neurasthenia; we are concerned simply with a retardation of development, dependent upon congenital predisposition. CHAPTER V PATHOLOGY In the previous chapters I have from time to time mentioned some phenomenon of comparatively rare occurrence; but for the most part I have described those processes only which are regularly met with, which cannot be regarded as exceptional peculiarities, and therefore must not be considered to be pathological manifestations. It is true that much that has been described comes within the province of the pathological; for example, many of the active manifestations of the sexual impulse occurring during the first period of childhood, such as the case quoted from Fere on page 81. For practical reasons, however, such cases as this cannot always be dealt with as members of a distinct pathological group. On the other hand, it is necessary to give a separate consideration to the pathological aspect of our subject. Many of the cases which must be grouped as pathological occur in girls. Thus, we meet with cases in which menstruation becomes established at the age of eight, five, two, or even earlier.[53] Carus reports the case of a woman whose medical history showed that she had begun to menstruate at the age of two years, and that she became pregnant for the first time when eight years old. In girls from ten to twelve years of age, pregnancy has many times been observed. A French physician had under observation a girl who when only three mouths old had well-developed breasts, and in whom only a little later the pubic and axillary hair grew and menstruation began. When twenty-seven months old, the child was again seen by the same physician, and at this time menstruation was proceeding regularly; the features had now lost the infantile type, and the body as a whole exhibited all the signs of premature development. A collection of cases made by Gebhard[54] contains one case in which menstruation was established at birth; in quite a number of the cases menstruation began during the first year of life.