Hence arises the impulse to sexual satisfaction (libido sexualis). This
impulse becomes stronger in proportion as cerebral excitement,
consequent on appropriate perceptions and the working of the
imagination, strengthens the intensity of these pleasurable sensations.
If the conditions are favorable to the performance of the sexual act by
means of which satisfaction is attained, the continually increasing
impulse finds expression in action; in other circumstances, inhibitory
perceptions intervene, sexual excitement diminishes, the activity of the
centre for erection is inhibited, and the sexual act itself is
prevented. In the case of civilized humanity the ready action of such
perceptions for the inhibition of the sexual impulse is necessary and
decisive. On the strength of the impulsive perceptions the constitution
and various organic processes have an important influence; on the
strength of the inhibitory perceptions, education and the cultivation of
self-control are powerfully operative.
In addition to mental influences, all forms of local irritation of the
sensory nerves of the female genital organs and adjacent parts, by
internal processes or external friction, serve to increase the strength
of the sexual impulse. Among internal processes which stimulate the
erectile centre by centripetal impulses must be included, the stimulus
of the enlarged graafian follicle, stasis in various vascular areas of
the genital organs in consequence of a sedentary mode of life, abdominal
plethora from excessive consumption of food and stimulating drinks, and
habitual constipation. External friction may be in the form of
intentional manipulation, but it may be due to certain bodily attitudes
or to the arrangement of the clothing.
In normally constituted individuals, the sexual impulse is by no means
constant in its intensity. Apart from the temporary indifference
resulting from sexual gratification, and apart from the decline in the
impulse that occurs after prolonged continence, ensuing after a certain
reactionary intensity of desire has been happily overcome, the mode of
life has a very great influence. The town-dweller, who is continually
reminded of sexual matters, and continually solicited to sexual
intercourse, is in any case more subject than the countryman to sexual
excitement. A sedentary and sheltered mode of life, a chiefly animal
diet, the free use of alcohol and of spices, and the like, have a
stimulating action on the sexual life. In the female, the sexual impulse
is stronger just after menstruation. In neuropathic women this increase
of excitement may occur to a pathological degree. Not infrequently also
in the climacteric period, women are subject to sexual excitement due to
pruritus, especially in those neuropathically predisposed. _Magnan_
reports the case of a lady who was subject to matutinal accesses of
intense erethismus genitalis. The same author writes of a young lady who
since puberty had been subject to continually increasing sexual impulse,
which she gratified by masturbation. Gradually it came to pass that the
sight of a good-looking man produced violent sexual excitement, and on
these occasions, since she felt herself unable to answer for her own
conduct, she used to lock herself up in her bedroom till the storm had
passed away. Ultimately she surrendered herself to any available man in
order to obtain rest from her torturing desires, but neither intercourse
nor onanism gave her relief, so that she was finally sent to an asylum.
As regards pathological increase of the sexual impulse, hyperæsthesia
sexualis, the constitution of the individual is, according to _von
Krafft-Ebing_ (Psychopathia Sexualis), of great importance. He writes:
“With a neuropathic constitution, a pathological increase of sexual
desire is often associated, and such individuals bear for the greater
part of their life the heavy burden of this constitutionally anomalous
sexual impulse. The intensity of the sexual impulse may be such as to
amount to an organic compulsion, and the freedom of the will may thus be
seriously imperilled. Non-satisfaction of this desire may induce a true
sexual heat (like that of lower animals), or a mental state
characterized by sensations of anxiety, in which the individual yields
to the impulse, and his responsibility for his action is most
questionable. Should the person so affected not give way to his desire,
he runs the danger, by this enforced abstinence, of injuring his nervous
system by the induction of neurasthenia, or of seriously aggravating
neurasthenia that already exists.
“Excessive sexual desire may arise either from peripheral or from
central causes. The former variety is less common. Such cases as do
occur, may arise from pruritus of the genitals, from eczema, or from
substances which by their remote local action stimulate sexual desire,
such for instance as cantharides.
“Sexual excitement of central origin is common in those suffering from
congenital neuropathic predisposition, in hysterical subjects, and in
states of mental exaltation. In such cases, when the cerebral cortex,
including the psychosexual centre, is in a state of hyperæsthesia
(abnormal excitability of the imagination, facilitated association of
ideas), not only optical and tactile sensations, but also auditory and
olfactory impressions, will arouse lascivious perceptions.
“Sexual hyperæsthesia may be continuous, with exacerbations, or
intermittent, and even periodic. In the last case, according to _von
Krafft-Ebing_, it is either an independent cerebral neurosis, or else a
partial manifestation of a general condition of mental excitement
(mania, dementia paralytica, dementia senilis, etc.).”
Erotogenic zones, the stimulation of which leads to an increase in the
intensity of the sexual impulse and of sexual sensibility, are in woman
first of all and principally the clitoris, which indeed is said to be
the only zone of this nature in the virgin state (an opinion held by
_von Krafft-Ebing_ and others, but certainly most improbable); next to
this comes the whole of the external genitals, and especially the parts
covered with hair; also the vagina by friction and inter coitum; finally
the nipple and its areola when stimulated by titillation—an increase of
the excitability of this region appears to result from suckling.
According to _Hensen_, the direct stimulation of the sexual impulse
proceeds by way of the dorsal nerve of the (penis or) clitoris; he
assumes, however, that certain states of the reproductive glands are
able to induce an increase in the irritability of the centres connected
with the aforesaid nerves. In women it certainly appears that particular
states of the ovary have a stimulating or inhibiting influence
respectively on sexual excitement, so that we might ascribe to the
ovaries the rôle of a regulator of the sexual impulse. The processes
that occur in the ovary at the time of the ripening and rupture of the
graafian follicle, and the resulting tension of the follicular wall,
induce by stimulation of the ovarian nerves an increased sensibility of
the central zones, and produce in a menstruating female a condition of
increased sexual excitability, so that slight stimuli will give rise to
a powerful orgasm more readily than would otherwise be the case, when
the reflex irritability of the centre is less pronounced and the sexual
impulse is consequently less intense. Still more than during these
ordinary menstrual processes may this stimulation be effective at the
time of the menarche, when the changes in the ovary occur for the first
time and with the greatest intensity, so that at this time the
individual may be especially susceptible to sexual stimulation.
At such times of sexual excitement, very slight external peripheral
stimuli, in the form either of tactile stimulation of the sensory nerves
of the skin and the external genital organs, or of stimulation of the
imaginative and perceptive faculties of the brain, suffice to induce a
powerful increase of the sexual impulse; whereas at other times, at
which no particular sexual excitement exists, much stronger stimuli are
needed to produce such an effect. Thus the sexual impulse in women is
more readily and more powerfully increased in proportion as the central
organ is in a condition of temporarily enhanced excitability in
consequence of the condition of the ovaries.
The gratification of this impulse, the act of copulation, produces the
specific sensation of sexual pleasure; in the female this is effected
chiefly by friction of the glans clitoridis, the organ when erect
projecting downwards at a right angle, and pressing upon the intromitted
penis—the friction of the glans produces powerful mechanical stimulation
of the numerous plexuses of sensory nerve fibres, which terminate in the
genital corpuscles of _Krause_. In woman, then, we find in the ovary the
place of origin and the means of regulation of the sexual impulse, and
in the clitoris we find the seat of the specific sensation of sexual
pleasure.
In the poorer classes of society, an increase of the sexual impulse
occurs in women chiefly in consequence of bad example and of unfavorable
domestic conditions, such as lead to persons of opposite sexes sleeping
in the same bed, and also in consequence of the abuse of alcohol. In the
well-to-do classes, it is the perusal of modern equivocal romances,
visits to theatres, balls, and evening parties, and, speaking generally,
idleness combined with luxurious living, that serve to stimulate the
sexual impulse in woman.
A certain dependence of the sexual impulse upon seasonal variations
appears to exist also in the human species. At any rate in certain
months of the year, a definite increase in the number of conceptions
continues to recur, which indicates that during these months a larger
number of sexually mature individuals is engaged in the discharge of
sexual functions. _Rosenstadt_ regards this as the manifestation of a
“physiological custom,” immanent in the physical constitution of
civilized man, and inherited by him from his animal ancestors. He
explains it in the following terms: “Primitive man inherited from his
mammalian forefathers the peculiarity of reproducing his kind only
during a certain definite period, the period of heat or rut. After
humanity had entered upon this period, copulation was effected _en
masse_, as was easy in view of the primitive community of sexual
intercourse before the origin of marriage. In the course of his progress
toward civilization, however, man began to reproduce his kind
indifferently throughout the entire year; but the original
“physiological custom,” in accordance with which reproduction occurred
at definite seasons only, did not disappear, and persists, indeed, to a
certain extent even to the present day as a survival of earlier
mammalian life, and manifests itself in the annual recurrence in certain
months of an increase in the number of conceptions. The analogy in
structure and function between the genital organs of the human species
and those of other mammals (the female anthropoid apes do not merely
exhibit from time to time a period of heat, but are subject to a more or
less regular menstruation), which for the most part reproduce their kind
only at certain definite periods, leads to the conclusion that in the
human species also the sexual impulse may originally have awakened only
at a particular season of the year, and that the persistence of this
physiological custom in man, in spite of the fact that sexual
intercourse occurs all through the year, and notwithstanding that the
conditions necessary to awaken the sexual impulse are actually
perennial, must be ascribed to inheritance.”
This view, which is maintained also by other gynecologists, finds
support in _Kulischer’s_ assumption, based upon ethnological
investigations, according to which coupling in primitive man took place
only at certain seasons, namely, at spring and at harvest-time. In
support of this view, which was held also by _von Hellwald_, _Kulischer_
refers to a number of actual and symbolical practices among different
races, which make the assumption extremely probable.
Sexual desire in women, the sexual impulse, outlasts the proper sexual
life, and manifests itself even after the cessation of menstruation,
when the possibility of conception has passed away; it appears,
therefore, to have no necessary connection with the function of
ovulation.
This is indicated by the always respectable number of women who enter
upon marriage even after the climacteric age. Thus the percentage of
brides who were more than 45 years of age was: In Prussia, 2.58 per
cent.; in England, 1.38 per cent.; in Sweden, 1.53 per cent.; in
Ireland, 0.31 per cent. Of quite peculiar interest are the figures
relating to elderly women who marry men considerably younger than
themselves. Thus we learn from the tables of _Routh_ that in the space
of 10 years in Ireland:
Women between the ages of 46 and 55 years married
Men below the age of 17 in 1 instance.
Men between the ages of 17 and 25 in 35 instances.
Men between the ages of 26 and 35 in 145 instances.
Men between the ages of 36 and 45 in 227 instances.
And women of ages greater than 55 years married
Men below the age of 17 in 1 instance.
Men between the ages of 17 and 25 in 3 instances.
Men between the ages of 26 and 35 in 12 instances.
Men between the ages of 36 and 45 in 15 instances.
Men between the ages of 46 and 55 in 52 instances.
In England during the year 1855 the age of the bride exceeded the
climacteric age in 778 instances. The brides were:
From 46 to 50 years of age in 135 instances.
From 51 to 55 years of age in 219 instances.
From 56 to 60 years of age in 89 instances.
From 61 to 65 years of age in 22 instances.
From 66 to 70 years of age in 7 instances.
From 71 to 75 years of age in 3 instances.
From 76 to 80 years of age in 3 instances.
In Bohemia in the year 1872 the oldest bride numbered no less than—86
years.
_Börner_ reports cases in which the sexual impulse remained in full
activity after the change of life, and in some cases was greatly
increased in intensity—these latter individuals being in a condition of
real torment, which induced them to masturbate to obtain relief.
The sexual impulse may be present in cases in which the ovaries are
entirely wanting. Thus, _Hauff_ reports the case of a young girl who had
no ovaries, but was nevertheless excessively addicted to masturbation.
_Gläveke_ speaks of a puella publica in whom the uterus and the ovaries
were entirely absent, but who asserted that she experienced during
coitus active sexual sensation. Both _Kussmaul_ and _Puech_ report
similar experiences in cases of absence or arrested development of the
uterus.
As regards the effect on the sexual impulse of the operation of
oöphorectomy, most authors state that no change occurs; still, there
remain many who express the opposite opinion. From the collective
summary of cases bearing on this question made by _Gläveke_, it appears
that after extirpation of the ovaries the sexual impulse remains
unchanged in the great majority of cases, or at most is but slightly
diminished in intensity. _Hegar_ states that he has often witnessed a
diminution of the sexual impulse after oöphorectomy, but that this
decline is by no means constant, indeed he states that one of his
patients assured him that in her case no decline in the intensity of the
sexual impulse had followed the operation. Similarly variable reports
were the experience of _Schmalfuss_. In one case he found there was but
little sexual inclination; in one case, disinclination; in one case
disinclination at first, followed by a return of inclination. _Bruntzel_
reports that in four patients subjected to oöphorectomy, in two cases
the sexual impulse persisted, but in the remaining two it was
extinguished. _Köberle_ is of opinion that sexual inclination diminishes
as a result of this operation. _Peaslee_, on the contrary, asserts that
the patients remain striking examples of womanhood, in whom all the
qualities peculiar to their sex are preserved. _Péan_ observed as a rule
no difference in the sexual impulse to result from this operation, but
he considers that the patients are apt to describe in exaggerated terms
the amount of sexual feeling that remains to them. In one case, _Spencer
Wells_ observed after oöphorectomy an increase in sexual excitability;
_Tissier_ had the same experience, and this author believes that in
these cases the sexual impulse is generally preserved. On the other
hand, _Bailly_ observed a case, in which both ovaries were removed on
account of new growths, where the sexual impulse at first became
excessive, and then completely disappeared. _Anger_ and _Goodell_ speak
in the same sense.
I am myself acquainted with a woman twenty-six years of age who in
girlhood underwent oöphorectomy on account of extremely severe nervous
troubles associated with menstruation; she had not experienced in
consequence any loss of the sexual impulse; she married a man belonging
to the upper strata of society, and consulted me four years later to
learn if she could by any means be rendered capable of bearing a child.
Two other cases have come within my personal experience in which young
women married after extirpation of the ovaries, and in whom sexual
desire and sexual sensation were all that could be wished.
In twenty-seven women who had undergone the operation of oöphorectomy,
_Gläveke_ made inquiries regarding the three following points: First,
whether the sexual impulse had been affected by the operation; secondly,
whether during intercourse sexual pleasure was experienced to the same
degree as formerly; and thirdly, whether during intercourse any kind of
difference was observed as compared with pre-operative experience. He
obtained the following results:
Sexual inclination was
Unaffected in 6 cases 22 per cent.
Diminished in 10 cases 37 per cent.
Extinguished in 11 cases 41 per cent.
Sexual pleasure during coitus was
Unaffected in 8 cases 31 per cent.
Diminished in 10 cases 38 per cent.
Extinguished in 8 cases 31 per cent.
In a considerable number of cases the sexual impulse was thus found by
_Gläveke_, not indeed to be entirely extinguished, but still notably
diminished. In another set of cases, the sexual impulse was entirely
extinguished, but only in one case was there actual aversion to coitus.
The women readily permitted intercourse when their husbands desired it,
but remained themselves quite indifferent. The greater number of these
women stated that the specific sensation of pleasure during coitus was
markedly weakened, but not entirely lost; in a small proportion, this
sensation was completely extinguished. In the case of seven women who
complained that coitus was very painful, _Gläveke_ found that the
calibre of the vagina was much diminished. In these cases, the sensation
of pleasure during coitus was either greatly diminished or completely
extinguished. The women permitted intercourse very unwillingly, their
unwillingness arising, not from any actual aversion, but because they
dreaded the pain which coitus produced. An extremely hysterical woman,
affected with severe prolapse of the uterus, stated that every attempt
at intercourse was frustrated by violent hysterical convulsions. The
sexual impulse appears always to suffer first and most severely, and
only after this is the sensation of pleasure during coitus affected. In
a few women only, according to the experience of this author, was the
sexual impulse quite unaffected by the removal of the ovaries.
Amputation of the clitoris appears notably to diminish both the sexual
impulse and the sensation of sexual pleasure, but the results of
clitoridectomy for the cure of masturbation are by no means always
favorable. In the women of the Russian sect of the _Skopstki_, the
clitoris, the nymphæ, and a part of the labia majora are removed, in
order to destroy sexual desire. According to _von Krafft-Ebing_ it is
probable that in the virgin the clitoris is the only erotogenic zone,
that is to say, that only by the stimulation of the clitoris can
erection, the orgasm, and the sensation of ejaculation be induced. It is
probable that the vagina becomes erotogenic only as a result of coitus;
thenceforward, however, the erotogenic significance of the clitoris is
notably lessened, and in multiparæ may entirely disappear.