When castration is performed without removal of the penis it is said that potency remains for at least ten years afterward, and Disselhorst, who in his Die accessorischen Geschlechtsdrüsen der Wirbelthiere takes the same view as has been here adopted, mentions that, according to Pelikan (Das Skopzentum in Rüssland), those castrated at puberty are fit for coitus long afterward. When castration is performed for surgical reasons at a later age it is still less likely to affect potency or to change the sexual feelings.[[13]] Guinard concludes that the sexual impulse after castration is relatively more persistent in man than in the lower animals, and is sometimes even heightened, being probably more dependent on external stimuli.[[14]]
Except in the East, castration is more often performed on women than on men, and then the evidence as to the influence of the removal of the ovaries on the sexual emotions shows varying results. It has been found that after castration sexual desire and sexual pleasure in coitus may either remain the same, be diminished or extinguished, or be increased. By some the diminution has been attributed to autosuggestion, the woman being convinced that she can no longer be like other women; the augmentation of desire and pleasure has been supposed to be due to the removal of the dread of impregnation. We have, of course, to take into account individual peculiarities, method of life, and the state of the health.
In France Jayle ("Effets physiologiques de la Castration chez la Femme," Revue de Gynécologie, 1897, pp. 403-57) found that, among 33 patients in whom ovariotomy had been performed, in 18 sexual desire remained the same, in 3 it was diminished, in 8 abolished, in 3 increased; while pleasure in coitus remained the same in 17, was diminished in 1, abolished in 4, and increased in 5, in 6 cases sexual intercourse was very painful. In two other groups of cases—one in which both ovaries and uterus were removed and another in which the uterus alone was removed—the results were not notably different.
In Germany Gläveke (Archiv für Gynäkologie, Bd. xxxv, 1889) found that desire remained in 6 cases, was diminished in 10, and disappeared in 11, while pleasure in intercourse remained in 8, was diminished in 10, and was lost in 8. Pfister, again (Archiv für Gynäkologie, Bd. lvi, 1898), examined this point in 99 castrated women; he remarks that sexual desire and sexual pleasure in intercourse were usually associated, and found the former unchanged in 19 cases, decreased in 24, lost in 35, never present in 21, while the latter was unchanged in 18 cases and diminished or lost in 60. Keppler (International Medical Congress, Berlin, 1890) found that among 46 castrated women sexual feeling was in no case abolished. Adler also, who discusses this question (Die Mangelhafte Geschlechtsempfindung des Weibes, 1904, p. 75 et seq.), criticises Gläveke's statements and concludes that there is no strict relation between the sexual organs and the sexual feelings. Kisch, who has known several cases in which the feelings remained the same as before the operation, brings together (The Sexual Life of Women) varying opinions of numerous authors regarding the effects of removal of the ovaries on the sexual appetite.
In America Bloom (as quoted in Medical Standard, 1896, p. 121) found that in none of the cases of women investigated, in which oöphorectomy had been performed before the age of 33, was the sexual appetite entirely lost; in most of them it had not materially diminished and in a few it was intensified. There was, however, a general consensus of opinion that the normal vaginal secretion during coitus was greatly lessened. In the cases of women over 33, including also hysterectomies, a gradual lessening of sexual feeling and desire was found to occur most generally. Dr. Isabel Davenport records 2 cases (reported in Medical Standard, 1895, p. 346) of women between 30 and 35 years of age whose erotic tendencies were extreme; the ovaries and tubes were removed, in one case for disease, in the other with a view of removing the sexual tendencies; in neither case was there any change. Lapthorn Smith (Medical Record, vol. xlviii) has reported the case of an unmarried woman of 24 whose ovaries and tubes had been removed seven years previously for pain and enlargement, and the periods had disappeared for six years; she had had experience of sexual intercourse, and declared that she had never felt such extreme sexual excitement and pleasure as during coitus at the end of this time.
In England Lawson Tait and Bantock (British Medical Journal, October 14, 1899, p. 975) have noted that sexual passion seems sometimes to be increased even after the removal of ovaries, tubes, and uterus. Lawson Tait also stated (British Gynæcological Journal, Feb., 1887, p. 534) that after systematic and extensive inquiry he had not found a single instance in which, provided that sexual appetite existed before the removal of the appendages, it was abolished by that operation. A Medical Inquiry Committee appointed by the Liverpool Medical Institute (ibid., p. 617) had previously reported that a considerable number of patients stated that they had suffered a distinct loss of sexual feeling. Lawson Tait, however, throws doubts on the reliability of the Committee's results, which were based on the statements of unintelligent hospital patients.
I may quote the following remarks from a communication sent to me by an experienced physician in Australia: "No rule can be laid down in cases in which both ovaries have been extirpated. Some women say that, though formerly passionate, they have since become quite indifferent, but I am of opinion that the majority of women who have had prior sexual experience retain desire and gratification in an equal degree to that they had before operation. I know one case in which a young girl hardly 19 years old, who had been accustomed to congress for some twelve months, had trouble which necessitated the removal of the ovaries and tubes on both sides. Far from losing all her desire or gratification, both were very materially increased in intensity. Menstruation has entirely ceased, without loss of femininity in either disposition or appearance. During intercourse, I am told, there is continuous spasmodic contraction of various parts of the vagina and vulva."
The independence of the sexual impulse from the distention of the sexual glands is further indicated by the great frequency with which sexual sensations, in a faint or even strong degree, are experienced in childhood and sometimes in infancy, and by the fact that they often persist in women long after the sexual glands have ceased their functions.
In the study of auto-erotism in another volume of these Studies I have brought together some of the evidence showing that even in very young children spontaneous self-induced sexual excitement, with orgasm, may occur. Indeed, from an early age sexual differences pervade the whole nervous tissue. I may here quote the remarks of an experienced gynecologist: "I venture to think," Braxton Hicks said many years ago, "that those who have much attended to children will agree with me in saying that, almost from the cradle, a difference can be seen in manner, habits of mind, and in illness, requiring variations in their treatment. The change is certainly hastened and intensified at the time of puberty; but there is, even to an average observer, a clear difference between the sexes from early infancy, gradually becoming more marked up to puberty. That sexual feelings exist [it would be better to say 'may exist'] from earliest infancy is well known, and therefore this function does not depend upon puberty, though intensified by it. Hence, may we not conclude that the progress toward development is not so abrupt as has been generally supposed?... The changes of puberty are all of them dependent on the primordial force which, gradually gathering in power, culminates in the perfection both of form and of the sexual system, primary and secondary."