The subject with which we are especially concerned is discussed in a work by Boireau-Laffecteur, Essai sur les Maladies Physiques et Morales des femmes,[[6]] Paris, 1793; and also in Marie-Clement’s Considerations Physiologiques sur les Diverses Epoques de la Vie des Femmes,[[7]] Paris, 1803. the same connection we must mention von Humboldt’s treatise, Ueber den Geschlechtsunterschied und dessen Einfluss auf die organische Natur.[[8]] The first comprehensive work in which an exhaustive inquiry was made into the functional disorders of the female genital organs and the relation of these disorders to the female organism as a whole and to the physical and mental peculiarities of woman was Busch’s: Das Geschlechtsleben des Weibes,[[9]] Leipzig, 1839.
In the second half of the nineteenth century a very large number of monographs were published, investigating and describing the reflex disturbances produced alike in the individual organs and in the nervous system as a whole by changes in the uterus and its annexa. Many of these works will be mentioned more particularly in the course of this treatise.
The sexual life, based upon the purpose, so important to every creature, of the propagation of the species, possesses in the female sex a vital significance enormously greater than sexual activity possesses in the male. From the very beginning of sexuality, when the idea of a bisexual differentiation dawns for the first time in the brain of the little girl, down to the sexual death of the withered matron, who laments the loss of her sexual potency, physical and mental activity, work and thought, function and sensation, arise for the most part, wittingly or unwittingly, from that germinal energy which is the manifestation of the unalterable law that the existing organism endeavors to reproduce its kind.
Every phase of the sexual life of woman, from the threshold of puberty to the extinction of sexual activity, the first appearance of menstruation, the complete development of the sexual organs, the act of copulation, conception, pregnancy, parturition, and the puerperium, finally the involutionary process which accompanies the cessation of menstruation at the climacteric period—every one of these sexual phases entails consecutive physiological processes and pathological changes alike in the individual organs and in the nutritive condition of the entire organism, in the functions of the cardio-vascular apparatus, of the brain and the nerves, of the skin and the sense-organs, in the processes of digestion and general metabolism. Herein we see a striking illustration of the old saying of von Helmont, propter solum uterum mulier est quod est;[[10]] also of the similar aphorism of Hippocrates, uterus omnium causa morborum qui mulieres infestant;[[11]] a conception summed up by Goethe in the words of Mephistopheles:
“Es ist ihr ewig Weh und Ach
So tausendfach
Aus einem Punkte zu kurieren.”
Just as in a tree the process of growth is made manifest to the superficial observer by the pleasure he feels at the sight of the buds and blossoms, by the refreshment he obtains from the fruit, and by the sadness which the withering of the leaves causes him, so in the sexual life of woman there are landmarks which no one can possibly overlook, by means of which three great epochs are distinguished. These are: puberty (the menarche), recognized by the first appearance of menstruation and the awakening of the sexual impulse; sexual maturity (the menacme), in the fully developed woman, characterized by the functions of copulation and reproduction; and sexual involution (the menopause), in which we see the gradual decline and ultimate extinction of sexual power and all its manifestations. In all these three epochs the sexual life of woman not only affects the hidden domain of the genital organs, but controls also all the vegetative, physical, and mental processes of the body, and is clearly and incontestably apparent in all vital manifestations. What Madame de Staël said of love is indeed true of the entire sexual life of woman: l’amour n’est qu’unc épisode de la vie de l’homme; c’est l’histoire tout entière de la femme.[[12]].
The sexual life of woman is coextensive with the peculiar vital activity of the female sex, for it endures from the moment when individuality first begins to develop out of the indifferent stage of childhood until the decline into the dead-level of senility.
To illustrate this fact, I have drawn up a curve of the sexual life of woman, making use of the statistical data available in central Europe regarding the age at which menstruation first appears, the age at which maidens marry, the age at which the largest number of women give birth to a child, and the age at which menstruation ceases; and reducing the figures to averages. * denotes the fifteenth year of life, as the average age at the menarche; ** denotes the twenty-second year of life as the average age at marriage; *** denotes the thirty-second year of life, in which woman exhibits her maximum fecundity; **** denotes the forty-sixth year of life as the average age at the menopause. (Fig. [1].)