Bed rest

Last updated
Bed rest
Brooklyn Museum - The Invalid - Louis Lang - overall.jpg
The Invalid (c. 1870), painting by Louis Lang in the Brooklyn Museum
Other namescessation, expiration, halt, shutdown, stoppage surcease, and termination

Bed rest, also referred to as the rest-cure, is a medical treatment in which a person lies in bed for most of the time to try to cure an illness. [1] Bed rest refers to voluntarily lying in bed as a treatment and not being confined to bed because of a health impairment which physically prevents leaving bed. The practice is still used although a 1999 systematic review found no benefits for any of the 17 conditions studied and no proven benefit for any conditions at all, beyond that imposed by symptoms. [2]

Contents

In the United States, nearly 20% of pregnant women have some degree of restricted activity prescribed [3] despite the growing data showing it to be dangerous, causing some experts to call its use "unethical". [2] [4] [5]

Medical uses

Extended bed rest has been proven to be a potentially harmful treatment needing more careful evaluation. [2]

Pregnancy

Women who are pregnant and are experiencing early labor, vaginal bleeding, and cervix complications have been prescribed bed rest. This practice in 2013 was strongly discouraged due to no evidence of benefit and evidence of potential harm. [6]

Evidence is unclear if it affects the risk of preterm birth and due to potential side effects the practice is not routinely recommended. [7] It is also not recommended for routine use in pregnant women with high blood pressure [8] or to prevent miscarriage. [9]

Women pregnant with twins or higher-order multiples are at higher risk for pregnancy complications. Routine bed rest in twin pregnancies (bed rest in the absence of complications) does not improve outcomes. [10] Bed rest is therefore not recommended routinely in those with a multiple pregnancy. [10]

Use in combination with assisted reproductive technology such as embryo transfer is also not recommended. [11]

Back pain

For people with back pain bed rest has previously been recommended. [12] Bed rest, however, is less beneficial than staying active. [13] As a treatment for low back pain, bed rest should not be used for more than 48 hours. [14]

Other

Adverse effects

Prolonged bed rest has long been known to have deleterious physiological effects, such as muscle atrophy and other forms of deconditioning such as arterial constriction. [18] Besides lack of physical exercise it was shown that another important factor is that the hydrostatic pressure (caused by gravity) acts anomalously, resulting in altered distribution of body fluids. In other words, when getting up, this can cause an orthostatic hypertension, potentially inducing a vasovagal response.

Additionally, prolonged bed rest can lead to the formation of skin pressure ulcers. [19] Even physical exercise in bed fails to address certain adverse effects. [20]

Phlebothrombosis is marked by the formation of a clot in a vein without prior inflammation of the wall of the vein. It is associated with prolonged bed rest, surgery, pregnancy, and other conditions in which blood flow becomes sluggish or the blood coagulates more readily than normal. The affected area, usually the leg, may become swollen and tender. The danger is that the clot may become dislodged and travel to the lungs (a pulmonary embolism). [21]

Technique

This man in 1945 England has been prescribed complete bed rest and accepts assistance so as not to sit up to drink. Sanatorium Nursing- Everyday Life at Broomfield Sanatorium, Chelmsford, Essex, England, 1945 D24435.jpg
This man in 1945 England has been prescribed complete bed rest and accepts assistance so as not to sit up to drink.

Complete bed rest refers to discouraging the person in treatment from sitting up for any reason, including daily activities like drinking water. [22]

Placing the head of a bed lower than the foot is sometimes used as a means of simulating the physiology of spaceflight. [23]

History

As a treatment, bed rest is mentioned in the earliest medical writings. The rest cure, or bed rest cure, was a 19th-century treatment for many mental disorders, particularly hysteria. "Taking to bed" and becoming an "invalid" for an indefinite period was a culturally accepted response to some of the adversities of life.[ citation needed ]

In addition to bed rest, patients were secluded from all family contact to reduce dependence on others. The only person who bed rest patients were allowed to see was the nurse who massaged, bathed, and clothed them. Not only were patients to be isolated in bed for an extended time, they were advised to avoid other activities that may mentally exhaust them such as writing or drawing. [24]

In some extreme cases electrotherapy was prescribed. The food the patient was served usually consisted of fatty dairy products to revitalize the body. This cure as well as its name were created by doctor Silas Weir Mitchell, and it was almost always prescribed to women, many of whom were suffering from depression, especially postpartum depression. It was not effective and caused many to go insane, suffer complications of prostration, or die.

Before the advent of effective antihypertension medications, bed rest was a standard treatment for markedly high blood pressure. It is still used in cases of carditis secondary to rheumatic fever. Its popularity and perceived efficacy have varied greatly over the centuries.

In 1892, feminist writer Charlotte Perkins Gilman published "The Yellow Wallpaper", a horror short story based on her experience when placed under the rest cure from Dr. Silas W. Mitchell himself. She wasn't allowed to write in a journal, paint a picture, or release her imagination in any way, though she was artistically inclined. If she ever felt ill, she was simply told to return to bed. Her specific instructions from Dr. Mitchell were to "Live as domestic a life as possible. Have your child with you all the time... Lie down an hour after each meal. Have but two hours' intellectual life a day. And never touch pen, brush or pencil as long as you live." [25] Gilman abided by Mitchell's instructions for several months before practically losing control of her sanity.

Eventually, Gilman divorced her husband and pursued a life as a writer and women's rights activist. She later explained in her biography The Living of Charlotte Perkins Gilman that she could not be restrained to the domestic lifestyle without losing her sanity, and that "it was not a choice between going and staying, but between going, sane, and staying, insane." [26]

The narrator in "The Yellow Wallpaper" reflected her own authentic account. The narrator was advised by her husband to perform the rest cure and avoid creative activities while struggling with fits of depression. After becoming obsessed with the yellow wallpaper in her room, the narrator suffers a mental breakdown and frees a "woman behind the wall," metaphorically resembling Gilman's own mental break and release from female expectations. Gilman sent her short story to Dr. Mitchell, hoping that he might change his treatment of women with mental health and help save people from her own experience. [27] The story became a symbol of feminism in the 1970s at the time of its rediscovery. [28]

The author Virginia Woolf was prescribed the rest cure, which she parodied in her novel Mrs Dalloway (1925) with the description "you invoke proportion; order rest in bed; rest in solitude; silence and rest; rest without friends, without books, without messages; six months rest; until a man who went in weighing seven stone six comes out weighing twelve". [29]

Some negative effects of bed rest were historically attributed to drugs taken in bed rest. [30]

See also

Related Research Articles

<span class="mw-page-title-main">Rheumatoid arthritis</span> Type of autoimmune arthritis

Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are involved, with the same joints typically involved on both sides of the body. The disease may also affect other parts of the body, including skin, eyes, lungs, heart, nerves, and blood. This may result in a low red blood cell count, inflammation around the lungs, and inflammation around the heart. Fever and low energy may also be present. Often, symptoms come on gradually over weeks to months.

<span class="mw-page-title-main">Asthma</span> Long-term inflammatory disease of the airways of the lungs

Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, coughing, chest tightness, and shortness of breath. These may occur a few times a day or a few times per week. Depending on the person, asthma symptoms may become worse at night or with exercise.

<span class="mw-page-title-main">Back pain</span> Area of body discomfort

Back pain is pain felt in the back. It may be classified as neck pain (cervical), middle back pain (thoracic), lower back pain (lumbar) or coccydynia based on the segment affected. The lumbar area is the most common area affected. An episode of back pain may be acute, subacute or chronic depending on the duration. The pain may be characterized as a dull ache, shooting or piercing pain or a burning sensation. Discomfort can radiate to the arms and hands as well as the legs or feet, and may include numbness or weakness in the legs and arms.

<span class="mw-page-title-main">Urinary incontinence</span> Uncontrolled leakage of urine

Urinary incontinence (UI), also known as involuntary urination, is any uncontrolled leakage of urine. It is a common and distressing problem, which may have a large impact on quality of life. It has been identified as an important issue in geriatric health care. The term enuresis is often used to refer to urinary incontinence primarily in children, such as nocturnal enuresis. UI is an example of a stigmatized medical condition, which creates barriers to successful management and makes the problem worse. People may be too embarrassed to seek medical help, and attempt to self-manage the symptom in secrecy from others.

<span class="mw-page-title-main">Exercise</span> Bodily activity intended to improve health

Exercise is intentional physical activity to enhance or maintain fitness and overall health.

<span class="mw-page-title-main">Kegel exercise</span> Pelvic floor exercise

Kegel exercise, also known as pelvic floor exercise, involves repeatedly contracting and relaxing the muscles that form part of the pelvic floor, now sometimes colloquially referred to as the "Kegel muscles". The exercise can be performed many times a day, for several minutes at a time but takes one to three months to begin to have an effect.

<span class="mw-page-title-main">Preterm birth</span> Birth at less than a specified gestational age

Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 weeks, very early preterm birth is between 28 and 32 weeks, early preterm birth occurs between 32 and 34 weeks, late preterm birth is between 34 and 36 weeks' gestation. These babies are also known as premature babies or colloquially preemies or premmies. Symptoms of preterm labor include uterine contractions which occur more often than every ten minutes and/or the leaking of fluid from the vagina before 37 weeks. Premature infants are at greater risk for cerebral palsy, delays in development, hearing problems and problems with their vision. The earlier a baby is born, the greater these risks will be.

<span class="mw-page-title-main">Peripheral neuropathy</span> Nervous system disease affecting nerves beyond the brain and spinal cord

Peripheral neuropathy, often shortened to neuropathy, refers to damage or disease affecting the nerves. Damage to nerves may impair sensation, movement, gland function, and/or organ function depending on which nerves are affected. Neuropathies affecting motor, sensory, or autonomic nerves result in different symptoms. More than one type of nerve may be affected simultaneously. Peripheral neuropathy may be acute or chronic, and may be reversible or permanent.

<span class="mw-page-title-main">Low back pain</span> Medical condition

Low back pain or lumbago is a common disorder involving the muscles, nerves, and bones of the back, in between the lower edge of the ribs and the lower fold of the buttocks. Pain can vary from a dull constant ache to a sudden sharp feeling. Low back pain may be classified by duration as acute, sub-chronic, or chronic. The condition may be further classified by the underlying cause as either mechanical, non-mechanical, or referred pain. The symptoms of low back pain usually improve within a few weeks from the time they start, with 40–90% of people recovered by six weeks.

<span class="mw-page-title-main">Pressure ulcer</span> Skin ulcer (bed sore)

Pressure ulcers, also known as pressure sores, bed sores or pressure injuries, are localised damage to the skin and/or underlying tissue that usually occur over a bony prominence as a result of usually long-term pressure, or pressure in combination with shear or friction. The most common sites are the skin overlying the sacrum, coccyx, heels, and hips, though other sites can be affected, such as the elbows, knees, ankles, back of shoulders, or the back of the cranium.

Labor induction is the process or treatment that stimulates childbirth and delivery. Inducing (starting) labor can be accomplished with pharmaceutical or non-pharmaceutical methods. In Western countries, it is estimated that one-quarter of pregnant women have their labor medically induced with drug treatment. Inductions are most often performed either with prostaglandin drug treatment alone, or with a combination of prostaglandin and intravenous oxytocin treatment.

<span class="mw-page-title-main">Electrotherapy</span> Use of electricity for medical purposes

Electrotherapy is the use of electrical energy as a medical treatment. In medicine, the term electrotherapy can apply to a variety of treatments, including the use of electrical devices such as deep brain stimulators for neurological disease. The term has also been applied specifically to the use of electric current to speed wound healing. Additionally, the term "electrotherapy" or "electromagnetic therapy" has also been applied to a range of alternative medical devices and treatments.

<span class="mw-page-title-main">Cervical cerclage</span> Obstetrics medical procedure

Cervical cerclage, also known as a cervical stitch, is a treatment for cervical weakness, when the cervix starts to shorten and open too early during a pregnancy causing either a late miscarriage or preterm birth. In women with a prior spontaneous preterm birth and who are pregnant with one baby, and have shortening of the cervical length less than 25 mm, a cerclage prevents a preterm birth and reduces death and illness in the baby.

<span class="mw-page-title-main">Venous ulcer</span> Medical condition

Venous ulcer is defined by the American Venous Forum as "a full-thickness defect of skin, most frequently in the ankle region, that fails to heal spontaneously and is sustained by chronic venous disease, based on venous duplex ultrasound testing." Venous ulcers are wounds that are thought to occur due to improper functioning of venous valves, usually of the legs. They are an important cause of chronic wounds, affecting 1% of the population. Venous ulcers develop mostly along the medial distal leg, and can be painful with negative effects on quality of life.

<span class="mw-page-title-main">Postpartum bleeding</span> Loss of blood following childbirth

Postpartum bleeding or postpartum hemorrhage (PPH) is often defined as the loss of more than 500 ml or 1,000 ml of blood following childbirth. Some have added the requirement that there also be signs or symptoms of low blood volume for the condition to exist. Signs and symptoms may initially include: an increased heart rate, feeling faint upon standing, and an increased breathing rate. As more blood is lost, the patient may feel cold, blood pressure may drop, and they may become restless or unconscious. In severe cases circulatory collapse, disseminated intravascular coagulation and death can occur. The condition can occur up to twelve weeks following delivery in the secondary form. The most common cause is poor contraction of the uterus following childbirth. Not all of the placenta being delivered, a tear of the uterus, or poor blood clotting are other possible causes. It occurs more commonly in those who already have a low amount of red blood, are Asian, have a larger fetus or more than one fetus, are obese or are older than 40 years of age. It also occurs more commonly following caesarean sections, those in whom medications are used to start labor, those requiring the use of a vacuum or forceps, and those who have an episiotomy.

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease that affects the central nervous system (CNS). Several therapies for it exist, although there is no known cure.

<span class="mw-page-title-main">Sulprostone</span> Chemical compound

Sulprostone is an analogue of prostaglandin E2 (PGE2) that has oxytocic activity in assays of rat kidney cells and tissues. There are four known receptors which mediate various but often different cellular and tissue responses to PGE2: prostaglandin EP1 receptor, prostaglandin EP2 receptor, prostaglandin EP3 receptor, and prostaglandin EP4 receptor. Sulprosotone binds to and activates the prostaglandin EP3 receptor with far greater efficacy than the other PGE2 receptors and also has the advantage of being relatively resistant, compared with PGE2, to becoming metabolically degraded. It is listed as a comparatively weak receptor agonist of the prostaglandin EP1 receptor. In all events, this as well as other potent synthetic EP3 receptor antagonists have the realized or potential ability to promote the beneficial effects of prostaglandin EP3 receptor activation.

A uterotonic, also known as an oxytocic or ecbolic, is a type of medication used to induce contraction or greater tonicity of the uterus. Uterotonics are used both to induce labor and to reduce postpartum hemorrhage.

<span class="mw-page-title-main">Diabetic foot ulcer</span> Medical condition

Diabetic foot ulcer is a breakdown of the skin and sometimes deeper tissues of the foot that leads to sore formation. It may occur due to a variety of mechanisms. It is thought to occur due to abnormal pressure or mechanical stress chronically applied to the foot, usually with concomitant predisposing conditions such as peripheral sensory neuropathy, peripheral motor neuropathy, autonomic neuropathy or peripheral arterial disease. It is a major complication of diabetes mellitus, and it is a type of diabetic foot disease. Secondary complications to the ulcer, such as infection of the skin or subcutaneous tissue, bone infection, gangrene or sepsis are possible, often leading to amputation.

The postpartum physiological changes are those expected changes that occur in the woman's body after childbirth, in the postpartum period. These changes mark the beginning of the return of pre-pregnancy physiology and of breastfeeding. Most of the time these postnatal changes are normal and can be managed with medication and comfort measures, but in a few situations complications may develop. Postpartum physiological changes may be different for women delivering by cesarean section. Other postpartum changes, may indicate developing complications such as, postpartum bleeding, engorged breasts, postpartum infections.

References

  1. ↑ Collin (2008). Dictionary of Medical Terms. A&C Black – via Credo Reference.
  2. 1 2 3 Allen, C; Glasziou, P; Del Mar, C (9 October 1999). "Bed rest: a potentially harmful treatment needing more careful evaluation". Lancet. 354 (9186): 1229–33. doi:10.1016/s0140-6736(98)10063-6. PMID   10520630. S2CID   12196831.
  3. ↑ Bed Rest During Pregnancy
  4. ↑ "Archived copy". Archived from the original on 2013-10-04. Retrieved 2013-06-23.{{cite web}}: CS1 maint: archived copy as title (link)
  5. ↑ McCall, Christina A.; Grimes, David A.; Lyerly, Anne Drapkin (June 2013). ""Therapeutic" bed rest in pregnancy: unethical and unsupported by data". Obstetrics and Gynecology. 121 (6): 1305–1308. doi:10.1097/AOG.0b013e318293f12f. ISSN   1873-233X. PMID   23812466.
  6. ↑ McCall, CA; Grimes, DA; Lyerly, AD (June 2013). ""Therapeutic" bed rest in pregnancy: unethical and unsupported by data". Obstetrics and Gynecology. 121 (6): 1305–8. doi:10.1097/aog.0b013e318293f12f. PMID   23812466.
  7. ↑ Sosa, CG; Althabe, F; Belizán, JM; Bergel, E (30 March 2015). "Bed rest in singleton pregnancies for preventing preterm birth". The Cochrane Database of Systematic Reviews. 2015 (3): CD003581. doi:10.1002/14651858.CD003581.pub3. hdl: 11336/51713 . PMC   7144825 . PMID   25821121.
  8. ↑ Meher, Shireen; Abalos, Edgardo; Carroli, Guillermo; Meher, Shireen (2005). "Bed rest with or without hospitalisation for hypertension during pregnancy". Cochrane Database of Systematic Reviews. 2010 (4): CD003514. doi:10.1002/14651858.CD003514.pub2. PMC   8715743 . PMID   16235323.
  9. ↑ Aleman, Alicia; Althabe, Fernando; Belizán, José M; Bergel, Eduardo; Althabe, Fernando (2005). "Bed rest during pregnancy for preventing miscarriage". Cochrane Database of Systematic Reviews. 2010 (2): CD003576. doi:10.1002/14651858.CD003576.pub2. PMC   8721648 . PMID   15846669.
  10. 1 2 Crowther, Caroline A; Han, Shanshan; Crowther, Caroline A (2010). "Hospitalisation and bed rest for multiple pregnancy". Cochrane Database of Systematic Reviews. 2010 (7): CD000110. doi:10.1002/14651858.CD000110.pub2. PMC   7051031 . PMID   20614420.
  11. ↑ Küçük, M (April 2013). "Bed rest after embryo transfer: Is it harmful?". European Journal of Obstetrics, Gynecology, and Reproductive Biology. 167 (2): 123–6. doi:10.1016/j.ejogrb.2012.11.017. PMID   23274041.
  12. ↑ Weiner, Richard (2002). Pain management: a practical guide for clinicians. Boca Raton: CRC Press. p. 741. ISBN   978-0-8493-0926-7.
  13. ↑ Hagen, KB; Jamtvedt, G; Hilde, G; Winnem, MF (1 March 2005). "The updated cochrane review of bed rest for low back pain and sciatica". Spine. 30 (5): 542–6. doi:10.1097/01.brs.0000154625.02586.95. PMID   15738787. S2CID   33969187.
  14. ↑ North American Spine Society (February 2013), "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation , North American Spine Society, retrieved 25 March 2013
  15. ↑ Moore, ZE; van Etten, MT; Dumville, JC (17 October 2016). "Bed rest for pressure ulcer healing in wheelchair users". The Cochrane Database of Systematic Reviews. 2016 (10): CD011999. doi:10.1002/14651858.CD011999.pub2. PMC   6457936 . PMID   27748506.
  16. ↑ "Sydenham Chorea Information Page | National Institute of Neurological Disorders and Stroke". ninds.nih.gov. Retrieved 30 January 2017.
  17. ↑ Izcovich, A; Popoff, F; Rada, G (28 June 2016). "Early mobilization versus bed rest for deep vein thrombosis". Medwave. 16 (Suppl2): e6478. doi: 10.5867/medwave.2016.6478 . PMID   27391009.
  18. ↑ Bleeker MW, De Groot PC, Rongen GA, et al. (October 2005). "Vascular adaptation to deconditioning and the effect of an exercise countermeasure: results of the Berlin Bed Rest study". Journal of Applied Physiology. 99 (4): 1293–300. doi:10.1152/japplphysiol.00118.2005. PMID   15932956.
  19. ↑ "Ulcer." The Columbia Encyclopedia, Columbia University, and Paul Lagasse, Columbia University Press, 2016. Credo Reference.
  20. ↑ Woods, Susan L. (2005). Cardiac nursing. Hagerstwon: Lippincott Williams & Wilkins. p. 921. ISBN   978-0-7817-4718-9.
  21. ↑ Sell, Rebecca; Rothenberg, Mikel; Chapman, Charles F. (November 1, 2012). Dictionary of Medical Terms (6th ed.). New York: Barron's Educational Series. ISBN   978-0-7641-4758-6. Archived from the original on 10 May 2017. Retrieved 5 September 2016.
  22. ↑ "Bed rest during pregnancy: Get the facts". Mayo Clinic. 2011. Retrieved 27 March 2014.
  23. ↑ Atsunori Kamiya; Satoshi Iwase; Daisaku Michikami; Qi Fu; Tadaaki Mano (1 March 2000). "Head-down bed rest alters sympathetic and cardiovascular responses to mental stress". American Journal of Physiology. Regulatory, Integrative and Comparative Physiology. 279 (2): R440–R447. doi:10.1152/ajpregu.2000.279.2.R440. PMID   10938230. S2CID   26443012. To examine effects of microgravity on vasomotor sympathetic and peripheral vasodilator responses to mental stress, we performed 10 min of mental arithmetic (MA) before and after 14 days of 6° head-down bed rest (HDBR), a ground-based simulation of spaceflight.
    • Millet, C.; Custaud, MA; Maillet, A; Allevard, AM; Duvareille, M; Gauquelin-Koch, G; Gharib, C; Fortrat, JO (March 2001). "Endocrine responses to 7 days of head-down bed rest and orthostatic tests in men and women". Clinical Physiology. 21 (2): 172–183. doi:10.1046/j.1365-2281.2001.00315.x. PMID   11318825.
    • Edgell, Heather (December 2007). "WISE-2005: adrenergic responses of women following 56-days, 6° head-down bed rest with or without exercise countermeasures". Environmental, Exercise and Respiratory Physiology.
    • Randa L. Shehab; Robert E. Schlegel (August–September 1998). "The NASA performance assessment workstation: Cognitive performance during head-down bed rest". Acta Astronautica. 43 (3–6): 223–233. Bibcode:1998AcAau..43..223S. doi:10.1016/s0094-5765(98)00156-8. PMID   11541926.
    • Wilson, Thad (4 January 2003). "Effects of 14 days of head-down tilt bed rest on cutaneous vasoconstrictor responses in humans". Journal of Applied Physiology. 94 (6): 2113–2118. doi:10.1152/japplphysiol.00067.2002. PMID   12524372. S2CID   6965213.
    • Meck, Janice V.; Dreyer, Sherlene A.; Warren, L. Elisabeth (May 2009). "Long-Duration Head-Down Bed Rest: Project Overview, Vital Signs, and Fluid Balance". Aviation, Space, and Environmental Medicine. 80 (Supplement 1): A1–A8. doi:10.3357/asem.br01.2009. PMID   19476163.
    • Shibasaki, Manabu (November 1, 2003). "Exercise throughout 6° head-down tilt bed rest preserves thermoregulatory responses". Journal of Applied Physiology. 95 (5): 1817–1823. doi:10.1152/japplphysiol.00188.2003. PMID   12882999.
  24. ↑ Geller, Jeffery L. (1994). Women of the Asylum: Voices from Behind the Walls 1840-1945. New York: Anchor Books. pp. 161–168.
  25. ↑ Gilman, Charlotte Perkins. "The Yellow Wallpaper". The Norton Anthology of English Literature. New York: Gale, 1996. 230‐37. Print.
  26. ↑ Geller, Jeffery L. (1994). Women of the Asylum: Voices from Behind the Walls 1840-1945. New York: Anchor Books. pp. 161–167.
  27. ↑ Gilman, Charlotte. ""Why I Wrote "The Yellow Wallpaper"". Charlotte Perkins Gilman.
  28. ↑ "Feminist Gothic in "The Yellow Wallpaper"".
  29. ↑ Lee, Hermione (1996). Virginia Woolf (1. publ. in Great Britain ed.). London: Chatto & Windus. ISBN   978-0-7011-6507-9.
  30. ↑ Dock, William (1944). "The evil sequelae of complete bed rest". Journal of the American Medical Association. 125 (16): 1083. doi:10.1001/jama.1944.02850340009004. ISSN   0002-9955.

Further reading

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.