Thus we can explain how it sometimes happens that a fondness conceived in childhood may endure on into adult life, and may even culminate in marriage. In large towns, indeed, such an occurrence is comparatively rare, but in small towns and in the country, quite a number of instances have been brought to my notice. As children, the two have grown up together. Their reciprocal fondness originated long prior to the formation of any conscious sexual sentiments; subsequently, when such sentiments have arisen, and the sexual impulse has awakened, it is natural that sexual relations should often ensue. Since in the country (in contrast with large towns, in which prostitution is commonly rampant) premarital sexual intercourse is comparatively frequent, we can readily understand that such a relationship as has been described will often culminate in marriage, for in the country marriage is far less often prevented by the occurrence of pre-marital intercourse than it is in large towns.

On the whole, however, the amatory manifestations of childhood are of brief duration. Separation at first gives rise to spiritual pain, but this is as a rule soon forgotten; similarly when the beloved one is snatched away by death, the child's grief is not enduring. Commonly such painful emotions speedily pass away; and whether the parting is due to death or to other causes, a new passion is apt shortly to replace the old. In exceptional cases, however, the death of the beloved one, or separation otherwise effected, may, even in the child lead to suicide or to severe nervous disturbances.

Hitherto I have spoken of the processes of detumescence and contrectation as isolated manifestations. As regards the relationships between these respective processes, there are various possibilities. In the first place, one may exist when the other is absent, that is to say, the phenomena of detumescence or the phenomena of contrectation may appear in isolation. Secondly, the two processes may be in complete association each with the other. A boy of thirteen years feels the impulse to draw near to a girl, and to kiss her; when this close contact takes place, erection ensues. Of all the cases known to me, the earliest age at which such a phenomenon occurred is given in a case published by Fere.[37]

Two cousins, boy and girl, were playmates from the time they were both about three years old. They played at being man and wife; and when they were not actually together, the boy's imagination was occupied with the subject. He thought continually about it, and when he was in bed at night erection occurred, accompanied by an agreeable sensation. He went to sleep, and dreamed that other persons got into bed with him and touched him. Among these persons was the little girl, his cousin. Such dreams recurred very frequently; the girl, moreover, was constantly in his waking thoughts. As he grew older, his fondness persisted; but when at the age of seventeen he made up his mind to tell his cousin of his love for her, she became engaged to someone else. Consequently he suffered from severe nervous shock.

In the third place, the two processes, contrectation and detumescence, may occur simultaneously, without the detumescence being associated with the object of the contrectation impulse. Thus cases occur in which boys experience organic sensations in the genital organs leading them to masturbate, and at the same time love someone; and yet when in the company of, and even when embracing the beloved, such a boy will not experience any specific sensations in the genital organs, nor will any impulse arise towards sexual contact with the beloved person.

When the two processes are associated in such a manner that proximity to the object of the contrectation impulse arouses the phenomena of detumescence, sexual acts between the two persons are very likely to result—provided, of course, that the affection is reciprocal. In this way many of the sexual acts effected between children originate; and the same is true of those in which children at times very readily lend themselves to the gratification of the sexual passion of adults. We learn from experience that in such cases attempts at actual intercourse may be made by children, usually accompanied by erection, but in most cases without ejaculation. I append a brief report of one case which came under my own observation.

CASE 4.—X., twenty-one years of age, apparently sprung from a healthy family, and at least free from hereditary taint, declares that his first experience of sexual sensations occurred at the early age of five or six years; at this age he became enamoured of a servant girl, who caressed him very frequently, and pressed her genital organs against his body. Later, when eight or nine years old, he fell in love with a girl of about the same age, and made attempts at coitus. He remembers quite distinctly that he then had erections, and also a kind of voluptuous sensation, but no ejaculation. After continuing this practice for a considerable time, he became aware, being very religiously brought up, that he was behaving very wrongly. He therefore gave up all attempts at sexual congress, and lived quite chastely until he attained the age of nineteen. Throughout this time he neither masturbated, nor endeavoured to effect coitus, nor practised any kind of sexual act. At the age of nineteen, however, the sexual impulse becoming very powerful, he began to masturbate, and has continued to do so up to the present time—- once, twice, thrice, or even four times weekly. Once he did not masturbate for as long as three months, but this was the only prolonged continent interval. He experiences a normal impulse towards members of the other sex. Prostitutes are repulsive to him; he is attracted chiefly by girls of exceptional intelligence. He feels quite certain that to kiss and embrace such a girl would be very pleasurable to him, although he is not aware of any definite impulse towards coitus. Masturbation has always been practised by him as a purely physical act, unaccompanied, that is to say, by any imaginative ideas.

In most cases, the complete association of the processes of detumescence and contrectation, such as occurs in the impulse towards coitus, first takes place at a somewhat later age. This is so even when the sensory element, which constitutes a part also of the contrectation impulse, has been already clearly manifested. The contrectation impulse does not consist solely in this, that the boy experiences a purely spiritual love for the girl; it may rather happen that certain definite sexual bodily peculiarities in a woman attract him. When such a boy one day unexpectedly sees a girl's breasts, this may exercise on him a powerful stimulus. Similarly, I have known instances in which, in the absence of any evidence of definite seduction, a woman's genital organs have excited a very young boy, without arousing any idea in his mind of contact between his own genitals and those of the woman. Conversely, on many girls, masculine attributes, and especially the male genital organs, sometimes exert a stimulating influence. But in these cases also, the complete fusion of the processes of detumescence and contrectation occurs very gradually. Sometimes the boy himself is greatly astonished to discover that close contact with a person whom he loves leads to erection and even ejaculation. At the outset the impulse is much less definite than it is in adults. It is by gradual stages only that the sense of indefinite longing develops into the impulse towards sexual union in coitus; at first the imagination contemplates pictures of a quite indefinite character.

Although, as we have seen, the processes both of detumescence and of contrectation may manifest themselves primarily in childhood as associated conscious sensations, by far the most common event is for the processes of contrectation to appear separately, before those of detumescence. From an inquiry relating to eighty-six heterosexual men, who to the best of my belief were sexually normal, I ascertained that in more than 75 per cent., the feelings of contrectation appeared first, and not until after this had happened was the boy's consciousness attracted by sensations in the genital organs. This appears rather remarkable, inasmuch as we must assume that in the phylogeny of our species the processes of detumescence appeared earlier. Originally, in the earlier ancestral types, reproduction was effected by fission or gemmation (simple division or budding), without any necessity for conjugation with another individual of the species; and reproduction by gemmation corresponds to the processes of detumescence, to the ejaculation of the spermatozoa by the male. But although in most individuals the processes of detumescence make their appearance in consciousness only in a secondary manner, it does not follow that in the actual course of development they are also secondary. They do not, indeed, enter so early the sphere of conscious impulses, but there is a considerable amount of evidence to show that important processes are going on in the external genital organs long before consciousness is directly affected by these processes—consider, for example, the consequences of early castration.

CASE 5.—This is a typical example of the primary awakening of the contrectation impulse, and the secondary superposition of the phenomena of detumescence. The patient is a man thirty-two years of age, somewhat neurasthenic, but, as far as I could ascertain, free from any other morbid manifestations. "At the age of seven I went to school; at first to a private school, in which little boys and girls were co-educated. In our playtime also the sexes were not separated; the girls came as friends to my house, and I visited them at theirs. Soon I became especially intimate with one of the girls; we did our lessons together. Thus it went on until I was nine years old, when I went to a school for boys only. My friendship with the girl at the other school persisted, however; we met from time to time, and all the more readily because a friendship had sprung up between our respective parents; they used to make holiday journeys together, and we children went with them. From the time when we were first at school together, this girl had always been more dear to me than the others, I do not know what it was in her by which I was particularly charmed. Was it that her general appearance seemed sympathetic to me; was it her abundant fair hair, her clear blue eyes, or her frank and natural manner? I do not know. But I remember quite distinctly that this same girl was a favourite with the other boys also, that they preferred to play with her, to have her as their companion. But it was to me that the girl, and perhaps her parents also, gave the preference. There was never any impropriety in our mutual relations; indeed, it is probable that I loved her too much for anything of the kind to be possible. Every night, before I went to sleep, I prayed to God to watch over this girl. As I have said before, my fondness was reciprocated; we often spoke to one another about our love, and of our dreams of the happy days to come, when we should be grown up, and should become man and wife. This was quite a settled matter; we had arranged every detail, how the wedding should be conducted, and whom we should invite to the ceremony. With this girl I shared all my possessions, although before I knew her I had been considered close-fisted. I was often angry when in games with the other girls she failed to win. In a word I can truthfully declare that I have hardly ever since loved so fondly and so sincerely as I did then. When I went to the boys' school, it was no longer possible for us to be together as much as before. Thus it came to pass, that the less we saw of one another, the less were my thoughts occupied with this girl. But I cannot remember that my fondness for her was ever replaced by a similar passion for a boy; nor, speaking generally, can I recall having ever at any time had any kind of sexual inclination towards one of my own sex. I would not venture absolutely to deny that this ever occurred; but, bearing in mind what I have learned from you on several occasions, I have carefully taxed my memory, and can only repeat what I told you at first, that I remember nothing of the kind. Somewhat later, in my dreams, boys occasionally played a part, but I cannot recall that these dreams about boys had any sexual complexion. They were vague images of boys sympathetic to me, but these dreams were not accompanied by any excitement of the genital organs, or by any other sexual manifestation. When I was thirteen years of age, my parents and those of my girl-friend had taken us to spend the summer at a seaside resort. The girl and I played together on the seashore, and occasionally, though we were now somewhat old for such an amusement, we dug sand-castles. As small children we had from time to time embraced one another, but a kiss had been the most intimate contact we had experienced. One day we were playing on the shore—I remember it very distinctly—and were rolling about together in the sand; thus occupied we came into close physical contact, and thereupon I had an erection. I remember too that the sensation of this was very agreeable. I cannot describe this agreeable feeling with precision, but there was no sense of sexual gratification, nor definite voluptuous sensation. From this time forward I always had the desire for close bodily contact with the girl. Moreover she was continually in my thoughts, and this to a much greater extent than formerly. It was my desire to gain a harmless pleasure by being always with her; it was impossible for me to imagine that we should ever be separated. I had naturally heard a great deal about marriage. With these and with similar thoughts I was occupied, but I cannot recall my thoughts in a more detailed manner. But to this day I remember very clearly my desire that the girl and I should never be separated from one another. We returned home, and in the ensuing winter, as in previous winters, we met at intervals. Naturally, physical contact was now much more difficult. One night I had a dream with seminal emission. Then, as for a long time before, I had been thinking a great deal about the girl; I dreamed of one of the scenes on the seashore which I have just described; it was in this dream that I had my first seminal emission. My fondness for the girl persisted. Only when she left the day-school in the town, and was sent away to a boarding-school, did my passion gradually abate. At first when she went away, I felt very unhappy and very lonely. My parents forced me to go out for walks with other boys and to play with them; I did so only with the greatest reluctance. Later, the girl did not disappear completely from my circle of acquaintances, but I lost all interest in her. From school I went to the university, having just before begun to masturbate. From the time I went to the university until the present day I have occasionally had intercourse with women, and my sexual development has been perfectly normal."

In so far as in what has gone before I have described the individual processes, there appear to be no important differences between the boy and the girl, over and above those dependent upon the different structure of the genital organs in the respective sexes. But one notable difference must now be indicated. Just as in adult life in the female sex sexual anaesthesia is very frequently observed, so that in coitus the specific voluptuous sensation is wanting, and indeed often enough the impulse to coitus itself is actually in abeyance (whereas in men the sexual impulse and sexual pleasure are very rarely absent), so also in the case of children a similar difference between the sexes is conspicuous. In female children the peripheral processes of the sexual impulse are, comparatively speaking, far less active than in the case of males. Thus it happens that, although in the girl the phenomena of the contrectation impulses are hardly, if at all, less conspicuous than they are in the boy, and appear at as early an age in the former as they do in the latter, yet in respect of detumescence there is an important distinction between girls and boys. A girl who has fallen in love with a boy will be greatly interested in all his doings, and will gladly embrace and even kiss him; but she will be far less disposed to proceed to actions in which the genital organs play a part than would a boy with a like affection for a girl. The same rule holds good when, in the undifferentiated stage of the sexual impulse, homosexual sentiments and practices ensue. In such cases, when girls are concerned, caresses of all kinds will follow, but the genital organs will in all probability not be involved; whereas in the case of an analogous fondness between two boys, manipulation of the genital organs is very likely to occur. Homosexual intimacies between girls are far more often platonic than similar intimacies between boys.

I have had occasion several times to allude to the practice of masturbation[38] by children, and will now proceed to give a more detailed description. I have previously alluded to masturbation as a manifestation of the detumescence impulse. Much more frequently, however, it occurs in those in whom the phenomena of the contrectation impulse have also been previously manifested. Sometimes it is a purely organic act, the individual masturbating in the entire absence of any imaginative sexual ideas; but at other times the imagination plays a notable part in the process, alike in children and in adults. When an imaginative idea is concerned in the process of masturbation, it is the idea of the object of the contrectation impulse; that is to say, the boy when masturbating thinks now of a girl, now, again (and this especially during the undifferentiated stage of the sexual impulse), of a boy, or in many cases of an adult; in the cases of girls who masturbate similar relationships obtain, Just as during youth masturbation is more commonly practised in association with than without imaginative sexual ideas, so also is it in the case of children; and even though imaginative activity may often be in abeyance when the masturbatory act is begun, during the progress of the act the imagination usually comes into operation. None the less, masturbation of a purely mechanical kind, in which the imagination plays no part, is comparatively more common during childhood than it is during youth. The peripheral processes of the detumescence impulse and the central processes of the contrectation impulse are not at this early age so intimately associated as they are later in life. Even when the contrectation impulse is already awakened, as usually happens before the detumescence impulse becomes active, when the detumescence impulse finally manifests itself, its gratification by means of masturbation without any imaginative activity is comparatively common in children. In such cases artificial stimulation of the genital organs is effected quite independently of the longing for intimate physical contact with and the embraces of another individual.

In an earlier chapter (pp. 31, 32) I have explained that in the adult the voluptuous sensation is closely associated with the psychosexual perceptions, associated, that is to say, with the mode of the contrectation impulse; I stated that as a rule the voluptuous sensation was experienced to the full in those cases only in which the sexual act was one adequate to the contrectation impulse of the person concerned. But when the association between the processes of detumescence and those of contrectation has not yet occurred, the voluptuous sensation is independent of the contrectation impulse. This explains the fact that in the child both the peripheral voluptuous sensation, and also the voluptuous acme and the sense of satisfaction, are more frequently independent of the processes of contrectation than is the case in the adult Gradually the two groups of processes become associated with one another; and, as we have learned, this association frequently occurs even in childhood. In the latter case, the voluptuous acme and the subjective sense of satisfaction ensue only when the sexual act or the sexual idea is adequate. But we must always remember that in the child more often than in the adult the voluptuous acme and the sense of satisfaction occur independently of the processes of contrectation.

An ejaculation of fluid secretions does not invariably occur when masturbation is practised. Whereas in the adult masturbation ordinarily culminates in ejaculation, in the child this is not usually the case; at any rate, as regards many children the occurrence of ejaculation is not demonstrable. I refer in this connexion to what I have already stated on page 54 et seq. It is self-evident from what has been previously said that during the second period of childhood masturbation is more likely than during the first period to culminate in ejaculation.

The methods by which the artificial stimulation of the genital organs is effected are extremely variable. The commonest way to masturbate is with the hands, but this is by no means the invariable practice. All kinds of little artifices are employed, partly to render it possible to masturbate unobserved in the presence of others, and partly in order to increase the intensity of the stimulus. Boys sometimes manipulate their genital organs through their trouser pockets; some even make a hole in the pocket to enable them to masturbate more effectually. In other cases, children, especially girls, lean against some article of furniture—a chair or a table—apparently in a harmless manner, but really in such a way that pressure is exercised upon the genital organs, which are stimulated by pressure or friction. In some, strong mechanical stimulation is required; in others, weaker stimuli suffice, because the way has previously been sufficiently prepared by psychical processes. In female children frequently, but less often in males, masturbation is effected by rubbing the crossed thighs one against the other. We learn from many girls that they tie a knot in the nightgown or chemise, and masturbate by rubbing this against the genital organs. I must allude also to horseback riding, working the treadle of a sewing machine, cycling, the vibration of a carriage or railway train in motion; we must, however, be careful not to attach undue importance to these factors of masturbation, for in such cases much depends upon the individuality, and much also upon the external mechanical conditions—- as, for instance, on the construction of the saddle used in cycling and the like. In the case of the male genital organs, the glans penis is the most sensitive portion, and mechanical stimulation of this structure in especial is likely to induce the practice of masturbation; in the case of the female genital organs, on the other hand, it is the clitoris which is most sensitive, and of which, therefore, we have especially to think in this connexion. But there is a tendency to overestimate the proportion of cases in which stimulation of the glans penis, in the male, or the clitoris, in the female, is the exciting cause of masturbation. In a very large number of cases of masturbation, it is not the glans, but some other portion of the penis, which is the focus of stimulation. In girls, also, in numerous instances, masturbation is effected by stimulation of the labia minora, and I am inclined to believe that the importance of the labia minora is in this respect not inferior to that of the clitoris. In solitude, and above all in bed, masturbation can naturally be effected much more readily. Some little girls grasp a pillow between their legs in such a way as to give rise to a masturbatory stimulus. Others introduce cylindrical objects into the vagina, a practice much commoner among fully-grown girls than among children. Still, physicians are sometimes called on to remove such articles from the vaginae of quite little girls. But it is an error to suppose that the hymen is frequently ruptured by practices of this kind; the rupture of the hymen is far too painful for it to be likely to be effected during masturbation.

Erogenic zones, that is to say, areas of the surface of the body whose stimulation gives rise, directly or indirectly, to voluptuous sensations, are met with often in early childhood. First of all we have those parts of the genital organs mentioned in the last paragraph; secondly, other regions of the body. Thus, in some individuals, stimulation of the anal and gluteal regions gives rise to voluptuous sensations. Freud[39] maintains that voluntary retention of the faeces is utilised for this purpose, but this appears to me very doubtful. In many children, however, gentle scratching of the anal region or the buttocks, and also more powerful stimulation of the gluteal region, such as occurs in flagellation, are associated with sexual excitement. Some children, with this end in view, stimulate the anal region with the finger or with some instrument. Other erogenic zones are also at times found in children, but not often; whereas in adults such erogenic zones are numerous, but differ greatly in different individuals. In this connexion, I need merely allude to the production of voluptuous sensations by tickling the nape of the neck.

Attempts have often been made to determine the comparative frequency of masturbation in the two sexes. On one point at least all writers are agreed, viz., that of boys an overwhelming majority masturbate occasionally. The only point in dispute is whether there are any exceptions. For my own part, I am confident that exceptions exist. I have received direct information on the point from leading men of science, and from others whose absolute veracity I have never had any reason to doubt. Healthy men, endowed with a normal sexual impulse, are occasionally to be found who have never masturbated at all. I go further, and believe that such persons are by no means so rare as many authorities maintain. Nevertheless, as regards the male sex, differences of opinion are, after all, not very extensive, since it is only in relation to a minority that these differences exist. But when we pass to the question of the extent of masturbation among girls, the differences become more acute. On this point also I have endeavoured to obtain exact information by means of numerous inquiries, with the following results. Among girls, masturbation is less general than it is among boys. Among those who have never masturbated during girlhood, we find women who as adults have powerful sexual impulse. On the other hand, many girls who masturbate do so very often. I believe, indeed, that cases in which masturbation is performed twice or thrice in brief succession are relatively commoner among girls than they are among boys. As regards this point my own experience harmonises with that of Guttceit.[40] On the other hand, Guttceit's assumption that almost all girls who attain the age of eighteen or twenty years without any opportunity for sexual intercourse practise masturbation conflicts with my own experience. I am acquainted with a number of women of a fairly ardent temperament who do not masturbate, although they have no opportunity for sexual intercourse. Moreover, this view is confirmed by the common experience regarding the relative sexual anaesthesia of women; it is an admitted fact that complete sexuality is in women far less readily awakened than it is in men.

I must take this opportunity of referring at some length to a matter which, though somewhat obscure, is none the less profoundly interesting. In many instances sexual excitement occurs in children as the result of a feeling of anxiety; in boys such anxiety may lead to ejaculation, with or without erection, and with more or less voluptuous sensation. A schoolboy informed me that he had had a seminal emission with a slight sense of voluptuous pleasure when in class he was in difficulties with a passage of unseen translation, and he was afraid he would be unable to finish the passage before the end of the lesson. Another reported to me a precisely similar experience; he was overcome with anxiety during a written examination, and had a seminal emission. A third had an ejaculation when, being detected in some offence against school discipline, he was sent for by the headmaster, and was afraid he would be expelled. Quite a number of similar cases have been reported to me of sexual excitement occurring in childhood as a sequel to anxiety. I have recorded the facts, and do not propose to discuss exhaustively the theoretical aspect of the matter. Perhaps the phenomenon is allied to masochism, since anxiety is to a certain extent painful. We may also, in this connexion, think of the seminal emissions sometimes observed in cases of suicidal hanging. Freud's theory may also be mentioned, that the anxiety-neurosis is referable to certain sexual processes; but we must not forget that Freud makes a similar assumption in the case of other neuroses as well. Stekel,[41] one of Freud's pupils, in an elaborate monograph, also lays stress on the sexual factor of the anxiety-neurosis. In my own view, however, Freud's generalisation is too comprehensive; inasmuch as he symbolises all things in accordance with his own peculiar preconceptions, the concept sexual receives, in his hands, an undue extension. But I do not deny the occasional association of sexual excitement with a sense of anxiety. Certain boys would appear to have a peculiar predisposition to the occurrence of such processes; at any rate, several persons have told me that during childhood they had frequently had ejaculations as a result of feelings of anxiety. As a rule, however, each of these persons has had such an experience either once only, or but very few times. Two identical instances have been reported to me as occurring in girls—ejaculation with an indefinite voluptuous sensation as a sequel of anxiety. These girls were from thirteen to fourteen years of age. In one of the two, the phenomenon recurred several times; and even at the present day, when she is a fully-grown woman, she occasionally experiences ejaculation in connexion with a feeling of anxiety.

CASE 6.—A student, twenty years of age, described his experiences to me in the following terms:—As regards his sexual development, he remembers that he was sixteen years of age when he first experienced sexual sensations. Before this time he had been told by other boys about sexual intercourse, masturbation, and many other things. He had, however, never masturbated, though he had once or twice attempted to do so. One day, when he was in the Upper Second Class, a mathematical problem was given out, and as he found a difficulty in solving it, he became anxious, all the more because his chances of promotion to a higher class were largely dependent on his success. When he had barely finished half the necessary calculations, the master announced that there were only ten minutes left, at the end of which time the exercise books would be collected. Thereupon his anxiety became extreme, and simultaneously he experienced his first seminal emission. He is unable to give a more detailed description of what occurred, and does not remember having had an erection; but, as he expresses it, the sensation was extremely pleasant. Subsequently, when in the First Class, the same experience recurred several times, that is to say, he had a seminal emission as a result of a similar feeling of anxiety. In other respects his sexual development was normal. Seminal dreams were accompanied by the idea of contact with a woman. On one occasion, however, he had a seminal emission during the night in association with a feeling of anxiety. He dreamed that he was being pursued by a mad dog, when suddenly he became, as it were, paralysed and unable to run a single step further. The consequent acute anxiety culminated in emission.

During sleep, sexually mature men and many sexually mature women have from time to time involuntary sexual orgasms;[42] these occur chiefly in persons without opportunities for sexual intercourse, who do not practise masturbation. In such involuntary orgasms the male ejaculates semen, the female indifferent glandular secretions. As a rule, the ejaculation is accompanied not merely by a voluptuous sensation, but also by a psychical process corresponding with the mode of sexual sensibility of the person concerned. A normal man during the orgasm dreams that he is embracing a woman; a normal woman that she is embracing a man; a homosexual man dreams of the embraces of another man. The dream-ejaculation is distinguished from the waking act of intercourse to this extent, that in the former the ejaculation usually takes place during the preparatory stages to the act of intercourse—during kissing, physical contact, or the embrace—so that the dream stops short of complete sexual intercourse. But in other respects the dream ordinarily corresponds to the psychical processes of the waking state. The same correspondence exists as regards sexual dreams that do not culminate in ejaculation. Children also experience sexual dreams either with or without orgasm. In those who have never masturbated in the waking state, a sexual dream is commonly the cause of the first experience of ejaculation; and this occurs more often than is generally believed. More especially in the female sex I have come across many cases in which the orgasm made a primary appearance during sleep. In both sexes alike it is usual for psychosexual phenomena to manifest themselves before the erotic dream makes its appearance; a boy, for instance, will during his waking life have felt an attraction towards members of the other sex before he has begun to dream of embracing a girl. We must not, however, forget that, apart from those cases in which a dream beyond question first unveils to consciousness the psychosexual life, dreams are forgotten very rapidly indeed, especially when the memory is not stimulated by so vivid an occurrence as the sexual orgasm. Hence, even though it is true that the psychosexual life commonly appears to begin during the waking state, we must admit that it is quite likely that psychosexual dreams may have previously occurred and have been forgotten. Thus, in many individuals, sexual perversions make their first appearance in dreams. It has even been suggested that dreams may exercise a similar influence to that of post-hypnotic suggestion; that is to say, that a dream may be the actual originating cause of sexual perversion. This is a matter which I cannot discuss further, more especially in view of the fact that the whole idea is too hypothetical.

The earlier the age at which the child begins to ripen sexually, the earlier do sexual dreams and nocturnal ejaculations make their appearance. I have known of numerous instances in which children ten or eleven years of age have had sexual dreams; occasionally, even, I have been informed of the occurrence of such dreams in children of seven or eight years of age. In children, as in adults, the object which is sexually exciting in the waking state plays a leading part in the sexual dream. But in the sexual dreams of children the imagination is even more active than it is in the sexual dreams of adults. All kinds of perverse dreams may, in children, accompany the emission, even when the corresponding ideas have no erotic association in the waking state. Things of which the child has learned from fairy tales, stories of robbers, of imprisoned or enchanted princesses, princes, fettered slaves—all may play a part in the psychosexual processes of the dream-life. Anyone unaware of the fact that in the great majority of children this tendency disappears spontaneously in the course of the further development of the sexual life might too readily infer the existence of some morbid perversion. In such instances we must, indeed, bear in mind the possibility of sexual perversion, especially in view of the fact that sexually perverse adults are often able to trace back into childhood the memory of sexual dreams characteristic of their peculiar type of perversion. Occasionally the feelings of anxiety of which we have spoken above may, even in dreams, lead to the occurrence of involuntary ejaculations. Thus we are told of dreams of pursuit by robbers or by wild animals, or of dreams of missing a train the dreamer has been running to catch, in which ejaculations occur. In isolated cases the dreams of children which are associated with ejaculations may be quite indistinct; in such cases, just as sometimes in the sexual dreams of adults, it is impossible to recognise any definite relationship to the psychosexual feelings of the waking state. In this connexion no difference between the sexes can be shown to exist, except this, that, at any rate as far as my own experience goes, nocturnal ejaculations are much more often absent in girls than in boys. Occasionally, manual or other artificial stimulation of the genital organs is effected during sleep; I have myself known several instances of this, both in boys and in girls. In several cases, at least, there were satisfactory grounds for believing that we were not concerned with masturbation practised at night in the waking state, but all the indications pointed to the fact that the processes wore carried on unconsciously during sleep. In isolated cases I have had children watched throughout the night, in order to clear up this point, and my conclusion was thus confirmed that children do at times play with the genital organs during sleep.

A classical description of her first nocturnal orgasm is given by Madame Roland in her Memoires Particuliers,[43] written during the last months of her life in prison in Paris at the time of the Terror. She menstruated for the first time, she informs us, soon after she had been partially enlightened regarding sexual matters by her grandmother. Even before menstruation began, she had experienced sexual excitement in dreams. "I had sometimes been awakened from a deep sleep in a most remarkable manner. My imagination played no part in what occurred; it was occupied with far more serious matters, and my tender conscience was far too strictly on guard against the deliberate pursuit of pleasure for me to make any attempt to dwell in imagination on what I regarded as a forbidden province of thought. But an extraordinary outbreak awakened my senses from their quiet slumber, and, my constitution being a very vigorous one, a process whose nature and cause were equally unknown to me made its appearance spontaneously. The first result of this experience was the onset of great mental anguish; I had learned from my 'Philothea'[44] that it was forbidden to enjoy any bodily pleasure, except in lawful wedlock; this teaching recurred to my mind; the sensations I had experienced could certainly be described as pleasurable; I had, therefore, committed a sin, and, indeed, a sin of the most shameful and grievous character, because it was the sin most of all displeasing to the Lamb without blemish and without spot. Great disturbance of mind, prayers and penances; how could I avoid a repetition of the offence? for I had not foreseen it in any way, but in the moment of the experience I had taken no trouble to prevent it. My watchfulness became extreme; I noticed that when lying in certain positions I was more exposed to the danger, and I avoided these positions with anxious conscientiousness. My uneasiness became so great that ultimately I came to wake up before the catastrophe. When unable to prevent it, I would jump out of bed, and, notwithstanding the cold of winter, stand bare-footed on the polished floor, crossing my arms, and praying earnestly to God to guard me from the snares of Satan." She goes on to describe her subsequent attempts to mortify the flesh by means of fasting.

I have hitherto described the individual sexual processes which are observed during childhood, I have already explained that in some, one process, in some, another process, is alone present, or, at any rate, preponderates. For instance, a girl may be sexually attracted towards a boy without the genital organs playing any conscious part in the attraction. But the converse may also occur. Moreover, the strength of the sexual feeling is subject to extensive individual variations. In some children the sexual impulse is so powerful that scandalous misconduct can hardly be avoided; on the other hand, we see cases in which the sexual impulse manifests itself at the normal age, but is so weak that it can scarcely be said to play any important part in the consciousness of the child. This is true of both components of the sexual impulse, of the phenomena of contrectation, no less than of those of detumescence. Formerly it was very generally believed that in sexually perverse persons the sexual sensations awakened unusually early in life. There is no foundation for this view. Normal sexual sensations can be detected very early in childhood. The existence of these was ignored, simply because the study of the normal was neglected for the study of the perverse. Moreover, the strength of the sexual sensations has no necessary association with the existence of perversions; these latter sometimes occur without being particularly strong. On the other hand, qualitatively normal sexual sensations may be associated with sexual hyperaesthesia, and they may attain a notable strength even during childhood.

In the third chapter I showed that in childhood the sexes are differentiated both physically and mentally, altogether apart from the genital organs and the sexual impulse; and I pointed out that games in particular afforded indications of mental sexual differentiation. Many games, indeed, may even be regarded as direct manifestations of the sexual impulse, and I must therefore now return to the consideration of this topic; but I shall confine myself to certain phenomena observable in the animal world, since the games of animals are, in this connexion, so much simpler than those of children. Play constitutes a major part of the activities of young animals; think, for instance, of a kitten playing with a hanging tassel or with a ball, of puppies chasing one another, and of young birds playing with fluttering wings. The games of young animals often exhibit the character of love-games, and are in that case sexually differentiated. Various authors, and especially Brehm, have recorded numerous examples of this; I give here a few instances, quoted from Groos.[45] The young male, even before its testicles have developed, woos the female by movements, song, or other characteristic sounds. The female, also sexually immature, responds coquettishly to these advances of the male. Song, which Brehm regards as a sign of the awakening of love, makes its appearance at an age when the animal is still unfitted for the reproductive act.

"Young magpies (Corvus pica) address one another in September, and often in August and in October, in consecutive clucking notes, and in this way make exactly the same kind of noise that they are always heard making in early spring just before the pairing season. The young male green woodpecker (Picus viridicanus) sings in September as beautifully as in April, as I have myself heard more than once; the young great spotted woodpecker (Picus major) may even be heard at times in autumn, just as in spring, making his characteristic tapping sound as he explores hard branches in search of insects. Both varieties of creeper begin to sing before they have changed their youthful plumage; their song closely resembles that of the adult birds in spring, but the note is somewhat shorter and weaker. Similarly, both the German varieties of crossbill commonly begin to sing before losing the plumage characteristic of youth. Young house-sparrows and hedge-sparrows not only chatter and swear at one another like the full-grown birds at pairing time, but also like the latter the young birds distend their throats, let their wings droop, peck at one another, and in fact behave as exactly as they will next spring when fully grown. Young linnets also begin to sing before losing their youthful plumage, learn to sing well during the moulting season, and often continue to warble right on into the winter; in a mild winter young linnets will sing just as well as old ones. The young woodlark begins to sing as soon as its first moulting is nearly over, and not only does this when perching, but flies aloft like the adult bird in the spring-time, and soars for a long time, singing continually. Titmice all sing when still quite young, but more especially the large crested titmouse and the marsh titmouse; the notes of the young marsh titmouse are precisely similar to those with which in spring the adult bird sings to his mate; and as regards the crested titmouse, in October 1821, I observed a young male bird making advances of a most marked character to a young hen, whilst the hen drooped its wings and spread out its tail—in short, these two young birds were behaving exactly as do the full-grown birds before pairing in the spring. The young cock starling conducts itself precisely as if it wished to pair. At the beginning of September, as soon as moulting is completed, this bird returns to its birthplace, apparently in order to take possession of the nest. It perches on the tree-top, just like the full-grown bird in March, and sings almost for the whole morning. While still perching, it flaps its wings, quarrels with and chases other young starlings; sometimes it even creeps into the hollow tree or other hiding-place containing the nest in which it was hatched. The yellow wagtail sings while still in its youthful plumage, and the young birds chase one another about while in this condition; during and immediately after the first moulting, these birds produce peculiar trilling notes, identical with those with which in April the cock bird salutes his mate, and they may also be seen in the remarkable fluttering flight characteristic of many birds in the pairing season. The grey wood wren begins to sing before the first moulting, but sings more powerfully during and after moulting, right on into the month of October, singing like a full-grown bird. At the same time this bird twists the body from side to side, and moves the tail to and fro; it quarrels also with birds of its own species, and quarrels, too, with other birds, sometimes with birds as much as four times its own size. In August and September young mountain fowl and heath fowl utter love calls to each other, not, indeed, so loudly as those of the adult birds, nor in association with the characteristic movements of the body made by these latter in the spring-time, but still unmistakable love calls.... According to Hudson, many kinds of American woodpecker carry on a kind of duet, and they practise this artistic performance from the very earliest youth. On meeting, the male and female, standing close together, and facing each other, utter their clear ringing concert, one emitting loud single measured notes, while the notes of its fellow are rapid, rhythmical triplets; their voices have a joyous character, and seem to accord, thus producing a kind of harmony. This manner of singing is perhaps most perfect in the oven-bird (Furnarius), and it is very curious that the young birds, when only partially fledged, are constantly heard in the nest or oven apparently practising these duets in the intervals when the parents are absent; single measured notes, triplets, and long concluding trills are all repeated with wonderful fidelity, and in character these notes are utterly unlike the hunger cry, which is like that of other fledglings."

In such cases as those just enumerated, actual copulation is not effected; but animals still sexually immature may perform coitus-like acts, and Groos's work contains observations of these made by Seitz and others. Seitz saw an antelope six weeks old making copulatory movements. In young dogs such movements may often be observed, also in young stallions and young bulls.

The view that in such cases the movements are imitative merely is untenable, for young animals which have never had any opportunity of watching the physical manifestations of love in older ones, will nevertheless themselves exhibit such manifestations. At most it remains open to dispute whether in these cases it is still permissible to speak of love-games, as do Groos and others, or whether we should not rather speak simply of manifestations of the activity of the sexual impulse. But the dispute does not involve differences of opinion regarding matters of fact; it is purely terminological. For, in the first place, Groos himself, who regards the games of childhood as a form of training, suitable to the nature of the individual, for its subsequent activities, recognises that games are sexually differentiated. He believes that we have to do, not, as some think, with imitative processes, but with preliminary practice, subserving the purposes of self-development; and he considers that girls naturally turn to games adapted to train them for their subsequent profession of motherhood, whilst boys incline to games corresponding to their predestined activity as men. Even if we accept this theory of Groos, we are compelled to recognise a sexual element in the games of youthful animals. In addition, however, we must note the fact that Groos gives a wider extension to the concept of play than other writers, and that he regards as love-games processes which others might perhaps describe as sexual manifestations. According to Groos, caressing contact is to be regarded as playful when, in the serious intercourse between the sexes, such contact appears to be merely a preliminary activity rather than an end in itself. Here two cases are possible: in one the carrying out of the instinctive activity to its real end is prevented by incapacity or by ignorance; in the other, it is prevented by a deliberate exercise of will. The former occurs in children; the latter, often enough in adults. Whatever view we hold regarding this matter, the sexually differentiated love-games of young animals must be regarded as a manifestation of the sexual life. None the less, in sexually immature animals, just as in the case of children, sexual differentiation is not always so marked as it is in adults; and it may happen that the sexes may exchange their roles. Cases observed by Seitz have been published by Groos and also by myself.[46] I have myself watched a young cow which repeatedly attempted to mount another young cow; I have also on several occasions seen young bitches attempt to cover dogs. To this part of our subject belongs the observation of Exner, that when dogs are playing wildly with one another one hardly ever sees a bitch among them. But if an exception should occur, the bitch is usually a young one. In animals, sexual differentiation is not complete until sexual maturity is attained, and the same is true of the human species, although, as I have shown above, children already manifest sexual differentiation in their games, their inclinations, and their general conduct.

I have thought it desirable to refer to the play of animals in this place, as well as to treat of the subject in its direct relationship to the sexual impulse. What is true of play is true also of the other interests and inclinations of the child, many of which are also associated with the sexual life; these have been described earlier, so that here I need merely allude to the matter in passing.

Hitherto I have described the sexual life of the child in so far as it is the subject of direct observation or can be recalled to memory. But it was explained at the outset that there is still another way of gaining clear knowledge of the subject, namely, by experiment; and it was shown that castration may be regarded as such an experiment. Although the reproductive capacity of the male is not developed prior to the formation of spermatozoa in the testicles, nevertheless we learn from the effects of castration that the testicles exhibit important functional activity much earlier in life. This fact was long overlooked, and its importance is even to-day largely underestimated, because we have been accustomed to regard the provision of an external secretion as the only function of the testicle. But it is now firmly established that these glands exercise influence in other ways. We know that bodily and mental development are affected by the removal of the testicles; and that the influence is greater the earlier in life the castration takes place. A number of secondary sexual characters remain undeveloped. The beard does not grow; in many instances a thick panniculus adiposus is formed; there are changes in the growth of the bones; the voice remains a soprano; and the other reproductive organs are imperfectly developed, the penis and the prostate remaining comparatively small An early castration does not, of course, result in the obliteration of all differences between the male and the female; we must rather say that a part only of the typical differential characters of sex remain undeveloped. The earlier assumption, that the secretion of semen competent to effect fertilisation influenced the development of the secondary sexual characters, has of late been more and more generally abandoned. Many considerations tell against such a theory, more especially a comparison of the three following facts. First, if castration is not effected until after the formation of spermatozoa has already begun, the familiar results of this operation are either entirely wanting, or else appear to a small extent only, and are limited to a small number of the secondary sexual characters. Secondly, the results of castration are most marked when the operation is performed in early childhood. Thirdly, when castration is effected in the later years of childhood, but before the secretion of fertilising semen has taken place, the results are intermediate in degree, being much less marked than in the second class of cases, but more extensive than in the first. If the secretion of a fertilising semen were the principal factor in the development of the secondary sexual characters, we should expect the results of castration to be the same whether the operation were performed early in childhood or late so long as it was done before any spermatozoa had been formed.

The secondary sexual characters are, therefore, independent of the formation of spermatozoa, and the appearance of these characters must depend upon other processes, occurring much earlier in life. Thus, in persons who were castrated in the eighth or ninth year of life, we note the presence of definite secondary sexual characters, which are, indeed, less strongly developed than in normal persons, but which do not appear at all when the castration has been effected at a still earlier age. The varying views of different authors regarding the influence of castration in early life upon the development of the secondary sexual characters may readily be explained with reference to the individual differences that may be observed in the functional activity of the testicles in different males before the power of reproduction has been acquired. Just as in boys the capacity for reproduction, and in girls the function of menstruation, does not appear at a fixed and definite age, so also in the case of the other processes that come into being under the influence of the activity of the reproductive glands, we have to reckon with such individual differences. For this reason, in persons who have been castrated at the same age, the subsequent course of development may vary to some degree, notwithstanding the apparent identity of the determining factor in each case. In some, the pelvis, the beard, the voice, and the mental qualities, develop in normal fashion; in others, there is interference with the development of one or all of these characters. In certain cases, the bodily structure is influenced by castration at an age when the mental development is no longer affected. This explains the fact that many oriental eunuchs, in whom castration is commonly effected shortly before the seventh or eighth year of life, while they exhibit the bodily configuration characteristic of the eunuch, are nevertheless capable of experiencing heterosexual feelings, and even passionate love.

In Western countries we rarely have an opportunity of studying the full consequences of castration, for with us the operation is hardly ever performed so early in life as it is in the East; and the reports that are available concerning oriental and other foreign eunuchs are to a large extent untrustworthy. None the less, from such reports, and from accounts that have come down to us from earlier days in the West (more especially in the case of the boys who were formerly castrated in Italy for the preservation of the soprano voice), we obtain evidence amply sufficient to justify the statements made above. Even more convincing are observations made on the lower animals. For example, in horses which have been castrated at a very early age the sexual impulse remains undeveloped; but we have to contrast with this the fact that a certain number of geldings possess a well-marked sexual impulse, because in these animals, though they were gelded while still immature, the operation was performed too late. All these observations combine to justify the inference that long before spermatozoa capable of effecting fertilisation are formed in the testicles, changes occur in these glands which are of great importance in relation to the sexual life, both in the human species and in the lower animals.

We cannot speak so positively as to the truth of this in the case of the reproductive glands in women, the ovaries, because alike in the human female and in the females of the lower animals oophorectomy is less commonly performed than is castration in the male. The literature of our subject contains few references to this matter. What little information we do possess, derived in part from travellers who have had opportunities for observation in extra-European countries, and in part from students of animal life, leads to the same conclusion as in the case of males, namely, that long before the age commonly regarded as the commencement of sexual maturity, important changes are going on in the reproductive glands.

No detailed discussion can be attempted here of the other observations there may be on record to show the existence of such sexual processes during childhood. We may merely refer, for example, to the results of the removal of one testicle before the commencement of puberty; this is followed by a compensatory hypertrophy of the other testicle—whereas removal of one testicle after the attainment of sexual maturity does not lead to any such hypertrophy of the remaining testicle, or if so, only in comparatively slight degree.

Although from the facts just stated it appears that, alike in human beings and in the lower animals, before the formation of the specific germ-cells and sperm-cells has begun in the reproductive glands of the respective sexes important processes take place in these glands, it still remains obscure what is the nature of these processes, and in what manner they influence the organism. One question complicating this problem, and one which is to-day frequently discussed, is the extent of the influence exercised by the reproductive glands on the development of the secondary sexual characters. I can here do little more than state the difficulty. Whereas it was formerly assumed that the reproductive glands exercised a direct determining influence in this direction, more recently another view has been put forward, among others by Halban.[47] According to this theory, the stimulus proceeding from the glands is protective merely, not formative, nor directly stimulating the growth of organs. In the fertilised ovum, it is supposed, the rudiment of sex already exists, likewise the rudiment of the reproductive gland, and the rudiments of the appropriate sexual characters. That is to say, the development of the secondary sexual characters is not determined by the presence of the reproductive gland; but the sex of the reproductive gland and the associated sexual characters are already determined by some common cause at the moment of fertilisation. But this theoretical controversy has no very important bearing on the problem with which we are especially concerned; and the influence of the reproductive gland upon the development of the secondary sexual characters is admitted as fully by Halban as it is by other writers, the only difference between the two views lying in the dispute whether the influence of the glands is of a formative or a protective nature. The influence exercised by the reproductive glands on the development of the secondary sexual characters can be adequately discussed, even though the precise way in which that influence is exerted remains in dispute.

As to the general nature of the influence, two chief theories have to be considered, viz., the nervous theory and the chemical theory. According to the former, we must assume that a stimulus originates in the reproductive glands, the testicles in the male, and the ovaries in the female, and that these glands excite a kind of reflex action—that is, that the stimulus passes to the central nervous system, and thence is "reflected" to the periphery, where it promotes, either the growth of particular parts of the body, e.g. the beard, or the development of definite properties in certain organs, e.g. the characteristics of the male larynx or of the female mamma. It is possible that the reflected impulse stimulates trophic nerves. But it may be that in cases of early castration the state of affairs is similar to that which obtains when from earliest infancy one of the sense organs is wanting, as a result of which the corresponding portions of the central nervous system are found to undergo atrophy.[48] On this assumption, the manifest arrest of the development of certain organs which results from castration is to be regarded as the sequel of a partial atrophy of certain portions of the brain. Of late, however, the chemical theory, that the results of castration are dependent on the lack of the internal secretion of the excised glands, has gained ground at the expense of the nervous theory. The reason for this change of view is that much which was unsuspected in former years has recently been learned about the chemical activities of other glands. It suffices to allude to the function of the thyroid body. According to this chemical theory, chemical substances are prepared in the reproductive glands, and these substances exert a specific influence in promoting the development of the secondary sexual characters. The same theory has been invoked to account for the alleged ill effects of sexual abstinence, it being suggested that the reabsorption of glandular products properly destined for excretion may give rise to toxic effects.[49] If it be assumed that the testicles can secrete substances upon the influence of which the development of the secondary sexual characters depends, it is obvious that these substances have nothing to do with the spermatozoa, inasmuch as the testicles exert the influence under consideration at an age at which the formation of spermatozoa has not yet begun. The substances that act in this way must be of a different kind. As was pointed out earlier in this book (p. 19), recent researches have shown that the testicles possess a twofold activity; and some French physicians even go so far as to say that the testicle is not a single gland, but two glands. They distinguish between the gland that prepares the spermatozoa and the interstitial gland.[50] Whilst the formation of spermatozoa subserves the generative act, the function of the interstitial gland is to prepare substances which pass into the lymph or blood-stream, and give rise to the development of the secondary sexual characters. Thus, the effects of castration are due, on this theory, not to the absence of the formation of spermatozoa, but to the absence of the products of the interstitial glands. French investigators consider that the assumption that such an interstitial gland exists is justified by the results of experimental work.

Whichever theory we accept, the chemical or the nervous, both theories harmonise equally with the fact that in boys, before the formation of spermatozoa begins, processes occur in the testicles which powerfully influence the organism. Thus, we learn also from a study of the results of castration how active is the sexual life even in childhood, since thus early in life influences proceed from the reproductive glands whereby the development of the secondary sexual characters is markedly affected.

The principal sexual processes occurring in childhood have now been described. Although we have been forced to admit the fact that in the child sexual processes are much more extensive than has commonly been believed, we must, on the other hand, guard ourselves against the exaggerations of those who interpret everything in sexual terms. In the chapter on diagnosis it will be necessary to refer to these exaggerations once again.

As a rule, of course, the manifestations of the sexual life of the child increase from year to year, although not always by continuous gradations. Thus, in consequence of misdirection, sexual manifestations may arise in the child, and then, if these evil communications are cut off, such manifestations may cease. But, altogether apart from deliberate seduction, we may observe periods of more rapid and periods of less rapid sexual development, the causes of which may remain obscure. Individual cases vary to such an extent, that it is impossible to lay down a rule to which there are no exceptions. This applies equally to both components of the sexual impulse, to the phenomena of detumescence as well as to those of contrectation.

But although as we have seen, the development of the sexual life is not always by regular progression, yet on the whole the increasing intensity of sexual manifestations from the years of childhood to the termination of the period of the puberal development cannot be denied. Especially extensive are the changes occurring at the end of the second period of childhood. At this period we note more particularly the development of the outward signs of sexual maturity. In the boy, we observe the growth of the beard and the pubic hair, and a more rapid enlargement of the testicles and the other organs of reproduction. In the girl, the breasts and the pelvis assume the adult female type, and ovulation and menstruation begin. During this period, also, the mental changes are extremely marked, even though in many cases these changes may have begun considerably earlier. The internal organic changes make themselves felt also in the sphere of action. The years of adolescence in the male are characterised by an impulse to travel, to adventures, but in addition to all kinds of ideal efforts and to religious activity. The loftiest ethical ideas alternate with a self-conscious bumptiousness. A change of disposition manifests itself which is sharply contrasted with the behaviour at an earlier and a subsequent age. This is no less true of the girl. That which formerly was no more than a vague indication, now becomes a manifest quality. More and more does the feminine mode of feeling display itself. The "tom-boyishness" so often seen in girls during the second period of childhood disappears. The former tomboy has become one[51]—

"In whose orbs a shadow lies Like the dusk in evening skies,"

and we see her—

"Standing, with reluctant feet, Where the brook and river meet, Womanhood and childhood fleet!

"Gazing, with a timid glance, On the brooklet's swift advance, On the river's broad expanse!"

The considerations put forward in this chapter show us how necessary it was to explain the conception of puberty at the very outset of this work. If the period of the puberal development be understood to correspond to the development and ripening of the sexual life, we see that this development begins much earlier than is commonly assumed in books on the subject. Writers have been too ready to identify with this developmental period the appearance of certain external manifestations, more especially the growth of the pubic hair in both sexes, the development of the breasts in the female, and the breaking of the voice in the male; and the appearance of certain definite outward signs—in the girl, the first menstruation, and in the boy, the first ejaculation—has usually been regarded as marking a turning-point in this development. But neither in the boy is the occurrence of the first ejaculation a proof of capacity for reproduction, or a proof that the period of the puberal development is completed; nor in the girl is the occurrence of the first menstruation, which may long precede the establishment of the far more important function of ovulation, characteristic in either of these respects. Observations made on children, accounts given by children and memories of childhood, and the results of castration (and oophorectomy),[52] all combine to prove the occurrence of sexual processes during childhood, at least as early as the beginning of the second period of childhood. At this time of life, the psychosexual in especial often plays a great part. If, notwithstanding all these facts, anyone desires to associate the beginning or the end of the puberal development, as was formerly done, with the appearance of "the external signs of puberty," no one can prevent this usage. But the scientific investigator, the physician, the schoolmaster, and the parents, should all alike fully understand that such external processes comprise but a small part of all that constitutes pubescence. A straining of terminology may at times be permissible; but on no account must we allow currency to so disastrous an error as the belief that the sexual life of the child either begins or is completed with the appearance of these external signs. The sexual life of the child begins long before, and the puberal development is not completed till many years after, the appearance of these external signs, which by most people are erroneously regarded as typical of pubescence.

Although I have detailed a number of phenomena characteristic of the sexual life of the child, it must not be assumed that these phenomena are common to all cases, or that every individual symptom is invariably observed. As I have previously explained, numerous exceptions occur. In some instances, only one symptom is discernible; in others, another only. The commonest early manifestations of the sexual life in childhood are, as was said before, the psychosexual phenomena. Frequently, the individual symptoms are so faintly marked that they can be detected only by a very thorough and careful examination. I wish merely to insist upon the fact that during the years of childhood which are commonly regarded as asexual, manifestations of the sexual life can with care almost always be detected, although at times their detection is by no means easy.

In conclusion, however, it is necessary to point out that there are a certain number of children in whom up to the fourteenth year of life, and even later, manifestations of the sexual life are hardly discernible; but we have to remember that the results of castration prove, as has been shown above, that even when, in early life, the occurrence of sexual processes cannot be demonstrated, such processes are nevertheless going on. We meet with individuals in whom, even during the first years of youth, the development of the sexual life is extremely backward. There are boys of fifteen or sixteen who from time to time have an involuntary seminal emission, but who exhibit no other indications whatever of an active sexual life—neither masturbation, nor any discernible psychosexual processes. Nevertheless, in most cases of this kind, more careful observation will bring to light much, besides the occurrence of the involuntary seminal emissions, which points to an awakening of sexuality. Still, in some individuals, it is remarkable how long entire sexual innocence may persist. This is doubtless due in such cases, not to any specially rigorous natural virtue, but simply to the fact that in these cases sexual development is much slower than the average. Those concerned are thus devoid of all understanding of the sexual, just in the same way as persons born blind lack all understanding of colour. In most of the cases in which such retardation occurs, the sexual life subsequently becomes entirely normal, showing that the only abnormality was the exceptional delay in the occurrence of the various processes. I have myself seen a number of cases in which the development of the sexual life was delayed to such an extent that ejaculation during coitus was not effected until towards the end of the third decade of life, although erections, and even occasional nocturnal emissions, had occurred long before. I believe that cases of this kind are to a small extent only, if at all, the result of educational influences, and they are in no way dependent upon the so-called sexual neurasthenia; we are concerned simply with a retardation of development, dependent upon congenital predisposition.



CHAPTER V

PATHOLOGY

In the previous chapters I have from time to time mentioned some phenomenon of comparatively rare occurrence; but for the most part I have described those processes only which are regularly met with, which cannot be regarded as exceptional peculiarities, and therefore must not be considered to be pathological manifestations. It is true that much that has been described comes within the province of the pathological; for example, many of the active manifestations of the sexual impulse occurring during the first period of childhood, such as the case quoted from Fere on page 81. For practical reasons, however, such cases as this cannot always be dealt with as members of a distinct pathological group. On the other hand, it is necessary to give a separate consideration to the pathological aspect of our subject. Many of the cases which must be grouped as pathological occur in girls. Thus, we meet with cases in which menstruation becomes established at the age of eight, five, two, or even earlier.[53] Carus reports the case of a woman whose medical history showed that she had begun to menstruate at the age of two years, and that she became pregnant for the first time when eight years old. In girls from ten to twelve years of age, pregnancy has many times been observed. A French physician had under observation a girl who when only three mouths old had well-developed breasts, and in whom only a little later the pubic and axillary hair grew and menstruation began. When twenty-seven months old, the child was again seen by the same physician, and at this time menstruation was proceeding regularly; the features had now lost the infantile type, and the body as a whole exhibited all the signs of premature development. A collection of cases made by Gebhard[54] contains one case in which menstruation was established at birth; in quite a number of the cases menstruation began during the first year of life.

A case was reported from New Orleans in which menstruation began at the age of three months and continued regularly thereafter. This was a case of premature general growth; at the age of four years the girl was over 4 feet high, and her breasts were the size of a large orange. As a general rule, in these cases of premature development of the reproductive organs in girls, the great size of the breasts attracts especial attention. According to Kisch (op. cit., p. 78), these girls with precocious menstruation and premature sexual development very commonly exhibit also a comparatively high body-weight, great development of fat, and early dentition; they look older than their years, and their genital organs also develop very early, with hair on the pubes and in the axillae; the labia majora and the breasts resemble those of full-grown women, and the pelvis also has the adult form. Commonly also the sexual impulse develops early, whilst in other respects the mental development lags behind the physical.

In the post-mortem room, corresponding conditions are occasionally found in the ovaries; and some writers express the opinion that such premature sexual development is commoner than would appear from the comparative rarity of reports on the subject. Unquestionably, examination of the ovaries of young girls not infrequently leads to the discovery of ripe ovarian follicles; in one case this happened in the body of a female infant born prematurely. In a girl five years of age, fifteen follicles were counted in the ovaries. Liegeois,[55] in post-mortem examinations, twice found mature ova in girls two years of age.

Similar cases of premature sexual development are occasionally seen also in boys. For example, Breschet, in the year 1820, reported the case of a boy three years of age who exhibited all the signs of puberty. His voice resembled that of a young man of sixteen to eighteen. The length of the flaccid penis was 9.6 cm. (3-3/4 inches), its diameter at the root was 7.2 cm. (2-3/4 inches); the length of the organ when erect was 13.5 cm. (5-1/4 inches). In the presence of girls or women the boy's penis became erect, his whole manner became more vivacious, and his hands were directed towards the genital organs of these females. Masturbation was never observed. The boy showed many additional signs of premature development. For instance, the central incisors of the upper jaw were cut at the age of three months. Breschet also quotes a case published by Mead, in which a boy had undergone the puberal development before the end of the first year of his life; when five years of age, he died of pulmonary consumption, attended with all the signs of old age. The same writer records another case, that of a boy five years of age, whose genital organs were fully developed, who had a well-grown beard, and exhibited, in short, all the (physical) characteristics of complete sexual maturity. In accordance with the theoretical views of that day, more especially as a result of the wide acceptance of the phrenological doctrines of Gall, it was generally believed that an exceptional development of the cerebellum (which was supposed by Gall to be the seat of the sexual impulse) was the determining cause of such premature awakening of the sexual impulse.

Contrasted with the cases just described, are those in which there is a retardation of the whole course of sexual development, so that the signs of sexual maturity are not manifested until an age greatly exceeding the average "age of puberty." In respect of one symptom or several, many individuals may remain throughout life in an infantile condition. This is occasionally seen, for example, in dwarfs. It would be of great interest, from this point of view, to make a careful study of the sexual behaviour of dwarfs. In this respect, dwarfs appear to vary greatly. These differences depend, in part, at least, upon the fact that many persons are classified as dwarfs who do not, strictly speaking, belong to this category. This statement applies more especially to those whose growth has been impaired by rickets; for, properly speaking, those only should be designated dwarfs who are, though small, generally well-proportioned; and the term should not be applied to those in whom the defective stature is consequent on rachitis or some similar disease. It appears doubtful, however, if the confusion of terms just mentioned explains all the observed differences in the sexuality of those commonly spoken of as "dwarfs." From data communicated to me concerning a fairly large community of dwarfs, living in a single place, and in whom the dwarfing appears to have no connexion with rickets, it would seem that in the case of true dwarfs there is considerable variation in sexual behaviour. This particular group of dwarfs constitute a society of persons living and working together. Although they are all living in close association, there seems to be a striking lack of warmth in their sexual relationships. Notwithstanding the fact that they have been living together for ten years, they still address one another formally as "Mr." and "Miss." In the case of the male dwarfs, with one exception all had fully developed genital organs; the exceptional instance was that of a member of the community then thirty years of age, in whom the genitals were rudimentary. All were endowed with normal sexual impulse, but this was directed towards persons of normal stature. In one of these dwarfs, an Italian, the genital organs remained undeveloped and hairless until he attained the age of twenty-eight; then these organs underwent the normal degree of growth, and at the same time pubic hair appeared. As already mentioned, the sexual inclinations of dwarfs appear as a rule to be directed towards fully grown persons, and I knew one dwarf twenty years of age who never missed an opportunity of pressing up against a certain very pretty young lady. These observations of my own regarding the sexual inclinations in dwarfs are confirmed by other cases recorded in the literature of the subject, although in isolated instances sexual attraction between a male and a female dwarf has been observed to eventuate in the birth of a child.

This is the place in which to refer to those cases of which a brief mention was made in the first chapter, to which von Krafft-Ebing has given the name of sexual paradoxy. Activity of the sexual impulse is sometimes observed at an age at which this impulse is normally quiescent. The term applies alike to cases in which the sexual impulse becomes active in early childhood, and to cases in which the impulse persists to an advanced age. Whilst the cases in which the phenomena of contrectation alone occurred have commonly been overlooked, considerable attention has been paid to those cases in which the sexual impulse manifests itself by peripheral changes, more especially by premature impulse towards masturbation or towards actual sexual congress with one of the other sex. It was shown, however, in the last chapter, that active manifestations of the sexual impulse during childhood are not always paradoxical. If we examine cases which have been published as coming under this latter category (I limit myself here to cases occurring in childhood, and am not speaking of sexual paradoxy in old age), we find that they are characterised more particularly by the strength with which the peripheral sexual impulse manifests itself. There is, in fact, a marked distinction between cases, according as we have to do with an occasional general sensation in the genital organs, or with masturbation to excess and with sexual assaults upon others. But we must not describe as sexual paradoxy all manifestations of the sexual life occurring in early childhood. A reference to the last chapter will show that the cases of sexual paradoxy, when accurately studied, differ from the normal rather quantitatively than qualitatively. During the first period of childhood, and more especially during the first few years of life, a case in which sexual activity in a child threatens the well-being of members of that child's social environment is so sharply differentiated from the normal that there can hardly arise even momentary hesitation regarding the paradoxical nature of the manifestation. On the other hand, we shall do well to follow von Krafft-Ebing in excluding from the category of sexual paradoxy those cases in which sexual excitement is caused solely by peripheral inflammatory stimuli, balanitis (inflammation of the glans penis), threadworms, and the like. These are not instances of sexual paradoxy, because the essential characteristic of the latter is that it originates centrally, even though its manifestations take a peripheral form.

I will now recount three cases which I regard as pathological in nature, and as examples of a paradoxical sexual impulse.

CASE 7.—The girl X., six years of age, stated by the mother to be free from all morbid inheritance, produces the general impression of being a nervous subject. She is affected with facial muscular spasms, especially affecting the corners of the mouth, the eyelids, and the neck. Her mental development, as far as can be judged from my own observations and from the account given by the parents, is perfectly normal; but attention is at once attracted by the appearance of premature development. The mother states that in the second year of life, owing to the carelessness of a nursemaid, the child fell out of her cradle, without, however, sustaining any manifest injury. The mother does not think there is any reason to suppose that the child has ever been led astray in sexual matters. For the past two years or more, the mother has noticed that the child likes to press up against articles of furniture in such a way that her genital organs come into contact with narrow edges or corners; for example, the back of a chair, and especially a small portfolio-stand in the room. At first the child did this very often. Then the mother forbade it, and the father whipped her several times for doing it; since then it has been done more furtively, but the mother has none the less often seen it done. When the child is in bed she plays with the genital organs with her fingers. A definite orgasm occurs: there are spastic twitchings of the whole body, the eyes brighten, the respiratory rhythm changes; all these changes, occurring as they do in association with the artificial stimulation of the genital organs, combine to prove that we have not to do here with a simple spasmodic neurosis, but with the artificial induction of the sexual orgasm. The process is, moreover, confined to peripheral manifestations. The most careful observation failed to show the existence, in association with the sexual excitement, of any especially tender sentiments towards other individuals.

CASE 8.—The boy Y. was brought to see me when he was eight and a half years of age. From the second year of life he had been noticed to be subject to masturbatory impulses, attended from the first with erection of the penis. The practice of masturbation increased to such a degree that before the boy was four years of age it was found necessary to keep him separate, as far as possible, from his brothers and sisters to save these latter from being corrupted by him. But notwithstanding this precaution, by the time he was five years old he had begun to make sexual attacks on a sister one year older than himself. He was cunning enough to arrange matters in such a way that he was alone with his sister, at times when the usual safeguards to keep him separate from the other children were suspended—for example, when his parents were away, and when his governess (who had been made fully acquainted with the circumstances) was keeping some assignation of her own. (All this was fully elucidated at a later date. The distressed parents were foolish enough to imagine that a child with inherited morbid predispositions of this character could be adequately safeguarded by means of hired help; they were painfully disillusioned when it appeared that the hired assistant, instead of watching the child, was pursuing her own pleasures—a point in which she merely imitated the parents, themselves earnest pleasure-seekers, deluding themselves with the belief that everything possible was being done for their child.) Although the parents had known all about the boy's habit of masturbation for many years past, it was only through a fortunate accident, and after the sexual malpractices with the sister had been going on for a long time, that these at length came to light. It appears that the boy had from time to time made sexual advances to other girls than his sister. One day, while playing with the little daughter belonging to a neighbouring family, he endeavoured to lead this child sexually astray. The little girl told her parents what had happened, and these latter consequently refused to allow her to play with Y. any more. This prohibition led Y.'s parents to inquire into the whole matter with great care. It was then discovered that for years past Y. had been engaged in sexual misconduct with his sister, his usual method being to play with her genital organs with his hands. In the girl, the frequent repetition of this act had given rise to abrasions and local inflammations.

The following case, the leading features of which are the early age at which seminal ejaculation occurred, and the marked hyperaesthesia of the sexual impulse, may also be regarded as an example of sexual paradoxy. This patient exhibits a number of different perverse modes of sexual sensibility, some of which have persisted to the present day.

CASE 9.—Z., now thirty years of age, admits prolonged sexual excesses, and divides his sexual history into two periods: the first period extends from the age of seven to the age of twelve, before he had learned the use of alcohol; during the second period, from the age of thirteen to the age of thirty-years, his sexual excesses occurred under the influence of alcohol. He gives his own history in the following terms:—

"In very early childhood my imagination began to exercise itself pleasurably in the pictured contemplation of the bodies of naked girls. I can also remember distinctly that my dreams were chiefly concerned with images of this character. In the later years of childhood (nine to twelve years) I masturbated to great excess, often five to ten times daily, sometimes actually while in class at school. Seminal emission had already begun—I remember this quite distinctly at the age of ten, and perhaps even at the age of nine years—but the quantity of semen was very small. I found several schoolmates with similar inclinations to my own, and with these I practised mutual masturbation. When I was eleven years old I became acquainted with a boy somewhat younger than myself, and in this case the proposal for mutual masturbation came from his side. At that time the thought that there was anything wrong in the practice had never entered my mind; on the contrary, I was always on the lookout for boys who would join with me in mutual masturbation. Such were my sexual habits, until as a boy of thirteen I for the first time had complete sexual intercourse with a woman, a prostitute. Thenceforward, for a time, I had intercourse at intervals of from four to six weeks, continuing in the meanwhile daily masturbation. Subsequently I sought and found opportunities for intercourse with women, married and unmarried, about once a week, for money. These almost daily venereal excesses appeared to have no bad effects on my physical health; my diet was at the time abundant, if not superabundant. On the other hand, I lacked effective will-power to make a successful stand against the promptings of my bodily lusts; nor was I able, though not devoid of talent, to perform any arduous or enduring mental work. There ensued also at this early stage a great infirmity of purpose, from which I still suffer to this day. I would take up now one thing, now another, at first with fiery zeal, soon to cast it aside in favour of some new undertaking, to be abandoned with the like precipitation.