Sex efficiency through exercises : special physical culture for women / by Th. H. van de Velde ; [photos, by E. Steinemann].

are strengthening to the muscles—which should have already- returned to their original state—but cannot restore the elasticity of a muscle which pregnancy and birth have stretched and neglect after birth has stiffened so that it is rigid. And a muscle which has remained stretched length- ways may be vigorously contracted but lacks the proper support from the adjacent connective tissues in repose (H. Kilstner, see Bibliography, No. 38). Of course, even the early phase of actual childbed has its changes, as the patient herself can clearly perceive. From day to day, she can trace the marvellous process of gradual but relatively rapid recovery after her ordeal, and of re- adjustment in the abdominal organs. She will appreciate a care which does not overtax her physical powers in that fortnight, and the exercises should increase and develop in sequence, just as do the changes in her body. The chief maxim to observe is that the woman must never feel overstrained after her ration of exercises. If she feels any overstrain, she has done too much. But it is quite possible to regulate and avoid this, as I have pointed out, by adopting the Swedish methods and grading movements by intercalating semi- active and semi-passive exercises, between complete passivity and vigorous movements against resistance. Thus, such a register of possible combinations is provided that no young mother, however muscularly feeble and inexpert, need be overtired, or, on the other hand, deprived of the full benefit of puerperal physical culture. I am of opinion that these special exercises in the fort- night after child-birth cannot be adequately replaced by simply letting the patient get up and return to ordinary routine. During the reaction against earlier errors and the mistaken view that a woman who had given birth to a child should be kept in bed and entirely inactive for a week at least and sometimes longer, there was a repudiation of this ultra-quiescent method, which took the form of urging the women to " get up as soon as possible." In certain clinics, there were even cases of physicians who " got them out of bed on the first day " ! But most specialists contented themselves with the second day or the third. Only a