General Causes of Sterility

marriage, relative, individuals, marriages, conception, sterile, sexual, husband, fruitful and whites

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Bastard We have seen the evil consequences of misce genation among animals, and have noticed that like results ocenr when human beings of different races intermarry. The union of Teutonic whites with negrocs gives us mulattoes; the union of Romanic whites with Indians or Malays gives us Mestizos. Difference of race certainly forms no obstacle to conception. It is difficult to decide whether fecundity is impaired thereby, since the half-breeds are mostly of illegi timate origin, and the fruitfulness of the occasional and unstable unions which originate from them cannot be compared with that of regular and permanent sexual union. Nor can we say much with certainty as to the fecundity of the offspring of such unions, for they intermarry, as a rule. with the full-blooded races, and so neutralize any ill effects which may be present. Unions between whites and negroes or Indians seem to be much more fruitful than those between whites and Australians; ster ility and physical deformity appearing to be common results in the latter case. Undoubtedly social and religious relations hinder the propagation of the bastard or mixed races. But the impression remains that human miscegenation has but little effect upon fecundity.

Want qf Sexual Unity.—The term " relative sterility,'' by which this condition was formerly known, has come to mean something entirely different, and the above designation seems to us to be preferable. It plays an important part in popular estimation and in popular medical writings. By it is meant the condition in which long and regular cohabi tation between two individuals remains without result, though each one can procreate with other individuals. Marriages which have long been &teriIe are pointed out, in which after their dissolution both man and wouian have produced children in another marriage. This is supposed to prove that the conjugation of two otherwise perfectly healthy persons may result in the neutralization of the power of propagation. Aristotle even promulgated a theory to account for this relative sterility, and it found a skillful advocate in Virey, who ascribes the failure to a want of " harmonie d'amour." Haller saw in the same fault the cause of many a sterile marriage. But one need not even be a physician to recognize the existence of the multitude of unhappy and yet fruitful marriages which every day occur, and which effectually disprove any such theory. Others believe that incompatibility of temperament among the parents hinders conception, but the experiences of ordinary marriages show this view to be untenable. :Finally, the experience of the gynecologists shows that differences in the amount of sexual passion are of no account. To this subject we will return later.

The theory which seeks to explain relative sterility by a difference in age between the conjugating parties is more plausible. If, however, this difference is extreme, the man must either be very old, or the woman be near the climacteric, and the sterility may well be ascribed to the virtual impotence of one or the other party.

It has been pointed out that a soil which will grow one kind of grain may be entirely unsuitable for another kind, but we are dealing here not with different species, but simply with different individuals of one and the same species. Breeders o' horses, cows, swine, dogs, doves, and other animals, have made observations similar' to those seen in human beings We may well claim that it is probably but very seldom that the conditions are such as to permit us to assume the existence of relative sterility. Only when, after many years of sterile married life, the parties main, other individuals and reproduce, can we assume its existence with any degree of certainty. Though it is claimed that such cases are of fre quent occurrence, I can recollect none, and even if I could, it would be necessary to obtain exact date as to the conditions of sexual congress in the first.marriage, before hazareing an opinion.

If I am not mistaken, the lay opinion as to relative sterility is based upon another and more frequent experience. I mean cases where preg nancy occurs after a long fruitless marriage, and is ascribed to the illegal influence of a third person, to whom perhaps the child that is born bears a striking resemblance. It is very evident here, however, that male ster ility has been the cause of the infecundity. Such cases, and those of childless widows, whose second marriage has been fruitful, are, therefore, indecisive, as the following example will show: Mrs. K., twenty-eight years old, married for the second time eight months ago. First marriage lasted five years, and was sterile. She con sulted me as t,o her prospects of offspring, and examination revealed noth ing abnormal. Four months later she conceived. Careful questioning revealed the fact that her first husband, though apparently healthy, had for years fulfilled his marital duties but very rarely and insufficiently. Ile died of a rapid phthisis. Here without doubt there was an absolute sterility of the first husband.

Of even less value are the eases where a new and sterile marriage fol lows a fornier fruitful one; advancing age, and acquired hindrances to conception playing an important part. The marriage of Napoleon with Josephine is often cited as an example of relative sterility. She had chil dren by her first marriage with Beauharnais, and none by Napoleon, and the latter had a. child from his -subsequent marriage to Maria Louisa. 'Phis only shows, however, that Josephine, thirty-five years old. entered upon her second marriage in a state of acquired sterility. The following case is a striking one of this kind: Mrs. L., thirty-nine years old, since fifteen years in second sterile marriage. First marriage lasted three years; one difficult delivery. Present husband had several children in his first marriage. The cause of the unfruitfulness was found in the woman; there were masses of exu dation in Douglas's pouch, which fixed the uterus posteriorly, and en closed the ovaries. She had liacl peritonitis after her childbirth.

But though many cases of relative sterility will not bear close investi gation, and turn out to be absolute sterility on the part of husband or wife. the possibility of the occurrence of the condition cannot be denied. The conjugation necessary to conception may be an imperfect one between any two individuals. In rare cases this may be due to imperfect cohab itation; as in the case related by a French author, where a stranger im pregnsted the woman by practising coitus in an unusual position. More commonly we must look at some impossibility of mixture of the elements of conception to explain the sterility. Marriages between blood .relations have been cited in this connection, but not very happily, since the sterility is only seen in the descendants of such marriages. It is then due to con stitutional degeneration, and cannot be referred to what we understand as relative sterility.

Much worthier of consideration is Mayrhofer's supposition, that the penetrating power of the zoosperms, and the resistance of the envelope of the ovum, may vary 41 different individuals. Ile bases his opinion upon Schenk's experiments upon the fructification of the mammalian ovum outside the mother, who found that the layer of cells originating from the discus oophorus and surrounding the egg, though apparently of like size and equally developed, might in one specimen permit the spermatozoa to reach the zona pellucida, and in another prevent their passage. The attempts at artificial bastard impregnation in batrachians and fishes, often difficult or impossible, have a bearing here.

It should always be remembered that cases of human sterility due ta sexual disharmony are exceedingly rare, aud that most cases supposed t() be of this nature can be otherwise explained.

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