[101] Pouchet, _Théorie de l'Ovulation Spontanée_, 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 (_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 these _Studies_: "The Sexual Impulse in Women."
II.
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 "the _scientific_ observation 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 research by 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 general _malaise_, 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 his _Medicina 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 diarrhoea, 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 on _Differences in the Nervous
Organization of Men and Women_, deals fully with the monthly
rhythm (pp. 270 et 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 the _Lancet_,
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, the menstrual 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. 44 et 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's _Psychological Dictionary_,
he refers to the periodic physiological heightening of the
reproductive _nisus_; 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. The _nisus generativus_ is 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 sometimes does 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 the _nisus generativus_ in 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's
_Psychological 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 the age 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 great intelligence, 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."
Periodicity has been noted in various disorders of nervous
character. Periodic insanity has long been known and studied
(see, e.g., Pilcz, _Die periodischen
Geistesstörungen_, 1901); it
is much commoner in women than in men. Periodicity has been
observed in stammering (a six-weekly period in one case), and
notably in hemicrania or migraine, by Harry Campbell, Osler, etc.
(The periodicity of a case of hemicrania has been studied in
detail by D. Fraser Harris, _Edinburgh Medical Journal_, July,
1902.) But the cycle in these cases is not always, or even
usually, of a menstrual type.
It is now possible to turn to an investigation which, although of very
limited extent, serves to place the question of a male menstrual cycle for
the first time on a sound basis. If there is such a cycle analogous to
menstruation in women, it must be a recurring period of nervous erethism,
and it must be demonstrably accompanied by greater sexual activity. In the
_American Journal of Psychology_ for 1888, Mr. Julius Nelson, afterward
Professor of Biology at the Rutgers College of Agriculture, New Brunswick,
published a study of dreams in which he recorded the results of detailed
observations of his dreams, and also of seminal emissions during sleep (by
him termed "gonekbole" or "ecbole"), during a period of something over two
years. Mr. Nelson found that both dreams and ecboles fell into a
physiological cycle of 28 days. The climax of maximum dreaming (as
determined by the number of words in the dream record) and the climax of
maximum ecbole fell at the same point of the cycle, the ecbolic climax
being more distinctly marked than the dream climax.
The question of cyclic physiological changes is considerably
complicated by our uncertainty regarding the