[253] The hysterical phenomenon of _globus hystericus_ was long afterward attributed to obstruction of respiration by the womb. The interesting case has been recorded by E. Bloch (_Wiener Klinische Wochenschrift_, 1907, p. 1649) of a lady who had the feeling of a ball rising from her stomach to her throat, and then sinking. This feeling was associated with thoughts of her husband's rising and falling penis, and was always most liable to occur when she wished for coitus.
[254] As Gilles de la Tourette points out, it is not difficult to show that epilepsy, the _morbus sacer_ of the ancients, owed much of its sacred character to this confusion with hysteria. Those priestesses who, struck by the _morbus sacer_, gave forth their oracles amid convulsions, were certainly not the victims of epilepsy, but of hysteria (_Traité de l'Hystérie_, vol. i, p. 3).
[255] Aretæus, _On the Causes and Symptoms of Acute Diseases_, Book ii, Chapter II.
[256] It may be noted that this treatment furnishes another instance of the continuity of therapeutic methods, through all changes of theory, from the earliest to the latest times. Drugs of unpleasant odor, like asafoetida, have always been used in hysteria, and scientific medicine to-day still finds that asafoetida is a powerful sedative to the uterus, controlling nervous conditions during pregnancy and arresting uterine irritation when abortion is threatened (see, e.g., Warman, _Der Frauenarzt_, August, 1895). Again, the rubbing of fragrant ointments into the sexual regions is but a form of that massage which is one of the modern methods of treating the sexual disorders of women.
[257] _Les Démoniaques dans l'Art_, 1887; _Les Malades et les Difformes dans l'Art_, 1889.
[258] Glafira Abricosoff, of Moscow, in her Paris thesis, _L'Hystérie aux xvii et xviii siécles_, 1897, presents a summary of the various views held at this time; as also Gilles de la Tourette, _Traité de l'Hystérie_, vol. i, Chapter I.
[260] Hegar, _Zusammenhang der Geschlechtskrankheiten mit nervösen Leiden_, Stuttgart, 1885. (Hegar, however, went much further than this, and was largely responsible for the surgical treatment of hysteria now generally recognized as worse than futile.) Balls-Headley, "Etiology of Nervous Diseases of the Female Genital Organs," Allbutt and Playfair, _System of Gynecology_, 1896, p. 141.
[261] Lombroso and Ferrero, _La Donna Delinquente_, 1893, pp. 613-14.
[262] Charcot and Marie, article on "Hysteria," Tuke's _Dictionary of Psychological Medicine_.
[263] Axenfeld and Huchard, _Traité des Névroses_, 1883, pp. 1092-94. Icard (_La Femme pendant la Période Menstruelle_, pp. 120-21) has also referred to recorded cases of hysteria in animals (Coste's and Peter's cases), as has Gilles de la Tourette (op. cit., vol. i, p. 123). See also, for references, Féré, _L'Instinct Sexuel_, p. 59.
[264] _Man and Woman_, 4th ed., p. 326. A distinguished gynæcologist, Matthews Duncan, had remarked some years earlier (_Lancet_, May 18, 1889) that hysteria, though not a womb disease, "especially attaches itself to the generative system, because the genital system, more than any other, exerts emotional power over the individual, power also in morals, power in social questions."
[265] Gilles de la Tourette, _Archives de Tocologie et de Gynécologie_, June, 1895.
[267] From the earliest times it was held that menstruation favors hysteria; more recently, Landouzy recorded a number of observations showing that hysterical attacks coincide with perfectly healthy menstruation; while Ball has maintained that it is only during menstruation that hysteria appears in its true color. See the opinions collected by Icard, _La Femme pendant la Période Menstruelle_, pp. 75-81.
[268] Krafft-Ebing, "Ueber Neurosen und Psychosen durch Sexuelle Abstinenz," _Jahrbücher für Psychiatrie_, vol. iii, 1888. It must, however, be added that the relief of hysteria by sexual satisfaction is not rare, and that Rosenthal finds that the convulsions are thus diminished. (_Allgemeine Wiener Medizinal-Zeitung_, Nos. 46 and 47, 1887.) So they are also, in simple and uncomplicated cases, according to Mongeri, by pregnancy.
[269] "All doctors who have patients in convents," remarks Marro (_La Pubertà_, p. 338), "know how hysteria dominates among them;" he adds that his own experience confirms that of Raciborski, who found that nuns devoted to the contemplative life are more liable to hysteria than those who are occupied in teaching or in nursing. It must be added, however, that there is not unanimity as to the prevalence of hysteria in convents. Brachet was of the same opinion as Briquet, and so considered it rare. Imbert-Goubeyre, also (_La Stigmatisation_, p. 436) states that during more than forty years of medical life, though he has been connected with a number of religious communities, he has not found in them a single hysterical subject, the reason being, he remarks, that the unbalanced and extravagant are refused admission to the cloister.
[271] It may not be unnecessary to point out that here and throughout, in speaking of the psychic mechanism of hysteria, I do not admit that any process can be _purely_ psychic. As Féré puts it in an admirable study of hysteria (_Twentieth Century Practice of Medicine_, 1897, vol. x, p. 556): "In the genesis of hysterical troubles everything takes place as if the psychical and the somatic phenomena were two aspects of the same biological fact."
[272] Pierre Janet, _L'Automatisme Psychologique_, 1889; _L'Etat mental des Hystériques_, 1894; _Névroses et Idées fixes_, 1898; Breuer und Freud, _Studien über Hysterie_, Vienna, 1895; the best introduction to Freud's work is, however, to be found in the two series of his _Sammlung Kleiner Schriften zur Neurosenlehre_, published in a collected form in 1906 and 1909. It may be added that a useful selection of Freud's papers has lately (1909) been published in English.
[273] We might, perhaps, even say that in hysteria the so-called higher centres have an abnormally strong inhibitory influence over the lower centres. Gioffredi (_Gazzetta degli Ospedali_, October 1, 1895) has shown that some hysterical symptoms, such as mutism, can be cured by etherization, thus loosening the control of the higher centres.
[274] Charcot's school could not fail to recognize the erotic tone which often dominates hysterical hallucinations. Gilles de la Tourette seeks to minimize it by the remark that "it is more mental than real." He means to say that it is more psychic than physical, but he implies that the physical element in sex is alone "real," a strange assumption in any case, as well as destructive of Gilles de la Tourette's own fundamental assertion that hysteria is a real disease and yet purely psychic.
[280] Ib. p. 146.
[281] _Sammlung_, first series, p. 229. Freud has developed his conception of sexual constitution in _Drei Abhandlungen zur Sexualtheorie_, 1905.
[282] As Moll remarks, Freud's conceptions are still somewhat subjective, and in need of objective demonstration; but whatever may be thought of their theories, he adds, there can be no doubt that Breuer and Freud have done a great service by calling attention to the important action of the sexual life on the nervous system.
[283] Gertrude Stein, "Cultivated Motor Automatism," _Psychological Review_, May, 1898.
[284] Charcot's most faithful followers refuse to recognize a "hysteric temperament," and are quite right, if such a conception is used to destroy the conception of hysteria as a definite disease. We cannot, however, fail to recognize a diathesis which, while still apparently healthy, is predisposed to hysteria. So distinguished a disciple of Charcot as Janet thoroughly recognizes this, and argues (_L'Etat mental_, etc., p. 298) that "we may find in the habits, the passions, the psychic automatism of the normal man, the germ of all hysterical phenomena." Féré held a somewhat similar view.
[286] M. Rosenthal, _Diseases of the Nervous System_, vol. ii, p. 44. Féré notes similar cases (_Twentieth Century Practice of Medicine_, vol. x, p. 551). Long previously, Gall had recorded the case of a young widow of ardent temperament who had convulsive attacks, apparently of hysterical nature, which always terminated in sexual orgasm (_Fonctions du Cerveau_, 1825, vol. iii, p. 245).
[287] There seems to be a greater necessity for such explosive manifestations in women than in men, whatever the reason may be. I have brought together some of the evidence pointing in this direction in _Man and Woman_, 4th ed., revised and enlarged, Chapters xii and xiii.
[288] There is no doubt an element of real truth in this ancient belief, though it mainly holds good of minor cases of hysteria. Many excellent authorities accept it. "Hysteria is certainly common in the single," Herman remarks (_Diseases of Women_, 1898, p. 33), "and is generally cured by a happy marriage." Löwenfeld (_Sexualleben und Nervenleiden_, p. 153) says that "it cannot be denied that marriage produces a beneficial change in the general condition of many hysterical patients," though, he adds, it will not remove the hysterical temperament. The advantage of marriage for the hysterical is not necessarily due, solely or at all, to the exercise of sexual functions. This is pointed out by Mongeri, who observes (_Allgemeine Zeitschrift für Psychiatrie_, 1901, Heft 5, p. 917): "I have known and treated several hysterical girls who are now married, and do not show the least neuropathic indications. Some of these no longer have any wish for sexual gratification, and even fulfil their marital duties unwillingly, though loving their husbands and living with them in an extremely happy way. In my opinion, marriage is a sovereign remedy for neuropathic women, who need to find a support in another personality, able to share with them the battle of life."
III.
III.
The Prevalence of Masturbation--Its Occurrence in Infancy and Childhood--Is it More Frequent in Males or Females?--After Adolescence Apparently more Frequent in Women--Reasons for the Sexual Distribution of Masturbation--The Alleged Evils of Masturbation--Historical Sketch of the Views Held on This Point--The Symptoms and Results of Masturbation--Its Alleged Influence in Causing Eye Disorders--Its Relation to Insanity and Nervous Disorders--The Evil Effects of Masturbation Usually Occur on the Basis of a Congenitally Morbid Nervous System--Neurasthenia Probably the Commonest Accompaniment of Excessive Masturbation--Precocious Masturbation Tends to Produce Aversion to Coitus--Psychic Results of Habitual Masturbation--Masturbation in Men of Genius--Masturbation as a Nervous Sedative--Typical Cases--The Greek Attitude toward Masturbation--Attitude of the Catholic Theologians--The Mohammedan Attitude--The Modern Scientific Attitude--In What Sense is Masturbation Normal?--The Immense Part in Life Played by Transmuted Auto-erotic Phenomena.
The foregoing sketch will serve to show how vast is the field of life--of normal and not merely abnormal life--more or less infused by auto-erotic phenomena. If, however, we proceed to investigate precisely the exact extent, degree, and significance of such phenomena, we are met by many difficulties. We find, indeed, that no attempts have been made to study auto-erotic phenomena, except as regards the group--a somewhat artificial group, as I have already tried to show--collected under the term "masturbation" while even here such attempts have only been made among abnormal classes of people, or have been conducted in a manner scarcely likely to yield reliable results.[289] Still there is a certain significance in the more careful investigations which have been made to ascertain the precise frequency of masturbation.
Berger, an experienced specialist in nervous diseases, concluded, in his _Vorlesungen_, that 99 per cent. of young men and women masturbate occasionally, while the hundredth conceals the truth;[290] and Hermann Cohn appears to accept this statement as generally true in Germany. So high an estimate has, of course, been called in question, and, since it appears to rest on no basis of careful investigation, we need not seriously consider it. It is useless to argue on suppositions; we must cling to our definite evidence, even though it yields figures which are probably below the mark. Rohleder considers that during adolescence at least 95 per cent. of both sexes masturbate, but his figures are not founded on precise investigation.[291] Julian Marcuse, on the basis of his own statistics, concludes that 92 per cent. male individuals have to some extent masturbated in youth. Perhaps, also, weight attaches to the opinion of Dukes, physician to Rugby School, who states that from 90 to 95 per cent. of all boys at boarding school masturbate.[292] Seerley, of Springfield, Mass., found that of 125 academic students only 8 assured him they had never masturbated; while of 347, who answered his questions, 71 denied that they practiced masturbation, which seems to imply that 79 per cent. admitted that they practiced it.[293] Brockman, also in America, among 232 theological students, of the average age of 23½ years and coming from various parts of the United States, found that 132 spontaneously admitted that masturbation was their most serious temptation and all but one of these admitted that he yielded, 69 of them to a considerable extent. This is a proportion of at least 56 per cent., the real proportion being doubtless larger, since no question had been asked as to sexual offenses; 75 practiced masturbation after conversion, and 24 after they had decided to become ministers; only 66 mentioned sexual intercourse as their chief temptation; but altogether sexual temptations outnumbered all others together.[294] Moraglia, who made inquiry of 200 women of the lower class in Italy, found that 120 acknowledged either that they still masturbate or that they had done so during a long period.[295] Gualino found that 23 per cent. men of the professional classes in North Italy masturbate about puberty; no account was taken of those who began later. "Here in Switzerland," a correspondent writes, "I have had occasion to learn from adult men, whom I can trust, that they have reached the age of twenty-five, or over, without sexual congress. '_Wir haben nicht dieses Bedürfniss_,' is what they say. But I believe that, in the case of the Swiss mountaineers, moderate onanism is practiced, as a rule." In hot countries the same habits are found at a more precocious age. In Venezuela, for instance, among the Spanish creoles, Ernst found that in all classes boys and girls are infested with the vice of onanism. They learn it early, in the very beginning of life, from their wet-nurses, generally low Mulatto women, and many reasons help to foster the habit; the young men are often dissipated and the young women often remain single.[296] Niceforo, who shows a special knowledge of the working-girl class at Rome, states that in many milliners' and dressmakers' workrooms, where young girls are employed, it frequently happens that during the hottest hours of the day, between twelve and two, when the mistress or forewoman is asleep, all the girls without exception give themselves up to masturbation.[297] In France a country _curé_ assured Debreyne that among the little girls who come up for their first communion, 11 out of 12 were given to masturbation.[298] The medical officer of a Prussian reformatory told Rohleder that nearly all the inmates over the age of puberty masturbated. Stanley Hall knew a reform school in America where masturbation was practiced without exception, and he who could practice it oftenest was regarded with hero-worship.[299] Ferriani, who has made an elaborate study of youthful criminality in Italy, states that even if all boys and girls among the general population do not masturbate, it is certainly so among those who have a tendency to crime. Among 458 adult male criminals, Marro (as he states in his _Caratteri dei Delinquenti_) found that only 72 denied masturbation, while 386 had practiced it from an early age, 140 of them before the age of thirteen. Among 30 criminal women Moraglia found that 24 acknowledged the practice, at all events in early youth (8 of them before the age of 10, a precocity accompanied by average precocity in menstruation), while he suspected that most of the remainder were not unfamiliar with the practice. Among prostitutes of whatever class or position Moraglia found masturbation (though it must be pointed out that he does not appear to distinguish masturbation very clearly from homosexual practices) to be universal; in one group of 50 prostitutes everyone had practiced masturbation at some period; 28 began between the ages of 6 and 11; 19, between 12 and 14, the most usual period--a precocious one--of commencing puberty; the remaining 3 at 15 and 16; the average age of commencing masturbation, it may be added, was 11, while that of the first sexual intercourse was 15.[300] In a larger group of 180 prostitutes, belonging to Genoa, Turin, Venice, etc., and among 23 "elegant cocottes," of Italian and foreign origin, Moraglia obtained the same results; everyone admitted masturbation, and not less than 113 preferred masturbation, either solitary or mutual, to normal coitus. Among the insane, as among idiots, masturbation is somewhat more common among males, according to Blandford, in England, as also it is in Germany, according to Näcke,[301] while Venturi, in Italy, has found it more common among females.[302] There appears to be no limit to the age at which spontaneous masturbation may begin to appear. I have already referred to the practice of thigh-rubbing in infants under one year of age. J.P. West has reported in detail 3 cases of masturbation in very early childhood--2 in girls, 1 in a boy--in which the practice had been acquired spontaneously, and could only be traced to some source of irritation in pressure from clothing, etc.[303] Probably there is often in such cases some hereditary lack of nervous stability. Block has recorded the case of a girl--very bright for her age, though excessively shy and taciturn--who began masturbating spontaneously at the age of two; in this case the mother had masturbated all her life, even continuing the practice after marriage, and, though she succeeded in refraining during pregnancy, her thoughts still dwelt upon it, while the maternal grandmother had died in an asylum from "masturbatory insanity."
Freud considers that auto-erotic manifestations are common in infancy, and that the rhythmic function of any sensitive spot, primarily the lips, may easily pass into masturbation. He regards the infantile manifestations of which thumb-sucking is the most familiar example (Lüdeln or Lutschen in German) as auto-erotic, the germ arising in sucking the breasts since the lips are an erogenous zone which may easily be excited by the warm stream of milk. But this only occurs, he points out, in subjects in whom the sensitivity of the lip zone is heightened and especially in those who at a later age are liable to become hysterical.[304] Shuttleworth also points out that the mere fidgetiness of a neurotic infant, even when only a few months old, sometimes leads to the spontaneous and accidental discovery of pleasurable sexual sensations, which for a time appease the restlessness of nervous instability, though a vicious circle is thus established. He has found that, especially among quite young girls of neurotic heredity, self-induced excitement, often in the form of thigh-friction, is more common than is usually supposed.[305] Normally there appears to be a varying aptitude to experience the sexual organism, or any voluptuous sensations before puberty. I find, on eliciting the recollections of normal persons, that in some cases there have been voluptuous sensations from casual contact with the sexual organs at a very early age; in other cases there has been occasional slight excitement from early years; in yet other cases complete sexual anæsthesia until the age of puberty. That the latter condition is not due to mere absence of peripheral irritation is shown by a case I am acquainted with, in which a boy of 7, incited by a companion, innocently attempted, at intervals during several weeks, to produce erection by friction of the penis; no result of any kind followed, although erections occurred spontaneously at puberty, with normal sexual feelings.[306] I am indebted to a correspondent for the following notes:-- "From my observation during five years at a boarding-school, it _seems_ that eight out of ten boys were more or less addicted to the practice. But I would not state _positively_ that such was the proportion of masturbators among an average of thirty pupils, though the habit was very common. I know that in one bedroom, sleeping seven boys, the whole number masturbated frequently. The act was performed in bed, in the closets, and sometimes in the classrooms during lessons. Inquiry among my friends as to onanism in the boarding-schools to which they were sent, elicited somewhat contradictory answers concerning the frequency of the habit. Dr. ----, who went to a French school, told me that _all_ the older boys had younger accomplices in mutual masturbation. He also spoke with experience of the prevalence of the practice in a well-known public school in the west of England. B. said _all_ the boys at his school masturbated; G. stated that _most_ of his schoolmates were onanists; L. said 'more than half' was the proportion.
"At my school, manual masturbation was both solitary and mutual; and sometimes younger boys, who had not acquired the habit, were induced to manipulate bigger boys. One very precocious boy of fifteen always chose a companion of ten 'because his hand was like a woman's.' Sometimes boys entered their friend's bed for mutual excitement. In after-life they showed no signs of inversion. Another boy, aged about fourteen, who had been seduced by a servant-girl, embraced the bolster; the pleasurable sensations, according to his statement, were heightened by imagining that the bolster was a woman. He said that the enjoyment of the act was greatly increased during the holidays, when he was able to spread a pair of his sister's drawers upon the pillow, and so intensify the illusion.
"Before puberty the boys appeared to be more continent than afterward. A few of the older and more intelligent masturbators regulated the habit, as some married men regulate intercourse. The big boy referred to, who chose always the same manipulator, professed to indulge only once in twenty days, his reason being that more frequent repetition of the act would injure his health. About twice a week for boys who had reached puberty, and once a week for younger boys, was, I think, about the average indulgence. I have never met with a parallel of one of those cases of excessive masturbation recorded by many doctors. There may have been such cases at this school; but, if so, the boys concealed the frequency of their gratifications.
"My experience proved that many of the lads regarded masturbation as reprehensible; but their plea was 'everyone does it.' Some, often those who indulged inordinately and more secretly than their companions, gravely condemned the practice as sinful. A few seemed to think there was 'no harm in it,' but that the habit might stunt the growth and weaken the body if practiced very frequently. The greater number made no attempt to conceal the habit, they enlarged upon the pleasure of it; it was 'ever so much nicer than eating tarts,' etc.
"The chief cause I believe to be initiation by an older schoolmate. But I have known accidental causes, such as the discovery that swarming up a pole pleasurably excited the organ, rubbing to allay irritation, and simple, curious handling of the erect penis in the early morning before rising from bed."
I quote the foregoing communication as perhaps a fairly typical experience in a British school, though I am myself inclined to think that the prevalence of masturbation in schools is often much overrated, for, while in some schools the practice is doubtless rampant, in others it is practically unknown, or, at all events, only practiced by a few individuals in secret. My own early recollections of (private) school-life fail to yield any reminiscences of any kind connected with either masturbation or homosexuality; and, while such happy ignorance may be the exception rather than the rule, I am certainly inclined to believe that--owing to race and climate, and healthier conditions of life--the sexual impulse is less precocious and less prominently developed during the school-age in England than in some Continental countries. It is probably to this delayed development that we should attribute the contrast that Ferrero finds (_L'Europa Giovane_, pp. 151-56), and certainly states too absolutely, between the sexual reserve of young Englishmen and the sexual immodesty of his own countrymen.
In Germany, Näcke has also stated ("Kritisches zum Kapitel der Sexualität," _Archiv für Psychiatrie_, pp. 354-56, 1899) that he heard nothing at school either of masturbation or homosexuality, and he records the experience of medical friends who stated that such phenomena were only rare exceptions, and regarded by the majority of the boys as exhibitions of "_Schweinerei_." At other German schools, as Hoche has shown, sexual practices are very prevalent. It is evident that at different schools, and even at the same school at different times, these manifestations vary in frequency within wide limits.
Such variations, it seems to me, are due to two causes. In the first place, they largely depend upon the character of the more influential elder boys. In the second place, they depend upon the attitude of the head-master. With reference to this point I may quote from a letter written by an experienced master in one of the most famous English public schools: "When I first came to ----, a quarter of a century ago, Dr. ---- was making a crusade against this failing; boys were sent away wholesale; the school was summoned and lectured solemnly; and the more the severities, the more rampant the disease. I thought to myself that the remedy was creating the malady, and I heard afterward, from an old boy, that in those days they used to talk things over by the fireside, and think there must be something very choice in a sin that braved so much. Dr. ---- went, and, under ----, we never spoke of such things. Curiosity died down, and the thing itself, I believe, was lessened. We were told to warn new boys of the dangers to health and morals of such offences, lest the innocent should be caught in ignorance. I have only spoken to a few; I think the great thing is not to put it in boys' heads. I have noticed solitary faults most commonly, and then I tell the boy how he is physically weakening himself. If you notice, it is puppies that seem to go against Nature, but grown dogs, never.
So, if two small boys acted thus, I should think it merely an instinctive feeling after Nature, which would amend itself. Many here would consider it a heinous sin, but those who think such things sins make them sins. I have seen, in the old days, most delightful little children sent away, branded with infamy, and scarce knowing why--you might as well expel a boy for scratching his head when it itched. I am sure the soundest way is to treat it as a doctor would, and explain to the boy the physical effects of over-indulgence of any sort. When it is combated from the monkish standpoint, the evil becomes an epidemic." I am, however, far from anxious to indorse the policy of ignoring the sexual phenomena of youth. It is not the speaking about such things that should be called in question, but the wisdom and good sense of the speaker. We ought to expect a head-master to possess both an adequate acquaintance with the nature of the phenomena of auto-erotism and homosexuality, and a reasonable amount of tact in dealing with boys; he may then fairly be trusted to exercise his own judgment. It may be doubted whether boys should be made too alive to the existence of sexual phenomena; there can be no doubt about their teachers. The same is, of course, true as regards girls, among whom the same phenomena, though less obtrusive, are not less liable to occur.
As to whether masturbation is more common in one sex than the other, there have been considerable differences of opinion. Tissot considered it more prevalent among women; Christian believed it commoner among men; Deslandes and Iwan Bloch hold that there are no sexual differences, and Garnier was doubtful. Lawson Tait, in his _Diseases of Women_, stated his opinion that in England, while very common among boys, it is relatively rare among women, and then usually taught. Spitzka, in America, also found it relatively rare among women, and Dana considers it commoner in boys than in girls or adults.[307] Moll is inclined to think that masturbation is less common in women and girls than in the male sex. Rohleder believes that after puberty, when it is equally common in both sexes, it is more frequently found in men, but that women masturbate with more passion and imaginative fervor.[308] Kellogg, in America, says it is equally prevalent in both sexes, but that women are more secretive. Morris, also in America, considers, on the other hand, that persistent masturbation is commoner in women, and accounts for this by the healthier life and traditions of boys. Pouillet, who studied the matter with considerable thoroughness in France, came to the conclusion that masturbation is commoner among women, among whom he found it to be equally prevalent in rich and poor, and especially so in the great centres of civilization. In Russia, Guttceit states in his _Dreissig Jahre Praxis_, that from the ages of 10 to 16 boys masturbate more than girls, who know less about the practice which has not for them the charm of the forbidden, but after 16 he finds the practice more frequent in girls and women than in youths and men. Näcke, in Germany, believes that there is much evidence pointing in the same direction, and Adler considers masturbation very common in women. Moraglia is decidedly of the opinion, on the ground of his own observations already alluded to, that masturbation is more frequent among women; he refers to the fact--a very significant fact, as I shall elsewhere have to point out--that, while in man there is only one sexual centre, the penis, in woman there are several centres,--the clitoris, the vagina, the uterus, the breasts,[309]--and he mentions that he knew a prostitute, a well-developed brunette of somewhat nervous temperament, who boasted that she knew fourteen ways of masturbating herself.
My own opinion is that the question of the sexual distribution of masturbation has been somewhat obscured by that harmful tendency, to which I have already alluded, to concentrate attention on a particular set of auto-erotic phenomena. We must group and divide our facts rationally if we wish to command them. If we confine our attention to very young children, the available evidence shows that the practice is much more common in females,[310] and such a result is in harmony with the fact that precocious puberty is most often found in female children.[311] At puberty and adolescence occasional or frequent masturbation is common in both boys and girls, though, I believe, less common than is sometimes supposed; it is difficult to say whether it is more prevalent among boys or girls; one is inclined to conclude that it prevails more widely among boys. The sexual impulse, and consequently the tendency to masturbation, tend to be aroused later, and less easily in girls than in youths, though it must also be remembered that boys' traditions and their more active life keep the tendency in abeyance, while in girls there is much less frequently any restraining influence of corresponding character.[312] In my study of inversion I have found that ignorance and the same absence of tradition are probably factors in the prevalence of homosexual tendencies among women.[313] After adolescence I think there can be no doubt that