Studies in the Psychology of Sex Volume Ii Part 21

[172]

???pt?d?a, vol. vi, p. 197.

[173]

The term "cunnilinctus" was suggested to me by the late Dr. J. Bonus, and I have ever since used it; the Latin authors commonly used "c.u.n.n.i.l.i.n.g.u.s" for the actor, but had no corresponding term for the action. Hirschfeld has lately used the term "cunnilinctio" in the same sense, but such a formation is quite inadmissible. For information on the cla.s.sic terms for this perversion, see, e.g., Iwan Bloch, Ursprung der Syphilis, vol. ii, p. 612 et seq.

[174]

Casanova, Memoires, ed. Gamier, vol. iv, p. 597.

[175]

Hirschfeld deals in a full and authoritative manner with the differential diagnosis of inversion and the other groups of transitional s.e.xuality in Die h.o.m.os.e.xualitat, ch. ii; also in his fully ill.u.s.trated book Geschlechtsubergange, 1905.

[176]

Havelock Ellis, "Auto-erotism," in vol. i of these Studies; Iwan Bloch, Ursprung der Syphilis, vol. ii, p. 589; ib., Die Prost.i.tution, vol, i, pp. 385-6; for early references, Crusius, Untersuchungen zu den Mimiamben der Herondas, pp. 129-30.

[177]

I have found a notice of a similar case in France, during the sixteenth century, in Montaigne's Journal du Voyage en Italie en 1850 (written by his secretary); it took place near Vitry le Francois. Seven or eight girls belonging to Chaumont, we are told, resolved to dress and to work as men; one of these came to Vitry to work as a weaver, and was looked upon as a well-conditioned young man, and liked by everyone. At Vitry she became betrothed to a woman, but, a quarrel arising, no marriage took place. Afterward "she fell in love with a woman whom she married, and with whom she lived for four or five months, to the wife's great contentment, it is said; but, having been recognized by some one from Chaumont, and brought to justice, she was condemned to be hanged. She said she would even prefer this to living again as a girl, and was hanged for using illicit inventions to supply the defects of her s.e.x" (Journal, ed. by d'Ancona, 1889, p. 11).

[178]

Roux, Bulletin Societe d'Anthropologie, 1905, No. 3. Roux knew a Comarian woman who, at the age of 50, after her husband's death, became h.o.m.os.e.xual and made herself an artificial p.e.n.i.s which she used with younger women.

[179]

Hirschfeld, Die h.o.m.os.e.xualitat, p. 47.

[180]

There are few traces of feminine h.o.m.os.e.xuality in English social history of the past. In Charles the Second's Court, the Memoires de Ghrammont tell us, Miss Hobart was credited with Lesbian tendencies. "Soon the rumor, true or false, of this singularity spread through the court. They were gross enough there never to have heard of that refinement of ancient Greece in the tastes of tenderness, and the idea came into their heads that the ill.u.s.trious Hobart, who seemed so affectionate to pretty women, must be different from what she appeared." This pa.s.sage is interesting because it shows us how rare was the exception. A century later, however, h.o.m.os.e.xuality among English women seems to have been regarded by the French as common, and Bacchaumont, on January 1, 1773, when recording that Mlle. Heinel of the Opera was settling in England, added: "Her taste for women will there find attractive satisfaction, for though Paris furnishes many tribades it is said that London is herein superior."

[181]

"I believe," writes a well-informed American correspondent, "that s.e.xual inversion is increasing among Americans-both men and women-and the obvious reasons are: first, the growing independence of the women, their lessening need for marriage; secondly, the nervous strain that business compet.i.tion has brought upon the whole nation. In a word, the rapidly increasing masculinity in women and the unhealthy nervous systems of the men offer the ideal factors for the production of s.e.xual inversion in their children."

[182]

h.o.m.os.e.xual women, like h.o.m.os.e.xual men, now insert advertis.e.m.e.nts in the newspapers, seeking a "friend." Nacke ("Zeitungsannoncen von weiblichen h.o.m.os.e.xuellen," Archiv fur Kriminal-Anthropologie, 1902, p. 225) brought together from Munich newspapers a collection of such advertis.e.m.e.nts, most of which were fairly unambiguous: "Actress with modern ideas desires to know rich lady with similar views, for the sake of friendly relations, etc.;" "Young lady of 19, a pretty blonde, seeks another like herself for walks, theatre, etc.," and so on.

CHAPTER V.-THE NATURE OF s.e.xUAL INVERSION.

a.n.a.lysis of Histories-Race-Heredity-General Health-First Appearance of h.o.m.os.e.xual Impulse-s.e.xual Precocity and Hyperesthesia-Suggestion and Other Exciting Causes of Inversion-Masturbation-Att.i.tude Toward Women-Erotic Dreams-Methods of s.e.xual Relations.h.i.+p-Pseudo-s.e.xual Attraction-Physical s.e.xual Abnormalities-Artistic and Other Apt.i.tudes-Moral Att.i.tude of the Invert.

Before stating briefly my own conclusions as to the nature of s.e.xual inversion, I propose to a.n.a.lyze the facts brought out in the histories which I have been able to study.[183]

RACE.-All my cases, 80 in number, are British and American, 20 living in the United States and the rest being British. Ancestry, from the point of view of race, was not made a matter of special investigation. It appears, however, that at least 44 are English or mainly English; at least 10 are Scotch or of Scotch extraction; 2 are Irish and 4 others largely Irish; 4 have German fathers or mothers; another is of German descent on both sides, while 2 others are of remote German extraction; 2 are partly, and 1 entirely, French; 2 have a Portuguese strain, and at least 2 are more or less Jewish. Except the apparently frequent presence of the German element, there is nothing remarkable in this ancestry.

HEREDITY.-It is always difficult to deal securely with the significance of heredity, or even to establish a definite basis of facts. I have by no means escaped this difficulty, for in some cases I have not even had an opportunity of cross-examining the subjects whose histories I have obtained. Still, the facts, so far as they emerge, have some interest. I possess some record of heredity in 62 of my cases. Of these, not less than 24, or in the proportion of nearly 39 per cent., a.s.sert that they have reason to believe that other cases of inversion have occurred in their families, and, while in some it is only a strong suspicion, in others there is no doubt whatever. In one case there is reason to suspect inversion on both sides. Usually the inverted relatives have been brothers, sisters, cousins, or uncles. In one case a bis.e.xual son seems to have had a bis.e.xual father.

This hereditary character of inversion (which was denied by Nacke) is a fact of great significance, and, as it occurs in cases with which I am well acquainted, I can have no doubt concerning the existence of the tendency. The influence of suggestion may often be entirely excluded, especially when the persons are of different s.e.x. Both Krafft-Ebing and Moll noted a similar tendency. Von Romer states that in one-third of his cases there was inversion in other members of the family. Hirschfeld also found that there is a relatively high proportion of cases of family inversion.

Twenty-six, so far as can be ascertained, belong to reasonably healthy families; minute investigation would probably reduce the number of these, and it is noteworthy that even in some of the healthy families there was only one child born of the parents' marriage. In 28 cases there is more or less frequency of morbidity or abnormality-eccentricity, alcoholism, neurasthenia, insanity, or nervous disease-on one or both sides, in addition to inversion or apart from it. In some of these cases the inverted offspring is the outcome of the union, of a very healthy with a thoroughly morbid stock; in some others there is a minor degree of abnormality on both sides.

GENERAL HEALTH.-It is possible to speak with more certainty of the health of the individual than of that of his family. Of the 80 cases, 53-or about two-thirds-may be said to enjoy good, and sometimes even very good, health, though occasionally there is some slight qualification to be made. In 22 cases the health is delicate, or at best only fair; in these cases there is sometimes a tendency to consumption, and often marked neurasthenia and a more or less unbalanced temperament. Four cases are morbid to a considerable degree; the remaining case has had insane delusions which required treatment in an asylum. A considerable proportion, included among those as having either good or fair health, may be described as of extremely nervous temperament, and in most cases they so describe themselves; a certain proportion of these combine great physical and, especially, mental energy with this nervousness; all these are doubtless of neurotic temperament.[184] Very few can be said to be conspicuously lacking in energy. On the whole, therefore, a large proportion of these inverted individuals are pa.s.sing through life in an unimpaired state of health, which enables them to do at least their fair share of work in the world; in a considerable proportion of my cases that work is of high intellectual value. Only in 5 cases, it will be seen, or at most 6, can the general health be said to be distinctly bad.

This result may, perhaps, seem surprising. It must, however, be remembered that my cases do not, on the whole, represent the cla.s.s which alone the physician is usually able to bring forward: i.e., the s.e.xual inverts who are suffering from a more or less severe degree of complete nervous breakdown.

There is no frequent relations.h.i.+p between h.o.m.os.e.xuality and insanity, and such h.o.m.os.e.xuality as is found in asylums is mostly of a spurious character. This point was specially emphasized by Nacke (e.g., "h.o.m.os.e.xualitat und Psychose," Zeitschrift fur Psichiatrie, vol. lxviii, No. 3, 1911). He quoted the opinions of various distinguished alienists as to the rarity with which they had met genuine inverts, and recorded his own experiences. He had never met a genuine invert in the asylum throughout his extensive experience, although he was quite willing to admit that there may be unrecognized inverts in asylums, and one patient informed him, after leaving, that he was inverted, and had attracted the attention of the police both before and afterward, though nothing happened in the asylum. Among 1500 patients in the asylum during one year, active pedicatio occurred in about 1 per cent. of cases, these patients being frequently idiots or imbeciles and at the same time masturbators, solitary or mutual. Hirschfeld informed Nacke that, among h.o.m.os.e.xual persons, hysterical conditions (not usually on hereditary basis) are fairly common, and neurasthenia of high degree decidedly frequent, but though stages of depression are common he had never seen pure melancholia and very seldom mania, but paranoiac delusional ideas frequently, and he agreed with Bryan of Broadmoor that religious delusions are not uncommon. General paralysis occurs, but is comparatively rare, and the same may be said of dementia praec.o.x. On the whole, although Hirschfeld was unable to give precise figures, there was no reason whatever to suppose an abnormal prevalence of insanity. This was Nacke's own view. It is quite true, Nacke concluded, that h.o.m.os.e.xual actions occur in every form of psychosis, especially in congenital and secondary dements, and at periods of excitement, but we are here more concerned with "pseudo-h.o.m.os.e.xuality" than with true inversion. Hirschfeld finds that 75 per cent. inverts are of sound heredity; this seems too large a proportion; in any case allowance must be made for differences in method and minuteness of investigation.

I am fairly certain that thorough investigation would very considerably enlarge the proportion of cases with morbid heredity. At the same time this enlargement would be chiefly obtained by bringing minor abnormalities to the front, and it would then have to be shown how far the families of average or normal persons are free from such abnormalities. The question is sometimes asked: What family is free from neuropathic taint? At present it is difficult to answer this question precisely. There is good ground to believe that a fairly large proportion of families are free from such taint. In any case it seems probable that the families to which the inverted belong do not usually present such profound signs of nervous degeneration as we were formerly led to suppose. What we vaguely call "eccentricity" is common among them; insanity is much rarer.

FIRST APPEARANCE OF h.o.m.os.e.xUAL INSTINCT.-Out of 72 cases, in 8 the instinct veered round to the same s.e.x in adult age or at all events after p.u.b.erty; in 3 of these there had been a love-disappointment with a woman; no other cause than this can be a.s.signed for the transition; but it is noteworthy that in at least 2 of these cases the s.e.xual instinct is undeveloped or morbidly weak, while a third individual is of somewhat weak physique, and another has long been in delicate health. In a further case, also somewhat morbid, the development was rather more complicated.

In 64 cases, or in a proportion of 88 per cent., the abnormal instinct began in early life, without previous attraction to the opposite s.e.x.[185] In 27 of these it dates from about p.u.b.erty, usually beginning at school. In 39 cases the tendency began before p.u.b.erty, between the ages of 5 and 11, usually between 7 and 9, sometimes as early as the subject can remember. It must not be supposed that, in these numerous cases of the early appearance of h.o.m.os.e.xuality, the manifestations were of a specifically physical character, although erections are noted in a few cases. For the most part s.e.xual manifestations at this early age, whether h.o.m.os.e.xual or heteros.e.xual, are purely psychic.[186]

s.e.xUAL PRECOCITY AND HYPERESTHESIA.-It is a fact of considerable interest and significance that in so large a number of my cases there was distinct precocity of the s.e.xual emotions, both on the physical and psychic sides. There can be little doubt that, as many previous observers have found, inversion tends strongly to be a.s.sociated with s.e.xual precocity. I think it may further be said that s.e.xual precocity tends to encourage the inverted habit where it exists. Why this should be so is obvious, if we believe-as there is some reason for believing-that at an early age the s.e.xual instinct is comparatively undifferentiated in its manifestations. The precocious accentuation of the s.e.xual impulse leads to definite crystallization of the emotions at a premature stage. It must be added that precocious s.e.xual energy is likely to remain feeble, and that a feeble s.e.xual energy adapts itself more easily to h.o.m.os.e.xual relations.h.i.+ps, in which there is no definite act to be accomplished, than to normal relations.h.i.+ps. It is difficult to say how many of my cases exhibit s.e.xual weakness. In 6 or 7 it is evident, and it may be suspected in many others, especially in those who are, and often describe themselves as, "sensitive" or "nervous," as well as in those whose s.e.xual development was very late. In many cases there is marked hyperesthesia, or irritable weakness. Hyperesthesia simulates strength, and, while there can be little doubt that some s.e.xual inverts (and more especially bis.e.xuals) do possess unusual s.e.xual energy, in others it is but apparent; the frequent repet.i.tion of seminal emissions, for example, may be the result of weakness as well as of strength. It must be added that this irritability of the s.e.xual centers is, in a considerable proportion of inverts, a.s.sociated with marked emotional tendencies to affection and self-sacrifice. In the extravagance of his affection and devotion, it has been frequently observed, the male invert resembles many normal women.

SUGGESTION AND OTHER EXCITING CAUSES OF INVERSION.-In 18 of my cases it is possible that some event, or special environment, in early life had more or less influence in turning the s.e.xual instinct into h.o.m.os.e.xual channels, or in calling out a latent inversion. In 3 cases a disappointment in normal love seems to have produced a profound nervous and emotional shock, acting, as we seem bound to admit, on a predisposed organism, and developing a fairly permanent tendency to inversion. In 8 cases there was seduction by an older person, but in at least 4 or 5 of these there was already a well-marked predisposition. In at least 8 other cases, example, usually at school, may probably be regarded as having exerted some influence. It is noteworthy that in very few of my cases can we trace the influence of any definite "suggestion," as a.s.serted by Schrenck-Notzing, who believes that, in the causation of s.e.xual inversion (as undoubtedly in the causation of erotic fetichism), we must give the first place to "accidental factors of education and external influence." He records the case of a little boy who innocently gazed in curiosity at the p.e.n.i.s of his father who was urinating, and had his ears boxed, whence arose a train of thought and feeling which resulted in complete s.e.xual inversion. In two of the cases I have reported we have parallel incidents, and here we see clearly that the h.o.m.os.e.xual tendency already existed. I do not question the occurrence of such incidents, but I refuse to accept them as supplying the causation of inversion, and in so doing I am supported by all the evidence I am able to obtain. I am in agreement with a correspondent who wrote:-

"Considering that all boys are exposed to the same order of suggestions (sight of a man's naked organs, sleeping with a man, being handled by a man), and that only a few of them become s.e.xually perverted, I think it reasonable to conclude that those few were previously const.i.tuted to receive the suggestion. In fact, suggestion seems to play exactly the same part in the normal and abnormal awakening of s.e.x."

I would go so far as to a.s.sert that for normal boys and girls the developed s.e.xual organs of the adult man or woman-from their size, hairiness, and the mystery which envelops them-nearly always exert a certain fascination, whether of attraction or horror.[187] But this has no connection with h.o.m.os.e.xuality, and scarcely with s.e.xuality at all. Thus, in one case known to me, a boy of 6 or 7 took pleasure in caressing the organs of another boy, twice his own age, who remained pa.s.sive and indifferent; yet this child grew up without ever manifesting any h.o.m.os.e.xual instinct. The seed of suggestion can only develop when it falls on a suitable soil. If it is to act on a fairly normal nature the perverted suggestion must be very powerful or iterated, and even then its influence will probably only be temporary, disappearing in the presence of the normal stimulus.[188]

Not only is "suggestion" unnecessary to develop a s.e.xual impulse already rooted in the organism, but when exerted in an opposite direction it is powerless to divert that impulse. We see this ill.u.s.trated in several of the cases whose histories I have presented. Thus in one case a boy was seduced by the housemaid at the age of 14 and even derived pleasure from the girl, yet none the less the native h.o.m.os.e.xual instinct a.s.serted itself a year later. In another case heteros.e.xual suggestions were offered and accepted in early life, yet, notwithstanding, the h.o.m.os.e.xual attraction was slowly evolved from within.

I have, therefore, but little to say of the influence of suggestion, which was formerly exalted to a position of the first importance in books on s.e.xual inversion. This is not because I underestimate the great part played by suggestion in many fields of normal and abnormal life. It is because I have been able to find but few decided traces of it in s.e.xual inversion. In many cases, doubtless, there may be some slight elements of suggestion in developing the inversion, though they cannot be traced.[189] Their importance seems usually questionable even when they are discovered. Take Schrenck-Notzing's case of the little boy whose ears were boxed for what his father considered improper curiosity. I find it difficult to realize that a mighty suggestion can thereby be generated unless a strong emotion exists for it to unite with; in that case the seed falls on prepared soil. Is the wide prevalence of normal s.e.xuality due to the fact that so many little boys have had their ears boxed for taking naughty liberties with women? If so, I am quite prepared to accept Schrenck-Notzing's explanation as a complete account of the matter. I know of one case, indeed, in which an element of what may fairly be called suggestion can be detected. It is that of a physician who had always been on very friendly terms with men, but had s.e.xual relations exclusively with women, finding fair satisfaction, until the confessions of an inverted patient one day came to him as a revelation; thereafter he adopted inverted practices and ceased to find any attraction in women. But even in this case, as I understand the matter, suggestion merely served to reveal his own nature to the man. For a physician to adopt the perverted habits which the visit of a chance patient suggests to him can scarcely be a phenomenon of pure suggestion. We have no reason to suppose that this physician practised every perversion he heard of from patients; he adopted that which fitted his own nature.[190] In another case h.o.m.os.e.xual advances were made to a youth and accepted, but he had already been attracted to men in childhood. Again, in another case, there were h.o.m.os.e.xual influences in the boyhood of a subject who became bis.e.xual, but as the subject's father was of similar bis.e.xual temperament we can attach no potency to the mere suggestions. In another case we find h.o.m.os.e.xual influence in childhood, but the child was already delicate, shy, nervous, and feminine, clearly possessing a temperament predestined to develop in a h.o.m.os.e.xual direction.

The irresistible potency of the inner impulse is well ill.u.s.trated in a case presented by Hirschfeld and Burchard: "My daughter Erna," said the subject's mother, "showed boyish inclinations at the age of 3, and they increased from year to year. She never played with dolls, only with tin soldiers, guns, and castles. She would climb trees and jump ditches; she made friends with the drivers of all the carts that came to our house and they would place her on the horse's back. The annual circus was a joy to her for all the year. Even as a child of 4 she was so fearless on horseback that lookers-on shouted Bravo! and all declared she was a born horsewoman. It was her greatest wish to be a boy. She would wear her elder brother's clothes all day, notwithstanding her grandmother's indignation. Cycling, gymnastics, boating, swimming, were her pa.s.sion, and she showed skill in them. As she grew older she hated prettily adorned hats and clothes. I had much trouble with her for she would not wear pretty things. The older she grew the more her masculine and decided ways developed. This excited much outcry and offence. People found my daughter unfeminine and disagreeable, but all my trouble and exhortations availed nothing to change her." Now this young woman whom all the influences of a normal feminine environment failed to render feminine was not physiologically a woman at all; the case proved to be the unique instance of an individual possessing all the external characteristics of a woman combined with internal testicular tissue capable of emitting true masculine s.e.m.e.n through the feminine urethra. No suggestions of the environment could suffice to overcome this fundamental fact of internal const.i.tution. (Hirschfeld and Burchard, "Spermasekretion aus einer weiblichen Harnrohre," Deutsche medizinische Wochenschrift, No. 52, 1911.)

I may here quote three American cases (not previously published), for which I am indebted to Prof. G. Frank Lydston, of Chicago. They seem to me to ill.u.s.trate the only kind of suggestions which play much part in the evolution of inversion. I give them in Dr. Lydston's words:-

CASE I.-A man, 45 years of age, attracted by the allusion to my essay on "Social Perversion" contained in the English translation of Krafft-Ebing's Psychopathia s.e.xualis, consulted me regarding the possible cure of his condition. This individual was a finely educated, very intelligent man, who was an excellent linguist, had considerable musical ability, and was in the employ of a firm whose business was such as to demand on the part of its employes considerable legal ac.u.men, clerical ability, and knowledge of real-estate transactions. This man stated that at the age of p.u.b.erty, without any knowledge of perversity of s.e.xual feeling, he was thrown intimately in contact with males of more advanced years, who took various means to excite his s.e.xual pa.s.sions, the result being that perverted s.e.xual practices were developed, which were continued for a number of years. He thereafter noticed an aversion to women. At the solicitations of his family he finally married, without any very intelligent idea as to what, if anything, might be expected of him in the marital relation. Absolute impotence-indeed, repugnance for a.s.sociation with his wife-was the lamentable sequence. A divorce was in contemplation when, fortunately for all parties concerned, the wife suddenly died. Being a man of more than ordinary intelligence, this individual, prior to seeking my aid, had sought vainly for some remedy for his unfortunate condition. He stated that he believed there was an element of heredity in his case, his father having been a dipsomaniac and one brother having died insane. He nevertheless stated it to be his opinion that, notwithstanding the hereditary taint, he would have been perfectly normal from a s.e.xual standpoint had it not been for acquired impressions at or about the period of p.u.b.erty. This man presented a typically neurotic type of physique, complained of being intensely nervous, was prematurely gray, of only fair stature, and had an uncontrollable nystagmus, which, he said, had existed for some fifteen years. As might be expected, treatment in this case was of no avail. I began the use of hypnotic suggestion at the hands of an expert professional hypnotist. The patient, being called out of the State, finally gave up treatment, and I have no means of knowing what his present condition is.

CASE II.-A lady patient of mine who happened to be an actress, and consequently a woman of the world, brought to me for an opinion some correspondence which had pa.s.sed between her younger brother and a man living in another State, with whom he was on quite intimate terms. In one of these letters various flying trips to Chicago for the purpose of meeting the lad, who, by the way, was only 17 years of age, were alluded to. It transpired also, as evidenced by the letters, that on several occasions the young lad had been taken on trips in Pullman cars by his friend, who was a prominent railroad official. The character of the correspondence was such as the average healthy man would address to a woman with whom he was enamored. It seemed that the author of the correspondence had applied to his boy affinity the name Cinderella, and the protestations of pa.s.sionate affection that were made toward Cinderella certainly would have satisfied the most exacting woman. The young lad subsequently made a confession to me, and I put myself in correspondence with his male friend, with the result that he called upon me and I obtained a full history of the case. The method of indulgence in this case was the usual one of oral masturbation, in which the lad was the pa.s.sive party. I was unable to obtain any definite data regarding the family history of the elder individual in this case, but understand that there was a taint of insanity in his family. He himself was a robust, fine-looking man, above middle age, who was well educated and very intelligent, as he necessarily must have been, because of the prominent position he held with an important railway company. I will state, as a matter of interest, that the lad in this case, who is now 23 years of age, has recently consulted me for impotentia coeundi, manifesting a frigidity for women, and, from the young man's statements, I am convinced that he is well on the road to confirmed s.e.xual perversion.

An interesting point in this connection is that the young man's sister, the actress already alluded to, has recently had an attack of acute mania.

I have had other unpublished cases that might be of interest, but these two are somewhat cla.s.sical, and typify to a greater or less degree the majority of other cases. I will, however, mention one other case, occurring in a woman.

CASE III.-A married woman 40 years of age. Has been deserted by her husband because of her perverted s.e.xuality. Neurotic history on both sides of the family, and several cases of insanity on mother's side. In this case affinity for the same s.e.x and perverted desire for the opposite s.e.x existed, a combination by no means infrequent. Hypnotic suggestion tried, but without success. Cause was evidently suggestion and example on the part of another female pervert with whom she a.s.sociated before her marriage. Marriage was late, at age of 35. In all these cases there was an element of what may be called suggestion, but it was really much more than this; it was probably in each case active seduction by an elder person of a predisposed younger person. It will be observed that in each case there was, at the least, an organic neurotic basis for suggestion and seduction to work on. I cannot regard these cases as ent.i.tled to modify our att.i.tude toward suggestion.

MASTURBATION.-Moreau believed that masturbation was a cause of s.e.xual inversion, and Krafft-Ebing looked upon it as leading to all sorts of s.e.xual perversions; the same opinion was currently repeated by many writers. It is not now accepted. Moll emphatically rejected the idea that masturbation can be the cause of inversion; Nacke repeatedly denies that masturbation, any more than seduction, can ever produce true inversion; Hirschfeld attaches to it no etiological significance. Many years ago I gave special attention to this point and reached a similar conclusion. That masturbation, especially at an early age, may sometimes enfeeble the s.e.xual activities, and aid the manifestations of inversion, I certainly believe. But beyond this there is little in the history of my male cases to indicate masturbation as a cause of inversion. It is true that 44 out of 51 admit that they have practised masturbation,-at all events, occasionally, or at some period in their lives,-and it is possible that this proportion is larger than that found among normal people. Even if so, however, it is not difficult to account for, bearing in mind the fact that the h.o.m.os.e.xual person has not the same opportunities as has the heteros.e.xual person to gratify his instincts, and that masturbation may sometimes legitimately appear to him as the lesser of two evils.[191] Not only has masturbation been practised at no period in at least 7 of the cases (for concerning several I have no information), but in several others it was never practised until long after the h.o.m.os.e.xual instinct had appeared, in 1 case not till the age of 40, and then only occasionally. In at least 8 it was only practised at p.u.b.erty; in at least 8, however, it began before the age of p.u.b.erty; at least 9 left off before about the age of 20. Unfortunately, as yet, we have little definite evidence as to the prevalence and extent of masturbation among normal individuals.

Among the women masturbation is found in at least 5 cases out of 7. In 1 case there was no masturbation until comparatively late in life, and then only at rare intervals and under exceptional circ.u.mstances. In another case, some years after the h.o.m.os.e.xual attraction had been experienced, it was practised, though not in excess, from the age of p.u.b.erty for about four years, and then abandoned; during these years the physical s.e.xual feelings were more imperative than they were afterward felt to be. In 2 cases masturbation was learned spontaneously soon after p.u.b.erty, and in 1 of these practised in excess before the manifestations of inversion became definite. In all cases the subjects are emphatic in a.s.serting that this practice neither led to, nor was caused by, the h.o.m.os.e.xual attraction, which they regard as a much higher feeling, and it must be added that the occasional practice of masturbation is very far from rare among fairly normal women.[192]