PREGNANCY, PARTURITION, AND LACTATION 445 



The skin, especially in brunettes, has a marked tendency to show an 

 increased deposit of pigment in its lower epidermal layers. The areola 

 of the breasts, the abdomen, and the vulva are the chief areas concerned. 

 About the navel there may be deposited a ring of sigment, and a line of 

 similar nature two or three centimeters wide tends to connect the mons 

 and the sternal cartilages. Truzzis supposes these pigmentations to be 

 the result of trophic changes set going reflexly from the genital apparatus. 

 White lines, more or less circular in form, coming from the mechanical 

 stretching of the skin, tend to appear on the abdomen. As in menstru- 

 ation, skin-eruptions tend to be more common during pregnancy. The 

 growth of hair is accelerated or stimulated, as is also the production of 

 the dermal secretions (sebum and sweat). 



The thyroid is well known to swell during pregnancy (as after coitus), 

 resuming its usual size after labor. The exact reason for this hyper- 

 trophy has so far not been learned. In some important way the gland 

 is probably closely related to the genital functions generally. 



MENTAL CHANGES. During pregnancy a number of psychical altera- 

 tions occur, and as we do not know fully the physical basis of mind, they 

 must be mentioned in a class by themselves. They are of no little 

 practical importance to the mother, but it is not apparent (despite cen- 

 turies of superstition to the contrary) that they exert any influence on 

 the offspring within her. 



With the increased tendency to insanity during pregnancy we are not 

 concerned. This is the natural result of the additional strain placed by 

 pregnancy on a nervous system already burdened with a more or less 

 neurotic taint. These effects (melancholia or mania for the most part) 

 are more common in unmarried women, the mental stress being then 

 sometimes unduly great. 



The psychical changes in normal women while pregnant are to be seen 

 largely in the affective, or emotional, aspect of mind. Sometimes the 

 whole disposition is changed, many a husband finding his wife happier 

 and more ompanionable while pregnant than at any other times. But 

 the opposite change may occur and women usually good-natured 

 become peevish, irritable, and unhappy. To some extent the causes 

 of these changes lie in the woman's mental attitude toward children, 

 toward pain, and perhaps even toward their personal safety. Those who 

 look forward with normal delight to the possession of the promised 

 child will in general be happy while pregnant, the whole organism being 

 dominated by the child-forming process. To many even strongly 

 feminine women, however, the dread of the unknown experience of 

 labor, with its usual pain and usually much exaggerated danger, directs 

 the feelings throughout all of pregnancy, and makes the more or less 

 obvious bodily inconveniences worse to bear. These mental changes 

 are none the less important because not exactly definable, and form no 

 inconsiderable part of the phenomena of pregnancy in the average 

 civilized woman. As regards the declining birth-rate in many regions, 

 these degenerative mental attitudes of women are more important 



