Guéneau de Mussy suggests the following, very characteristic, method of ensuring fertilization, one which also certainly dates from great antiquity: “Sed haud illicitum mihi visum est, si post diversa tentamina diutius uxor infecunda manserit, ipsum maritum digitum post coitum in vaginam immittere, et ita receptum semen uteri osteo admovere. Et cum ostiolo uteri haeret, ut in pervium canalem spermatozoidum motibus faventibus, prodeat, sperare non absurdum.” Eustache reports a case, the wife of a physician, in which this manoeuvre was effective in ensuring conception.
A similar procedure has been employed with success by Kehrer, in a case of enfeebled potency on the part of the male, leading to premature ejaculation. A speculum was introduced into the vagina, and through this instrument the semen, ejaculated in consequence of sexual excitement, was introduced into the vaginal fornix; conception ensued. In an analogous manner, A. Peyer recommended, in a case of partial impotence, in which special manipulations were needed to bring about ejaculation, that conception should be favoured in the following manner: Erection having been effected by ordinary sexual contact, the manipulations needed to produce ejaculation were carried out, and the penis was intromitted into the vagina the moment before ejaculation occurred. This has been done with fruitful results. Englisch reports the case of a hypospadiac who, in order to render coitus effective, used a condom in the anterior extremity of which he made an aperture. In this way he became the father of three children.
In very obese men with extremely protuberant abdomens, we may recommend for the furtherance of conception that they should have intercourse with their wives a parte posteriori; and the same recommendation may be made in cases in which the wife herself is extremely obese. In Australia, it is said that among the indigens, coitus is usually practiced a posteriori; and there is a saying in the Talmud to the effect that sexual intercourse performed in the ordinary manner does not lead to the conception of infants so good, wise, talented, and promising as those whose conception is the result of coitus a posteriori. Mohammed, on the other hand, declares, “Your wives are your tillage, go therefore unto it in whatsoever manner ye will.”
In cases of retroflexion of the uterus, with a markedly forward direction of the vaginal portion of the cervix, I have recommended to the husband that he should perform coitus with his wife in the upright sitting posture. In this posture the fundus uteri passes downwards and forwards, whilst the vaginal portion of the cervix passes upwards and backwards.
In cases of retroversion of the uterus with the formation of a cul-de-sac in the posterior vaginal fornix, Pajot recommends, with the aim of temporarily restoring the uterus to a position in which the occurrence of conception is favored, that for three or four days prior to coitus the patient should retain the fæces, eating the while freely of eggs and rice, and taking a small opium pill every evening; in cases of anteversion, the patient should retain her urine for a considerable time—five or six hours—before coitus; and in cases of lateral version he recommends that the patient should have intercourse while lying on that side towards which the vaginal portion of the cervix is directed.
Edis recommends that in cases in which there is sterility dependent upon backward displacements of the uterus, that the organ should be replaced while the patient is in the genu-pectoral posture, and a pessary inserted; coitus should then be effected without the patient’s changing her posture.
In the human species as compared with the lower animals, there has been a notable diminution in the frequency of the separate acts of intercourse, a diminution dependent upon the higher vital aims of the former. Burdach formulates as a physiological law that the frequency of sexual intercourse is inversely related to the duration of the act.
Amongst all civilized races, sexual intercourse ceases during menstruation, since in the normal man there is aversion to intercourse with a menstruating female.
By the Mosaic law, intercourse with a woman during menstruation and for seven days after the cessation of the flow, was forbidden under pain of death. The Talmud further ordains that a purifying bath shall be taken by the woman a week after menstruation. By intercourse itself, moreover, both man and woman were rendered unclean to the evening; and, according to the Mosaic law, both must bathe after the act of coitus. In the Koran, also, intercourse is forbidden during menstruation, and until the woman has been purified with water. The law’s of Islam demand from a man who marries a virgin that he shall have intercourse with her the first seven nights in succession; whilst he who marries a wife no longer virgin, needs to visit her only the first three nights in succession. Subsequently, during married life, the Mohammedan shall have intercourse with his wife regularly once a week. Amongst many savage races, intercourse is forbidden with a woman during pregnancy, the puerperium, and lactation.
The first act of intercourse is difficult and painful to the virgin. At times the rupture of the hymen is exceedingly difficult. Even after this, it is some time before genuine pleasure is experienced in sexual intercourse.