[256] It may be noted that this treatment furnishes another instance of
the continuity of therapeutic methods, through all changes of theory, from
the earliest to the latest times. Drugs of unpleasant odor, like
asafoetida, have always been used in hysteria, and scientific medicine
to-day still finds that asafoetida is a powerful sedative to the uterus,
controlling nervous conditions during pregnancy and arresting uterine
irritation when abortion is threatened (see, e.g., Warman, _Der
Frauenarzt_, August, 1895). Again, the rubbing of fragrant ointments into
the sexual regions is but a form of that massage which is one of the
modern methods of treating the sexual disorders of women.
[257] _Les Démoniaques dans l'Art_, 1887; _Les Malades et les Difformes
dans l'Art_, 1889.
[258] Glafira Abricosoff, of Moscow, in her Paris thesis, _L'Hystérie aux
xvii et xviii siécles_, 1897, presents a summary of the various views held
at this time; as also Gilles de la Tourette, _Traité de l'Hystérie_, vol.
i, Chapter I.
[259] _Edinburgh Medical Journal_, June, 1883, p. 1123, and _Mental
Diseases_, 1887, p. 488.
[260] Hegar, _Zusammenhang der Geschlechtskrankheiten mit nervösen
Leiden_, Stuttgart, 1885. (Hegar, however, went much further than this,
and was largely responsible for the surgical treatment of hysteria now
generally recognized as worse than futile.) Balls-Headley, "Etiology of
Nervous Diseases of the Female Genital Organs," Allbutt and Playfair,
_System of Gynecology_, 1896, p. 141.
[261] Lombroso and Ferrero, _La Donna Delinquente_, 1893, pp. 613-14.
[262] Charcot and Marie, article on "Hysteria," Tuke's _Dictionary of
Psychological Medicine_.
[263] Axenfeld and Huchard, _Traité des Névroses_, 1883, pp. 1092-94.
Icard (_La Femme pendant la Période Menstruelle_, pp. 120-21) has also
referred to recorded cases of hysteria in animals (Coste's and Peter's
cases), as has Gilles de la Tourette (op. cit., vol. i, p. 123). See also,
for references, Féré, _L'Instinct Sexuel_, p. 59.
[264] _Man and Woman_, 4th ed., p. 326. A distinguished gynæcologist,
Matthews Duncan, had remarked some years earlier (_Lancet_, May 18, 1889)
that hysteria, though not a womb disease, "especially attaches itself to
the generative system, because the genital system, more than any other,
exerts emotional power over the individual, power also in morals, power in
social questions."
[265] Gilles de la Tourette, _Archives de Tocologie et de Gynécologie_,
June, 1895.
[266] _Rivista Sperimentale di Freniatria_, 1897, p. 290; summarized in
the _Journal of Mental Science_, January, 1898.
[267] From the earliest times it was held that menstruation favors
hysteria; more recently, Landouzy recorded a number of observations
showing that hysterical attacks coincide with perfectly healthy
menstruation; while Ball has maintained that it is only during
menstruation that hysteria appears in its true color. See the opinions
collected by Icard, _La Femme pendant la Période Menstruelle_, pp. 75-81.
[268] Krafft-Ebing, "Ueber Neurosen und Psychosen durch Sexuelle
Abstinenz," _Jahrbücher für Psychiatrie_, vol. iii, 1888. It must,
however, be added that the relief of hysteria by sexual satisfaction is
not rare, and that Rosenthal finds that the convulsions are thus
diminished. (_Allgemeine Wiener Medizinal-Zeitung_, Nos. 46 and 47, 1887.)
So they are also, in simple and uncomplicated cases, according to Mongeri,
by pregnancy.
[269] "All doctors who have patients in convents," remarks Marro (_La
Pubertà_, p. 338), "know how hysteria dominates among them;" he adds that
his own experience confirms that of Raciborski, who found that nuns
devoted to the contemplative life are more liable to hysteria than those
who are occupied in teaching or in nursing. It must be added, however,
that there is not unanimity as to the prevalence of hysteria in convents.
Brachet was of the same opinion as Briquet, and so considered it rare.
Imbert-Goubeyre, also (_La Stigmatisation_, p. 436) states that during
more than forty years of medical life, though he has been connected with a
number of religious communities, he has not found in them a single
hysterical subject, the reason being, he remarks, that the unbalanced and
extravagant are refused admission to the cloister.
[270] Parent-Duchâtelet, _De la Prostitution_, vol. i, p. 242.
[271] It may not be unnecessary to point out that here and throughout, in
speaking of the psychic mechanism of hysteria, I do not admit that any
process can be _purely_ psychic. As Féré puts it in an admirable study of
hysteria (_Twentieth Century Practice of Medicine_, 1897, vol. x, p. 556):
"In the genesis of hysterical troubles everything takes place as if the
psychical and the somatic phenomena were two aspects of the same
biological fact."
[272] Pierre Janet, _L'Automatisme Psychologique_, 1889; _L'Etat mental
des Hystériques_, 1894; _Névroses et Idées fixes_, 1898; Breuer und Freud,
_Studien über Hysterie_, Vienna, 1895; the best introduction to Freud's
work is, however, to be found in the two series of his _Sammlung Kleiner
Schriften zur Neurosenlehre_, published in a collected form in 1906 and
1909. It may be added that a useful selection of Freud's papers has lately
(1909) been published in English.
[273] We might, perhaps, even say that in hysteria the so-called higher
centres have an abnormally strong inhibitory influence over the lower
centres. Gioffredi (_Gazzetta degli Ospedali_, October 1, 1895) has shown
that some hysterical symptoms, such as mutism, can be cured by
etherization, thus loosening the control of the higher centres.
[274] Charcot's school could not fail to recognize the erotic tone which
often dominates hysterical hallucinations. Gilles de la Tourette seeks to
minimize it by the remark that "it is more mental than real." He means to
say that it is more psychic than physical, but he implies that the
physical element in sex is alone "real," a strange assumption in any case,
as well as destructive of Gilles de la Tourette's own fundamental
assertion that hysteria is a real disease and yet purely psychic.
[275] See, e.g., his substantial volume, _Die Traumdeutung_, 1900, 2d ed.
1909.
[276] _Sammlung_, first series, p. 208.
[277] _Studien über Hysterie_, p. 217.
[278] _Sammlung_, first series, p. 162.
[279] _Sammlung_, second series, p. 102.
[280] Ib. p. 146.
[281] _Sammlung_, first series, p. 229. Freud has developed his conception
of sexual constitution in _Drei Abhandlungen zur Sexualtheorie_, 1905.
[282] As Moll remarks, Freud's conceptions are still somewhat subjective,
and in need of objective demonstration; but whatever may be thought of
their theories, he adds, there can be no doubt that Breuer and Freud have
done a great service by calling attention to the important action of the
sexual life on the nervous system.
[283] Gertrude Stein, "Cultivated Motor Automatism," _Psychological
Review_, May, 1898.
[284] Charcot's most faithful followers refuse to recognize a "hysteric
temperament," and are quite right, if such a conception is used to destroy
the conception of hysteria as a definite disease. We cannot, however, fail
to recognize a diathesis which, while still apparently healthy, is
predisposed to hysteria. So distinguished a disciple of Charcot as Janet
thoroughly recognizes this, and argues (_L'Etat mental_, etc., p. 298)
that "we may find in the habits, the passions, the psychic automatism of
the normal man, the germ of all hysterical phenomena." Féré held a
somewhat similar view.
[285] A.F.A. King, "Hysteria," _American Journal of Obstetrics_, May 18,
1891.
[286] M. Rosenthal, _Diseases of the Nervous System_, vol. ii, p. 44. Féré
notes similar cases (_Twentieth Century Practice of Medicine_, vol. x, p.
551). Long previously, Gall had recorded the case of a young widow of
ardent temperament who had convulsive attacks, apparently of hysterical
nature, which always terminated in sexual orgasm (_Fonctions du Cerveau_,
1825, vol. iii, p. 245).
[287] There seems to be a greater necessity for such explosive
manifestations in women than in men, whatever the reason may be. I have
brought together some of the evidence pointing in this direction in _Man
and Woman_, 4th ed., revised and enlarged, Chapters xii and xiii.
[288] There is no doubt an element of real truth in this ancient belief,
though it mainly holds good of minor cases of hysteria. Many excellent
authorities accept it. "Hysteria is certainly common in the single,"
Herman remarks (_Diseases of Women_, 1898, p. 33), "and is generally cured
by a happy marriage." Löwenfeld (_Sexualleben und Nervenleiden_, p. 153)
says that "it cannot be denied that marriage produces a beneficial change
in the general condition of many hysterical patients," though, he adds, it
will not remove the hysterical temperament. The advantage of marriage for
the hysterical is not necessarily due, solely or at all, to the exercise
of sexual functions. This is pointed out by Mongeri, who observes
(_Allgemeine Zeitschrift für Psychiatrie_, 1901, Heft 5, p. 917): "I have
known and treated several hysterical girls who are now married, and do not
show the least neuropathic indications. Some of these no longer have any
wish for sexual gratification, and even fulfil their marital duties
unwillingly, though loving their husbands and living with them in an
extremely happy way. In my opinion, marriage is a sovereign remedy for
neuropathic women, who need to find a support in another personality, able
to share with them the battle of life."
III.
The Prevalence of Masturbation--Its Occurrence in Infancy and
Childhood--Is it More Frequent in Males or Females?--After Adolescence
Apparently more Frequent in Women--Reasons for the Sexual Distribution of
Masturbation--The Alleged Evils of Masturbation--Historical Sketch of the
Views Held on This Point--The Symptoms and Results of Masturbation--Its
Alleged Influence in Causing Eye Disorders--Its Relation to Insanity and
Nervous Disorders--The Evil Effects of Masturbation Usually Occur on the
Basis of a Congenitally Morbid Nervous System--Neurasthenia Probably the
Commonest Accompaniment of Excessive Masturbation--Precocious Masturbation
Tends to Produce Aversion to Coitus--Psychic Results of Habitual
Masturbation--Masturbation in Men of Genius--Masturbation as a Nervous
Sedative--Typical Cases--The Greek Attitude toward Masturbation--Attitude
of the Catholic Theologians--The Mohammedan Attitude--The Modern
Scientific Attitude--In What Sense is Masturbation Normal?--The Immense
Part in Life Played by Transmuted Auto-erotic Phenomena.
The foregoing sketch will serve to show how vast is the field of life--of
normal and not merely abnormal life--more or less infused by auto-erotic
phenomena. If, however, we proceed to investigate precisely the exact
extent, degree, and significance of such phenomena, we are met by many
difficulties. We find, indeed, that no attempts have been made to study
auto-erotic phenomena, except as regards the group--a somewhat artificial
group, as I have already tried to show--collected under the term
"masturbation" while even here such attempts have only been made among
abnormal classes of people, or have been conducted in a manner scarcely
likely to yield reliable results.[289] Still there is a certain
significance in the more careful investigations which have been made to
ascertain the precise frequency of masturbation.
Berger, an experienced specialist in nervous diseases, concluded, in his
_Vorlesungen_, that 99 per cent. of young men and women masturbate
occasionally, while the hundredth conceals the truth;[290] and Hermann
Cohn appears to accept this statement as generally true in Germany. So
high an estimate has, of course, been called in question, and, since it
appears to rest on no basis of careful investigation, we need not
seriously consider it. It is useless to argue on suppositions; we must
cling to our definite evidence, even though it yields figures which are
probably below the mark. Rohleder considers that during adolescence at
least 95 per cent. of both sexes masturbate, but his figures are not
founded on precise investigation.[291] Julian Marcuse, on the basis of his
own statistics, concludes that 92 per cent. male individuals have to some
extent masturbated in youth. Perhaps, also, weight attaches to the opinion
of Dukes, physician to Rugby School, who states that from 90 to 95 per
cent. of all boys at boarding school masturbate.[292] Seerley, of
Springfield, Mass., found that of 125 academic students only 8 assured him
they had never masturbated; while of 347, who answered his questions, 71
denied that they practiced masturbation, which seems to imply that 79 per
cent. admitted that they practiced it.[293] Brockman, also in America,
among 232 theological students, of the average age of 23½ years and coming
from various parts of the United States, found that 132 spontaneously
admitted that masturbation was their most serious temptation and all but
one of these admitted that he yielded, 69 of them to a considerable
extent. This is a proportion of at least 56 per cent., the real proportion
being doubtless larger, since no question had been asked as to sexual
offenses; 75 practiced masturbation after conversion, and 24 after they
had decided to become ministers; only 66 mentioned sexual intercourse as
their chief temptation; but altogether sexual temptations outnumbered all
others together.[294] Moraglia, who made inquiry of 200 women of the lower
class in Italy, found that 120 acknowledged either that they still
masturbate or that they had done so during a long period.[295] Gualino
found that 23 per cent. men of the professional classes in North Italy
masturbate about puberty; no account was taken of those who began later.
"Here in Switzerland," a correspondent writes, "I have had occasion to
learn from adult men, whom I can trust, that they have reached the age of
twenty-five, or over, without sexual congress. '_Wir haben nicht dieses
Bedürfniss_,' is what they say. But I believe that, in the case of the
Swiss mountaineers, moderate onanism is practiced, as a rule." In hot
countries the same habits are found at a more precocious age. In
Venezuela, for instance, among the Spanish creoles, Ernst found that in
all classes boys and girls are infested with the vice of onanism. They
learn it early, in the very beginning of life, from their wet-nurses,
generally low Mulatto women, and many reasons help to foster the habit;
the young men are often dissipated and the young women often remain
single.[296] Niceforo, who shows a special knowledge of the working-girl
class at Rome, states that in many milliners' and dressmakers' workrooms,
where young girls are employed, it frequently happens that during the
hottest hours of the day, between twelve and two, when the mistress or
forewoman is asleep, all the girls without exception give themselves up to
masturbation.[297] In France a country _curé_ assured Debreyne that among
the little girls who come up for their first communion, 11 out of 12 were
given to masturbation.[298] The medical officer of a Prussian reformatory
told Rohleder that nearly all the inmates over the age of puberty
masturbated. Stanley Hall knew a reform school in America where
masturbation was practiced without exception, and he who could practice
it oftenest was regarded with hero-worship.[299] Ferriani, who has made an
elaborate study of youthful criminality in Italy, states that even if all
boys and girls among the general population do not masturbate, it is
certainly so among those who have a tendency to crime. Among 458 adult
male criminals, Marro (as he states in his _Caratteri dei Delinquenti_)
found that only 72 denied masturbation, while 386 had practiced it from an
early age, 140 of them before the age of thirteen. Among 30 criminal women
Moraglia found that 24 acknowledged the practice, at all events in early
youth (8 of them before the age of 10, a precocity accompanied by average
precocity in menstruation), while he suspected that most of the remainder
were not unfamiliar with the practice. Among prostitutes of whatever class
or position Moraglia found masturbation (though it must be pointed out
that he does not appear to distinguish masturbation very clearly from
homosexual practices) to be universal; in one group of 50 prostitutes
everyone had practiced masturbation at some period; 28 began between the
ages of 6 and 11; 19, between 12 and 14, the most usual period--a
precocious one--of commencing puberty; the remaining 3 at 15 and 16; the
average age of commencing masturbation, it may be added, was 11, while
that of the first sexual intercourse was 15.[300] In a larger group of 180
prostitutes, belonging to Genoa, Turin, Venice, etc., and among 23
"elegant cocottes," of Italian and foreign origin, Moraglia obtained the
same results; everyone admitted masturbation, and not less than 113
preferred masturbation, either solitary or mutual, to normal coitus. Among
the insane, as among idiots, masturbation is somewhat more common among
males, according to Blandford, in England, as also it is in Germany,
according to Näcke,[301] while Venturi, in Italy, has found it more common
among females.[302]
There appears to be no limit to the age at which spontaneous masturbation
may begin to appear. I have already referred to the practice of
thigh-rubbing in infants under one year of age. J.P. West has reported in
detail 3 cases of masturbation in very early childhood--2 in girls, 1 in a
boy--in which the practice had been acquired spontaneously, and could only
be traced to some source of irritation in pressure from clothing,
etc.[303] Probably there is often in such cases some hereditary lack of
nervous stability. Block has recorded the case of a girl--very bright for
her age, though excessively shy and taciturn--who began masturbating
spontaneously at the age of two; in this case the mother had masturbated
all her life, even continuing the practice after marriage, and, though she
succeeded in refraining during pregnancy, her thoughts still dwelt upon
it, while the maternal grandmother had died in an asylum from
"masturbatory insanity."
Freud considers that auto-erotic manifestations are common in infancy, and
that the rhythmic function of any sensitive spot, primarily the lips, may
easily pass into masturbation. He regards the infantile manifestations of
which thumb-sucking is the most familiar example (Lüdeln or Lutschen in
German) as auto-erotic, the germ arising in sucking the breasts since the
lips are an erogenous zone which may easily be excited by the warm stream
of milk. But this only occurs, he points out, in subjects in whom the
sensitivity of the lip zone is heightened and especially in those who at a
later age are liable to become hysterical.[304] Shuttleworth also points
out that the mere fidgetiness of a neurotic infant, even when only a few
months old, sometimes leads to the spontaneous and accidental discovery of
pleasurable sexual sensations, which for a time appease the restlessness
of nervous instability, though a vicious circle is thus established. He
has found that, especially among quite young girls of neurotic heredity,
self-induced excitement, often in the form of thigh-friction, is more
common than is usually supposed.[305]
Normally there appears to be a varying aptitude to experience the sexual
organism, or any voluptuous sensations before puberty. I find, on
eliciting the recollections of normal persons, that in some cases there
have been voluptuous sensations from casual contact with the sexual organs
at a very early age; in other cases there has been occasional slight
excitement from early years; in yet other cases complete sexual anæsthesia
until the age of puberty. That the latter condition is not due to mere
absence of peripheral irritation is shown by a case I am acquainted with,
in which a boy of 7, incited by a companion, innocently attempted, at
intervals during several weeks, to produce erection by friction of the
penis; no result of any kind followed, although erections occurred
spontaneously at puberty, with normal sexual feelings.[306]
I am indebted to a correspondent for the following notes:--
"From my observation during five years at a boarding-school, it
_seems_ that eight out of ten boys were more or less addicted to
the practice. But I would not state _positively_ that such was
the proportion of masturbators among an average of thirty pupils,
though the habit was very common. I know that in one bedroom,
sleeping seven boys, the whole number masturbated frequently. The
act was performed in bed, in the closets, and sometimes in the
classrooms during lessons. Inquiry among my friends as to onanism
in the boarding-schools to which they were sent, elicited
somewhat contradictory answers concerning the frequency of the
habit. Dr. ----, who went to a French school, told me that _all_
the older boys had younger accomplices in mutual masturbation. He
also spoke with experience of the prevalence of the practice in a
well-known public school in the west of England. B. said _all_
the boys at his school masturbated; G. stated that _most_ of his
schoolmates were onanists; L. said 'more than half' was the
proportion.
"At my school, manual masturbation was both solitary and mutual;
and sometimes younger boys, who had not acquired the habit, were
induced to manipulate bigger boys. One very precocious boy of
fifteen always chose a companion of ten 'because his hand was
like a woman's.' Sometimes boys entered their friend's bed for
mutual excitement. In after-life they showed no signs of
inversion. Another boy, aged about fourteen, who had been seduced
by a servant-girl, embraced the bolster; the pleasurable
sensations, according to his statement, were heightened by
imagining that the bolster was a woman. He said that the
enjoyment of the act was greatly increased during the holidays,
when he was able to spread a pair of his sister's drawers upon
the pillow, and so intensify the illusion.
"Before puberty the boys appeared to be more continent than
afterward. A few of the older and more intelligent masturbators
regulated the habit, as some married men regulate intercourse.
The big boy referred to, who chose always the same manipulator,
professed to indulge only once in twenty days, his reason being
that more frequent repetition of the act would injure his health.
About twice a week for boys who had reached puberty, and once a
week for younger boys, was, I think, about the average
indulgence. I have never met with a parallel of one of those
cases of excessive masturbation recorded by many doctors. There
may have been such cases at this school; but, if so, the boys
concealed the frequency of their gratifications.
"My experience proved that many of the lads regarded masturbation
as reprehensible; but their plea was 'everyone does it.' Some,
often those who indulged inordinately and more secretly than
their companions, gravely condemned the practice as sinful. A few
seemed to think there was 'no harm in it,' but that the habit
might stunt the growth and weaken the body if practiced very
frequently. The greater number made no attempt to conceal the
habit, they enlarged upon the pleasure of it; it was 'ever so
much nicer than eating tarts,' etc.
"The chief cause I believe to be initiation by an older
schoolmate. But I have known accidental causes, such as the
discovery that swarming up a pole pleasurably excited the organ,
rubbing to allay irritation, and simple, curious handling of the
erect penis in the early morning before rising from bed."
I quote the foregoing communication as perhaps a fairly typical
experience in a British school, though I am myself inclined to
think that the prevalence of masturbation in schools is often
much overrated, for, while in some schools the practice is
doubtless rampant, in others it is practically unknown, or, at
all events, only practiced by a few individuals in secret. My own
early recollections of (private) school-life fail to yield any
reminiscences of any kind connected with either masturbation or
homosexuality; and, while such happy ignorance may be the
exception rather than the rule, I am certainly inclined to
believe that--owing to race and climate, and healthier conditions
of life--the sexual impulse is less precocious and less
prominently developed during the school-age in England than in
some Continental countries. It is probably to this delayed
development that we should attribute the contrast that Ferrero
finds (_L'Europa Giovane_, pp. 151-56), and certainly states too
absolutely, between the sexual reserve of young Englishmen and
the sexual immodesty of his own countrymen.
In Germany, Näcke has also stated ("Kritisches zum Kapitel der
Sexualität," _Archiv für Psychiatrie_, pp. 354-56, 1899) that he
heard nothing at school either of masturbation or homosexuality,
and he records the experience of medical friends who stated that
such phenomena were only rare exceptions, and regarded by the
majority of the boys as exhibitions of "_Schweinerei_." At other
German schools, as Hoche has shown, sexual practices are very
prevalent. It is evident that at different schools, and even at
the same school at different times, these manifestations vary in
frequency within wide limits.
Such variations, it seems to me, are due to two causes. In the
first place, they largely depend upon the character of the more
influential elder boys. In the second place, they depend upon the
attitude of the head-master. With reference to this point I may
quote from a letter written by an experienced master in one of
the most famous English public schools: "When I first came to
----, a quarter of a century ago, Dr. ---- was making a crusade
against this failing; boys were sent away wholesale; the school
was summoned and lectured solemnly; and the more the severities,
the more rampant the disease. I thought to myself that the remedy
was creating the malady, and I heard afterward, from an old boy,
that in those days they used to talk things over by the fireside,
and think there must be something very choice in a sin that
braved so much. Dr. ---- went, and, under ----, we never spoke of
such things. Curiosity died down, and the thing itself, I
believe, was lessened. We were told to warn new boys of the
dangers to health and morals of such offences, lest the innocent
should be caught in ignorance. I have only spoken to a few; I
think the great thing is not to put it in boys' heads. I have
noticed solitary faults most commonly, and then I tell the boy
how he is physically weakening himself. If you notice, it is
puppies that seem to go against Nature, but grown dogs, never.
So, if two small boys acted thus, I should think it merely an
instinctive feeling after Nature, which would amend itself. Many
here would consider it a heinous sin, but those who think such
things sins make them sins. I have seen, in the old days, most
delightful little children sent away, branded with infamy, and
scarce knowing why--you might as well expel a boy for scratching
his head when it itched. I am sure the soundest way is to treat
it as a doctor would, and explain to the boy the physical effects
of over-indulgence of any sort. When it is combated from the
monkish standpoint, the evil becomes an epidemic." I am, however,
far from anxious to indorse the policy of ignoring the sexual
phenomena of youth. It is not the speaking about such things that
should be called in question, but the wisdom and good sense of
the speaker. We ought to expect a head-master to possess both an
adequate acquaintance with the nature of the phenomena of
auto-erotism and homosexuality, and a reasonable amount of tact
in dealing with boys; he may then fairly be trusted to exercise
his own judgment. It may be doubted whether boys should be made
too alive to the existence of sexual phenomena; there can be no
doubt about their teachers. The same is, of course, true as
regards girls, among whom the same phenomena, though less
obtrusive, are not less liable to occur.
As to whether masturbation is more common in one sex than the other, there
have been considerable differences of opinion. Tissot considered it more
prevalent among women; Christian believed it commoner among men; Deslandes
and Iwan Bloch hold that there are no sexual differences, and Garnier was
doubtful. Lawson Tait, in his _Diseases of Women_, stated his opinion that
in England, while very common among boys, it is relatively rare among
women, and then usually taught. Spitzka, in America, also found it
relatively rare among women, and Dana considers it commoner in boys than
in girls or adults.[307] Moll is inclined to think that masturbation is
less common in women and girls than in the male sex. Rohleder believes
that after puberty, when it is equally common in both sexes, it is more
frequently found in men, but that women masturbate with more passion and
imaginative fervor.[308] Kellogg, in America, says it is equally prevalent
in both sexes, but that women are more secretive. Morris, also in America,
considers, on the other hand, that persistent masturbation is commoner in
women, and accounts for this by the healthier life and traditions of boys.
Pouillet, who studied the matter with considerable thoroughness in France,
came to the conclusion that masturbation is commoner among women, among
whom he found it to be equally prevalent in rich and poor, and especially
so in the great centres of civilization. In Russia, Guttceit states in his
_Dreissig Jahre Praxis_, that from the ages of 10 to 16 boys masturbate
more than girls, who know less about the practice which has not for them
the charm of the forbidden, but after 16 he finds the practice more
frequent in girls and women than in youths and men. Näcke, in Germany,
believes that there is much evidence pointing in the same direction, and
Adler considers masturbation very common in women. Moraglia is decidedly
of the opinion, on the ground of his own observations already alluded to,
that masturbation is more frequent among women; he refers to the fact--a
very significant fact, as I shall elsewhere have to point out--that, while
in man there is only one sexual centre, the penis, in woman there are
several centres,--the clitoris, the vagina, the uterus, the
breasts,[309]--and he mentions that he knew a prostitute, a well-developed
brunette of somewhat nervous temperament, who boasted that she knew
fourteen ways of masturbating herself.
My own opinion is that the question of the sexual distribution of
masturbation has been somewhat obscured by that harmful tendency, to which
I have already alluded, to concentrate attention on a particular set of
auto-erotic phenomena. We must group and divide our facts rationally if we
wish to command them. If we confine our attention to very young children,
the available evidence shows that the practice is much more common in
females,[310] and such a result is in harmony with the fact that
precocious puberty is most often found in female children.[311] At
puberty and adolescence occasional or frequent masturbation is common in
both boys and girls, though, I believe, less common than is sometimes
supposed; it is difficult to say whether it is more prevalent among boys
or girls; one is inclined to conclude that it prevails more widely among
boys. The sexual impulse, and consequently the tendency to masturbation,
tend to be aroused later, and less easily in girls than in youths, though
it must also be remembered that boys' traditions and their more active
life keep the tendency in abeyance, while in girls there is much less
frequently any restraining influence of corresponding character.[312] In
my study of inversion I have found that ignorance and the same absence of
tradition are probably factors in the prevalence of homosexual tendencies
among women.[313] After adolescence I think there can be no doubt that
masturbation is more common in women than in men. Men have, by this time,
mostly adopted some method of sexual gratification with the opposite sex;
women are to a much larger extent shut out from such gratification;
moreover, while in rare cases women are sexually precocious, it more often
happens that their sexual impulses only gain strength and
self-consciousness after adolescence has passed. I have been much
impressed by the frequency with which masturbation is occasionally
(especially about the period of menstruation) practiced by active,
intelligent, and healthy women who otherwise lead a chaste life. This
experience is confirmed by others who are in a position to ascertain the
facts among normal people; thus a lady, who has received the confidence of
many women, told me that she believes that all women who remain unmarried
masturbate, as she found so much evidence pointing in this direction.[314]
This statement certainly needs some qualification, though I believe it is
not far from the truth as regards young and healthy women who, after
having normal sexual relationships, have been compelled for some reason or
other to break them off and lead a lonely life.[315] But we have to
remember that there are some women, evidently with a considerable degree
of congenital sexual anæsthesia (no doubt, in some respect or another
below the standard of normal health), in whom the sexual instinct has
never been aroused, and who not only do not masturbate, but do not show
any desire for normal gratification; while in a large proportion of other
cases the impulse is gratified passively in ways I have already referred
to. The auto-erotic phenomena which take place in this way, spontaneously,
by yielding to revery, with little or no active interference, certainly
occur much more frequently in women than in men. On the other hand,
contrary to what one might be led to expect, the closely-related
auto-erotic phenomena during sleep seem to take place more frequently in
men, although in women, as we have found ground for concluding, they
reverberate much more widely and impressively on the waking psychical
life.
We owe to Restif de la Bretonne what is perhaps the earliest
precise description of a woman masturbating. In 1755 he knew a
dark young woman, plain but well-made, and of warm temperament,
educated in a convent. She was observed one day, when gazing from
her window at a young man in whom she was tenderly interested, to
become much excited. "Her movements became agitated; I approached
her, and really believe that she was uttering affectionate
expressions; she had become red. Then she sighed deeply, and
became motionless, stretching out her legs, which she stiffened,
as if she felt pain." It is further hinted that her hands took
part in this manoeuvre (_Monsieur Nicolas_, vol. vi, p. 143).
Pictorial representations of a woman masturbating also occur in
eighteenth century engravings. Thus, in France, Baudouin's "Le
Midi" (reproduced in Fuchs's _Das Erotische Element in der
Karikatur_, Fig. 92), represents an elegant young lady in a
rococo garden-bower; she has been reading a book she has now just
dropped, together with her sunshade; she leans languorously back,
and her hand begins to find its way through her placket-hole.
Adler, who has studied masturbation in women with more care than
any previous writer, has recorded in detail the auto-erotic
manifestations involved in the case of an intelligent and
unprejudiced woman, aged 30, who had begun masturbating when
twenty, and practiced it at intervals of a few weeks. She
experienced the desire for sexual gratification under the
following circumstances: (1) spontaneously, directly before or
after menstruation; (2) as a method to cure sleeplessness; (3)
after washing the parts with warm (but not cold) water; (4) after
erotic dreams; (5) quite suddenly, without definite cause. The
phenomena of the masturbatory process fell into two stages: (1)
incomplete excitement, (2) the highest pleasurable gratification.
It only took place in the evening, or at night, and a special
position was necessary, with the right knee bent, and the right
foot against the knee of the extended left leg. The bent index
and middle fingers of the right hand were then applied firmly to
the lower third of the left labium minus, which was rubbed
against the underlying parts. At this stage, the manifestations
sometimes stopped, either from an effort of self-control or from
fatigue of the arm. There was no emission of mucus, or general
perspiration, but some degree of satisfaction and of fatigue,
followed by sleep. If, however, the manipulation was continued,
the second stage was reached, and the middle finger sank into the
vagina, while the index finger remained on the labium, the rest
of the hand holding and compressing the whole of the vulva, from
pubes to anus, against the symphysis, with a backwards and
forwards movement, the left hand also being frequently used to
support and assist the right. The parts now gave a mushroom-like
feeling to the touch, and in a few seconds, or after a longer
interval, the complete feeling of pleasurable satisfaction was
attained. At the same moment there was (but only after she had
had experience of coitus) an involuntary elevation of the pelvis,
together with emission of mucus, making the hand wet, this mucus
having an odor, and being quite distinct from the ordinary
odorless mucus of the vagina; at the same time, the finger in the
vagina felt slight contractions of the whole vaginal wall. The
climax of sexual pleasure lasted a few seconds, with its
concomitant vaginal contractions, then slowly subsided with a
feeling of general well-being, the finger at the same time
slipping out of the vagina, and she was left in a state of
general perspiration, and sleep would immediately follow; when
this was not the case, she was frequently conscious of some
degree of sensibility in the sacrum, lasting for several hours,
and especially felt when sitting. When masturbation was the
result of an erotic dream (which occurred but seldom), the first
stage was already reached in sleep, and the second was more
quickly obtained. During the act it was only occasionally that
any thoughts of men or of coitus were present, the attention
being fixed on the coming climax. The psychic state afterwards
was usually one of self-reproach. (O. Adler, _Die Mangelhafte
Geschlechtsempfindung des Weibes_, 1904, pp. 26-29.) The
phenomena in this case may be regarded as fairly typical, but
there are many individual variations; mucus emissions and vaginal
contractions frequently occur before actual orgasm, and there is
not usually any insertion of the finger into the vagina in women
who have never experienced coitus, or, indeed, even in those who
have.
We must now turn to that aspect of our subject which in the past has
always seemed the only aspect of auto-erotic phenomena meriting attention:
the symptoms and results of chronic masturbation. It appears to have been
an Englishman who, at the beginning of the eighteenth century, first
called popular attention to the supposed evils of masturbation. His book
was published in London, and entitled: _Onania, or the Heinous Sin of
Self-pollution, and all its Frightful Consequences in both Sexes,
Considered, with Spiritual and Physical Advice_, etc. It is not a serious
medical treatise, but an early and certainly superior example of a kind of
literature which we have since become familiar with through the daily
newspapers. A large part of the book, which is cleverly written, is
devoted in the later editions to the letters of nervous and
hypochondriacal young men and women, who are too shy to visit the author,
but request him to send a bottle of his "Strengthening Tincture," and
mention that they are inclosing half a guinea, a guinea, or still larger
sum. Concerning the composition of the "Strengthening Tincture" we are not
informed.[316] This work, which was subsequently attributed to a writer
named Bekkers, is said to have passed through no less than eighty
editions, and it was translated into German. Tissot, a physician of
Lausanne, followed with his _Traité de l'Onanisme: Dissertation sur les
Maladies produites par la Masturbation_, first published in Latin (1760),
then in French (1764), and afterward in nearly all European languages. He
regarded masturbation as a crime, and as "an act of suicide." His book is
a production of amusing exaggeration and rhetoric, zealously setting forth
the prodigious evils of masturbation in a style which combines, as
Christian remarks, the strains of Rousseau with a vein of religious piety.
Tissot included only manual self-abuse under the term "onanism;" shortly
afterward, Voltaire, in his _Dictionnaire Philosophique_, took up the
subject, giving it a wider meaning and still further popularizing it.
Finally Lallemand, at a somewhat later period (1836), wrote a book which
was, indeed, more scientific in character, but which still sought to
represent masturbation as the source of all evils. These four writers--the
author of _Onania_, Tissot, Voltaire, Lallemand--are certainly responsible
for much. The mistaken notions of many medical authorities, carried on by
tradition, even down to our own time; the powerful lever which has been
put into the hand of unscrupulous quacks; the suffering, dread, and
remorse experienced in silence by many thousands of ignorant and often
innocent young people may all be traced in large measure back to these
four well-meaning, but (on this question) misguided, authors.
There is really no end to the list of real or supposed symptoms and
results of masturbation, as given by various medical writers during the
last century. Insanity, epilepsy, numerous forms of eye disease,
supra-orbital headache, occipital headache (Spitzka), strange sensations
at the top of the head (Savage), various forms of neuralgia (Anstie, J.
Chapman), tenderness of the skin in the lower dorsal region (Chapman),
mammary tenderness in young girls (Lacassagne), mammary hypertrophy
(Ossendovsky), asthma (Peyer), cardiac murmurs (Seerley), the appearance
of vesicles on wounds (Baraduc), acne and other forms of cutaneous
eruptions (the author of _Onania_, Clipson), dilated pupils (Skene,
Lewis, Moraglia), eyes directed upward and sideways (Pouillet), dark rings
around the eyes, intermittent functional deafness (Bonnier), painful
menstruation (J. Chapman), catarrh of uterus and vagina (Winckel,
Pouillet), ovarian disease (Jessett), pale and discolored skin (Lewis,
Moraglia), redness of nose (Gruner), epistaxis (Joal, J.N. Mackenzie),
morbid changes in nose (Fliess), convulsive cough of puberty (Gowers),
acidity of vagina (R.W. Shufeldt), incontinence of urine in young women
(Girandeau), warts on the hands in women (Durr, Kreichmar, von Oye),
hallucinations of smell and hearing, (Griesinger, Lewis), intermittent
functional deafness (Bonnier), indican in the urine (Herter), an
indescribable odor of the skin in women (Skene), these are but a few of
the signs and consequences of masturbation given by various prominent
authorities.[317]
That many of these manifestations do occur in connection with masturbation
is unquestionable; there is also good reason to believe that some of them
may be the results of masturbation acting on an imperfectly healthy
organism. But in all such cases we must speak with great caution, for
there appears to be little reliable evidence to show that simple
masturbation, in a well-born and healthy individual, can produce any evil
results beyond slight functional disturbances, and these only when it is
practiced in excess. To illustrate the real pathological relationships of
masturbation, a few typical and important disorders may be briefly
considered.
The delicate mechanism of the eye is one of the first portions of the
nervous apparatus to be disturbed by any undue strain on the system; it is
not surprising that masturbation should be widely incriminated as a cause
of eye troubles. If, however, we inquire into the results obtained by the
most cautious and experienced ophthalmological observers, it grows evident
that masturbation, as a cause of disease of the eye, becomes merged into
wider causes. In Germany, Hermann Cohn, the distinguished ophthalmic
surgeon of Breslau, has dealt fully with the question.[318] Cohn, who
believes that all young men and women masturbate to some extent, finds
that masturbation must be excessive for eye trouble to become apparent. In
most of his cases there was masturbation several times daily during from
five to seven years, in many during ten years, and in one during
twenty-three years. In such cases we are obviously dealing with abnormal
persons, and no one will dispute the possibility of harmful results; in
some of the cases, when masturbation was stopped, the eye trouble
improved. Even in these cases, however, the troubles were but slight, the
chief being, apparently, photopsia (a subjective sensation of light) with
otherwise normal conditions of pupil, vision, color-sense, and retina. In
some cases there was photophobia, and he has also found paralysis of
accommodation and conjunctivitis. At a later date Salmo Cohn, in his
comprehensive monograph on the relationship between the eye and the sexual
organs in women, brought together numerous cases of eye troubles in young
women associated with masturbation, but in most of these cases
masturbation had been practiced with great frequency for a long period and
the ocular affections were usually not serious.[319] In England, Power has
investigated the relations of the sexual system to eye disease. He is
inclined to think that the effects of masturbation have been exaggerated,
but he believes that it may produce such for the most part trivial
complaints as photopsisæ, muscsæ, muscular asthenopia, possibly
blepharospasm, and perhaps conjunctivitis. He goes on, however, to point
out that more serious complaints of the eye are caused by excess in normal
coitus, by sexual abstinence, and especially by disordered menstruation.
Thus we see that even when we are considering a mechanism so delicately
poised and one so easily disturbed by any jar of the system as vision,
masturbation produces no effect except when carried to an extent which
argues a hereditarily imperfect organism, while even in these cases the
effects are usually but slight, moreover, in no respect specific, but are
paralleled and even exceeded by the results of other disturbances of the
sexual system.
Let us turn to the supposed influence of masturbation in causing insanity
and nervous diseases. Here we may chiefly realize the immense influence
exerted on medical science by Tissot and his followers during a hundred
years. Mental weakness is the cause and not the result of excessive
masturbation, Gall declared,[320] but he was a man of genius, in
isolation. Sir William Ellis, an alienist of considerable reputation at
the beginning of the last century, could write with scientific equanimity:
"I have no hesitation in saying that, in a very large number of patients
in all public asylums, the disease may be attributed to that cause." He
does, indeed, admit that it may be only a symptom sometimes, but goes on
to assert that masturbation "has not hitherto been exhibited in the awful
light in which it deserves to be shown," and that "in by far the greater
number of cases" it is the true cause of dementia.[321] Esquirol lent his
name and influence to a similar view of the pernicious influence of
masturbation. Throughout the century, even down to the present day, this
point of view has been traditionally preserved in a modified form. In
apparent ignorance of the enormous prevalence of masturbation, and
without, so far as can be seen, any attempt to distinguish between cause
and effect or to eliminate the hereditary neuropathic element, many
alienists have set down a large proportion of cases of insanity, idiocy,
epilepsy, and disease of the spinal cord to uncomplicated masturbation.
Thus, at the Matteawan State Hospital (New York) for criminal lunatics and
insane prisoners, from 1875 to 1907, masturbation was the sole assigned
cause of insanity in 160 men (out of 2,595); while, according to Dr. Clara
Barrus, among 121 cases of insanity in young women, masturbation is the
cause in ten cases.[322] It is unnecessary to multiply examples, for this
traditional tendency is familiar to all.
It appears to have been largely due to Griesinger, in the middle of the
last century, that we owe the first authoritative appearance of a saner,
more discriminating view regarding the results of masturbation. Although
still to some extent fettered by the traditions prevalent in his day,
Griesinger saw that it was not so much masturbation itself as the feelings
aroused in sensitive minds by the social attitude toward masturbation
which produced evil effects. "That constant struggle," he wrote, "against
a desire which is even overpowering, and to which the individual always in
the end succumbs, that hidden strife between shame, repentance, good
intentions, and the irritation which impels to the act, this, after not a
little acquaintance with onanists, we consider to be far more important
than the primary direct physical effect." He added that there are no
specific signs of masturbation, and concluded that it is oftener a symptom
than a cause. The general progress of educated opinions since that date
has, in the main, confirmed and carried forward the results cautiously
stated by Griesinger. This distinguished alienist thought that, when
practiced in childhood, masturbation might lead to insanity. Berkhan, in
his investigation of the psychoses of childhood, found that in no single
case was masturbation a cause. Vogel, Uffelmann, and Emminghaus, in the
course of similar studies, have all come to almost similar
conclusions.[323] It is only on a congenitally morbid nervous system,
Emminghaus insists, that masturbation can produce any serious results.
"Most of the cases charged to masturbation," writes Kiernan (in a private
letter), basing his opinion on wide clinical experience, "are either
hebephrenia or hysteria in which an effect is taken for the cause."
Christian, during twenty years' experience in hospitals, asylums, and
private practice in town and country, has not found any seriously evil
effects from masturbation.[324] He thinks, indeed, that it may be a more
serious evil in women than in men. But Yellowlees considers that in women
"it is possibly less exhausting and injurious than in the other sex,"
which was also the opinion of Hammond, as well as of Guttceit, though he
found that women pushed the practice much further than men, and Näcke, who
has given special attention to this point, could not find that
masturbation is a definite cause of insanity in women in a single
case.[325] Koch also reaches a similar conclusion, as regards both sexes,
though he admits that masturbation may cause some degree of psychopathic
deterioration. Even in this respect, however, he points out that "when
practiced in moderation it is not injurious in the certain and
exceptionless way in which it is believed to be in many circles. It is the
people whose nervous systems are already injured who masturbate most
easily and practice it more immoderately than others"; the chief source of
its evil is self-reproach and the struggle with the impulse.[326]
Kahlbaum, it is true, under the influence of the older tradition, when he
erected katatonia into a separate disorder (not always accepted in later
times), regarded prolonged and excessive masturbation as a chief cause,
but I am not aware that he ever asserted that it was a sole and sufficient
cause in a healthy organism. Kiernan, one of the earliest writers on
katatonia, was careful to point out that masturbation was probably as much
effect as cause of the morbid nervous condition.[327] Maudsley (in _Body
and Mind_) recognized masturbation as a special exciting cause of a
characteristic form of insanity; but he cautiously added: "Nevertheless, I
think that self-abuse seldom, if ever, produces it without the
co-operation of the insane neurosis."[328] Schüle also recognized a
specific masturbatory insanity, but the general tendency to reject any
such nosological form is becoming marked; Krafft-Ebing long since rejected
it and Näcke decidedly opposes it. Kraepelin states that excessive
masturbation can only occur in a dangerous degree in predisposed
subjects; so, also, Forel and Löwenfeld, as at an earlier period,
Trousseau.[329] It is true that Marro, in his admirable and detailed study
of the normal and abnormal aspects of puberty, accepts a form of
masturbatory insanity; but the only illustrative case he brings forward is
a young man possessing various stigmata of degeneracy and the son of an
alcoholic father; such a case tells us nothing regarding the results of
simple masturbation.[330] Even Spitzka, who maintained several years ago
the traditional views as to the terrible results of masturbation, and
recognized a special "insanity of masturbation," stated his conclusions
with a caution that undermined his position: "Self-abuse," he concluded,
"to become a sole cause of insanity, must be begun early and carried very
far. In persons of sound antecedents it rarely, under these circumstances,
suffices to produce an actual vesania."[331] When we remember that there
is no convincing evidence to show that masturbation is "begun early and
carried very far" by "persons of sound antecedents," the significance of
Spitzka's "typical psychosis of masturbation" is somewhat annulled. It is
evident that these distinguished investigators, Marro and Spitzka, have
been induced by tradition to take up a position which their own scientific
consciences have compelled them practically to evacuate.
Recent authorities are almost unanimous in rejecting masturbation
as a cause of insanity. Thus, Rohleder, in his comprehensive
monograph (_Die Masturbation_, 1899, pp. 185-92), although taking
a very serious view of the evil results of masturbation, points
out the unanimity which is now tending to prevail on this point,
and lays it down that "masturbation is never the direct cause of
insanity." Sexual excesses of any kind, he adds (following
Curschmann), can, at the most, merely give an impetus to a latent
form of insanity. On the whole, he concludes, the best
authorities are unanimous in agreeing that masturbation may
certainly injure mental capacity, by weakening memory and
depressing intellectual energy; that, further, in hereditarily
neurotic subjects, it may produce slight psychoses like _folie du
doute_, hypochondria, hysteria; that, finally, under no
circumstances can it produce severe psychoses like paranoia or
general paralysis. "If it caused insanity, as often as some
claim," as Kellogg remarks, "the whole race would long since have
passed into masturbatic degeneracy of mind.... It is especially
injurious in the very young, and in all who have weak nervous
systems," but "the physical traits attributed to the habit are
common to thousands of neurasthenic and neurotic individuals."
(Kellogg, _A Text-book of Mental Diseases_, 1897, pp. 94-95.)
Again, at the outset of the article on "Masturbation," in Tuke's
_Dictionary of Psychological Medicine_, Yellowlees states that,
on account of the mischief formerly done by reckless statements,
it is necessary to state plainly that "unless the practice has
been long and greatly indulged, no permanent evil effects may be
observed to follow." Näcke, again, has declared ("Kritisches zum
Kapitel der Sexualität," _Archiv für Psychiatrie_, 1899): "There
are neither somatic nor psychic symptoms peculiar on onanism. Nor
is there any specific onanistic psychosis. I am prepared to deny
that onanism ever produces any psychoses in those who are not
already predisposed." That such a view is now becoming widely
prevalent is illustrated by the cautious and temperate discussion
of masturbation in a recent work by a non-medical writer,
Geoffrey Mortimer (_Chapters on Human Love_, pp. 199-205).
The testimony of expert witnesses with regard to the influence of
masturbation in producing other forms of psychoses and neuroses is
becoming equally decisive; and here, also, the traditions of Tissot are
being slowly effaced. "I have not, in the whole of my practice," wrote
West, forty years ago, "out of a large experience among children and
women, seen convulsions, epilepsy, or idiocy _induced_ by masturbation in
any child of either sex. Neither have I seen any instance in which
hysteria, epilepsy, or insanity in women after puberty was _due_ to
masturbation, as its efficient cause."[332] Gowers speaks somewhat less
positively, but regards masturbation as not so much a cause of true
epilepsy as of atypical attacks, sometimes of a character intermediate
between the hysteroid and the epileptoid form; this relationship he has
frequently seen in boys.[333] Leyden, among the causes of diseases of the
spinal cord, does not include any form of sexual excess. "In moderation,"
Erb remarks, "masturbation is not more dangerous to the spinal cord than
natural coitus, and has no bad effects";[334] it makes no difference, Erb
considers, whether the orgasm is effected normally or in solitude. This is
also the opinion of Toulouse, of Fürbringer, and of Curschmann, as at an
earlier period it was of Roubaud.
While these authorities are doubtless justified in refusing to ascribe to
masturbation any part in the production of psychic or nervous diseases, it
seems to me that they are going somewhat beyond their province when they
assert that masturbation has no more injurious effect than coitus. If
sexual coitus were a purely physiological phenomenon, this position would
be sound. But the sexual orgasm is normally bound up with a mass of
powerful emotions aroused by a person of the opposite sex. It is in the
joy caused by the play of these emotions, as well as in the discharge of
the sexual orgasm, that the satisfaction of coitus resides. In the absence
of the desired partner the orgasm, whatever relief it may give, must be
followed by a sense of dissatisfaction, perhaps of depression, even of
exhaustion, often of shame and remorse. The same remark has since been
made by Stanley Hall.[335] Practically, also, as John Hunter pointed out,
there is more probability of excess in masturbation than in coitus.
Whether, as some have asserted, masturbation involves a greater nervous
effort than coitus is more doubtful.[336] It thus seems somewhat
misleading to assert that masturbation has no more injurious effect than
coitus.[337]
Reviewing the general question of the supposed grave symptoms and signs
of masturbation, and its pernicious results, we may reach the conclusion
that in the case of moderate masturbation in healthy, well-born
individuals, no seriously pernicious results necessarily follow.[338] With
regard to the general signs, we may accept, as concerns both sexes, what
the Obstetrical and Gynecological Society of Berlin decided in 1861, in a
discussion of it in women, that there are none which can be regarded as
reliable.[339]
We may conclude finally, with Clouston, that the opposing views on the
subject may be simply explained by the fact that the writers on both sides
have ignored or insufficiently recognized the influence of heredity and
temperament. They have done precisely what so many unscientific writers on
inebriety have continued to do unto the present day, when describing the
terrible results of alcohol without pointing out that the chief factor in
such cases has not been the alcohol, but the organization on which the
alcohol acted. Excess may act, according to the familiar old-fashioned
adage, like the lighted match. But we must always remember the obvious
truth, that it makes a considerable difference whether you threw your
lighted match into a powder magazine or into the sea.
While we may thus dismiss the extravagant views widely held during the
past century, concerning the awful results of masturbation, as due to
ignorance and false tradition, it must be pointed out that, even in
healthy or moderately healthy individuals, any excess in solitary
self-excitement may still produce results which, though slight, are yet
harmful. The skin, digestion, and circulation may all be disordered;
headache and neuralgia may occur; and, as in normal sexual excess or in
undue frequency of sexual excitement during sleep, there is a certain
general lowering of nervous tone. Probably the most important of the
comparatively frequent results--though this also arises usually on a
somewhat morbid soil--is neurasthenia with its manifold symptoms. There
can be little doubt that the ancient belief, dating from the time of
Hippocrates, that sexual excesses produce spinal disease, as well as the
belief that masturbation causes insanity, are largely due to the failure
to diagnose neurasthenia.
The following case of neurasthenia, recorded by Eulenburg, may be
given as a classical picture of the nervous disturbances which
may be associated with masturbation, and are frequently regarded
as solely caused by habits of masturbation: Miss H.H., 28 years
of age, a robust brunette, with fully developed figure, without
any trace of anæmia or chlorosis, but with an apathetic
expression, bluish rings around the eyes, with hypochondriacal
and melancholy feelings. She complains of pressure on the head
("as if head would burst"), giddiness, ringing in the ears,
photopsia, hemicrania, pains in the back and at sacrum, and
symptoms of spinal adynamia, with a sense of fatigue on the least
exertion in walking or standing; she sways when standing with
closed eyes, tendon-reflexes exaggerated; there is a sense of
oppression, intercostal neuralgia, and all the signs of
neurasthenic dyspepsia; and cardialgia, nausea, flatulence,
meteorism, and alternate constipation and diarrhoea. She chiefly
complains of a feeling of weight and pain in the abdomen, caused
by the slightest movement, and of a form of pollution (with
clitoridian spasms), especially near menstruation, with copious
flow of mucus, characteristic pains, and hyperexcitability.
Menstruation was irregular and profuse. Examination showed tumid
and elongated nymphæ, with brown pigmentation; rather large
vagina, with rudimentary hymen; and retroflexion of uterus.
After much persuasion the patient confessed that, when a girl of
12, and as the result of repeated attempts at coitus by a boy of
16, she had been impelled to frequent masturbation. This had
caused great shame and remorse, which, however, had not sufficed
to restrain the habit. Her mother having died, she lived alone
with her invalid father, and had no one in whom to confide.
Regarding herself as no longer a virgin, she had refused several
offers of marriage, and thus still further aggravated her mental
condition. (Eulenburg, _Sexuale Neuropathie_, p. 31.)
Since Beard first described neurasthenia, many diverse opinions
have been expressed concerning the relationships of sexual
irregularities to neurasthenia. Gilles de la Tourette, in his
little monograph on neurasthenia, following the traditions of
Charcot's school, dismisses the question of any sexual causation
without discussion. Binswanger (_Die Pathologie und Therapie der
Neurasthenie_), while admitting that nearly all neurasthenic
persons acknowledge masturbation at some period, considers it is
not an important cause of neurasthenia, only differing from
coitus by the fact that the opportunities for it are more
frequent, and that the sexual disturbances of neurasthenia are,
in the majority of cases, secondary. Rohleder, on the other hand,
who takes a very grave view of the importance of masturbation,
considers that its most serious results are a question of
neurasthenia. Krafft-Ebing has declared his opinion that
masturbation is a cause of neurasthenia. Christian, Leyden, Erb,
Rosenthal, Beard, Hummel, Hammond, Hermann Cohn, Curschmann,
Savill, Herman, Fürbringer, all attach chief importance to
neurasthenia as a result of masturbation. Collins and Phillip
(_Medical Record_, March 25, 1899), in an analysis of 333 cases
of neurasthenia, found that 123 cases were apparently due to
overwork or masturbation. Freud concludes that neurasthenia
proper can nearly always be traced to excessive masturbation, or
to spontaneous pollutions. (E.g., _Sammlung Kleiner Schriften zur
Neurosenlehre_, first series, p. 187.) This view is confirmed by
Gattel's careful study (_Ueber die Sexuellen Ursachen der
Neurasthenie und Angstneurose_, 1898). Gattel investigated 100
consecutive cases of severe functional nervous disorder in
Krafft-Ebing's clinic at Vienna, and found that in every case of
neurasthenia in a male (28 in all) there was masturbation, while
of the 15 women with neurasthenia, only one is recorded as not
masturbating, and she practiced _coitus reservatus_. Irrespective
of the particular form of the nervous disorder, Gattel found that
18 women out of 42, and 36 men out of 58, acknowledged
masturbation. (This shows a slightly larger proportion among the
men, but the men were mostly young, while the women were mostly
of more mature age.) It must, however, always be remembered that
we have no equally careful statistics of masturbation in
perfectly healthy persons. We must also remember that we have to
distinguish between the _post_ and the _propter_, and that it is
quite possible that neurasthenic persons are specially
predisposed to masturbation. Bloch is of this opinion, and
remarks that a vicious circle may thus be formed.
On the whole, there can be little doubt that neurasthenia is
liable to be associated with masturbation carried to an excessive
extent. But, while neurasthenia is probably the severest
affection that is liable to result from, or accompany,
masturbation, we are scarcely yet entitled to accept the
conclusion of Gattel that in such cases there is no hereditary
neurotic predisposition. We must steer clearly between the
opposite errors of those, on the one hand, who assert that
heredity is the sole cause of functional nervous disorders, and
those, on the other hand, who consider that the incident that may
call out the disorder is itself a sole sufficient cause.
In many cases it has seemed to me that masturbation, when practiced in
excess, especially if begun before the age of puberty, leads to inaptitude
for coitus, as well as to indifference to it, and sometimes to undue
sexual irritability, involving premature emission and practical impotence.
This is, however, the exception, especially if the practice has not been
begun until after puberty. In women I attach considerable importance, as a
result of masturbation, to an aversion for normal coitus in later life. In
such cases some peripheral irritation or abnormal mental stimulus trains
the physical sexual orgasm to respond to an appeal which has nothing
whatever to do with the fascination normally exerted by the opposite sex.
At puberty, however, the claim of passion and the real charm of sex begin
to make themselves felt, but, owing to the physical sexual feelings having
been trained into a foreign channel, these new and more normal sex
associations remain of a purely ideal and emotional character, without the
strong sensual impulses with which under healthy conditions they tend to
be more and more associated as puberty passes on into adolescence or
mature adult life. I am fairly certain that in many women, often highly
intellectual women, the precocious excess in masturbation has been a main
cause, not necessarily the sole efficient cause, in producing a divorce in
later life between the physical sensuous impulses and the ideal emotions.
The sensuous impulse having been evolved and perverted before the
manifestation of the higher emotion, the two groups of feelings have
become divorced for the whole of life. This is a common source of much
personal misery and family unhappiness, though at the same time the clash
of contending impulses may lead to a high development of moral character.
When early masturbation is a factor in producing sexual inversion it
usually operates in the manner I have here indicated, the repulsion for
normal coitus helping to furnish a soil on which the inverted impulse may
develop unimpeded.
This point has not wholly escaped previous observers, though they
do not seem to have noted its psychological mechanism. Tissot
stated that masturbation causes an aversion to marriage. More
recently, Loiman ("Ueber Onanismus beim Weibe," _Therapeutische
Monatshefte_, April, 1890) considered that masturbation in women,
leading to a perversion of sexual feeling, including inability to
find satisfaction in coitus, affects the associated centres.
Smith Baker, again ("The Neuropsychical Element in Conjugal
Aversion," _Journal of Nervous and Mental Disease_, September,
1892), finds that a "source of marital aversion seems to lie in
the fact that substitution of mechanical and iniquitous
excitations affords more thorough satisfaction than the mutual
legitimate ones do," and gives cases in point. Savill, also, who
believes that masturbation is more common in women than is
usually supposed, regards dyspareunia, or pain in coition, as one
of the signs of the habit.
Masturbation in women thus becomes, as Raymond and Janet point
out (_Les Obsessions_, vol. ii, p. 307) a frequent cause of
sexual frigidity in marriage. These authors illustrate the train
of evils which may thus be set up, by the case of a lady, 26
years of age, a normal woman, of healthy family, who, at the age
of 15, was taught by a servant to masturbate. At the age of 18
she married. She loved her husband, but she had no sexual
feelings in coitus, and she continued to masturbate, sometimes
several times a day, without evil consequences. At 24 she had to
go into a hospital for floating kidney, and was so obliged to
stop masturbating. She here accidentally learnt of the evil
results attributed to the habit. She resolved not to do it again,
and she kept her resolution. But while still in hospital she fell
wildly in love with a man. To escape from the constant thought of
this man, she sought relations with her husband, and at times
masturbated, but now it no longer gave her pleasure. She wished
to give up sexual things altogether. But that was easier said
than done. She became subject to nervous crises, often brought on
by the sight of a man, and accompanied by sexual excitement. They
disappeared under treatment, and she thereupon became entirely
frigid sexually. But, far from being happy, she has lost all
energy and interest in life, and it is her sole desire to attain
the sexual feelings she has lost. Adler considers that even when
masturbation in women becomes an overmastering passion, so far as
organic effects are concerned it is usually harmless, its effects
being primarily psychic, and he attaches especial significance to
it as a cause of sexual anæsthesia in normal coitus, being,
perhaps, the most frequent cause of such anæsthesia. He devotes
an important chapter to this matter, and brings forward numerous
cases in illustration (Adler, _Die Mangelhafte
Geschlechtsempfindung des Weibes_, pp. 93-119, also 21-23). Adler
considers that the frequency of masturbation in women is largely
due to the fact that women experience greater difficulties than
men in obtaining sexual satisfaction, and so are impelled by
unsatisfying coitus to continue masturbation after marriage. He
adds that partly from natural shyness, partly from shame of
acknowledging what is commonly accounted a sin, and partly from
the fear of seeming disgusting or unworthy of sympathy in the
doctor's eyes, women are usually silent on this matter, and very
great tact and patience may be necessary before a confession is
obtained.
On the psychic side, no doubt, the most frequent and the most
characteristic result of persistent and excessive masturbation is a morbid
heightening of self-consciousness without any co-ordinated heightening of
self-esteem.[340] The man or woman who is kissed by a desirable and
desired person of the opposite sex feels a satisfying sense of pride and
elation, which must always be absent from the manifestations of
auto-erotic activity.[341] This must be so, even apart from the
masturbator's consciousness of the general social attitude toward his
practices and his dread of detection, for that may also exist as regards
normal coitus without any corresponding psychic effects. The masturbator,
if his practice is habitual, is thus compelled to cultivate an artificial
consciousness of self-esteem, and may show a tendency to mental arrogance.
Self-righteousness and religiosity constitute, as it were, a protection
against the tendency to remorse. A morbid mental soil is, of course,
required for the full development of these characteristics. The habitual
male masturbator, it must be remembered, is often a shy and solitary
person; individuals of this temperament are especially predisposed to
excesses in all the manifestations of auto-erotism, while the yielding to
such tendencies increases the reserve and the horror of society, at the
same time producing a certain suspicion of others. In some extreme cases
there is, no doubt, as Kraepelin believes, some decrease of psychic
capacity, an inability to grasp and co-ordinate external impressions,
weakness of memory, deadening of emotions, or else the general phenomena
of increased irritability, leading on to neurasthenia.
I find good reason to believe that in many cases the psychic influence of
masturbation on women is different from its effect on men. As Spitzka
observed, although it may sometimes render women self-reproachful and
hesitant, it often seems to make them bold. Boys, as we have seen, early
assimilate the tradition that self-abuse is "unmanly" and injurious, but
girls have seldom any corresponding tradition that it is "unwomanly," and
thus, whether or not they are reticent on the matter, before the forum of
their own conscience they are often less ashamed of it than men are and
less troubled by remorse.
Eulenburg considers that the comparative absence of bad effects
from masturbation in girls is largely due to the fact that,
unlike boys, they are not terrorized by exaggerated warnings and
quack literature concerning the awful results of the practice.
Forel, who has also remarked that women are often comparatively
little troubled by qualms of conscience after masturbation,
denies that this is due to a lower moral tone than men possess
(Forel, _Die Sexuelle Frage_, p. 247). In this connection, I may
refer to History IV, recorded in the Appendix to the fifth volume
of these _Studies_, in which it is stated that of 55 prostitutes
of various nationalities, with whom the subject had had
relations, 18 spontaneously told him that they were habitual
masturbators, while of 26 normal women, 13 made the same
confession, unasked. Guttceit, in Russia, after stating that
women of good constitution had told him that they masturbated as
much as six or ten times a day or night (until they fell asleep,
tired), without bad results, adds that, according to his
observations, "masturbation, when not excessive, is, on the
whole, a quite innocent matter, which exerts little or no
permanent effect," and adds that it never, in any case, leads to
_hypochondria onanica_ in women, because they have not been
taught to expect bad results (_Dreissig Jahre Praxis_, p. 306).
There is, I think, some truth--though the exceptions are
doubtless many--in the distinction drawn by W.C. Krauss
("Masturbational Neuroses," _Medical News_, July 13, 1901): "From
my experience it [masturbation] seems to have an opposite effect
upon the two sexes, dulling the mental and making clumsy the
physical exertions of the male, while in the female it quickens
and excites the physical and psychical movements. The man is
rendered hypoesthetic, the woman hyperesthetic."
In either sex auto-erotic excesses during adolescence in young men and
women of intelligence--whatever absence of gross injury there may
be--still often produce a certain degree of psychic perversion, and tend
to foster false and high-strung ideals of life. Kraepelin refers to the
frequency of exalted enthusiasms in masturbators, and I have already
quoted Anstie's remarks on the connection between masturbation and
premature false work in literature and art. It may be added that excess in
masturbation has often occurred in men and women whose work in literature
and art cannot be described as premature and false. K.P. Moritz, in early
adult life, gave himself up to excess in masturbation, and up to the age
of thirty had no relations with women. Lenau is said--though the statement
is sometimes denied--to have been a masturbator from early life, the habit
profoundly effecting his life and work. Rousseau, in his _Confessions_,
admirably describes how his own solitary, timid, and imaginative life
found its chief sexual satisfaction in masturbation.[342] Gogol, the
great Russian novelist, masturbated to excess, and it has been suggested
that the dreamy melancholy thus induced was a factor in his success as a
novelist. Goethe, it has been asserted, at one time masturbated to excess;
I am not certain on what authority the statement is made, probably on a
passage in the seventh book of _Dichtung und Wahrheit_, in which,
describing his student-life at Leipzig, and his loss of Aennchen owing to
his neglect of her, he tells how he revenged that neglect on his own
physical nature by foolish practices from which he thinks he suffered for
a considerable period.[343] The great Scandinavian philosopher, Sören
Kierkegaard, suffered severely, according to Rasmussen, from excessive
masturbation. That, at the present day, eminence in art, literature, and
other fields may be combined with the excessive practice of masturbation
is a fact of which I have unquestionable evidence.
I have the detailed history of a man of 30, of high ability in a
scientific direction, who, except during periods of mental
strain, has practiced masturbation nightly (though seldom more
than once a night) from early childhood, without any traceable
evil results, so far as his general health and energy are
concerned. In another case, a schoolteacher, age 30, a hard
worker and accomplished musician, has masturbated every night,
sometimes more than once a night, ever since he was at school,
without, so far as he knows, any bad results; he has never had
connection with a woman, and seldom touches wine or tobacco.
Curschmann knew a young and able author who, from the age of 11
had masturbated excessively, but who retained physical and mental
freshness. It would be very easy to refer to other examples, and
I may remark that, as regards the histories recorded in various
volumes of these _Studies_, a notable proportion of those in
which excessive masturbation is admitted, are of persons of
eminent and recognized ability.
It is often possible to trace the precise mechanism of the relationship
between auto-erotic excitement and intellectual activity. Brown-Séquard,
in old age, considered that to induce a certain amount of sexual
excitement, not proceeding to emission, was an aid to mental work. Raymond
and Janet knew a man considering himself a poet, who, in order to attain
the excitation necessary to compose his ideal verses, would write with one
hand while with the other he caressed his penis, though not to the extent
of producing ejaculation.[344] We must not believe, however, that this is
by any means the method of workers who deserve to be accepted seriously;
it would be felt, to say the least, as unworthy. It is indeed a method
that would only appeal to a person of feeble or failing mental power. What
more usually happens is that the auto-erotic excitement develops, _pari
passu_ and spontaneously, with the mental activity and at the climax of
the latter the auto-erotic excitement also culminates, almost or even
quite spontaneously, in an explosion of detumescence which relieves the
mental tension. I am acquainted with such cases in both young men and
women of intellectual ability, and they probably occur much more
frequently than we usually suspect.
In illustration of the foregoing observations, I may quote the
following narrative, written by a man of letters: "From puberty
to the age of 30 (when I married), I lived in virgin continence,
in accord with my principle. During these years I worked
exceedingly hard--chiefly at art (music and poetry). My days
being spent earning my livelihood, these art studies fell into my
evening time. I noticed that productive power came in
periods--periods of irregular length, and which certainly, to a
partial extent, could be controlled by the will. Such a period of
vital power began usually with a sensation of melancholy, and it
quickened my normal revolt against the narrowness of conventional
life into a red-hot detestation of the paltriness and pettiness
with which so many mortals seem to content themselves. As the
mood grew in intensity, this scorn of the lower things mixed with
and gave place to a vivid insight into higher truths. The
oppression began to give place to a realization of the eternity
of the heroic things; the fatuities were seen as mere fashions;
love was seen as the true lord of life; the eternal romance was
evident in its glory; the naked strength and beauty of men were
known despite their clothes. In such mood my work was produced;
bitter protest and keen-sighted passion mingled in its building.
The arising vitality had certainly deep relation to the
periodicity of the sex-force of manhood. At the height of the
power of the art-creative mood would come those natural emissions
with which Nature calmly disposes of the unused force of the
male. Such emissions were natural and healthy, and not exhaustive
or hysterical. The process is undoubtedly sane and protective,
unless the subject be unhealthy. The period of creative art power
extended a little beyond the end of the period of natural seed
emission--the art work of this last stage being less vibrant, and
of a gentler force. Then followed a time of calm natural rest,
which gradually led up to the next sequence of melancholy and
power. The periods certainly varied in length of time, controlled
somewhat by the force of the mind and the mental will to create;
that is to say, I could somewhat delay the natural emission, by
which I gained an extension of the period of power."
How far masturbation in moderately healthy persons living without normal
sexual relationships may be considered normal is a difficult question only
to be decided with reference to individual cases. As a general rule, when
only practiced at rare intervals, and _faute de mieux_, in order to obtain
relief for physical oppression and mental obsession, it may be regarded as
the often inevitable result of the unnatural circumstances of our
civilized social life. When, as often happens in mental degeneracy,--and
as in shy and imaginative persons, perhaps of neurotic temperament, may
also sometimes become the case,--it is practiced in preference to sexual
relationships, it at once becomes abnormal and may possibly lead to a
variety of harmful results, mental and physical.[345]
It must always be remembered, however, that, while the practice of
masturbation may be harmful in its consequences, it is also, in the
absence of normal sexual relationships, frequently not without good
results. In the medical literature of the last hundred years a number of
cases have been incidentally recorded in which the patients found
masturbation beneficial, and such cases might certainly have been
enormously increased if there had been any open-eyed desire to discover
them. My own observations agree with those of Sudduth, who asserts that
"masturbation is, in the main, practiced for its sedative effect on the
nervous system. The relaxation that follows the act constitutes its real
attraction.... Both masturbation and sexual intercourse should be classed
as typical sedatives."[346]
Gall (_Fonctions du Cerveau_, 1825, vol. iii, p. 235) mentioned a
woman who was tormented by strong sexual desire, which she
satisfied by masturbation ten or twelve times a day; this caused
no bad results, and led to the immediate disappearance of a
severe pain in the back of the neck, from which she often
suffered. Clouston (_Mental Diseases_, 1887, p. 496) quotes as
follows from a letter written by a youth of 22: "I am sure I
cannot explain myself, nor give account of such conduct.
Sometimes I felt so uneasy at my work that I would go to the
water-closet to do it, and it seemed to give me ease, and then I
would work like a hatter for a whole week, till the sensation
overpowered me again. I have been the most filthy scoundrel in
existence," etc. Garnier presents the case of a monk, aged 33,
living a chaste life, who wrote the following account of his
experiences: "For the past three years, at least, I have felt,
every two or three weeks, a kind of fatigue in the penis, or,
rather, slight shooting pains, increasing during several days,
and then I feel a strong desire to expel the semen. When no
nocturnal pollution follows, the retention of the semen causes
general disturbance, headache, and sleeplessness. I must confess
that, occasionally, to free myself from the general and local
oppression, I lie on my stomach and obtain ejaculation. I am at
once relieved; a weight seems to be lifted from my chest, and
sleep returns." This patient consulted Gamier as to whether this
artificial relief was not more dangerous than the sufferings it
relieved. Gamier advised that if the ordinary _régime_ of a
well-ordered monastry, together with anaphrodisiac sedatives,
proved inefficacious, the manoeuvre might be continued when
necessary (P. Garnier, _Célibat et Célibataires_, 1887, p. 320).
H.C. Coe (_American Journal of Obstetrics_, p. 766, July, 1889)
gives the case of a married lady who was deeply sensitive of the
wrong nature of masturbation, but found in it the only means of
relieving the severe ovarian pain, associated with intense sexual
excitement, which attended menstruation. During the
intermenstrual period the temptation was absent. Turnbull knew a
youth who found that masturbation gave great relief to feelings
of heaviness and confusion which came on him periodically; and
Wigglesworth has frequently seen masturbation after epileptic
fits in patients who never masturbated at other times. Moll
(_Libido Sexualis_, Bd. I, p. 13) refers to a woman of 28, an
artist of nervous and excitable temperament, who could not find
sexual satisfaction with her lover, but only when masturbating,
which she did once or twice a day, or oftener; without
masturbation, she said, she would be in a much more nervous
state. A friend tells me of a married lady of 40, separated from
her husband on account of incompatibility, who suffered from
irregular menstruation; she tried masturbation, and, in her own
words, "became normal again;" she had never masturbated
previously. I have also been informed of the case of a young
unmarried woman, intellectual, athletic, and well developed, who,
from the age of seven or eight, has masturbated nearly every
night before going to sleep, and would be restless and unable to
sleep if she did not.
Judging from my own observations among both sexes, I should say that in
normal persons, well past the age of puberty, and otherwise leading a
chaste life, masturbation would be little practiced except for the
physical and mental relief it brings. Many vigorous and healthy unmarried
women or married women apart from their husbands, living a life of sexual
abstinence, have asserted emphatically that only by sexually exciting
themselves, at intervals, could they escape from a condition of nervous
oppression and sexual obsession which they felt to be a state of hysteria.
In most cases this happens about the menstrual period, and, whether
accomplished as a purely physical act--in the same way as they would
soothe a baby to sleep by rocking it or patting it--or by the co-operation
of voluptuous mental imagery, the practice is not cultivated for its own
sake during the rest of the month.
In illustration of the foregoing statements I will here record a
few typical observations of experiences with regard to
masturbation. The cases selected are all women, and are all in a
fairly normal, and, for the most part, excellent, state of
health; some of them, however, belong to somewhat neurotic
families, and these are persons of unusual mental ability and
intelligence.
OBSERVATION I.--Unmarried, aged 38. She is very vigorous and
healthy, of a strongly passionate nature, but never masturbated
until a few years ago, when she was made love to by a man who
used to kiss her, etc. Although she did not respond to these
advances, she was thrown into a state of restless sexual
excitement; on one occasion, when in bed in this restless state,
she accidentally found, on passing her hand over her body, that,
by playing with "a round thing" [clitoris] a pleasurable feeling
was produced. She found herself greatly relieved and quieted by
these manipulations, though there remained a feeling of tiredness
afterward. She has sometimes masturbated six times in a night,
especially before and after the menstrual period, until she was
unable to produce the orgasm or any feeling of pleasure.
OBSERVATION II.--Unmarried, aged 45, of rather nervous
temperament. She has for many years been accustomed, usually
about a week before the appearance of the menses, to obtain
sexual relief by kicking out her legs when lying down. In this
way, she says, she obtains complete satisfaction. She never
touches herself. On the following day she frequently has pains
over the lower part of the abdomen, such pains being apparently
muscular and due to the exertion.
OBSERVATION III.--Aged 29, recently married, belonging to a
neurotic and morbid family, herself healthy, and living usually
in the country; vivacious, passionate, enthusiastic,
intellectual, and taking a prominent part in philanthropic
schemes and municipal affairs; at the same time, fond of society,
and very attractive to men. For many years she had been
accustomed to excite herself, though she felt it was not good for
her. The habit was merely practiced _faute de mieux_. "I used to
sit on the edge of the bed sometimes," she said, "and it came
over me so strongly that I simply couldn't resist it. I felt that
I should go mad, and I thought it was better to touch myself than
be insane.... I used to press my clitoris in.... It made me very
tired afterward--not like being with my husband." The confession
was made from a conviction of the importance of the subject, and
with the hope that some way might be found out of the
difficulties which so often beset women.
OBSERVATION IV.--Unmarried, aged 27; possesses much force of
character and high intelligence; is actively engaged in a
professional career. As a child of seven or eight she began to
experience what she describes as lightning-like sensations,
"mere, vague, uneasy feelings or momentary twitches, which took
place alike in the vulva or the vagina or the uterus, not
amounting to an orgasm and nothing like it." These sensations,
it should be added, have continued into adult life. "I always
experience them just before menstruation, and afterward for a few
days, and, occasionally, though it seems to me not so often,
during the period itself. I may have the sensation four or five
times during the day; it is not dependent at all upon external
impressions, or my own thoughts, and is sometimes absent for days
together. It is just one flash, as if you would snap your
fingers, and it is over."
As a child, she was, of course, quite unconscious that there was
anything sexual in these sensations. They were then usually
associated with various imaginary scenes. The one usually
indulged in was that a black bear was waiting for her up in a
tree, and that she was slowly raised up toward the bear by means
of ropes and then lowered again, and raised, feeling afraid of
being caught by the bear, and yet having a morbid desire to be
caught. In after years she realized that there was a physical
sexual cause underlying these imaginations, and that what she
liked was a feeling of resistance to the bear giving rise to the
physical sensation.
At a somewhat later age, though while still a child, she
cherished an ideal passion for a person very much older than
herself, this passion absorbing her thoughts for a period of two
years, during which, however, there was no progress made in
physical sensation. It was when she was nearly thirteen years of
age, soon after the appearance of menstruation, and under the
influence of this ideal passion, that she first learned to
experience conscious orgasm, which was not associated with the
thought of any person. "I did not associate it with anything high
or beautiful, owing to the fact that I had imbibed our current
ideas in regard to sexual feelings, and viewed them in a very
poor light indeed." She considers that her sexual feelings were
stronger at this period than at any other time in her life. She
could, however, often deny herself physical satisfaction for
weeks at a time, in order that she might not feel unworthy of the
object of her ideal passion. "As for the sexual satisfaction,"
she writes, "it was experimental. I had heard older girls speak
of the pleasure of such feelings, but I was not taught anything
by example, or otherwise. I merely rubbed myself with the
wash-rag while bathing, waiting for a result, and having the same
peculiar feeling I had so often experienced. I am not aware of
any ill effects having resulted, but I felt degraded, and tried
hard to overcome the habit. No one had spoken to me of the habit,
but from the secrecy of grown people, and passages I had heard
from the Bible, I conceived the idea that it was a reprehensible
practice. And, while this did not curb my desire, it taught me
self-control, and I vowed that each time should be the last. I
was often able to keep the resolution for two or three weeks."
Some four years later she gradually succeeded in breaking herself
of the practice in so far as it had become a habit; she has,
however, acquired a fuller knowledge of sexual matters, and,
though she has still a great dread of masturbation as a vice, she
does not hesitate to relieve her physical feelings when it seems
best to her to do so. "I am usually able to direct my thoughts
from these sensations," she writes, "but if they seem to make me
irritable or wakeful, I relieve myself. It is a physical act,
unassociated with deep feeling of any kind. I have always felt
that it was a rather unpleasant compromise with my physical
nature, but certainly necessary in my case. Yet, I have abstained
from gratification for very long periods. If the feeling is not
strong at the menstrual period, I go on very well without either
the sensation or the gratification until the next period. And,
strange as it may seem, the best antidote I have found and the
best preventive is to think about spiritual things or someone
whom I love. It is simply a matter of training, I suppose,--a
sort of mental gymnastics,--which draws the attention away from
the physical feelings." This lady has never had any sexual
relationships, and, since she is ambitious, and believes that the
sexual emotions may be transformed so as to become a source of
motive power throughout the whole of life, she wishes to avoid
such relationships.
OBSERVATION V.--Unmarried, aged 31, in good health, with,
however, a somewhat hysterical excess of energy. "When I was
about 26 years of age," she writes, "a friend came to me with the
confession that for several years she had masturbated, and had
become such a slave to the habit that she severely suffered from
its ill effects. At that time I had never heard of self-abuse by
women. I listened to her story with much sympathy and interest,
but some skepticism, and determined to try experiments upon
myself, with the idea of getting to understand the matter in
order to assist my friend. After some manipulation, I succeeded
in awakening what had before been unconscious and unknown. I
purposely allowed the habit to grow upon me, and one night--for I
always operated upon myself before going to sleep, never in the
morning--I obtained considerable pleasurable satisfaction, but
the following day my conscience awoke; I also felt pain located
at the back of my head and down the spinal column. I ceased my
operations for a time, and then began again somewhat regularly,
once a month, a few days after menstruation. During those months
in which I exercised moderation, I think I obtained much local
relief with comparatively little injury, but, later on, finding
myself in robust health, I increased my experiments, the habit
grew upon me, and it was only with an almost superhuman effort
that I broke myself free. Needless to say that I gave no
assistance to my suffering friend, nor did I ever refer to the
subject after her confession to me.
"Some two years later I heard of sexual practices between women
as a frequent habit in certain quarters. I again interested
myself in masturbation, for I had been told something that led me
to believe that there was much more for me to discover. Not
knowing the most elementary physiology, I questioned some of my
friends, and then commenced again. I restricted myself to relief
from local congestion and irritation by calling forth the
emission of mucus, rather than by seeking pleasure. At the same
time, I sought to discover what manipulation of the clitoris
would lead to. The habit grew upon me with startling rapidity,
and I became more or less its slave, but I suffered from no very
great ill effects until I started in search of more discoveries.
I found that I was a complete ignoramus as to the formation of a
woman's body, and by experiments upon myself sought to discover
the vagina. I continued my operations until I obtained an
entrance. I think the rough handling of myself during this final
stage disturbed my nervous system, and caused me considerable
pain and exhaustion at the back of my head, the spinal column,
the back of my eyes, and a general feeling of languor, etc.
"I could not bear to be the slave of a habit, and after much
suffering and efforts, which only led to falls to lower depths of
conscious failure, my better self rebelled, until, by a great
effort and much prayer, I kept myself pure for a whole week. This
partial recovery gave me hope, but then I again fell a victim to
the habit, much to my chagrin, and became hopeless of ever
retracing my steps toward my ideal of virtue. For some days I
lost energy, spirit, and hope; my nervous system appeared to be
ruined, but I did not really despair of victory in the end. I
thought of all the drunkards chained by their intemperate habits,
of inveterate smokers who could not exist without tobacco, and of
all the various methods by which men were slaves, and the longing
to be freed of what had, in my case, proved to be a painful and
unnecessary habit, increased daily until, after one night when I
struggled with myself for hours, I believed I had finally
succeeded.
"At times, when I reached a high degree of sexual excitement, I
felt that I was at least one step removed from those of morbid
and repressed sex, who had not the slightest suspicion of the
latent joys of womanhood within them. For a little while the
habit took the shape of an exalted passion, but I rapidly tired
it out by rough, thoughtless, and too impatient handling.
Revulsion set in with the pain of an exhausted and badly used
nervous system, and finding myself the slave of a passion, I
determined to endeavor to be its master.
"In conclusion, I should say that masturbation has proved itself
to be to me one of the blind turnings of my life's history, from
which I have gained much valuable experience."
The practice was, however, by no means thus dismissed. Some time
later the subject writes: "I have again restarted masturbation
for the relief of localized feelings. One morning I was engaged
in reading a very heavy volume which, for convenience sake, I
held in my lap, leaning back on my chair. I had become deep in
my study for an hour or so when I became aware of certain
feelings roused by the weight of the book. Being tempted to see
what would happen by such conduct, I shifted so that the edge of
the volume came in closer contact. The pleasurable feelings
increased, so I gave myself up to my emotions for some thirty
minutes.
"Notwithstanding the intense pleasure I enjoyed for so long a
period, I maintain that it is wiser to refrain, and, although I
admit in the same breath that, by gentle treatment, such pleasure
may be harmless to the general health, it does lead to a desire
for solitude, which is not conducive to a happy frame of mind.
There is an accompanying reticence of speech concerning the
pleasure, which, therefore, appears to be unnatural, like the
eating of stolen fruit. After such an event, one seems to require
to fly to the woods, and to listen to the song of the birds, so
as to shake off after-effects."
In a letter dated some months later, she writes: "I think I have
risen above the masturbation habit." In the same letter the
writer remarks: "If I had consciously abnormal or unsatisfied
appetites I would satisfy them in the easiest and least harmful
way."
Again, eighteen months later, she writes: "It is curious to note
that for months this habit is forgotten, but awakens sometimes to
self-assertion. If a feeling of pressure is felt in the head, and
a slight irritation elsewhere, and experience shows that the time
has come for pacification, exquisite pleasure can be enjoyed,
never more than twice a month, and sometimes less often."
OBSERVATION VI.--Unmarried, actively engaged in the practice of
her profession. Well-developed, feminine in contour, but boyish
in manner and movements; strong, though muscles small, and
healthy, with sound nervous system; never had anæmia. Thick brown
hair; pubic hair thick, and hair on toes and legs up to
umbilicus; it began to appear at the age of 10 (before pubic
hair) and continued until 18. A few stray hairs round nipples,
and much dark down on upper lip, as well as light down on arms
and hands. Hips, normal; nates, small; labia minora, large; and
clitoris, deeply hooded. Hymen thick, vagina, probably small.
Considerable pigmentation of parts. Menstruation began at 15, but
not regular till 17; is painless and scanty; the better the state
of health, the less it is. No change of sexual or other feelings
connected with it; it lasts one to three days.
"I believe," she writes, "my first experience of physical sex
sensations was when I was about 16, and in sleep. But I did not
then recognize it, and seldom, indeed, gave the subject of sex a
thought. I was a child far beyond the age of childhood. The
accompanying dreams were disagreeable, but I cannot remember what
they were about. It was not until I was nearly 19 that I knew the
sexual orgasm in my waking state. It surprised me completely,
but I knew that I had known it before in my sleep.