THE PHENOMENA OF SEXUAL PERIODICITY.


I.

The Various Physiological and Psychological Rhythms--Menstruation--The Alleged Influence of the Moon--Frequent Suppression of Menstruation among Primitive Races--Mittelschmerz--Possible Tendency to a Future Intermenstrual Cycle--Menstruation among Animals--Menstruating Monkeys and Apes--What is Menstruation--Its Primary Cause Still Obscure--The Relation of Menstruation to Ovulation--The Occasional Absence of Menstruation in Health--The Relation of Menstruation to "Heat"--The Prohibition of Intercourse during Menstruation--The Predominance of Sexual Excitement at and around the Menstrual Period--Its Absence during the Period Frequently Apparent only.



Throughout the vegetable and animal worlds the sexual functions are periodic. From the usually annual period of flowering in plants, with its play of sperm-cell and germ-cell and consequent seed-production, through the varying sexual energies of animals, up to the monthly effervescence of the generative organism in woman, seeking not without the shedding of blood for the gratification of its reproductive function, from first to last we find unfailing evidence of the periodicity of sex. At first the sun, and then, as some have thought, the moon, have marked throughout a rhythmic impress on the phenomena of sex. To understand these phenomena we have not only to recognize the bare existence of that periodic fact, but to realize its implications.

Rhythm, it is scarcely necessary to remark, is far from characterizing sexual activity alone. It is the character of all biological activity, alike on the physical and the psychic sides. All the organs of the body appear to be in a perpetual process of rhythmic contraction and expansion. The heart is rhythmic, so is the respiration. The spleen is rhythmic, so also the bladder. The uterus constantly undergoes regular rhythmic contractions at brief intervals. The vascular system, down to the smallest capillaries, is acted on by three series of vibrations, and every separate fragment of muscular tissue possesses rhythmic contractility. Growth itself is rhythmic, and, as Malling-Hansen and subsequent observers have found, follows a regular annual course as well as a larger cycle. On the psychic sides attention is rhythmic. We are always irresistibly compelled to impart a rhythm to every succession of sounds, however uniform and monotonous. A familiar example of this is the rhythm we can seldom refrain from hearing in the puffing of an engine. A series of experiments, by Bolton, on thirty subjects showed that the clicks of an electric telephone connected in an induction-apparatus nearly always fell into rhythmic groups, usually of two or four, rarely of three or five, the rhythmic perception being accompanied by a strong impulse to make corresponding muscular movements.[75]

It is, however, with the influence--to some extent real, to some extent, perhaps, only apparent--of cosmic rhythm that we are here concerned. The general tendency, physical and psychic, of nervous action to fall into rhythm is merely interesting from the present point of view as showing a biological predisposition to accept any periodicity that is habitually imposed upon the organism.[76] Menstruation has always been associated with the lunar revolutions.[77] Darwin, without specifically mentioning menstruation, has suggested that the explanation of the allied cycle of gestation in mammals, as well as incubation in birds, may be found in the condition under which ascidians live at high and low water in consequence of the phenomena of tidal change.[78] It must, however, be remembered that the ascidian origin of the vertebrates has since been contested from many sides, and, even if we admit that at all events some such allied conditions in the early history of vertebrates and their ancestors tended to impress a lunar cycle on the race, it must still be remembered that the monthly periodicity of menstruation only becomes well marked in the human species.[79] Bearing in mind the influence exerted on both the habits and the emotions even of animals by the brightness of moonlight nights, it is perhaps not extravagant to suppose that, on organisms already ancestrally predisposed to the influence of rhythm in general and of cosmic rhythm in particular, the periodically recurring full moon, not merely by its stimulation of the nervous system, but possibly by the special opportunities which it gave for the exercise of the sexual functions, served to implant a lunar rhythm on menstruation. How important such a factor may be we have evidence in the fact that the daily life of even the most civilized peoples is still regulated by a weekly cycle which is apparently a segment of the cosmic lunar cycle.

Mantegazza has suggested that the sexual period became established with relation to the lunar period because moonlight nights were favorable to courting,[80] and Nelson remarks that in his experience young and robust persons are subject to recurrent periods of wakefulness at night which they attribute to the action of the full moon. One may perhaps refer also to the tendency of bright moonlight to stir the emotions of the young, especially at puberty, a tendency which in neurotic persons may become almost morbid.[81]

It is interesting to point out that, the farther back we are able to trace the beginnings of culture, the more important we find the part played by the moon. Next to the alteration of day and night, the moon's changes are the most conspicuous and startling phenomena of Nature; they first suggest a basis for reckoning time; they are of the greatest use in primitive agriculture; and everywhere the moon is held to have vast influence on the whole of organic life. Hahn has suggested that the reason why mythological systems do not usually present the moon in the supreme position which we should expect, is that its immense importance is so ancient a fact that it tends, with mythological development, to become overlaid by other elements.[82] According to Seler, Quetzalcouatl and Tezeatlipoca, the two most considerable figures in the Mexican pantheon, are to be regarded mainly as complementary forms of the moon divinity, and the moon was the chief Mexican measurer of time.[83] Even in Babylonia, where the sun was most specially revered, at the earliest period the moon ranked higher, being gradually superseded by the worship of the sun.[84] Although such considerations as these will by no means take us as far back as the earliest appearance of menstruation, they may serve to indicate that the phases of the moon probably played a large part in the earliest evolution of man. With that statement we must at present rest content.

It is possible that the monthly character of menstruation, while representing a general tendency of the human race, always and everywhere prevalent, may be modified in the future. It is a noteworthy fact that among many primitive races menstruation only occurs at long intervals. Thus among Eskimo women menstruation follows the peculiar cosmic conditions to which the people are subjected; Cook, the ethnologist of the Peary North Greenland expedition, found that menstruation only began after the age of nineteen, and that it was usually suppressed during the winter months, when there is no sun, only about one in ten women continuing to menstruate during this period.[85] It was stated by Velpeau that Lapland and Greenland women usually only menstruate every three months, or even only two or three times during the year. On the Faroe Islands it is said that menstruation is frequently absent. Among the Samoyeds, Mantegazza mentions that menstruation is so slight that some travelers have denied its existence. Azara noted among the Guaranis of Paraguay that menstruation was not only slight in amount, but the periods were separated by long intervals. Among the Indians in North America, again, menstruation appears to be scanty. Thus, Holder, speaking of his experience with the Crow Indians of Montana, says: "I am quite sure that full-blood Indians in this latitude do not menstruate so freely as white women, not usually exceeding three days."[86] Among the naked women of Tierra del Fuego, it is said that there is often no physical sign of the menses for six months at a time. These observations are noteworthy, though they clearly indicate, on the whole, that primitiveness in race is a very powerless factor without a cold climate. On the other hand, again, there is some reason to suppose that in Europe there is a latent tendency in some women for the menstrual cycle to split up further into two cycles, by the appearance of a latent minor climax in the middle of the monthly interval. I allude to the phenomenon usually called _Mittelschmerz_, middle period, or intermenstrual pain.

Since the investigations of Goodman, Stephenson, Van Ott, Reinl, Jacobi, and others, it has been generally recognized that menstruation is a continuous process, the flow being merely the climax of a menstrual cycle, a physiological wave which is in constant flux or reflux. This cycle manifests itself in all a woman's activities, in metabolism, respiration, temperature, etc., as well as on the nervous and psychic side. The healthier the woman is, the less conscious is the cyclic return of her life, but the cycle may be traced (as Hegar has found) even before puberty takes place, while Salerni has found that even in amenorrhoea the menstrual cycle still manifests itself in the temperature and respiration. (_Rivista Sperimentale di Freniatria_, XXX, fasc. 2-3.)

For a summary of the phenomena of the menstrual cycle, see Havelock Ellis, _Man and Woman_, fourth ed., revised and enlarged, Ch. XI; "The Functional Periodicity of Women." Cf. Keller, _Archives Generales de Medecine_, May, 1897; Hegar, _Allgemeine Zeitschrift fuer Psychiatrie_, 1901, Heft 2 and 3; Helen MacMurchy, _Lancet_, Oct. 5. 1901; A.E. Giles, _Transactions Obstetrical Society London_, vol. xxxix, p. 115, etc.

_Mittelschmerz_ is a condition of pain occurring about the middle of the intermenstrual period, either alone or accompanied by a slight sanguineous discharge, or, more frequently, a non-sanguineous discharge. (In a case described by Van Voornveld, the manifestation was confined to a regularly occurring rise of temperature.) The phenomenon varies, but seems usually to occur about the fourteenth day, and to last two or three days. Laycock, in 1840 (_Nervous Diseases of Women_, p. 46), gave instances of women with an intermenstrual period. Depaul and Gueniot (_Dictionnaire Encyclopedique des Sciences Medicales_, Art., "Menstruation," p. 694) speak of intermenstrual symptoms, and even actual flow, as occurring in women who are in a perfect state of health, and constituting genuine "_regles surnumeraries_." The condition is, however, said to have been first fully described by Valleix; then, in 18725 by Sir William Priestley; and subsequently by Fehling, Fasbender, Sorel, Halliday Croom, Findley, Addinsell, and others. (See, for instance, "Mittelschmerz," by J. Halliday Croom, _Transactions of Edinburgh Obstetrical Society_, vol. xxi, 1896. Also, Krieger, _Menstruation_, pp. 68-69.) Fliess (_Die Beziehungen zwischen Nase und weiblichen Geschlechts-Organen_, p. 118) goes so far as to assert that an intermenstrual period of menstrual symptoms--which he terms _Nebenmenstruation_--is "a phenomenon well known to most healthy women." Observations are at present too few to allow any definite conclusions, and in some of the cases so far recorded a pathological condition of the sexual organs has been found to exist. Rosner, of Cracow, however, found that only in one case out of twelve was there any disease present (_La Gynecologie_, June, 1905), and Storer, who has met with twenty cases, insists on the remarkable and definite regularity of the manifestations, wholly unlike those of neuralgia (_Boston Medical and Surgical Journal_, April 19, 1900). There is no agreement as to the cause of _Mittelschmerz_. Addinsell attributed it to disease of the Fallopian tubes. This, however, is denied by such competent authorities as Cullingworth and Bland Sutton. Others, like Priestley, and subsequently Marsh (_American Journal of Obstetrics_, July, 1897), have sought to find the explanation in the occurrence of ovulation. This theory is, however, unsupported by facts, and eventually rests on the exploded belief that ovulation is the cause of menstruation. Rosner, following Richelet, vaguely attributes it to the diffused hyperaemia which is generally present. Van de Velde also attributes it to an abnormal fall of vascular tone, causing passive congestion of the pelvic viscera. Others again, like Armand Routh and MacLean, in the course of an interesting discussion on _Mittelschmerz_ at the Obstetric Society of London, on the second day of March, 1898, believe that we may trace here a double menstruation, and would explain the phenomenon by assuming that in certain cases there is an intermenstrual as well as a menstrual cycle. The question is not yet ripe for settlement, though it is fully evident that, looking broadly at the phenomena of rut and menstruation, the main basis of their increasing frequency as we rise toward civilized man is increase of nutrition, heat and sunlight being factors of nutrition. When dealing with civilized man, however, we are probably concerned not merely with general nutrition, but with the nervous direction of that nutrition.

At this stage it is natural to inquire what the corresponding phenomena are among animals. Unfortunately, imperfect as is our comprehension of the human phenomena, our knowledge of the corresponding phenomena among animals is much more fragmentary and incomplete. Among most animals menstruation does not exist, being replaced by what is known as heat, or oestrus, which usually occurs once or twice a year, in spring and in autumn, sometimes affecting the male as well as the female.[87] There is, however, a great deal of progression in the upward march of the phenomena, as we approach our own and allied zooelogical series. Heat in domesticated cows usually occurs every three weeks. The female hippopotamus in the Zooelogical Gardens has been observed to exhibit monthly sexual excitement, with swelling and secretion from the vulva. Progression is not only toward greater frequency with higher evolution or with increased domestication, but there is also a change in the character of the flow. As Wiltshire,[88] in his remarkable lectures on the "Comparative Physiology of Menstruation," asserted as a law, the more highly evolved the animal, the more sanguineous the catamenial flow.

It is not until we reach the monkeys that this character of the flow becomes well marked. Monthly sanguineous discharges have been observed among many monkeys. In the seventeenth century various observers in many parts of the world--Bohnius, Peyer, Helbigius, Van der Wiel, and others--noted menstruation in monkeys.[89] Buffon observed it among various monkeys as well as in the orang-utan. J.G. St. Hilaire and Cuvier, many years ago, declared that menstruation exists among a variety of monkeys and lower apes. Rengger described a vaginal discharge in a species of cebus in Paraguay, while Raciborski observed in the Jardin des Plantes that the menstrual haemorrhage in guenons was so abundant that the floor of the cage was covered by it to a considerable extent; the same variety of monkey was observed at Surinam, by Hill, a surgeon in the Dutch army, who noted an abundant sanguineous flow occurring at every new moon, and lasting about three days, the animal at this time also showing signs of sexual excitement.[90]

The macaque and the baboon appear to be the non-human animals, in which menstruation has been most carefully observed. In the former, besides the flow, Bland Sutton remarks that "all the naked or pale-colored parts of the body, such as the face, neck, and ischial regions, assume a lively pink color; in some cases, it is a vivid red."[91] The flow is slight, but the coloring lasts several days, and in warm weather the labia are much swollen.

Heape[92] has most fully and carefully described menstruation in monkeys. He found at Calcutta that the _Macacus cynomolgus_ menstruated regularly on the 20th of December, 20th of January, and about the 20th of February. The _Cynocephalus porcaria_ and the _Semnopithecus entellus_ both menstruated each month for about four days. In the _Macaci rhesus_ and _cynomolgus_ at menstruation "the nipples and vulva become swollen and deeply congested, and the skin of the buttocks swollen, tense, and of a brilliant-red or even purple color. The abdominal wall also, for a short space upward, and the inside of the thighs, sometimes as far down as the heel, and the under surface of the tail for half its length or more, are all colored a vivid red, while the skin of the face, especially about the eyes, is flushed or blotched with red." In late gestation the coloring is still more vivid. Something similar is to be seen in the males also.

Distant, who kept a female baboon for some time, has recorded the dates of menstruation during a year. He found that nine periods occurred during the year. The average length between the periods was nearly six weeks, but they occurred more frequently in the late autumn and the winter than in the summer.[93]

It is an interesting fact, Heape noted, that, notwithstanding menstruation, the seasonal influence, or rut, still persisted in the monkeys he investigated.

In the anthropoid apes, Hartmann remarks that several observers have recorded periodic menstruation in the chimpanzee, with flushing and enlargement of the external parts, and protrusion of the external lips, which are not usually visible, while there is often excessive enlargement and reddening of these parts and of the posterior callosities during sexual excitement. Very little, however, appears to be definitely known regarding any form of menstruation in the higher apes. M. Deniker, who has made a special study of the anthropoid apes, informs me that he has so far been unable to make definite observations regarding the existence of menstruation. Moll remarks that he received information regarding such a phenomenon in the orang-utan. A pair of orang-utans was kept in the Berlin Zooelogical Gardens some years ago, and the female was stated to have at intervals a menstrual flow resembling that of women, and during this period to refrain from sexual congress, which was otherwise usually exercised at regular intervals, at least every two or three days; Moll adds, however, that, while his informant is a reliable man, the length of time that has elapsed may have led him to make mistakes in details. Keith, in a paper read before the Zooelogical Society of London, has described menstruation in a chimpanzee; it occurred every twenty-third or twenty-fourth day, and lasted for three days; the discharge was profuse, and first appeared in about the ninth or tenth year.[94]

What is menstruation? It is easy to describe it, by its obvious symptoms, as a monthly discharge of blood from the uterus, but nearly as much as that was known in the infancy of the world. When we seek to probe more intimately into the nature of menstruation we are still baffled, not merely as regards its cause, but even as regards its precise mechanism. "The primary cause of menstruation remains unexplained"; "the cause of menstruation remains as obscure as ever"; so conclude two of the most thorough and cautious investigators into this subject.[95] It is, however, widely accepted that the main cause of menstruation is a rhythmic contraction of the uterus,--the result of a disappointed preparation for impregnation,--a kind of miniature childbirth. This seems to be the most reasonable view of menstruation; i.e., as an abortion of a decidua. Burdach (according to Beard) was the first who described menstruation as an abortive parturition. "The hypothesis," Marshall and Jolly conclude, "that the entire pro-oestrous process is of the nature of a preparation for the lodgment of the ovum is in accordance with the facts."[96] Fortunately, since we are here primarily concerned with its psychological aspects, the precise biological cause and physiological nature of menstruation do not greatly concern us.

There is, however, one point which of late years has been definitely determined, and which should not be passed without mention: the relation of menstruation to ovulation. It was once supposed that the maturation of an ovule in the ovaries was the necessary accompaniment, and even cause, of menstruation. We now know that ovulation proceeds throughout the whole of life, even before birth, and during gestation,[97] and that removal of the ovaries by no means necessarily involves a cessation of menstruation. It has been shown that regular and even excessive menstruation may take place in the congenital absence of a trace of ovaries or Fallopian tubes.[98] On the other hand, a rudimentary state of the uterus, and a complete absence of menstruation, may exist with well-developed ovaries and normal ovulation.[99] We must regard the uterus as to some extent an independent organ, and menstruation as a process which arose, no doubt, with the object, teleologically speaking, of cooperating more effectively with ovulation, but has become largely independent.[100]

It is sometimes stated that menstruation may be entirely absent in perfect health. Few cases of this condition have, however, been recorded with the detail necessary to prove the assertion. One such case was investigated by Dr. H.W. Mitchell, and described in a paper read to the New York County Medical Society, February 22, 1892 (to be found in _Medical Reprints_, June, 1892). The subject was a young, unmarried woman, 24 years of age. She was born in Ireland, and, until her emigration, lived quietly at home with her parents. Being then twenty years of age, she left home and came to New York. Up to that time no signs of menstruation had appeared, and she had never heard that such a function existed. Soon after her arrival in New York, she obtained a situation as a waiting-maid, and it was noticed, after a time, that she was not unwell at each month. Friends filled her ears with wild stories about the dreadful effects likely to follow the absence of menstruation. This worried her greatly, and as a consequence she became pale and anaemic, with loss of flesh, appetite, and sleep, and a long train of imaginary nervous symptoms. She presented herself for treatment, and insisted upon a uterine examination. This revealed no pathological condition of her uterus. She was assured that she would not die, or become insane, nor a chronic invalid. In consequence she soon forgot that she differed in any way from other girls. A course of chalybeate tonics, generous diet, and proper care of her general health, soon restored her to her normal condition. After close observation for several years, she submitted to a thorough examination, although entirely free from any abnormal symptoms. The examination revealed the following physical condition: Weight, 105 pounds (her weight before leaving Ireland was 130); girth of chest, twenty-nine and a half inches; girth of abdomen, twenty-five inches; girth of pelvis, thirty-four and a half inches; girth of thigh, upper third, twenty inches; heart healthy, sounds and rhythm perfectly normal; pulse, 76; lungs healthy; respiratory murmur clear and distinct over every part; respiration, easy and twenty per minute; the mammae are well developed, firm, and round; nipples, small, no areola; her skin is soft, smooth, and healthy; figure erect, plump, and symmetrical; her bowels are regular; kidneys, healthy. She has a good appetite, sleeps well, and in no particular shows any sign of ill health. The uterine examination reveals a short vagina, and a small, round cervix uteri, rather less in size than the average, and projecting very slightly into the vaginal canal. Depth of uterus from os to fundus, two and a quarter inches, is very nearly normal. No external sign of abnormal ovaries. She is a well-developed, healthy young woman, performing all her physiological functions naturally and regularly, except the single function of menstruation. No vicarious menstruation takes the place of the natural function, though she has been watched very closely during the past two years, nor the least periodical excitement. It is added that, though the clitoris is normal, the mons veneris is almost destitute of hair, and the labia rather undeveloped, while, "as far as is known," sexual instincts and desire are entirely absent. These latter facts, I may add, would seem to suggest that, in spite of the health of the subject, there is yet some concealed lack of development of the sexual system, of congenital character. In a case recorded by Plant (_Centralblatt fuer Gynaekologie_, No. 9, 1896, summarized in the _British Medical Journal_, April 4, 1896), in which the internal sexual organs were almost wholly undeveloped, and menstruation absent, the labia were similarly undeveloped, and the pubic hair scanty, while the axillary hair was wholly absent, though that of the head was long and strong.

We may now regard as purely academic the discussion formerly carried on as to whether menstruation is to be regarded as analogous to heat in female animals. For many centuries at least the resemblance has been sufficiently obvious. Raciborski and Pouchet, who first established the regular periodicity of ovulation in mammals, identified heat and menstruation.[101] During the past century there was, notwithstanding, an occasional tendency to deny any real connection. No satisfactory grounds for this denial have, however, been brought forward. Lawson Tait, indeed, and more recently Beard, have stated that menstruation cannot be the period of heat, because women have a disinclination to the approach of the male at that time.[102] But, as we shall see later, this statement is unfounded. An argument which might, indeed, be brought forward is the very remarkable fact that, while in animals the period of heat is the only period for sexual intercourse, among all human races, from the very lowest, the period of menstruation is the one period during which sexual intercourse is strictly prohibited, sometimes under severe penalties, even life itself. This, however, is a social, not a physiological, fact.

Ploss and Bartels call attention to the curious contrast, in this respect, between heat and menstruation. The same authors also mention that in the Middle Ages, however, preachers found it necessary to warn their hearers against the sin of intercourse during the menstrual period. It may be added that Aquinas and many other early theologians held, not only that such intercourse was a deadly sin, but that it engendered leprous and monstrous children. Some later theologians, however, like Sanchez, argued that the Mosaic enactments (such as Leviticus, Ch. XX, v. 18) no longer hold good. Modern theologians--in part influenced by the tolerant traditions of Liguori, and, in part, like Debreyne (_Moechialogie_, pp. 275 et seq.) informed by medical science--no longer prohibit intercourse during menstruation, or regard it as only a venial sin.

We have here a remarkable, but not an isolated, example of the tendency of the human mind in its development to rebel against the claims of primitive nature. The whole of religion is a similar remolding of nature, a repression of natural impulses, an effort to turn them into new channels. Prohibition of intercourse during menstruation is a fundamental element of savage ritual, an element which is universal merely because the conditions which caused it are universal, and because--as is now beginning to be generally recognized--the causes of human psychic evolution are everywhere the same. A strictly analogous phenomenon, in the sexual sphere itself, is the opposed attitude in barbarism and civilization toward the sexual organs. Under barbaric conditions and among savages, when no magico-religious ideas intervene, the sexual organs are beautiful and pleasurable objects. Under modern conditions this is not so. This difference of attitude is reflected in sculpture. In savage and barbaric carvings of human beings, the sexual organs of both sexes are often enormously exaggerated. This is true of the archaic European figures on which Salomon Reinach has thrown so much light, but in modern sculpture, from the time when it reached its perfection in Greece onward, the sexual regions in both men and women are systematically minimized.[103]

With advancing culture--as again we shall see later--there is a conflict of claims, and certain considerations are regarded as "higher" and more potent than merely "natural" claims. Nakedness is more natural than clothing, and on many grounds more desirable under the average circumstances of life, yet, everywhere, under the stress of what are regarded as higher considerations, there is a tendency for all races to add more and more to the burden of clothes. In the same way it happens that the tendency of the female to sexual intercourse during menstruation[104] has everywhere been overlaid by the ideas of a culture which has insisted on regarding menstruation as a supernatural phenomenon which, for the protection of everybody, must be strictly tabooed.[105] This tendency is reinforced, and in high civilization replaced, by the claims of an aesthetic regard for concealment and reserve during this period. Such facts are significant for the early history of culture, but they must not blind us to the real analogy between heat and menstruation, an analogy or even identity which may be said to be accepted now by most careful investigators.[106]

If it is, perhaps, somewhat excessive to declare, with Johnstone, that "woman is the only animal in which rut is omnipresent," we must admit that the two groups of phenomena merge into or replace each other, that their object is identical, that they involve similar psychic conditions. Here, also, we see a striking example of the way in which women preserve a primitive phenomenon which earlier in the zooelogical series was common to both sexes, but which man has now lost. Heat and menstruation, with whatever difference of detail, are practically the same phenomenon. We cannot understand menstruation unless we bear this in mind.

On the psychic side the chief normal and primitive characteristic of the menstrual state is the more predominant presence of the sexual impulse. There are other mental and emotional signs of irritability and instability which tend to slightly impair complete mental integrity, and to render, in some unbalanced individuals explosions of anger or depression, in rarer cases crime, more common;[107] but the heightening of the sexual impulse, languor, shyness, and caprice are the more human manifestations of an emotional state which in some of the lower female animals during heat may produce a state of fury.

The actual period of the menstrual flow, at all events the first two or three days, does not, among European women, usually appear to show any heightening of sexual emotion.[108] This heightening occurs usually a few days before, and especially during, the latter part of the flow, and immediately after it ceases.[109] I have, however, convinced myself by inquiry that this absence of sexual feeling during the height of the flow is, in large part, apparent only. No doubt, the onset of the flow, often producing a general depression of vitality, may tend directly to depress the emotions, which are heightened by the general emotional state and local congestion of the days immediately preceding; but among some women, at all events, who are normal and in good health, I find that the period of menstruation itself is covered by the period of the climax of sexual feeling. Thus, a married lady writes: "My feelings are always very strong, not only just before and after, but during the period; very unfortunately, as, of course, they cannot then be gratified"; while a refined girl of 19, living a chaste life, without either coitus or masturbation, which she has never practiced, habitually feels very strong sexual excitement about the time of menstruation, and more especially during the period; this desire torments her life, prevents her from sleeping at these times, and she looks upon it as a kind of illness.[110] I could quote many other similar and equally emphatic statements, and the fact that so cardinal a relationship of the sexual life of women should be ignored or denied by most writers on this matter, is a curious proof of the prevailing ignorance.[111]

This ignorance has been fostered by the fact that women, often disguise even to themselves the real state of their feelings. One lady remarks that while she would be very ready for coitus during menstruation, the thought that it is impossible during that time makes her put the idea of it out of her mind. I have reason to think that this statement may be taken to represent the real feelings of very many women. The aversion to coitus is real, but it is often due, not to failure of sexual desire, but to the inhibitory action of powerful extraneous causes. The absence of active sexual desire in women during the height of the flow may thus be regarded as, in part, a physiological fact, following from the correspondence of the actual menstrual flow to the period of _pro-oestrum_, and in part, a psychological fact due to the aesthetic repugnance to union when in such a condition, and to the unquestioned acceptance of the general belief that at such a period intercourse is out of the question. Some of the strongest factors of modesty, especially the fear of causing disgust and the sense of the demands of ceremonial ritual, would thus help to hold in check the sexual emotions during this period, and when, under the influence of insanity, these motives are in abeyance, the coincidence of sexual desire with the menstrual flow often becomes more obvious.[112]

It must be added that, especially among the lower social classes, the primitive belief of the savage that coitus during menstruation is bad for the man still persists. Ploss and Bartels mention that among the peasants in some parts of Germany, where it is believed that impregnation is impossible during menstruation, coitus at that time would be frequent were it not thought dangerous for the man.[113] It has also been a common belief both in ancient and modern times that coitus during menstruation engenders monsters.[114]

Notwithstanding all the obstacles that are thus placed in the way of coitus during menstruation, there is nevertheless good reason to believe that the first coitus very frequently takes place at this point of least psychic resistance. When still a student I was struck by the occurrence of cases in which seduction took place during the menstrual flow, though at that time they seemed to me inexplicable, except as evidencing brutality on the part of the seducer. Negrier,[115] in the lying-in wards of the Hotel-Dieu at Angers, constantly found that the women from the country who came there pregnant as the result of a single coitus had been impregnated at or near the menstrual epoch, more especially when the period coincided with a feast-day, as St. John's Day or Christmas.

Whatever doubt may exist as to the most frequent state of the sexual emotions during the period of menstruation, there can be no doubt whatever that immediately before and immediately after, very commonly at both times,--this varying slightly in different women,--there is usually a marked heightening of actual desire. It is at this period (and sometimes during the menstrual flow) that masturbation may take place in women who at other times have no strong auto-erotic impulse. The only women who do not show this heightening of sexual emotion seem to be those in whom sexual feelings have not yet been definitely called into consciousness, or the small minority, usually suffering from some disorder of sexual or general health, in whom there is a high degree of sexual anaesthesia.[116]

The majority of authorities admit a heightening of sexual emotion before or after the menstrual crisis. See e.g., Krafft-Ebing, who places it at the post-menstrual period (_Psychopathia Sexualis_, Eng. translation of tenth edition, p. 27). Adler states that sexual feeling is increased before, during and after menstruation (_Die Mangelhafte Geschlechtsempfindung des Weibes_, 1904, p. 88). Kossmann (Senator and Kaminer, _Health and Disease in Relation to Marriage_, I, 249), advises intercourse just after menstruation, or even during the latter days of the flow, as the period when it is most needed. Guyot says that the eight days after menstruation are the period of sexual desire in women (_Breviaire de l'Amour Experimentale_, p. 144). Harry Campbell investigated the periodicity of sexual desire in healthy women of the working classes, in a series of cases, by inquiries made of their husbands who were patients at a London hospital. People of this class are not always skilful in observation, and the method adopted would permit many facts to pass unrecorded; it is, therefore, noteworthy that only in one-third of the cases had no connection between menstruation and sexual feeling been observed; in the other two-thirds, sexual feeling was increased, either before, after, or during the flow, or at all of these times; the proportion of cases in which sexual feeling was increased before the flow, to those in which it was increased after, was as three to two. (H. Campbell, _Nervous Organization of Men and Women_, p. 203.)

Even this elementary fact of the sexual life has, however, been denied, and, strange to say, by two women doctors. Dr. Mary Putnam Jacobi, of New York, who furnished valuable contributions to the physiology of menstruation, wrote some years ago, in a paper on "The Theory of Menstruation," in reference to the question of the connection between oestrus and menstruation: "Neither can any such rhythmical alternation of sexual instinct be demonstrated in women as would lead to the inference that the menstrual crisis was an expression of this," i.e., of oestrus. Dr. Elizabeth Blackwell, again, in her book on _The Human Element in Sex_, asserts that the menstrual flow itself affords complete relief for the sexual feelings in women (like sexual emissions during sleep in men), and thus practically denies the prevalence of sexual desire in the immediately post-menstrual period, when, on such a theory, sexual feeling should be at its minimum. It is fair to add that Dr. Blackwell's opinion is merely the survival of a view which was widely held a century ago, when various writers (Bordeu, Roussel, Duffieux, J. Arnould, etc.), as Icard has pointed out, regarded menstruation as a device of Providence for safeguarding the virginity of women.



FOOTNOTES:

[75] Thaddeus L. Bolton, "Rhythm," _American Journal of Psychology_, January, 1894.

[76] It is scarcely necessary to warn the reader that this statement does not prejudge the question of the inheritance of acquired characters, although it fits in with Semon's Mnemic theory. We can, however, very well suppose that the organism became adjusted to the rhythms of its environment by a series of congenital variations. Or it might be held, on the basis of Weismann's doctrine, that the germ-plasm has been directly modified by the environment.

[77] Thus, the Papuans, in some districts, believe that the first menstruation is due to an actual connection, during sleep, with the moon in the shape of a man, the girl dreaming that a real man is embracing her. (_Reports Cambridge Expedition to Torres Straits_, vol. v, p. 206.)

[78] Darwin, _Descent of Man_, p. 164.

[79] While in the majority of women the menstrual cycle is regular for the individual, and corresponds to the lunar month of 28 days, it must be added that in a considerable minority it is rather longer, or, more usually, shorter than this, and in many individuals is not constant. Osterloh found a regular type of menstruation in 68 per cent, healthy women, four weeks being the most usual length of the cycle; in 21 per cent, the cycle was always irregular. See Naecke, "Die Menstruation und ihr Einfluss bei chronischen Psychosen," _Archiv fuer Psychiatrie_, 1896, Bd, 28, Heft 1.

[80] Among the Duala and allied negro peoples of Bantu stock dances of markedly erotic character take place at full moon. Gason describes the dances and sexual festivals of the South Australian blacks, generally followed by promiscuous intercourse, as taking place at full moon. (_Journal of the Anthropological Institute_, November, 1894, p. 174.) In all parts of the world, indeed, including Christendom, festivals are frequently regulated by the phases of the moon.

[81] It has often been held that the course of insanity is influenced by the moon. Of comparatively recent years, this thesis has been maintained by Koster (_Ueber die Gesetze des periodischen Irreseins und verwandter Nervenzustaende_, Bonn, 1882), who argues in detail that periodic insanity tends to fall into periods of seven days or multiples of seven.

[82] Ed. Hahn, _Demeter und Baubo_, p. 23.

[83] E. Seler, _Zeitschrift fuer Ethnologie_, 1907, Heft I, p. 39. And as regards the primitive importance of the moon, see also Frazer, _Adonis, Attis, Osiris_, Ch. VIII.

[84] Jastrow, _Religion of Babylonia_, 1898, pp. 68, 75-79, 461.

[85] Even in England, Barnes has known women of feeble sexual constitution who menstruated only in summer (R. Barnes, _Diseases of Women_, 1878, p. 192).

[86] A.B. Holder, "Gynecic Notes among American Indians," _American Journal of Obstetrics_, No. 6, 1892.

[87] In the male, the phenomenon is termed rut, and is most familiar in the stag. I quote from Marshall and Jolly some remarks on the infrequency of rut: "'The male wild Cat,' Mr. Cocks informs us, (like the stag), 'has a rutting season, calls loudly, almost day and night, making far more noise than the female.' This information is of interest, inasmuch as the males of most carnivores, although they undoubtedly show signs of increased sexual activity at some times more than at others, are not known to have anything of the nature of a regularly recurrent rutting season. Nothing of the kind is known in the Dog, nor, so far as we are aware, in the males of the domestic Cat, or the Ferret, all of which seem to be capable of copulation at any time of the year. On the other hand, the males of Seals appear to have a rutting season at the same time as the sexual season of the female." (Marshall and Jolly, "Contributions to the Physiology of Mammalian Reproduction," _Philosophical Transactions_, 1905, B. 198.)

[88] A. Wiltshire, _British Medical Journal_, March, 1883. The best account of heat known to me is contained in Ellenberger's _Vergleichende Physiologie der Haussauegethiere_, 1892, Band 4, Theil 2, pp. 276-284.

[89] Schurig (_Parthenologia_, 1729, p. 125), gives numerous references and quotations.

[90] Quoted by Icard, _La Femme_, etc., p. 63.

[91] Bland Sutton, _Surgical Diseases of the Ovaries_, and _British Gynecological Journal_, vol. ii.

[92] W. Heape, "The Menstruation of _Semnopithecus Entellus_," _Philosophical Transactions_, 1894; "Menstruation and Ovulation of _Macacus Rhesus_," _Philosophical Transactions_, 1897.

[93] W.L. Distant, "Notes on the Chacma Baboon," _Zooelogist_, January, 1897, p, 29.

[94] _Nature_, March 23, 1899.

[95] W. Heape, "The Menstruation of _Semnopithecus Entellus_," _Philosophical Transactions_, 1894, p. 483; Bland Sutton, _Surgical Diseases of the Ovaries_, 1896.

[96] T. Bryce and J. Teacher (_Contributions to the Study of the Early Development of the Human Ovum_, 1908), putting the matter somewhat differently, regard menstruation as a cyclical process, providing for the maintenance of the endometrium in a suitable condition of immaturity for the production of the decidua of pregnancy, which they believe may take place at any time of the month, though most favorably shortly before or after a menstrual period which has been accompanied by ovulation.

[97] Robinson, _American Gynecological and Obstetrical Journal_, August, 1905.

[98] Bossi, _Annali di Ostetrica e Ginecologia_, September, 1896; summarized in the _British Medical Journal_, October 31, 1896. As regards the more normal influence of the ovaries over the uterus, see e.g. Carmichael and F.H.A. Marshall, "Correlation of the Ovarian and Uterine Functions," _Proceedings Royal Society_, vol. 79, Series B, 1907.

[99] Beuttner, _Centralblatt fuer Gynaekologie_, No. 49, 1893; summarized in _British Medical Journal_, December, 1893. Many cases show that pregnancy may occur in the absence of menstruation. See, e.g., _Nouvelles Archives d'Obstetrique et de Gynecologie_, 25 Janvier, 1894, supplement, p. 9.

[100] It is still possible, and even probable, that the primordial cause of both phenomena is the same. Heape (_Transactions Obstetrical Society of London_, 1898, vol. xl, p. 161) argues that both menstruation and ovulation are closely connected with and influenced by congestion, and that in the primitive condition they are largely due to the same cause. This primary cause he is inclined to regard as a ferment, due to a change in the constitution of the blood brought about by climatic influences and food, which he proposes to call gonadin. (W. Heape, _Proceedings of Royal Society_, 1905, vol. B. 76, p. 266.) Marshall, who has found that in the ferret and other animals, ovulation may be dependent upon copulation, also considers that ovulation and menstruation, though connected and able to react on each other, may both be dependent upon a common cause; he finds that in bitches and rats heat can be produced by injection of extract from ovaries in the oestrous state (F.H.A. Marshall, _Philosophical Transactions_, 1903, vol. B. 196; also Marshall and Jolly, id., 1905, B. 198). Cf. C.J. Bond, "An Inquiry Into Some Points in Uterine and Ovarian Physiology and Pathology in Rabbits," _British Medical Journal_, July 21, 1906.

[101] Pouchet, _Theorie de l'Ovulation Spontanee_, 1847. As Blair Bell and Pontland Hick remark ("Menstruation," _British Medical Journal_, March 6, 1909), the repeated oestrus of unimpregnated animals (once a fortnight in rabbits) is surely comparable to menstruation.

[102] Tait, _Provincial Medical Journal_, May, 1891; J. Beard, _The Span of Gestation_, 1897, p. 69. Lawson Tait is reduced to the assertion that ovulation and menstruation are identical.

[103] As Moll points out, even the secondary sexual characters have undergone a somewhat similar change. The beard was once an important sexual attraction, but men can now afford to dispense with it without fear of loss in attractiveness. (_Libido Sexualis_, Band I, p. 387.) These points are discussed at greater length in the fourth volume of these _Studies_, "Sexual Selection in Man."

[104] It is not absolutely established that in menstruating animals the period of menstruation is always a period of sexual congress; probably not, the influence of menstruation being diminished by the more fundamental influence of breeding seasons, which affect the male also; monkeys have a breeding season, though they menstruate regularly all the year round.

[105] See Appendix A.

[106] Bland Sutton, loc. cit., p. 896.

[107] See H. Ellis, _Man and Woman_, Chapter XI.

[108] This is by no means true of European women only. Thus, we read in an Arabic book, _The Perfumed Garden_, that women have an aversion to coitus during menstruation. On the other hand, the old Hindoo physician, Susruta, appears to have stated that a tendency to run after men is one of the signs of menstruation.

[109] The actual period of the menstrual flow corresponds, in Heape's terminology, to the congestive stage, or _pro-oestrum_, in female animals; the _oestrus_, or period of sexual desire, immediately follows the _pro-oestrum_, and is the direct result of it. See Heape, "The 'Sexual Season' of Mammals," _Quarterly Journal of Microscopical Science_, 1900, vol. xliv, Part I.

[110] It may be noted that (as Barnes, Oliver, and others have pointed out) there is heightened blood-pressure during menstruation. Haig remarks that he has found a tendency for high pressure to be accompanied by increased sexual appetite (_Uric Acid_, 6th edition, p. 155).

[111] Sir W.F. Wade, however, remarked, some years ago, in his Ingleby Lectures (_Lancet_, June 5, 1886): "It is far from exceptional to find that there is an extreme enhancement of concupiscence in the immediate precatamenial period," and adds, "I am satisfied that evidence is obtainable that in some instances, ardor is at its maximum during the actual period, and suspect that cases occur in which it is almost, if not entirely, limited to that time." Long ago, however, the genius of Haller had noted the same fact. More recently, Icard (_La Femme_, Chapter VI and elsewhere, e.g., p. 125) has brought forward much evidence in confirmation of this view. It may be added that there is considerable significance in the fact that the erotic hallucinations, which are not infrequently experienced by women under the influence of nitrous oxide gas, are more likely to appear at the monthly period than at any other time. (D.W. Buxton, _Anesthetics_, 1892, p. 61.)

[112] Gehrung considers that in healthy young girls amorous sensations are normal during menstruation, and in some women persist, during this period, throughout life. More usually, however, as menstrual period after menstrual period recurs, without the natural interruption of pregnancy, the feeling abates, and gives place to sensations of discomfort or pain. He ascribes this to the vital tissues being sapped of more blood than can be replaced in the intervals. "The vital powers, being thus kept in abeyance, the amative sensations are either not developed, or destroyed. This, superadded by the usual moral and religious teachings, is amply sufficient, by degrees, to extinguish or prevent such feelings with the great majority. The sequestration as 'unclean,' of women during their catamenial period, as practiced in olden times, had the same tendency." (E.C. Gehrung, "The Status of Menstruation," _Transactions American Gynecology Society_, 1901, p. 48.)

[113] It is possible there may be an element of truth in this belief. Diday, of Lyons, found that chronic urethorrhoea is an occasional result of intercourse during menstruation. Raciborski (_Traite de la Menstruation_, 1868, p. 12), who also paid attention to this point, while confirming Diday, came to the conclusion that some special conditions must be present on one or both sides.

[114] See, e.g., Ballantyne, "Teratogenesis," _Transactions of the Edinburgh Obstetrical Society_, 1896, vol. xxi, pp. 324-25.

[115] As quoted by Icard, _La Femme_, etc., p. 194. I have not been able to see Negrier's work.

[116] I deal with the question of sexual anaesthesia in women in the third volume of these _Studies_: "The Sexual Impulse in Women."