self-feeling of maturity, of being especially favored, attractive, or perhaps irresistible, while abnormal acts impair self-respect and tend to a sense of shame and of being an outcast to the better self as well as to society. This, which I nowhere find mentioned in the medical writers, I deem central. Generally, i either the form, presence, or more often some particular ob- ject connected with the other sex is imagined with the utmost intensity. What sight, hearing, touch, and other senses per- form is now the result of the imagination, which is fevered and in the act made morbidly intense and acute, so that here 1 believe we have a glimpse of the cause, not only of the marvelous intensity of the lascivious fancy, but of certain of the morbid perversions which have never yet been explained. The imagination is subjected to a most excessive strain in order to produce the desired climax, and sometimes a ritual of forms becomes established and closely associated with the voluptuous sensations. This may be in the formi of definite and specific pictures, so that some of the forms of erotic fetishism are begun, or it may take the form of almost ritual- ized acts, or again erotic zones may be developed. The psy- chic methods of arousing adequate stimuli always involve a realism of fancy of which youth is especially capable and prone at this age, and for this time and purpose place the imagination not only on the level of reality in vividness, but above it. This is especially seen in the sad and well-known cases of mental masturbation which are not infrequent. The reciprocal relations between this vice and certain of the per- versions of the power of imagery in youth, showing how easily illusions and hallucinations may arise in this soil, where love and fancy normally celebrate their glorious nuptials, is one of the most inviting chapters I know in the whole range of the new psychology. Not only the relations of the mind and the body in general, but the connection of art and Eros, can here be approached with a rich casuistic, if largely mor- bid, material.
We know that, despite the enormous number of sperma- tozoa in the average individual, the loss of concentration of albumin, lecithin, peptones, etc., can be a great drain upon the system. Moreover, spermin is now thought to play a very important role in removing products of decomposition.
442 THE PSYCHOLOGY OF ADOLESCENCE Spermin/ C5H14N2, is found normally in considerable* quan- tities in the testes, prostate, thymus, milt, ovaries, and the blood, and is thought to play an important role in the respira- tion of tissues. When dissolved, it advances interorganic oxidation, and is a ferment which helps to remove the prod- ucts of the regressive metamorphoses of albuminous sub- stances or leucomains (as, since Gautier, all nitrogenous in- termediate products of such change are called which are not oxidized as far as urea). These are formed constantly in both normal and morbid states, and at least many of these are toxic, like ptomaines. The accumulation of these pre- disposes the system to infection and causes other diseases. Spermin, according to this view, removes these products by further oxidation, thus preventing disease. Its activity diminishes with the alkalescence of the blood. The adminis- tration of testicular and other extracts of spermin, orally or subcutaneously, has thus beneficent therapeutic effects, and the reduction of it by masturbation, excessive venery, or dis- ease favors all the disorders due to the accumulation of the above products of decomposition. Nerve tissue is freshened and self-feeling increased, and, as the upholders of the spermin-therapeutics hold, without any aid from suggestion.
No doubt individual differences in this, as in all other re- spects, are great, and there is every indication that every organ suffers from the excessive loss of this substance, which is perhaps the highest and most complex of all things in the physical world.
The old phrase, post coitus triste, is illustrated in excess of all forms, and especially in self-abuse. Weakness always brings more or less depression, and in some cases the physical ex- haustion of muscles and nerves, if intensified by excess, brings pain and traces of convulsion, epilepsy, palpitation, and pho- tophobia, differing according to individual predispositions and powers of resistance. Neurasthenia, cerebrasthenia, spinal neurasthenia, and psychic impotence generally result not more in the loss of fluid than from expenditure of physical force and often by tissues connected with the sympathetic ^ A. Poehl: Einwirkung des Spermins auf den Staffumsatz. Zeits. f. klin.
SEXUAL DEVELOPMENT 443 system. Subjective light sensations, optical cramps, perhaps Basedow's disease, intensification of the patellar reflex, weak sluggishness of heart action and circulation seen in cold extremities, purple and dry skin, lassitude and flaccidity, clammy hands, anemic complexion, dry cough, and many digestive perversions can be often directly traced to this scourge of the human race. The onanistic psychosis seems especially to predispose to convulsive disorders like epilepsy, to which it is so akin, but weakness of memory and attention, paranoia, agitation, cachexia, various neuroses of the stom- ach which Preyer and Fournier have studied, dwarfing or hypertrophy of the organs themselves, and many of the lighter and transitory forms of psychic alienations, are pro- duced.
One of the most direct moral effects is lying, secretive- ness, and hypocrisy which conceals or denies a whole area of interests very real to the subject, and this is closely connected with cowardice, timidity, egoism, and frivolity. The power of pity and sympathy is often almost extinguished. Self- control and will-power, purposive self-direction, resolute abil- ity to grapple with difficulties mental or physical, to carry work that is begun through to its completion, are certain to decline.
Sometimes from excessive prudery the opposite state of loss of modesty may follow excessive venery. The masturba- tor's heart, so often discussed, is weak like his voice. Dr. Seerley diagnoses a murmur which he thinks an almost infal- lible sign. Dr. G. Bachin describes the " masturbator's heart," based on six interesting cases.^ The very rise of tem- perature during the act lapses to listlessness and frigidity, and clamminess afterward. Too great tension, which may pre- dispose to convulsions and reach an almost epileptic degree, is followed by an exhaustion which makes all lesser excita- tions seem pale and uninteresting. One who has tasted these forbidden joys of youth has a languid appetite for the larger, if less fevered, pleasure of the intellect, of friendship, of high enthusiasms, and lapses to a nil admirari indifference which is one of the worst signs in youth.
* Deutsche Arch. f. klin. Med., 1895, p. 201 et seq.
444 THE PSYCHOLOGY OF ADOLESCENCE These effects might perhaps be summed up as phenomena of arrest. Growth, especially in the moral and intellectual regions, is dwarfed and stunted. There are early physical signs of decrepitude and senescence. Gray hairs, and espe- cially baldness, a stooping and enfeebled gait, the impulsive and narrow egoism which always goes with overindulgence, marks of early caducity which may crop out in retina, in cochlea, in the muscular or nervous system, in the stomach — all the troubles ascribed to this cause are distinctly senescent in their nature. Life has been lived out with abandon; its energies have been overdrawn, and its wheels have run down like the mainspring of a clock the regulator of which has been lost, so that the term " fast " has a profound biological significance.
While it can not, of course, be mathematically demon- strated, it is nevertheless probable that worse and earlier than any of these psychic effects are those that appear in the offspring. Beginning with the gradual descendance rather than ascendance of the long line of posterity in proportion as the evil has become more intense, its effects are manifest, nearer, perhaps, in the incomplete maturity of mind and body in the next generation; in persistent infantilism or overripe- ness of children. If more intense, it affects the number of posterity, the power to nurse offspring by the female, and finally ends in complete sterility, always the penalty of the excessive selfishness, the greatest and most unpardonable of all sins, where the individual uses up in his own life all the energy of which he is merely the pilot and guardian and which is meant to transmit life to countless generations. This enfeeblement, brain instability, and all the deciduous phenomena connected with this vice; the loss of higher inter- ests; the easy fatigue; inertness of affection, make the marital and paternal office at best inadequate and all high enthusi- asms impossible, even though it were, as Schopenhauer said, something which might be permissible in those too old to become parents. The whole problem is so difficult and at the same time so vital that we are all liable to the fallacy of the feeble mind which grasps a problem too large for it, viz., to have recourse to extreme superficial views and to lay undue emphasis upon special and partial causes, cures, SEXUAL DEVELOPMENT 445 or aspects of it. But although the best may be mistaken, let us not yield to the temptation of cowardice or psychic dis- honesty, and ignore or deny its magnitude or importance. That here an immense problem looms up for all who study any department of the great science of man, whether his body or his mind, will now be generally recognized.
Another question much debated and of interest here is whether self-abuse itself can be the cause of a distinct type of insanity. The opinions of experts here have differed widely!^feome believe its effects are seen only in forms of general deterioration and arrested development; others con- nect it in a more or less causal way with one or more of the morbid forms of sex perversion, or hold that it makes a psycho-physical soil which readily bears their dread fruit. Dr. Clark,^ whose interesting demonstration that the act of self-abuse was attended by a rise of temperature of one or two degrees during the first half-hour, falling slowly later, and who thinks it rarely self-learned, doubts the existence of a true masturbatic insanity, although in those already insane some form of violence, bhnd fury, heightened automatisms, excited movements or efforts to escape often follow the act. Restlessness and constant mobility he holds to be in part a predisposition and sometimes an effect. Gowers thinks mas- turbation can properly be called a cause of epilepsy only if the arrest of the habit arrests the disease, but that the contin- uance of the disease after the arrest of the practise does not disprove causality, for, once established, the " conclusive habit" tends to continue. He inclines to think it more fre- quently causes untypical attacks than true epilepsy, and that self-abuse is a cause he does not doubt.
Spitzka ^ believes in masturbatic insanity, the onset of which he thinks marked by great variations of symptoms from day to day and week to week, now by destructiveness, now by lethargy, etc. At first the patient is listless in the morning and recuperates during the day; but in the late and hopeless stages the patient is best in the morning and grows silly, irritable, and lapses into progressive stupor toward night.
» Journal of Mental Science, 1888, p. 388.
* Journal of Mental Science, 1888, pp. 52 and 216.
446 THE PSYCHOLOGY OF ADOLESCENCE Insanity due to masturbation he thinks five times as common among males as females, because for the latter Nature sets no limits. In persons of sound constitutions and heredity, it must be begun early and carried far to produce actual vesania, and he agrees with Clouston that quack advertisements pro- duce nearly as much insanity by their appeals to fear and remorse as self-abuse itself. The symptoms are cerebral anemia, atonic muscles and expression, clammy hands, alter- nating spells of gluttony and anorexia, cowardice, suspecting the purity of all others, avoidance of rough, mai^^sports, neglect of toilet and dress, spells of sulks, pets and peevish- ness, tcedium vitcB, outrageous selfishness, cunning self-accu- sation, cruelty, maliciousness, imperative ideas, morbid fear, strange somatic sensations, etc. Katatonia and cataleptic stupor may be episodes in insanity of this type. It differs from hebephrenia as original paranoia does from progressive dementia. The former is the ruin of an incomplete mental edifice, the latter is an edifice improperly founded and unsym- metrically completed. Spitzka considers sexual excess less dangerous, because self-abuse is begun earlier, can be carried to greater lengths, and is not limited, like the former, by the erector mechanism. The latter is usually attended by more or less of the noble emotion of love, masculine supremacy is as- serted, and it is often felt to be an object of manly ambition while secret vice is only shameful, so that the moral effects of the two are almost antithetical.
Maudsley ^ thinks masturbatic can not always be distin- guished from pubescent insanity, and that active alienation rarely results from self-abuse if the heredity is good. The vice he thinks most common and most severe in weak boys who have been most carefully protected, and been least among vigorous boys who have an abundance of other indulgences. The best help lies not in moral and religious appeals, but in stigmatizing it as dirty, sure to show in the face, etc., because vanity and a manly tone are often stronger than conscience. He regards the morbid mental symptoms from this cause as less serious if the habit breaks out early in pubescence before the sexual func- tion has transformed the modes of thought and feeling, than if SEXUAL DEVELOPMENT 447 it occurs later when sex has advanced further in its trans- formation of character. In a boy of seventeen or eighteen work is neglected, done in a slouchy and fitful way; he is moody, lazy, devoid of interest even in amusements, sullen, morose, self-sufficient, solitary, slovenly, or fastidious and ex- acting, hypochondriacal, and disposed to treat his imaginary ailments with special forms of exercise and diet. If it comes on later, society and especially ladies are shunned; there are fancied love sentiments and dramas with those very slightly known; physicians are consulted about imaginary symptoms or some sex problem. If the victim becomes engaged, he is even fuller of scruples about his fitness to marry, fears incompati- bility or infidelity, like the heroes of Ibsen's Love's Comedy, that marriage degrades love, and so passes to new engagements. Sometimes his morality is superfine and scornful of the base ways of the world, while he is in thought and fact nasty and sensual. As a husband such an one is apt to be irascible, tyran- nous, exacting, suspicious, and sometimes assaults and even murders result. As he does not really respect himself, he thinks he has lost the respect of others. The habit of self-abuse is less frequent and less hurtful in women.
Sturgis ^ believes that masturbation in some cases is the direct product of an hereditary tendency toward nervous and mental disorders, and that such a neurotic condition not only predisposes to this habit, but renders such subjects particularly prone to the evil effects which result from it. These, for the ordinary healthy young adult, he believes, as a rule, are very slight, although he estimates the percentage to be not less than eighty. Thus a great deal of the evil ascribed to this habit he holds exaggerated and overdrawn. The fright caused by be- lief in a derangement in this part of his nature is so common and great that he declares " that a large proportion of patients who consult the surgeon for treatment are really more hypo- chondriacs than sexual cripples; they dwell constantly upon the condition of these organs." Very little imagined change or peculiarity '* produces a condition of nervous irritation which prevents them from thinking of anything else, and precludes them from pursuing their daily occupations with the ordinary * Sexual Debility in Man, New York, 1900, p. 98 et seq.
44^ THE PSYCHOLOGY OF ADOLESCENCE zest and vigor with which they have been accustomed to per- form their duties." Even where there is a sHght real cause it would often play but a small role but for the mental disturbance thus produced.
Aristotle held that the testes maintained a tension of nerves and veins as a weaver's weight keeps his warp tight. Marro quotes a case of psychic impotence and melancholy due to lack of development of one testicle that was completely cured by an operation which inserted a silver one which the patient sup- posed normal. Two views are now prevalent to explain the close relation between these organs and the general vigor of the nervous system. One is that it is biologico-chemical and medi- ated by glandular secretions. This was held by Brown-Sequard and led to his spermal injections, and is strongly advocated by Poehl. Many men, especially in various stages of senescence, have reported great benefits from this treatment in increased energy for mental and physical work and in general buoyancy of spirits, but the opinion is now gaining ground that this is psychic and to a great extent due to suggestions. The other view is that it is dynamic and mediated by means of the nervous system and to some extent by consciousness. In the present state of our knowledge it is impossible to decide between these views; there may be truth in both. Certain it is, however, that the spermatozoa are very different from other testicular secretions, and that the two are, to quite an extent, independent vari- ables. In his History of Medicine, Sprengel describes periods when the view, still met with among the ignorant, was felt in medical theory and practise that this fluid, like phlegm, might be noxious if allowed to accumulate. I have seen letters to quacks in which it was regarded as an excretion, and, like those of the bladder and intestines, something to be got rid of. I have conversed with at least four college students and gradu- ates who held this view in both theory and practise and de- fended it. It hardly need be said that everything relevant that we know in biology and physiology indicates that nothing could be more false and pernicious.
While nothing is known of any special nerves mediating afferent sexual impressions, the reflex theory has long assumed special centers for sex activities. Gall thought the cerebellum the chief central organ of this function. Budge thought it in SEXUAL DEVELOPMENT 449 the lumbar cord, which was assumed to mediate erection and ejaculation. Luys urged the claim of the pons; Tarchanoff of the corpora quadrigemina, basing his conclusions upon experi- ments on the frog; Albertoni of the thalami from studies of the turtle, which did suggest their importance for the act of em- bracing. Magnan assumed a hierarchy of four centers, viz., the spinal, niediating immediate reflexes, as in the onanism of complete idiocy and perhaps identical with the centers of Budge; the posterior spinal cerebral, limited by the medulla and mediating visual images and instinctive and brutal orgasms evoked by sight; third, the anterior cerebro-spinal, mediating psychic influences, and finally the anterior part of the cerebral centers representing the state of ecstatics and entomaniacs. Loss of balance and harmony between these four accounts for all alterations and perversions. The center has also been placed in the olfactory region, and Roux thinks it is the Ro- landic near the ending of the nerves of general sensibility.
Rowe ^ holds that the primum movens of sexual phenomena is not central but peripheral. He agrees with K. Ebing, Beaunis, Tarchanoff, and Delbeuf, that the genesic glands, and more specifically the seminal elements themselves, are the points of departure for sensations absolutely new at puberty which profoundly modify intelligence, habit, and character. The heart, lungs, legs, and even the fore brain and testicles of frogs can be removed without arresting copulation when it has been be- gun, while section of the seminal vesicles stops it at once. Dilating them with a neutral fluid starts up afferent nervous processes which create artificial desire. This latter thus rests on the impulse of organs to function. The well-established cases of precocious maternity before menstruation, and the frequency of sexual precocity in idiots, which Sollier has noted, show that the desire may, in exceptional cases, antedate the complete development of the organs, and is not therefore en- tirely dependent upon them.
Wherever the higher center is, it is the seat of the purely affective state which precedes any intellectual representation, which makes the profound metamorphoses of puberty, that may cause an indefinable malaise, to sometimes reach the in- 450 THE PSYCHOLOGY OF ADOLESCENCE tensity of an obsession. With enamored adults there is often, besides the desire of pleasure, the very different desire to find quietude and surcease of excitation. Representative sex life is a complex of many kinds of sensations and images differing vastly according to habit and association. Sexual need is most closely associated with sensation of the organs. In the sexual psychopathy, which is due to precocious need before organs are developed, this association is not effected. Later and with experience the need awakens the images, and following Roux's terminology, there is a sexual hunger, or conversely the images awaken the need and there is sexual appetite, and the primacy is now of one and now of the other. In the next stage the opposite sex is closely felt, but without personal preference, representing perhaps Magnan's spinal and posterior cerebral stage. Every comely girl and every boy are attractive to each other, but there should be no falling in love. Coquetting on one side and showing off on the other impel each sex to a higher ideal and make each a stimulus to the other. Next in the spinal and anterior cerebral stage sexual selection occurs, and here the imagination transcends and perhaps transforms reality; and finally in the anterior cerebral stage the ideal and the real meet in the realization of the needs of marriage and companionship. Moll ^ assumes as the basis of sexual life two instincts, one which he calls contrectation or the tendency to touch, and the other the instinct of detumescence, or that to change — espe- cially to discharge — the sexual organs, and from this he de- velops a theory which has much explanatory power for many abnormal phenomena. He agrees with Carus, and cites the philological indications gathered by Kleinpaul ^ to the same effect, that sexual life begins on a somatic basis with these two instincts, that there is a stage of relative undifferentiation in early puberty, and that it is at this point that heterosexuality makes itself manifest. At this time love, in the higher romantic and idealizing sense of the word, can also develop. With men this instinct, for physical reasons, is more in the foreground of consciousness, while women often give themselves to those