THE SEXUAL LIFE OF THE CHILD

By Dr. Albert Moll

TRANSLATED FROM THE GERMAN BY DR. EDEN PAUL

WITH AN INTRODUCTION BY EDWARD L. THORNDIKE PROFESSOR OF EDUCATIONAL PSYCHOLOGY TEACHERS COLLEGE, COLUMBIA UNIVERSITY

NEW YORK THE MACMILLAN COMPANY 1919 All rights reserved

COPYRIGHT, 1912, BY THE MACMILLAN COMPANY.

Set up and electrotyped. Published June, 1912.

NORWOOD PRESS J. S. Cushing Co.—Berwick & Smith Co. Norwood, Mass., U.S.A.



INTRODUCTION

Dr. Moll is a gifted physician of long experience whose work with those problems of medicine and hygiene which demand scientific acquaintance with human nature has made him well known to experts in these fields. In this book he has undertaken to describe the origin and development, in childhood and youth, of the acts and feelings due to sex; to explain the forces by which sex-responses are directed and misdirected; and to judge the wisdom of existing and proposed methods of preventing the degradation of a child's sexual life.

This difficult task is carried out, as it should be, with dignity and frankness. In spite of the best intentions, a scientific book on sex-psychology is likely to appear, at least in spots, to gratify a low curiosity; but in Dr. Moll's book there is no such taint. Popular books on sex-hygiene, on the other hand, are likely to suffer from a pardonable but harmful delicacy whereby the facts of anatomy, physiology, and psychology which are necessary to make their principles comprehensible and useful, are omitted, veiled, or even distorted. Dr. Moll honors his readers by a frankness which may seem brutal to some of them. It is necessary.

With dignity and frankness Dr. Moll combines notable good sense. In the case of any exciting movement in advance of traditional custom, the forerunners are likely to combine a certain one-sidedness and lack of balance with their really valuable progressive ideas. The greater sagacity and critical power are more often found amongst the men of science who avoid public discussion of exciting social or moral reforms, and are suspicious of startling and revolutionary doctrines or practices. It is therefore fortunate that a book on the sexual life during childhood should have been written by a man of critical, matter-of-fact mind, of long experience as a medical specialist, and of wide scholarship, who has no private interest in any exciting psychological doctrine or educational panacea.

The translation of this book will be welcomed by men and women from many different professions, but alike in the need of preparation to guide the sex-life of boys and girls and to meet emergencies caused by its corruption by weakness within or attack from without. Of the clergymen in this country who are in real touch with the lives of their charges, there is hardly a one who does not, every so often, have to minister to a mind whose moral and religious distress depends on an unfortunate sex history. Conscientious and observant teachers realize, in a dim way, that they cannot do justice to even the purely intellectual needs of pupils without understanding the natural history of those instinctive impulses, which, concealed and falsified as they are under our traditional taboos, nevertheless retain enormous potency. The facts, so clearly shown in the present volume, that the life of sex begins long before its obvious manifestations at puberty, and that the direction of its vaguer and less differentiated habits in these earlier years is as important as its hygiene at the more noticeable climax of the early 'teens, increase the teacher's responsibility. Moreover, there is probably not a teacher of ten years' standing who has not faced—or by ignorance neglected—some emergency where moderate insight into the laws whereby the vague instincts of sex are turned into healthy and unhealthy habits, and form right and wrong attitudes, could have rescued a boy or girl from years of wretched anxiety, or degraded conduct, or both.

The social worker, still more emphatically, knows his or her need of a surer equipment for the wise direction of the life of sex in childhood and its protection from the abominable suggestions of those who are themselves sexually diseased or depraved. The casual questioning of medical or legal friends, reminiscences of vague references in the Bible or classic literature, and the miscellaneous experiences which life itself throws in one's way, are hopelessly inadequate.

The conscientious practitioner of medicine, too, will gladly add to the scanty, though accurate, knowledge of the sex-instinct and its pathology which is all that even the best medical course can compass, the facts presented by a specialist in this field. The easiest way for those parents who accept the responsibility for rational guidance of their children in matters of sex-behavior to discharge this responsibility is by the aid of the family physician. For the physician in such cases to gain the child's confidence, understand his individual dangers and possible false attitudes, and give more than perfunctory general counsel, knowledge of the psychology of sex-behavior, as well as its physiology, is necessary. In general, also, modern medical practice must look after the prevention of bad habits and unnecessary anxieties in respect to the sex-life as well as their cure; and the science of preventive medicine in this field receives a substantial contribution from this summary of the sex-life of childhood.

There are now many men and women who are dissatisfied with doing for their children merely what outgrown customs decree, who are willing to give time and study, as well as money and affection, in their service, and who are eager to see or hear or read anything pertinent to their welfare. For many such parents, if they are of the scientific, matter-of-fact type, Dr. Moll's book may prove the means of answering many troublesome questions and of prompting to a wiser cooperation with church, school, and the medical profession in safeguarding their own—and, we may hope, all other—children against blunders and contaminations.

One word of caution is perhaps necessary for those readers who are unused to descriptions of symptoms of diseases, abnormalities, and defects. Such readers are likely to interpret perfectly ordinary facts as the symptoms which they have been studying. So the medical student at the beginning of his reading, fears appendicitis when he has slight indigestion, and sees incipient tuberculosis in every household! So the embryonic psychologist finds 'degenerates' in every crowd of boys, 'hypnotic suggestion' in every popular preacher, and 'aphasia' in any friend who forgets names and faces! Dr. Moll gives more protection against such exaggerated inferences than is commonly given in books on pathology, but many of his readers will do well to be on their guard lest they interpret perfectly innocent behavior as a symptom of abnormality. The mischief done by our present ignorance and neglect of important features of sex-behavior should be prevented without the incidence of mischief from exaggerated expectations and unwise meddling.

It would be evasive to shirk mention of the fact that many of the most devoted servants of health and morals object to public discussion of the facts of sex. They discard enlightenment about sex as relatively unimportant because a clean ancestry, decency in the family and neighborhood, and noble needs in friendship, love, and marriage must, in any case, be the main roots of healthy direction and ideal restraint of the sex-instinct. Or they fear enlightenment as a possible stimulus to undesirable imagination and experimentation. Or they dislike, even abhor, it as esthetically repulsive—shocking to an unreasoned but cherished craving for silence about these things—a craving which the customs of our land and time have made an unwritten law of society.

Of the first of these three attitudes, it may be said briefly that the relative unimportance of enlightenment is a fact, but no argument against it. Modesty, austerity, and clean living on the part of parents will counterbalance much negligence in direct guidance or protection. But the former need be in no wise lessened by improving the latter. Of the second, I dare affirm that if the men and women in America should stop whatever they are doing for an evening and read this book, there would be less harmful imagination as a result than from the occupations which its reading would replace. Of all the causes of sexual disorder, the reading of scientific books by reputable men is surely the least! The third—that is, the esthetic—repulsion toward publicity in respect to the natural history of sex, I will not pretend to judge. Only we must not strain at gnats and swallow camels. It is no sign of true esthetic or moral sensitiveness for a person to be shocked by 'Ghosts,' 'Mrs. Warren's Profession,' or 'The Sexual Life of the Child,' who finds pleasant diversion in the treatment of sex-behavior in the ordinary novel, newspaper, or play.

On the whole, the gain from giving earnest men and women the facts they need, seems likely to outweigh by much the harm done to such light minds as will be misled, or to such sentimental minds as will be wounded, by enlightenment about sex. No harm will be done to those men and women whose interest in the welfare of children makes them eager to face every problem that it involves, and whose faith in the ideal possibilities of love between the sexes is too well-grounded to be disturbed by the facts of its natural history.

EDWARD L. THORNDIKE.

MAY, 1912.



PREFACE

The number of books and essays dealing with sexual topics published during recent years is by no means small; but although some of the works in question have added considerably to our knowledge, the advance of sexual science as a whole has not been proportionate to the extent of these contributions. The reason is that insufficient attention has been paid to special problems; and the majority of writers have either repeated what has already been said by another, in identical or equivalent words, or else they have published comprehensive treatises on the sexual life, which may, perhaps, be of interest to the laity, but do not in any way enrich our science. Further advances in our knowledge of the sexual life can be effected only by the investigation of special problems. Such work is, indeed, laborious; but that it is also fruitful, has been clearly shown, not only in the first instance by von Krafft-Ebing, but more recently, above all, by Havelock Ellis, whose special studies have contributed more to the advance of sexual science than the work of dozens of other writers.

The recognition of the need for specialised investigations has led me, in this province of scientific work as in other departments, to devote myself to the elucidation of certain definite problems. For several reasons I determined to study the sexual life of the child. In the first place, I believe that an advance in our knowledge of the sexual life of the child will indirectly enrich our knowledge also of the sexual life of the adult. In order to understand the sexual life, the gradual development of that life must be recognised, and for this purpose it is essential that we should study the sexual life of the child. Moreover, the modern movement in favour of the sexual enlightenment of young persons renders indispensable the possession of precise knowledge of the sexuality of the child; and such knowledge is no less necessary to all instructors of youth, especially to those to whom the psychical life of children is a matter of concern. Judges and magistrates also, as we shall see in the seventh chapter, are very greatly interested in this matter: it is, in fact, hardly open to question that erroneous legal decisions and the unjust condemnation of reputed criminals can only be avoided by giving our judicial authorities the opportunity of obtaining sound knowledge concerning the sexual life of children in all its modes of manifestation. By all these considerations I have been induced to study the problem of the sexuality of children from the most widely different points of view. Although other writers, such as Freud, Bell, and Koetscher, have contributed certain data towards the solution of these questions, no comprehensive study of the subject has hitherto been attempted. My material does not consist only of the reports of patients. In addition, in order to avoid a one-sided dependence upon pathological considerations, I have accepted with greater confidence the reports concerning the sexual life of children which I have received from healthy individuals, both men and women. I take this opportunity of tendering my most heartfelt thanks to all those who have assisted me in this manner.

ALBERT MOLL.



CONTENTS Page

INTRODUCTION v

PREFACE xi

CONTENTS xiii

CHAP.

I. INTRODUCTORY AND HISTORICAL 1

Subdivisions of the Period of Childhood—The Notion of Puberty—Methods of Investigation.

Rousseau and Tissot—The Philanthropes—Medical Literature—The Older Psychology—History of Civilisation—Studies of Prostitution—Works on Zoology—Biographies—Belletristic Literature—Erotic Literature—Studies of Sexual Perversions—Recent Special Researches—Diaries.

II. THE REPRODUCTIVE ORGANS—THE SEXUAL IMPULSE 17

The Male Reproductive Organs—Erection—Ejaculation—The Voluptuous Sensation—Female Reproductive Organs—Menstruation and Ovulation—Peripheral Processes, Erection, Ejaculation, and Voluptuous Sensation, in the Female—The Reproductive Organs in Children.

Components of the Sexual Impulse—Excitement of the Sexual Impulse—The Sexual Impulse and the Voluptuous Sensation.

III. SEXUAL DIFFERENTIATION IN CHILDHOOD 33

Secondary Sexual Characters—First Period of Childhood—Second Period of Childhood—Psychical Differences in Children—The Teachings of Experimental Psychology—The Teachings of Empirical Psychology (Erfahrungspsychologie)—Inborn Character of Sexual Differences—Pathological Experiences—Criminological Experiences.

IV. SYMPTOMATOLOGY 50

Erections in the Child—Ejaculation—Origin of Ejaculation—Voluptuous Sensation.

The Undifferentiated Sexual Impulse—Examples—Phenomena of Contrectation in the Child—The Object of Desire—Romanticism—Manifestations of Love—Jealousy—Love-Letters and Love-Poems—Vanity—Shame—Differences between Boys and Girls—Changes in the Object of Desire.

Interdependence of the Processes of Contrectation and Detumescence—Temporal Relationship between these respective Processes.

Masturbation—The Voluptuous Sensation—Modes of Masturbation—Erogenic Zones—Comparison between Boys and Girls.

Ejaculation as a Consequence of Feelings of Anxiety—Pollutions—Madame Roland's Description—Individual Differences—Sexual Phenomena in the Youth of the Lower Animals.

The Teachings of Castration—Significance of the Reproductive Glands—Theories.

The Years of Ripening—Retardation of Sexual Development.

V. PATHOLOGY 114

Pathologically Premature Menarche in Girls—Premature Puberty in Boys—Conditions met with in Dwarfs—Sexual Parodoxy—Examples.

Sexual Perversions—Premature Development—Congenital Character of Perversions—Illusions of Memory—Disappearance of the Perversions of Childhood—The Association Theory—Criticism of this Theory—Instances in which Perversions could be traced back to a very early Age—Origin of Sexual Perversions in Non-Sexual Dispositions—Homosexuality and Friendship—Sexual Cruelty and Cruelty of other Kinds—Diagnostic Difficulties—Exhibitionism—Skatophilia—Hermaphroditism.

VI. ETIOLOGY AND DIAGNOSIS 146

Family Tendencies—Abnormal Nervous System—Race—Climate—Position in Life—Town and Country—Modern Civilisation—Importance of Congenital Predisposition—Seduction—Local Stimulation—Chemical Stimuli—Psychical Stimuli.

Diagnostic Difficulties—Recognition by means of Observation—Erroneous Diagnoses of Masturbation—The Value of Physical Signs—Value of a Confidant—Misleading Statements and Conduct on the part of Children.

Non-Sexual Erections—Non-Sexual Manipulations—Sucking Movements—Nail-Biting—Imitativeness—Impossibility of any Definite Demarcation of Sexual Feelings.

VII. IMPORTANCE OF THE SEXUAL LIFE OF THE CHILD 179

The Sexual Life and Morbid Hereditary Predisposition—Hygienic Dangers—The Dangers of Masturbation in General—Of Masturbation in the Child—Masturbation without Ejaculation—Exaggerated Views to be Avoided—Amatory Passion and Suicide—Freud's Theory—Infectious Diseases.

Ethical Dangers—Masturbation and Ethics—Social Dangers—Social Degradation of Girls—Seduction of Girls—Forensic Importance of the Sexual Life—Children's Evidence—Circumstances affecting Culpability—Penal Responsibility of Children—Intellectual Dangers—Sexuality and Altruism.

Sexual Perversions and the Choice of a Profession—Punishments and Masochism—Curiosity of Children—Sexuality and Art—The Question of the Offspring.

Importance of Tardy Sexual Development.

VIII. THE CHILD AS AN OBJECT OF SEXUAL PRACTICES 219

Paedophilia Erotica—Other Sexual Offences against Children—Sexual Acts Performed on Children—Significance of each Acts to the Child—Artificial Production of Sexual Perversions—False Accusations—Statistics of Accusations by Children—Reasons for Protecting Children——Injuries effected on Children by the Law—Responsibility of Paedophiles.

Exhibitionism—Sadism—Newspaper Advertisement.

IX. SEXUAL EDUCATION 246

Limits of Educability—General Hygiene—Custom and Morality—Inculcation of the Sentiments of Shame and Disgust—Influence upon these Sentiments of Habit and Example—Morality and Nakedness—Excessive Sentiments of Shame and Disgust—The Nude in Art—Morality in Fanatics—Erotic Books and Pictures.

Co-Education of the Sexes—Children's Balls—Diversion of the Sexual Impulse—Religious Education—The Bible—The Confessional—Hypnotism—Psycho-Analysis—Counteraction of Psychical Contagion.

Sexual Enlightenment—General Educational Interests—Hygienic Reasons for Enlightenment—The Dangers of Venereal Infection—Of Masturbation—Ethical Reasons—Forensic Reasons—Social Reasons—Age at which Enlightenment is Desirable—Place of Enlightenment; School or Home—The School Physician—Importance of the Mother—Individualisation—Mode of Enlightenment.—Reasons urged against Enlightenment—Need that the Instructor should be an Enlightened Person—Exaggerated Views regarding the Importance of Sexual Enlightenment.

Physical Hygienic Measures—Stimulation by Means of the Bed—Local Stimulation—Mechanical Measures—Hydrotherapeutic Measures—Dirt—Sport and Games—Fere's Method.

Pedagogy and Sexual Perversions—Dangers from Paedophiles—Necessity for Heterosexual Influences—Dangers of Corporal Punishment—The Right of the Teacher to Inflict Punishment—Conclusion.

INDEX OF SUBJECTS 325

INDEX OF NAMES 337

THE SEXUAL LIFE OF THE CHILD



CHAPTER I

INTRODUCTORY AND HISTORICAL

To speak of "the sexual life of the child" seems at first sight to involve a contradiction in terms. It is generally assumed that the sexual life first awakens at the on-coming of puberty (the attainment of sexual maturity of manhood or womanhood); the on-coming of puberty is regarded as the termination of childhood; in fact the term child is usually defined as the human being from the time of birth to the on-coming of puberty. But this contradiction is apparent merely, and depends on the assumption that the on-coming of puberty is indicated by certain outward signs (more especially the first menstruation and the first seminal emission), insufficient attention being paid to the long period of development which usually precedes these occurrences. And yet, during this period of preliminary development, the occurrence of certain manifestations of the sexual life is plainly demonstrable.

The period of childhood is subdivided into several sub-epochs, but the delimitation and nomenclature of these varies so much with different investigators, that to avoid misunderstanding I must first define the subdivisions which I myself propose to employ. If we regard the beginning of the fifteenth year as the termination of childhood, we may divide childhood into two equal periods, the first extending from birth to the completion of the seventh year, the second from the beginning of the eighth to the end of the fourteenth year. I shall in this work designate these two periods as the first and the second period of childhood respectively. In the first period of childhood, the first year of life may be further distinguished as the period of infancy.[1] The first and second periods of childhood comprise childhood in the narrower sense of the term. The years that immediately follow the beginning of the fifteenth year I shall denote as the period of youth. Inasmuch as the symptoms of this latter come to differ from those of childhood proper, not abruptly, but gradually, the first years, at least, of youth will often come under our consideration, and I shall speak of this period of life as the third period of childhood. Although childhood in the narrower sense comprises the first and second periods only, childhood in the wider sense includes also the third period. It is hardly possible that any misunderstanding can arise if the reader will bear in mind that whenever I speak of childhood without qualification, I allude only to the period of life before the beginning of the fifteenth year. For all these periods of childhood, first, second, and third, I shall for practical convenience when speaking of males use the word boy, and when speaking of females, the word girl.

The use of this terminology must not be regarded as implying that the distinctions indicated correspond in any way to fixed natural lines of demarcation; on the contrary, individual variations are numerous and manifold. Not only does the rate of development differ in different races (in the Caucasian race, more especially, the age of puberty comes comparatively late, so that among the members of this race childhood is prolonged); but further, within the limits of one and the same race, notable differences occur. More than all have we to take into account the differences between the sexes, childhood terminating earlier in the female sex than in the male—among our own people [the Germans] this difference is commonly estimated at as much as two years. In addition, in this respect, there are marked differences between different classes of the population, a matter to which we shall return in Chapter VI.

It is also necessary to point out here in what sense I employ the term puberty (nubility, sexual ripeness, or maturity), and the associated terms, nubile and sexually mature. Much confusion exists in respect of the application of these terms. Some use puberty to denote a period of time, others, a point of time, and in various other ways the word is differently used by different authors. Similarly as regards the term nubile; some consider an individual to be nubile as soon as he or she is competent for procreation, others speak of anyone as nubile only when the development of the sexual life is completed. Obviously, these two notions are very different; for instance, a girl of thirteen who has begun to menstruate may be competent for the act of procreation, and yet her sexual development may still be far from complete. The confusion as regards the use of the substantive puberty is no less perplexing. One writer uses it to denote the time at which procreative capacity begins, and believes he is right in assuming that in the male this time is indicated by the occurrence of the first involuntary sexual orgasm.[2] I may point out in passing that there is a confusion here between procreative capacity and competence for sexual intercourse, for as a rule the first seminal emissions contain no spermatozoa. But, apart from such confusions, the term puberty is used in various senses. Thus, a second writer denotes by puberty the point of time at which the sexual development is completed; a third means by puberty the period which elapses between the occurrence of the first involuntary orgasm and the completion of sexual development; a fourth uses the word to denote the entire period of life during which procreative capacity endures; and finally, a fifth includes under the notion of puberty the whole course of life after the completion of sexual development. In this work I shall mean by puberty the period of life between the completion of sexual development and the extinction of the sexual life. The period during which the state of puberty is being attained will be spoken of as the period of puberal development, and I shall therefore speak of the beginning and the end of the puberal development. The terms nubility, sexual maturity, nubile, and sexually mature, will be used with a similar signification. As regards the puberal development, let me at the outset draw attention to the fact that it takes place very gradually; and further, as we shall see, that it begins much earlier than is commonly believed. In the young girl, from the date of the first menstruation to the time at which she has become fitted for marriage, the average lapse of time is assumed by Ribbing[3] to be two years. This is a fair estimate, but it does not correspond to the totality of the period of the puberal development. If we estimate that period from its true beginning its duration greatly exceeds two years, for the first indications of the puberal development are manifest in the girl long before the first menstruation, and in the boy long before the first discharge of semen. The approach of puberty is indicated by numerous symptoms, some of which are psychical and some physical in character. In perfectly healthy children, as will be shown in the sequel, individual symptoms may make their appearance as early as the age of seven or eight, and further symptoms successively appear during succeeding years, until the puberal development is completed.

What methods are available for the study of the sexual life of the child? Three methods have to be considered: first, the observation of children; secondly, experiment; and thirdly, reports made by individuals regarding their own experiences. As regards the last mentioned, we must distinguish clearly between accounts reproduced from memory long after the incidents to which they relate, and accounts given by children of their state at the time of narration. But both varieties of clinical history are defective. The child is often incompetent to describe his sensations—think, for instance, of the processes of the earliest years of life. Even when the child is able to make reports, a sense of shame will often interfere with the truthfulness of his account. Whilst as regards the memory-pictures of adults, recourse to this method often fails us because the experiences are so remote as to have been largely, if not entirely, forgotten. The autobiographies of sexually perverse individuals have drawn my attention to the fallacious nature of memory. Its records are uncertain, but that especially is recorded which has aroused interest. Not only the interest felt in the experiences at the time determines what shall be recorded, but also the interest felt later when reviving these experiences in memory. Childish experiences are very readily forgotten, either if they were uninteresting at the time, or if subsequently they have become uninteresting. During childhood, a homosexual woman has experienced sexual feeling, directed now towards boys, now towards girls. Later in life, when the homosexuality has developed fully, the memory of the inclination towards boys fades away, and her homosexual sentiments only are remembered. As a result, we often find that the homosexual woman—and the converse is equally true of the homosexual man—declares at first, when inquiries are made, that she has never experienced any inclination for members of the other sex; whereas, at any rate in a large proportion of cases, a stricter examination of her memory, or the reports of other individuals, will reveal beyond dispute that in childhood heterosexual inclinations were not lacking.

A further defect of memory has been made manifest to me by the study of perversions. Processes which in childhood were entirely devoid of any sexual tinge, but which later became associated with sex-feelings, very readily acquire false sexual associations also when they are revived in memory. Consider, for instance, the case of a homosexual man. He remembers that, as a small boy, he was very fond of sitting on his uncle's knees, and he believes that the pleasure he formerly experienced was tinged by sexual feeling. In reality this was by no means the case. His uncle took the boy on his knee in order to tell him a story. Possibly, also, the riding movements which the uncle imitated by jogging his knees up and down gave the child pleasure, which, however, was entirely devoid of any admixture of sexual feeling. But in the consciousness of the full-grown man, in whom homosexual feeling has later undergone full development, all this becomes distorted. The non-sexual motives are forgotten; he believes that even in early childhood he had homosexual inclinations, and that for this reason it gave him pleasure to ride on his uncle's knees.

Nor is observation in any way adapted to furnish us with a clear picture of the sexual life of the child. So little can be directly observed, that in the absence of reports much would remain entirely unknown. From the moment when the children gain a consciousness, however obscure, of the nature of sexual processes, they almost invariably endeavour to conceal their knowledge as much as possible, so that we shall discover its existence only by a rare chance. None the less, the results of direct observation are often important; sometimes because we are able to watch children when they are unaware of our attention, and sometimes because they do not as yet fully understand the nature of the processes under observation, and for this reason are less secretive.

The third method, that of experiment, is available to us only in the form of castration. I need not dilate on the inadequacy of this application of the experimental method, even apart from the fact that it subserves our purposes almost exclusively in respect of the male sex—for in the case of young girls, castration (oophorectomy) is almost entirely unknown.

Thus we see that all our methods of investigation exhibit extensive lacunae, and further, that they are all in many respects fallacious; we shall therefore endeavour to supplement each by the others, in order to arrive at results which shall be as free from error as possible. Thus guided, we learn that sexual incidents occur in childhood far more frequently than is usually supposed. So common are they, that they cannot possibly escape the notice of any practising physician or educationalist who pays attention to the question, provided, of course, that he enjoys the confidence of the parents. These latter have often been aware of such sexual manifestations in their children for a long time, but a false shame has prevented them from asking the advice of the physician. They have been afraid lest he should regard the child as intellectually or morally deficient, or as the offspring of a degenerate family. In addition, we have to take into account self-deception on the part of the parents, who, indeed, often deceive themselves willingly, saying to themselves that the matter is of no importance, and that the symptoms will disappear spontaneously.

Having given this brief account of the terminology to be employed and of the methods of investigation, I propose to sketch no less briefly the history of the subject.

Casual references to the sexual life of the child are to be found even in the older scientific literature. In the latter half of the eighteenth century, and at the beginning of the nineteenth, interest in the subject became more general. Two works, in especial, published almost simultaneously, attracted the attention of physicians and educationalists. One of these, Rousseau's Emile, discusses the proper conduct of parents and elders in relation to the awakening sexual life, and what they should do in order to delay that awakening as much as possible. The other, the celebrated work of Tissot, depicts the dangers of masturbation, but deals chiefly with persons who have attained sexual maturity. None the less, in consequence of this book, much attention was directed to the sexual life of the child. Earlier works on masturbation, such as that of Sarganeck, for instance, had not succeeded in arousing any enduring interest in this question. But Rousseau's and Tissot's books induced a large number of physicians and educationalists to occupy themselves in this province of study. Thus at this early day many authorities were led to advocate the sexual enlightenment of children, in order to guide them in the avoidance of the dangers of the sexual life. An excellent historical and critical study of this movement, written by Thalhofer, has recently been published.[4] Among the educationalists who took part in it may be mentioned Basedow, Salzmann, Campe, and Niemeyer. The modern movement in favour of sexual enlightenment originated chiefly in the endeavour to prevent the diffusion of venereal diseases; but the earlier movement, occurring at a time when much less was known about venereal diseases, had a different aim. This was rather to prevent masturbation and other sexual excesses, on account of their direct effect upon the organism; an aim not neglected by the modern movement for sexual enlightenment, though subsidiary to the object of the prevention of the venereal diseases. Teachers of that day touched, of course, upon the subject of the sexual life of the child. But this was done cursorily, for when instruction was given on the sexual life, not the actual experience of children, but the sexual life of mature persons, was the subject of discourse. This must be said also of the works of those physicians who, like Hufeland in his Makrobiotik (written as a sequel to the work of Tissot), spoke of the dangers of masturbation.

A few of the numerous medical books dealing with the puberal development deserve mention in this place; for instance, Marro, La Puberta (first edition, published in 1897), and Bacque, La Puberte (Argenteuil, 1876). A number of recent works on masturbation have also touched on the topic of the sexual life of the child.

Apart from these recent special investigations, the older and the more recent medical and anthropological literature contains numerous observations which concern the subject of this book. More especially do we find reports of cases in which the external manifestations of sexual maturity appeared in very early childhood. Now we find an account of a girl menstruating at four years of age, now an account of a three-year-old boy who exhibited many of the external signs of sexual maturity. Even in the older, purely psychological works we find occasional references to the sexual life of the child—a fact that will surprise no one who is acquainted with the high development of the empirical psychology (Erfahrungspsychologie) of that day (1800). The Venus Urania of Ramdohr, for instance, a work on the psychology of love, emphasises the frequency of amatory sentiments in children.

In works dealing with the history of civilisation, we also encounter occasional references to our subject. Take, for instance, the knightly Code of Love (Liebeskodex), a work highly esteemed in the days of chivalry, and legendarily supposed to have originated in King Arthur's Court. Paragraph 6 of this Code runs: "A man shall not practise love until he is fully grown." According to Rudeck,[5] from whom I quote this instance, the aim of the admonition was to protect the youth of the nobility from unwholesome consequences. Obviously, the love affairs of immature persons must have been the determining cause of any allusion to the matter. We may also draw attention in this connexion to many marriage laws, which show that the subject has come under consideration, either because they expressly sanction the marriages of children, or, conversely, because they forbid such unions. At the present day, among many peoples (as, for instance, the Hindus), child-marriages are frequent; and in many countries in which such marriages are now illegal, they were sanctioned in former ages. Many works on prostitution also touch on our chosen subject. Parent-Duchatelet, in his great book, refers to girls who had become prostitutes at the ages of twelve or even ten years. I shall show later that in individual instances such early prostitution is directly dependent upon the sexuality of the children concerned. Many ethnological works also contribute to our knowledge of the sexual life of the child, describing, as they do, in certain races, the early awakening of sexual activity.

Remarkably little material do we find, however, in many works in which we might have expected to find a great deal. I refer to works on education and on the psychology of the child. In exceptional instances, indeed, as I have already indicated, the educationalists have taken part in the movement in favour of sexual enlightenment. But when we consider the enormous importance and great frequency of the sexual processes of the child, we are positively astounded at the manner in which this department of knowledge has been ignored by those who have written on the science and art of education, and by those psychologists who have occupied themselves in the study of the mind of the child. Has it been a false notion of morality by which these investigators have been withheld from the elucidation of the sexual life of the child? Or has the reason merely been their defective powers of observation? As a matter of fact, I suppose that both these causes have operated in producing this remarkable gap in our knowledge.

A certain amount of material is to be found in a number of books on zoology, and also in a few quite recent works on comparative psychology. Among works of the former class I mention especially that of Brehm, who has reported a considerable number of individual details; of books on comparative psychology, one of the most useful for our purposes is that of Groos,[6] who gives us much valuable information regarding love-games of young animals.

I may also point out that in the autobiographies, biographies, memoirs, &c., of celebrated persons, we find much information regarding premature amatory sentiments. Goethe, in his Wahrheit und Dichtung, relates that as a boy of ten or so he fell in love with a young Frenchwoman, the sister of his friend Derones. Of Alfred de Musset, his brother and biographer, Paul Musset, records that at the early age of four he was passionately in love with a girl cousin. It is on record that Dante fell in love at the age of nine, Canova at five, and Alfieri at ten. Well known also is the story of Byron's love, at eight years of age, for Mary Duff. Moebius tells us of himself that when a boy of ten he was desperately enamoured of a young married woman. We are told of Napoleon I. that when a boy of nine he fell in love with his father's cousin, a handsome woman of thirty, then on a visit to his home, and that he caressed her in the most passionate manner. Belonging to an earlier day was Felix Platter, the celebrated Swiss physician of the sixteenth century, who tells us in his autobiography that when he was a child he loved to be kissed by a certain young married woman. In Un Coeur Simple, Flaubert describes the development of the love-sentiments. "For mankind there is so much love in life. At the age of four we love horses, the sun, flowers, shining weapons, uniforms; at ten we love a little girl, our playmate; at thirteen we love a buxom, full-necked woman. The first time I saw the two breasts of a woman, entirely unclothed, I almost fainted. Finally, at the age of fourteen or fifteen, we love a young girl, who is a little more to us than a sister and a little less than a mistress; and then, at sixteen, we love a woman once more, and marry her."

Most charmingly Hebbel describes his first experience of love, when but four years old. "It was in Susanna's dull schoolroom, also, that I learned the meaning of love; it was, indeed, in the very hour when I first entered it, at the age of four. First love! Who is there who will not smile as he reads these words? Who will fail to recall memories of some Anne or Margaret, who once seemed to him to wear a crown of stars, and to be clad in the blue of heaven and the gold of dawn; and now—but it would be malicious to depict the contrast! Who will fail to admit that it seemed to him then as if he passed on the wing through the garden of the earth, flitting from flower to flower, sipping from their honey-cups; passing too swiftly, indeed, to become intoxicated, but pausing long enough at each to inhale its divine perfume!... It was some time before I ventured to raise my eyes, for I felt that I was under inspection, and this embarrassed me. But at length I looked up, and my first glance fell upon a pale and slender girl who sat opposite me: her name was Emily, and she was the daughter of the parish-clerk. A passionate trembling seized me, the blood rushed to my heart; but a sentiment of shame was also intermingled with my first sensations, and I lowered my eyes to the ground once more, as rapidly as if I had caught sight of something horrible. From that moment Emily was ever in my thoughts; and the school, so greatly dreaded in anticipation, became a joy to me, because it was there only that I could see her. The Sundays and holidays which separated me from her were as greatly detested by me as in other circumstances they would have been greatly desired; one day when she stayed away from school, I felt utterly miserable. In imagination she was always before my eyes, wherever I went; when alone, I was never weary of repeating her name; above all, her black eyebrows and intensely red lips were ever before my eyes, whereas I do not remember that at this time her voice had made any impression on me, although later this became all-important."

In belletristic literature, also, we find occasional references to the love-sentiment in childhood. Groos refers to an instance which he thinks perhaps the most delicate known to him, and one in which the erotic element is but faintly emphasised, namely, Gottfried Keller's Romeo und Julia. "In a spot entirely covered with green undergrowth the girl stretched herself on her back, for she was tired, and began in a monotonous tone to sing a few words, repeating the same ones over and over again; the boy crouched close beside her, half inclined, he also, to stretch himself at full length on the ground, so lethargic did he feel. The sun shone into the girl's open mouth as she sang, lighting up her glistening white teeth, and gleaming on her full red lips. The boy caught sight of her teeth, and, holding the girl's head and eagerly examining her teeth, said, 'Tell me, how many teeth has one?' The girl paused for a moment, as if thinking the matter carefully over, but then answered at random, 'A hundred.' 'No!' he cried; 'thirty-two is the proper number; wait a moment, I'll count yours.' He counted them, but could not get the tale right to thirty-two, and so counted them again, and again, and again. The girl let him go on for some time, but as he did not come to an end of his eager counting, she suddenly interrupted him, and said, 'Now, let me count yours.' The boy lay down in his turn on the undergrowth; the girl leaned over him, with her arm round his head; he opened his mouth, and she began counting: 'One, two, seven, five, two, one,' for the little beauty did not yet know how to count. The boy corrected her, and explained to her how to count properly; so she, in her turn, attempted to count his teeth over and over again: and this game seemed to please them more than any they had played together that day. At last, however, the girl sank down on her youthful instructor's breast, and the two children fell asleep in the bright midday sunshine."

In erotic literature we also occasionally find descriptions belonging to our province, as, for instance, in the Satyricon of Petronius Arbiter. Indeed, a certain kind of erotic literature, more especially pornographic literature, selects this subject by preference. Thus, I may allude to the Anti-Justine of Retif de la Bretonne. In a certain section of such literature, improper practices between children and their parents and other blood relatives play a part.

Recently, in connexion with two different fields of study, attention has been directed to the sexual life of the child. The first of these is concerned with the abnormal, and especially the perverse, manifestations of the sexual life, a study of which Westphal, and above all von Krafft-Ebing, have been the founders. The other is the modern movement in favour of the sexual enlightenment of children. As regards the latter, the literature to which it has given rise has not, indeed, contributed much, beyond a few casual references, in the way of positive material concerning the sexual life of the child. But none the less, it is this movement which has made it of prime importance that our subject should be carefully investigated. As regards studies of the abnormalities of the sexual impulse, under the name of paradoxical sexual impulse cases have been published in which that impulse manifested itself at an age of life in which it is normally non-existent—old age and childhood. Recent research has brought to light a large number of cases of this nature. Among those who have reported such cases, we must mention first of all von Krafft-Ebing, and in addition, Fere, Fuchs, Pelofi, and Lombroso.

In addition to these various works, others must be mentioned which have arisen mainly out of the recently awakened interest in the sexual life; for example, works on puberty, the psychology of love, and similar topics. In his Fisiologia del Amore (Physiology of Love), Mantegazza emphasises the love-manifestations of childhood. The same may be said of many other general works on the sexual life, and more especially, as previously mentioned, of works on prostitution. Certain works on offences against morality have also enriched our knowledge in this province.

It might at first sight appear from what has been said that the literature of the sexual life of the child was extremely voluminous, but this is not in reality the case. Almost always, this important question is handled in a casual or cursory manner. A thorough presentation of the subject has not, as far as my knowledge extends, hitherto been attempted. Freud rightly insists that even in all, or nearly all, the works on the psychology of the child, this important department is ignored. Quite recently, indeed, special works have appeared upon the sexual life of the child, among which I must first of all mention Freud's own contribution to the subject, forming part of his Drei Abhandlungen zur sexuellen Theorie (Three Essays on the Sexual Theory, Leipzig and Vienna, 1905).[7] But what this writer describes as an indication of infantile sexuality, viz., certain sucking movements, has, in my opinion, nothing to do with the sexual life of the child—as little to do with sexuality as have the functions of the stomach or any other non-genital organ. A number of other processes occurring in childhood, which Freud and his followers have recently described as sexual in nature, and as playing a great part later in life in connexion with hysteria, neurasthenia, compulsion-neuroses, the anxiety-neurosis, and dementia praecox, have very little true relationship to the sexual life of the child. In any case, Freud has not systematically studied the individual manifestations of the sexual life of the child. I must also mention a small work by Koetscher, Das Erwachen des Geschlechtsbewusstseins und seine Anomalien (The Awakening of the Consciousness of Sex and its Anomalies, Wiesbaden, 1907). Koetscher, however, does not give any detailed account of the sexual life of the child; he starts, rather, from the sexual life of the adult, and only as a supplement to his account of this does he give a few data regarding the awakening of the consciousness of sex. In the American Journal of Psychology, July 1902, we find an elaborate study of the sexual life of the child. In this paper, A Preliminary Study of the Emotion of Love between the Sexes, the writer, Sanford Bell, devotes much attention to the love-sentiments in childhood. He discusses, indeed, only heterosexual, qualitatively normal inclinations, and his essay deals only with the psychological aspects of the question. The processes taking place in the genital organs do not come within the scope of the writer's observations, and, indeed, are outside the limits of his chosen theme. A great many other points connected with the question are also left untouched. None the less, the paper is full of matter. The same must be said of the works of the English investigator, Havelock Ellis, who is, in my opinion, the leader of all those at present engaged in the study of sexual psychology and pathology. Unfortunately his writings are not so well known in Germany as they deserve to be, the reason being that owing to their strictly scientific character they are not so noisily obtruded on the public notice as are certain other widely advertised and reputedly scientific works. In his various books, and above all in his six volumes entitled Studies in the Psychology of Sex (F. A. Davies Company, Philadelphia, Pa.), as a part of his general contributions to our knowledge of the sexual life, Havelock Ellis records numerous observations relating to the years of childhood; especially valuable in this connexion are the biographies given in the third volume of the above-mentioned Studies.

A valuable source of data for our field of inquiry exists in the form of unpublished diaries, autobiographies, and albums, which are not accessible to the general public. I have myself had the opportunity of studying a number of records of this nature, and have formed the opinion that a quantity of invaluable material lies hidden in these recesses. I may add that the records I have been able to use have not only related to living persons; in addition, I have been able to study a number of albums and diaries dating from an earlier day. These have remained unpublished, in part because they appeared to be of interest only to the families of the writers, and in part because many of them were in intention purely private memoranda, a written record for the sole use of the writer.

Speaking generally, however, this province of research has received but little scientific attention; and of comprehensive studies, intended to throw light on every aspect of the sexual life of the child, not a single one is known to me.



Chapter II

THE SEXUAL ORGANS—THE SEXUAL IMPULSE

A proper understanding of physiological functions is based upon anatomical knowledge of the organs concerned. For our purpose, therefore, a knowledge of the sexual organs of the child is essential. The proper course, in this instance, appears to be to start with an account of the adult organs, and then to describe the distinctive characteristics of the same organs in the child. Let us, then, begin with the organs of the adult man.

The membrum virile or penis is visible externally, and behind it is situated the scrotum. Within this latter are two ovoid structures, named testicles or testes. Each testicle is enveloped in a fibrous capsule, known as the tunica albuginea, from which fibrous septa pass into the interior of the organ, thus dividing it into a number of separate lobules. Each lobule is composed of seminiferous tubules, which are greatly convoluted and likewise branched, the branches being continuous with those of neighbouring tubules, both within the same lobule, and (by perforating the fibrous septa) in adjoining lobules. In the walls of the seminiferous tubules the spermatozoa are formed. The seminiferous tubules unite to form the efferent ducts (vasa efferentia), about a dozen in number for each testicle; immediately passing out of the testicle, these efferent ducts make up the epididymis, situated at the upper and back part of the testicle. After numerous convolutions, these unite at length on each side to form a single canal, which leaves the epididymis under the name of the vas deferens; this is the excretory duct of the testicle, conveying the secretion of that organ to the exterior. The vas deferens traverses the inguinal canal into the abdominal cavity, and therein passes downwards to the prostatic portion of the urethra (vide infra). The anterior portion only of the penis is visible externally, dependent in front of the scrotum; the posterior portion is concealed by the scrotum and the skin of the perineum. The terminal segment of the penis is formed by the glans, which is covered by the foreskin or prepuce. This last is sometimes artificially removed: either on ritual grounds, as, for instance, among the Jews; or for medical reasons, for example, when the preputial orifice is greatly constricted. At the anterior extremity of the glans penis is the orifice of the urethra (meatus). The urethra is a canal running through the entire length of the penis, opening by its proximal extremity into the urinary bladder, and serving for the passage of the urine from the bladder to the exterior of the body. The main substance of the penis is composed of three cavernous bodies, the paired corpora cavernosa penis, and the single corpus spongiosum, or corpus cavernosum urethrae. These consist of what is known as erectile tissue, a spongy mass within whose lacunar spaces a large quantity of blood can, in certain conditions, be retained. When this occurs, the penis becomes notably thicker and longer, and simultaneously hard and inflexible. This process is known as erection of the penis, and is requisite to render possible the introduction of the organ into the genital canal of the female.

The proximal segment of the urethra is surrounded by the prostate gland. The secretion of this gland is conveyed into the urethra by numerous short ducts, known as the prostatic ducts. Behind the prostate, at the base or fundus of bladder, are the paired seminal vesicles. The duct of the seminal vesicle joins the vas deferens of the same side (both functionally and embryologically the seminal vesicle is no more than a diverticulum of the vas deferens); passing on under the name of the common seminal or ejaculatory duct, the canal opens into the prostatic portion of the urethra (the orifices of the two common seminal ducts are in the folds of mucous membrane forming the right and left lateral margins of the prostatic utricle or uterus masculinus). These ducts convey the secretion of the testicles into the urethra along which canal it passes to the exterior. Behind the posterior part of the urethra, but distal to the prostate gland, are situate also the paired glands of Cowper, or suburethral glands, whose excretory ducts likewise open into the urethra. There are glands also in the walls of the seminal vesicles, the vasa deferentia, and the urethra; the urethral glands are commonly known as the glands of Littre.

As previously mentioned, it is in the testicles that the secretion necessary for the reproductive act is prepared. This secretion is evacuated during sexual intercourse, and also during masturbation and involuntary seminal emissions. The testicular secretion is a tenacious fluid. When examined microscopically, it is seen to contain countless spermatozoa, structures about 50 [Greek: m] (1/500 inch) in length, with a thick head and a long filiform tail. They represent the male reproductive cells, which during coitus are introduced into the interior of the female reproductive organs; a single spermatozoon unites with the ovum of the female to form the fertilised ovum. The spermatozoa are formed in the walls of the convoluted seminiferous tubules. The cells lining these tubules are of several different kinds (although in childhood they are not differentiated as they are after the puberal development has taken place). One variety of these cells, the spermatogonia, undergo an increase of size at puberty, and from these spermatogonia, after passing through several intermediate transitional stages, the spermatozoa are formed.

It was formerly believed that the sole function of the testicles was the production of the spermatozoa; recently, however, the opinion has gained ground that these organs have in addition another specific function, that of internal secretion. Whilst the spermatogonia become transformed into spermatozoa, other cellular structures of the testicle, more especially the interstitial cells, produce, it is assumed, the internal secretion of the gland. The constituents of this internal secretion, having been poured into the general circulation, are supposed to give rise to the specific masculine sexual development, and, in particular, to lead to the appearance of the secondary sexual characters. This matter will subsequently be discussed in detail, and here I shall merely add that perhaps none of the proper constituents of the internal secretion find their way into the external secretion of the testicle.

This external secretion of the testicles does, however, receive the admixture of a number of other secretions, to constitute the semen as actually discharged, viz., the secretion of the prostate gland, that of the seminal vesicles, Cowper's glands, and the glands of the vasa deferentia, and perhaps also that of the glands of Littre. The term semen is, indeed, often applied to the secretion of the testicles alone; but to avoid misunderstanding, Fuerbringer[8] recommends that only the mixed secretion, as actually discharged, should be spoken of as the semen, and that this term should never be employed to denote the testicular secretion alone.

In what has gone before, I have not only described the structure of the male sexual organs, but have alluded also in passing to their functions. These latter must, however, be described more fully. Let us begin with erection, which, as we saw, is due to distension of the penis with blood. How is this distension brought about? It results from stimulation of the erection centre. Until recently, it was supposed that this centre was situated in the lumbar enlargement of the spinal cord; but now, owing to the researches of L. R. Mueller, it is believed to form part of the sympathetic plexuses of the pelvis. Stimulation of the centre leads to distension of the penis with blood, and thus to erection of that organ. The stimulation of the centre can be effected in either of two ways.

In the first place, by psychical processes. Thus, in a man, the sight of a woman exercises such a stimulus, the stimulation proceeding from the brain along the spinal cord to reach the centre. The psychical stimulus may also consist of reminiscences. In this way the memory of an attractive woman may be just as effective in causing erection as if she were actually visible at the moment; reading erotic literature may have the same result. When the sexual impulse is perverted, the ideas causing erection will naturally be themselves of a perverse character. Thus, in the homosexual male, erection occurs at the sight or remembrance of a man; in the fetichist, the idea of the fetich is operative—in the case of the body-linen fetichist, for instance, the idea of articles of underclothing.

In the second place, the activity of the erection centre can be aroused by physical stimuli. To this category belong masturbatory manipulations, stimulation of the glans penis and other parts of the genital organs. But other erogenic areas exist, the stimulation of which produces the same results. Among these areas, the buttocks must be particularly mentioned. But individual peculiarities play a great part in this connexion. Thus, in many persons, a slight stimulation of the nape of the neck, of the scalp, &c., has an erogenic effect. In all cases alike, the stimulus is conducted along the sensory nerves to the erection centre, and it is the stimulation of this centre which by reflex action leads to distension of the penis with blood and its consequent erection. The physical stimulus leading to erection may also result from some pathological process, such as inflammation of the penis or of the urethra. Finally, certain internal physiological processes may be the starting-point of the afferent physical stimuli leading to erection; for example, distension of the bladder, and also of the seminal vesicles, and of the seminiferous tubules of the testicle. In addition, it is probable that many of the processes of growth occurring in the reproductive glands act in a similar way. These internal stimuli all pass to the erection centre along the afferent (sensory) nerves, and induce erection by reflex action; and it is important to bear in mind that this effect may result without any direct affection of consciousness by the originating afferent impulses.

Although either kind of stimuli, psychical or physical, acting alone, may give rise to erection, experience shows that in most instances the two varieties co-operate in the production of this effect. Thus, in the sexually mature man, the accumulation of semen in the seminal vesicles gives rise, not only to excitement of the erection centre, but also to voluptuous ideas, and these latter, in their turn, further stimulate the erection centre.

Normally, during coitus, erection is followed by ejaculation. A special nerve centre for ejaculation is also supposed to exist; and the ejaculation centre, like the erection centre, was formerly believed to be situated in the lumbar enlargement of the spinal cord, but recent investigations have shown that it also most probably forms part of the sympathetic plexuses of the pelvis. This centre also may be stimulated either by psychical or by physical stimuli. In normal conditions, however, much more powerful stimuli are needed to cause ejaculation than those which are competent to give rise to erection. For this reason, erections often occur without leading to ejaculation, whereas in normal conditions ejaculation hardly ever occurs without erection. In fact, ejaculation in the absence of erection is almost peculiar to pathological states, and may occur, for instance, in many forms of impotence, in which the ejaculation centre still remains susceptible to stimulation, whilst the erection centre is exhausted. Whereas stimulation of the erection centre exercises its reflex influence through the vasomotor nerves, thus leading to distension of the penis with blood, the reflex impulses resulting from stimulation of the ejaculation centre are transmitted by the motor nerves to certain muscles—those, namely, whose contraction forcibly expels the accumulated semen. The contractions of the affected muscles occur rhythmically, the stimulation of the ejaculation centre giving rise to a series of contractions alternating with relaxations. True ejaculation, resulting from the activity of these muscles, must be distinguished from the appearance of a drop or two of fluid at the urethral meatus, which occasionally occurs at the outset of sexual excitement—the so-called urethrorrhoea ex libidine. This fluid runs out while the ejaculatory muscles are quiescent. It was formerly believed that it consisted of the secretion of the prostate gland; but Fuerbringer, to whom we are indebted for the most valuable researches in this province, has shown that this view is erroneous. These drops are, he states, derived solely from the glands of Littre and the glands of Cowper (urethral and suburethral glands).

Sexual excitement is accompanied throughout by a sensation of pleasure, specifically known as voluptuous pleasure, the voluptuous sensation, or simply voluptuousness (in Latin, libido sexualis). Several stages of the voluptuous sensation must be distinguished: its onset; the equable voluptuous sensation; the voluptuous acme, coincident with the rhythmical contraction of the perineal muscles and the ejaculation of the semen; and, finally, the quite sudden diminution and cessation of the voluptuous sensation. Associated with the last stage we usually have a sense of satisfaction, and simultaneously a cessation of the sexual impulse; a sense of ease and calm ensues, and at the same time a feeling of fatigue. This voluptuous sensation localised in the genital organs must, of course, be distinguished from the general sense of pleasure produced in a man by the idea of, or by contact with, a woman in whom he is sexually interested.

Now let us pass on to the consideration of the reproductive organs in the female. The most conspicuous part of the external genital organs consists of two large folds, situated on either side of the median line, and known as the labia majora. Within these are two much smaller folds, the labia minora or nymphae. In the median line, in the space between the labia minora, we see two apertures: the anterior of these is the urethral orifice (meatus), from which the comparatively short and almost straight urethra of the female passes upwards and backwards to the bladder; the posterior aperture is the vaginal orifice. The labia minora, divergent posteriorly, converge as they pass forwards like the limbs of a V; at the apex of the V is the clitoris; in shape and structure this resembles the penis of the male, but it is much smaller, and is solid, not being perforated by the urethra. It contains two corpora cavernosa, which unite to form the body of the organ, whilst the distal extremity is known as the glans, and is homologous to the glans penis. Posteriorly to the clitoris, and beneath the mucous membrane on either side, is an additional mass of erectile tissue, known as the vaginal bulb, or bulb of the vestibule. Just outside the vaginal orifice on either side are visible the orifices of the ducts of Bartholin's glands (known also as Duverney's glands); these are homologous with Cowper's glands in the male.

When we attempt to pass from the vaginal orifice to the internal reproductive organs, we find that in the virgin an obstacle exists, the hymen or maidenhead, consisting of a duplicature of the mucous membrane. It is very variable in form, but in the great majority of instances it diminishes the size of the vaginal inlet to such an extent as to render coitus impossible until the hymen has been torn. Through the vaginal orifice access is gained to the interior of the vagina, a tubular structure, but flattened from before backwards, so that in the quiescent state the anterior and posterior walls of the passage are in apposition. The uterus or womb is a muscular, pear-shaped organ, with an elongated central cavity, which opens into the upper part of the vagina. At the upper end of the cavity of the uterus are two small laterally placed apertures, which lead into the Fallopian tubes (or oviducts). These tubes pass outwards in a somewhat sinuous course towards the ovaries, the reproductive glands of the female, homologous with the testicles in the male, and situated on either side of the upper extremity of the uterus. The shape of the ovaries is somewhat ovoid. They contain a large number of vesicular structures, the ovarian follicles, the largest, ripe follicles being known as Graafian follicles, whilst the smaller, partially developed follicles are termed primitive ovarian follicles, or primitive Graafian follicles. In the interior of each follicle is an ovum. In the sexually mature woman, a Graafian follicle ripens at regular intervals of four weeks. When ripe, the follicle bursts, the ovum is expelled, and passes through the Fallopian tube into the interior of the uterus: here it is either fertilised by uniting with a spermatozoon derived from the male, in which case it proceeds to develop into an embryo; or else it remains unfertilised, in which case it is shortly expelled from the body.

In the uterus, as well as in the ovaries, an important change occurs at intervals of four weeks, characterised by an increased flow of blood to the organ, culminating in an actual outflow of blood from the vessels into the uterine cavity, and thence through the vagina to the exterior of the body; the whole process is known as menstruation, the monthly sickness or the (monthly) period. After the fertilisation of the ovum, during pregnancy, that is to say, menstruation usually ceases until after the birth of the child, and often until the completion of lactation.

I do not propose to discuss here the nature of the connexion between these periodic processes in the ovaries and the uterus, respectively—that is, between ovulation and menstruation. I shall, however, take this opportunity of stating that, as careful investigations have shown, the periodic processes in question are not limited to the uterus and the ovaries, but affect also the external genital organs, which become congested simultaneously with menstruation; and further, that the entire feminine organism is affected by an undulatory rhythm of nutrition, the rise and fall of which correspond to menstruation and to the intermenstrual interval, respectively.

I must now give some account of the peripheral processes occurring in the female genital organs in connexion with the sexual act. In part, they are completely analogous to those which take place in the male. I have already pointed out that in many respects the clitoris in the female corresponds to the penis in the male, In the clitoris, also, erection occurs, conditioned partly by psychical and partly by physical stimuli. The psychical stimuli consist of ideas relating to the male. The physical stimuli may, just as in the case of the other sex, vary in their nature. Thus, the condition of the reproductive glands may act as a physical stimulus to erection; also the touching of certain regions of the body, especially the clitoris, the labia minora, or other erogenic zones. Under the influence of such stimuli, the venus plexuses making up the vaginal bulbs also become distended with blood. In fact, speaking generally, sexual excitement is characterised by a vigorous flow of blood to the genital organs. During coitus, in woman, as in man, a process of ejaculation normally occurs, taking the form of rhythmical muscular contractions, affecting not only the perineal muscles, but also the muscular investment of the vagina, and occasionally, perhaps, the uterus itself. These muscular contractions also favour the expulsion of a secretion, but this secretion does not contain the reproductive cells of the female, and consists merely of a mixture of indifferent secretions—the secretion of Bartholin's glands, that of the uterine mucous membrane, and that of the mucous glands of the vagina and vulva. In the woman also, even at the outset of the sexual act, a secretion from the local glands takes place, whereby the genital region is moistened prior to the actual orgasm. We have as yet no precise knowledge as to which glands are concerned in the production of this phenomenon, which is homologous to the urethrorrhaea ex libidine of the male. In woman, as in man, the curve of voluptuousness exhibits four phases: an ascending limb, the equable voluptuous sensation, the acme, and the rapid decline. There are, however, in this respect, certain differences between man and woman, to which von Krafft-Ebing drew attention, and whose existence was confirmed by Otto Alder.[9] Whereas in the male the curve of voluptuousness both rises and falls with extreme abruptness, in the female both the onset and the decline of voluptuous sensation are slower and more gradual. There is an additional difference between man and woman. In woman very often voluptuous pleasure is entirely lacking; certainly such absence is far commoner in women than in men—a condition of affairs which must on no account be confused with absence of the sexual impulse. Even when the sexual impulse is perfectly normal, the entire voluptuous curve with its acme may be wanting. In such cases, the after-sense of complete satisfaction, which occurs more especially when ejaculation has been associated with an extremity of voluptuous pleasure, it is commonly also lacking. Finally, it is necessary to add that in woman, as in man, the reproductive glands appear to have a duplex function—such is, at least, the belief to which recent investigations more and more definitely point. The ovaries, that is to say, do not only produce ova; they also, like the testicles, furnish an internal secretion, and the absorption and distribution of this secretion by the blood are supposed to cause the development of the secondary sexual characters in woman.

Having now concluded our account of the structure and functions of the productive organs of adults, let us turn to consider the differences between these organs and those of children. In the child, the testicles are considerably smaller; smaller also are the penis and the other genital organs. In the adult, the root of the penis is surrounded by the pubic hair; this hair is absent in the child. The most important distinctive characteristic, however, lies in the fact that in the child the morphological elements upon which the capacity for procreation depends, namely, the spermatozoa, are not yet present in the testicles. The spermatozoa first make their appearance during that year of life which is usually regarded as the year of the puberal development. The microscopical appearances of the testicle, of which an account has previously been given, thus naturally differ according as the specimen under examination has been taken from a child or from an adult. As regards the other glands considered to form part of the genital organs, some of these secrete even in childhood. This matter will be subsequently discussed in some detail.

In the female sex, also, there are notable differences in the condition of the genital organs between the adult and the child. In the first place, the relative sizes of the various organs differ greatly. But other differences are also noticeable, not dependent, however, on differences in age, but on whether there has or has not been experience of sexual intercourse, and on whether pregnancy and parturition have occurred. When we compare a female child with an adult woman, the first obvious difference is in the shape of the external genital organs. In the child, the vulva is placed much higher and more to the front, so that it is distinctly visible even when the thighs are in close apposition. In the child, also, the labia majora are less developed, for as womanhood approaches a great deposit of fat takes place in these structures. Again, in the child, the outer surfaces of the labia majora and that part of the skin of the abdomen just in front of the labia (the mons veneris) are as hairless as the rest of the body, whereas in the adult woman these regions are covered with the pubic hair. According to Marthe Francillon,[10] to whom we are indebted for an elaborate study of puberty in the female sex, during the puberal development changes occur also in the clitoris. The genital corpuscles of Krause and the corpuscles of Finger (Wollustkoerperchen), the terminals of the nerves passing to the erectile tissue of the clitoris, undergo at this time a marked increase in size. The clitoris itself, hitherto comparatively small, now attains a length of three to four centimetres (1.2 to 1.6 inch), in the quiescent state, and of four and a half to five centimetres (1.8 to 2 inches) when erect. In the virgin also, as previously mentioned, the hymen is present, a structure of very variable form. After defloration its remnants persist in the form of small prominences around the margin of the vaginal inlet (carunculae myrtiformes). But, quite independently of defloration, in the child the vaginal orifice is much smaller than in the riper girl. The uterus undergoes remarkable changes. In the foetus, during the latter part of intra-uterine life, this organ grows very rapidly; but immediately after birth its growth is arrested, so that in a girl of nine it is little larger than in the new-born infant. During the period of puberal development, however, the growth of the organ is once more extremely rapid. Its shape also changes at this time. In the child, the uterus is longer in proportion to its thickness; in childhood, too, the comparative length of the cervix in relation to that of the body of the organ is much greater than in the adult woman. We need only allude in passing to the fact that later in life marked changes occur in the uterus as a result of pregnancy and parturition. The hyperaemia and the bleeding that take place periodically during menstruation lead to certain changes in the mucous surface of the uterus. Ovulation, which in the sexually mature woman recurs at four-weekly intervals, also gives rise to certain permanent changes in the ovaries. The site of each ruptured Graafian follicle becomes cicatrised, and in consequence of the formation of these little scars, the ovary no longer retains the smoothness of surface which was characteristic of the organ in childhood. From birth onwards the ovaries gradually increase in size, but the growth is disproportionate in different diameters. Thus, for instance, during the eighth year of life, growth is chiefly in thickness, so that the ratio between the length and the thickness becomes less than before. The structure of the ovaries also varies at different ages. In a girl of three years, the primitive ovarian follicles number about 400,000; at the age of eight it is estimated that their number has been reduced to about 36,000. Certainly the majority of the primitive follicles come to nothing. True Graafian follicles, of which an account has already been given, are not usually formed prior to the beginning of the puberal development; occasionally, however, they are formed in the ovaries of immature girls.

Let us now pass to the consideration of the sexual impulse. We learn from personal observation that two entirely distinct processes participate in this impulse. In the first place, we have the physical processes that take place in the genital organs; these are in part unperceived, but in part they affect consciousness in the form of common sensations, or as ordinary tactile and other similar sensations. In the second place, we have those higher psychical processes by means of which man is attracted to woman, and woman to man. In our actual experience of the normal sexual life, both these groups of processes do, as a matter of fact, work in unison; but not only is it possible for us to distinguish them analytically; it is, in addition, possible in many instances to observe them in action clinically isolated each from the other. A long while ago I utilised this distinction for the analysis of the sexual impulse, describing the impulse in so far as it was confined to the peripheral organs as the detumescence-impulse (from detumescere, to decrease in size), and in so far as it takes the form of processes tending towards bodily and mental approximation to another individual, as the contrectation-impulse (from contrectare to touch, or to think about). The distinction will become clearer to our minds if we familiarise ourselves first with cases in which either process occurs independently of the other. The detumescence-impulse is sometimes the sole manifestation of the sexual impulse. Certain idiots practise masturbation as a physical act, because sensations proceeding from the genital organs impel them to do so, precisely as itching of an area of the skin impels us to scratch. They masturbate without thinking of another person, and they feel no impulsion whatever towards sexual contact with another person. Analogous phenomena may be witnessed in the animal world also, in connexion with the masturbatory acts of monkeys, bulls, and stallions. When a stallion kicks its genital organs again and again with its hind-foot, and repeats the action until ejaculation ensues, we are hardly justified in assuming that the animal has the idea of a mare before its mind. We must rather suppose that we have to do with a local physical stimulus, to which the stallion reacts in the manner above described. The other component, also, of the sexual impulse, the contrectation-impulse, manifests itself, occasionally, at any rate, in isolation. Certain boys, long before the appearance of any signs of the puberal development, are impelled towards physical contact with members of the other sex, to kiss them, to think of them, although these boys may exhibit no tendency whatever to masturbate, or to manipulate their genital organs. It often happens, indeed, that such a boy is himself greatly astonished to find, some day, that these ideas are reflected to the genital organs, giving rise to erection; or, when he is embracing a girl, to experience erection and ejaculation. In the sexually mature normal man, the detumescence-impulse and the contrectation-impulse act in unison, and hence he is impelled towards intimate contact with the woman, and is ultimately driven to effect detumescence by the practice of coitus. Nevertheless, we must hold fast to the idea that in the normal adult man the sexual processes may also be theoretically analysed into these two components.

This is true also of woman, in whom the processes in the genital organs are equally separable from those which impel to contact with a member of the other sex. But in woman, the processes in the genital organs do not culminate in the ejection of the reproductive cells, that is, of the ovum, but, as we have seen, in the ejaculation of indifferent secretions. In the woman, also, the detumescence impulse is occasionally met with in isolation—for example, in many female idiots. In the animal world, too, we encounter it as an isolated phenomenon. Certain mares, when rutting, rub their hind quarters against some object in their stalls. The contrectation-impulse may also manifest itself in isolation in woman. It is then directed towards the male, but is not in any way associated with the wish for a definite sexual act. Most commonly, however, in woman also the two components of the sexual impulse are united, and from this union results the impulsion towards coitus. But to this extent the conditions in woman are apt to differ from those in man, inasmuch as, in the former, voluptuous sensations are more often in abeyance; or in woman voluptuous pleasure may not arise during coitus, but may be produced in some other way, as, for instance, by a masturbatory act.

The sexual impulse, and indeed either of its components, may be excited either by bodily or by mental stimuli; but we must always bear in mind the fact that in normal adults, both male and female, the two components are so intimately associated that they can as a rule be separated only by artificial analysis. The nature and mode of operation of the stimuli need not be further discussed, since enough has been said about the matter in our description of erection. Nor is it necessary in this place to deal with such differences as may exist between the psychosexual life of the child and that of the adult, since this matter will be fully considered in the fourth chapter. In this chapter my aim has merely been to give a general description of the sexual impulse.

Here I need allude to one more point only, a knowledge of which is indispensable for the understanding of the sexual life of the child, namely, the connexion between the central processes and the peripheral voluptuous sensation. Let us ask, in the first place, by what means the voluptuous sensation, the voluptuous acme, and the sense of satisfaction, are produced. Various factors are here operative. A homosexual man, in heterosexual coitus, by keeping present to his imagination the idea of coitus with a man, may succeed in obtaining erection and ejaculation; but he does not experience the voluptuous acme, nor does he feel the sense of satisfaction. Notwithstanding the fact that the peripheral processes occur in normal fashion, the sense of satisfaction remains in abeyance; because the act is in his case inadequate, the sexual act in which he is engaged lacks harmonious relationship to his sexual impulse. But the same homosexual man, embracing a man with whom he is in full sympathy, will experience alike the voluptuous acme and the sense of satisfaction. Mutatis mutandis, the like is true of woman. Many cases which have been regarded as instances of sexual anaesthesia would appear in quite another light if the woman concerned were to have intercourse with a sexually sympathetic man. I have myself known cases in which women were able to experience the voluptuous acme in intercourse with men whom they earnestly loved, whilst in intercourse with men to whom they were indifferent, the voluptuous sensation and the sense of satisfaction were wanting, even though in some of these cases the peripheral processes culminated in ejaculation. Such a physically complete sexual act, without voluptuous acme or sense of satisfaction, may occur when the woman, having intercourse with a man whom she does not love, pictures in imagination that she is having intercourse with her lover. Unquestionably, the psychical processes are of the greatest importance in contributing to the occurrence of the voluptuous sensation and the sense of satisfaction. On the other hand, of course, certain peripheral conditions must also be fulfilled if the voluptuous acme is to ensue. Among these conditions may be mentioned a certain anatomical state of the skin and the nerves concerned. Experience also shows that in the adult the voluptuous acme coincides with the act of ejaculation. Ejaculation is effected by the rhythmical contraction of certain definite muscles, and Otto Adler believes that it is these contractions which are principally effective in producing the voluptuous acme, and that actual ejaculation is not indispensable. He believes, that is, that the voluptuous acme may occur in the absence of any discharge of actual secretion.

In any case, let us hold fast to the fact that in the adult, for the occurrence of the voluptuous acme and of the sense of full satisfaction, certain central processes are, in general, indispensable.



CHAPTER III

SEXUAL DIFFERENTIATION IN CHILDHOOD

In the previous chapter, I have described the differences between the reproductive organs of men and women, and between those of adults and children, respectively. Man and woman are, however, distinguished one from the other, not only by differences in their reproductive organs, but by other qualities as well, some of these being bodily, others mental. Such distinctive characters are spoken of as secondary sexual characters, in contradistinction to the primary sexual characters, the reproductive organs. Our terminology would, perhaps, be more exact if we were to regard the reproductive glands alone, the testicles and the ovaries, as primary sexual characters; including the rest of the genital organs among the secondary sexual characters. Havelock Ellis[11] distinguishes, in addition to the primary and secondary sexual characters (as commonly defined), tertiary sexual characters, by which he denotes those differences between the sexes which do not attract our attention when we compare individual members of the two sexes, but which become noticeable when we compare the average male with the average female type. Among such tertiary sexual characters may be mentioned the comparatively flatter skull, the greater size and activity of the thyroid gland, and the lesser corpuscular richness of the blood, in women. Especially distinct are the secondary sexual characters in respect of general bodily structure. The form of the skeleton is different in the two sexes. Thus, in woman the pelvis is wider and shallower than in man. In the hair also there are notable differences: in woman the hair of the head tends to grow much longer, and woman is much less liable than man to premature baldness; the beard, on the other hand, is a masculine peculiarity. In woman the breasts attain a much greater development. The larynx is in man more prominent and longer; in woman it is wider and shallower. Woman's skin is more delicate than man's. And so on.

Now what have we to say regarding these sexual differences in the case of children? During the age which we have defined as the first period of childhood, except in the matter of the genital organs, we can detect hardly any important bodily characters distinguishing the sexes. Still, even at this early age some differences have been recorded. Thus, the average weight of new-born girls is less than that of new-born boys, the figures given by Stratz[12] being, for boys, 3500 grams (7.7 lbs.); for girls, 3250 grams (7.15 lbs.). According to a very large number of measurements, the mean length of the new-born girl is somewhat less than that of the new-born boy, the difference amounting to nearly 1 cm. (2/5ths inch). Craniometric records, taken at the end of the first period of childhood, exhibit differences between the sexes; in general, the measurements show that the girl's head is smaller than the boy's in respect both of length and breadth. Further, dynamometric records, taken from children six years of age, have shown that the grasp in girls is less powerful than in boys. But if we except such differences as these, which relate rather to averages than to individuals, and which, moreover, are for the most part demonstrable only during the latter part of the first period of childhood, we find that, apart from the reproductive organs, very little difference between the sexes can be detected during the first years of life. Many investigators have been unable to confirm the assertion that even in the first year of life the hips are more powerfully developed in girls than in boys. Fehling,[13] however, declares that as early as the fifth month of intra-uterine life, sexual differences manifest themselves in the formation of the pelvis. However this may be, it is beyond question that during the earlier years of the first period of childhood the differences between the sexes are comparatively trifling. But towards the end of this period, sexual differentiation becomes more marked. According to Stratz, it is at this time that the characteristic form of the lower half of the body develops. The thighs and the hips of the young girl exhibit a somewhat more marked deposit of fat than is seen in the boy of the same age. To a lesser extent the same is true of the calves. It is often assumed that even in very early childhood the sexes can be distinguished by the formation of the face. The girl's face is said to be rounder and fuller than the boy's; the expression of countenance in the former, to be more bashful and modest. Stratz, however, urges in opposition to this view, with justice, in my opinion, that we have here to do only with the effects of individual educational influences, or perhaps with individual variations, from which no general conclusions can safely be drawn.

During the second period of childhood sexual differences become much more distinct. Before considering these differences, I must say a few words regarding the growth of the child, since in this particular there exists a notable distinction between the sexes. Careful measurements have shown that during certain years of childhood growth occurs especially in height, whereas in other years the main increase is in girth. For this reason, it is customary to follow Bartels in his subdivision of each of the two periods of childhood into two subperiods. The age from one to four years is the first period of growth in girth; from the beginning of the fifth to the completion of the seventh year is the first period of growth in height; from the beginning of the eighth to the completion of the tenth year is the second period of growth in girth; and from the beginning of the eleventh to the completion of the fourteenth year is the second period of growth in height. During these periods there are certain differences in respect of growth between boys and girls. Although in general the growth in height of the boy exceeds that of the girl, there is a certain period during which the average height of girls is greater than that of boys. From the beginning of the eleventh year onwards, the girl grows in height so much more rapidly than the boy, that from this age until the beginning of the fifteenth year the average height of girls exceeds that of boys, although at all other ages the reverse is the case. In our consideration of the differences between the sexes, these differences in respect of growth must not be overlooked.

In addition to these, other important differences between the sexes manifest themselves during the second period of childhood. In the first place, it is an established fact that in the girl the secondary sexual characters make their appearance earlier than in the boy, the boy remaining longer in the comparatively neutral condition of childhood. We have seen that in the girl, at the end of the first period of childhood, the lower half of the body begins to resemble that of the woman in type. During the second period of childhood, this peculiarity becomes more marked; the pelvis and the hips widen, the thighs and the buttocks become more and more rounded; the enduring feminine characteristics in these respects are acquired. More gradually, the feminine development of the upper half of the body succeeds that of the lower; the transition from the lower jaw to the neck become less abrupt, and the face becomes fuller. The sexual difference in the growth of the hair also manifests itself in childhood. Whether cut or uncut, the girl's hair tends to grow longer than the boy's. Later, the typical development of the breasts occurs. As early as the beginning of the second period of childhood, the surface of the areola mammae may become slightly raised; but the typical deposit of fat, leading to the hemispherical prominence of the breast, does not begin until towards the close of the second period of childhood. Even later than this is the growth of the axillary and pubic hair. Various answers are given to the question as to the relation in time between the appearance of menstruation and the development of the sexual characters just described. Unquestionably there are great differences in this respect. Whereas Axel Key declared that the secondary sexual characters appeared before the first menstruation, according to C. H. Stratz this is true only of girls belonging to the lower classes; whilst according to his own observations on girls belonging to the upper classes of society, the first menstruation precedes the development of the breasts and the growth of the pubic and axillary hair.