Conditions of nutrition, which are always accompanied by a combination of other hygienic conditions all tending toward the same effects, have also an influence upon the development of puberty.
Puberty is retarded by malnutrition. As a result of an inquiry made among the inmates of the Pia Barolo Society, which offers an asylum to reformed prostitutes, Marro[23] records that out of ninety rescued girls only those above the age of fourteen had begun to menstruate: notwithstanding that the normal period for the development of puberty in Italian women is between the years of twelve and thirteen. Furthermore, among the girls above the age of fourteen, menstruation had not yet begun in all cases; on the contrary, a large proportion of them still failed to show the phenomena of puberty:
| Age in years | Whole number | Number menstruating |
|---|---|---|
| 14-15 | 11 | 4 |
| 15-16 | 11 | 7 |
| 16-17 | 11 | 8 |
| 17-18 | 8 | 7 |
All the rest (thirty in number) menstruated for the first time after the age of eighteen.
Among those in whom menstruation had appeared earlier, the order of appearance was as follows:
| Years | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 |
| Number | 1 | 3 | 4 | 5 | 12 | 17 | 9 | 5 |
When we consider that we are dealing with rescued girls, we may conclude that direct sexual stimulus does not facilitate the normal development of puberty, but on the contrary, in conjunction with other causes, retards it. Accordingly, we must not confound the normal development of the organism with its disorders: whatever aids the natural development of life is useful and healthy. There may be conditions unfavourable to the development of puberty, which are favourable to the development of sexual vices (see, further on, the other causes influencing puberty, and moral conditions in colleges).
In his work above cited, Marro compares his figures obtained from the Pia Barolo Society with those of Dr. Bianco[24] taken from 78 young girls in city institutes representing young women in easy circumstances:
| Date of first menstruation. | Girls in the Pia Barolo Society. Percentage | Girls in city institutes for the wealthy classes. Percentage |
|---|---|---|
| 10 years | 1.7 | —— |
| 11 years | 5.3 | 1.3 |
| 12 years | 7.1 | 13.3 |
| 13 years | 8.9 | 18.7 |
| 14 years | 21.4 | 29.3 |
| 15 years | 30.3 | 20.0 |
| 16 years | 16.0 | 8.0 |
| 17 years | 8.9 | 4.0 |