[Reprinted from the American Gynaecological and Obstetrical Journal 
for December, 1894.] 
THE RELATION OF TIGHT LACING TO UTERINE DE- 
VELOPMENT AND ABDOMINAL AND PELVIC DIS- 
EASE.* 
By Charles Graham Cannaday, M. D., Roanoke, Va., 
Member of the American Medical Association ; American Electro-therapeutic Association ; 
British Gynaecological Association, London ; Pan-American Medical Congress, etc. 
The only excuse necessary to offer for the production of this paper 
is found in the absolute necessity for seriously considering the sub- 
ject of tight lacing as it exists in civilized countries. 
The subject dealt with in this article is of special interest to the 
general practitioner as well as to the gynaecologist, while to the race 
it is of serious importance—so serious as to be already displaying its 
deleterious results in characters so vivid as to call forth the gravest 
apprehensions from true philanthropists. “What read you there that 
hath so cowarded and chased your blood out of appearance ? ” 
This is not claimed as an original idea by the writer ; yea, for 
many years articles numerous and lengthy have been produced with 
results nil. Sommering, of England, published almost a century ago 
an article bearing directly on tight lacing and its effects, and was able 
to record no less than one hundred articles by different authors on 
the subject, while since his time to attempt a classification of all works 
touching briefly on this subject would entail no trifling expenditure 
of time and patience. 
Convinced clearly as to the truth and firmness of this article’s claim, 
the writer feels a certain degree of trepidation in condemning in un- 
mistakable terms the unconcern of an intelligent profession living in 
the presence of such an injurious custom, and at the same time not 
offering a united protest. 
Its importance as an setiological factor in pelvic ills has been lost 
to view in the mad rush for scientific research and inventive methods. 
* Read before the International Medical Congress in Rome, Italy, 1894. Charles Graham Cannaday, M. D. 
2 
There is to-day no one subject respecting which so much importance 
should be attached by profession, laity, state, and philanthropist as 
causative of abnormal conditions. 
That those countries most progressive in art, science, and gynae- 
cology—Germany, United States of America, England, and France— 
so .endowed with such illustrious and thoughtful lights, dead and liv- 
ing, should have failed to thoroughly awaken concerted interest in 
such an important factor in the causation of disease is to be won- 
dered at as much as the perpetuation by the patrons of progress and 
refinement of so uncomfortable and harmful a relic of barbarism. This, 
in the latter case, is attributable in avast majority of the cases to igno- 
rance, they being novices as to anatomy and strangers to physiology ; 
females consider it a light jest when they are informed as to its injuri- 
ous effects. It shall be the object of this writer to faithfully portray 
the evil effects of tight lacing, both as a factor in the causation of dis- 
ease and as an obstacle to that normal condition of affairs which 
offers the greatest resistance to the invasion of disease, and at the 
same time to contrast the well-developed conditions and freedom 
from pelvic ills in those who do not practice tight lacing, with those 
frail constitutions, barrenness, and invalidation found in its patrons. 
Nor is it to be understood that tight lacing is confined to those 
who wear corsets only, for the clothing may be worn so tight as to do 
practically the same harm, though in a less degree, by its gradual 
compression. 
It is earnestly desired to firmly impress the idea that tight lacing 
is not the only cause that may produce maldevelopment of the uterus 
and appendages, and occasion diseased conditions, but that it is one 
of the chief factors. 
A brief review of the anatomy of the female pelvis may aid in the 
better comprehension of the idea intended to be conveyed. 
The pelvis consists of bones, to all intents and practical purposes 
as a solid unyielding structure with the false pelvis representing a 
truncated cone, its base looking upward and slightly flattened on its 
anterior ; the external and internal oblique, transversalis, pyramidalis, 
and rectus muscles, with sheaths and tendons, combine to form the 
lateral and anterior walls of a cylinder continuous with the last-named 
structure. Great strength and resistance is added to this cylindrical 
body by the spinal column lined by the quadratus-lumborum muscles, 
constituting the posterior. 
Inclosed in this cylindrical body from diaphragm downward are 
organs and structures readily displaced by pressure. Among these The Relation of Tight Lacing to Uterine Development. 
3 
we find the uterus, which after birth remains undeveloped to the same 
extent, practically speaking, as in infancy, until near the approach of 
puberty, when it develops rapidly and continues to increase in size 
proportionally to the whole body until its maximum of development 
is attained—usually between sixteen and twenty years (Puech). 
The virgin uterus averages two and one third to three inches in 
length, its width at the level of the Fallopian tubes two inches, its 
weight about twelve drachms ; it is suspended in the pelvis by liga- 
ments “amounting to little besides folds of peritonaeum” and the 
proximity of the anterior and posterior segments of the pelvis. 
The Fallopian tubes and ovaries, with feeble supports, spread out 
to the right and left of the uterus, in connection with the broad liga- 
ments, almost at right angles. The ovaries formed from the Wolffian 
bodies are not of exception as to growth and development. At the 
age of eleven, generally, they rapidly develop, and at puberty a new 
era sets in—viz., maturation and periodical rupture of the Graafian 
follicles ; the remaining parts of the generative organs before and 
at puberty undergo a rapid increase in size. 
The vascular supply consists of tortuous canals with free anas- 
tomosis and lax walls. From twelve to sixteen years at least eighty- 
five per cent, of girls develop generative organs. It must be remem- 
bered that the uterus and appendages are covered almost entirely by 
peritonaeum, which is susceptible to injury from slight causes ; that 
the construction of the vessels supplying the blood is of such a nature 
as to favor either anaemia or congestion in proportion to the degree of 
compression exerted. 
The mobility of the uterus and the plasticity of the bone and 
tissues with the increased supply of blood the parts are receiving, or 
should receive, enables us more clearly to comprehend the effects of 
pressure on an organ requiring rest and freedom to develop during 
such important transformation. It is at this time, or earlier, that 
parents allow their girls to commence the use of corsets and use their 
own ideas, which are generally not moderate as to the degree of 
constriction. “ Either thou art most ignorant by age or thou wert 
born a fool.” While—“Nature stood with stupid eyes and gaping 
mouth that testified surprise.” The corset as usually worn is so con- 
structed as to exert its greatest pressure from above the brim of the 
pelvis downward, compressing the abdominal walls and contracting the 
lower parts of the thorax and pushing inward the costal cartilages until 
the seventh and eighth are in close contact, often the eighth overlap. 
The liver, from being placed above the maximum of constriction and 4 
Charles Graham Cannaday, M. D. 
having the half cubical form, is not displaced downward, but acts in 
connection with the unyielding thoracic walls as a potent means of 
displacing downward the displaceable organs (Symington). 
Gibson, in 1884, in his illustrations on the chest, has considered it 
as readily displaceable, though this must be exceptional. The maxi- 
mum of constriction, occurring as it does in the direct neighborhood 
of the stomach, must seriously affect this viscus. When distended, 
the pylorus is belowr and the splenic portion above, the constriction 
forming the hour-glass stomach at times found in this class of cases, 
the pylorus being much larger and reaching to a point corresponding 
to a line uniting the spines of the iliac crests. The duodenum is 
found near the same lines. The jejunum, ileum, and mesentery are 
crowded into the pelvis along with the transverse and ascending 
colon. The cul-de-sac of Douglas is filled with the small intestines, 
which help to antevert the uterus when the rectum is loaded with 
faeces, also when the bladder is distended and the rectum empty, the 
uterus is retroposed, after displacing the folds of intestines from the 
posterior cul-de-sac. 
The compression is of so considerable a degree as to seriously 
interfere with the peristaltic action of the intestines, and by impairing 
their sensitiveness, constipation is produced in a large number of 
cases. Compression of any part in proportion to its intensity just in 
that degree interferes with physiological functions. Therefore we 
may deduct the following : 
1. That uterine development is greatest from eleven to fifteen 
years of age. 
2. That tight lacing is usually commenced about that period of 
the beginning of uterine development. 
3. That the corsets as usually worn produce both displacement 
and compression, and that they are worn through the entire day as 
tight as can be borne. 
4. That displacement and compression interfere with nutrition 
and development of the pelvic contents more seriously than is gener- 
ally supposed. 
5. That a badly developed generative organ in the female offers 
diminished resistance to the invasion of disease and renders physio- 
logical work defective and necessarily painful. The uterus is nor- 
mally freely movable and readily displaced by pressure; with the 
finger on the os it can be elevated one and a half to two inches. If 
the dorsal, semi-prone, lateral, or knee-chest position be assumed, we 
shall find the fundus gravitating to the dependent part. The Relation of Tight Lacing to Uterine Development. 
5 
The bimanual method is mainly effective by reason of this mobility. 
The ligaments of the uterus are composed of such tissues as favor 
stretching. Compression continued daily on such compressible or- 
gans as the uterus and appendages first diminishes the blood supply 
by lessening the caliber of the blood-vessels, and, secondly, by dimin- 
ishing the rapidity of the flow. The pressure at night being relieved 
weakens the walls of the capillaries, render them inefficient carriers 
of the pabulum so necessary for the physiological performance of de- 
velopment ; and equally well does it render imperfect the attempts by 
certain systems to transform certain conditions of physiological organs 
into a state of inertness—viz., certain canals, bodies, etc., that should 
be obliterated. 
What would be expected were we to bandage a limb tightly from 
infancy ? And still the vascular supply of the uterus is more easily 
interfered with by compression than a limb or foot. Hence we must 
admit a certain degree of maldevelopment of any organ which is 
subject to abnormal compression during its period of develop- 
ment. 
The Egyptians, the acknowledged founders and promoters of 
civilization, education, and art, while permitting great variations in 
objects of luxury—vases, furniture, and other things depending on 
caprice—were forbidden to introduce any innovations in articles of 
dress tending to change the human figure or modify the true teach- 
ings of art. 
Among the Africans, Indians, Chinese, and, in fact, all of the 
nations who do not practice tight lacing, we find the minimum 
amount of pelvic diseases, the most perfect pregnancy, confinement 
amounting to little pain or inconvenience, and satisfactory puerperium 
with the absence of any complications. Generally speaking, those 
who have practiced in the rural districts for the well-developed and 
healthy, and subsequently in the city for the delicate, badly nourished 
and poorly developed, where tight lacing is practically universal, will 
be thoroughly convinced that there is an explanation to be found in 
some way for the frequency of female ills in the latter, in contradis- 
tinction to its absence in the former. The great interest which has 
centered about gynaecology in the last score of years, the frequency 
and severity of pelvic diseases in the female at present in comparison 
with the pre-corset era is a fact for serious consideration ; the in- 
creased sterility in high social life is not to be lightly considered and 
will give to the political economist food for grave deliberation, and 
the philanthropist considerable concern. In comparison with un- 6 
Charles Graham Cannaday, M. D. 
civilized nations, customs of distorting—distracting, if you please, de- 
velopment—ours far exceeds, and the deleterious results are not to be 
predicted by any moderate calculations. 
If Darwin’s theory of natural selection is regarded as teaching 
the truth, we may in the future expect our fair sex to have waists as 
slim as wasps, and generative organs incapable of performing physio- 
logical functions. 
That the girl who has practiced tight lacing sufficiently long to 
hinder development of the uterus is relieved by a course of electricity, 
massage and gymnastics properly and timely applied is offered as 
additional argument supporting the claim of this paper. 
It is believed that mal-development of the uterus is necessarily 
bound to be present in every woman who practices tight lacing to 
any considerable extent prior to maturity of the uterus and append- 
ages, and it remains to explain how this maldevelopment conduces 
to diseased conditions and renders physiological functions of organs 
incomplete and painful. 
Peritonitis, if you will, parametritis, and perimetritis, may all be de- 
scribed under one head, as they are generally considered as implicating 
chiefly the peritonaeum, which is composed of pavement epithelial 
cells, basement membrane, connective tissue, and vessels, and secretes 
a serous portion of the blood through stomata that exist between the 
epithelial cells. That localized inflammation or thickening often 
exists in the female pelvic peritonaeum and seldom occurs in any 
other portion, renders it highly probable that pressure so interferes 
with its nutrition by diminishing the blood supply as to render it 
peculiarly liable to inflammatory attacks from slight causes. Hence 
we frequently find the fundus uteri retroverted and bound down by 
adhesions or anteverted or anteposed and adhered in virgins. The 
writer met several cases of this kind, and in each instance tight lacing 
had been persisted in from twelve years of age. If long-continued 
friction in old hernial sacs produces localized thickening and peri- 
tonitis, it must be expected the same will result from tight lacing in 
the pelvic peritonaeum ; and to this more than any other may be attrib- 
uted the increasing frequency and severity of pelvic pain in females 
accustomed to tight lacing. 
Displacements of the uterus, that subject about which so much 
has been written and whose treatment has been so diversified and 
varied ; that “ falling of the womb,” which is so prevalent in the minds 
of such a large percentage of women and is a “ hobby ” for so many 
of our doctors, can find its main cause in tight lacing. The Relation of Tight Lacing to Uterine Development. 
7 
We find neither displacements of the uterus nor many diseased 
conditions, for that matter, of the generative organs in other forms of 
mammalia than mankind. Displacements are very frequent. Frankel 
has found backward displacements present in eighteen per cent, of 
women examined by him. Zeigenspeck, whose conclusions are re- 
spected by most authors, considers change in the uterine walls in 
displacements as secondary to the symptoms. The symptoms are 
always secondary to the displacement. The aetiology of prolapsus 
uteri, as described by Hart and Barbour, is: 
1. Deficient support by the entire fixed portion. 
2. Deficient tone of entire displaceable segments of pelvic floor 
and slackening of loose tissues around it. 
3. Intra-abdominal pressure. 
As tight lacing produces mal-development of the pelvic contents 
as well as displacing all displaceable parts, a rfcumd of what has been 
said in reference to displacements must convince all that tight lacing 
is one of the most potent factors in its causation. Menstruation may 
be affected in many ways by this custom. Amenorrhoea may be the 
result of a poorly developed mucosa and its annexa together with 
faultily developed ovaries—a condition which, unless corrected, may 
lead to atrophy; or we may have congestion with profuse and long 
flows ; or dysmenorrhoea, which the writer believes is due mostly to 
mal-development both of the nervous system, and the muscular and 
cellular tissues, rendering them inadequate to the physiological labor 
required. Cancer, so frequently occurring in civilized nations, must 
have its explanation in some custom peculiar to such civilization. 
There are embryonic cells in the uterus that remain through life; they 
are considered the cause of epithelioma of the cervix, and the cervix 
in ninety-eight per cent, of cases is the seat of cancer, local irritation 
being its chief generator. Tight lacing produces irritation by press- 
ing down the cervix against adjacent parts. 
Strength is added to this by quoting the views of Hart and Bar- 
bour : “ Up to puberty the mortality for carcinoma of the sexes is the 
same. Afterward the relative proportion of female to male deaths 
gradually rises till it attains its maximum—about the age of sixty 
years—after which it falls away again.” 
Miscarriages are frequently due directly to this cause, and indi- 
rectly to maldevelopment of the female generative organs, proving 
their incapacity to nourish the embryo. Lacerated cervix, weak and 
inefficient contractions of the uterus in labor, protracted puerperium, 
the result of subinvolution, may usually find their true explanation 8 
Charles Graham Cannaday, M. D. 
from this source. The increased frequency of endometritis, sterility, 
stenosis, erosion and atresia of the cervix and os, the varied aches 
and pains referred to the pelvis, must be largely attributed to this 
cause. A large percentage of the growths’ cysts, etc., peculiar to the 
female pelvis can be traced to maldevelopment. 
Doran has shown that the parovarium is nothing more or less than 
nine or ten vertical tubes, six or seven of which have been obliterated 
and remain as fibrous threads ; these are the remains of the Wolffian 
bodies. These tubes are lined with cubical or broken-down epithe- 
lium, and are lost in the hilum of the ovary below, while the hori- 
zontal tubes from which they originate above may be traced to the 
side of the uterus forming the canal of Gartner. 
It is no longer a disputed point that para-uterine cysts, as well as 
papillomatous cysts of the hilum, parovarium, and cysts of the broad 
ligaments, have their origin in these unobliterated ducts and the re- 
mains of the Wolffian bodies. Mal-development must necessarily ac- 
count for this condition of affairs. Waldemyer shows a section of 
the ovary—Pfliiger’s ducts—that have not developed as they should 
have into Graafian follicles, and which may be the point for the origin 
of an ovarian cyst. 
Fibroids and most solid tumors have their aetiology in maldevel- 
opment of the sexual organs. Their occurrence chiefly after puberty 
and not after the menopause; their most frequent recurrence, as 
shown by Schroder and Gusserow, together with the frequent occur- 
rence of various tumors in the same uterus or appendages—all tend 
to corroborate the position taken in this article. Time and space 
will fail me to follow this further, but the field is a large one. The 
great benefit obtained in pelvic ills from electrical treatment is due 
to its effect as an aid to development. The pain every woman feels, 
who has practiced tight lacing, on leaving off her corset is due to the 
effort of the parts to return to their normal position. Simonides on 
a certain occasion said : “ Health is the best for mortal man, next 
beauty.” To-day civilization has reversed this statement. 
The ancient Egyptian’s highest aim in life was to be well buried ; 
the civilized nations of this period to be dressed after the order of 
style, be that as it may. “ Whatever is off the hinges of custom is be- 
lieved to be off the hinges of reason.” 
Goethe’s expression, that ‘‘Art is called art simply because it is 
not Nature,” is borne out in reference to the figure of the female who 
wears a corset. The visitor who can casually obseive the beautiful 
and natural figures of Venus de Medici, with many other Roman and The Relation of Tight Lacing to Uterine Development. 
9 
Grecian sculptures, must be convinced that tight lacing was not prac- 
ticed by those noble matrons. 
Kay Robertson predicts that man will become toothless and toe- 
less, with flaccid muscles, and limbs almost incapable of locomotion. 
It is to be regretted that this prophecy did not extend to the female 
of our day. Are civilized customs and forms of dress more conducive 
to health than those of the savages ? It is thought not. Whitman, in 
answering his own question as to who is the friendly and flowing 
savage, says : “ Is he waiting for civilization, or is he past it and mas- 
tering it ? ” 
The hand of the Chinese aesthetic, with its long and curling nails ; 
the savages of the east coast of Australia, with a bone the thickness of 
a man’s finger and six inches long transfixing the nasal septum ; the 
natives of the Corn Islands off the Mosquito Coast in Central America, 
with beards of tortoise-shell dangling from an artificial hole in the 
chin and lips ; the Botocudo Indians, the Esquimaux and Thlinkeet of 
Alaska, and many tribes of Africa, by puncturing their lips, nose, ears, 
and chin, and applying weights and dilators resulting in frightful de- 
formities—may have their eccentricities and absurdities, but their evil 
effects will not compare with those of tight lacing. 
The artificial flattened and elongated occipital portion of the head 
by bandages worn on infants’ heads by the ancient natives of Peru, 
many interesting specimens of which can be seen in the museum of 
the Royal College of Surgeons, London, approach more nearly those 
of tight lacing in their injurious effects than any other. 
This article is intended to call the profession’s serious attention to 
the evil effects of tight lacing, and to urge upon them some steps that 
may inform the laity as to the true effects of such fashion ; also to 
present a solid professional front antagonistic to such a deleterious 
custom. The fact of tolerating such a custom as tight lacing, which 
originated in mediaeval times, classes us with the uncivilized and bar- 
barous, seeks to oppose the Creator of our bodies, and the example 
given us by Nature. “ Seest thou not what a deformed thief this 
Fashion is ? ”