Part 9 (2/2)
It is obvious that in such a case as this the physician is largely diagnostician and director, the actual treatment consisting in getting a selfish and inert social system to help out one of its victims. That a sick man should be left to sink or swim, though he has previously been industrious and a good member of society, is injustice and social inefficiency. That a woman, under such circ.u.mstances, should be left with the entire burden on her hands is part of the stupidity and cruelty of society.
How avert such a thing? For one thing do away with the name ”Charity” in relief work,--and find some system by which industry will adequately care for its victims. What system will do that? I fear it may be called socialistic to suggest that some of the fifteen billions spent last year on luxuries might better be s.h.i.+fted to social amelioration. The record in automobile production would be more pleasing if it did not mean a s.h.i.+ft 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 and represents the kind of woman usually held up as most commonly afflicted with ”nervousness.” ”If she really had something to do,” say the critics, ”she would not be nervous.”
This is fundamentally true of her, though not true of the majority of women whom we have discussed. It seems difficult to believe that hard work and worry may bring the same results as idleness and dissatisfaction, but it is true that both deenergize the organism, the body and mind, and so are kindred evils. What's the matter with the poor is their poverty, while the matter with the rich is their wealth.
Mrs. A. De L. is of middle-cla.s.s people whose parents lived beyond their means and educated their only daughter to do the same. Here is one of the anomalies of life: bitterly aware of their folly, the extravagant and struggling deliberately push their children into the same road. Mrs.
De L. learned early that the chief objects of life in general were to keep up appearances and kill time; that as a means to success a woman must get a rich husband and keep beautiful. Being an intelligent girl and pretty she managed to get the rich husband,--and settled down to the rich housewife's neurosis.
Her husband was old-fas.h.i.+oned despite his rather new wealth, and they had two children,--a large modern American family. Though he allowed her to have servants he insisted that she manage their household, which she did with rebellion for a short time, and then rather quickly broke away from it by turning over the household to a housekeeper. This brought about the silent disapproval of her husband, who let her ”have her own way”, as he said, ”because it's the fas.h.i.+on nowadays.”
She became a seeker of pleasure and sensation, drifting from one type of amus.e.m.e.nt to the other in an intricately mixed cooperation and rivalry with members of her set. She followed every fad that infests staid old Boston, from the esoteric to the erotic. She became an accomplished dancer, 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 a month or two,--and became a professional at bridge. Summers she rested by chasing pleasure and flirting with male _habitues_ of fas.h.i.+onable summer resorts; part of the winter she recuperated at Palm Beach, where she vied for the leaders.h.i.+p of her set with her dearest enemy.
Her husband financed all her ventures with a disillusioned shrug of his shoulders. As she entered the thirties she became intensely dissatisfied with herself and her life, tried to get back to active supervision of her home but found herself in the way, though her children were greatly pleased and her husband sceptical. The need of excitement and change persisted; gradually an intense boredom came over her. Her interest in life was dulled and she began a mad search for some sensation that would take away the distressing self-reproach and dissatisfaction. Shortly after this she lost the power to sleep and had a host of symptoms which need not be detailed here.
The medical treatment was first to restore sleep. I may say that this is a first step of great importance, no matter how the sleeplessness originates. 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 life habits. It was pointed out that all the philosophies of life were based on simple living and work, and that all the wise men from the beginning of the written word to our own times have shown the futility of seeking pleasure. It was shown that to be a sensation seeker was to court boredom and apathy, and that these had deenergized her.
For interest in the world is the great source of energy and the great marshaler of energy. From the child bored by lack of playmates, who brightens up at the sight of a woolly little dog, to the old and vigorous man who makes the mistake of resigning from work, this function of interest can be shown.
She was advised to get a fundamental, nonegoistic purpose, one that would rally both her emotions and her intelligence into service. Finally she was told bluntly that on these steps depended her health and that from now on any breakdown would be merely a confession of failure in reasonableness 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 advice given I cannot say. From the earliest time to this, necessity has been the main spur to purpose, and probably the lure of social compet.i.tion drew the lady back to her old life. Experience, though the best teacher, seems to have the same need of repet.i.tion 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 nervous housewife the subject is essentially medical. We shall therefore not detail any case, but it is wise to reemphasize some facts.
There are bodily diseases of which the early and predominant symptoms are cla.s.sed as ”nervousness.” Hyperthyroidism, or Graves' Disease, a condition in which there is overactivity of the thyroid gland and which is particularly prevalent among young women, is one of those diseases.
In this condition excitability, irritability, emotional outbursts, fatigue, restlessness, digestive disorders, vasomotor disorders, appear before the characteristic symptoms do.
Neuro-syphilis is another such disease. This is an involvement of the nervous system by syphilis. One of the tragedies that distresses even hardened doctors is to find some fine woman who has acquired neuro-syphilis through her husband, though he himself may remain well.
In the early stages this disease not only has neurasthenic symptoms but is very responsive to treatment, and thus the early diagnosis is of great importance.
What is known as reflex nervousness arises as a result of minor local conditions, such as astigmatism and other eye conditions, trouble with the nose and throat and trouble with the organs of generation. The latter is especially important in any consideration of nervousness in the housewife, particularly in the woman who has borne children.
Frequently too the existence of hemorrhoids, resulting from constipation, acts to increase the irritability of a woman who is perhaps too modest to consult a physician regarding such trouble. Where such modesty exists (and it is found in the very women one would be apt to think were the very last to be swayed by it), then a competent woman physician should be consulted. With good women physicians and surgeons in every large community there is no reason for reluctance to be examined on the part of any woman.
Further details are not necessary. Enough has been said to emphasize the fact that the nervousness of the housewife is first a medical problem and then a social-psychological one.
Case IV. A case presenting bad hygiene as the essential factor.
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