Chapter 4

Brittany, the custom still prevails of lighting a large bonfire at the time of the summer solstice; it is called Tan Heol, or Tan St. Jean. In Ireland, the bonfires also take place on St. John's Eve, and a correspondent, who has often witnessed them in County Waterford, writes that "women, with garments raised, jump through these fires, and conduct which, on ordinary occasions would be reprobated, is regarded as excusable and harmless." Outside Europe, the Berbers of Morocco still maintain this midsummer festival, and in the Rif they light bonfires; here the fires seem to be now regarded as mainly purificatory, but they are associated with eating ceremonies which are still regarded as multiplicative. (Westermarck, "Midsummer Customs in Morocco," _Folk-Lore_, March, 1905.)

[141] Mannhardt (op. cit., p. 469) quotes a description of an Ehstonian festival in the Island of Moon, when the girls dance in a circle round the fire, and one of them,--to the envy of the rest, and the pride of her own family,--is chosen by the young men, borne away so violently that her clothes are often torn, and thrown down by a youth, who places one leg over her body in a kind of symbolical coitus, and lies quietly by her side till morning. The spring festivals of the young people of Ukrainia, in which, also, there is singing, dancing, and sleeping together, are described in "Folk-Lore de l'Ukrainie." Kryptadia, vol. v, pp. 2-6, and vol. viii, pp. 303 et seq.

[142] M. Kowalewsky, "Marriage Among the Early Slavs," _Folk-Lore_, December, 1890.

[143] A. Tille, however (_Yule and Christmas_, 1899), while admitting that the general Aryan division of the year was dual, follows Tacitus in asserting that the Germanic division of the year (like the Egyptian) was tripartite: winter, spring, and summer.

[144] Grimm, _Teutonic Mythology_ (English translation by Stallybrass), pp. 612-630, 779, 788.

[145] Wellhausen, _Reste Arabischen Heidentums_, 1897, p. 98.

[146] See, e.g., the chapter on ritual in Gérard-Varet's interesting book, _L'Ignorance et l'Irreflexion_, 1899, for a popular account of this and allied primitive conceptions.

[147] Jastrow, _Religion of Babylonia_, especially pp. 485, 571; regarding the priestesses, Jastrow remarks: "Among many nations, the mysterious aspects of woman's fertility lead to rites that, by a perversion of their original import, appear to be obscene. The prostitutes were priestesses attached to the Ishtar cult, and who took part in ceremonies intended to symbolize fertility." Whether there is any significance in the fact that the first two months of the Babylonian year (roughly corresponding to our March and April), when we should expect births to be at a maximum, were dedicated to Ea and Bel, who, according to varying legends, were the creators of man, and that New Year's Day was the festival of Bau, regarded as the mother of mankind, I cannot say, but the suggestion may be put forward.

[148] _Celtic Heathendom_, p. 421.

[149] Grimm, _Teutonic Mythology_, p. 1465. In England, the November, bonfires have become merged into the Guy Fawkes celebrations. In the East, the great primitive autumn festivals seem to have fallen somewhat earlier. In Babylonia, the seventh month (roughly corresponding to September) was specially sacred, though nothing is known of its festivals, and this also was the sacred festival month of the Hebrews, and originally of the Arabs. In Europe, among the southern Slavs, the Reigen, or Kolo--wild dances by girls, adorned with flowers, and with skirts girt high, followed by sexual intercourse--take place in autumn, during the nights following harvest time.

[150] A. Tille, _Yule and Christmas_, p. 21, etc.

[151] Long before Wargentin, however, Rabelais had shown some interest in this question, and had found that there were most christenings in October and November, this showing, he pointed out, that the early warmth of spring influenced the number of conceptions (_Pantagruel_, liv. v, Ch. XXIX). The spring maximum of conceptions is not now so early in France.

[152] Villermé, "De la Distribution par mois des conceptions," _Annales d'Hygiène Publique_, tome v, 1831, pp. 55-155.

[153] Sormani, _Giornale di Medicina Militare_, 1870.

[154] Throughout Europe, it may be said, marriages tend to take place either in spring or autumn (Oettinger _Moralstatistik_, p. 181, gives details). That is to say, that there is a tendency for marriages to take place at the season of the great public festivals, during which sexual intercourse was prevalent in more primitive times.

[155] Hill, _Nature_, July 12, 1888.

[156] G. Mayr, _Die Gesetzmässigkeit im Gesellschaftsleben_, 1877, p. 240.

[157] Edward Smith (_Health and Disease_), who attributes this to the lessened vitality of offspring at that season. Beukemann also states that children born in September have most vitality.

[158] Westermarck has even suggested that the December maximum of conceptions may be due to better chance of survival for September offspring (_Human Marriage_, Chapter II). It may be noted that though the maximum of conceptions is in May, relatively the smallest proportion of boys is conceived at that time. (Rauber, _Der Ueberschuss an Knabengeburten_, p. 39.)

[159] Krieger found that the great majority of German women investigated by him menstruated for the first time in September, October, or November. In America, Bowditch states that the first menstruation of country girls more often occurs in spring than at any other season.

[160] _Women's Medical Journal_, 1894.

[161] It is, perhaps, worth while noting that the wisdom of the mediæval Church found an outlet for this "spring fever" in pilgrimages to remote shrines. As Chaucer wrote, in the _Canterbury Tales_:--

"Whané that Aprille with his showers sote The droughts of March hath piercèd to the root, Thaen longen folk to gon on pilgrimages, And palmers for to seeken strangé stronds."

[162] L.W. Kline, "The Migratory Impulse," _American Journal of Psychology_, 1898, vol. x, especially pp. 21-24.

[163] Mania comes to a crisis in spring, said the old physician, Aretæus (Bk. 1, Ch. V).

[164] This is, at all events, the case in France, Prussia, and Italy. See, for instance, Durkheim's discussion of the cosmic factors of suicide, _Le Suicide_, 1897, Chapter III. In Spain, as Bernaldo de Quirós shows (_Criminologia_, p. 69), there is a slight irregular rise in December, but otherwise the curve is perfectly regular, with maximum in June, and minimum in January.

[165] This holds good of a south European country, taken separately. A chart of the annual incidence of suicide by hanging, in Roumania, presented by Minovici (_Archives d'Anthropologie Criminelle_, 1905, p. 587), shows climaxes of equal height in May and September.

[166] Morselli, _Suicide_, pp. 55-72.

[167] Ogle himself was inclined to think that these breaks were accidental, being unaware of the allied phenomena with which they may be brought into line. It is true that (as Gaedeken objects to me) the autumnal break is very slight, but it is probably real when we are dealing with so large a mass of data.

[168] _Pedagogical Seminary_, June, 1891, p. 298. For a very full summary and bibliography of investigations regarding growth, see F. Burk, "Growth of Children in Height and Weight," _American Journal of Psychology_, April, 1898.

[169] _L'Année Psychologique_, 1898.

[170] _Lancet_, June 6, 1891. Edward Smith had pointed out many years earlier that scarlet fever is most fatal in periods of increasing vitality.

[171] Havelock Ellis, "The Bladder as a Dynamometer," _American Journal of Dermatology_, May, 1902.

[172] See, e.g., summary in _Internationales Centrablatt für Anthropologie_, 1902, Heft 4, p. 207.

[173] Summarized in _Zeitschrift für Psychologie der Sinnesorgane_, 1903, p. 135.

[174] Camerer found that from September to November is the period of greatest metabolic activity.

[175] Haig, _Uric Acid_, 6th edition, 1903, p. 33.

AUTO-EROTISM: A STUDY OF THE SPONTANEOUS MANIFESTATIONS OF THE SEXUAL IMPULSE.

I.

Definition of Auto-erotism--Masturbation only Covers a Small Portion of the Auto-erotic Field--The Importance of this Study, especially To-day--Auto-erotic Phenomena in Animals--Among Savage and Barbaric Races--The Japanese _rin-no-tama_ and other Special Instruments for Obtaining Auto-erotic Gratification--Abuse of the Ordinary Implements and Objects of Daily Life--The Frequency of Hair-pin in the Bladder--The Influence of Horse-exercise and Railway Traveling--The Sewing-machine and the Bicycle--Spontaneous Passive Sexual Excitement--_Delectatio Morosa_--Day-dreaming--_Pollutio_--Sexual Excitement During Sleep--Erotic Dreams--The Analogy of Nocturnal Enuresis--Differences in the Erotic Dreams of Men and Women--The Auto-erotic Phenomena of Sleep in the Hysterical--Their Frequently Painful Character.

By "auto-erotism" I mean the phenomena of spontaneous sexual emotion generated in the absence of an external stimulus proceeding, directly or indirectly, from another person. In a wide sense, which cannot be wholly ignored here, auto-erotism may be said to include those transformations of repressed sexual activity which are a factor of some morbid conditions as well as of the normal manifestation of art and poetry, and, indeed, more or less color the whole of life.

Such a definition excludes the normal sexual excitement aroused by the presence of a beloved person of the opposite sex; it also excludes the perverted sexuality associated with an attraction to a person of the same sex; it further excludes the manifold forms of erotic fetichism, in which the normal focus of sexual attraction is displaced, and voluptuous emotions are only aroused by some object--hair, shoes, garments, etc.--which, to the ordinary lover, are of subordinate--though still, indeed, considerable--importance.[176] The auto-erotic field remains extensive; it ranges from occasional voluptuous day-dreams, in which the subject is entirely passive, to the perpetual unashamed efforts at sexual self-manipulation witnessed among the insane. It also includes, though chiefly as curiosities, those cases in which individuals fall in love with themselves. Among auto-erotic phenomena, or on the borderland, we must further include those religious sexual manifestations for an ideal object, of which we may find evidence in the lives of saints and ecstatics.[177] The typical form of auto-erotism is the occurrence of the sexual orgasm during sleep.

I do not know that any apology is needful for the invention of the term "auto-erotism."[178] There is no existing word in current use to indicate the whole range of phenomena I am here concerned with. We are familiar with "masturbation," but that, strictly speaking, only covers a special and arbitrary subdivision of the field, although, it is true, the subdivision with which physicians and alienists have chiefly occupied themselves. "Self-abuse" is somewhat wider, but by no means covers the whole ground, while for various reasons it is an unsatisfactory term. "Onanism" is largely used, especially in France, and some writers even include all forms of homosexual connection under this name; it may be convenient to do so from a physiological point of view, but it is a confusing and antiquated mode of procedure, and from the psychological standpoint altogether illegitimate; "onanism" ought never to be used in this connection, if only on the ground that Onan's device was not auto-erotic, but was an early example of withdrawal before emission, or _coitus interruptus_.

While the name that I have chosen may possibly not be the best, there should be no question as to the importance of grouping all these phenomena together. It seems to me that this field has rarely been viewed in a scientifically sound and morally sane light, simply because it has not been viewed as a whole. We have made it difficult so to view it by directing our attention on the special group of auto-erotic facts--that group included under masturbation--which was most easy to observe and which in an extreme form came plainly under medical observation in insanity and allied conditions, and we have wilfully torn this group of facts away from the larger group to which it naturally belongs. The questions which have been so widely, so diversely, and--it must unfortunately be added--often so mischievously discussed, concerning the nature and evils of masturbation are not seen in their true light and proportions until we realize that masturbation is but a specialized form of a tendency which in some form or in some degree normally affects not only man, but all the higher animals. From a medical point of view it is often convenient to regard masturbation as an isolated fact; but in order to understand it we must bear in mind its relationships. In this study of auto-erotism I shall frequently have occasion to refer to the old entity of "masturbation," because it has been more carefully studied than any other part of the auto-erotic field; but I hope it will always be borne in mind that the psychological significance and even the medical diagnostic value of masturbation cannot be appreciated unless we realize that it is an artificial subdivision of a great group of natural facts.

The study of auto-erotism is far from being an unimportant or merely curious study. Yet psychologists, medical and non-medical, almost without exception, treat its manifestations--when they refer to them at all--in a dogmatic and off-hand manner which is far from scientific. It is not surprising, therefore, that the most widely divergent opinions are expressed. Nor is it surprising that ignorant and chaotic notions among the general population should lead to results that would be ludicrous if they were not pathetic. To mention one instance known to me: a married lady who is a leader in social-purity movements and an enthusiast for sexual chastity, discovered, through reading some pamphlet against solitary vice, that she had herself been practicing masturbation for years without knowing it. The profound anguish and hopeless despair of this woman in face of what she believed to be the moral ruin of her whole life cannot well be described. It would be easy to give further examples, though scarcely a more striking one, to show the utter confusion into which we are thrown by leaving this matter in the hands of blind leaders of the blind. Moreover, the conditions of modern civilization render auto-erotism a matter of increasing social significance. As our marriage-rate declines, and as illicit sexual relationships continue to be openly discouraged, it is absolutely inevitable that auto-erotic phenomena of one kind or another, not only among women but also among men, should increase among us both in amount and intensity. It becomes, therefore, a matter of some importance, both to the moralist and the physician, to investigate the psychological nature of these phenomena and to decide precisely what their attitude should be toward them.

I do not purpose to enter into a thorough discussion of all the aspects of auto-erotism. That would involve a very extensive study indeed. I wish to consider briefly certain salient points concerning auto-erotic phenomena, especially their prevalence, their nature, and their moral, physical, and other effects. I base my study partly on the facts and opinions which during the last thirty years have been scattered through the periodical and other medical literature of Europe and America, and partly on the experience of individuals, especially of fairly normal individuals.

Among animals in isolation, and sometimes in freedom--though this can less often be observed--it is well known that various forms of spontaneous solitary sexual excitement occur. Horses when leading a lazy life may be observed flapping the penis until some degree of emission takes place. Welsh ponies, I learn from a man who has had much experience with these animals, habitually produce erections and emissions in their stalls; they do not bring their hind quarters up during this process, and they close their eyes, which does not take place when they have congress with mares. The same informant observed that bulls and goats produce emissions by using their forelegs as a stimulus, bringing up their hind quarters, and mares rub themselves against objects. I am informed by a gentleman who is a recognized authority on goats, that they sometimes take the penis into the mouth and produce actual orgasm, thus practicing auto-fellatio. As regards ferrets, the Rev. H. Northcote states: "I am informed by a gentleman who has had considerable experience of ferrets, that if the bitch, when in heat, cannot obtain a dog she pines and becomes ill. If a smooth pebble is introduced into the hutch, she will masturbate upon it, thus preserving her normal health for one season. But if this artificial substitute is given to her a second season, she will not, as formerly, be content with it."[179]

Stags in the rutting season, when they have no partners, rub themselves against trees to produce ejaculation. Sheep masturbate; as also do camels, pressing themselves down against convenient objects; and elephants compress the penis between the hind legs to obtain emissions.[180] Blumenbach observed a bear act somewhat similarly on seeing other bears coupling, and hyenas, according to Ploss and Bartels, have been seen practicing mutual masturbation by licking each other's genitals. Mammary masturbation, remarks Féré, is found in certain female and even male animals, like the dog and the cat.[181] Apes are much given to masturbation, even in freedom, according to the evidence of good observers; for while no female apes are celibates, many of the males are obliged to lead a life of celibacy.[182] Male monkeys use the hand in masturbation, to rub and shake the penis.[183]

In the human species these phenomena are by no means found in civilization alone. To whatever extent masturbation may have been developed by the conditions of European life, which carry to the utmost extreme the concomitant stimulation, and repression of the sexual emotions, it is far from being, as Mantegazza has declared it to be, one of the moral characteristics of Europeans.[184] It is found among the people of nearly every race of which we have any intimate knowledge, however natural the conditions under which men and women may live.[185] Thus, among the Nama Hottentots, among the young women at all events, Gustav Fritsch found that masturbation is so common that it is regarded as a custom of the country; no secret is made of it, and in the stories and legends of the race it is treated as one of the most ordinary facts of life. It is so also among the Basutos, and the Kaffirs are addicted to the same habit.[186] The Fuegians have a word for masturbation, and a special word for masturbation by women.[187] When the Spaniards first arrived at Vizcaya, in the Philippines, they found that masturbation was universal, and that it was customary for the women to use an artificial penis and other abnormal methods of sexual gratification. Among the Balinese, according to Jacobs (as quoted by Ploss and Bartels), masturbation is general; in the boudoir of many a Bali beauty, he adds, and certainly in every harem, may be found a wax penis to which many hours of solitude are devoted. Throughout the East, as Eram, speaking from a long medical experience, has declared, masturbation is very prevalent, especially among young girls. In Egypt, according to Sonnini, it is prevalent in harems. In India, a medical correspondent tells me, he once treated the widow of a wealthy Mohammedan, who informed him that she began masturbation at an early age, "just like all other women." The same informant tells me that on the _façade_ of a large temple in Orissa are bas-reliefs, representing both men and women, alone, masturbating, and also women masturbating men. Among the Tamils of Ceylon masturbation is said to be common. In Cochin China, Lorion remarks, it is practiced by both sexes, but especially by the married women.[188] Japanese women have probably carried the mechanical arts of auto-erotism to the highest degree of perfection. They use two hollow balls about the size of a pigeon's egg (sometimes one alone is used), which, as described by Joest, Christian, and others,[189] are made of very thin leaf of brass; one is empty, the other (called the little man) contains a small heavy metal ball, or else some quicksilver, and sometimes metal tongues which vibrate when set in movement; so that if the balls are held in the hand side by side there is a continuous movement. The empty one is first introduced into the vagina in contact with the uterus, then the other; the slightest movement of the pelvis or thighs, or even spontaneous movement of the organs, causes the metal ball (or the quicksilver) to roll, and the resulting vibration produces a prolonged voluptuous titillation, a gentle shock as from a weak electric inductive apparatus; the balls are called _rin-no-tama_, and are held in the vagina by a paper tampon. The women who use these balls delight to swing themselves in a hammock or rocking-chair, the delicate vibration of the balls slowly producing the highest degree of sexual excitement. Joest mentions that this apparatus, though well known by name to ordinary girls, is chiefly used by the more fashionable _geishas_, as well as by prostitutes. Its use has now spread to China, Annam, and India. Japanese women also, it is said, frequently use an artificial penis of paper or clay, called e.g.. Among the Atjeh, again, according to Jacobs (as quoted by Ploss), the young of both sexes masturbate and the elder girls use an artificial penis of wax. In China, also, the artificial penis--made of rosin, supple and (like the classical instrument described by Herondas) rose-colored--is publicly sold and widely used by women.[190]

It may be noticed that among non-European races it is among women, and especially among those who are subjected to the excitement of a life professionally devoted to some form of pleasure, that the use of the artificial instruments of auto-erotism is chiefly practiced. The same is markedly true in Europe. The use of an artificial penis in solitary sexual gratification may be traced down from classic times, and doubtless prevailed in the very earliest human civilization, for such an instrument is said to be represented in old Babylonian sculptures, and it is referred to by Ezekiel (Ch. XVI. v. 17). The Lesbian women are said to have used such instruments, made of ivory or gold with silken stuffs and linen. Aristophanes (_Lysistrata_, v. 109) speaks of the manufacture by the Milesian women of a leather artificial penis, or olisbos. In the British Museum is a vase representing a _hetaira_ holding such instruments, which, as found at Pompeii, may be seen in the museum at Naples. One of the best of Herondas's mimes, "The Private Conversation," presents a dialogue between two ladies concerning a certain olisbos (or nbôn), which one of them vaunts as a dream of delight. Through the Middle Ages (when from time to time the clergy reprobated the use of such instruments[191]) they continued to be known, and after the fifteenth century the references to them became more precise. Thus Fortini, the Siennese novelist of the sixteenth century, refers in his _Novelle dei Novizi_ (7th Day, Novella XXXIX) to "the glass object filled with warm water which nuns use to calm the sting of the flesh and to satisfy themselves as well as they can"; he adds that widows and other women anxious to avoid pregnancy availed themselves of it. In Elizabethan England, at the same time, it appears to have been of similar character and Marston in his satires tells how Lucea prefers "a glassy instrument" to "her husband's lukewarm bed." In sixteenth century France, also, such instruments were sometimes made of glass, and Brantôme refers to the godemiche; in eighteenth century Germany they were called _Samthanse_, and their use, according to Heinse, as quoted by Dühren, was common among aristocratic women. In England by that time the dildo appears to have become common. Archemholtz states that while in Paris they are only sold secretly, in London a certain Mrs. Philips sold them openly on a large scale in her shop in Leicester Square. John Bee in 1835, stating that the name was originally dil-dol, remarks that their use was formerly commoner than it was in his day. In France, Madame Gourdan, the most notorious brothel-keeper of the eighteenth century, carried on a wholesale trade in _consolateurs_, as they were called, and "at her death numberless letters from abbesses and simple nuns were found among her papers, asking for a 'consolateur' to be sent."[192] The modern French instrument is described by Gamier as of hardened red rubber, exactly imitating the penis and capable of holding warm milk or other fluid for injection at the moment of orgasm; the compressible scrotum is said to have been first added in the eighteenth century.[193]

In Islam the artificial penis has reached nearly as high a development as in Christendom. Turkish women use it and it is said to be openly sold in Smyrna. In the harems of Zanzibar, according to Baumann, it is of considerable size, carved out of ebony or ivory, and commonly bored through so that warm water may be injected. It is here regarded as an Arab invention.[194]

Somewhat similar appliances may be traced in all centres of civilization. But throughout they appear to be frequently confined to the world of prostitutes and to those women who live on the fashionable or semi-artistic verge of that world. Ignorance and delicacy combine with a less versatile and perverted concentration on the sexual impulse to prevent any general recourse to such highly specialized methods of solitary gratification.

On the other hand, the use, or rather abuse, of the ordinary objects and implements of daily life in obtaining auto-erotic gratification, among the ordinary population in civilized modern lands, has reached an extraordinary degree of extent and variety we can only feebly estimate by the occasional resulting mischances which come under the surgeon's hands, because only a certain proportion of such instruments are dangerous. Thus the banana seems to be widely used for masturbation by women, and appears to be marked out for the purpose by its size and shape[195]; it is, however, innocuous, and never comes under the surgeon's notice; the same may probably be said of the cucumbers and other vegetables more especially used by country and factory girls in masturbation; a lady living near Vichy told Pouillet that she had often heard (and had herself been able to verify the fact) that the young peasant women commonly used turnips, carrots, and beet-roots. In the eighteenth century Mirabeau, in his _Erotikca Biblion_ gave a list of the various objects used in convents (which he describes as "vast theatres" of such practices) to obtain solitary sexual excitement. In more recent years the following are a few of the objects found in the vagina or bladder whence they could only be removed by surgical interference[196]: Pencils, sticks of sealing-wax, cotton-reels, hair-pins (and in Italy very commonly the bone-pins used in the hair), bodkins, knitting-needles, crochet-needles, needle-cases, compasses, glass stoppers, candles, corks, tumblers, forks, tooth-picks, toothbrushes, pomade-pots (in a case recorded by Schroeder with a cockchafer inside, a makeshift substitute for the Japanese _rin-no-tama_), while in one recent English case a full-sized hen's egg was removed from the vagina of a middle-aged married woman. More than nine-tenths of the foreign bodies found in the female bladder or urethra are due to masturbation. The age of the individuals in whom such objects have been found is usually from 17 to 30, but in a few cases they have been found in girls below 14, infrequently in women between 40 and 50; the large objects, naturally, are found chiefly in the vagina, and in married women.[197]

Hair-pins have, above all, been found in the female bladder with special frequency; this point is worth some consideration as an illustration of the enormous frequency of this form of auto-erotism. The female urethra is undoubtedly a normal centre of sexual feeling, as Pouillet pointed out many years ago; a woman medical correspondent, also, writes that in some women the maximum of voluptuous sensation is at the vesical sphincter or orifice, though not always so limited. E.H. Smith, indeed, considers that "the urethra is the part in which the orgasm occurs," and remarks that in sexual excitement mucus always flows largely from the urethra.[198] It should be added that when once introduced the physiological mechanism of the bladder apparently causes the organ to tend to "swallow" the foreign object. Yet for every case in which the hair-pin disappears and is lost in the bladder, from carelessness or the oblivion of the sexual spasm, there must be a vast number of cases in which the instrument is used without any such unfortunate result. There is thus great significance in the frequency with which cases of hair-pin in the bladder are strewn through the medical literature of all countries.

In 1862, a German surgeon found the accident so common that he invented a special instrument for extracting hair-pins from the female bladder, as, indeed, Italian and French surgeons have also done. In France, Denucé, of Bordeaux, came to the conclusion that hair-pin in the bladder is the commonest result of masturbation as known to the surgeon. In England cases are constantly being recorded. Lawson Tait, stating that most cases of stone in the bladder in women are due to the introduction of a foreign body, very often a hair-pin, adds: "I have removed hair-pins encrusted with phosphates from ten different female bladders, and not one of the owners of these bladders would give any account of the incident."[199] Stokes, again, records that during four years he had four cases of hair-pin in the female urethra.[200] In New York one physician met with four cases in a short experience.[201] In Switzerland Professor Reverdin had a precisely similar experience.[202]

There is, however, another class of material objects, widely employed for producing physical auto-erotism, which in the nature of things never reaches the surgeon. I refer to the effects that, naturally or unnaturally, may be produced by many of the objects and implements of daily life that do not normally come in direct contact with the sexual organs. Children sometimes, even when scarcely more than infants, produce sexual excitement by friction against the corner of a chair or other piece of furniture, and women sometimes do the same.[203] Guttceit, in Russia, knew women who made a large knot in their chemises to rub against, and mentions a woman who would sit on her naked heel and rub it against her. Girls in France, I am informed, are fond of riding on the _chevaux-de-bois_, or hobby-horses, because of the sexual excitement thus aroused; and that the sexual emotions play a part in the fascination exerted by this form of amusement everywhere is indicated by the ecstatic faces of its devotees.[204] At the temples in some parts of Central India, I am told, swings are hung up in pairs, men and women swinging in these until sexually excited; during the months when the men in these districts have to be away from home the girls put up swings to console themselves for the loss of their husbands.

It is interesting to observe the very wide prevalence of swinging, often of a religious or magic character, and the evident sexual significance underlying it, although this is not always clearly brought out. Groos, discussing the frequency of swinging (_Die Spiele der Menschen_, p. 114) refers, for instance, to the custom of the Gilbert Islanders for a young man to swing a girl from a coco palm, and then to cling on and swing with her. In ancient Greece, women and grown-up girls were fond of see-saws and swings. The Athenians had, indeed, a swinging festival (Athenæus, Bk. XIV, Ch. X). Songs of a voluptuous character, we gather from Athenæus, were sung by the women at this festival. J.G. Frazer (_The Golden Bough_, vol. ii, note A, "Swinging as a Magical Rite") discusses the question, and brings forward instances in which men, or, especially, women swing. "The notion seems to be," he states, "that the ceremony promotes fertility, whether in the vegetable or in the animal kingdom; though why it should be supposed to do so, I confess myself unable to explain" (loc. cit., p. 450). The explanation seems, however, not far to seek, in view of the facts quoted above, and Frazer himself refers to the voluptuous character of the songs sometimes sung.

Even apart from actual swinging of the whole body, a swinging movement may suffice to arouse sexual excitement, and may,--at all events, in women,--constitute an essential part of methods of attaining solitary sexual gratification. Kiernan thus describes the habitual auto-erotic procedure of a young American woman: "The patient knelt before a chair, let her elbows drop on its seat, grasping the arms with a firm grip, then commenced a swinging, writhing motion, seeming to fix her pelvis, and moving her trunk and limbs. The muscles were rigid, the face took on a passionate expression; the features were contorted, the eyes rolled, the teeth were set, and the lips compressed, while the cheeks were purple. The condition bore a striking resemblance to the passional stage of grand hysteria. The reveling took only a moment to commence, but lasted a long time. Swaying induced a pleasurable sensation, accompanied with a feeling of suction upon the clitoris. Almost immediately after, a sensation of bursting, caused by discharge from the vulvo-vaginal glands, occurs, followed by a rapture prolonged for an indefinite time." The accompanying sexual imagery is so vivid as almost to become hallucinatory. (J.G. Kiernan, "Sex Transformation and Psychic Impotence," _American Journal of Dermatology_, vol. ix, No. 2.)

Somewhat similarly sensations of sexual character are sometimes experienced by boys when climbing up a pole. It is not even necessary that there should be direct external contact with the sexual organs, and Howe states that gymnastic swinging poles around which boys swing while supporting the whole weight on the hands, may suffice to produce sexual excitement.

Several writers have pointed out that riding, especially in women, may produce sexual excitement and orgasm.[205] It is well-known, also, that both in men and women the vibratory motion of a railway-train frequently produces a certain degree of sexual excitement, especially when sitting forward. Such excitement may remain latent and not become specifically sexual.[206] I am not aware that this quality of railway traveling has ever been fostered as a sexual perversion, but the sewing-machine has attracted considerable attention on account of its influence in exciting auto-erotic manifestations. The early type of sewing-machine, especially, was of very heavy character and involved much up and down movement of the legs; Langdon Down pointed out many years ago that this frequently produced great sexual erethism which led to masturbation.[207] According to one French authority, it is a well-recognized fact that to work a sewing-machine with the body in a certain position produces sexual excitement leading to the orgasm. The occurrence of the orgasm is indicated to the observer by the machine being worked for a few seconds with uncontrollable rapidity. This sound is said to be frequently heard in large French workrooms, and it is part of the duty of the superintendents of the rooms to make the girls sit properly.[208]

"During a visit which I once paid to a manufactory of military clothing," Pouillet writes, "I witnessed the following scene. In the midst of the uniform sound produced by some thirty sewing-machines, I suddenly heard one of the machines working with much more velocity than the others. I looked at the person who was working it, a brunette of 18 or 20. While she was automatically occupied with the trousers she was making on the machine, her face became animated, her mouth opened slightly, her nostrils dilated, her feet moved the pedals with constantly increasing rapidity. Soon I saw a convulsive look in her eyes, her eyelids were lowered, her face turned pale and was thrown backward; hands and legs stopped and became extended; a suffocated cry, followed by a long sigh, was lost in the noise of the workroom. The girl remained motionless a few seconds, drew out her handkerchief to wipe away the pearls of sweat from her forehead, and, after casting a timid and ashamed glance at her companions, resumed her work. The forewoman, who acted as my guide, having observed the direction of my gaze, took me up to the girl, who blushed, lowered her face, and murmured some incoherent words before the forewoman had opened her mouth, to advise her to sit fully on the chair, and not on its edge.

"As I was leaving, I heard another machine at another part of the room in accelerated movement. The forewoman smiled at me, and remarked that that was so frequent that it attracted no notice. It was specially observed, she told me, in the case of young work-girls, apprentices, and those who sat on the edge of their seats, thus much facilitating friction of the labia."

In cases where the sewing-machine does not lead to direct self-excitement it has been held, as by Fothergill,[209] to predispose to frequency of involuntary sexual orgasm during sleep, from the irritation set up by the movement of the feet in the sitting posture during the day. The essential movement in working the sewing-machine is the flexion and extension of the ankle, but the muscles of the thighs are used to maintain the feet firmly on the treadle, the thighs are held together, and there is a considerable degree of flexion or extension of the thighs on the trunk; by a special adjustment of the body, and sometimes perhaps merely in the presence of sexual hyperæsthesia, it is thus possible to act upon the sexual organs; but this is by no means a necessary result of using the sewing-machine, and inquiry of various women, with well-developed sexual feelings, who are accustomed to work the treadle, has not shown the presence of any tendency in this direction.

Sexual irritation may also be produced by the bicycle in women. Thus, Moll[210] remarks that he knows many married women, and some unmarried, who experience sexual excitement when cycling; in several cases he has ascertained that the excitement is carried as far as complete orgasm. This result cannot, however, easily happen unless the seat is too high, the peak in contact with the organs, and a rolling movement is adopted; in the absence of marked hyperæsthesia these results are only effected by a bad seat or an improper attitude, the body during cycling resting under proper conditions on the buttocks, and the work being mainly done by the muscles of the thighs and legs which control the ankles, flexion of the thigh on the pelvis being very small. Most medical authorities on cycling are of opinion that when cycling leads to sexual excitement the fault lies more with the woman than with the machine. This conclusion does not appear to me to be absolutely correct. I find on inquiry that with the old-fashioned saddle, with an elevated peak rising toward the pubes, a certain degree of sexual excitement, not usually producing the orgasm (but, as one lady expressed it, making one feel quite ready for it), is fairly common among women. Lydston finds that irritation of the genital organs may unquestionably be produced in both males and females by cycling. The aggravation of hæmorrhoids sometimes produced by cycling indicates also the tendency to local congestion. With the improved flat saddles, however, constructed with more definite adjustment to the anatomical formation of the parts, this general tendency is reduced to a negligible minimum.

Reference may be made at this point to the influence of tight-lacing. This has been recognized by gynæcologists as a factor of sexual excitement and a method of masturbation.[211] Women who have never worn corsets sometimes find that, on first putting them on, sexual feeling is so intensified that it is necessary to abandon their use.[212] The reason of this (as Siebert points out in his _Buch für Eltern_) seems to be that the corset both favors pelvic congestion and at the same time exerts a pressure on the abdominal muscles which brings them into the state produced during coitus. It is doubtless for the same reason that, as some women have found, more distension of the bladder is possible without corsets than with them.

In a further class of cases no external object whatever is used to procure the sexual orgasm, but the more or less voluntary pressure of the thighs alone is brought to bear upon the sexual regions. It is done either when sitting or standing, the thighs being placed together and firmly crossed, and the pelvis rocked so that the sexual organs are pressed against the inner and posterior parts of the thighs.[213] This is sometimes done by men, and is fairly common among women, especially, according to Martineau,[214] among those who sit much, such as dressmakers and milliners, those who use the sewing-machine, and those who ride. Vedeler remarks that in his experience in Scandinavia, thigh-friction is the commonest form of masturbation in women. The practice is widespread, and a medical correspondent in India tells me of a Brahmin widow who confessed to this form of masturbation. I am told that in London Board Schools, at the present time, thigh-rubbing is not infrequent among the girl scholars; the proportion mentioned in one school was about ten per cent, of the girls over eleven; the thigh-rubbing is done more or less openly and is interpreted by the uninitiated as due merely to a desire to relieve the bladder. It is found in female infants. Thus, Townsend records the case of an infant, 8 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.[215] The frequency of thigh-friction among women as a form of masturbation is due to the fact that it is usually acquired innocently and it involves no indecorum. Thus Soutzo reports the case of a girl of 12 who at school, when having to wait her turn at the water-closet, for fear of wetting herself would put her clothes between her legs and press her thighs together, moving them backwards and forwards in the effort to control the bladder; she discovered that a pleasurable sensation was thus produced and acquired the habit of practicing the manoeuvre for its own sake; at the age of 17 she began to vary it in different ways; thus she would hang from a tree with her legs swinging and her chemise pressed between her thighs which she would rub together.[216] Thigh-friction in some of its forms is so comparatively decorous a form of masturbation that it may even be performed in public places; thus, a few years ago, while waiting for a train at a station on the outskirts of a provincial town, I became aware of the presence of a young woman, sitting alone on a seat at a little distance, whom I could observe unnoticed. She was leaning back with legs crossed, swinging the crossed foot vigorously and continuously; this continued without interruption for some ten minutes after I first observed her; then the swinging movement reached a climax; she leant still further back, thus bringing the sexual region still more closely in contact with the edge of the bench and straightened and stiffened her body and legs in what appeared to be a momentary spasm; there could be little doubt as to what had taken place. A few moments later she slowly walked from her solitary seat into the waiting-room and sat down among the other waiting passengers, quite still now and with uncrossed legs, a pale quiet young woman, possibly a farmer's daughter, serenely unconscious that her manoeuvre had been detected, and very possibly herself ignorant of its true nature.

There are many other forms in which the impulse of auto-erotism presents itself. Dancing is often a powerful method of sexual excitement, not only among civilized but among savage peoples, and Zache describes the erotic dances of Swaheli women as having a masturbatory object.[217] Stimulation of the nates is a potent adjuvant to the production of self-excitement, and self-flagellation with rods, etc., is practiced by some individuals, especially young women.[218] Urtication is another form of this stimulation; Reverdin knew a young woman who obtained sexual gratification by flogging herself with chestnut burrs, and it is stated that in some parts of France (departments of the Ain and Côte d'Or) it is not uncommon for young girls to masturbate by rubbing the leaves of the _Linaria cymbalaria_ (here called "pinton" or "timbarde") on to the sexual parts, thus producing a burning sensation.[219] Stimulation of the mamma, normally an erogenous centre in women, may occasionally serve as a method for obtaining auto-erotic satisfaction, including the orgasm, in both sexes. I have been told of a case in a man, and a medical correspondent in India informs me that he knows a Eurasian woman, addicted to masturbation, who can only obtain the orgasm by rubbing the genitals with one hand while with the other she rubs and finally squeezes her breasts. The tactile stimulation even of regions of the body which are not normally erogenous zones in either sex may sometimes lead on to sexual excitement; Hirschsprung, as well as Freud, believes that this is often the case as regards finger-sucking and toe-sucking in infancy. Even stroking the chin, remarks Debreyne, may produce a pollution.[220] Taylor refers to the case of a young woman of 22, who was liable to attacks of choreic movements of the hands which would terminate in alternately pressing the middle finger on the tip of the nose and the tragus of the ear, when a "far-away, pleased expression" would appear on her face; she thus produced sexual excitement and satisfaction. She had no idea of wrong-doing and was surprised and ashamed when she realized the nature of her act.[221]

Most of the foregoing examples of auto-erotism, are commonly included, by no means correctly, under the heading of "masturbation." There are, however, a vast number of people, possessing strong sexual emotions and living a solitary life, who experience, sometimes by instinct and sometimes on moral grounds, a strong repugnance for these manifestations of auto-erotism. As one highly intelligent lady writes: "I have sometimes wondered whether I could produce it (complete sexual excitement) mechanically, but I have a curious unreasonable repugnance to trying the experiment. It would materialize it too much." The same repugnance may be traced in the tendency to avoid, so far as possible, the use of the hands. It is quite common to find this instinctive unreasoning repugnance among women, a healthy repugnance, not founded on any moral ground. In men the same repugnance exists, more often combined with, or replaced by, a very strong moral and æsthetic objection to such practices. But the presence of such a repugnance, however invincible, is very far from carrying us outside the auto-erotic field. The production of the sexual orgasm is not necessarily dependent on any external contact or voluntary mechanical cause.

As an example, though not of specifically auto-erotic manifestations, I may mention the case of a man of 57, a somewhat eccentric preacher, etc., who writes: "My whole nature goes out so to some persons, and they thrill and stir me so that I have an emission while sitting by them with no thought of sex, only the gladness of soul found its way out thus, and a glow of health suffused the whole body. There was no spasmodic conclusion, but a pleasing gentle sensation as the few drops of semen passed." (In reality, no doubt, not semen, but urethral fluid.) This man's condition may certainly be considered somewhat morbid; he is attracted to both men and women, and the sexual impulse seems to be irritable and weak; but a similar state of things exists so often in women, no doubt due to sexual repression, and in individuals who are in a general state of normal and good health, that in these it can scarcely be called morbid. Brooding on sexual images, which the theologians termed _delectatio morosa_, may lead to spontaneous orgasm in either sex, even in perfectly normal persons. Hammond described as a not uncommon form of "psychic coitus," a condition in which the simple act of imagination alone, in the presence of the desired object, suffices to produce orgasm. In some public conveyance, theatre, or elsewhere, the man sees a desirable woman and by concentrating his attention on her person and imagining all the stages of intimacy he quickly succeeds in producing orgasm.[222] Niceforo refers to an Italian work-girl of 14 who could obtain ejaculation of mucus four times a day, in the workroom in the presence of the other girls, without touching herself or moving her body, by simply thinking of sexual things.[223]

If the orgasm occurs spontaneously, without the aid of mental impressions, or any manipulations _ad hoc_, though under such conditions it ceases to be sinful from the theological standpoint, it certainly ceases also to be normal. Sérieux records the case of a somewhat neurotic woman of 50, who had been separated from her husband for ten years, and since lived a chaste life; at this age, however, she became subject to violent crises of sexual orgasm, which would come on without any accompaniment of voluptuous thoughts. MacGillicuddy records three cases of spontaneous orgasm in women coming under his notice.[224] Such crises are frequently found in both men and women, who, from moral reasons, ignorance, or on other grounds are restrained from attaining the complete sexual orgasm, but whose sexual emotions are, literally, continually dribbling from them. Schrenck-Notzing knows a lady who is spontaneously sexually excited on hearing music or seeing pictures without anything lascivious in them; she knows nothing of sexual relationships. Another lady is sexually excited on seeing beautiful and natural scenes, like the sea; sexual ideas are mixed up in her mind with these things, and the contemplation of a specially strong and sympathetic man brings the orgasm on in about a minute. Both these ladies "masturbate" in the streets, restaurants, railways, theatres, without anyone perceiving it.[225] A Brahmin woman informed a medical correspondent in India that she had distinct though feeble orgasm, with copious outflow of mucus, if she stayed long near a man whose face she liked, and this is not uncommon among European women. Evidently under such conditions there is a state of hyperæsthetic weakness. Here, however, we are passing the frontiers of strictly auto-erotic phenomena.

_Delectatio morosa_, as understood by the theologians, is distinct from desire, and also distinct from the definite intention of effecting the sexual act, although it may lead to those things. It is the voluntary and complacent dallying in imagination with voluptuous thoughts, when no effort is made to repel them. It is, as Aquinas and others point out, constituted by this act of complacent dallying, and has no reference to the duration of the imaginative process. Debreyne, in his _Moechialogie_ (pp. 149-163), deals fully with this question, and quotes the opinions of theologians. I may add that in the early Penitentials, before the elaboration of Catholic theology, the voluntary emission of semen through the influence of evil thoughts, was recognized as a sin, though usually only if it occurred in church. In Egbert's Penitential of the eighth or ninth century (cap. IX, 12), the penance assigned for this offence in the case of a deacon, is 25 days; in the case of a monk, 30 days; a priest, 40 days; a bishop, 50. (Haddon and Stubbs, _Councils and Ecclesiastical Documents_, vol. iii, p. 426.)

The frequency of spontaneous orgasm in women seems to have been recognized in the seventeenth century. Thus, Schurig (_Syllepsilogia_, p. 4), apparently quoting Riolan, states that some women are so wanton that the sight of a handsome man, or of their lover, or speech with such a one, will cause them to ejaculate their semen.

There is, however, a closely allied, and, indeed, overlapping form of auto-erotism which may be considered here: I mean that associated with revery, or day-dreaming. Although this is a very common and important form of auto-erotism, besides being in a large proportion of cases the early stage of masturbation, it appears to have attracted little attention.[226] The day-dream has, indeed, been studied in its chief form, in the "continued story," by Mabel Learoyd, of Wellesley College. The continued story is an imagined narrative, more or less peculiar to the individual, by whom it is cherished with fondness, and regarded as an especially sacred mental possession, to be shared only, if at all, with very sympathizing friends. It is commoner among girls and young women than among boys and young men; among 352 persons of both sexes, 47 per cent. among the women and only 14 per cent. among the men, have any continued story. The starting-point is an incident from a book, or, more usually, some actual experience, which the subject develops; the subject is nearly always the hero or the heroine of the story. The growth of the story is favored by solitude, and lying in bed before going to sleep is the time specially sacred to its cultivation.[227] No distinct reference, perhaps naturally enough, is made by Miss Learoyd to the element of sexual emotion with which these stories are often strongly tinged, and which is frequently their real motive. Though by no means easy to detect, these elaborate and more or less erotic day-dreams are not uncommon in young men and especially in young women. Each individual has his own particular dream, which is always varying or developing, but, except in very imaginative persons, to no great extent. Such a day-dream is often founded on a basis of pleasurable personal experience, and develops on that basis. It may involve an element of perversity, even though that element finds no expression in real life. It is, of course, fostered by sexual abstinence; hence its frequency in young women. Most usually there is little attempt to realize it. It does not necessarily lead to masturbation, though it often causes some sexual congestion or even spontaneous sexual orgasm. The day-dream is a strictly private and intimate experience, not only from its very nature, but also because it occurs in images which the subject finds great difficulty in translating into language, even when willing to do so. In other cases it is elaborately dramatic or romantic in character, the hero or heroine passing through many experiences before attaining the erotic climax of the story. This climax tends to develop in harmony with the subject's growing knowledge or experience; at first, merely a kiss, it may develop into any refinement of voluptuous gratification. The day-dream may occur either in normal or abnormal persons. Rousseau, in his _Confessions_, describes such dreams, in his case combined with masochism and masturbation. A distinguished American novelist, Hamlin Garland, has admirably described in _Rose of Dutcher's Coolly_ the part played in the erotic day-dreams of a healthy normal girl at adolescence by a circus-rider, seen on the first visit to a circus, and becoming a majestic ideal to dominate the girl's thoughts for many years.[228] Raffalovich[229] describes the process by which in sexual inverts the vision of a person of the same sex, perhaps seen in the streets or the theatre, is evoked in solitary reveries, producing a kind of "psychic onanism," whether or not it leads on to physical manifestations.

Although day-dreaming of this kind has at present been very little studied, since it loves solitude and secrecy, and has never been counted of sufficient interest for scientific inquisition, it is really a process of considerable importance, and occupies a large part of the auto-erotic field. It is frequently cultivated by refined and imaginative young men and women who lead a chaste life and would often be repelled by masturbation. In such persons, under such circumstances, it must be considered as strictly normal, the inevitable outcome of the play of the sexual impulse. No doubt it may often become morbid, and is never a healthy process when indulged in to excess, as it is liable to be by refined young people with artistic impulses, to whom it is in the highest degree seductive and insidious.[230] As we have seen, however, day-dreaming is far from always colored by sexual emotion; yet it is a significant indication of its really sexual origin that, as I have been informed by persons of both sexes, even in these apparently non-sexual cases it frequently ceases altogether on marriage.

Even when we have eliminated all these forms of auto-erotic activity, however refined, in which the subject takes a voluntary part, we have still left unexplored an important portion of the auto-erotic field, a portion which many people are alone inclined to consider normal: sexual orgasm during sleep. That under conditions of sexual abstinence in healthy individuals there must inevitably be some auto-erotic manifestations during waking life, a careful study of the facts compels us to believe. There can be no doubt, also, that, under the same conditions, the occurrence of the complete orgasm during sleep with, in men, seminal emissions, is altogether normal. Even Zeus himself, as Pausanias has recorded, was liable to such accidents: a statement which, at all events, shows that to the Greek mind there was nothing derogatory in such an occurrence.[231] The Jews, however, regarded it as an impurity,[232] and the same idea was transmitted to the Christian church and embodied in the word _pollutio_, by which the phenomenon was designated in ecclesiastical phraseology.[233] According to Billuart and other theologians, pollution in sleep is not sin, unless voluntarily caused; if, however, it begins in sleep, and is completed in the half-waking state, with a sense of pleasure, it is a venial sin. But it seems allowable to permit a nocturnal pollution to complete itself on awaking, if it occurs without intention; and St. Thomas even says "_Si pollutio placeat ut naturæ exoneratio vel alleviatio peccatum non creditur_."

Notwithstanding the fair and logical position of the more distinguished Latin theologians, there has certainly been a widely prevalent belief in Catholic countries that pollution during sleep is a sin. In the "Parson's Tale," Chaucer makes the parson say: "Another sin appertaineth to lechery that cometh in sleeping; and the sin cometh oft to them that be maidens, and eke to them that be corrupt; and this sin men clepe pollution, that cometh in four manners;" these four manners being (1) languishing of body from rank and abundant humors, (2) infirmity, (3) surfeit of meat and drink, and (4) villainous thoughts. Four hundred years later, Madame Roland, in her _Mémoires Particulières_, presented a vivid picture of the anguish produced in an innocent girl's mind by the notion of the sinfulness of erotic dreams. She menstruated first at the age of 14. "Before this," she writes, "I had sometimes been awakened from the deepest sleep in a surprising manner. Imagination played no part; I exercised it on too many serious subjects, and my timorous conscience preserved it from amusement with other subjects, so that it could not represent what I would not allow it to seek to understand. But an extraordinary effervescence aroused my senses in the heat of repose, and, by virtue of my excellent constitution, operated by itself a purification which was as strange to me as its cause. The first feeling which resulted was, I know not why, a sort of fear. I had observed in my _Philotée_, that we are not allowed to obtain any pleasure from our bodies except in lawful marriage. What I had experienced could be called a pleasure. I was then guilty, and in a class of offences which caused me the most shame and sorrow, since it was that which was most displeasing to the Spotless Lamb. There was great agitation in my poor heart, prayers and mortifications. How could I avoid it? For, indeed, I had not foreseen it, but at the instant when I experienced it, I had not taken the trouble to prevent it. My watchfulness became extreme. I scrupulously avoided positions which I found specially exposed me to the accident. My restlessness became so great that, at last I was able to awake before the catastrophe. When I was not in time to prevent it, I would jump out of bed, with naked feet on to the polished floor, and with crossed arms pray to the Saviour to preserve me from the wiles of the devil. I would then impose some penance on myself, and I have carried out to the letter what the prophet King probably only transmitted to us as a figure of Oriental speech, mixing ashes with my bread and watering it with my tears."

To the early Protestant mind, as illustrated by Luther, there was something diseased, though not impure, in sexual excitement during sleep; thus, in his _Table Talk_ Luther remarks that girls who have such dreams should be married at once, "taking the medicine which God has given." It is only of comparatively recent years that medical science has obtained currency for the belief that this auto-erotic process is entirely normal. Blumenbach stated that nocturnal emissions are normal.[234] Sir James Paget declared that he had never known celibate men who had not such emissions from once or twice a week to twice every three months, both extremes being within the limits of good health, while Sir Lauder Brunton considers once a fortnight or once a month about the usual frequency, at these periods the emissions often following two nights in succession. Rohleder believes that they may normally follow for several nights in succession. Hammond considers that they occur about once a fortnight.[235] Ribbing regards ten to fourteen days as the normal interval.[236] Löwenfeld puts the normal frequency at about once a week;[237] this seems to be nearer the truth as regards most fairly healthy young men. In proof of this it is only necessary to refer to the exact records of healthy young adults summarized in the study of periodicity in the present volume. It occasionally happens, however, that nocturnal emissions are entirely absent. I am acquainted with some cases. In other fairly healthy young men they seldom occur except at times of intellectual activity or of anxiety and worry.

Lately there has been some tendency for medical opinion to revert to the view of Luther, and to regard sexual excitement during sleep as a somewhat unhealthy phenomenon. Moll is a distinguished advocate of this view. Sexual excitement during sleep is the normal result of celibacy, but it is another thing to say that it is, on that account, satisfactory. We might, then, Moll remarks, maintain that nocturnal incontinence of urine is satisfactory, since the bladder is thus emptied. Yet, we take every precaution against this by insisting that the bladder shall be emptied before going to sleep. (_Libido Sexualis_, Bd. I, p. 552.) This remark is supported by the fact, to which I find that both men and women can bear witness, that sexual excitement during sleep is more fatiguing than in the waking state, though this is not an invariable rule, and it is sometimes found to be refreshing. In a similar way, Eulenburg (_Sexuale Neuropathie_, p. 55) states that nocturnal emissions are no more normal than coughing or vomiting.

Nocturnal emissions are usually, though not invariably, accompanied by dreams of a voluptuous character in which the dreamer becomes conscious in a more or less fantastic manner of the more or less intimate presence or contact of a person of the opposite sex. It would seem, as a general rule, that the more vivid and voluptuous the dream, the greater is the physical excitement and the greater also the relief experienced on awakening. Sometimes the erotic dream occurs without any emission, and not infrequently the emission takes place after the dreamer has awakened.

The widest and most comprehensive investigation of erotic dreams is that carried out by Gualino, in northern Italy, and based on inquiries among 100 normal men--doctors, teachers, lawyers, etc.--who had all had experience of the phenomenon. (L. Gualino, "Il Sogno Erotico nell' Uomo Normale," _Rivista di Psicologia_, Jan.-Feb., 1907.) Gualino shows that erotic dreams, with emissions (whether or not seminal), began somewhat earlier than the period of physical development as ascertained by Marro for youths of the same part of northern Italy. Gualino found that all his cases had had erotic dreams at the age of seventeen; Marro found 8 per cent, of youths still sexually undeveloped at that age, and while sexual development began at thirteen years, erotic dreams began at twelve. Their appearance was preceded, in most cases for some months, by erections. In 37 per cent, of the cases there had been no actual sexual experiences (either masturbation or intercourse); in 23 per cent, there had been masturbation; in the rest, some form of sexual contact. The dreams are mainly visual, tactual elements coming second, and the _dramatis persona_ is either an unknown woman (27 per cent, cases), or only known by sight (56 per cent.), and in the majority is, at all events in the beginning, an ugly or fantastic figure, becoming more attractive later in life, but never identical with the woman loved during waking life. This, as Gualino points out, accords with the general tendency for the emotions of the day to be latent in sleep. Masturbation only formed the subject of the dream in four cases. The emotional state in the pubertal stage, apart from pleasure, was anxiety (37 per cent.), desire (17 per cent.), fear (14 per cent.). In the adult stage, anxiety and fear receded to 7 per cent, and 6 per cent., respectively. Thirty-three of the subjects, as a result of sexual or general disturbances, had had nocturnal emissions without dreams; these were always found exhausting. Normally (in more than 90 per cent.) erotic dreams are the most vivid of all dreams. In no case was there knowledge of any monthly or other cyclic periodicity in the occurrence of the manifestations. In 34 per cent, of cases, they tended to occur very soon after sexual intercourse. In numerous cases they were peculiarly frequent (even three in one night) during courtship, when the young man was in the habit of kissing and caressing his betrothed, but ceased after marriage. It was not noted that position in bed or a full bladder exerted any marked influence in the occurrence of erotic dreams; repletion of the seminal vesicles is regarded as the main factor.

In Germany erotic dreams have been discussed by Volkelt (_Die Traum-Phantasie_, 1875, pp. 78-82), and especially by Löwenfeld (_Sexual-Probleme_, Oct., 1908), while in America, Stanley Hall thus summarizes the general characteristics of erotic dreams in men: "In by far the most cases, consciousness, even when the act causes full awakening from sleep, finds only scattered images, single words, gestures, and acts, many of which would perhaps normally constitute no provocation. Many times the mental activity seems to be remote and incidental, and the mind retains in the morning nothing except, perhaps, a peculiar dress pattern, the shape of a finger-nail, the back of a neck, the toss of a head, the movement of a foot, or the dressing of the hair. In such cases, these images stand out for a time with the distinctness of a cameo, and suggest that the origin of erotic fetichisms is largely to be found in sexual dreams. Very rarely is there any imagery of the organs themselves, but the tendency to irradiation is so strong as to re-enforce the suggestion of so many other phenomena in this field, that nature designs this experience to be long circuited, and that it may give a peculiar ictus to almost any experience. When waking occurs just afterward, it seems at least possible that there may be much imagery that existed, but failed to be recalled to memory, possibly because the flow of psychic impressions was over very familiar fields, and this, therefore, was forgotten, while any eruption into new or unwonted channels, stood out with distinctness. All these psychic phenomena, although very characteristic of man in his prime, are not so of the dreams of dawning puberty, which are far more vivid." (G. Stanley Hall, _Adolescence_, vol. i, p. 455.)

I may, further, quote the experience of an anonymous contributor--a healthy and chaste man between 30 and 38 years of age--to the _American Journal of Psychology_ ("Nocturnal Emissions," Jan., 1904): "Legs and breasts often figured prominently in these dreams, the other sexual parts, however, very seldom, and then they turned out to be male organs in most cases. There were but two instances of copulation dreamt. Girls and young women were the, usual _dramatis personæ_, and, curiously enough, often the aggressors. Sometimes the face or faces were well known; sometimes, only once seen; sometimes, entirely unknown. The orgasm occurs at the most erotic part of the dream, the physical and psychical running parallel. This most erotic or suggestive part of the dream was very often quite an innocent looking incident enough. As, for example: while passing a strange young woman, overtaken on the street, she calls after me some question. At first, I pay no heed, but when she calls again, I hesitate whether to turn back and answer or not--emission. Again, walking beside a young woman, she said, 'Shall I take your arm?' I offered it, and she took it, entwining her arm around it, and raising it high--emission. I could feel stronger erection as she asked the question. Sometimes, a word was enough; sometimes, a gesture. Once emission took place on my noticing the young woman's diminished finger-nails. Another example of fetichism was my being curiously attracted in a dream by the pretty embroidered figure on a little girl's dress. As an illustration of the strange metamorphoses that occur in dreams, I one night, in my dream (I had been observing partridges in the summer) fell in love with a partridge, which changed under my caresses to a beautiful girl, who yet retained an indescribable wild-bird innocence, grace, and charm--a sort of Undina!"

These experiences may be regarded as fairly typical of the erotic dreams of healthy and chaste young men. The bird, for instance, that changes into a woman while retaining some elements of the bird, has been encountered in erotic dreams by other young men. It is indeed remarkable that, as De Gubernatis observes, "the bird is a well-known phallic symbol," while Maeder finds ("Interprétations de Quelques Rêves," _Archives de Psychologie_, April, 1907) that birds have a sexual significance both in life and in dreams. The appearance of male organs in the dream-woman is doubtless due to the dreamer's greater familiarity with those organs; but, though it occurs occasionally, it can scarcely be said to be the rule in erotic dreams. Even men who have never had connection with a woman, are quite commonly aware of the presence of a woman's sexual organs in their erotic dreams.

Moll's comparison of nocturnal emissions of semen with nocturnal incontinence of urine suggests an interesting resemblance, and at the same time seeming contrast. In both cases we are concerned with viscera which, when overfilled or unduly irritable, spasmodically eject their contents during sleep. There is a further resemblance which usually becomes clear when, as occasionally happens, nocturnal incontinence of urine persists on to late childhood or adolescence: both phenomena are frequently accompanied by vivid dreams of appropriate character. (See e.g. Ries, "Ueber Enuresis Nocturna," _Monatsschrift für Harnkrankheiten und Sexuelle Hygiene_, 1904; A.P. Buchan, nearly a century ago, pointed out the psychic element in the experiences of young persons who wetted the bed, _Venus sine Concubitu_, 1816, p. 47.) Thus, in one case known to me, a child of seven, who occasionally wetted the bed, usually dreamed at the same time that she wanted to make water, and was out of doors, running to find a suitable spot, which she at last found, and, on awaking, discovered that she had wetted the bed; fifteen years later she still sometimes had similar dreams, which caused her much alarm until, when thoroughly awake, she realized that no accident had happened; these later dreams were not the result of any actual strong desire to urinate. In another case with which I am acquainted, a little girl of eight, after mental excitement or indigestible meals, occasionally wetted the bed, dreaming that she was frightened by some one running after her, and wetted herself in consequence, after the manner of the Ganymede in the eagle's clutch, as depicted by Rembrandt. These two cases, it may be noted, belong to two quite different types. In the first case, the full bladder suggests to imagination the appropriate actions for relief, and the bladder actually accepts the imaginative solution offered; it is, according to Fiorani's phrase, "somnambulism of the bladder." In the other case, there is no such somnambulism, but a psychic and nervous disturbance, not arising in the bladder at all, irradiates convulsively, and whether or not the bladder is overfull, attacks a vesical nervous system which is not yet sufficiently well-balanced to withstand the inflow of excitement. In children of somewhat nervous temperament, manifestations of this kind may occur as an occasional accident, up to about the age of seven or eight; and thereafter, the nervous control of the bladder having become firmly established, they cease to happen, the nervous energy required to affect the bladder sufficing to awake the dreamer. In very rare cases, however, the phenomenon may still occasionally happen, even in adolescence or later, in individuals who are otherwise quite free from it. This is most apt to occur in young women even in waking life. In men it is probably extremely rare.

The erotic dream seems to differ flagrantly from the vesical dream, in that it occurs in adult life, and is with difficulty brought under control. The contrast is, however, very superficial. When we remember that sexual activity only begins normally at puberty, we realize that the youth of twenty is, in the matter of sexual control, scarcely much older than in the matter of vesical control he was at the age of six. Moreover, if we were habitually, from our earliest years, to go to bed with a full bladder, as the chaste man goes to bed with unrelieved sexual system, it would be fully as difficult to gain vesical control during sleep as it now is to gain sexual control. Ultimately, such sexual control is attained; after the age of forty, it seems that erotic dreams with emission become more and more rare; either the dream occurs without actual emission, exactly as dreams of urination occur in adults with full bladder, or else the organic stress, with or without dreams, serves to awaken the sleeper before any emission has occurred. But this stage is not easily or completely attained. St. Augustine, even at the period when he wrote his _Confessions_, mentions, as a matter of course, that sexual dreams "not merely arouse pleasure, but gain the consent of the will." (X. 41.) Not infrequently there is a struggle in sleep, just as the hypnotic subject may resist suggestions; thus, a lady of thirty-five dreamed a sexual dream, and awoke without excitement; again she fell asleep, and had another dream of sexual character, but resisted the tendency to excitement, and again awoke; finally, she fell asleep and had a third sexual dream, which was this time accompanied by the orgasm. (This has recently been described also by Näcke, who terms it _pollutio interrupta, Neurologisches Centralblatt_, Oct. 16, 1909; the corresponding voluntary process in the waking state is described by Rohleder and termed _masturbatio interrupta, Zeitschrift für Sexualwissenschaft_, Aug., 1908.) The factors involved in the acquirement of vesical and sexual control during sleep are the same, but the conditions are somewhat different.

There is a very intimate connection between the vesical and the sexual spheres, as I have elsewhere pointed out (see e.g. in the third volume of these _Studies_, "Analysis of the Sexual Impulse"). This connection is psychic as well as organic. Both in men and women, a full bladder tends to develop erotic dreams. (See e.g. K.A. Scherner, _Das Leben des Traums_, 1861, pp. 187 et seq.; Spitta also points out the connection between vesical and erotic dreams, _Die Schlaf und Traumzustände_, 2d ed., 1882, pp. 250 et seq.) Raymond and Janet state (_Les Obscessions_, vol. ii, p. 135) that nocturnal incontinence of urine, accompanied by dreams of urination, may be replaced at puberty by masturbation. In the reverse direction, Freud believes (_Monatsschrift für Psychiatrie_, Bd. XVIII, p. 433) that masturbation plays a large part in causing the bed-wetting of children who have passed the age when that usually ceases, and he even finds that children are themselves aware of the connection.

The diagnostic value of sexual dreams, as an indication of the sexual nature of the subject when awake, has been emphasized by various writers. (E.g., Moll, _Die Konträre Sexualempfindung_, Ch. IX; Näcke, "Der Traum als feinstes Reagens für die Art des sexuellen Empfindens," _Monatsschrift für Kriminalpsychologie_, 1905, p. 500.) Sexual dreams tend to reproduce, and even to accentuate, those characteristics which make the strongest sexual appeal to the subject when awake.

At the same time, this general statement has to be qualified, more especially as regards inverted dreams. In the first place, a young man, however normal, who is not familiar with the feminine body when awake, is not likely to see it when asleep, even in dreams of women; in the second place, the confusions and combinations of dream imagery often tend to obliterate sexual distinctions, however free from perversions the subjects may be. Thus, a correspondent tells me of a healthy man, of very pure character, totally inexperienced in sexual matters, and never having seen a woman naked, who, in his sexual dreams, always sees the woman with male organs, though he has never had any sexual inclinations for men, and is much in love with a lady. The confusions and associations of dream imagery, leading to abnormal combinations, may be illustrated by a dream which once occurred to me after reading Joest's account of how a young negress, whose tattoo-marks he was sketching, having become bored, suddenly pressed her hands to her breasts, spirting two streams of lukewarm milk into his face, and ran away laughing; I dreamed of a woman performing a similar action, not from her breasts, however, but from a penis with which she was furnished. Again, by another kind of confusion, a man dreams sexually that he is with a man, although the figure of the partner revealed in the dream is a woman. The following dream, in a normal man who had never been, or wished to be, in the position shown by the dream, may be quoted: "I dreamed that I was a big boy, and that a younger boy lay close beside me, and that we (or, certainly, he) had seminal emissions; I was complacently passive, and had a feeling of shame when the boy was discovered. On awaking I found I had had no emission, but was lying very close to my wife. The day before, I had seen boys in a swimming-match." This was, it seems to me, an example of dream confusion, and not an erotic inverted dream. (Näcke also brings forward inverted dreams by normal persons; see e.g. his "Beiträge zu den sexuellen Träumen," _Archiv für Kriminal-Anthropologie_, Bd. XX, 1908, p. 366.)

So far as I have been able to ascertain, there seem to be, generally speaking, certain differences in the manifestations of auto-erotism during sleep in men and women which I believe to be not without psychological significance. In men the phenomenon is fairly simple; it usually appears about puberty continues at intervals of varying duration during sexual life provided the individual is living chastely, and is generally, though not always, accompanied by erotic dreams which lead up to the climax, its occurrence being, to some extent, influenced by a variety of circumstances: physical, mental, or emotional excitement, alcohol taken before retiring, position in bed (as lying on the back), the state of the bladder, sometimes the mere fact of being in a strange bed, and to some extent apparently by the existence of monthly and yearly rhythms. On the whole, it is a fairly definite and regular phenomenon which usually leaves little conscious trace on awaking, beyond probably some sense of fatigue and, occasionally, a headache. In women, however, the phenomena of auto-erotism during sleep seem to be much more irregular, varied, and diffused. So far as I have been able to make inquiries, it is the exception rather than the rule for girls to experience definitely erotic dreams about the period of puberty or adolescence.[238] Auto-erotic phenomena during sleep in women who have never experienced the orgasm when awake are usually of a very vague kind; while it is the rule in a chaste youth for the orgasm thus to manifest itself, it is the exception in a chaste girl. It is not, as a rule, until the orgasm has been definitely produced in the waking state--under whatever conditions it may have been produced--that it begins to occur during sleep, and even in a strongly sexual woman living a repressed life it is often comparatively infrequent.[239] Thus, a young medical woman who endeavors to deal strenuously with her physical sexual emotions writes: "I sleep soundly, and do not dream at all. Occasionally, but very rarely, I have had sensations which awakened me suddenly. They can scarcely be called dreams, for they are mere impulses, nothing connected or coherent, yet prompted, I know, by sexual feeling. This is probably an experience common to all." Another lady (with a restrained psycho-sexual tendency to be attracted to both sexes), states that her first sexual sensations with orgasm were felt in dreams at the age of 16, but these dreams, which she has now forgotten, were not agreeable and not erotic; two or three years later spontaneous orgasm began to occur occasionally when awake, and after this, orgasm took place regularly once or twice a week in sleep, but still without erotic dreams; she merely dreamt that the orgasm was occurring and awoke as it took place.

It is possible that to the comparative rarity in chaste women of complete orgasm during sleep, we may in part attribute the violence with which repressed sexual emotion in women often manifests itself.[240] There is thus a difference here between men and women which is of some significance when we are considering the natural satisfaction of the sexual impulse in chaste women.

In women, who have become accustomed to sexual intercourse, erotic dreams of fully developed character occur, with complete orgasm and accompanying relief--as may occasionally be the case in women who are not acquainted with actual intercourse;[241] some women, however, even when familiar with actual coitus, find that sexual dreams, though accompanied by emissions, are only the symptoms of desire and do not produce actual relief.

Some interest attaches to cases in which young women, even girls at puberty, experience dreams of erotic character, or at all events dream concerning coitus or men in erection, although they profess, and almost certainly with truth, to be quite ignorant of sexual phenomena. Several such dreams of remarkable character have been communicated to me. One can imagine that the psychologists of some schools would see in these dreams the spontaneous eruption of the experiences of the race. I am inclined to regard them as forgotten memories, such as we know to occur sometimes in sleep. The child has somehow seen or heard of sexual phenomena and felt no interest, and the memory may subsequently be aroused in sleep, under the stimulation of new-born sexual sensations.

It is a curious proof of the ignorance which has prevailed in recent times concerning the psychic sexual nature of women that, although in earlier ages the fact that women are normally liable to erotic dreams was fully recognized, in recent times it has been denied, even by writers who have made a special study of the sexual impulse in women. Eulenburg (_Sexuale Neuropathie_, 1895, pp. 31, 79) appears to regard the appearances of sexual phenomena during sleep, in women, as the result of masturbation. Adler, in what is in many respects an extremely careful study of sexual phenomena in women (_Die Mangelhafte Geschlechtsempfindung des Weibes_, 1904, p. 130), boldly states that they do not have erotic dreams. In 1847, E. Guibout ("Des Pollutions Involontaires chez la Femme," _Union Médicale_, p. 260) presented the case of a married lady who masturbated from the age of ten, and continued the practice, even after her marriage at twenty-four, and at twenty-nine began to have erotic dreams with emissions every few nights, and later sometimes even several times a night, though they ceased to be voluptuous; he believed the case to be the first ever reported of such a condition in a woman. Yet, thousands of years ago, the Indian of Vedic days recognized erotic dreams in women as an ordinary and normal occurrence. (Löwenfeld quotes a passage to this effect from the Oupnek'hat, _Sexualleben und Nervenleiden_, 2d ed., p. 114.) Even savages recognize the occurrence of erotic dreams in women as normal, for the Papuans, for instance, believe that a young girl's first menstruation is due to intercourse with the moon in the shape of a man, the girl dreaming that a man is embracing her. (_Reports Cambridge Expedition to Torres Straits_, vol. v., p. 206.) In the seventeenth century, Rolfincius, in a well-informed study (_De Pollutione Nocturna_, a Jena Inaugural Dissertation, 1667), concluded that women experience such manifestations, and quotes Aristotle, Galen, and Fernelius, in the same sense. Sir Thomas Overbury, in his _Characters_, written in the early part of the same century, describing the ideal milkmaid, says that "her dreams are so chaste that she dare tell them," clearly implying that It was not so with most women. The notion that women are not subject to erotic dreams thus appears to be of comparatively recent origin.

One of the most interesting and important characters by which the erotic dreams of women--and, indeed, their dreams generally--differ from those of men is in the tendency to evoke a repercussion on the waking life, a tendency more rarely noted in men's erotic dreams, and then only to a minor extent. This is very common, even in healthy and normal women, and is exaggerated to a high degree in neurotic subjects, by whom the dream may even be interpreted as a reality, and so declared on oath, a fact of practical importance.

Hersman--having met with a case in which a school-girl with chorea, after having dreamed of an assault, accused the principal of a school of assault, securing his conviction--obtained the opinions of various American alienists as to the frequency with which such dreams in unstable mental subjects lead to delusions and criminal accusations. Dercum, H.C. Wood, and Rohé had not personally met with such cases; Burr believed that there was strong evidence "that a sexual dream may be so vivid as to make the subject believe she has had sexual congress"; Kiernan knew of such cases; C.H. Hughes, in persons with every appearance of sanity, had known the erotic dreams of the night to become the erotic delusions of the day, the patient protesting violently the truth of her story; while Hersman reports the case[242] of a young lady in an asylum who had nightly delusions that a medical officer visited her every night, and had to do with her, coming up the hot-air flue. I am acquainted with a similar case in a clever, but highly neurotic, young woman, who writes: "For years I have been trying to stamp out my passional nature, and was beginning to succeed when a strange thing happened to me last autumn. One night, as I lay in bed, I felt an influence so powerful that a man seemed present with me. I crimsoned with shame and wonder. I remember that I lay upon my back, and marveled when the spell had passed. The influence, I was assured, came from a priest whom I believed in and admired above everyone in the world. I had never dreamed of love in connection with him, because I always thought him so far above me. The influence has been upon me ever since--sometimes by day and nearly always by night; from it I generally go into a deep sleep, which lasts until morning. I am always much refreshed when I awake. This influence has the best effect upon my life that anything has ever had as regards health and mind. It is the knowledge that I am loved _fittingly_ that makes me so indifferent to my future. What worries me is that I sometimes wonder if I suffer from a nervous disorder merely." The subject thus seemed to regard these occurrences as objectively caused, but was sufficiently sane to wonder whether her experiences were not due to mental disorder.[243]

The tendency of the auto-erotic phenomena of sleep to be manifested with such energy as to flow over into the waking life and influence conscious emotion and action, while very well marked in normal and healthy women, is seen to an exaggerated extent in hysterical women, in whom it has, therefore, chiefly been studied. Sante de Sanctis, who has investigated the dreams of many classes of people, remarks on the frequently sexual character of the dreams of hysterical women, and the repercussion of such dreams on the waking life of the following day; he gives a typical case of hysterical erotic dreaming in an uneducated servant-girl of 23, in whom such dreams occur usually a few days before the menstrual period; her dreams, especially if erotic, make an enormous impression on her; in the morning she is bad-tempered if they were unpleasant, while she feels lascivious and gives herself up to masturbation if she has had erotic dreams of men; she then has a feeling of pleasure throughout the day, and her sexual organs are bathed with moisture.[244] Pitres and Gilles de la Tourette, two of Charcot's most distinguished pupils, in their elaborate works on hysteria, both consider that dreams generally have a great influence on the waking life of the hysterical, and they deal with the special influence of erotic dreams, to which, doubtless, we must refer those conceptions of _incubi_ and _succubi_ which played so vast and so important a part in the demonology of the Middle Ages, and while not unknown in men were most frequent in women. Such erotic dreams--as these observers, confirming the experience of old writers, have found among the hysterical to-day--are by no means always, or even usually, of a pleasurable character. "It is very rare," Pitres remarks, when insisting on the sexual character of the hallucinations of the hysterical, "for these erotic hallucinations to be accompanied by agreeable voluptuous sensations. In most cases the illusion of sexual intercourse even provokes acute pain. The witches of old times nearly all affirmed that in their relations with the devil they suffered greatly.[245] They said that his organ was long and rough and pointed, with scales which lifted on withdrawal and tore the vagina." (It seems probable, I may remark, that the witches' representations, both of the devil and of sexual intercourse, were largely influenced by familiarity with the coupling of animals). As Gilles de la Tourette is careful to warn his readers, we must not too hastily assume, from the prevalence of nocturnal auto-erotic phenomena in hysterical women, that such women are necessarily sexual and libidinous in excess; the disorder is in them psychic, he points out, and not physical, and they usually receive sexual approaches with indifference and repugnance, because their sexual centres are anæsthetic or hyperæsthetic. "During the period of sexual activity they seek much more the care and delicate attention of men than the genital act, which they often only tolerate. Many households, begun under the happiest auspices--the bride all the more apt to believe that she loves her betrothed in virtue of her suggestibility, easily exalted, perhaps at the expense of the senses--become hells on earth. The sexual act has for the hysterical woman more than one disillusion; she cannot understand it; it inspires her with insurmountable repugnance."[246] I refer to these hysterical phenomena because they present to us, in an extreme form, facts which are common among women whom, under the artificial conditions of civilized life, we are compelled to regard as ordinarily healthy and normal. The frequent painfulness of auto-erotic phenomena is by no means an exclusively hysterical phenomenon, although often seen in a heightened form in hysterical conditions. It is probably to some extent simply the result of a conflict in consciousness with a merely physical impulse which is strong enough to assert itself in spite of the emotional and intellectual abhorrence of the subject. It is thus but an extreme form of the disgust which all sexual physical manifestations tend to inspire in a person who is not inclined to respond to them. Somewhat similar psychic disgust and physical pain are produced in the attempts to stimulate the sexual emotions and organs when these are exhausted by exercise. In the detailed history which Moll presents, of the sexual experiences of a sister in an American nursing guild,--a most instructive history of a woman fairly normal except for the results of repressed sexual emotion, and with strong moral tendencies,--various episodes are narrated well illustrating the way in which sexual excitement becomes unpleasant or even painful when it takes place as a physical reflex which the emotions and intellect are all the time struggling against.[247] It is quite probable, however, that there is a physiological, as well as a psychic, factor in this phenomenon, and Sollier, in his elaborate study of the nature and genesis of hysteria, by insisting on the capital importance of the disturbance of sensibility in hysteria, and the definite character of the phenomena produced in the passage between anæsthesia and normal sensation, has greatly helped to reveal the mechanism of this feature of auto-erotic excitement in the hysterical.

No doubt there has been a tendency to exaggerate the unpleasant character of the auto-erotic phenomena of hysteria. That tendency was an inevitable reaction against an earlier view, according to which hysteria was little more than an unconscious expression of the sexual emotions and as such was unscientifically dismissed without any careful investigation. I agree with Breuer and Freud that the sexual needs of the hysterical are just as individual and various as those of normal women, but that they suffer from them more, largely through a moral struggle with their own instincts, and the attempt to put them into the background of consciousness.[248] In many hysterical and psychically abnormal women, auto-erotic phenomena, and sexual phenomena generally, are highly pleasurable, though such persons may be quite innocent of any knowledge of the erotic character of the experience. I have come across interesting and extreme examples of this in the published experiences of the women followers of the American religious leader, T.L. Harris, founder of the "Brotherhood of the New Life." Thus, in a pamphlet entitled "Internal Respiration," by Respiro, a letter is quoted from a lady physician, who writes: "One morning I awoke with a strange new feeling in the womb, which lasted for a day or two; I was so very happy, but the joy was in my womb, not in my heart."[249] "At last," writes a lady quoted in the same pamphlet, "I fell into a slumber, lying on my back with arms and feet folded, a position I almost always find myself in when I awake, no matter in which position I may go to sleep. Very soon I awoke from this slumber with a most delightful sensation, every fibre tingling with an exquisite glow of warmth. I was lying on my left side (something I am never able to do), and was folded in the arms of my counterpart. Unless you have seen it, I cannot give you an idea of the beauty of his flesh, and with what joy I beheld and felt it. Think of it, luminous flesh; and Oh! such tints, you never could imagine without seeing. He folded me so closely in his arms," etc. In such cases there is no conflict between the physical and the psychic, and therefore the resulting excitement is pleasurable and not painful.

At this point our study of auto-erotism brings us into the sphere of mysticism. Leuba, in a penetrating and suggestive essay on Christian mysticism, after quoting the present _Study_, refers to the famous passages in which St. Theresa describes how a beautiful little angel inserted a flame-tipped dart into her heart until it descended into her bowels and left her inflamed with divine love. "What physiological difference," he asks, "is there between this voluptuous sensation and that enjoyed by the disciple of the Brotherhood of New Life? St. Theresa says 'bowels,' the woman doctor says 'womb,' that is all."[250]

The extreme form of auto-erotism is the tendency for the sexual emotion to be absorbed and often entirely lost in self-admiration. This Narcissus-like tendency, of which the normal germ in women is symbolized by the mirror, is found in a minor degree in some men, and is sometimes well marked in women, usually in association with an attraction for other persons, to which attraction it is, of course, normally subservient. "The mirror," remarks Bloch (_Beiträge_ 1, p. 201), "plays an important part in the genesis of sexual aberration.... It cannot be doubted that many a boy and girl have first experienced sexual excitement at the sight of their own bodies in a mirror."

Valera, the Spanish novelist, very well described this impulse in his _Genio y Figura_. Rafaela, the heroine of this novel, says that, after her bath: "I fall into a puerility which may be innocent or vicious, I cannot decide. I only know that it is a purely contemplative act, a disinterested admiration of beauty. It is not coarse sensuality, but æsthetic platonism. I imitate Narcissus; and I apply my lips to the cold surface of the mirror and kiss my image. It is the love of beauty, the expression of tenderness and affection for what God has made manifest, in an ingenuous kiss imprinted on the empty and incorporeal reflection." In the same spirit the real heroine of the _Tagebuch einer Verlorenen_ (p. 114), at the point when she was about to become a prostitute, wrote: "I am pretty. It gives me pleasure to throw off my clothes, one by one, before the mirror, and to look at myself, just as I am, white as snow and straight as a fir, with my long, fine, hair, like a cloak of black silk. When I spread abroad the black stream of it, with both hands, I am like a white swan with black wings."

A typical case known to me is that of a lady of 28, brought up on a farm. She is a handsome woman, of very large and fine proportions, active and healthy and intelligent, with, however, no marked sexual attraction to the opposite sex; at the same time she is not inverted, though she would like to be a man, and has a considerable degree of contempt for women. She has an intense admiration for her own person, especially her limbs; she is never so happy as when alone and naked in her own bedroom, and, so far as possible, she cultivates nakedness. She knows by heart the various measurements of her body, is proud of the fact that they are strictly in accordance with the canons of proportion, and she laughs proudly at the thought that her thigh is larger than many a woman's waist. She is frank and assured in her manners, without sexual shyness, and, while willing to receive the attention and admiration of others, she makes no attempt to gain it, and seems never to have experienced any emotions stronger than her own pleasure in herself. I should add that I have had no opportunity of detailed examination, and cannot speak positively as to the absence of masturbation.

In the extreme form in which alone the name of Narcissus may properly be invoked, there is comparative indifference to sexual intercourse or even the admiration of the opposite sex. Such a condition seems to be rare, except, perhaps, in insanity. Since I called attention to this form of auto-erotism (_Alienist and Neurologist_, April, 1898), several writers have discussed the condition, especially Näcke, who, following out the suggestion, terms the condition Narcissism. Among 1,500 insane persons, Näcke has found it in four men and one woman (_Psychiatrische en Neurologische Bladen_, No. 2, 1899), Dr. C.H. Hughes writes (in a private letter) that he is acquainted with such cases, in which men have been absorbed in admiration of their own manly forms, and of their sexual organs, and women, likewise, absorbed in admiration of their own mammæ and physical proportions, especially of limbs. "The whole subject," he adds, "is a singular phase of psychology, and it is not all morbid psychology, either. It is closely allied to that æsthetic sense which admires the nude in art."

Féré (_L'Instinct Sexuel_, 2d ed., p. 271) mentions a woman who experienced sexual excitement in kissing her own hand. Näcke knew a woman in an asylum who, during periodical fits of excitement, would kiss her own arms and hands, at the same time looking like a person in love. He also knew a young man with dementia præcox? who would kiss his own image ("Der Kuss bei Geisteskranken," _Allgemeine Zeitschrift für Psychiatrie_, Bd. LXIII, p. 127). Moll refers to a young homosexual lawyer, who experienced great pleasure in gazing at himself in a mirror (_Konträre Sexualempfindung_, 3d ed., p. 228), and mentions another inverted man, an admirer of the nates of men, who, chancing to observe his own nates in a mirror, when changing his shirt, was struck by their beauty, and subsequently found pleasure in admiring them (_Libido Sexualis_, Bd. I, Theil I, p. 60). Krafft-Ebing knew a man who masturbated before a mirror, imagining, at the same time, how much better a real lover would be.

The best-observed cases of Narcissism have, however, been recorded by Rohleder, who confers upon this condition the ponderous name of automonosexualism, and believes that it has not been previously observed (H. Rohleder, _Der Automonosexualismus_, being Heft 225 of _Berliner Klinik_, March, 1907). In the two cases investigated by Rohleder, both men, there was sexual excitement in the contemplation of the individual's own body, actually or in a mirror, with little or no sexual attraction to other persons. Rohleder is inclined to regard the condition as due to a congenital defect in the "sexual centre" of the brain.

FOOTNOTES:

[176] All the above groups of phenomena are dealt with in other volumes of these _Studies_: the manifestations of normal sexual excitement, in vols. iii, iv, and v; homosexuality, in vol. ii, and erotic fetichism, in vol. v.

[177] See Appendix C.

[178] Letamendi, of Madrid, has suggested "_auto-erastia_" to cover what is probably much the same field. In the beginning of the nineteenth century, Hufeland, in his _Makrobiotic_, invented the term "_geistige Onanie_," to express the filling and heating of the imagination with voluptuous images, without unchastity of body; and in 1844, Kaan, in his _Psychopathia Sexualis_, used, but did not invent, the term "_onania psychica_." Gustav Jaeger, in his _Entdeckung der Seele_, proposed "monosexual idiosyncrasy," to indicate the most animal forms of masturbation taking place without any correlative imaginative element, a condition illustrated by cases given in Moll's _Untersuchungen über die Libido Sexualis_, Bd. I, pp. 13 et seq. Dr. Laupts (a pseudonym for the accomplished psychologist, Dr. Saint-Paul) uses the term _autophilie_, for solitary vice. (_Perversion et Perversité Sexuelles_, 1896, p. 337.) But all these terms only cover a portion of the field.

[179] H. Northcote, _Christianity and Sex Problems_, p. 231.

[180] Rosse observed two elephants procuring erection by entwining their proboscides, the act being completed by one elephant opening his mouth and allowing the other to tickle the roof of it. (I. Rosse, _Virginia Medical Monthly_, October, 1892.)

[181] Féré, "Perversions sexuelles chez les animaux," _Revue Philosophique_, May, 1897.

[182] Tillier, _L'Instinct Sexuel_, 1889, p. 270.

[183] Moll, _Libido Sexualis_, Bd. I, p. 76. The same author mentions (ibid., p. 373) that parrots living in solitary confinement masturbate by rubbing the posterior part of the body against some object until ejaculation occurs. Edmund Selous ("Habits of the Peewit," _Zoölogist_, April, 1902) suggests that the peewit, when rolling on the ground, and exerting pressure on the anal region, is moved by a sexual impulse to satisfy desire; he adds that actual orgasm appears eventually to take place, a spasm of energy passing through the bird.

[184] Dr. J.W. Howe (_Excessive Venery, Masturbation, and Continence_, London and New York, 1883, p. 62) writes of masturbation: "In savage lands it is of rare occurrence. Savages live in a state of Nature. No moral obligations exist which compel them to abstain from a natural gratification of their passions. There is no social law which prevents them from following the dictates of their lower nature. Hence, they have no reason for adopting onanism as an outlet for passions. The moral trammels of civilized society, and ignorance of physiological laws, give origin to the vice." Every one of these six sentences is incorrect or misleading. They are worth quoting as a statement of the popular view of savage life.

[185] I can recall little evidence of its existence among the Australian aborigines, though there is, in the Wiradyuri language, spoken over a large part of New South Wales, a word (whether ancient or not, I do not know) meaning masturbation (_Journal of the Anthropological Institute_, July-Dec., 1904, p. 303). Dr. W. Roth (_Ethnological Studies Among the Northwest-Central Queensland Aborigines_, p. 184), who has carefully studied the blacks of his district, remarks that he has no evidence as to the practice of either masturbation or sodomy among them. More recently (1906) Roth has stated that married men in North Queensland and elsewhere masturbate during their wives' absence. As regards the Maori of New Zealand, Northcote adds, there is a rare word for masturbation (as also at Rarotonga), but according to a distinguished Maori scholar there are no allusions to the practice in Maori literature, and it was probably not practiced in primitive times. The Maori and the Polynesians of the Cook Islands, Northcote remarks, consider the act unmanly, applying to it a phrase meaning "to make women of themselves." (Northcote, loc. cit., p. 232.)

[186] Greenlees, _Journal of Mental Science_, July, 1895. A gentleman long resident among the Kaffirs of South Natal, told Northcote, however, that he had met with no word for masturbation, and did not believe the practice prevailed there.

[187] Hyades and Deniker, _Mission Scientifique du Cap Horn_, vol. vii, p. 295.

[188] _La Criminalité en Cochin-Chine_, 1887, p. 116; also Mondière, "Monographie de la Femme Annamite," _Mémoires Société d'Anthropologie_, tome ii, p. 465.

[189] Christian, article on "Onanisme," _Dictionnaire Encyclopédique des Sciences Médicales_; Ploss and Bartels, _Das Weib_; Moraglia, "Die Onanie beim normalen Weibe," _Zeitschrift für Criminal-Anthropologie_, 1897; Dartigues, _De la Procréation Volontaire des Sexes_, p. 32. In the eighteenth century, the _rin-no-tama_ was known in France, sometimes as "pommes d'amour." Thus Bachaumont, in his Journal (under date July 31, 1773), refers to "a very extraordinary instrument of amorous mystery," brought by a traveler from India; he describes this "boule erotique" as the size of a pigeon's egg, covered with soft skin, and gilded. Cf. F.S. Krauss, _Geschlechtsleben in Brauch und Sitte der Japaner_, Leipzig, 1907.

[190] It may be worth mentioning that the Salish Indians of British Columbia have a myth of an old woman having intercourse with young women, by means of a horn worn as a penis (_Journal of the Anthropological Institute_, July-Dec., 1904, p. 342).

[191] In Burchard's Penitential (cap. 142-3), penalties are assigned to the woman who makes a phallus for use on herself or other women. (Wasserschleben, _Bussordnungen der abendländlichen Kirche_, p. 658.) The _penis succedaneus_, the Latin _phallus_ or _fascinum_, is in France called _godemiche_; in Italy, _passatempo_, and also _diletto_, whence _dildo_, by which it is most commonly known in England. For men, the corresponding _cunnus succedaneus_ is, in England, called _merkin_, which meant originally (as defined in old editions of Bailey's _Dictionary_) "counterfeit hair for women's privy parts."

[192] Dühren, _Der Marquis de Sade und Seine Zeit_, 3d ed., pp. 130, 232; id. _Geschlechtsleben in England_, Bd. II, pp. 284 et seq.

[193] Gamier, _Onanisme_, p. 378.

[194] _Zeitschrift für Ethnologie_, 1899, p. 669.

[195] The mythology of Hawaii, one may note, tells of goddesses who were impregnated by bananas they had placed beneath their garments. B. Stern mentions (_Medizin in der Türkei_, Bd. II, p. 24) that the women of Turkey and Egypt use the banana, as well as the cucumber, etc., for masturbation. In a poem in the _Arabian Nights_, also ("History of the Young Nour with the Frank"), we read: "O bananas, of soft and smooth skins, which dilate the eyes of young girls ... you, alone among fruits are endowed with a pitying heart, O consolers of widows and divorced women." In France and England they are not uncommonly used for the same purpose.

[196] See, e.g., Winckel, _Die Krankheiten der weiblichen Harnrohre und Blase_, 1885, p. 211; and "Lehrbuch der Frauenkrankheiten," 1886, p. 210; also, Hyrtl, _Handbuch du Topographischen Anatomie_, 7th ed., Bd. II, pp. 212-214. Grünfeld (_Wiener medizinische Blätter_, November 26, 1896), collected 115 cases of foreign body in the bladder--68 in men, 47 in women; but while those found in men were usually the result of a surgical accident, those found in women were mostly introduced by the patients themselves. The patient usually professes profound ignorance as to how the object came there; or she explains that she accidentally sat down upon it, or that she used it to produce freer urination. The earliest surgical case of this kind I happen to have met with, was recorded by Plazzon, in Italy, in 1621 (_De Partibus Generationi Inservientibus_, lib. ii, Ch. XIII); it was that of a certain honorable maiden with a large clitoris, who, seeking to lull sexual excitement with the aid of a bone needle, inserted it in the bladder, whence it was removed by Aquapendente.

[197] A. Poulet, _Traité des Corps étrangers en Chirurgie_, 1879. English translation, 1881, vol. ii, pp. 209, 230. Rohleder (_Die Masturbation_, 1899, pp. 24-31) also gives examples of strange objects found in the sexual organs.

[198] E.H. Smith, "Signs of Masturbation in the Female," _Pacific Medical Journal_, February, 1903, quoted by R.W. Taylor, _Practical Treatise on Sexual Disorders_, 3d ed., p. 418.

[199] L. Tait, _Diseases of Women_, 1889, vol. i, p. 100.

[200] _Obstetric Journal_, vol. i, 1873, p. 558. Cf. G.J. Arnold, _British, Medical Journal_, January 6, 1906, p. 21.

[201] Dudley, _American Journal of Obstetrics_, July, 1889, p. 758.

[202] A. Reverdin, "Epingles à Cheveux dans la Vessie," _Revue Médicale de la Suisse Romande_, January 20, 1888. His cases are fully recorded, and his paper is an able and interesting contribution to this by-way of sexual psychology. The first case was a school-master's wife, aged 22, who confessed in her husband's presence, without embarrassment or hesitation, that the manoeuvre was habitual, learned from a school-companion, and continued after marriage. The second was a single woman of 42, a _curé's_ servant, who attempted to elude confession, but on leaving the doctor's house remarked to the house-maid, "Never go to bed without taking out your hair-pins; accidents happen so easily." The third was an English girl of 17 who finally acknowledged that she had lost two hair-pins in this way. The fourth was a child of 12, driven by the pain to confess that the practice had become a habit with her.

[203] "One of my patients," remarks Dr. R.T. Morris, of New York, (_Transactions of the American Association of Obstetricians_, for 1892, Philadelphia, vol. v), "who is a devout church-member, had never allowed herself to entertain sexual thoughts referring to men, but she masturbated every morning, when standing before the mirror, by rubbing against a key in the bureau-drawer. A man never excited her passions, but the sight of a key in any bureau-drawer aroused erotic desires."

[204] Freud (_Drei Abhandlungen zur Sexualtheorie_, p. 118) refers to the sexual pleasure of swinging. Swinging another person may be a source of voluptuous excitement, and one of the 600 forms of sexual pleasure enumerated in De Sade's _Les 120 Journées de Sodome_ is (according to Dühren) to propel a girl vigorously in a swing.

[205] The fact that horse exercise may produce pollutions was well recognized by Catholic theologians, and Sanchez states that this fact need not be made a reason for traveling on foot. Rolfincius, in 1667, pointed out that horse-riding, in those unaccustomed to it, may lead to nocturnal pollutions. Rohleder (_Die Masturbation_, pp. 133-134) brings together evidence regarding the influence of horse exercise in producing sexual excitement.

[206] A correspondent, to whom the idea was presented for the first time, wrote: "Henceforward I shall know to what I must attribute the bliss--almost the beatitude--I so often have experienced after traveling for four or five hours in a train." Penta mentions the case of a young girl who first experienced sexual desire at the age of twelve, after a railway journey.

[207] Langdon Down, _British Medical Journal_, January 12, 1867.

[208] Pouillet, _L'Onanisme chez la Femme_, Paris, 1880; Fournier, _De l'Onanisme_, 1885; Rohleder, _Die Masturbation_, p. 132.

[209] _West-Riding Asylum Reports_, 1876, vol. vi.

[210] _Das Nervöse Weib_, 1898, p. 193.

[211] In the Appendix to volume iii of these _Studies_, I have recorded the experience of a lady who found sexual gratification in this manner.

[212] Dr. J.G. Kiernan, to whom I am indebted for a note on this point, calls my attention also to the case of a homosexual and masochistic man (_Medical Record_, vol. xix) whose feelings were intensified by tight-lacing.

[213] Some women are also able to produce the orgasm, when in a state of sexual excitement, by placing a cushion between the knees and pressing the thighs firmly together.

[214] _Leçons sur les Déformations Vulvaires_, p. 64. Martineau was informed by a dressmaker that it is very frequent in workrooms and can usually be done without attracting attention. An ironer informed him that while standing at her work, she crossed her legs, slightly bending the trunk forward and supporting herself on the table by the hands; then a few movements of contraction of the adductor muscles of the thigh would suffice to produce the orgasm.

[215] C.W. Townsend, "Thigh-friction in Children under one Year," Annual Meeting of the American Pediatric Society, Montreal, 1896. Five cases are recorded by this writer, all in female infants.

[216] Soutzo, _Archives de Neurologie_, February, 1903, p. 167.

[217] Zache, _Zeitschrift für Ethnologie_, 1899, p. 72. I have discussed what may be regarded as the normally sexual influence of dancing, in the third volume of these _Studies_, "The Analysis of the Sexual Impulse."

[218] The case has been recorded of a Russian who had the spontaneous impulse to self-flagellation on the nates with a rod, for the sake of sexual excitement, from the age of 6. (_Rivista Mensile di Psichiatria_ April, 1900, p. 102.)

[219] Kryptadia, vol. v, p. 358. As regards the use of nettles, see Dühren, _Geschlechtsleben in England_, Bd. II, p. 392.

[220] Debreyne, _Moechialogie_, p. 177.

[221] R.W. Taylor, _A Practical Treatise on Sexual Disorders_, 3rd ed., Ch. XXX.

[222] Hammond, _Sexual Impotence_, pp. 70 et seq.

[223] Niceforo, _Il Gergo_, p. 98.

[224] _Functional Disorders of the Nervous System in Women_, p. 114.

[225] Schrenck-Notzing, _Suggestions-therapie_, p. 13. A. Kind (_Jahrbuch für Sexuelle Zwischenstufen_, Jahrgang ix, 1908, p. 58) gives the case of a young homosexual woman, a trick cyclist at the music halls, who often, when excited by the sight of her colleague in tights, would experience the orgasm while cycling before the public.

[226] Janet has, however, used day-dreaming--which he calls "_reveries subconscients_"--to explain a remarkable case of demon-possession, which he investigated and cured. (_Névroses et Idées fixes_, vol. i, pp. 390 et seq.)

[227] "Minor Studies from the Psychological Laboratory of Wellesley College," _American Journal of Psychology_, vol. vii, No. 1. G.E. Partridge ("Reverie," _Pedagogical Seminary_, April, 1898) well describes the physical accompaniments of day-dreaming, especially in Normal School girls between sixteen and twenty-two. Pick ("Clinical Studies in Pathological Dreaming," _Journal of Mental Sciences_, July, 1901) records three more or less morbid cases of day-dreaming, usually with an erotic basis, all in apparently hysterical men. An important study of day-dreaming, based on the experiences of nearly 1,500 young people (more than two-thirds girls and women), has been published by Theodate L. Smith ("The Psychology of Day Dreams," _American Journal Psychology_, October, 1904). Continued stories were found to be rare--only one per cent. Healthy boys, before fifteen, had day-dreams in which sports, athletics, and adventure had a large part; girls put themselves in the place of their favorite heroines in novels. After seventeen, and earlier in the case of girls, day-dreams of love and marriage were found to be frequent. A typical confession is that of a girl of nineteen: "I seldom have time to build castles in Spain, but when I do, I am not different from most Southern girls; i.e., my dreams are usually about a pretty fair specimen of a six-foot three-inch biped."

[228] The case has been recorded of a married woman, in love with her doctor, who kept a day-dream diary, at last filling three bulky volumes, when it was discovered by her husband, and led to an action for divorce; it was shown that the doctor knew nothing of the romance in which he played the part of hero. Kiernan, in referring to this case (as recorded in John Paget's _Judicial Puzzles_), mentions a similar case in Chicago.

[229] _Uranisme_, p. 125.

[230] The acute Anstie remarked, more than thirty years ago, in his work on _Neuralgia_: "It is a comparatively frequent thing to see an unsocial, solitary life (leading to the habit of masturbation) joined with the bad influence of an unhealthy ambition, prompting to premature and false work in literature and art." From the literary side, M. Léon Bazalgette has dealt with the tendency of much modern literature to devote itself to what he calls "mental onanism," of which the probable counterpart, he seems to hint, is a physical process of auto-erotism. (Léon Bazalgette, "L'onanisme considéré comme principe createur en art," _L'Esprit Nouveau_, 1898.)

[231] Pausanias, _Achaia_, Chapter XVII. The ancient Babylonians believed in a certain "maid of the night," who appeared to men in sleep and roused without satisfying their passions. (Jastrow, _Religion of Babylonia_, p. 262.) This succubus was the Assyrian Liler, connected with the Hebrew Lilith. There was a corresponding incubus, "the little night man," who had nocturnal intercourse with women. (Cf. Ploss, _Das Weib_, 7th ed., pp. 521 et seq.) The succubus and the incubus (the latter being more common) were adopted by Christendom; St. Augustine (_De Civitate Dei_, Bk. XV, Ch. XXIII) said that the wicked assaults of sylvans and fauns, otherwise called incubi, on women, are so generally affirmed that it would be impudent to deny them. Incubi flourished in mediæval belief, and can scarcely, indeed, be said to be extinct even to-day. They have been studied by many authors; see, e.g., Dufour, _Histoire de la Prostitution_, vol. v, Ch. XXV, Saint-André, physician-in-ordinary to the French King, pointed out in 1725 that the incubus was a dream. It may be added that the belief in the succubus and incubus appears to be widespread. Thus, the West African Yorubas (according to A.B. Ellis) believe that erotic dreams are due to the god Elegbra, who, either as a male or a female, consorts with men and women in sleep.

[232] "If any man's seed of copulation go out from him, then he shall bathe all his flesh in water and be unclean until the even. And every garment, and every skin, whereon is the seed of copulation, shall be washed with water and be unclean until the even." Leviticus, XV, v. 16-17.

[233] It should be added that the term _pollutio_ also covers voluntary effusion of semen outside copulation. (Debreyne, _Moechialogie_, p. 8; for a full discussion of the opinions of theologians concerning nocturnal and diurnal pollutions, see the same author's _Essai sur la Théologie Morale_, pp. 100-149.)

[234] _Memoirs_, translated by Bendyshe, p. 182.

[235] _Sexual Impotence_, p. 137.

[236] _L'Hygiène Sexuelle_, p. 169.

[237] _Sexualleben und Nervenleiden_, p. 164.

[238] I may here refer to the curious opinion expressed by Dr. Elizabeth Blackwell, that, while the sexual impulse in man is usually relieved by seminal emissions during sleep, in women it is relieved by the occurrence of menstruation. This latter statement is flagrantly at variance with the facts; but it may perhaps be quoted in support of the view expressed above as to the comparative rarity of sexual excitement during sleep in young girls.

[239] Löwenfeld has recently expressed the same opinion. Rohleder believes that pollutions are physically impossible in a _real_ virgin, but that opinion is too extreme.

[240] It may be added that in more or less neurotic women and girls, erotic dreams may be very frequent and depressing. Thus, J.M. Fothergill (_West-Riding Asylum Report_, 1876, vol. vi) remarks: "These dreams are much more frequent than is ordinarily thought, and are the cause of a great deal of nervous depression among women. Women of a highly-nervous diathesis suffer much more from these drains than robust women. Not only are these involuntary orgasms more frequent among such women, but they cause more disturbance of the general health in them than in other women."

[241] I may remark here that a Russian correspondent considers that I have greatly underestimated the frequency of erotic manifestations during sleep in young girls. "All the women I have interrogated on this point," he informs me, "say that they have had such pollutions from the time of puberty, or even earlier, accompanied by erotic dreams. I have put the question to some twenty or thirty women. It is true that they were of southern race (Italian, Spanish, and French), and I believe that Southerners are, in this matter, franker than northern women, who consider the activity of the flesh as shameful, and seek to conceal it." My correspondent makes no reference to the chief point of sexual difference, so far as my observation goes, which is that erotic dreams are comparatively rare in those women "_who have yet had no sort of sexual experience in waking life_." Whether or not this is correct, I do not question the frequency of erotic dreams in girls who have had such experience.

[242] C.C. Hersman, "Medico-legal Aspects of Eroto-Choreic Insanities," _Alienist and Neurologist_, July, 1897. I may mention that Pitres (_Leçons cliniques sur l'Hystérie_, vol. ii, p. 34) records the almost identical case of a hysterical girl in one of his wards, who was at first grateful to the clinical clerk to whom her case was intrusted, but afterward changed her behavior, accused him of coming nightly through the window, lying beside her, caressing her, and then exerting violent coitus three or four times in succession, until she was utterly exhausted. I may here refer to the tendency to erotic excitement in women under the influence of chloroform and nitrous oxide, a tendency rarely or never noted in men, and of the frequency with which the phenomenon is attributed by the subject to actual assault. See H. Ellis, _Man and Woman_, pp. 269-274.

[243] In Australia, some years ago, a man was charged with rape, found guilty of "attempt," and sentenced to eighteen months' imprisonment, on the accusation of a girl of 13, who subsequently confessed that the charge was imaginary; in this case, the jury found it impossible to believe that so young a girl could have been lying, or hallucinated, because she narrated the details of the alleged offence with such circumstantial detail. Such cases are not uncommon, and in some measure, no doubt, they may be accounted for by auto-erotic nocturnal hallucinations.

[244] Sante de Sanctis, _I sogni e il sonno nell'isterismo e nella epilessia_, Rome, 1896, p. 101.

[245] Pitres, _Leçons cliniques sur l'Hystérie_, vol. ii, pp. 37 et seq. The Lorraine inquisitor, Nicolas Remy, very carefully investigated the question of the feelings of witches when having intercourse with the Devil, questioning them minutely, and ascertained that such intercourse was usually extremely painful, filling them with icy horror (See, e.g., Dufour, _Histoire de la Prostitution_, vol. v, p. 127; the same author presents an interesting summary of the phenomena of the Witches' Sabbath). But intercourse with the Devil was by no means always painful. Isabel Gowdie, a Scotch witch, bore clear testimony to this point: "The youngest and lustiest women," she stated, "will have very great pleasure in their carnal copulation with him, yea, much more than with their own husbands.... He is abler for us than any man can be. (Alack! that I should compare him to a man!)" Yet her description scarcely sounds attractive; he was a "large, black, hairy man, very cold, and I found his nature as cold within me as spring well-water." His foot was forked and cloven; he was sometimes like a deer, or a roe; and he would hold up his tail while the witches kissed that region (Pitcairn, _Criminal Trials in Scotland_, vol. iii, Appendix VII; see, also, the illustrations at the end of Dr. A. Marie's _Folie et Mysticisme_, 1907).

[246] Gilles de la Tourette, loc. cit., p. 518. Erotic hallucinations have also been studied by Bellamy, in a Bordeaux thesis, _Hallucinations Erotiques_, 1900-1901.

[247] On one occasion, when still a girl, whenever an artist whom she admired touched her hand she felt erection and moisture of the sexual parts, but without any sensation of pleasure; a little later, when an uncle's knee casually came in contact with her thigh, ejaculation of mucus took place, though she disliked the uncle; again, when a nurse, on casually seeing a man's sexual organs, an electric shock went through her, though the sight was disgusting to her; and when she had once to assist a man to urinate, she became in the highest degree excited, though without pleasure, and lay down on a couch in the next room, while a conclusive ejaculation took place. (Moll, _Libido Sexualis_, Bd. I, p. 354.)

[248] Breuer and Freud, _Studien über Hysterie_, 1895, p. 217.

[249] Calmeil (_De la Folie_, vol. i, p. 252) called attention to the large part played by uterine sensations in the hallucinations of some famous women ascetics, and added: "It is well recognized that the narrative of such sensations nearly always occupies the first place in the divagations of hysterical virgins."

[250] H. Leuba, "Les Tendances Religieuses chez les Mystiques Chrétiens," _Revue Philosophique_, November, 1902, p. 465. St. Theresa herself states that physical sensations played a considerable part in this experience.

II.

Hysteria and the Question of Its Relation to the Sexual Emotions--The Early Greek Theories of its Nature and Causation--The Gradual Rise of Modern Views--Charcot--The Revolt Against Charcot's Too Absolute Conclusions--Fallacies Involved--Charcot's Attitude the Outcome of his Personal Temperament--Breuer and Freud--Their Views Supplement and Complete Charcot's--At the Same Time they Furnish a Justification for the Earlier Doctrine of Hysteria--But They Must Not be Regarded as Final--The Diffused Hysteroid Condition in Normal Persons--The Physiological Basis of Hysteria--True Pathological Hysteria is Linked on to almost Normal States, especially to Sex-hunger.

The nocturnal hallucinations of hysteria, as all careful students of this condition now seem to agree, are closely allied to the hysterical attack proper. Sollier, indeed, one of the ablest of the more recent investigators of hysteria, has argued with much force that the subjects of hysteria really live in a state of pathological sleep, of vigilambulism.[251] He regards all the various accidents of hysteria as having a common basis in disturbances of sensibility, in the widest sense of the word "sensibility,"--as the very foundation of personality,--while anæsthesia is "the real _sigillum hysteriæ_." Whatever the form of hysteria, we are thus only concerned with a more or less profound state of vigilambulism: a state in which the subject seems, often even to himself, to be more or less always asleep, whether the sleep may be regarded as local or general. Sollier agrees with Féré that the disorder of sensibility may be regarded as due to an exhaustion of the sensory centres of the brain, whether as the result of constitutional cerebral weakness, of the shock of a violent emotion, or of some toxic influence on the cerebral cells.

We may, therefore, fitly turn from the auto-erotic phenomena of sleep which in women generally, and especially in hysterical women, seem to possess so much importance and significance, to the question--which has been so divergently answered at different periods and by different investigators--concerning the causation of hysteria, and especially concerning its alleged connection with conscious or unconscious sexual emotion.[252]

It was the belief of the ancient Greeks that hysteria came from the womb; hence its name. We first find that statement in Plato's _Timæus_: "In men the organ of generation--becoming rebellious and masterful, like an animal disobedient to reason, and maddened with the sting of lust--seeks to gain absolute sway; and the same is the case with the so-called womb, or uterus, of women; the animal within them is desirous of procreating children, and, when remaining unfruitful long beyond its proper time, gets discontented and angry, and, wandering in every direction through the body, closes up the passages of the breath, and, by obstructing respiration,[253] drives them to extremity, causing all varieties of disease."

Plato, it is true, cannot be said to reveal anywhere a very scientific attitude toward Nature. Yet he was here probably only giving expression to the current medical doctrine of his day. We find precisely the same doctrine attributed to Hippocrates, though without a clear distinction between hysteria and epilepsy.[254] If we turn to the best Roman physicians we find again that Aretæus, "the Esquirol of antiquity," has set forth the same view, adding to his description of the movements of the womb in hysteria: "It delights, also, in fragrant smells, and advances toward them; and it has an aversion to foetid smells, and flies from them; and, on the whole, the womb is like an animal within an animal."[255] Consequently, the treatment was by applying foetid smells to the nose and rubbing fragrant ointments around the sexual parts.[256]

The Arab physicians, who carried on the traditions of Greek medicine, appear to have said nothing new about hysteria, and possibly had little knowledge of it. In Christian mediæval Europe, also, nothing new was added to the theory of hysteria; it was, indeed, less known medically than it had ever been, and, in part it may be as a result of this ignorance, in part as a result of general wretchedness (the hysterical phenomena of witchcraft reaching their height, Michelet points out, in the fourteenth century, which was a period of special misery for the poor), it flourished more vigorously. Not alone have we the records of nervous epidemics, but illuminated manuscripts, ivories, miniatures, bas-reliefs, frescoes, and engravings furnish the most vivid iconographic evidence of the prevalence of hysteria in its most violent forms during the Middle Ages. Much of this evidence is brought to the service of science in the fascinating works of Dr. P. Richer, one of Charcot's pupils.[257]

In the seventeenth century Ambroise Paré was still talking, like Hippocrates, about "suffocation of the womb"; Forestus was still, like Aretæus, applying friction to the vulva; Fernel was still reproaching Galen, who had denied that the movements of the womb produced hysteria.

It was in the seventeenth century (1618) that a French physician, Charles Lepois (Carolus Piso), physician to Henry II, trusting, as he said, to experience and reason, overthrew at one stroke the doctrine of hysteria that had ruled almost unquestioned for two thousand years, and showed that the malady occurred at all ages and in both sexes, that its seat was not in the womb, but in the brain, and that it must be considered a nervous disease.[258] So revolutionary a doctrine could not fail to meet with violent opposition, but it was confirmed by Willis, and in 1681, we owe to the genius of Sydenham a picture of hysteria which for lucidity, precision, and comprehensiveness has only been excelled in our own times.

It was not possible any longer to maintain the womb theory of Hippocrates in its crude form, but in modified forms, and especially with the object of preserving the connection which many observers continued to find between hysteria and the sexual emotions, it still found supporters in the eighteenth and even the nineteenth centuries. James, in the middle of the eighteenth century, returned to the classical view, and in his _Dictionary of Medicine_ maintained that the womb is the seat of hysteria. Louyer Villermay in 1816 asserted that the most frequent causes of hysteria are deprivation of the pleasures of love, griefs connected with this passion, and disorders of menstruation. Foville in 1833 and Landouzy in 1846 advocated somewhat similar views. The acute Laycock in 1840 quoted as "almost a medical proverb" the saying, "_Salacitas major, major ad hysteriam proclivitas_," fully indorsing it. More recently still Clouston has defined hysteria as "the loss of the inhibitory influence exercised on the reproductive and sexual instincts of women by the higher mental and moral functions" (a position evidently requiring some modification in view of the fact that hysteria is by no means confined to women), while the same authority remarks that more or less concealed sexual phenomena are the chief symptoms of "hysterical insanity."[259] Two gynæcologists of high position in different parts of the world, Hegar in Germany and Balls-Headley in Australia, attribute hysteria, as well as anæmia, largely to unsatisfied sexual desire, including the non-satisfaction of the "ideal feelings."[260] Lombroso and Ferrero, again, while admitting that the sexual feelings might be either heightened or depressed in hysteria, referred to the frequency of what they termed "a paradoxical sexual instinct" in the hysterical, by which, for instance, sexual frigidity is combined with intense sexual pre-occupations; and they also pointed out the significant fact that the crimes of the hysterical nearly always revolve around the sexual sphere.[261] Thus, even up to the time when the conception of hysteria which absolutely ignored and excluded any sexual relationship whatever had reached its height, independent views favoring such a relationship still found expression.

Of recent years, however, such views usually aroused violent antagonism. The main current of opinion was with Briquet (1859), who, treating the matter with considerable ability and a wide induction of facts, indignantly repelled the idea that there is any connection between hysteria and the sexual facts of life, physical or psychic. As he himself admitted, Briquet was moved to deny a sexual causation of hysteria by the thought that such an origin would be degrading for women ("_a quelque chose de dégradant pour les femmes_").

It was, however, the genius of Charcot, and the influence of his able pupils, which finally secured the overthrow of the sexual theory of hysteria. Charcot emphatically anathematized the visceral origin of hysteria; he declared that it is a psychic disorder, and to leave no loop-hole of escape for those who maintained a sexual causation he asserted that there are no varieties of hysteria, that the disease is one and indivisible. Charcot recognized no primordial cause of hysteria beyond heredity, which here plays a more important part than in any other neuropathic condition. Such heredity is either direct or more occasionally by transformation, any deviation of nutrition found in the ancestors (gout, diabetes, arthritis) being a possible cause of hysteria in the descendants. "We do not know anything about the nature of hysteria," Charcot wrote in 1892; "we must make it objective in order to recognize it. The dominant idea for us in the etiology of hysteria is, in the widest sense, its hereditary predisposition. The greater number of those suffering from this affection are simply born _hystérisables_, and on them the occasional causes act directly, either through autosuggestion or by causing derangement of general nutrition, and more particularly of the nutrition of the nervous system."[262] These views were ably and decisively stated in Gilles de la Tourette's _Traité de l'Hystérie_, written under the inspiration of Charcot.

While Charcot's doctrine was thus being affirmed and generally accepted, there were at the same time workers in these fields who, though they by no means ignored this doctrine of hysteria or even rejected it, were inclined to think that it was too absolutely stated. Writing in the _Dictionary of Psychological Medicine_ at the same time as Charcot, Donkin, while deprecating any exclusive emphasis on the sexual causation, pointed out the enormous part played by the emotions in the production of hysteria, and the great influence of puberty in women due to the greater extent of the sexual organs, and the consequently large area of central innervation involved, and thus rendered liable to fall into a state of unstable equilibrium. Enforced abstinence from the gratification of any of the inherent and primitive desires, he pointed out, may be an adequate exciting cause. Such a view as this indicated that to set aside the ancient doctrine of a physical sexual cause of hysteria was by no means to exclude a psychic sexual cause. Ten years earlier Axenfeld and Huchard had pointed out that the reaction against the sexual origin of hysteria was becoming excessive, and they referred to the evidence brought forward by veterinary surgeons showing that unsatisfied sexual desire in animals may produce nervous symptoms very similar to hysteria.[263] The present writer, when in 1894 briefly discussing hysteria as an element in secondary sexual characterization, ventured to reflect the view, confirmed by his own observation, that there was a tendency to unduly minimize the sexual factor in hysteria, and further pointed out that the old error of a special connection between hysteria and the female sexual organs, probably arose from the fact that in woman the organic sexual sphere is larger than in man.[264]

When, indeed, we analyze the foundation of the once predominant opinions of Charcot and his school regarding the sexual relationships of hysteria, it becomes clear that many fallacies and misunderstandings were involved. Briquet, Charcot's chief predecessor, acknowledged that his own view was that a sexual origin of hysteria would be "degrading to women"; that is to say, he admitted that he was influenced by a foolish and improper prejudice, for the belief that the unconscious and involuntary morbid reaction of the nervous system to any disturbance of a great primary instinct can have "_quelque chose de dégradant_" is itself an immoral belief; such disturbance of the nervous system might or might not be caused, but in any case the alleged "degradation" could only be the fiction of a distorted imagination. Again, confusion had been caused by the ancient error of making the physical sexual organs responsible for hysteria, first the womb, more recently the ovaries; the outcome of this belief was the extirpation of the sexual organs for the cure of hysteria. Charcot condemned absolutely all such operations as unscientific and dangerous, declaring that there is no such thing as hysteria of menstrual origin.[265] Subsequently, Angelucci and Pierracini carried out an international inquiry into the results of the surgical treatment of hysteria, and condemned it in the most unqualified manner.[266] It is clearly demonstrated that the physical sexual organs are not the seat of hysteria. It does not, however, follow that even physical sexual desire, when repressed, is not a cause of hysteria. The opinion that it was so formed an essential part of the early doctrine of hysteria, and was embodied in the ancient maxim: "_Nubat illa et morbus effugiet_." The womb, it seemed to the ancients, was crying out for satisfaction, and when that was received the disease vanished.[267] But when it became clear that sexual desire, though ultimately founded on the sexual apparatus, is a nervous and psychic fact, to put the sexual organs out of count was not sufficient; for the sexual emotions may exist before puberty, and persist after complete removal of the sexual organs. Thus it has been the object of many writers to repel the idea that unsatisfied sexual desire can be a cause of hysteria. Briquet pointed out that hysteria is rare among nuns and frequent among prostitutes. Krafft-Ebing believed that most hysterical women are not anxious for sexual satisfaction, and declared that "hysteria caused through the non-satisfaction of the coarse sensual sexual impulse I have never seen,"[268] while Pitres and others refer to the frequently painful nature of sexual hallucinations in the hysterical. But it soon becomes obvious that the psychic sexual sphere is not confined to the gratification of conscious physical sexual desire. It is not true that hysteria is rare among nuns, some of the most tremendous epidemics of hysteria, and the most carefully studied, having occurred in convents,[269] while the hysterical phenomena sometimes associated with revivals are well known. The supposed prevalence among prostitutes would not be evidence against the sexual relationships of hysteria; it has, however, been denied, even by so great an authority as Parent-Duchâtelet who found it very rare, even in prostitutes in hospitals, when it was often associated with masturbation; in prostitutes, however, who returned to a respectable life, giving up their old habits, he found hysteria common and severe.[270] The frequent absence of physical sexual feeling, again, may quite reasonably be taken as evidence of a disorder of the sexual emotions, while the undoubted fact that sexual intercourse usually has little beneficial effect on pronounced hysteria, and that sexual excitement during sleep and sexual hallucinations are often painful in the same condition, is far from showing that injury or repression of the sexual emotions had nothing to do with the production of the hysteria. It would be as reasonable to argue that the evil effect of a heavy meal on a starving man must be taken as evidence that he was not suffering from starvation. The fact, indeed, on which Gilles de la Tourette and others have remarked, that the hysterical often desire not so much sexual intercourse as simple affection, would tend to show that there is here a real analogy, and that starvation or lesion of the sexual emotions may produce, like bodily starvation, a rejection of those satisfactions which are demanded in health. Thus, even a mainly _a priori_ examination of the matter may lead us to see that many arguments brought forward in favor of Charcot's position on this point fall to the ground when we realize that the sexual emotions may constitute a highly complex sphere, often hidden from observation, sometimes not conscious at all, and liable to many lesions besides that due to the non-satisfaction of sexual desire. At the same time we are not thus enabled to overthrow any of the positive results attained by Charcot and his school.

It may, however, be pointed out that Charcot's attitude toward hysteria was the outcome of his own temperament. He was primarily a neurologist, the bent of his genius was toward the investigation of facts that could be objectively demonstrated. His first interest in hysteria, dating from as far back as 1862, was in hystero-epileptic convulsive attacks, and to the last he remained indifferent to all facts which could not be objectively demonstrated. That was the secret of the advances he was enabled to make in neurology. For purely psychological investigation he had no liking, and probably no aptitude. Anyone who was privileged to observe his methods of work at the Salpêtrière will easily recall the great master's towering figure; the disdainful expression, sometimes, even, it seemed, a little sour; the lofty bearing which enthusiastic admirers called Napoleonic. The questions addressed to the patient were cold, distant, sometimes impatient. Charcot clearly had little faith in the value of any results so attained. One may well believe, also, that a man whose superficial personality was so haughty and awe-inspiring to strangers would, in any case, have had the greatest difficulty in penetrating the mysteries of a psychic world so obscure and elusive as that presented by the hysterical.[271]

The way was thus opened for further investigations on the psychic side. Charcot had affirmed the power, not only of physical traumatism, but even of psychic lesions--of moral shocks--to provoke its manifestations, but his sole contribution to the psychology of this psychic malady,--and this was borrowed from the Nancy school,--lay in the one word "suggestibility"; the nature and mechanism of this psychic process he left wholly unexplained. This step has been taken by others, in part by Janet, who, from 1889 onward, has not only insisted that the emotions stand in the first line among the causes of hysteria, but has also pointed out some portion of the mechanism of this process; thus, he saw the significance of the fact, already recognized, that strong emotions tend to produce anæsthesia and to lead to a condition of mental disaggregation, favorable to abulia, or abolition of will-power. It remained to show in detail the mechanism by which the most potent of all the emotions effects its influence, and, by attempting to do this, the Viennese investigators, Breuer and especially Freud, have greatly aided the study of hysteria.[272] They have not, it is important to remark, overturned the positive elements in their great forerunner's work. Freud began as a disciple of Charcot, and he himself remarks that, in his earlier investigations of hysteria, he had no thought of finding any sexual etiology for that malady; he would have regarded any such suggestion as an insult to his patient. The results reached by these workers were the outcome of long and detailed investigation. Freud has investigated many cases of hysteria in minute detail, often devoting to a single case over a hundred hours of work. The patients, unlike those on whom the results of the French school have been mainly founded, all belonged to the educated classes, and it was thus possible to carry out an elaborate psychic investigation which would be impossible among the uneducated. Breuer and Freud insist on the fine qualities of mind and character frequently found among the hysterical. They cannot accept suggestibility as an invariable characteristic of hysteria, only abnormal excitability; they are far from agreeing with Janet (although on many points at one with him), that psychic weakness marks hysteria; there is merely an appearance of mental weakness, they say, because the mental activity of the hysterical is split up, and only a part of it is conscious.[273] The superiority of character of the hysterical is indicated by the fact that the conflict between their ideas of right and the bent of their inclinations is often an element in the constitution of the hysterical state. Breuer and Freud are prepared to assert that the hysterical are among "the flower of humanity," and they refer to those qualities of combined imaginative genius and practical energy which characterized St. Theresa, "the patron saint of the hysterical."

To understand the position of Breuer and Freud we may start from the phenomenon of "nervous shock" produced by physical traumatism, often of a very slight character. Charcot had shown that such "nervous shock," with the chain of resulting symptoms, is nothing more or less than hysteria. Breuer and Freud may be linked on to Charcot at this point. They began by regarding the most typical hysteria as really a _psychic traumatism_; that is to say, that it starts in a lesion, or rather in repeated lesions, of the emotional organism. It is true that the school of Charcot admitted the influence of moral shock, especially of the emotion of fear, but that merely as an "_agent provocateur_," and with a curious perversity Gilles de la Tourette, certainly reflecting the attitude of Charcot, in his elaborate treatise on hysteria fails to refer to the sphere of the sexual emotions even when enumerating the "_agents provocateurs_."[274]

The influence of fear is not denied by Breuer and Freud, but they have found that careful psychic analysis frequently shows that the shock of a commonplace "fear" is really rooted in a lesion of the sexual emotions. A typical and very simple illustration is furnished in a case, recorded by Breuer, in which a young girl of seventeen had her first hysterical attack after a cat sprang on her shoulders as she was going downstairs. Careful investigation showed that this girl had been the object of somewhat ardent attentions from a young man whose advances she had resisted, although her own sexual emotions had been aroused. A few days before, she had been surprised by this young man on these same dark stairs, and had forcibly escaped from his hands. Here was the real psychic traumatism, the operation of which merely became manifest in the cat. "But in how many cases," asks Breuer, "is a cat thus reckoned as a completely sufficient _causa efficiens_?"

In every case that they have investigated Breuer and Freud have found some similar secret lesion of the psychic sexual sphere. In one case a governess, whose training has been severely upright, is, in spite of herself and without any encouragement, led to experience for the father of the children under her care an affection which she refuses to acknowledge even to herself; in another, a young woman finds herself falling in love with her brother-in-law; again, an innocent girl suddenly discovers her uncle in the act of sexual intercourse with her playmate, and a boy on his way home from school is subjected to the coarse advances of a sexual invert. In nearly every case, as Freud eventually found reason to believe, a primary lesion of the sexual emotions dates from the period of puberty and frequently of childhood, and in nearly every case the intimately private nature of the lesion causes it to be carefully hidden from everyone, and even to be unacknowledged by the subject of it. In the earlier cases Breuer and Freud found that a slight degree of hypnosis is necessary to bring the lesion into consciousness, and the accuracy of the revelations thus obtained has been tested by independent witness. Freud has, however, long abandoned the induction of any degree of hypnosis; he simply tries to arrange that the patient shall feel absolutely free to tell her own story, and so proceeds from the surface downwards, slowly finding and piecing together such essential fragments of the history as may be recovered, in the same way he remarks, as the archæologist excavates below the surface and recovers and puts together the fragments of an antique statue. Much of the material found, however, has only a symbolic value requiring interpretation and is sometimes pure fantasy. Freud now attaches great importance to dreams as symbolically representing much in the subject's mental history which is otherwise difficult to reach.[275] The subtle and slender clues which Freud frequently follows in interpreting dreams cannot fail sometimes to arouse doubt in his readers' minds, but he certainly seems to have been often successful in thus reaching latent facts in consciousness. The primary lesion may thus act as "a foreign body in consciousness." Something is introduced into psychic life which refuses to merge in the general flow of consciousness. It cannot be accepted simply as other facts of life are accepted; it cannot even be talked about, and so submitted to the slow usure by which our experiences are worn down and gradually transformed. Breuer illustrates what happens by reference to the sneezing reflex. "When an irritation to the nasal mucous membrane for some reason fails to liberate this reflex, a feeling of excitement and tension arises. This excitement, being unable to stream out along motor channels, now spreads itself over the brain, inhibiting other activities.... _In the highest spheres of human activity we may watch the same process_." It is a result of this process that, as Breuer and Freud found, the mere act of confession may greatly relieve the hysterical symptoms produced by this psychic mechanism, and in some cases may wholly and permanently remove them. It is on this fact that they founded their method of treatment, devised by Breuer and by him termed the cathartic method, though Freud prefers to call it the "analytic" method. It is, as Freud points out, the reverse of the hypnotic method of suggestive treatment; there is the same difference, Freud remarks, between the two methods as Leonardo da Vinci found for the two technical methods of art, _per via di porre_ and _per via di levare_; the hypnotic method, like painting, works by putting in, the cathartic or analytic method, like sculpture, works by taking out.[276]

It is part of the mechanism of this process, as understood by these authors, that the physical symptoms of hysteria are constituted, by a process of conversion, out of the injured emotions, which then sink into the background or altogether out of consciousness. Thus, they found the prolonged tension of nursing a near and dear relative to be a very frequent factor in the production of hysteria. For instance, an originally rheumatic pain experienced by a daughter when nursing her father becomes the symbol in memory of her painful psychic excitement, and this perhaps for several reasons, but chiefly because _its presence in consciousness almost exactly coincided with that excitement_. In another way, again, nausea and vomiting may become a symbol through the profound sense of disgust with which some emotional shock was associated. Then the symbol begins to have a life of its own, and draws hidden strength from the emotion with which it is correlated. Breuer and Freud have found by careful investigation that the pains and physical troubles of hysteria are far from being capricious, but may be traced in a varying manner to an origin in some incident, some pain, some action, which was associated with a moment of acute psychic agony. The process of conversion was an involuntary escape from an intolerable emotion, comparable to the physical pain sometimes sought in intense mental grief, and the patient wins some relief from the tortured emotions, though at the cost of psychic abnormality, of a more or less divided state of consciousness and of physical pain, or else anæsthesia. In Charcot's third stage of the hysterical convulsion, that of "_attitudes passionnelles_," Breuer and Freud see the hallucinatory reproduction of a recollection which is full of significance for the origin of the hysterical manifestations.

The final result reached by these workers is clearly stated by each writer. "The main observation of our predecessors," states Breuer,[277] "still preserved in the word 'hysteria,' is nearer to the truth than the more recent view which puts sexuality almost in the last line, with the object of protecting the patient from moral reproaches. Certainly the sexual needs of the hysterical are just as individual and as various in force as those of the healthy. But they suffer from them, and in large measure, indeed, they suffer precisely through the struggle with them, through the effort to thrust sexuality aside." "The weightiest fact," concludes Freud,[278] "on which we strike in a thorough pursuit of the analysis is this: From whatever side and from whatever symptoms we start, we always unfailingly reach the region of the sexual life. Here, first of all, an etiological condition of hysterical states is revealed.... At the bottom of every case of hysteria--and reproducible by an analytical effort after even an interval of long years--may be found one or more facts of precocious sexual experience belonging to earliest youth. I regard this as an important result, as the discovery of a _caput Nili_ of neuropathology." Ten years later, enlarging rather than restricting his conception, Freud remarks: "Sexuality is not a mere _deus ex machina_ which intervenes but once in the hysterical process; it is the motive force of every separate symptom and every expression of a symptom. The morbid phenomena constitute, to speak plainly, the patient's sexual activity."[279] The actual hysterical fit, Freud now states, may be regarded as "the substitute for a once practiced and then abandoned _auto-erotic_ satisfaction," and similarly it may be regarded as an equivalent of coitus.[280]

It is natural to ask how this conception affects that elaborate picture of hysteria laboriously achieved by Charcot and his school. It cannot be said that it abolishes any of the positive results reached by Charcot, but it certainly alters their significance and value; it presents them in a new light and changes the whole perspective. With his passion for getting at tangible definite physical facts, Charcot was on very safe ground. But he was content to neglect the psychic analysis of hysteria, while yet proclaiming that hysteria is a purely psychic disorder. He had no cause of hysteria to present save only heredity. Freud certainly admits heredity, but, as he points out, the part it plays has been overrated. It is too vague and general to carry us far, and when a specific and definite cause can be found, the part played by heredity recedes to become merely a condition, the soil on which the "specific etiology" works. Here probably Freud's enthusiasm at first carried him too far and the most important modification he has made in his views occurs at this point: he now attaches a preponderant influence to heredity. He has realized that sexual activity in one form or another is far too common in childhood to make it possible to lay very great emphasis on "traumatic lesions" of this character, and he has also realized that an outcrop of fantasies may somewhat later develop on these childish activities, intervening between them and the subsequent morbid symptoms. He is thus led to emphasize anew the significance of heredity, not, however, in Charcot's sense, as general neuropathic disposition but as "sexual constitution." The significance of "infantile sexual lesions" has also tended to give place to that of "infantilism of sexuality."[281]

The real merit of Freud's subtle investigations is that--while possibly furnishing a justification of the imperfectly-understood idea that had floated in the mind of observers ever since the name "hysteria" was first invented--he has certainly supplied a definite psychic explanation of a psychic malady. He has succeeded in presenting clearly, at the expense of much labor, insight, and sympathy, a dynamic view of the psychic processes involved in the constitution of the hysterical state, and such a view seems to show that the physical symptoms laboriously brought to light by Charcot are largely but epiphenomena and by-products of an emotional process, often of tragic significance to the subject, which is taking place in the most sensitive recess of the psychic organism. That the picture of the mechanism involved, presented to us by Professor Freud, cannot be regarded as a final and complete account of the matter, may readily be admitted. It has developed in Freud's own hands, and some of the developments will require very considerable confirmation before they can be accepted as generally true.[282] But these investigations have at least served to open the door, which Charcot had inconsistently held closed, into the deeper mysteries of hysteria, and have shown that here, if anywhere, further research will be profitable. They have also served to show that hysteria may be definitely regarded as, in very many cases at least, a manifestation of the sexual emotions and their lesions; in other words, a transformation of auto-erotism.

The conception of hysteria so vigorously enforced by Charcot and his school is thus now beginning to appear incomplete. But we have to recognize that that incompleteness was right and necessary. A strong reaction was needed against a widespread view of hysteria that was in large measure scientifically false. It was necessary to show clearly that hysteria is a definite disorder, even when the sexual organs and emotions are swept wholly out of consideration; and it was also necessary to show that the lying and dissimulation so widely attributed to the hysterical were merely the result of an ignorant and unscientific misinterpretation of psychic elements of the disease. This was finally and triumphantly achieved by Charcot's school.

There is only one other point in the explanation of hysteria which I will here refer to, and that because it is usually ignored, and because it has relationship to the general psychology of the sexual emotions. I refer to that physiological hysteria which is the normal counterpart of the pathological hysteria which has been described in its physical details by Charcot, and to which alone the term should strictly be applied. Even though hysteria as a disease may be described as one and indivisible, there are yet to be found, among the ordinary and fairly healthy population, vague and diffused hysteroid symptoms which are dissipated in a healthy environment, or pass nearly unnoted, only to develop in a small proportion of cases, under the influence of a more pronounced heredity, or a severe physical or psychic lesion, into that definite morbid state which is properly called hysteria.

This diffused hysteroid condition may be illustrated by the results of a psychological investigation carried on in America by Miss Gertrude Stein among the ordinary male and female students of Harvard University and Radcliffe College. The object of the investigation was to study, with the aid of a planchette, the varying liability to automatic movements among normal individuals. Nearly one hundred students were submitted to experiment. It was found that automatic responses could be obtained in two sittings from all but a small proportion of the students of both sexes, but that there were two types of individual who showed a special aptitude. One type (probably showing the embryonic form of neurasthenia) was a nervous, high-strung, imaginative type, not easily influenced from without, and not so much suggestible as autosuggestible. The other type, which is significant from our present point of view, is thus described by Miss Stein: "In general the individuals, often blonde and pale, are distinctly phlegmatic. If emotional, decidedly of the weakest, sentimental order. They may be either large, healthy, rather heavy, and lacking in vigor or they may be what we call anæmic and phlegmatic. Their power of concentrated attention is very small. They describe themselves as never being held by their work; they say that their minds wander easily; that they work on after they are tired, and just keep pegging away. They are very apt to have premonitory conversations, they anticipate the words of their friends, they imagine whole conversations that afterward come true. The feeling of having been there is very common with them; that is, they feel under given circumstances that they have had that identical experience before in all its details. They are often fatalistic in their ideas. They indulge in day-dreams. As a rule, they are highly suggestible."[283]

There we have a picture of the physical constitution and psychic temperament on which the classical symptoms of hysteria might easily be built up.[284] But these persons were ordinary students, and while a few of their characteristics are what is commonly and vaguely called "morbid," on the whole they must be regarded as ordinarily healthy individuals. They have the congenital constitution and predisposition on which some severe psychic lesion at the "psychological moment" might develop the most definite and obstinate symptoms of hysteria, but under favorable circumstances they will be ordinary men and women, of no more than ordinary abnormality or ordinary power. They are among the many who have been called to hysteria at birth; they may never be among the few who are chosen.

We may have to recognize that on the side of the sexual emotions, as well as in general constitution, a condition may be traced among normal persons that is hysteroid in character, and serves as the healthy counterpart of a condition which in hysteria is morbid. In women such a condition Has been traced (though misnamed) by Dr. King.[285]

Dr. King describes what he calls "sexual hysteria in women," which he considers a chief variety of hysteria. He adds, however, that it is not strictly a disease, but simply an automatic reaction of the reproductive system, which tends to become abnormal under conditions of civilization, and to be perpetuated in a morbid form. In this condition he finds twelve characters: 1. Time of life, usually between puberty and climacteric. 2. Attacks rarely occur when subject is alone. 3. Subject appears unconscious, but is not really so. 4. She is instinctively ashamed afterward. 5. It occurs usually in single women, or in those, single or married, whose sexual needs are unsatisfied. 6. No external evidence of disease, and (as Aitken pointed out) the nates are not flattened; the woman's physical condition is not impaired, and she may be specially attractive to men. 7. Warmth of climate and the season of spring and summer are conducive to the condition. 8. The paroxysm in short and temporary. 9. While light touches are painful, firm pressure and rough handling give relief. 10. It may occur in the occupied, but an idle, purposeless life is conducive. 11. The subject delights in exciting sympathy and in being fondled and caressed. 12. There is defect of will and a strong stimulus is required to lead to action.

Among civilized women, the author proceeds, this condition does not appear to subserve any useful purpose. "Let us, however, go back to aboriginal woman--to woman of the woods and the fields. Let us picture ourselves a young aboriginal Venus in one of her earliest hysterical paroxysms. In doing so, let us not forget some of the twelve characteristics previously mentioned. She will not be 'acting her part' alone, or, if alone, it will be in a place where someone else is likely soon to discover her. Let this Venus be now discovered by a youthful Apollo of the woods, a man with fully developed animal instincts. He and she, like any other animals, are in the free field of Nature. He cannot but observe to himself: 'This woman is not dead; she breathes and is warm; she does not look ill; she is plump and rosy.' He speaks to her; she neither hears (apparently) nor responds. Her eyes are closed. He touches, moves, and handles her at his pleasure. She makes no resistance. What will this primitive Apollo do next? He will cure the fit, and bring the woman back to consciousness, satisfy her emotions, and restore her volition--not by delicate touches that might be 'agonizing' to her hyperesthetic skin, but by vigorous massage, passive motions, and succussion that would be painless. The emotional process on the part of the woman would end, perhaps, with mingled laughter, tears, and shame; and when accused afterward of the part which the ancestrally acquired properties of her nervous system had compelled her to act, as a preliminary to the event, what woman would not deny it and be angry? But the course of Nature having been followed, the natural purpose of the hysterical paroxysm accomplished, there would remain as a result of the treatment--instead of one discontented woman--two happy people, and the possible beginning of a third."

"Natural, primary sexual hysteria in woman," King concludes, "is a temporary modification of the nervous government of the body and the distribution of nerve-force (occurring for the most part, as we see it to-day, in prudish women of strong moral principle, whose volition has disposed them to resist every sort of liberty or approach from the other sex), consisting in a transient abdication of the general, volitional, and self-preservational ego, while the reins of government are temporarily assigned to the usurping power of the reproductive ego, so that the reproductive government overrules the government by volition, and thus, as it were, forcibly compels the woman's organism to so dispose itself, at a suitable time and place, as to allow, invite, and secure the approach of the other sex, whether she will or not, to the end that Nature's imperious demand for reproduction shall be obeyed."

This perhaps rather fantastic description is not a presentation of hysteria in the technical sense, but we may admit that it presents a state which, if not the real physiological counterpart of the hysterical convulsion, is yet distinctly analogous to the latter. The sexual orgasm has this correspondence with the hysterical fit, that they both serve to discharge the nervous centres and relieve emotional tension. It may even happen, especially in the less severe forms of hysteria, that the sexual orgasm takes place during the hysterical fit; this was found by Rosenthal, of Vienna, to be always the case in the semiconscious paroxysms of a young girl whose condition was easily cured;[286] no doubt such cases would be more frequently found if they were sought for. In severe forms of hysteria, however, it frequently happens, as so many observers have noted, that normal sexual excitement has ceased to give satisfaction, has become painful, perverted, paradoxical. Freud has enabled us to see how a shock to the sexual emotions, injuring the emotional life at its source, can scarcely fail sometimes to produce such a result. But the necessity for nervous explosion still persists.[287] It may, indeed, persist, even in an abnormally strong degree, in consequence of the inhibition of normal activities generally. The convulsive fit is the only form of relief open to the tension. "A lady whom I long attended," remarks Ashwell, "always rejoiced when the fit was over, since it relieved her system generally, and especially her brain, from painful irritation which had existed for several previous days." That the fit mostly fails to give real satisfaction, and that it fails to cure the disease, is due to the fact that it is a morbid form of relief. The same character of hysteria is seen, with more satisfactory results for the most part, in the influence of external nervous shock. It was the misunderstood influence of such shocks in removing hysteria which in former times led to the refusal to regard hysteria as a serious disease. During the Rebellion of 1745-46 in Scotland, Cullen remarks that there was little hysteria. The same was true of the French Revolution and of the Irish Rebellion, while Rush (in a study _On the Influence of the American Revolution on the Human Body_) observed that many hysterical women were "restored to perfect health by the events of the time." In such cases the emotional tension is given an opportunity of explosion in new and impersonal channels, and the chain of morbid personal emotions is broken.

It has been urged by some that the fact that the sexual orgasm usually fails to remove the disorder in true hysteria excludes a sexual factor of hysteria. It is really, one may point out, an argument in favor of such an element as one of the factors of hysteria. If there were no initial lesion of the sexual emotions, if the natural healthy sexual channel still remained free for the passage of the emotional overflow, then we should expect that it would much oftener come into play in the removal of hysteria. In the more healthy, merely hysteroid condition, the psychic sexual organism is not injured, and still responds normally, removing the abnormal symptoms when allowed to do so. It is the confusion between this almost natural condition and the truly morbid condition, alone properly called hysteria, which led to the ancient opinion, inaugurated by Plato and Hippocrates, that hysteria may be cured by marriage.[288] The difference may be illustrated by the difference between a distended bladder which is still able to contract normally on its contents when at last an opportunity of doing so is afforded and the bladder in which distension has been so prolonged that nervous control had been lost and spontaneous expulsion has become impossible. The first condition corresponds to the constitution, which, while simulating the hysterical condition, is healthy enough to react normally in spite of psychic lesions; the second corresponds to a state in which, owing to the prolonged stress of psychic traumatism,--sexual or not,--a definite condition of hysteria has arisen. The one state is healthy, though abnormal; the other is one of pronounced morbidity.

The condition of true hysteria is thus linked on to almost healthy states, and especially to a condition which may be described as one of sex-hunger. Such a suggestion may help us to see these puzzling phenomena in their true nature and perspective.

At this point I may refer to the interesting parallel, and probable real relationship, between hysteria and chlorosis. As Luzet has said, hysteria and chlorosis are sisters. We have seen that there is some ground for regarding hysteria as an exaggerated form of a normal process which is really an auto-erotic phenomenon. There is some ground, also, for regarding chlorosis as the exaggeration of a physiological state connected with sexual conditions, more specifically with the preparation for maternity. Hysteria is so frequently associated with anæmic conditions that Biernacki has argued that such conditions really constitute the primary and fundamental cause of hysteria (_Neurologisches Centralblatt_, March, 1898). And, centuries before Biernacki, Sydenham had stated his belief that poverty of the blood is the chief cause of hysteria.

It would be some confirmation of this position if we could believe that chlorosis, like hysteria, is in some degree a congenital condition. This was the view of Virchow, who regarded chlorosis as essentially dependent on a congenital hyoplasia of the arterial system. Stieda, on the basis of an elaborate study of twenty-three cases, has endeavored to prove that chlorosis is due to a congenital defect of development (_Zeitschrift für Geburtshülfe und Gynäkologie_, vol. xxxii, Part I, 1895). His facts tend to prove that in chlorosis there are signs of general ill-development, and that, in particular, there is imperfect development of the breasts and sexual organs, with a tendency to contracted pelvis. Charrin, again, regards utero-ovarian inadequacy as at least one of the factors of chlorosis. Chlorosis, in its extreme form, may thus be regarded as a disorder of development, a sign of physical degeneracy. Even if not strictly a cause, a congenital condition may, as Stockman believes (_British Medical Journal_, December 14, 1895), be a predisposing influence.

However it may be in extreme cases, there is very considerable evidence to indicate that the ordinary anæmia of young women may be due to a storing up of iron in the system, and is so far normal, being a preparation for the function of reproduction. Some observations of Bunge's seem to throw much light on the real cause of what may be termed physiological chlorosis. He found by a series of experiments on animals of different ages that young animals contain a much greater amount of iron in their tissues than adult animals; that, for instance, the body of a rabbit an hour after birth contains more than four times as much iron as that of a rabbit two and a half months old. It thus appears probable that at the period of puberty, and later, there is a storage of iron in the system preparatory to the exercise of the maternal functions. It is precisely between the ages of fifteen and twenty-three, as Stockman found by an analysis of his own cases (_British Medical Journal_, December 14, 1895), that the majority of cases occur; there was, indeed, he found, no case in which the first onset was later than the age of twenty-three. A similar result is revealed by the charts of Lloyd Jones, which cover a vastly greater number of cases.

We owe to Lloyd Jones an important contribution to the knowledge of chlorosis in its physiological or normal relationships. He has shown that chlorosis is but the exaggeration of a condition that is normal at puberty (and, in many women, at each menstrual period), and which, there is good reason to believe, even has a favorable influence on fertility. He found that light-complexioned persons are more fertile than the dark-complexioned, and that at the same time the blood of the latter is of less specific gravity, containing less hæmoglobin. Lloyd Jones also reached the generalization that girls who have had chlorosis are often remarkably pretty, so that the tendency to chlorosis is associated with all the sexual and reproductive aptitudes that make a woman attractive to a man. His conclusion is that the normal condition of which chlorosis is the extreme and pathological condition, is a preparation for motherhood (E. Lloyd Jones, "Chlorosis: The Special Anæmia of Young Women," 1897; also numerous reports to the British Medical Association, published in the _British Medical Journal_. There was an interesting discussion of the theories of chlorosis at the Moscow International Medical Congress, in 1898; see proceedings of the congress, volume in, section v, pp. 224 et seq.).

We may thus, perhaps, understand why it is that hysteria and anæmia are often combined, and why they are both most frequently found in adolescent young women who have yet had no sexual experiences. Chlorosis is a physical phenomenon; hysteria, largely a psychic phenomenon; yet, both alike may, to some extent at least, be regarded as sexual aptitude showing itself in extreme and pathological forms.

FOOTNOTES:

[251] _Genèse et Nature de l'Hystérie_, 1898; and, for Sollier's latest statement, see "Hystérie et Sommeil," _Archives de Neurologie_, May and June, 1907. Lombroso (_L'Uomo Delinquente_, 1889, vol. ii, p. 329), referring to the diminished metabolism of the hysterical, had already compared them to hibernating animals, while Babinsky states that the hysterical are in a state of subconsciousness, a state, as Metchnikoff remarks (_Essais optimistes_, p. 270), reminiscent of our prehistoric past.

[252] Professor Freud, while welcoming the introduction of the term "auto-erotism," remarks that it should not be made to include the whole of hysteria. This I fully admit, and have never questioned. Hysteria is far too large and complex a phenomenon to be classed as entirely a manifestation of auto-erotism, but certain aspects of it are admirable illustrations of auto-erotic transformation.

[253] The hysterical phenomenon of _globus hystericus_ was long afterward attributed to obstruction of respiration by the womb. The interesting case has been recorded by E. Bloch (_Wiener Klinische Wochenschrift_, 1907, p. 1649) of a lady who had the feeling of a ball rising from her stomach to her throat, and then sinking. This feeling was associated with thoughts of her husband's rising and falling penis, and was always most liable to occur when she wished for coitus.

[254] As Gilles de la Tourette points out, it is not difficult to show that epilepsy, the _morbus sacer_ of the ancients, owed much of its sacred character to this confusion with hysteria. Those priestesses who, struck by the _morbus sacer_, gave forth their oracles amid convulsions, were certainly not the victims of epilepsy, but of hysteria (_Traité de l'Hystérie_, vol. i, p. 3).

[255] Aretæus, _On the Causes and Symptoms of Acute Diseases_, Book ii,