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 then had her own breakfast, which usually consisted of toast and coffee.  At noon she had a very small piece of meat or an egg and a few potatoes with tea.  At night she ate sparingly of the dinner, which usually was meat, potatoes, another vegetable, and a dessert.  Her husband here stated that she ate at this meal less than the boy of four and a half.

Comparing her buxom figure with the diet a discrepancy was at once apparent.  She then confessed with shame that she was a constant nibbler, eating a bit of this or that every half hour or so, and consequently never had an appetite.  The food thus nibbled usually was either spicy or sweet, and she consumed quite a bit of candy.  Her bowels moved infrequently and she always needed laxatives.  In her spare time she felt rather “logy”, rarely went out, except now and then at night with her husband, and spent her leisure hours on the couch reading or nibbling.