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Complete Abstinence During-Pregnancy—Bad Results of Complete Abstinence—Intensity of Relations During First Four Months—Intercourse During Fifth, Sixth and Seventh Months—Intercourse During Eighth and Ninth Months—Abstinence After Birth of Child.
The question whether sexual intercourse is permissible during pregnancy is often put to the physician. Some extremists and theorists demand complete abstinence during the entire duration of pregnancy. Such abstinence is not only not feasible, but is unnecessary and may prove a disrupting factor; it may create not only dissension, it may wreck the love-life of husband and wife. I know of cases where the wife, influenced by the wrong teachings about the necessity of complete abstinence during pregnancy, about the possible injury to the child from intercourse, persisted in keeping the husband away; and the result was that the husband began to go to other women, and he got in the habit to such an extent that he refused to give up entirely, even after the child was born. It cannot be expected from a married man, who is used to more or less regular sexual relations, to abstain entirely for nine or ten months. Such a demand is unreasonable and uncalled for. All claims about the injurious effects of intercourse on the mother and child lack proof and foundation. During the first four months of pregnancy no change need be made in the usual sex relations. Their "intensity" should be moderated, their frequency need not. During the fifth, sixth and seventh months intercourse should be indulged in at rarer intervals—once in two or three weeks—the act should be performed without any violence or intensity, and the usual position should be reversed or changed to a lateral one. During the eighth and ninth months relations had best be given up altogether.
And this abstinence should last until about six weeks after the birth of the child. During this period the uterus undergoes what we call involution; that is, it goes back to the size and shape it had before pregnancy, and it is best not to disturb this process by sexual excitement, which causes engorgement and congestion.
Belief in Sexual Intercourse for Propagation Only—What Such Practice Would Lead to—Nature and the Sex-fanatics—Sexual Desire in Woman After Menopause—Sex Instinct of Sterile Men and Women—Sex Instinct Has Other High Purposes.
Some people sincerely believe that the sexual instinct is for reproductive purposes only; they claim we should never indulge in sexual intercourse unless it be for the purpose of bringing a child into the world. The act performed without such aim in view is stigmatized by them as carnal lust, as a sin. Some even say that such an act is equivalent to an act of prostitution. To argue the question with such people would be a waste of time. It is not fair to impugn the good faith, the sincerity of your opponents, because I have convinced myself that the most insane, most bizarre notions may be held by otherwise sane people in perfect sincerity. But we cannot help questioning the reasoning faculties of people holding such beliefs.
Let us see where the belief of "sex relations for procreation only" would lead us to. In a normal healthy couple impregnation follows one connection. So if a couple wanted to limit themselves to three or four or six children, they would be entitled to have relations only three, four or six times in their lives. For it must be remembered that during pregnancy sexual relations would be prohibited, as during pregnancy no further impregnation can take place, and no intercourse must take place which has not for its purpose the conception of a new human being. If the people were believers in big families, and agreed to have twelve children—no anti-Malthusian would expect more than that—they would be entitled to twelve relations during their marital life. Assuming that not every act is followed by pregnancy, but that it takes on the average three or four times to bring about the desired result, we will have it that during the wife's childbearing period the couple may indulge in sex relations from once in three or four years to once or twice a year.
Can a sane person knowing anything about the sexual instinct make any such demands from married people living in the same house and perhaps occupying the same bed? It must be borne in mind that as soon as the wife has reached the menopause all relations must cease, because she can no longer become pregnant, and intercourse without a probable or possible pregnancy is a sin. Also remember that no matter how beautiful, young and passionate the wife may be, if she has some little trouble which makes pregnancy impossible, sex relations must be absolutely abstained from. And of course if the husband or wife is sterile, all relations must be renounced forever, no matter how strong the libido may be in one or both.
It is strange that Nature did not act according to the formula of our sex fanatics; no pregnancy, no intercourse. If she had meant it to be that way, she would have abolished sexual desire in woman immediately after the menopause. Unfortunately this is not the case. For we know that the sexual libido in women after the menopause is often and for several years stronger than before. Why? Nor has Nature abolished the sexual instinct and the passionate desire for sex relations in all those men and women who are for some reason or other sterile, or otherwise so defective that no child can result from the union.
As I stated at the beginning, it is a waste of time to argue the matter. Those who believe that sex relations are for racial purposes only, are welcome to their belief, and are welcome to live up to it. (How few of them do, though, honestly and consistently?) We must reiterate our opinion that the sex instinct has other high purposes besides that of perpetuating the race, and sex relations may and should be indulged in as often as they are conducive to man's and woman's physical, mental and spiritual health. No iron-clad rules can be laid down as to the frequency. For some people three times a year may be sufficient, others may require relations three times a month (the best for the average) and still others may not be satisfied with less than three times a week. The human libido sexualis cannot be put into an iron mould, and you should pay no attention to religious fanatics who are ignorant of physiology and psychology and who can only blunder and bungle up things.
Vaginismus—Dyspareunia—Difference Between Vaginismus and Dyspareunia—Adherent Clitoris a Cause of Masturbation and Convulsions.
By the term vaginismus we understand a painful spasm or contraction of the vaginal orifice which makes intercourse very difficult, or impossible.
Certain cases of vaginismus, or rather false vaginismus, may be due to laceration or inflammation of the vaginal orifice, but in genuine cases of vaginismus no local disease can be found, because genuine vaginismus is of nervous origin.
Dyspareunia means painful or difficult intercourse, from whatever cause. It differs from vaginismus in that the cause is generally a local one, that is, it may be inflammation, laceration as after a confinement, small size or atresia of the vagina, etc. When vaginismus is present, it is present in reference to all men, in fact the mere touch of the finger or an instrument may call forth a painful spasm; while dyspareunia may show itself with one man and be absent with another. The origin of the word dyspareunia shows that this may be the case, for dyspareunos in Greek means badly mated.
Dyspareunia must not be confused with true vaginismus. In dyspareunia the sexual act can be freely indulged in, only the act is painful or disagreeable. In vaginismus intercourse is impossible. In exceptional cases where the husband attempts to use brute force, the wife may faint away, she may get a convulsion or become wildly hysterical. If the husband insists in attempting relations, the wife may run away, or in exceptional cases even attempt suicide.
The word phimosis means "muzzling," and it is a term applied to a constriction or narrowing of the foreskin, so that the glands of the clitoris cannot be freely uncovered. This condition may give rise to an accumulation of smegma or secretion which may cause inflammation, itching, and nervous irritation. This in its turn may be the cause of masturbation. It is claimed by some that an adherent clitoris may even be the cause of convulsions resembling epilepsy. In some cases it leads to an irritable bladder, inability to retain the urine, and nocturnal bed-wetting.
In all girls, big or little, that show a tendency to masturbate or simply to handle the genitals, or that complain of itching, the clitoris should be examined and if adhesions are found they should be separated. This can easily be done under a local anesthetic.
Definition of Sterility—Husband Should First be Examined—One-child Sterility—The Fertile Woman—Salpingitis as a Cause of Sterility—Leucorrhea and Sterility—Displacement of Uterus and Sterility—Closure of Neck of Womb and Sterility—Sterility and Constitutional Disease—Treatment of Sterility.
Sterility or barrenness is a condition of inability to have children. In former years the opinion prevailed generally, whenever a couple was childless, that the fault was exclusively the woman's. It wasn't even thought that the man could be to blame. We now know that in at least fifty per cent. of cases of sterility, or childless marriages, the fault is not the woman's but the man's. It is therefore very unwise in conditions of sterility to subject the wife to treatment without first examining the husband. Nevertheless, this is still often the case, particularly among the lower classes or among the ignorant. There are cases where the woman goes from one doctor to another for years and is subjected to all kinds of treatment, when a simple examination of the husband would show that the fault lies with him.
Some women have one child and are unable afterwards to give birth to any more. Such a condition is called one-child-sterility. It is generally due to an inflammation of the Fallopian tubes which closes up the openings of the tubes into the womb, so that no more ova can pass from the ovaries through the tubes into the womb. This inflammation may be the result of childbirth, for childbirth alone may set up an inflammation, or it may be due to an infection contracted from the husband.
In order to be fertile, that is, to be able to conceive and give birth to a living child, the woman's external and internal genital organs must be normal, her ovaries must produce healthy ova, and there must be no obstruction on the way, so that the ova and the spermatozoa can meet. The mucous membrane of the womb must also be healthy, so that when the impregnated ovum gets attached to the womb it may develop there without any trouble, and not become diseased or poorly nourished and cast off.
We must always remember that the woman's share in bringing forth children and perpetuating the race is much more important than the man's. When a man has discharged his spermatozoa his work is done—the woman's only commences.
The conditions which cause sterility in women are many, but the most common cause is a salpingitis or an inflammation of the Fallopian tubes, which may be caused by gonorrhea or any other inflammation. A severe leucorrhea may also
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