is no convincing evidence to show that masturbation is "begun early and
carried very far" by "persons of sound antecedents," the significance of
Spitzka's "typical psychosis of masturbation" is somewhat annulled. It is
evident that these distinguished investigators, Marro and Spitzka, have
been induced by tradition to take up a position which their own scientific
consciences have compelled them practically to evacuate.

Recent authorities are almost unanimous in rejecting masturbation
as a cause of insanity. Thus, Rohleder, in his comprehensive
monograph (_Die Masturbation_, 1899, pp. 185-92), although taking
a very serious view of the evil results of masturbation, points
out the unanimity which is now tending to prevail on this point,
and lays it down that "masturbation is never the direct cause of
insanity." Sexual excesses of any kind, he adds (following
Curschmann), can, at the most, merely give an impetus to a latent
form of insanity. On the whole, he concludes, the best
authorities are unanimous in agreeing that masturbation may
certainly injure mental capacity, by weakening memory and
depressing intellectual energy; that, further, in hereditarily
neurotic subjects, it may produce slight psychoses like _folie du
doute_, hypochondria, hysteria; that, finally, under no
circumstances can it produce severe psychoses like paranoia or
general paralysis. "If it caused insanity, as often as some
claim," as Kellogg remarks, "the whole race would long since have
passed into masturbatic degeneracy of mind.... It is especially
injurious in the very young, and in all who have weak nervous
systems," but "the physical traits attributed to the habit are
common to thousands of neurasthenic and neurotic individuals."
(Kellogg, _A Text-book of Mental Diseases_, 1897, pp. 94-95.)
Again, at the outset of the article on "Masturbation," in Tuke's
_Dictionary of Psychological Medicine_, Yellowlees states that,
on account of the mischief formerly done by reckless statements,
it is necessary to state plainly that "unless the practice has
been long and greatly indulged, no permanent evil effects may be
observed to follow." Näcke, again, has declared ("Kritisches zum
Kapitel der Sexualität," _Archiv für Psychiatrie_, 1899): "There
are neither somatic nor psychic symptoms peculiar on onanism. Nor
is there any specific onanistic psychosis. I am prepared to deny
that onanism ever produces any psychoses in those who are not
already predisposed." That such a view is now becoming widely
prevalent is illustrated by the cautious and temperate discussion
of masturbation in a recent work by a non-medical writer,
Geoffrey Mortimer (_Chapters on Human Love_, pp. 199-205).

The testimony of expert witnesses with regard to the influence of
masturbation in producing other forms of psychoses and neuroses is
becoming equally decisive; and here, also, the traditions of Tissot are
being slowly effaced. "I have not, in the whole of my practice," wrote
West, forty years ago, "out of a large experience among children and
women, seen convulsions, epilepsy, or idiocy _induced_ by masturbation in
any child of either sex. Neither have I seen any instance in which
hysteria, epilepsy, or insanity in women after puberty was _due_ to
masturbation, as its efficient cause."[332] Gowers speaks somewhat less
positively, but regards masturbation as not so much a cause of true
epilepsy as of atypical attacks, sometimes of a character intermediate
between the hysteroid and the epileptoid form; this relationship he has
frequently seen in boys.[333] Leyden, among the causes of diseases of the
spinal cord, does not include any form of sexual excess. "In moderation,"
Erb remarks, "masturbation is not more dangerous to the spinal cord than
natural coitus, and has no bad effects";[334] it makes no difference, Erb
considers, whether the orgasm is effected normally or in solitude. This is
also the opinion of Toulouse, of Fürbringer, and of Curschmann, as at an
earlier period it was of Roubaud.

While these authorities are doubtless justified in refusing to ascribe to
masturbation any part in the production of psychic or nervous diseases, it
seems to me that they are going somewhat beyond their province when they
assert that masturbation has no more injurious effect than coitus. If
sexual coitus were a purely physiological phenomenon, this position would
be sound. But the sexual orgasm is normally bound up with a mass of
powerful emotions aroused by a person of the opposite sex. It is in the
joy caused by the play of these emotions, as well as in the discharge of
the sexual orgasm, that the satisfaction of coitus resides. In the absence
of the desired partner the orgasm, whatever relief it may give, must be
followed by a sense of dissatisfaction, perhaps of depression, even of
exhaustion, often of shame and remorse. The same remark has since been
made by Stanley Hall.[335] Practically, also, as John Hunter pointed out,
there is more probability of excess in masturbation than in coitus.
Whether, as some have asserted, masturbation involves a greater nervous
effort than coitus is more doubtful.[336] It thus seems somewhat
misleading to assert that masturbation has no more injurious effect than
coitus.[337]

Reviewing the general question of the supposed grave symptoms and signs
of masturbation, and its pernicious results, we may reach the conclusion
that in the case of moderate masturbation in healthy, well-born
individuals, no seriously pernicious results necessarily follow.[338] With
regard to the general signs, we may accept, as concerns both sexes, what
the Obstetrical and Gynecological Society of Berlin decided in 1861, in a
discussion of it in women, that there are none which can be regarded as
reliable.[339]

We may conclude finally, with Clouston, that the opposing views on the
subject may be simply explained by the fact that the writers on both sides
have ignored or insufficiently recognized the influence of heredity and
temperament. They have done precisely what so many unscientific writers on
inebriety have continued to do unto the present day, when describing the
terrible results of alcohol without pointing out that the chief factor in
such cases has not been the alcohol, but the organization on which the
alcohol acted. Excess may act, according to the familiar old-fashioned
adage, like the lighted match. But we must always remember the obvious
truth, that it makes a considerable difference whether you threw your
lighted match into a powder magazine or into the sea.

While we may thus dismiss the extravagant views widely held during the
past century, concerning the awful results of masturbation, as due to
ignorance and false tradition, it must be pointed out that, even in
healthy or moderately healthy individuals, any excess in solitary
self-excitement may still produce results which, though slight, are yet
harmful. The skin, digestion, and circulation may all be disordered;
headache and neuralgia may occur; and, as in normal sexual excess or in
undue frequency of sexual excitement during sleep, there is a certain
general lowering of nervous tone. Probably the most important of the
comparatively frequent results--though this also arises usually on a
somewhat morbid soil--is neurasthenia with its manifold symptoms. There
can be little doubt that the ancient belief, dating from the time of
Hippocrates, that sexual excesses produce spinal disease, as well as the
belief that masturbation causes insanity, are largely due to the failure
to diagnose neurasthenia.

The following case of neurasthenia, recorded by Eulenburg, may be
given as a classical picture of the nervous disturbances which
may be associated with masturbation, and are frequently regarded
as solely caused by habits of masturbation: Miss H.H., 28 years
of age, a robust brunette, with fully developed figure, without
any trace of anæmia or chlorosis, but with an apathetic
expression, bluish rings around the eyes, with hypochondriacal
and melancholy feelings. She complains of pressure on the head
("as if head would burst"), giddiness, ringing in the ears,
photopsia, hemicrania, pains in the back and at sacrum, and
symptoms of spinal adynamia, with a sense of fatigue on the least
exertion in walking or standing; she sways when standing with
closed eyes, tendon-reflexes exaggerated; there is a sense of
oppression, intercostal neuralgia, and all the signs of
neurasthenic dyspepsia; and cardialgia, nausea, flatulence,
meteorism, and alternate constipation and diarrhoea. She chiefly
complains of a feeling of weight and pain in the abdomen, caused
by the slightest movement, and of a form of pollution (with
clitoridian spasms), especially near menstruation, with copious
flow of mucus, characteristic pains, and hyperexcitability.
Menstruation was irregular and profuse. Examination showed tumid
and elongated nymphæ, with brown pigmentation; rather large
vagina, with rudimentary hymen; and retroflexion of uterus.
After much persuasion the patient confessed that, when a girl of
12, and as the result of repeated attempts at coitus by a boy of
16, she had been impelled to frequent masturbation. This had
caused great shame and remorse, which, however, had not sufficed
to restrain the habit. Her mother having died, she lived alone
with her invalid father, and had no one in whom to confide.
Regarding herself as no longer a virgin, she had refused several
offers of marriage, and thus still further aggravated her mental
condition. (Eulenburg, _Sexuale Neuropathie_, p. 31.)

Since Beard first described neurasthenia, many diverse opinions
have been expressed concerning the relationships of sexual
irregularities to neurasthenia. Gilles de la Tourette, in his
little monograph on neurasthenia, following the traditions of
Charcot's school, dismisses the question of any sexual causation
without discussion. Binswanger (_Die Pathologie und Therapie der
Neurasthenie_), while admitting that nearly all neurasthenic
persons acknowledge masturbation at some period, considers it is
not an important cause of neurasthenia, only differing from
coitus by the fact that the opportunities for it are more
frequent, and that the sexual disturbances of neurasthenia are,
in the majority of cases, secondary. Rohleder, on the other hand,
who takes a very grave view of the importance of masturbation,
considers that its most serious results are a question of
neurasthenia. Krafft-Ebing has declared his opinion that
masturbation is a cause of neurasthenia. Christian, Leyden, Erb,
Rosenthal, Beard, Hummel, Hammond, Hermann Cohn, Curschmann,
Savill, Herman, Fürbringer, all attach chief importance to
neurasthenia as a result of masturbation. Collins and Phillip
(_Medical Record_, March 25, 1899), in an analysis of 333 cases
of neurasthenia, found that 123 cases were apparently due to
overwork or masturbation. Freud concludes that neurasthenia
proper can nearly always be traced to excessive masturbation, or
to spontaneous pollutions. (E.g., _Sammlung Kleiner Schriften zur
Neurosenlehre_, first series, p. 187.) This view is confirmed by
Gattel's careful study (_Ueber die Sexuellen Ursachen der
Neurasthenie und Angstneurose_, 1898). Gattel investigated 100
consecutive cases of severe functional nervous disorder in
Krafft-Ebing's clinic at Vienna, and found that in every case of
neurasthenia in a male (28 in all) there was masturbation, while
of the 15 women with neurasthenia, only one is recorded as not
masturbating, and she practiced _coitus reservatus_. Irrespective
of the particular form of the nervous disorder, Gattel found that
18 women out of 42, and 36 men out of 58, acknowledged
masturbation. (This shows a slightly larger proportion among the
men, but the men were mostly young, while the women were mostly
of more mature age.) It must, however, always be remembered that
we have no equally careful statistics of masturbation in
perfectly healthy persons. We must also remember that we have to
distinguish between the _post_ and the _propter_, and that it is
quite possible that neurasthenic persons are specially
predisposed to masturbation. Bloch is of this opinion, and
remarks that a vicious circle may thus be formed.

On the whole, there can be little doubt that neurasthenia is
liable to be associated with masturbation carried to an excessive
extent. But, while neurasthenia is probably the severest
affection that is liable to result from, or accompany,
masturbation, we are scarcely yet entitled to accept the
conclusion of Gattel that in such cases there is no hereditary
neurotic predisposition. We must steer clearly between the
opposite errors of those, on the one hand, who assert that
heredity is the sole cause of functional nervous disorders, and
those, on the other hand, who consider that the incident that may
call out the disorder is itself a sole sufficient cause.

In many cases it has seemed to me that masturbation, when practiced in
excess, especially if begun before the age of puberty, leads to inaptitude
for coitus, as well as to indifference to it, and sometimes to undue
sexual irritability, involving premature emission and practical impotence.
This is, however, the exception, especially if the practice has not been
begun until after puberty. In women I attach considerable importance, as a
result of masturbation, to an aversion for normal coitus in later life. In
such cases some peripheral irritation or abnormal mental stimulus trains
the physical sexual orgasm to respond to an appeal which has nothing
whatever to do with the fascination normally exerted by the opposite sex.
At puberty, however, the claim of passion and the real charm of sex begin
to make themselves felt, but, owing to the physical sexual feelings having
been trained into a foreign channel, these new and more normal sex
associations remain of a purely ideal and emotional character, without the
strong sensual impulses with which under healthy conditions they tend to
be more and more associated as puberty passes on into adolescence or
mature adult life. I am fairly certain that in many women, often highly
intellectual women, the precocious excess in masturbation has been a main
cause, not necessarily the sole efficient cause, in producing a divorce in
later life between the physical sensuous impulses and the ideal emotions.
The sensuous impulse having been evolved and perverted before the
manifestation of the higher emotion, the two groups of feelings have
become divorced for the whole of life. This is a common source of much
personal misery and family unhappiness, though at the same time the clash
of contending impulses may lead to a high development of moral character.
When early masturbation is a factor in producing sexual inversion it
usually operates in the manner I have here indicated, the repulsion for
normal coitus helping to furnish a soil on which the inverted impulse may
develop unimpeded.

This point has not wholly escaped previous observers, though they
do not seem to have noted its psychological mechanism. Tissot
stated that masturbation causes an aversion to marriage. More
recently, Loiman ("Ueber Onanismus beim Weibe," _Therapeutische
Monatshefte_, April, 1890) considered that masturbation in women,
leading to a perversion of sexual feeling, including inability to
find satisfaction in coitus, affects the associated centres.
Smith Baker, again ("The Neuropsychical Element in Conjugal
Aversion," _Journal of Nervous and Mental Disease_, September,
1892), finds that a "source of marital aversion seems to lie in
the fact that substitution of mechanical and iniquitous
excitations affords more thorough satisfaction than the mutual
legitimate ones do," and gives cases in point. Savill, also, who
believes that masturbation is more common in women than is
usually supposed, regards dyspareunia, or pain in coition, as one
of the signs of the habit.

Masturbation in women thus becomes, as Raymond and Janet point
out (_Les Obsessions_, vol. ii, p. 307) a frequent cause of
sexual frigidity in marriage. These authors illustrate the train
of evils which may thus be set up, by the case of a lady, 26
years of age, a normal woman, of healthy family, who, at the age
of 15, was taught by a servant to masturbate. At the age of 18
she married. She loved her husband, but she had no sexual
feelings in coitus, and she continued to masturbate, sometimes
several times a day, without evil consequences. At 24 she had to
go into a hospital for floating kidney, and was so obliged to
stop masturbating. She here accidentally learnt of the evil
results attributed to the habit. She resolved not to do it again,
and she kept her resolution. But while still in hospital she fell
wildly in love with a man. To escape from the constant thought of
this man, she sought relations with her husband, and at times
masturbated, but now it no longer gave her pleasure. She wished
to give up sexual things altogether. But that was easier said
than done. She became subject to nervous crises, often brought on
by the sight of a man, and accompanied by sexual excitement. They
disappeared under treatment, and she thereupon became entirely
frigid sexually. But, far from being happy, she has lost all
energy and interest in life, and it is her sole desire to attain
the sexual feelings she has lost. Adler considers that even when
masturbation in women becomes an overmastering passion, so far as
organic effects are concerned it is usually harmless, its effects
being primarily psychic, and he attaches especial significance to
it as a cause of sexual anæsthesia in normal coitus, being,
perhaps, the most frequent cause of such anæsthesia. He devotes
an important chapter to this matter, and brings forward numerous
cases in illustration (Adler, _Die Mangelhafte
Geschlechtsempfindung des Weibes_, pp. 93-119, also 21-23). Adler
considers that the frequency of masturbation in women is largely
due to the fact that women experience greater difficulties than
men in obtaining sexual satisfaction, and so are impelled by
unsatisfying coitus to continue masturbation after marriage. He
adds that partly from natural shyness, partly from shame of
acknowledging what is commonly accounted a sin, and partly from
the fear of seeming disgusting or unworthy of sympathy in the
doctor's eyes, women are usually silent on this matter, and very
great tact and patience may be necessary before a confession is
obtained.

On the psychic side, no doubt, the most frequent and the most
characteristic result of persistent and excessive masturbation is a morbid
heightening of self-consciousness without any co-ordinated heightening of
self-esteem.[340] The man or woman who is kissed by a desirable and
desired person of the opposite sex feels a satisfying sense of pride and
elation, which must always be absent from the manifestations of
auto-erotic activity.[341] This must be so, even apart from the
masturbator's consciousness of the general social attitude toward his
practices and his dread of detection, for that may also exist as regards
normal coitus without any corresponding psychic effects. The masturbator,
if his practice is habitual, is thus compelled to cultivate an artificial
consciousness of self-esteem, and may show a tendency to mental arrogance.
Self-righteousness and religiosity constitute, as it were, a protection
against the tendency to remorse. A morbid mental soil is, of course,
required for the full development of these characteristics. The habitual
male masturbator, it must be remembered, is often a shy and solitary
person; individuals of this temperament are especially predisposed to
excesses in all the manifestations of auto-erotism, while the yielding to
such tendencies increases the reserve and the horror of society, at the
same time producing a certain suspicion of others. In some extreme cases
there is, no doubt, as Kraepelin believes, some decrease of psychic
capacity, an inability to grasp and co-ordinate external impressions,
weakness of memory, deadening of emotions, or else the general phenomena
of increased irritability, leading on to neurasthenia.

I find good reason to believe that in many cases the psychic influence of
masturbation on women is different from its effect on men. As Spitzka
observed, although it may sometimes render women self-reproachful and
hesitant, it often seems to make them bold. Boys, as we have seen, early
assimilate the tradition that self-abuse is "unmanly" and injurious, but
girls have seldom any corresponding tradition that it is "unwomanly," and
thus, whether or not they are reticent on the matter, before the forum of
their own conscience they are often less ashamed of it than men are and
less troubled by remorse.

Eulenburg considers that the comparative absence of bad effects
from masturbation in girls is largely due to the fact that,
unlike boys, they are not terrorized by exaggerated warnings and
quack literature concerning the awful results of the practice.
Forel, who has also remarked that women are often comparatively
little troubled by qualms of conscience after masturbation,
denies that this is due to a lower moral tone than men possess
(Forel, _Die Sexuelle Frage_, p. 247). In this connection, I may
refer to History IV, recorded in the Appendix to the fifth volume
of these _Studies_, in which it is stated that of 55 prostitutes
of various nationalities, with whom the subject had had
relations, 18 spontaneously told him that they were habitual
masturbators, while of 26 normal women, 13 made the same
confession, unasked. Guttceit, in Russia, after stating that
women of good constitution had told him that they masturbated as
much as six or ten times a day or night (until they fell asleep,
tired), without bad results, adds that, according to his
observations, "masturbation, when not excessive, is, on the
whole, a quite innocent matter, which exerts little or no
permanent effect," and adds that it never, in any case, leads to
_hypochondria onanica_ in women, because they have not been
taught to expect bad results (_Dreissig Jahre Praxis_, p. 306).
There is, I think, some truth--though the exceptions are
doubtless many--in the distinction drawn by W.C. Krauss
("Masturbational Neuroses," _Medical News_, July 13, 1901): "From
my experience it [masturbation] seems to have an opposite effect
upon the two sexes, dulling the mental and making clumsy the
physical exertions of the male, while in the female it quickens
and excites the physical and psychical movements. The man is
rendered hypoesthetic, the woman hyperesthetic."

In either sex auto-erotic excesses during adolescence in young men and
women of intelligence--whatever absence of gross injury there may
be--still often produce a certain degree of psychic perversion, and tend
to foster false and high-strung ideals of life. Kraepelin refers to the
frequency of exalted enthusiasms in masturbators, and I have already
quoted Anstie's remarks on the connection between masturbation and
premature false work in literature and art. It may be added that excess in
masturbation has often occurred in men and women whose work in literature
and art cannot be described as premature and false. K.P. Moritz, in early
adult life, gave himself up to excess in masturbation, and up to the age
of thirty had no relations with women. Lenau is said--though the statement
is sometimes denied--to have been a masturbator from early life, the habit
profoundly effecting his life and work. Rousseau, in his _Confessions_,
admirably describes how his own solitary, timid, and imaginative life
found its chief sexual satisfaction in masturbation.[342] Gogol, the
great Russian novelist, masturbated to excess, and it has been suggested
that the dreamy melancholy thus induced was a factor in his success as a
novelist. Goethe, it has been asserted, at one time masturbated to excess;
I am not certain on what authority the statement is made, probably on a
passage in the seventh book of _Dichtung und Wahrheit_, in which,
describing his student-life at Leipzig, and his loss of Aennchen owing to
his neglect of her, he tells how he revenged that neglect on his own
physical nature by foolish practices from which he thinks he suffered for
a considerable period.[343] The great Scandinavian philosopher, Sören
Kierkegaard, suffered severely, according to Rasmussen, from excessive
masturbation. That, at the present day, eminence in art, literature, and
other fields may be combined with the excessive practice of masturbation
is a fact of which I have unquestionable evidence.

I have the detailed history of a man of 30, of high ability in a
scientific direction, who, except during periods of mental
strain, has practiced masturbation nightly (though seldom more
than once a night) from early childhood, without any traceable
evil results, so far as his general health and energy are
concerned. In another case, a schoolteacher, age 30, a hard
worker and accomplished musician, has masturbated every night,
sometimes more than once a night, ever since he was at school,
without, so far as he knows, any bad results; he has never had
connection with a woman, and seldom touches wine or tobacco.
Curschmann knew a young and able author who, from the age of 11
had masturbated excessively, but who retained physical and mental
freshness. It would be very easy to refer to other examples, and
I may remark that, as regards the histories recorded in various
volumes of these _Studies_, a notable proportion of those in
which excessive masturbation is admitted, are of persons of
eminent and recognized ability.

It is often possible to trace the precise mechanism of the relationship
between auto-erotic excitement and intellectual activity. Brown-Séquard,
in old age, considered that to induce a certain amount of sexual
excitement, not proceeding to emission, was an aid to mental work. Raymond
and Janet knew a man considering himself a poet, who, in order to attain
the excitation necessary to compose his ideal verses, would write with one
hand while with the other he caressed his penis, though not to the extent
of producing ejaculation.[344] We must not believe, however, that this is
by any means the method of workers who deserve to be accepted seriously;
it would be felt, to say the least, as unworthy. It is indeed a method
that would only appeal to a person of feeble or failing mental power. What
more usually happens is that the auto-erotic excitement develops, _pari
passu_ and spontaneously, with the mental activity and at the climax of
the latter the auto-erotic excitement also culminates, almost or even
quite spontaneously, in an explosion of detumescence which relieves the
mental tension. I am acquainted with such cases in both young men and
women of intellectual ability, and they probably occur much more
frequently than we usually suspect.

In illustration of the foregoing observations, I may quote the
following narrative, written by a man of letters: "From puberty
to the age of 30 (when I married), I lived in virgin continence,
in accord with my principle. During these years I worked
exceedingly hard--chiefly at art (music and poetry). My days
being spent earning my livelihood, these art studies fell into my
evening time. I noticed that productive power came in
periods--periods of irregular length, and which certainly, to a
partial extent, could be controlled by the will. Such a period of
vital power began usually with a sensation of melancholy, and it
quickened my normal revolt against the narrowness of conventional
life into a red-hot detestation of the paltriness and pettiness
with which so many mortals seem to content themselves. As the
mood grew in intensity, this scorn of the lower things mixed with
and gave place to a vivid insight into higher truths. The
oppression began to give place to a realization of the eternity
of the heroic things; the fatuities were seen as mere fashions;
love was seen as the true lord of life; the eternal romance was
evident in its glory; the naked strength and beauty of men were
known despite their clothes. In such mood my work was produced;
bitter protest and keen-sighted passion mingled in its building.
The arising vitality had certainly deep relation to the
periodicity of the sex-force of manhood. At the height of the
power of the art-creative mood would come those natural emissions
with which Nature calmly disposes of the unused force of the
male. Such emissions were natural and healthy, and not exhaustive
or hysterical. The process is undoubtedly sane and protective,
unless the subject be unhealthy. The period of creative art power
extended a little beyond the end of the period of natural seed
emission--the art work of this last stage being less vibrant, and
of a gentler force. Then followed a time of calm natural rest,
which gradually led up to the next sequence of melancholy and
power. The periods certainly varied in length of time, controlled
somewhat by the force of the mind and the mental will to create;
that is to say, I could somewhat delay the natural emission, by
which I gained an extension of the period of power."

How far masturbation in moderately healthy persons living without normal
sexual relationships may be considered normal is a difficult question only
to be decided with reference to individual cases. As a general rule, when
only practiced at rare intervals, and _faute de mieux_, in order to obtain
relief for physical oppression and mental obsession, it may be regarded as
the often inevitable result of the unnatural circumstances of our
civilized social life. When, as often happens in mental degeneracy,--and
as in shy and imaginative persons, perhaps of neurotic temperament, may
also sometimes become the case,--it is practiced in preference to sexual
relationships, it at once becomes abnormal and may possibly lead to a
variety of harmful results, mental and physical.[345]

It must always be remembered, however, that, while the practice of
masturbation may be harmful in its consequences, it is also, in the
absence of normal sexual relationships, frequently not without good
results. In the medical literature of the last hundred years a number of
cases have been incidentally recorded in which the patients found
masturbation beneficial, and such cases might certainly have been
enormously increased if there had been any open-eyed desire to discover
them. My own observations agree with those of Sudduth, who asserts that
"masturbation is, in the main, practiced for its sedative effect on the
nervous system. The relaxation that follows the act constitutes its real
attraction.... Both masturbation and sexual intercourse should be classed
as typical sedatives."[346]

Gall (_Fonctions du Cerveau_, 1825, vol. iii, p. 235) mentioned a
woman who was tormented by strong sexual desire, which she
satisfied by masturbation ten or twelve times a day; this caused
no bad results, and led to the immediate disappearance of a
severe pain in the back of the neck, from which she often
suffered. Clouston (_Mental Diseases_, 1887, p. 496) quotes as
follows from a letter written by a youth of 22: "I am sure I
cannot explain myself, nor give account of such conduct.
Sometimes I felt so uneasy at my work that I would go to the
water-closet to do it, and it seemed to give me ease, and then I
would work like a hatter for a whole week, till the sensation
overpowered me again. I have been the most filthy scoundrel in
existence," etc. Garnier presents the case of a monk, aged 33,
living a chaste life, who wrote the following account of his
experiences: "For the past three years, at least, I have felt,
every two or three weeks, a kind of fatigue in the penis, or,
rather, slight shooting pains, increasing during several days,
and then I feel a strong desire to expel the semen. When no
nocturnal pollution follows, the retention of the semen causes
general disturbance, headache, and sleeplessness. I must confess
that, occasionally, to free myself from the general and local
oppression, I lie on my stomach and obtain ejaculation. I am at
once relieved; a weight seems to be lifted from my chest, and
sleep returns." This patient consulted Gamier as to whether this
artificial relief was not more dangerous than the sufferings it
relieved. Gamier advised that if the ordinary _régime_ of a
well-ordered monastry, together with anaphrodisiac sedatives,
proved inefficacious, the manoeuvre might be continued when
necessary (P. Garnier, _Célibat et Célibataires_, 1887, p. 320).
H.C. Coe (_American Journal of Obstetrics_, p. 766, July, 1889)
gives the case of a married lady who was deeply sensitive of the
wrong nature of masturbation, but found in it the only means of
relieving the severe ovarian pain, associated with intense sexual
excitement, which attended menstruation. During the
intermenstrual period the temptation was absent. Turnbull knew a
youth who found that masturbation gave great relief to feelings
of heaviness and confusion which came on him periodically; and
Wigglesworth has frequently seen masturbation after epileptic
fits in patients who never masturbated at other times. Moll
(_Libido Sexualis_, Bd. I, p. 13) refers to a woman of 28, an
artist of nervous and excitable temperament, who could not find
sexual satisfaction with her lover, but only when masturbating,
which she did once or twice a day, or oftener; without
masturbation, she said, she would be in a much more nervous
state. A friend tells me of a married lady of 40, separated from
her husband on account of incompatibility, who suffered from
irregular menstruation; she tried masturbation, and, in her own
words, "became normal again;" she had never masturbated
previously. I have also been informed of the case of a young
unmarried woman, intellectual, athletic, and well developed, who,
from the age of seven or eight, has masturbated nearly every
night before going to sleep, and would be restless and unable to
sleep if she did not.

Judging from my own observations among both sexes, I should say that in
normal persons, well past the age of puberty, and otherwise leading a
chaste life, masturbation would be little practiced except for the
physical and mental relief it brings. Many vigorous and healthy unmarried
women or married women apart from their husbands, living a life of sexual
abstinence, have asserted emphatically that only by sexually exciting
themselves, at intervals, could they escape from a condition of nervous
oppression and sexual obsession which they felt to be a state of hysteria.
In most cases this happens about the menstrual period, and, whether
accomplished as a purely physical act--in the same way as they would
soothe a baby to sleep by rocking it or patting it--or by the co-operation
of voluptuous mental imagery, the practice is not cultivated for its own
sake during the rest of the month.

In illustration of the foregoing statements I will here record a
few typical observations of experiences with regard to
masturbation. The cases selected are all women, and are all in a
fairly normal, and, for the most part, excellent, state of
health; some of them, however, belong to somewhat neurotic
families, and these are persons of unusual mental ability and
intelligence.

OBSERVATION I.--Unmarried, aged 38. She is very vigorous and
healthy, of a strongly passionate nature, but never masturbated
until a few years ago, when she was made love to by a man who
used to kiss her, etc. Although she did not respond to these
advances, she was thrown into a state of restless sexual
excitement; on one occasion, when in bed in this restless state,
she accidentally found, on passing her hand over her body, that,
by playing with "a round thing" [clitoris] a pleasurable feeling
was produced. She found herself greatly relieved and quieted by
these manipulations, though there remained a feeling of tiredness
afterward. She has sometimes masturbated six times in a night,
especially before and after the menstrual period, until she was
unable to produce the orgasm or any feeling of pleasure.

OBSERVATION II.--Unmarried, aged 45, of rather nervous
temperament. She has for many years been accustomed, usually
about a week before the appearance of the menses, to obtain
sexual relief by kicking out her legs when lying down. In this
way, she says, she obtains complete satisfaction. She never
touches herself. On the following day she frequently has pains
over the lower part of the abdomen, such pains being apparently
muscular and due to the exertion.

OBSERVATION III.--Aged 29, recently married, belonging to a
neurotic and morbid family, herself healthy, and living usually
in the country; vivacious, passionate, enthusiastic,
intellectual, and taking a prominent part in philanthropic
schemes and municipal affairs; at the same time, fond of society,
and very attractive to men. For many years she had been
accustomed to excite herself, though she felt it was not good for
her. The habit was merely practiced _faute de mieux_. "I used to
sit on the edge of the bed sometimes," she said, "and it came
over me so strongly that I simply couldn't resist it. I felt that
I should go mad, and I thought it was better to touch myself than
be insane.... I used to press my clitoris in.... It made me very
tired afterward--not like being with my husband." The confession
was made from a conviction of the importance of the subject, and
with the hope that some way might be found out of the
difficulties which so often beset women.

OBSERVATION IV.--Unmarried, aged 27; possesses much force of
character and high intelligence; is actively engaged in a
professional career. As a child of seven or eight she began to
experience what she describes as lightning-like sensations,
"mere, vague, uneasy feelings or momentary twitches, which took
place alike in the vulva or the vagina or the uterus, not
amounting to an orgasm and nothing like it." These sensations,
it should be added, have continued into adult life. "I always
experience them just before menstruation, and afterward for a few
days, and, occasionally, though it seems to me not so often,
during the period itself. I may have the sensation four or five
times during the day; it is not dependent at all upon external
impressions, or my own thoughts, and is sometimes absent for days
together. It is just one flash, as if you would snap your
fingers, and it is over."

As a child, she was, of course, quite unconscious that there was
anything sexual in these sensations. They were then usually
associated with various imaginary scenes. The one usually
indulged in was that a black bear was waiting for her up in a
tree, and that she was slowly raised up toward the bear by means
of ropes and then lowered again, and raised, feeling afraid of
being caught by the bear, and yet having a morbid desire to be
caught. In after years she realized that there was a physical
sexual cause underlying these imaginations, and that what she
liked was a feeling of resistance to the bear giving rise to the
physical sensation.

At a somewhat later age, though while still a child, she
cherished an ideal passion for a person very much older than
herself, this passion absorbing her thoughts for a period of two
years, during which, however, there was no progress made in
physical sensation. It was when she was nearly thirteen years of
age, soon after the appearance of menstruation, and under the
influence of this ideal passion, that she first learned to
experience conscious orgasm, which was not associated with the
thought of any person. "I did not associate it with anything high
or beautiful, owing to the fact that I had imbibed our current
ideas in regard to sexual feelings, and viewed them in a very
poor light indeed." She considers that her sexual feelings were
stronger at this period than at any other time in her life. She
could, however, often deny herself physical satisfaction for
weeks at a time, in order that she might not feel unworthy of the
object of her ideal passion. "As for the sexual satisfaction,"
she writes, "it was experimental. I had heard older girls speak
of the pleasure of such feelings, but I was not taught anything
by example, or otherwise. I merely rubbed myself with the
wash-rag while bathing, waiting for a result, and having the same
peculiar feeling I had so often experienced. I am not aware of
any ill effects having resulted, but I felt degraded, and tried
hard to overcome the habit. No one had spoken to me of the habit,
but from the secrecy of grown people, and passages I had heard
from the Bible, I conceived the idea that it was a reprehensible
practice. And, while this did not curb my desire, it taught me
self-control, and I vowed that each time should be the last. I
was often able to keep the resolution for two or three weeks."
Some four years later she gradually succeeded in breaking herself
of the practice in so far as it had become a habit; she has,
however, acquired a fuller knowledge of sexual matters, and,
though she has still a great dread of masturbation as a vice, she
does not hesitate to relieve her physical feelings when it seems
best to her to do so. "I am usually able to direct my thoughts
from these sensations," she writes, "but if they seem to make me
irritable or wakeful, I relieve myself. It is a physical act,
unassociated with deep feeling of any kind. I have always felt
that it was a rather unpleasant compromise with my physical
nature, but certainly necessary in my case. Yet, I have abstained
from gratification for very long periods. If the feeling is not
strong at the menstrual period, I go on very well without either
the sensation or the gratification until the next period. And,
strange as it may seem, the best antidote I have found and the
best preventive is to think about spiritual things or someone
whom I love. It is simply a matter of training, I suppose,--a
sort of mental gymnastics,--which draws the attention away from
the physical feelings." This lady has never had any sexual
relationships, and, since she is ambitious, and believes that the
sexual emotions may be transformed so as to become a source of
motive power throughout the whole of life, she wishes to avoid
such relationships.

OBSERVATION V.--Unmarried, aged 31, in good health, with,
however, a somewhat hysterical excess of energy. "When I was
about 26 years of age," she writes, "a friend came to me with the
confession that for several years she had masturbated, and had
become such a slave to the habit that she severely suffered from
its ill effects. At that time I had never heard of self-abuse by
women. I listened to her story with much sympathy and interest,
but some skepticism, and determined to try experiments upon
myself, with the idea of getting to understand the matter in
order to assist my friend. After some manipulation, I succeeded
in awakening what had before been unconscious and unknown. I
purposely allowed the habit to grow upon me, and one night--for I
always operated upon myself before going to sleep, never in the
morning--I obtained considerable pleasurable satisfaction, but
the following day my conscience awoke; I also felt pain located
at the back of my head and down the spinal column. I ceased my
operations for a time, and then began again somewhat regularly,
once a month, a few days after menstruation. During those months
in which I exercised moderation, I think I obtained much local
relief with comparatively little injury, but, later on, finding
myself in robust health, I increased my experiments, the habit
grew upon me, and it was only with an almost superhuman effort
that I broke myself free. Needless to say that I gave no
assistance to my suffering friend, nor did I ever refer to the
subject after her confession to me.

"Some two years later I heard of sexual practices between women
as a frequent habit in certain quarters. I again interested
myself in masturbation, for I had been told something that led me
to believe that there was much more for me to discover. Not
knowing the most elementary physiology, I questioned some of my
friends, and then commenced again. I restricted myself to relief
from local congestion and irritation by calling forth the
emission of mucus, rather than by seeking pleasure. At the same
time, I sought to discover what manipulation of the clitoris
would lead to. The habit grew upon me with startling rapidity,
and I became more or less its slave, but I suffered from no very
great ill effects until I started in search of more discoveries.
I found that I was a complete ignoramus as to the formation of a
woman's body, and by experiments upon myself sought to discover
the vagina. I continued my operations until I obtained an
entrance. I think the rough handling of myself during this final
stage disturbed my nervous system, and caused me considerable
pain and exhaustion at the back of my head, the spinal column,
the back of my eyes, and a general feeling of languor, etc.

"I could not bear to be the slave of a habit, and after much
suffering and efforts, which only led to falls to lower depths of
conscious failure, my better self rebelled, until, by a great
effort and much prayer, I kept myself pure for a whole week. This
partial recovery gave me hope, but then I again fell a victim to
the habit, much to my chagrin, and became hopeless of ever
retracing my steps toward my ideal of virtue. For some days I
lost energy, spirit, and hope; my nervous system appeared to be
ruined, but I did not really despair of victory in the end. I
thought of all the drunkards chained by their intemperate habits,
of inveterate smokers who could not exist without tobacco, and of
all the various methods by which men were slaves, and the longing
to be freed of what had, in my case, proved to be a painful and
unnecessary habit, increased daily until, after one night when I
struggled with myself for hours, I believed I had finally
succeeded.

"At times, when I reached a high degree of sexual excitement, I
felt that I was at least one step removed from those of morbid
and repressed sex, who had not the slightest suspicion of the
latent joys of womanhood within them. For a little while the
habit took the shape of an exalted passion, but I rapidly tired
it out by rough, thoughtless, and too impatient handling.
Revulsion set in with the pain of an exhausted and badly used
nervous system, and finding myself the slave of a passion, I
determined to endeavor to be its master.

"In conclusion, I should say that masturbation has proved itself
to be to me one of the blind turnings of my life's history, from
which I have gained much valuable experience."