106

Blank No. 12 Series II Form B. 6

12 - What knowledge of sexual phisology had you before marriage?

b) how did you obtain it? I had a very complete knowedge
obtained from lady physicians who were my friends.

13 - Number of times married. If more than once additional blanks
will be furnished you to answer the following questions separately
in regard to each marriage? Once ---

14 - Number of years married? Eight years ---

15 - Do you habitually sleep with your husband? b) what reasons
for so doing or not? Yes, when he is at home. I sleep much better
and feel altogether more comfortable. The first year in our married, I had
a separate bed, believing that was the right thing; but I abandoned it en-
tirely before the end of the year.

16 - Number of conceptions? One ---

17 - Number of children? State in connection with each a) date
of birth? b) sex? c) whether healthy or not? d) note any
characteristic and the cause. e) note either immediate
or after effect on your health of the birth of each of your
children. f ) give time of first menstruation after birth
of each child. One child, a perfectly formed boy of twelve pounds
weight, and unusual size; head especially large. Child died during
labor on account of its length and severity, the doctors
said. I think I have never had quite the strength since.
My illness was unusually long and severe. I began t men-
struate in the seventh month after my confinement.

-195-