Chlorotic girls, 1870-1920: a historical perspective on female adolescence.

In light of the current interest in anorexia nervosa, this historical study explores the relationship of culture to age- and gender-specific symptomatologies. Between 1870 and 1920, chlorosis, a form of anemia, was widely reported in female adolescents in the United States. Diagnosis occurred on both the clinical and popular levels, yet neither the etiology nor the symptoms were precisely clear. Treatment generally included rest and large doses of iron salts. In large part, chlorosis was a cultural construction embedded in the context of Victorian medicine and family life. Physicians expected to see chlorosis in adolescent girls in the process of sexual maturation; girls learned to have the disease from family, friends, the popular press, and their doctors. Changes in diet and nutrition after 1900, coupled with increased understanding of ovarian function and iron deficiency anemia, provide only a partial explanation of the disease's eventual decline. By 1920, a changed social environment made chlorosis a social liability for girls and their mothers.