Sleep is so complex a process, and sleeplessness the resultant of so many different maladjustments, that it is, of course, possible that the woman may sleep well enough, even if she be deprived of the relief and pleasure of perfect union. But in so many married women sleeplessness and a consequent nervous condition are coupled with a lack of the complete sex relation, that one of the first questions a physician should put to those of his women patients who are worn and sleepless is: Whether her husband really fulfils his marital duty in their physical relation.
From their published statements, and their admissions to me, it appears that many practising doctors are either almost unaware of the very existence of orgasm in women, or look upon it as a superfluous and accidental phenomenon. Yet to have had a moderate number of orgasms at some time at least is a necessity for the full development of a woman's health and all her powers.
As this book is written for those who are married, I say nothing here about the lives of those who are still unmarried, though, particularly after the age of thirty has been reached, they may be very difficult and need much study and consideration. It is, however, worth noticing how prevalent sleeplessness is among a class of women who have never had any normal sex-life or allowed any relief to their desires. There is little doubt that the complete lack of a normal sex relation is one of the several factors which render many middle-aged unmarried women nervous and sleepless.
Yet for the unmarried woman the lack is not so acute nor so localised as it is for the married woman who is thwarted in the natural completion of her sex-functions after they have been directly stimulated.
The unmarried woman, unless she be in love with some particular man, has no definite stimulus to her sex desires beyond the natural upwelling of the creative force. The married woman, however, is not only diffusely stirred by the presence of the man she loves, but is also acutely locally and physically stimulated by his relation with her. And if she is then left in mid-air, without natural relief to her tension, she is in this respect far worse off than the unmarried woman.
When a wife is left sleepless through the neglect of the mate who slumbers healthily by her side, it is not surprising if she spends the long hours reviewing their mutual position; and the review cannot yield her much pleasure or satisfaction. For, deprived of the physical delight of mutual orgasm (though, perhaps, like so many wives, quite unconscious of all it can give), she sees in the sex act an arrangement where pleasure, relief and subsequent sleep, are all on her husband's side, while she is merely the passive instrument of his enjoyment. Nay, more than that: if following every union she has long hours of wakefulness, she then sees clearly the encroachment on her own health in an arrangement in which she is not merely passive, but is actively abused.
Another of the consequences of the incomplete relation is that often, stirred to a point of wakefulness and vivacity by the preliminary sex-stimulation (of the full meaning of which she may be unconscious), a romantic and thoughtful woman is then most able to talk intimately and tenderly—to speak of the things most near and sacred to her heart. And she may then be terribly wounded by the inattention of her husband, which, coming so soon after his ardent demonstrations of affection, appears peculiarly callous. It makes him appear to her to be indifferent to the highest side of marriage—the spiritual and romantic intercourse. Thus she may see in the man going off to sleep in the midst of her love-talk, a gross and inattentive brute—and all because she has never shared the climax of his physical tension, and does not know that its natural reaction is sleep.
These thoughts are so depressing even to the tenderest and most loving woman, and so bitter to one who has other causes of complaint, that in their turn they act on the whole system and increase the damage done by the mere sleeplessness.
The older school of physiologists dealt in methods too crude to realise the physiological results of our thoughts, but it is now well known that anger and bitterness have experimentally recognisable physiological effects, and are injurious to the whole system.
It requires little imagination to see that after months or years of such embittered sleeplessness, the woman tends not only to become neurasthenic but also resentful towards her husband. She is probably too ignorant and unobservant of her own physiology to realise the full meaning of what is taking place, but she feels vaguely that he is to blame, and that she is being sacrificed for what, in her still greater ignorance of his physiology, seems to her to be his mere pleasure and self-indulgence.