Such cases are exceedingly rare in the male. As a rule, autoeroticism in men is accomplished by the hand alone, hence the name “masturbation.” In some cases neither the hand nor any other means is needed to obtain the desired end. The fancy of concarnatio alone will produce the orgasm, as in the following case, told the author in confidence:
A young man, twenty years of age, while sitting behind an attractive young lady in theatre, was in the habit of allowing his fancy free rein by imagining himself of being in complexu venereo with his fair neighbor. This thought alone sufficed to induce ejaculation and orgasm. One Sunday while sitting near a fair worshipper in church, he got so excited that he had to practise ideal congressum cum ea during the sermon.
The causes of masturbation are different at the different periods of the individual’s life. In early childhood, a neuropathic predisposition, eczema, pruritus, phimosis, accumulation of smegma, early retiring and late rising, spicy food and exciting drinks, absolute ignorance of sex and seduction by vicious servants will be the principal causes for autoeroticism. During the time of school-life seduction is the cause par excellence of masturbation. Self-abuse is widely spread in schools. No institution is free from it. In nearly every school there is at least one lecherous boy who is apt to be peculiarly fascinating to his fellows and who will promulgate the habit. In some schools the evil reaches a wide extension. The tradition of the school and the material of the pupils is of great influence. Particularly dangerous, as hatcheries and divulgers of the evil, are those institutions in which numerous pupils are present who have passed the normal age by several years. They come, as a rule, from the country to enter the advanced classes. The time of puberty is another period favorable for acquiring the habit of masturbation. When the genital centres are fully developed, the individual gets a conscious realization of its sexual power, and the psychological reactions of animal passion manifest themselves in the desire to cause a relaxation and a discharge of the nervous tension and of the physical genital congestion. The opportunity for the natural discharge being connected with great difficulties, especially for the girl, there is danger that the child will resort to masturbation to be relieved from the nervous tension and the material congestion.
During the post-puberty period which in men reaches to the twenty-fourth year and in women to the twentieth year of age, the extension of the masturbatic practices gradually decreases, and by the time manhood and womanhood have been reached, masturbation has almost entirely disappeared. Its presence after this period may be considered pathological except it is practised out of necessity as in the following case:
Mr. A., thirty-five years old, married twelve years, father of two healthy children, was always well. Three years ago he left his native country and came to America. Faute de mieux, he began to practise autoeroticism inordinately and continued in this practice until he became a nervous wreck, showing all the symptoms of neurasthenia besides impotence and nocturnal emissions.
In this case the patient became perfectly well after his wife arrived in this country.
While moderate masturbation at certain periods of life is almost a natural phenomenon, masturbation practised inordinately is the most disastrous psycho-sexual disease. There is in the first place general neurasthenia, with all its accompanying symptoms, as photopsias, glistening and dazzling before the eyes, photophobias, dry conjunctivitis, particularly found among masturbating girls and old maids, and functional sexual disturbances, as diurnal pollutions and spermatorrhoea. Other symptoms are indolence, lack of energy, shyness in demeanor, want of self-reliance, disinclination to study, incapacity of serious work, shortness of memory, absent-mindedness, unsteadiness of character, hypochondria and melancholia.
The children become peevish and irritable, they are reserved in conversation, apathetic in manner, hesitating in actions, slovenly in dress, and contradictory. Cerebral anemia is of common occurrence among those addicted to excesses in masturbation. Vertigo is hence a common symptom, and fainting spells are not rare. Girls especially are liable to be affected by syncope. Palpitation and arythmia of the heart is very common. Perspiration breaks forth on the slightest exertion, and the slightest exercise occasions shortness of breath. Neuralgia of the testicles, ovaries and the bladder is frequently found in these patients. The patient is frequently seized with the desire to pass water. The calls to urinate are particularly frequent in the morning hours, while in the afternoon and in the night-time the calls are less urgent. Particular danger of long-continued masturbation lies in the development of impotency in men and frigidity in women.
One of the most disastrous effects of excessive masturbation, an effect which has also a sociological bearing, is that it renders the patient unfit for marriage, not only because it is so often the cause of impotence, but because the dreams which accompany the masturbatic acts are not realized in marriage, and the patient returns to his former pastime.
Another most harmful effect of excessive masturbation is the weakness of the will which becomes more and more pronounced until it finally ends in aboulia. The patient is affected by a complete inability to act as he feels.