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be the cause of sterility, because the leucorrheal discharge may be fatal to the spermatozoa. Another cause is a severe bending or turning of the uterus either forwards or backwards. The opening of the neck of the womb, the os, may also be closed, or practically so, from ulceration, from strong applications, etc. In some cases sterility may be due to severe constitutional disease, when the person is very much run down and so anemic that menstruation stops. Unfortunately this is not always the case, for women even in the last stages of consumption may, and often do, become pregnant. Syphilis unfortunately does not cause sterility; it only causes miscarriages until controlled by treatment.

The treatment of sterility can be successfully carried out only by a competent physician, particularly by one who is devoting himself specially to this kind of work. But I want once more to impress upon every woman who is sterile, and who wants to have a child, not to have herself treated or even examined until her husband has been subjected to an examination.






Chapter FortyToC THE HYMEN

Difference Between Chastity and Virginity—Worship of Intact Hymen—Sacrificing Hymen Sometimes Essential for Health of the Girl—Certificate from Physician who has Ruptured Hymen.


I have mentioned in a previous chapter that the absence of the hymen was no proof of unchastity, just as the presence of the hymen was no proof of perfect chastity. Chastity and virginity are not synonymous, and a girl may possess physical virginity, that is, an intact hymen, and still be morally unchaste. She may be in the habit of indulging in unnatural sexual practices. But the laity does not know these facts or does not want to know them, and the intact hymen is still worshipped like a fetish. This would be of little consequence, if it did not often result in unnecessary suffering to the female child or girl. Much disease and a good deal of sterility result from the fear of tampering with the hymen.

When a boy gets some trouble with his genital organs, such as phimosis, or balanitis or whatever it may be, he is at once taken to a physician, who institutes the necessary treatment. When a little girl complains of itching around the genitals or of some discharge, the mother will hesitate long before taking her to a doctor. She will be afraid he will do something to the hymen. And so she will temporize, using salves and washes, and the disease will in the meantime be making progress, that is, getting worse. When she does take her to a physician, and he says that in order to treat the case thoroughly the hymen has to be stretched or opened, the mother will withhold her consent, and the disease will be allowed to progress. I know of many such cases. This is wrong. When the health of the girl demands and her future child-bearing power is at stake, no hesitation should be felt in sacrificing the hymen.

Though in the future the fuss which is now made about the hymen, the excessive veneration in which it is held, will appear ridiculous, and though I consider it foolish and rather humiliating to the girl, nevertheless, now, when the average husband does lay so much stress on the presence of an unruptured hymen, a physician who in the course of an operation or treatment has occasion to cut or rupture the hymen, will do well to give the patient a certificate to that effect. In case any question regarding the girl's chastity comes up in the future, she can prove by the doctor's certificate that her loss of virginity was not due to sexual relations. Of course the relations between husband and wife, or between prospective husband and wife, should be such that no "certificate" should be necessary; but reality differs from the ideal, and in some cases that we know the husband's suspicions were allayed by the doctor's oral or written statement.

This is as good a place as any to emphasize, that if the bride has a very strong, tough and resistant hymen, the new husband should not use brute force in rupturing it. First, because the pain may be too excruciating and this may create in the wife an aversion to intercourse which may last for many months or years—in some cases forever. Second, a severe hemorrhage may result, which may require the aid of a physician to stop. Wherever a case of very resistant hymen is encountered, the husband should make several attempts; gradual and gentle dilatation, with the aid of a little vaseline and not forcible rupture should be the aim; the result will usually be satisfactory. In exceptional cases, a physician may have to be called in. The operation of cutting the hymen is a trifling one.

It is also interesting to know that some wives have sex relations for months and years, and the hymen remains unruptured. Pregnancy may also result with an intact hymen.






Chapter Forty-oneToC IS THE ORGASM NECESSARY FOR IMPREGNATION?

Suppression of Orgasm by Woman to Prevent Impregnation—Bad Results of Suppression by the Woman—Orgasm: Relation of to Impregnation—A Hypothesis—A Fanciful Hypothesis—Why Passionate Women Frequently Fail to Become Mothers—Advice to Passionate Women who Desire to Conceive.


Among the laity the opinion is quite prevalent that in order for a woman to conceive she must experience an orgasm, she must have had a pleasurable voluptuous sensation during the act. If she has no orgasm, impregnation cannot take place. So sure are some women that this is so that when they want to avoid conception they repress any orgastic feeling; as they say, they don't let themselves go. Which, I will say, by the way, is one of the causes of female frigidity. If you don't habitually permit a certain feeling to develop, if you repeatedly repress it at the very beginning, at its first manifestation, it is apt to atrophy altogether, to become permanently suppressed, or the suppression develops into a nervous disorder.

Among the medical profession no perfect unanimity has been reached as to the rôle of the orgasm in impregnation. Some sexologists like Kisch and Vaerting believe it does play an important rôle; others, like Forel, believe it plays none. That the orgasm is not necessary for impregnation admits of no discussion. Women who suffer from frigidity in an extreme degree, women who never experienced an orgasm, women who repress their orgasm, women in sleep or under narcosis, women who have been raped, women who loathe their husbands, become pregnant frequently and readily. But does it play any rôle at all? Does it facilitate impregnation? Other things being equal, will intercourse accompanied by an orgasm be more likely to prove fruitful than one in which the orgasm was entirely absent? This question I am forced to answer in the affirmative. Because from the various investigations I have made it can hardly be subject to doubt that the uterus during an orgasm exerts a certain amount of suction; and that impregnation is more likely to follow when the spermatozoa are sucked up into the uterus than when left to make their own way by their own power of motion, stands to reason and goes without saying. In the former instance it takes less time for the spermatozoa to reach the ovum, and there is less chance for them to perish on the way—from malnutrition or from coming in contact with secretions of an acid reaction. There is another point. I do not bring it forth as a proved fact or as a fact susceptible to proof. It is a mere hypothesis, but in my opinion it is a correct and plausible hypothesis. I believe that the strong spasmodic contractions that take place during the orgasm have an influence not only in accelerating the bursting of a Graafian follicle and the extrusion of an ovum, but they are instrumental in aiding the Fallopian tube to grasp the ovum and helping it along on the road towards the uterus. It is therefore not at all inconceivable that conception may take place during or within a very short time after an act which is accompanied by a proper orgasm. Many women claim to experience peculiar unmistakable sensations as soon as conception has taken place, and by calculating the day of probable delivery we know that they are right. Taking therefore all the various data into consideration we are fully justified in saying that while an orgasm or a voluptuous sensation during the act is not at all necessary to impregnation, it is in many cases a helpful factor.

It is claimed by some that the offspring resulting from an orgastic act is apt to be healthier and better developed than offspring resulting from sexual intercourse in which the parties experience no orgasm. The reason given being that conception in the first instance taking place quickly, the spermatozoa are better nourished and more vigorous. In my opinion this is merely a fanciful hypothesis which needn't be taken seriously.

It will be found rather frequently that women of strong passionate natures, with strong orgastic feelings, and normal in every way, fail to become mothers. A careful investigation of their menstrual discharge will show that it is not because they failed to conceive, but because the impregnated ovum is expelled each time; in other words, they have each month a miniature miscarriage. And these miscarriages, or rather abortions, are due to the spasmodic contractions of the uterus and its adnexae which accompany the orgasm. In such cases I have advised the woman to try to remain passive during the act, to repress the orgasm, and the results have in some instances shown the wisdom of my advice. After conception has taken place, after one period has been missed, the woman should abstain from intercourse altogether or at least for two or three months until the fetus is securely attached to, or ensconced in, the uterus.






Chapter Forty-twoToC FRIGIDITY IN WOMEN

Meaning of Term Frigidity—Types of Frigidity—Large Percentage of Frigid Women—Repression of Sexual Manifestations and Frigidity—Frigidity and Masturbation—Frigidity and Sexual Weakness of Husband—Frigidity and Dislike of Husband—Organic Causes of Frigidity—A Frigid Woman May Become Passionate—Treatment of Frigidity.


The word frigidity means coldness, and when a woman has no desire for sexual relations or experiences no pleasure when she has sexual relations, she is said to be frigid.

Some cases suffer only from lack of desire, others only from lack of pleasure, and still others from both. In some cases the frigidity is congenital, that is, the lack of desire with inability to experience pleasure during the act is inborn. In most cases, however, it is acquired, or is only temporary, and is due to various causes. Frigidity is much more widespread among women than it is among men. Some physicians claim it is present in fifty per cent. of all women. This may be an exaggeration, but if we put the number at twenty-five per cent. we will be quite near the truth.

The causes of frigidity in women are many, but here are the most important ones: First and foremost is the repression of all sexual manifestations which the unmarried woman has to practice, and has had to practice for many centuries. So that a part of the frigidity is hereditary. You cannot entirely eradicate a natural instinct, but that by continually repressing it, by giving it no chance to assert itself, you may weaken it—about this there can be no question.

The second cause is masturbation. Cases that have been addicted to excessive masturbation are very apt to develop not only frigidity, but complete aversion to the sexual act, and inability to experience any pleasure or orgasm. Such cases we come across every day.

A third very important cause is sexual weakness in

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