On the other hand, it is asserted in the laws of the Hindus that sexual desire in women can as little be satisfied or fed full as a devouring fire can be fed full of combustible materials, or as the ocean can be overfilled by the rivers that pour their waters into it.

Lombroso finds a proof of the sexual indifference of women and of the greater sexual needs of man, in the existence of prostitution, with which can be contrasted the existence only among the degenerate classes (both rich and poor) of a small group of male prostitutes (alfons, souteneurs). This author also refers to the rarity and uniformity in women of the sexual psychoses so frequent in men, as indications of the minor intensity of sexual desire in the former; and he refers also to a series of facts, as for instance, to the occurrence of platonic love, which, though indeed often hypocritical, has a real existence more often in the female sex than in the male; to the long-enduring chastity of girls, and to vows of chastity, which are rarely made except by females; moreover, the ready adaptation of women to polygamy, as well as their scrupulous observance of monogamy, which latter for the male is nominal rather than actual. If in general the opposite view concerning women prevails, this is ascribed by Lombroso to the fact, that love is the most important circumstance in a woman’s life. The reason therefore, however, is to be found, not in the erotic sphere, but in the desire for the satisfaction of the maternal instinct, and in a woman’s need for protection. A celebrated accoucheur, Giordano, has remarked: “Man loves woman for the sake of the vulva; what woman loves in man is the husband and the father. Comprehensively we may express the matter by saying that woman has less eroticism and more sexuality.”

As a rule, remarks Erb, it is believed that the sexual impulse is less intense in women than in men. This is true enough, he writes, as regards youthful and virgin individuals, who have not yet come into intimate contact with men, and in whom sexual desire and sensibility have not yet been directly excited; later, however, when sexual intercourse has been begun, a change usually takes place, and the sexual needs become active in women also, and demand satisfaction. It is well known that not a few women experience powerful and uncontrolled sensual inclinations, just like those of men. On the other hand, we must insist that quite a large number of women possess the so-called naturae frigidae, and have no sensual inclination to sexual intercourse, to which they are either indifferent, or in some cases strongly averse, even regarding it with horror. This lack of the sexual sense in women, is especially common in hysterical subjects, and Erb reports that he has encountered quite a large number of cases of this character. Whether in quite healthy women with normal sexual impulse, complete abstinence from sexual intercourse, too often compulsory but sometimes voluntarily undertaken, is harmful in its consequences—this, says Erb, is a question very difficult to answer. Many such unfortunate women have assured him that they suffered severely in consequence of their enforced continence; the majority of these became neurasthenic or hysterical. The complication of purely physical influences with mental influences, increases the difficulty of the problem. Neurologists have observed women on whom continence was forced either during marriage or after its dissolution, who thereupon fell into a state of severe nervous exhaustion or nervous excitement, or suffered from threatening or even actually developed psychoses. That sexual abstinence is “absolutely harmless,” as moralists and many physicians would so gladly believe, appears to Erb a quite unwarrantable assumption.

“In the processes of reproduction,” continues Erb in his discussion of this subject, “woman is the principal sufferer. With inhuman cruelty, nature has condemned woman to a far more difficult rôle than man in the intercourse of the sexes and in the preservation of the species; she is overpowered and forced by man, she is compelled to make the most severe sacrifices for the sake of the new generation, first when it is germinating within her womb, and later when it is entrusted to her care; and only too frequently she fails to find the respect and protection due to her for the performance of these functions! Compared with the sacrifices made by woman, the temporary continence which is all that is demanded from man will be admitted to be a small matter! It is fortunate that as a rule the young woman who has never come into intimate contact with the male, appears to be endowed by nature with a relatively weak sexual impulse! This unequal and unjust distribution of the male and female rôles on the part of nature may be regretted, but it cannot be altered.”

The modern advocates of the rights of women, who demand that in the sexual sphere also, woman should receive emancipation, oppose the view that in the male the sexual impulse is stronger than in the female, and also the view that whilst in the male the impulse is simply one toward sexual congress, in the female the determining motive to intercourse is furnished by the desire for motherhood. They complain of “the perverse repression in woman of the sexual impulse and its physiological gratification,” since sexual energy and sexual sensibility are equal in intensity and identical in quality in the female and in the male. Thus, Johanna Elberskirchen writes (Die Sexualempfindung bei Weib und Mann—Sexual Sensation in Woman and Man): “Body and soul, the whole being is subordinated to a single powerful feeling and impulse, a single will flows through nerves and blood, forcing and driving the female toward the male with irresistible power; the yearning, the longing for the relief of sexual tension, the craving for the euphoria and fleshly delight that dominate the whole personality. And this elementary sexual longing it is that clouds the woman’s brain, that drives her into the man’s arms, that leads her to forget all the shame threatening her and her child, that brings her to sexual union—not the longing for a child, not the so-called impulse to motherhood.” And again: “Woman yearns for love, all her love-organs cry out for love, soul and body * * *. We do not long only for the rude sexual act. We spiritualise it—at least some of us do so; at any rate we individualize it. It is one particular man whom we desire, he alone can still our longing, our bodily and mental hunger for love. He satisfies us with all his love-affinities.” Naturally, also, the consequence is deduced, “a free course must be given to sexual sensation in women, and to the satisfaction of sexual desire, within physiological limits, within the bounds of physiological necessity.”

Löwenfeld asserts that in the life of woman the sexual functions play a comparatively much greater part than in the life of man, woman’s thoughts and feelings are, that is to say, much more powerfully influenced by sexual matters than those of men; but none the less he is of opinion that in the normal woman the desire for sexual satisfaction is on the average less keen than in the normal man. Distinctly greater in woman is the erotic element only, the need to love and to be loved after an ideal manner, which is excited by the reproductive glands just as much as is the simple sensual desire. Very frequently, manifestations of this ideal need are erroneously attributed to the sensual impulse, yet this latter may be entirely absent in cases in which the erotic element is strongly developed. According to Löwenfeld, the sexual impulse is altogether wanting in young girls before the time of puberty, and in elderly women (in the case of the latter we consider this assertion most questionable); this lack of the sexual impulse persists in girls for an indeterminate time even after puberty, as long as they remain free from all experience of sexual stimulation. In this respect they offer a notable contrast to males of the same age. In normal girls, according to the same author, erotic dreams and similar occurrences are entirely wanting, and specific sexual sensations therefore remain absolutely unknown to them; hence it follows that the sexual impulse cannot, properly speaking, arise in such individuals, and in so far as they experience any desire for sexual intercourse it can only take the form of a craving for some enjoyment, the nature of which is entirely unknown. The absolute lack of the sexual impulse (complete frigidity) persists, according to Löwenfeld, in a not inconsiderable proportion of women even after their introduction to sexual intercourse—Effertz estimates that such complete frigidity is permanent in 10 per cent. of all women—and in a still greater proportion of women the sensual impulse never exceeds a certain minimal intensity (partial frigidity). It is probable that in the higher classes of society, inherited predisposition, education, and perhaps also higher intelligence, combine to diminish the intensity of the sexual impulse. In contrast with these women of frigid temperament, however, we meet with women, certainly in very limited numbers, whose sexual passions are extremely powerful, and whose needs no man can satisfy.

Hegar, who considers that the sexual impulse in women is seldom very powerful, draws the following conclusions in respect of the influence of sexual gratification, on the one hand, or of continence, on the other, on the duration of life and on physical and mental health: “As far as comparisons between married women and women vowed to celibacy (nuns and members of other celibate religious orders) justify any conclusion, sexual activity and inactivity, respectively, would appear to have little influence on the duration of life. Comparisons between married and single women show, indeed, that the gratification of the sexual impulse and the processes of reproduction are distinctly injurious when experienced before the attainment of complete sexual maturity. In married women up to the age of thirty, in some countries even up to the age of forty, the mortality is greater than in unmarried women. The notably smaller mortality of married women, as compared with unmarried, after the age of forty, is usually explained as the result of the complete fulfilment of the genital functions. It may, however, find a truer explanation in the selection effected by marriage, especially when we take into consideration that from the women thus selected the weaker individuals have been previously weeded out by the processes of reproduction:

“The lesser mortality of married men from the age of twenty upwards is to be explained by the selection of the fit which occurs in marriage, by the smaller proportion of marriages among men engaged in hazardous occupations, and by the deterioration in the quality of the unmarried which results from emigration. Still the directly favorable influence of marriage is undeniable, and, no doubt, the ethical factors of this institution have a beneficial effect, whereas the gratification of the sexual impulse hardly enters into the account.

“Suicide is certainly very little dependent upon repression of the sexual impulse, since all the motives arising out of the affairs of love play together but a small part among the causes of suicide.

“The beneficial influence of marriage in the prevention of insanity is in part apparent merely, since, in the selection exercised by marriage, those predisposed to mental disorder, and those in whom such disorder has already manifested itself, are, for the most part, already excluded. Still, as regards the male sex at any rate, the beneficial influence of marriage is undeniable, and consists principally in the favorable ethical factors of this state. In women, on the other hand, the advantage of marriage is doubtful, since the nerve centres and the nervous system as a whole are strongly affected by the processes of reproduction.

“Satyriasis, nymphomania, and hysteria are in no way dependent upon the repression of the sexual impulse.

“Criminality in the married is comparatively less common than in the unmarried. In criminal assaults on young persons, repressed sexual impulse plays a part.

“Chlorosis is not in any way dependent on repression of the sexual impulse. A disease apparently analogous to chlorosis, occurring in unmarried women from twenty to thirty years of age, is dependent rather on mental causes, and is relieved by other means than marriage, especially by suitable occupation. Marriage and gestation are distinctly injurious in cases of true chlorosis.

“The satisfaction of the sexual impulse, and still more gestation, favor in women the origin and growth of tumors, give rise often to mechanical disturbances, and open the way for the invasion of toxic pathogenic germs.

“Osteomalacia occurs only in parous women.”

Moll divides the sexual impulse into two components: The impulse toward intimate contact (in a sense both physical and mental) with a person of the opposite sex, which he calls the contrectation-impulse (Kontrektationstrieb); and the impulse to bring about a change in the genital organs, which he calls the detumescence-impulse (Detumeszenztrieb). The former impulse induces intimate physical and mental contact between the two persons concerned, the latter impulse induces the local processes of copulation. In women, detumescence results from the passing off of local swelling and the release of nervous tension in the genital organs, with the discharge of indifferent glandular secretions, notably the secretion of Bartholin’s glands, and perhaps also the secretion of the uterine glands. The intensity of the detumescence-impulse in women varies greatly in different individuals, these variations being more extensive than those occurring in the male. In some women the impulse toward intimate contact, the contrectation-impulse, is normal, though the detumescence-impulse is wholly wanting (vide Dyspareunia).

Runge defines the sexual impulse as the impulse which brings the sexes together. This impulse is subservient to an instinct, namely the instinct of reproduction; that is to say, the sexual impulse induces the individual to perform actions which subserve the purpose of reproduction without the agent’s being directly or chiefly concerned with this purpose.

The sexual impulse, as sensation, perception, and impulse, is, according to von Krafft-Ebing, a function of the cerebral cortex; a centre for the sexual sense has not as yet, however, been localized. The close relations which obtain between the sexual life and the sense of smell lead to the supposition that the sexual and the olfactory spheres of the cerebral cortex are in close proximity one with the other. The development of the sexual life has its beginnings in the organic sensations of the developing reproductive glands. A mutual dependence now arises between the cerebral cortex as place of origin of sensations and perceptions, and the organs of generation. By anatomico-physiological processes these now give rise to sexual perceptions, representations, and impulses. The cerebral cortex, by apperceived or reproduced sensuous perceptions, influences the organs of generation. This influence is effected by the intermediation of the centres of vascular innervation and ejaculation, which are situated in the lumbar enlargement of the spinal cord, and are certainly in close proximity one with the other. Both are reflex centres.

The psycho-physiological process embraced in the conception of the sexual impulse is according to von Krafft-Ebing constituted in the following manner:

I. Of the central or peripherally aroused perceptions.

II. Of the pleasurable sensations associated with these.

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:

In England during the year 1855 the age of the bride exceeded the climacteric age in 778 instances. The brides were:

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:

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.

Nymphomania, Anæsthesia and Psychopathia Sexualis.

The sexual impulse in women is subject to morbid changes, both in the way of increase and of diminution, exhibiting abnormal violent increase (nymphomania), or declining to the state of complete frigidity and sexual indifference, or, finally, manifesting itself in some perverse manner (psychopathia sexualis).

Psychopathically increased sexual impulse in woman is known as nymphomania or uteromania. In such women there is a dominant state of psychical hyperæthesia, principally in the genital sphere. The most indifferent perceptions give rise to erotic sensations and to lascivious impulses. All sensory perceptions obtain a sexual content, and induce stimulation of the cerebral cortex. All sensation and all activity in such unhappy beings ultimately concentrates itself in the act of copulation, or in some other form of sexual gratification, the greatest perversities of sexual practice frequently arising, masturbation, tribadism, and, for the most part, prostitution, even in the case of married women.

The nymphomaniacal woman, says von Krafft-Ebing, endeavors to allure men by means of exposure of the genital organs or indecent gestures; the sight of man produces intense sexual excitement, which is gratified by masturbation or by stimulatory movements of the pelvis. According to this author, nymphomania is not very infrequent at the climacteric period; it may even occur in old age. Abstinence in association with simultaneous excitement of the sexual sphere by mental or by peripheral stimuli (pruritus pudendi, oxyuris, etc.), may induce these states, probably, however, only in those hereditarily predisposed.

The history of antiquity contains records of the corrupt practices of nymphomaniacal empresses. Thus, Messalina furnishes a well-known historical example of the abnormal violence of a pathologically intensified sexual impulse in woman. She was given the agnomen of invicta, having received the embraces of fourteen athletes. Pliny says of her, die ac nocte superavit quinto et vicessimo concubitu; and Juvenal writes of her the verses,

In corrupt Rome, Messalina was not the only woman necdum satiata, ever insatiable; we need only refer to the orgies of an Aggripina, a Livia, a Mallonia, or a Poppæa; and Seneca hurls against the women of his day the reproach, adeo perversum commentæ genus impudicitiæ viros ineunt. And of Cleopatra, the beautiful Egyptian queen, Marcus Antonius writes in a letter to his physician, Soranus, that she had such violent sexual desire as to lead to her having connection in a brothel with 106 men.

Through the report of Herodotus it is well known that the pyramid of Cheops was built by the numerous lovers of the daughter of this king, who raised this enormous monument in recognition of the innumerable times she had yielded herself to their desires. On record also are the sexual excesses of the Roman ladies at the festival of Saturn, the festival of the Bona Dea, and the festival of Priapus; indeed, many of these women allowed themselves to be debauched in the temples (Ploss and Bartels).

But returning to the present day, both gynecologists and alienists record numerous cases of great pathological increase in the intensity of the sexual impulse in women. According to Lombroso, such continued ardency of sexual desire occurs chiefly in women with an inherited tendency to crime and to prostitution, whose natures exhibit a commingling of lasciviousness with barbarism. He gives examples of such women, one of whom surrendered herself to her husband’s laborers; another had as her lovers all the desperadoes of Texas; a third had intercourse with all the herdsmen of her village; a fourth, though her husband occupied a good social position, led the life of a prostitute; a fifth, a cultured and intelligent woman, entertained a common bricklayer, and wrote to him letters full of shameless declarations of her sexual passion; further he writes of a series of criminals, in whom, indeed, increased sexual desire is a common phenomenon; one of these, a thief, experienced sexual excitement at a mere glance at a good-looking man; a murderess, in whom lascivious feeling induced masturbation whenever she saw a man, and who made experiments in sexual intercourse with dogs; another, who often took to bed with her, in addition to her son, three or four men selected at random from the streets; and many others. Jolly reports the case of a widow, a celebrated lionne of the demi-monde, who kept in her desk, side by side with devotional literature, a number of lascivious books and preparations of cantharides, and entertained quite a number of powerfully-built lovers drawn from the lowest canaille.

In hysterical women the sexual impulse is frequently excessive, and may increase to such a degree as to produce hallucinations of coitus; sometimes, on the other hand, the impulse is extinguished, or psychopathically metamorphosed, passing in a most paradoxical manner from sexual frigidity to lascivious reflections and continuous occupation with sexual affairs; not uncommon in such women are false accusations of indecent assaults of which they assert themselves the victims.

Lombroso gives several examples of the increase of the sexual impulse in hysterical women: “A hysterical girl visited a physician, and said to him: ‘I am still a virgin, take me;’ she submitted him to the utmost extremity of provocation, and asserted afterward that she had been violated. Another hysterical subject, a rich young lady, met a workman in the street, offered herself to him, was accepted, and when she returned home related the affair with laughter. A third sought men from the street in order to find one suffering from syphilis, her object being to infect her own husband with the disease.”

According to the observations of Schüle, young married, hysterical women not infrequently run away with a waiter during the honeymoon journey. This author also points out that in women moral insanity is especially apt to manifest itself during the first years of married life. Many advocate a far-reaching libertinism, and threaten to enter a brothel. In these forms we observe, in addition to ill-temper and malignity, especially obscenity and tribadism.

Such a case, observed by Giraud and quoted by von Krafft-Ebing, is the following: Marianne L., of Bordeaux, during the night, while her master was sleeping soundly under the influence of narcotics she had administered, was in the habit of giving up her master’s children to her lover for his sexual gratification, and made them witnesses of the most immoral scenes. It appeared that L. was hysterical, suffering from hemianæsthesia and convulsive seizures, and that before her illness she had been a sensible and trustworthy individual. After the illness, however, she prostituted herself in the most shameless manner and completely lost her moral sense.

Galen relates of his own mother that she suffered from nymphomania, and that in the attacks she bit her female slaves like a wild animal.

As a negative aspect of the sexual impulse in woman we must regard the absence of the impulse, or anæsthesia sexualis, and also the deficiency of the sensation of pleasure during the act of copulation, or dyspareunia.

Of dyspareunia we shall speak more at length later, in connection with the pathology of copulation. As regards the entire lack of the sexual impulse, however, in women whose genital organs are normally developed and normal in the performance of their functions, and whose cerebral condition is also normal, we must consider such lack an extremely rare condition, if indeed it ever occurs. It is only in cases in which the female genital organs are wanting, wholly or to a considerable extent, or in which there are important cerebral disturbances or states of mental degeneration, that the sexual impulse is wanting.

Normally, in the young, sexually unspoiled girl, the sexual instinct^[34] slumbers in the cerebral cortex, but becomes active, as sensation, perception, and impulse, as soon as the cerebral centre has been aroused by mental impressions or by physical peripheral stimulation of the genital organs and their environment. Among stimuli of the latter class must be reckoned the menstrual stimulus, set on foot by the developmental processes of puberty. These stimuli arouse in the cerebral cortex sensations and perceptions which, rising to specific sexual feelings, produce an impulse to increase the intensity of these feelings by purposive action; thus is awakened the sexual impulse, the strength of which is extremely variable.

Only when the cerebral cortex, as the place of origin of sensations and perceptions, fails to perform its functions in the manner just described, or when the anatomico-physiological processes in the genital organs which normally act as peripheral stimuli fail to occur, or when there is a failure in the conducting tracts, are sexual perceptions and impulses lacking. Such anomalies may be congenital. A milder form is that, likewise congenital, in which a woman has a sexually “cold nature;” in these cases the sexual impulse is not completely wanting, but it is so slight in intensity that it can be awakened only by very powerful stimuli, and in her normal state the woman so affected is quite free from any wish for sexual gratification.

Such congenital subnormal intensity or entire lack of the sexual impulse may be due to very various causes. According to von Krafft-Ebing, these causes may be organic or functional, mental or physical, and central or peripheral. The declining intensity of the sexual impulse with the advance of years, and the temporary disappearance of that impulse after the sexual act, are both physiological occurrences. Education and mode of life have a marked influence on the intensity of the vita sexualis. Strenuous mental activity, earnest study, severe physical exertion, mental depression, and sexual continence, notably diminish the excitability of the sexual impulse. At first, indeed, abstinence leads to an increase in the intensity of the impulse, but sooner or later the functional activity of the organs of generation declines, and therewith also the intensity of the sexual impulse. As peripheral causes of diminution or disappearance of the sexual impulse, von Krafft-Ebing mentions oöphorectomy, degeneration of the reproductive glands, marasmus, sexual excess, whether in the form of coitus or of masturbation, and alcoholism. In like manner is to be interpreted the disappearance of the sexual impulse in general disorders of nutrition (diabetes, morphinism, etc.).

A decline in the intensity of the sexual impulse in consequence of degeneration of the conducting tracts, is found, according to von Krafft-Ebing, in diseases of the brain and the spinal cord. Central affection of the sexual impulse may be due to organic disease of the cerebral cortex (dementia paralytica, general paralysis of the insane, in the later stages), or it may be due to functional disorder, such as hysteria, or to mental diseases (melancholia or hypochondriasis).

Finally, in some instances, the sexual impulse in women manifests itself, not in the normal manner with copulation with the male as its goal, but in a form demanding some abnormal kind of gratification (psychopathia sexualis), whether it be because sexual intercourse with the male affords the woman no enjoyment, or simply because no opportunity exists for such intercourse.

Masturbation is very frequent; the habit having been acquired from bad example by the girl during the menarche, it is sometimes continued by the wife during married life. In these cases we often find distinct changes in the genital organs, such as hypertrophy of the clitoris, enlargement and bluish discoloration of the nymphæ, retroversion of the uterus, tenderness and displacement of the ovaries, considerable vaginal discharge, and sometimes menorrhagia.

Kussmaul draws attention to the connection between masturbation and nymphomania, on the one hand, and imperfect development of the uterus and the other genital organs, on the other. Campbell records the case of a woman addicted to masturbation, who had never menstruated, and who, in addition to imperfectly developed genital organs, had a dermoid cyst of the ovary. In a young woman who indulged in masturbation, Aran found that the uterus and its annexa were imperfectly developed. Vaddington also describes a case of abnormal sexual impulse which was associated with absence of the uterus.

Troggler reports the case of a woman twenty years of age, who had been six months married to a healthy, potent man, was herself healthy and blooming, with a good family history, and had never suffered from any severe illness. At the age of thirteen she had learned to masturbate, effecting this by stimulation of the clitoris. Now she found no gratification in coitus, so that she continued to masturbate, and during coitus obtained satisfaction by manual friction of the clitoris. Examination showed that the clitoris was strikingly large, the vagina flaccid, and that there was some vaginal discharge; in other respects the genital organs were normal.

Not infrequent, it may be in those whose mental condition is in other respects fairly normal or it may be in psychopathic subjects, is the existence of contrary sexual sensation, or sexual inversion, a condition which has been described by Casper, Westphal, von Krafft-Ebing, and Moll, and has indeed been well known since the days of antiquity. In the case of a considerable number of notable women, homosexual practices have been recorded. According to the observations of Coffignon, in Paris the homosexual instinct, when occurring in other women than prostitutes, is found chiefly among the ladies of the aristocracy.

Of homosexually inclined women, some engage in the practice of tribadism, familiar to the ancient world, and recorded by Martial in a satire, in which sexual gratification is obtained by mutual friction of the genital organs, or by penetration of one woman’s clitoris into the vagina of the other; whilst some indulge in the amor lesbicus, in which gratification is obtained lambendo linguâ genitalia, a very ancient practice indeed, transported from Phœnicia to Greece (where in especial it was indulged in by the women of Lesbos), and later from Syria to Italy, where it was widely diffused among the Romans of the imperial age. Sappho, celebrated as the tenth muse, is supposed to have been addicted to the practice of Lesbian love.

All such homosexual (female) individuals are, then, endowed with the perverse instinct toward sexual connection with women instead of with men. In such cases, the genitals are usually quite normal; sometimes, however, the woman thus affected is markedly of a male type, being called by von Krafft-Ebing a gynandrist, the affection itself being termed gynandry; when the woman concerned not only possesses a homosexual impulse, but also in other respects exhibits tendencies properly characteristic of the male sex, she is called virago, and the affection is termed viraginity.

I had under my care such a woman, belonging to the upper circles of society, who had been married sixteen years before, had lived a married life for six years (during which she remained barren), and had then separated from her husband. She was of a very masculine disposition, smoked, gamed, drank like a student, and preferred to wear men’s clothing, and she bestowed her affections on a female companion. Examination of the genital organs disclosed no abnormality beyond a slight vaginal catarrh. Menstruation was regular, and the general appearance showed no departure, with the exception of a slight moustache that shaded the upper lip, from that of a normal feminine beauty.

Mantegazza is of opinion that in the case of many unhappy marriages, in which the source of the unhappiness is obscure, the trouble is to be found in the homosexual inclination of the wife. Martineau and Moll report that married women who are homosexually inclined, indulge in sexual intercourse with other women behind their husbands’ back. Duhousset, at a meeting of the Anthropological Society at Paris in 1877, related the almost incredible case of a married homosexual woman who, in intercourse with another woman, transferred to the latter her husband’s semen, so as to induce pregnancy.

Many writers on forensic medicine, Tardieu, Pfaff, Schauenstein, Wald, and Mantegazza, for instance, have recorded that in numerous circles of European society women practice masturbation and tribadism (sodomy, so called) with dogs and monkeys; and Plutarch’s statement is well known regarding Egyptian women and the sacred goat, Mendes, that the women who were locked in with this animal practiced sodomy therewith; and again it is asserted that the serpents in the temple of Æsculapius and also in private houses were employed in the practice of sodomy.

Von Maschka records a case which came before the courts a few years ago in Prague, in which a woman forty-four years old confessed that “in consequence of the very ardent temperament she possessed, she had, perhaps, as often as six times indulged herself with her house dog, which jumped between her legs and licked her; that she took the animal between her bare legs, stroked its belly until its penis became erect; then, supporting herself on the back of a chair, she pressed the animal against herself, introduced its penis between her labia majora, and let it continue its movements until its semen had been ejaculated.” Examination of the genital organs of this woman disclosed no abnormality.

Schauenstein reports the case of a girl who carried out unchaste practices with a little dog to an utterly immoderate extent, so that after the lapse of some years she died in an asylum. In a case recorded by Wald, a maid servant was observed in lewd practices with a poodle; she supported herself on elbows and knees, while the dog copulated with her from behind.

A woman about thirty years of age, who had lived with her husband in sterile marriage for nine years, complained to me that she had not for a long time had sexual intercourse, since during copulation she not only experienced no sexual pleasure, but actually felt a loathing to the act; on the other hand, she was subject to an uncontrollable impulse to handle the genital organs of children, both of the male and of the female sex, and this performance gave her sexual gratification; during the menstrual period, this impulse overpowered her will. Local examination in this patient showed that the uterus was enlarged and retroflexed, and that there was anæsthesia of the vagina.

Anjel reports the following case of periodic psychopathia sexualis, associated with menstruation. A lady of quiet disposition, near the climacteric. Serious congenital predisposition. During youth suffered from attacks of minor epilepsy. Married, but childless. Several years ago, after violent emotional disturbance, she had a hystero-epileptic seizure, followed by post-epileptic mania lasting several weeks. Thereafter, insomnia for several months. As a sequel, continually recurrent menstrual insomnia, accompanied by an impulse to embrace boys under ten years of age, to kiss them, and to handle their genital organs. Impulse toward coitus, to close sexual contact with a grown man, non-existent at this time. The patient often speaks openly of her morbid impulse, and begs that she may be supervised, as she feels unable to answer for her own conduct. In the intervals, however, she carefully avoids all reference to the matter, is strictly decent in her conduct, and in no way sexually ardent.

Tribadism is frequently mentioned by the writers of classical antiquity, especially by those of Greece, where the cult of naked beauty encouraged sexual excitement of this character. This form of unchastity was common among the flute-playing girls of Greece, and at the secret festivals of such associates Aphrodite Peribasia was invoked. Lucian, in his dialogues of hetairai, depicts the intensely passionate nature of these homosexual unions between girls. Lombroso reproduces Juvenal’s description of such a love-feast. “When the flute calls to the dance, the mænads, inflamed with wine and beer, loosen their long tresses, they sigh languishingly and eagerly, and an ardent desire draws them one to another, the desire and the passion of the dance gives their voices an alluring sound; nothing now can serve to bridle their unrestrained desires. Lacasella swings her wreath, which she has won in the contest of lascivious gestures and movements, but even she must give way before Medullina with her ardent postures. About these games there is no trace of unreality, and the most rigid Spartan, hardened from the very cradle, even old Nestor himself, notwithstanding his hernia, could not fail to be stimulated by such an inflammatory spectacle.”

In the present day, also, the practice of tribadism is more widely diffused than people in general imagine. I have often encountered instances of it in ladies of good position, who were past their first youth, who would not or could not marry, and who undertook extensive and long-enduring journeys with a female “companion,” of similar age, or perhaps a little younger. Their erotic needs, which could not be gratified in normal fashion, led to this sexual perversion—a tendency observable especially in persons with neuropathic predisposition, or with a liability to hysteria or to epilepsy. Sometimes such girls, even before puberty, show an inclination to wear boys’ clothes, to avoid all feminine manual occupations, and to examine and to handle the genital organs of their playmates. Even after puberty, such tribadists like to make a parade of masculine attitudes, they have their hair cut short, wear clothes of a masculine cut, smoke a great deal, and show in their conversation, and still more in their letters, great exaltation of the passions. It not infrequently happens that an elderly lady who has lived well in her day, and from youth upward has had much intercourse with men, comes at last to lament her worthlessness to men, and from this proceeds to the idea of obtaining sexual enjoyment by means of tribadism. The tribadistic union sometimes lasts for several years, but in most cases the alliances are quickly and frequently changed.

According to Taxil, tribadism is fairly common among the married women of Paris, and in upper-class women is extremely prevalent. This author describes with what industry and perseverance many elderly tribadists endeavor to win for themselves and to seduce young girls, just as old women often work hard to gain money for the enjoyment of the favored person.

In these unions, according to the descriptions of Lombroso, very remarkable phenomena occur. A particular jargon arises with tender designations for this or that bodily beauty; a violent jealousy develops, and a newly united pair keep together as much as possible for fear of losing one another’s affection; the “friends” tread always in one another’s footsteps. This author rightly points out that the very numerous romances describing relations of this kind prove the diffusion of this vice in “high life.” Novels of this class are referred to by Mantegazza in his book, “Woman as Criminal and Prostitute.” He mentions: Diderot, “La Religieuse;” Balzac, “La Fille aux Yeux d’Or;” Gautier, “Mademoiselle de Maupin;” Feydeau, “Le Comtesse de Cholis;” Flaubert, “Salammbô;” Bélot, “Mademoiselle Giraud ma Femme;” Willbraud, “Fridolins Heimliche Ehe;” Graf Stadion, “Brick and Brack;” Sacher-Masoch, “Venus im Pelz.” Zola, also, in “Nana” and “La Curée,” and Butti in “L’Antona,” make some reference to this matter.

Sauval relates of the dissolute life at the court of the French king, Francis I, that the women learned also to play the part of men; a princess had a hermaphrodite maid-of-honor, and the court and all Paris gossiped about the Lesbian-loving ladies, whose husbands were delighted, since they were thus quite freed from jealousy, and prized their wives above all on this account. Such a mode of life was so pleasing to many ladies that they refused to marry, and refused also to allow their “friends” to marry.

Tribadism is very common among prostitutes. According to Parent-Duchatelet, tribadism begins only after prostitution has long been practised, between the twenty-fifth and the thirtieth year of life; generally there is a notable difference in age and also in beauty between the two women forming a tribadistic alliance, and as a rule the younger and prettier of the pair is the more passionately sensitive and the more constant. Parent-Duchatelet endeavours to explain the origin of tribadism by referring to the manner in which in brothels and reformatories the women are closely packed together, to the enforced abstinence from normal sexual intercourse (in prisons and reformatories), to the loathing for men sometimes felt by prostitutes, and to the opportunities for mutual observation of the most intimate nudities. Even women who at first object to it most vehemently, commonly give way to this vice after eighteen or twenty months.

Among 103 prostitutes examined by Lombroso, he found tribadism to be practiced by five. He considers the principal cause of tribadism to be in the lascivious search for new and unnatural pleasures, and quotes in illustration the characteristic remark of Catharine II, herself a tribadist, “Why did not nature endow us with a sixth sense?” Female criminals who seduce others to the practice of tribadism have usually themselves acquired the vice during a long term of imprisonment—it is, in fact, the long-sentence criminals, women with a congenital inclination toward crime, that incline also to unnatural vice. The influence of environment is, according to Lombroso, indicated by the fact that the most confirmed criminals, in prisons for women, corrupt in this manner so many of the inmates who are merely “criminaloids,” and corrupt even the wardresses. Further, he is led to conclude, the confinement in close association of so many extremely sensual and prostituted women, leads to the origin of a kind of ferment of new lascivious desires, and causes an increase of one form of degeneracy by means of another. Prostitutes often see one another naked, sleep two or three together in the same bed; similar things occur in boarding-schools. In asylums also we may observe that the admission of a tribadist will result in the infection of all the inmates with this vice.

According to Moll’s estimate, 25 per cent. of the prostitutes of Berlin practice tribadism. According to the experience of this author, in cases in which tribadists live in concubinage, one of them is always a prostitute; the active and the passive rôle are always played by the same respective members of the alliance; the active member is called “papa” or “uncle,” is usually a prostitute, and, like the man in the married state, possesses great comparative freedom in sexual matters, whilst the passive member, the “mother,” is not allowed to form any sexual relations outside the concubinage.

According to Ricardi, many frigid prostitutes practice with pleasure clitoris-masturbation, cunnilictio, and, especially, sapphism, preferring these perversions to the normal sexual act. Moreover, among prostitutes and female criminals there is no lack of lovers of martyrization, of flagellation, even to the drawing of blood, of tyrannical treatment, and of the initiation of children into the mysteries of sex.