By the term _menacme_ I designate the culmination of the sexual
development of woman, during which the processes of reproduction,
copulation, conception, pregnancy, parturition, and lactation occur.
The processes of puberty in woman are fully completed at the age of from
eighteen to twenty years, so that from this time forward she is fully
equipped for the performance of her sexual duties. The first act in the
fulfilment of these duties is copulation, which in civilized countries
is in the great majority of women first undertaken at the commencement
of married life. The average age at marriage in the women of this part
of the world is 22; but marriages at an earlier age are very common, and
in many circles of society the average age is as low as 20. The fullest
maturity of sexual activity in women occurs, however, in the
thirty-second year of life, this being the year in which on the average
the maximum fertility is attained.
At the menacme, the beauty and energy of women attain their fullest
evolution, her sexual characteristics their strongest development. It is
this period of life, however, that entails the greatest dangers to
beauty and health in connection with the functions of the genital
organs. Copulation, the first act of sexual intercourse with the male,
often produces in the female injuries from which she never completely
recovers. Gonorrhœal infection has been a source of unspeakable miseries
to women. Motherhood itself entails the risk of a great number and
variety of illnesses, which, as puerperal sequelæ, affect this phase of
woman’s life. The struggle for existence, in which woman at her prime is
also involved, and the fulfilment of duties to husband and children,
further lead to the production of a series of changes, both physical and
mental, in the feminine organism, which influence all the functions.
The great characteristic of this epoch is maternity. In maternity the
fully developed woman lives and has her being, but to maternity also she
often succumbs as a sacrifice to the fulfilment of her natural
functions. Inasmuch as in this sexual phase the functions of the genital
organs are of greater importance, to the same degree is enhanced the
importance of the mutual relations between these organs and the other
organs of the female body.
Another influence of fundamental importance in the sexually mature woman
is that of the sexual impulse, the force of which is at times
overwhelming, so that its gratification is sometimes sought without
regard for the consequences to married and family life.
The physiology and pathology of the menacme coincides with the normal
processes and pathological changes respectively of the female genital
organs consequent on their functional activity as organs of sexual
sensation and of reproduction. Woman as wife and mother stands at the
climax of her existence.
In a quite astonishing manner, however, many of the advocates of the
modern movement for the emancipation of women contest the significance
of maternity to women.
A modern authoress and supporter of women’s rights, _Ellen Key_, avows
that she was in error when at an earlier date she “regarded maternity as
the central point in woman’s existence.” She asserts that it lies within
the sphere of a woman’s individual rights, as of a man’s, to reject
marriage, or to accept marriage while rejecting maternity. “The grounds
for the rejection of maternity may as well be deeply altruistic as
deeply egoistic. It lies within the sphere of individual rights to
dispense with love or with maternity when either is regarded or both are
regarded from this point of view. It is entirely within a woman’s rights
to transform herself into a member of the ‘third sex,’ the sex of the
worker bee, of the neuter ant, if she finds therein her greatest
pleasure. * * * Women exist in whom erotic feeling is totally atrophied;
there are yet others who fail to find in intercourse with the modern man
that soulful and deep erotic harmony which they rightly desire; and
there are others still more numerous who desire love, but not maternity,
which indeed they dread.”
A celebrated German authoress of the present day, _Gabriele Reuter_,
refers in similar terms to the justifiable fear with which so many
aspiring and hard-working women regard maternity, “the perpetual,
watchful, emotional dread of motherhood, a dread which causes them to
turn at bay. A dread, a hatred, it is, which has grown so strong, so
active, that one might almost regard it as an obscure perverse instinct,
awakened and developed and strengthened by bitter necessity. It is as if
in the innermost recesses of their nature such women had a belief that
should they pay their tribute to sex they would loose all the energy,
clearness, and brightness of mind, by means of which they have raised
themselves above the level of their sex. And perhaps women of a certain
type are justified in this fear.”
Fortunately, however, the woman who does not prize maternity still
remains an exception. The great instinct for the preservation of the
species, which nature has planted deeply in every human being, still as
a rule in women remains much more powerful than the instinct of
self-preservation at every one else’s expense—more powerful than such
self-sufficient egoism. And now as ever it is the duty of humanity to
educate women for maternity from her youth upward, so that she is in
every way fitted for the supreme duty of her sexual nature, the renewal
of life from generation to generation.
Against the significance and importance of maternity to woman, the
mountainous waves of the movement for the emancipation of women dash
themselves as vainly as against the solid rock. Much justification may
be found for the efforts of women in modern civilized communities to
engage in departments of activity to which hitherto men only have been
admitted; and as regards the intellectual capacity of women we may
acknowledge their competence for the higher scientific professions; but
while admitting this we must hold firmly to the physiological standpoint
and must more especially bear in mind the sexual life of woman. Such
professions only are suitable for a woman as do not entail a restriction
of the sphere of her reproductive activity, a hindrance to her principal
duty, that of maternity, an interference with the discharge of her
obligations to husband and children, or a diminution of her domestic
value and an evasion of her responsibilities in family life. As _L. von
Stein_ so justly remarks, the woman who spends the whole day at a desk,
in the law courts, or in a house of assembly, may be a most honorable
and most useful individual, but she is no longer a woman, she cannot be
a wife, she cannot be a mother. In the condition of our society, the
emancipation of woman is in its very nature the negation of marriage.
We may not agree with the great misogynist, _Schopenhaur_, in his
depreciation of the female sex, or in his assertion that woman exists
simply and solely for the propagation of the species, and that “her life
should therefore flow more quietly, more inconspicuously, and more
gently than that of man toward its goal;” nor need we regard as
justified the severe sentence of the philosopher, _E. von Hartmann_,
that from the moral standpoint, “the greater number of women pass the
whole of their lives in a state of minority, and, therefore, to the end
stand in need of supervision and guidance;” but the statement made by
_Friedr. Nietsche_ in his book _Also sprach Zarathustra_ deserves
acceptation, “Everything in woman is a riddle, and everything in woman
has its answer: it is called pregnancy,” and again, “For woman, man is
only the means; the end is always the child.”
Unsearchable in its judgments, nature has imposed on woman alone the
consequences of the act of generation; man has the pleasure, but not the
labor and the pain. We might indeed regard as highly unjust the
distribution of the rôles in the process of reproduction, were it not
that in a mother’s love and a mother’s joys, woman finds a compensatory
solace. The man’s part is a much easier one and costs far less than that
of woman; with the gratification of his sexual desire, man shakes off
any further responsibility, whereas the woman’s body becomes the
workshop in the wonderful act of creation of a new human life.
Maternity, says _Lombroso_, is the characteristic function of the female
sex, upon which rests her whole organic and physical variability, and
this function is indeed throughout of an altruistic nature. Although
there is a certain antagonism between the sexual impulse and
maternity—according to _Icard_, the sexual impulse is extinguished in
women during pregnancy,—still, maternity appears to depend upon sexual
perceptions. For instance, the act of suckling the infant often arouses
voluptuous sensations, and _Icard_ mentions a case in which a woman
permitted fertilization to occur solely on account of the pleasure
obtained by suckling. The anatomical cause of this fact is to be found
in the connections between the nipple and the uterus by way of the
sympathetic nervous system. * * * It is likewise probable that in the
happy feeling of maternity there intermingle very gentle voluptuous
sensations derived from the genital organs. According to _Bain_ also,
very delicate sensations of contact form an element in maternal love.
The epoch of the menacme is that in which, independently of maternity,
the sexual impulse often becomes so powerful in woman as to be entirely
dominant. The problems relating to marriage and to the sexual position
of woman, so widely discussed at the present day, are, therefore, of
especial importance in regard to women at this period of life. The
forcible repression and control of the sexual impulse inculcated by
moral and religious ordinances are now, according to the modern leaders,
both male and female, of the woman’s movement, to be abandoned; and it
is loudly asserted that every woman has the same right as man to
physical love and the happiness it produces. Hence, free love is
demanded. “Freedom in love, freedom for love—this is what the dignity of
the human race demands,” asserts the authoress of a book recently
published (_Elisabeta von Steinborn_, _The Sexual Position of Woman_).
With laws for the regulation of marriage, this section of the women’s
rights party will have nothing to do. A truly good and honorable man,
they contend, has as little need of laws to regulate his amorous
relations as he has of laws against murder and theft. In the first
place, love, the sexual relation between man and woman, must be free,
and humanity, freed from vexations and needless control, will then seek
and find the proper path, even if at the expense of a few errors by the
way. Only after this unrestrained sexual intercourse has lasted for a
long time, will free marriage become the rule. “Out of this phase will
develop the monogamic system willed by God, for which, in its most ideal
form, we are not yet sufficiently ripe.” It is hardly necessary to
discuss in detail the general deleterious influence of such unlimited,
unregulated free love upon the community, upon human society as a whole,
to describe the results of free love, to attempt to realize the chaos
which it would bring about in the social relations of civilized
humanity. We must rather indicate it as desirable from the medical
standpoint also, that such a change in general domestic economy shall be
aimed at as will enable the great majority of women to share in married
life and family happiness, and thus making allowance both for human
nature and the demands of social life, to effect a true harmony between
sexual morality and sexual practice.
[Illustration:
FIG. 48.—The female pudendum, or vulva, with the labia majora. The
vulval cleft. Female perineum. Mons veneris, with the pubic hair.
(From Toldt: Atlas of Human Anatomy.—Rebman Company, New York.)
]
We must point out that in so far as the modern woman’s movement aims at
dispensing with man and at basing the entire life of woman upon the
independent ego, that movement is in opposition to nature and its
eternal laws. A woman who thus seeks the solution of the woman’s
question in the direction of freedom and independence is one who
endeavors to avoid the burthen of womanhood. She desires to escape,
always from guardianship, often from maternity, and usually from the
restrictions, the unselfishness of womanhood. But none the less does she
remain unable to escape from her femininity.
[Illustration:
FIG. 49.—Vestibule of the vagina, with the labia minora or nymphæ, the
vaginal and urethral orifices, and the glans clitoridis. (From
Toldt: Atlas of Human Anatomy.—Rebman Company, New York.)
]
“The true significance of woman,” insists _Laura Marholm_ in opposition
to the modern tendency, “has at all times consisted rather in what she
is than in what she performs, and it is precisely in the former point
that the women of the present day seem so unusually wanting. Their
performances are indeed many and various, they study and they write
innumerable books, they are the directors or principals of all possible
concerns and collect funds for every possible object, they wear doctors’
gowns, conduct agitations, and found clubs, and they come continually
more and more into publicity. And yet their public significance is after
all diminished. The greater the influence of woman in the mass and as a
numerical majority, the less is her influence as an individual, the
smaller is the triumph of her sex. She herself has induced man to sound
the trumpet note of the abhorrence of women. _Tolstoi_ in The _Kreuzer
Sonata_, _Strindberg_ in numerous dramas, _Huysmans_ in _En Ménage_,
write in this strain; and in the works of many lesser luminaries we
encounter this mistrust of love. * * * The modern system of education
for girls, with its polyglossia and polymathy, favors a superficial
development of the understanding, and produces women who are pretentious
without being profound.”
Feminine beauty suffers during the menacme from the stress of the
demands made on the sexual activity as well as on the functional
capacity of the individual. Repeated, rapidly succeeding pregnancies and
confinements impair the beauty of the breasts and the abdomen, the
figure and the carriage. In consequence of suckling, the breasts,
hitherto firm and elastic, usually become more or less pendent and
wrinkled, sometimes also flabby and inelastic, sometimes nodular.
Diseases of the genital organs and the disorders of the general health
dependent thereon, leave disfiguring wrinkles in the face and other
traces in the whole structure of the body. Toil, anxiety, and grief also
write their horrible marks deeply on the appearance. The mature
working-class woman, through sharing in masculine labors, through
long-continued muscular exertion, and through neglect of bodily care,
frequently assumes in her features, her carriage, her figure, and her
whole appearance, a rather masculine type.
The beauty and the youthful freshness of girls belonging to the
labouring classes seldom endure for long after the menarche, and in
cases in which the environment is one of poverty, they last through a
very short part only of the epoch of the menacme. The early appearance
of wrinkles in the face, the stiff, angular character of the movements,
the ungraceful carriage of the body, all these combine to make a woman
of five-and-twenty who groans under the burthen of toil appear at the
first glance an elderly woman, and a closer investigation shows what
damage has been wrought to the attributes of beauty, how the breasts are
flabby and flattened, the belly prominent, the buttocks pendulous, the
arms muscular.
In the well-to-do classes, again, at this period of life, when generous
diet combines with insufficient exercise, an abundant deposit of adipose
tissue may already have occurred, resulting in a great impairment of
beauty, the body and limbs being enlarged, the gait and the carriage
correspondingly altered for the worse—changes which seem desirable only
to those orientals to whom such obesity, such exaggeration of
femininity, is sexually stimulating. If, however, this deposit of fat is
not excessive, this it is which endows women during these years of
fullest development with an imposing appearance and buxom form. In
favourable circumstances, beauty of this type may persist to the
fortieth year of life and even beyond, and it is of such a character as
to justify the proverb that woman’s first sexual epoch is dedicated to
love, her second to voluptuousness.
[Illustration:
FIG. 50.—The uterus, the left Fallopian tube and the left ovary, in
their connection with the broad ligament of the uterus, which has
been fully unfolded. Seen from behind. From a virgin, aged nineteen
years. (From Toldt: Atlas of Human Anatomy.—Rebman Company, New
York.)
]
“Bountiful nature,” writes _Mantegazza_, regarding woman at this sexual
epoch, “sends to woman an ingenious engineer, who enlarges the hills to
mountains and fills up the valleys with a soft alluvium of fat. The
commencing wrinkles disappear, being smoothed out under the beneficial
influence of this plastic material; the slender, elastic palm-tree stems
are converted into majestic columns of Parian marble; quality is
replaced by quantity, and if the eye has lost a few provinces, the hand
has gained just as many. * * * A certain number of chosen women
understand how to preserve for as long as ten years the unstable
equilibrium of the period which separates these two ages of life. There
are divine beings who with every oscillation of their tresses or rocking
of their hips, with every undulation of their bosom, every serpentine
movement of their limbs, instil desire. * * * They constitute our most
intense delight, and our intensest torment, they make our life a
blessing or a curse, they are the uttermost goal of human passion, of
human voluptuous desire.”
[Illustration:
FIG. 51.—Female internal genital organs in the fully developed state.
(From Toldt: Atlas of Human Anatomy.—Rebman Company, New York.)
]
Among the injuries to beauty effected by pregnancy, one above all
evident to the eye is the almost invariably ensuing change in the skin,
principally taking the form of a change in pigmentation, with the
appearance of spots varying in size and tint, on the face and especially
on the lips and the forehead; there is greatly increased pigmentation
also of the areola mammæ and the linea alba, and in addition of the
labia majora and minora and of the anal region. It is not certain
whether this chloasma uterinum is dependent, as _Jeamin_ assumes, on the
discontinuance of menstruation, or, as _Virchow_ believes, on changes in
the blood and the blood-pressure. Sometimes also, in pregnant women, we
observe on the face, chiefly on the nose and the cheeks, dilatations of
the small cutaneous vessels, often associated with acne nodules.
A permanent disfigurement is caused by the _lineæ_ (vel _striæ_)
_albicantes_, white lines or streaks of varying length and resembling
scar tissue in appearance on the skin of the abdomen, the adjoining
parts of the buttocks and thighs, the lower part of the front of the
thorax, and the mammæ. They are not true scars, not being new formations
of connective tissue, being on the contrary dependent on solutions of
continuity, on relative diminution, that is to say, of the connective
tissue layer of the skin. They are formed in consequence of the fact
that the connective tissue bundles are not able to keep pace in their
superficial enlargement with the necessarily rapid extension of the
cutis, hence great meshes appear in the former, situate in the direction
of the greatest tension of the skin. (_Spietschka_ and _Grünfeld_).
Transiently during pregnancy, but in some cases permanently also, the
beauty of the lower extremities is apt to be impaired by enlargements of
the veins, the formation of varices, and sometimes also by œdema; these
conditions depend upon the hindrance to the venous return caused by the
pressure of the pregnant uterus. Thick, vermicular, bluish strings or
nodular enlargements appear in the course of the great veins, with
consequent eczema and ulceration. In pregnant woman, eczema is common in
other regions, on the face, the hands, the forearms, and the genitals;
also erythema, urticaria, and the pustular eruption known as impetigo
herpetiformis.
Parturition and lactation entail further disfigurement of the skin
through the production of various lesions, such as cracks and fissures
of the skin of the breast, dermatitis due to venous thrombosis in the
lower extremities, scarring of the breast after mastitis, etc.
In the description of the sexual life of woman in the epoch of the
menacme, we shall consider at some length copulation and conception, the
relations of fertility and sterility, the important topic of the use of
measures for the prevention of pregnancy, and the interesting subject of
the determination of sex; on the other hand, pregnancy, parturition, and
the puerperal state, since these subjects are specially treated in the
ordinary textbooks on midwifery, we shall discuss only in so far as
certain relations between these reproductive processes and the organism
as a whole and its functions, appear to us especially worthy of note.
ANATOMICAL CHANGES IN THE FEMALE GENITAL ORGANS IN THE PERIOD OF THE
MENACME.
In the fully-developed woman during the period of the menacme, the mons
Veneris forms a rounded elevation which consists of very dense
connective tissue containing large quantities of fat, while the
integument that covers it is usually coated with a thick growth of hair.
The form of this hairy covering, which by the Roman poets was designated
_Hebe_, by the Greeks _zunaikomustax_ (translated by _Albrecht Dürer_ as
_Weybsbart_—woman’s beard), by _Galen_ termed _ornamentum loci_, is
various, and, as an external sexual character, it deserves more accurate
observation than it has hitherto received from anatomists.
The hairy covering of the female genital organs is in adults, and
especially in brunettes, very abundant; above, it is usually sharply
limited by a transverse line across the top of the mons Veneris, and it
extends outwards only a little beyond the labia majora, whilst below it
extends only to about the middle of the sides of the perineum. According
to _Bergh_, however, who made an exact study of this matter in 2,200
women of ages for the most part between fourteen and thirty years, in
some cases the shape of the patch of hair (which is in such instances
always very thick) resembles that so common in the male, there being a
pointed process, usually rather narrow, extending upward toward the
navel. This masculine form of the pubic hair is by no means common in
women; according to _Lombroso_ it is met with more frequently in Italian
women than in those belonging to other European nations. In most women,
the thick hairy covering of the mons Veneris is sharply limited above by
the curved line that indicates the upper margin of the eminence, whereas
in men a strip of hair usually passes up from the mons pubis to the
umbilicus. Still, exceptions are met with. Thus, in 100 women,
_Schultze_ found five in whom the hairy covering extended up to the
navel. Sometimes other variations occur, for instance, the hair may
extend laterally into the groin, occasionally as far as the anterior
superior spine of the ilium, and across the upper part of the front of
the thigh, not infrequently in association with a thick growth of hair
along the sides of the perineum as far as the anus. Of women with the
hair growing in this fashion, not a few appeared to _Bergh_ to have
unusually strong sexual passion.
In contradistinction to these cases in which the development of the
pubic hair is thick and even excessive, we meet with others in which it
is very scanty, and this not only in quite young individuals (at an age
from 15 to 18 years), with but slight development of the labia, but also
in older and fully developed women—for the most part blondes.
The growth of the pubic hair is thickest and strongest near the median
line, whilst laterally the hairy covering is thinner and weaker. The
thickness is extremely variable. “In some women we find a flattened,
occasionally frizzled, turf-like covering; in others, a dense, elevated,
luxuriant bush of hair” (_Bergh_). The length of the pubic hair is
variable, but as a rule it is somewhat shorter in the female than in the
male. Still, cases have been known in women in which it reached to the
knees.
The colour of the pubic hair commonly resembles that of the hair of the
head, but the pubic hair is usually the darker of the two. Blondes with
dark or black eyebrows have, according to _Bergh_, usually dark or black
pubic hair. The pubic hair turns grey late in life, later as a rule than
the hair of any other part, a fact known already to _Aristotle_; it is
rather late in life also that the pubic hair becomes thin, and in this
state it remains almost invariably up to an advanced age, even when the
scalp has become almost or quite bald.
The pubic hair, according to the same author, is seldom straight, being
almost always curly, frizzled, or more or less rolled up into rings or
spirals, generally forming smaller or larger locks. Fairly often, we
meet with curled locks, either one pair or two, symmetrically disposed
on either side of the depression adjoining the præputium clitoridis;
these usually have an outward direction. Much more rarely we find
similar locks symmetrically attached further back on the labia.
In the case of 1,000 adult women examined by _Eggel_ with regard to the
colour of the pubic hair, the colour of the eyes, and the colour of the
hair of the head, there were 239 with dark eyes, 333 with dark hair on
the head, and 329 with dark pubic hair; contrariwise, 761 had light
eyes, 667 light hair on the head, and 679 light pubic hair. Obviously,
then, a considerable number of women with light-coloured eyes must have
had dark pubic hair. _Roth_, in 1,000 North German women examined by
him, found the pubic hair blonde, but a rather dark blonde, in a large
majority of the cases; in red-haired women, the pubic hair was in all
cases bright red, in black-haired women the pubic hair was black in
two-thirds only of the cases, in nearly a third it was brown, in two
cases dark blonde; in Jewesses, in a large majority of instances, the
pubic hair is brown. The arrangement of the pubic hair is described by
_Roth_ as very variable. “Sometimes it is short and frizzly, sometimes a
luxuriant bushy growth; sometimes the hairs are scanty and thinly set;
sometimes they are irregularly distributed; sometimes we see only a
narrow strip of long hairs down the middle of the mons Veneris, which is
bare at the sides. In some the lateral boundaries of the pubic hair are
sharply defined, in others the hairy covering spreads beyond the usual
limits.”
Among the ancient Greeks and Romans, it was customary for women to
remove the pubic hair, a custom even now observed by all oriental races;
for this reason in ancient art the nude female body is depicted without
pubic hair. According to _Stratz_, in the _Chansons de Bilitis_ it is
said of the priestesses of Astarte: “They never draw their hairs out, in
order that the dark triangle of the goddess shall represent on their
bodies the form of a temple.”
The physiological purpose of the pubic hair is to prevent irritation of
the genital organs by the sweat that would otherwise run down upon them,
and to protect the skin from direct friction during the act of
copulation.
The labia majora in women during the menacme are usually strongly
developed, their outer surface is hairy; in parous women we almost
invariably observe small or even large lacerations of the frænulum
pudendi or fourchette, in front of the posterior commissure of the
vulva. On the inner surface also of the labia majora, the general
characters of which are those of mucous membrane rather than of skin,
fine hairs are also to be found. In multiparæ, and even in women who
have frequently had sexual intercourse, these inner surfaces of the
labia majora are not usually any longer in mutual contact, so that the
rima urogenitalis or vulval cleft gapes more or less. In well-nourished
women who have led the “sheltered life,” the dense and fat-containing
connective tissue of the labia majora (continuous with and similar to
that of the mons Veneris) gives these structures a certain firmness and
elasticity, and the labia minora or nymphæ do not project beyond them.
But when the genital organs are not well preserved, projection of the
nymphæ occurs. In women whose genital organs are beautifully formed, the
nymphæ are of a soft, delicate consistency, and their mucous membrane is
of a pink color; but when the reproductive organs have been subjected to
excessive stimulation, the nymphæ are dry, hard, brown in color, and
they project from the vulval cleft. In women of the Hottentot and
Bosjesman races, the nymphæ attain, as is well known, an excessive
length, forming the so-called “Hottentot-apron;” and in certain other
indigenous races of Africa, the enormous size of these organs renders
resection necessary.
During this sexual epoch, in women with strong sexual passion and having
frequent sexual intercourse, the clitoris is largely developed, and
sometimes the dorsum of the organ protrudes from between the anterior
extremities of the labia majora.
The vaginal orifice gapes a little, so that the irregular carunculæ
myrtiformes are visible. In parous women, the vaginal orifice is
enlarged in such a manner that the wall of the vagina passes directly
and without limitation into the wall of the vestibule, and the external
orifice (meatus) of the urethra is situate immediately in front of the
anterior vaginal column, and thus lies within the vaginal orifice.
The breasts of a strong, healthy woman who has attained complete sexual
maturity are more or less firm in consistency, and considerable in size,
exceeding now _Ovid’s_ demand concerning these organs, _ut sit quod
capiat nostra tegatque manus_. The normal hemispherical form and the
somewhat soft texture are subject to many variations, these being
dependent upon race, climate, and sexual activity and also upon the kind
of clothing worn. The nipple and its encircling areola are usually of a
brownish colour; but in beautiful women they sometimes retain the pink
colour characteristic of these structures in the virgin. In parous women
who have suckled their children, the breasts are usually pendent, and
often the left breast will be found to be somewhat larger than the
other; generally also in such women the nipples are longer and thicker
than normal. Not infrequently the nipples are withdrawn into a furrow of
the skin, and become prominent only on local stimulation or as a result
of sexual excitement. Sometimes in the region of the areola, especially
in brunettes, we see a circle of small glands, which produce eminences
beneath the skin.
It is easy to understand that the breasts of such women in general no
longer have the virginal form of small hemispheres, but have matured to
a greater fulness and size. This, however, does not diminish their
beauty, for the ideal of beauty must take into account the natural
development of the body. Whereas at the present time, under the
influence of the modern negation or at any rate undervaluation of
maternity as the goal of woman’s life, it is the tendency of a certain
school of art to misprize the influence of that state on the form of the
breast, and to esteem the “flat bosom,” at an earlier day under the
influence of _Rousseau’s Emile_, a book in which mothers are strongly
urged to suckle their own children, the full bosom as a beauty was the
fashion in art.
Only a perverted taste can find a woman beautiful without bosom—without
“that golden chalice, from which men quaff love, and children life”
(_Mantegazza_),—an angular, flat being, without a rounded form. Nothing
but a morbid desire for equality with man can induce woman herself to
endeavor to conceal also the external manifestation of her sexual
characteristics, and by her clothing to disguise, like a nun, the sexual
curves of her figure.
Great deposit of fat, such as occurs from liberal feeding in conjunction
with a sedentary mode of life, or as a result of several pregnancies,
destroys the beautiful form of the breasts, which attain an immoderate
size, thus disturbing the grace and symmetry of the feminine figure, a
fact recognized already by the Romans. _Hyrtl_ condemns, from the point
of view of anatomical beauty, the nude female figures in the pictures of
Rubens, remarking that “the goddesses and angels of this painter are as
luxuriant in their development as a Flemish dairy-maid;” and the buxom
“goat’s-udder breast” prized by the Arabs does not represent any nobler
ideal of beauty. Sometimes these excessively large and fat breasts hang
down in a conical form, or, as more or less flattened hemispheres, reach
right down over the gastric region; moreover, the interspace between the
two breasts seems to disappear, and they touch or rub against one
another.
According to _Ploss_ and _Bartels_, the various forms of breast
occurring in different races may be classified as follows: A. According
to size: 1, very large; 2, large; 3, medium; 4, small. B. According to
consistency and firmness: 1, high; 2, semi-pendent; 3, pendent. C.
According to shape: 1, shell-shaped (disc-shaped); 2, hemispherical; 3,
conical. The nipples also, according to these authors, exhibit
variations dependent upon race, being in some cases small and flat, like
a little knob, in some cases large and conical in shape, with a broad
base and a rounded extremity, and in some cases large and cylindrical,
having almost the shape of a finger-joint. The areola, finally, is in
some women quite pale in color, in some dark pink, in some brown and
even almost black from excess of pigment.
The uterus of a woman who has attained complete sexual maturity, has
undergone such alterations in its proportions that the cervix and the
body are of almost the same length. The constriction, visible
externally, indicating the separation between these two segments of the
organ, is depressed somewhat toward the external os. In sexually active
women, a widening and an increased curvature of the region of the fundus
occur, the uterine extremities of the Fallopian tubes becoming more
widely separated; at the same time the posterior wall becomes more and
more convex. The more frequently the uterus has functioned as a
reproductive organ, the more strongly marked is the convexity of the
body of that organ. The relative lengths of the corporal and cervical
portions of the uterine cavity are now the reverse of those that obtain
in the uterus of the child; the transverse and antero-posterior
diameters have greatly increased. Transverse diameter at the fundus;
virgin, 4 centimetres (1.575″), multipara, 5.5–6.5 centimetres
(2.165–2.559″): sagittal (antero-posterior) diameter; virgin, 2
centimetres (0.787″); multipara, 3–3.5 centimetres (1.181–1.378″).
(_Chrobak_ and _von Rosthorn_.)
During the menacme, in consequence of the act of reproduction, the
uterus undergoes important changes in form. In a nulliparous married
woman, the uterus differs little from that of a virgin; the cavity is
somewhat more extensive, the convexity of the outer surface a little
greater, there is some increase in width in the neighborhood of the
fundus, the plicæ palmatæ (_arbor vitæ uterinum_) are confined to the
cervical canal; further, under the influence of copulation the
appearance of the vagina changes, it becomes larger, and its walls
become smoother, sometimes quite smooth, from the disappearance of the
rugæ of the mucous membrane and especially of those attached to the
posterior vaginal column. Much more extensive are the alterations in the
uterus of a multipara. According to _Toldt_, “the parts of the cavity
representing the cornua, which are pointed on either side as they pass
toward the Fallopian tubes, become completely included in the lower
undivided portion of the cavity, this change being effected chiefly by
means of the increasing outward curvature of the walls, so that the
cavity comes to assume an amygdaloid form; the cervical canal is also
enlarged, especially the lower part, where also the plicæ palmatæ
(_arbor vitæ uterinum_) becomes less distinct; the vaginal portion of
the cervix is shortened, the os uteri externum gapes, the lips of the
cervix are tumid, nearly equal in length, and usually beset with scarred
depressions.” In nulliparae, the vaginal portion of the cervix is, as in
a virgin, of a rather tough consistency, smooth on the surface, while
the external os is small, like a dimple, or transversely oval; the color
of the vaginal portion of the cervix is identical with that of the
vaginal mucous membrane in general. Through frequent copulation,
however, the form of the vaginal portion of the cervix is so far altered
inasmuch as it is more freely supplied with blood, and, therefore,
changes slightly, in consistency. In multiparæ, in consequence of
lacerations of the cervix, the os uteri externum changes to a wide
transverse fissure with tumid margins, justifying the old designation of
this orifice as _os tincæ_;, carp’s mouth. A large size of the external
and internal os, moderate enlargement of the cavity, rounding of the
upper angles adjacent to the uterine orifices of the Fallopian tubes,
increased convexity of the walls, and partial or complete effacement of
the plicæ palmatæ (_arbor vitæ uterinum_), are the characteristics of
the uterus of a multipara (_Chrobak_ and _von Rosthorn_). According to
_Hennig_, the vaginal portion of the cervix is longest in women who have
undergone defloration, and in nulliparae; widest in prostitutes;
narrowest in childless wives; thickest in young widows. This author
gives the following measurements of the external os, showing its
variations in accordance with age and sexual activity:
In childhood, transversely oval 0.46–0.56 cm. (0.18–0.22″)
In the virgin, rounded 0.20–0.50 cm. (0.08–0.20″)
In prostitutes, transversely, oval 0.60–2.50 cm. (0.24–0.98″)
In sterile married women, round 0.16 cm. (0.06″)
In parous married women, transverse fissure 1.10 cm. (0.43″)
After the menopause 0.81 cm. (0.32″)
In the fully-developed woman, the ovaries undergo changes in size,
shape, and consistency, these changes being dependent upon the
age, the sexual functional activity, and the constitutional
predispositions of the individual. The average length of the ovary
is 3–4 centimetres (1.18–1.58″); the average width, 2–3
centimetres (0.79–1.18″); and the average thickness 1 centimetre
(0.39″). The surface of this organ gradually assumes a ragged
appearance, from the scarred depressions caused by the great
number of successive menstruations (ovulations)—sometimes the
appearance produced resembles that of a mulberry.
In the vagina at this sexual epoch, the surface of the anterior and
posterior vaginal walls is rendered uneven and rugose by well-developed
vaginal columns (_columnæ rugarum_), which feel almost as hard as
cartilage, and project considerably above the general level of the wall;
the transverse ridges (_rugæ_) run horizontally outward from the
columns. By frequent copulation, the rugæ are partially effaced, and the
columns themselves become flatter and softer; still, except in cases in
which the genital functions are exercised to great excess, the vagina
remains tense and rugose until after several children have been born,
when it becomes soft, flaccid, and smooth. Even in women who have been
accustomed to frequent intercourse, the narrowest portion of the vagina
is still the orifice and the part of the passage lying immediately
within the orifice, which can be constricted by the levator ani muscle;
childbirth, however, brings about great and permanent distension of
these parts also. The widest and most distensible portion of the vagina
is the uppermost segment, the region of the fornices.
A special significance must be attached to the glands of the cervix
uteri, which, according to my own observations, have the function of
providing a secretion that increases the mobility of the spermatozoa,
and this enables them more readily to find their way into the uterus. I
have endeavored, by a series of histological observations, to determine
the properties of these glands and the changes they undergo in the
different phases of sexual life. The most important results of these
researches may be stated as follows. These glands, which are lined with
columnar ciliated epithelium, are but slightly developed before puberty,
being then simple excavations; at the time of the menarche, they become
tubular; later, during the menacme, they become long, dendriform,
blind-ending glands, which during menstruation and under the influence
of sexual excitement, furnish a secretion, variable in quantity, and in
quality distinguished especially by its alkaline reaction; further, in
connection with a number of pathological disorders of the female genital
organs, these glands undergo various changes both in their anatomical
structure and in their secretory activity. At the time of the menopause
and after the climacteric age, these glands, which have hitherto
consisted of branched tubules, tend to undergo cystic degeneration,
leading to the formation of the vesicles known as _ovula Nabothi_. After
the climacteric, the existence of these cysts may be regarded as a
normal occurrence; and, sometimes arranged in grape-like clusters, they
often project so as to occupy the greater part of the lumen of the
cervical canal.
[Illustration:
FIG. 52.—Sagittal section through the cervix uteri of a woman 26 years
of age, dendriform branched glands.
]
[Illustration:
FIG. 53.—Cervix of a woman 72 years of age, with glands that have
undergone cystic degeneration.
]
[Illustration:
FIG. 54.—Sagittal section through the cervix uteri of a woman 65 years
of age. The glands have undergone cystic degeneration.
]
Diseases of the uterine mucous membrane during the period of sexual
maturity often induce various pathological changes in these cervical
glands. In consequence of obstruction of their excretory ducts, they may
undergo cystic degeneration, forming follicles filled with mucus and
epithelium, or cavities containing blood, which pass through the
substance of the cervix in every direction; or they may give rise to the
formation of slowly-growing glandular polypi and other glandular new
formations—changes the general result of all of which is to interfere
with the secretory function of the glands.