The Sexual Life Of The Child Part 7

Penta reports the case of a girl twelve years of age who first experienced s.e.xual excitement during a railway journey. Certain men have informed me that they became s.e.xually excited for the first time while driving over a rough stone pavement. It is obvious in these cases that the rapidly repeated succussion stimulates the peripheral genital organs, and that in this way s.e.xual sensibility is awakened. Havelock Ellis[76] reports cases in which boys first experienced s.e.xual pleasure when wrestling. Thus, a physician wrote regarding a boy of twelve or thirteen, that he experienced an extraordinarily pleasant sensation whilst wrestling with another boy, and that thenceforward he sought every opportunity to wrestle, often three or four times daily, and continued to do this until he was nearly nineteen years of ago. Whilst in this instance we are told that contact of the p.e.n.i.s with the opponent's hips was effected, and that probably the s.e.xual excitement was induced in this manner, I must point out that a m.a.s.o.c.h.i.s.tic-s.a.d.i.s.tic form of excitement may also result from wrestling, and that it is to this that we must refer the s.e.xual desires and voluptuous sensations that are aroused in many males by the act of wrestling.

Chemical stimuli must be regarded as a sub-variety of physical stimuli.

It is sometimes a.s.serted that a diet too rich in meat or otherwise too stimulating is dangerous in this regard. But an examination of the available material will show that this opinion lacks foundation. There is no proof that the s.e.xual impulse can be prematurely awakened by a meat diet, or by any other particular diet. I cannot regard such an a.s.sertion as proved even as regards alcohol. Although I hold very strongly that no alcohol should be given to children, this is not because there is any proof that in children to whom alcohol is given the awakening of the s.e.xual impulse occurs earlier than in others. But once the awakening of the s.e.xual life has taken place, it is true that alcohol may have an exciting influence, and this in two different ways.

On the one hand, if so much alcohol is taken as to interfere with the natural psychical inhibitions, s.e.xual practices may occur that would not otherwise have occurred. On the other hand, also large quant.i.ties of alcohol may often induce an after-effect, after the intoxicating effects have completely pa.s.sed away, manifesting itself, it may be, in the form of s.e.xual excitement, but also, and chiefly, in the form of common sensations in the genital organs. To complete the account of this matter it is necessary to add that there are many persons who consume large quant.i.ties of alcohol, who yet are extremely moderate in s.e.xual relationships. But alcohol should not be administered to children, for reasons altogether independent of its influence upon the s.e.xual life.

Psychical stimuli are perhaps even more important than physical stimuli.

Here also seduction has to be considered, especially during the second period of childhood, in which danger may arise from playmates or school-fellows. This applies equally to children of either s.e.x. Danger may also arise from adults, not only through systematic seduction on the part of grown persons who deliberately debase the mind of youth, but also in other ways. The conversations of adults often lead to s.e.xual acts on the part of children, who understand far more of what is said in their presence than grownups commonly believe. While the child is to all appearance immersed in a book, while a girl is playing with her doll, or a boy with his tin soldiers, the parents or some other adults carry on a conversation in the child's presence under the influence of an utterly false belief that the latter's occupation engrosses his or her entire attention. Yet many children, in such cases, are listening to what is being said with all their ears. Especially foolish, however, are those parents who believe that by the employment of innuendo they are able to conceal from any children who may be present the true inwardness of their conversation. In these matters children are as a rule far sharper than their elders are accustomed to believe. It is hardly necessary for me to point out that opportunities for direct observation are especially dangerous to children. I allude more particularly to the case of children living in the same house with prost.i.tutes; but the danger is hardly less when the children have an opportunity of observing their own parents engaged in s.e.xual acts, or even in the mere preparation for such acts. Forel[77] quotes the report of an experienced physician to the effect that the children of peasants who have watched the copulation of animals often attempt to perform such acts with one another, when bathing, or when any other opportunity offers.

In the preceding portions of this chapter I have attempted to distinguish individual influences from general influences, to distinguish congenital influences affecting the germinal rudiments from environmental influences acting after birth, and to distinguish psychical stimuli from physical stimuli. But it is obvious that the maintenance of a sharp distinction in these respects is very difficult, and indeed often quite impossible. A few additional considerations will elucidate this statement. Let us consider, for instance, seduction: here the separation of the psychical from the physical element cannot possibly be effected, because, as a rule, in these cases the two elements co-operate simultaneously. Let us consider the cases in which, owing to a congenital racial peculiarity, the s.e.xual life awakens earlier than is usual among ourselves. In such cases, the manners and customs of the race in which this early development of s.e.xuality is usual will be found to be especially adapted to attract the child's attention to s.e.xual matters earlier than is here customary. It suffices to remind the reader of the celebrations of p.u.b.erty and of the early marriages common among such races. Here it is hardly possible to separate the congenital characters from the effects of environment. But although, for the reasons given, the discrimination between the individual factors may be exceedingly difficult, still an attempt at discrimination must be made, more especially in view of the fact that a purposive s.e.xual education can be attempted only when due consideration has been paid to the various etiological factors.

It would naturally be of the utmost importance to be able to foresee the cases in which it is likely that the s.e.xual processes of childhood would undergo an exceptionally early development. But as a rule we are unable to do this; and we must therefore be satisfied with the attempt to determine in individual cases whether manifestations of the s.e.xual life occur during childhood, and if so, which manifestations. But even here we encounter difficulties, which in many instances are insuperable, but in others arise from the incompetence of adults. This is all the more deplorable because the effectiveness of s.e.xual education is minimised through the lack of insight. Just as in the practice of medicine an accurate diagnosis is an indispensable prerequisite to correct therapeutics, so also here. Since in the earliest years the child has no conscious understanding of s.e.xual processes, whilst children in whom a s.e.xual consciousness has begun to dawn conceal most carefully from their elders all manifestations of their s.e.xual life, diagnosis is possible only through knowledge of mankind in conjunction with tact.

Let us first consider the phenomena of contrectation. We shall notice sometimes that a little boy, perhaps seven years of age or even younger, will withdraw from the society of other boys, and will seek the company of some particular individual, for example that of a girl friend of his sister, of about his own age. Similar phenomena occur in girls. A little girl in her tenth year will frequently be noticed to find something to speak to her mother about whenever a particular male friend of the family visits the house. Even a shrewd and observant mother will often fail to take note of the reason why on these occasions her little daughter invariably comes into the room. The child will have every possible kind of excuse ready to enable her to seek the company of this particular person. At times this goes further. We then notice that the child endeavours to come into physical contact with the object of affection, showing him great tenderness, and showering on him caresses.

Such a desire for intimate physical caresses must always arouse the suspicion that s.e.xual feelings have now been awakened. We must not, of course, a.s.sume that every childish caress is s.e.xually determined; but we should always bear in mind this possibility in cases in which the child's desire to caress someone is well marked. If such feelings manifest themselves towards the end of the first period of childhood or at the beginning of the second, observation will be comparatively easy, for the younger the child is the less competent is it to conceal its feelings. The consciousness that there is anything wrong in the gratification of such sentiments awakens as a rule very gradually indeed.

Similarly, it will be far easier in the case of children to observe peripheral processes in the genital organs than it is to make such observations in adults. Thus, even in the case of infants in arms, but more often in the case of boys who are somewhat older, the mother or the nurse may be surprised to observe erections when the boy is undressed for his bath or some other reason, or when he has kicked off the bedclothes at night. In other cases the child may be seen handling his genital organs, either openly or beneath his clothing. Often, in the absence of manual stimulation, the child adopts some other means of stimulating his genital organs. Thus, in girls the legs will be crossed, and the thighs rubbed lightly each against the other. In other cases, both in boys and in girls, the child will lean against a piece of furniture in what appears to be a perfectly innocent manner; but in reality pressure is being exercised on the genital organs, it may be by the corner of a table, it may be by the back of a chair; and then the stimulus is strengthened by various movements. In some such way children will effect masturbatory stimulation and obtain s.e.xual gratification, in the presence, not only of their mother, but in that of quite a number of other persons. Guttceit[78] reports the case of a woman who squatted down so that her bare heel came into contact with the genitals, and she then m.a.s.t.u.r.b.a.t.ed by rubbing the two parts together. I myself have known the case of a young girl who sat with her legs beneath her, and m.a.s.t.u.r.b.a.t.ed with the boot she was wearing. In many instances we are enabled, by watching the child's movements, to ascertain with such certainty what it is doing, that no confirmatory evidence is needed. We notice, especially, that when the o.r.g.a.s.m is approaching, the movements change in character and rhythm. The eyes become bright, and the face a.s.sumes an excited and voluptuous expression. This may be observed even in infants in arms. Townsend[79] reports the case of an infant, eight months old, "who would cross her right thigh over the left, close her eyes and clench her fists; after a minute or two there would be complete relaxation, with sweating and redness of face; this would occur about once a week or oftener; the child was quite healthy, with no abnormal condition of the genital organs."

In the absence of these definite indications, it is necessary to be cautious in coming to a diagnosis. Failing such caution, mistakes which may entail serious consequences are likely to arise. Two cases are known to me in which, after suspicion had rightly or wrongly been aroused, the child's most harmless movements were regarded as masturbatory in character. If a child becomes aware that its mother or some other person in authority is making such a mistake, the effect will naturally be very unfavourable. We have also to reckon with the fact that children who are somewhat older, from eight or nine years upwards, hardly ever m.a.s.t.u.r.b.a.t.e when others are present, but only when they believe themselves to be un.o.bserved--in bed, in the closet, or when out walking. In such cases it is hardly possible to diagnose masturbation with certainty; more especially in view of the fact that the signs that may betray an older boy--stains on the shirt or other articles of underclothing--are usually lacking during the first two periods of childhood. It must be added that such stains on linen resulting from e.j.a.c.u.l.a.t.i.o.n do not at first contain spermatozoa, and for this reason their diagnostic value is greatly lessened (see pp. 52-56). Still, the possible appearance of these stains is a matter to which attention should always be paid, and this in girls as well as in boys. In many instances, also, our diagnosis may be supported by the discovery of articles used for onanistic[80] purposes.

In the case of boys we shall seldom, comparatively speaking, be able to do this; although, even in boys, operation is sometimes needed for the removal of articles used for onanistic purposes, which have found their way into the urethra or the bladder. In girls, such operations are more frequently required. Hairpins, pencils, and various other articles used for onanistic purposes, are from time to time removed from the v.a.g.i.n.a or the female bladder. Other signs that are supposed to indicate the habitual practice of masturbation are of little diagnostic value. It is traditionally held that masturbation in girls leads to elongation of the c.l.i.toris, but there appears to be no warrant in fact for this opinion.

As I have previously pointed out, laceration of the hymen does not in general result from masturbation. Other signs, such as local irritation or swelling, are hardly ever seen in boys, and in girls are seen only in cases in which they m.a.s.t.u.r.b.a.t.e to excess. _In girls, moderate reddening of the external genital organs has no significance whatever; and I take this opportunity of giving a special warning against inferring from the existence of such reddening that masturbation is practised, and also against attaching any importance to this symptom in a case in which a s.e.xual a.s.sault is supposed to have been committed on a little girl._

Certain other signs which have been believed to support a diagnosis of masturbation, do not even justify suspicion. Among these reputed signs may be mentioned: black lines under the eyes, pallor of the cheeks, inflammation of the eyes, &c. Generally speaking, it must be said that in s.e.xually immature children nothing but direct observation will justify a definite diagnosis of masturbation, except in cases in which the child itself makes confession to someone in its confidence. For the diagnosis of auto-erotism, however, it is not necessary to establish the occurrence in the child of the voluptuous acme; it suffices for this diagnosis if there occur signs of those general voluptuous sensations which were described on page 58. In many cases in which the practice of masturbation is diagnosed, and in cases in which children themselves confess to masturbating thirty times a day or more, we can hardly suppose that the voluptuous acme or o.r.g.a.s.m is attained.

It is sometimes maintained that the early appearance of the physical manifestations of p.u.b.erty is an indication that psychos.e.xual processes are also occurring prematurely. Thus, Kisch[81] expresses the opinion that in many cases premature s.e.xual development manifests itself in children by the enlargement of the b.r.e.a.s.t.s, and by the growth of the axillary and pubic hair, in the absence of the commencement of menstruation, Kussmaul also observed cases in which, in comparatively early girlhood, all the physical signs of p.u.b.erty were present although menstruation had not yet begun. According to my own experience, we must be careful to avoid taking an exaggerated view of such a connexion.

Pa.s.sionate psychos.e.xual processes may occur in young children in the absence of any physical signs of premature s.e.xual development. An impulse to m.a.s.t.u.r.b.a.t.e may also arise quite independently of the commencement of the adult development of the external genital organs.

Psychically determined erections may likewise occur, although the physical development is by no means far advanced. We shall therefore do wisely to avoid taking a narrow view of such a connexion, inasmuch as it may be that the physical signs of p.u.b.erty on the one hand, and the phenomena of detumescence and contrectation on the other, may occur in conjunction at a very early age, whilst, in other cases, phenomena of the one cla.s.s or of the other may occur in isolation. This statement is true, not merely of the secondary s.e.xual characters, whose development by no means always affords a measure for the degree of development of the s.e.xual impulse, but it is true also of the reproductive organs themselves. Halban[82] reports the case of a boy six years of age, whose p.e.n.i.s was as large as that of a full-grown man, but in whom, apart from the erection, all the characters were infantile. Still more often do we note the independence in many young men of the individual symptoms of s.e.xual development from the growth of the beard, for this latter is often still lacking at an age when the s.e.xual life in general has attained an extensive development. Still less importance must be attached to other occasional signs. According to Marc d'Espine[83]

"p.u.b.erty occurs early in girls with dark hair, grey eyes, a delicate white skin, and of powerful build; late, on the other hand, in girls with chestnut hair, greenish eyes, a coa.r.s.e, darkly-pigmented skin, and of delicate, weakly build;" but the evidence to justify any such generalisation is lacking. It is possible that the opinion quoted is supported to some extent by certain a.s.sociated racial peculiarities, but we must be on our guard against accepting inferences of too sweeping a character. Still less, of course, are such peculiarities a trustworthy aid for the diagnosis of the occurrence of s.e.xual acts at an early age.

The safest way of obtaining accurate information as to the practice of masturbation and other s.e.xual acts is by means of confessions made to some person in the child's confidence. Cases are known to me in which children have very readily confided in some elder person. If this does not often occur, the fault commonly lies with the child's elder a.s.sociates, who do not understand how to establish a truly confidential relationship with the children under their care. If a child finds that no one will speak to it about s.e.xual matters, it must ultimately become secretive about its own s.e.xual life. The child sees very clearly that every word it utters about such things is repressed as improper, and soon learns that the whole field of s.e.xuality is regarded as something unclean, about which not a word must be uttered. The ordinary behaviour of adults inevitably produces this impression in the child's mind, and it will readily be understood what an effect this has in preventing us from gaining information about the s.e.xual life of the child. In many mothers, the abhorrence of the s.e.xual is carried to such an extreme that while in other respects they keep their children scrupulously clean, they feel so strongly that the genital organs must not be touched, that they neglect to secure the ordinary cleanliness of this region of the body.

The best confidant for a young child will usually be the mother, not only because she sees more of the child than the father and because her relationship is a more intimate one than his, but in addition because a woman's insight into certain things generally excels a man's. As a matter of fact, for the reasons stated, masturbation in young children is in most cases discovered by the mother. It will be obvious that I speak here only of those mothers who have real affection for and sympathy with their children, and who share their children's interests; I do not refer to those mothers who think they have adequately fulfilled their maternal duties by paying a nurse or a governess, whilst themselves immersed in the pleasures of society--or perhaps engaged in the preparation and delivery of lectures on the best way of bringing up children, on the Woman's Movement, Woman's Suffrage, and similar topics--or, it may be, attending these same lectures--those who, in any case, prefer some other occupation to the care of their own children.

Above all, let not those who have the care of children be deceived, either by diligence, or by conduct exemplary in other ways, or indeed by earnest study of the Bible, by pious protestations, or by regular attendance at church. I know a boy of twelve, reputed to be extremely religious, and ostensibly on religious grounds going to church every Sunday; but whose real motive in the church-going was the hope to meet the girl of whom he was enamoured. Extensive experience of the conduct of adults should teach us the necessity for extreme caution in these respects. I recall the case of a gentleman whose reputation was that of a paragon of all the virtues. When others of an evening went out to enjoy a gla.s.s or two of beer, or in search of even lighter pleasures, he was supposed always to turn homewards, ostensibly in order to work.

Only after some years was the fact disclosed that he was an habitual loose-liver, enjoying indiscriminate s.e.xual intercourse with unmarried girls and with his neighbours' wives, although to his friends and comrades he had appeared to be a man of exceptionally strict life, and this above all in s.e.xual relationships. The same may be true also of quite little children. Hebbel relates that in his first year at school be sat next to a boy who appeared to be engaged in the most earnest study of the catechism, whilst under the rose he was pouring into young Hebbel's ear all kinds of obscenities, and was asking him if he was still stupid enough to believe that children were brought by a stork or were found in a basket in the cabbage-patch. Many parents, too, know so little about their children in these respects, that they are utterly astonished when some day their eyes are opened to the facts of the case by their family physician. I knew a boy of fourteen who went regularly to church, and who in other respects was a fine fellow, and a diligent pupil at school He was brought to see me because he was affected with spasmodic movements. On examination, I found him to be suffering from a severe attack of gonorrhoea, which he had contracted in intercourse with his aunt's servant-maid. When I told his mother the truth, she was at first extremely angry at what she was convinced must be a mistake on my part; but further inquiry disclosed the fact that for a year or more the boy had been intimate with prost.i.tutes and other girls.

I have been writing of processes occurring in the reproductive organs, such as erections, seminal and other discharges, and masturbation; and of the means for the recognition of these processes. But it is necessary to recognise that we must not a.s.sume without further inquiry that all processes occurring in the genital organs are of a s.e.xual nature, although in individual instances the distinction between the s.e.xual and the non-s.e.xual may be extremely difficult, or even impossible. Thus, of erections occurring before the reproductive glands ripen, not all are of a s.e.xual nature. We know, too, that even in the adult, non-s.e.xual erections may occur. The clearest instances of this are met with in the form of priapism, the princ.i.p.al characteristic of this condition being the occurrence of permanent erection which has nothing at all to do with the s.e.xual impulse. The same is true for the most part of matutinal erections, the precise cause of which is not yet determined. They are commonly referred to distension of the bladder, which is supposed by reflex action to lead to distension of the corpora cavernosa of the p.e.n.i.s. It is certain, at any rate, that these matutinal erections are not caused by s.e.xual thoughts, nor as a rule do they induce s.e.xual feelings. We must distinguish between these processes; just as recently we have learned to distinguish herpes progenitalis, the characteristic of which is its localisation to the genital organs, from herpes s.e.xualis, which is directly dependent upon s.e.xual processes. If we regard this distinction between s.e.xual and non-s.e.xual erections as applicable also to erections in childhood, we are justified in a.s.suming that many erections, in infants-in-arms, for instance, are non-s.e.xual in nature, even though in appearance there is nothing to distinguish them from s.e.xual erections. In infants, erections may arise from external stimuli or from distension of the bladder, which must be distinguished from the erections which have a definitely s.e.xual causation. We must, of course, admit the possibility that such primarily non-s.e.xual erections may secondarily give rise to s.e.xual processes; inasmuch as by the stimuli resulting from the erection, the child's attention may be directed to the genital organs. Just as we must guard against regarding every erection in the child as a s.e.xual process, so also must we be cautious in our estimate of the significance of manual stimulations.

Children often stimulate various parts of the body. Some children will rub the lobule of the ear, others will suck their fingers, or will stimulate their mouths in other ways. Some children have the offensive habit of picking their nose; and it is evident that many cases in which children stimulate the genital organs manually are on the same footing with nose-picking and numerous similar habits. In such cases we have not to do with a specific genital sensation to which the child responds; but with a stimulus which may be pathological, but is not necessarily s.e.xual. In many cases, indeed, the stimulus is not even pathological.

We have to take the following point into consideration. As soon as the child begins to become conscious of the existence of its organs, it fingers them. It does this with its nose and its ears, just as it does with its feet; and it is obvious that the genital organs will receive the same treatment. A gentleman who had grown up in the country related to me that as a child he had often been present when cows were being milked, and that in the evenings, after he had gone to bed, he performed the milking movement on his p.e.n.i.s, and was greatly astonished at the fact that no milk flowed forth. He a.s.sured me that the like experience had occurred to quite a number of boys who had been his playmates in the country. It is certain that such manipulations of the genital organs, entirely non-s.e.xual in origin, may lead to the practice of masturbation.

But we must not immediately conclude that every manipulation of the genital organs in a child is s.e.xually determined.

It is true that many investigators regard numerous movements on the part of children as s.e.xual processes, even when the genital organs are in no way involved. Freud[84] above all, discovers s.e.xuality in the life of the child in cases in which, I am convinced, s.e.xual elements play no part whatever. Sucking movements in children are regarded by Freud as s.e.xual phenomena. He considers that the lips and the fingers are erogenic zones. With just as much reason, every movement might be regarded as s.e.xual--as, for instance, the clenching by a child of its little fists. As long ago as 1879, Lindner,[85] of Budapest, published an able essay about the movements made by children sucking their fingers, lips, &c., and suggested that there was some connexion between these sucking movements and s.e.xual processes. He stated that many children, when sucking the lips, the fingers, the back of the hand or some other part, or when sucking a rubber teat, simultaneously rubbed some other region of the body--in some cases the lobule of the ear, the nipple, or the genital organs; this was sometimes done with one hand only, sometimes, if both hands were free, with both. This statement is perfectly correct. It may happen that the child stops rubbing the genital organs as soon as the sucking is interfered with; or, conversely, the sucking may cease as soon as we withdraw the child's hands from its genital organs. But, even in these cases, the friction of the genital organs does not necessarily possess a specifically s.e.xual character, since friction of the lobule of the ear or of some other part of the body is an equivalent act. It is certain that there is here no intimate connexion between the act of sucking and the s.e.xual life. Thus, there is no proof whatever for the view of Lindner, which has recently been carried to a still greater extreme by Freud, that this "voluptuous sucking" (_Wonnesaugen_) is a truly s.e.xual process. We may, indeed, a.s.sume, as does Rohleder,[86] that such sucking movements occur with especial frequency in children with a congenital morbid predisposition, and that to this extent therefore it is connected with masturbation. But in my opinion it is essential to regard the two movements as clearly independent in character.

Certain other childish habits, such as nail-biting, have also been described as s.e.xual manifestations. What I have said of sucking movements applies to this also. It is true that nail-biting and masturbation may both occur in the same child, and French writers have maintained that there is a causal nexus between the two processes. If we regard nail-biting as a "tic" occurring chiefly in neuropaths, and if we a.s.sume that the neuropathic congenital predisposition is the basis of the premature awakening of s.e.xuality, it may be supposed that to that extent there exists a relationship between the two phenomena, inasmuch as we may refer both manifestations to a common cause, viz., the neuropathic predisposition. But there is no justification whatever for regarding, as some do, one manifestation as the direct consequence of the other.

Speaking generally, we shall do wisely to exercise caution in defining the limits of the s.e.xual life of the child. If a boy runs after a girl, and if the two flirt one with the other, it will often be merely from a desire to imitate their elders. In many instances, even, in which the genital organs play a part in such imitation, we must distinguish what is done from the s.e.xual life proper of the child. If children play at "father and mother," if the "midwife" comes, and "childbirth" takes place, the play may certainly depend upon an early awakening of the s.e.xual life; but this is not necessarily the case. There may be no more than innocent imitation of grownups, as the following case shows. A number of little boys and girls, almost all under eight years of age, played at being prost.i.tutes, souteneurs, and men-about-town. The little girls each demanded a penny when they had allowed the little boys to touch their genital organs. It was an extremely characteristic fact that the leader of this band was a feeble-minded boy, whose parents I had advised to send him to an asylum, because, after various dangerous actions, he had attempted one night to kill his little sister eighteen months old by inserting beans in her nose. Such acts as that first described may, of course, depend upon a premature awakening of the s.e.xual impulse; and when a number of children engage in amus.e.m.e.nts of this kind we not infrequently find that in the leader and seducer the s.e.xual impulse is already awakened, whilst the others act merely in obedience, at first, at least, to an imitative impulse. Certainly, I have known a few instances in which children with premature s.e.xual development very rapidly came to a mutual understanding, and in whom their intimate a.s.sociation was dependent upon prematurely awakened s.e.xual impulses.

Just as s.e.xual acts in which the genital organs play a part occasionally arise, not from premature awakening of the s.e.xual impulse, but from imitation merely, so also, as previously explained, may this happen in the case of more harmless processes. Braggadocio here plays a great part, and also the desire to act like grown-ups. Thus, the boy who runs after girls, and makes appointments with them, sometimes does this merely to show off before his companions, and to produce in them the impression that he is a "manly" fellow. We must take care to separate these cases, also, from those that are genuinely s.e.xual.

If it is difficult to separate the s.e.xual from the merely imitative, no less difficult may it be to distinguish psychos.e.xual processes from others. If a child lavishes caresses on mother, governess, or sister, it may be difficult to discover definite characteristics enabling us to distinguish whether the motive is or is not s.e.xual. But, generally speaking, when a child exhibits an intimate and caressive affection for its mother we shall not incline to think of processes of the s.e.xual life. We cannot dispute the truth of the statement made by various authors, that in these caressive inclinations s.e.xual elements are intermingled. But this talk of the intermingling of s.e.xual sentiments arises in reality only from the fact that neither on theoretical nor on practical grounds are we in a position to draw a clear line of demarcation between the s.e.xual and the non-s.e.xual; and we must avoid stretching this idea of the intermixture of s.e.xual elements beyond the fact that a scientifically based practical distinction is not always possible.

_We have to admit that above all in the mind of the child the various feelings comprised under the idea of "sympathy" (friendship, affection for parents, love of children, s.e.xual love) cannot always be marked off each from the other after the manner of provinces on a map._ Even jealousy, which is often regarded as characteristic of the erotic sentiments, does not necessarily possess a s.e.xual basis. The boy, in his love for his mother, is jealous of his father, jealous of one of his brothers or sisters, jealous even of a dog to which his mother pays attention. How little jealousy may depend upon a s.e.xual motive, may be learned by the observation of animal life; a dog becomes jealous if its master takes notice of another dog, or even pays attention to his own children. _In children, more especially, the extension of jealousy is far greater than it is in adults._ Whereas in adults this sentiment is chiefly, if not exclusively, a.s.sociated with the erotic feelings, in children this is by no means the case. In the child, jealousy may clearly be a.s.sociated with every possible variety of sympathetic feeling. For this reason, it is impossible for us to draw a distinction between s.e.xual and other psychical processes, simply on the ground of the a.s.sociated manifestation of jealousy.

On what grounds, then, can we decide that certain processes are of a s.e.xual nature? In many instances, only the subsequent development will show that one process was s.e.xual, another non-s.e.xual. If one day a boy, embracing, as often before, his girl friend, has an erection, and then perhaps endeavours to draw her towards him so that her body presses against his genital organs, or even has an e.j.a.c.u.l.a.t.i.o.n with a voluptuous sensation, we may a.s.sume the influence of a contrectation impulse, which has existed for some time, but only now has for the first time been localised in the peripheral genital organs. On the other hand, if in the same boy when he hugs his mother no peripheral s.e.xual manifestations occur, either now or subsequently, we must a.s.sume that in the earlier embraces of his mother there was no s.e.xual element. But no such simple solution of the difficulty is really possible. It may happen that in the case of feelings originally s.e.xual their further development is inhibited. A boy might experience s.e.xual sentiments towards his mother; but it is very probable that in such a case convention, education, and perhaps also the very frequent a.s.sociation with his mother, would repress the growth of these sentiments. This criticism is a sound one, and in my opinion the materials are lacking to enable us to overcome its force. For why should certain processes occurring in childhood--for example, a boy's impulse to caress his mother--be regarded as non-s.e.xual; and yet the same processes subsequently be regarded as s.e.xual, merely because they ultimately become a.s.sociated with the phenomena of detumescence? Take the case of a boy seven years of age; he loves and cuddles his mother; he is drawn also to a girl friend of the same age as himself, and kisses her with equal pleasure. The boy grows older, and after some years begins to have definite erections when he embraces and kisses his friend; but nothing of the kind occurs when he embraces and kisses his mother. Now, have we any right to a.s.sert, simply owing to the subsequent appearance of these peripheral manifestations in the one case and not in the other, that originally, when between the boy's inclination towards his girl friend and his inclination towards his mother no clear distinction could be drawn, the former was s.e.xual, the latter non-s.e.xual in nature?

The dilemma is unanswerable, unless we admit that, in the child, sympathetic feelings, which we shall subsequently be able to cla.s.sify without difficulty, are, when they first appear, not always susceptible of any such differentiation; and that for this reason we are just as little able to distinguish a boy's love for his mother from has non-s.e.xual friendship for a little girl, as we are able to distinguish either from a s.e.xual love for another girl. To a very acute observer, certain slight indications may in many cases give some idea of how the matter really stands; but we are here largely concerned with subjective interpretations, rather than with distinctions that are objectively demonstrable. The difficulty of drawing distinctions is all the greater in view of the fact that in the case of non-s.e.xual feelings s.e.xuality constantly plays a certain part. Our sentiments are complex, and compounded of many and various elements; s.e.xual contrasts play their part in family relationships; and it is not by pure chance that harmony exists by preference between father and daughter, and between mother and son. This s.e.xual contrast tends to manifest itself in all displays of family affection. Thus, many men will tell us that in early boyhood they loved to kiss their mother and sisters, rather than their father and brothers. In my experience, the a.n.a.logous s.e.xual contrast does not show its effects so clearly in the case of women as in the case of men. I cannot be certain if the differences I have observed in this respect depend merely upon chance. It is certainly a fact that men, in their confidences to me, have remarkably often reported childish memories of the working of this s.e.xual contrast. And conversely, many h.o.m.os.e.xuals have a.s.sured me that in boyhood they kissed their father with much greater pleasure than their mother.

Our diagnosis will, naturally, be greatly facilitated in those cases in which the phenomena of contrectation are plainly reflected to the reproductive organs. I, at any rate, believe that in practice such an a.s.sociation suffices completely to establish the diagnosis. We can, indeed, recognise this also in the dream life, at least as soon as the first nocturnal emissions have occurred. In the first edition of my work on _Contrary s.e.xuality_ (Berlin, 1891), I drew attention to the fact that those affected with perverse s.e.xuality commonly have perverse dreams; and Nacke has further discussed the significance of s.e.xual dreams for the diagnosis of s.e.xual perversions. In children also we shall find in their s.e.xual dreams, especially when these dreams have begun to be accompanied with seminal emissions, a certain a.s.sistance in the delimitation of their s.e.xual sentiments from other manifestations of sympathetic sentiment. But this aid in diagnosis is not available till comparatively late in childhood, _i.e._ not until e.j.a.c.u.l.a.t.i.o.n has already begun. Even before this epoch dreams may have a s.e.xual character, and may be conditioned by s.e.xual processes. But practically, before the occurrence of e.j.a.c.u.l.a.t.i.o.n and o.r.g.a.s.m in dreams, an exact diagnosis is opposed by so many difficulties, that little of value can in this way be gained.

In this chapter we have examined the considerations that must guide us in our study and diagnosis of the s.e.xual life of the child. It is, naturally, an important question, whether signs exist pointing to an abnormal development of the s.e.xual life, and more especially to the growth of a s.e.xual perversion. This matter has been discussed with considerable detail, and I need not, in conclusion, add anything to the emphatic warning previously given, against making apparently perverse manifestations in childhood the basis of a definite diagnosis or prognosis.

CHAPTER VII

IMPORTANCE OF THE s.e.xUAL LIFE OF THE CHILD

The problem of the significance of s.e.xual phenomena in the child is naturally one of great importance. We have here, in fact, two problems to consider: first, whether the appearance of s.e.xual phenomena in childhood indicates a morbid or in other ways abnormal state; and, secondly, what are the consequences of the occurrence of s.e.xual phenomena in the child. An example will help to ill.u.s.trate the need for drawing this distinction. Certain malformations of the external ear are indications of the existence of a morbid degenerative condition; but from the malformation itself there is nothing to fear. Similarly with the s.e.xual life of the child, it may happen that a manifestation indicates the existence of morbidity, although the manifestation does not by itself entail upon the child any serious consequences. On the other hand, s.e.xual phenomena in the child deserve in some cases the most attentive study, owing to the dangers likely to result from their occurrence.

With regard to the first question, whether s.e.xual manifestations in the child indicate _per se_ the existence of a morbid state, it is not necessary to say much here, since the subject has been fully discussed in the section on Etiology (see page 148). In any case, we must avoid exaggerating the importance of s.e.xual feelings in the child. Ribbing[87]

contends that we must regard it as abnormal when a boy of thirteen or fourteen is obsessed (_hante_) by erotic ideas. This is true enough if there is real obsession by such ideas, but it is not true if there is no more than an occasional uprising of s.e.xual feelings. On page 118 of this work, I explained that an over-development of the s.e.xual life in the child was an indication of the existence of a congenital morbid predisposition.

Pa.s.sing to the second question, as to the consequences of the occurrence of s.e.xual phenomena in the child, these consequences may be very various in nature. They arise more especially in the hygienic, social, ethical, educational, forensic, and intellectual domains.

First of all, then, let us consider the dangers to health.

The earlier the s.e.xual impulse awakens, the earlier also arises the danger of s.e.xual practices, and more particularly of masturbation.

Common sensations in the genital organs, the feelings a.s.sociated therewith, the impulse to allay the unsatisfied libido--all these may lead the boy to handle and rub his p.e.n.i.s. The girl is affected by similar stimuli. In these cases, the first act of masturbation does not depend upon the desire to enjoy a voluptuous sensation, but results from the impulse to allay vague feelings of uneasiness. Only subsequently, when the child has learned by experience that mechanical stimulation of the genital organs induces voluptuous sensations, or when he has been taught this fact by a seducer, does the desire to produce voluptuous sensations become the mainspring driving to masturbation. The danger, of course, increases, in proportion as the child comes fully to understand that in this way it can produce agreeable sensations, all the more because the child is either unaware of the injurious consequences of the practice, or, if it has been informed of these consequences, the knowledge cannot weigh in the balance against the easily induced enjoyment. But, let me say here at the outset, the dangers of masturbation have been greatly exaggerated. Chiefly since the publication, at the end of the eighteenth century, of Tissot's book on masturbation, but to some extent also even earlier, it has been usual to refer to masturbation the occurrence of innumerable diseases, including mental disorders and locomotor ataxia. I do not propose to reproduce the account given by Tissott, and after him by Hufeland, and also by the innumerable quacks and swindlers who trade in the "cure" of "secret diseases"--these latter, preying upon the fears of humanity, declare that every possible affliction in both s.e.xes may result from masturbation, and recommend innumerable miraculous remedies for these often imaginary ills. Disorders and displacements of the uterus, ulcers and cancer, gastralgia and gastric spasms, jaundice, pains in the nose, are supposed in women to result from masturbation, as well as fluor albus, nymphomania, &c. There is hardly a single organ of the body of which disease and destruction have not by many been referred to masturbation. In reality all this is false. It is more than doubtful whether, as far as adults are concerned, occasional masturbation is necessarily more harmful than normal s.e.xual intercourse. According to my own observations, the princ.i.p.al question is whether, in masturbation, the bodily and mental stimuli employed to obtain s.e.xual gratification involve an especial shock to the nervous system--a greater shock than results from normal s.e.xual intercourse. More powerful shock may, indeed, arise from the fact that the masturbatory act is apt to be repeated with excessive frequency; and we have to admit that the chief danger of masturbation lies in the fact that there is so grave a risk of s.e.xual excess. Owing, too, to the frequency of repet.i.tion, a need will very readily arise for an increase in the stimulation, and this may apply alike to the bodily stimuli and to the mental; and the stronger the stimuli have to be, the more powerful also will be the general effect on the nervous system. Thus the danger of shock to the nervous system from masturbation will be seen to depend, first, upon the frequency with which the act is repeated, and, secondly, upon the increasing intensity of the stimulation. To this extent, therefore, masturbation may be more dangerous than normal s.e.xual intercourse; for this latter also, unless it is to exert an unfavourable influence on the health, must not involve mental and bodily stimulation of too powerful a kind. The good effects of s.e.xual intercourse depend upon its adequacy to the feelings, upon the absence of any exhausting imaginative activity, and upon the absence also of artificial bodily stimulation. But artificial stimuli and exhausting imaginative activity are often a.s.sociated with coitus also, in cases in which the stimulus evoked by the personality of the s.e.xual partner is inadequate. Again, the powerful efforts which must as a rule be made by persons who desire to repeat the act of intercourse several times within a brief period, will have a similar effect upon the system to the powerful imaginative activity in cases of masturbation. The resemblances, on the one hand, and the differences, on the other, between masturbation and normal s.e.xual intercourse, will be apparent to those who carefully consider the facts just stated; and it will also become apparent in what circ.u.mstances masturbation must be regarded as injurious. This is all I have to say concerning masturbation in adults.

The idea that masturbation is, generally speaking, dangerous, is by many restricted to the practice during childhood and youth, the belief in its danger at this stage of life being based upon the view that the organs are at this time insufficiently developed. But even this contention cannot be regarded as fully established. I will, in the first place, consider those cases only in which masturbation is practised after the formation of s.e.m.e.n has begun, but when the processes by which bodily maturity is attained are not yet fully completed. To the theoretical a.s.sumption that masturbation is especially hurtful in cases in which the organs are not yet adequately developed, we may oppose the consideration that the completer development of organs is favoured by exercise. We cannot further discuss such theoretical speculations, which lack the firm foundation of experience. On the whole, I agree with the estimate of the consequences of masturbation expressed by Aschaffenburg,[88] a man to whom we are indebted for the refutation of many extravagant views. Experience teaches that almost all men, healthy and unhealthy, moral and immoral, have m.a.s.t.u.r.b.a.t.ed for some years, once or several times a week, towards the end of the second and during the beginning of the third period of childhood. In view of this experience, what right have we to maintain seriously that masturbation is, generally speaking, dangerous to health. It is, of course, possible to contend that these persons would have developed better if they had not m.a.s.t.u.r.b.a.t.ed. But there is equal ground for a.s.serting the opposite. We possess no evidence whatever to show that those young persons who never m.a.s.t.u.r.b.a.t.e are in after life stronger and healthier than the others. I know some persons who have never m.a.s.t.u.r.b.a.t.ed. In the case of some of these, it was because the impulse to m.a.s.t.u.r.b.a.t.e was lacking; others, notwithstanding the existence of a strong impulse, refrained from masturbation under the influence of religious or ethical motives. In both of these groups, I have seen persons exhibiting the very morbid symptoms which Tissot and his followers referred to masturbation; and I was quite unable to convince myself that abstinence from masturbation secured any notable advantage. Whilst I do not a.s.sert that the morbid phenomena which I observed in these individuals arose in consequence of their refraining from masturbation, I consider that there is no justification for the converse a.s.sumption in the case of those who did m.a.s.t.u.r.b.a.t.e. I believe that many of those patients who never m.a.s.t.u.r.b.a.t.ed were the subjects of congenital morbid predisposition, and that, as a direct consequence of this fact in many of them, the s.e.xual impulse was of minimum intensity or developed exceptionally late; I consider, therefore, that the morbid manifestations in the domain of the nervous system were dependent, not upon the fact that they did not m.a.s.t.u.r.b.a.t.e, but princ.i.p.ally upon the congenital morbid predisposition.

Whilst I thus reject the view that masturbation in children is generally dangerous, this must not be regarded as implying that I consider the practice altogether indifferent as far as its influence upon health is concerned. In the child, as in the adult, there is danger in the fact that the act is so easy that it is likely to be repeated very frequently, and thus to become habitual. In addition, the masturbator is apt to require strong physical and mental stimuli, and this increase of the stimulus may become dangerous. A special danger of persistent masturbation is to be found in the possibility that impotence may result. The masturbator, being accustomed to stimulate his genital organs by manipulations, and by various methods increasing in intensity of stimulus, will often find subsequently that the normal stimuli, acting in part in the form of the sensory processes in the genital organs, and in part in the form of the normal psychical influences proceeding from without, are no longer competent to induce the normal s.e.xual reactions (erection and e.j.a.c.u.l.a.t.i.o.n). This affects chiefly members of the male s.e.x, but in some instances the same is true also of women. It is true that in women the s.e.xual act is rather of a pa.s.sive character, erection not being in them essential as it is in the male; but in the case of women also, long-continued masturbation, whether practised in childhood or subsequently, may bring about so intimate a dependence of s.e.xual desire, e.j.a.c.u.l.a.t.i.o.n, and gratification, upon the artificial stimuli, that the occurrence of these phenomena in normal coitus may be hindered or completely inhibited.

Some writers contend that s.e.xual perversions, h.o.m.os.e.xuality, for example, may be induced by masturbation, but I myself doubt this. For such a development to be possible, it is necessary that very special influences should be in operation, more particularly a congenital predisposition, or the cultivation of the perversion by perverse imaginative processes--this latter, indeed, occurring very readily in masturbators. But masturbation to excess is far more likely to induce general neurasthenia than to give rise to s.e.xual perversions. When I speak of excessive masturbation, however, it must be admitted that the term is a relative one. What is harmful excess in one person is not necessarily excess in another. This is true of children as well as of adults. I have seen children who, owing to premature awakening of the s.e.xual life, have begun to m.a.s.t.u.r.b.a.t.e at a very early age, without any serious effect upon health. Having seen such children again in adult life, after the lapse of more than fifteen years, I consider that I have had opportunities for forming a sound judgment upon this point. We have to take into account the fact that when a youthful masturbator subsequently exhibits nervous manifestations, these often result from the anxiety he has experienced on being informed of the serious consequences of masturbation. Not masturbation itself, but fear of the effects of the practice, is here responsible for the resulting injury to health. Experience teaches that a certain sort of popular literature has an especially unfavourable influence in this respect. Moreover, in many cases, self-reproach on _moral_ grounds, it may be in childhood, but more often later in life, must in such persons be regarded as the cause of the appearance of nervous and mental symptoms. The dread of having committed a deadly sin, or an extremely immoral act, explains a part of the results which are commonly referred directly to masturbation. The dangers of masturbation must not be underestimated, but exaggeration must equally be avoided. I do not believe that in children masturbation is, generally speaking, more dangerous than it is in adults; but I consider that masturbation resulting from a spontaneous impulse is less harmful, than when artificial bodily and mental stimuli are freely employed. And though the dangers are slightest when masturbation is not continued for a long period, still, in this connexion, a period of a few years cannot be regarded as so very long; at any rate, practical experience shows us that we must avoid over-estimating the importance of masturbation even if continued for several years.

A particular description must now be given of masturbation as practised in boys before the formation of s.e.m.e.n has begun--that is, before the fourteenth or fifteenth year of life. Fere[89] regards o.r.g.a.s.m without e.j.a.c.u.l.a.t.i.o.n as very dangerous, and compares its effects with the phenomena of fatigue. The nervous discharge occurring in the o.r.g.a.s.m may certainly explain the depressed state of many masturbators, also their tired appearance, dilated pupils, and languid movements. We note also mental disturbances as well as physical, especially diminished powers of attention and memory, and somnolence up to the point of narcolepsy.

According to Fere, the physical and the mental symptoms alike can be detected by precise investigations. In children suspected of masturbation, dynamometric observations disclosed a notable diminution, to the extent even of one-half, when the children were not kept under constant observation and when other signs of masturbation existed; and in these cases experimental observation also showed a diminution of the power of attention. The test applied was to erase some particular letter of the alphabet from one page of a book. When such a test is employed, the practice of masturbation is said to have an unfavourable effect, and to cause mistakes. I do not think that these so-called precise investigations are of much value, for suggestion on the part of the experimenter, who is sometimes prejudiced, may play a great part in producing the results. Even when transient phenomena of fatigue appear, and are demonstrable by experiment, it does not follow that any permanent injury has been done, and just as little do otherwise transient manifestations of fatigue necessarily indicate anything pathological, or foreshadow the onset of any progressive morbid state.

The clinical material offered in support of the idea that masturbation is especially dangerous in children too young to have an e.j.a.c.u.l.a.t.i.o.n should, moreover, be carefully and critically examined. I myself formerly accepted the view of most authoritative writers as to the grave danger of masturbation in these circ.u.mstances. But we can no longer do this unconditionally. The gradual change in my own views arose as follows. From the commencement of my medical practice I was frequently consulted about masturbation in children. Many of these cases date from ten, fifteen, and even twenty years back. I have recently inst.i.tuted inquiries as to the present condition of my former patients. In so far as information was obtainable, I have been astonished to learn how well boys, who from the age of eight, nine, or ten had m.a.s.t.u.r.b.a.t.ed for several years, had developed as youths and as full-grown men. I have had similar experiences in the case of girls. Among my patients, I have had girls who m.a.s.t.u.r.b.a.t.ed at the age of five or six years; and ten to twenty years later, when some of them have married, I have gathered information regarding their subsequent development, either from the patients themselves or from their a.s.sociates. Here also it was very remarkable to learn how rarely unfavourable consequences have occurred from the practice of masturbation in early childhood, notwithstanding the dangers commonly supposed to attend thereon. Especially rare have ill consequences been in those cases in which masturbation was not pushed to the point of inducing o.r.g.a.s.m, but in which the children have m.a.s.t.u.r.b.a.t.ed simply in order to procure agreeable local stimulation. But in some instances also, in which o.r.g.a.s.m without e.j.a.c.u.l.a.t.i.o.n had been observed, no bad results have occurred. Such results are, however, much more likely to follow in cases in which there has been prolonged s.e.xual excitement preparatory to the o.r.g.a.s.m, whilst this latter has been artificially deferred as long as possible. Where this has been habitual, I have, in some of the patients, seen serious consequences, and especially neurasthenic symptoms, result from masturbation. But the persons thus affected were in many cases the subjects of such severe hereditary taint, that it was impossible to decide to what extent their troubles were due to congenital predisposition, and to what extent they were referable to masturbation or to other noxious influences. It is, moreover, probable that when the nervous system is less resistent in consequence of congenital predisposition, the bad effects of masturbation will more readily appear than in those whose inheritance is a sound one.

As a result of these experiences, I feel justified in coming to the following conclusions regarding masturbation during childhood. _It has not been proved that masturbation during childhood, with or without e.j.a.c.u.l.a.t.i.o.n, is generally dangerous. The possibility of danger resulting from the practice is, however, increased by long-continued and frequently repeated masturbation; also by the artificial postponement of the voluptuous acme, and by congenital predisposition to nervous disorders._ My notes of the cases which I have seen during many years of medical practice show that, even in children, masturbation does not necessarily do any harm.

CASE 15.--The girl X., four years of age, was brought to see me because it had been noticed that she frequently tried to handle her genital organs, and also that she stimulated the same organs by means of rubbing movements of the crossed thighs. Her mother had further from time to time noticed rocking movements, a.s.sociated with a fixed stare, which had aroused suspicions of the occurrence of the s.e.xual o.r.g.a.s.m. Various methods were tried to put a stop to these practices, but without result.

Hypnotic treatment was not tried, because the child was still too young and her attention wandered too much. Mechanical methods of control were also fruitless. The trouble continued for five years, during all of which time the child was under my own observation. She went to school, where she proved a diligent scholar, and was one of the most successful pupils; her physical condition was also excellent. Thenceforward, for several years, I received no precise information about the patient, although from time to time I saw some of her a.s.sociates. But after about eight years, I had an opportunity of learning her later history. The child which had begun to m.a.s.t.u.r.b.a.t.e when four years old was now a young lady of eighteen. When fourteen years old she had for some months suffered from chlorosis, but had never been troubled by any other serious illness. I could not learn with certainty whether the habit of masturbation had been discontinued; but there had been no definite evidence of the practice of masturbation, or of any other artificial s.e.xual stimulation, after the age of nine. At the present time X. is perfectly healthy.

CASE 16.--The boy Y. was brought to me when eight years old. It had been noticed that at night, whether sleeping or waking, he very often handled his genital organs. Erection of the p.e.n.i.s had also been observed from time to time. His mother and his governess believed that he m.a.s.t.u.r.b.a.t.ed every night. When this had been going on for several years, the patient was brought to me for suggestive treatment. Mechanical means were simultaneously employed, his hands being fastened at night in such a way that he could not bring them into contact with his genital organs. But he speedily loosed himself from his bonds. The trouble abated in severity, but continued none the less for several years. I saw the patient again when he was twenty-four years of age. No abnormality whatever could be observed. He had normal s.e.xual potency, and was entirely free from neurasthenic symptoms.