THE SEXUAL ORGANS--THE SEXUAL IMPULSE
A proper understanding of physiological functions is based upon
anatomical knowledge of the organs concerned. For our purpose,
therefore, a knowledge of the sexual organs of the child is essential.
The proper course, in this instance, appears to be to start with an
account of the adult organs, and then to describe the distinctive
characteristics of the same organs in the child. Let us, then, begin
with the organs of the adult man.
The _membrum virile_ or _penis_ is visible externally, and behind it is
situated the scrotum. Within this latter are two ovoid structures, named
_testicles_ or _testes_. Each testicle is enveloped in a fibrous
capsule, known as the _tunica albuginea_, from which fibrous _septa_
pass into the interior of the organ, thus dividing it into a number of
separate _lobules_. Each lobule is composed of _seminiferous tubules_,
which are greatly convoluted and likewise branched, the branches being
continuous with those of neighbouring tubules, both within the same
lobule, and (by perforating the fibrous septa) in adjoining lobules. In
the walls of the seminiferous tubules the _spermatozoa_ are formed. The
seminiferous tubules unite to form the efferent ducts (_vasa
efferentia_), about a dozen in number for each testicle; immediately
passing out of the testicle, these efferent ducts make up the
_epididymis_, situated at the upper and back part of the testicle. After
numerous convolutions, these unite at length on each side to form a
single canal, which leaves the epididymis under the name of the _vas
deferens_; this is the excretory duct of the testicle, conveying the
secretion of that organ to the exterior. The vas deferens traverses the
inguinal canal into the abdominal cavity, and therein passes downwards
to the prostatic portion of the urethra (_vide infra_). The anterior
portion only of the _penis_ is visible externally, dependent in front
of the scrotum; the posterior portion is concealed by the scrotum and
the skin of the perineum. The terminal segment of the penis is formed by
the _glans_, which is covered by the _foreskin_ or _prepuce_. This last
is sometimes artificially removed: either on ritual grounds, as, for
instance, among the Jews; or for medical reasons, for example, when the
preputial orifice is greatly constricted. At the anterior extremity of
the glans penis is the orifice of the urethra (_meatus_). The _urethra_
is a canal running through the entire length of the penis, opening by
its proximal extremity into the urinary bladder, and serving for the
passage of the urine from the bladder to the exterior of the body. The
main substance of the penis is composed of three cavernous bodies, the
paired _corpora cavernosa penis_, and the single _corpus spongiosum_, or
_corpus cavernosum urethræ_. These consist of what is known as _erectile
tissue_, a spongy mass within whose lacunar spaces a large quantity of
blood can, in certain conditions, be retained. When this occurs, the
penis becomes notably thicker and longer, and simultaneously hard and
inflexible. This process is known as _erection_ of the penis, and is
requisite to render possible the introduction of the organ into the
genital canal of the female.
The proximal segment of the urethra is surrounded by the _prostate
gland_. The secretion of this gland is conveyed into the urethra by
numerous short ducts, known as the _prostatic ducts_. Behind the
prostate, at the base or fundus of bladder, are the paired _seminal
vesicles_. The duct of the seminal vesicle joins the _vas deferens_ of
the same side (both functionally and embryologically the seminal vesicle
is no more than a diverticulum of the vas deferens); passing on under
the name of the _common seminal_ or _ejaculatory duct_, the canal opens
into the prostatic portion of the urethra (the orifices of the two
common seminal ducts are in the folds of mucous membrane forming the
right and left lateral margins of the _prostatic utricle_ or _uterus
masculinus_). These ducts convey the secretion of the testicles into the
urethra along which canal it passes to the exterior. Behind the
posterior part of the urethra, but distal to the prostate gland, are
situate also the paired _glands of Cowper_, or _suburethral glands_,
whose excretory ducts likewise open into the urethra. There are glands
also in the walls of the seminal vesicles, the vasa deferentia, and the
urethra; the urethral glands are commonly known as the _glands of
Littré_.
As previously mentioned, it is in the testicles that the secretion
necessary for the reproductive act is prepared. This secretion is
evacuated during sexual intercourse, and also during masturbation and
involuntary seminal emissions. The testicular secretion is a tenacious
fluid. When examined microscopically, it is seen to contain countless
spermatozoa, structures about 50 [Greek: m] (1/500 inch) in length, with
a thick head and a long filiform tail. They represent the male
reproductive cells, which during coitus are introduced into the interior
of the female reproductive organs; a single spermatozoon unites with the
ovum of the female to form the fertilised ovum. The spermatozoa are
formed in the walls of the convoluted seminiferous tubules. The cells
lining these tubules are of several different kinds (although in
childhood they are not differentiated as they are after the puberal
development has taken place). One variety of these cells, the
_spermatogonia_, undergo an increase of size at puberty, and from these
spermatogonia, after passing through several intermediate transitional
stages, the spermatozoa are formed.
It was formerly believed that the sole function of the testicles was the
production of the spermatozoa; recently, however, the opinion has gained
ground that these organs have in addition another specific function,
that of internal secretion. Whilst the spermatogonia become transformed
into spermatozoa, other cellular structures of the testicle, more
especially the interstitial cells, produce, it is assumed, the internal
secretion of the gland. The constituents of this internal secretion,
having been poured into the general circulation, are supposed to give
rise to the specific masculine sexual development, and, in particular,
to lead to the appearance of the secondary sexual characters. This
matter will subsequently be discussed in detail, and here I shall merely
add that perhaps none of the proper constituents of the internal
secretion find their way into the external secretion of the testicle.
This external secretion of the testicles does, however, receive the
admixture of a number of other secretions, to constitute the semen as
actually discharged, viz., the secretion of the prostate gland, that of
the seminal vesicles, Cowper's glands, and the glands of the vasa
deferentia, and perhaps also that of the glands of Littré. The term
semen is, indeed, often applied to the secretion of the testicles alone;
but to avoid misunderstanding, Fürbringer[8] recommends that only the
mixed secretion, as actually discharged, should be spoken of as the
semen, and that this term should never be employed to denote the
testicular secretion alone.
In what has gone before, I have not only described the structure of the
male sexual organs, but have alluded also in passing to their functions.
These latter must, however, be described more fully. Let us begin with
_erection_, which, as we saw, is due to distension of the penis with
blood. How is this distension brought about? It results from stimulation
of the erection centre. Until recently, it was supposed that this centre
was situated in the lumbar enlargement of the spinal cord; but now,
owing to the researches of L. R. Müller, it is believed to form part of
the sympathetic plexuses of the pelvis. Stimulation of the centre leads
to distension of the penis with blood, and thus to erection of that
organ. The stimulation of the centre can be effected in either of two
ways.
In the first place, by psychical processes. Thus, in a man, the sight of
a woman exercises such a stimulus, the stimulation proceeding from the
brain along the spinal cord to reach the centre. The psychical stimulus
may also consist of reminiscences. In this way the memory of an
attractive woman may be just as effective in causing erection as if she
were actually visible at the moment; reading erotic literature may have
the same result. When the sexual impulse is perverted, the ideas causing
erection will naturally be themselves of a perverse character. Thus, in
the homosexual male, erection 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 the nature 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
sensations, or as ordinary tactile and other similar sensations. In the
second place, we have those higher psychical processes by means of which
man is attracted to woman, and woman to man. In our actual experience of
the normal sexual life, both these groups of processes do, as a matter
of fact, work in unison; but not only is it possible for us to
distinguish them analytically; it is, in addition, possible in many
instances to observe them in action clinically isolated each from the
other. A long while ago I utilised this distinction for the analysis of
the sexual impulse, describing the impulse in so far as it was confined
to the peripheral organs as the _detumescence-impulse_ (from
_detumescere_, to decrease in size), and in so far as it takes the form
of processes tending towards bodily and mental approximation to another
individual, as the _contrectation-impulse_ (from _contrectare_ to touch,
or to think about). The distinction will become clearer to our minds if
we familiarise ourselves first with cases in which either process occurs
independently of the other. The detumescence-impulse is sometimes the
sole manifestation of the sexual impulse. Certain idiots practise
masturbation as a physical act, because sensations proceeding from the
genital organs impel them to do so, precisely as itching of an area of
the skin impels us to scratch. They masturbate without thinking of
another person, and they feel no impulsion whatever towards sexual
contact with another person. Analogous phenomena may be witnessed in the
animal world also, in connexion with the masturbatory acts of monkeys,
bulls, and stallions. When a stallion kicks its genital organs again and
again with its hind-foot, and repeats the action until ejaculation
ensues, we are hardly justified in assuming that the animal has the
idea of a mare before its mind. We must rather suppose that we have to
do with a local physical stimulus, to which the stallion reacts in the
manner above described. The other component, also, of the sexual
impulse, the contrectation-impulse, manifests itself, occasionally, at
any rate, in isolation. Certain boys, long before the appearance of any
signs of the puberal development, are impelled towards physical contact
with members of the other sex, to kiss them, to think of them, although
these boys may exhibit no tendency whatever to masturbate, or to
manipulate their genital organs. It often happens, indeed, that such a
boy is himself greatly astonished to find, some day, that these ideas
are reflected to the genital organs, giving rise to erection; or, when
he is embracing a girl, to experience erection and ejaculation. In the
sexually mature normal man, the detumescence-impulse and the
contrectation-impulse act in unison, and hence he is impelled towards
intimate contact with the woman, and is ultimately driven to effect
detumescence by the practice of coitus. Nevertheless, we must hold fast
to the idea that in the normal adult man the sexual processes may also
be theoretically analysed into these two components.
This is true also of woman, in whom the processes in the genital organs
are equally separable from those which impel to contact with a member of
the other sex. But in woman, the processes in the genital organs do not
culminate in the ejection of the reproductive cells, that is, of the
ovum, but, as we have seen, in the ejaculation of indifferent
secretions. In the woman, also, the detumescence impulse is occasionally
met with in isolation--for example, in many female idiots. In the animal
world, too, we encounter it as an isolated phenomenon. Certain mares,
when rutting, rub their hind quarters against some object in their
stalls. The contrectation-impulse may also manifest itself in isolation
in woman. It is then directed towards the male, but is not in any way
associated with the wish for a definite sexual act. Most commonly,
however, in woman also the two components of the sexual impulse are
united, and from this union results the impulsion towards coitus. But to
this extent the conditions in woman are apt to differ from those in
man, inasmuch as, in the former, voluptuous sensations are more often in
abeyance; or in woman voluptuous pleasure may not arise during coitus,
but may be produced in some other way, as, for instance, by a
masturbatory act.
The sexual impulse, and indeed either of its components, may be excited
either by bodily or by mental stimuli; but we must always bear in mind
the fact that in normal adults, both male and female, the two components
are so intimately associated that they can as a rule be separated only
by artificial analysis. The nature and mode of operation of the stimuli
need not be further discussed, since enough has been said about the
matter in our description of erection. Nor is it necessary in this place
to deal with such differences as may exist between the psychosexual life
of the child and that of the adult, since this matter will be fully
considered in the fourth chapter. In this chapter my aim has merely been
to give a general description of the sexual impulse.
Here I need allude to one more point only, a knowledge of which is
indispensable for the understanding of the sexual life of the child,
namely, the connexion between the central processes and the peripheral
voluptuous sensation. Let us ask, in the first place, by what means the
voluptuous sensation, the voluptuous acme, and the sense of
satisfaction, are produced. Various factors are here operative. A
homosexual man, in heterosexual coitus, by keeping present to his
imagination the idea of coitus with a man, may succeed in obtaining
erection and ejaculation; but he does not experience the voluptuous
acme, nor does he feel the sense of satisfaction. Notwithstanding the
fact that the peripheral processes occur in normal fashion, the sense of
satisfaction remains in abeyance; because the act is in his case
inadequate, the sexual act in which he is engaged lacks harmonious
relationship to his sexual impulse. But the same homosexual man,
embracing a man with whom he is in full sympathy, will experience alike
the voluptuous acme and the sense of satisfaction. _Mutatis mutandis_,
the like is true of woman. Many cases which have been regarded as
instances of sexual anæsthesia would appear in quite another light if
the woman concerned were to have intercourse with a sexually
sympathetic man. I have myself known cases in which women were able to
experience the voluptuous acme in intercourse with men whom they
earnestly loved, whilst in intercourse with men to whom they were
indifferent, the voluptuous sensation and the sense of satisfaction were
wanting, even though in some of these cases the peripheral processes
culminated in ejaculation. Such a physically complete sexual act,
without voluptuous acme or sense of satisfaction, may occur when the
woman, having intercourse with a man whom she does not love, pictures in
imagination that she is having intercourse with her lover.
Unquestionably, the psychical processes are of the greatest importance
in contributing to the occurrence of the voluptuous sensation and the
sense of satisfaction. On the other hand, of course, certain peripheral
conditions must also be fulfilled if the voluptuous acme is to ensue.
Among these conditions may be mentioned a certain anatomical state of
the skin and the nerves concerned. Experience also shows that in the
adult the voluptuous acme coincides with the act of ejaculation.
Ejaculation is effected by the rhythmical contraction of certain
definite muscles, and Otto Adler believes that it is these contractions
which are principally effective in producing the voluptuous acme, and
that actual ejaculation is not indispensable. He believes, that is, that
the voluptuous acme may occur in the absence of any discharge of actual
secretion.
In any case, let us hold fast to the fact that in the adult, for the
occurrence of the voluptuous acme and of the sense of full satisfaction,
certain central processes are, in general, indispensable.