Sex and Society by William I. Thomas

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A committee reported to the British Association for the Advancement of
Science, in 1894,[45] that of some 50,000 children (26,287 boys, and
23,713 girls) seen personally by Dr. Francis Warner (1892-94) 8,941
were found defective in some respect. Of these, 19 per cent. (5,112)
were boys, and 16 per cent. (3,829) were girls.

An examination of 1,345 idiots and imbeciles in Scotland by Mitchell
showed the following distribution of the sexes:

Male Female Male Female
Idiots 430 284 or 100 to 66.0
Imbeciles 321 310 or 100 to 96.5

showing that "the excess of males is much greater among idiots than
among imbeciles; in other words, that the excess of males is most
marked in the graver forms of the disease."[46]

A census of the insane in Prussia in 1880 showed that 9,809 males and
7,827 females were born idiots. Koch's statistics of insanity show
that in idiots there is almost always a majority of males, in the
insane, a majority of females. But the majority of male idiots is so
much greater than the majority of female insane that when idiots and
insane are classed together there remains a majority of males.[47]
Insanity is, however, more frequently induced by external conditions,
and less dependent on imperfect or arrested cerebral development.
Mayr has shown from statistics of Bavaria that insanity is infrequent
before the sixteenth year; and even before the twentieth year the
number of insane is not considerable.[48] In insanity the chances
of recovery of the female are greater than those of the male, and
mortality is higher among insane men than among insane women. There
is practical agreement among pathologists on this point.[49] Campbell
points out in detail[50] that the male sex is more liable than
the female to gross lesions of the nervous system--a fact which he
attributes to the greater variability of the male.

An excess of all other anatomical anomalies, except cleft palate,
is reported among males. Manley reports that of 33 cases of harelip
treated by him only 6 were females.[51] It appears also that
supernumerary digits are more frequent in males. Wilder[52] has
recorded 152 cases of individuals with supernumerary digits, of whom
86 were males, 39 females, and 27 of unknown sex. A similar relation,
according to Bruce, exists in regard to supernumerary nipples.[53]

Muscular abnormalities, monstrosities, deaf-mutism, clubfoot, and
transposition of viscera are also reported as of commoner occurrence
in men than in women.[54] Lombroso states that congenital criminals
are more frequently male than female.[55] Cunningham noted an eighth
(true) rib in 14 of 70 subjects examined. It occurred 7 times in
males and 7 times in females, but the number of females examined
was twice as large as the number of males.[56] The reports of the
registrar-general show that for the years 1884-88, inclusive, the
deaths from congenital defects (spina bifida, imperforate anus, cleft
palate, harelip, etc.) were, taking the average of the five years,
49.6 per million of the persons living in England for the male sex,
and 44.2 for the female.[57]

It has already been noted as a general rule throughout nature that
the male seeks the female and physicians generally believe that men
are sexually more active than women,[58] though woman's need of
reproduction is greater,[59] and celibacy unquestionably impresses
the character of women more deeply than that of man. Additional
evidence of the greater sexual activity of man is furnished by
the overwhelmingly large proportion of the various forms of sexual
perversion reported by psychiatrists in the male sex.

Pathological variations do not become fixed in the species, because
of their disadvantageous nature, but their excess in the male is, as
we have seen in the case of variations which have become fixed, an
expression of the more energetic somatic habit of the male.

A very noticeable expression of the anabolism of woman is her tendency
to put on fat. "Women, as a class, show a greater tendency to put on
fat than men, and the tendency is particularly well marked at puberty,
when some girls become phenomenally stout."[60] The distinctive beauty
of the female form is due to the storing of adipose tissue, and the
form even of very slender women is gracefully rounded in comparison
with that of man. Bischoff found the following relation between muscle
and fat in a man of 33, a woman of 22, and a boy of 16, all of whom
died accidentally and in good physical condition:

Man Woman Boy
Muscle 41.18 35.8 44.2
Fat 18.2 28.2 13.9

The steatopyga of the women of some races and the accumulation of
adipose tissue late in life are quasi-pathological expressions of this
tendency.

In tracing the transition from lower to higher forms of life, we find
a great change in the nature of the blood, or what answers to
the blood, and the constitution of the blood is some index of the
intensity of the metabolic processes going on within the organism. The
sap of plants is thin and watery, corresponding with the preponderant
anabolism of the plant. "Blood is a peculiar kind of sap," and there
is almost as much difference between this sap in warm-blooded and
cold-blooded animals as between the latter and plants. Rich, red blood
characterizes the forms of life fitted for activity and bursts of
energy. In his exhaustive work on the blood Hayem has given a summary
of the results of the investigations of chemists and physiologists
on the differences in the composition of the blood in the two sexes.
Contrary to the assertion of Robin, Hayem finds that the white
blood-corpuscles are not more numerous in women than in men, and he
also states that the number of haematoblasts is the same in the two
sexes. All chemists are agreed, however, that the number of red
corpuscles is greater in men than in women. Nasse found in man 0.05824
of iron to 100, and in woman only 0.0499. Becquerel and Rodier give
0.0565 for man, 0.0511 for woman, and Schmidt, Scherer, and others
give similar results. Welcker (using a chromometer) found between
the corpuscles of man and woman the relation of 5 to 4.7, and Hayem
confirmed this by numeration. Cadet found in woman on the average 4.9
million corpuscles per cubic millimeter, and in man 5.2 million. More
recently Korniloff, using still another method--the spectroscope of
Vierordt--has reached about the same result. The proportion of red
blood-corpuscles varies according to individual constitution, race,
and sex. In robust men Lacanu found 136 red corpuscles in 1,000; in
weak men, only 116 in 1,000; in robust women, only 126 in 1,000; and
in weak women, 117.[61] Professor Jones has taken the specific gravity
of the blood of above 1,500 individuals of all ages and of both
sexes.[62] An examination of his charts shows that the specific
gravity of the male is higher than that of the female between the
ages of 16 and 68. Between the ages of 16 and 45 the average specific
gravity of the male is about 1,058, and that of the female about
1,054.5. At 45 years the specific gravity of the male begins to fall
rapidly and that of the female to rise rapidly, and at 55 they are
almost equal; but the male remains slightly higher until 68 years,
when it falls below that of the female. The period of marked
difference in the specific gravity of the blood is thus seen to be
coincident with the period of menstruation in the female. A chart
constructed by Leichtenstern, based upon observations on 191
individuals and showing variations in the amount of haemoglobin
with age, is also reproduced by Professor Jones, suggesting that
the variations in specific gravity of the blood with age and sex
are closely related to variations in the amount of haemoglobin.
Leichtenstern states that the excess in men of haemoglobin is 7 per
cent. until the tenth year, 8 per cent. between 11 and 50 years, and
5 per cent. after the fiftieth year.[63] Jones states further[64] that
the specific gravity is higher in persons of the upper classes and
lower in the poorer classes. Observations of boys who were inmates of
workhouses gave a mean specific gravity of 1,052.8 and on schoolboys
a mean of 1,056, while among the undergraduate students of Cambridge
University he found a mean of 1,059.5. Several men of very high
specific gravity in the last group had distinguished themselves in
athletics. "Workhouse boys are in most cases of poor physique, and
one can hardly find a better antithesis than the general type of
physique common among the athletic members of such a university as
Cambridge."[65] There is no more conclusive evidence of an organic
difference between man and woman than these tests of the blood.
They permit us to associate a high specific gravity, red corpuscles,
plentiful haemoglobin, and a katabolic constitution.

A comparison of the waste products of the body and of the quantity
of materials consumed in the metabolic process indicates a relatively
larger consumption of energy by man. It is stated that man produces
more urine than woman in the following proportion: men, 1,000 to 2,000
grams daily; women, 1,000 to 1,400 grams. As age advances, the amount
diminishes absolutely and relatively in proportion to the diminution
of the energy of the metabolic process. A table prepared from adults
of both sexes, twenty-five years of age, of the average weight of
sixty kilograms, shows a larger proportion both of inorganic and
organic substances in the urine of men.[66] Milne Edwards has found
that the bones of the male are slightly richer in inorganic substances
than those of the female.[67]

The lung capacity of women is less, and they consume less oxygen and
produce less carbonic acid than men of equal weight, although the
number of respirations is slightly higher than in man. On this account
women suffer deprivation of air more easily than men. They are not so
easily suffocated, and are reported to endure charcoal fumes better,
and live in high altitudes where men cannot endure the deprivation of
oxygen.[68] The number of deaths from chloroform is reckoned as from
two to four times as great in males as in females, and this although
chloroform is used in childbirth. Children also bear chloroform
well.[69] Women, like children, require more sleep normally than men,
but "Macfarlane states that they can better bear the loss of sleep,
and most physicians will agree with him.... One of the greatest
difficulties we have to contend with in nervous men is sleeplessness,
a result, no doubt, of excessive katabolism."[70] Loss of sleep is
a strain which, like gestation, women are able to meet because of
their anabolic surplus. The fact that women undertake changes more
reluctantly than men, but adjust themselves to changed fortunes more
readily, is due to the same metabolic difference. Man has, in short,
become somatically a more specialized animal than woman, and feels
more keenly any disturbance of normal conditions, while he has not
the same physiological surplus as woman with which to meet the
disturbance.

Lower forms of life have the remarkable quality of restoring a lost
organ, and of living as separate individuals if divided. This power
gradually diminishes as we ascend the scale of life, and is lost by
the higher forms. It is a remarkable fact, however, that the lower
human races, the lower classes of society, women and children, show
something of the same quality in their superior tolerance of surgical
disease. The indifference of savage races to wounds and loss of
blood has everywhere been remarked by ethnologists. Dr. Bartels has
formulated the law of resistance to surgical and traumatic treatment
in the following sentence: "The higher the race, the less the
tolerance, and the lower the culture-condition in a given race, the
greater the tolerance."[71] The greater disvulnerability of women is
generally recognized by surgeons. The following figures from Lawrie,
Malgaigne, and Fenwick are representative:[72]

LAWRIE (GLASGOW)

==============================================================
| Men |Deaths|| Women |Deaths
---------------------------+---------+------++---------+------
Pathological amputations...|110 cases| 29 || 41 cases| 7
Traumatic amputations......|106 " | 59 || 14 " | 4
|---------+------++---------+------
Total..................|216 cases| 88 || 55 cases| 11
|----------------++----------------
|or, 40.74 deaths|| 20 deaths
| per 100 || per 100
--------------------------------------------------------------
A difference of 20.74 per cent. in favor of women.

MALGAIGNE (HOSPITALS OF PARIS)

==============================================================
| Men |Deaths|| Women |Deaths
---------------------------+---------+------++---------+------
Major pathological amputa- | | || |
tions................... |280 cases| 138 || 98 cases| 44
Minor pathological amputa- | | || |
tions................... |106 cases| 9 || 40 cases| 2
Major traumatic amputations|165 " | 107 || 17 " | 10
Minor traumatic amputations| 73 " | 13 || 10 " | 0
|---------+------++--------+------
Total..................|624 cases| 267 ||165 cases| 56
|----------------++----------------
|or, 37.98 deaths|| 34.18 deaths
| per 100 || per 100
--------------------------------------------------------------
A difference of 3.8 per cent. in favor of women.

FENWICK (NEWCASTLE, GLASGOW, EDINBURGH)

==============================================================
| Men |Deaths|| Women |Deaths
---------------------------+---------+------++---------+------
Amputations................|304 cases| 86 || 64 cases| 16
|----------------++----------------
|or, 27.86 deaths|| 25 deaths per
| per 100 || 100
--------------------------------------------------------------
A difference of 2.86 per cent. in favor of women.

TOTAL FOR THE THREE SERIES

===============================================================
| Men |Deaths|| Women |Deaths
---------------------------+----------+------++---------+------
Amputations................|1144 cases| 441 ||284 cases| 83
|-----------------++----------------
|or, 38.56 deaths || 29.29 deaths
| per 100 || per 100
---------------------------------------------------------------
A difference of 9.27 per cent. in favor of women.

Legouest states in the same article that the lowest mortality of all
is in children from 5 to 15 years of age. Ellis quotes a passage from
a paper read by Lombroso at the International Congress of Experimental
Psychology held in London:

Billroth experimented on women when attempting a certain
operation (excision of the pylorus) for the first time,
judging that they were less sensitive and therefore more
_disvulnerable_, i.e., better able to resist pain. Carle
assured me that women would let themselves be operated upon
almost as though their flesh were an alien thing. Giordano
told me that even the pains of childbirth caused relatively
little suffering to women, in spite of their apprehensions.
Dr. Martini, one of the most distinguished dentists of Turin,
has informed me of the amazement he has felt at seeing women
endure more easily and courageously than men every kind of
dental operation. Mela, too, has found that men will, under
such circumstances, faint oftener than women.[73]

The same tolerance of pain and misery in women is shown by an
examination of the number of male and female suicides from physical
suffering. Von Oettingen states that in 30,000 cases the percentage of
suicides from physical suffering was in men 11.4, in women 11.3;[74]
and Lombroso, following Morselli, gives the following table
representing the proportion out of a hundred suicides of each sex
resulting from the same cause:[75]

------------------------------------------------------
| Men | Women
----------------------------------+---------+----------
Germany (1852-61).................| 9.61 | 8.08
Prussia (1869-77).................| 6.00 | 7.00
Saxony (1875-78)..................| 4.61 | 6.21
Belgium...........................| 1.34 | 0.84
France (1873-78) .................| 14.28 | 13.56
Italy (1866-77)...................| 6.70 | 8.50
Vienna (1851-59)..................| 9.20 | 10.04
Vienna (1869-78)..................| 7.73 | 70.37
Paris (1851-59)...................| 10.27 | 11.22
Madrid (1884).....................| 31.81 | 31.25
------------------------------------------------------

But these figures represent the numbers of suicides in each hundred of
either sex, whereas suicide is three to four times as frequent among
men as among women, and the absolute proportion of suicide among men
from physical pain is, therefore, overwhelmingly great. Still more
significant is a table given by Lombroso showing the percentage of
suicides from want:[76]

------------------------------------------------------
| Men | Women
--------------------------------------+-------+-------
Germany (1852-61).....................| 37.75 | 18.46
Saxony (1875-78)......................| 6.64 | 1.52
Belgium...............................| 4.65 | 4.02
Italy (1866-77).......................| 7.00 | 4.60
Italy (1866-77) (financial reverses)..| 12.80 | 2.20
Norway (1866-70)......................| 10.30 | 4.50
Vienna (1851-59)......................| 6.64 | 3.10
------------------------------------------------------

But the excess of male suicides over females is so great that,
reckoned absolutely, about one woman to seven or ten men is driven by
want to take her life.

Physical suffering and want are among the motives which,
constitutional differences aside, would appeal with about the same
force to the two sexes. But the great excess both of suicide (3 or
4 men to 1 woman) and of crime (4 or 5 men to 1 woman) in men, while
directly conditioned by a manner of life more subject to vicissitude
and catastrophe, is still remotely due to the male, katabolic tendency
which has historically eventuated in a life of this nature in the
male.

Woman offers in general a greater resistance to disease than man. The
following table from the registrar-general's report for 1888[77] gives
the mortality in England per million inhabitants at all ages and for
both sexes from 1854 to 1887 in a group of diseases chiefly affecting
young children:

------------------------------------------------------
Disease | Year | Male | Female
----------------------------+---------+------+--------
Smallpox....................| 1854-87 | 183 | 148
Measles.....................| 1848-87 | 426 | 408
Scarlet fever...............| 1859-85 | 763 | 738
Diphtheria..................| 1859-87 | 157 | 176
Croup.......................| 1848-87 | 221 | 192
Whooping-cough..............| 1848-87 | 451 | 554
Diarrhoea, dysentery........| 1848-87 | 932 | 835
Enteric fever...............| 1869-87 | 288 | 277
------------------------------------------------------

or, a total mortality of 3,421 per million for the males and 3,328 for
the females. The greater fatality of diphtheria and whooping-cough in
the female is attributed to the smaller larynx of girls, and to their
habit of kissing. In diphtheria, indeed, the number of girls attacked
is in excess of that of the boys, and it does not appear that their
mortality is higher when this is considered.[78] Statistics based on
nearly half a million deaths from scarlet fever in England and Wales
(1859-85) show a mean annual in males of 778, and in females of 717,
per million living.[79] Dr. Farr reports on the mortality from cholera
in the epidemic years of 1849, 1854, and 1866, that

the mean mortality from all causes in the three cholera years
was, for males, 19.3 in excess, for females, 17.0 in excess
of the average mortality to 10,000 living; so females suffered
less than males.... The mortality is higher in boys than in
girls at all ages under 15; at the ages of reproduction, 25 to
45, the mortality of women, many of them pregnant, exceeds the
mortality of men; but at the ages after 65 the mortality of
men exceeds the mortality of women.[80]

Statistics show that woman is more susceptible to many diseases,
but in less danger than man when attacked, because of her anabolic
surplus, and also that the greatest mortality in woman is during the
period of reproduction, when the specific gravity of the blood is low
and her anabolic surplus small. It is significant also that the point
of highest mortality from disease and of the highest rate of suicide
in the female, as compared with the male, falls at about 15 years,
and is to be associated with the rapid physiological changes preceding
that time.[81]

The numerical relation of the sexes at birth seems to be more variable
in those regions where economic conditions and social usages are least
settled, but in civilized countries the relation is fairly constant,
and statistics of 32 countries and states between the years 1865 and
1883 show that to every 100 girls 105 boys are born, or including
stillborn, 100 girls to 106.6 boys.[82] But the mortality of male
children so much exceeds that of female that at the age of five the
sexes are about in numerical equilibrium; and in the adult population
of all European countries the average numerical relation of the
sexes is reckoned as 102.1 women to 100 men. Von Oettingen gives a
representative table;[83] compiled from statistics of eight European
countries, showing that (omitting the stillborn) 124.71 boys to 100
girls die before the end of the first year, and that between the years
of 2 and 5 the proportion is 102.91 boys to 100 girls; or, about 25
per cent. excess of boys in the first year, and 3 per cent. in the
years between 1 and 5. In the intra-uterine period and at the very
threshold of life the mortality of males is still greater. The figures
of Wappaeus were 100 stillborn girls to 140.3 boys; Quetelet gave
the proportion as 100:133.5; and the statistics of fourteen European
countries during the years 1865-83 show that 130.2 boys were stillborn
to every 100 girls.[84] So that, while more boys than girls are
born living, still more are born dead. That this astonishingly high
mortality is due in part to the somewhat larger size of boys at
birth and the narrowness of the maternal pelvis is indicated by the
statement of Collins, of the Rotunda Lying-in Hospital, Dublin, that
within half an hour after birth only 1 female died to 16 males; within
the first hour 2 females to 19 males; and within the first 6 hours, 7
females to 29 males.[85] But that this explanation is not sufficient
is shown by the fact that a high mortality of boys extends through
the whole of the first year, and through five years, in a diminishing
ratio, and also that the tenacity of woman on life, as will be shown
immediately, is greater at every age than man's except during a period
of about five years following puberty. "There must be," says Ploss,
"some cause which operates more energetically in the removal of
male than of female children just before and after birth;"[86] but,
besides the more violent movement of boys and their greater size,
no explanation of the cause has been advanced more acceptably than
Haushofer's teleological one, quoted by Ploss, that Nature wished to
make a more perfect being of man and therefore threw more obstacles
in his way. A satisfactory explanation is found if we regard the young
female as more anabolic, and more quiescent, with a stored surplus of
nutriment by which in the helpless and critical period of change from
intra- to extra-uterine conditions it is able to get its adjustment to
life. The constructive phase of metabolism has prevailed in them even
during fetal life. That there is need of a surplus of nutrition in
the child at birth, or that a surplus will stand it in good stead,
is indicated by the results of the weighing of children communicated
by Winckel to the Gynaecological Society in Berlin in 1862. Winckel
weighed 100 new-born children, 56 boys and 44 girls, showing that
birth was uniformly followed by a loss of weight. The average
diminution was about 108 grams the first day, and but little less
the second day. At the end of five days the loss was 220 grams,
six-sevenths of which occurred during the first two days.[87] The
tendency to decreased vitality in girls after maturity and before
marriage, just referred to, must be associated with the katabolic
changes implied in menstruation and the newness to the system of this
destructive phase of metabolism.

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