The Sexual Life of the Child. Albert Moll
on the fact, which he regards as especially striking, that the difference in the sex-incidence of this disease is manifest even in childhood. As regards colour-blindness, there is a notable preponderance among males, and since we here have to do with a congenital affection, this preponderance is as marked among children as among adults. Many defects of speech also exhibit a notable difference in their sex-incidence. Hermann Gutzmann21 has shown that in the case of stammerers we find 71 per cent. boys and 29 per cent. girls. I take this opportunity of referring briefly to the fact that, as Max Marcuse22 reports, certain diseases of the skin exhibit sexual differentiation of type even during childhood. The disseminated cutaneous gangrene of children is far more frequent in girls than it is in boys; Broker, among twelve cases, found ten girls. Alopecia areata, on the other hand, affects both sexes with equal frequency, but affects them at different ages. Whereas during the first years of life girls are more frequently attacked; when the age of twenty is passed, the relation between the sexes in this respect are reversed.
Criminological experiences appear also to confirm the notion of an inherited sexual differentiation, in children as well as in adults. According to various statistics, embracing not only the period of childhood, but including as well the period of youth, we learn that girls constitute one-fifth only of the total number of youthful criminals. A number of different explanations have been offered to account for this disproportion. Thus, for instance, attention has been drawn to the fact that a girl's physical weakness renders her incapable of attempting violent assaults upon the person, and this would suffice to explain why it is that girls so rarely commit such crimes. In the case of offences for which bodily strength is less requisite, such as fraud, theft, &c., the number of youthful female offenders is proportionately larger, although here also they are less numerous than males of corresponding age charged with the like offences. It has been asserted that in the law courts girls find more sympathy than boys, and that for this reason the former receive milder sentences than the latter; hence it results that in appearance merely the criminality of girls is less than that of boys. Others, again, refer the differences in respect of criminality between the youthful members of the two sexes to the influences of education and general environment. Morrison,23 however, maintains that all these influences combined are yet insufficient to account for the great disproportion between the sexes, and insists that there exists in youth as well as in adult life a specific sexual differentiation, based, for the most part, upon biological differences of a mental and physical character. I have referred to these criminological data for the sake of completeness, but I feel it necessary to add that their importance in relation to our subject of study is comparatively trifling, since most of the cases in question are offences committed by persons who can no longer properly be regarded as children.
As we have seen, during childhood, and especially during the second period of childhood, there exists a larger number of sexual differences both mental and physical. Some of these are obviously discernible when we compare isolated individuals; others only become apparent when we institute a statistical comparison. And when such differences appear in childhood, we find that they are quantitatively less extensive than the sexual differences of adults. For the sexual life is in the child less developed than it is in the adult. We shall learn that in the matter of the sexual impulse, the child exhibits an imperfect differentiation. A similarly imperfect differentiation is found in childhood in respect of a number of other qualities. Thus, there are many diseases which later in life manifest a sexual differentiation, but in childhood are undifferentiated. We observe a similar age-distinction in respect of suicide, which occurs in Europe far more frequently in men than in women, the ratio among suicides being three or four men to one woman. Among child-suicides there is far less disproportion between the sexes. According to Havelock Ellis, indeed, the suicidal tendency makes its appearance in girls at an earlier age than in boys.
Such a marked differentiation as there is between the adult man and the adult woman certainly does not exist in childhood. Similarly in respect of many other qualities, alike bodily and mental, in respect of many inclinations and numerous activities, we find that in childhood sexual differentiation is less marked than it is in adult life. None the less, we have learned in this chapter, a number of sexual differences can be shown to exist even in childhood; and as regards many other differences, though they are not yet apparent, we are nevertheless compelled to assume that they already exist potentially in the organs of the child.
CHAPTER IV
SYMPTOMATOLOGY
The data recorded in the preceding chapter suffice to show that the activity of the sexual life begins in childhood, for the secondary sexual characters and the other sexual peculiarities which manifest themselves thus early in life are dependent upon sex. We shall now proceed to the systematic description of the direct manifestations of the sexual life, and we can most usefully begin with the genital organs.
Erections occur during childhood; they have been observed even in infancy. They sometimes result from external stimuli, especially of a pathological nature, such as a strictured prepuce, or inflammatory states of the penis. Occasionally in the child, as normally in the adult male, distension of the bladder with urine leads to erection of the penis. Although in these cases the erection is not induced by sexual processes, it is nevertheless not devoid of significance in relation to the sexual life. The sensations in the genital organs to which the pathological stimuli give rise are further increased by the erection, and the child's attention is therefore increasingly drawn to his sexual organs. His attention may, of course, be directed to his genital organs by such stimuli as those we have described, even though these latter do not lead to the occurrence of erection. By such sensations, the child is very readily induced to manipulate his genital organs. Just as the little child soon learns to scratch other itching regions of the skin, so also he learns to scratch his genital organs when these are the seat of an itching eruption, or when in any other way irritating sensations arise in this region. Pflüger and Preyer24 have made investigations regarding the itching-reflex (Kitzelreflexe), and although in many respects their results are divergent, yet one point is clearly established by both, namely, that within a few months after birth a distinct itching-reflex is in operation, inasmuch as the child endeavours to scratch itching areas. Thus, by itching of the genital organs, a child is readily led to practise masturbation; and this is not necessarily effected by the hands, but sometimes by the feet, or by rubbing the thighs against one another, this last being generally done when the child is in the sitting posture. When erections occur in the child, we cannot always trace them to external stimuli, for in many cases they are due to stimuli of other kinds. Erection may, in fact, result from internal stimuli, connected with the development of the genital organs, and more especially that of the testicles. Moreover, such developmental stimuli may induce the child to manipulate the genital organs, and thus give rise to masturbation, without in the first instance causing erection. It appears that such stimuli leading to the practice of masturbation occur, during the first years of childhood, chiefly, if not exclusively, in children with morbid hereditary predisposition.
Such processes as these, viz., inflammatory stimuli originating in the external genital organs, or developmental stimuli proceeding from the testicles, may lead to the practice of masturbation without having directly affected the child's consciousness. Just as in the pithed frog, if we stimulate one foot with acetic acid, the other foot scratches the irritated area, so a child may, with his hands or in some other way, scratch itching regions of the body, and, above all, of the external genital organs, without its being necessary for us to assume that he is fully conscious of what he is doing. Further, as we have already pointed out, such masturbation may or may not be preceded by a reflex erection. And just as the boy soon learns that itching is relieved by scratching, so also he learns that by means of artificial stimulation he may induce sensations of a voluptuous character. It is the same with the little girl, in whom sensations occur in the genital organs, due in some cases to developmental, and in others to pathological stimuli (skin eruptions are an instance of the latter kind), and these lead to manipulations of the genital organs.
In contradistinction to the cases just described, in which the child has learned spontaneously to practise artificial stimulation