LETTER XXI.. Sterility or Barrenness.

STERILITY OR BARRENNESS.

Their Causes—The Catamenial Discharge as affecting it—Fluor Albus—Corpulency—The Treatment appropriate in these Cases.

When a woman is not able to conceive, the defect must depend upon a malformation, a diseased state, or a diseased action of the generative organs.

Causes.—Organic barrenness happens in those cases where there is some structural hindrance or defect, either natural or accidental. The vagina may be imperforate, so as wholly to preclude the intermission of the seminal fluid; the ovaria may be either wholly wanting or too small; or the Fallopian tubes imperforate; or the uterus so small as not to be capable of its proper functions. The hymen may also be so hard and resisting as to prevent the natural measures for conception.

In most cases of barrenness, however, the organs of generation appear to be properly formed, but their action is imperfect or disordered.

If the menses have not appeared, or if the discharge is scanty, and occurs at irregular periods, the woman rarely conceives.

So also when the menstrual flux is more frequently repeated than it is in its natural course, or when it occurs even after the proper time, in too great profusion, and, as is generally the case, intermixed with genuine blood, there is little prospect of conception taking place. In such cases there often appears to be as little desire for cohabitation as there is power of fecundity.

Pregnancy seldom happens when the catamenial discharge is attended with great and spasmodic pain, particularly if the discharge is small in amount, and of deteriorated quality. If, under such circumstances, conception does take place, the next periodical flow is very apt to cause the uterus to discharge the germ, thus bringing on an early miscarriage.

The state of weakness and debility of the uterine system occasioned by too frequent sexual intercourse, is a common cause of sterility. Those unfortunate creatures who follow a life of prostitution seldom bear children.

Bad cases of fluor albus often indicate a state of the uterus and ovaries which does not admit of conception.

There is also to be mentioned, among the causes of barrenness, what has been called by medical writers copulative incongruity. “Every one,” observes Dr. Good, “must have noticed occasional instances in which a husband and wife, apparently in sound health and vigor of life, have no increase while together, either of whom, nevertheless, upon the death of the other, has become the parent of a numerous family; and both of whom, in one or two curious instances of divorce, upon a second marriage. In various instances, indeed, the latent cause of sterility, whatever it consists in, seems gradually to diminish, and the pair that was years childless is at length endowed with a progeny.”

Corpulency is also to be mentioned among the causes of barrenness. Women who are very fat are often sterile, from the fact that obesity is in reality a state of disease.

It is supposed by many that barrenness is almost always the fault of the female. But this is not necessarily so; the husband, as well as the wife, may be feeble in the procreative function; and men who have lived a debauched or dissipated life are very apt to be so. Hence it is that women are often blamed when they ought not to be.

Treatment.—In regard to the therapeutic management suitable to be adopted in such cases, it is to be remarked, that if organic disease is the cause of the difficulty, we cannot, as a general thing, expect by any means to effect a cure. But in a large majority of cases the difficulty is only a functional one; in many of these, therefore, a cure may be brought about.

The sum total of the therapeutic management proper to be adopted in such cases is, invigorating the general health. That which will best tend to fortify and strengthen the system generally is also best for the local weakness. Nor is a cure to be effected in a short period of time in most cases of sterility. It may require many months, and even years, to accomplish the object.

“Abstinence by consent for many months,” observes Dr. Good, “has proved a more frequent remedy than any other, and especially when the intercourse has been so incessantly repeated as to break down the staminal strength; and hence the separation produced by a voyage to India has often proved successful.”

Some years ago I wrote in my note-book the following paragraphs on this subject:

“A few months since, one of my patients, a gentleman of this city, informed me that a lady relative of his, with whom also I am acquainted, had been married about eight years, remaining, much to her sorrow, childless. She experienced frequent miscarriages, accompanied with much general debility. About two years since the subject of water-treatment came under her observation. She at once commenced a course of bathing, with due attention to regimen, etc. She became much improved, and, in due time, bore a healthy, well-formed child. She attributed this most desirable result to the effects of water in restoring her general health.

“Another lady remained without offspring for fifteen years after marriage. Her husband, in building a new house since the introduction of Croton water into this city, erected also convenient bathing fixtures. The lady practiced perseveringly a course of bathing, and became much improved in her bodily health. She, too, was at length blessed with an offspring, and, as she believed, in consequence of the course she had pursued in restoring her general health.

“I have known and heard of numbers of cases in which, by a prudent course of bathing, exercise, etc., the use of a plain and unstimulating diet, and the observing of proper temperance in the marital privileges, persons have borne children when most earnestly, and by a great variety of means, that object had been sought in vain. Yet be it ever remembered, that little is to be expected from either water or diet without strict temperance in all things.”

The vegetable diet, so called, is very favorable to reproduction in the human species. See how Ireland, a small island comparatively, sends its inhabitants all over Great Britain and the wide extent of the United States. Yet the mass of Irish people, as every one knows, subsist, while in their own country, mainly on potatoes and sour milk, or a diet equally simple. The celebrated Dr. Cheyne remarked, from much experience, that the total milk and seed diet (meaning by seed, farinaceous substances generally), persevered in for two years, was in almost all cases sufficient to enable the barren to become pregnant by the appropriate means.

Fortify and invigorate the general health, observing at the same time the strictest “temperance in all things.” These are the means by which to overcome that, to many, unfortunate state, barrenness.

You, then, who may be in the condition we have been considering, if you wish to be cured of it, leave none of the tonic means, none of the good rules of health untried. If you are faithful in every thing, so may you expect to succeed. But if it should be found that it is not possible for you to conceive, you will yet have the satisfaction of knowing that your toils have not been in vain; your health will become so much improved as to reward you a thousand-fold for every good thing you do.

I ought to remark also, before closing, that when a woman who has been for a time barren becomes again pregnant, she must be very careful of herself during this period, as with a little imprudence abortion is very likely to occur.