No Perfect Substitute for Mother's Milk—When Nursing is Injurious to Mother and Child—Modified Milk—Artificial Foods—Care Essential in Selecting Wet Nurse—Suckling Child Benefits Mother—Reciprocal Affection Strengthened by Nursing—Sexual Feelings While Nursing—Alcoholics are Injurious—Attention to Condition of Nipples During Pregnancy Essential—Treatment of Sunken Nipples—Treatment of Tender Nipples—Treatment of Cracked Nipples—How to Stop the Secretion of Milk When Necessary—Menstruation While Nursing—Pregnancy in the Nursing Woman.
No Perfect Substitute for Mother's Milk—When Nursing is Injurious to Mother and Child—Modified Milk—Artificial Foods—Care Essential in Selecting Wet Nurse—Suckling Child Benefits Mother—Reciprocal Affection Strengthened by Nursing—Sexual Feelings While Nursing—Alcoholics are Injurious—Attention to Condition of Nipples During Pregnancy Essential—Treatment of Sunken Nipples—Treatment of Tender Nipples—Treatment of Cracked Nipples—How to Stop the Secretion of Milk When Necessary—Menstruation While Nursing—Pregnancy in the Nursing Woman.
Every mother should nurse her child—if she can. There is no perfect substitute for mother's milk. There is only one excuse for a mother not nursing—that is when she has no milk, or when the quality of the milk is so poor that the child does not thrive on it, or when the mother is run down, is threatened with or is suffering with tuberculosis, etc. In such cases the nursing would prove injurious to both mother and child.
When the mother cannot nurse the child, it should be brought up artificially on modified cow's milk. Formulas for modified milk have been worked out for every month of the child's life, and if the formulas are carefully followed, and the bottle andnipples are properly sterilized, the child should have no trouble, but should thrive and grow like on good mother's milk. If the child is sickly or delicate and does not thrive on modified cow's milk or on the other artificial foods, such as Horlick's malted milk, or Nestlé's food, then a wet nurse may become necessary. But before engaging a wet nurse great care should be taken to make sure that she is healthy, that the age of her child is approximately the same as the age of the child which she is about to nurse, and particularly that she is free from any syphilitic taint. One, two or more Wassermann tests should be made to settle the question definitely.
Mothers should bear in mind that suckling the child is good not only for the child, but for the mother as well. Lactation helps theinvolutionof the uterus: the uterus of a nursing mother returns more quickly and more perfectly to its normal ante-pregnant condition than the uterus of the mother who cannot or will not nurse her child.
It is asserted that the reciprocal affection between mother and child is greater in cases in which the child suckled its mother's breast. This is quite likely. It is also asserted that the nursing mother transmits certain traits to its child, which the non-nursing mother cannot. This is merely a hypothesis without any scientific proof.
On the other hand, the statement that many women experience decidedly pleasurable sexual feelings while nursing seems to be well substantiated.
That the mother who nurses her child should partake of sufficient nourishment goes without saying. But the advice often given to nursing mothers to partake of beer, ale or wine is a bad one. It is a question if a mother partaking of considerable quantities of alcoholic beverages may not transmit the taste for alcohol to her children. No, alcoholics should be left alone, but milk, eggs, meat, fruit and vegetables should be partaken of in abundance.
Preparing the Nipples.For the infant to be able to nurse properly the nipples of the breast must be in good condition. If the nipples are sunken, depressed, it is torture for the child to nurse. It uses up a lot of energy uselessly, becomes exhausted, and gets very little milk; while if the nipples be tender or cracked the process of nursing is a torture for the mother.
It is therefore necessary to attend to the nipples in due time—to begin at the fifth or sixth month is not too early. If the nipples are sufficiently prominent, little need be done for them except to wash them with a little boric acid solution (one teaspoonful of boric acid to a glass of water) occasionally, and now and then to rub in a little petrolatum, plainor borated. But if the nipples are sunken so that they are below the surface of the breast, or if they are only slightly above the surface of the breast, they must be treated. Gentle traction must be made on them with the fingers three or four times a day. There are only a few cases where persistent manipulation will not develop the nipple and make it stand out prominently.
If the nipple is tender it should be washed two or three times a day with a mixture of alcohol and water; one part of alcohol to three parts of water is sufficient. In washing the nipple with this diluted alcohol it should be dried and a little petrolatum or vaseline rubbed in. This done two or three times a day during the last month or two of the pregnancy will generally produce a good healthy nipple.
The Treatment of Cracked Nipples.If the care of the nipple has been neglected, and it develops cracks or fissures so that the nursing of the child causes the mother severe pain, the nursing should be done through a nipple shield, and in the meantime between the nursings the nipple should be rubbed with the following preparation, which is excellent and which I can fully recommend: thymol iodide, ½ dram; olive oil, ½ ounce. This should be applied every hour to the nipple and covered with a little cotton; before each nursing, however, it must bewell washed off with warm water or warm boric acid solution. When the nipples are cracked, the infant's lips should also before nursing be carefully wiped out with boric acid solution. For the baby's mouth contains bacteria which while harmless in themselves may if they get into the cracks of the nipple set up an inflammation of the breast or "mastitis" and cause an abscess. If the cracks are excruciatingly painful, as they sometimes are, it is necessary to give the one breast a rest for twenty-four hours and have the child nurse at the other until the cracks have partially healed.
When It Is Necessary to Dry Up the Breasts.In case of the death of the child, or if the mother for some other reason finds herself unable to nurse, such as in cases where there is absolutely no nipple, instead of the prominence of the nipple there being a deep depression, it becomes necessary to stop the secretion of the milk, or as it is said in common parlance, "to dry up the breasts." In former days, not so very long ago, and the practice is still common enough to call attention to it and to condemn it, the breasts used to be tightly bandaged, or they used to be pumped every few hours. The first causes unnecessary pain and trouble, while the second procedure, the pumping, does exactly the reverse to what it is intended to do. Instead ofdrying up the breasts it keeps up the secretion. The best thing to do in a case like that is to leave the breasts alone, not to pump them, but just gently support them with a bandage and then in three or four days the secretion of the milk will gradually disappear. There is some discomfort the first twenty-four or forty-eight hours, but if left alone the discomfort is less than if the breasts are manipulated, bandaged or pumped.
Menstruation or Pregnancy While Nursing.Many women do not menstruate and do not become pregnant while they are nursing. Some women will not conceive, no matter how long they may nurse the child—a year or two or longer. And some women take advantage of this fact, and in order to avoid another child they will keep up the nursing as long as possible. In Egypt and other Oriental countries where our means for the prevention of conception are unknown, it is no rare sight to see a child three or four years old interrupting his work or his play and running up to suckle his mother's breast. But not all women have this good luck. Some women (about fifty per cent.) begin to menstruate in the sixth month of lactation, while some become pregnant even before they begin to menstruate. It only too often happens that a woman considering lactation her safeguard omits to use any precautionsand finds herself, to her great discomfiture, in a pregnant condition.
When a nursing woman discovers that she is pregnant she should give up nursing at once. The milk is apt to become of poor quality, but even where this is not the case, it is too much for a woman to feed one child in the uterus and one at the breast.
Definition of Word Abortion—Definition of Word Miscarriage—Spontaneous Abortion—Induced Abortion—Therapeutic Abortion—Criminal Abortion—Missed Abortion—Habitual Abortion—Syphilis as Cause of Abortion and Miscarriage—Dangers of Abortion—Abortion an Evil.
Definition of Word Abortion—Definition of Word Miscarriage—Spontaneous Abortion—Induced Abortion—Therapeutic Abortion—Criminal Abortion—Missed Abortion—Habitual Abortion—Syphilis as Cause of Abortion and Miscarriage—Dangers of Abortion—Abortion an Evil.
The word abortion, used somewhat loosely, signifies the premature expulsion of the fetus; the expulsion of the fetus from the womb before it is viable, i.e., before it is capable of living independently. Used in a stricter sense, the word abortion is applied to the expulsion of the fetus up to the end of the 16th week; to the expulsion of the fetus between the 16th and the 28th week the term miscarriage is applied; and when the expulsion of the fetus takes place after the 28th week, but before full term, we use the term premature labor. The laity does not like the term abortion, as it is under the impression that the term always signifies criminal abortion; it therefore prefers to use the term miscarriage ("miss"), regardless of the time at which the expulsion of the fetus takes place.
When an abortion (or miscarriage) takes place by itself, without any outside aid, we call itspontaneous abortion. When it is brought on by artificial means, whether by the woman herself or by somebody else, we call itinducedabortion. When an abortion is induced for the purpose of saving the woman's life, we call ittherapeuticabortion; this is considered perfectly legal and proper. But where an abortion is induced merely to save an unmarried mother's reputation, or because the married mother is too poor or too weak to have any more children, or is reluctant to have any (or any more) for any other reason, it is calledcriminalorillegalabortion, and, if discovered, subjects the mother and the person who produced the abortion to severe punishment.
When the fetus for some reason dies in its mother's womb, it is generally expelled within a few hours or days. Sometimes this is not the case, and the dead fetus is retained for several weeks, or months or even years; to such a phenomenon we apply the termmissedabortion. Some women suffer from what might be called the abortion habit; they can hardly ever carry a child to full term, but lose it in the same month or even in the same week of gestation during each pregnancy; we call this habitual abortion. And this habitual abortion maybe independent of disease, such, for instance, as syphilis. The termsthreatened,imminentandinevitableabortion require no further explanation.
The Causes of Abortion.Outside of the abortion habit, which may be due partly to heredity or be caused by a diseased condition of the lining membrane of the uterus, the principal cause of abortion and miscarriage is syphilis. And when a woman has had two or three or four or more miscarriages in succession we generally assume the cause to be syphilis, and in most cases the assumption will be correct.
When an abortion is performed by an experienced physician, with the observance of the utmost cleanliness (asepsis and antisepsis), then the abortion is accompanied with very little or no danger; but when performed carelessly, by incompetent, non-conscientious physicians and midwives, the operation is fraught with great danger to the patient's health or to her very life. And abortion is a great cause of premature death and chronic invalidism among women. And as long as the people will remain ignorant of the proper means of regulating their offspring, so long will abortion thrive.
While I recognize that there are cases in which the performance of an abortion is perfectly justifiable from a moral standpoint, for instance in casesof rape or where the mother is unmarried, nevertheless abortion must be recognized as an evil, a necessary evil now and then, but an evil, nevertheless. It is never to be undertaken lightly, or to be considered in a frivolous spirit; and it is the duty of all serious-minded and humanitarian men and women to do everything in their power to remove those conditions which make abortion necessary and unavoidable.
Meaning of the Term—Misleading Information by Quasi-Scientists—Exaggerated Ideas Regarding Prenatal Care—Nervous Connection Between Mother and Child—Cases Under Author's Observation—Effects on Offspring—Advice to Pregnant Women—Germ-plasm of Chronic Alcoholic—A Glass of Wine and the Spermatozoa—False Statements—Cases of Violence and Accidents During Pregnancy.
Meaning of the Term—Misleading Information by Quasi-Scientists—Exaggerated Ideas Regarding Prenatal Care—Nervous Connection Between Mother and Child—Cases Under Author's Observation—Effects on Offspring—Advice to Pregnant Women—Germ-plasm of Chronic Alcoholic—A Glass of Wine and the Spermatozoa—False Statements—Cases of Violence and Accidents During Pregnancy.
By prenatal care we understand the care taken during pregnancy before the child is born. Used in a wider sense the term includes the care which both parents should take of themselves even before the child is conceived.
Of course the father and the mother should be in the best possible physical and mental condition during the time of conception and even before conception, and the mother should take the very best care of herself—she should be in good health and as calm a spirit as possible during the entire period of gestation. For the general health and condition of the mother does influence the child.
And still I feel impelled to say something which may meet with violent opposition in some quarters.The trouble is, there are too many half-baked scientists in our midst. They spread misleading information and the public at large is too apt to take every statement that has a quasi-scientific seal for something absolute, for something positive, for something that admits of no exceptions.
I have seen so much misery caused by wrong prenatal care teaching and by the foolish, exaggerated ideas on the subject, that I consider it my duty to say something in order to counteract those erroneous notions. I consider it my special mission to destroy error, mysticism and superstition. And the prenatal care teaching as imparted by some unfortunately partakes of all three of the above.
Of course, I repeat, the mother should try to be in the best possible condition while she is carrying the child. Nevertheless, it is foolish to imagine if the mother is not quite well, or is worried about something, or has a fit of anger, that it is invariably going to be reflected on the child. The child, as we know, has no nervous connection whatever with the mother, and it is only very violent or prolonged shocks that are apt to have an injurious influence.
I know of children that were carried by their mothers in anger and in anguish from the day of conception to the day of delivery. And still they were born perfectly normal. I know of a child whosemother was suffering the most hellish tortures of jealousy during the entire period of pregnancy, and still the child was born perfectly healthy, perfectly normal, and is now a splendid specimen of manhood. I know children whose mothers went through severe attacks of pneumonia, typhoid fever, etc., and still they were born perfectly healthy and perfectly normal. I know children whose mothers were using every means to abort them, took all kinds of internal medicines until they were deathly sick, and still they were born perfectly healthy and normal. I know children whose mothers tried to abort them by mechanical means, who went to abortionists who made one or more attempts to induce the abortion—I know even cases where the mothers bled as a result of such attempts—and nevertheless, the children were born perfectly healthy, developed normally physically and mentally.
Of course these are not things that I would advise women to do or to undergo. I would not advise pregnant women to worry, to be sick, to take poisonous medicines or to make attempts at abortion, but I merely bring up these points to emphasize to my readers not to take the necessity of prenatal care in too absolute a sense, and not to worry themselves unnecessarily if the conditions during their pregnancy are not all that could be desired. The childis not necessarily going to be affected. The condition of the germ-plasms, i.e., the condition of the ovum and the spermatozoa at the time of conception is more important than all subsequent care during gestation.
As there are foolish people who possess a peculiar knack of misinterpreting and misunderstanding everything, I wish to emphasize that hygiene during pregnancy should not be neglected. Everything possible should be done to put the mother in the best possible physical and mental condition. All I want to say is that it is bad to be insane on the subject, that it is bad to take things in an absolute sense, and that it is bad to exaggerate.
You will often hear it said that a child that was conceived when the father was in an exhilarated condition is apt to be epileptic, or nervous, or insane, and what not. This is also to be taken with a grain of salt. A chronic alcoholic has a defective germ-plasm, and his children are apt to be defective. But a glass of wine at a wedding banquet cannot affect the previously formed spermatozoa. And the statements about children being born defective or developing defectively because their fathers took an occasional glass of wine are unworthy of serious consideration; are unworthy of any consideration.
In connection with the above the reports of somecases ofviolenceandaccidentsduring pregnancy which, in spite of their severity, did not affect the children, will prove of interest.
A delicate little woman missed her periods. She was sure she couldn't be more than two weeks over-due. And this is what she did. For five nights in succession she took hot mustard baths and she took them so hot that each time she nearly fainted and came out from them like a broiled lobster. No effect. She then took a box of pills which cost her two dollars. No effect except causing diarrhea. She then took two boxes of capsules which upset her stomach and made her fearfully nauseous. No other effect. She then ate one-half a colocynth, which made her terribly sick, causing a bloody diarrhea. She had to stay in bed for three or four days. She then took burning vaginal injections with some ipecac in them. No effect except making her feel raw so that she needed large amounts of cold cream. She then took secale cornutum and radix gossypii. No effect except giving her a headache, making her sick to her stomach and completely destroying her appetite, so that within a very short time she lost nearly ten pounds. She was then told that long walks might be efficient. She took walks of six and seven miles at a time, coming home more dead than alive. No effect. She then heard that jumping offa table is a very efficient means. She did it a dozen times in succession so that she was completely fagged out and out of breath. Eight and a half months later she gave birth to a perfectly healthy, well-formed boy weighing eight pounds.
The following case was reported by Brillaud-Laujardiere. A farmer who was responsible for the condition of a servant of his household conceived the idea of riding horseback with her in order to bring about an abortion, and pushing her off when the horse was running at great speed. This he repeated several times. The woman gave birth to a perfectly normal infant at full term.
Hofmann reports that another farmer, under similar circumstances, brutally kicked the woman in the abdomen repeatedly until she lost consciousness. The pregnancy continued to full term notwithstanding. In another case of Hofmann's, a woman allowed a heavy door to fall upon her, but the pregnancy was not affected.
Dr. Guibout relates that a German woman, living with her husband in California, being pregnant, wished to return to Munich, her home-town, to be delivered. The train in which she travelled through Panama collided with another train. Threatened abortion required her to take a rest. She took a steamer and after a very rough passage reachedPortsmouth. From there she went to Paris. Here she fell down a flight of stairs in the hotel where she was stopping. Again she was threatened with abortion, but after a rest was in good condition and continued her journey. She finally reached home, and was delivered at full term of a normal infant.
Vibert reports the case of a woman who was in a train accident which injured her severely, killed two of her children, but did not affect her pregnancy. She was delivered at the proper time of a normal baby.
Time of Menopause—Cause of Suffering During Menopause—Reproductive Function and Sexual Function Not Synonymous—Increased Libido During Menopause—Change of Life in Men.
Time of Menopause—Cause of Suffering During Menopause—Reproductive Function and Sexual Function Not Synonymous—Increased Libido During Menopause—Change of Life in Men.
In the chapter on menstruation I referred briefly to the menopause. I will consider it here somewhat more in detail.
The menopause, also called the climacteric, and in common language "change of life," is the period at which woman ceases to menstruate. The average age at which this occurs is about forty-eight. But while some women continue to menstruate up to the age of fifty, fifty-two, and even fifty-five, others cease to menstruate at the age of forty-five or even forty-two. Between forty-four and fifty-two are the normal limits. Anything before or beyond that is exceptional.
Just as the beginning of menstruation may set in without any trouble of any kind, and just as some women have not the slightest unpleasant symptoms during the entire period of their menstrual life, sothe menopause occurs in some women without any trouble, physical or psychic. The periods between the menses become perhaps a little longer, or a little irregular, the menstrual flow becomes more and more scanty, then one or several periods may be skipped altogether, and the menopause is permanently established. Many women, however, the majority probably, suffer considerably during the transitional year or years of the menopause. Symptoms are both of a physical and of a psychic character, but the psychic symptoms predominate. There may be headache, capricious appetite, or complete loss of appetite, considerable loss of flesh, or on the contrary very sudden and rapid putting on of fat, great irritability, insomnia, profuse perspiration; hot flashes throughout the body, and particularly in the face, which make the face "blushing" and congested, are particularly frequent. Then the woman's character may be completely changed. From gentle and submissive she may become pugnacious and quarrelsome. Jealousy without any grounds for it may be one of the disagreeable symptoms, making both the wife and the husband very unhappy. In some exceptional cases a genuine neurosis or psychosis may develop.
Cause of Suffering During Menopause.It is my conviction, and I have had this conviction for manyyears, that many, if not most, of the distressing symptoms of the menopause are due, not to the menopause itself, but to the wrong ideas about this period that have prevailed for so many centuries. We know the influence of the mind over the body, and the pernicious effect which wrong ideas may exercise over our feelings. The generally prevalent opinion among women, and men for that matter, and not only of the laity but unfortunately of the medical profession as well, is that the menopause is the end of woman's sexual life. Every woman is laboring under the erroneous impression that with the establishment of the menopause, with the cessation of the menses, she ceases to be a woman, and as she does not become a man, she becomes something of a neuter being, neither woman nor man. And she has the idea that after the menopause she can have no further attraction for her husband or for other men. Naturally such an idea has a very depressing effect on any human being. Any human being fights to the last to retain all its human functions, especially the function which is considered as important as is the sexual function.
Reproductive Function and Sexual Function Not Synonymous.Of course with the permanent cessation of the menses the woman'sreproductivefunction is at an end. But the reproductive function isnotsynonymous with the sexual function, I must insist again and again, and naturally until this erroneous idea is dispelled much unnecessary misery will be the lot of our women. If women in general will learn that with the establishment of the menopause they donotcease to be women, if they will learn that the sexual desire in women lasts long beyond the cessation of the menopause, many women being as passionate at sixty as at thirty, if they will learn that their attractiveness or non-attractiveness to the male sex does not depend upon the menopause, but upon their general condition, if they will learn that many women at fifty and sixty are much more attractive than some women at half that age, they will not take the onset of the menopause so tragically and they will thereby avoid the greater part of their mental and emotional suffering.
The actual atrophy of the ovaries, uterus, external genitals and the breasts can, of course, not be prevented, but that atrophy is a slow and gradual process, and is not in itself the cause of the various distressing symptoms that we have enumerated.
The treatment of the menopause, if the symptoms are at all disagreeable, or distressing, should be in the hands of a competent physician. A little wholesome advice may be more efficient than gallons of medicine and bushels of pills. In general the womanshould try to lead as calm and peaceful a life as possible. Warm baths daily are beneficial, constipation should be guarded against, hot vaginal douches are often efficient against the disagreeable flushes, and last, but not least, the husband should during this critical period be doubly kind and doubly considerate of his wife. It is during the years between forty-five and fifty-five that the wife is most in need of her husband's sympathy and support.
Increased Libido During Menopause.There is one rather delicate symptom which I must not pass unmentioned. Some women during the years while the menopause is being established, and for some years after the menopause, experience a greatly heightened sexual desire. In some cases this increased libido is normal, that is, no other pathologic symptoms or local conditions can be discovered. In some cases the increased libido is distinctly due to local congestion, congestion of the ovaries, the uterus, etc. In some cases, I can distinctly testify, it is psychic or autosuggestive. Because the woman thinks, and believes that other people think, that she is soon going to lose all her sexuality, she unconsciously works herself up into a sexual passion which sometimes may be of long duration and may even lead to disastrous results.
What to do in such cases? Where the woman'slibido is normal or near normal, then naturally it should be normally gratified. But if the libido seems to be abnormally strong and the demands for sexual gratification are too frequent, then the woman should be treated and sexual gratification should not be indulged in, because in such cases, as a rule, sexual gratification only adds fuel to the fire, and the woman's demands may become more and more frequent, more and more insistent. In exceptional cases it may even reach the intensity of nymphomania. In such cases the aid of a tactful physician is indispensable.
To people not familiar with the subject it sounds rather strange to speak of "change of life" in men.
Man, possessing no menstrual function, cannot have any menopause, but still sexologists and psychologists who have studied the subject carefully are convinced that between the ages of forty-five and fifty-five men also undergo a certain change which may be spoken of as the change of life or the male climacteric.
They become irritable, capricious, very susceptible to feminine charms, are apt to fall in love, and in many the sexual instinct is greatly increased. Asin women, this increase of the sexual desire is sometimes due to pathologic causes, such as an inflamed prostate gland—in other cases it is of psychic origin.
Just as a man should be particularly kind and considerate to his wife during her menopause, so the wife, understanding that her husband is going through a critical period, will also increase her tact, patience and consideration.
Definition of Masturbation—Its Injurious Effects in Girls as Compared with Boys—Married Life of the Girl Masturbator—Necessity for Change in Injurious Attitude of Parents who Discover the Habit—Common-sense Treatment of the Habit—How to Prevent Formation of Habit—Parents' Advice to Children—Hot Baths as Factor in Masturbation—Other Physical Factors—Mental Masturbation and Its Effects.
Definition of Masturbation—Its Injurious Effects in Girls as Compared with Boys—Married Life of the Girl Masturbator—Necessity for Change in Injurious Attitude of Parents who Discover the Habit—Common-sense Treatment of the Habit—How to Prevent Formation of Habit—Parents' Advice to Children—Hot Baths as Factor in Masturbation—Other Physical Factors—Mental Masturbation and Its Effects.
Masturbation or self-abuse is a term applied to a bad habit which consists in handling and rubbing the genitals. It is a bad habit because it is apt to injure the health and future development of the girl. The more frequently it is practiced, the more injurious it is. It is more injurious than when practiced by boys, because the effects are usually more permanent. Girls who indulge in the habit of masturbation to excess not only weaken themselves, become anemic and get a dingy, pimply complexion, but they lose their desire for normal sexual relations when they grow up, and are unable to derive any pleasure from the sexual act when they get married. In fact, many girls who masturbated excessively get a strong aversion to the normal sexualact, and their married life is an unhappy one. Their husbands often have to ask for a divorce. Fortunately, the habit is much less widespread among girls than it is among boys. While about ninety per cent. of all boys—nine out of every ten—masturbate more or less, only about ten or at most twenty per cent. of girls are addicted to this habit. But whatever the percentage may be, the habit is an injurious one, and if you value your health, your beauty and proper growth and mental development, you should not indulge in it. If you are already indulging, if you are used to handling your genitals, if a bad companion has initiated you into the habit, you should give it up. And mothers should watch their children, guard them against developing the habit, and do everything possible to cure them of it, if prevention comes too late.
But while as you see I do not deny the evil effects of masturbation, it is necessary to state that a great change has taken place in our opinions on the subject, and it is but right that parents should know of this change of opinion among the medical profession, particularly among those who specialize in sexology.
Wrong Behavior of Parents.When parents make the "awful" discovery that their child is fondling its genitals or is indulging in masturbation, theyfeel as if a great calamity had befallen them. They could not feel worse if they learned that the child was a thief or a pyromaniac. Imbued with the medieval idea of the "sinfulness" of the habit, as well as its injuriousness, they begin to scold the child, to frighten it, to make it believe that it is doing something terrible, that it has disgraced them and itself; and they try to persuade it that, unless it stops immediately, the most direful consequences are awaiting it. The results of this mode of procedure are disastrous—much more so than is the masturbation itself.
Often the scolding and the exposure of the child are done in the presence of others. This implants in the poor girl a sullen resentment that only makes it more difficult for it to break the habit. When the child is brought to the physician, you can see by its behavior, by its downcast looks, by its sulkiness, by its attempt to refrain from tears, and other signs, that it regards the physician in exactly the same light as a youthful criminal regards the judge before whom he has been brought for trial.
It is time, high time, that this silly and injurious attitude toward a practice, which is very common, be radically changed. It is time that parents and physicians learn that the injuriousness of the habit has been greatly, grossly exaggerated. It is timethat they know that the vast majority of boys and girls get over the habit without being much, or any, the worse for it. The knowledge of this fact will not only save them and the children much needless anguish and suffering, but will make it much easier to deal with the latter, make it much easier to get them divorced from the habit.
If we look at the matter in a sensible, common-sense way, and do not tell the child caught in the practice that it has done something disgracefully vicious and criminal, but speak to it kindly and tell it that it is doing something that may injure it greatly, that may interfere with its future mental and physical health and development, then we shall have far greater success in our endeavors to break the boy or the girl of the habit of masturbation. As I have said in another place:
"In my opinion, stigmatizing even the most moderate indulgence in masturbation as a vice has a deleterious effect upon the people who so indulge and makes it harder for them to break off the habit. Every thinking physician and sexologist can tell you that picturing the masturbatory habit in too lurid colors and stigmatizing it with too strong epithets has, as a rule, the contrary effect to the one expected. The victims of the habit consider themselves degraded, irretrievably lost. They lose theirself-respect, and it is, on account of that, harder for them to break themselves of the habit."
We shall accomplish a good deal more with our youthful and older patients if we leave alone, altogether, the moral side of the question—if there be any moral side to it—and emphasize the physical injuriousness of the habit. We do not want to diminish the self-respect of our boys and girls, we want to increase it; and we can not do this if we make them believe that a masturbator is a vicious criminal. Inspire your patients with confidence, tell them that indulgence in the habit jeopardizes their future growth, both physical and mental, their health and happiness, and you will find them easier to control.
I am not trying to minimize the danger of masturbation, for, if indulged in from an early age and to great excess, the resultsmaybe disastrous. But, even if I were to minimize the evil consequences, that would be less of a sin than to exaggerate them the way it has been done for so many years, by so many people in the profession and out of it. The evil results of exaggerating the influence of masturbation have been so great in the past that, if now the pendulum were to swing to the other extreme, I am sure it would not be a bad thing at all.
To deal with the subject of thetreatmentof masturbation belongs to a medical treatise. But, a few remarks on how to prevent children from acquiring the habit of masturbation will not be out of place.
Prevention of the Habit of Masturbation.The keynote of preventing the habit is, carefully to watch the child from its earliest infancy. We know that not infrequently stupid or vicious nursemaids, wet-nurses, and even governesses ignorantly or deliberately induce the habit in children under their charge. This, of course, must be prevented. Even children of the age of nine, ten, eleven years should not be left alone, but always be under supervision. Too close friendship between boys or girls, particularly of different ages, should be looked upon with suspicion.
A number of girls never should sleep in the same room without supervision by an older person.
The sleeping together of two in the same bed, whether it be two children or a grown person and a child, should not be permitted under any circumstances. I admit of no exceptions to this demand. It makes no difference whether the other person is a mother, a father, a brother or a sister. Leaving out of the question anydeliberateelement, the thing is dangerous; for, very often, unintentionally,unwittingly, masturbation is initiated by this intimate contact.
The child—boy or girl—should sleep alone, on a rather hard mattress. The covering should be light. A coverlet may be put over the feet. The child always should sleep with the arms out upon the cover or blanket, neverunderthe same. If this is done from childhood on, it is very easy to get used to this way of sleeping, and many a case of masturbation will thus be obviated. The child should not be permitted to loll in bed: it must be taught to get up as soon as it awakes in the morning. The general bringing-up must be of a strengthening, hardening character; and this applies both to the body and the will. When the children reach the age of nine, ten, eleven, twelve or thirteen years (we must use discrimination and judgment, for, some children of nine are as developed as are others of thirteen), we must tell them that it is bad and injurious to handle one's genitals, and we must warn them to shun any companions who wish to initiate them into any manipulations of these parts or who show an inclination to talk about the sexual organs and sex matters.
Hot baths are very injurious for young children in their influence in this direction. There is no question that a hot bath has a very decided stimulating effect upon the sexual desire of adults as well as ofchildren, both male and female; in fact, I have had several patients of either sex tell me that their first masturbatory act was committed while they were in a hot bath. Of course, the sensation having been pleasurable, they kept on repeating the experience.
Every factor liable to give rise to the habit should be removed. Thus, for instance, eczema about the genitals, strongly acid urine, seatworms, and the like, should be treated until cured. That anything having a tendency prematurely to awaken the sexual instinct should be rigorously avoided, goes without saying.
Mental or Psychic Masturbation.Some girls and women will abstain from handling themselves with their hands (manual masturbation), but will practice what we call mental masturbation. That is, they will concentrate their minds on the opposite sex, will picture to themselves various lascivious scenes, until they feel "satisfied." This method is extremely injurious and exhausting and is very likely to lead to neurasthenia and a nervous breakdown. You should break yourself of it, by all means, if you can. For it is even more injurious than the regular habit.