PERIOD I. THE FUNCTIONS AND DISORDERS OF THE REPRODUCTIVE ORGANS IN CHILDHOOD. PART I. NORMAL FUNCTIONS. IN a state of health no sexual idea should ever enter a child's mind. All its vital energy should be employed in building up the growing body, and in storing up external impressions and educating the brain to receive them. During a well-regulated childhood, and in the case of ordinary temperaments, there is no temptation to infringe this primary law of nature. The sexes, it is true, in English homes, are allowed most unrestricted companionship. Experience shows, however, that this intimacy is not only unattended with evil results, but is productive, in the immense majority of instances, of great benefit. At a very early age the pastimes of the boy and girl diverge. The boy takes to more boisterous amusements, and affects the society of boys older than himself, simply because they make rougher, or, in his opinion, manlier playfellows, while the little girls' quieter games are despised, and their society, to a considerable extent, deserted. This tendency, often stigmatized as rudeness, and lamented over by anxious parents, may almost be regarded as a provision of nature against possible danger. At any rate, in healthy subjects, and especially in children brought up in the pure air, and amid the simple amusements of the country, perfect freedom from, and indeed total ignorance of, any sexual affection is, as it should always be, the rule. The first and only feeling exhibited between the sexes in the young should be that pure fraternal and sisterly affection, which it is the glory and blessing of our simple English home-life to create and foster with all its softening influences on the after-life. Education, of course, still further separates children, as they grow into boys and girls-and the instinctive and powerful check of natural modesty is an additional safeguard. Thus it happens that with most healthy and well-brought up children, no sexual notion or feeling has ever entered their heads, even in the way of speculation. I believe that healthy children's curiosity is hardly ever excited on sexual subjects except in cases when such questions are purposely suggested, or where bad example has demoralized them. Nor is this purity and ignorant innocence in children in any way unnatural. It is true that a different rule prevails among many of the lower animals. For instance, no one can have seen young lambs gamboling together without noticing at what an early age the young rams evince the most definite sexual propensities. This precocity in them is evidently intuitive, as it cannot depend on the force of example. But the condition of the two cases is widely different. The animal's life is generally much shorter than that of man-its growth is more rapid, its office in the world is lower and more material, its maturity is sooner reached, and sexual propensities are therefore naturally exhibited at a much earlier age. In still lower forms of life the sexual period is earlier still. In many species of insects, no sooner is the perfect insect produced than it proceeds at once to the exercise of the function of procreation, which, completed, its own existence ceases. Very different should be the case with the human being, whose slowly-maturing frame needs all the strength, and all the nutrition it so urgently demands for the creation, nourishment, and consolidation of the muscular and osseous systems, rather than for sexual development. PART II. DISORDERS IN CHILDHOOD. IT were well if the child's reproductive organs always remained in this quiescent state till puberty. This is unfortunately not the case. CHAPT. I.-SEXUAL PRECOCITY. In many instances, either from hereditary predisposition, bad companionship, or other evil influences, sexual feelings are excited at a very early age, and too often with the most deplorable consequences. Slight signs are sufficient to indicate when a boy has this unfortunate predisposition. He shows marked preferences. You will see him single out one girl, and evidently derive an unusual pleasure, for a boy, in her society. His penchant does not take the ordinary form of a boy's good nature, but little attentions that are generally reserved for a later period prove that his feeling is different, and sadly premature. He may be quite healthy, and fond of playing with other boys, still there are slight but ominous indications of propensities fraught with danger to himself. His play with the girl is different from his play with his brothers. His kindness to her is a little too ardent. He follows her he does not know why. He fondles her with a tenderness painfully suggestive of a vague dawning of passion. No one can find fault with him. He does nothing wrong. Parents and friends are delighted at his gentleness and politeness, and not a little amused at the early flirtation. But if they were wise they would rather feel profound anxiety; and he would be an unfaithful or unwise medical friend who did not, if an opportunity occurred, warn them that the boy, unsuspicious and innocent as he is, should be carefully watched, and removed from every influence that could possibly excite his slumbering tendencies. The premature development of the sexual inclination is not alone repugnant to all we associate with the term childhood, but is also fraught with danger to his dawning manhood. Extreme youth should be attended by complete repose of the generative functions, unbroken by anything like even a desire for their employment. On the judicious treatment of a case such as has been sketched, it probably depends whether the dangerous propensity is so kept in check as to preserve the boy's health and innocence, or whether one more shattered constitution and wounded conscience is to be added to the victims of early sexual tendencies and careless training. For it should not be forgotten that in such cases a quasisexual power often accompanies these premature sexual inclinations. Few, perhaps, know how early a mere infant may experience erections. The medical man, however, often notices that a little child's penis towards morning is completely erect, though the fact has escaped the observation of both parent and nurse. They may or may not have remarked that the boy on being taken out of bed in the morning cannot make water at once. It would be as well if it were known that this often depends, as I believe, upon a more or less complete erection. PREDISPOSING CAUSES.-What the cause of this early sexual disposition in a young child may be, it is difficult to lay down with certainty in any given case. My own belief is, that there are not a few sources, in some or all of which this fatal tendency may take its rise; I should specify hereditary predisposition as by no means the least common. It cannot be denied that as children from their birth inherit a peculiar conformity of features or frame from the male or female parent, so they frequently evince, in the earlier years of childhood, mental characteristics and peculiarities, that nothing but hereditary predisposition can account for. And I believe that, as in body and mind, so also in the passions, the sins of the father are frequently visited on the heads of the children. No man or woman, I believe, can have habitually indulged their own sexual passions, to the exclusion of higher and nobler pleasures and employments, without running the risk of finding that a disposition to follow the same course has been inherited by their offspring. It is in this way only that we can explain the early and apparently almost irresistible propensity in generation after generation toward the indulgence of many animal feelings. No doubt vicious tendencies are frequently, perhaps most frequently, acquired. But I firmly believe that, when acquired, moral as well as physical diseases can be transmitted to the progeny. EXCITING CAUSES.-There are, however, not a few directly exciting causes which can, and do frequently, not only foster this terrible proclivity to early sexual feeling when acquired by inheritance, but even of themselves alone beget it. We see in many children, at a very early age, an almost ungovernable disposition to tickle and scratch the sexual organs. This most dangerous habit is not unfrequently, I believe, produced by irritation of the rectum arising from worms. In other instances it Of the existence of arises from some irritability of the bladder. this latter cause another symptom often exists, viz., the constant wetting of the bed at night. Irritation of the glans penis by the collection of secretion under the prepuce is another cause which should not be neglected. Since the time when my attention was first called to this subject I have had abundant evidence that the influence of the prepuce on these sexual dispositions has not been sufficiently noted. In the child the prepuce entirely covers the glans penis, keeping it in that constantly susceptible state which the contact of two folds of mucous membrane induces. We must recollect, moreover, that the child never draws back the foreskin, and that although the smegma is but sparely, if at all, secreted in early childhood, yet that it may, under excitement, make its appearance, and have to be removed, as in the adult, by daily ablution. PREVENTIVE TREATMENT.-My own opinion is that a long prepuce in children is a much more frequent cause of evil habits than parents or medical men have any idea of. The collection of smegma between the glans and the prepuce is almost certain to produce irritation. But I have never heard of any steps ever having been taken by those having the care of youth to induce boys to adopt proper habits of cleanliness in this respect. Children are educated to remove dirt from every other part of their bodies (where it is of less importance in its consequences than it is here). But probably no nurse, parent, schoolmaster, or even doctor, would at first relish the proposal that a boy of twelve in his bath should be told (for if not told he will never do it) to draw back his foreskin and thoroughly cleanse the glans penis every day. In my own experience of children, I have found this practice so beneficial, that I never hesitate to recommend it in any cases where there is the least sign of irritation from this cause. The only objection to recommending, and even enforcing, this thorough cleanliness in early childhood is that you run the risk of directing the boy's attention to manipulations which may excite sexual desires. My own experience in practice all points the other way. Of course it is only when a child has already evinced some irritation of the parts or other derangement in the natural condition of things that any manipulation at all is advisable, or, indeed, that any occasion for peculiar cleanliness arises. And, when any such irritation or derangement exists, if the proper steps (of which cleanliness is the most effectual) are not taken to check it, the child will in ignorance handle the organs, and the dangers arising in this way |