Читать книгу The sexual life of woman in its physiological, pathological and hygienic aspects - E. Heinrich Kisch - Страница 6
ОглавлениеFig. 6.
Still another point of view from which the influences affecting the female organism as a whole may be regarded has very recently become apparent in consequence of the doctrine of Brown-Séquard relating to the internal secretions of ductless glands. As regards the female reproductive glands, which in consequence of their structure must be referred to the group of ductless glands, and yet owing to their secretory function must be classed among secreting glands (so that the nature of the ovary is that of a secreting gland without an excretory duct), it would appear that these glands are not concerned only with the specific female reproductive functions of menstruation and ovulation, but that they also exercise a powerful influence on the nutritive processes, on metabolism and hæmatopoiesis, and on growth and development in their mental as well as their physical relations.
It is supposed that these glands under normal conditions enrich the blood with certain substances, which in part assist in hæmatopoiesis, and in part by regulating the vascular tone in the various organs are concerned in the normal processes of assimilation and general metabolism. According to Etienne and Demange, ovariin possesses an oxidising power similar to that possessed by spermin. Thus it becomes easy to understand how disturbances in the functions of the ovaries give rise to disturbances in the processes of general metabolism and of assimilation. Some go even further, though in doing so they leave the ground of assured fact, suggesting that the ovary in certain circumstances produces toxins, or that the normal ovary possesses an antitoxic function, and speaking of an occasional ovarian auto-intoxication of the body or of a menstrual intoxication. Thus, chlorosis is by some regarded as a disturbance of hæmatopoiesis, dependent on an abnormal condition of the female reproductive organs during the period of development, and referable to a disturbance of the internal secretion of the ovaries (Charrin, von Noorden, Salmon, Etienne, and Demange). And it is now generally assumed, the assumption being based on the observations recently made concerning the organo-therapeutic employment of the chemical constituents of the ovary, that many of the disorders, and especially those connected with the vasomotor system, common during the climacteric period, are dependent on the deficiency of the products of the internal secretion of the ovary that accompanies the cessation of the menses.
Recent experimental investigations on this subject have shown that the interconnection between the female genital organs and the organism as a whole, between the functions of the reproductive organs and the functions of other organs, does not depend on nervous influences only, but that in this interconnection the blood vascular system and the lymphatic vascular system also play their parts. Goltz has proved by actual experiment that the nervous influence on menstruation and ovulation is not the only determinant. In a bitch, he divided the spinal cord at the level of the first lumbar vertebra, and observed, as soon as the animal had recovered from the operation, the appearance of the usual signs of heat; the bitch was impregnated, and gave birth to one living and two dead puppies; lactation and sucking took place as in a normal animal. When the bitch was killed and the body examined it was found that no reunion had taken place in the severed spinal cord. The experiments of Halban gave similar results. He found that in apes, if the ovaries are removed from their normal situation and successfully transplanted to some region remote from the genital organs, the animals remain capable of menstruating. But if the ovaries, which have been transplanted beneath the skin or beneath the peritoneum, are subsequently entirely removed, menstruation, which has continued regularly after the first operation, ceases altogether after the second. It follows from these experiments that the cessation of the menstrual process may be considered to be brought about through the intermediation of the lymphatic or blood-vascular system, by the absence of a kind of internal secretion.
Loewy and Richter have further proved by experiment that in spayed bitches the consumption of nitrogen is less by about 20 per cent. and the entire gaseous interchange less by about 9 per cent., as compared with what takes place in normal animals, and that this change in respiratory metabolism lasts for a long time after the oöphorectomy, for as much as nine to twelve months. If dried ovaries are given to such animals in their food, the gaseous interchange rises to the former level and even higher.
The undulatory movement of the vital processes in woman is apparently in some way dependent on ovulation, though the nature of the connection has not hitherto been fully elucidated. This view is confirmed by the fact that no such rhythmic variation in the bodily functions can be detected either in girls under thirteen years of age, or in women from fifty-eight to eighty years of age in whom menstrual activity has entirely disappeared. The menstrual rhythm begins at puberty and ends when ovulation ceases.
A further contribution to the doctrine of the undulatory movement of the vital processes in woman is to be found in my own observations that pathological symptoms which have become manifest before and at the time of the first onset of menstruation, and have given but little trouble throughout the period of developed and regular sexual activity, are apt when menstruation ceases to recrudesce, and to become as prominent as they were at the commencement of the sexual life. Women who at the time of puberty suffered from cardiac troubles, from digestive disturbances, or from various forms of nervous irritation, and in whom as they grew up these disorders passed more or less into abeyance, are apt at the climacteric period to exhibit, as I have frequently been able to observe, a violent return of these symptoms, in the form, as the case may be, of tachycardia, of dyspeptic troubles, or of psychoneuroses. In this connection we may mention an observation of Potain’s, who distinguishes a peculiar form of chlorosis, occurring in individuals of delicate constitution, which, though apparently cured, reappears at the menopause.
Related to the sexual life of woman is another attribute, one intimately connected with the idea of the female sex, and one which since the primeval days of humanity has filled men with delight and poets with inspiration—the attribute of beauty.
The beauty of woman, a prominent secondary sexual character, makes its first appearance at puberty, when the girl’s form, hitherto undifferentiated in its external bodily configuration, begins to assume a soft and rounded appearance, when the features become regular, the breasts enlarge, and the pubic hair begins to grow—when, in short, to the primary sexual characters already existing, the secondary sexual characters are superadded.
Feminine beauty continues to increase until the attainment of sexual maturity. In her third decade woman arrives at the acme of her sexual life and at the same time attains the perfection of her beauty.
The ensuing sexual phases, pregnancy, parturition, and lactation, entail a decline in beauty, not rapid indeed, but advancing gradually, with the slow yet sure-footed pace of time. The organic revolutions accompanying these processes leave traces recorded upon the surface of the body in conspicuous and indelible characters. The illnesses, also, which so often accompany the fulfilment of sexual functions, in injuring health impair also beauty.
A woman who has given birth to and nursed an infant begins to lay on fat, and this tendency to obesity becomes more pronounced as the climacteric period approaches. The breasts become inelastic and pendent, the abdomen becomes ungracefully prominent; the tonicity of the entire organism gradually declines, and, in consequence of the loss of elasticity in the subcutaneous cellular tissue, the dreaded wrinkles make their appearance and the features become wizened. Beauty is a thing of the past. With the cessation of the sexual life the external secondary sexual characters disappear, and the old woman is even farther removed than the old man from our conception of beauty.
As Mantegazza insists, the beauties peculiar to women are one and all sexual; they depend, that is to say, upon the peculiar functions that nature has allotted to woman in the great mystery of procreation. One of the most vivid and poetical descriptions in ancient or modern literature of these secondary sexual characters on which feminine beauty depends is to be found in the Song of Solomon.
In the following figure (Fig. 7) the curve of beauty of woman is given as drawn up by Stratz. In one case it may rise very quickly, to decline with equal quickness—the so-called beauté du diable;[16] in other cases, again, the curve rises very slowly, and declines also very slowly, the culmination of the curve being in this case attained later, and when attained being absolutely higher, than in the case of the steeper curve.
Fig. 7.
The age at which the maximum of beauty is attained is a very variable one. In the southern races this often occurs as early as the fourteenth or fifteenth year of life; but in the peoples of the Teutonic stock, Germans, Dutch, Scandinavians, and English, not as a rule before the twentieth year, and it may be even later. Stratz has known cases in which women did not attain the prime of their beauty until the thirtieth and even the thirty-third year. The same author, a most competent authority as regards the subject of feminine beauty, affirms that a beautiful woman is most beautiful when the period of maximum beauty coincides in her case with the first month of her first pregnancy. With the commencement of pregnancy the processes of nutrition are accelerated, all the tissues are tensely filled, the skin is more delicately and at the same time more brightly tinted owing to the greater activity of the circulation, the breasts become firmer and more elastic. Thus the attractive characteristics of beauty at its fullest maturity become enhanced, but for a short time only, since the enlargement of the abdomen in the further course of pregnancy impairs the harmony of the figure. Finally we must point out, before dismissing this subject, that women of the so-called better classes arrive as a rule at maturity later, and remain beautiful for a longer period, than women of the working classes.
The degree to which the female organism as a whole is influenced by the processes of the sexual life that occur in the genital organ depends upon many of the characteristics that combine to make up the individuality. Inherited characteristics, temperament, and race, play a great part in this connection; and not less important than these are the social conditions, the environment, in which the women under consideration pass their life. Thus, among women belonging to the poorer, labouring classes, the reflex manifestations in other organs dependent upon the processes of the genital organs are less frequent and less intense than among women belonging to the well-to-do strata of society and to the cultured classes; less also in the country than in large towns. In phlegmatic individuals, such manifestations exhibit less intensity than in those of an active, ardent temperament; they are less frequent in persons with a powerful constitution than in those endowed by inheritance with an unstable nervous system. Finally, they are less often encountered among families whose upbringing has aimed at hardening the constitution and at inculcating the control of instinctive impulses, than among those in whom from early childhood sensibility and impulsiveness have been given a loose rein.
Extremely variable also are the sympathetic disturbances and morbid states which depend on the processes of the sexual life of woman. “Le cri de l’organe souffrant ne vient pas de l’utérus, mais de tout l’organisme,”[17] says Courty. And a large number of isolated observations has shown how complex are the relations between the healthy and unhealthy female genital organs and the other organs of the body as well as the organism as a whole. Precise and incontestable proofs exist of such relations between the female genital organs and morbid changes in the eye and ear, the skin, the respiratory organs, and the vascular and nervous systems.
The influence exercised by the reproductive system on the general vital processes of woman is indicated also by the general statistics of mortality and the incidence of disease. Mortality in women, the earliest years of childhood being left out of consideration, is at its highest precisely during the great sexual epochs, namely at the time of puberty, during pregnancy, during the puerperium, and at the climacteric period. The complete performance of the reproductive functions entails a higher proportion of illnesses and death; and statistical records show that the mortality of married women between twenty and forty years of age, during the period, that is to say, in which in consequence of marriage they fulfil the duties of sexual intercourse and procreation, and are exposed to the dangers connected with these sexual acts, is much higher than the mortality of unmarried women of corresponding ages. Infection with the gonococcus and with the virus of syphilis, chronic salpingitis, metritis, and parametritis, the manifold diseases of pregnancy, the diseases of the puerperium, the various displacements of the uterus, osteomalacia—all these are pathological states the dependence of which upon the sexual life of the married or at any rate sexually active woman is indisputable. But the complete renunciation of sexual activity appears also to exercise an injurious influence on the health, and to give rise or at least predispose to morbid manifestations. Hysteria, for instance, chlorosis, uterine myomata, and various neuroses, have long been supposed to depend in part upon such renunciation, though the causal connection cannot be regarded as yet fully established.
Especially true as regards woman, indeed, is that which Ribbing says concerning the sexual life in general: “Since all human life and being has its origin in sexual relations, these sexual relations may be regarded as the heart of humanity. We may work day and night for the good of humanity, we may sacrifice for that good our time and our blood, but all this work and all this sacrifice appear to me to remain useless if we neglect and despise the sexual life, the eternally self-renewing elementary school of true altruism.”
From the vital phase in which, marked by the visible manifestations of puberty and by the first appearance of menstruation, ovulation is assumed to begin, the sexual life of woman continues to the period of life in which, marked by the climacteric cessation of menstruation, ovulation also ceases. The total duration of this sexual period in woman’s life is usually about thirty years; but it is subject to great variations, from six to forty-six years according to the available statistics, these variations depending upon climate, race, constitution, and the sexual activity of the person under consideration.
The duration and the intensity of the sexual life of woman depends upon a series of external conditions affecting the individual, but especially upon the inherited predispositions, upon the constitutional conditions, upon the varying vital power of the individual. My own observations have led me to formulate, as a general law, that the earlier a woman (climatic and social conditions being similar in the cases under comparison) arrives at puberty, the earlier, that is to say, that menstruation first makes its appearance, the greater will be the intensity and the longer the duration of sexual activity, the more will the woman in question be predisposed to bear many children, the more powerfully will the sexual impulse manifest itself in her, and the later will the menopause appear. It seems that in such women a more intense vitality animates the reproductive system, bringing about an earlier ripening of ova, a more favorable predisposition on the part of these ova to fertilization by the spermatozoa, a livelier manifestation of sexual sensibility, and a longer duration of ovarian functional activity.
My general views on this subject are embodied in the following propositions:
1. The duration of sexual activity is less in the women belonging to the countries of southern Europe than in those belonging to the countries of northern Europe. It would appear that in those climates in which ovulation begins sooner and menstruation first appears at an earlier age, the menopause also appears earlier; but that, on the contrary, in those climates in which puberty is late in its appearance, the decline of sexual activity is similarly postponed.
2. Women in our mid-European climates, in whom puberty appears at an early age, the first menstruation occurring between the ages of thirteen and sixteen, exhibit a more prolonged duration of the sexual life, of menstrual functional activity, than women in whom menstruation begins late, between the ages of seventeen and twenty. Extremely early appearance of the first menstruation—so early as to be altogether abnormal—has, however, the same significance as abnormally late onset of menstruation; both indicate that the sexual life will be of short duration.
3. Women whose reproductive organs have been the seat of a sufficient amount of functional activity, who have had frequent sexual intercourse, have given birth to several children, and have themselves suckled their children, have a sexual life of longer duration, as manifested by the continuance of menstruation, than women whose circumstances have been just the opposite of these, unmarried women, for instance, women early widowed, and barren women. Sexual intercourse at a very early age, however, accelerates the onset of the climacteric period and the termination of the sexual life. The same result follows severe or too frequent confinements.
4. The sexual life has a shorter duration in the women of the laboring classes and belonging to the lower strata of social life, as compared with upper class and well-to-do women. Bodily hardships, grief, and anxiety also hasten the onset of sexual death.
5. Women who are weakly and always ailing have a shorter sexual life than women who are powerfully built and always in good health. When irregularities and disorders have appeared in the various sexual phases, the decline of sexual activity occurs earlier than in women whose functions have in this respect been normal. Certain constitutional conditions, such as extreme obesity, certain acute diseases, such as typhoid fever, malaria, and cholera, and certain diseases of the uterus and its annexa, chronic inflammatory conditions for instance, bring about a notable shortening of the duration of the sexual life.
In 500 cases that have come under my own observation, the women concerned belonging to very various nationalities, the duration of the sexual life, as witnessed by the continuance of menstruation, was as follows:
Menstruation continued for:
| 6 years in | 1 woman. |
| 7 years in | 1 woman. |
| 9 years in | 2 women. |
| 11 years in | 4 women. |
| 15 years in | 6 women. |
| 16 years in | 8 women. |
| 17 years in | 12 women. |
| 18 years in | 15 women. |
| 19 years in | 9 women. |
| 20 years in | 6 women. |
| 21 years in | 18 women. |
| 22 years in | 20 women. |
| 23 years in | 24 women. |
| 24 years in | 18 women. |
| 25 years in | 16 women. |
| 26 years in | 25 women. |
| 27 years in | 26 women. |
| 28 years in | 29 women. |
| 29 years in | 36 women. |
| 30 years in | 22 women. |
| 31 years in | 32 women. |
| 32 years in | 49 women. |
| 33 years in | 31 women. |
| 34 years in | 26 women. |
| 35 years in | 12 women. |
| 36 years in | 12 women. |
| 37 years in | 10 women. |
| 38 years in | 8 women. |
| 39 years in | 6 women. |
| 40 years in | 2 women. |
| 43 years in | 2 women. |
| 45 years in | 1 woman. |
| 46 years in | 1 woman. |
Thus we see that the duration of the sexual life varies from 6 to 46 years. The most frequent duration is one of 32 years, next to this one of 29, next again, 31, 33, and 37 years, respectively. In 6 women only did the duration of the sexual life exceed 40 years, and in 4 only was it less than 11 years. In half of all my cases the duration of the sexual life was between 27 and 34 years, and from these figures we obtain an average duration of about 30 years.
For North Germany, Krieger gives data from which it appears that in this region the average duration of the sexual life is 30.49 years. In more than half of the 722 cases recorded by this writer the duration was between 31 and 37 years. In isolated cases the duration was very short, not exceeding 8, 9, or 10 years, or, on the other hand, as long as 47 years; whilst the number of cases increased fairly regularly up to the duration of 34 years, and thereafter again diminished.
As regards Austria, Szukits has collected information in the case of 269 women, and found, in these, that the duration of the sexual life varied from 12 to 45 years. The average duration was 29.16 years; in more than half of the women, the period of sexual activity lasted from 21 to 30 years; the shortest period observed was 12 years, the longest 45 years.
The period of sexual activity lasted:
| 12 years in | 2 women. |
| 14 years in | 1 woman. |
| 15 years in | 2 women. |
| 17 years in | 3 women. |
| 19 years in | 3 women. |
| 20 years in | 17 women. |
| 21 years in | 10 women. |
| 22 years in | 7 women. |
| 23 years in | 5 women. |
| 24 years in | 17 women. |
| 25 years in | 7 women. |
| 26 years in | 13 women. |
| 27 years in | 5 women. |
| 28 years in | 26 women. |
| 29 years in | 18 women. |
| 30 years in | 17 women. |
| 31 years in | 8 women. |
| 32 years in | 8 women. |
| 33 years in | 13 women. |
| 34 years in | 8 women. |
| 35 years in | 18 women. |
| 36 years in | 19 women. |
| 37 years in | 14 women. |
| 38 years in | 9 women. |
| 39 years in | 8 women. |
| 40 years in | 1 woman. |
| 42 years in | 1 woman. |
| 43 years in | 1 woman. |
| 44 years in | 2 women. |
| 45 years in | 2 women. |
In Poland, according to Raciborski, the duration of sexual activity is in Jewesses 23 years, but in women of Slavonic blood 31 years.
In France, according to Courty and Puech, the usual duration of the sexual life is from 28 to 30 years.
According to Puech, among 10 women menstrual activity lasted:
| 33 years in | 2 women. |
| 35 years in | 1 woman. |
| 36 years in | 2 women. |
| 39 years in | 2 women. |
| 43 years in | 2 women. |
| 44½ years in | 1 woman. |
Brierre de Boismont gives the following particulars of the duration of menstrual activity in 178 Frenchwomen:
| 5 years in | 1 woman. |
| 6 years in | 1 woman. |
| 8 years in | 1 woman. |
| 11 years in | 1 woman. |
| 16 years in | 4 women. |
| 17 years in | 4 women. |
| 18 years in | 1 woman. |
| 19 years in | 3 women. |
| 20 years in | 3 women. |
| 21 years in | 4 women. |
| 22 years in | 3 women. |
| 23 years in | 12 women. |
| 24 years in | 8 women. |
| 25 years in | 8 women. |
| 26 years in | 11 women. |
| 27 years in | 7 women. |
| 28 years in | 6 women. |
| 29 years in | 7 women. |
| 30 years in | 13 women. |
| 31 years in | 13 women. |
| 32 years in | 9 women. |
| 33 years in | 9 women. |
| 34 years in | 7 women. |
| 35 years in | 5 women. |
| 36 years in | 10 women. |
| 37 years in | 6 women. |
| 38 years in | 5 women. |
| 39 years in | 2 women. |
| 40 years in | 7 women. |
| 41 years in | 1 woman. |
| 42 years in | 3 women. |
| 44 years in | 2 women. |
| 48 years in | 1 woman. |
For England, Tilt gives the mean duration of menstrual activity, as observed in 500 women, as 31.21 years; it varies between 11 and 47 years; there are more cases with a period of 34 years than with any other integral number of years. Tilt found the duration to be:
| 11 years in | 1 woman. |
| 13 years in | 1 woman. |
| 15 years in | 3 women. |
| 16 years in | 1 woman. |
| 17 years in | 2 women. |
| 18 years in | 4 women. |
| 19 years in | 1 woman. |
| 20 years in | 3 women. |
| 21 years in | 6 women. |
| 22 years in | 11 women. |
| 23 years in | 11 women. |
| 24 years in | 10 women. |
| 25 years in | 22 women. |
| 26 years in | 11 women. |
| 27 years in | 25 women. |
| 28 years in | 29 women. |
| 29 years in | 35 women. |
| 30 years in | 36 women. |
| 31 years in | 33 women. |
| 32 years in | 38 women. |
| 33 years in | 35 women. |
| 34 years in | 49 women. |
| 35 years in | 33 women. |
| 36 years in | 26 women. |
| 37 years in | 16 women. |
| 38 years in | 15 women. |
| 39 years in | 15 women. |
| 40 years in | 6 women. |
| 41 years in | 4 women. |
| 42 years in | 7 women. |
| 43 years in | 5 women. |
| 44 years in | 3 women. |
| 45 years in | 1 woman. |
| 46 years in | 1 woman. |
| 47 years in | 3 women. |
For London the average figure is 34 years; for Paris, 30 years; for Vienna, 29 years; and for Berlin, 34 years.
From the data of various observers obtained from diverse nationalities, the following table has been compiled, exhibiting the mean duration of the sexual life:
| Comparative Table Showing the Duration of the Sexual Life in Various Nationalities. | |||||||
|---|---|---|---|---|---|---|---|
| Germany. | Austria. | France. | England. | Denmark. | Norway. | Russia. | |
| Number of Cases | 722 | 265 | 178 | 500 | 312 | 391 | 100 |
| Mean duration of menstrual activity, in years | 30.4 | 29.1 | 29.1 | 31.8 | 27.9 | 32 | 31 |
| Observers’ names | Krieger, L. Mayer. | Szukits. | Brierre de Boismont. | Whitehead. | Hannover. | Faye & Vogt. | Lieven. |
In the temperate zone the sexual life of woman lasts longer than in the colder and subarctic regions. Still more favorable is the contrast between the temperate zone and the countries of the tropics, in which the duration of the period of menstrual activity is limited to eighteen or twenty years. According to some isolated observations the duration of sexual activity in Arabian women in Africa was as little as nine years.
A certain influence on the duration of the sexual life is exercised by the commencement of menstruation at an earlier or later age than the average. The total duration of menstrual activity is more variable in women who begin to menstruate early than in women who begin to menstruate late, in whom the duration of the sexual life is a more regular one. In those women who begin to menstruate early the mean duration of the sexual life is about thirty-three years, in those who begin to menstruate late it is about twenty-seven years.
The following data, based on the observation of 250 cases, are published by W. Guy, regarding the duration of the sexual life, that is to say of menstrual activity, in women beginning to menstruate early and those beginning to menstruate late, respectively:
| Menstruation began. | Duration of the sexual life. | |
|---|---|---|
| In | 5 cases in the 8th to the 10th year | Averaging 36.60 years. |
| In | 70 cases in the 11th to the 13th year | Averaging 33.65 years. |
| In | 110 cases in the 14th to the 16th year | Averaging 30.85 years. |
| In | 56 cases in the 17th to the 19th year | Averaging 28.35 years. |
| In | 9 cases in the 20th year or later | Averaging 20.45 years. |
A further analysis of these 250 cases is given by Guy in the following table:
| First appearance of menstruation. | Average age at which menstruation ceased, in years. | Duration of menstrual activity. | ||
|---|---|---|---|---|
| In | 1 case in the | 8th year | 42 | 34 years. |
| In | 2 cases in the | 9th year | 46 | 37 years. |
| In | 2 cases in the | 10th year | 47 | 37 years. |
| In | 10 cases in the | 11th year | 47.10 | 36.10 years. |
| In | 29 cases in the | 12th year | 45.34 | 33.34 years. |
| In | 31 cases in the | 13th year | 46.16 | 33.16 years. |
| In | 39 cases in the | 14th year | 45.33 | 31.33 years. |
| In | 40 cases in the | 15th year | 46.30 | 31.30 years. |
| In | 41 cases in the | 16th year | 46.14 | 30.14 years. |
| In | 26 cases in the | 17th year | 45.18 | 28.18 years. |
| In | 19 cases in the | 18th year | 46.87 | 28.87 years. |
| In | 11 cases in the | 19th year | 46.18 | 27.18 years. |
| In | 5 cases in the | 20th year | 40.80 | 20.80 years. |
| In | 3 cases in the | 21st year | 41.66 | 20.66 years. |
| In | 1 case in the | 23d year | 41 | 18 years. |
Hannover also gives data respecting the relation between the duration of menstrual activity and the early or late appearance of menstruation. These data are tabulated as follows:
| First appearance of menstruation. | Average age at which menstruation ceased, in years. | Duration of menstrual activity. | ||
|---|---|---|---|---|
| In | 5 cases in the | 12th year | 47.80 | 35.80 years. |
| In | 10 cases in the | 13th year | 45.89 | 32.89 years. |
| In | 50 cases in the | 14th year | 44.98 | 30.98 years. |
| In | 34 cases in the | 15th year | 45.56 | 30.56 years. |
| In | 38 cases in the | 16th year | 44.13 | 29.13 years. |
| In | 36 cases in the | 17th year | 43.00 | 26.00 years. |
| In | 49 cases in the | 18th year | 44.96 | 26.96 years. |
| In | 33 cases in the | 19th year | 44.79 | 25.79 years. |
| In | 38 cases in the | 20th year | 45.36 | 25.36 years. |
| In | 10 cases in the | 21st year | 44.10 | 23.10 years. |
| In | 4 cases in the | 22d year | 43.50 | 21.50 years. |
| In | 3 cases in the | 23d year | 44.33 | 21.33 years. |
| In | 4 cases in the | 24th year | 39.50 | 15.50 years. |
Totals: In 412 cases the average age at the menopause was 44.82, and the average duration of menstrual activity was 27.973 years.
From the tables of L. Mayer, Krieger has instituted a comparison between the duration of menstrual activity in 101 women who began to menstruate early and 180 women who began to menstruate late, finding in the case of the former a mean duration of 33.673 years, and in the case of the latter a mean duration of 27.344 years, showing therefore a sexual life longer on an average by 6.429 years in those in whom puberty was early as compared with those in whom puberty was late.
From the tables of Tilt, based on the observation of 164 cases, 76 women in whom menstruation appeared early and 88 in whom it appeared late, we learn that among the former the shortest duration of menstrual activity was 18 years, among the latter 12 years; among the former the longest duration was 37 years, among the latter only 33. The majority of those who began to menstruate early continued to menstruate for 28, 31, 32, 33, 34, 35, 36, 38, or 39 years; those who began to menstruate late, for 23, 27, 28, 30, or 31 years. The mean duration of the sexual life in those who began to menstruate early was 33.66 years; in those who began to menstruate late it was 28.28 years. Since the average duration of the menstrual function is given by Tilt as 31.33 years, those who began to menstruate early exceeded this average by 2.33 years, while those who began to menstruate late exhibited a duration of menstrual activity of at least three years less than the average.
In addition to climate, nationality, and the age at which menstruation begins, the sexual activity of women also exercises an influence on the duration of their sexual life, and of especial importance in this connection are the number of children born, and exercise or neglect of the function of lactation. From my own observations on this matter it appears, that in women who are healthy and of powerful constitution, whose reproductive organs have been sufficiently exercised, who have given birth to several children and have suckled these children themselves, the duration of menstrual activity is in general notably longer than in women whose circumstances have been just the opposite in these respects. Among the women in my own series of cases in whom menstrual activity lasted longest, of the 177 women in whom menstruation ceased between the forty-fifth and the fiftieth year of life, 1 only was unmarried, 2 were married but childless, 32 married with 1 or 2 children only, and 142 married and with more than 2 children; of the 89 women in whom menstruation ceased between the fiftieth and the fifty-fifth year of life, none were either unmarried or childless, 19 were married with 1 or 2 children, 17 married and with more than 2 children; of the 17 women in whom menstruation ceased later than the fifty-fifth year of life, there were 2 only with less than 2 children, but 10 who had each given birth to from 6 to 8 children. A similar influence is exercised by the function of lactation. Among 40 women who had not suckled their children, the average duration of menstrual activity was 4 years less than the general mean.
As regards the conditions of life, L. Mayer affirms that the duration of sexual activity among well-to-do women is on the average a year and a half longer than among women of the working classes.
Metschnikoff has drawn attention to the remarkable disharmony in the development of three of the phases of the sexual life of woman, inasmuch as the sexual impulse, the union of the sexes, and the capacity for procreation, which, considering their nature and purpose, might have been expected to be attuned so as to act in harmony, exhibit as a matter of fact no such relation; the different factors of the sexual function develop independently and unharmoniously. In a child not yet fitted to fulfil the function of procreation, the sexual impulse will none the less make its appearance, and be liable to misuse. In the girl the pelvis does not attain that complete development which fits it for the process of parturition until toward the age of twenty, whilst puberty occurs at the age of sixteen. “A girl of ten is capable of aspiring to play the part of a woman, but not before the age of sixteen is she fitted to play that part, nor indeed fitted to become a mother before the age of twenty.”
In general, we may say, regarding the women of our own part of the world, that in those who are healthy, who lead a regular life, are well fed, free from the pressure of anxieties, with their sexual functions sufficiently exercised, the duration of the sexual life is longer than in women whose circumstances are the reverse of those just enumerated. It is a sign of decadence when women of the well-to-do classes, leading a life of ease, manifest a diminished duration of the sexual life. The greatest physical power and the highest ethical development are associated with a lengthening of life in general, and associated also with a lengthening alike in the sexual life of woman and the sexual potency of man. A decline in morals and culture entails a diminution of sexual vital capacity, this being true alike of individuals, of families, and of nations. Woman is venerated and valued the more, the longer the duration of her sexual life; a woman in whom the sexual life is short quickly loses value and significance, both in domestic and in social circles.
The social significance of the sexual life of woman is disproportionately greater and farther reaching than the sexuality of the male, as the former is concerned with the fundamental principles of human social life, influencing the constitution of the family, and controlling the good of the coming race. Sexual purity, which to the youth is a romantic dream, is to the maiden a vital condition of existence; adultery, in the husband a pardonable transgression, is in the wife an overwhelming sin committed against family life. To the freedom of the male in affairs of love is opposed the strict restraint of the female, based on monogamic marriage. The sexual needs and desires of the female are transformed in an ideal manner by means of the feeling of duty of the wife and mother; the violent pressure of the sexual impulse is restrained by the opposition of ethical forces. When this restraint fails, the running off the rails that ensues has a far profounder influence in the case of the female than of the male, an influence not limited to her own personality, but dragging down the whole family into the abyss of consequences, into the depths of moral and physical destruction.
Though in nature everywhere the same, the sexual life of woman exhibits in the various gradations of social life different outward manifestations, from the brutal sexual congress that does not greatly shun publicity, to the modern would-be philosophical free love. And throughout all variations the two darkest points remain, the illegitimate child and venereal infection, both of which entail upon the woman the most unspeakable anxieties and the greatest possible misery, whilst the man who is in either case to blame passes comparatively unscathed.
The social sexual position of woman suffers most at the present day from the mature age at which under existing social conditions men are alone able to marry and from the ever-increasing number of cases of venereal infection. In both these directions social science and medical skill must work hand in hand for the amelioration of the sexual life of woman.
On the twentieth century falls the duty of furnishing a solution for these problems. Contesting voices are heard on all sides. Tolstoi’s rigid demand for complete sexual abstinence, the exhortation of the professors of the German universities to their students in favor of moral purity, the associations for the official prevention of venereal diseases, the agitation among young men in favor of abstinence from sexual intercourse before marriage, finally, the clamorous voices of the supporters of women’s rights—all these are influences within the sphere of sexual morality, which must lead slowly but surely to extensive social changes in the sexual life of women.
The discussion of the sexual life of woman, which for many centuries was concealed by a thick veil from the eyes of the profane, or was viewed only through the frosted glass of poetical metaphor, has in recent times assumed a quite revolting character. Not only have the acquired liberties and the social aims of the present day a tendency to give to women in general a freer and higher position, to emancipate them from the bonds in which owing to the conditions of family life they have so long been shackled, but some members of the women’s rights party go even farther, and demand for women greater freedom in the sphere of sexual activity.
With this end in view the sexual life of woman is used as the fulcrum of the lever, and is withdrawn from the twilight into the open light of day, or indeed too often into a dazzling and altogether false illumination. Women writers especially, who have hitherto been accustomed to delude themselves and the world with sensational representations of the feminine soul, of feminine modesty, and the fineness of feminine sensibility in matters sexual, now find their greatest joy in unveiling themselves and their sisters before the face of all the world, and in discussing in the plainest language the most intimate processes of the genital organs. In writings exhibiting but little good taste, though all the more temperament, they emphasize again and again one side only of the sexual life, to wit, the sexual impulse, the force of which is intentionally exaggerated to a high degree, so that it is described as a mighty current of passion, which may with great pains be held in check for a season, but must ultimately break loose, and with devastating rage must overwhelm everything which has hitherto been regarded as discipline and good morals. Young girls, even, step down into the arena to take part in the contest concerning the reform that is to take place in the relations between men and women. Especially sensational in this connection was Eine für Viele. Aus dem Tagebuche eines Mädchens von Vera,[18] a book which, totally ignoring the biological differentiation of the sexes and their diverse sociological course of development, goes so far as to insist that from the man entering upon marriage, as from the woman, sexual purity and virginity are to be demanded. (The heroine of the book commits suicide because her lover has in earlier years had experience of sexual intercourse.)
From a mistaken standpoint other supporters of women’s rights oppose the ideal method in sex-relations, life-long monogamy, and the ideal of sexual sensibility, motherhood, and they put forward quite new sexual pretensions on behalf of women, as belonging to them by natural right. Upon these pretensions it is the duty of physicians, who truly know and truly prize womanhood, to pass their judgment, and that judgment, which will find ample justification in the ensuing descriptions of the individual phases of the sexual life of woman, is that the modern movement on behalf of the emancipation of women goes much too far. We do not, however, mean to imply that this movement is totally unjustified.
The growing girl must not, as has hitherto been the case, be kept in a state of ignorance (which is indeed in most cases apparent merely) regarding the sexual processes of her own body, she must no longer, when she asks to be informed concerning these matters, be put off with conventional lies and prevarication. But her enlightenment must not be effected in such a manner as to lead to excitement and excessive stimulation, to the awakening of slumbering feelings, and to the conversion of fantasy into a devouring flame. Sexual enlightenment must not be made an excuse for the unchaining of sensibility. When about to be married, a woman should certainly be instructed regarding her sexual duties and rights, and enter as one well informed into the act in which she is to play a leading part. But she ought not, with the excessive valuation of herself attained in recent times, to regard the man as her enemy, as one whom she is always justified in fighting and always ready to fight with the equal weapons of sexual transgression. It cannot be doubted that the ideal of “pure marriage” at an early age is one greatly to be prized as the foundation of a powerful future generation; but the real nature of the male must not be overlooked, nor must his sexual honor be put to too difficult a test. We regard as reasonable the modern demand of woman that in marriage her individuality should not be buried, and that space should be given for the development of her personality; but every sober-minded person will reject the “moral demand” for “ideal passion” in accordance with “entire mutual freedom” in the sexual relation between man and wife, and will regard such free love as social insanity and as a barbaric retrogression toward the rude sexual habits of savage peoples. Further, in view of the continually increasing intensity of the struggle for existence and in view of the difficulties of the task of rearing children, we cannot fail to recognize that it is not right for women to be overburdened with the task of reproduction, and that she does not live simply and solely for the bearing of children—but those rush to the other extreme who undervalue motherhood and the duties of maternity, who speak scornfully of the woman who is “a mother, and a mother only,” who despise women whom they regard merely as “means for the production of children,” and who employ all possible methods to free women from the pressing claims of nature and of society.
In all social circumstances, and in all times the great principle of sexual morality must dominate the sexual life of woman. As the ethical characteristics of the three great epochs in that sexual life we recognize the purity of the maiden, the faithfulness of the wife, and the love of the mother. But within the limits imposed by these demands it is still possible to satisfy the modern claim for a free development of the personality, and to accommodate the circumstances of the sexual life to the individual vital needs and vital claims of the present day.
