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.