The Corset : Questions of 
Pressure and Displace- 
ment. 
BY 
ROBERT L. DICKINSON, M. D., 
BROOKLYN", 
LECTURER ON OBSTETRICS, LONG ISLAND COLLEGE 
HOSPITAL. 
REPRINTED FROM 
®je Neto Yorfc fHetncaI journal 
for November 5, 1887. Reprinted from the New York Medical Journal 
for November 5, 1887. 
THE CORSET: 
QUESTIONS OF PRESSURE AND DISPLACEMENT.* 
By ROBERT L. DICKINSON, M.D., Brooklyn, 
LECTURER ON OBSTETRICS, LONG ISLAND COLLEGE HOSPITAL. 
Ridicule, argument, and invective have been freely ex- 
pended upon the artificial small waist since the days of 
Martial and Galen. Yet the habit of corset-wearing has 
received little systematic study, and men's opinions are 
widely at variance. We frequently meet with the state- 
ment that corset-wearing works great injury ; we discover 
a catalogue of five-and-ninety different diseases and dis- 
orders due to tight lacing; we find Bouvier, who has written 
the elaborate and interesting history of this article of dress, 
vigorously asserting that "the modern corset, moderately 
tightened, is without appreciable influence on the health of 
the healthy woman"-and we encounter all shades of opin 
ion between these extremes. Bat unsupported assertion is 
poor evidence, although a general impression must carry 
some weight. To obtain clear perceptions of the action of 
the corset, I have endeavored to measure the amount of 
pressure it exerts, to ascertain the distribution of the press- 
ure, and to determine the displacements resulting there- 
* Read before the Brooklyn Pathological Society, April 28, 1887. 2 
THE CORSET: 
from, studying the subject with as little bias as possible, 
stating bald facts, and rarely expressing opinions. 
First a few words as to past usages. In the day of the 
primitive man, writes Bouvier, as soon as men were suffi- 
ciently elevated above the beast to admire the forms of 
women, women .began to shape themselves to an ideal. 
Homer's Juno wore a many-layered girdle. The Greek 
women raised up hanging breasts and bandaged in promi- 
nent abdomens. The fascia and strophinum of the Roman 
lady, that the later poets tell of, were accused of deforming 
a chest, or crowding in an abdomen, or bringing about a 
curvature as effectually as any tight lacing of our day. 
These were the bandages, numerous and variously stiffened, 
that Galen inveighed against. In the dark ages the accom- 
plishment vanished from western Europe, not to reappear 
until the sixteenth century. Then came the day of the per- 
fect flower of small waists, as they have not been known 
before or since. The old portraits excite our wonder with 
good cause. The "corps" or corset of Catherine de Medici 
and Elizabeth was a " terrible engine," a case or sheath 
of nearly solid metal, rigid and unyielding. " To make 
their forms thin as a Spaniard's," cried Montaigne, " what 
hell will not women suffer, strained and lashed (quindees et 
cenglees) to the very quick ? " Deep excoriations resulted 
from this pressure, and sometimes, he says, death ensued, 
even as Ambroise Pare also testified, citing his sectio ca- 
daveris on a patient who died from such cause, in whom 
the lower ribs rode over one another (chevauxgaienf). Be- 
fore the year 1600, iron, ivory, and wooden busks* are 
credited with many abortions and much pulmonary haemor- 
rhage. 
* The " busk " is the front plate of the corset, which may be broad 
and of one solid piece, or divided and furnished with buttons as in the 
modern model. QUESTIONS OF PRESSURE AND DISPLACEMENT. 
3 
Men wore corsets for a time. The next step was to 
begin at the cradle. In order to produce men and women 
of beautiful proportions and new forms one could not com- 
mence too early, and " any mother would have laid herself 
open to the charge of gross indifference to her children's 
welfare who neglected these early cares, reputed indis- 
pensable to any regular formation of body." 
The French Revolution swept away the iron and bone cui- 
rass and brought in its stead the comparatively pliable and 
yielding corset of our time. I find in the journals and cur- 
rent stories evidence that in the early part of this century 
tight lacing was far more prevalent than to-day. Women 
occasionally died in the harness. Goodman, of Boston, 
writing in 1829, speaks of a not unusual practice of wearing 
the corset at night, tightening it when lying down, and 
again in the morning on rising. He found servants wear- 
ing such busks as to prevent sufficient stooping or crouch- 
ing to put the kettle on, or place it on any lower level than 
a bench. 
Observations on Corset Pressure.-The first test applied 
was to determine the external pressure by the manometer.* 
The bent U-tube carries between its arms a sliding scale, 
graduated in both directions. All the tubing is practically 
inelastic. That near the bag and the bag itself are re en- 
forced with cloth so that it is entirely inelastic. The T- 
branch running downward permits the bag to be filled or 
emptied without disturbing the mercury. The whole ap- 
paratus is filled with water to the perfect exclusion of air; 
the mercury is poured in so as to displace the water, and 
the water in the long limb adjusted above the mercury to 
the same level as that in the horizontal bend opposite. 
The bag must contain just sufficient water to bring its sides 
* This apparatus is modified from those of Croom and Schatz. 4 
THE CORSET: 
parallel and about one fourth of an inch apart, so that 
we get four square inches of contact when it is held be- 
tween two plane sur- 
faces. When the bag is 
on the same level as the 
fluid in the tubes, the 
mercury columns exact- 
ly balance; the zero 
point of the scale is then 
adjusted to the top of 
the mercury ; the bag is 
slipped beneath the cor- 
set, the instrument is so 
held that the bag and 
tops of the water col- 
umns are on the same 
level, the corset is closed, 
and the readings are 
made. Care is taken, 
before every observation, 
to make sure that the 
levels are right, since a 
slight lowering of the 
manometer sends up the 
mercury column appreci- 
ably. Two inches of mercury displaced-i. e., an inch on 
each side-will signify a pound of pressure to the four 
square inches of bag surface. To obtain the number of 
pounds pressure on one square inch of surface, the reading 
is divided by eight. The division tends to minimize any 
error. 
Before recording these figures we may glance at other 
pressures in the body. I prefer to give the figures in 
pounds to the square inch, inasmuch as confusion arises 
Fig. 1.-A manometer for testing the press- 
ure. The hag, E, is slipped under the 
corset. QUESTIONS OF PRESSURE AND DISPLACEMENT. 
5 
from one observer speaking of an inch of mercury displace- 
ment when he refers to one column only, which would be 
named by another two inches displacement. If I speak of 
the mercury column I refer to the difference between the 
two levels. 
TABLE OF VARIOUS PRESSURES IN THE BODY 
AS COMPARED WITH CORSET PRESSURE. 
Pounds pr'ss- 
ure to 
square inch, 
in decimals. 
In 
eighths 
of a 
pound. 
Blood-pressure, according to Foster, about 
During labor pains, uterine force (Schatz) 
3-5 
29 
1-6 to 5 
" " " pressure in bladder, average 
(Croom) 
1-88 
15 
" " " pressure in bladder, maximum. 
Pressure in rectum in making straining efforts 
(Schatz) 
3'2 
25 
3 
24 
Expiratory force of lungs in man (Hutchinson) ... 
2-50 to 3 
16 
Inspiratory or suction force (Hutchinson) 
2 
12 
Pneumatic cabinet, increase of pressure bearable 
by patient 
■5 
4 
" " decrease of pressure bearable 
by patient (Westbrook).... 
•5 
4 
Corset.-1st, Tight Lacing. 
The maximum pressure recorded was over the car- 
tilages of the sixth and seventh ribs after a deep 
inspiration 
1-625 
13 
Average pressure over sixth and seventh cartilages 
after full inspiration 
1-25 
10 
Quiescent condition, over these cartilages 
" " mid-axillary line over sixth 
and seventh ribs 
•625 
5 
•5 
4 
" " epigastrium 
•25 
2 
" " navel 
•125 
1 
2d, Loose Corsets: 0'4 less than the preceding. 
The words "tight" and "loose" as applied to corsets 
need to be defined. They lack precision, but are neces- 
sary. We can not determine any limit of contraction in 
inches as the dividing line, since in cases cited farther on 
1^ inch lessening of waist measure with one woman will 
cause more pressure and more distress than 5 inches in an- 6 
THE CORSET: 
other. The guide must be the patient's sensations-when 
we can trust her testimony-and signs that are readily ap- 
preciated, such as the restricted respiration and movement, 
evident discomfort when the corset is first hooked, flushing 
of the face in a warm room, and the indentations in the 
skin after removal of the corset. 
Appearance goes for nothing; a large bust and wide 
hips or shoulders give an impression of slenderness in the 
waist which may be entirely deceitful. 
The total pressure exerted by a given corset is obtained 
as follows: The areas of like pressures are chalked out on 
the corset by shifting the bag about under the corset, and 
testing at every move with' the manometer. Knowing the 
number of square inches in an area and the number of 
pounds of pressure to the square inch, the pressure exerted 
on that area is found; adding the pressures in the various 
areas together gives us a total. This is by no means abso- 
lutely accurate, but furnishes a tangible figure. This esti- 
mate errs on the side of too low pressure by entirely leaving 
out of account the pressure below the crest of the ilium 
laterally and posteriorly. 
I give two illustrative cases : 
X. Y., habit of tight lacing; four children ; lax abdominal 
wall; corset rather short. Circumference at waist without 
corset, 29 inches; circumference at waist over corset, 23£ 
inches; difference, 5| inches. The total pressure of her corset 
is 65 pounds. 
A. Z., vigorous, well built; one child eight years ago ; has a 
strong abdominal wall; do not think she has worn tight corsets 
in some years, as she states; corset long. Waist measure with- 
out corsets, 27 inches; waist measure over loose corsets, 27 
inches; no difference. Pressure, 40 pounds. 
Same patient, waist measure without corsets, 27 inches; 
waist measure over fairly tight corsets, 25| inches; difference, 
inch. Pressure, 73| pounds. QUESTIONS OF PRESSURE AND DISPLACEMENT. 
7 
The patient X. Y. had a flabby abdominal wall from frequent 
pregnancies and constant corset pressure. The patient A. Z. 
has a muscular abdominal wall; she says she works at home 
without corsets. These facts explain the seeming discrepancy 
that in the first case, with 5| inches of constriction, the pressure 
is 65 pounds, while in the second, with 1| inch, it is pounds. 
In one the parts readily yield; in the other firm resistance is 
encountered. 
The least pressure I have estimated from a corset is 21 
pounds; the greatest pressure I have found is 88 pounds. 
A notable point in the use of the manometer is the 
distinct fall of the mercury during the first twenty seconds 
after the primary rise that occurs when the corset is hooked. 
This fall is followed by a slight rise or reaction before the 
mercury steadies itself. The main fall averages one inch 
(one eighth of a pound to the square inch), and must be due 
to the displacement of organs and the expulsion of blood 
from the liver and abdomen and of air from the lungs. 
Within the half minute that follows any exertion, such 
as rising, lying down, turning over, or straining, the mer- 
cury rises from £ to 1| inch, then gradually falls to its 
steady level. The reasons for these facts we may best 
study farther on in connection with the two cavities and 
their contained viscera. 
On taking off a corset, one often observes that if the 
circumference of the waist is taken at once, and again a 
few minutes later, an increase of about an inch will have 
occurred. 
Waist Measure.-Six inches difference between the cir- 
cumference of the waist over the corset and the waist with 
the corset removed is the greatest difference I have meas- 
ured. Five and a half and five I have met with once each. 
The least difference is in those cases where the measurement 
with and without is the same. 8 
THE CORSET: 
The average contraction of the 52 cases given in the 
table is 2^ inches. The maximum there is 4| inches, the 
minimum 1 inch. 
Fig. 2.-The heavy outline is the tracing of the corseted woman; the light, 
the same without corsets. QUESTIONS OF PRESSURE AND DISPLACEMENT. 
9 
In the woman who wears no corsets the many layers of 
bands about the waist on which heavy skirts drag are suffi- 
cient to cause considerable constriction, as Dr. Mosher states. 
Fig. 3.-The heavy outline is the tracing of the corseted woman; the light, the 
same without corsets. 
We have seen that the amount of contraction at the 
waist bears no constant proportion to the amount of press- 
ure exerted by a corset; we shall see that it bears no con- 10 
THE CORSET: 
stant proportion to the diminution of vital capacity, except 
ing a very general one. The shape of the corset and the 
strength of its bones are other factors we must know, and 
the habit of the individual, the resisting or yielding nature 
of the abdominal walls, and the readiness with which organs 
are displaced, bear largely on the problem. 
Effects of Pressure on the Thorax and Abdomen.-The 
" statical and dynamic mechanism of the thoracic and ab- 
dominal cavities" differ widely, as Walshe remarks. The 
chest may be said to be filled with air, the belly with 
water. Schatz connected a glass tube filled with water 
with the water-filled lower bowel, and found that the fluid 
in the tube was always on a level with the highest part of 
the abdominal cavity,* whether the patient stood, sat, or 
lay down, and whether much or little water was injected. 
The thoracic organs may readily accommodate themselves 
to a pressure that simply squeezes out some residual air; 
the abdominal viscera must be displaced. Accommodation 
can only be favored by expulsion of blood from the cavity 
and reabsorption of the gases distending the intestine. Let 
us first consider the cavity of the chest. 
Effect on the Chest-Alteration in Shape.-My sketches 
of the changes in contour of the thorax and abdomen were 
made by accurately ascertaining the normal and the corset 
outline in the same subject by blackboard tracings or shad- 
ows thrown on manilla paper. These seemingly exaggerat- 
ed proportions have been verified by caliper measurements, 
and I have been careful to undervalue rather than to over- 
state my fact. The organs were filled in from the frozen 
sections of Braun, Ruedinger, and Hart, from the valuable 
atlas and illustrated writings of Sibson, and from Frerichs. 
The thoracic cavity suffers less diminution in size and 
alteration in shape from corset-wearing than the abdominal. 
* With certain allowances easily explained. QUESTIONS OF PRESSURE AND DISPLACEMENT. 
11 
The principal constricting effect is exerted below the fifth 
rib. In the mid-axillary line the lung does not descend 
below the sixth rib in tranquil breathing. Below this 
level the " chest-wall " practically is the cover for the ab- 
dominal viscera, and it is on these that the corsets bear. 
" The transverse diameter of the chest from the seventh 
rib to seventh rib, instead of being greater than that from 
fifth to fifth, as it is in males, is in females considerably less. 
The difference is greater or less according as the stays are 
worn more or less tight" (Sibson). Below the seventh rib 
the transverse diameter of the bony cage normally dwin- 
Figs. 4 and 5.-The shape of the cavity when the corsets are tight; the same 
without corsets. 
dies (Sappey), and from eleventh to eleventh is from one 
to one inch and a half less than the transverse diameter at 
the seventh or eighth. Bouvier measured one hundred 
and fifty subjects of both sexes and all ages, and found 12 
THE CORSET: 
this relation constant. The corset increases this differ- 
ence, and starts the downward taper at the fifth rib instead 
of at the seventh. Narrowing of the triangle between the 
cartilages of the lower ribs to a groove of the width of a 
finger is the extreme that Engel has sometimes seen. The 
Fig. 6.-The displacement of viscera (tracings). Fig. 7. The normal position 
of the organs (tracings). 
inferior edge of the lung is therefore compressed, and its 
ability to distend the lower part of the pleural cavity seri- 
ously crippled. Compensation in part is effected by the QUESTIONS OF PRESSURE AND DISPLACEMENT. 
13 
tendency of the corset when firmly adjusted to raise the 
shoulders-which I find quite constant-forcing the upper 
lobes to do the breathing, as Sibson has proved, raising the 
thoracic, or five upper ribs, widening the interspaces (also 
a constant condition in the female), and in this way expand- 
ing the highest part of the conical thoracic cavity. This 
broadening above and constriction below are shown in Figs. 
2, 4, 5, 6, and 7. Freer play of the apices in women who 
wear corsets would lead one to expect consolidation at these 
points to be relatively less frequent than in men, while affec- 
tions at the base should be more commonly met with. An 
increased tendency to emphysema of the upper lobes might 
also be anticipated. 
One other change may be noted in some frozen sections, 
and is occasionally observed in examination of the chest- 
namely, a more marked inward curve in the lower part of 
the sternum than is usually found in men, whereby the an- 
tero-posterior diameter of the lower part of the chest is 
somewhat diminished. 
The Thoracic Breathing of Women.-May the peculiar 
character of the respiration in women be attributed to the 
use of corsets ? Two observers who are especially qualified 
to testify have stated the case so forcibly that I quote them 
entire. Sibson has made by far the most extended of all 
the studies of the mechanism of respiration. His painstak- 
ing accuracy is Teutonic. Walshe's opinion carries great 
weight. Sibson says: 
" In the adult female the form of the chest and abdomen 
and the respiratory movements are often undoubtedly modi- 
fied by tight lacing. 
" The form of the chest and the respiratory movements 
do not differ perceptibly in girls and boys below the age of 
ten. Although the form of the chest remains nearly the 
same until the age of twelve, the abdominal movement is 14 
THE CORSET: 
then somewhat less and the thoracic somewhat greater in 
girls than boys. At this age and earlier stays are worn, 
and though they do not compress the body materially, yet 
they restrain the free 'expansion of the lower ribs during 
free exercise. After the age of fourteen the form of the 
chest and the respiratory movements differ materially in 
females and males. 
" When stays are on there is a great exaggeration in the 
thoracic movement, the second ribs moving forward from 
0'06 to 0'2 inch, while, when the stays are off, they only 
move forward from 0'03 to 0'1 (that is, one half as far). On 
the other hand, the movements of the lower ribs are much 
more restrained when the stays are on-the abdominal move- 
ment then being 0'06 to 0'11 inch, whereas when they are 
off it is 0'08 to 0'2 inch. The difference at the waist 
when measured with the tape is very striking, the increased 
measure during extreme inspiration being 0'05 to 0'3 of an 
inch when they are on, and from 0'6 to 1'5 when off (from 
two to thirty times as much). I have found the circumfer- 
ence at the waist from one to two inches less when stays 
were worn than when they were taken off. . . . 
" I think it probable that in females, even if they wore 
no stays, the thoracic respiration would be relatively greater 
and the diaphragmatic less than in man ; but this is only 
surmise." 
Delicate men, he says further, approximate to the female 
thoracic breathing, vigorous women to the male abdominal 
breathing, and long-distance runners have the least thoracic 
breathing of all men (in the quiescent condition). 
The diaphragm would seem, therefore, to be a muscle 
capable of developing to meet increased demands as much 
as any other that the athlete strengthens. 
Walshe objects to the supposition that the sexual differ- 
ence is "preordained to meet the difficulties of pregnancy," QUESTIONS OF PRESSURE AND DISPLACEMENT. 
15 
as Boerhaave maintains, and asks whether ascitic females es- 
cape dyspnma. " If we were forced," he says, " to the ad- 
mission that the activity of infra-clavicular respiration-move- 
ment in the female is in the main designed by nature "- 
for which no cause can be detected-" and independent of 
extraneous influence, still I can not help thinking that the 
great excess of that movement and the limitation of thoracic 
play to the upper thorax in the civilized adult female are 
due in no small part to the unyielding cases interfering with 
inferior costal and phrenic action. The agricultural woman, 
who knows not stays, breathes more like a man than the 
town female. Besides, during sleep the conditions of pec- 
toral and ventral action of the female are much less strik- 
ingly different from those in the male than in the waking 
state ; the waist is relieved for a time from constriction. 
And, further, the male and female dog breathe almost exact- 
ly alike, as do the horse and mare; the action is abdominal 
and lower costal." 
Dr. Mays, of Philadelphia, has recently studied the res- 
piratory movements of Indian girls in the Lincoln Institu- 
tion. They had always worn loose clothing. They ranged 
between ten and twenty years of age. Tracings from their 
costal and abdominal respiratory movements showed a very 
close analogy to those of the civilized male, and that, " so 
far as the Indian is concerned, the abdominal is the original 
type of respiration in both male and female, and that the 
costal type in the civilized female is developed through the 
constricting influence of dress around the abdomen. This 
is markedly shown in the greater prominence of the costal 
movements in those girls who were either one half or three 
fourths white, and who were hence dominated to a greater 
or less extent by the influence of civilized blood. ... It 
is also evident that the costal type of respiration in the civ- 
ilized female is not due to the influence of gestation." 16 
THE CORSET: 
" The expansion of the lower ribs," says Sibson, " is 
much more impeded than the descent of the diaphragm." 
By measurements to be detailed farther on, I find that, 
comparing full inspiration and complete expiration, the 
pelvic floor has a range of respiratory movement about one 
fourth less when the corsets are fairly tight than when they 
are off, whereas the lower ribs are so firmly incased as 
scarcely to expand at all. An old, broken, or very loose 
corset allows some inferior costal play; but, since this is 
the location of the ring of most marked constriction, even 
these cripple it considerably. 
In what degree the total expansion is limited by this ar- 
ticle of dress I have attempted to work out by studying the 
vital capacity * with and without corsets. To compare the 
expansion as measured ordinarily in men by passing a tape- 
measure about the chest is scarcely accurate when applied 
to women; since the soft parts vary in thickness, the mammae 
being pushed upward by the corset and hanging down 
without it. The spirometer test is not open to any serious 
objection. I am greatly indebted to Dr. L. M. Hall for the 
labor involved in working out for me the following table : 
Table showing the Effect of Corsets on Expansion in Fifty-two Women. 
Age. 
WAIST. 
Diff'r- 
ence. 
VITAL CAPACITY. 
Diff'r- 
ence. 
With. 
Without. 
With. 
Without. 
Totals 
Averages 
Extremes 
1,100 
21-15 
13 
35 
l,245i 
23'95 
21 
29 
1,3784 
26-52 
23| 
30| 
133| 
2'57 
1 
6,944 
133-54 
80 
220 
8,487 
163'21 
100 
260 
1,543 
29-67 
5 
75 
* Hutchinson employed " vital capacity " to indicate the total num- 
ber of cubic inches of air a man could expel from his lungs after the 
deepest inspiration. QUESTIONS OF PRESSURE AND DISPLACEMENT.. 
17 
The average age is twenty-one. The average waist with 
the corset off measures 26| inches. The average measure- 
ment over the corset is 24 inches, or 2£ inches less. The 
average vital capacity is 163 cubic inches without corsets. 
The average vital capacity, wearing the corset, is 30 cubic 
inches less. 
The individuals upon whom these observations were 
made were servants of the best class. One half were native- 
born, the other half Irish (seventeen), German, Swedish, 
and English. Except on festive occasions, our immigrants 
have rarely worn corsets before reaching this country. All 
these are women who work, and, consequently, should have 
a more vigorous muscular system and better expansion 
than wealthier corset-wearers, although Dr. Hall states that 
these servants lace tighter and are less healthy in appear- 
ance than the young ladies of the institution in which the 
observations were made. Among women who lead less 
active lives, while wearing closer-fitting street- and evening- 
dresses, it might be expected that the interference with ex- 
pansion would be greater and of more serious import. In 
the cases given above the limitation is three sixteenths, or 
nearly one fifth. 
We must remember always that our witnesses are in- 
clined to perjury. The testimony is made to favor the cor- 
set, if possible, and to prove that it is not tight. 
This table contains no instance of the eighteen- or six- 
teen-inch waists of which we hear accounts. The least 
measure js 21 inches. Nineteen inches and a half is the 
smallest circumference I have measured over the corset; the 
patient's normal measurement was 24 inches. 
To ascertain whether there was any constant proportion 
or relation between the amount of constriction and the 
diminution of the vital capacity, I worked out a number of 
tables, which showed that the lessening of the circumfer- 18 
THE CORSET: 
ence of the waist and the lessening of the vital capacity bore 
no constant relation. The problem is not so simple. Hut- 
chinson found in his study of vital capacity (in 4,800 males) 
that the chest circumference bore no direct relation to the 
vital capacity. In a man of five feet one inch the vital capa- 
city averages 175 cubic inches, and it varies eight cubic 
inches for each inch in height. I have not been able to find 
the average height of woman, or any statements relating to 
her vital capacity as compared with man's. From occasional 
measurements in gymnasiums, however, I know that it is 
less than man's in proportion to her height. 
Effects of the Pressure on the Abdomen.-1The abdomi- 
nal cavity has far greater pressure and much more marked 
Fig. 9.-Antero-posterior section ; shape of cavities with and without corsets. 
alteration in shape to suffer than the thoracic. The change 
in its lateral walls has been considered in part, and figured QUESTIONS OF PRESSURE AND DISPLACEMENT. 
19 
in Figs. 3 and 4. In antero-posterior section (Fig. 9) the 
deformity to which I would especially direct attention is 
the close approximation of the belly-wall to the spinal col- 
umn, and the bulging of the hypogastrium. I have pict- 
ured no exaggerated instance, but give the tracing from a 
muscular young woman who has never been pregnant, with 
an abdominal wall of better vigor than common. 
Fig. 10.-Section through umbilicus, least pressure; the black spaces indicate 
the empty intestines. 
It will be seen that without the corset the breasts pro- 
ject beyond the abdomen, just as in a finely developed man 
Fig. 11.-Through first lumbar vertebra, great pressure ; the intestine (black) is 
the colon. 20 
THE CORSET: 
the pectorals first touch a perpendicular; whereas, when 
the corset has raised the "bust" and crowded the abdomen 
down and out, the supra-pubic wall becomes the most promi- 
nent and projecting part of the profile. 
Fig. 12.-Section through epigastrium, area subjected to greatest pressure. 
In transverse section the abdominal area at the level of 
the ensiform (Fig. 12) is normally about twice as great as 
that at the umbilicus (Fig. 10)-above, deep, roomy, bean- 
shaped ; below, narrowing and contracting to scarcely more 
than a slit that curves about the broadened mass of the 
spinal column and psoas muscles. 
The corset reverses this. The constriction binds closest 
the broadest part; the viscera are displaced downward; the 
lower umbilical region swells out; the greatest area must 
grow small, and the smallest enlarge. 
The point of greatest pressure, we have seen, was over 
the cartilages. On both sides the liver will be pressed upon, 
and this at a point where it is covered by lung only during 
deep inspiration (Fig. 12). The lateral pressure will crowd 
liver and spleen toward the median line. The stomach will 
be pinched between its more solid neighbors, though both 
liver and spleen mold readily under pressure. QUESTIONS OF PRESSURE AND DISPLACEMENT. 
21 
Two inches lower, the section (Fig. 11) contrasts strong- 
ly with the first. That showed nearly solid viscera; this 
presents large air-filled spaces. Here the pancreas, kid- 
neys, and a small part of the liver only would receive stress, 
and they are protected by large air-cushions in front. 
Again, two inches lower, the section greatly differs from 
the second. At this level, that of the navel, there are no 
viscera, except intestines distended with gas. 
So that we find that (1) where the solid organs are, 
the greatest pressure comes ; (2) where the hollow viscera 
lie, little pressure comes; (3) on organs that are compara- 
tively fixed in their places, much stress is brought to bear; 
and (4) on organs freely movable, like the intestines, less 
direct displacing force is exerted. 
Effect of Pressure on the Abdominal Wall.-Long-con- 
tinued compression of the wall of the abdomen in the epi- 
gastric and hypochondriac regions gradually brings about a 
thinning of its adipose layer.* Below the ring of con- 
striction the fat accumulates. The woman who abhors " a 
stomach " yet adopts the most effective means of cultivating 
one. Flabby, old, or obese persons are especially prone to 
pile up panniculus adiposus below the navel. I have ex- 
amined many stout young men in good condition, and have 
yet to find one in whom this tendency is evident. On the 
contrary, the fatty layer above the umbilicus is usually 
thicker than that below it. These men wear suspenders. 
In eleven healthy women below thirty who have been in 
the habit of wearing corsets (of varying degrees of tight- 
ness) the fat below the navel has always been found to be 
more than twice as thick as that above, while one to three 
is no uncommon ratio. That this is not normal is proved 
by the fact that in two teachers of gymnastics, measured for 
me by Dr. Mosher, the fatty layer was thicker above. 
* First mentioned, I believe, by Larget. " Th^se de Paris," 1827. 22 
THE CORSET: 
The two sections in Fig. 13 speak for themselves. The 
man and woman were each twenty-one years of age. The 
woman, Braun says, was well 
developed and finely formed, 
and her abdominal wall had 
never been stretched by a preg- 
nant uterus, as one would sup- 
pose at first glance. Above the 
pubes the wall is four times as 
thick as it is higher up. 
That the compression acts 
on muscle as well as fat is 
clear when we call to mind 
the contrast between the hard 
abdominal parietes of the aver- 
age man and the lax belly of 
most women. How could the 
gynaecologist make his bi-man- 
ual were it otherwise ? Engel 
reports cases in which the 
peristaltic movements could be 
watched through walls thinned 
from tight lacing. Of course 
disuse and the less need of con- 
stantly balancing the body has 
much to do with the atrophy of 
the abdominal muscles of the fe- 
male. If Schroeder and his fol- 
lowers are right in attributing- 
the expulsion of the head after 
it reaches the pelvic floor mainly 
to these muscles, we must credit 
the necessity for the use of for- 
ceps in a large number of cases 
Fig. 13.-Sections of the anterior 
abdominal wall of the young fe- 
male (F) and male (M), showing 
thinning from the pressure of 
corsets. (Braun, frozen.) QUESTIONS OF PRESSURE AND DISPLACEMENT. 
23 
to the practice of corset-wearing. It is worth noting that 
the figure given by Schatz as the intra-abdominal pressure 
not uncommon in man during straining efforts is nearly the 
same as the maximum pressure in the bladder during ex- 
pulsive pains (Croom), which the uterine wall has some part 
in augmenting1 by its forward displacement. 
Effect of the Pressure on the Pelvic Floor.-With the 
corsets snugly adjusted the general cavity of the trunk is 
cased in walls that are nearly unyielding at all places but 
Fig. 14.-Tracing from the pelvic floor with and without corsets. 
two. The ribs, spinal column, and corset-bones sheathe the 
body as far down as the iliac crests laterally and the hypo- 
gastrium in front. Of the supra-pubic projection we have 
spoken. The other outlet for the pressure is the pelvic 
floor. It can be studied only in the horizontal position, 24 
THE CORSET: 
either by tracings taken from the thin lead strip passed 
along the groove from symphysis to sacrum and accu- 
rately molded, or by measurement of the projection of the 
floor by the instrument of Dr. Frank P. Foster. This 
projection is measured on a perpendicular erected on a line 
joining the tip of the coccyx and the lower edge of the 
symphysis pubis. In Sims's position, while the patient 
" has her clothing on but the corset unbuttoned," * the 
average projection was determined by Dr. Foster to be 2'5 
cm., or one inch. I find that tight lacing increases this 
projection over one third-the average of 5 cases measured 
being 0'9 cm. (0'8 cm. minimum, IT cm. maximum). This 
is twice as much depression as the deepest inspiration causes 
(0T cm.), and often is very close to the extreme yielding of 
the pelvic floor brought about by straining or bearing down, 
which is in the neighborhood of 4 centimetres, or one and 
a half inch plus. 
I quote the figures in a well-marked case (Sims's posi- 
tion) : 
Without corsets. 
With corsets tight. 
Quiet 
2-6 cm. (1 inch). 
3'2 cm. (1| inch). 
4'0 cm. (1-J- plus). 
3'7 cm. (1J in. scant). 
4 cm. (If in.). 
4 cm. (Iff in.). 
Deep inspiration 
Straining 
Pelvic Floor Projection. 
I am inclined to believe that after a large number of 
cases have accumulated I can show that it is those women 
having roomy pelves, or pelves of less inclination than 
usual, whose pelvic floors sag most under pressure from 
above. 
Effect on the Uterus.-This displacement of the pelvic 
floor and this abdominal pressure, acting on a cavity prob- 
* Letter from Dr. Foster, April 8th. QUESTIONS OF PRESSURE AND DISPLACEMENT. 
25 
ably governed by the laws of fluid pressure, bear largely on 
the moot question of the importance of the corset as an 
agent in producing uterine disease and displacement. I 
think there can be no question that the uterus must descend 
with the structures about it. With a corset that is " quite 
tight," but not so tight as the patient " could bear it, as in 
a new dress or at a ball," this displacement is a third of an 
inch. The distance seems insignificant, and may only be 
considered of importance in view of the following facts: 
1. That this is almost the deepest position to which the 
structures can be forced by straining down. 
2. That the long-continued action of the depressing 
force is exerted during the period of growth. 
3. In view of the results likely to ensue in case of weak- 
ened and enfeebled supports, in case of increased size and 
weight of the uterus-normally present during menstruation 
-and in case of incipient displacement. It naturally follows: 
4. That this forcing downward is sufficient to render 
the uterine supports tense (be they ligament, " column," or 
pelvic surroundings in toto), and that in their taut condi- 
tion any extra or added stress, like deep breathing, or exer- 
tion, or bending, might well be enough to each time slight- 
ly overstrain these stretched supports. Slowly and steadily 
as this force acts, yielding must in time occur. 
In fact, Engel states that in every one of thirty autopsies 
in which evidences of tight lacing were found, prolapsus 
was present in some degree, except where adhesions had 
prevented it. 
It might be noted that the ovarian veins,- which usually 
are valveless, run upward into the region of greatest press- 
ure to empty there, and that the hsemorrhoidal branches of 
the portal vein, which also lack valves, will suffer from the 
damming back that must be caused by the severe com- 
pression of the liver. 26 
THE CORSET: 
The distortion of Fig. 15 does not need much commen- 
tary. The more this damsel bends, the greater the down- 
Fig. 15.-The effect of bending forward, when seated, with and without corsets. 
ward and backward push of her busk. Will not this ac- 
count in part for the uterine troubles of women supposed to 
be due to many of their sedentary occupations, such as sew- 
ing-machine work ? The man bending forward relaxes his 
abdominal wall and enormously lowers his intra-abdominal 
pressure by so doing (Schatz), but the corseted female, who 
writes or sews, produces the opposite effect. In some cases 
I have recorded that in this position the pressure over the 
navel is about double that in the erect position, notwith- 
standing the abdominal relaxation. The exceptions to this 
augmentation of pressure are found where the corset-bones 
are broken or weakened and bend in into the epigastrium, 
and out again away from the pubes. 
Effect of the Pressure on the Liver.-In viewing the 
transverse sections (Figs. 11 and 12) we saw that the zone QUESTIONS OF PRESSURE AND DISPLACEMENT. 
27 
of most marked pressure was over the liver. Laterally the 
ribs may be resistant enough to counteract this strain to a 
Fig. 16.-The heavy outline with corsets, the thin outline without corsets, the 
patient seated and bending forward. 
considerable extent; but over the cartilages, where the 
strongest compression of all is exerted, and in the epigas- 
tric region, the force must act with greater directness to 
push the anterior edge downward. Corbin, who has studied 
this displacement post mortem, states that, as this viscus is 28 
THE CORSET: 
fixed behind, its anterior part drops, so that the surface, 
normally superior and horizontal, becomes anterior and ver- 
Fig. 17.-The tilting of the liver in certain cases of tight lacing. How the fur- 
row of Fig. 6 is produced. 
tical. . . . This effect is constant and is found in all, how- 
ever loose the lacing may have been." 
" On the face that is anterior there exists in most QUESTIONS OF PRESSURE AND DISPLACEMENT. 
29 
women a transverse depression or gully, more or less pro- 
nounced, so marked in some cases that the liver looks al- 
most cut in two. The bottom of this groove is at times 
whitish in color from thickening of the peritonaeum, cap- 
sule, and cellular tissue." In the discussion following the 
reading of this paper instances were cited to show that a 
habit of wearing about the waist a very tight cord or belt 
by men will cause like furrows, and that such fissures may 
result in more or less complete detachment of portions of 
The organ. 
Indeed, Braun asserts that " it is open to proof that the 
form of the liver is not an independent one, but varies with 
the pressure and volume of neighboring organs; so that in 
a normal condition it must possess a softness of structure 
which can be compared with fat and connective tissue, and 
which yields to the movements and change of position of 
the organs in contact with it." 
I am the more inclined to believe this on account of the 
exceeding great blood supply of the organ. It is said to 
. contain about one fourth the blood in the body. This 
peculiarity would allow of very marked fluctuations in size 
and in shape. The very distinct fall of the mercury col- 
umn-one half to one inch and a half-twenty seconds 
after hooking the corset may be due in part to the liver 
emptying itself of blood. 
The earlier corsets are worn, the more the liver would 
be affected, since it is proportionately much larger in the 
child than in the adult. Previous to puberty its weight 
may be as much as one thirtieth, or even one twentieth, of 
that of the entire body; in the adult it averages one fortieth. 
"The practice of tight lacing," says Murchison, "may 
cause displacements and malformations of the liver which 
may simulate enlargement and which are of considerable 
importance in diagnosis. Tight lacing may act on the liver 30 
THE CORSET: 
in three ways-according to the situation, the tightness, and 
the duration of the constricting cause. 
" a. The liver may be displaced upward or downward 
according as the pressure is applied below or above. The 
precise situation where the pressure is applied will vary with 
the prevailing fashion of dress; but most commonly in this 
country the displacement is downward, and this may be to 
such an extent that the lower margin reaches the ilium, and 
the liver appears to fill up the whole of the right side and 
front of the abdomen." [Frerichs and other writers speak 
of this amount of change in location.] 
" b. In consequence of lateral compression the liver may 
be elongated in its vertical diameter so that a larger portion 
of it is brought into apposition with the abdominal and 
thoracic walls. This is a very common result of tight lac- 
ing " (Figs. 6 and 17). 
"c. When the pressure is exerted by a tight cord, it may 
produce deep fissures in the substance of the liver, as the 
result of which portions of the organ may be more or less 
detached, and may even be felt as movable tumors through 
the abdominal parietes." 
" Apparent enlargements of the liver from tight lacing 
are far more common than is generally believed." 
Though it is somewhat of a repetition, I must give an 
epitome of some thirty autopsies that Engel reports. 
The lower edge of the liver, he says, is often displaced 
below the iliac crests. It is nothing unusual to find the 
fundus of the gall-bladder at the level of the crest. The 
furrow is often a hand wide. It rarely runs into the left 
lobe. The portion of hepatic tissue connecting the two 
parts is scarce over a finger's breadth. Not seldom scar-like 
bands and obliterated vessels of large caliber traverse the 
isthmus. Yet adhesions at this point are of the rarest oc- 
currence, QUESTIONS OF PRESSURE AND DISPLACEMENT. 
31 
Above the furrow, in the upper division of the right lobe, 
which is often much thinned from pressure, one sometimes 
encounters two deep indentations which run from behind 
obliquely or directly forward. In these the peritonaeum and 
underlying hepatic tissue are normal. 
The portion below the transverse groove may be thicker 
than that above. Its lower edge is blunt and rounded. Be- 
hind, it is strongly concave. 
The ligamentum rotundum is displaced to the left. 
These changes are shown in Figs. 6, 7, and 17. 
If, from the testimony of these five observers-Braun, 
Corbin, Engel, Frerichs, and Murchison-the extreme mobil- 
ity of the liver has been proved, although we grant that 
these extremes result from tight lacing, are we not justified 
in believing that even a loosely adjusted corset must defi- 
nitely displace so. mobile an organ ? The difference be- 
tween the loosest corset and the tightest is less than might 
be imagined. I have not been able to double the pressure 
on requesting a patient to lace her loose corset to the ut- 
most she could bear. 
Engel found the stomach displaced in the following re- 
markable manner : It was shoved to the left. Its long axis, 
from a horizontal or oblique direction, was changed to a ver- 
tical, so that the lesser curvature ran down directly to the 
left of the spinal column. The pyloric end was depressed 
as far as the fourth lumbar vertebra. Constriction not un- 
like the liver-furrow was occasionally met with, but without 
pathological changes in the walls. The pancreas may be 
dragged down to a perpendicular position on the face of the 
vertebral column, reaching down to the promontory. These 
were extreme cases, of course. 
A few of the most palpable changes brought about by 
corset pressure have thus been briefly described. There are 
many others as much more important as they are more subtle 32 
THE CORSET: 
and difficult of proof, such as the disturbances of abdominal 
circulation, the effect on digestion, the limitation of exer- 
cise, and the slowly increasing action on the general health 
-questions of disturbed physiology which I hope to at- 
tack in the future. The necessary observations accumu- 
late slowly. The conclusions reached at this time may 
be tabulated as follows : 
Conclusions. 
1. The maximum pressure at any one point was 1'625 
pound to the square inch. This was during inspiration. 
The maximum in quiet breathing was over the sixth and 
seventh cartilages, and was 0'625 pound. 
2. The estimated total pressure of the corset varies be- 
tween thirty and eighty pounds-in a loose corset about 
thirty-five pounds, in a tight corset sixty-five pounds. 
3. Within half a minute after hooking the corset such 
an adjustment occurs that a distinct fall in pressure results. 
4. The circumference of the waist is no criterion of 
tightness. The difference between the waist measure with 
and without corsets gives no direct clew either to the num- 
ber of pounds pressure or to the diminution in vital ca- 
pacity. Relaxation and habit seem to affect these factors 
largely. 
5. The capacity for expansion of the chest was found to 
be restricted one fifth when the corset was on. 
6. The thoracic character of the breathing in women is 
largely due to corset-wearing. 
7. The thoracic cavity is less affected by the corset than 
the abdominal. 
8. The abdominal wall is thinned and weakened by the 
pressure of stays. 
9. The liver suffers more direct pressure and is more fre- 
quently displaced than any other organ. QUESTIONS OF PRESSURE AND DISPLACEMENT. 
33 
10. The pelvic floor is bulged downward by tight lacing 
one third of an inch (0'9 cm.). 
Partial Bibliography. 
Bouvier.-" Etudes historiques et medicates sur 1'usage des 
corsets," " Bull, de 1'acad. de m6d. de Paris," 1852-53, 355. 
Bouvier et Bouland.-"Corset," "Diet, encycl. des sci. 
m6d.," Paris, 1877. 
Winslow.-" Mem. de l'acad. des sciences," 1741. 
Soemmering.-" Ueber die Wirkungen d. Schniirbrusten," 
1793. 
Engel.-"Wiener med. Wochenschrift," 1860 (529), "Die 
Wirkungen d. Schnurleibes." 
Frerichs.-" Diseases of the Liver." 
Mays.-"Therapeutic Gazette," May, 1887. 
Murchison.-" Diseases of the Liver." 
Walshe.-London " Med. Times and Gazette," 1829. 
Sibson.-"Medical Anatomy," p. 962, " Med.-chir. Trans.," 
1848. 
Croom.-" The Bladder during Parturition." 
Schatz.-" Archiv f. Gyn.," iii, 58 ; iv, 193. 
Corbin.-" Des effets produits par les corsets sur le foie," 
" Gaz. m6d. de Paris," 1830. 
Foster.-" Am. Jour, of Obstet.," 1870. 
Hutchinson, J.-"The Spirometer, the Stethoscope, and the 
Spring Balance," London, 1852. ft REASONS WHY 
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