Part 7 (1/2)

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 relations.h.i.+ps. 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 s.h.i.+rt 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 relations.h.i.+p 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 relations.h.i.+p 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 relations.h.i.+ps. 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 relations.h.i.+p 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.