A widely accepted belief in the nineteenth century was that the health of American girls was inferior to that of their European counterparts. Dr. Clarke, a respected Boston physician, writing in 1871, had this to say about the alleged sickliness of American girls.
The delicate bloom, early but rapidly fading beauty, and singular pallor of American girls and women have almost passed into a proverb. The first observation of a European that lands upon our shores, is that our women are a feeble race; and, if he is a physiological observer, he is sure to add, they will give birth to a feeble race, not of women only, but of men as well. "I never saw before so many pretty girls together", said Lady Amberly to the writer, after a visit to the public schools of Boston; and then added, "They all looked sick." Circumstance have repeatedly carried me to Europe, where I am always surprised by the red cells that fills (sic) and colors (sic) the faces of ladies and peasant girls, reminding one of the canvas of Rubens and Murillo; and am always equally surprised on my return, by crowds of pale, bloodless female faces, that suggest consumption, scrofula, anemia, and neuralgia. To a large extent, our present system of educating girls is the cause of this pallor and weakness.1