Histories of Some Severe Cases : Part 1

The Nervous Housewife
by Abraham Myerson, M.D.

(Page 10 of 18)

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

It will be seen, upon reading these cases, that a rather pessimistic attitude is taken toward some of them. It would be nice to present a series of cases all of which recovered, and it would be easy to do that by picking the cases. Such a series would be optimistic in its trend; it would however have the small demerit of being false to life. Though the majority of women suffering from nervousness may be relieved or cured, a number cannot be essentially benefited. Some of them have temperaments utterly incompatible with matrimony, others have husbands of the incorrigible type, others have life situations to change which would make it necessary to change society. Therefore in these cases all a doctor can do is to relieve symptoms, relieve some of the distress and rest content with that.

I am essentially neither pessimist nor optimist in the presentation of these cases, nor do I seek to present the man or woman's case with prejudice. In life a realistic attitude is the best, for if we were to remove much of the sentimental self-deception at present so prevalent, huge reforms would occur almost overnight. Sentimentality decorates and disguises 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, that symptoms are suggested to a great many people. How deeply suggestible the mass of people can be is only appreciated when one sees the result of public health lectures and books. Many persons tend to develop all the symptoms they hear of, from pains and aches to mental failure. Even in the medical schools this is so, and every medical teacher is consulted each year by students who feel sure they have the diseases he has 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 a difficulty is met with in the natural reluctance to telling what often seems to the patient painful and unnecessary details. To some people it seems 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 some women understand well enough the source of their conflicts, they are ashamed to tell and rest mainly on the surface of their symptoms. To obtain 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 the physician has to a certain extent relieved the patient. In other words, except in the cases where the woman is quite prepared to tell of her intimate difficulties, it is best to go slowly from the medical to the social-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 of Massachusetts. She had several brothers and sisters, all of whom reached maturity and most of whom married.

Before marriage she was a salesgirl in a department store, worked fairly hard for rather small pay, but was strong, jolly, liked dancing and amusements, 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 he was not very well for some time following a pneumonia in the third year of their marriage. They drew upon all their savings and fell seriously in debt. This meant borrowing and scrimping for several years, - a fact which had great bearing on the wife's illness later.

They had three children, born the twelfth month, the third year, and the fourth year after marriage. After the first child the mother was very well, nursed the baby successfully, and the little family flourished. Then came the unfortunate illness of the husband, which threw him out of work for six months, during which time they lived on an allowance from his union, his savings, and finally ran into debt. This greatly grieved the man and depressed the woman, but both bore up well under it until the birth of the second child, when their circumstances forced them to move to a poorer apartment. The wife was delivered by a dispensary physician, who did his duty well but allowed the woman, who protested she felt well, to get up and care for her husband and baby much earlier than she should have done.

The nursing of this baby was more difficult. The mother's breasts did not seem to be nearly as active as in the previous case. The baby cried a great deal and needed attention a good part of the night. The husband was unable to help as he had previously done and the fatigue of the care of child and man brought a condition where the woman was tired all the time. Still she bore up well, though when the summer came she greatly missed the little two weeks' vacation that she and her husband had yearly taken together from the days of their courtship.

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

Boston
Little, Brown, And Company
1920