II.

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 ofpro-œstrum, and in part, a psychological fact due to the æsthetic 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. Négrier,[115]in the lying-in wards of the Hôtel-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 placein 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 anæsthesia.[116]

The majority of authorities admit a heightening of sexual emotion before or after the menstrual crisis. Seee.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 (Bréviaire de l'Amour Expérimentale, 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 œstrus 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 œstrus. Dr. Elizabeth Blackwell, again, in her book onThe Human Element in Sex, asserts that the menstrual flow itself affordscomplete 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.

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 œstrus 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 œstrus. Dr. Elizabeth Blackwell, again, in her book onThe Human Element in Sex, asserts that the menstrual flow itself affordscomplete 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.

[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 Näcke, "Die Menstruation und ihr Einfluss bei chronischen Psychosen,"Archiv für 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 Nervenzustände, 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 für 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'sVergleichende Physiologie der Haussaügethiere, 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, andBritish Gynecological Journal, vol. ii.

[92]

W. Heape, "The Menstruation ofSemnopithecus Entellus,"Philosophical Transactions, 1894; "Menstruation and Ovulation ofMacacus Rhesus,"Philosophical Transactions, 1897.

[93]

W. L. Distant, "Notes on the Chacma Baboon,"Zoölogist, January, 1897, p, 29.

[94]

Nature, March 23, 1899.

[95]

W. Heape, "The Menstruation ofSemnopithecus 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 theBritish Medical Journal, October 31, 1896. As regards the more normal influence of the ovaries over the uterus, seee.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 für Gynäkologie, No. 49, 1893; summarized inBritish Medical Journal, December, 1893. Many cases show that pregnancy may occur in the absence of menstruation. See,e.g.,Nouvelles Archives d'Obstétrique et de Gynécologie, 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 œstrous 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,Théorie de l'Ovulation Spontanée, 1847. As Blair Bell and Pontland Hick remark ("Menstruation,"British Medical Journal, March 6, 1909), the repeated œstrus 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 theseStudies, "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, orpro-œstrum, in female animals; theœstrus, or period of sexual desire, immediately follows thepro-œstrum, 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 urethorrhœa is an occasional result of intercourse during menstruation. Raciborski (Traité 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 Négrier's work.

[116]

I deal with the question of sexual anæsthesia in women in the third volume of theseStudies: "The Sexual Impulse in Women."

The Question of a Monthly Sexual Cycle in Men—The Earliest Suggestions of a General Physiological Cycle in Men—Periodicity in Disease—Insanity, Heart Disease, etc.—The Alleged Twenty-three Days' Cycle—The Physiological Periodicity of Seminal Emissions during Sleep—Original Observations—Fortnightly and Weekly Rhythms.

For some centuries, at least, inquisitive observers here and there have thought they found reason to believe that men, as well as women, present various signs of a menstrual physiological cycle. It would be possible to collect a number of opinions in favor of such a monthly physiological periodicity in men. Precise evidence, however, is, for the most part, lacking. Men have expended infinite ingenuity in establishing the remote rhythms of the solar system and the periodicity of comets. They have disdained to trouble about the simpler task of proving or disproving the cycles of their own organisms.[117]It is over half a century since Laycock wrote that "thescientificobservation and treatment of disease are impossible without a knowledge of the mysterious revolutions continually taking place in the system"; yet the task of summarizing the whole of our knowledge regarding these "mysterious revolutions" is even to-day no heavy one. As to the existence of a monthly cycle in the sexual instincts of men, with a single exception, I am not aware that any attempt has been made to bring forward definite evidence.[118]A certain interest and novelty attaches, therefore, to the evidence I am able to produce, although that evidence will not suffice to settle the question finally.

The great Italian physician, Sanctorius, who was in so many ways the precursor of our modern methods of physiological researchby the means of instruments of precision, was the first, so far as I am aware, to suggest a monthly cycle of the organism in men. He had carefully studied the weight of the body with reference to the amount of excretions, and believed that a monthly increase in weight to the amount of one or two pounds occurred in men, followed by a critical discharge of urine, this crisis being preceded by feelings of heaviness and lassitude.[119]Gall, another great initiator of modern views, likewise asserted a monthly cycle in men. He insisted that there is a monthly critical period, more marked in nervous people than in others, and that at this time the complexion becomes dull, the breath stronger, digestion more laborious, while there is sometimes disturbance of the urine, together with generalmalaise, in which the temper takes part; ideas are formed with more difficulty, and there is a tendency to melancholy, with unusual irascibility and mental inertia, lasting a few days. More recently Stephenson, who established the cyclical wave-theory of menstruation, argued that it exists in men also, and is really "a general law of vital energy."[120]

Sanctorius does not appear to have published the data on which his belief was founded. Keill, an English, follower of Sanctorius, in hisMedicina Statica Britannica(1718), published a series of daily (morning and evening) body-weights for the year, without referring to the question of a monthly cycle. A period of maximum weight is shown usually, by Keill's figures, to occur about once a month, but it is generally irregular, and cannot usually be shown to occur at definite intervals. Monthly discharges of blood from the sexual organs and other parts of the body in men have been recorded in ancient and modern times, and were treated of by the older medical writers as an affliction peculiar to men with a feminine system. (Laycock,Nervous Diseases of Women, p. 79.) A summary of such cases will be found in Gould and Pyle (Anomalies and Curiosities of Medicine, 1897, pp. 27-28). Laycock (Lancet, 1842-43, vols. i and ii) brought forward cases of monthly and fortnightly cycles in disease, and asserted "the general principle that there are greater and less cycles of movements going on in the system, involving each other, and closely connected with the organization of the individual." He was inclined to accept lunar influence,and believed that the physiological cycle is made up of definite fractions and multiples of a period of seven days, especially a unit of three and a half days. Albrecht, a somewhat erratic zoölogist, put forth the view a few years ago that there are menstrual periods in men, giving the following reasons: (1) males are rudimentary females, (2) in all males of mammals, a rudimentary masculine uterus (Müller's ducts) still persists, (3) totally hypospadic male individuals menstruate; and believed that he had shown that in man there is a rudimentary menstruation consisting in an almost monthly periodic appearance, lasting for three or four days, of white corpuscles in the urine (Anomalo, February, 1890). Dr. Campbell Clark, some years since, made observations on asylum attendants in regard to the temperature, during five weeks, which tended to show that the normal male temperature varies considerably within certain limits, and that "so far as I have been able to observe, there is one marked and prolonged rise every month or five weeks, averaging three days, occasional lesser rises appearing irregularly and of shorter duration. These observations are only made in three cases, and I have no proof that they refer to the sexual appetite" (Campbell Clark, "The Sexual Reproductive Functions," Psychological Section, British Medical Association, Glasgow, 1888; also, private letters). Hammond (Treatise on Insanity, p. 114) says: "I have certainly noted in some of my friends, the tendency to some monthly periodic abnormal manifestations. This may be in the form of a headache, or a nasal hæmorrhage, or diarrhœa, or abundant discharge of uric acid, or some other unusual occurrence. I think," he adds, "this is much more common than is ordinarily supposed, and a careful examination or inquiry will generally, if not invariably, establish the existence of a periodicity of the character referred to."Dr. Harry Campbell, in his book onDifferences in the Nervous Organization of Men and Women, deals fully with the monthly rhythm (pp. 270et seq.), and devotes a short chapter to the question, "Is the Menstrual Rhythm peculiar to the Female Sex?" He brings forward a few pathological cases indicating such a rhythm, but although he had written a letter to theLancet, asking medical men to supply him with evidence bearing on this question, it can scarcely be said that he has brought forward much evidence of a convincing kind, and such as he has brought forward is purely pathological. He believes, however, that we may accept a monthly cycle in men. "We may," he concludes, "regard the human being—both male and female—as the subject of a monthly pulsation which begins with the beginning of life, and continues till death," menstruation being regarded as a function accidentally ingrafted upon this primordial rhythm.It is not unreasonable to argue that the possibility of such a menstrual cycle is increased, if we can believe that in women, also, themenstrual cycle persists even when its outward manifestations no longer occur. Aëtius said that menstrual changes take place during gestation; in more modern times, Buffon was of the same opinion. Laycock also maintained that menstrual changes take place during pregnancy (Nervous Diseases of Women, p. 47). Fliess considers that it is certainly incorrect to assert that the menstrual process is arrested during pregnancy, and he refers to the frequency of monthly epistaxis and other nasal symptoms throughout this period (W. Fliess,Beziehungen zwischen Nase und Geschlechts-Organen, pp. 44et seq.). Beard, who attaches importance to the persistence of a cyclical period in gestation, calls it the muffled striking of the clock. Harry Campbell (Causation of Disease, p. 54) has found post-climacteric menstrual rhythm in a fair sprinkling of cases up to the age of sixty.

Dr. Harry Campbell, in his book onDifferences in the Nervous Organization of Men and Women, deals fully with the monthly rhythm (pp. 270et seq.), and devotes a short chapter to the question, "Is the Menstrual Rhythm peculiar to the Female Sex?" He brings forward a few pathological cases indicating such a rhythm, but although he had written a letter to theLancet, asking medical men to supply him with evidence bearing on this question, it can scarcely be said that he has brought forward much evidence of a convincing kind, and such as he has brought forward is purely pathological. He believes, however, that we may accept a monthly cycle in men. "We may," he concludes, "regard the human being—both male and female—as the subject of a monthly pulsation which begins with the beginning of life, and continues till death," menstruation being regarded as a function accidentally ingrafted upon this primordial rhythm.

It is not unreasonable to argue that the possibility of such a menstrual cycle is increased, if we can believe that in women, also, themenstrual cycle persists even when its outward manifestations no longer occur. Aëtius said that menstrual changes take place during gestation; in more modern times, Buffon was of the same opinion. Laycock also maintained that menstrual changes take place during pregnancy (Nervous Diseases of Women, p. 47). Fliess considers that it is certainly incorrect to assert that the menstrual process is arrested during pregnancy, and he refers to the frequency of monthly epistaxis and other nasal symptoms throughout this period (W. Fliess,Beziehungen zwischen Nase und Geschlechts-Organen, pp. 44et seq.). Beard, who attaches importance to the persistence of a cyclical period in gestation, calls it the muffled striking of the clock. Harry Campbell (Causation of Disease, p. 54) has found post-climacteric menstrual rhythm in a fair sprinkling of cases up to the age of sixty.

It is somewhat remarkable that, so far as I have observed, none of these authors refer to the possibility of any heightening of the sexual appetite at the monthly crisis which they believe to exist in men. This omission indicates that, as is suggested by the absence of definite statements on the matter of increase of sexual desire at menstruation, it was an ignored or unknown fact. Of recent years, however, many writers, especially alienists, have stated their conviction that sexual desire in men tends to be heightened at approximately monthly intervals, though they have not always been able to give definite evidence in support of their statements.

Clouston, for instance, has frequently asserted this monthly periodic sexual heightening in men. In the article, "Developmental Insanity," in Tuke'sPsychological Dictionary, he refers to the periodic physiological heightening of the reproductivenisus; and, again, in an article on "Alternation, Periodicity, and Relapse in Mental Diseases" (Edinburgh Medical Journal, July, 1882), he records the case of "an insane gentleman, aged 49, who, for the past twenty-six years, has been subject to the most regularly occurring brain-exaltation every four weeks, almost to a day. It sometimes passes off without becoming acutely maniacal, or even showing itself in outward acts; at other times it becomes so, and lasts for periods of from one to four weeks. It is always preceded by an uncomfortable feeling in the head, and pain in the back, mental hebetude, and slight depression. Thenisus generativusis greatly increased, and he says that, if in that condition, he has full and free seminal emissions during sleep, the excitement passes off; if not, it goes on. A full dose of bromide or iodide of potassium often, but not always, has the effect of stopping the excitement, and a very long walk sometimesdoes the same. When the excitement gets to a height, it is always followed by about a week of stupid depression." In the same article Clouston remarks: "I have for a long time been impressed with the relationship of the mental and bodily alternations and periodicities in insanity to the great physiological alternations and periodicities, and I have generally been led to the conclusion that they are the same in all essential respects, and only differ in degree of intensity or duration. By far the majority of the cases in women follow the law of the menstrual and sexual periodicity; the majority of the cases in men follow the law of the more irregular periodicities of thenisus generativusin that sex. Many of the cases in both sexes follow the seasonal periodicity which perhaps in man is merely a reversion to the seasonal generative activities of the majority of the lower animals." He found that among 338 cases of insanity, chiefly mania and melancholia, 46 per cent, of females and 40 per cent, of males showed periodicity,—diurnal, monthly, seasonal, or annual, and more marked in women than in men, and in mania than in melancholia,—and adds: "I found that the younger the patient, the greater is the tendency to periodic remission and relapse. The phenomenon finds its acme in the cases of pubescent and adolescent insanity."Conolly Norman, in the article "Mania, Hysterical" (Tuke'sPsychological Dictionary), states that "the activity of the sexual organs is probably in both sexes fundamentally periodic."Krafft-Ebing records the case of a neurasthenic Russian, aged 24, who experienced sexual desires of urologinic character, with fair regularity, every four weeks (Psychopathia Sexualis), and Näcke mentions the case of a man who had nocturnal emissions at intervals of four weeks (Archiv für Kriminal-Anthropologie, 1908, p. 363), while Moll (Libido Sexualis, Bd. I, pp. 621-623) recorded the case of a man, otherwise normal, who had attacks of homosexual feeling every four weeks, and Rohleder (Zeitschrift für Sexualwissenschaft, Nov., 1908) gives the case of an unmarried slightly neuropathic physician who for several days every three to five weeks has attacks of almost satyriacal sexual excitement.Féré, whose attention was called to this point, from time to time noted the existence of sexual periodicity. Thus, in a case of general paralysis, attacks of continuous sexual excitement, with sleeplessness, occurred every twenty-eight days; at other times, the patient, a man of 42, in the stage of dementia, slept well, and showed no signs of sexual excitation (Société de Biologie, October 6, 1900). In another case, of a man of sound heredity and good health till middle life, periodic sexual manifestations began from puberty, with localized genital congestion, erotic ideas, and copious urination, lasting for two or three days. These manifestations became menstrual, with a period of intermenstrual excitement appearing regularly, but never became intense. Between theage of 36 and 42, the intermenstrual crises gradually ceased; at about 45, the menstrual crises ceased; the periodic crises continued, however, with the sole manifestation of increased frequency of urination (Société de Biologie, July 23, 1904). In a third case, of sexual neurasthenia, Féré found that from puberty, onwards to middle life, there appeared, every twenty-five to twenty-eight days, tenderness and swelling below the nipple, accompanied by slight sexual excitation and erotic dreams, lasting for one or two days (Revue de Médecine, March, 1905).

Conolly Norman, in the article "Mania, Hysterical" (Tuke'sPsychological Dictionary), states that "the activity of the sexual organs is probably in both sexes fundamentally periodic."

Krafft-Ebing records the case of a neurasthenic Russian, aged 24, who experienced sexual desires of urologinic character, with fair regularity, every four weeks (Psychopathia Sexualis), and Näcke mentions the case of a man who had nocturnal emissions at intervals of four weeks (Archiv für Kriminal-Anthropologie, 1908, p. 363), while Moll (Libido Sexualis, Bd. I, pp. 621-623) recorded the case of a man, otherwise normal, who had attacks of homosexual feeling every four weeks, and Rohleder (Zeitschrift für Sexualwissenschaft, Nov., 1908) gives the case of an unmarried slightly neuropathic physician who for several days every three to five weeks has attacks of almost satyriacal sexual excitement.

Féré, whose attention was called to this point, from time to time noted the existence of sexual periodicity. Thus, in a case of general paralysis, attacks of continuous sexual excitement, with sleeplessness, occurred every twenty-eight days; at other times, the patient, a man of 42, in the stage of dementia, slept well, and showed no signs of sexual excitation (Société de Biologie, October 6, 1900). In another case, of a man of sound heredity and good health till middle life, periodic sexual manifestations began from puberty, with localized genital congestion, erotic ideas, and copious urination, lasting for two or three days. These manifestations became menstrual, with a period of intermenstrual excitement appearing regularly, but never became intense. Between theage of 36 and 42, the intermenstrual crises gradually ceased; at about 45, the menstrual crises ceased; the periodic crises continued, however, with the sole manifestation of increased frequency of urination (Société de Biologie, July 23, 1904). In a third case, of sexual neurasthenia, Féré found that from puberty, onwards to middle life, there appeared, every twenty-five to twenty-eight days, tenderness and swelling below the nipple, accompanied by slight sexual excitation and erotic dreams, lasting for one or two days (Revue de Médecine, March, 1905).

It is in the domain of disease that the most strenuous and, on the whole, the most successful efforts have been made to discover a menstrual cycle in men. Such a field seems promising at the outset, for many morbid exaggerations or defects of the nervous system might be expected to emphasize, or to free from inhibition, fundamental rhythmical processes of the organism which in health, and under the varying conditions of social existence, are overlaid by the higher mental activities and the pressure of external stimuli. In the eighteenth century Erasmus Darwin wrote a remarkable and interesting chapter on "The Periods of Disease," dealing with solar and lunar influence on biological processes.[121]Since then, many writers have brought forward evidence, especially in the domain of nervous and mental disease, which seems to justify a belief that, under pathological conditions, a tendency to a male menstrual rhythm may be clearly laid bare.

We should expect an organ so primitive in character as the heart, and with so powerful a rhythm already stamped upon its nervous organization, to be peculiarly apt to display a menstrual rhythm under the stress of abnormal conditions. This expectation might be strengthened by the menstrual rhythm which Mr. Perry-Coste has found reason to suspect in pulse-frequency during health. I am able to present a case in which such a periodicity seems to be indicated. It is that of a gentleman who suffered severely for some years before his death from valvular disease of the heart, with a tendency to pulmonary congestion, and attacks of "cardiac asthma." His wife, a lady of greatintelligence, kept notes of her husband's condition,[122]and at last observed that there was a certain periodicity in the occurrence of the exacerbations. The periods were not quite regular, but show a curious tendency to recur at about thirty days' interval, a few days before the end of every month; it was during one of these attacks that he finally died. There was also a tendency to minor attacks about ten days after the major attacks. It is noteworthy that the subject showed a tendency to periodicity when in health, and once remarked laughingly before his illness: "I am just like a woman, always most excitable at a particular time of the month."

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