ETIOLOGY AND DIAGNOSIS
The last chapter dealt with pathological phenomena in the sexual life of
the child. From the considerations urged in this and in earlier
chapters, it will have become apparent that sexual manifestations in
childhood are not necessarily to be regarded as pathological. This
conclusion does not conflict with the assumption that certain factors
influence the sexual life of the child. The numerous individual
differences suffice to indicate the existence of such factors. Many of
these are of a pathological character, but others have no connexion with
the domain of pathology. Among the factors thus influencing the sexual
life of the child, we can distinguish those affecting the germinal
rudiments from those which exercise their influence later. Those of the
former group first demand our attention.
In certain families, the early awakening of sexuality is observed with
remarkable frequency. These are often neuropathic or psychopathic
families, and moreover the early awakening of the sexual life is
frequently associated with neuropathic or psychopathic symptoms. But
this is by no means always the case, and often enough such persons
belong to healthy families and are themselves healthy. We are therefore
not entitled to regard the occurrence of sexual manifestations in
childhood as a proof of degeneration or of a morbid inheritance. But
equally erroneous is the opposite view, that the early awakening of
sexuality is an indication of exceptional endowments. It is true that in
many persons of genius premature sexual passion has been observed, and
such manifestations are by no means always confined to the contrectation
impulse. We learn, too, in our consulting rooms, that not infrequently
the most diligent schoolboys exhibit at a comparatively early age the
phenomena alike of contrectation and of detumescence. But the fallacy of
drawing general conclusions from this fact is shown by the additional
fact that in idiots and imbeciles premature awakening of the sexual life
is also of common occurrence. In cases such as were formerly described
as moral insanity, but which in Germany to-day are classed with
imbecility, sexual assaults on others are very common at an early age.
This is true also of other forms of idiocy and imbecility. In asylums
for such patients, feeble-minded children not infrequently make sexual
attempts on nurses and on other inmates. In this connexion, we have to
consider both components of the sexual impulse, the phenomena of
contrectation as well as those of detumescence. In the case of low-grade
idiots, we often see the phenomena of pure detumescence, without the
accompaniment of any sexual inclination directed towards another person;
this is simply physical masturbation, performed under the promptings of
an organic impulse. But not only in imbeciles and idiots, and in persons
of genius, but also in those with perfectly normal mental endowments,
the sexual impulse, and more especially the phenomena of contrectation,
may appear at a very early age. Persons with artistic tendencies develop
in this way with comparative frequency. We must, for these reasons,
guard against the misconception that the early awakening of sexuality is
_per se_ pathological. The fact that the study of the sexual life has
been undertaken chiefly by medical men, and above all by neurologists
and alienists, has inevitably introduced a certain bias into the results
of the investigation. Opportunities for the study of the sexual life of
normal persons have been comparatively rare; for those in whom the early
awakening of sexuality has been recorded have for the most part sought
medical advice and treatment for some other reason, and the physician
has taken the opportunity to make inquiries into the patient's sexual
history. The boundary-line between what is pathological and what is
normal can be determined only by an extended study of the sexual life in
normal persons. By very numerous inquiries I have done my best to effect
this; and a careful examination of the accumulated material leads to the
above-mentioned conclusion, that an early awakening of the sexual life
is commoner in those with an abnormal nervous system than it is in
healthy persons: but it also appears that an abnormal sensitiveness of a
non-pathological character, such as is exhibited by persons with the
artistic temperament, and likewise a disposition excitable to a degree
which cannot yet be called morbid, predispose the subjects to an early
awakening of sexuality.
To attain to clear views on this question, it is necessary to bear
certain distinctions in mind: first, as regards the different periods of
childhood; and, secondly, as regards the two components of the sexual
impulse (detumescence and contrectation). My own investigations have led
me to draw the following conclusions. _During the first period of
childhood, that is to say, up to the end of the seventh year of life,
the occurrence of manifestations of the sexual impulse must arouse
suspicions of the existence of a congenital morbid predisposition._ But
as regards the phenomena of detumescence, which are confined to the
peripheral genital organs, we must make an exception to this rule if
they do not appear spontaneously, but result either from local
inflammatory or other morbid changes, or from deliberate seduction of
the child to the performance of sexual manipulations; at any rate, in
such cases, the probability of the existence of _congenital morbid
predisposition_ is greatly diminished. _I am also forced to regard as
suspicious the occurrence of phenomena of contrectation during the first
period of childhood, although not to the same extent as are the
peripheral manifestation of the sexual impulse--and I hold this view
notwithstanding the numerous cases recorded by Sanford Bell. Passing to
the second period of childhood, the phenomena of contrectation may
appear at the very beginning of this period, that is, during the eighth
year of life, without justifying the inference that any morbid
predisposition exists. Regarding the phenomena of detumescence, we must
not hold them to be necessarily morbid when they make their appearance
during the last years of the second period of childhood; but when this
occurs earlier, during the tenth or eleventh year of life for instance,
some suspicion may reasonably be aroused._ In this general survey of the
material, it did not appear that any important difference existed
between the two sexes in the matters under consideration; but I believe
that in girls the phenomena of contrectation often make their
appearance somewhat earlier than in boys, whereas, on the other hand,
the occurrence of the phenomena of detumescence at an early age is more
likely to indicate the existence of congenital morbid predisposition in
girls than it is in boys.
In the delimitation of the pathological from the healthy, I have
endeavoured to lay down broad general lines. It must not be supposed
that precisely at the close of the first period of childhood, that is to
say, at the end of the seventh year of life, the sexual life, and our
opinions as to the significance of its manifestations, undergo sudden
alterations. Our estimates as to the significance of phenomena occurring
during the early months of the eighth year of life, will not differ
materially from our estimates as to the significance of the same
phenomena when they occur during the last months of the seventh year. My
conclusions have no more than a general application, based as they are
on the recorded experiences and on my own personal observations of
numerous persons, healthy and diseased.
Let us consider further what are the factors favouring an early
awakening of the sexual life. I have previously mentioned the fact that
in certain families a remarkably early sexual development is quite
common. This is true also of certain races. But the data bearing on this
question are not quite so trustworthy as might be wished. The fact that
among certain nations marriage sometimes takes place at a remarkably
early age, is no certain proof of the early awakening of sexuality in
persons of this nationality; for the marriage may be a purely ceremonial
affair, and may be effected long before the individual is ripe for
sexual intercourse or for procreation; and the first act of intercourse
may not take place until several years after the ceremony of marriage.
Among ourselves, marriage, especially in the case of men, does not as a
rule take place until long after the age of puberty, and it therefore
seems to us very remarkable when, in another race, men marry ten years
earlier; but this must not be taken as a proof that sexual development
occurs at an earlier age. We can gain some knowledge of the subject from
the statistical inquiries which have been made regarding the appearance
of that manifestation of puberty which is most readily available for
such inquiries, namely, the first occurrence of menstruation.
Ribbing[67] has made a study of this question, and gives the following
figures regarding the commencement of menstruation in women of different
nationalities in various places: Swedish Lapland, 18 years; Christiania,
16 years, 9 months, 25 days; Berlin, 15 years, 7 months, 6 days; Paris
15 years, 7 months, 18 days, and 14 years, 5 months, and 17 days;
Madeira, 14 years, 3 months; Sierra Leone and Egypt, 10 years. From
these data we should naturally he led to infer that there would be great
variations in the age at which other manifestations of the sexual life
first make their appearance, and experience justifies this inference.
Some writers attribute to climate a great influence in this respect;
whilst others regard this view as erroneous, and believe that the
differences observed depend rather on racial peculiarities. By advocates
of the former view it is assumed that a hot climate leads to the early
appearance of menstruation, whilst a cold climate retards the
development of this function. Those who dispute the influence of climate
bring forward instances of a contrary kind. Thus, among the Samoyede
Eskimos, menstruation begins at the age of twelve or thirteen,
notwithstanding the fact that they dwell within the Arctic circle;
whereas, among the Danes and the Swedes, menstruation begins at about
the age of sixteen or seventeen years. Again, we are told that among the
Creoles of the Antilles, as in France, menstruation rarely begins before
the fourteenth year, whilst in the same islands, girls of African race
begin to menstruate, as in Africa, at ten or eleven years of age.[68]
These objections to the climatic theory are certainly serious ones. But
when we are considering the possible influence of climate upon
menstruation, we have to remember that it is possible that climate may
exert its influence cumulatively in successive generations, and may not
produce its full effect upon the age at which menstruation begins, until
after the lapse of several generations. We certainly lack evidence to
show that in isolated individuals a change of climate affects the first
appearance of menstruation. But it is not impossible that climate may
exert such an influence in the course of several generations. Such a
view would appear to receive support from our observations on animals,
for the sexual life of the latter is notably influenced by the seasons,
and change of season resembles in many respects change of climate. In
most animals, and more especially in those living in a state of nature,
the sexual impulse becomes active at stated intervals only, and these
intervals are related to the duration of pregnancy in such a way that
the birth of the young occurs always at a season in which the nutritive
conditions are favourable. It is widely assumed that even in the human
species there remain vestiges of such a periodicity in the sexual
impulse. I have discussed this matter very fully elsewhere,[69] and will
here do no more than draw attention to the fact that the poetry of
spring, which sings partly of love alone, and partly of the relations
between love and the annual awakening of nature, bears upon the
influence of this season of the year upon the sexual impulse. It seems
that the spring also exerts an influence upon the love-sentiments of the
child. It is possible that suggestion here plays a certain part,
inasmuch as from childhood onwards poetry and many observations teach
that there is a connexion between love and the season of spring. Sanford
Bell considers that the importance of spring in this connexion depends
on the fact that at this season children begin to meet one another in
the open, subject to less restraint, and perhaps more frequently. But he
does not exclude the possible existence of an inherited vestige of
periodicity in the sexual impulse.
It is widely assumed that among the higher social classes the awakening
of the sexual life occurs earlier than among the lower. But it can
hardly be said that trustworthy statistics exist to illustrate this
point; and the most we can admit is that it may be true of the
commencement of menstruation--though even here the data available hardly
suffice to afford proof of the thesis. It is said that in girls of the
upper classes menstruation begins on the average at an earlier age than
in girls of the lower classes; and also that menstruation begins earlier
in towns than in the country. Rousseau[70] asserted this long ago,
taking his facts from Buffon, who attributed the fact to the sparer and
poorer fare of the country folk. Rousseau, while admitting that
menstruation began later in the country districts, considered that diet
had nothing to do with the matter, since even where (as in Valais) the
peasants enjoyed a liberal fare, puberty, in both sexes, occurred later
than in the majority of towns, in which an excessively rich diet was
often customary. He believed that the difference between town and
country in this respect depended rather upon the more enduring repose of
the imagination in the country, this latter itself arising from the
greater fixity of customs in the rural districts. Speaking generally,
however, the question whether in the country the sexual life awakens
later than it does in the towns, cannot be said to have been decisively
answered.
Closely connected with the question of the alleged later awakening of
the sexual life in the country is the belief that in the country
children are also more moral and remain longer uncorrupted.
I myself do not believe that children are more moral in the country, or
that they here remain longer uncorrupted than in towns, whether large or
small. Nor is it proved that in former times the country possessed any
advantage in these respects, as compared with our own days and with the
modern town. The entire fable of rural innocence appears to rest, not
upon an actual comparison between town and country, but rather upon the
more lively interest felt in town life, and especially in the life of
the great towns: in towns, immorality has been more carefully studied
and more often _described_; and on account of the greater concentration
of town life, it is also more readily apparent. But any one who studies
erotic literature and descriptions of manners and customs, at any rate,
anyone who studies these without prejudice, will find ample ground for
the opinion that even in earlier times morality stood in the country on
no higher level than in the towns. The opinion that country life was
more moral has existed from very early times, and it is interesting to
observe the way in which in erotic literature we at times encounter a
satirical use of this fact, describing the painful disillusionment of a
man who has hoped to find perfect innocence in his loved one from the
country, and has been bitterly disappointed.
I do not propose to give numerous examples of rural immorality in
earlier times; two will suffice, both dating from the eighteenth
century, and both bearing on the seduction of children. Laukhard,[71]
born in the year 1758, at Wendelsheim, in the Lower Palatinate, tells us
how, when six years of age, he was introduced by a manservant into the
secrets of the sexual life, so that he was speedily in a position "to
take part, with consummate ability and to the admiration of all, in the
most shameless lewd sports and conversations of the menials of the
household." And Laukhard adds in a note that, in the Palatinate,
obscenity was so universal, and among the common people the general
conversation was so utterly shameless, that a Prussian grenadier would
have blushed on hearing the foul talk of the Jacks and Gills of the
Palatinate. He also relates that he soon found an opportunity of
practising with one of the servant-girls what the manservant who had
been his instructor had extolled to him as the _non plus ultra_ of the
higher knowledge. If we compare with this the descriptions given by
Rétif de la Bretonne, who was born in the year 1734 in the village of
Sacy in Lower Burgundy, and was the son of a well-to-do peasant, and if
we study a number of similar accounts of country life, we shall hardly
be inclined to take a very roseate view regarding rural morals in former
days. We learn from Rétif,[72] that while still quite a little boy, only
four years of age, he had the most diverse sexual experiences with a
grown-up girl, Marie Piôt, after she had induced an erection of his
penis by tickling his genital organs. These and numerous similar
accounts, which we find in the works of writers of previous centuries,
are not likely to sustain the conviction that rural morals were formerly
distinguished by exceptional purity.
But if this claim must be disputed as regards rural life in former
times, it is still more certain that we must deny that to-day a higher
moral level obtains in the country than in the towns, and this is true
above all as regards children. It is certain that sexual activity in
children does not begin later in the country. My views as to present
conditions in the country are derived mainly from information directly
communicated to myself. From a number of grown-up persons, now residing
in the metropolis, but born and bred in the country, I have received
details of their own early sexual experiences. I have in addition had
opportunities for direct personal inquiries in rural districts and in
the smaller country towns. Lastly, I have received reports voluntarily
furnished to me by persons still residing in the country. Combining all
these sources of information, I am justified in asserting that in the
country sexual practices among children are of exceedingly common
occurrence.
Just as the recent increasing development of large towns has been
regarded as responsible for immorality and for premature sexual
activities in children, so also has modern civilisation in general been
blamed for the same results. There has always existed a tendency to
depreciate the morals of contemporary periods, and to exalt in
comparison the morals of an earlier day. In books of earlier
generations, in those, for instance, which appeared between the middle
of the eighteenth century and the middle of the nineteenth century, we
find, just as we find in the writings of our own day, lamentations upon
existing corruption, especially as regards the morals of children, and
panegyrics upon the morality of an earlier time. But when we examine the
documents of the past, we find adequate proof of the fact that morals
stood at no higher level in former times than to-day, and, more
particularly, we learn that the sexual morals of children were no better
then than now. If this were otherwise, how could we explain the fact
that, in the year 1527, for instance, the Town Council of Ulm issued an
order to the brothel-keepers of that town that they were no longer to
admit to the brothels boys of from twelve to fourteen years of age, but
rather were to drive them away with birch-rods. This fact, with many
others, is recorded by Hans Boesch;[73] and collectively they suffice to
prove, not merely that the children of former times were no whit more
moral than those of our own day, but also that the awakening of sexual
activity occurred just as early then as now.
But although I contest the alleged general influence of the life of
large towns and of modern civilisation upon the morality and the sexual
activities of children, I admit at once that peculiar conditions of
place and time may exert a great influence in these respects.
Frequently, no detailed analysis of these conditions is possible; but
sometimes such an analysis can be effected. Only by the assumption that
these special influences exist can we understand how it is that such
marked differences exist at different times in the same place. I know
certain schools in Berlin in which masturbation, and even mutual
masturbation, are widely diffused; and I know others regarding which in
this respect no unfavourable reports can be made. I know, indeed, of
schools about which I have received from former pupils, persons whose
trustworthiness I have absolutely no reason to doubt, reports which
prove that a remarkably high level of sexual morality must have existed
in these schools. On the other hand, ex-pupils of other schools,
attended by boys of very various classes of the population, have
informed me that at these schools there was hardly a boy who did not
masturbate. It is not always possible to ascertain the causes of such
differences. One child, perhaps, may corrupt an entire class. But I
believe also that the influence of the schoolmasters, and especially
that of the headmaster, may be of enormous importance in this respect.
Similar differences exist in the country. It is even believed by some
that there are differences between the Catholic and Protestant
inhabitants of the rural districts. How extensive may be the differences
even within a comparatively small area, is shown by an example, which I
will quote, from C. Wagner.[74] One of the districts studied by him was
the Province of Jagst in Würtemberg, and he reports that there is a
striking difference between the Alt-Würtemberg and the Franconian
districts. The report states that in the former district the greater
number of parents appear to recognise it as their sacred duty to bring
up their children properly and to watch over their development. Moral
depravity could not be said to be general among the children of this
region. Very different was it in the Franconian districts, in which not
only were the children cared for much less perfectly, but in which also
"the children saw and heard much too early things which impair or
destroy the innocence and purity of the heart." We are told that
shamelessness in the satisfaction of natural needs was general; some
cases of self-abuse were reported; and obscene and lascivious
conversation was common. The causes assigned for this in the report are:
overcrowding in the dwellings, there being in some cases but a single
bed for children of school age of different sexes; also that children
had been present when cattle were performing the sexual act. Often in
the country we are told that children have been corrupted by grown
persons, through sleeping in the same bed with the latter.
What has just been said bears upon the influences which at the opening
of this chapter I classed with the second group of the influences
affecting the sexual life of the child, namely, those that come into
play only after birth. But whatever degree of importance we may
attribute to these, it cannot be doubted that congenital predisposition
plays a very important part in inducing an early awakening of the sexual
life. What we see in this case is similar to what happens in respect of
other qualities than the sexual. Some persons are congenitally
predisposed to a one-sided development; and in some persons there occurs
a phenomenally early development of certain particular talents. It will
suffice to remind the reader of children who while still quite young can
perform extraordinary arithmetical operations, and of those who at six
or seven years of age can play beautifully on the piano or some other
instrument. In these latter cases the most important feature is the
congenital predisposition, but this predisposition has, of course, to be
aroused to activity; and the same is true in the case of the sexual
impulse. This explains why it is that the most careful education often
fails to prevent the premature commencement of the amatory life; and it
explains also, on the other hand, why it is that even in the most
unfavourable circumstances, sexual phenomena do not always make their
appearance during childhood. I know of persons who have passed the years
of childhood in a brothel, amid surroundings obviously calculated to
turn their attention to sexuality, but in whom nevertheless during
childhood no development of the sexual life appeared to have occurred.
The popular saying, "What is bred in the bone will not out of the
flesh," may be to some degree an overstatement, but nevertheless
corresponds to the actual facts. But we must not go to the other
extreme, and refuse to recognise the importance of the influences
surrounding the developing child. We must bear in mind that congenital
predispositions vary in strength; and a little reflection will convince
us that the awakening of the sexual life will be hindered by a
favourable environment, but facilitated and accelerated by an
unfavourable one. In cases of seduction, the congenital predisposition
often plays no more than a secondary part. Sexual acts in childhood
resulting from seduction often exhibit a merely imitative character, and
do not appear to proceed from an organically conditioned impulse; in
such cases the sexual malpractices are often discontinued when the
seducing influence is withdrawn; but if this influence is exercised
persistently and systematically, it may have a permanent effect even in
cases in which the congenital predisposition is slight.
This is all I have to say about the relationship between the congenital
predisposition and the external influences of life. Turning now to
consider these influences by themselves, we have to distinguish between
those that are somatic or physical and those that are psychical in
nature. Influences of these two classes may co-operate simultaneously,
or may pass one into the other; and, speaking generally, it is by no
means always easy to maintain a sharp distinction between them.
Seduction may in some instances arise largely by way of physical
stimulation, as, for example, when another person deliberately handles
the genital organs of a child. Nurses sometimes stroke or tickle a
child's genitals in order to put an end to a screaming fit. But in some
cases--and these are more numerous than is commonly supposed--nursemaids
do this under the impulse of their own lustful feelings. Such actions
are not necessarily the outcome of a perverse sexual impulse, although
they may be due to such an impulse in the form of pædophilia, as I shall
have to explain in detail when I come to describe that perversion.
Frequently the offenders are not in the least aware of the danger of
what they are doing, and do it merely in sport. In many instances the
seduction is effected by other children, and often at a very early age.
Recently a case was reported to me in which a boy only five years of age
led older children astray. In schools, a closet used by both boys and
girls is by many considered extremely dangerous. In the country, the
fact that children have a long way to go to school often gives
opportunity for improper conduct; and this is especially likely to occur
if there are copses near the road in which the children can conceal
themselves from observation. When children in the country traverse long
distances on the way to preparatory confirmation classes, misconduct is
exceptionally likely, for such children are now at an age at which the
activity of the sexual life is becoming more manifest. Whether the
seduction be the work of other children or of adults, the child thus led
astray is likely subsequently to induce artificially as often as
possible the agreeable sensations with which it has now been made
acquainted, more especially in view of the fact that in children the
imitative impulse is far more strongly developed than it is in adults,
in whom imitative inclinations are counteracted by numerous inhibitions.
What is true of seduction is true also of the various affections of the
genital organs which induce an impulse to scratch, such as eczema,
prurigo, urticaria, &c. Affections of regions adjoining the genital
organs may also lead to similar troubles--for instance, threadworms in
the rectum or the vagina.
Clothing, also, especially in boys the breeches, may give rise during
childhood to unwholesome stimulation. Hufeland, in his _Makrobiotik_,
long ago advised against the wearing of breeches by little boys. The
Schaumburg-Lippe body-physician, Faust,[75] in a work published in the
year 1791, strongly recommended that boys should not wear breeches.
Frequently the climbing of the pole in the gymnasium is regarded as
being the etiological factor in the induction of premature masturbation.
Experience shows that occasionally the first voluptuous sensations do
actually arise during the act of climbing the pole. A similar report is
made also in regard to the climbing of trees and of gymnastic exercises
on the parallel and horizontal bars. It is obvious that pressure on the
genital organs will very readily arise in these ways. But cases are
reported in which the child experiences sexual excitement from
exercising on the horizontal bar, not when he is straddling the bar, but
when he is hanging to it by the hands. It must in these cases remain
doubtful whether the sexual excitement results from the pressure of the
breeches, or is a direct result of the hanging posture. Where pressure
is exerted on the genital organs, it is not always the _strength_ of the
stimulus which is most significant. A nursemaid may do much more harm by
gently tickling a child's genital organs than by pressing them forcibly.
Nor have we to think only of the quality of the stimulus, but also of
its newness; for an unfamiliar stimulus may cause sexual excitement
simply because it is unfamiliar. Various stimuli have to be considered,
in addition to those previously enumerated. I may refer here to
flagellation. It is well known that in many children the first
experience of sexual excitement results from a whipping; indeed, a
perverse mode of sexual sensibility lasting throughout the whole of life
may thus originate. I shall return to this matter in the chapter on
Sexual Education. I will merely refer here to certain other stimuli
which have in many cases aroused sexual excitement for the first time.
Penta reports the case of a girl twelve years of age who first
experienced sexual excitement during a railway journey. Certain men have
informed me that they became sexually excited for the first time while
driving over a rough stone pavement. It is obvious in these cases that
the rapidly repeated succussion stimulates the peripheral genital
organs, and that in this way sexual sensibility is awakened. Havelock
Ellis[76] reports cases in which boys first experienced sexual pleasure
when wrestling. Thus, a physician wrote regarding a boy of twelve or
thirteen, that he experienced an extraordinarily pleasant sensation
whilst wrestling with another boy, and that thenceforward he sought
every opportunity to wrestle, often three or four times daily, and
continued to do this until he was nearly nineteen years of ago. Whilst
in this instance we are told that contact of the penis with the
opponent's hips was effected, and that probably the sexual excitement
was induced in this manner, I must point out that a masochistic-sadistic
form of excitement may also result from wrestling, and that it is to
this that we must refer the sexual desires and voluptuous sensations
that are aroused in many males by the act of wrestling.
Chemical stimuli must be regarded as a sub-variety of physical stimuli.
It is sometimes asserted that a diet too rich in meat or otherwise too
stimulating is dangerous in this regard. But an examination of the
available material will show that this opinion lacks foundation. There
is no proof that the sexual impulse can be prematurely awakened by a
meat diet, or by any other particular diet. I cannot regard such an
assertion as proved even as regards alcohol. Although I hold very
strongly that no alcohol should be given to children, this is not
because there is any proof that in children to whom alcohol is given the
awakening of the sexual impulse occurs earlier than in others. But once
the awakening of the sexual life has taken place, it is true that
alcohol may have an exciting influence, and this in two different ways.
On the one hand, if so much alcohol is taken as to interfere with the
natural psychical inhibitions, sexual practices may occur that would
not otherwise have occurred. On the other hand, also large quantities of
alcohol may often induce an after-effect, after the intoxicating effects
have completely passed away, manifesting itself, it may be, in the form
of sexual excitement, but also, and chiefly, in the form of common
sensations in the genital organs. To complete the account of this matter
it is necessary to add that there are many persons who consume large
quantities of alcohol, who yet are extremely moderate in sexual
relationships. But alcohol should not be administered to children, for
reasons altogether independent of its influence upon the sexual life.
Psychical stimuli are perhaps even more important than physical stimuli.
Here also seduction has to be considered, especially during the second
period of childhood, in which danger may arise from playmates or
school-fellows. This applies equally to children of either sex. Danger
may also arise from adults, not only through systematic seduction on the
part of grown persons who deliberately debase the mind of youth, but
also in other ways. The conversations of adults often lead to sexual
acts on the part of children, who understand far more of what is said in
their presence than grownups commonly believe. While the child is to all
appearance immersed in a book, while a girl is playing with her doll, or
a boy with his tin soldiers, the parents or some other adults carry on a
conversation in the child's presence under the influence of an utterly
false belief that the latter's occupation engrosses his or her entire
attention. Yet many children, in such cases, are listening to what is
being said with all their ears. Especially foolish, however, are those
parents who believe that by the employment of innuendo they are able to
conceal from any children who may be present the true inwardness of
their conversation. In these matters children are as a rule far sharper
than their elders are accustomed to believe. It is hardly necessary for
me to point out that opportunities for direct observation are especially
dangerous to children. I allude more particularly to the case of
children living in the same house with prostitutes; but the danger is
hardly less when the children have an opportunity of observing their own
parents engaged in sexual acts, or even in the mere preparation for
such acts. Forel[77] quotes the report of an experienced physician to
the effect that the children of peasants who have watched the copulation
of animals often attempt to perform such acts with one another, when
bathing, or when any other opportunity offers.
In the preceding portions of this chapter I have attempted to
distinguish individual influences from general influences, to
distinguish congenital influences affecting the germinal rudiments from
environmental influences acting after birth, and to distinguish
psychical stimuli from physical stimuli. But it is obvious that the
maintenance of a sharp distinction in these respects is very difficult,
and indeed often quite impossible. A few additional considerations will
elucidate this statement. Let us consider, for instance, seduction: here
the separation of the psychical from the physical element cannot
possibly be effected, because, as a rule, in these cases the two
elements co-operate simultaneously. Let us consider the cases in which,
owing to a congenital racial peculiarity, the sexual life awakens
earlier than is usual among ourselves. In such cases, the manners and
customs of the race in which this early development of sexuality is
usual will be found to be especially adapted to attract the child's
attention to sexual matters earlier than is here customary. It suffices
to remind the reader of the celebrations of puberty and of the early
marriages common among such races. Here it is hardly possible to
separate the congenital characters from the effects of environment. But
although, for the reasons given, the discrimination between the
individual factors may be exceedingly difficult, still an attempt at
discrimination must be made, more especially in view of the fact that a
purposive sexual education can be attempted only when due consideration
has been paid to the various etiological factors.
It would naturally be of the utmost importance to be able to foresee the
cases in which it is likely that the sexual processes of childhood would
undergo an exceptionally early development. But as a rule we are unable
to do this; and we must therefore be satisfied with the attempt to
determine in individual cases whether manifestations of the sexual life
occur during childhood, and if so, which manifestations. But even here
we encounter difficulties, which in many instances are insuperable, but
in others arise from the incompetence of adults. This is all the more
deplorable because the effectiveness of sexual education is minimised
through the lack of insight. Just as in the practice of medicine an
accurate diagnosis is an indispensable prerequisite to correct
therapeutics, so also here. Since in the earliest years the child has no
conscious understanding of sexual processes, whilst children in whom a
sexual consciousness has begun to dawn conceal most carefully from their
elders all manifestations of their sexual life, diagnosis is possible
only through knowledge of mankind in conjunction with tact.
Let us first consider the phenomena of contrectation. We shall notice
sometimes that a little boy, perhaps seven years of age or even younger,
will withdraw from the society of other boys, and will seek the company
of some particular individual, for example that of a girl friend of his
sister, of about his own age. Similar phenomena occur in girls. A little
girl in her tenth year will frequently be noticed to find something to
speak to her mother about whenever a particular male friend of the
family visits the house. Even a shrewd and observant mother will often
fail to take note of the reason why on these occasions her little
daughter invariably comes into the room. The child will have every
possible kind of excuse ready to enable her to seek the company of this
particular person. At times this goes further. We then notice that the
child endeavours to come into physical contact with the object of
affection, showing him great tenderness, and showering on him caresses.
Such a desire for intimate physical caresses must always arouse the
suspicion that sexual feelings have now been awakened. We must not, of
course, assume that every childish caress is sexually determined; but we
should always bear in mind this possibility in cases in which the
child's desire to caress someone is well marked. If such feelings
manifest themselves towards the end of the first period of childhood or
at the beginning of the second, observation will be comparatively easy,
for the younger the child is the less competent is it to conceal its
feelings. The consciousness that there is anything wrong in the
gratification of such sentiments awakens as a rule very gradually
indeed.
Similarly, it will be far easier in the case of children to observe
peripheral processes in the genital organs than it is to make such
observations in adults. Thus, even in the case of infants in arms, but
more often in the case of boys who are somewhat older, the mother or the
nurse may be surprised to observe erections when the boy is undressed
for his bath or some other reason, or when he has kicked off the
bedclothes at night. In other cases the child may be seen handling his
genital organs, either openly or beneath his clothing. Often, in the
absence of manual stimulation, the child adopts some other means of
stimulating his genital organs. Thus, in girls the legs will be crossed,
and the thighs rubbed lightly each against the other. In other cases,
both in boys and in girls, the child will lean against a piece of
furniture in what appears to be a perfectly innocent manner; but in
reality pressure is being exercised on the genital organs, it may be by
the corner of a table, it may be by the back of a chair; and then the
stimulus is strengthened by various movements. In some such way children
will effect masturbatory stimulation and obtain sexual gratification, in
the presence, not only of their mother, but in that of quite a number of
other persons. Guttceit[78] reports the case of a woman who squatted
down so that her bare heel came into contact with the genitals, and she
then masturbated by rubbing the two parts together. I myself have known
the case of a young girl who sat with her legs beneath her, and
masturbated with the boot she was wearing. In many instances we are
enabled, by watching the child's movements, to ascertain with such
certainty what it is doing, that no confirmatory evidence is needed. We
notice, especially, that when the orgasm is approaching, the movements
change in character and rhythm. The eyes become bright, and the face
assumes an excited and voluptuous expression. This may be observed even
in infants in arms. Townsend[79] reports the case of an infant, eight
months old, "who would cross her right thigh over the left, close her
eyes and clench her fists; after a minute or two there would be complete
relaxation, with sweating and redness of face; this would occur about
once a week or oftener; the child was quite healthy, with no abnormal
condition of the genital organs."
In the absence of these definite indications, it is necessary to be
cautious in coming to a diagnosis. Failing such caution, mistakes which
may entail serious consequences are likely to arise. Two cases are known
to me in which, after suspicion had rightly or wrongly been aroused, the
child's most harmless movements were regarded as masturbatory in
character. If a child becomes aware that its mother or some other person
in authority is making such a mistake, the effect will naturally be very
unfavourable. We have also to reckon with the fact that children who are
somewhat older, from eight or nine years upwards, hardly ever masturbate
when others are present, but only when they believe themselves to be
unobserved--in bed, in the closet, or when out walking. In such cases it
is hardly possible to diagnose masturbation with certainty; more
especially in view of the fact that the signs that may betray an older
boy--stains on the shirt or other articles of underclothing--are usually
lacking during the first two periods of childhood. It must be added that
such stains on linen resulting from ejaculation do not at first contain
spermatozoa, and for this reason their diagnostic value is greatly
lessened (see pp. 52-56). Still, the possible appearance of these stains
is a matter to which attention should always be paid, and this in girls
as well as in boys. In many instances, also, our diagnosis may be
supported by the discovery of articles used for onanistic[80] purposes.
In the case of boys we shall seldom, comparatively speaking, be able to
do this; although, even in boys, operation is sometimes needed for the
removal of articles used for onanistic purposes, which have found their
way into the urethra or the bladder. In girls, such operations are more
frequently required. Hairpins, pencils, and various other articles used
for onanistic purposes, are from time to time removed from the vagina or
the female bladder. Other signs that are supposed to indicate the
habitual practice of masturbation are of little diagnostic value. It is
traditionally held that masturbation in girls leads to elongation of the
clitoris, but there appears to be no warrant in fact for this opinion.
As I have previously pointed out, laceration of the hymen does not in
general result from masturbation. Other signs, such as local irritation
or swelling, are hardly ever seen in boys, and in girls are seen only in
cases in which they masturbate to excess. _In girls, moderate reddening
of the external genital organs has no significance whatever; and I take
this opportunity of giving a special warning against inferring from the
existence of such reddening that masturbation is practised, and also
against attaching any importance to this symptom in a case in which a
sexual assault is supposed to have been committed on a little girl._
Certain other signs which have been believed to support a diagnosis of
masturbation, do not even justify suspicion. Among these reputed signs
may be mentioned: black lines under the eyes, pallor of the cheeks,
inflammation of the eyes, &c. Generally speaking, it must be said that
in sexually immature children nothing but direct observation will
justify a definite diagnosis of masturbation, except in cases in which
the child itself makes confession to someone in its confidence. For the
diagnosis of auto-erotism, however, it is not necessary to establish
the occurrence in the child of the voluptuous acme; it suffices for this
diagnosis if there occur signs of those general voluptuous sensations
which were described on page 58. In many cases in which the practice of
masturbation is diagnosed, and in cases in which children themselves
confess to masturbating thirty times a day or more, we can hardly
suppose that the voluptuous acme or orgasm is attained.
It is sometimes maintained that the early appearance of the physical
manifestations of puberty is an indication that psychosexual processes
are also occurring prematurely. Thus, Kisch[81] expresses the opinion
that in many cases premature sexual development manifests itself in
children by the enlargement of the breasts, and by the growth of the
axillary and pubic hair, in the absence of the commencement of
menstruation, Kussmaul also observed cases in which, in comparatively
early girlhood, all the physical signs of puberty were present although
menstruation had not yet begun. According to my own experience, we must
be careful to avoid taking an exaggerated view of such a connexion.
Passionate psychosexual processes may occur in young children in the
absence of any physical signs of premature sexual development. An
impulse to masturbate may also arise quite independently of the
commencement of the adult development of the external genital organs.
Psychically determined erections may likewise occur, although the
physical development is by no means far advanced. We shall therefore do
wisely to avoid taking a narrow view of such a connexion, inasmuch as it
may be that the physical signs of puberty on the one hand, and the
phenomena of detumescence and contrectation on the other, may occur in
conjunction at a very early age, whilst, in other cases, phenomena of
the one class or of the other may occur in isolation. This statement is
true, not merely of the secondary sexual characters, whose development
by no means always affords a measure for the degree of development of
the sexual impulse, but it is true also of the reproductive organs
themselves. Halban[82] reports the case of a boy six years of age,
whose penis was as large as that of a full-grown man, but in whom, apart
from the erection, all the characters were infantile. Still more often
do we note the independence in many young men of the individual symptoms
of sexual development from the growth of the beard, for this latter is
often still lacking at an age when the sexual life in general has
attained an extensive development. Still less importance must be
attached to other occasional signs. According to Marc d'Espine[83]
"puberty occurs early in girls with dark hair, grey eyes, a delicate
white skin, and of powerful build; late, on the other hand, in girls
with chestnut hair, greenish eyes, a coarse, darkly-pigmented skin, and
of delicate, weakly build;" but the evidence to justify any such
generalisation is lacking. It is possible that the opinion quoted is
supported to some extent by certain associated racial peculiarities, but
we must be on our guard against accepting inferences of too sweeping a
character. Still less, of course, are such peculiarities a trustworthy
aid for the diagnosis of the occurrence of sexual acts at an early age.
The safest way of obtaining accurate information as to the practice of
masturbation and other sexual acts is by means of confessions made to
some person in the child's confidence. Cases are known to me in which
children have very readily confided in some elder person. If this does
not often occur, the fault commonly lies with the child's elder
associates, who do not understand how to establish a truly confidential
relationship with the children under their care. If a child finds that
no one will speak to it about sexual matters, it must ultimately become
secretive about its own sexual life. The child sees very clearly that
every word it utters about such things is repressed as improper, and
soon learns that the whole field of sexuality is regarded as something
unclean, about which not a word must be uttered. The ordinary behaviour
of adults inevitably produces this impression in the child's mind, and
it will readily be understood what an effect this has in preventing us
from gaining information about the sexual life of the child. In many
mothers, the abhorrence of the sexual is carried to such an extreme that
while in other respects they keep their children scrupulously clean,
they feel so strongly that the genital organs must not be touched, that
they neglect to secure the ordinary cleanliness of this region of the
body.
The best confidant for a young child will usually be the mother, not
only because she sees more of the child than the father and because her
relationship is a more intimate one than his, but in addition because a
woman's insight into certain things generally excels a man's. As a
matter of fact, for the reasons stated, masturbation in young children
is in most cases discovered by the mother. It will be obvious that I
speak here only of those mothers who have real affection for and
sympathy with their children, and who share their children's interests;
I do not refer to those mothers who think they have adequately fulfilled
their maternal duties by paying a nurse or a governess, whilst
themselves immersed in the pleasures of society--or perhaps engaged in
the preparation and delivery of lectures on the best way of bringing up
children, on the Woman's Movement, Woman's Suffrage, and similar
topics--or, it may be, attending these same lectures--those who, in any
case, prefer some other occupation to the care of their own children.
Above all, let not those who have the care of children be deceived,
either by diligence, or by conduct exemplary in other ways, or indeed by
earnest study of the Bible, by pious protestations, or by regular
attendance at church. I know a boy of twelve, reputed to be extremely
religious, and ostensibly on religious grounds going to church every
Sunday; but whose real motive in the church-going was the hope to meet
the girl of whom he was enamoured. Extensive experience of the conduct
of adults should teach us the necessity for extreme caution in these
respects. I recall the case of a gentleman whose reputation was that of
a paragon of all the virtues. When others of an evening went out to
enjoy a glass or two of beer, or in search of even lighter pleasures, he
was supposed always to turn homewards, ostensibly in order to work.
Only after some years was the fact disclosed that he was an habitual
loose-liver, enjoying indiscriminate sexual intercourse with unmarried
girls and with his neighbours' wives, although to his friends and
comrades he had appeared to be a man of exceptionally strict life, and
this above all in sexual relationships. The same may be true also of
quite little children. Hebbel relates that in his first year at school
be sat next to a boy who appeared to be engaged in the most earnest
study of the catechism, whilst under the rose he was pouring into young
Hebbel's ear all kinds of obscenities, and was asking him if he was
still stupid enough to believe that children were brought by a stork or
were found in a basket in the cabbage-patch. Many parents, too, know so
little about their children in these respects, that they are utterly
astonished when some day their eyes are opened to the facts of the case
by their family physician. I knew a boy of fourteen who went regularly
to church, and who in other respects was a fine fellow, and a diligent
pupil at school He was brought to see me because he was affected with
spasmodic movements. On examination, I found him to be suffering from a
severe attack of gonorrhoea, which he had contracted in intercourse
with his aunt's servant-maid. When I told his mother the truth, she was
at first extremely angry at what she was convinced must be a mistake on
my part; but further inquiry disclosed the fact that for a year or more
the boy had been intimate with prostitutes and other girls.
I have been writing of processes occurring in the reproductive organs,
such as erections, seminal and other discharges, and masturbation; and
of the means for the recognition of these processes. But it is necessary
to recognise that we must not assume without further inquiry that all
processes occurring in the genital organs are of a sexual nature,
although in individual instances the distinction between the sexual and
the non-sexual may be extremely difficult, or even impossible. Thus, of
erections occurring before the reproductive glands ripen, not all are of
a sexual nature. We know, too, that even in the adult, non-sexual
erections may occur. The clearest instances of this are met with in the
form of priapism, the principal characteristic of this condition being
the occurrence of permanent erection which has nothing at all to do with
the sexual impulse. The same is true for the most part of matutinal
erections, the precise cause of which is not yet determined. They are
commonly referred to distension of the bladder, which is supposed by
reflex action to lead to distension of the corpora cavernosa of the
penis. It is certain, at any rate, that these matutinal erections are
not caused by sexual thoughts, nor as a rule do they induce sexual
feelings. We must distinguish between these processes; just as recently
we have learned to distinguish herpes progenitalis, the characteristic
of which is its localisation to the genital organs, from herpes
sexualis, which is directly dependent upon sexual processes. If we
regard this distinction between sexual and non-sexual erections as
applicable also to erections in childhood, we are justified in assuming
that many erections, in infants-in-arms, for instance, are non-sexual in
nature, even though in appearance there is nothing to distinguish them
from sexual erections. In infants, erections may arise from external
stimuli or from distension of the bladder, which must be distinguished
from the erections which have a definitely sexual causation. We must, of
course, admit the possibility that such primarily non-sexual erections
may secondarily give rise to sexual processes; inasmuch as by the
stimuli resulting from the erection, the child's attention may be
directed to the genital organs. Just as we must guard against regarding
every erection in the child as a sexual process, so also must we be
cautious in our estimate of the significance of manual stimulations.
Children often stimulate various parts of the body. Some children will
rub the lobule of the ear, others will suck their fingers, or will
stimulate their mouths in other ways. Some children have the offensive
habit of picking their nose; and it is evident that many cases in which
children stimulate the genital organs manually are on the same footing
with nose-picking and numerous similar habits. In such cases we have not
to do with a specific genital sensation to which the child responds; but
with a stimulus which may be pathological, but is not necessarily
sexual. In many cases, indeed, the stimulus is not even pathological.
We have to take the following point into consideration. As soon as the
child begins to become conscious of the existence of its organs, it
fingers them. It does this with its nose and its ears, just as it does
with its feet; and it is obvious that the genital organs will receive
the same treatment. A gentleman who had grown up in the country related
to me that as a child he had often been present when cows were being
milked, and that in the evenings, after he had gone to bed, he performed
the milking movement on his penis, and was greatly astonished at the
fact that no milk flowed forth. He assured me that the like experience
had occurred to quite a number of boys who had been his playmates in the
country. It is certain that such manipulations of the genital organs,
entirely non-sexual in origin, may lead to the practice of masturbation.
But we must not immediately conclude that every manipulation of the
genital organs in a child is sexually determined.
It is true that many investigators regard numerous movements on the part
of children as sexual processes, even when the genital organs are in no
way involved. Freud[84] above all, discovers sexuality in the life of
the child in cases in which, I am convinced, sexual elements play no
part whatever. Sucking movements in children are regarded by Freud as
sexual phenomena. He considers that the lips and the fingers are
erogenic zones. With just as much reason, every movement might be
regarded as sexual--as, for instance, the clenching by a child of its
little fists. As long ago as 1879, Lindner,[85] of Budapest, published
an able essay about the movements made by children sucking their
fingers, lips, &c., and suggested that there was some connexion between
these sucking movements and sexual processes. He stated that many
children, when sucking the lips, the fingers, the back of the hand or
some other part, or when sucking a rubber teat, simultaneously rubbed
some other region of the body--in some cases the lobule of the ear, the
nipple, or the genital organs; this was sometimes done with one hand
only, sometimes, if both hands were free, with both. This statement is
perfectly correct. It may happen that the child stops rubbing the
genital organs as soon as the sucking is interfered with; or,
conversely, the sucking may cease as soon as we withdraw the child's
hands from its genital organs. But, even in these cases, the friction of
the genital organs does not necessarily possess a specifically sexual
character, since friction of the lobule of the ear or of some other part
of the body is an equivalent act. It is certain that there is here no
intimate connexion between the act of sucking and the sexual life. Thus,
there is no proof whatever for the view of Lindner, which has recently
been carried to a still greater extreme by Freud, that this "voluptuous
sucking" (_Wonnesaugen_) is a truly sexual process. We may, indeed,
assume, as does Rohleder,[86] that such sucking movements occur with
especial frequency in children with a congenital morbid predisposition,
and that to this extent therefore it is connected with masturbation. But
in my opinion it is essential to regard the two movements as clearly
independent in character.
Certain other childish habits, such as nail-biting, have also been
described as sexual manifestations. What I have said of sucking
movements applies to this also. It is true that nail-biting and
masturbation may both occur in the same child, and French writers have
maintained that there is a causal nexus between the two processes. If we
regard nail-biting as a "tic" occurring chiefly in neuropaths, and if we
assume that the neuropathic congenital predisposition is the basis of
the premature awakening of sexuality, it may be supposed that to that
extent there exists a relationship between the two phenomena, inasmuch
as we may refer both manifestations to a common cause, viz., the
neuropathic predisposition. But there is no justification whatever for
regarding, as some do, one manifestation as the direct consequence of
the other.
Speaking generally, we shall do wisely to exercise caution in defining
the limits of the sexual life of the child. If a boy runs after a girl,
and if the two flirt one with the other, it will often be merely from a
desire to imitate their elders. In many instances, even, in which the
genital organs play a part in such imitation, we must distinguish what
is done from the sexual life proper of the child. If children play at
"father and mother," if the "midwife" comes, and "childbirth" takes
place, the play may certainly depend upon an early awakening of the
sexual life; but this is not necessarily the case. There may be no more
than innocent imitation of grownups, as the following case shows. A
number of little boys and girls, almost all under eight years of age,
played at being prostitutes, souteneurs, and men-about-town. The little
girls each demanded a penny when they had allowed the little boys to
touch their genital organs. It was an extremely characteristic fact that
the leader of this band was a feeble-minded boy, whose parents I had
advised to send him to an asylum, because, after various dangerous
actions, he had attempted one night to kill his little sister eighteen
months old by inserting beans in her nose. Such acts as that first
described may, of course, depend upon a premature awakening of the
sexual impulse; and when a number of children engage in amusements of
this kind we not infrequently find that in the leader and seducer the
sexual impulse is already awakened, whilst the others act merely in
obedience, at first, at least, to an imitative impulse. Certainly, I
have known a few instances in which children with premature sexual
development very rapidly came to a mutual understanding, and in whom
their intimate association was dependent upon prematurely awakened
sexual impulses.
Just as sexual acts in which the genital organs play a part occasionally
arise, not from premature awakening of the sexual impulse, but from
imitation merely, so also, as previously explained, may this happen in
the case of more harmless processes. Braggadocio here plays a great
part, and also the desire to act like grown-ups. Thus, the boy who runs
after girls, and makes appointments with them, sometimes does this
merely to show off before his companions, and to produce in them the
impression that he is a "manly" fellow. We must take care to separate
these cases, also, from those that are genuinely sexual.
If it is difficult to separate the sexual from the merely imitative, no
less difficult may it be to distinguish psychosexual processes from
others. If a child lavishes caresses on mother, governess, or sister, it
may be difficult to discover definite characteristics enabling us to
distinguish whether the motive is or is not sexual. But, generally
speaking, when a child exhibits an intimate and caressive affection for
its mother we shall not incline to think of processes of the sexual
life. We cannot dispute the truth of the statement made by various
authors, that in these caressive inclinations sexual elements are
intermingled. But this talk of the intermingling of sexual sentiments
arises in reality only from the fact that neither on theoretical nor on
practical grounds are we in a position to draw a clear line of
demarcation between the sexual and the non-sexual; and we must avoid
stretching this idea of the intermixture of sexual elements beyond the
fact that a scientifically based practical distinction is not always
possible.
_We have to admit that above all in the mind of the child the various
feelings comprised under the idea of "sympathy" (friendship, affection
for parents, love of children, sexual love) cannot always be marked off
each from the other after the manner of provinces on a map._ Even
jealousy, which is often regarded as characteristic of the erotic
sentiments, does not necessarily possess a sexual basis. The boy, in his
love for his mother, is jealous of his father, jealous of one of his
brothers or sisters, jealous even of a dog to which his mother pays
attention. How little jealousy may depend upon a sexual motive, may be
learned by the observation of animal life; a dog becomes jealous if its
master takes notice of another dog, or even pays attention to his own
children. _In children, more especially, the extension of jealousy is
far greater than it is in adults._ Whereas in adults this sentiment is
chiefly, if not exclusively, associated with the erotic feelings, in
children this is by no means the case. In the child, jealousy may
clearly be associated with every possible variety of sympathetic
feeling. For this reason, it is impossible for us to draw a distinction
between sexual and other psychical processes, simply on the ground of
the associated manifestation of jealousy.
On what grounds, then, can we decide that certain processes are of a
sexual nature? In many instances, only the subsequent development will
show that one process was sexual, another non-sexual. If one day a boy,
embracing, as often before, his girl friend, has an erection, and then
perhaps endeavours to draw her towards him so that her body presses
against his genital organs, or even has an ejaculation with a voluptuous
sensation, we may assume the influence of a contrectation impulse, which
has existed for some time, but only now has for the first time been
localised in the peripheral genital organs. On the other hand, if in the
same boy when he hugs his mother no peripheral sexual manifestations
occur, either now or subsequently, we must assume that in the earlier
embraces of his mother there was no sexual element. But no such simple
solution of the difficulty is really possible. It may happen that in the
case of feelings originally sexual their further development is
inhibited. A boy might experience sexual sentiments towards his mother;
but it is very probable that in such a case convention, education, and
perhaps also the very frequent association with his mother, would
repress the growth of these sentiments. This criticism is a sound one,
and in my opinion the materials are lacking to enable us to overcome its
force. For why should certain processes occurring in childhood--for
example, a boy's impulse to caress his mother--be regarded as
non-sexual; and yet the same processes subsequently be regarded as
sexual, merely because they ultimately become associated with the
phenomena of detumescence? Take the case of a boy seven years of age; he
loves and cuddles his mother; he is drawn also to a girl friend of the
same age as himself, and kisses her with equal pleasure. The boy grows
older, and after some years begins to have definite erections when he
embraces and kisses his friend; but nothing of the kind occurs when he
embraces and kisses his mother. Now, have we any right to assert, simply
owing to the subsequent appearance of these peripheral manifestations in
the one case and not in the other, that originally, when between the
boy's inclination towards his girl friend and his inclination towards
his mother no clear distinction could be drawn, the former was sexual,
the latter non-sexual in nature?
The dilemma is unanswerable, unless we admit that, in the child,
sympathetic feelings, which we shall subsequently be able to classify
without difficulty, are, when they first appear, not always susceptible
of any such differentiation; and that for this reason we are just as
little able to distinguish a boy's love for his mother from has
non-sexual friendship for a little girl, as we are able to distinguish
either from a sexual love for another girl. To a very acute observer,
certain slight indications may in many cases give some idea of how the
matter really stands; but we are here largely concerned with subjective
interpretations, rather than with distinctions that are objectively
demonstrable. The difficulty of drawing distinctions is all the greater
in view of the fact that in the case of non-sexual feelings sexuality
constantly plays a certain part. Our sentiments are complex, and
compounded of many and various elements; sexual contrasts play their
part in family relationships; and it is not by pure chance that harmony
exists by preference between father and daughter, and between mother and
son. This sexual contrast tends to manifest itself in all displays of
family affection. Thus, many men will tell us that in early boyhood they
loved to kiss their mother and sisters, rather than their father and
brothers. In my experience, the analogous sexual contrast does not show
its effects so clearly in the case of women as in the case of men. I
cannot be certain if the differences I have observed in this respect
depend merely upon chance. It is certainly a fact that men, in their
confidences to me, have remarkably often reported childish memories of
the working of this sexual contrast. And conversely, many homosexuals
have assured me that in boyhood they kissed their father with much
greater pleasure than their mother.
Our diagnosis will, naturally, be greatly facilitated in those cases in
which the phenomena of contrectation are plainly reflected to the
reproductive organs. I, at any rate, believe that in practice such an
association suffices completely to establish the diagnosis. We can,
indeed, recognise this also in the dream life, at least as soon as the
first nocturnal emissions have occurred. In the first edition of my work
on _Contrary Sexuality_ (Berlin, 1891), I drew attention to the fact
that those affected with perverse sexuality commonly have perverse
dreams; and Näcke has further discussed the significance of sexual
dreams for the diagnosis of sexual perversions. In children also we
shall find in their sexual dreams, especially when these dreams have
begun to be accompanied with seminal emissions, a certain assistance in
the delimitation of their sexual sentiments from other manifestations of
sympathetic sentiment. But this aid in diagnosis is not available till
comparatively late in childhood, _i.e._ not until ejaculation has
already begun. Even before this epoch dreams may have a sexual
character, and may be conditioned by sexual processes. But practically,
before the occurrence of ejaculation and orgasm in dreams, an exact
diagnosis is opposed by so many difficulties, that little of value can
in this way be gained.
In this chapter we have examined the considerations that must guide us
in our study and diagnosis of the sexual life of the child. It is,
naturally, an important question, whether signs exist pointing to an
abnormal development of the sexual life, and more especially to the
growth of a sexual perversion. This matter has been discussed with
considerable detail, and I need not, in conclusion, add anything to the
emphatic warning previously given, against making apparently perverse
manifestations in childhood the basis of a definite diagnosis or
prognosis.