The Sexual Life of the Child. Albert Moll
of the connexion between these periodic processes in the ovaries and the uterus, respectively—that is, between ovulation and menstruation. I shall, however, take this opportunity of stating that, as careful investigations have shown, the periodic processes in question are not limited to the uterus and the ovaries, but affect also the external genital organs, which become congested simultaneously with menstruation; and further, that the entire feminine organism is affected by an undulatory rhythm of nutrition, the rise and fall of which correspond to menstruation and to the intermenstrual interval, respectively.
I must now give some account of the peripheral processes occurring in the female genital organs in connexion with the sexual act. In part, they are completely analogous to those which take place in the male. I have already pointed out that in many respects the clitoris in the female corresponds to the penis in the male, In the clitoris, also, erection occurs, conditioned partly by psychical and partly by physical stimuli. The psychical stimuli consist of ideas relating to the male. The physical stimuli may, just as in the case of the other sex, vary in their nature. Thus, the condition of the reproductive glands may act as a physical stimulus to erection; also the touching of certain regions of the body, especially the clitoris, the labia minora, or other erogenic zones. Under the influence of such stimuli, the venus plexuses making up the vaginal bulbs also become distended with blood. In fact, speaking generally, sexual excitement is characterised by a vigorous flow of blood to the genital organs. During coitus, in woman, as in man, a process of ejaculation normally occurs, taking the form of rhythmical muscular contractions, affecting not only the perineal muscles, but also the muscular investment of the vagina, and occasionally, perhaps, the uterus itself. These muscular contractions also favour the expulsion of a secretion, but this secretion does not contain the reproductive cells of the female, and consists merely of a mixture of indifferent secretions—the secretion of Bartholin's glands, that of the uterine mucous membrane, and that of the mucous glands of the vagina and vulva. In the woman also, even at the outset of the sexual act, a secretion from the local glands takes place, whereby the genital region is moistened prior to the actual orgasm. We have as yet no precise knowledge as to which glands are concerned in the production of this phenomenon, which is homologous to the urethrorrhæa ex libidine of the male. In woman, as in man, the curve of voluptuousness exhibits four phases: an ascending limb, the equable voluptuous sensation, the acme, and the rapid decline. There are, however, in this respect, certain differences between man and woman, to which von Krafft-Ebing drew attention, and whose existence was confirmed by Otto Alder.9 Whereas in the male the curve of voluptuousness both rises and falls with extreme abruptness, in the female both the onset and the decline of voluptuous sensation are slower and more gradual. There is an additional difference between man and woman. In woman very often voluptuous pleasure is entirely lacking; certainly such absence is far commoner in women than in men—a condition of affairs which must on no account be confused with absence of the sexual impulse. Even when the sexual impulse is perfectly normal, the entire voluptuous curve with its acme may be wanting. In such cases, the after-sense of complete satisfaction, which occurs more especially when ejaculation has been associated with an extremity of voluptuous pleasure, it is commonly also lacking. Finally, it is necessary to add that in woman, as in man, the reproductive glands appear to have a duplex function—such is, at least, the belief to which recent investigations more and more definitely point. The ovaries, that is to say, do not only produce ova; they also, like the testicles, furnish an internal secretion, and the absorption and distribution of this secretion by the blood are supposed to cause the development of the secondary sexual characters in woman.
Having now concluded our account of the structure and functions of the productive organs of adults, let us turn to consider the differences between these organs and those of children. In the child, the testicles are considerably smaller; smaller also are the penis and the other genital organs. In the adult, the root of the penis is surrounded by the pubic hair; this hair is absent in the child. The most important distinctive characteristic, however, lies in the fact that in the child the morphological elements upon which the capacity for procreation depends, namely, the spermatozoa, are not yet present in the testicles. The spermatozoa first make their appearance during that year of life which is usually regarded as the year of the puberal development. The microscopical appearances of the testicle, of which an account has previously been given, thus naturally differ according as the specimen under examination has been taken from a child or from an adult. As regards the other glands considered to form part of the genital organs, some of these secrete even in childhood. This matter will be subsequently discussed in some detail.
In the female sex, also, there are notable differences in the condition of the genital organs between the adult and the child. In the first place, the relative sizes of the various organs differ greatly. But other differences are also noticeable, not dependent, however, on differences in age, but on whether there has or has not been experience of sexual intercourse, and on whether pregnancy and parturition have occurred. When we compare a female child with an adult woman, the first obvious difference is in the shape of the external genital organs. In the child, the vulva is placed much higher and more to the front, so that it is distinctly visible even when the thighs are in close apposition. In the child, also, the labia majora are less developed, for as womanhood approaches a great deposit of fat takes place in these structures. Again, in the child, the outer surfaces of the labia majora and that part of the skin of the abdomen just in front of the labia (the mons veneris) are as hairless as the rest of the body, whereas in the adult woman these regions are covered with the pubic hair. According to Marthe Francillon,10 to whom we are indebted for an elaborate study of puberty in the female sex, during the puberal development changes occur also in the clitoris. The genital corpuscles of Krause and the corpuscles of Finger (Wollustkörperchen), the terminals of the nerves passing to the erectile tissue of the clitoris, undergo at this time a marked increase in size. The clitoris itself, hitherto comparatively small, now attains a length of three to four centimetres (1.2 to 1.6 inch), in the quiescent state, and of four and a half to five centimetres (1.8 to 2 inches) when erect. In the virgin also, as previously mentioned, the hymen is present, a structure of very variable form. After defloration its remnants persist in the form of small prominences around the margin of the vaginal inlet (carunculæ myrtiformes). But, quite independently of defloration, in the child the vaginal orifice is much smaller than in the riper girl. The uterus undergoes remarkable changes. In the foetus, during the latter part of intra-uterine life, this organ grows very rapidly; but immediately after birth its growth is arrested, so that in a girl of nine it is little larger than in the new-born infant. During the period of puberal development, however, the growth of the organ is once more extremely rapid. Its shape also changes at this time. In the child, the uterus is longer in proportion to its thickness; in childhood, too, the comparative length of the cervix in relation to that of the body of the organ is much greater than in the adult woman. We need only allude in passing to the fact that later in life marked changes occur in the uterus as a result of pregnancy and parturition. The hyperæmia and the bleeding that take place periodically during menstruation lead to certain changes in the mucous surface of the uterus. Ovulation, which in the sexually mature woman recurs at four-weekly intervals, also gives rise to certain permanent changes in the ovaries. The site of each ruptured Graafian follicle becomes cicatrised, and in consequence of the formation of these little scars, the ovary no longer retains the smoothness of surface which was characteristic of the organ in childhood. From birth onwards the ovaries gradually increase in size, but the growth is disproportionate in different diameters. Thus, for instance, during the eighth year of life, growth is chiefly in thickness, so that the ratio between the length and the thickness becomes less than before. The structure of the ovaries also varies at different ages. In a girl of three years, the primitive ovarian follicles number about 400,000; at the age of eight it is estimated that their number has been reduced to about 36,000. Certainly the majority of the primitive follicles come to nothing. True Graafian follicles, of which an account has already been given, are not usually formed prior to the beginning of the puberal development; occasionally, however, they are formed in the ovaries of immature girls.
Let us now pass to the consideration of the sexual impulse. We learn from personal observation that two entirely distinct processes participate in this impulse. In the first place, we have the physical processes that take place in the genital organs; these are in part unperceived, but in part they affect consciousness in the form of common