Ribbing, the Swedish professor, in his Hygiène Sexuelle, advocates sexual abstinence outside marriage, and asserts its harmlessness. Gilles de la Tourette, Féré, and Augagneur in France agree. In Germany Fürbringer (Senator and Kaminer, Health and Disease in Relation to Marriage, vol. i, p. 228) asserts that continence is possible and necessary, though admitting that it may, however, mean serious mischief in exceptional cases. Eulenburg (Sexuale Neuropathie, p. 14) doubts whether anyone, who otherwise lived a reasonable life, ever became ill, or more precisely neurasthenic, through sexual abstinence. Hegar, replying to the arguments of Bebel in his well-known book on women, denies that sexual abstinence can ever produce satyriasis or nymphomania. Näcke, who has frequently discussed the problem of sexual abstinence (e.g., Archiv für Kriminal-Anthropologie, 1903, Heft 1, and Sexual-Probleme, June, 1908), maintains that sexual abstinence can, at most, produce rare and slight unfavorable results, and that it is no more likely to produce insanity, even in predisposed individuals, than are the opposite extremes of sexual excess and masturbation. He adds that, so far as his own observations are concerned, the patients in asylums suffer scarcely at all from their compulsory sexual abstinence.
It is in England, however, that the virtues of sexual abstinence have been most loudly and emphatically proclaimed, sometimes indeed with considerable lack of cautious qualification. Acton, in his Reproductive Organs, sets forth the traditional English view, as well as Beale in his Morality and the Moral Question. A more distinguished representative of the same view was Paget, who, in his lecture on "Sexual Hypochondriasis," coupled sexual intercourse with "theft or lying." Sir William Gowers (Syphilis and the Nervous System, 1892, p. 126) also proclaims the advantages of "unbroken chastity," more especially as a method of avoiding syphilis. He is not hopeful, however, even as regards his own remedy, for he adds: "We can trace small ground for hope that the disease will thus be materially reduced." He would still, however, preach chastity to the individual, and he does so with all the ascetic ardor of a mediæval monk. "With all the force that any knowledge I possess, and any authority I have, can give, I assert that no man ever yet was in the slightest degree or way the worse for continence or better for incontinence. From the latter all are worse morally; a clear majority are worse physically; and in no small number the result is, and ever will be, utter physical shipwreck on one of the many rocks, sharp, jagged-edged, which beset the way, or on one of the many beds of festering slime which no care can possibly avoid." In America the same view widely prevails, and Dr. J. F. Scott, in his Sexual-Instinct (second edition, 1908, Ch. III), argues very vigorously and at great length in favor of sexual abstinence. He will not even admit that there are two sides to the question, though if that were the case, the length and the energy of his arguments would be unnecessary.
Among medical authorities who have discussed the question of sexual abstinence at length it is not, indeed, usually possible to find such unqualified opinions in its favor as those I have quoted. There can be no doubt, however, that a large proportion of physicians, not excluding prominent and distinguished authorities, when casually confronted with the question whether sexual abstinence is harmless, will at once adopt the obvious path of least resistance and reply: Yes. In only a few cases will they even make any qualification of this affirmative answer. This tendency is very well illustrated by an inquiry made by Dr. Ludwig Jacobsohn, of St. Petersburgh ("Die Sexuelle Enthaltsamkeit im Lichte der Medizin," St. Petersburger Medicinische Wochenschrift, March 17, 1907). He wrote to over two hundred distinguished Russian and German professors of physiology, neurology, psychiatry, etc., asking them if they regarded sexual abstinence as harmless. The majority returned no answer; eleven Russian and twenty-eight Germans replied, but four of them merely said that "they had no personal experience," etc.; there thus remained thirty-five. Of these E. Pflüger, of Bonn, was skeptical of the advantage of any propaganda of abstinence: "if all the authorities in the world declared the harmlessness of abstinence that would have no influence on youth. Forces are here in play that break through all obstacles." The harmlessness of abstinence was affirmed by Kräpelin, Cramer, Gärtner, Tuczek, Schottelius, Gaffky, Finkler, Selenew, Lassar, Seifert, Gruber; the last, however, added that he knew very few abstinent young men, and himself only considered abstinence good before full development, and intercourse not dangerous in moderation even before then. Brieger knew cases of abstinence without harmful results, but himself thought that no general opinion could be given. Jürgensen said that abstinence in itself is not harmful, but that in some cases intercourse exerts a more beneficial influence. Hoffmann said that abstinence is harmless, adding that though it certainly leads to masturbation, that is better than gonorrhœa, to say nothing of syphilis, and is easily kept within bounds. Strümpell replied that sexual abstinence is harmless, and indirectly useful as preserving from the risk of venereal disease, but that sexual intercourse, being normal, is always more desirable. Hensen said that abstinence is not to be unconditionally approved. Rumpf replied that abstinence was not harmful for most before the age of thirty, but after that age there was a tendency to mental obsessions, and marriage should take place at twenty-five. Leyden also considered abstinence harmless until towards thirty, when it leads to psychic anomalies, especially states of anxiety, and a certain affectation. Hein replied that abstinence is harmless for most, but in some leads to hysterical manifestations and indirectly to bad results from masturbation, while for the normal man abstinence cannot be directly beneficial, since intercourse is natural. Grützner thought that abstinence is almost never harmful. Nescheda said it is harmless in itself, but harmful in so far as it leads to unnatural modes of gratification. Neisser believes that more prolonged abstinence than is now usual would be beneficial, but admitted the sexual excitations of our civilization; he added that of course he saw no harm for healthy men in intercourse. Hoche replied that abstinence is quite harmless in normal persons, but not always so in abnormal persons. Weber thought it had a useful influence in increasing will-power. Tarnowsky said it is good in early manhood, but likely to be unfavorable after twenty-five. Orlow replied that, especially in youth, it is harmless, and a man should be as chaste as his wife. Popow said that abstinence is good at all ages and preserves the energy. Blumenau said that in adult age abstinence is neither normal nor beneficial, and generally leads to masturbation, though not generally to nervous disorders; but that even masturbation is better than syphilis. Tschiriew saw no harm in abstinence up to thirty, and thought sexual weakness more likely to follow excess than abstinence. Tschish regarded abstinence as beneficial rather than harmful up to twenty-five or twenty-eight, but thought it difficult to decide after that age when nervous alterations seem to be caused. Darkschewitcz regarded abstinence as harmless up to twenty-five. Fränkel said it was harmless for most, but that for a considerable proportion of people intercourse is a necessity. Erb's opinion is regarded by Jacobsohn as standing alone; he placed the age below which abstinence is harmless at twenty; after that age he regarded it as injurious to health, seriously impeding work and capacity, while in neurotic persons it leads to still more serious results. Jacobsohn concludes that the general opinion of those answering the inquiry may thus be expressed: "Youth should be abstinent. Abstinence can in no way injure them; on the contrary, it is beneficial. If our young people will remain abstinent and avoid extra-conjugal intercourse they will maintain a high ideal of love and preserve themselves from venereal diseases."
The harmlessness of sexual abstinence was likewise affirmed in America in a resolution passed by the American Medical Association in 1906. The proposition thus formally accepted was thus worded: "Continence is not incompatible with health." It ought to be generally realized that abstract propositions of this kind are worthless, because they mean nothing. Every sane person, when confronted by the demand to boldly affirm or deny the proposition, "Continence is not incompatible with health," is bound to affirm it. He might firmly believe that continence is incompatible with the health of most people, and that prolonged continence is incompatible with anyone's health, and yet, if he is to be honest in the use of language, it would be impossible for him to deny the vague and abstract proposition that "Continence is not incompatible with health." Such propositions are therefore not only without value, but actually misleading.
It is obvious that the more extreme and unqualified opinions in favor of sexual abstinence are based not on medical, but on what the writers regard as moral considerations. Moreover, as the same writers are usually equally emphatic in regard to the advantages of sexual intercourse in marriage, it is clear that they have committed themselves to a contradiction. The same act, as Näcke rightly points out, cannot become good or bad according as it is performed in or out of marriage. There is no magic efficacy in a few words pronounced by a priest or a government official.
Remondino (loc. cit.) remarks that the authorities who have committed themselves to declarations in favor of the unconditional advantages of sexual abstinence tend to fall into three errors: (1) they generalize unduly, instead of considering each case individually, on its own merits; (2) they fail to realize that human nature is influenced by highly mixed and complex motives and cannot be assumed to be amenable only to motives of abstract morality; (3) they ignore the great army of masturbators and sexual perverts who make no complaint of sexual suffering, but by maintaining a rigid sexual abstinence, so far as normal relationships are concerned, gradually drift into currents whence there is no return.
Between those who unconditionally affirm or deny the harmlessness of sexual abstinence we find an intermediate party of authorities whose opinions are more qualified. Many of those who occupy this more guarded position are men whose opinions carry much weight, and it is probable that with them rather than with the more extreme advocates on either side the greater measure of reason lies. So complex a question as this cannot be adequately investigated merely in the abstract, and settled by an unqualified negative or affirmative. It is a matter in which every case requires its own special and personal consideration.
"Where there is such a marked opposition of opinion truth is not exclusively on one side," remarks Löwenfeld (Sexualleben und Nervenleiden, second edition, p. 40). Sexual abstinence is certainly often injurious to neuropathic persons. (This is now believed by a large number of authorities, and was perhaps first decisively stated by Krafft-Ebing, "Ueber Neurosen durch Abstinenz," Jahrbuch für Psychiatrie, 1889, p. 1). Löwenfeld finds no special proclivity to neurasthenia among the Catholic clergy, and when it does occur, there is no reason to suppose a sexual causation. "In healthy and not hereditarily neuropathic men complete abstinence is possible without injury to the nervous system." Injurious effects, he continues, when they appear, seldom occur until between twenty-four and thirty-six years of age, and even then are not usually serious enough to lead to a visit to a doctor, consisting mainly in frequency of nocturnal emissions, pain in testes or rectum, hyperæsthesia in the presence of women or of sexual ideas. If, however, conditions arise which specially stimulate the sexual emotions, neurasthenia may be produced. Löwenfeld agrees with Freud and Gattel that the neurosis of anxiety tends to occur in the abstinent, careful examination showing that the abstinence is a factor in its production in both sexes. It is common among young women married to much older men, often appearing during the first years of marriage. Under special circumstances, therefore, abstinence can be injurious, but on the whole the difficulties due to such abstinence are not severe, and they only exceptionally call forth actual disturbance in the nervous or psychic spheres. Moll takes a similar temperate and discriminating view. He regards sexual abstinence before marriage as the ideal, but points out that we must avoid any doctrinal extremes in preaching sexual abstinence, for such preaching will merely lead to hypocrisy. Intercourse with prostitutes, and the tendency to change a woman like a garment, induce loss of sensitiveness to the spiritual and personal element in woman, while the dangers of sexual abstinence must no more be exaggerated than the dangers of sexual intercourse (Moll, Libido Sexualis, 1898, vol. i, p. 848; id., Konträre Sexualempfindung, 1899, p. 588). Bloch also (in a chapter on the question of sexual abstinence in his Sexualleben unserer Zeit, 1908) takes a similar standpoint. He advocates abstention during early life and temporary abstention in adult life, such abstention being valuable, not only for the conservation and transformation of energy, but also to emphasize the fact that life contains other matters to strive for beyond the ends of sex. Redlich (Medizinische Klinik, 1908, No. 7) also, in a careful study of the medical aspects of the question, takes an intermediate standpoint in relation to the relative advantages and disadvantages of sexual abstinence. "We may say that sexual abstinence is not a condition which must, under all circumstances and at any price, be avoided, though it is true that for the majority of healthy adult persons regular sexual intercourse is advantageous, and sometimes is even to be recommended."
It may be added that from the standpoint of Christian religious morality this same attitude, between the extremes of either party, recognizing the advantages of sexual abstinence, but not insisting that they shall be purchased at any price, has also found representation. Thus, in England, an Anglican clergyman, the Rev. H. Northcote (Christianity and Sex Problems, pp. 58, 60) deals temperately and sympathetically with the difficulties of sexual abstinence, and is by no means convinced that such abstinence is always an unmixed advantage; while in Germany a Catholic priest, Karl Jentsch (Sexualethik, Sexualjustiz, Sexualpolizei, 1900) sets himself to oppose the rigorous and unqualified assertions of Ribbing in favor of sexual abstinence. Jentsch thus expresses what he conceives ought to be the attitude of fathers, of public opinion, of the State and the Church towards the young man in this matter: "Endeavor to be abstinent until marriage. Many succeed in this. If you can succeed, it is good. But, if you cannot succeed, it is unnecessary to cast reproaches on yourself and to regard yourself as a scoundrel or a lost sinner. Provided that you do not abandon yourself to mere enjoyment or wantonness, but are content with what is necessary to restore your peace of mind, self-possession, and cheerful capacity for work, and also that you observe the precautions which physicians or experienced friends impress upon you."