“Since the sexual act gives rise to a low and falling blood-pressure, it must necessarily alleviate conditions which are due to high and increasing blood-pressure—for example, mental depression and ill-humour—andif my observations are correct, we have here an explanation of the relation between conditions of high blood-pressure with mental and physical depression, on the one hand, and masturbatory practices on the other, for such practices alleviate this condition, and are readily indulged in for this purpose” (quoted by Havelock Ellis).
“Since the sexual act gives rise to a low and falling blood-pressure, it must necessarily alleviate conditions which are due to high and increasing blood-pressure—for example, mental depression and ill-humour—andif my observations are correct, we have here an explanation of the relation between conditions of high blood-pressure with mental and physical depression, on the one hand, and masturbatory practices on the other, for such practices alleviate this condition, and are readily indulged in for this purpose” (quoted by Havelock Ellis).
The statement made to Dr. Garnier by a monk, thirty-three years of age, bears out this view:
“If no nocturnal seminal emissions occur, the tension of the semen gives rise to general depression, headache, and sleeplessness. I admit that sometimes, in order to obtain relief, I lie upon the abdomen, and so produce a seminal discharge. I immediately feelfreed, as if aburdenhad been lifted from me, and sleep returns” (ibid., p. 273).
“If no nocturnal seminal emissions occur, the tension of the semen gives rise to general depression, headache, and sleeplessness. I admit that sometimes, in order to obtain relief, I lie upon the abdomen, and so produce a seminal discharge. I immediately feelfreed, as if aburdenhad been lifted from me, and sleep returns” (ibid., p. 273).
Similar motives for masturbation are alleged by many otherwise healthy onanists. They apply, moreover, in an equal degree to the normal, not excessive, sexual intercourse of ordinary human beings. Persons belonging to the most diverse classes of society—men of letters, shopmen, labourers, etc.—of whom I have inquired regarding the effect of seminal emissions, whether produced by masturbation or by coitus, have unanimously agreed in describing to me this sense of “freeing” from a burden, from pressure, from harmful substances accumulated in the body—a sense of mental energy and creative power after such discharges of sexual tension not exceeding normal limits. The frequency of these discharges varies in different individuals; in one the intervals were short, in another they were long. This point has a very important bearing upon the “question of sexual abstinence,” and we shall return to it in the discussion of that topic.
Masturbation is often the means for inducing sleep and repose; it dulls nervous sensibility, and connected with this is the fact thatpainis often allayed by masturbation. Here I may refer once more to the previously quoted (p. 44) view of a talented young alienist, Edmund Forster, that, in association with sexual tension, there occurs an increased stimulation of thepain-perceiving nervesof the genital organs. It is conceivable that sexual tension, especially if it depends upon chemical causes, also increases pains arising from other areas of the body, and that the discharge of sexual tension would thus alleviate or completely allay these pains. Coe reports (American Journal of Obstetrics, 1889, p. 766) the case of a woman who was accustomed by masturbation to obtain immediate relief of intense menstrual ovarian pains. It is very remarkable thatthese pains were accompanied by a powerful sexual impulse, which ceased whenthe pain ceased, and did not return during the intermenstrual period. Here we have a striking testimony of the accuracy of Forster’s view. The phrenologist Gall was aware of the manner in which masturbation relieves pain.
In addition to these more natural causes of masturbation, which in themselves suffice to explain the wide diffusion of the practice, we have also to consider masturbation dependent uponseductionand uponmorbid states.
To seduction must be referred all the phenomena ofgroup-masturbation(masturbation on the large scale) inschools,[405]training-ships, barracks, factories (especially in this case as regards female employees!), prisons, etc. One leads another astray, and masturbation is diffused like an epidemic disease; the individuals are subjected to the influence of thesuggestion of the crowd, which they are unable to resist. Thomalla describes boarding-schools in which masturbation was practised for a wager, and that boy won the prize in whom seminal emission first occurred! He further speaks of a school club in which obscene readings were held, and in which by means of forbidden pictures the boys were sexually excited until erection occurred, then followed general masturbation, also accompanied by wagers.
This group-masturbation is the best proof of the fact that those who masturbate are not simply individuals with an inherited morbid predisposition; for nothing is easier to suggest than masturbation. HavelockEllis[406]reports the following case of an unmarried healthy young woman, thirty-one years of age, which throws a strong light on this suggested manifestation:
“When I was about twenty-six years of age, a female friend informed me that she had masturbated already for several years, and was so much enslaved by the habit that she suffered seriously from its ill-effects. I listened to her account with sympathy and interest, but felt rather sceptical,and I resolved to make the attempt on myself, with the intention of understanding the matter better, so that I might be able to help my friend. With a little trouble Isucceeded in awakening what had hitherto slumbered in me unknown. I intentionally allowed the habit to become stronger, and one night—for I usually did it just before going to sleep, never in the morning—I really experienced an extremely agreeable sensation. But the next morning my conscience was aroused, and I felt pains also in the back of the head and along the spine. For a time I discontinued the habit, but later began it again, masturbating with considerable regularity once a month, a few days after each menstruation.... The habit overcameme with alarming rapidity, and I soon became more or less its slave.... In conclusion, I must say that masturbation has proved to me one of the blind chances in my life’s history, out of which I have derived many valuable experiences.”
“When I was about twenty-six years of age, a female friend informed me that she had masturbated already for several years, and was so much enslaved by the habit that she suffered seriously from its ill-effects. I listened to her account with sympathy and interest, but felt rather sceptical,and I resolved to make the attempt on myself, with the intention of understanding the matter better, so that I might be able to help my friend. With a little trouble Isucceeded in awakening what had hitherto slumbered in me unknown. I intentionally allowed the habit to become stronger, and one night—for I usually did it just before going to sleep, never in the morning—I really experienced an extremely agreeable sensation. But the next morning my conscience was aroused, and I felt pains also in the back of the head and along the spine. For a time I discontinued the habit, but later began it again, masturbating with considerable regularity once a month, a few days after each menstruation.... The habit overcameme with alarming rapidity, and I soon became more or less its slave.... In conclusion, I must say that masturbation has proved to me one of the blind chances in my life’s history, out of which I have derived many valuable experiences.”
Frequently local morbid changes in or near the genital organs lead to the practice of masturbation, such as skin troubles, intestinal worms, phimosis, inflammatory states of the penis or near the entrance of the vagina, prurigo and other itching affections of the penis, constipation, urinary anomalies, etc. Further, mental disorders, epilepsy, and degenerative nerve troubles, are frequent causes of masturbation. Masturbation has been observed after epileptic paroxysms in patients who at other times never masturbate. There is no doubt that neurasthenia powerfully predisposes to masturbation.Excessivemasturbation is almost always the consequence, not the cause, of associated neurasthenia; it is “the manifestation of a disease in course of development or of a permanently existing degenerativepredisposition.”[407]To these cases of invincible, habitual, excessive masturbation Oppenheim’s view applies—that the disposition to onanism is ofteninherited. A characteristic instance of this is offered by an observation of Block’s (Havelock Ellis,op. cit., p. 240) in the case of a little girl, who began to masturbate at the early age of two years, and had probably inherited this tendency from her mother and grandmother, for they had both masturbated throughout life, whilst the grandmother had actually died in an asylum of “masturbatory insanity.” In the majority of cases in whichmasturbation makes its first appearance in sucklingswe have to do with such an inheritance. In many cases the peculiar oscillatory movements of sucklings may merely be the expression of the sense of general comfort, as Fürbringer believes, and may have nothing to do with actual masturbation; but, on the other hand, it cannot be denied that veritable masturbation may be observed in the first and second years of life. Havelock Ellis, J. P. West, and Louis Mayer have reported such cases. In children somewhat older than this—from three years upwards—seduction and suggestion certainly play a great part. The author of “Splitter” was told by a professor that, when visiting an institution for small children in St. G[allen], he saw a girl about three years of age who was making suspicious movements. The matron, whoseattention was called to the matter, said that almost all babies were already infected when they first came to the institution (“Splitter,” p. 375).
Another disputed question relates to thediffusion of masturbation in the female sex. Is the practice commoner or less common among women than among men?Metchnikoff[408]is of opinion that in girls it is much less common than in boys, because sexual excitability generally develops much later in the female sex. Female monkeys masturbate only in exceptional cases, whereas in male monkeys masturbation is very common. The circumstance which Metchnikoff adduces in further support of his view of the rarity of masturbation in women—that, namely, most girls are enlightened regarding sexual sensibility only after marriage—proves very little, because the sensations aroused in woman by masturbation are of a very different nature from those produced by coitus, and coitus often first makes them acquainted with entirely new sensations. Tissot regards masturbation as commoner in women than in men; Deslandes believed that there was no difference between the sexes. Lawson Tait, Spitzka, and Dana, inclined rather to Metchnikoff’s view as to the greater rarity of the practice among women. Albert Eulenburg considers masturbation “not quite so common among young women as among young men,” but still “far more common than parents, teachers, and the laity of both sexes as a ruleimagine.”[409]Havelock Ellis considers thatafterpuberty masturbation is commoner in women because men can then much more readily obtain gratification in a normal manner by means of intercourse with the other sex. Otto Adler estimates the frequency of masturbation to be very great, because he regards it as the principal cause of deficient sexual sensibility in women, which latter condition he also believes to be extremely common, although he does not go so far as to accept Rohleder’s enormous proportion of 95 masturbators in every 100 women(!).[410]L. Löwenfeld, who characterizes Rohleder’s and Berger’s (99 %) estimates as exaggerations, considers that the frequency of masturbation in women is not so great as inmen.[411]In reality, masturbation, given similar circumstances and causes, is probably diffused to an approximately equal extent among both sexes.
But this relates only to peripheral-mechanical masturbation; from this “psychical onanism” has rightly been separated—that form of masturbation in which, simply by ideas, without the assistance of manual stimulation of the genital organs, sexual excitement is caused and the orgasm is induced. Psychical onanism, of which EduardReich[412]remarked that our own time nourishes it to the fullest possible extent, develops in the majority of cases out of masturbation proper. In this form theimaginationis tasked with representing all the factors of normal sexual gratification. The simple physical act suffices only in the first beginnings of this vice. Every practised onanist understands that he must soon call his imagination to his aid in order to produce sexual gratification, and that ultimately ideas alone dominate the entire libido, and the orgasm often enough terminates an act which in every respect has throughout remained purely ideal.
“So great is the power of imagination,” remarks the experienced Rouband, “that quite alone, without the assistance of physical stimulation, it can produce the venereal orgasm, with ejaculation of the semen, as happened to one of my fellow-students every time he thought of hisbeloved.”[413]
“So great is the power of imagination,” remarks the experienced Rouband, “that quite alone, without the assistance of physical stimulation, it can produce the venereal orgasm, with ejaculation of the semen, as happened to one of my fellow-students every time he thought of hisbeloved.”[413]
Hammond even knew an actual sect of such “onanists by means of simple ideal unchastity,” who formed a sort of club or society, and who were known to one another by certainsigns.[414]A patient related to him that in his thoughts of women whom he met, or those who were sitting opposite to him in the railway-carriage, he was accustomed to undress them in imagination; he then would represent to himself very plainly their genital organs, and during this representation he experienced very active voluptuous sensations, culminating in ejaculation. Löwenfeld has also observed several such cases. Eulenburg speaks of an “ideal cohabitation.” The ideas are usually of a lascivious nature, but this is not always the case. Von Schrenck-Notzing reports the case of a lady twenty years of age in whom the simple idea of men, but also agreeable sensory perceptions, such as theatrical scenes, or musical impressions, or beautiful pictures, gave rise to the sexualorgasm.[415]
Allied with psychical onanism is the brooding over sexual ideas—thedelectatio morosaof the theologians—and erotic excitement associated with dream-imaginations, or “sexual day-dreams” (Havelock Ellis). This is the spinning out of a continuous erotic history with any hero or any heroine, which is carried on from day to day. Most commonly this occurs in bed before going to sleep. Sexual activities form the material of these histories. We often find carefully worked out and more or less erotic day-dreams in young men, and especially in young women, frequently containing perverse elements. This dreaming, according to Havelock Ellis, does not necessarily lead to masturbation, although it often induces seminal discharges. It occurs both in healthy and in abnormal persons, especially in imaginative individuals. Rousseau experienced such erotic day-dreams. The American author Garland, in his novel, “Rose of Dutcher’s Coolly,” has admirably described the part played by a circus-rider in the erotic day-dreams of anormal healthy girlduring theperiod ofpuberty.[416]
In close relationship with these psychical-onanistic day-dreams there stands another phenomenon, to which, as far as I know, I was the first to refer, which I have denoted by the termerotographomania.[417]There are numerous men and women who induce their lovers—male or female, as the case may be—prostitutes, masseuses, etc., to write to themletterswith a sexually stimulating content; or also, as very frequently occurs, they themselves write such letters, containing numerous obscenities. Such correspondence, filled with ardent erotism, seems recently to have made its appearance as a peculiar refinement of sexuality; this also has the effect of a kind of psychical onanism. The interchange of obscene letters of this character recently played a part in the trial of two homosexual individuals in East Prussia. There exists, also, a comparatively blameless, more or less physiological, erotographomania of the time of puberty, in which most passionate letters are written to imaginary lovers, and the still obscure sexual impulse finds a satisfaction in these erotic imaginations.
After this brief account of the various forms and varieties of masturbation, we now turn to consider theconsequencesof the practice. In the course of time there has been a remarkable change of views in respect of this matter. The true founder ofthe scientific literature of masturbation, Tissot, in his celebrated monograph (“Masturbation; or, the Treatment of the Diseases that result from Self-Abuse”; St. Petersburg, 1774), regarded masturbation as the evil of all evils, and deduced from it all possible severe troubles. His book bears as motto the verse by Von Canitz:
“Wenn schnöde Wollust dich erfüllt,So werde durch ein SchreckensbildVerdorrter TotenknochenDer Kitzel unterbrochen.”[“When base lust fills thy thoughts,Let a horrible picture rise before thy mindOf withered dead men’s bones,So let the sensual stimulation be driven away.”]
“Wenn schnöde Wollust dich erfüllt,So werde durch ein SchreckensbildVerdorrter TotenknochenDer Kitzel unterbrochen.”[“When base lust fills thy thoughts,Let a horrible picture rise before thy mindOf withered dead men’s bones,So let the sensual stimulation be driven away.”]
“Wenn schnöde Wollust dich erfüllt,So werde durch ein SchreckensbildVerdorrter TotenknochenDer Kitzel unterbrochen.”
[“When base lust fills thy thoughts,Let a horrible picture rise before thy mindOf withered dead men’s bones,So let the sensual stimulation be driven away.”]
It is dominated by a thoroughgoing pessimism. In this view he is followed by Voltaire, in his “Dictionnaire Philosophique,” and by the authors of the first seventy years of the nineteenth century. Such gloomy views are expressed, above all, by Lallemand, in his celebrated book upon involuntary losses of semen; but they are shared by German physicians also, as, for example, B. Hermann Leitner, in his treatise, “De Masturbatione” (Buda-Pesth, 1844), and in the preface to his book we read: “The writers who speak of the terrible results of self-abuse do not exaggerate; on the contrary, their picture is not sufficientlygloomy.”[418]Modern medical science has, however, reduced these exaggerations to a reasonable measure. For this we have, above all, to thank W. Erb and Fürbringer. The old belief in the enormous dangers and the eminent injuriousness of masturbation, still remains as a bugbear in certain popular writings, some of which have been published in hundreds of editions. Who has not heard of the “Selbstbewahrung” (“Self-Abuse”) ofRetaus,[419]the prototype of this dangerous literature, which must be regarded as the principal source of sexual hypochondria; frequently, also, it induces direct sexual stimulation, because it does indeed describe the devil, but describes also voluptuousness!
At the present day all experienced physicians who have been occupied in the study of masturbation and its consequences hold the view thatmoderatemasturbation in healthy persons, withoutmorbid inheritance, has no bad results at all. It is only excess that does harm; but even excess in healthy persons does less harm than in those with inherited morbid predisposition. I may express the matter in this way: it is not masturbation (Ger.Onanie) that is harmful, but “onanism” (Ger.Onanismus)—that is to say, the habitual and excessive practice of masturbation, continued for a number of years,which certainly has an injurious influence on health. The boundary line at which the harmless masturbation (Onanie) ceases and the injurious onanism (Onanismus) begins cannot generally be defined. The difference between individuals makes their reactions in this respect very different. For example, Curschmann reports the case of a talented and brilliant author who, notwithstanding the fact that he had masturbated to excess for eleven years, remained physically and mentally vigorous, and pursued his literary labours with notable success. Fürbringer reports a similar case in a University lecturer. The following case, which came under my own observation, shows that even excessive masturbation need not impair health and working powers. A man of letters, forty years of age, probably misled by a nursemaid in the first instance, had masturbated without intermission since the age of five, and since puberty had done soseveral times a day(three to ten times), without any interference with his powers for work. He is a big, powerful, healthy man, of a really imposing appearance. No one would suspect him to be a habitual masturbator. That from the masturbation (Ger.Onanie) of childhood and youth there developed a condition of formal onanism (Ger.Onanismus) in the adult is in this case principally to be ascribed to the continued abuse of alcohol. The patient drinks daily twelve to fourteen glasses of Munich beer. He is also a heavy smoker. No evidence of inherited predisposition to masturbation can be obtained. For the patient the female sex exists only in the imagination; he has very rarely had sexual intercourse, and avoids ladies’ society, although he has good fortune with women. It is the same with masturbation as it is with sexual intercourse: the effects vary according to the individual. Recently masturbation and coitus have been compared in this respect. Sir James Paget in his lecture on “Sexual Hypochondriasis” says: “Masturbation does neither more nor less harm than sexual intercourse practised with the same frequency in the same conditions of general health and age and circumstance.” Erb and Curschmann go even further; for they consider that masturbation has less influence on the nervous system than coitus.In reality,however, masturbation is almost always more harmful than coitus. The reasons for this are obvious. In the first place, masturbation is begun much earlier, generally at an age when the body has not yet developed any marked capacity for resistance. Masturbation in childhood is, therefore, especiallyharmful.[420]Löwenfeld (op. cit., p. 127) is of opinion that self-abuse begun before virility is attained more readily gives rise to weakness of the nervous system than masturbation begun later in life. In neuropathic children he saw several times, as a consequence of masturbation, well-marked general nervousness, paroxysms of anxiety, sleeplessness, and arrest of mental development. In the second place, masturbation is more dangerous than coitus in this way—that it can be carried outmuch more frequently, on account of the more frequent opportunities, so that masturbation four, five, or even more, times in asingleday is by no means rare. In the third place, thespiritual influenceof masturbation is much more harmful than that of normal coitus. The “solitary” vice influences the psyche and the character in the mere child. The youthful masturbator seeks solitude, becomes shy of human beings, reserved, morose, unhappy, hypochondriacal. In the adult the sense of the debasing character and of the sinfulness of masturbation is much more lively; self-confidence departs; the masturbator regards himself as absolutely “enslaved” by his vice, the eternalstruggleagainst the ever-recurring impulse gives rise more to mental depression than to actual physical harm. From this there results a whole series of diseases of the will, for by masturbation much less harm is done to the intellect than to the vital energy, the capacity for spiritual and physical activity. The cold, blasé manner of many young men, who seem never to have known the natural youthful joy of life, the whole “demi-virginity” of modern young girls—all these are without doubt dependent upon masturbation and upon psychical onanism. The egoism of the onanist in the sexual relationship increases his egoism in other respects, gives rise to cold-heartedness, and blunts the more delicate ethical perceptions. The campaign against masturbation as a group manifestation is eminently asocialcampaign for altruism; it insists that young people should take their share in all questions relating to the common good. Peculiar extravagances and unnatural characteristics in art and literature may also be partly attributed to masturbation. Manyworks clearly bear its imprints. Thus Havelock Ellis rightly refers in this connexion to the peculiar melancholy in Gogol’s stories, for Gogol masturbated to great excess. It would be possible to mention also certain writings of our own time which inevitably give rise to such a suspicion.
The reader will do well to consult the interesting discussion of masturbation from the philosophical standpoint by Schopenhauer (“Neue Paralipomena,” ed. Grisebach, pp. 226, 227).
Thephysicalconsequences of immoderate and habitual masturbation may also be really serious. Theeyeespecially suffers manifold injuries, as has been proved by the investigations of Hermann Cohn. Irritable states of the conjunctiva, spasms of the eyelids, weakness of accommodation, subjective sensations of light, and photophobia, may result from masturbation. Theheartalso is sympathetically affected. Krehl even speaks of “masturbator’s heart” as a consequence of the long-lasting nervous hyperexcitability, which injures the heart and the vessels, and is manifested by irregularity of the pulse and by sensations of pressure and pain in the cardiac region, by palpitation, etc. Discontinuance of the habit leads to an immediate disappearance of all these alarming symptoms. Very important is also the causal connexion between masturbation andnervousormental disorders. Here, however, as Aschaffenburg has recently insisted, we must distinguish clearly between masturbationresultingfrom previously existing nervo-psychical troubles, in which a vicious circle develops—for here the masturbation is partly the consequence of the original trouble, partly the cause of an aggravation of this trouble—and the effects of onanism on thehealthycentral nervous system. Here Aschaffenburg is in agreement with the views of those who consider these effects are less serious than earlier writers were accustomed to assume. Aschaffenburg also recognizes that the most harmful effect is to be found in thepsychicalinfluence of masturbation, in the continuous, but ever-vain, contest against the habit. This is the source of the majority of the hypochondriacal and other troubles. He often succeeded, by the discovery of this psychical mode of origin, in putting an end to a number of morbid manifestations. As soon as the patientbecomes awarethat these have a purely mental cause, he at once feels himself freed from them. That masturbation isnevera direct cause of mental disorder is now generally recognized byalienists.[421]At the most, masturbation is no more than a favouring element in the production ofsuch disorder. “Masturbatory insanity” occurs only in those with marked hereditary predisposition, and who already have been extremelyneurasthenic.[422]
But masturbation can unquestionably give rise topurely local changesin the genital organs, such asinflammatory states of the prostate gland,spermatorrhœa, andprostatorrhœa; in womenfluor albus,excessively painful menstruation, andother disturbances of the menstrual function, and in connexion with these phenomena there may appear the morbid picture of “sexual neurasthenia,” which we have soon to describe.
A very serious result of onanism (not ofOnanie) is thedisinclination to normal sexual intercourseto which the habit gives rise, and theproduction of sexual perversions. The former is more marked in the female sex, the latter more in the male sex. Masturbation is the principal cause of sexual frigidity in women and of a disinclination to normal intercourse. Undoubtedly psychical influences here play the principal part; but also a certain blunting of the sensations of the genital organs by means of excessive masturbatory stimulation. They are no longer susceptible to the normal stimulatory influence of coitus. Moreover, masturbation is often effected by stimulation applied tosome definite portionof the female reproductive organs, most frequently to the clitoris or the labia; and these parts in such cases are not sufficiently stimulated by coitus. In the male the especially sensitive portions of the penis are stimulated alike by masturbation and in coitus, for which reason man, notwithstanding the practice of masturbation, is much more readily able to obtain sexual gratification in the course of ordinary sexual intercourse. Notwithstanding this, there are also certain peculiar methods of masturbation in the male, the effect of which is not attained by coitus. In such cases men also may fail to induce the sexual orgasm by ordinary intercourse.
The close relationship of masturbation to sexual perversions is obvious. The more frequently the onanistic act is repeated, the more the normal sensibility is blunted, the stronger and more peculiar are the stimuli, which must be of a nature diverging from the ordinary, demanded in order to induce a sexual orgasm. The content of the lascivious ideas must be varied more and more frequently, and soon passes entirely into the sphere of the perverse. Gradually these perverse sexual ideas become more firmly rooted, and ultimately develop into complete sexualperversions. A classical example of this is the case reported byTardieu[423]of a man who was in the habit ofmasturbating seven or eight times every day, and ultimately inflamed his imagination to the point of representing the act of intercourse with female corpses. At length he passed to thepractical carrying outof this horrible idea, which had now assumed definite sadistic characters. He arranged to obtain a view of opened female bodies, killed dogs, dug up human corpses—all in order thereby to provide satisfaction for his imagination, which had been disordered in consequence of masturbation, and thus to obtain sexual gratification. In the etiology of pseudo-homosexuality masturbation unquestionably plays a part—a fact to which Havelock Ellis has drawnattention.[424]The Mexican “mujerados” are trained for pæderasty by means of masturbation repeated several times daily. Ideas of bestial intercourse may even be aroused by masturbation. VonSchrenck-Notzing[425]reports the case of a woman who had masturbated for thirty years, and ultimately came to represent to herself in imagination that she was having intercourse with a stallion.
The prospects of the satisfactorytreatmentandcureof masturbation are unquestionably greater in the case of children. To attain perfect success, parents, teachers, and physicians must co-operate. Above all, it is necessary to relieve any local and general morbid conditions favouring the practice of masturbation. The diet should be light and unstimulating, the clothing and bedding light and cool. In the year 1791 the body physician of the Schaumburg-Lippe family, Dr. Bernhard Christian Faust, published a remarkable work under the title “How to Regulate the Human Sexual Impulse,” with a preface by the celebrated pedagogue J. H. Campe (Brunswick, 1791). In this book he maintained the thesis that the principal cause of masturbation in boys was the wearing ofbreeches. According to him, thewrapping upof children in swaddling clothes causes premature stimulation of the sexual organs. Later, in consequence of wearing breeches, there is produced “a great and damp warmth, which is especially marked in the region of the sexual organs, where the shirt falls into folds” (p. 46). Also, the boy, “when he wishes to pass water, must take his little penis out of his breeches. At first, and for a long time after he begins to wear them, the little boy cannot manage this himself; other children,maids, and menservants, help him, and pull and play with his sexual parts. By this handling, pulling, and playing, which he himself does, or which others do for him, with his sexual organs, the boy is led (also the girl, who very often assists, and whom the blameless boy, out of gratitude, wishes to help in return) into constant acquaintanceship with parts which he would otherwise have regarded as sacred, unclean, and shameful. The child becomes accustomed to play with his sexual organs, andoccasional masturbationdevelops into habitual self-abuse,all brought about by wearing breeches” (p. 45). To prevent all this, he suggested that boys from nine to fourteen years of age should wear clothing resembling rather that of girls. Then these children would be “according to Nature, children, and would ripen late; and the human sexual impulse would come under control, and mankind would be better and happier” (p. 217).
Although the far-reaching and systematic development of this thesis appears ludicrous, still, there is an element of truth in it, and unsuitably tight and warm clothing certainly favours the tendency to masturbation.
According to the suggestion of Ultzmann, in the case of nursing infants and of small children, the hands may be confined in little bags or tied to the side of the bed. The methods of the older physicians, who appeared before the child armed with great knives and scissors, and threatened a painful operation, or even to cut off the genital organs, may often be found useful, and may effect a radical cure. Theactualcarrying out of small operations is also sometimes helpful. Fürbringer cured a young fellow in whom no instruction and no punishment had proved effective, by simply cutting off the anterior part of his foreskin with jagged scissors. In the case of a young lady who often in company indulged her passionate impulse towards masturbation, he brought about a cure by repeated cauterization of the vulva. Other physicians perforate the foreskin and introduce a ring. Cages have even been provided for the genital organs to prevent masturbation, the key being kept by the father (!). Enveloping the penis in bandages without any opening has also been tried. Corporal punishment sometimes has a good effect. Of the greatest value iscontinuous care, to safeguard the children against seduction. “Parents, protect your children from servants,” exclaimed Rétif de la Bretonne. Valuable also areearnest warnings and explanations,increase of energy and force of will(by sports and games, and by work in the garden, and by the setting of tasks which stimulate ambition).Climatic curesandhydro-therapeutic methodsare also valuable means in the treatment of masturbation. The same measures may be employed in the treatment of masturbation inadults. In their case, however,psycho-therapeuticsplays the principal part. In many cases here also local cauterization of the urethra and massage of the prostate may bring about a cure.Utterly perversewould it be to introduce youthful onanists to actual sexual intercourse, after the manner of the Parisian “soup-merchants,” as the common speech names them, who, in order to cure their youthful scholars of masturbation, take them intobrothels.[426]
Masturbation is intimately connected withirritable nervous weakness, or “neurasthenia,” this typical disease of civilization, and more especially with the genital form of the disease, “sexual neurasthenia.” In an analysis of 333 cases of neurasthenia Collins and Philipp found that 123 cases—that is, more than one-third—resulted from overwork or frommasturbation.[427]Freud, von Krafft-Ebing, Savill, Gattel, and Rohleder see in masturbation the true cause of neurasthenia. Fürbringer, Löwenfeld, and Eulenburg are of opinion that other injuries must also come into play in order to produce the typical picture of sexual neurasthenia. It is certain that very frequently the order of causation is reversed,neurastheniabeing theprimaryand masturbation the secondary disorder. Masturbation is then only asymptomof sexual neurasthenia. The same duplex mode of consideration may also be applied to the other morbid phenomena of which the clinical picture of sexual neurasthenia is composed. Every one of these symptoms of irritable weakness, the excessive sexual excitability, the deficient sexual sensibility, the seminal discharges, and the impotence, can, like masturbation, exhibit a certainindependence, can be induced by various causes, and may lead to sexual neurasthenia; it may be, on the other hand, that they first developed in the soil of sexual neurasthenia. It is often impossible to determine the truebeginningof the vicious circle. It therefore appears to be more practical to describe the morbid picture of sexual neurasthenia (which we owe toBeard)[428]according to its individual symptoms, as is done also by A.Eulenburg[429]in an admirable essay, and by L. Löwenfeld in his well-known work on “The Sexual Life and Nervous Disorders.”
Theabnormal increase in the sexual impulse(sexual hyperæsthesia,satyriasis,nymphomania) begins at the point at which the normal sexual impulse is exceeded; and that point is subject to wide individual variations, according to the age, race, habits, and external influences. The normal sexual impulse can also be temporarily increased by special circumstances—as, for example, by prolonged sexual abstinence, and by various kinds of erotic stimulation, without our being justified in speaking of “hyperæsthesia.” This is always an abnormal condition, which may be referred to various causes. It is more frequent in men (“satyriasis”) than in women (“nymphomania”); it may be permanent or periodic; it almost always arises from lasciviousideas, and, according to its cause, is accompanied by a greater or less diminution of responsibility, or even by complete lack of responsibility. The readiness with which sexual ideas give rise to an abnormally increased desire and to reaction on the part of the genital apparatus is characteristic of sexual hyperæsthesia; and this may attain such a degree that the man (or woman) may really be “sexually insane,” and, like the wild animals, rush at the first creature he meets of the opposite sex in order to gratify his lust; or he may be overpowered by some abnormal variety of the sexual impulse, so that he seizes in sexual embrace any other living or lifeless object, and in this state may perform acts of pæderasty, bestiality, violation of children, etc. In these most severe cases we can always demonstrate the existence of mental disorder, general paralysis, mania, or periodical insanity, and very often ofepilepsy(Lombroso), as a cause. In a more chronic and milder form, sexual hyperæsthesia is observed after excessive masturbation, often also in association with a congenitally neuropathic constitution. Löwenfeld describes a peculiar form ofnocturnalsexual hyperæsthesia occurring in married men, especially men in the forties or fifties, who for various reasons are compelled to abstain from conjugal intercourse, and who live continently.In the daytimethese patients were free from their trouble; it appeared only atnight. Soon, or some hours after going to sleep, aviolent, painful, enduring erection of the penis(priapism) set in, which disturbed their sleep, and left them in the morning with a feeling of enervation. In such a case obviously there is a hyperexcitability of the genital erection centre. The erection results as a reflex effect of stimuli proceeding from the genital organs, but manifests itself only when,during sleep, the inhibitions proceeding from the brain are in abeyance. This nocturnal priapism may, according to Löwenfeld’s observations, last foryears.[430]
Sexual hyperæsthesia in women, or “nymphomania,” is, in its slighter forms, also in most cases a consequence of excessive masturbation. Such women do not so much exhibit a more powerful inclination towards sexual intercourse, which, on the contrary, is incompetent to satisfy their abnormal and perverse sexual excitability. We rather see in them an impulsion to obtain new sensations in their sexual organs in any possible way. These are the women who, for example, consult the gynæcologist as often as possible, because examination with the speculum or other manipulations induce in them sexual excitement. During the climacteric—the time when menstruation ceases—such states are also met with. Nymphomania proper always develops upon the foundation of severe neurasthenia and hysteria, or of direct brain and mental disorder. Then is produced the type of the “man-mad” woman, as described by Juvenal in the person of the Empress Messalina, who in the brothel gave herself to all comers, without obtaining complete satisfaction of her sexual desire. Such types exist also at the present day. Thus, the brothers de Goncourt in their Diary reported the case of an old housekeeper who for several decades indulged in the most lascivious love orgies, had innumerable lovers, and a “secret life full of nocturnal orgies in strange beds, full of nymphomaniaclusts.”[431]There recently lived in Charlottenburg the wife of a workman, well known on account of her incredible sexual ardour and man-mania. Her husband, a professional stabber, was imprisoned for life. His wife often gave herself in a single day to four or five different men; every male creature that approached her she asked to perform the sexual act with her.—The following almost incredible case of this nature is reported by Trélat:
Madame V., of a strong constitution, agreeable exterior, good-natured manner, but very reserved, came under the care of Trélat on January 1, 1854. Notwithstanding the fact that she was sixty years of age, she still worked very diligently, and hardly spared herself time for meals. Nothing in her outward appearance or in her actions indicated during her stay in the asylum that she was in any way affected with mental disorder. During the four years not a single obscene word, not a gesture, not the slightest passionate movement, indicated anger or impatience.Since her earliest years she has pursued handsome men and given herself to them. When a young girl, by this degrading conduct she reduced her parents to despair. Of an amiable character, she blushed when anyone spoke a word to her. She cast her eyes down when in the presence of several persons; but as soon as she was alone with a young or old man, or even with a child, she was immediately transformed; she lifted her petticoats, and attacked with a raging energy him who was the object of her insane love. In such moments she was a Messalina, whereas a few instants before one would have regarded her as a virgin. A few times she met with resistance, and received severe moral lectures, but far more often there was no obstacle to her desires. Although various distressing adventures occurred, her parents arranged for her marriage, in the hope thereby to put an end to the moral disturbance. But her marriage was only a new scandal. She loved her husband passionately; and she loved with the like passion every man with whom she happened to be alone; and she exhibited so much cunning and cleverness that she made a mock of any attempts at watching her, and often attained her end. Now it was a manual worker busy at his trade, now some one walking past her in the street, to whom she spoke, and whom she brought home with her on any possible excuse—a young man, a servant, a child returning from school! In her exterior she appeared so blameless, and she spoke so gently, that every one followed her without mistrust. More than once she was beaten or robbed; but this did not prevent her continuing the same way of life. Even when she had become a grandmother there was no change.One day she enticed a boy, twelve years of age, into her house, having told him that his mother was coming to see her. She gave him sweets, embraced and kissed him, and as she then began to take off his clothes and approached him with obscene gestures, the boy strove to resist her. He struck her, and he related everything to his brother, twenty-four years of age. The brother entered the house pointed out by the boy, and abused the corrupt woman to the uttermost, saying: “In such circumstances one helps oneself, without having recourse to law, in order not to bring one’s name into disrepute by public proceedings. I hope this disturbance will teach you not to behave in this way again.” While this scene was going on, the woman’s son-in-law chanced to come in, realized the situation before there was time to tell him anything, and at once took sides with the incensed young man.She was shut up in a convent, where she behaved in so good, sweet, amiable, and modest a manner, that no one would have believed that she had ever committed the slightest fault, and representations were made to the effect that she ought to be allowed to return to her home. All the inmates of the convent had been charmed by the zeal with which she took part in the religious exercises. When she was free again, the scandalous doings were immediately resumed, and so it went on all through her life.After she had reduced her husband and children to despair, they finally hoped that age would extinguish the fire with which she was consumed. They were mistaken. The more excesses she committed, the more she wanted to commit, the more vigorous she appeared. It is hardly credible that such debased ideas and habitsshould leave intact such a sweet expression of countenance, a voice so youthful, a behaviour so full of calm repose, and a glance of such clear assurance. She became a widow. Her children, on account of her horrible mode of life, could not any longer keep her at home, and they sent her to a distant place, where they provided her with an allowance. Since she was now old, she was at length compelled to offer payment for the shameful services which she demanded; and as the small allowance she received did not suffice for this purpose, she worked with untiring zeal in order to be able to pay the great number of her lovers.To see the old, alert woman sitting at her work, as I myself saw her, when aged seventy or upwards, without spectacles, always cleanly and carefully, but not strikingly, dressed, with a simple and honourable appearance, and an open countenance—to suspect her shameful mode of life would never occur to anyone. Several of the wretched men who were paid by her related how diligent she was. She assured Trélat of her morality, in the hope that he would discharge her, and so enable her to resume her mode of life. Trélat could not agree to this, and he succeeded in obtaining from one of these men an accurate account of her shameless loves.This corrupt woman preserved her repose of manner, her excellent appearance, and her honourable demeanour until her death. She died at the age of seventy-four years from a cerebral hæmorrhage. There was no remarkable change in the brain (Journ. de Méd. de Paris, 1889, No. 16).
Madame V., of a strong constitution, agreeable exterior, good-natured manner, but very reserved, came under the care of Trélat on January 1, 1854. Notwithstanding the fact that she was sixty years of age, she still worked very diligently, and hardly spared herself time for meals. Nothing in her outward appearance or in her actions indicated during her stay in the asylum that she was in any way affected with mental disorder. During the four years not a single obscene word, not a gesture, not the slightest passionate movement, indicated anger or impatience.
Since her earliest years she has pursued handsome men and given herself to them. When a young girl, by this degrading conduct she reduced her parents to despair. Of an amiable character, she blushed when anyone spoke a word to her. She cast her eyes down when in the presence of several persons; but as soon as she was alone with a young or old man, or even with a child, she was immediately transformed; she lifted her petticoats, and attacked with a raging energy him who was the object of her insane love. In such moments she was a Messalina, whereas a few instants before one would have regarded her as a virgin. A few times she met with resistance, and received severe moral lectures, but far more often there was no obstacle to her desires. Although various distressing adventures occurred, her parents arranged for her marriage, in the hope thereby to put an end to the moral disturbance. But her marriage was only a new scandal. She loved her husband passionately; and she loved with the like passion every man with whom she happened to be alone; and she exhibited so much cunning and cleverness that she made a mock of any attempts at watching her, and often attained her end. Now it was a manual worker busy at his trade, now some one walking past her in the street, to whom she spoke, and whom she brought home with her on any possible excuse—a young man, a servant, a child returning from school! In her exterior she appeared so blameless, and she spoke so gently, that every one followed her without mistrust. More than once she was beaten or robbed; but this did not prevent her continuing the same way of life. Even when she had become a grandmother there was no change.
One day she enticed a boy, twelve years of age, into her house, having told him that his mother was coming to see her. She gave him sweets, embraced and kissed him, and as she then began to take off his clothes and approached him with obscene gestures, the boy strove to resist her. He struck her, and he related everything to his brother, twenty-four years of age. The brother entered the house pointed out by the boy, and abused the corrupt woman to the uttermost, saying: “In such circumstances one helps oneself, without having recourse to law, in order not to bring one’s name into disrepute by public proceedings. I hope this disturbance will teach you not to behave in this way again.” While this scene was going on, the woman’s son-in-law chanced to come in, realized the situation before there was time to tell him anything, and at once took sides with the incensed young man.
She was shut up in a convent, where she behaved in so good, sweet, amiable, and modest a manner, that no one would have believed that she had ever committed the slightest fault, and representations were made to the effect that she ought to be allowed to return to her home. All the inmates of the convent had been charmed by the zeal with which she took part in the religious exercises. When she was free again, the scandalous doings were immediately resumed, and so it went on all through her life.
After she had reduced her husband and children to despair, they finally hoped that age would extinguish the fire with which she was consumed. They were mistaken. The more excesses she committed, the more she wanted to commit, the more vigorous she appeared. It is hardly credible that such debased ideas and habitsshould leave intact such a sweet expression of countenance, a voice so youthful, a behaviour so full of calm repose, and a glance of such clear assurance. She became a widow. Her children, on account of her horrible mode of life, could not any longer keep her at home, and they sent her to a distant place, where they provided her with an allowance. Since she was now old, she was at length compelled to offer payment for the shameful services which she demanded; and as the small allowance she received did not suffice for this purpose, she worked with untiring zeal in order to be able to pay the great number of her lovers.
To see the old, alert woman sitting at her work, as I myself saw her, when aged seventy or upwards, without spectacles, always cleanly and carefully, but not strikingly, dressed, with a simple and honourable appearance, and an open countenance—to suspect her shameful mode of life would never occur to anyone. Several of the wretched men who were paid by her related how diligent she was. She assured Trélat of her morality, in the hope that he would discharge her, and so enable her to resume her mode of life. Trélat could not agree to this, and he succeeded in obtaining from one of these men an accurate account of her shameless loves.
This corrupt woman preserved her repose of manner, her excellent appearance, and her honourable demeanour until her death. She died at the age of seventy-four years from a cerebral hæmorrhage. There was no remarkable change in the brain (Journ. de Méd. de Paris, 1889, No. 16).
With regard to the treatment of abnormal sexual hyperexcitability, the severer forms—satyriasis and nymphomania—urgently needasylum treatment. In the slighter forms favourable results will be obtained by means of psycho-therapeutics, the internal use of sedatives (such as monobromide of camphor and bromide of potassium), regulation of the diet, suitable clothing andbedding.[432]
The converse of sexual hyperæsthesia issexual anæsthesia, or theabnormal diminution of the sexual impulse. It occurs in both sexes as acongenitalcondition, owing in such cases to atrophy or absence of the genital organs, after exhausting diseases, or in consequence of arrest of development of the reproductive organs from unknown causes. This latter condition is denoted by A. Eulenburg by the name of “psycho-sexual infantilism.” The same author also terms sexual anæsthesia “sexual loss of appetite.” It is commoner in women than in men. It is often merelyapparent—a pseudo-anæsthesia—becausethe man does not understand how to awaken the still slumbering sexual perceptions (vide supra,p. 86). Recently Otto Adler has written a comprehensive and interesting monograph on this “Deficient Sexual Sensibility in Women” (Berlin, 1904). According to him, the statement of Guttzeit,that of ten women, four have no sensation at all “in coitu,” and submit to it without any agreeable sensation at all during the friction, and without any intimation of the intense pleasure of ejaculation—that is, that 40 % of women suffer from coldness and lack of sensibility, from “frigidity”—is indeed somewhat exaggerated in respect of the percentage; but still it is a correct expression of the fact that deficient sexual sensibility is much commoner in women than it is in men, in whomEffertz,[433]for example, estimates the frequency of frigidity at only 1%.[434]In women various circumstances explain the frequency of deficient sexual sensibility. First of all,masturbationlowers sexual excitability in women much more than it does in man, and, above all, it blunts sensibility for normal sexual intercourse, both by means of psychical influences and by the insensibility of the external genital organs, owing to deficient stimulation of the clitoris during normal intercourse, whereas this organ is most powerfully stimulated during masturbation. Sexual frigidity also occurs in women in consequence of maladroitness and brutality of the manin coitu, giving rise rather to pain than to voluptuous sensations, and very frequently being the cause of the first onset of the so-calledvaginal spasm, or“vaginismus.”[435]It is also due in some cases to impotence on the part of the man.
In an interesting and valuable work, Carl Laker, in the year 1889, described, as “A Peculiar Form of Perversion of the Sexual Impulse in the Female” (GermanArchives of Gynæcology, 1889, vol. xxxiv., No. 3, pp. 293et seq.), cases of sexual frigidity in womanin coitu, which are not to be regarded as cases of “anæsthesia sexualis,” since thesexual impulsewas normal—indeed, frequently was increased—and it was sexual gratification in normal intercourse which was completely wanting. In these cases gratification was obtainable only by simple or mutual onanism. There existed a normal inclination towards the other sex, associated with mental and physical health. The author assumes that, in consequence of some anatomical abnormality, stimulation of the sensory nerves by which the voluptuous sensation is perceived, especially those of the clitoris, failed to occur; but perhaps by a change of posturein coituthis stimulation can still be effected. The case previously reported by me on page 86 belongs to this category ofrelativeortemporarysexual anæsthesia; whereas in cases of genuineabsolutesexual anæsthesia the sexualimpulsealso is in abeyance at the outset, or disappears in consequence of excesses and in female libertines and in prostitutes.
Thetreatmentof deficient sexual sensibility in women must, above all, take into consideration psychical influences, and depends, therefore, more on the husband or lover than it does on the physician; the conditions of intercourse must be adapted to the particular circumstances of the case (as by change of posture in coitus, preparatory tenderness, etc.). Painful sensibility in vaginismus can sometimes be cured by mechanical treatment, by the removal of painful remnants of the hymen, by the cure of small lesions, and also by extension by means of the speculum. It also appears, as is evidenced by an observation of Courty, that at the time of impregnation there occurs a stronger stimulation and voluptuous sensationin coituin women who are at other times frigid.
Sexually frigid women of the lower classes are apt, as Effertz points out, to become prostitutes. During the practice of their profession they always keep a cool head, because they are at first and always sexually insensitive, and can devote their whole energy and regulate all their actions towards the plunder of the man. The following case reported by Effertz (op. cit., p. 51) illustrates this connexion very clearly: