the cradle, a difference can be seen in manner, habits of
mind, and in illness, requiring variations in their treatment.
The change is certainly hastened and intensified at the time of
puberty; but there is, even to an average observer, a clear
difference between the sexes from early infancy, gradually
becoming more marked up to puberty. That sexual feelings exist
[it would be better to say 'may exist'] from earliest infancy is
well known, and therefore this function does not depend upon
puberty, though intensified by it. Hence, may we not conclude
that the progress toward development is not so abrupt as has been
generally supposed?... The changes of puberty are all of them
dependent on the primordial force which, gradually gathering in
power, culminates in the perfection both of form and of the
sexual system, primary and secondary."

There appear to have been but few systematic observations on the
persistence of the sexual impulse in women after the menopause.
It is regarded as a fairly frequent phenomenon by Kisch, and also
by Loewenfeld (_Sexualleben und Nervenleiden_, p. 29). In America,
Bloom (as quoted in _Medical Standard_, 1896), from an
investigation of four hundred cases, found that in some cases the
sexual impulse persisted to a very advanced age, and mentions a
case of a woman of 70, twenty years past the menopause, who had
been long a widow, but had recently married, and who declared
that both desire and gratification were as great, if not greater,
than before the menopause.

Reference may finally be made to those cases in which the sexual impulse
has developed notwithstanding the absence, verified or probable, of any
sexual glands at all. In such cases sexual desire and sexual gratification
are sometimes even stronger than normal. Colman has reported a case in
which neither ovaries nor uterus could be detected, and the vagina was too
small for coitus, but pleasurable intercourse took place by the rectum and
sexual desire was at times so strong as to amount almost to nymphomania.
Clara Barrus has reported the case of a woman in whom there was congenital
absence of uterus and ovaries, as proved subsequently by autopsy, but the
sexual impulse was very strong and she had had illicit intercourse with a
lover. She suffered from recurrent mania, and then masturbated
shamelessly; when sane she was attractively feminine