ess 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.

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 marital
state it includes the sexual indulgence.

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

Questioned as to her habits, Mrs. F. said she did all her own housework
except the washing and ironing and scrubbing. She had a little girl
three times a week to take the baby out. Before marriage she had been a
stenographer, but never earned high pay and had no love for her work. In
fact she gave it up with relief and found housework with its
disagreeable features much more to her taste than business. She had been
of a placid, pleasant temperament and could not understand the change in
her.

Since all this did not explain her symptoms, closer inquiry was made
into her habits. She arose with her husband at seven-thirty, prepared
his breakfast, sent the oldest child off to kindergarten and th