"Standing, with reluctant feet, Where the brook and river meet, Womanhood and childhood fleet! "Gazing, with a timid glance, On the brooklet's swift advance, On the river's broad expanse!"
The considerations put forward in this chapter show us how necessary it was to explain the conception of puberty at the very outset of this work. If the period of the puberal development be understood to correspond to the development and ripening of the sexual life, we see that this development begins much earlier than is commonly assumed in books on the subject. Writers have been too ready to identify with this developmental period the appearance of certain external manifestations, more especially the growth of the pubic hair in both sexes, the development of the breasts in the female, and the breaking of the voice in the male; and the appearance of certain definite outward signs—in the girl, the first menstruation, and in the boy, the first ejaculation—has usually been regarded as marking a turning-point in this development. But neither in the boy is the occurrence of the first ejaculation a proof of capacity for reproduction, or a proof that the period of the puberal development is completed; nor in the girl is the occurrence of the first menstruation, which may long precede the establishment of the far more important function of ovulation, characteristic in either of these respects. Observations made on children, accounts given by children and memories of childhood, and the results of castration (and oöphorectomy),[52] all combine to prove the occurrence of sexual processes during childhood, at least as early as the beginning of the second period of childhood. At this time of life, the psychosexual in especial often plays a great part. If, notwithstanding all these facts, anyone desires to associate the beginning or the end of the puberal development, as was formerly done, with the appearance of "the external signs of puberty," no one can prevent this usage. But the scientific investigator, the physician, the schoolmaster, and the parents, should all alike fully understand that such external processes comprise but a small part of all that constitutes pubescence. A straining of terminology may at times be permissible; but on no account must we allow currency to so disastrous an error as the belief that the sexual life of the child either begins or is completed with the appearance of these external signs. The sexual life of the child begins long before, and the puberal development is not completed till many years after, the appearance of these external signs, which by most people are erroneously regarded as typical of pubescence.
Although I have detailed a number of phenomena characteristic of the sexual life of the child, it must not be assumed that these phenomena are common to all cases, or that every individual symptom is invariably observed. As I have previously explained, numerous exceptions occur. In some instances, only one symptom is discernible; in others, another only. The commonest early manifestations of the sexual life in childhood are, as was said before, the psychosexual phenomena. Frequently, the individual symptoms are so faintly marked that they can be detected only by a very thorough and careful examination. I wish merely to insist upon the fact that during the years of childhood which are commonly regarded as asexual, manifestations of the sexual life can with care almost always be detected, although at times their detection is by no means easy.
In conclusion, however, it is necessary to point out that there are a certain number of children in whom up to the fourteenth year of life, and even later, manifestations of the sexual life are hardly discernible; but we have to remember that the results of castration prove, as has been shown above, that even when, in early life, the occurrence of sexual processes cannot be demonstrated, such processes are nevertheless going on. We meet with individuals in whom, even during the first years of youth, the development of the sexual life is extremely backward. There are boys of fifteen or sixteen who from time to time have an involuntary seminal emission, but who exhibit no other indications whatever of an active sexual life—neither masturbation, nor any discernible psychosexual processes. Nevertheless, in most cases of this kind, more careful observation will bring to light much, besides the occurrence of the involuntary seminal emissions, which points to an awakening of sexuality. Still, in some individuals, it is remarkable how long entire sexual innocence may persist. This is doubtless due in such cases, not to any specially rigorous natural virtue, but simply to the fact that in these cases sexual development is much slower than the average. Those concerned are thus devoid of all understanding of the sexual, just in the same way as persons born blind lack all understanding of colour. In most of the cases in which such retardation occurs, the sexual life subsequently becomes entirely normal, showing that the only abnormality was the exceptional delay in the occurrence of the various processes. I have myself seen a number of cases in which the development of the sexual life was delayed to such an extent that ejaculation during coitus was not effected until towards the end of the third decade of life, although erections, and even occasional nocturnal emissions, had occurred long before. I believe that cases of this kind are to a small extent only, if at all, the result of educational influences, and they are in no way dependent upon the so-called sexual neurasthenia; we are concerned simply with a retardation of development, dependent upon congenital predisposition.
CHAPTER V
PATHOLOGY
In the previous chapters I have from time to time mentioned some phenomenon of comparatively rare occurrence; but for the most part I have described those processes only which are regularly met with, which cannot be regarded as exceptional peculiarities, and therefore must not be considered to be pathological manifestations. It is true that much that has been described comes within the province of the pathological; for example, many of the active manifestations of the sexual impulse occurring during the first period of childhood, such as the case quoted from Féré on page 81. For practical reasons, however, such cases as this cannot always be dealt with as members of a distinct pathological group. On the other hand, it is necessary to give a separate consideration to the pathological aspect of our subject. Many of the cases which must be grouped as pathological occur in girls. Thus, we meet with cases in which menstruation becomes established at the age of eight, five, two, or even earlier.[53] Carus reports the case of a woman whose medical history showed that she had begun to menstruate at the age of two years, and that she became pregnant for the first time when eight years old. In girls from ten to twelve years of age, pregnancy has many times been observed. A French physician had under observation a girl who when only three mouths old had well-developed breasts, and in whom only a little later the pubic and axillary hair grew and menstruation began. When twenty-seven months old, the child was again seen by the same physician, and at this time menstruation was proceeding regularly; the features had now lost the infantile type, and the body as a whole exhibited all the signs of premature development. A collection of cases made by Gebhard[54] contains one case in which menstruation was established at birth; in quite a number of the cases menstruation began during the first year of life.