Seduction may in some instances arise largely by way of physical stimulation, as, for example, when another person deliberately handles the genital organs of a child. Nurses sometimes stroke or tickle a child's genitals in order to put an end to a screaming fit. But in some cases—and these are more numerous than is commonly supposed—nursemaids do this under the impulse of their own lustful feelings. Such actions are not necessarily the outcome of a perverse sexual impulse, although they may be due to such an impulse in the form of pædophilia, as I shall have to explain in detail when I come to describe that perversion. Frequently the offenders are not in the least aware of the danger of what they are doing, and do it merely in sport. In many instances the seduction is effected by other children, and often at a very early age. Recently a case was reported to me in which a boy only five years of age led older children astray. In schools, a closet used by both boys and girls is by many considered extremely dangerous. In the country, the fact that children have a long way to go to school often gives opportunity for improper conduct; and this is especially likely to occur if there are copses near the road in which the children can conceal themselves from observation. When children in the country traverse long distances on the way to preparatory confirmation classes, misconduct is exceptionally likely, for such children are now at an age at which the activity of the sexual life is becoming more manifest. Whether the seduction be the work of other children or of adults, the child thus led astray is likely subsequently to induce artificially as often as possible the agreeable sensations with which it has now been made acquainted, more especially in view of the fact that in children the imitative impulse is far more strongly developed than it is in adults, in whom imitative inclinations are counteracted by numerous inhibitions. What is true of seduction is true also of the various affections of the genital organs which induce an impulse to scratch, such as eczema, prurigo, urticaria, &c. Affections of regions adjoining the genital organs may also lead to similar troubles—for instance, threadworms in the rectum or the vagina.
Clothing, also, especially in boys the breeches, may give rise during childhood to unwholesome stimulation. Hufeland, in his Makrobiotik, long ago advised against the wearing of breeches by little boys. The Schaumburg-Lippe body-physician, Faust,[75] in a work published in the year 1791, strongly recommended that boys should not wear breeches. Frequently the climbing of the pole in the gymnasium is regarded as being the etiological factor in the induction of premature masturbation. Experience shows that occasionally the first voluptuous sensations do actually arise during the act of climbing the pole. A similar report is made also in regard to the climbing of trees and of gymnastic exercises on the parallel and horizontal bars. It is obvious that pressure on the genital organs will very readily arise in these ways. But cases are reported in which the child experiences sexual excitement from exercising on the horizontal bar, not when he is straddling the bar, but when he is hanging to it by the hands. It must in these cases remain doubtful whether the sexual excitement results from the pressure of the breeches, or is a direct result of the hanging posture. Where pressure is exerted on the genital organs, it is not always the strength of the stimulus which is most significant. A nursemaid may do much more harm by gently tickling a child's genital organs than by pressing them forcibly. Nor have we to think only of the quality of the stimulus, but also of its newness; for an unfamiliar stimulus may cause sexual excitement simply because it is unfamiliar. Various stimuli have to be considered, in addition to those previously enumerated. I may refer here to flagellation. It is well known that in many children the first experience of sexual excitement results from a whipping; indeed, a perverse mode of sexual sensibility lasting throughout the whole of life may thus originate. I shall return to this matter in the chapter on Sexual Education. I will merely refer here to certain other stimuli which have in many cases aroused sexual excitement for the first time. Penta reports the case of a girl twelve years of age who first experienced sexual excitement during a railway journey. Certain men have informed me that they became sexually excited for the first time while driving over a rough stone pavement. It is obvious in these cases that the rapidly repeated succussion stimulates the peripheral genital organs, and that in this way sexual sensibility is awakened. Havelock Ellis[76] reports cases in which boys first experienced sexual pleasure when wrestling. Thus, a physician wrote regarding a boy of twelve or thirteen, that he experienced an extraordinarily pleasant sensation whilst wrestling with another boy, and that thenceforward he sought every opportunity to wrestle, often three or four times daily, and continued to do this until he was nearly nineteen years of ago. Whilst in this instance we are told that contact of the penis with the opponent's hips was effected, and that probably the sexual excitement was induced in this manner, I must point out that a masochistic-sadistic form of excitement may also result from wrestling, and that it is to this that we must refer the sexual desires and voluptuous sensations that are aroused in many males by the act of wrestling.
Chemical stimuli must be regarded as a sub-variety of physical stimuli. It is sometimes asserted that a diet too rich in meat or otherwise too stimulating is dangerous in this regard. But an examination of the available material will show that this opinion lacks foundation. There is no proof that the sexual impulse can be prematurely awakened by a meat diet, or by any other particular diet. I cannot regard such an assertion as proved even as regards alcohol. Although I hold very strongly that no alcohol should be given to children, this is not because there is any proof that in children to whom alcohol is given the awakening of the sexual impulse occurs earlier than in others. But once the awakening of the sexual life has taken place, it is true that alcohol may have an exciting influence, and this in two different ways. On the one hand, if so much alcohol is taken as to interfere with the natural psychical inhibitions, sexual practices may occur that would not otherwise have occurred. On the other hand, also large quantities of alcohol may often induce an after-effect, after the intoxicating effects have completely passed away, manifesting itself, it may be, in the form of sexual excitement, but also, and chiefly, in the form of common sensations in the genital organs. To complete the account of this matter it is necessary to add that there are many persons who consume large quantities of alcohol, who yet are extremely moderate in sexual relationships. But alcohol should not be administered to children, for reasons altogether independent of its influence upon the sexual life.
Psychical stimuli are perhaps even more important than physical stimuli. Here also seduction has to be considered, especially during the second period of childhood, in which danger may arise from playmates or school-fellows. This applies equally to children of either sex. Danger may also arise from adults, not only through systematic seduction on the part of grown persons who deliberately debase the mind of youth, but also in other ways. The conversations of adults often lead to sexual acts on the part of children, who understand far more of what is said in their presence than grownups commonly believe. While the child is to all appearance immersed in a book, while a girl is playing with her doll, or a boy with his tin soldiers, the parents or some other adults carry on a conversation in the child's presence under the influence of an utterly false belief that the latter's occupation engrosses his or her entire attention. Yet many children, in such cases, are listening to what is being said with all their ears. Especially foolish, however, are those parents who believe that by the employment of innuendo they are able to conceal from any children who may be present the true inwardness of their conversation. In these matters children are as a rule far sharper than their elders are accustomed to believe. It is hardly necessary for me to point out that opportunities for direct observation are especially dangerous to children. I allude more particularly to the case of children living in the same house with prostitutes; but the danger is hardly less when the children have an opportunity of observing their own parents engaged in sexual acts, or even in the mere preparation for such acts. Forel[77] quotes the report of an experienced physician to the effect that the children of peasants who have watched the copulation of animals often attempt to perform such acts with one another, when bathing, or when any other opportunity offers.
In the preceding portions of this chapter I have attempted to distinguish individual influences from general influences, to distinguish congenital influences affecting the germinal rudiments from environmental influences acting after birth, and to distinguish psychical stimuli from physical stimuli. But it is obvious that the maintenance of a sharp distinction in these respects is very difficult, and indeed often quite impossible. A few additional considerations will elucidate this statement. Let us consider, for instance, seduction: here the separation of the psychical from the physical element cannot possibly be effected, because, as a rule, in these cases the two elements co-operate simultaneously. Let us consider the cases in which, owing to a congenital racial peculiarity, the sexual life awakens earlier than is usual among ourselves. In such cases, the manners and customs of the race in which this early development of sexuality is usual will be found to be especially adapted to attract the child's attention to sexual matters earlier than is here customary. It suffices to remind the reader of the celebrations of puberty and of the early marriages common among such races. Here it is hardly possible to separate the congenital characters from the effects of environment. But although, for the reasons given, the discrimination between the individual factors may be exceedingly difficult, still an attempt at discrimination must be made, more especially in view of the fact that a purposive sexual education can be attempted only when due consideration has been paid to the various etiological factors.
It would naturally be of the utmost importance to be able to foresee the cases in which it is likely that the sexual processes of childhood would undergo an exceptionally early development. But as a rule we are unable to do this; and we must therefore be satisfied with the attempt to determine in individual cases whether manifestations of the sexual life occur during childhood, and if so, which manifestations. But even here we encounter difficulties, which in many instances are insuperable, but in others arise from the incompetence of adults. This is all the more deplorable because the effectiveness of sexual education is minimised through the lack of insight. Just as in the practice of medicine an accurate diagnosis is an indispensable prerequisite to correct therapeutics, so also here. Since in the earliest years the child has no conscious understanding of sexual processes, whilst children in whom a sexual consciousness has begun to dawn conceal most carefully from their elders all manifestations of their sexual life, diagnosis is possible only through knowledge of mankind in conjunction with tact.
Let us first consider the phenomena of contrectation. We shall notice sometimes that a little boy, perhaps seven years of age or even younger, will withdraw from the society of other boys, and will seek the company of some particular individual, for example that of a girl friend of his sister, of about his own age. Similar phenomena occur in girls. A little girl in her tenth year will frequently be noticed to find something to speak to her mother about whenever a particular male friend of the family visits the house. Even a shrewd and observant mother will often fail to take note of the reason why on these occasions her little daughter invariably comes into the room. The child will have every possible kind of excuse ready to enable her to seek the company of this particular person. At times this goes further. We then notice that the child endeavours to come into physical contact with the object of affection, showing him great tenderness, and showering on him caresses.
Such a desire for intimate physical caresses must always arouse the suspicion that sexual feelings have now been awakened. We must not, of course, assume that every childish caress is sexually determined; but we should always bear in mind this possibility in cases in which the child's desire to caress someone is well marked. If such feelings manifest themselves towards the end of the first period of childhood or at the beginning of the second, observation will be comparatively easy, for the younger the child is the less competent is it to conceal its feelings. The consciousness that there is anything wrong in the gratification of such sentiments awakens as a rule very gradually indeed.
Similarly, it will be far easier in the case of children to observe peripheral processes in the genital organs than it is to make such observations in adults. Thus, even in the case of infants in arms, but more often in the case of boys who are somewhat older, the mother or the nurse may be surprised to observe erections when the boy is undressed for his bath or some other reason, or when he has kicked off the bedclothes at night. In other cases the child may be seen handling his genital organs, either openly or beneath his clothing. Often, in the absence of manual stimulation, the child adopts some other means of stimulating his genital organs. Thus, in girls the legs will be crossed, and the thighs rubbed lightly each against the other. In other cases, both in boys and in girls, the child will lean against a piece of furniture in what appears to be a perfectly innocent manner; but in reality pressure is being exercised on the genital organs, it may be by the corner of a table, it may be by the back of a chair; and then the stimulus is strengthened by various movements. In some such way children will effect masturbatory stimulation and obtain sexual gratification, in the presence, not only of their mother, but in that of quite a number of other persons. Guttceit[78] reports the case of a woman who squatted down so that her bare heel came into contact with the genitals, and she then masturbated by rubbing the two parts together. I myself have known the case of a young girl who sat with her legs beneath her, and masturbated with the boot she was wearing. In many instances we are enabled, by watching the child's movements, to ascertain with such certainty what it is doing, that no confirmatory evidence is needed. We notice, especially, that when the orgasm is approaching, the movements change in character and rhythm. The eyes become bright, and the face assumes an excited and voluptuous expression. This may be observed even in infants in arms. Townsend[79] reports the case of an infant, eight months old, "who would cross her right thigh over the left, close her eyes and clench her fists; after a minute or two there would be complete relaxation, with sweating and redness of face; this would occur about once a week or oftener; the child was quite healthy, with no abnormal condition of the genital organs."
In the absence of these definite indications, it is necessary to be cautious in coming to a diagnosis. Failing such caution, mistakes which may entail serious consequences are likely to arise. Two cases are known to me in which, after suspicion had rightly or wrongly been aroused, the child's most harmless movements were regarded as masturbatory in character. If a child becomes aware that its mother or some other person in authority is making such a mistake, the effect will naturally be very unfavourable. We have also to reckon with the fact that children who are somewhat older, from eight or nine years upwards, hardly ever masturbate when others are present, but only when they believe themselves to be unobserved—in bed, in the closet, or when out walking. In such cases it is hardly possible to diagnose masturbation with certainty; more especially in view of the fact that the signs that may betray an older boy—stains on the shirt or other articles of underclothing—are usually lacking during the first two periods of childhood. It must be added that such stains on linen resulting from ejaculation do not at first contain spermatozoa, and for this reason their diagnostic value is greatly lessened (see pp. [52]-[56]). Still, the possible appearance of these stains is a matter to which attention should always be paid, and this in girls as well as in boys. In many instances, also, our diagnosis may be supported by the discovery of articles used for onanistic[80] purposes. In the case of boys we shall seldom, comparatively speaking, be able to do this; although, even in boys, operation is sometimes needed for the removal of articles used for onanistic purposes, which have found their way into the urethra or the bladder. In girls, such operations are more frequently required. Hairpins, pencils, and various other articles used for onanistic purposes, are from time to time removed from the vagina or the female bladder. Other signs that are supposed to indicate the habitual practice of masturbation are of little diagnostic value. It is traditionally held that masturbation in girls leads to elongation of the clitoris, but there appears to be no warrant in fact for this opinion. As I have previously pointed out, laceration of the hymen does not in general result from masturbation. Other signs, such as local irritation or swelling, are hardly ever seen in boys, and in girls are seen only in cases in which they masturbate to excess. In girls, moderate reddening of the external genital organs has no significance whatever; and I take this opportunity of giving a special warning against inferring from the existence of such reddening that masturbation is practised, and also against attaching any importance to this symptom in a case in which a sexual assault is supposed to have been committed on a little girl.