# Some Remarks on Corsets

Published in Littell's Living Age
SOME REMARKS ON CORSETS.
By W. E. FOTHERGILL, M.A., B.Sc., M.D.,
Assistant Physician to the Northern Hospital for Women and Children, Manchester; Lecturer in Obstetrics, Owens College.
The Medical Press and Circular for June 24th, 1903, contains a most interesting article entitled "Some Remarks On Chlorosis," by Dr. William Williams. The author asks why chlorosis is a disease of young females; why the general condition as regards flesh is not materially affected as well as that of the blood; and why they recover so quickly on the adoption of loose clothing, low diet, and mild purgatives ? His answer begins as follows :—
"Taking the above questions in the order they come, the only answer forthcoming to the first is, that women are clothed differently to men, and that young women or girls, not having become as yet accustomed to tight lacing, continue to suffer until their shapes are permanently altered, and the abdominal organs have become acclimatised to the change of locality. Most girls fill out rapidly on the advent of puberty, and such subjects would suffer most from a corset fixed in size, to say nothing of the fact that stoutishly inclined young women would be just the ones to entertain ​most anxiety about the size of their waists, and to take most pains with them. As to the general condition in regard to flesh being unaffected, or not so much so, and the rapidity with which recovery takes place, the explanation, I think, must be that the altered state of the blood cannot have been of very long duration."
I have read the above with peculiar pleasure, because I believe Dr. Williams to be perfectly right. Some time ago my own observations led me to write in a similar sense. Thus I find, on page 491 of my "Manual of Midwifery": "Many cases of toxæmia can be directly traced to the use of the corset. The injury to the liver is often caused by tight lacing before pregnancy."
… Some forms of anæmia are closely related to hepatic toxæmia. They resist all treatment until the liver is relieved from pressure by loosening the corset, when the addition of calomel to the ordinary treatment is quickly followed by success. Anæmia of this kind is a frequent forerunner of toxæmic troubles during pregnancy."
I have by me some manuscript on a cognate subject hitherto unpublished, part of which I may offer in support of the conclusion briefly ex­pressed by myself in the above lines, and worked out by Dr. Williams in his recent paper. My notes are as follows:—
"Innumerable women doubtless alter the out­ward conformation of their bodies, and also the shape size and arrangement of their livers and other viscera, without causing any derangement of health which Can be directly traced to tight lacing. In any variation from health, however, the habit goes against the patient, aggravates alimentary, respiratory and circulatory disturbances, and often prevents complete restora­tion. In short, the fashion weakens the strong;, and may cause positive disease in the weak. Take, for example, this common form of anæmia known as chlorosis. As to sex, this condition is practi­cally confined to females. As to age, it is commonest in the decade following puberty, It occurs mainly in young women and girls who live by bodily work, and accordingly have, as a rule, good muscular development. Again, chlorotic women are well nourished in general. They belong to a class which feeds well, though not always judiciously, and if starved it is not by want of food, but by inability to digest it—by the dyspepsia which is secondary to the anæmia. The condition is not hereditary. What is the prime factor in its causation? I have made a habit of measuring the waists of anæmic patients, who appear very often as out-patients at hospitals for women. Two measurements are taken; one over the corset, one after it has been removed, The result of prolonged observation shows that the waists of young women of the working classes measure on an average three inches more without the corset than with it. The patients are never conscious of any compression, and firmly believe that their clothes are loose. If, however, they are kept in bed two or three weeks, the waist measurement increases, and the pressure of the corset is plainly felt for a few days after ordinary clothing is resumed. I believe the sequence of events to be as follows:— The 'grown-up' corset is adopted at the age of puberty. when the girl is thin and undeveloped. During the years that follow the chest and the pelvis enlarge, but ​the waist is not allowed to increase proportionately. Many a big young woman will state with pride that her waist measurement has not increased since she was a girl. It has not had the oppor­tunity of doing so! Now, the working classes tend, by breeding and occupation, to be more thickset than the middle and upper classes. Their daily labour tends to develop the chest and cover it with muscle. Their waists should be larger in proportion; but the working girl thinks even more of a slim waist than does her more highly educated sister. When it is further considered that in matters of food, attention to the action of the bowels, fresh air, and bathing, the more intelligent portion of the population is more careful than the lower, the occurrence of chlorosis as a disease of the working classes is very largely explained. Compression of the liver, stomach and intestines causes constipation and dyspepsia; these are in­creased by indoor life in house or workshop, and a state of toxæmia is set up by the retention of morbid products, which in turn causes a condition of anæmia or chlorosis. Many of the cases will not yield to the administration of iron, even if the liver be attacked with calomel and the bone marrow stimulated with arsenic at the same time. A fortnight in bed works wonders in these cases, probably because putting the patient to bed is the only way in which she can be made to take off her corsets. It is these patients who, when they marry and become pregnant, suffer more than others from the series of troubles which depend primarily on inefficient action of the liver and intestines, and which are now frequently grouped together under the name "hepatic toxæmia." During pregnancy, indeed, the corset is seen at its worst. By pre­serving "a waist" as long as possible in gestation many women keep down the growing uterus, thereby distending and weakening the muscles of the lower abdominal wall, and altering the rela­tions of the contained viscera. In this way the recti become permanently separated, and all chance of regaining the figure after parturition is lost. Again, the use of the corset during the later weeks of the puerperium, when the uterus is still large and more movable than usual, is a fertile cause of prolapse and retroversion with pelvic gestation."
The above quotation may convey the idea that I was at the time of writing opposed to the use of corsets in general. This was by no means the case, and as a good deal of nonsense on the subject still appears from time to time in the daily papers, and even in the medical journals, I need offer no apology for summarising the facts of the case before concluding these remarks.
A great many dress reformers have written against the use of the corset, holding that any use of this article is abuse, and that it should be dis­carded altogether. Their arguments have convinced but few, and their example has not been followed even by these. For they have not gone to the root of the matter, and have not realised that In the modern dress of woman the corset is an essential factor. From the point of view of dress, the human body consists of three portions. There is an upper part with bony walls—the chest; a lower part with bony walls—the pelvis; and a middle part with soft anterior and lateral walls between the two. Consider the dress of a labouring man! He wears a coat and waist­coat which he removes when at work. His trousers are supported by a belt so as to leave his ​shoulders free from weight. Where is the belt fastened? It does not encircle the waist or soft-­walled middle portion of the body below the ribs and above the iliac crests. If worn there tight enough to support the heavy trousers it would press uncomfortably on the abdominal viscera. It is therefore worn over the bony pelvis, whose walls protect from its pressure the organs within. The navvy's leather belt is worn low, passing below the anterior superior iliac spines on either side, much in the position of a hernia truss. In this position a belt passes over hardly any muscle, and impedes no movement, nor does it compress any internal organs. The same region is chosen for the support of the skirts or trousers worn by women in many Oriental countries. Thus the Moorish dancer wears a short jacket covering the shoulders and chest, and a divided skirt whose band rests on the hips below the iliac crests, the middle soft part of the body between thorax and pelvis being left uncovered or protected by a soft garment which exercises no pressure on the waist. Thus the Oriental woman and the western labour­ing man support their lower garments in the same way, namely, on the hip bones. The ordinary civilised man who does not work hard transmits the weight of his lower garments by braces to his shoulders. But what is the course adopted by the civilised woman? She wears heavy skirts whose weight is supported by bands round her waist—that soft portion of the body which is pro­tected by no bony walls. How is it possible to wear round this portion of the body bands which support the weight of numerous and often heavy garments? The answer is, By means of the corset. This garment forms a bridge connecting the firm chest wall with the firm pelvis—an artificial completion of the bony wall which Nature has left incomplete in the middle portion of the body. The use of the corset is to transmit the pressure of the skirt-bands to the hips and the ribs, and so to protect from their pressure the organs in the region of the waist. The conclusion is that so long as skirt-bands are fastened round the waist, corsets should be worn. They should be stiffer than usually made if they are effectively to protect the soft middle portion of the body from the pressure of the waist-band. The front should be quite straight, and the waist measurement should be at least as large as the wearer's waist measured over a single soft garment. During pregnancy this measurement should be gradually increased as the uterus grows and rises. It is clear that so long as women hang their skirts round their waists they must have corsets to protect their waists from their skirts. This is the use of the article; its abuse consists in employing it as a means of compressing that which it was meant to protect from compression, namely, the soft middle portion of the body. That this misuse or abuse of the garment is still very common no one will deny.
It must be allowed, however, that fashion in corsets has of late made a move in the right direction, which, it is to be hoped, will be per­manent. The modern article with straight, stiff front is certainly much better than its predecessor which had a pronounced curve in the midriff, and lessened the waist by pushing out the ab­domen.
Dr. J. C. Martin, F.R.S., Professor of Physiology in the University of Melbourne, has been appointed Director of the Jenner Institute of Preventive Medicine.