Hygiene and Physiology of Women Volume X: Sex Survey

Blank No.46 Dec. 27, 1913

1-Sept. 28, 1879 6th child of father (50 yrs old) 3rd child of mother 2- Early life in city '7 yrs. 3- Height 5'4 ft 4- Wt. 104 5- Dark 6- [Nervous?] perhaps 7- Stanford 1900 A.B. 8- No occupation 9- [Neither?] 10- Fair b)much better after marriage Pneumonia 2x, Typhoid Appendicitis once before 11- 1st 12, Established at once a) 28 days, reg. b) c)abundant d)7 (4) e) backache - before [depression?] and during 1st [and?] 2nd f) leuc no h)no [uterine?] i) not [constipation?]

Blank No.46 12- No knowledge - no knowledge of [leisuring of?] [pleasuring of?] marriage.

14- 1900 Sept 1 15b- 1st [night?] 16- 2 conceptions 17- Girl - May 9,1901 - had typhoid at 2 yrs old [stronger?] new. delicate child, 5 weeks to [?] - nursed 9 months. Menstruation after stopped nursing boy) May 31, 1903. (1 month early) [?] - nursed 4 months, menstruation within a month or 1.5 months [after his birth?] 18- 1st accident 2nd choice

19- 1st yr about 2x weekly Now about 1 per week

20- Continued through pregnancy about 1 per week until 3/4 of [time was at end?]. [hers?] during [2nd?] pregnancy. yes - desire for it. 21- Desire for it at other times about 1 per week. b)after period is over even. When tired [even?] acceptable. Wants petting and this natural result

Blank No.46 18) 1st accident 2nd choice 19) 2x weekly, then 1x weekly 20) yes - yes 21) Yes. Just after, relaxed - little tired - sleep 22) Yes 23) a- Necessity? to man? No. to woman? no. [?] b- no c)reproduction: [?] d) a [phase?] of [expression?] of love and could not [survive?] of it without. a way of showing [?] d)natural, pleasurable, because you love the [other?]

24- [condoms?] always no effect on health

25- 1 per week. Very active physically (husband) Husband always [waits?] until he is satisfied, and [?] when she is [not?] tired

Blank No.47 Date: Dec. 25,1913 Series III. Form C.

1- Date of your birth? Oct 10, 1853 Early life in city or country? Born what child of your mother? 1st Of your father? 1st 2- Your weight? 124 lbs 3- Your height? 5ft 8in 5- Complexion? Fair 6- Temperament? 7- Where educated (degrees if any)? Public school Kansas City, Vassar College, no degree 8- Occupation before marriage? a)in city or country? b)time spent? Born Oct.10,1853, first child of both parents. [From?] 20th [?] 45th 8 (on the coverage) 4 [?] brown [hair?] grey [?] Public school of Kansas City, Vassar College, no clique [From?] life, life [in?] home

9- Diseases or tendencies in family? Long lived very healthy [Exception?] on [?] very long lived - disease almost [unknown?] 10- Your general health before marriage? Good. b)Since marriage? Good. Paralysis? Brain Fever? Chronic headache? Nervous Prostation? Catarrh? Hernia? Dyspepsia? Habitual Constipation? Appendicitis? Pleurisy? Pneumonia? Bronchitis? Constipation? Insomnia? Rheumatism? Jaundice? Varicose Veins? Catarrh, Pneumonia, Varicose Veins Excellent health always Catarrh in childhood after [vaccination?] by old house to house method. Varicose veins in right leg during [?] 3 pregnancies pneumonia about my 8th year

Blank No.47 Series III Form C. Have you ever had any trouble with the uterus (or womb) [or?] other pelvic organs? before marriage? Since marriage? and what was it. Congestion of [?] for some time during first 3 year after birth of 1st child. Fibroid [?] of school year growth during change of life. [Formation?] of [tumor?] preceeded by two or three years of excessive menstrual flow, with [much?] attendant [services?] Are you or were you ever habitually constipated? Seldom - never habitually so.

12- What knowledge of sexual physiology had you before marriage and where did you obtain it? [?] - can hardly remember how acquired