Dress-Reform (Woolson)/Lecture 4
LECTURE IV.
BY ARVILLA B. HAYNES, M.D.
Ladies,—When I was invited to take part in these lectures on Dress-Reform, I consented to do so, not because I thought I was qualified above others to speak or teach on this subject, but because I felt a deep interest in what was to be brought before you.
I consider the theme one of great importance,—so great, indeed, that it cannot be overcstimated. When we see disease the rule, and health the exception, it seems fitting for women to pause and inquire the cause of this unnatural state of things. And the answer comes back to us from every side, "There is a perversion of the natural functions, and a disregard of hygienic laws."
In the brief time allotted to a single lecture, it would be impossible to exhaust a subject of so much interest, or one so fruitful of good and ill to mankind. As it has been my privilege to observe from the standpoint of a physician, I shall speak from the same, hoping by so doing to speak with greater authority. And my endeavor will be to present to you the practical side of this question, leaving the artistic and æsthetic for other hands. If I repeat any thing that has been said by those who have preceded me, I hope you will consider the statement to be of so much importance that it insists upon arresting your attention.
I propose to speak on the influence of external conditions on the human body.
The conditions that demand our attention in connection with the subject before us are mechanical pressure, and sudden alternations of temperature arising from the application of cold and dampness to the surface of the body. Both of these conditions are greatly affected by our artificial covering,—the dress.
As we approach this temple of nature, the human body, examine its structure and observe its perfect adaptation to uses, we see much that excites our wonder and admiration. Looking at the lowest forms of animal life, we find they are made up of an aggregation of cells, every part like every other part, and all homogeneous in character. As we rise a little in the scale, there is a differentiation of parts: organs are developed, at first rudimentary. A little higher still, these organs are more fully developed, and others are added. And so on, until we pass through the different classes, and arrive at the vertebrate animals and man.
In these highest organisms, where work is to be done, there is a division of the labor, and organs and systems are set apart to perform certain functions. In studying this complex structure, we must first understand its anatomy, or the normal relation of one part to another, before we can understand deformities, or a departure from the normal relation. We must also understand its physiology, or the functions of the several systems or organs, before we can understand any perversion of these functions. So you will allow me to examine a little the body we would properly clothe, and see the relation of one part to another, also the functions these several organs and systems are called upon to perform. By so doing we shall better understand the influence of the external conditions furnished by dress.
We see the human body as a symmetrical whole. It has a bony framework or skeleton, that gives form and outline to the body. This is clothed with muscles, that are traversed by a system of glands, and permeated by bloodvessels and nerves. Over all is placed a covering, the integument or skin.
Within, we find three great cavities,—the cranial cavity, the cavity of the chest, and the abdominal cavity. Within the cavity of the cranium is lodged that great nervous centre, the brain; and intimately connected with this is the spinal cord, enclosed in a bony canal. From these two nervous centres proceed nerves of sensation and of voluntary motion, which serve as channels of communication to all parts of the body.
The cavity of the chest is formed principally by the ribs, attached to the vertebræ posteriorly, and to the sternum anteriorly, by cartilage. Its walls are more or less flexible. Within the chest the heart and lungs are located.
Below the chest we have the abdominal cavity, with muscular walls. It contains the liver on the right, on the left the spleen, the stomach somewhat to the left, and the alimentary canal arranged in convolutions. Below, in the pelvis, are found the organs of generation.
Each organ contained in these several cavities has its own peculiar work to perform; and this brings us to a consideration of the various systems.
The digestive system lies at the foundation of all the organic functions; for on this organized beings depend for their growth, development, and maintenance during life. After a nutrient fluid has been claborated by the digestive organs from the alimentary substances they receive, it must be conveyed to all parts of the body to be assimilated; hence the circulating system. This nutrient fluid must be maintained in a state of purity, and we have excrcting organs. The kidneys belong to the excreting organs; and the function of the skin is correlated to that of the kidneys. The respiratory system is of importance in maintaining the blood in a state of purity, as it performs the double office of removing carbonic acid and of introducing oxygen. All these are separate and distinct functions, yet they are mutually dependent on one another; and on their uniform and harmonious operation the life of the individual depends.
In the normal condition, or in a state of health, these functions go on without consciousness; that is, they are involuntary. The heart pulsates with the same regularity, asleep or awake; respiration, also, is carried on in a tranquil and uniform manner. The kidneys fulfil their office of excretion; and the skin is at all times eliminating the substances that would be deleterious if allowed to remain in the system. The stomach, likewise, performs its part of the digestive process, without entering any protest through the nervous system.
The functions that are of primary importance to us in considering the influence of external conditions are the circulation and the respiration; and of these I wish to speak more fully. They also hold an important place among the organic functions.
The circulating system consists of the heart, the arteries, capillaries, and veins, and the fluid contained therein,—the blood. Of this system the heart is the central organ; and it is a muscle of great strength in proportion to its size. The arteries are hollow tubes, somewhat elastic, and with a contractile power. They are always full. They convey blood from the heart, and begin there as one large vessel; but soon they send off branches that divide and subdivide, till they terminate in numerous minute capillaries, that are intermediate between the arteries and veins. The capillaries are microscopic in size, and form a network in the tissues. The veins begin at the capillaries; and as they go towards the heart they unite, until they terminate at the heart as two large vessels, one bringing the blood from the head and upper extremitics, and the other from the trunk and lower extremities. The arteries convey the blood outward from the heart, and are deep-seated; the veins return the blood to the heart, and are both deep-seated and superficial. The veins return the blood of the general circulation to the right auricle of the heart. From this it is forced into the right ventricle, thence into the pulmonary artery, and then it is conveyed to the lungs. From the lungs it is returned by the pulmonary veins to the left auricle of the heart; it then passes into the left ventricle, and from this into the arteries; and is then conveyed over the system, and returned again to the right side of the heart.
This is the general circulation, and it is carried on with great rapidity. The whole amount of blood in the body is estimated as about onefifth or one-eighth of its weight; so that in a body weighing 120 lbs. we should have about 15 lbs. of blood. The capacity of the chambers of the heart is from 1½ to 2 oz. With the lower estimate, the heart pulsating sixty times per minute, which is the average rate, the whole amount of blood in the system will pass through the heart in about three minutes. The circulation, when unimpeded, is carried on in a regular and uniform manner, every part receiving its normal quantity of blood. The lungs, located upon the right and left sides of the chest, are essentially composed of the blood-vessels, and the numerous and minute divisions of the bronchi that terminate in a cluster of air-cells. They are supplied with nerves and glands, and are all held together by a delicate tissue or membranc. We sce the same arrangement of the blood-vessels in the lungs as elsewhere. The pulmonary artery enters the lungs as one large vessel, and divides into numerous minute branches, terminating in capillaries; and the veins begin at the capillaries, as small vessels that unite and return the blood to the left auricle of the heart. The circulation of the blood through the lungs is termed the lesser circulation; but it is a very important part of the economy of the system. The arrangement of the blood-vessels in the lungs serves admirably for the re-creation and purification of the blood. The minute capillaries form a network around the air-cells, and the blood is separated from the air in the cells by the most delicate of tissues, which allows only gases to pass through it. Here the exchange is made: the blood takes oxygen from the respired air, and gives up the carbon which it has received from waste material, and which acts as a poison when it remains in the system.
Respiration is one of the most important of the organic functions; and it is only by the constant and uniform flow of blood through the lungs,—and it passes through the lungs with the same rapidity that it passes through the heart,—and the no less constant and regular act of respiration, that the blood is kept in a condition to serve the purpose of nutrition.
Let us now look at the influence of mechanical pressure on these functions, which are performed in such a regular and uniform manner by a structure so complicated and delicate. In the arrangement of the organs in the cavities of the body there are no empty spaces. Every organ is in close relation to some other part or organ; and when one is pressed out of its normal position it must encroach on the space allotted to another. The chest-walls are more or less flexible; and when mechanical pressure is made around the lower portion of the chest, and over the free or floating ribs, it lessens materially the capacity of the cavity of the chest, and interferes very essentially with the full and free expansion of the lungs.
When the air-cells of the lungs are not filled with air at every inspiration, the blood is imperfectly aerated. The amount of oxygen supplied by the respired air is not in proportion to the amount of carbon to be eliminated. Consequently the blood remains more or less carbonized, and is unfit for the purpose of nutrition. This condition of the blood reacts on the nervous system, and through it on all the organic functions. The free action of the heart is impeded, also the regular contractions of the diaphragm,—that great muscle by which tranquil respiration is performed. The liver is displaced, and encroaches upon the space of the other abdominal organs. The free movement of the stomach is impeded, if active digestion is going on in that organ.
When pressure is made over this region, there cannot be natural motion in any part of the body. As soon as vigorous exercise is engaged in, every part of the system calls for oxygen. In order to supply it, the lungs take on increased action: respiration is quickened. Instead of breathing sixteen times per minute, the normal number, the respiratory effort is increased to twenty per minute; yet at this rapid rate the lungs are unable to meet the demands made upon them, and fatigue soon follows. All vital acts are peculiarly destructive of their agents.
The corset, as now manufactured and worn, is loosely hooked around the waist. Owing to its own weight and to that of the clothing buttoned over it, it drops down till it rests upon the hips. This arrangement does not remove the pressure caused by the dragging down of skirts at the waist: it only changes it from one point to another, and the result is equally injurious. When the clothing is worn in this way, pressure is made over the abdomen, the convolutions of the intestines are crowded together, and the weight of all the contents of the abdomen is thrown, more or less, upon the organs within the pelvis.
The steel spring in the front of the corset is used as a support for the body. It presses upon the stomach, causing tenderness of the great solar plexus of the sympathetic nerves that lie posterior to the stomach. It weakens the abdominal muscles, and destroys in a measure the true vertical bearing of the body.
When this vertical bearing of the body is maintained, every part above rests upon that below. The head rests upon the upper part of the vertebral column, the weight of the trunk upon the hips; and the same plan is carried out through the lower extremities to the arch of the foot. When the body is in this position, the vertebral column has two curves,—a lesser curve above, that gives increased capacity to the chest, and a greater one below. Then the abdominal muscles are tense, and the weight of the contents of the abdomen is thrown upon the pubic portion of the pelvis. But when these muscles are weakened and relaxed, and the greater and lower curve in the spinal column is impaired, owing to pressure from above, the weight of the contents of the abdomen is thrown into the pelvic cavity, causing displacement and prolapsis of the organs situated there.
Since strings have been discarded, and firm hooks and eyes used to fasten the corset, there may have been a decrease in chest diseases, but there has been a corresponding increase in uterine diseases. Some of the mechanical supports that have been invented for uterine displacements are adjusted with the design of restoring the natural curve in the lower portion of the vertebral column, thus giving the abdominal muscles their true lifting power, and throwing the weight of the abdominal viscera upon the pubic bones of the pelvis, where it belongs.
When questioned, ladies rarely admit that they wear their clothing tight. The hand can be readily passed under the bands, when the diaphragm is relaxed and the air is expelled from the lungs, and their garments are therefore considered loose and comfortable. They do appear to be so; but this is apparent rather than real. If the chest is subjected to pressure for a considerable length of time, it adapts itself to that condition; and we can go on increasing the pressure gradually, until we have contracted chest-walls and displacement of the abdominal organs. Such is the effect of habit on the system.
When the habit is injurious, the changes it effects may be slow and imperceptible, but they will break out ultimately in disease. For, although there is a certain amount of tolerance in the system, no natural law can be disregarded from day to day without bringing, sooner or later, a certain retribution; and the length of time before it appears will be just in proportion to the nature of the abuse and the amount of vital force that there is to resist it.
Let us now try the opposite experiment, and begin to increase the size of the bands, and to allow a little more room for the movements of the vital organs. If we continue to do this from time to time, till the bands have been lengthened three or four inches, at the end of a year we shall find that they are about as tight as when we began to enlarge them. But in this case the tendency will have been towards health. The chest-walls have expanded, and respiration has been more perfectly performed. The diaphragm discharges its natural function; the circulation is unimpeded; and there is greater freedom in all the movements of the body.
Mechanical pressure at any point retards the onward flow of the blood through the veins to the heart. The veins are superficial, or near the surface; and pressure around the limbs at any point will cause a passive congestion of the vessels below that point. This can be readily demonstrated. If you compress the veins of the wrist or arm, in a few minutes the veins of the hand and arm will be swollen. The blood cannot return to the heart. The same takes place if there is pressure at any point around the lower extremities, or on any of the large veins.
One of the important conditions to be maintained in the adjustment of our clothing is a uniform temperature over the surface of the body, without pressure and with the least weight. In our climate, flannel or woollen goods, as a general rule, should be worn next to the skin over the whole body, from the neck to the wrists and ankles. If there is any idiosyncrasy which prevents this material from being thus worn, it should be used as the second covering.
All the clothing should be supported from the shoulder. The corset should be discarded; but if it must be retained as an indispensable article of dress, as it is now considered, it should be made without whalebone or steel springs, and should be held up by a band over the shoulder. All the under-clothing external to this should either be attached to it, or so arranged that the weight may rest on the shoulder. This may be managed by means of suspenders, or by a waist fitted to the form. The less the weight, the better, provided the necessary warmth is secured.
The length of the bands around the waist should be sufficient to allow the utmost freedom to all the movements. Nothing ought to interfere with the action of the abdominal muscles and the diaphragm; and the greatest chest capacity should be secured, in order to enable the lungs to perform properly the function of respiration.
The skirts should be short enough to clear the pavement, and to prevent their lower edges from becoming damp. They should also allow freedom to the feet and limbs in that most healthful of all out-of-door excrcise,—walking. No elastic bands should encircle the limbs at any point, as they retard circulation by compressing the blood-vessels. The stockings may be upheld by elastic bands attached at the waist to that portion of the clothing which has its support from the shoulder.
When the clothing is arranged in this way, all the weight hanging from the shoulder and no pressure at any point, there is freedom of motion in every part. The organs are all in their true relation to one another, and their functions go on unimpeded.
When the temperature is such as to require extra clothing or wraps for the chest and upper extremities, the lower extremities also should receive attention. In the inclement season, when we are liable to sudden alternations of temperature, if the thermometer drops down to zero or near that point, and we go from furnace-heated houses into the open air, we put on cloaks or shawls, furs, and wraps of various kinds; and encase our hands, not only in gloves or mittens, but in muffs. This is all right, and should be done; but it is not sufficient. To the lower extremities we should also add leggins, and a pair of over-drawers made either of ladies' cloth or flannel; and, in wet weather, overshoes.
When one part of the body is over-heated, and another part exposed, the nerves of the exposed part are rendered more sensitive to receive impressions.
In treating of the influence of alternations of temperature which arise from the application of cold to the surface of the body, I shall use the word cold as meaning the absence of heat or caloric. Heat and light act externally as stimulants, and are among the conditions essential to life and health. The normal temperature of the body internally is one hundred degrees; on the surface, it is ninety-eight; and the vital functions cannot be carried on if the temperature is lowered in a considerable degree for any length of time.
Cold is a sedative, and when applied to the surface of the body it lowers the vital powers. It acts on the circulation by contracting the blood-vessels; and thus the blood is driven within from the exposed region. If one part is deprived of its normal quantity of blood, another part must have more than its normal quantity, consequently there must be congestion of some of the internal organs. This is what takes place when the extremities are too thinly clad to maintain an equal temperature over the surface. The lungs and the uterine organs are very liable to congestions from this cause, and this is particularly true in regard to girls at the age of puberty. At that period, the vital powers have been developing and perfecting the system, which is then very susceptible of external influences. Exposure to cold at this age often leads to derangements that become chronic, impairing the general health, and causing a vast amount of suffering, while in many cases they establish right conditions for the development of disease in after life. Who among us cannot trace sad results to only a cold?
A proper clothing of the extremities is one of the best preventives; and we may have congestion of any of the internal organs from a failure to do this.
When there is exposure to sudden changes of temperature, without sufficient clothing for protection, the impression on the nerves and on the circulation is often the exciting cause of acute disease. If we look over our medical works as authorities, we find a large number of diseases that are referable to this cause. Who has not observed the prevalence of coughs and colds, as soon as there is a change in the seasons, and summer passes into autumn? This is because there is not a corresponding change in the clothing. The function of the skin as an climinating organ is checked from these sudden alternations; and substances that should be removed remain in the system. When we remember that from one to three pounds of fluid pass off through the pores of the skin during every twenty-four hours, we see how important it is that the surface of the body should be kept at a proper and equable temperature for its normal action.
The externals of dress, though they involve a moral question, seem to me of far less consequence than the arrangement of the under-dress, for that involves health.. As now generally worn, the under-dress is weakening the present generation of women; and, from the unvarying laws of nature, the effect must be transmitted to future generations. Mothers will confer upon their offspring a lower and lower vitality; and, when we consider the already fearful mortality in infancy and childhood, there is little hope for the future, unless we can have some reform in this direction. And when the offspring is not thus early cut off from mortal life, in many cases tendencies to disease are inherited, which become active sooner or later; and thus life is robbed of usefulness and enjoyment. Instead of being self-maintaining and efficient co-workers with their fellows, such children find the burden of physical disability laid upon them; and they drag out a miserable existence, looking forward to a release from their physical weakness into that greater freedom of life and activity that they hope awaits them.
There is to-day a growing prejudice against medication; and, when disease invades the system, many seck through physical culture the means of restoration to health. The adoption of a hygienic dress would be one of the best preventives of disease; and often some such reform is absolutely necessary before strength can be regained.
To me the future looks hopeful, when women realize the cause of this tendency to disease, when they ask for knowledge of their own organisms, and inquire the way back to Nature. Let them but understand what they seek to know,—give them a knowledge of their own organisms, of the relation of one part to another, and a knowledge of the functions these organs are called upon to perform,—let them understand also the unvarying physical laws, and the certain retribution that follows their perversion, and thus enlightened, with their naturally quick perceptions, and their skill in adapting means to ends, they will soon render the dress of every woman and child conformable to the requirements of health.
Then, there will be harmony throughout the whole human system. Every part will be in its true relation to every other part. All the functions will go on without consciousness. Women will not know they have a nervous system merely from the complaints it makes of abuses, but they will understand its higher offices. The digestive apparatus will properly prepare the alimentary substances it receives into a nutrient fluid, to be conveyed to all parts of the system for their assimilation. The capacity of the lungs to oxygenize and decarbonize the blood will be equal to the demands made upon them, and the excreting organs will remove all waste and worn-out material from the body. No protest from any part of the system will be transmitted through the nerves of sensation to the seat of consciousness, the brain. There will be harmony, also, in the mental condition. The mind will be clear, all the faculties active, and every part amenable to the will will be quick to do its bidding. The spiritual, when not borne down by the physical, rises to loftier heights; and there is harmony throughout the whole being, in a threefold sense.
Let every woman feel the importance of these things, and let her appreciate the duties and responsibilities that rest upon her. Here is a large field for missionary labor; and every one of my hearers should be the good angel that scatters seeds of truth along her daily pathway. Do not excuse yourself by saying, I have not time or opportunity; but begin here and now. Begin with your child, your friend and neighbor; and remember for your encouragement the promise that "to him that hath shall be given." The time has come for these things; and let us hope the day is not far distant when the injunction to "know thyself" will be heeded by the many, instead of the few. A better humanity must result from awakening in the minds of women a desire for knowledge on matters connected with their physical welfare. When this knowledge is at length gained, every child will receive a transmitted organism that shall enable the good and true aspirations born in his soul to find right conditions for developing and blossoming into Christian grace. His life will bear fruit in Christian work here on earth; and its continuance hereafter will be the consummation of all that has gone before.