The Sexual Life of the Child. Albert Moll
occurs at the sight or remembrance of a man; in the fetichist, the idea of the fetich is operative—in the case of the body-linen fetichist, for instance, the idea of articles of underclothing.
In the second place, the activity of the erection centre can be aroused by physical stimuli. To this category belong masturbatory manipulations, stimulation of the glans penis and other parts of the genital organs. But other erogenic areas exist, the stimulation of which produces the same results. Among these areas, the buttocks must be particularly mentioned. But individual peculiarities play a great part in this connexion. Thus, in many persons, a slight stimulation of the nape of the neck, of the scalp, &c., has an erogenic effect. In all cases alike, the stimulus is conducted along the sensory nerves to the erection centre, and it is the stimulation of this centre which by reflex action leads to distension of the penis with blood and its consequent erection. The physical stimulus leading to erection may also result from some pathological process, such as inflammation of the penis or of the urethra. Finally, certain internal physiological processes may be the starting-point of the afferent physical stimuli leading to erection; for example, distension of the bladder, and also of the seminal vesicles, and of the seminiferous tubules of the testicle. In addition, it is probable that many of the processes of growth occurring in the reproductive glands act in a similar way. These internal stimuli all pass to the erection centre along the afferent (sensory) nerves, and induce erection by reflex action; and it is important to bear in mind that this effect may result without any direct affection of consciousness by the originating afferent impulses.
Although either kind of stimuli, psychical or physical, acting alone, may give rise to erection, experience shows that in most instances the two varieties co-operate in the production of this effect. Thus, in the sexually mature man, the accumulation of semen in the seminal vesicles gives rise, not only to excitement of the erection centre, but also to voluptuous ideas, and these latter, in their turn, further stimulate the erection centre.
Normally, during coitus, erection is followed by ejaculation. A special nerve centre for ejaculation is also supposed to exist; and the ejaculation centre, like the erection centre, was formerly believed to be situated in the lumbar enlargement of the spinal cord, but recent investigations have shown that it also most probably forms part of the sympathetic plexuses of the pelvis. This centre also may be stimulated either by psychical or by physical stimuli. In normal conditions, however, much more powerful stimuli are needed to cause ejaculation than those which are competent to give rise to erection. For this reason, erections often occur without leading to ejaculation, whereas in normal conditions ejaculation hardly ever occurs without erection. In fact, ejaculation in the absence of erection is almost peculiar to pathological states, and may occur, for instance, in many forms of impotence, in which the ejaculation centre still remains susceptible to stimulation, whilst the erection centre is exhausted. Whereas stimulation of the erection centre exercises its reflex influence through the vasomotor nerves, thus leading to distension of the penis with blood, the reflex impulses resulting from stimulation of the ejaculation centre are transmitted by the motor nerves to certain muscles—those, namely, whose contraction forcibly expels the accumulated semen. The contractions of the affected muscles occur rhythmically, the stimulation of the ejaculation centre giving rise to a series of contractions alternating with relaxations. True ejaculation, resulting from the activity of these muscles, must be distinguished from the appearance of a drop or two of fluid at the urethral meatus, which occasionally occurs at the outset of sexual excitement—the so-called urethrorrhoea ex libidine. This fluid runs out while the ejaculatory muscles are quiescent. It was formerly believed that it consisted of the secretion of the prostate gland; but Fürbringer, to whom we are indebted for the most valuable researches in this province, has shown that this view is erroneous. These drops are, he states, derived solely from the glands of Littré and the glands of Cowper (urethral and suburethral glands).
Sexual excitement is accompanied throughout by a sensation of pleasure, specifically known as voluptuous pleasure, the voluptuous sensation, or simply voluptuousness (in Latin, libido sexualis). Several stages of the voluptuous sensation must be distinguished: its onset; the equable voluptuous sensation; the voluptuous acme, coincident with the rhythmical contraction of the perineal muscles and the ejaculation of the semen; and, finally, the quite sudden diminution and cessation of the voluptuous sensation. Associated with the last stage we usually have a sense of satisfaction, and simultaneously a cessation of the sexual impulse; a sense of ease and calm ensues, and at the same time a feeling of fatigue. This voluptuous sensation localised in the genital organs must, of course, be distinguished from the general sense of pleasure produced in a man by the idea of, or by contact with, a woman in whom he is sexually interested.
Now let us pass on to the consideration of the reproductive organs in the female. The most conspicuous part of the external genital organs consists of two large folds, situated on either side of the median line, and known as the labia majora. Within these are two much smaller folds, the labia minora or nymphæ. In the median line, in the space between the labia minora, we see two apertures: the anterior of these is the urethral orifice (meatus), from which the comparatively short and almost straight urethra of the female passes upwards and backwards to the bladder; the posterior aperture is the vaginal orifice. The labia minora, divergent posteriorly, converge as they pass forwards like the limbs of a V; at the apex of the V is the clitoris; in shape and structure this resembles the penis of the male, but it is much smaller, and is solid, not being perforated by the urethra. It contains two corpora cavernosa, which unite to form the body of the organ, whilst the distal extremity is known as the glans, and is homologous to the glans penis. Posteriorly to the clitoris, and beneath the mucous membrane on either side, is an additional mass of erectile tissue, known as the vaginal bulb, or bulb of the vestibule. Just outside the vaginal orifice on either side are visible the orifices of the ducts of Bartholin's glands (known also as Duverney's glands); these are homologous with Cowper's glands in the male.
When we attempt to pass from the vaginal orifice to the internal reproductive organs, we find that in the virgin an obstacle exists, the hymen or maidenhead, consisting of a duplicature of the mucous membrane. It is very variable in form, but in the great majority of instances it diminishes the size of the vaginal inlet to such an extent as to render coitus impossible until the hymen has been torn. Through the vaginal orifice access is gained to the interior of the vagina, a tubular structure, but flattened from before backwards, so that in the quiescent state the anterior and posterior walls of the passage are in apposition. The uterus or womb is a muscular, pear-shaped organ, with an elongated central cavity, which opens into the upper part of the vagina. At the upper end of the cavity of the uterus are two small laterally placed apertures, which lead into the Fallopian tubes (or oviducts). These tubes pass outwards in a somewhat sinuous course towards the ovaries, the reproductive glands of the female, homologous with the testicles in the male, and situated on either side of the upper extremity of the uterus. The shape of the ovaries is somewhat ovoid. They contain a large number of vesicular structures, the ovarian follicles, the largest, ripe follicles being known as Graafian follicles, whilst the smaller, partially developed follicles are termed primitive ovarian follicles, or primitive Graafian follicles. In the interior of each follicle is an ovum. In the sexually mature woman, a Graafian follicle ripens at regular intervals of four weeks. When ripe, the follicle bursts, the ovum is expelled, and passes through the Fallopian tube into the interior of the uterus: here it is either fertilised by uniting with a spermatozoon derived from the male, in which case it proceeds to develop into an embryo; or else it remains unfertilised, in which case it is shortly expelled from the body.
In the uterus, as well as in the ovaries, an important change occurs at intervals of four weeks, characterised by an increased flow of blood to the organ, culminating in an actual outflow of blood from the vessels into the uterine cavity, and thence through the vagina to the exterior of the body; the whole process is known as menstruation, the monthly sickness or the (monthly) period. After the fertilisation of the ovum, during pregnancy, that is to say, menstruation usually ceases until after the birth of the child, and often until the completion of lactation.
I do not propose to discuss here