Sex efficiency through exercises : special physical culture for women / by Th. H. van de Velde ; [photos, by E. Steinemann].
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and prolonged exertion of the whole genital and perineal muscular apparatus, under the influence of the mind. The inspection I made confirms this view, besides suggesting other interesting considerations. There were no convulsive symptoms of any sort. There were no vehemently contracted muscles which hurt when " twanged " or tapped in the course of digital examination, as is often the case in this region. Nor can the result be attributed wholly to the muscular fibres of the levator vaginae (in the narrower sense of the term) ; it was a contributory agent, but not the sole. No. The whole posterior vaginal wall, which had been too slack to offer any counter-pressure and support to the displaced anterior wall, was now able to afford such support, together with the introitus which had resumed an almost normal diameter. The upper layer of the vagina was completely lacking in " tonicity" even after " recovery/' but the underlying tissues had become firmly elastic. The patient did not voluntarily relax the vagina inside, nevertheless it was possible to press back the posterior wall with complete ease by means of a speculum (or ecarteur). But she could and did operate a definite relaxation of the introitus or orifice in a perfectly natural way, in order to admit of digital and/or instrumental examination. This was a striking case of active relaxation [or dilation) at will. The circumstances of this case made a strong impression on me at the time. I am of opinion that the improvement cannot be wholly ascribed to the intentional exertion of the voluntary (rigid or striated) muscles of the pelvic floor, but that the smooth or involuntary adjacent muscles were also involved (for instance, those of the Ligamenta Cardinalia, the posterior vaginal wall and perhaps the Ligamenta Douglasii as well). I will not discuss the probability that a nervous impulse could extend to these particular muscles which are generally independent of the will, nor will I now consider further possible explanations of the undoubted facts* The exertion of the muscles of the pelvic floor, under the * I may, however, mention that other authors, as V. Liebermann (33>, treat of similar cases (Treatment of Prolapse by the Thure-Brandt method), and are obliged to assume that the ligaments have recovered their lost elasticity and power through remedial exercises.