This lack of orgasm may also happen in normal women. The woman is generally slower to reach the height of the venereal paroxysm than the man. Ab initio commixtionis, she experiences a certain degree of libido that is of greater intensity than that of the man, i. e., the ant-orgastic libido is of higher value in women than in men. But this libido is not developed to its utmost extent, the orgasm, as rapidly as it is with the man. Still in the normal woman normal conditions will finally ensue after some experience—it is known that in women lustful feelings are not always brought about by the first contact,—while the conditions are entirely different in the partially impotent woman. No one man, except he be a eunuch, is ever able to satisfy her in a natural way. Her nervous system remains in a constant state of excitement to the highest degree, analogous to satyriasis in men. Her active potency appears to the superficial observer to be increased, it is almost inexhaustible. The following case will illustrate this point:
A young lady, twenty-one years of age, for six months pregnant with her first child, showed at the examination normal internal genital organs, but small nymphae and an undeveloped clitoris. The patient coepit stuprum manu facere, tres annos nata, femora commissa fricando ultro citroque aut pulvillum aut aliam rem inter ea. As far as she can remember she always felt humorem in genitalibus suis after such manipulations. She practised stuprum manu several times daily until her marriage. Her husband left her in the first months of her pregnancy and she began to indulge in her favorite practices. “In coitione usitata frictiones continuas poscit”, and can endure them for hours. She claims to have the feeling of becoming wet several times during the “copulatione longa et continua,” but the libido does not materially increase cum humorem sentiat. The intensity of the libido remains always the same. She is continually uttering endearing words to her mate and is begging him, ne patiatur ejaculationem cito venire. She remains excited “postquam frictiones cessaverunt” and is always showing her disappointment when the penis “retractus est.” After a little while, her excitement gradually subsides, and the patient falls asleep. When she awakes she immediately “coitionem iterum poscit.”
Here we have a case of a partially impotent woman whose anaesthesia and slight development of the clitoris was in all probability the result of her early practice of masturbation. The orgasm cannot be induced, but the ant-orgastic state is accompanied by libido of a considerable degree. The glands furnish enough secretion to give the feeling of moisture; there is no real ejaculation as in normal congressus.
While the totally anaesthetic woman has no natural desire for coition, and in this respect resembles the woman who is suffering from idiopathic frigidity or impotence of voluptas, the woman with the power of experiencing libido, but afflicted with the anomaly of orgasmus retardatus, has an intense desire for conjugation. She seeks it oftener than the normal woman, for the reason that her desire is seldom satisfied. She demands, therefore, commixtionem continuam per horas et pæne quot noctibus. Such a Messalina is able commisceri centies in una nocte and yet be unsatisfied. Even if she had it in her power, like Katherine of Russia, to order cubili suo a whole regiment of soldiers quot noctibus, she would still remain unsatisfied. This anomaly, for these reasons, may often be confounded with the perversion of nymphomania, where a normal orgasm is induced with every copulation, but where an immediate reawakening of desires, after normal satisfaction, takes place. Through the similarity of the symptoms of orgasmus retardatus and nymphomania great mistakes in treatment have often been committed. The wisdom of amputating the clitoris in a case of nymphomania is very questionable, but the advice to amputate it in a case of impossible or retarded orgasm and permanently damage the already weakened nerves is a mistake that borders almost to malpractice. For the amputation of the clitoris will impede the inducement of the orgasm even to a greater extent than before. The genital apparatus, which was weakened by excesses in venere or in narcotics, is now irreparably destroyed for all time.
The case of Barrus shows what clitoridectomy may sometimes do. The patient, a young woman, stuprum faciebat manu more or less, all her life, and finally after suffering from several attacks of nymphomania decided to have the clitoris amputated. The result was not only failure to relieve the alleged nymphomania, but even an increase in its severity, causing a shameless and, almost literally, continuous indulgence in the habit.
The cause of orgasmus retardatus is almost always self-abuse, either in form of masturbation, mental erethism, or tactile eroticism. The excitability of the clitoris is so increased through these practices that it refuses to transfer its excitability upon the internal genital organs for the inducement of orgasm by coition. The ant-orgastic pleasure is hence intact or even increased, but the orgasm is seldom or never provoked.
The unsatisfied intercourse will in the long run cause a number of nervous troubles which take the form of hysteria or assume the character of neurasthenia. The unsatisfied initus repeatedly practised, in not leading to the acme of libido and to the relief from the congestion by the ejaculation, is the cause of chronic hyperaemia and stasis. This leads, in its farther progress, to chronic inflammations of the tissues, which are known under the respective names of metritis, perimetritis, parametritis, endometritis, salpingitis and ovaritis. The labia are tumefied and dry, the meatus urinarius inflamed and the urethra pouted out. The clitoris is elongated, inflamed and often abraded. The external genitals are in a state of burning heat. The vaginal mucous membrane is hard and excoriated, the cervix is congested and the external orifice inflamed.
Apart from these pathological changes caused by the failure or the retarding of the orgasm, the anomaly is of grave social importance. The woman with whom orgasm is impossible generally repels her husband. Her nerves never being exhausted, as in the normal woman (it is little known that a woman is more affected and fatigued by a real orgasm than a man), spatium congressus may last as long as the vaginal epithelia can endure it, which means a considerable length of time. This is mistaken by the husband for increased potency. He believes her to be more potent than he is, and, in the long run, a man dislikes a lascivious woman. What he wishes is a modest woman who never asks for conjugal embrace when he is not disposed to it, and at times even knows gently and tactfully to refuse her favors when they are asked. Orgasmus retardatus is hence not simply a question for the physician; it is a matter of serious social importance.
The correct treatment for this anomaly is, in the first place, total abstinence from sexual excitement in any form, and then strengthening of the nerves by tonics, hydrotherapeutics and electricity by Apostoli’s method.
Orgasmus praecox.—The exact opposite to orgasmus retardatus is the anomaly of orgasmus praecox. In men, suffering from this anomaly where ejaculation occurs before the penis has time to enter the vagina, the precipitated orgasm has the same effect as the real impotence of concubitus. In women suffering from orgasmus praecox, the orgasmus is induced as soon as the mentula reaches the vestibule.