the constant thought of this man, she sought relations with her husband, and at times masturbated, but now it no longer gave her pleasure. She wished to give up sexual things altogether. But that was easier said than done. She became subject to nervous crises, often brought on by the sight of a man, and accompanied by sexual excitement. They disappeared under treatment, and she thereupon became entirely frigid sexually. But, far from being happy, she has lost all energy and interest in life, and it is her sole desire to attain the sexual feelings she has lost. Adler considers that even when masturbation in women becomes an overmastering passion, so far as organic effects are concerned it is usually harmless, its effects being primarily psychic, and he attaches especial significance to it as a cause of sexual anæsthesia in normal coitus, being, perhaps, the most frequent cause of such anæsthesia. He devotes an important chapter to this matter, and brings forward numerous cases in illustration (Adler, Die Mangelhafte Geschlechtsempfindung des Weibes, pp. 93–119, also 21–23). Adler considers that the frequency of masturbation in women is largely due to the fact that women experience greater difficulties than men in obtaining sexual satisfaction, and so are impelled by unsatisfying coitus to continue masturbation after marriage. He adds that partly from natural shyness, partly from shame of acknowledging what is commonly accounted a sin, and partly from the fear of seeming disgusting or unworthy of sympathy in the doctor's eyes, women are usually silent on this matter, and very great tact and patience may be necessary before a confession is obtained.
On the psychic side, no doubt, the most frequent and the most characteristic result of persistent and excessive masturbation is a morbid heightening of self-consciousness without any co-ordinated heightening of self-esteem.[340] The man or woman who is kissed by a desirable and desired person of the opposite sex feels a satisfying sense of pride and elation, which must always be absent from the manifestations of auto-erotic activity.[341] This must be so, even apart from the masturbator's consciousness of the general social attitude toward his practices and his dread of detection, for that may also exist as regards normal coitus without any corresponding psychic effects. The masturbator, if his practice is habitual, is thus compelled to cultivate an artificial consciousness of self-esteem, and may show a tendency to mental arrogance. Self-righteousness and religiosity constitute, as it were, a protection against the tendency to remorse. A morbid mental soil is, of course, required for the full development of these characteristics. The habitual male masturbator, it must be remembered, is often a shy and solitary person; individuals of this temperament are especially predisposed to excesses in all the manifestations of auto-erotism, while the yielding to such tendencies increases the reserve and the horror of society, at the same time producing a certain suspicion of others. In some extreme cases there is, no doubt, as Kraepelin believes, some decrease of psychic capacity, an inability to grasp and co-ordinate external impressions, weakness of memory, deadening of emotions, or else the general phenomena of increased irritability, leading on to neurasthenia.
I find good reason to believe that in many cases the psychic influence of masturbation on women is different from its effect on men. As Spitzka observed, although it may sometimes render women self-reproachful and hesitant, it often seems to make them bold. Boys, as we have seen, early assimilate the tradition that self-abuse is "unmanly" and injurious, but girls have seldom any corresponding tradition that it is "unwomanly," and thus, whether or not they are reticent on the matter, before the forum of their own conscience they are often less ashamed of it than men are and less troubled by remorse.
Eulenburg considers that the comparative absence of bad effects from masturbation in girls is largely due to the fact that, unlike boys, they are not terrorized by exaggerated warnings and quack literature concerning the awful results of the practice. Forel, who has also remarked that women are often comparatively little troubled by qualms of conscience after masturbation, denies that this is due to a lower moral tone than men possess (Forel, Die Sexuelle Frage, p. 247). In this connection, I may refer to History IV, recorded in the Appendix to the fifth volume of these Studies, in which it is stated that of 55 prostitutes of various nationalities, with whom the subject had had relations, 18 spontaneously told him that they were habitual masturbators, while of 26 normal women, 13 made the same confession, unasked. Guttceit, in Russia, after stating that women of good constitution had told him that they masturbated as much as six or ten times a day or night (until they fell asleep, tired), without bad results, adds that, according to his observations, "masturbation, when not excessive, is, on the whole, a quite innocent matter, which exerts little or no permanent effect," and adds that it never, in any case, leads to hypochondria onanica in women, because they have not been taught to expect bad results (Dreissig Jahre Praxis, p. 306). There is, I think, some truth—though the exceptions are doubtless many—in the distinction drawn by W. C. Krauss ("Masturbational Neuroses," Medical News, July 13, 1901): "From my experience it [masturbation] seems to have an opposite effect upon the two sexes, dulling the mental and making clumsy the physical exertions of the male, while in the female it quickens and excites the physical and psychical movements. The man is rendered hypoesthetic, the woman hyperesthetic."
In either sex auto-erotic excesses during adolescence in young men and women of intelligence—whatever absence of gross injury there may be—still often produce a certain degree of psychic perversion, and tend to foster false and high-strung ideals of life. Kraepelin refers to the frequency of exalted enthusiasms in masturbators, and I have already quoted Anstie's remarks on the connection between masturbation and premature false work in literature and art. It may be added that excess in masturbation has often occurred in men and women whose work in literature and art cannot be described as premature and false. K. P. Moritz, in early adult life, gave himself up to excess in masturbation, and up to the age of thirty had no relations with women. Lenau is said—though the statement is sometimes denied—to have been a masturbator from early life, the habit profoundly effecting his life and work. Rousseau, in his Confessions, admirably describes how his own solitary, timid, and imaginative life found its chief sexual satisfaction in masturbation.[342] Gogol, the great Russian novelist, masturbated to excess, and it has been suggested that the dreamy melancholy thus induced was a factor in his success as a novelist. Goethe, it has been asserted, at one time masturbated to excess; I am not certain on what authority the statement is made, probably on a passage in the seventh book of Dichtung und Wahrheit, in which, describing his student-life at Leipzig, and his loss of Aennchen owing to his neglect of her, he tells how he revenged that neglect on his own physical nature by foolish practices from which he thinks he suffered for a considerable period.[343] The great Scandinavian philosopher, Sören Kierkegaard, suffered severely, according to Rasmussen, from excessive masturbation. That, at the present day, eminence in art, literature, and other fields may be combined with the excessive practice of masturbation is a fact of which I have unquestionable evidence.
I have the detailed history of a man of 30, of high ability in a scientific direction, who, except during periods of mental strain, has practiced masturbation nightly (though seldom more than once a night) from early childhood, without any traceable evil results, so far as his general health and energy are concerned. In another case, a schoolteacher, age 30, a hard worker and accomplished musician, has masturbated every night, sometimes more than once a night, ever since he was at school, without, so far as he knows, any bad results; he has never had connection with a woman, and seldom touches wine or tobacco. Curschmann knew a young and able author who, from the age of 11 had masturbated excessively, but who retained physical and mental freshness. It would be very easy to refer to other examples, and I may remark that, as regards the histories recorded in various volumes of these Studies, a notable proportion of those in which excessive masturbation is admitted, are of persons of eminent and recognized ability.
It is often possible to trace the precise mechanism of the relationship between auto-erotic excitement and intellectual activity. Brown-Séquard, in old age, considered that to induce a certain amount of sexual excitement, not proceeding to emission, was an aid to mental work. Raymond and Janet knew a man considering himself a poet, who, in order to attain the