THE SEXUAL LIFE OF WOMAN IN ITS PHYSIOLOGICAL, PATHOLOGICAL AND HYGIENIC ASPECTS
BY
E. HEINRICH KISCH, M. D.
Professor of the German Medical Faculty of the University of Prague; Physician to the Hospital and Spa of Marienbad; Member of the Board of Health, Etc., Etc.
ONLY AUTHORIZED TRANSLATION INTO THE ENGLISH LANGUAGE FROM THE GERMAN BY
M. EDEN PAUL, M. D.
WITH 97 ILLUSTRATIONS IN THE TEXT
NEW YORK REBMAN COMPANY 1123 BROADWAY
COPYRIGHT, 1910, BY REBMAN CO., NEW YORK
ALL RIGHTS RESERVED
Printed in America
TO MY ONLY SON
FRANZ KISCH, M. D.
AS A TOKEN OF PATERNAL AFFECTION
I DEDICATE THIS BOOK
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PREFACE.
The sexual life of woman—the appearance of the first indications of sexual activity, the development of that activity and its culmination in sexual maturity, the decline of that activity and its ultimate extinction in sexual death—the entire process of the most perfect work of natural creation—has throughout all ages kindled the inspiration of poets, aroused the enthusiasm of artists, and supplied thinkers with inexhaustible material for reflection.
In the following pages, this sexual life of woman will be considered both in relation to the female genital organs, and in relation to the feminine organism as a whole; in relation both to the physical and to the mental development of the individual; and in relation alike to the state of health and to the processes of disease. Thus from the standpoint of clinical investigation and of practical experience, the book will be a contribution towards the solution of the sexual problem, nowadays recognized as one of supreme importance.
It is thirty years since I published a work on the histological changes that occur in the ovaries during the climacteric period (Archiv. für Gynecologie, Vol. xii, Section 3); and ever since that time, the influence exerted upon the general health of women by the physiological and pathological processes occurring in their reproductive organs, has been to me a favourite subject for observation and experiment. The result of these studies is incorporated in my monographs, “The Climacteric Period in Women” (Erlangen, 1874), “Sterility in Women” (2nd Ed., Vienna, 1895), “The Uterus and the Heart” (Leipzig, 1898), and in various contributions to medical periodicals. I now have a welcome opportunity of drawing a general picture of sexual activity in women, and of illuminating this picture both by the light of my own experience and by numerous references to the works of other authors. In passing, I have devoted considerable attention to questions of education and personal hygiene, both of which are greatly influenced by the processes of the sexual life. Thus, I hope, the work will be rendered more interesting to the physician, and the general picture it is intended to convey will be more fully characterized by contemporary actuality.
Natural divisions of the subject are, I consider, furnished by the three great landmarks of the sexual life of woman: the onset of menstruation—the menarche: the culmination of sexual activity—the menacme; and the cessation of menstruation—the menopause. These several sexual epochs are differentiated by characteristic anatomical states of the reproductive organs, by the external configuration of the feminine body, by functional effects throughout the entire organism, and, finally, by pathological disturbances of the normal vital processes.
Thus in separate chapters a description is given of sexual processes, a detailed exposition of which will be vainly sought in the textbooks of gynecology, yet which are none the less of far-reaching importance in relation to the physical, mental, and social well-being of women, and in relation also to the development of human society; such topics are, the sexual impulse, copulation, fertility, sterility, the employment of means for the prevention of conception, the determination of sex, sexual hygiene. To the topics of pregnancy, parturition, lying-in, and lactation, since these are adequately discussed in works on midwifery, but little space has here been allotted.
It is my earnest hope that physicians and biologists may derive benefit from the book equal in amount to the pleasure I have gained in the work of writing it.
E. HEINRICH KISCH.
TABLE OF CONTENTS.
PAGE THE SEXUAL LIFE OF WOMAN—Introduction 1
I. THE SEXUAL EPOCH OF THE MENARCHE 37
First Appearance of Menstruation 45
Anatomical Changes in the Female Genital Organs at the Period of the Menarche 50
Menarche Praecox et Tardiva 78 Precocious and Retarded Menstrual Activity 78
Pathology of the Menarche 82 Anomalies of Menstruation 83 Inflammatory Processes 87 Disorders of Haematopoiesis 89 Cardiac Disorders 94 Diseases of the Nervous System 99 Masturbation 104 Disorders of Digestion 107 Diseases of the Respiratory Organs 107 Diseases of the Organs of the Senses 108 Hygiene during the Menarche 111 Menstruation 128 Pathology of Menstruation 143 Amenorrhœa, Menorrhagia, and Dysmenorrhœa 160 Vicarious Menstruation 164
The Sexual Impulse 166
Nymphomania, Anæsthesia and Psychopathia Sexualis 184
II. THE SEXUAL EPOCH OF THE MENACME 200
Anatomical Changes in the Female Genital Organs in the Period of the Menacme 209
Pathology of the Menacme 218 Dyspepsia Uterina 227 Cardiopathia Uterina 235 Nervous Diseases Secondary to Diseases of the Genital Organs 243
Competence for Marriage of Women suffering from Disease 250
Hygiene during the Menacme 261
Copulation and Conception 284 Copulation 284 Conception 304 Pathology of Copulation 323 Vaginismus 337 Cardiac Troubles Due to Sexual Intercourse 344 Dyspareunia 347
Fertility in Women 363 The Restriction of Fertility and the Use of Means for the Prevention of Pregnancy 388
The Determination of Sex 420 I. Statistical Investigations 422 II. Anatomical Investigations 446 III. Experimental Investigations 452
Sterility in Women 462 Incapacity for Ovulation 470 Interference with Conjugation, Conditions Preventing Access of the Spermatozoa to the Ovum 487 Diseases of the Ovaries and the Fallopian Tubes 489 Diseases of the Uterus 494 Pathological Changes in the Cervix Uteri 501 Displacements of the Uterus 515 Myoma of the Uterus 523 Diseases of the Vagina and the Vulva 526 Secretions of the Genital Organs 528 A. Absolute 540 B. Relative Sterility 540 Sexual Sensibility in Women 542 Incapacity for Incubation of the Ovum 549 Only-Child-Sterility 561 Operative Sterility 563 Table Showing the Causes of Sterility in Women 569
III. THE SEXUAL EPOCH OF THE MENOPAUSE 571
The Menopause 571
Changes in the Female Reproductive Organs at the Menopause 583
The Time of the Menopause 593
The Age at which the Menopause occurs 593 1. Race 594 2. The Age at which the Menarche Occurred 595 3. The Woman’s Sexual Activity 597 4. The Social Circumstances of the Woman’s Life 599 5. General Constitutional and Pathological Conditions 599 6. Premature, Delayed, and Sudden Onset of the Menopause 600