Читать книгу The sexual life of woman in its physiological, pathological and hygienic aspects - E. Heinrich Kisch - Страница 7

Table of Contents

(PUBERTY.)

The term menarche (μήν, a month, ἀρχή, the beginning) was introduced by me into medical literature to denote the period of life in which, as a sign of puberty, menstruation first makes its appearance.

The age at which this occurs is subject to variations depending upon race, occupation, hereditary tendencies, and climate; but in Germany and Austria the average age at puberty is 14 or 15, the extreme limits being 12 to 19.

Until about the age of 13, the physical differentiation of the sexes, except for the anatomical peculiarities of the genital organs, is in our climates a trifling one. But at puberty the important changes occur by which the sexes are so strikingly differentiated. Whereas in the growing boy all physical change takes the form of increasing strength and energy, in the development of the girl, we note the appearances of the rounded outlines so characteristic of womanhood. At the same time the voice alters, becoming less sharp, with a softer quality, and yet a fuller tone; and we may observe that young brunettes have commonly a contralto voice, young blondes, more often a soprano. The intellectual changes undergone by the girl at puberty are no less extensive and characteristic than the physical changes. In brief, the undifferentiated, neuter girl is transformed into a young woman, endowed with all the attributes, mental and bodily, characteristic of femininity.

As regards the age at which the menarche usually occurs, and the manner in which its occurrence is anticipated or retarded by the various influences already mentioned, the following propositions may be put forward, based on the available statistics and observations:

1. Climate is an important factor. In the torrid zone, menstruation appears at a very early age, on the average from 11 to 14; in the temperate zone, it appears later, on the average from the age of 13 to 16; in the frigid zone, later still, on the average from the age of 15 to 18. The mean temperature of the atmosphere appears to have a direct influence on the age at which menstruation begins, the hotter the climate, the earlier being the menarche. The height of the place of residence above the sea level and its distance from the coast also have a certain influence.

2. Race and constitution have a distinct influence upon the age at which menstruation makes its appearance. In women of the Semitic races the menarche occurs earlier than in women of the Aryan races. The average age at which menstruation begins is in Jewish girls, from 14 to 15; in Magyar girls from 15 to 16; in German girls from 16 to 16½; and in Slavonic girls from 16 to 17.

In general the menarche is earlier in girls of a sanguine, lively temperament and a powerful constitution than in girls of a phlegmatic temperament and a weakly constitution; further, other things being equal, menstruation appears earlier in brunettes, girls with black hair, thick skin, dark eyes, and a dark complexion, than it appears in blondes, girls with light hair, thin skin, blue eyes, and a fair complexion.

3. The age at which menstruation begins is also affected by the conditions of life and the social circumstances. In the higher circles of society, in the upper, well-to-do classes, menstruation appears earlier than among women of the laboring classes, who are compelled to strive for their daily bread. Amongst upper-class girls the menarche occurs at the age of 14 in one-fourth of their number, whereas among lower-class girls barely one-sixth begin to menstruate at the age of 14.

In large towns, again, menstruation appears earlier than in small towns, whilst in the open country the menarche is still further delayed. In the women of Paris the average age at the menarche is 14 years and 6 months, in the women of smaller French towns it is 14 years and 9 months, in French countrywomen it is 14 years and 10 months.

How far the mode of nutrition is concerned in the production of these results is not yet determined.

4. The time of the menarche appears to be influenced by inheritance to this extent, that the daughters of women who began to menstruate early begin themselves to menstruate at an early age, whereas in other families we observe that both mothers and daughters began to menstruate late. But this relation is by no means a constant one.

Ploss has collected observations made in various countries and towns regarding the age at which menstruation begins, and the mean results of these observations are given below.

The average age at which menstruation began was:

In Swedish Lapland	18 years,	0 months,	0 days.
In Christiania	16 years,	9 months,	25 days.
In Copenhagen	16 years,	9 months,	12 days.
In Munich	16 years,	5 months,	12 days.
In Göttingen	16 years,	2 months,	2 days.
In Vienna	15 years,	8 months,	15 days.
In Berlin	15 years,	7 months,	6 days.
In Stockholm	15 years,	6 months,	22 days.
In Manchester	15 years,	6 months,	0 days.
In Warsaw	15 years,	1 month,	23 days.
In London, between	15 years,	1 month,	4 days.
and	14 years,	9 months,	9 days.
In Paris, between	15 years,	7 months,	18 days.
and	14 years,	5 months,	17 days.
In Madeira	14 years,	3 months,	0 days.
In Montpellier	14 years,	2 months,	0 days.
In Corfu	14 years,	0 months,	0 days.
In Marseilles	13 years,	11 months,	11 days.
In Calcutta	12 years,	6 months,	0 days.
In Egypt	10 years,	0 months,	0 days.

The collective results of the investigations of French authors regarding the average age at which menstruation first appears are given in the following table:

I. In Temperate Climates:
Observer.	Place.	No. of Cases.	Average Age.
De Soye	Paris	1,000	15 years,	0 months.
Dubois	Paris	600	15 years,	3 months.
Raciborski	Paris	200	14 years,	5 months.
M. Despines	Paris	85	14 years,	11 months.
Arau	Paris	100	15 years,	4 months.
Courty	Montpellier	600	14 years,	3 months.
Puech	Nîmes	941	14 years,	2 months.
M. Despines	Toulon	43	14 years,	1 month.
M. Despines	Marseilles	25	14 years,	1 month.
Puech	Toulon	144	14 years,	1 month.
Grey	London	1,498	15 years,	6 months.
Lee & Murphy	London	1,719	15 years,	6 month
Torisiano	Corfu	33	14 years,	6 months.
Lebrun	Warsaw	100	15 years,	1 month.

from these observations we obtain an average of 15 years.

II. In Cold Climates:
Observer.	Place.	No. of Cases.	Average Age.
Ravn	Copenhagen	3,840	16 years,	9 months.
Frugel	Christiania	157	16 years,	6 months.
Dubois	Russia	600	16 years,	8 months.
Faye	Norway	100	15 years,	6 months.
Lundborg	Esquimaux	16	15 years,	6 months.
Wistrand	Stockholm	100	15 years,	7 months.

from these observations we obtain an average of 16 years and 3 months.

III. In Hot Climates:
Observer.	Place.	No. of Cases.	Average Age.
Goodeve	Calcutta	239	12 years,	5 months.
Lith	Deccan	217	13 years,	5 months.
Robertson	Calcutta	540	12 years,	6 months.
Webb	Calcutta	39	12 years,	5 months.
Dubois	Asia	600	12 years,	11 months.

from these observations we obtain an average of 12 years and 7 months.

In 6,550 cases collected by Krieger menstruation first appeared:

At the age of:
9 years in	1 instance.
10 years in	7 instances.
11 years in	43 instances.
12 years in	184 instances.
13 years in	605 instances.
14 years in	1193 instances.
15 years in	1240 instances.
16 years in	1026 instances.
17 years in	758 instances.
18 years in	582 instances.
19 years in	425 instances.
20 years in	281 instances.
21 years in	111 instances.
22 years in	55 instances.
23 years in	15 instances.
24 years in	15 instances.
25 years in	1 instance.
26 years in	4 instances.
27 years in	2 instances.
28 years in	1 instance.
29 years in	1 instance.

From these figures it appears that in the 6,550 cases under consideration, the age 15 was that at which the first appearance of menstruation was most frequently observed, namely in 1,240 instances, or 18.9 per cent. The age 14 comes next, with 1,193 instances, or 18.2 per cent. The case in this series in which menstruation appeared earliest, namely in the ninth year, was observed by Mayer, the girl being a blonde of average height, good family, and German descent; the case in which menstruation appeared latest, namely in the twenty-ninth year, was that of a woman living in Berlin, who was sickly and chlorotic up to the time of her marriage, and in whom menstruation did not appear until some years after that event.

As regards climatic influences, all the data at our disposal prove that the hotter the climate the earlier the menarche. According to Marc d’Espine the age at puberty varies in an almost geometrical ratio with the mean annual temperature.

The dependence of the menarche upon climatic influences is clearly shown by the statistical data collected from various regions of the world. We append the general compilation of Gebhard dealing with this question.