entranceinto what in the majority of cases is a rather monotonous existence. 

All these things--vanity, emotionality, romanticism, courtship--are poortraining for the home. They hinder even the strongest woman, they arefetters for the more delicate. 

In taking up the special types predisposed to the nervousness of thehousewife it is to be emphasized that conditions may bring about theneurosis in the normal housewife. Nevertheless, there are groups ofwomen who, because of their make-up or constitution, acquire theneurosis much more easily and much more intensely than do the normalwomen. They are the types most commonly seen in the hospital clinic orin the private consulting room of the neurologist. 

First comes the hyperæsthetic type. One of the chief marks of advancingcivilization is an increasing refinement of taste and desire. Thefundamental human needs are food, shelter, clothes, sex relations, andcompanionship. These the savage has as well as his civilized brother, and he finds them not only necessary but agreeable. What we callprogress improves the food and the shelter, modifies the clothes, elaborates the sex relations and the code governing companionship. Witheach step forward the cruder methods become more actively disagreeable, and only the refined methods prove agreeable. In other words, desirekeeps pace with improvement, so that although great advances materiallyhave been made, there has been little advance, if any, in contentment. This is because as we progress in refinement little things come to beimportant, manner becomes more essential than matter, and we get to thehyperæsthetic stage. 

Thus the dinner becomes less important than the manner of serving it. Inthe "highest circles" it is the _savoir faire_, the niceties of conduct, that count more than character. Words become the means of playing withthought rather than the means of expressing it, and thought itselfscorns the elemental and fundamental and busies itself with the vagariesof existence. 

From another angle, to the hyperæsthetic more and more things havebecome disagreeable. To the man of simple tastes and simple feelings, only the calamities are disagreeable; to the hyperæsthetic every breezehas a sting, and life is full of pin pricks. "The slings and arrows ofoutrageous fortune" are multiplied in number, and furthermore thereaction to them is intensified. In the "Arabian Nights" the princessboasts that a rose petal bruises her skin, while her competitor indelicacy is made ill by a fiber of cotton in her silken garments. Sowith the hyperæsthetic; an unintentional overlooking is reacted to as adeadly insult; the thwarting of any desire robs life of its savor;sounds become noises; a bit of litter, dirt; a little reality, intolerable crudity. 

A woman with this temperament is a poor candidate for matrimony unlessthere goes with it a capacity for adjustment, unusual in this type. Mostmen have their habitual crudities, their daily lapses, and every home isthe theater of a constant struggle with the disagreeable. Intenselypleased by the utmost refinements, these are too uncommon to make up forthe shortcomings. The hyperæsthetic woman is constantly the prey of themost deënergizing of emotions, --disgust. "It makes me sick" is not anexaggerated expression of her feeling. And her afflicted household sizeup the situation with the brief analysis, "Everything makes hernervous. " Every one in her household falls under the tyranny of herdisposition, mingling their concern with exasperation, their pity with asilent almost subconscious contempt. 

Next comes the over-conscientious type. Whatever conscience is, whetherimplanted by God, or the social code sanctified by training, teaching, and a social nature, there can be no question that, as the Court ofAppeals, it does harm as well as good. 

There are people whose lack of conscience is back of all manner ofcrimes, from murder down to careless, slack work; whose cruelty, lust, and selfishness operate unhampered by restraint. On the other hand thereare others whose hypertrophied conscience works in one of twodirections. If they are zealots, convinced of the righteousness of theirown decisions and conclusions, their conscience spurs them on toreforming the world. Since they are more often wrong than right, theybecome, as it were, a sort of misdirected Providence, raising havoc withthe happiness and comfort of others. Whether the conscienceless orthose overburdened with this type of conscience have done more harm inthe world is perhaps an open question, which I leave to the historiansfor settlement. 

The other type of the overconscientious does definite harm tothemselves. This type I have called the "Seekers of Perfection" and itis their affliction that they are miserable with anything less. They areparticularly hard on themselves, differing in this wise from the byhyperæsthetic. Constantly they examine and reëxamine what they havedone. "Is it the best I can do?" "Should I rest now; have I the right torest?"

Into every moment of enjoyment they obtrude conscience, or ratherconscience obtrudes itself. They become wedded to a purpose, and thenthat purpose becomes a tyrant allowing no escape, even for a briefpleasure, from its chains. Nothing is right that wastes any time;nothing is good but the best. The sense of humor is conspicuouslylacking in this type, for one of the main functions of humor is toseason effort and straining purpose with proportion. 

Should one of these unfortunates be a housewife, then she is continually"picking up", continually pursuing that household Will-o'-the-Wisp, "finishing the work. " For it is the nature of housework that it is neverfinished, no matter how much is done. This overconscientious person, unless she is made of steel springs and resilient rubber, breathlesslychasing this phantom all day and into the night, gives way under thestrain, even though she have a dozen servants to help. For to this typeeach helper is not at all an aid. At once up goes the standard of whatis to be done, and each servant becomes an added care, an addedresponsibility. 

"I'd love to go out with you, " wails this housewife, "but there'ssomething I must finish to-day. " The word _must_, self-imposed, becomesthe mania of her life, to the open rebellion of her household. The worddrives her to the real neglect of her husband, who becomes irritated ather constant and to him needless activity, coupled with her complaints. 

"Why don't you rest if you are tired, " is his stock remonstrance; "thehouse looks all right to me. "

But it is futile. She becomes irritated, perhaps cries and says, "Justlike a man. It's clean to you if there are no cobwebs on the walls. "

Whereupon the debate closes, but the woman is the more deënergized andthe man exasperated at the unreasonableness of women in general and hiswife in particular. 

It is probably true that woman has more conscience, in so far as detailis concerned, than man. She is more of a lover of order and neatness, more wedded to decorum. Man loves comfort and his interest is morespecialized and analytical, and as a rule he hates fussiness. 

This hatred of fussiness makes him long for the masculine clubroom, gives him the kind of uneasiness that sends him off on a fishing trip orhunting expedition. Further, and this is of great social importance, many a broken home, many an unexplainable triangle of the Wife, theHusband, and the Other Woman owes its existence, not to the charms ofthe other woman, but to the overconscientious wife. 

The third type predisposed to the neurosis of the housewife is theoveremotional woman. 

We have already considered the effect of certain types of emotion onhealth and endurance and may formulate it as follows: Emotion may actas a great bodily disturbance, affecting every organ and every functionof the body. What we call nervousness is largely made up of abnormalemotional response, of persistent emotion, of the blocking of energy byemotion. 

Now people differ from the very start of life in their response tosituations. One baby, if he does not get what he wants, turns hisattention to something else, and another will cry for hours or until hegets it. One will manifest anger and strike at being blocked or impededin his desires, and the other will implore and plead in a baby way forhis wish. 

In the face of difficulties one man shows fear and worry, another actshastily and without premeditation, a third flares up in what we call afighting spirit and seeks to batter down the resistance, and still afourth becomes very active mentally, calling upon all of his pastexperience and seeking a definite plan to gain his end. 

A loss, a deprivation, plunges one type of person into deepest sorrow, ahelpless sorrow, inert and symbolic of the hopeless frustration oflove. The same affliction striking at another man's heart makes himdeeply and soberly reflective, and out of it there ensues a greatphilanthropy, a great memorial to his grief. For the one, sorrow hasdeënergized; for the other it has energized, has raised the efforts to anobler plane. 

Now there are women, and also men, to whom emotion acts like an overdoseof a drug. Parenthetically, emotion and certain drugs have very similareffects. No matter how joyous the occasion and how exuberant their joy, a mood may settle into their lives like a fog and obscure everything. This mood may arise from the smallest disappointment; or a sudden visionof possible disaster to one they love may appear before them throughsome stray mental association. They are at the mercy of every sad memoryand of every look into the future. 

Preëminently, they are the victims of that form of chronic fear calledworry, more aptly named by Fletcher "fearthought. " He implied by thisname that it was a sort of degenerated "forethought. "

If the baby has a cough, then it may have tuberculosis or pneumonia orsome disastrous illness, of which death is the commonest ending. Howoften is the doctor called in by these women and needlessly, and how shedoes keep his telephone busy! It is true that a cough may be earlytuberculosis, but this is the last possibility rather than the first. 

If the husband is late, Heaven knows what may have happened. She hasvisions of him lying dead in some morgue, picked up by the police, orhe's in a hospital terribly injured by an automobile, or, perchance, arobber has sandbagged him and dragged him into a dark alley. If she is abit jealous, and he is at all attractive, then the disaster lies thatway. It doesn't matter that his work may be such that he cannot be athome regularly or on schedule; the sinister explanation takes possessionof her to the exclusion of the more rational; _she has a sort ofaffinity for the terrible_. And when her husband comes home, theprofound fear in many cases turns sharply and quickly to anger at him. Her distorted sense of responsibility makes him the culprit for herunnecessary fear. 

Now it is true that almost every woman has something of this tendency, but it is only the extreme case that I am here depicting. In thisextreme form, this type of woman is commonly found among the Jews. TheJewish home reverberates with emotionality and largely through thisattitude of the Jewish housewife. 

Such a woman is apt to make a slave of her family through their fear ofarousing her emotions. How frequently people are chained by theirsympathies, how frequently they are impeded in enjoyment by the tyrannyof some one else's weakness, would fill one of the biggest chapters in atrue history of the human race, --a book that will probably never bewritten. 

Naturally enough, this housewife finds plenty to worry about, to reactto, and since these reactions are physical, they have a lowering effecton her energy. 

To those familiar with the conception that every emotion, every feeling, needs a discharge, it will seem heretical when I say that the excessivedischarge of emotion is harmful. Freud finds the root of most nervoustrouble in repressed emotion. That is in part true, but it is also truethat excessive emotionality is a high-grade injury, for emotionaldischarge is habit forming. It becomes habitual to cry too much, to acttoo angry, to fear too much. The conquest and disciplining of emotion isone of the great objects of training. It has for its goal the supremacyof the noblest organ of the human being, his brain. For proper livingthere must be emotion--there always will be--but it must be temperedwith intelligence if the best good of the individual and the race is tobe reached. 

The type of woman we must now study is a very modern product, thenon-domestic type. 

That the great majority of women have a maternal instinct does notnullify the fact that a small number have none whatever. One of thefacts of life, not taken into account with a fraction of its truesignificance and importance, is the variability of the race, the widerange of abilities, instincts, emotions, aspirations, and tastes. Aquality is said to be normal when the majority of the group possess it, but it may be utterly lacking in a smaller number who are therebydeclared abnormal. 

At present, it is normal for woman to be domestic, _i. E. _ to yearn forhusband, home, and children; to want to be a housewife. Unfortunately, all these yearnings do not hang closely together, and a woman may want ahusband and be swept by her own desire and opportunity into matrimony, and yet she may "detest" children, may dislike the housekeepingactivities of marriage. The sex and other instincts upon which marriageis based are not always linked with the maternal and home-keepinginstincts. 

While this has probably always been true, it mattered little in oldendays. A woman regarded the home as her destiny and generally hadexperienced no other life. But as was shown in the first chapter, industry and feminism have given woman a taste of other kinds of lifeand have developed her individual points of character and abilities. Perhaps she has been the bookkeeper of a large concern; or the privatesecretary to a man of exciting affairs; or she has been the buyer forsome house; or she has dabbled in art or literature; or she has been afactory girl mingling with hundreds of others, working hard, but in alarge group; or a saleslady in a department store, --and domestic life isexpected of her as if she had been trained for it. In fact, she has beentrained away from it. 

The novelists delight to tell us of the woman who seeks a career andenters the struggle of her profession and fails. And then there comes, just when her failure is greatest and she is most weepingly feminine, the patient hero, and he holds out his arms, and she slips into them, oh, so joyously! She now has a home, and will be happy--long row ofasterisks, and have children; and if it is a movie, a year or moreelapses and we are permitted to gaze upon a charming domestic scene. 

But alas for reel life as against real life! We are not shown how sheyearns for the activities of her old career; we are not shown thefeeling she constantly has that she is too good for housekeeping. If shehas been fortunate enough to marry a rich and indulgent man, she becomesa dilettante in her work, playing with art or science. If her firstvocation was business, she is bored to death by domesticity. But if shemarries poverty, she looks on herself as a drudge, and though loyaltyand pride may keep her from voicing her regrets, they eat like a cankerworm in the bud, --and we have the neurosis of this type of housewife. Orelse her experience in business makes her size up her husband morekeenly, and we find her rebelling against his failure, criticizing himeither openly to the point of domestic disharmony, or inwardly to herown disgust. 

It is not meant that all business and professional women, all typistsand factory girls are dissatisfied with marriage or develop an abnormalamount of neurosis. Many a girl of this type really loves housekeeping, really loves children, and makes the ideal housewife. Intelligent, clear-eyed, she manages her home like a business. But if independentexperience and a non-domestic nature happen to reside in the same woman, then the neurosis appears in full bloom. Against the adulation given towomen singers and actresses, against the fancied rewards of literatureand business, the domestic lot seems drab to this non-domestic type. 

Here the question arises: Is there room in our society for matrimony anda business career? That a large number of exceptional women have foundit possible to be mothers, housewives, authors, and singers at one andthe same time does not take away from the fact that in the majority ofcases such a combination means either a childless marriage or theturning over of an occasional child to servants: it means theabandonment of the home and the living in hotels, except in the fewcases where there is wealth and trusty servants. Wherever women who havechildren are poor and work in factories, there is the greatest infantmortality, there is the greatest amount of juvenile delinquency, andthere is the greatest amount of marital difficulty. Our presentconception of matrimony demands that woman remains in the home untilsuch time at least as her children are able to care largely forthemselves. 

In the history of the worst cases of the housewife's neurosis one findspreviously existing trouble, though, as I have before this emphasized, the neurosis may develop in the previously normal. This previouslyexisting trouble is the "nervous breakdown" in high school or incollege, or in the factory and the office, though it must be said itoccurs relatively less often in the latter places than the former. Thisprevious breakdown often appears as the direct result from emotionalstrain such as an unhappy love affair, or the fear of failure inexaminations. It may have followed acute illness, like influenza orpneumonia. But the original temperament was nervous, high-strung, delicate; one learns of an appetite that disappeared easily, a sleepreadily disturbed, in short, an easily lowered or obstructed output ofenergy. 

This type of woman, neurotic from her very birth, is often the very bestproduct of our civilization from the standpoint of character andability, just as the male neurasthenic is often the backbone of progressand advancement. But we are concerned with these questions: "Whathappens to her in marriage?" "How about her fitness for marriage?"

As to the first question, we may say that all depends on whom and howshe marries. For after all a woman does not marry _matrimony_, shemarries a _man_, a home, and generally children. And if the neuroticwoman marries a devoted, kindly, conscientious man with wealth enough togive her servants in the household and variety in her experiences, sheis as reasonably well off as could be expected. She is no worse off thanif she had remained single and continued to be a school teacher, socialworker, typist, factory hand the rest of her days, --and she hasfulfilled more of her desires and functions. But if she marries anunsympathetic, impatient man or a poor one, or a combination, then thefirst child brings a breakdown that persists, with now and then shortperiods of betterment, for many years. Then we have the chronic invalid, the despair of a household, the puzzle of the doctors. "Not reallysick, " say the latter to the discouraged husband, seeking to adjusthimself to his wife, "only neurasthenic. All the organs are O. K. " Todifferentiate between a lowered energy and imaginary illness or lazinessis a hard task to which this husband is usually unequal. Though someshow of duty and kindness remains, love dies in such a household. Andthe very effort to give sympathy where doubt exists as to thegenuineness of the affliction is painful and increases the chasm betweenwife and husband. 

That some of the sweetest marriages result where the wife is of thistype does not change the general situation that such a marriage is anincreased risk. Should a man knowingly marry such a woman? The questionis futile in the overwhelming majority of cases. He will marry her, isthe answer. For the fascinating woman is frequently of this type. Witness the charm of the neuropathic eye with its widely dilated pupilthat changes with each emotion, the mobile face, --delicate, with a playof color, red and white, that is charming to look at, but which the grimphysician calls "Vasomotor instability. " There is nothing neutral aboutthis type; she is either very lovely or a freak. 

So all advice in the matter is of little avail. And racially speaking itis good that it is of no avail. I believe firmly that such a woman ismore often the mother of high ability than her more placid sister; thatsomething of the delicacy of feeling and intensity of reaction ofneurasthenia is a condition of genius. We are too far away from any realknowledge of heredity to advise for or against marriage in the most ofcases on this basis, and certainly we must not repeat Lombroso andNordau's errors and call all variations from stupidity degeneration. 

But this does not change the domestic situation of the man who isusually much more concerned with his own comfort than the mathematicalpossibilities of his offspring being geniuses. Certainly such a womanas the type now considered is not a poor man's wife, for she reallyneeds what only the rich can have, --servants, variety, frequentvacations, and freedom from worry. Now worry cannot be shut out of eventhe richest home, for illness, old age, and death are grim visitors whoask no man's leave. But poverty and its worries are kept away by wealth, and poverty is perhaps the most persistent tormentor of man. 

Essential in the study of "nervousness" is the physical examination, andwe here pass to the physically ill housewife. 

It is important to remember that the diagnosis of neurasthenia is, properly speaking, what is called by physicians a diagnosis ofexclusion. That is to say, after one has excluded all possible illnessesthat give rise to symptoms like neurasthenia, then and then only is thediagnosis justified. That is, a woman physically ill, with heart, lung, or kidney disease, or with derangements of the sexual organs, may actprecisely like a nervous housewife, --may have pains and aches, changesin mood, loss of control of emotion; in a word may be deënergized. 

It is not often enough remembered that bearing children, though anatural process, is hazardous, not only in its immediate dangers but tothe future health of the woman. Injuries to the internal and externalparts occur with almost every first birth, especially if that birthoccurs after twenty-five years of age. Repair of the parts immediatelyis indicated, but in what percentage of cases is this done? In a verysmall percentage of cases, I venture to state, not only in my own smallexperience in this work, but on the statements of men of largeexperience and high authority. 

In this connection I may state that the leading obstetricians believethat the woman of to-day has a harder time in labor than herpredecessors. Aside from the more or less mythical stories of the savagewomen who deliver themselves on the march, there seems to be noreasonable doubt that in an increasing civilization and feminization, woman becomes less able to deliver herself, especially at the firstbirth. 

Why is this? After all, it is a fundamental matter. And moreover it ismore often the tennis-playing, horseback-riding, athletic girl whofalls short in this respect than the soft-limbed, shrinking, old-fashioned girl. Does a strenuous existence make against easymotherhood? It would seem so; it would seem the more masculine theoccupations of woman become, the less able are they to carry out thetruly female functions. But this is a digression from our point. 

A retroverted uterus, a lacerated perineum, such minor difficulties asflat feet, such major ones as valvular disease of the heart, are causesof ill health to be ruled out before "nervousness" (or its medicalequivalents) is to be diagnosed. 

It is superfluous to say that we have here briefly considered only a fewof the types specially predisposed to difficulty. Moreover men and womendo not readily fall into "types. " A woman may be hyperæsthetic in onesphere of her tastes and as thick-skinned as a rhinoceros in others. Shemay squirm with horror if her husband snores in his sleep, but bewilling to live in an ugly modern apartment house with a poodle dog forher chief associate. Or the overconscientious woman may expend herenergies in chasing the last bit of dirt out of her house but bewilling to poison her family with three delicatessen meals a day. Theoveremotional housewife may flood the household with her tears overtrifles but be a very Spartan in the grave emergencies of life. And theneurotic woman, a chronic invalid for housework, may do a dragoon's workfor Woman Suffrage. It may be that no man can understand women; it is afact they do not understand themselves. But in this they are not unlikemen. 

One might speak of the jealous woman, the selfish woman, the womanenvious of her more fortunate sisters, poisoning herself by bitterthoughts. These traits belong to all men and women; they are part ofhuman nature, and they have their great uses as well as theirdifficulties. Jealousy, selfishness, envy, three of the cardinal sins ofthe theologian, are likewise three of the great motive forces ofmankind. They are important as reactions against life, not as qualities, and we shall so consider them in a later chapter. 

Though we have discussed the types predisposed to the nervousness of thehousewife, it is a cardinal thesis of this book that great forces ofsociety and the nature of her life situation are mainly responsible. From now on we are face to face with these factors and must considerthem frankly and fully. 

CHAPTER IV

THE HOUSEWORK AND THE HOME AS FACTORS IN THE NEUROSIS

One of the most remarkable of the traits of man is the restlessadvancement of desire, --and consequently the never-ending search forcontentment. What we look upon as a goal is never more than a rung inthe ladder, and pressure of one kind or another always forces us on tofurther weary climbing. 

This is based on a great psychological law. If you put your hand in warmwater it _feels_ warm only for a short time, and you must add stillwarmer water to renew the stimulus. Or else you must withdraw your hand. The law, which is called the Weber-Fechner Law, applies to all of ourdesires as well as to our sensations. To appreciate a thing you mustlose it; to reach a desire's gratification is to build up new desires. 

This is to be emphasized in the case of the housewife, but with thisadditional factor: that how one reacts to being a housewife depends onwhat one expects out of life and housekeeping. If one expects little outof life, aside from being a housewife, then there is contentment. If oneexpects much, demands much, then the housewife's lot leads todiscontent. 

What is disagreeable is not a fixed thing, except for pain, hunger, thirst, and death. The disagreeable is the balked desire, the obstructedwish, the offended taste. It is a main thesis of this book that theneurosis of the housewife has a large part of its origin in theincreasing desires of women, in their demands for a fuller, more variedlife than that afforded by the lot of the housewife. Dissatisfaction, discontent, disgust, discouragement, hidden or open, are part of thefactors of the disease. Furthermore there is an increasing sensitivenessof woman to the disagreeable phases of housework. 

What are these phases that are attended with difficulty? 1. The statusof the house work. 

It is an essential phase of housework that as soon as woman can affordit she turns it over to a servant. Furthermore there is greater andgreater difficulty in getting servants, which merely means that even theso-called servant class dislikes the work. No amount of argumenttherefore leads away from the conclusion that housework must beessentially disagreeable, in its completeness. There may be phases of itthat are agreeable; some may like the cooking or the sewing, but no onelikes these things plus the everlasting picking up; no one likes thedusting, the dishwashing, the clothes washing and ironing, the work thatis no sooner finished than it beckons with tyrannical finger to bebegun. To say nothing of the care of the children!

I do not class as a housewife the woman who has a cook, two maids, abutler, and a chauffeur, --the woman who merely acts as a sort of managerfor the home. I mean the poor woman who has to do all her own work, ornearly all; I mean her somewhat more fortunate sister who has a maidwith whom she wrestles to do her share, --who relieves her somewhat butnot sufficiently to remove the major part of housewifery. After all, only one woman in ten has any help at all!

It is therefore no exaggeration when I say that though the housewifemay be the loveliest and most dignified of women, her work is to a largeextent menial. One may arise in indignation at this and speak of thescience of housekeeping, of cleanliness, of calories in diet, ofchild-culture; one may strike a lofty attitude and speak of the Home(capital H), and how it is the corner stone of Society. I can but agree, but I must remind the indignant ones that ditch diggers, garbagecollectors, sewer cleaners are the backbone of sanitation andcivilization, and yet their occupations are disagreeable. 

"Fine words butter no parsnips. " There are some rare souls who lend tothe humblest tasks the dignity of their natures, but the average personfrets and fumes under similar circumstances. In its aims and purposeshousekeeping is the highest of professions; in its methods and techniqueit ranks amongst the lowest of occupations. We must separate results, ideals, aims, and possibilities from methods. 

All work at home has the difficulty of the segregation, the isolation ofthe home. Man, the social animal who needs at least some one to quarrelwith, has deliberately isolated his household, somewhat as a squirrelhides nuts, --on a property basis. There has grown up a definite, aesthetic need of privacy; all of modesty and the essential familyfeeling demand it. 

This is good for the man, and perhaps for the children, but not for thewoman. Her work is done alone, and at the time her husband comes homeand wants to stay there, she would like to get out. Work that is in themain lonely, and work that on the whole leaves the mind free, leadsalmost inevitably to daydreaming and introspection. These areessentials, in the housework, --monotony, daydreaming, and introspection. 

Let us consider monotony and its effects. The need of new stimuli is aparamount need of the human being. Solitary confinement is the worstpunishment, so cruel that it is prohibited in some communities. We needthe cheerful noises of the world, we need as releasers of our energiesthe sights, sounds, smells of the earth; we must have the voices and thepresence of our fellows, not for education, but for the maintenance ofinterest in living. For the mind to turn inward on itself ispleasurable only in rare snatches, for short periods of time or for rareand abnormal people. Man's mind loves the outside world but becomesuneasy when confronted by itself. 

The human being, whether male or female, housewife or industrial worker, is a seeker of sensations. Without new sensations man falls into boredomor a restless and unhappy state, from which the mind seeks freedom. Itis true that one may become a mere seeker of sensations, a restless andfickle pleasure lover who passes from the normal to the abnormal, exoticin his vain search for what is logically impossible, --lasting novelty. Variety however is not the mere spice of life; it is the basis ofinterest and concentrated purpose as well. 

People of course vary greatly in what they regard as variety, and thisis often a constitutional matter as well as a matter of education. Whatis new, striking and interest-provoking to the child has not the samevalue to the adult; what is boredom to the city man might be of hugeinterest to the country man. A person trained to a certain type of life, taught to expect certain things, may find no need of other newerthings. In other words people accustomed to a wide range of stimuli needa wide range, while people unaccustomed to such a range do not need it. 

The most important stimuli are other _persons_, capable of setting intoaction new thoughts, new emotions, new conduct. We need what GrahamWallas calls "face to face associations of ideas", --ideas called intobeing by words, moods, and deeds of others. 

It is this group of stimuli that the busy housewife conspicuously lacks. "She has no one to talk to, " especially in the modern apartment life. Itis true she has her children to scold, to discipline, to teach, and totalk _at_; but contact with child minds is not satisfying, has not theflavor of companionship, is not reciprocal in the sense that adult mindsare. There therefore results introspection and daydreaming, both ofwhich may be of slight importance to some women but which are distinctlydisastrous to others. 

If the married life is satisfactory the daydreaming and introspectionmay be very pleasurable, as they usually are at the beginning ofmarriage. The young bride dreams of love that does not swerve, ofunderstanding that persists, of success, of riches to come, of childrenthat are lovely and marvelous. And the happy woman also finds herthoughts pleasant ones, and her castles in the air are mere enlargementsof her life. 

But the dissatisfied woman, the unhappy woman, finds her daydreamspleasant and unpleasant at the same time. She is constantly coming backto reality; reality constantly obtrudes itself into her dreams. Thedaydreaming is rebelled against as foolish, as puerile, as futile. Astruggle takes place in the mind; disloyal and disastrous thoughts creepin which are constantly dismissed but always reappear. The profoundestdisgust and deënergization may appear, and fatigue, aches, pains, andweariness of life often results. 

One may compare interest to a tonic. How often does one see a littlegroup, who for the time being are not interesting to one another, sitsleepy, tired, bored, yawning, restless. Then a new person enters, aperson of importance or of interest. The fatigue disappears like magic, and all are bright, energetic, sparkling. The basis of club life is themonotony of the home; man uses the saloon, the clubroom, the pool room, the street corner, the lodge meeting, as an escape from theunstimulating atmosphere of wife and family, --the hearth. But for thehousewife there is usually no escape, though she needs it more than herhusband does. 

Furthermore the non-domestic type, the woman with especial ability, thewoman who has been courted, petted, and sought for before marriage isthe one who reacts most to the monotony of the home. There are plenty ofwomen who consider the home a refuge from a world they find morestrenuous, more fatiguing than they can stand, or who find in houseworka consecration to their ordained duty. Which type is the better womandepends upon the point of view, but it is safe to say that feminism andthe industrial world are making it harder and harder for an increasingnumber of women to settle down to home-keeping. 

The housewife is _par excellence_ a sedentary creature. She goes to workwhen she gets up in the morning, within doors. She goes to bed at night, very frequently without having stirred from the home. A great manywomen, especially those who have no help and have children, find it nextto impossible to get out of doors except for such incidental matters ashanging out the clothes or going to the grocery. 

It is true that some women so situated get out each day. But they arepossessed either of greater energy or skill or else own a less urgentconscience. At least for many women it gets to be a habit to stay in. Ifthere is a moment of leisure, a chair or a couch, and a book or paper, seem the logical way of resting up. 

Now sedentary life has several main effects upon health and mood. Ittends quite definitely to lower the vigor of the entire organism. Perhaps it is the poor ventilation, perhaps it is the lack of theexercise necessary for good muscle tone that brings about this result. Though the housewife may work hard her muscles need the tone of walking, running, swimming, lifting, that our life for untold centuries beforecivilization made necessary and pleasurable. 

With this sedentary life comes loss of appetite or capricious appetite. Frequently the housewife becomes a nibbler of food, she eats a biteevery now and then and never develops a real appetite. Nor is this afemale reaction to "food close-at-hand"; watch any male cook, or betterstill take note of the man of the house on a Sunday. He spends a goodpart of his day making raids on the ice chest, and it is a frequentenough result to find him "logy" on Monday. 

Furthermore, in the household without a servant, the housewife rarelyeats her meal in peace and comfort. She jumps up and down from eachcourse, and immediately after the meal she rarely relaxes or rests. Thedishes _must_ be cleared away and washed, and this keeps from her thatpeace of mind so necessary for good digestion. 

An increasing refinement of taste adds to these difficulties. If thefamily eat in the dining room, have separate plates for each course, andvarious utensils for each dish, have snowy linen instead ofoilcloth, --then there is more work, more strain, less real comfort. Muchof what we call refinement is a cruel burden and entails a grievouswaste of human energy and happiness. 

An important result of the sedentary life is constipation. Woman, underthe best of circumstances, is more liable to this difficulty than hermate, just as the human being is more liable to it than the four-leggedbeast. Man's upright position has not been well adjusted by appropriatestructures. Childbearing, lack of vigorous exercise, the corset, and thehustle and bustle of the early morning hours so that regular habits arenot formed, bring about a sluggish bowel. Indeed it is a cynicismamongst physicians that the proper definition of woman is "a constipatedbiped. "

While it is a lay habit to ascribe overmuch to constipation, it is alsotrue that it does definite harm. For many people a loaded bowel acts asa mood depressant, as illustrated by the Voltaire story. For others itdestroys the appetite and brings about an uneasiness that affects theefficiency. Whether there is a poisoning of the organism, anautointoxication, in such a condition is not a settled matter. But theimportance of the constipation habit lies chiefly in its effect uponmood and energy, in its relation to neurasthenia. 

These factors, the nature of housework, monotony and the results ofsedentary life bear with especial weight upon the woman of littlemeans. It is absolutely untrue that nervousness is a disease of wealth. There are cases enough where lack of purpose and lack of routine tasks, as in the case of wealthy women, lead to a rapid demoralization anddeënergization. It is also true that the search for pleasure leads to asterile sort of strenuousness that breaks down the health, as well asinflicting injury on the personality. 

Poverty is picturesque only to the outsider. "It's hell to be poor" isthe poor man's summary of the situation. There are serious psychicalinjuries in poverty which will demand our attention later, and stillmore serious bodily ones. In the case of the housewife, poverty on thephysical side means (1) never-ending work; (2) no escape from drudgeryand monotony; (3) insufficient convalescence from the injuries ofchildbearing; (4) a poor home, badly constructed, badly managed, withoutconveniences and necessities. 

That there are plenty of poor women who bear up well under their burdensis merely a testimony to the inherent vitality of the race. A man wouldbe a wreck morally, physically, and mentally if he coped with hiswife's burdens for a month. Either that or the housekeeping would getdown to bare essentials. If a man kept such a house, dusting andcleaning would be rare events, meals would become as crude as the needsof life would allow, ironing and linen would be wiped off asnon-essential, and the children would run around like so many littleanimals. In other words an integral part of what we call civilization inthe home would disappear. 

Perhaps men would reorganize the home. The housekeeper of to-day is onlyin spots coöperative; her social sense is undeveloped. Men might, and Ithink likely would, arrange for a group housekeeping such as that whichthey enjoy in their clubs. 

This digression aside, there are debilitating factors in the housewife'slot which need some amplification. We have referred to the insufficienttime for convalescence from childbirth. There are _sequelæ_ ofchildbirth, such as varicose veins, flat feet, back strain, that renderthe victim's life a burden. The rich woman finds it easy to secure restenough and proper medical attention. But the poor woman, not able torest, and with recourse either to her overbusy family doctor or to theoverburdened, careless, out-patient department of some hospital, dragsalong with her troubles year in and year out, becomes old before hertime, and loses through constant pain and distress the freshness oflife. 

It is impossible to separate the psychical factors from the physical, largely because there is no separation. One of the aims of a woman'slife is to be beautiful, or at least good looking. From her earliestdays this is held out to her as a way to praise, flattery, and power. Itbecomes a cardinal purpose, a goal, even an ideal. 

Unlike the purposes of men this goal is attained early, if at all, andthen Nature or Life strip it away. The well-to-do woman or theexceptional poor woman may succeed in keeping her figure and her facialbeauty for a relatively long time, though by the forties even these haveusually given up the struggle. For the poor woman the fading comesearly, --household work, bearing children, sedentary life, worry, and anon-appreciative husband bringing about the fatal change. 

I doubt if men see their youth slipping away with the anguish of women. To men, maturity means success, greater proficiency, moreachievement, --means purpose-expanding. To women, to whom the mainpurpose of life is marriage, it means loss of their physical hold ontheir mate, loss of the longed for and delightful admiration of others;it means substantially the frustration of purpose. 

And I have noticed that the very worst cases of neurosis of thehousewife come in the early thirties, in women previously beautiful orextraordinarily attractive. They watch the crows'-feet, the finewrinkles, the fat covering the lines of the neck and body with somethingof the anguish that the general watches the enemy cutting off his linesof communication or a statesman marks the rise of an implacable rival. 

Popular literature, popular art, and popular drama, including in this bya vigorous stretching of the idea the movie, are in a conspiracy againstreality. This is of course because of the tyranny of the "Happy Ending. "While the happy ending is psychologically and financially necessary, inso far as the publishers, editors, and producers are concerned, whatreally happens is that the disagreeable phases of life, not beingfaced, persist. To have a blind side for the disagreeable does not ruleit out of existence; in fact, it thus gains in effect. 

To say that housekeeping is looked upon essentially as menial, to saythat it is monotonous, that it is sedentary, and has the ill effectsthat arise from these characteristics, is not to deny that it hasagreeable phases. It has an agreeable side in its privacy, itsindividuality, and it fosters certain virtues necessary to civilization. That I do not lay stress on these is because novelist, dramatist, andscenario author, as well as churchman and statesman, have always dwelton these. The agreeable phases of the housewife's work do not cause herneurosis; it is the disagreeable in her life that do. Or rather it iswhat any individual housewife finds disagreeable that is of importance, and it is my task to show what these things are, how they work, andfinally what to do about it. 

CHAPTER V

REACTION TO THE DISAGREEABLE

A few preliminary words about the disagreeable in the housewife's lotwill be of value. 

We may divide the things, situations, and happenings of life into threegroups, --the agreeable, the indifferent, and the disagreeable. No twomen will agree in detail in judging what is agreeable, indifferent, ordisagreeable. There are as many different points of view as there arepeople, and in the end what is one man's meat may literally be anotherman's poison. There are, however, only a few ways of reacting to whatone considers the disagreeable. The agreeable things of life do notcause a neurosis, though they may injure character or impair efficiency. And we may neglect the theoretical indifferent. 

1. A disagreeable thing may be so disastrous in our viewpoint as tocause fear. This fear may be expressed as flight, which is a normalreaction, or it may be expressed by a sort of paralysis of function, asthe fainting spell, or the great weakness which makes flight impossible. Fear is a much abused emotion. People speak glibly about taking it outof life, on the ground that it is wholly harmful. "Children must notexperience fear; it is wrong, it is immoral; they should grow up insunshine and gladness, without fear. " A whole sect, many minorreligions, take this Pollyanna attitude toward reality. 

As a matter of fact fear is _a_ (I almost said _the_) great motive forceof human life. Fear of the elements was the incentive to shelter; fearof starvation started agriculture and the storage of food; fear ofdisease and death gives medicine its standing; fear of the unknown isthe backbone of conservatism, and fear of the rainy day is the source ofthrift. Fear of death is not only the basis of religion, but of lifeinsurance as well. Fear of the finger of scorn and the blame of ourfellows is the great force in morality. And no amount of attempted unitywith God will ever take the place of the injunction to fear Him!

2. While fear then is back of the constructive forces of life it workshand in hand with another emotion that is also greatly disparaged bysentimentalists, --anger. The disagreeable, by balking an instinct, byobstructing a wish or purpose, may arouse anger. The anger may blazeforth in a sudden destructive fury in an effort to remove the obstacle, or it may simmer as a patient sullenness, or it may link itself withthought and become a careful plan to overcome the opposition. It mayrange all the way from the blow of violence to burning indignationagainst wrong and injustice; it is the source of the fighting spirit. Without fear, purpose would never be born; without anger in some form orother it would never be fulfilled. 

3. But while fear and anger work well in succession, or at differenttimes, when both emotions are awakened by some disagreeable situation orthing, when there is a helpless anger, when the instinct to fight isparalyzed by fear, when doubt arises, then there is deënergization. 

Thus a hostile situation, an intensely disagreeable situation, may bemet with energy: viz. Planning, constructive flight, destructiveaction, or it may be met with a deënergization, confusion, paralysis, hopeless anger. It may cause an intense inner conflict with highconstant emotions, fatigue, incapacity to choose the proper action, andthe peculiar agony of doubt. 

This last type of reaction is a very common one in the housewife. Forthe situation is never clear-cut for decision--there is the idealimplanted by training, education, social pressure, and her own desire tolive in conformity with this ideal; there is opposing it disgust, anger, weariness, lack of interest that her house duties bring with them. Thisconflict leads nowhere so far as action is concerned, for she canneither accept nor reject the situation. 

This is to say: The human being needs primarily a definite point ofview, a definite starting place for his actions. Some belief, some goal, some definite purpose is needed for the rallying of the energy of mindand body. Drifting is intolerable to the acute, active mind bent uponsome achievement before death. Man is the only animal keenly aware ofhis mortality, and consequently he is the only one to fear the passingof time. This passing of time can be received equably by the oneconscious of achievement, or who has some compensation in belief andpurpose; it becomes intolerable to those in doubt. 

Fundamentally one may say that neurasthenia and the allied diseaseswhich we are here summing up as the nervousness of the housewife arereactions to the disagreeable. The fatigue, pains and aches, changes inmood and emotion are born of this reaction, except in those cases wherethey arise from definite bodily disease, and even here a vicious circleis established. The weakness and fatigue state, the consciousness ofimpaired power brought about by sickness, are reacted to in aneurasthenic manner. It is not often enough realized by physicians thata physical defect or a physical injury may be reacted to so as to bringabout nervous and mental symptoms; may cause the emotions of fear, hopeless anger, and sorrow; may cause an agony of doubt. 

With these few words on types of reactions to the disagreeable let usturn again to the disagreeable factors in our housewife's life which maycause her neurosis. 

The child is the central bond of the home and is of course thebiological reason for marriage. The maternal instinct has long beenrecognized as one of the great civilizing factors, the source of much ofhuman sympathy and the gentler emotions. While the beautiful side of themother-child relationship is well known and cannot be overestimated, thematernal instinct has its fierce, its jealous, its narrow aspect. Loveand sympathy for one's own in a competitive world have often as theirnatural results injustice and hardness for the children of others. Whilethe best type of mother irradiates her love for her own into love forall children, it is not uncommon for women to find their chiefest sourceof rivalry in the progress and welfare of their children. 

Maternal devotion is largely its own reward. The child takes thematernal sacrifices for granted, and after the first few years theinterests of parent and child diverge. There is a never-ending strugglebetween the rising and the receding generations, which is inherent inthe nature of things and will always exist wherever the young are free. All the world honors the mother, but few children return in anythinglike equality the love and sacrifices of their own mother. 

Is the maternal instinct waning in intensity in this period offeminization? There have always been some bad, careless, selfishmothers; has their number increased? Probably not, yet the maternalinstinct now has competition in the heart of the modern woman. Thedesire to participate in the world's activity, the desire to learn, toacquire culture, engenders a restless impatience with the closed-in lifeof the mother-housewife. This interferes with single-minded motherhood, brings about conflict, and so leads to mental and bodily unrest. Ofcourse this interferes little or not at all with some, probably most ofthe present-day mothers, but is a factor of importance in the lives ofmany. 

The nervous housewife has several difficulties in her relations to herchildren. These are of importance in understanding her and have beentouched on before this, but it will be of advantage to consider them asa group. 

We have said that the opinion of obstetricians is that the modern womanhas more difficulty in delivering herself than did her ancestress. Ifthis is true (and we may be dealing with the fact that obstetricians areoften the ones to see the difficult cases, or that these stand out intheir memories) there are several explanations. 

First, women marry later than they did. It may be said that the firstchild is easiest born before the mother is twenty-five years of age, andthat from that time on a first child is born with rapidly increasingdifficulty. The pelvis, like all the bony-joint structures of the body, loses plasticity with years, and plasticity is the prime need forchildbearing. Similarly with the uterus, which is of course a muscularorgan, but possesses an elastic force that diminishes as the woman growsolder. 

Second, the vigor of the uterine contractions upon which the passage ofthe baby depends is controlled largely by the so-called sympatheticnervous system, though glands throughout the body are very importantfactors as well. This part of the nervous system and these glands arepart of the mechanism of emotion as well as of childbearing, and emotionplays a rôle of importance in childbearing. The modern woman _fears_childbearing as her ancestress did not, partly through greaterknowledge, partly through her divided attitude towards life. 

Having a harder time in childbearing means a slower convalescence, aneed for more rest and care. Then nursing becomes somehow moredifficult, more wearing to the mother; she rebels more against it, andyet, knowing its importance, she tries to "keep her milk. " It oftenseems that the more women know about nursing, the less able they are tonurse, that the ignorant slum-dweller who nurses the child each time itcries and drinks beer to furnish milk does better than her enlightenedsister who nurses by the clock and drinks milk as a source of her baby'ssupply. 

The feeling of great responsibility for her child's welfare that themodern woman has acquired, as a result of popular education in thesematters, undoubtedly saves infants' lives and is therefore worth theprice. A secondary result of importance, and one not good, is the addedliability to fatigue and breakdown that the mother acquires. This factorwe meet again in the next phase of our subject, the education andtraining of children. 

Though the number of children has conspicuously decreased, the care andattention given them has increased in inverse proportion. The woman withsix children or more turned over the younger children to the older ones, so that her burden, though heavy, was much less than it may seem. Further, though she loved and cared for them, she knew far less ofhygiene than her descendant; she did not try to bring them up in agermless way; and her household activities kept her too busy to allowher to notice each running nose, or each "festering sore. " Not havingnearly so much knowledge of disease, she had much less fear and wasspared this type of deënergization. Her daughter views with alarm eachcough and sneeze, has sinister forebodings with each rash; pays anenormous attention to the children's food, and through an increasingattention to detail in her child's life and actions has a greaterliability to break under the greater responsibility andconscientiousness. 

It must be remembered that the feeling of responsibility andapprehensive attention is not merely "mental. " It means fatigue, moredisturbance of appetite, and less restful sleep. These are things ofgreat importance in causing nervousness; in fact, they constitute alarge part of it. 

Perhaps another generation will find that hygiene can be taught withoutproducing fussiness and fear. Certainly popular education has its value, but it has a morbid side that now needs attention. This morbid side isnot only bad for the mother but is unqualifiedly bad for the child. 

For the child of to-day, the center of the family stage in hisattention, is often either spoiled or made neurasthenic by histreatment. Either he is frankly indulged, or else an over-criticalattitude is taken toward him. "Bad habits must not be formed" is theactuating motive of the overconscientious parents, for they do not seemto know that the "trial and error" method is the natural way oflearning. Children take up one habit after another for the sake ofexperience and discard them by themselves. For a child to lie, to steal, to fight, to be selfish, to be self-willed is not at all unnatural; forhim to have bad table manners and to forget admonition in general andagainst these manners in particular is his birthright, so to speak. 

Yet many a mother of to-day torments her child into a bad introspectionand self-consciousness, herself into neurasthenia, and her husband intoseething rebellion, because of her desire for perfection, because of herfear that a "bad act" may form into a habit and thence into a viciouscharacter. 

Especially is this true of the overæsthetic, overconscientious typesdescribed in Chapter III. I have seen women who made the dinner tableless a place to eat than a place where a child was pilloried for hismanners, --pilloried into sullen, appetiteless state. 

So, too, an unfortunate publicity given to child prodigies brought withit for a short time an epidemic of forced intellectual feeding ofchildren, that produced only a precocious neurasthenia as its greatresult. Similarly the Montessori method of child training which madeevery woman into a kindergarten teacher did a hundred times more harmthan good, despite the merits of the system. That a child needs toexperiment with life himself means that it will be a long time beforethe average mother will know how to help him. 

A factor that tends to perplex the mother and hurts the training of thechild is her doubt as how "to discipline. " Shall it be the old-fashionedcorporal punishment of a past generation, the appeal to pain and blame?Shall it be the nowadays emphasized moral suasion, the appeal toconscience and reason? With all the preachers of new methods filling herear she finds that moral suasion fails in her own child's case, and yetshe is afraid of physical punishment. 

This is not the place to study child training in any extensive manner, yet it needs be said that praise and blame, pleasure and pain, are thegreat incentives to conduct. One cannot drive a horse with one rein;neither can one drive a child into social ways, social conformity by oneemotion or feeling. Corporal punishment is a necessity, sparingly usedbut vigorously used when indicated. Of course praise is needed and so isreward. 

What is here to be emphasized is that a sense of great responsibilityand an over-critical attitude toward the children is a factor ofimportance in the nervous state of the modern housewife. Increasingknowledge and increasing demand have brought with them bad as well asgood results. Here as elsewhere a little knowledge is a dangerous thing, but a more serious difficulty is this, --though fads in training arisethat are loudly proclaimed as the only way, there is as yet no realscience of character or of character growth. 

The tragedy of illness is acute everywhere, and the sick child is inevery household. In many cases I have traced the source of thehousewife's neurosis to the care and worry furnished by one child. Thereare truly delicate children who "catch everything", who start off bybeing difficult to nurse, and who pass from one infection to anotheruntil the worried mother suspects disease with every change in thechild's color. A sick child is often a changed child, changed in all thefundamental emotions, --cranky, capricious, unaffectionate, difficult tocare for. A sick child means, except where servants and nurses can becommanded, disturbed sleep, extra work, confinement to the house, heavyexpense, and a heightened tension that has as its aftermath, in manycases, collapse. The savor of life seems to go, each day is a throbbingsuspense. 

With recovery, if the woman can rest, in the majority of cases nomarked degree of deënergization follows. But in too many cases rest isnot possible, though it is urgently needed. The mother needs the care ofconvalescence more than does the child. 

There is an extraordinary lack of provision for the tired housewife. True there are sanataria galore, with beautiful names, in pretty places, well equipped with nurses and doctors to care for their patients. Butthese are prohibitive in price, and at the present writing the cheapestplace is about forty dollars per week. This rate puts them out of thereach of the great majority who need them. 

Moreover, where there are small children and where there is no trustyservant or some kindly relative or friend it seems impossible for thehousewife to leave the home. Her husband must work daily for their breadand unless they are willing to turn to the charitable organizations, itis necessary for the housewife to carry on, despite her fatigue. So atthe best she gets an hour or two extra rest a day, takes a "littletonic" from the family doctor and gets along with her pains, her aches, and moods as best she can. 

But the sick do not always recover. Fortunately, the average humanbeing grieves a while over death, but the life struggle soon absorbshim, and the bereavement itself becomes a memory. But now and then onemeets mothers whose griefs and deprivations seem without end. Noreligion, no philosophy can bring them back into continuity with theirlives. They go about in a sorrowful dream, hugging their affliction, resenting any effort to comfort or console; without interest in thedaily task or in those whom they should love. They offer the severestproblem in readjustment, in reënergization, for they actively resentbeing helped. Sometimes one believes their grief is an effort to atonefor neglect real or fancied, a self-punishment which is not remitteduntil full atonement has been made. 

Aside from the physical difficulties in the bearing and rearing ofchildren, and in addition to the ordinary mental difficulties, such asjudging what discipline to use, there are especial problems of someimportance. Men vary in character from the saint to the villain, inability from the genius to the idiot. The children they once were varyas much. There are children who go through the worst of homes, theworst of environments, the worst of trainings, --and come out pure gold, with characters all the better for the struggle. There are others whomno amount of love, discipline, training, and benefits help; they aredespicable from the ordinary viewpoint from the first of life to thelast. Some children, adversely situated as to poverty and health, becomegeniuses, and their reverse is in the poor child whom heredity, earlydisease, or some freak of nature dooms to feeble-mindedness. 

The heart of the mother is in her child; she glories in its progress, and she refuses to see its defects until they glare too brightly to beoverlooked. Then she has a heartbreak all the more bitter for hermaternal love. 

It is the incorrigibly bad child and the mentally deficient child whoevoke the severest, most neurasthenic reaction on the part of thehousewife. Not only is pride hurt, not only is the expanded self-loveinjured, but such children are a physical care and burden of such anature as to outbalance that of three or four normal children. 

The bad child, egoistic, undisciplinable, destructive, and quarrelsome, or the child who cannot be taught honesty, or the one who continuallyruns away, is an unending source of "nervousness" to his mother. As timegoes on and the difficulty is seen to be fundamental, a battle betweenhostility and love springs up in the mother's breast that plays havocwith her strength and character. The very worst cases of housewifeneurosis are seen in such mothers; the most profound interference withmood, emotion, purpose, and energy results. 

Similarly, with the mother of the feeble-minded child. At first thechild is viewed as a bit slow in walking, talking, in keeping clean, andthe mother explains it all away on this ground or that. A previousillness, a fall in which the head was hurt, difficulty with theteething, diet, etc. , all receive the blame. Alas! In the course of timethe child goes to kindergarten and the terrible report comes back that"the child cannot learn, is clumsy, etc. ", and the teacher thinks heshould be examined. Then either through the examination or through thepressure of repeated observations mother love yields to the truth andfeeble-mindedness is recognized. 

There are plenty of women who, with this fact established, adjustthemselves, make up their minds to it. But others find that it takes allthe pleasure out of their lives, become morbid, and do not enjoy theirnormal children. For with all due respect to eugenics and statistics Iam convinced that the most of feeble-mindedness is accidental orincidental, and not a matter of heredity. Once a mother gets imbued withthe notion that the condition is hereditary, she falls into agonies offear for her other children. In my mind there is a thoroughlyreprehensible publicity given to half-baked work in heredity, mentalhygiene, and the like that does far more harm than good and interfereswith the legitimate work. 

There is no offhand solution for the case of the incorrigible boy orgirl. Of course the largest number sooner or later reform, sometimesovernight, and in a way to remind one of the religious conversions thatJames speaks of in his "Varieties of Religious Experiences. " So long asa child has a social streak in his make-up, so long as he at least isresponsive to the praise and blame of others and understands that hedoes wrong, so long may one hope for him. But the child to whom theopinion of others seems of no value, who follows his own egoism withoutcheck or control by the accepted standard of conduct, by the moral law, by the praise and blame of those near to him, is almost hopeless. Someday intelligence may keep him out of trouble, but by itself it cannotchange his nature. 

It is not sufficiently realized that while there has been a rise offeminism there has also been a great change in the status of children, achange that makes their care far more difficult than in the past. Theyhave risen from subordinate figures in the household, schooled inabsolute obedience, "to be seen and not heard, " to the central figuresin the household. One of the strangest of revolutions has taken place inAmerica, taken place in almost every household, and without the noticeof historians or sociologists. That is because these professionalstudents of humanity have their attention focused on little groups offigures called the leaders, and not nearly enough on that mass whichgives the leaders their direction and power. 

The age of the child! His development parallels that of women, in thatan individualization has taken place. In the past education and trainingtook notice of the child-group, not of the individual child. Butchild-culture has taken on new aspects, punishment has been largelysuperseded, individual study and treatment are the thing. Personality isthe aim of education, especial aptitudes are recognized in the varioustypes of schools that have arisen: commercial, industrial, classical;yes, and even schools for the feeble-minded. 

All this is admirable, and in another century will bring remarkableresults. Even to-day some good has come, but this is largely vitiated byother influences. 

Aside from the fact that the attention paid the child often increaseshis self-importance and makes his wishes more capricious, there arefactors that tend to rob him of his naïveté. 

These factors are the movies, the newspapers, and the spread ofluxurious habits amongst children. 

The movies are marvelous agents for the spread of information andmisinformation. Because of the natural settings they give to the mostabsurd and unnatural stories, their essential falsity and unreality isoften made the more pernicious. Their possibilities for good areenormous, their actual performance is conspicuously to lower the publictaste, to create a habit which discourages earnest reading orintelligent entertainment. For children they act as a stimulant of anunwholesome kind, acquainting them with realistic crime, vice, andvulgarity, giving them a distaste for childlike enjoyment. One seesnowadays altogether too often the satiated child who seeks excitement, the cynical, overwise child filled with the lore of the movies. 

In similar fashion the "comic" cartoons of the newspapers have anextraordinary fascination for children. Every child wants to read thefunny page, though the funny page is not for childish reading. The humoris coarse, slangy, and distinctly vulgar; very clever frequently andthoroughly enjoyable to those whom it cannot harm. 

If the historians of, say, 4500 A. D. Were by chance to get hold of a fewcopies of our newspapers of 1920 they might legitimately conclude thatthe denizen of this remote period expressed surprise by falling backwardout of his shoes, expressed disagreement by striking the other personover the head with a brick or a club; that women were always taller thantheir mates and usually "beat them up"; that all husbands, especially ifelderly, chased after every young and pretty girl. They might concludethat the language of the mass of the people was of such remarkable typesas this: "You tell them Casket, I'm Coffin", or "the Storm and Strife iscoming; beat it!"

No one I think enjoys the comic page more than the present writer, --yetit spreads a demoralizing virus amongst children. Of what use is it toteach children good English when the newspaper deliberately teaches themthe cheapest slang? Of what use is it to teach them manners andkindliness when the newspaper constantly spreads boorishness and "roughhouse" conduct? Of what use is it to raise taste when this is injured atthe very outset of life by giving bad taste a fascinating attraction?

Throughout the community there is a stir and excitement that isreflecting on the children. There are so many desirable luxuries in theworld now, so many revealed by movie and symbolized by the automobile, the cabaret, the increasing vulgarity of the theater (the disappearanceof the drama and the omnipresent girl and music show), a restless searchfor pleasure throughout the community even before the War, have notmissed the child. 

All these things make the lot of the housewife harder in so far as thetraining of her children is concerned. She is dealing with a more alert, more sophisticated, more sensuous child, --and one who knows his placeand power. The press and the theater both have knowledge of this and arecent witty play dealt with the sins of the children, paraphrasing ofcourse the classic of a bygone day, "Sins of the Fathers. " And a wiseold gentleman said to his grandson recently, when the lad complainedabout his mother, "Of course you are right. Every son has a right to beobeyed by his mother. "

I am by no means a pessimist. Every forward step has its bad side, butnevertheless is a forward step. It is in the nature of things that weshall never reach a millennium, though we may considerably improve thevalue and dignity of human life. Democracy has a rôle in the world ofgreat importance, --but the spread of education and opportunity to themass may make it more difficult for the best ideals and customs tosurvive in the avalanche of mediocrity that becomes released by theagencies that profit by appealing to the mass. So, too, the rise of thewoman and child bring us face to face with new problems, which I thinkare less difficult problems than those they have superseded andreplaced, but which are yet of importance. 

And a great problem is this: how to individualize the child and keepfrom spoiling him; how to give him freedom and pleasure, and keep himfrom sophistication. 

CHAPTER VI

POVERTY AND ITS PSYCHICAL RESULTS

In the story of Buddha it is related that it was the shock of learningof the existence of four great evils which aroused his desire to savemankind. These evils were Old Age, Sickness, Death, and Poverty. Theologians and the sentimentalists are unanimous in their praise ofpoverty, --the theologians because they seek their treasure in heaven, and the sentimentalists because they are incorrigible dodgers ofreality, because they cannot endure the existence of evil. But Buddhaknew better, and the common sense of mankind has shown itself in thedesperate struggle to reach riches. 

We have spoken of the part played by the physical disadvantages ofpoverty in causing the nervousness of the housewife. It is not allegedor affirmed that all poor housewives suffer from the neurosis, --thatwould be nonsense. But poor food, poor housing, poor clothing, the lackof vacations, the insufficient convalescence from illness and childbirthare not blessings nor do they have anything but a bad effect, an effecttraceable in the conditions we are studying. 

Furthermore, the woman who does all her own housework, including thecooking, scrubbing, washing, ironing, and the multitudinous details ofhousekeeping, in addition to the bearing and rearing of children, doesmore than any human being should do. It is very well to say, "See whatthe women of a past generation did, " but could we look at the thingobjectively, we would see that they were little better than slaves. Thatis the long and short of it, --the Emancipation Proclamation did notinclude them. 

Aside from the physical effects of poverty on the housewife, there arefactors of psychical importance that call for a hearing. After all, whatis poverty in one age is riches in another; what is poverty for one manis wealth to his neighbor. More than that, what a man considers richesin anticipation is poverty in realization. Here again we deal with themounting of desire. 

The philosophical, contented woman, satisfied with her life even thoughit is poor, is exempted from one great factor making for breakdown. Contentment is the great shield of the nervous system, the great bulwarkagainst fatigue and obsession. But contentment leads away fromachievement, which springs from discontent, from yearning desire. Whether civilization in the sense of our achievements is worth the pricepaid is a matter upon which the present writer will not presume to passjudgment. Whether it is or not, Mankind is committed to struggle onward, regardless of the result to his peace of mind. 

There are two principal psychical injuries with poverty--fear andworry--and we must pass to their consideration as factors in theneuroses of some women. 

Worry is chronic fear directed against a life situation, usuallyanticipated. Man the foreseeing must worry or he dies, --dies ofstarvation, disease, disaster. It is true that worry may be excessiveand directed either against imaginary or inevitable ills; ills thatnever come, ills that must come, like old age and death. 

Men in comfortable places cry "Why worry?" meaning of course that themost of worry is about ills that are never realized. That is true, butthe person living just on the brink of disaster, ruined or madedependent on charity by unemployment, a long illness, or any failure ofpower and strength, cannot be as philosophical as the man fortified by anice bank account or dividend-paying investments. These well-to-doadvisers of the poor remind one of the heroes of ancient fables who, having magic weapons and impenetrable armor, showed no fear in battle. One wonders how much courage they would have had if armed as theirfoemen were. 

For the poor housewife who sees no escape from poverty, whose husband iseither a workman or a struggling business man always on the edge offailure, life often seems like a wall closing in, a losing battlewithout end. 

Especially in the middle-aged, in those approaching fifty, does thishappen. Aside from the condition produced by "change of life", theso-called involution period, there is a reaction of the "time of life"that is found very commonly. For old age is no longer far off on thehorizon; it is close at hand, around the corner, and the looking-glassproclaims its coming. The woman wonders whether her husband will long beable to keep up, --and then "what will become of us?"

To be thrown on the benevolence of children is a sad ending toindependent natures, to people of experience. Crudely put, those whohave been dependents are now sustainers; those who have been led nowguide; the inferiors are the superiors. This is not cynicism, for withthe best intentions in the world, if the children are also poor, thecare of the parents is a burden that they cannot help showing, sooner orlater. 

Looking forward to such an ending to the hard work and struggle of alifetime is part of the worry of poverty, to be classed with the fear ofsickness and unemployment. 

We may loudly proclaim that one honest man is as good as another, thatcharacter is the measure of worth, that success cannot be measured bymoney. These things are true; the difficulty is not to make peoplebelieve it, it is to make people _feel_ it. Deeply ingrained in povertyis not alone to be deprived of things desired; more important is thefeeling of inferiority that goes with the condition. Only in theBohemia of the novelists do the poor feel equal to the rich. 

One of the fundamental strivings of the human being is the enlargementof the self-feeling, which fundamentally is the wish to be superior, tohave the admiration and homage of others. All daydreaming builds thisair castle; all ambition has this as its goal. No matter how we disguiseit to ourselves and others, the main ends of purpose are power andplace. True, we may wish for power and place so as to help others; wemay wish them as the result of constructive work and achievement, butthe enlargement of self-feeling is the end result of the striving. 

To be poor is to be inferior in feeling and applies equally to men andwomen. Man is a competitive-social animal and competes in everything, from the cleverness and beauty of his children to the excellence of histaste in hats. Money has the advantage of being the symbol of value, ofbeing concrete and definite, and of having the inestimable property ofpurchasing power. 

Now woman is as competitive as her mate. A housewife vies with herneighboring housewives in her clothes, her good looks, her youth, herhusband, her children, her home, her housekeeping, her money, --vies withher in folly as well as in wisdom. How much of the extravagance of women(and here is a difficulty to be dealt with later) arises from rivalryonly the tongues of women could tell, but it is safe to say that thegreater part of it has this origin. 

Jealousy and envy are harsh words, yet they stand for traits having agreat psychological value. Part of the impetus for effort rises fromthese feelings, and an incredibly large part. Many a man who bendsunremitting in his effort has in mind some man of whose success he isenvious, or whose efforts he watches with a jealousy hidden almost fromhimself. 

Upon women these feelings play with devastating force. One may besatisfied with what he has until some one else he knows gets more; thatis to say, the causes of most of the dissatisfaction and discontent ofthe world are envy and jealousy. In many cases it may be a righteoussort of jealousy or envy. A woman, especially because she is a rival ofher fellow-woman mainly in small things, becomes acutely miserable whenshe is outstripped by her neighbor and especially if she is passed byher relatives and intimate friends. 

Poverty is especially hard on those intensely ambitious for theirchildren. "They must have the education I did not have; they must have agood time in life which I never had; I don't want them to be poor alltheir lives like we are. " Here is the woman who works herself to thebone, yet is content and well save for her fatigue, if her childrenrespond to her efforts by success in study and by ambitious efforts oftheir own. But if the struggling mother is so unfortunate as to havedrawn in Nature's lottery an unappreciative or a weak-minded child, thenthe breakdown is tragic. 

A poor man is much more apt to be philosophical about poverty for hischildren than his wife is. He is willing to do what he can for them, buthe is more apt to realize what mother love is blind to, --that theaverage child is unappreciative of the parents' efforts and takes themfor granted. The man is more apt to think and say, "Let them stand ontheir own feet and make their own way; it will do them good. " The motherusually longs to spare her children struggle, the father rarely sharesthis desire except in a mild way. 

It may be that there was a time when classes were more fixed, thatpoverty had less of humiliation and blocked desire than it has atpresent. That society of all grades is restless with the desire forluxury seems without doubt. How profoundly the psychology of the massesis being altered by education, by the newspaper, the magazine, themovie, the automobile, the fashion changes that make a dress obsolete ina season and above all the department store and the alluringadvertisement, no one can hope to even estimate. Modern capitalism reapsgreat wealth by developing the luxurious, the spendthrift tastes of thepoor. It would be a peculiar poetic justice that will make thatdevelopment into the basis of revolution. 

The women of the poor are perhaps even more restless than the men. Infact, it is the women that set the pace in these matters. This isbecause to woman has fallen the spending of the family funds, a fact ofgreat importance in bringing about discord in the house. As the shopperthe poor woman now sees the beautiful things that her ancestors knewnothing of, since there were no department stores in those days. To-daydesires are awakened that cannot be fulfilled; she sees other womenbuying what she can only long for, and an active discontent with her lotappears. 

Unphilosophical this, and severely to be deprecated as unworthy ofwoman. This has been done so often and so effectively(?) by divines, reformers, press, that a mere physician begs leave to remark that it isa natural sequence of the publicity luxury to-day has. _The mostsuccessful commercial minds of America are in a conspiracy against thepoor Housewife to make her discontented with her lot by increasing herdesires_; they are on the job day and night and invade every corner ofher world; well, they have succeeded. The divines, etc. , who thunderagainst luxury have no word to say against the department store and theadvertising manager. 

CHAPTER VII

THE HOUSEWIFE AND HER HUSBAND

The husband differs from the wife in this fundamental, --that essentiallyhe is not a house man as she is a house woman. For the man the home isthe place where he houses his family and where he rests at night. Herealso he spends his leisure time in amount varying with his domesticity. Man writes songs and books about the home, but the woman lives there. Perhaps that is why women have not written sentimental verse about it. 

Marriage is variously regarded. "It is a sacrament, a religioussanction, and not to be dissolved by anything but Death. " So say a verylarge group of our people. "It is a contract, governed by law, enteredinto under certain conditions and to be dissolved only by law. " This isthe attitude of practically all the governments of the world and rapidlyis becoming the dominant point of view. Though the religious combatthis conception of marriage, no marriage is legal on religious sanctionalone, and the increase of divorce among those claiming to be Catholicsis an undisputed fact. 

It is only in the last century that the contract side of marriage hasbeen emphasized and become dominant. There has resulted a conflictbetween the sacramental, sacred point of view and the secular. Thisconflict, like all other social conflicts, is a part of the inner lifeof most of the men and women of this generation, influencing theirattitude toward marriage, the home, the mate. 

For when we say a thing is part of the "spirit of the times" we meanmerely that arising as a development of, or a change from, old ideas inthe minds of leaders, it has become propagated among the mass. It hasbecome part of their thought, incentive to their action, source of theirenergies. 

Thus sentiment and religion proclaim the sacredness of marriage, itseternal nature, its indissolubility. The law asserts it to be a civilrelationship, to be made or unmade by law itself; experience teachesthat if it is sacred, then sacredness includes folly, indiscretion, brutality, and crime. Therefore the marriage relationship has become asource of conflict for our times, with opposing champions shouting outtheir point of view, with books, the movies, the press, the stage, withdaily experience adducing cases. The scene of conflict is in the moodsand emotions of all of us. 

This divided view is particularly the attitude of women and becomes partof the neurosis of the housewife. 

After all a woman does not marry an institution; she marries a man withwhom she lives, sharing his life. In the natural course of events shebecomes the mother of the children to whom he is father. We may dismissas nonimportant the occasional freak marriage where a man and woman liveapart, have no children and meet occasionally, --for obvious purposes. Such a marriage is not only sterile biologically, not only empty of thevirtues of marriage, but encounters none of its difficulties. 

This intimate individual relationship makes marriage when complete andsuccessful the happiest human experience. Soberly speaking, it is thenthe flower of existence, satisfying biologically and humanly, givingpeace and satisfaction to body and mind. This is the ideal, the "happyending" at which most romances, novels, plays, and all the daydreams ofyouth leave us. Warm, cozy, intense domesticity, where passion islegitimate and love and friendship eternal; where children play aroundthe hearth fire; of which death only is the ending!

This ideal is not realized largely because no ideal is. How often is itclosely approximated? Experience says seldom. That implies no reproachagainst marriage, for we are to judge marriage by the rest of life andnot by an ideal. A world in which great wars occur frequently, in whicheconomic conflict is constant, in which sickness and disaster are neverabsent; where education is occasional, where reason has yet to rule inthe larger policies and where folly occupies the high places, --whyexpect marriage to be more nearly perfect than the life of which it is apart? To be reasonably comfortable and happy in marriage is all we mayexpect. 

What are the difficulties confronting the partners which impedehappiness and especially which bring the neurosis of the housewife? Forafter all we can only examine the field for our own purpose. 

We may divide the difficulties as follows from the standpoint of theneurosis of the housewife:

1. Those that arise from the sex relationship itself. 

2. Those that arise from conflicts of will, purpose, ideas. 

3. Those that arise from the types of husbands. 

4. Those that arise from the types of wives. (This has already beenconsidered under the heading Types Predisposed to the Neurosis. )

Before we go on to the consideration of these various factors we mustrepeat what has been emphasized frequently in this book. 

That the change in the status of woman implies difficulty in themarriage relationship. If only _one_ will is expected to be dominant inthe household, the man's, then there can arise no conflict. If the formof the household is unaltered, but if the woman demands its control orexpects equality, then conflict arises. If a woman expects a man to beather at his pleasure, as has everywhere been the case and still is insome places, if she considers it just, brutality exists only in extremesof violence. If she considers a blow, or even a rough word, anunendurable insult, then brutality arises with the commonestdisagreement. In other words, it is comparatively easy to deal with awoman expecting an inferior position, whose individual tastes, wills, ideas, and ideals have never been developed, --the ancient woman; it isvery much more difficult to deal with her modern sister. 

Happily the day is passing when prudery governed the discussion of sex. Lewdness exists in concealment, suggestion is more provocatory thanfrankness. The morbidness of men who condemned themselves to celibacyhas influenced the world; their fear of sex led to a misguided silenceshrouding the wrecks of many a life. 

The sex relationship is the basis of marriage. The famous couplet ofRosalind still holds good. The sex instinct (or rather instincts, forcoupled with sex-desire is love of beauty, admiration, joy ofpossession, triumph, etc. ) has the unique place of being more regulatedby law and custom than any other basic instinct. The law holds that nomarriage is consummated until the sex act has taken place, regardlessof the words of preacher or State official. The happiness of the firstyear or years of married life is mostly in its voluptuous bonds, forcompanionship and comradeship have really not yet arisen. Complementaryto this it may be said that much of married misery, especially for thewoman, arises from the first marital embrace. 

This last is because of the ignorance of men and women, an ignorancewholly due to prudery. The majority of women have been chaste beforemarriage; the majority of men have not. One would expect thereforeknowledge of men, the knowledge of experience. But the experience hasbeen gained with women of a certain type and has not equipped the man todeal with his wife. Though most women know in advance what is expectedof them, some are even ignorant of the most elemental facts of sex, andeven those who know are unprepared for reality. 

Too frequently the man regards himself as a Grand Seigneur with aparamount "Jus Primis Noctis. " True, the majority of men are abashed inthe presence of innocence and deal gently with it, --but others follow ina repellent way their instinct of possession. Any neurologist ofexperience has cases where sexual frigidity and neurasthenia in a womancan be traced back to the shock of that all-important first night. 

There are savage races in which preparation for marriage is anelementary part of education. We need not follow them into absurdity, but more than the last silly whispered words to bride and groom at theceremony is necessary. A formal antenuptial enlightenment, frank andexpert, is needed by our civilization. 

The sex appetite varies as widely as any other human character. Generally speaking, it is believed that sexual passion in women is moreepisodic than in men, often relating to the menstrual period. In manycases it does not develop as a conscious factor in the woman's lifeuntil after marriage, and sometimes not until the first child is born. Certainly desire in the girl is a more generalized, less local, lessconscious excitement than it is in the boy who cannot misunderstand hisfeelings. I think it may safely be said that allowing for the freedom ofboys and men, there is native to the male a more urgent passion than tothe female. This would be biologically necessary, since upon himdevolves not only courtship but the fundamental activity in the sexualact. A passionless woman may have sexual relation, a passionless mancannot. 

The disparity in sex desire between a husband and wife may be slight orgreat. No statistics on the subject will ever be gathered, from the verynature of the facts, but it is safe to say that much more disparityexists than is suspected. And likewise it causes more trouble than issuspected. Where the virility of the mate is inadequate there breeds asubtle dissatisfaction that may corrode domestic happiness and bringabout conflict on subjects quite remote from the real issue. Contrariwise, to have relations forced or coaxed on one where desire islacking brings about disgust, nervous reactions, fatigue of markednature. 

A woman sexually well mated often clings beyond reason to an unworthymate. Many an inexplicable marriage, many a fantastic loyalty of a goodwoman to a bad man has its origin where it is least expected, in the sexattachment. Demureness of appearance, refinement of manner, nobleideals are not at all inconsistent with powerful sex feeling. There isno reason why strong, well-controlled passion should be consideredanything but a virtue, why the pleasure of the sexual field should, under the social restriction, be regarded as impure. 

Too often the latter is the case. Fantastic puritanical ideas oftengovern both men and women. I have in mind several couples who desired tolive continent until such time as children were desired. The biologicalreasons for the sexual relations seemed to them the only "pure" reasons. Needless to say the resolution broke down under the intimacy of oneroof, but meanwhile a conflict was engendered that took some vigorouscounsel to dissipate. 

This purely occidental idea that sexual pleasure is somehow unworthy isresponsible for a disparity of a further kind. There are parts of thephysical side of love in which the majority of men need education, though in the well-adjusted married life the proper knowledge comes. Nature has not completely adjusted the sexes to one another; it is thepart of the man to bring about that adjustment. This part of theadjustment need not here be detailed; the books of Havelock Ellis areexplicit on the matter. Certainly no small share of the difficulties ofour housewife result, for it is a law that excitement withoutgratification brings about nervous instability. 

Whether or not the American domestic life is too intimate, too constant, is an important question. For the majority of people, after the firstecstasy of the bridal year, separate rooms might be better than a singlechamber occupied together. There are people to whom one bed and one roomis symbolic of their close unity, of their joined lives, who findcomfort and companionship in the knowledge that their life partnersleeps beside them. Where sexual compatibility or adjustment exists, there is nothing but commendation for this arrangement. Where it doesnot exist, the separate chambers are better for obvious reasons. 

A development of recent times is the rapidly increasing use of what arepolitely known as birth-control measures. This development is rapidlychanging the number of births in the community to a figure below thatnecessary for the perpetuation of the race. We are not concerned herewith the morality or immorality of these measures. Modern womanundoubtedly will continue to take the stand that childbearing should bevoluntary, that involuntary motherhood is incompatible with her dignityand status as a person. In this, through the increasing cost of livingas well as sympathy with her attitude, she will be backed by herhusband. I predict without fear that Church and State will have toadjust themselves to this situation. 

The fear of pregnancy has brought about this situation, that many awoman undergoes an agony of symptoms which is only relieved when hermonthly function appears. This fear makes the sexual relationship a riskalmost outweighing its pleasure. The notoriously "unsafe" character ofthe contraceptive measures has only diminished this fear, not completelyallayed it. 

Moreover the contraceptive measures, according to the law that every"solution" breeds new problems, have their place in causing nervousness. Rarely do these measures replace the natural act in satisfaction. Further, some are unable to conquer their repugnance and disgust andsome are left excited and unsatisfied. Vasomotor disturbances, neurasthenic symptoms, obsessions, and hysterical phenomena occur inmany women as well as in some men. One of the stock questions of theneurologists when examining a married man or woman complaining ofneurasthenic symptoms relates to the contraceptive measures used. Thechannel of discharge of sexual excitement is race old. And this newdevelopment blocks that channel. For many persons this is sufficient todeënergize the organism. 

At the present time there are two trends in the sex sphere, so far aswomen are concerned. There is the masculine trend, which is usuallycalled feminism. Women tend to take up the work formerly exclusivelybelonging to men; they tend to dress more like men, with flat shoes, collars and ties, and tailor-made clothes. They take up the vices ofmen, --smoking, drinking, --are building up a club life, live in bachelorapartments, call each other by their last names, etc. 

Whether with this goes a greater sexual license or not it is difficultto say. The observers best qualified to comment think there has been adecrease in female chastity, --that the entrance of women in industriallife, the growth of the cities, the increase in automobiles, the greaterfreedom of women, the dropping of restraint in manner and speech, havebrought women's morals somewhat nearer to men's. 

The other trend, not entirely separate except for externals, is markedby a hyper-sexuality, an emphasis of femaleness. This is by far the morecommon phenomenon and probably more widely spread through society. Thedress of women in general is more daring, more designed for sexallurement than for a century past. Women paint and powder in a way thatonly the demimonde did a generation ago, reminding one of the ladies ofthe French Court in the eighteenth century. Further, the plays of theday would be called mere burlesque a generation back; the girl and musicshow has the center of the stage, and the drama in America has almostdisappeared. There is an epidemic of magazines that flirt with therisqué; with titles that are sometimes much more clever than theircontents. 

Such eras have been with us before this, have come and gone. It isdoubtful if they ever affected so large a number of people. Theexcitement of the daily life is increased in a sexual way, and thisbrings an unrest that reacts on the anchor of the home, the housewife. She too tugs at her moorings; life must be speeded up for her too aswell as for the younger and unattached women. She becomes moredissatisfied and therefore more nervous. 

Altogether the sexual relationship of modern marriage needs a candidexamination. No drastic change is indicated, but education in sexualaffairs for men and women is a need. Even the prudish admit the pleasureof the sex-life, and that seems to be their fundamental aversion to it. Most of the advice and injunctions in the past seem to have come fromthe sexually abnormal. It is time that this was changed; in fact, it isbeing changed. The danger lies in a swing to extremes, in leaving thefields to those who think reform lies in the abolition of restraint, inthe disregard of all social supervision and obligation. Free love ismore disastrous if possible than prudery. 

CHAPTER VIII

THE HOUSEWIFE AND HER HOUSEHOLD CONFLICTS

The problems of life are not all sexual, and in fact even in therelations of men and women there are more important factors. After all, as Spencer pointed out in a marvelous chapter, love itself is acomposite of many things, some, of the earth, earthy, and some of thefinest stuff our human life holds. The aspirations, the ideals, theyearnings of the girl attach themselves to some man as theirfulfillment; the chivalrous feelings, the desire to protect and cherish, the passion for beauty of the man lead to some girl as their goal. Thereare few for whom the glow and ardor of their young love bring norefinement of their passion; there are few who have not felt a pulsatingunity with all that love and live, at least for some ecstatic moments. Something of what James has so beautifully designated as the "aura ofinfinity that hangs over a young girl" also lingers over the love of menand women. 

All the cynics and epigram makers in the world agree that love ends withmarriage, and this not only in modern times but even back into thosedays of the French Court of Love, when Margaret de Valois decided thatthe lover had more claims than the husband. Romance dies with marriageis the plaint of poet and novelists; the charm of woman disappears withher mystery, with possession. And the typical humorist speaks of thecurl papers and kimono of the wife, the snores and unshaven beard of thehusband. "Familiarity is the death of passion" is the theme of countlesswriters who bemoan its passing in the matrimonial state. 

How much harm the romantic tales have done to marriage and thesober-satisfying everyday life, no one can estimate, no one canoverestimate. Romanticism, which extols sex as the prime and only thingof life, prudery which closes its eyes to it and makes sour faces, needspecial places in Dante's Inferno. Neither has dealt withreality, --reality, which is satisfying and pleasant unless examinedwith the prejudices instilled by the hypersexual romance writer and theperverted sexuality of the prude. 

Nevertheless that two people brought up entirely differently, and havingdifferent attitudes towards love and life, should come into sharpconflict is to be expected. Further, that disillusionment follows afterthe excitement and heightened expectation of courtship is inevitable. Marriage at the best includes a settlement to routine; it carries withit an adjustment to reality, a getting down to earth that is painful anddisappointing to minds fed to expect thrill and passion with eachmoment. 

The idealization of the mate--the man or woman--gives way to a graduallyincreasing knowledge of imperfection and common clay. Common sense, earnestness of purpose, willingness to adjust, and a sense of humor savethe situation and change the love of the engaged period into a moresolid, robust affection which gains in durability and wearing qualitywhat it loses in intensity. 

Unfortunately, in many cases to a great extent and in all to someextent, there arises dissension natural wherever two human beings meeton anything like equal terms. 

In times past (and in many countries at the present time), thepatriarchal household prevailed. The Head of the House was the father, asovereign either stern or indulgent according to his nature. Perhaps hiswife ruled him through his love for her, as women have ruled from thebeginning of things, but if she did it was not by right but byprivilege. 

America has changed all that, so say all native and foreign observers. Here the woman rules; here she drags her husband after her like a tailto a kite; here she is mistress and he obeys, though nominally stillhead of the household. All the humorists emphasize this, and thenovelist depicts it as the common situation. The husband is representedas yoked to the wheel of his wife's whims, tyrannized over by the one heworks for. 

This is surely a gross exaggeration, though it furnishes excellentmaterial for satire. The man still makes the main conditions of life forboth; his name is taken, his work sustains the household, his pursesupplies the means of existence, his industrial business situationdetermines the residence, his social standing is theirs. This does notprevent him from being "henpecked" in many cases, but on the whole itassures his superior status. 

Nevertheless it is true that the American woman of whatever origin has awill of her own as no other woman has. Since the expression of will isone of the chief sources of human pleasures, one of the chief, mostpersistent activities, man and wife enter into a contest for supremacyin the household. It may be settled quietly and without even recognizingits existence, on the common plan that the woman shall have charge ofthe home and the man of his business; it may rage with violence over thefundamental as well as the trivial things of home. After all, it is notthe importance of a thing that determines the size of the row it mayraise; men have killed each other over a nickel because defeat over eventhis trifle was intolerable. 

What are the chief sources of conflict? For to name them all would besimply to name every possible source of difference of opinion thatexists. Let us take as an example Extravagance. 

This is a new development. In the former days the bulk of purchases wasmade by the husband, in whose hands the purse strings were tightlyclutched. With the growth of the cities and industry, the development ofthe department store and rise of shopping as an institution, the mangave place to his wife largely because industry would not let him offduring the daytime. So the housewife disbursed most of the funds of herhome, --and there arose one of the fiercest and most persistent ofdomestic conflicts. 

Despite the fact that most American husbands turn over their purses totheir wives, they still regard the money as their own. The desire to"get ahead" is an insistent one, returning with redoubled force aftereach expenditure. He finds his entire income gone each week or month, orfinds less left than he expected. "Where does it all go?" is his cry;"Must we spend as much as we do?" "How do people get along who get lessthan we do?"

To this his wife has the answer, "We must have _this_, and we _must_have that. We must live as our neighbors do. "

Here is the keynote to the situation. There has been a democratizationof society of this nature; there has been a spread throughout thecommunity of aristocratic tastes. The woman of even the poor and themiddle classes must have her spring and autumn suits, her dresses forsummer, her summer and winter hats. Her husband too must change hisclothes with each shift of the season. For this the enterprise of theclothing trade, the splendid display of the department stores areresponsible, awakening desire and dissatisfaction. 

While the man accuses the woman of extravagance, he is as guilty as she. He too spends money freely, --on his cigars and cigarettes, on everyedition of the newspapers, on the shine which he might easily applyhimself, on a thousand and one nickels that become a muckle. TheAmerican is lavish, hates to stint, detests being a "piker", says, "Oh, what's the difference; it will all be the same in a hundred years, " butkicks himself mentally afterwards. 

Meanwhile he quarrels with his wife, who really is extravagant. In thisbattle the man wins, even if he loses, for he rarely broods over thedefeat. But it brings about a sense of tension in his wife; it bringsabout a disunion in her heart, because she wants to please her husband, and at the same time she wants to "keep up" with her neighbors andfriends. And who sets the pace for her, for all of her group; whoestablishes the standard of expenditure? Not the thrifty, saving woman, not the one who mends her clothes and makes her own hats, but theextravagant woman, the rich woman perhaps of recently acquired wealthwho cares little for a dollar. Against her better judgment the woman ofthe house enters a race with no ending and becomes intenselydissatisfied, while her husband becomes desperate over the bills. 

This disunion in her spirit does what all such disunions do, --itpredisposes her to a breakdown. It makes the housework harder; it makesthe relations with her husband more difficult. It takes away pleasureand leaves discontent and doubt, --the mother-stuff of nervousness. 

While most American husbands are generous, there are enough stingy onesto set off their neighbors. To these men the goal of life is theaccumulation of money, as indeed it is with the majority. But to themthat goal is to be reached by saving every penny, by denying themselvesand theirs all expenditures beyond the necessities. 

The woman who marries such a man is humiliated to the quick by hisattitude. That a man values a dollar more than he does her wish is aninsult to the sensitive woman. There ensues either a never-ending battlewith estrangement, or else a beaten woman (for the stingy are stubborn)accepts her lot with a broken spirit, sad and deënergized. Or perhaps, it should be added, a third result may come about; the woman accepts theman's ideal of life and joins with him in their scrimping campaign. Withthis agreement life goes on happily enough. 

It is not of course meant that all or a great majority of American womenhave difficulties with their husbands over money. But I have in mindseveral patients who would be happy if this never-ending problem weresettled. The struggle "gets on the nerves" of the partners; they saythings they regret and act with an impatience that has its root infatigue. 

This difficulty over money and its spending gets worse in the latethirties and early forties, for it is then the man realizes with astartled spirit that he is getting into middle age, that sickness anddeath are taking their toll of his friends, and that he has not got on. The sense of failure irritates him, depresses him. He finds that he andhis wife look at the money situation from a different angle. 

"If you loved me, " says she, "you would see things a little more myway. "

"If you loved me, " says he, "you would not act to worry me so. "

Here in the year 1920, the high cost of living is becoming the strain oflife. Capital and Labor are at each other's throats; men cry "profiteer"at those whom good fortune and callous conscience have allowed to takeadvantage of the world crisis. The air is filled with the whispers thata crash is coming, though the theaters are crowded, the automobilemanufacturers are burdened with orders, and the shops brazenly displaythe most gorgeous and extravagant gowns. That the marital happiness ofthe country is threatened by this I do not see recorded in any of thediscussions on the subject. Yet this phase of the high cost of living isperhaps its most important result. 

The housewife's money difficulties are not confined to the question ofexpenditure. For there is a factor not consciously put forward butevident upon a little probing. 

If a woman remains poor, either actually or relatively, she always knowssome man with whom she was familiar in her youth who became rich, or shehas a woman friend whose husband has become successful. A subtle sort ofregret for her marriage may and does arise in many a woman, a subtledisrespect for her husband because of his failure. The husband becomesaware of her decreased admiration, and he is hurt in his tenderestplace, his pride. One of the worst cases of neurasthenia I have seen ina housewife arose in such a woman, who struggled between loyalty andcontempt until exhausted. For she came of a successful family, she hadmarried against their counsel and her husband, though good, was anentire failure financially. Measuring men by their success, she foundher lowered position almost unendurable but was too proud to acknowledgeher error. Out of this division in feelings came a completedeënergization. 

Whether or not such a housewife deserves any sympathy in her trouble, it is certain she presents a problem to every one connected with her. 

While money and expenditure afford a fertile field from whichnervousness arises, there are others of importance. 

Disagreement and disunion, conflict, arise over the training and care ofthe children. Here the different reactions of a man and woman--_e. G. _ toa boy's pranks--causes a taking of sides that is disastrous to the peaceof the family. Usually the American father believes his wife is toofussy about his son's manners and derelictions, secretly or otherwise heis quite pleased when his son develops into a "regular" boy, --tough, mischievous, and aggressive. But sometimes it is the overstern fatherwho arouses the mother's concern for the child. If a frank quarrelresults, no definite neurotic symptoms follow. It is when the womanfears to side against the husband and watches the discipline withvexation and inner agony that she lowers her energy in the wayrepeatedly described. 

Next perhaps to actual disloyalty women feel most the cessation of theattentions, courtesies, and remembrances of their unmarried life. Womenexpect this to happen and usually they forgive it in the man who devoteshimself to his family, struggles for a livelihood or better, and helpsin the care of the children. It is the hyperæsthetic type of housewifespoken of previously who weighs against her husband's devotion a minordereliction in courtesy. 

For it is too common in women to let a momentary neglect orabsent-minded discourtesy outweigh a lifetime of devotion. This is partof a feminine devotion to manner and form, of which men are, comparatively speaking, innocent. 

Aside from this phase of woman's character there are men who eitherrapidly or gradually resume after marriage their bachelor freedom, tothe neglect of their wives. Though for some time after marriage theygive up their "freedom" to play consort and escort, sooner or later theysink back into finding their recreation with their male friends, --atclub, lodge, saloon, pool room, etc. When night comes they are restless. At first one excuse or another takes them out, later they break boldlyfrom the domestic ties and only occasionally and under protest do theystay at home or escort the housewife to church, visiting, or thetheater. 

(It needs be said at this point that in America married life oftenproceeds too far in the domestication of the man, in his completeseparation from male companionship, in a never-broken companionshipbetween man and wife. This is distinctly unhealthy for the man, for herequires in his recreation the sense of freedom from restraint that hecan have only in masculine company; where the difficult attitude ofchivalry can be discarded for an equality and a frankness impossibleeven with his wife. )

The housewife, thus left alone, though wounded, may adjust herself. Shemay build up a companionship for herself in church or amongst herneighbors; she may leave her husband and get a divorce; she may becomeunfaithful on the basis that turn about is fair play; she may devoteherself with greater zeal to her home and children and build up a serenelife against odds. 

But often she does none of these things. Hurt in her pride, shestruggles to gain back her husband. Tears and reproaches fail, sicknesssometimes succeeds. If she is childless she becomes obsessed with thebelief that a child would hold her husband home. If she is failing inthe freshness of her beauty she makes a pathetic effort to hold herindifferent mate through cosmetics and beauty specialists. Without thecourage and character to make or break the situation she falls into afeeling of inferiority from which originates her headaches, her feelingsof unreality, her loss of enthusiasm, her depressed mind and body. 

This type of woman, dependent upon the love and affection of her husbandfor her health and strength, mental and physical, is the type thatwoman's education and training, at least in the past, have tended tomake. She has not been taught, she has not the power, to stand in lifealone; she is the clinging vine to the man's oak, she is the traditionalwoman. She is happy and well with the right man, but Heaven help her ifthe marriage ceremony links her with a philanderer! For she has beentaught to accept as true and right that mischievous couplet:

 Love is of man's life a thing apart, 'Tis woman's whole existence. 

We need for our womanhood a braver standpoint than that, one morefirmly based, less apt to bring failure and disaster. For neither mannor woman should love be the whole existence. It should be a fundamentalpurpose interwoven with other purposes. 

Fortunately one source of domestic difficulty will soon pass fromAmerica, --alcoholism. Politicians and theorizers may speak of the blowto individual liberty and satirically prophesy that soon coffee andtobacco will be legislated out also. They need to read GilbertChesterton and learn that though "a tree grows upward it stops growingand never reaches the sky. " To see, as I do, the almost complete absenceof delirium tremens from the emergency and city hospitals, where onceevery Sunday morning found a dozen or two of raving men; to witness thedisappearance of alcoholic insanity from our asylums, where once itconstituted fifteen per cent of the male admissions; to see cruelty tochildren drop to one tenth of its former incidence; to know that formerdrunkards are steadily at work to the joy of their wives and the good oftheir own souls, --this is to make one bitterly impatient with thechatter about the "joy and pleasure of life gone, " etc. Etc. , that hasbecome the stock-in-trade of the stage and the press. Though alcoholismdid not cause all poverty, it stupefied men's minds so that theypermitted much preventable poverty; though it did not cause allimmorality, a few drinks often sent a good man to the brothel; and whatis more, many of the brothel inmates endured their life largely becauseof the stupefying use of alcohol. 

No one knows the evil of alcohol more than the poor housewife. Of coursethe woman brought up to believe that drunkenness was to be expected in aman--and who often drank with him--was a victim without severe mentalanguish, though her whole life was ruined by drink. But for the refinedwoman who married a clean, clever young fellow only to have him comehome some day reeking of liquor, --silly, obscene, helpless, --_her_contact with John Barleycorn took the joy and sweetness from her life. She often adjusted herself, but in many cases adjustment failed, and achronic state of bruised and tingling nervousness resulted. 

A future generation will not consider it possible that the people of acentury that saw the use of wireless, the airship, radium, and theX-ray could think intoxication with its literal poisoning funny, couldmake a stock humorous situation out of it, and could regard thehabit-forming drug that caused it a necessity. 

After all is said and done, the fiercest domestic conflicts arise out ofthe inherent childishness of men and women. Pride and the unwillingnessto concede personal error, overtender egoism, bossiness, and rebellionagainst it, petty jealousies and stubbornness, --these are the basicelements in discord. Children quarrel about trifles, children areunreasonably jealous, children fight for leadership and seek constantlyto enlarge their ego as against their comrades. Any one who watches twofive-year-olds for an hour will observe a dozen conflicts. So with manyhusbands and wives. 

Unreason, petty jealousy, stubbornness over trifles, bossiness (notleadership), overready temper and overready tears, --these cause moredomestic difficulty than alcohol and unfaithfulness put together. Theeducation of American women is certainly not tending to eradicate thesedefects, which are not necessarily feminine, from her character. In thedomestic struggle the man has the major faults as his burden; the womanhas a host of minor ones. She claims equality for her virtues yetdemands a tender consideration for her weaknesses. 

Dealing with petty annoyances, disagreeing over petty matters, with hermind engrossed in her disillusions and grievances, many a woman findsher disagreeables a burden too much for her "nerves. " That a philosophyof life would save her is of course obvious, but this is a matter whichwe shall deal with later. 

CHAPTER IX

THE SYMPTOMS AS WEAPONS AGAINST THE HUSBAND

Throughout life, two great trends may be picked out of the intricacy ofhuman motives and conduct. The one is (or may be called) the Will toPower, the other the Will to Fellowship. The will to power is the desireto conquer the environment, to lead one's fellows, to accumulate wealth(power), to write a great book (influence or power), to become areligious leader (power), to be successful in any department of humaneffort. In every group, from a few tots playing in the grass togray-headed statesmen deciding a world's destinies, there is a struggleof these wills to power. In the children's group this takes the trivial(to us) form as to who shall be "policeman" or "teacher", in thestatesmen it takes the "weighty" form as to which river shall form aboundary line and which group of capitalists shall exploit this or thatbenighted country. The will to power includes all trends which inflatethe ego, --love of admiration, pride, reluctance to admit error, desirefor beauty, lust for possession, cruelty, even philanthropy, which inmany cases is the good man's desire for power over the lives of hisfellows. 

Side by side with this group of instincts and purposes, interplaying andinterweaving with it, modifying it and being modified by it, is thegroup we call the will to fellowship. This is the social sense, the needof other's good will, the desire to help, sympathy, love, friendlyfeeling, self-sacrifice, sense of fair play, all the impulses that areessentially maternal and paternal, devotion to the interests of others. This will to fellowship permeates all groups, little and big, old andyoung, and is the cement stuff of life, holding society together. 

There are those who find no difference between the _egoism_ of the willto power and the _altruism_ of the will to fellowship. They assert thatif egoism is given a wider range, so that the ego includes others, youhave altruism, which therefore is only an egoism of a larger ego. However true this may be logically, for all practical purposes we mayseparate these two trends in human nature. 

In each individual there goes on from cradle to grave a struggle betweenthe will to power and the will to fellowship. The teaching of moralityis largely the government, the subordination of the will to power; theteaching of success and achievement is largely the discovery of means bywhich it is to be gained. However we may disguise it to ourselves, poweris what we mainly seek, though we may call our goal knowledge, science, benevolence, invention, government, money. 

Without the will to fellowship the will to power is tyranny, harshness, cruelty, autocracy, and men hate the possessor of such a character. Without the will to power, the will to fellowship is sterile, futile, and the owner becomes lost in a world of striving people who brush himaside. The two must mingle. And a curious thing becomes evident in thelife of men, which in itself is simple enough to understand. When menwho have been ruthless, concentrated on success, specialists in the willto power, reach their goal, they often turn to the thwarted will tofellowship for real satisfaction in life, become philanthropists, worldbenefactors, etc. On the other hand those who start out with ideals ofaltruism and service, specialists in the will to fellowship, generallylose enthusiasm for this and turn slowly, half reluctantly, to the willfor power. In life's cycle it is common to see the egotist turnphilanthropist, and the altruist, the idealist, lose faith and become anegotist. 

How does this apply to the nervous housewife? Simply this, that thereare various ways of seeking power, of gaining one's ends. 

There is first the method of force, directly applied. The strong mandisdains subtlety, persuasion, sweeps opposition aside. "Might is right"is his motto; he beats down opposition by fist, by sword, by thunderingvoice, or look. Men who use this method are little troubled by codes;they follow the primitive line of direct attack. 

There is second the method of strategy, the disguise of purpose, thedisguise of means. The effort is to shift the attention of the opponentto another place and then to walk off with the prize. "Possession isnine points of the law" say these folk. And a straight line is _not_the shortest way for strategy. Or exchange with your opponent, give what_seems_ valuable for what _is_ valuable and then fall back on the adage, "A fair exchange is no robbery. "

Third, there is persuasion. Here, by stirring your opponent intofriendliness, he talks matters over, he aligns his interest with yours. Compromise is the keynote, coöperation the watchword. "'Tis folly tofight, we both lose by battle; whose is the gain?"

Fourth is the method of the weak, to gain an end through weakness, through arousing sympathy, by parading grief, by awakening thediscomfort of unpleasant emotion in an opponent who is of course not animplacable enemy. This has been woman's weapon from time immemorial;tears and sobs are her sword and gun. Unable to cope with man on anequal plane, through his superior physical strength, his intrenchedsocial and legal position, she took advantage of her beauty anddesirability, of his love; if that failed, she fell back on her griefand sorrow by which to plague him into submission, into yielding. Children use this weapon constantly; they cry for a thing and developsymptoms in the face of some disagreeable event, such as a threatenedpunishment. In their day-dreams the idea of dying to punish their cruelparents is a favorite one. 

This appeal to the conscience of the stronger through a demonstration ofweakness may be called "Will to Power through Weakness. " It has longbeen known to women that a man is usually helpless in the presence ofwoman's tears, if it is apparent that something he has done has broughtabout the deluge. And in the case of some housewives, certainsimilarities between tears and the symptoms appear that show that inthese cases, at least, the symptoms of nervousness appear as asubstitute for tears in the marital conflict. 

Not that this is a deliberate and fully conscious process, nor that itcauses the symptoms. On the contrary, it is a use for them!

Such a conclusion of course is not to be reached in those cases wherethe symptoms arise out of sickness of some kind, or where they followlong and arduous household tasks. But every one knows that the womanwho gets sick, has a nervous headache, weakness, a loss of appetite, orbecomes blue as soon as she loses in some domestic argument, or when herwill is crossed; these symptoms persist until the exasperated buthelpless husband yields the point at issue. Then recovery takes placealmost at once. 

In some of the severer cases of neurasthenia in women such a mechanismcan be traced. There is a definite relation between the onset of theattacks and some domestic difficulty, and though the recovery does nottake place at once, an adjustment in favor of the wife causes thecondition to turn soon for the better. 

I do not claim that the above is an original discovery. True, themedical men have not formulated it in their textbooks, but everyexperienced practitioner knows it to occur. And the humorists and thesatirists of the daily press use the theme every day. The favorite pointis that the brutal husband is forced to his knees through thedisabilities of his wife, and that cure takes place when--he gets herthe bonnet or dress she wants, when the trip to Florida is ordered, etc. Etc. 

Discreditable to women? Discreditable to those women who use it? Menwould do the same in the face of superior force. In the battle of willsthat goes on in life the weak must use different weapons than thestrong. Doubtless the women of another day, trained otherwise than ourpresent-day women and having a different relationship to men, willabandon, at least in larger part, the weapons of weakness. Whereverwomen work with men on a plane of equality they ask no favors and resortto no tears. They play the game as men do, as "good sports. " But wherethe relationship is the one-sided affair of matrimony, a certain typeuses her tears, her aches and pains, her moods, and her failings to gainher point. 

CHAPTER X

HISTORIES OF SOME SEVERE CASES

The cases that follow represent mainly the severe types of nervousnessin the housewife. To every case that comes to the neurologist there area hundred that explain their symptoms as "stomach trouble", "backache", etc. , who remain well enough to carry on, and who think their pains andaches inevitably wrapped with the lot of woman. 

It will be seen, upon reading these cases, that a rather pessimisticattitude is taken toward some of them. It would be nice to present aseries of cases all of which recovered, and it would be easy to do thatby picking the cases. Such a series would be optimistic in its trend; itwould however have the small demerit of being false to life. Though themajority of women suffering from nervousness may be relieved or cured, anumber cannot be essentially benefited. Some of them have temperamentsutterly incompatible with matrimony, others have husbands of theincorrigible type, others have life situations to change which wouldmake it necessary to change society. Therefore in these cases all adoctor can do is to _relieve symptoms_, relieve some of the distress andrest content with that. 

I am essentially neither pessimist nor optimist in the presentation ofthese cases, nor do I seek to present the man or woman's case withprejudice. In life a realistic attitude is the best, for if we were toremove much of the sentimental self-deception at present so prevalent, huge reforms would occur almost overnight. Sentimentality decorates anddisguises all kinds of horridness and makes us feel kindly toward evil. Strip it away, and we would immediately break down the evil. 

There is always this danger in presenting "cases" to a lay public, thatsymptoms are suggested to a great many people. How deeply suggestiblethe mass of people can be is only appreciated when one sees the resultof public health lectures and books. Many persons tend to develop allthe symptoms they hear of, from pains and aches to mental failure. Evenin the medical schools this is so, and every medical teacher isconsulted each year by students who feel sure they have the diseases hehas described. 

So in presenting the following cases symptoms will be largely omitted. What will be presented is history and to a certain extent treatment. That part of treatment which is strictly medical can only be indicated. 

It may be said that in obtaining the intimate history of a woman adifficulty is met with in the natural reluctance to telling what oftenseems to the patient painful and unnecessary details. To some people itseems inconceivable that fears, pains and aches, sleeplessness, etc. , can arise out of difficulties like the monotony of housework, temperament, or troubles with the husband. Furthermore, though somewomen understand well enough the source of their conflicts, they areashamed to tell and rest mainly on the surface of their symptoms. Toobtain the truth it is necessary to see the patient over and over again, to get somewhat closer to her. This is especially easy to do after thephysician has to a certain extent relieved the patient. In other words, except in the cases where the woman is quite prepared to tell of herintimate difficulties, it is best to go slowly from the medical to thesocial-psychological point of view. 

Case I. The overworked, under-rested type of housewife. 

Mrs. A. J. , thirty years old, is a woman of American birth and ancestry. Her parents were poor, her father being a mechanic in a factory town ofMassachusetts. She had several brothers and sisters, all of whom reachedmaturity and most of whom married. 

Before marriage she was a salesgirl in a department store, worked fairlyhard for rather small pay, but was strong, jolly, liked dancing andamusements, liked men and had her girl friends. 

At the age of twenty-two she married a mechanic of twenty-four, a good, sober, steady man, devoted to her and very domestic. Unfortunately hewas not very well for some time following a pneumonia in the third yearof their marriage. They drew upon all their savings and fell seriouslyin debt. This meant borrowing and scrimping for several years, --a factwhich had great bearing on the wife's illness later. 

They had three children, born the twelfth month, the third year, andthe fourth year after marriage. After the first child the mother wasvery well, nursed the baby successfully, and the little familyflourished. Then came the unfortunate illness of the husband, whichthrew him out of work for six months, during which time they lived on anallowance from his union, his savings, and finally ran into debt. Thisgreatly grieved the man and depressed the woman, but both bore up wellunder it until the birth of the second child, when their circumstancesforced them to move to a poorer apartment. The wife was delivered by adispensary physician, who did his duty well but allowed the woman, whoprotested she felt well, to get up and care for her husband and babymuch earlier than she should have done. 

The nursing of this baby was more difficult. The mother's breasts didnot seem to be nearly as active as in the previous case. The baby crieda great deal and needed attention a good part of the night. The husbandwas unable to help as he had previously done and the fatigue of the careof child and man brought a condition where the woman was tired all thetime. Still she bore up well, though when the summer came she greatlymissed the little two weeks' vacation that she and her husband hadyearly taken together from the days of their courtship. 

The husband recovered, but his strength came back very slowly. He wentto work as soon as possible but worked only part time for six months. Atnight he came home utterly exhausted and could not help his wife at all. 

During the next year both children were sick, first with scarlet feverand then with whooping cough. The mother did most of the nursing, thoughby this time the father was able to help and did. The necessary expensesso depleted the family treasury that when the summer came neither couldafford to go away. 

Both noticed that the mother was getting more irritable than was naturalto her. She went out very seldom and her youthful good looks had largelybeen replaced by a sharp-featured anxiety. Though she carried onfaithfully she had to rest frequently and at night tossed restlessly, though greatly fatigued. 

She became pregnant again, much to her dismay and to the great regretof her husband. At times she thought of abortion, but only in adesperate way. The last few months of her term were in the very hotmonths of the year and she was very uncomfortable. However, she wasdelivered safely, got up in a week to help in the care of her other twochildren and to get the house into shape again. Her milk was fairlyplentiful, despite her fatigue and "jumpy nerves. " Unfortunately at thistime, when they had accumulated a little surplus and she was lookingforward to better clothes for her family and more comforts, the plant atwhich her husband was employed suspended operations because of some"high finance" mix-up. Coming at this time, the news struck terror intoher heart; she broke down, became "hysterical" _i. E. _ had an emotionaloutburst. This passed away, but now she was sleepless, had no appetite, complained of headache and great fatigue. 

Though she was assured that the plant would reopen soon (in fact it soondid), she made little progress. That she was suffering from apsychoneurosis was evident; what remained was to bring about treatment. 

This was done by enlisting a development of recent days, --the SocialService agencies. Out of the old-time charity has come a fine successor, social service; out of the amateurish, self-consciously gracious andsweet Lady Bountiful has come the social worker. Unfortunately socialservice has not yet dropped the name "Charity", perhaps has not beenable to do so, largely because the well-to-do from whom the money mustcome like to think of themselves as charitable, rather than as thebeneficiaries of the social system giving to the unfortunates of thatsystem. 

Let me say one more word about social service and the social worker, though I feel that a volume of praise would be more fitting. The socialworker has become an indispensable part of the hospital organization, aninvestigator to bring in facts, a social adjuster to bring about cure. For a hospital to be without a social service department is to confessitself behind the times and inefficient. 

Briefly, this is what was done for this family. 

Their prejudices against social aid were removed by emphasizing thatthey were not recipients of charity. The husband was allowed to pay, orarrange to pay, for a six weeks' stay in the country for the mother andthe new baby. The home for this purpose was found by the agency and wasthat of a kindly elderly couple who took the woman into their hearts aswell as over their threshold. The social worker arranged with a nursingorganization to send a worker to the man's house each day to clean upthe home while the children stayed in a nursery. One way or another thehusband and children were made comfortable, and the wife came back fromher stay, made over, eager to get back to her work. 

It is obvious that in such a case as this the physician is largelydiagnostician and director, the actual treatment consisting in getting aselfish and inert social system to help out one of its victims. That asick man should be left to sink or swim, though he has previously beenindustrious and a good member of society, is injustice and socialinefficiency. That a woman, under such circumstances, should be leftwith the entire burden on her hands is part of the stupidity andcruelty of society. 

How avert such a thing? For one thing do away with the name "Charity" inrelief work, --and find some system by which industry will adequatelycare for its victims. What system will do that? I fear it may be calledsocialistic to suggest that some of the fifteen billions spent last yearon luxuries might better be shifted to social amelioration. The recordin automobile production would be more pleasing if it did not mean ashift from real social wealth to individual luxury. 

Case II. The over-rich, purposeless woman. 

This type is of course the direct opposite of the woman in Case I andrepresents the kind of woman usually held up as most commonly afflictedwith "nervousness. " "If she really had something to do, " say thecritics, "she would not be nervous. "

This is fundamentally true of her, though not true of the majority ofwomen whom we have discussed. It seems difficult to believe that hardwork and worry may bring the same results as idleness anddissatisfaction, but it is true that both deënergize the organism, thebody and mind, and so are kindred evils. What's the matter with thepoor is their poverty, while the matter with the rich is their wealth. 

Mrs. A. De L. Is of middle-class people whose parents lived beyond theirmeans and educated their only daughter to do the same. Here is one ofthe anomalies of life: bitterly aware of their folly, the extravagantand struggling deliberately push their children into the same road. Mrs. De L. Learned early that the chief objects of life in general were tokeep up appearances and kill time; that as a means to success a womanmust get a rich husband and keep beautiful. Being an intelligent girland pretty she managed to get the rich husband, --and settled down to therich housewife's neurosis. 

Her husband was old-fashioned despite his rather new wealth, and theyhad two children, --a large modern American family. Though he allowed herto have servants he insisted that she manage their household, which shedid with rebellion for a short time, and then rather quickly broke awayfrom it by turning over the household to a housekeeper. This broughtabout the silent disapproval of her husband, who let her "have her ownway", as he said, "because it's the fashion nowadays. "

She became a seeker of pleasure and sensation, drifting from one type ofamusement to the other in an intricately mixed coöperation and rivalrywith members of her set. She followed every fad that infests staid oldBoston, from the esoteric to the erotic. She became an accomplisheddancer, ran her own car, followed the races, went to art exhibitions, subscribed to courses of lectures of which she would attend the first, dabbled in new religions, became enthusiastic: about social work for amonth or two, --and became a professional at bridge. Summers she restedby chasing pleasure and flirting with male _habitués_ of fashionablesummer resorts; part of the winter she recuperated at Palm Beach, whereshe vied for the leadership of her set with her dearest enemy. 

Her husband financed all her ventures with a disillusioned shrug of hisshoulders. As she entered the thirties she became intensely dissatisfiedwith herself and her life, tried to get back to active supervision ofher home but found herself in the way, though her children were greatlypleased and her husband sceptical. The need of excitement and changepersisted; gradually an intense boredom came over her. Her interest inlife was dulled and she began a mad search for some sensation that wouldtake away the distressing self-reproach and dissatisfaction. Shortlyafter this she lost the power to sleep and had a host of symptoms whichneed not be detailed here. 

The medical treatment was first to restore sleep. I may say that this isa first step of great importance, no matter how the sleeplessnessoriginates. For even if an idea or a disturbing emotion is its cause, the sleeplessness may become a habit and needs energetic attention. 

With this done, attention was paid to the social situation, the lifehabits. It was pointed out that all the philosophies of life were basedon simple living and work, and that all the wise men from the beginningof the written word to our own times have shown the futility of seekingpleasure. It was shown that to be a sensation seeker was to courtboredom and apathy, and that these had deënergized her. 

For interest in the world is the great source of energy and the greatmarshaler of energy. From the child bored by lack of playmates, whobrightens up at the sight of a woolly little dog, to the old andvigorous man who makes the mistake of resigning from work, this functionof interest can be shown. 

She was advised to get a fundamental, nonegoistic purpose, one thatwould rally both her emotions and her intelligence into service. Finallyshe was told bluntly that on these steps depended her health and thatfrom now on any breakdown would be merely a confession of failure inreasonableness and purpose. 

That she improved greatly and came back to her normal health I know. Whether she continued to remain well and how far she followed the advicegiven I cannot say. From the earliest time to this, necessity has beenthe main spur to purpose, and probably the lure of social competitiondrew the lady back to her old life. Experience, though the best teacher, seems to have the same need of repetition that all teaching does. 

Case III. The physically sick woman who displays nervousness. 

Though this is one of the most important of the types of nervoushousewife the subject is essentially medical. We shall therefore notdetail any case, but it is wise to reemphasize some facts. 

There are bodily diseases of which the early and predominant symptomsare classed as "nervousness. " Hyperthyroidism, or Graves' Disease, acondition in which there is overactivity of the thyroid gland and whichis particularly prevalent among young women, is one of those diseases. In this condition excitability, irritability, emotional outbursts, fatigue, restlessness, digestive disorders, vasomotor disorders, appearbefore the characteristic symptoms do. 

Neuro-syphilis is another such disease. This is an involvement of thenervous system by syphilis. One of the tragedies that distresses evenhardened doctors is to find some fine woman who has acquiredneuro-syphilis through her husband, though he himself may remain well. In the early stages this disease not only has neurasthenic symptoms butis very responsive to treatment, and thus the early diagnosis is ofgreat importance. 

What is known as reflex nervousness arises as a result of minor localconditions, such as astigmatism and other eye conditions, trouble withthe nose and throat and trouble with the organs of generation. Thelatter is especially important in any consideration of nervousness inthe housewife, particularly in the woman who has borne children. Frequently too the existence of hemorrhoids, resulting fromconstipation, acts to increase the irritability of a woman who isperhaps too modest to consult a physician regarding such trouble. Wheresuch modesty exists (and it is found in the very women one would be aptto think were the very last to be swayed by it), then a competent womanphysician should be consulted. With good women physicians and surgeonsin every large community there is no reason for reluctance to beexamined on the part of any woman. 

Further details are not necessary. Enough has been said to emphasize thefact that the nervousness of the housewife is first a medical problemand then a social-psychological one. 

Case IV. A case presenting bad hygiene as the essential factor. 

Bad hygiene is something more than exposure to bad air, poor food, contaminated water, etc. It includes habits and times of eating, attention to the bowels, outdoor exercise, sleep, and in the maritalstate it includes the sexual indulgence. 

The housewife under consideration, Mrs. T. F. , aged twenty-eight, marriedfive years, two children, complained mainly of headache, occasionaldizziness, great irritability, and fatigue, so that quarrels with herhusband were very common, though there seemed nothing to quarrel about. The family was not rich, but lived in a comfortable apartment; therewere no serious financial burdens, the children were reasonably healthyand good, and the closest questioning revealed the husband as a kindlyman who never took the initiative in quarrels but who was never able tokeep silent under provocation. The couple was still in love and thereseemed to be no essential incompatibility. 

Questioned as to her habits, Mrs. F. Said she did all her own houseworkexcept the washing and ironing and scrubbing. She had a little girlthree times a week to take the baby out. Before marriage she had been astenographer, but never earned high pay and had no love for her work. Infact she gave it up with relief and found housework with itsdisagreeable features much more to her taste than business. She had beenof a placid, pleasant temperament and could not understand the change inher. 

Since all this did not explain her symptoms, closer inquiry was madeinto her habits. She arose with her husband at seven-thirty, preparedhis breakfast, sent the oldest child off to kindergarten and then hadher own breakfast, which usually consisted of toast and coffee. At noonshe had a very small piece of meat or an egg and a few potatoes withtea. At night she ate sparingly of the dinner, which usually was meat, potatoes, another vegetable, and a dessert. Her husband here stated thatshe ate at this meal less than the boy of four and a half. 

Comparing her buxom figure with the diet a discrepancy was at onceapparent. She then confessed with shame that she was a constant nibbler, eating a bit of this or that every half hour or so, and consequentlynever had an appetite. The food thus nibbled usually was either spicy orsweet, and she consumed quite a bit of candy. Her bowels movedinfrequently and she always needed laxatives. In her spare time she feltrather "logy", rarely went out, except now and then at night with herhusband, and spent her leisure hours on the couch reading or nibbling. 

This in itself would have quite explained much of her trouble. It hasbeen pointed out that body and mind are not separable; that mentalfunctions are based on the bodily functions, and that mood may rest onno more exalted cause then the condition of the bowels. But a moreintimate questioning revealed sexual habits which are easily driftedinto by people of an amorous turn of character and who are really fondof one another. These both husband and wife frankly said they had notmeant to speak of, but with their disclosure it was evident that a gooddeal of importance was to be attached to them. 

The correction of the life habits was of course the fundamental need. The young woman was instructed in detail as to diet, the care of thebowels and outdoor exercise. Since she was in perfect condition exceptfor stoutness she could easily look for recovery, and as an addedincentive the restoration of youthful good looks was held out ascertain. 

The sexual life was frankly discussed, and necessary restrictions wereimposed. Both the husband and wife agreed willingly to the changesordered and promised faithfully to carry out instructions. 

The patient made a splendid recovery and very rapidly. Here was adeënergization dependent solely upon the sedentary life of the housewifeand upon ignorance of sex hygiene. Here were quarreling and impendingmarital disaster removed by attention to details in living. Here was acomplete proof that not only does a sound mind need a sound body, butthat a sound marriage needs one as well. 

Case V. The hyperæsthetic woman. 

Mrs. J. F. Is twenty-seven years of age. She was born in the UnitedStates, of middling well-to-do people. Her father was a gruff, heartyman, not in the least bit finicky, who really despised manners and thelike, though he was conventional enough in his own way. Her mother wasan old-fashioned housewife, fond of her home and family, in fact perhapsmore attached to the former than the latter. She hated servants and gotalong without them (except for a day woman) until she became rather tooold to do the work. 

J. 's sister and two brothers were duplicates of the parents, --hearty, stolid, and remarkably plain looking. J. , the younger sister, though notthe youngest in the family, was as different from her family as if shehad sprung from another stock. She was slender, very pretty, with aquick, alert mind which jumped at conclusions, because labored analysisfatigued it. Above all, from the very start of life she was sensitive toa degree that perplexed her family, who were however intenselysympathetic because they adored her. This adoration arose from the factthat J. Was brighter and prettier than most of her friends, and that hercleverness in many directions--music, writing, talking, handiwork--wasthe talk of their little group. 

This sensitiveness arose from two main factors. First, an egoismfostered by the worship of her friends and the leadership of hergroup, --an egoism which led her to regard as a sort of insult anythingdisagreeable. Accustomed to praise, the least criticism implied oroutspoken cut like a knife; accustomed to being waited upon, sheresented physical discomfort of the slightest kind. Second, there mustalso have been an actual physical sensitiveness to sights, sounds, smells, tastes, etc. That made her perceive what others failed tonotice. This led to an artistry manifested by her nice work in music anddecoration and also by an excessive displeasure at the inartistic. 

With this training, experience, and natural temperament she should havemarried a rich collector of art products, who would have added her tohis collection and cherished her as his most fragile possession. Instead, through the working of that strange law of contraries by whichNature strikes averages between extremes, she fell in love with a hulkof a man whose ideas on art were limited to calling a picture "pretty", who loved sports and the pleasures of the table, and whose businessmotto was "Beat the other guy to it. " A successful man, troubled withfew subtleties either of approach or conscience, he viewed the marriagerelationship in the old-fashioned way and the new American indulgence. Aman's wife was to be given all the clothes she wanted, servants to helprun the home, ought to bear two or three children, and love herindulgent husband. As for any real intimacy, he knew nothing of it. Kindly, self-indulgent, wife-indulgent, child-indulgent, ruthless inbusiness, he may stand as something America has produced without anyeffort. 

From the very first night J. 's world was shattered. We need not enterinto details in this matter, but a woman of this type needs finesse inthe initiation into marriage more than at any other time. Cave-man styleoutraged her every fiber, and the man was dumbfounded at her reaction. Though he tried to make amends his very effort and lack of understandingcomplicated matters. 

Aside from this matter, which in the course of time became adjusted, sothat though she rebelled desire arose in her, she found herself at oddswith her husband's tastes and conduct in little things. Though his tablemanners were good enough, the gusto of his eating annoyed her and tookaway her own appetite. When they went to a play together the coarsejokes and the plainly sensuous aroused his enthusiasm. He lackedsubtlety and could not understand the "finer" things of life. As he grewsettled in matrimony, which he enjoyed in spite of her nerves (which hetook for granted as like a woman), he grew stouter and this irritatedand jarred her. 

She finally realized she no longer loved him. It is doubtful if sherealized this before the birth of her first and only child. She lackedmaternal feeling and rebelled with a bitter rebellion against thedistortion of her figure that came with the pregnancy. The nursingordered by the doctor and expected by all around her nearly drove her"wild", she said, for she felt like a "cow", a "female. " Indeed shereacted bitterly against the femaleness that marriage forced on her andhated the essential maleness of her husband. Her emotional reactionagainst nursing took away her milk, and finally the disgusted familydoctor ordered the baby weaned and he was turned over to a servant. 

She went back to her own life, determined to become a housewife, to seeif she could not love her husband and her home. But everything he didirritated her, and everything in the house made her feel as in a"luxurious cage. " Yet she was by no means a feminist; she detested"noisy suffragettes", thought women doctors and lawyers ridiculous, andhad been brought up to regard marriage as indissoluble. 

Gradually out of the conflict, the chilling fear that she had made amistake which could not be rectified, the constant irritation andannoyances, the revolt against her own sex feeling and her lifesituation, arose the neurosis. It took the form mainly of suddenunaccountable fears with faint dizzy feelings. The family physician onthe aside told me that it was "just a case of a damn fool woman witheverybody too good to her. "

What constitutes a "damn fool" will include every person in the world, according to some one else. It seemed obvious to me that J. Was notmeant by nature to be a housewife or any kind of wife. Matrimonially shewas a misfit, unless she met some man of a type like herself, though Idoubt if any man could have pleased her. I doubt if her over-exactingtaste would not rebel against the animal in life itself. For though theanimal of life is essentially as fine as the human, certain types findit impossible to acknowledge it in themselves. 

At any rate I advised separation for a time, --six months at least. Itold the woman her reaction to her husband was abnormal and finicky. Sheanswered that she knew this but could not conceive of any change. Wediscussed the matter in all its ramifications, and though she and herhusband agreed to the separation, I knew that he was determined to holdher to her contract. She improved somewhat but I believe that such atemperament is incompatible with marriage, at least to such a man. Theoutlook is therefore a poor one. 

Case VI. The over-conscientious housewife, --the seeker of perfection. 

The woman whose history is to be discussed comes from a family of NewEngland stock, _i. E. _ the Anglo-Saxon strain modified by New Englandclimate, diet, history, religion, and tradition into a distinct type. This type, often traditionally conservative and often extraordinarilyradical, has this prevailing trait, --standards of right and wrong areset up somehow or other, and a remarkably consistent effort is made tomaintain these inflexibly. However, the hyperconscientious are notpeculiarly New England alone; I have met Jewish women, Italians, French, Irish, and Negroes who showed the same loyalty to a self-imposed ideal. 

This lady, Mrs. F. B. , thirty-five years of age, with three children, was brought by her husband against her will. He declared that both sheand he were on the verge of nervous prostration; that unless somethingwas done he would start beating her, this last of course representing atype of humorous desperation that usually has a wish concealed in it. She was "worn to a frazzle", always tired, sleepless, of capriciousappetite, irritable, complaining, and yet absolutely refused to see aphysician. She had taken tonics by the gallon, been overhauled by adozen specialists, all of whom say, "nothing wrong of anyimportance--yet she is a wreck and I am getting to be one. "

Her husband was a jolly looking personage from the Middle West, in asmall business which kept his family comfortably. He looked domestic andadmitted he was, which his wife corroborated. Evidently he wasexasperated and worried as he gave the history of the case, with hiswife now and then putting in a word: "Now, John, you are stretchingthings there; don't believe him, Doctor; not so bad as all that, " etc. 

She was a slender person, rather dowdily dressed as compared with herhusband, with garments quite a little behind the prevailing mode. Herhair was unbecomingly put up, and it was evident that she disdainedcosmetics of any kind, even the innocent rice powder. Her hands werequite unmanicured, though they were, of course, clean and neat. The hatwas the simplest straw, home trimmed and neat, but a mere "lid" comparedto the creations most women of her class were at the time wearing. Thatclothes were meant to be ornamental as well as useful was an attitudeshe completely rejected. 

It turned out that life to her was an eternal housekeeping, --from thebeginning of the day to the end she was on the job. Though she had amaid this did not relieve her much, for she constantly fretted and fumedover the maid's slackness. Everything had to be spotless _all the time_;she could not bear the disordered moments of bedtime, of the earlymorning hours, of wash day, of meal preparation, of the children's room, etc. She was obsessed by cleanliness and order, and her exasperatedefforts, her reaction to any untidiness kept her husband and childrenbound in a fear like her own, though they rebelled and scolded her forit. 

"She's always after the children, " said her husband. "She is crazyabout them, but she has got them so they don't dare call their soultheir own. They don't bring their playmates into the house largelybecause they know that mother, though she wants children to play, goesafter them picking up and cleaning. "

This restlessness in the presence of disorder was accompanied by theeffort to eradicate all vices, all discourtesies, all errors in mannersfrom the children. She feared "bad habits" as she feared immorality. Shethought that any rudeness might grow into a habit, must be broken early;any selfish manifestation might be the beginning of a gross selfishness, any lying or pilfering might be the beginning of a career of crime. 

Here one might hold forth on the necessity for trial and error inchildren's lives. They want to try things, they form little habits for aday, a week, a month which they discard after a while; they try outwords and phrases, playing with them and then pass on to a newexperiment. They are insatiable seekers of experience, untiring in theirquest for experiment, --and they learn thereby. Not every mickle growsinto a muckle, and the supplanting of habits, the discarding of them asunsatisfactory, is as marked a phenomenon as the formation of habits. 

So our patient allowed nothing for imperfections, experimental stages, developing tastes in her children. She was, however, hardest on herself, self-critical, scolded herself constantly because her house was neverperfect, her work never done. She never had time to go out; she hadbecome a veritable slave to a conscience that prodded her every time sheread a book, took a nap, or went to a picture show. 

It was not at first obvious either to her or her husband that her ownideal of cleanliness and perfection was responsible for herneurasthenia. If her "stomach was out of order ought she not have somestomach remedy; if her nerves were out of order would the doctor notprescribe a nerve tonic or a sedative?" The idea of a medicine foreverything is still strong in the community and especially amongstdwellers in small towns, and represents a latent belief in magic. 

In addition to such medicines as I thought the situation demanded, andto such advice as bore on her attitude to work and play, I hinted thatdressing more fashionably might be of value. For the poorly dressedalways have a feeling of inferiority in the presence of the betterdressed, and this feeling is seriously disagreeable. To raise theego-feeling one must remove feelings of inferiority, and here was arelatively simple situation. This woman really cared about clothes, admired them, but had got it into her head early in life that it wassinful to be vain about one's looks. Though she had discarded the sinidea the notion lingered in the form of "unworthy of a sensible woman", "extravagance", etc. As she was painfully self-conscious in the presenceof others as a result, this was a hidden reason for sticking to herhome. 

This woman had a really fine intelligence, wanted to be well and made agallant effort to change her attitude. In this she succeeded, became asshe put it more "careless of her things and more careful of her people. "Of course one cannot expect her ever to be anything but a finehousekeeper but she manages to be comfortable and has conquered anover-zealous conscience. 

CHAPTER XI

OTHER TYPICAL CASES

Case VII. The ambitious woman discontented with her husband's ability. 

In the American marriage relationship the woman makes the home and theman makes the fortune. In some countries the wife is an active businesspartner. This is notably true in France, among the Jews in Russia, andmany immigrant races in the United States. The wife may even take theleadership if her superiority clearly shows up. Perhaps the Americanmethod works well enough in a majority of cases, but there are superiorwomen yoked to inferior men who finally despair of their husband'sadvancement, and who, as the phrase goes, ought to be "wearing thetrousers" themselves. 

Mrs. D. J. , thirty-nine years old, married fourteen years, two children, had excellent health before marriage. Her family, originally poor, hadbeen characterized by great success. Her brothers occupy importantplaces in the business world and are wealthy. One of her sisters ismarried to a man who is successful in law, and the other sister is anexecutive in a department store. 

Before marriage Mrs. J. Was in her brother's business, and at the timeof her marriage earned a comfortable salary. She married a man whoinherited a small business, and when they married she was enthusiasticover the prospects of this business. But unfortunately her husband neverfollowed her plans; he listened impatiently and went ahead in his ownway. As a result of his conservatism they had not advanced at allfinancially. Though they were not poor as compared with the mass ofpeople, they were poor as compared with her brothers and brother-in-law. 

In addition to the exasperation over her husband's attitude toward hercounsel (which was approved by her brothers), she developed a disrespectfor him, a feeling that he was to be a failure and a certain contemptcrept into her attitude. Against this she struggled, but as the timewent on the feeling became almost too strong to be disguised and causedmany quarrels. It is probable that if her own brothers and sisters hadnot done so well her feeling toward her husband would not have reachedthe proportions it did, for she became envious of the good things theyenjoyed and to a certain extent resented her sisters-in-law's attitudetoward her husband and herself as poor. The part futile jealousy andenvy play in life will not be underestimated by those who will candidlyview their own feelings when they hear of the success of those who arenear them. One of the reasons that ostentation and bragging are in suchdisfavor is because of the unpleasant envy and jealousy they tendinvoluntarily to arouse. 

With disrespect came a distaste for sexual relations, and here was acomplicating factor of a decisive kind. She developed a disgust thatbrought about hysterical symptoms and finally she took refuge in refusalto live as a wife. This aroused her husband's anger and suspicions; heaccused her of infidelity and had her watched. The disunion proceeded tothe point of actual separation, and she then passed into an acutenervous condition, marked by fear, restlessness, sleeplessness, andfatigue. 

The analysis of this patient's reactions was difficult and as muchsurmised as acknowledged. With her breakdown her husband's affectionimmediately revived and his solicitude and tenderness awoke her oldfeeling, together with remorse for her attitude towards his lack ofbusiness success. It was obvious to me in the few times I saw her thatshe was working out her own salvation and that no one's assistance wasnecessary after she understood herself. Intelligence is a primeessential to cure in such cases, --an ignorant or unintelligent womanwith such reactions cannot be dealt with. Gradually her intelligencetook command, new resolves and purposes grew out of her illness, and itmay confidently be said that though she never will be a phlegmaticobserver of her husband's struggles she has conquered her old criticismand hostility. 

Case VII. The nondomestic type and the mother-in-law. 

That there is a nondomestic type of woman to-day is due to the rise offeminism and the fascination of industry. Where a woman has once been inthe swirl of business, has been part of an organization and has tastedfinancial success, settling down may be possible, but is much moredifficult than to the woman of past generations. Such a woman probablyhas never cooked a meal, or mended a stocking, or washed dishes, --andshe has been financially independent. For love of a man she gives allthis up, and even under the best of circumstances has her agonies ofdoubt and rebellion. 

Mrs. A. O'L. Had added to these difficulties the mother-in-law question. She was an orphan when she married, and was the private secretary of abusiness man who because she was efficient and intelligent and loyalgave her a good salary. She knew his affairs almost as well as he didand was treated with deference by the entire organization. 

She married at twenty-six a man entirely worthy of her love, a juniorofficial in a bank, looked on as a rising man, of excellent personalhabits and attractive physique. She resigned her position gladly andwent into the home he furnished, prepared to become a good wife andmother. 

Unfortunately there already was a woman in the house, Mr. O'L. 's mother. She was a good lady, a widow, and had made her home with the son forsome years. She was a capable, efficient housewife, with a narrow rangeof sympathies, and with no ambitions. There arose at once the almostinevitable conflict between mother-in-law and daughter-in-law. 

Some day perhaps we shall know just why the husband's mother and hiswife get along best under two roofs, though the husband's fatherpresents no great difficulties. Perhaps in the attachment of a mother toa son there is something of jealousy, which is aroused against the otherwoman; perhaps women are more fiercely critical of women than men are. Perhaps the mother, if she has a good son, is apt to think no woman goodenough for him, and if she is not consulted in the choosing is apt tofeel resentment. Perhaps to be supplanted as mistress of the householdor to fear such supplantment is the basic factor. At any rate, the oldChinese pictorial representation of trouble as "two women under oneroof" represents the state in most cases where mother-in-law anddaughter-in-law live together. 

The senior Mrs. O'L. Began a campaign of criticism against the youngerwoman. There was enough to find fault with, since the wife wasabsolutely inexperienced. But she was entirely new to hostile criticism, and it impeded her learning. Furthermore, she was not inclined to tryall of the mother-in-law's suggestions; she had books which tookdiametrically the opposite point of view in some matters. There weresome warm discussions between the ladies, and a spirit of rebellion tookpossession of the wife. This was emphasized by the fact that she foundherself very lonely and longed secretly for the hum and stir of theoffice; for the deference and the courtesy she had received there. Further, the distracted husband, in his rôles of husband and son, foundhimself displeasing both his wife and his mother. He tried to get thegirl to subordinate herself, since he knew that this would be impossiblefor his mother. To this his wife acceded, but was greatly hurt in herpride, felt somehow lowered, and became quite depressed. The houseseemed "like a prison with a cross old woman as a jailer", as sheexpressed it. 

Another factor of importance needs some space. The bridal year needsseclusion, on account of a normal voluptuousness that attends it. Nooutsider should witness the embraces and the kisses; no outsider shouldbe present to impede the tender talks and the outlet of feeling. Itsometimes happens that the elderly have a reaction against alllove-making; having outlived it they are disgusted thereby, they find itanimal like, though indeed it is the lyric poetry of life. So it was inthis case; the mother was a third party where three is more than acrowd, and she was a critical, disgusted third party. The young womanfound herself taking a similar attitude to the love-making, foundherself inhibiting her emotions and had a furtive feeling of being spiedon. 

The previously strong, energetic girl quickly broke down. Physicalstrength and energy may come entirely from a united spirit; a disunitedspirit lowers the physical endurance remarkably. She became disloyal tomatrimony, rebelled against housework, and yet loved her husbandintensely. A prey to conflicting ideas and emotions, she fell into acircular thinking and feeling, where depressed thoughts cannot bedismissed and depressed energy follows depressed mood. Prominent in thesymptoms were headache, sleeplessness, etc. , for which the neurologistwas consulted. 

How to remedy this situation was to tax the wisdom of a Solomon. Itprobably would have remained insoluble, had not the statement I madethat the main element in the difficulty was the mother-in-law _vs. _daughter-in-law situation come to the ears of the old lady. Conscientious and well-meaning, that lady announced her determination totake up her residence with a married daughter who already had awell-organized household, and whose husband was a favorite of themother's. Despite the mother-in-law joke of the humorists, themother-in-law is far more friendly to a daughter's husband than to ason's wife. 

This solved part of my patient's problem. There remained the adjustmentto domestic life. This was hard, and though in part successful, it wasdelayed by the sterility of the marriage. The husband and wife agreedthat pending a child she might well become active again in the largerworld. Though the best place would have been her old work, pride andconvention stood in the way, and so she entered upon more or lessamateurish social work. Finally, perhaps as an unconsciously humorouscompensation for her own troubles, she became an ardent and thoroughlyefficient secretary to a league of housewives that aimed at betterconditions. This work took up her time except for the supervising of aservant, and this nondomestic arrangement worked well since she had nochildren. 

Case VIII. The childless, neglected woman. 

It happened that two of the severest cases I have seen occurred, one ina Jewish woman and the other in a young Irish woman, with such anidentity of symptoms and social domestic background that either casemight have been interchanged for the other without any appreciabledifference. The factors in the cases might simply be summarized aschildlessness, anxiety, neglect, and loneliness, and in each case themain symptoms were anxiety, attacks of cardiac symptoms, fatigue, andsleeplessness. 

The young Jewish woman, thirty years of age, had been married since theage of twenty. Before marriage she worked in the needle trades, was welland strong and had no knowledge of any particular nervous or mentaldisease in her family. She married a man of twenty-four, who had alsobeen in the tailoring business and had branched out in a small way inbusiness. This business required him to go to work at about seven-thirtyin the morning and he finished at nine-thirty in the evening. In theearlier years of their marriage he came home rather promptly at the endof his long day and the pair were quite happy. 

At about the third year after marriage the woman became quite alarmed ather continued sterility. She commenced to consult physicians and in thecourse of the next three years underwent three operations with noresult. She began to brood over this, especially since about this timeher husband began to show a decided lack of interest in the home. Hewould come home at twelve and later, and she found that he was playingcards, --in fact had become a confirmed gambler. When she firstdiscovered this, she became greatly worried; made a trip to New Yorkwhere his people lived and induced them to bring pressure to bear on himfor reform. This they did, with the result that for about six months heremained away from cards and gave more attention to his wife. 

The reform lasted only for a short period and then the husband plungeddeeper into gaming than ever, and there were periods of three and fourdays at a stretch when he would not return home at all. At such timesthe lonely wife, who still loved her husband, fell into a perturbed andagitated frame of mind, the worse because she confided her difficultiesto no one. When he would return, shamefaced and repentant, she wouldreproach him bitterly and this would bring about renewed attention, gifts, etc. , for a week or so, --and then backsliding. Finally even thebrief spasmodic reforms grew less common, her reproaches were answeredhotly or listened to with indifference, and she became "practically awidow" except for the occasions when the sexual feeling mastered themboth. 

The neurosis in this case approached almost an insanity. The dwellingalone, the desperate obsessive desire for a child to bring back his loveand attentions and to satisfy her own maternal instinct, the pain thesight of happy couples with children gave her and which made her shunother women and their company, the fear that her husband was unfaithful(which fear was probably justified), and the lack of any fixed ordefinite purpose, the lack of a great pride or self-sufficiency, broughton symptoms that necessitated her removal to a sanitarium. 

This of course pricked the conscience of her husband. He visited herfrequently, vowed a complete change, promised to bring his business tothe point where he would be able to come home at six, etc. , etc. Gradually she improved and finally made a partial recovery. 

Whether or not the husband kept his promises I cannot say. On thechances he did. Most confirmed gamblers, however, remain gamblers. Thelure of excitement is more potent to such men than a wife whose charmhas gone, through familiarity, through time itself, through theinconstancy of passion and love. The gambler usually knows no duty; heis kind and generous but only to please himself. He is easily bored andhis sympathies rarely stand the disagreeable long; he knows only one_constant_ attraction, --Chance. 

The other woman suffered in much the same way except that she wasfortunate enough finally to be deserted by her husband. This ended herdoubts and fears, broke her down for a short while, and then she wentback to industry. In this I have no doubt she found only an incompletesatisfaction for her yearnings and desires, but she had something totake up her time, and built up contacts with others in a way that wasimpossible in her lonely home. 

Case IX. The will to power through weakness; a case of hysteria in thehome. 

This case is classic in the outspoken value of the symptoms to thewoman. It is not of course typical, except as the extreme is typical, and that is what is usually meant, Roosevelt, we say, was a typicalAmerican, meaning that he represented in extreme development a certaintype of man. So this case shows very clearly what is not so clear atfirst in many cases of conflict between man and wife. 

The woman in question was twenty-seven, of French-Canadian origin, butthoroughly American in appearance and speech. She was of a middle-classrural family and had married a farmer who finally had given up his farmand was a mechanic in a small city. 

The young woman had always been irritable, egoistic, and sensitive. Asa girl if anything happened to "shock her nerves", _i. E. _ to displeaseher, she fainted, vomited, or went into "hysterics. " As a result herfamily treated her with great caution and probably were well pleasedwhen she married off their hands and left the home. 

Married life soon provided her with sufficient to displease her. Herhusband drank but not sufficiently to be classed as a heavy drinker. Hewas a quiet, rather taciturn man, utterly averse to the pleasures forwhich his wife longed. She wanted to go to dances, to take in thetheaters, to live in more expensive rooms, and especially she becamegreatly attached to a group of people of a sporty type whom her husbandtersely called "tinhorn bluffs" and whom he refused to visit. 

They quarreled vigorously and the quarrels always ended one way, --shebecame sick in one way or other. This usually brought her husband aroundto her way of thinking, at least for a time, and much against his willhe would go with her to her friends. 

Finally, however, she set her heart on living with these people, and heset his will firmly against hers. She then developed such an alarmingset of symptoms that after a while the physician who asked my opinionhad made up his mind that she had a brain tumor. She was paralyzed, speechless, did not eat and seemed desperately ill. 

The diagnosis of hysteria was established by the absence of any evidenceof organic disease and by the history of the case. The relief ofsymptoms was brought about by means which I need not detail here, butwhich essentially consisted in proving to the patient that no trueparalysis existed and in tricking her into movement and speech. 

When she was well enough to be up and about and to talk freely, she andher husband were both informed that the symptoms arose because her willwas thwarted, and _that_ part of their function was to bring the man tohis knees. He agreed to this, but she took offense and refused to comeany more to see me, --a not unnatural reaction. 

The outlook in such a case is that the couple will live like cats anddogs. Such a temperament as this woman's is inborn. She is essentially, in the complete meaning of the word, unreasonable. Her nature demands asympathetic attention and consideration that her character does notwarrant. Throughout life she demands to receive but has no desire togive. Nor is she powerful enough to take, so there arise emotionalcrises with marked disturbance in bodily energy, and especially symptomsthat frighten the onlooker, such as paralyses, blindness, deafness, fainting spells, etc. Whatever is the source of these symptoms, they arefrequently used to gain some end or purpose through the sympathy anddiscomfort of others. 

Not all hysteria, either in men or women, is united with such acharacter as this woman's. Sufficient stress and strain may bring abouthysterical symptoms in a relatively normal person and short hystericalreactions are common in the normal woman. The height of cynicism may befound in the discovery that war causes hysteria in some men in much thesame way that matrimony causes hysteria in some women. A humorous reviewof a paper on the domestic neuroses was entitled "Kitchen Shell Shock. "But severe hysteria, when it arises in the housewife, springs mainlyfrom her disposition and not from the kitchen. 

Case X. The unfaithful husband. 

Monogamous marriage is based upon the assumption that loyalty to asingle male is moral and possible. It is probable that in no age hasthis agreement been loyally carried out by the husbands; it is probablethat in our own time the single standard of morals has first beenstrongly emphasized. With the rise of women into equality one of theimportant demands they have made is that men remain as loyal asthemselves. Therefore the reaction to unchastity or unfaithfulness onthe part of the man is apt to be more severe than in the past, on thetheory that where more is demanded failure in performance is felt thekeener. 

The housewife, Mrs. F. C. , aged thirty-five, is a prepossessing woman, the mother of two children, and has been married for nine years. Herhealth has always been fairly good, though in the last four years shehas been somewhat irritable. She attributed this to struggle to makeboth ends meet, her husband being a workman with wages just over theborder line of sufficiency. They quarreled "no more than other couplesdo", were as much in love "as other couples are", to use her phrases. She was above her class in education, read what are usually calledadvanced books, was "strong for suffrage", etc. However she was a goodhousekeeper, devoted to her children and faithful to her husband. Theirsexual relations were normal and up till six months before I saw her shethought herself a well-mated, rather fortunate woman. 

Out of a clear sky came proof of long-continued unfaithfulness on thepart of her "domestic" husband: a chance bill for women's clothesfluttered out of his pocket and under the bed, so that next morning shefound it; an unbelieving moment and then a visit to the address on thebill, and proof plenty that he had been disloyal, not only to her but tothe children, who had been obliged to scrimp along while he helpedmaintain another woman. Humiliated beyond measure by her disaster, unable to endure her past memories of happiness and faith, with anunstable world rocking before her, through the revelation that a quiet, contented, loving man could be completely false, she found no adequatereason for living and became a helpless prey to her troubled mind. "Atemporary unfaithfulness, a yielding to sudden temptation" she couldunderstand, but a determined plan of duplicity shattered her wholescheme of values. A very severe psychoneurosis followed, and herchildren and she were taken over by her parents and cared for. 

Sleeplessness was so prominent in her case and so evidently the centralphysical symptom that its control was difficult and required a regularcampaign for success. With sleep restored and the resumption of eating, the most of her acute symptoms were passed, though a profound depressionremained. 

Her husband, thoroughly abashed and ashamed, made furtive attempts atreconciliation. These were absolutely rejected, and from her attitude itwas obvious that no reconciliation was possible. "Had he not been foundout, " said the wife, "he would still be living with her. I can nevertrust him again; I would die before I lived with him. "

Little by little her pride recovered, for in such cases the deepestwound is to the ego, the self-valuation. The deepest effort of life isto increase that valuation by increasing its power and its respect byothers; the keenest hurt comes with the lowering of the valuation ofone's own personality. A woman gives herself to a man, without loweringa self-feeling if he is tender and faithful; if he holds her cheap, asby flagrant disloyalty, then her surrender is her most painful ofmemories. 

With the recovery of pride came the restoration of her interest in herchildren, and her purposes reshaped themselves into definite plans. Partof the process in readjustment in any disordered life is to centralizethe dispersed purposes, to redirect the life energies. She agreed thatshe would accept aid from the husband, as his duty, but only for thechildren. For herself, as soon as the children were a year or so older, she would go back to industry and become self-supporting. Her plansmade, her recovery proceeded to a firm basis, and I have no doubt as toits permanence. Nevertheless, life has changed its complexion for her, and there will be many moments of agony. These are inevitable and partof the recovery process. 

I shall not attempt to settle the larger problem of whether she shouldhave forgiven her husband and returned to him. Granting that hisrepentance was genuine, granting that no further lapse would occur, shewould never be able to forget that when he deceived her he had _acted_the part of a devoted husband. She would never be able fully to trusthim, and this would spoil their married happiness entirely. "For thechildren's sake, " cry some readers; well, that is the only strongargument for return. But on the whole it seems to me that an honestseparation, an honest revolt of a proud woman is better than a dishonestreunion, or a "patient Griselda" acceptance of gross wrong. 

Case XI. The unfaithful wife. 

In such cases as the preceding and the one now to be detailed, thedifficulties of the physician are multiplied by his entrance intoethics. Ordinarily medicine has nothing to do with morals; to the doctorsaint and sinner are alike, and the only immorality is not to followorders. To do one's duty as a doctor, with one's sole aim the physicalhealth of the patient, may mean to advise what runs counter to thepresent-day code of morals. This is the true "Doctor's Dilemma. " Insuch cases discretion is the safest reaction, and discretion bids thephysician say, "Call in some one else on that matter; I am only adoctor. "

A true neurologist must regard himself as something more than aphysician. He needs be a good preacher, an astute man of the world, aswell as something of a lawyer. The patient expects counsel of anintimate kind, expects aid in the most difficult situations, viz. , theconflicts of health and ethics. 

Mrs. A. R. , thirty-one years of age and very attractive, has been marriedsince the age of eighteen. She has two children, and her husband, tenyears her senior, is a man of whose character she says, "Every onethinks he is perfect. " A little overstaid and over dignified, inclinedto be pompous and didactic, he is kind-hearted and loyal, and successfulin a small business. He is an immigrant Swiss and she is American born, of Swiss parentage. 

Always romantic, Mrs. A. R. Became greatly dissatisfied with her homelife. At times the whole scheme of things, matrimony, settled life, goton her nerves so that she wanted to scream. She was bored, and it seemedto her that soon she would be old without ever having really lived. "Imarried before I had any fun, and I haven't had any fun since I marriedexcept"--Except for the incident that broke down her health by swingingher into mental channels that made her long for the quiet domesticityagainst which she had so rebelled. Her daydreaming was erotic, butromantically so, not realistic. 

There are in the community adventurers of both sexes whose main interestin life is the conquest of some woman or man. The male sex adventurersare of two main groups, a crude group whose object is frank possessionand a group best called sex-connoisseurs, who seek victims among themarried or the hitherto virtuous; who plan a campaign leisurely and towhom possession must be preceded by difficulties. Frequently thesegentry have been crude, but as satiation comes on a new excitement issought in the invasion of other men's homes. Undoubtedly they have aphilosophy of life that justifies them. 

Since this is not a novel we may omit the method by which one of thesemen found his way to the secret desires of our patient, and how heproceeded to develop her dissatisfaction into momentary physicaldisloyalty. She came out of her dereliction dazed; could it be she whohad done this, who had descended into the vilest degradation? She brokeoff all relations with the man, probably much to his surprise anddisgust, and plunged into a self-accusatory internal debate that broughtabout a profound neurasthenia. 

Naturally she did not of her own accord speak of herunfaithfulness, --largely because no one knew of it. Her husband did notin the least suspect her; he thought she needed a rest, a change, littlerealizing how "change" had broken her down. (For after all, the most ofinfidelity is based on a sort of curiosity, a seeking of a new stimulus, rather than true passion. ) The truth was forced out of her when it wasevident to me that something was obsessing her. 

When she had confessed her difficulty the question arose as to herhusband. She was no longer dissatisfied, no longer eager for romance;but could she live with him if she had been unfaithful? Ought she not totell him; and yet she feared to do this, feared the result to him, forshe felt sure he would forgive her. In reality the conflict in her mindarose first from self-depreciation and second from indecision as toconfession. 

As to the self-accusation, I told her that though she had been veryfoolish she had punished herself severely enough; that her reaction wasthat of an _essentially moral_ person; that an essentially immoral womanwould have continued in her career, and at least would not have been soremorseful. As to confessing, I told her that I believed that if shecame to peace without such a confession wisdom would dictate not to makeit, and that perhaps a little romanticism was still present in thequixotic idea of confession. Discretion is sometimes the better part ofveracity, and I felt sure that she would not find it difficult to forgether pain. 

It may be questioned whether such advice was ethical. I am sure no twoprofessors of ethics could agree on the matter, and where they woulddisagree I chose the policy of expediency. Moreover, I felt certain thatMrs. R. 's remorse did not need the purge of confession to her husband, that she was not of that deeply fixed nature which requires heroicmeasures. Her confession to me was sufficient, and since it was apparentthat she would not repeat her folly it was not necessary to go toextremes. 

The last two cases make pertinent some further remarks on sex. It haspreviously been stated that the sex field is the one in which arise manyof the difficulties which breed the psychoneuroses. It would not be theplace here to give details of cases, though every neurologist ofexperience is well aware of the neuroses that arise in marriage, amongboth men and women. Some day society will reach the plane where mattersrelating to the great function by which the world is perpetuated can bediscussed with the freedom allowed to the discussion of the details ofnutrition. 

No one seriously doubts that women are breaking away from traditionalideas in these matters. There was a time (the Victorian Age) in theUnited States and England when prudery ruled supreme in the manners anddress of women. That this has largely disappeared is a good thing, butwhether there is a tendency to another extreme is a matter wheredivision of opinion will occur. A transition from long skirts to dressthat will permit complete freedom of movement and resembling in afeminine way the garments of men would be unqualifiedly good. It wouldremove undue emphasis of sex and accentuate the essential human-ness ofwoman. But a transition from long skirts to short tight ones, impedingmovement, is the transition from prudery to pruriency and is by no meansa clear gain. Plenty of scope for art and beauty might be found in acostume of which pantalettes of some kind are the basis. I doubt ifwomen will ever be regarded quite as human beings so long as they paint, wear fantastic coiffures, hobble along on foolish heels, and are clad inover tight short skirts. 

Similarly with the literature of the period. The so-called sex story, the sex problem, obsesses the writers. Nor are these frank, freediscussions of the essential difficulties in the relation between manand woman. Usually the stories deal with the difficulties of the idlerich woman without children, or concern themselves with trivialtriangles. In the type of interminable continued stories that everynewspaper now carries, the woman's difficulties range around the mostabsurd petty jealousies, and she never seems to cook or sew or have anyresponsibility, and they always end so "sweetly. " On the stage theepidemic of girl and music shows has quite displaced the drama. Here sexis exploited to the point of the risque and sometimes beyond it. 

Sex is overemphasized by our civilization on its distracting side, itsspicy and condimental values, and underemphasized so far as itsrealities go. The aim seems to be to titillate sex feeling constantly, and a precocious acquaintance with this form of stimulation is the lotof most city children. Such things would have no serious results to thehousewife if they did not arouse expectations that marriage does notfulfill at all. This is the great harm of prurient clothes, literature, art, and stage, --it unfits people for sex reality. 

In how far the delayed marriages of men and women are good or bad it isalmost impossible to decide. That unchastity increases with delay is acertainty, that fewer children are born is without doubt. Whether thefixation of habit makes it harder for the wife to settle down to thehousehold, and the man less domestic, cannot be answered with yes orno. There seems to be no greater wisdom of choice shown in mature thanin early marriages, though this would be best answered by an analysis ofdivorce records. 

That contraceptive measures have come to stay; that they are increasingin use, the declining birth rate absolutely evidences. I take no stockin the belief that education reduces fertility through some biologicaleffect; where it reduces fertility it does so through a knowledge ofcause, effect, and prevention. Some day it will come to pass thatcontraceptive measures will be legal, in view of the fact that ourjurists and law makers are showing a decline in the size of their ownfamilies. When that time comes the discussion of means of this kindconsistent with nervous health will be frank, and some part of theneurasthenia of our modern times will disappear. The vaster racialproblems that will arise are not material for discussion in this book. 

Though not perhaps completely relevant to the nervousness of thehousewife, it is not without some point to touch on the "neurosis of theengaged. " The freedom of the engaged couple is part of the emancipationof youth in our time. Frankly, a love-making ensues that stops justshort of the ultimate relationship, an excitement and a tension arearoused and perpetuated through the frequent and protracted meetings. Sweet as this period of life is, in many cases it brings about a mildexhaustion, and in other cases, relatively few, a severe neurosis. Onthe whole the engagement period of the average American couple is not agood preparation for matrimony. How to bring about restraint withoutinterfering with normal love-making is not an easy decision to make. Butit would be possible to introduce into the teaching of hygiene thenecessity of moderation in the engaged period; it would be especially ofservice to those whose engagement must be prolonged to be advisedconcerning the matter. Here is a place for the parents, the familyfriend, or the family physician. 

Men and women as they enter matrimony are only occasionally equippedwith real knowledge as to the physiology and psychology of the sex life. That a great deal of domestic dissatisfaction and unhappiness could beobviated if wisdom and experience instructed the husband and wife inthe matter I have not the slightest doubt. The first rift in thedomestic lute often dates from difficulties in the intimate life of thepair, difficulties that need not exist if there were knowledge. Thatreason and love may coexist, that the beauty of life is not dependent ona sentimentalized ignorance are cardinal in my code of beliefs. He whobelieves that sentiment disappears with enlightenment is the true cynic, the true pessimist. He who believes that intelligence and knowledgeshould guide instinct and that happiness is thus more certain is betterthan an optimist; he is a rationalist, a realist. 

CHAPTER XII

TREATMENT OF THE INDIVIDUAL CASES

It is obvious that what is largely a problem of the times cannot bewholly considered as an individual problem. Yet individual cases doyield to treatment (to use the slang of medicine) or at least a largeproportion do. The minor cases in point of symptoms are very frequentlythe most stubborn, since neither the patient nor the family are willingto concede that to alter the life situation is as important as thetaking of medicine. 

Most housewives are nervous, both in their own eyes and in those oftheir husbands, yet rightly they are not regarded as sick. They areuncomfortable, even unhappy, and the way out seems impossible to find. Ibelieve that even with things as they are, adjustments are possible thatcan help the average woman. It is conceded that where the life situationinvolves an unalterable factor, relief or help may be unobtainable. 

It is necessary first of all to rule out physical disease. To do thismeans a thorough physical study. By doing this a considerable number ofwomen will be immensely helped. Flat feet, varicose veins, injuries tothe organs of generation, eye strain, relaxed gastro-intestinal tract, and the major diseases, --these must be remembered as factors that maydetermine nervousness. 

With this question settled, let us assume that there is no suchdifficulty or it has been remedied, and we have next to consider thelife situation of the patient. Here we enter into a difficult place, where knowledge of life and understanding of men and women, as well astact, are the essentials. 

It is necessary to remedy whatever bad hygienic habits exist. A richwoman may have settled down to a deënergizing life, with too much timein bed, too many matinées, too many late nights, too many bonbons, etc. Aside from the psychical injuries that such a life produces, it is badfor "the nerves" in its effects upon digestion, bodily tone, and thesources of mood. On some simple detail of life, some unfortunate habit, the whole structure of misery may rest. 

I always keep in mind an incident of some years ago when I lived in asmall town in Massachusetts. For some reason our furnace threw coal gasinto the house in such a way as nearly to poison us. The landlord sentseveral plumbers down, and one after the other suggested drasticremedies, --a new chimney, a new furnace, etc. Finally the landlord and Iinvestigated for ourselves. At the bottom of the chimney we found aninconspicuous loose brick which allowed air to enter the chimney beneaththe entrance of the pipe from the stove. We got ten cents' worth of limeand fastened the brick in firmly. A complete cure, where the specialistshad failed. 

So there often exists some drain on the energy and strength of the womanwhich may be simple and easily changed, and yet is critical in itssignificance and importance. 

An overdomestic woman may stick too closely to the house; anunderdomestic one may go too often to movies and suffer the fatigue ofmind and body that comes from over-indulgence in this most popularindoor sport. Carelessness about the eating and the care of the bowelfunctions may have started a vicious chain of things leading throughirritability and fatigue into neurasthenia. We say human beings are allthe same, but the range of individual susceptibility to trouble is suchthat a difficulty not important to most people will raise havoc withothers who are in most ways perfectly normal. 

Look then for the bad hygiene! Look for the evils of the sedentary lifeLook for the root of the trouble in lack of exercise, poor habits ofeating, insufficient air, disturbed sleep! Search for physicaldifficulties before inquiring into the psychical life. 

If poverty exists, then one may inquire into the amount of work done, the character of the home, the opportunities for recreation andrecuperation. All or any of the factors I have mentioned in previouschapters may be critical, and the moil and turmoil of a crowded tenementhome may be responsible. That such conditions do not break all womendown does not prove that they do not break _some_ women down, women withfiner sensibilities, or lesser endurance (which often go together). Themost depressing problems are met among the poor, the cases where one cansee no way out because the social machinery is inadequate to care forits victims. 

What is one to do when one meets a poor woman with three or four ormore children, living in a crowded way, overworked, racked in her nervesby her fears, worries, and the disagreeable in her life, drudging frommorning till night, yearning for better things, despairing of gettingthem, tormented by desires and ambitions that must be thwarted? "Whatright has a poor woman anyway to desires above her station, and why doesnot she resign herself to her lot?" ask the comfortable. Unfortunatelyphilosophy and resignation are difficult even for philosophers andsaints, and much more so for the aspiring woman. And our Americancivilization preaches "Strive, Strive!" too constantly for muchphilosophy and resignation of an effective kind to be found. 

One must give tonics, prescribe rest, try to get social agenciesinterested, obtain vacations and convalescent care, etc. Can one purge awoman of futile longings and strivings, rid her of natural fears andeven of absurd fears? It can be done to a limited degree, if the patienthas intelligence and if one gives liberally of one's time and sympathy. But unfortunately the consulting room for the poor is in the crowdedclinic, the thronged dispensary, and how is the overworked physician togive the time and energy necessary?

For the time required is the least requirement. To deal adequately withthe neurasthenic is to have unending sympathy and patience and an energythat is limitless. Without such energy or endurance the physician eitherslumps to a prescriber of tonics and sedatives, a dispenser of suchstale advice as "Don't worry" and "You need a rest", or else himselfgives out. 

In dealing with the cases in the better-to-do and the rich, one has moreweapons in the armamentarium. The worry is more futile here, moreridiculous, and one can attack it vigorously. Usually it is not overworkin these cases; it is monotony, boredom, discontent with something orother, a vicious circle of depressing thoughts and emotions, somedifficulty in the sex life, some reaction against the husband, arebellion of a weak, futile kind against life, maladjustment of atemperament to a situation. 

Some difficulties, even when ascertained and clearly understood, areinsurmountable. "The truth shall make ye free" is true only in the verylargest sense. Some temperaments are inborn, and are as unchangeable asthe nose on one's face. In such cases the ordinary physical therapeuticshelp the acute symptoms that flare up now and then, and that is as muchas one may expect. 

But it is certain that in the majority of cases more than this may beaccomplished. It is often a great surprise and relief to a woman torealize that her overconscientiousness, her fussiness, her rebellion, and discontent, her reaction to something or other is back of hersymptoms. She has feared disease of the brain, tumor, insanity, or hasblamed her trouble on some other definite physical basis. 

If one deals with intelligence, explanation helps a great deal. Theintelligent usually want to be convinced; they do not ask for miracles, they seek counsel as well as treatment. 

It is my firm belief that the function of intelligence is to controlinstinct and emotion, and that temperament, if inborn, is notunchangeable, even at maturity. Once you convince a person that his orher symptoms are due to fear, worry, doubt, and rebellion you enlist thepersonal efforts to change. 

A new philosophy of life must be presented. Less fussiness, less fear, more endurance, less reaction to the trifles of their life arenecessary. The aimless drifter must be given a central purpose or taughtto seek one; the dissatisfied and impatient must be asked, "Why shouldlife give you all you want?" "What cannot be remedied must be endured!"What a wealth of wisdom in the proverb! One seeks to establish an idealof fortitude, of patience, of fidelity to duty, --old-fashioned words, but serenity of spirit is their meaning. Suddenly to come face to facewith one's self, to strip away the self-imposed disguise, to see clearlythat jealousy, impatience, luxurious, and never satisfied tastes, aselfish and restless spirit, are back of ennui and fatigue, pains andaches of body and mind, is to step into a true self-understanding. 

If a situation demands action, even drastic action, "surgical" action, then that action must be forthcoming, even though it hurts. To enddoubt, perplexity, to cease being buffeted between hither and yon, is toend an intolerable life situation. I have in mind certain domesticsituations, such as the effort to keep up in appearance and activitywith those of more means and ability. 

Sexual difficulties, so important and so common, demand the coöperationof the husband for remedy. He should be seen (for usually the wifeconsults the physician alone) and the situation gone over with him. Menare usually willing to help, willing to seek a way out. A neurasthenicwife is a sore trial to the patience and endurance of her husband and heis anxious enough to help cure her. 

Where there is conflict of other kinds the situation is complicated bythe intricacy of the factors. Financial difficulties especially weardown the patience and endurance of the partners, and the physiciancannot prescribe a golden cure. In prosperous times there is lessneurasthenia than in the unprosperous, just as there is less suicide. 

Sometimes it is just one thing, one difficulty, over which the conflictrages. I have in mind two such cases, where one habit of the husbanddeënergized his wife by outraging her pride and love. When he wasinduced to yield on this point the wife came back to herself, --a highlystrung, very efficient self. 

In fact, the basis of treatment is the painstaking study of theindividual woman and then the painstaking _adjustment_ of thatindividual woman. It may mean the adjustment of the whole lifesituation to that housewife, or conversely the adjustment of thehousewife to the life situation. 

In many marital difficulties that one sees, not so much in practice asin contact with normal married couples, the trouble reminds one of theorang-outang in Kipling's story who had "too much Ego in his Cosmos. "Marriage, to be successful, is based on a graceful recession of the egoin the cosmos of each of the partners. The prime difficulty is this;people do not like to recede the ego. And the worst offenders are theones who are determined to stand up for the right, which usually is adisguised way of naming their desire. 

One might speak of a thousand and one things that every man and everywoman knows. One might speak of the death of love and the growth ofirritation, the disappearance of sympathy, --these are the hopelesssituations. But far more common and important, though less tragic, isthe disappearance of the little attentions, the little love-making, thedisappearance of good manners. Men are not the only or the worstoffenders in this; the nervous housewife is very apt to be the scoldand the nag. Perhaps the neurasthenia of the husband arises from hisrevolt against the incessant demands of his wife, but that's anotherstory. 

At any rate, there is what seems to be a cardinal point of differencebetween men and women, perhaps arising from some essential difference inmake-up, perhaps in part due to difference in training. An essentialneed of the average American-trained woman is sympathy, constantlyexpressed, constantly manifested. The average man tends to becomematter-of-fact, the average woman finds in matter-of-factness the deathof love. She acts as if she believed that the little acts of love andsympathy are the more important as manifesting the real state offeeling, that the major duties were of less importance. 

On this point most men and women never seem to agree. The man getsimpatient over the constant demand for his attention. He thinks itunreasonable and childish. Intent upon his own struggle he is apt tothink her affairs are minor matters. He thinks his wife makes mountainsout of molehills and lacks a sense of proportion. He forgets that thedevotion of the husband is the woman's anchor to windward, her grip onsafety, --that his success and struggle are hers only in so far as he andshe are intimate and lover-like. And women, even those who trust theirhusbands absolutely so far as physical loyalty goes, jealously watchthem for the appearance of boredom, or lack of interest, for the fallingoff of the lover's spirit and feeling. 

After marriage the rivalry of men expresses itself in business more thanin love. Even where a woman does not fear another woman as a rival shefears the rivalry of business, --and with reason. So she cravesattention, sympathy, as well as the dull love of everyday life. Sheought to have it; it is her recompense for her lot, for her marriedlife, her smaller interests. Now and then some great man intent upon agreat work has some excuse for absorption in that work; for the greatmajority of men there is no such excuse. Their own affairs are alsominor and are no more important than those of their wives. Fair playdemands that the women they have immured in a home have a prior claim totheir company, in at least the majority of the leisure hours. If in thetime to come the home alters and a woman who continues to work marriesa man who works, and they meet only at night, then it will be ethicalfor each to go his or her way. Marriage at present must mean the givingup of freedom for the man as well as for the woman, in the interests ofjustice and the race. 

In medicine we prescribe bitter tonics which have the property ofincreasing appetite and vigor. For the husband of every woman there isthis bit of advice; sympathy and attention constitute a sweet tonic, which if judiciously administered is of incomparable power andefficiency. 

CHAPTER XIII

THE FUTURE OF WOMAN, THE HOME, AND MARRIAGE

No true sportsman ever prophesies. For the odds are overwhelmingly infavor of the prophet. If he is right, he can brag the rest of his daysof his seer-like vision. If he is wrong, no one takes the trouble toreproach or mock him. 

Therefore I do not claim to be a prophet in discussing the future ofwoman, the home, and marriage. At any time just one invention may comealong that will totally alter the face of things. Moreover we are now inthe midst of great changes in industry, in social relations, in thelargest matters of national and international nature. Men and womenalike are involved in these changes, but it is impossible to judge theoutcome. For history records many abortive reformations, manyreactionary centuries and eras as well as successful reformations andprogressive ages. 

Whether or not it fits woman to be a housewife of the traditional kind, feminism is certain to develop further. Women will enter into morediverse occupations than ever before, they will enter politics, theywill find their way to direct power and action. More and more those whowork will be specialized and individualized--- the woman executive, thewriter, the artist, the doctor, lawyer, architect, chemist, andsociologist--will resist the dictum "Woman's place is the Home. " Thewoman of this group will either be forced into celibacy, or inever-increasing numbers she will insist on some sort of arrangementwhereby she can carry on her work. She will perhaps refuse to bearchildren and transform domesticity into an apartment hotel life, inwhich she and her husband eat breakfast and dinner together and spendthe rest of the waking time separately, as two men might. 

Such a development, while perhaps satisfying the ideas of progress ofthe feminist, will be bad eugenically. There will be a removal from therace of the value of these women, the intellectual members of theirsex. Whether the work this group of women do will equal the value ofthe children they might have had no one can say. 

But after all, the number of women who will enter the professions andremain in them on the conditions above stated will be relatively small. The main function of women will always be childbearing. If ever therecomes a time when the drift will be away from this function, then acounter-movement will start up to sway women back into this sphere oftheir functions. Moreover, the bulk of women entering industry willenter it in the humbler occupations and they will in the main be willingenough to marry and bear children, even in the limited way. Yet sincethey enter marriage with a wider experience than ever before, theconditions of marriage and the home must change, even though gradually. 

So on the whole we may look to an increasing individuality of woman, anincreasing feeling of worth and dignity as an individual, an increasingreluctance to take up life as the traditional housewife. Rebellionagainst the monotony and the seclusive character of the home willincrease rather than diminish, and it must be faced without prejudiceand without any reliance on any authority, either of church or state, that will force women back to "womanly" ways of thinking, feeling ordoing. 

Sooner or later we shall have to accept legally what we now recognize asfact, --the restriction of childbearing. Whether we regard it as good orbad, the modern woman will not bear and nurse a large family. And themodern man, though he has his little joke about the modern family, isone with his wife in this matter. With husband and wife agreed thereseems little to do but accept the situation. 

That this condition of affairs is leaving the peopling of the world tothe backward, the ignorant, and the careless is at present accepted bymost authors. One has only to read the serious articles on this subjectin the journals devoted to racial biology to realize how deeplyimportant the matter is. Yet there may be some undue alarm felt, forcontraceptive measures are becoming so prevalent in Europe, America, andAsia that all races will soon be on the same footing, and moreover allclasses in society except the feeble-minded are learning theprocedures. The prolificness of the feeble-minded is indeed a menace, and society may find itself compelled to lower their fertilityartificially. 

What will probably happen is that the one, two, or three-child familywill be born before the mother's thirty-fifth year, and she will then orbefore forty become free from the severest burdens of the housewife. What will she do with her time; what will the better-to-do woman do?Will she gradually give her energies to the community, or will she whileaway her time in the spurious culture that occupies so many club womento-day?

It is safe to say that women will enter far more largely than everbefore into movements for the betterment of the race. Though their wayof life may breed neurasthenia for some, it will have this greatadvantage, --the mother feeling will sweep into society, will enterpolitics, and social discussions. That we need that feeling no one willdeny who has ever tried to enlist social energies for race bettermentand failed while politicians stepped in for all the funds necessary evenfor some anti-social activities. We have too much legalism in our socialstructure and not near enough of the humanism that the socially mindedmother can bring. 

Is the increasing incidence of divorce a revolt against domesticity? Tosome extent yes, but where women obtain the divorce it is mainly arefusal to tolerate unfaithfulness, desertion, incompatibility oftemperament. It does not mean that the family is threatened bydivorce, --rather that the family is threatened by the conditions forwhich divorce is nowadays obtained and which were formerly not reasonsfor divorce. In many countries adultery on the part of the man, crueland abusive treatment, chronic intoxication, and desertion were notgrounds for divorce. These to-day are the grounds for divorce, and inthe opinion of the writer they should invalidate a marriage. I would goeven further and say that wherever there was concealed insanity orvenereal disease the marriage should be annulled, as it is in someStates. 

Divorce will not then diminish, despite the campaign against it, untilthe conditions for which it is sought are removed. Until that timecomes, to bind two people together who are manifestly unhappy simplyencourages unfaithfulness and cruelty, and is itself a cruelty. 

Whether we can devise a system where woman's individuality and humannesscan have scope and yet find her willing to accept the rôles of motherand homekeeper, is a serious question. It seems to me certain that womanwill continue to demand her freedom, regardless of her status as wifeand mother. She will continue to receive more and more general andspecial education, and she will continue to find the rôle of thetraditional housewife more uncongenial. Out of that maladaptation andthe discontent and rebellion will arise her neurosis. 

In other words what we must seek to do--those of us who are not bound bytradition alone but who seek to modify institutions to human beingsrather than the reverse--is to find out what changes in the home andmatrimonial conditions are necessary for the woman of to-day andto-morrow. 

That there has been a huge migration to the cities in the last centuryis one of its outstanding peculiarities. This urban movement has meantthe greater concentration of humans in a given area, and it is thereforedirectly responsible for the apartment house. That is to say, there hasbeen a trend away from individual homes, completely segregated andindividualized, to houses where at least part of the housework waseliminated, in a sense was coöperative. This coöperation is increasing;more and more houses have janitors, more and more houses furnish heat. In the highest class of apartment house the trend is toward permanenthotel life, with the exception that individual housekeeping is possible. 

Because of the limited space and the desire of the modern well-to-dowoman to escape as much as possible from housekeeping, because of thesmaller families (which idea has been fostered by landlords), the numberof rooms and the size of the rooms have grown less. The kitchenetteapartment is a new departure for those who can afford more room, for itis well known that the poor in the slums have long since lived in one ortwo rooms serving all purposes. The huge modern apartment house, thehuge modern tenement house, are part first of the urban movement andsecond of that movement away from housekeeping which has been sketchedin the Introduction. 

The home has been praised as the nucleus of society, its center, itsheart. Its virtues have been so unanimously extolled that one need butrecite them. It is the embodiment of family, the soul of mother, father, and children. It is the place where morality and modesty are taught. Init arise the basic virtues of love of parents, love of children, love ofbrothers and sisters; sympathy is thus engendered; loyalty has here itssource. The privacy of the home is a refuge from excitement and struggleand gives rest and peace to the weary battler with the world. It is asanctuary where safety is to be sought, and this finds expression in theEnglish proverb, "Every Englishman's home is his castle. " It is areward, a purpose in that men and women dream of their own home and arethrilled by the thought. Throughout its quiet runs the scarlet thread ofits sex life. Home is where love is legitimate and encouraged. 

Yet the home has great faults; it is no more a divine institution thananything else human is. Without at all detracting from its great, itsindispensable virtues, let us, as realists, study its defects. 

On the physical-economic side is the inefficiency and waste inseparablefrom individual housekeeping. Labor-saving machinery and devices areoften too expensive for the individual home, and so small stoves do thecooking and the heating, each individual housewife or her helper washesby hand the dishes of each little group. Shopping is a matter for eachwoman, and necessitates numberless small shops; perhaps the biggestwaste of time and energy lies here. The cooking is done according to theintelligence and knowledge of nutrition of each housewife, andhousewives, like the rest of the world, range in intelligence fromfeeble-mindedness to genius, with a goodly number of the uninformed, unintelligent, and careless. Poets and novelists and the stage extolhome cooking, but the doctors and dietitians know there are as manykinds of home cooking as there are kinds of homekeepers. The laboratoryand not the home has been the birthplace of the science of nutrition, and we have still many traditions regarding the merits of home cookingand feeding to break from. 

Take as one minor example the gorging encouraged on Sunday and certainholidays. The housewife feels it her duty to slave in a kitchen allSunday morning that an over-big meal may be eaten in half an hour by herfamily. She encourages gluttony by feeling that her standing as cook isdirectly proportional to the heartiness of her meal. Thanksgiving, Christmas, --the good cheer of gluttony is sentimentalized and hallowedinto poetry and music. The table that groans under its good cheer hasits sequence in the diners who groan without cheer. 

While we might further dilate on the physical deficiencies andinefficiencies of the segregated home, there is a disadvantage of vasterimportance. After all, institutionalized cooking is rarely satisfactory, because it lacks the spirit of good home cooking, the desire to meetindividual taste without profit. It lacks the ideal of service. 

There are bad effects from the segregation and the privacy of the home, even of the good kind. For there are very many bad homes; those in whichdrunkenness, immorality, quarreling, selfishness, improvidence, brutality, and crime are taught by example. After all, we like to speaktoo much in generalities--the Home, Woman, Man, Labor, Capital, Mankind--forgetting there is no such thing as "the Home. " There arehomes of all kinds with every conceivable ideal of life and training andhaving only one thing in common, --that they are segregated social units, based usually on the family relationship. Montaigne very truly saidapproximately this: "He who generalizes says 'Hello' to a crowd; he who_knows_ shakes hands with individuals. "

In the first place the home (to show my inconsistency in regard togeneralizing) is the place where prejudice is born, nourished, and grownto its fullest proportions. The child born and reared in a home isexposed to the contagion of whatever silliness and prejudice actuate thelives and dominate the thought and feeling of its parents. And thequirks and twists to which it is exposed affect its life eitherpositively or negatively, for it either accepts their prejudices ordevelops counter-prejudices against them. To cite a familiar case; it istraditional that some of the children brought up overstrictly, overcarefully, throw off as soon as possible and as completely aspossible conventional morals and manners. Such persons have simplyoverreacted to their training, revolted against the prejudice of theirteaching by building counter-prejudices. 

Further, the home fosters an anti-social feeling, or perhaps it would bekinder to say a non-social feeling. Your home-loving person comes in thecourse of time to that state of mind where little else is of importance;the home becomes the only place where his sympathies and his altruisticpurposes find any real outlet. The capitalist of the stage (and of reallife too) is one so devoted to his home and family that he decorates oneand the other with the trophies of other homes. There is none so devotedto his home as the peasant, and there is no one so individualistic, sointent in his own prosperity. The home encourages an intense altruism, but usually a narrow one. The feeling of warmth and comfort of thehearth fire when a blizzard rages outside too often makes us forget thepoor fellows in the blizzard. 

Thus the home is the backbone of conservatism, which is good, but itbecomes also the basis of reactionary feeling. It is the people thatbreak away from home and home ties who do the great things. 

When the home is quiet and harmonious it is the place where greatvirtues are developed. But when it is noisy and disharmonious, then itsvery seclusiveness, its segregation, lends to the quarrels thebitterness of civil war. The intensity of feeling aroused isproportional to the intimacy of the home and not to the importance ofthe thing quarreled about. Good manners and that sign and symbol oflargeness of spirit, tolerance for the opinions of others, rarely areborn in the home. 

It is hardly realized how much quarreling, how much of intense emotionalviolence goes on in many homes. Its isolation and the absence of therestraining influence of formality and courtesy bring the wills of thefamily members into sharp conflict. Words are used that elsewhere wouldbring the severest physical answer, or bring about the most completedisruption of friendly relations. Love and anger, duty and self-interestbring about intense inner conflict in the home, and the struggle betweenthe two generations, the rising and the receding, is here at its height. 

That courtesy to each other might be taught the children, might beinsisted on by the parents is my firm belief. Love and intimacy need notexclude form. Manners and morals are not exclusive of each other. If themarriage ceremony included the vow to be polite, it might leave outalmost everything else. The home should be the place where tolerance, courtesy, and emotional control are taught both by precept and example. 

Can the home be altered to bring in more of the social spirit and yetmaintain its great virtues, its extraordinary attraction for the humanheart? It's an old story that criticism, the pointing out of defect, iseasy, while good suggestions are few and difficult to convert intoprograms for action. In medicine diagnosis is far ahead oftreatment, --so in society at large. 

Any plans that have for their end a sort of social barracks, with menand women and their children living in apartments, but eating anddrinking in large groups, will meet the fiercest resistance from thesentiment of our times and cannot succeed, unless it is forced on us bysome breakdown of the social structure. Nevertheless a largercoöperation, at least in the cities, will come. Buildings must be builtso that a deal of individual labor disappears. Just as coöperativestores are springing up, so coöperative kitchens, community kitchensorganized for service would be a great benefit. Especially for the poor, without servants, where the woman is frequently forced to neglect herown rest and the children's welfare because she must cook, would such adevelopment be of great value. Unfortunately the few community kitchensnow operating have in mind only the middle-class housewife and not thehousewife in most need, --the poor housewife. Here is a plan for realsocial service; cooking for the poor of the cities, scientific, nutritious, tasty, at cost. Much of the work of medicine would beeliminated with one stroke; much of racial degeneracy and misery woulddisappear in a generation. 

That the home needs labor-saving devices in order that much of thedisagreeable work may be eliminated is unquestioned. Inventive geniushas only given a fragmentary attention to the problems of the housewife. Most of the devices in use are far beyond the means of the poor and eventhe lower middle class. Furthermore, though they save labor many ofthem do not save time. The tests by which the good household deviceought to be judged are these:

First--Is it efficient?

Second--Is it labor saving?

Third--Is it time saving?

We need to break away from traditional cooking apparatus and traditionaldiet. The installation and use of fireless cookers, self-regulatingovens, is a first step. The discarding of most of the puddings, roasts, fancy dishes that take much time in the preparation and that keep thehousewife in the kitchen would not only save the housewife but wouldalso be of great benefit to her husband. The cult of hearty eating, which results in keeping a woman (mistress or maid) in the kitchen forthree or more hours that a man may eat for twenty or thirty minutes isfolly. The type of meal that either takes only a short time forpreparation and devices which render the attention of the housewifeunnecessary are ethical and healthy, both for the family and society. The joys of the table are not to be despised, and only the dyspeptic orthe ascetic hold them in contempt; but simplicity in eating is the veryheart of the joy of the table. 

Elaboration and gluttony are alike in this, --they increase the houseworkand decrease the well-being of the diner. 

How to maintain the sweetness of the family spirit of the home and yetbring into it a wider social spirit, break down its isolatedindividualistic character, is a problem I do not pretend to be able tosolve. Ancient nations emphasized the social-national aspect of lifeovermuch, as for example the Spartans; the modern home overemphasizesthe family aspect. We must avoid extremes by clinging to the virtues andcorrecting the vices of the home. 

Alarmists are constantly raising the cry that marriage is declining andthat society is thereby threatened at its very heart. There is thepessimist who feels that the "irreligion" of to-day is responsible;there is the one who blames feminism; and there is the type that findsin Democracy and liberalism generally the cause of the recedingold-fashioned morality. Divorce, late marriage, and child-restrictionare the manifestations of this decadence, and the press, the pulpit, science, and the State all have taken notice of these modern phenomena, though with widely differing attitudes. 

That matrimony is changing cannot be questioned or denied. The mainchange is that woman is entering more and more as an equal partner whoserights the modern law recognizes as the ancient law did not. She is nolonger to be classed as exemplified by the famous words of Petruchio, when he claimed his wife, the erstwhile shrew, as his property inexactly the same sense as any domestic animal, linking the wife with thehorse, the cow, the ass, as the chattels of the man. The law agreed tothis attitude of the man, the Church supported it; woman, strangelyenough, seemed to glory in it. 

With the rise of woman into the status of a human being (a revolutionnot yet accomplished in entirety) the property relationship weakened butlingers very strongly as a tradition that molds the lives of husband andwife. Women are still held more rigidly to their duties as wives thanmen to their duties as husbands, and the will of the husband still rulesin the major affairs of life, even though in a thousand details the wiferules. Theoretically every man willingly acknowledges the importance ofhis wife as mother and homekeeper, but practically he acts as if hiswork were the really important activity of the family. The obedience ofthe wife is still asked for by most of the religious ceremonies of thetimes. Two great opinions are therefore still struggling in the home andin society; one that matrimony implies the dependence and essentialinferiority of woman, and the other that the man and woman are equalpartners in the relationship. I fully realize that the advocate of thefirst opinion will deny that the inferiority of woman is at all impliedin their standpoint. But it is an inferior who vows obedience, it is theinferior who loses legal rights, it is the inferior who yields toanother the "headship" of the home. 

The struggle of these two opinions will have only one outcome, thecomplete victory of the modern belief that the sexes are, all in all, equal, and that therefore marriage is a contract of equals. Meanwhilethe struggling opinions, with the scene of conflict in every home, inevery heart, cause disorder as all struggles do. When the victory iscomplete, then conduct will be definite and clear-cut, then the homewill be reorganized in relation to the new belief, and then new problemswill arise and be met. How conduct will be changed, what the newproblems will be and how they will be met, I do not pretend to know. 

Meanwhile there is this to say, --that marriage should be guarded so thatthe grossly unfit do not marry. A thorough physical examination is asnecessary for matrimony as it is for civil service, and many of thehorrors every generation of doctors has witnessed could be eliminated atonce and for all time. 

Further, if marriage is a desirable state, and on the whole it must bepreferred to a single existence, surely so long as our code of moralsremains unchanged, and so long as we believe the race must beperpetuated, then the too late marriage should be discouraged. The idealage for women to enter matrimony is from twenty-two to twenty-five; theideal age for men is from twenty-five to twenty-eight. It is not myprovince to deal at length with this subject, but I may state that Ibelieve that continence beyond these ages becomes increasinglydifficult, that immorality is encouraged, that adaptability becomeslessened, and that wiser selection of mates does _not_ occur. But howbring about early marriages in a time when the luxuries seem to havebecome necessities, and therefore the necessity of marriage is eyed moreand more as an extravagance of the foolhardy? How bring about earlymarriage when women are earning pay almost equal to that of the men andare therefore more reluctant to enter matrimony unless at a highstandard of living. The late marriage is an evil, but how it can bedisplaced by the early marriage under the present social scheme I do notsee. 

We have considered divorce before this. It is not an evil but a symptomof evil; not a disease in itself. It cannot be lessened or abolishedunless we are willing to state that a man and a woman should livetogether as husband and wife, hating, despising, or fearing one another. We cannot countenance brutality, unfaithfulness, or temperamentalmismating. It is true that divorces are often obtained for trivialreasons, but usually the partners are not adapted to one another, according to modern ways of thinking and feeling. What is commonplacein one age is cruelty in the next, and this is a matter not of argumentbut of expectation and feeling. 

Nothing more need be said of contraceptive measures than this: they areinevitably increasing in use and soon will be part of the averagemarriage. Society must recognize this, and the lawmakers must legalizewhat they themselves practise. 

Matrimony, the home, woman, these are nodal points in the network of ourhuman lives. But they are not fixed centers, and the great weaver, Time, changes the design constantly. Through them run the threads of the greatinstincts, of tradition, of economic change, of the ideas, ideals, andactivities of man the restless. Man will always love woman, woman willalways love man; children will be born and reared, and sex conflict, maladjustment, will always be secondary to these great facts. How menand women will live together, how they will arrange for the children, will be questions that women will help the world answer as well as theirmates. That the main trend of things is for better, more ethical, morejust relationship, I do not doubt. The secondary, most noisy changesare perhaps evil, the main primary change is good. 

Meanwhile in the hurly-burly of new things, of complex relationships, working blindly, is the nervous housewife. This book has been writtenthat she may know herself better and thus move towards the light; thather husband may win sympathy and understanding and be bound to her in acloser, better union, and that the physician and Society may seek thedirect and the remote means to helping her. 

INDEX

Alcoholism and housewife, 157Anger, 88

Beauty, loss of, 88Birth control, 14-16Birth control measures and nervousness, 137

Cases, treatment of, 231-243Child and cartoons, 113 and movies, 111Childbearing and modern woman, 15Children and the neurosis, 97-115

Daydreaming, 81Diet and Cooking, 259Disagreeable, reaction to the, 90Divorce, 13

Emotions, effects of, 27-30; 42-45Engagement period, 229Extravagance of the housewife, 145

Fear, 93Feminism and individualization of woman, 10-13

Happiness and high cost of living, 151Histories of cases: case with bad hygiene, 183-187 hyperæsthetic woman, 187-193 over-rich, purposeless type, 177-181 overworked, under-rested type, 171-177 physically ill type, 181-183Holmes, Oliver Wendell, 5Home, aboriginal, 5 faults of, 225 future of, 250 isolation of, 77Household conflicts, 141-159Housewife, hyperæsthetic type of, 51 non-domestic type of, 61 overconscientious type of, 53 overemotional type of, 57 physically ill, 69 previously neurotic, 65 types predisposed to nervousness, 47-73Housewife and abnormal child, 107 and childbearing, 99 and neglect, 153 and poverty, 117Housewife of past generation, 3Housework, evolution of, 5-10 nature of, 75Housework and factory, 9Husband and housewife, 127Hysteria, 35

Jealousy and envy, 123

Marriage, conflicting views of, 127Marriage and sex relationship, 131-140Monotony, effects of, 79Nervousness, 17-20Nervousness and child hygiene, 100Nervousness and sick child, 104Neurasthenia, causes, 9 symptoms, 20-26Neurasthenia and fear, 23

Pruriency of our times, 275Psychasthenia, 31Psychoneuroses, 18

Sedentary life, effects of, 83Sex and society, 139Subconscious, 29Symptoms as weapons against husband, 161

Voltaire and constipation, 23

Will to power through weakness, 163, 212Woman, arts and crafts, 6-8Woman, discontent of, 13 future of, 244 training of, 48-50Woman, industry and home, 8-10Worry, 119

_By the Author of "RELIGION and HEALTH"_

=HEALTH THROUGH WILL POWER=

_By_ JAMES J. WALSH, M. D. 

_Medical Director of Fordham University School of Sociology_

12mo. Cloth. 288 pages. 

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