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.
[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 manœuvre 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]Κρυπτάδια, vol. v, p. 358. As regards the use of nettles, see Dühren, Geschlechtsleben in England, Bd. II, p. 392.
[220]Debreyne, Mœchialogie, 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, Mœchialogie, 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 fœtid 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 fœtid 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]