According to the suggestion of Ultzmann, in the case of nursing infants and of small children, the hands may be confined in little bags or tied to the side of the bed. The methods of the older physicians, who appeared before the child armed with great knives and scissors, and threatened a painful operation, or even to cut off the genital organs, may often be found useful, and may effect a radical cure. The actual carrying out of small operations is also sometimes helpful. Fürbringer cured a young fellow in whom no instruction and no punishment had proved effective, by simply cutting off the anterior part of his foreskin with jagged scissors. In the case of a young lady who often in company indulged her passionate impulse towards masturbation, he brought about a cure by repeated cauterization of the vulva. Other physicians perforate the foreskin and introduce a ring. Cages have even been provided for the genital organs to prevent masturbation, the key being kept by the father (!). Enveloping the penis in bandages without any opening has also been tried. Corporal punishment sometimes has a good effect. Of the greatest value is continuous care, to safeguard the children against seduction. “Parents, protect your children from servants,” exclaimed Rétif de la Bretonne. Valuable also are earnest warnings and explanations, increase of energy and force of will (by sports and games, and by work in the garden, and by the setting of tasks which stimulate ambition). Climatic cures and hydro-therapeutic methods are also valuable means in the treatment of masturbation. The same measures may be employed in the treatment of masturbation in adults. In their case, however, psycho-therapeutics plays the principal part. In many cases here also local cauterization of the urethra and massage of the prostate may bring about a cure. Utterly perverse would it be to introduce youthful onanists to actual sexual intercourse, after the manner of the Parisian “soup-merchants,” as the common speech names them, who, in order to cure their youthful scholars of masturbation, take them into brothels.[426]
Masturbation is intimately connected with irritable nervous weakness, or “neurasthenia,” this typical disease of civilization, and more especially with the genital form of the disease, “sexual neurasthenia.” In an analysis of 333 cases of neurasthenia Collins and Philipp found that 123 cases—that is, more than one-third—resulted from overwork or from masturbation.[427] Freud, von Krafft-Ebing, Savill, Gattel, and Rohleder see in masturbation the true cause of neurasthenia. Fürbringer, Löwenfeld, and Eulenburg are of opinion that other injuries must also come into play in order to produce the typical picture of sexual neurasthenia. It is certain that very frequently the order of causation is reversed, neurasthenia being the primary and masturbation the secondary disorder. Masturbation is then only a symptom of sexual neurasthenia. The same duplex mode of consideration may also be applied to the other morbid phenomena of which the clinical picture of sexual neurasthenia is composed. Every one of these symptoms of irritable weakness, the excessive sexual excitability, the deficient sexual sensibility, the seminal discharges, and the impotence, can, like masturbation, exhibit a certain independence, can be induced by various causes, and may lead to sexual neurasthenia; it may be, on the other hand, that they first developed in the soil of sexual neurasthenia. It is often impossible to determine the true beginning of the vicious circle. It therefore appears to be more practical to describe the morbid picture of sexual neurasthenia (which we owe to Beard)[428] according to its individual symptoms, as is done also by A. Eulenburg[429] in an admirable essay, and by L. Löwenfeld in his well-known work on “The Sexual Life and Nervous Disorders.”
The abnormal increase in the sexual impulse (sexual hyperæsthesia, satyriasis, nymphomania) begins at the point at which the normal sexual impulse is exceeded; and that point is subject to wide individual variations, according to the age, race, habits, and external influences. The normal sexual impulse can also be temporarily increased by special circumstances—as, for example, by prolonged sexual abstinence, and by various kinds of erotic stimulation, without our being justified in speaking of “hyperæsthesia.” This is always an abnormal condition, which may be referred to various causes. It is more frequent in men (“satyriasis”) than in women (“nymphomania”); it may be permanent or periodic; it almost always arises from lascivious ideas, and, according to its cause, is accompanied by a greater or less diminution of responsibility, or even by complete lack of responsibility. The readiness with which sexual ideas give rise to an abnormally increased desire and to reaction on the part of the genital apparatus is characteristic of sexual hyperæsthesia; and this may attain such a degree that the man (or woman) may really be “sexually insane,” and, like the wild animals, rush at the first creature he meets of the opposite sex in order to gratify his lust; or he may be overpowered by some abnormal variety of the sexual impulse, so that he seizes in sexual embrace any other living or lifeless object, and in this state may perform acts of pæderasty, bestiality, violation of children, etc. In these most severe cases we can always demonstrate the existence of mental disorder, general paralysis, mania, or periodical insanity, and very often of epilepsy (Lombroso), as a cause. In a more chronic and milder form, sexual hyperæsthesia is observed after excessive masturbation, often also in association with a congenitally neuropathic constitution. Löwenfeld describes a peculiar form of nocturnal sexual hyperæsthesia occurring in married men, especially men in the forties or fifties, who for various reasons are compelled to abstain from conjugal intercourse, and who live continently. In the daytime these patients were free from their trouble; it appeared only at night. Soon, or some hours after going to sleep, a violent, painful, enduring erection of the penis (priapism) set in, which disturbed their sleep, and left them in the morning with a feeling of enervation. In such a case obviously there is a hyperexcitability of the genital erection centre. The erection results as a reflex effect of stimuli proceeding from the genital organs, but manifests itself only when, during sleep, the inhibitions proceeding from the brain are in abeyance. This nocturnal priapism may, according to Löwenfeld’s observations, last for years.[430]
Sexual hyperæsthesia in women, or “nymphomania,” is, in its slighter forms, also in most cases a consequence of excessive masturbation. Such women do not so much exhibit a more powerful inclination towards sexual intercourse, which, on the contrary, is incompetent to satisfy their abnormal and perverse sexual excitability. We rather see in them an impulsion to obtain new sensations in their sexual organs in any possible way. These are the women who, for example, consult the gynæcologist as often as possible, because examination with the speculum or other manipulations induce in them sexual excitement. During the climacteric—the time when menstruation ceases—such states are also met with. Nymphomania proper always develops upon the foundation of severe neurasthenia and hysteria, or of direct brain and mental disorder. Then is produced the type of the “man-mad” woman, as described by Juvenal in the person of the Empress Messalina, who in the brothel gave herself to all comers, without obtaining complete satisfaction of her sexual desire. Such types exist also at the present day. Thus, the brothers de Goncourt in their Diary reported the case of an old housekeeper who for several decades indulged in the most lascivious love orgies, had innumerable lovers, and a “secret life full of nocturnal orgies in strange beds, full of nymphomaniac lusts.”[431] There recently lived in Charlottenburg the wife of a workman, well known on account of her incredible sexual ardour and man-mania. Her husband, a professional stabber, was imprisoned for life. His wife often gave herself in a single day to four or five different men; every male creature that approached her she asked to perform the sexual act with her.—The following almost incredible case of this nature is reported by Trélat:
Madame V., of a strong constitution, agreeable exterior, good-natured manner, but very reserved, came under the care of Trélat on January 1, 1854. Notwithstanding the fact that she was sixty years of age, she still worked very diligently, and hardly spared herself time for meals. Nothing in her outward appearance or in her actions indicated during her stay in the asylum that she was in any way affected with mental disorder. During the four years not a single obscene word, not a gesture, not the slightest passionate movement, indicated anger or impatience.
Since her earliest years she has pursued handsome men and given herself to them. When a young girl, by this degrading conduct she reduced her parents to despair. Of an amiable character, she blushed when anyone spoke a word to her. She cast her eyes down when in the presence of several persons; but as soon as she was alone with a young or old man, or even with a child, she was immediately transformed; she lifted her petticoats, and attacked with a raging energy him who was the object of her insane love. In such moments she was a Messalina, whereas a few instants before one would have regarded her as a virgin. A few times she met with resistance, and received severe moral lectures, but far more often there was no obstacle to her desires. Although various distressing adventures occurred, her parents arranged for her marriage, in the hope thereby to put an end to the moral disturbance. But her marriage was only a new scandal. She loved her husband passionately; and she loved with the like passion every man with whom she happened to be alone; and she exhibited so much cunning and cleverness that she made a mock of any attempts at watching her, and often attained her end. Now it was a manual worker busy at his trade, now some one walking past her in the street, to whom she spoke, and whom she brought home with her on any possible excuse—a young man, a servant, a child returning from school! In her exterior she appeared so blameless, and she spoke so gently, that every one followed her without mistrust. More than once she was beaten or robbed; but this did not prevent her continuing the same way of life. Even when she had become a grandmother there was no change.
One day she enticed a boy, twelve years of age, into her house, having told him that his mother was coming to see her. She gave him sweets, embraced and kissed him, and as she then began to take off his clothes and approached him with obscene gestures, the boy strove to resist her. He struck her, and he related everything to his brother, twenty-four years of age. The brother entered the house pointed out by the boy, and abused the corrupt woman to the uttermost, saying: “In such circumstances one helps oneself, without having recourse to law, in order not to bring one’s name into disrepute by public proceedings. I hope this disturbance will teach you not to behave in this way again.” While this scene was going on, the woman’s son-in-law chanced to come in, realized the situation before there was time to tell him anything, and at once took sides with the incensed young man.
She was shut up in a convent, where she behaved in so good, sweet, amiable, and modest a manner, that no one would have believed that she had ever committed the slightest fault, and representations were made to the effect that she ought to be allowed to return to her home. All the inmates of the convent had been charmed by the zeal with which she took part in the religious exercises. When she was free again, the scandalous doings were immediately resumed, and so it went on all through her life.
After she had reduced her husband and children to despair, they finally hoped that age would extinguish the fire with which she was consumed. They were mistaken. The more excesses she committed, the more she wanted to commit, the more vigorous she appeared. It is hardly credible that such debased ideas and habits should leave intact such a sweet expression of countenance, a voice so youthful, a behaviour so full of calm repose, and a glance of such clear assurance. She became a widow. Her children, on account of her horrible mode of life, could not any longer keep her at home, and they sent her to a distant place, where they provided her with an allowance. Since she was now old, she was at length compelled to offer payment for the shameful services which she demanded; and as the small allowance she received did not suffice for this purpose, she worked with untiring zeal in order to be able to pay the great number of her lovers.
To see the old, alert woman sitting at her work, as I myself saw her, when aged seventy or upwards, without spectacles, always cleanly and carefully, but not strikingly, dressed, with a simple and honourable appearance, and an open countenance—to suspect her shameful mode of life would never occur to anyone. Several of the wretched men who were paid by her related how diligent she was. She assured Trélat of her morality, in the hope that he would discharge her, and so enable her to resume her mode of life. Trélat could not agree to this, and he succeeded in obtaining from one of these men an accurate account of her shameless loves.