23. [Lack of development of the breasts] in females, after puberty, is a common result of self-pollution. Still it would be entirely unsafe to say that every female with small mammary glands had been addicted to this vice, especially at the present time when a fair natural development is often destroyed by the constant pressure and heat of "pads." But this sign may well be given a due bearing.
24. [Capricious appetite] particularly characterizes children addicted to secret vice. At the commencement of the practice, they almost invariably manifest great voracity for food, gorging themselves in the most gluttonous manner. As the habit becomes fixed, digestion becomes impaired, and the appetite is sometimes almost wanting, and at other times almost unappeasable.
25. One very constant peculiarity of such children is their extreme fondness for unnatural, hurtful, and irritating articles. Nearly all are greatly attached to salt, pepper, spices, cinnamon, cloves, vinegar, mustard, horse-radish, and similar articles, and use them in most inordinate quantities. A boy or girl who is constantly eating cloves or cinnamon, or who will eat salt in quantities without other food, gives good occasion for suspicion.
26. [Eating clay, slate-pencils, plaster, chalk,] and other indigestible articles is a practice to which girls who abuse themselves are especially addicted. The habit sometimes becomes developed to such a wonderful extent that the victims almost rival the clay-eaters of the Amazon in gratifying their propensity.
27. Disgust for simple food is one of the traits which a victim of this vice is sure to possess. He seems to loathe any food which is not rendered hot and stimulating with spices and other condiments, and cannot be induced to eat it.
28. [The use of tobacco] is good presumptive evidence that a boy is also addicted to a practice still more filthy. Exceptions to this rule are very rare indeed, if they exist, which we somewhat doubt. The same influences which would lead a boy to the use of tobacco would also lead him to solitary vice, and each sin would serve to exaggerate the other.
29. [Unnatural paleness] and colorless lips, unless they can be otherwise accounted for, may be attributed to secret sin. The face is a great tell-tale against this class of sinners. Justice demands, however, that an individual should be given the benefit of a doubt so long as there is a chance for the production of these symptoms by any other known cause, as overwork, mental anxiety, or dyspepsia.
30. [Acne], or pimples, on the face are also among the suspicious signs, especially when they appear upon the forehead as well as upon other portions of the face. Occasional pimples upon the chin are very common in both sexes at puberty and for a few years afterward, but are without significance, except that the blood may be somewhat gross from unwholesome diet or lack of exercise.
31. [Biting the finger nails] is a practice very common in girls addicted to this vice. In such persons there will also be found, not infrequently, slight soreness or ulceration at the roots of the nails, and warts, one or more, upon one or both the first two fingers of the hand—usually the right.
32. The eyes often betray much. If, in addition to want of luster and natural brilliancy, they are sunken, present red edges, are somewhat sore, perhaps, and are surrounded by a dark ring, the patient, especially if a child, should be suspected and carefully watched. It should be observed, however, that dyspepsia, debility from any cause, and especially loss of sleep, will produce some or all of these signs, and no one should be accused of the vice upon the evidence of these indications alone, neither could he be justly suspected so long as his symptoms could be accounted for by legitimate causes.