The solitary vice

MASTURBATION AS “A HEINOUS SIN”

By the time Dr Robertson dismissed “masturbational insanity” as a “popular superstition” (see box), belief in masturbation as a cause of mental illness had flourished as a medical superstition for fully a century. To be sure, sexual self-service had been regarded as immoral for a much longer period, because it was an “unnatural” practice. For that same reason, the act had on occasion been supposed to be unphysiologic as well; so perverse an assault on nature must necessarily injure the body designed by nature. Thus, an early 18th-century treatise on The Heinous Sin of Self-Pollution advised young male readers that if they persisted in their evil indulgence, they would arrive at manhood unmanned, either impotent or subject to ejaculatio praecox and, in either case, rendered “ridiculous to women.”^1(pp45-46)

THE CONNECTION WITH INSANITY

A connection of the heinous sin with insanity began to be forged in the later 1700s, as Enlightenment era values fostered an understanding of mental imbalance as illness that might be cured. The construction of asylums to treat the mentally ill brought physicians into closer and more frequent contact with patients who masturbated often and openly. Because sexual arousal involved stimulation of the nervous system, it was easy to conclude that chronic nervous excitation attending the unnatural act of masturbation might eventually undermine the health of the brain. By the early 1800s, European and American physicians concurred that masturbation led to insanity.²

During the 1830s, the notion was extended into the realm of popular belief by America's first lay health reformer, Sylvester Graham (1794-1851). Remembered today only as the inventor of a whole wheat cracker that constituted the modern era's first health food, Graham was a Presbyterian minister who preached a system of health behavior derived not from scientific observation, but from a moral logic based on 2 unquestioned premises: first was the puritanical conviction that all pleasurable sensation was satanic temptation in disguise, and second was the certainty that any behavior that was immoral had to be unhealthful as well. An efficient God wouldn't have ordered things any other way. In practical translation, any activity appearing to be stimulating, to emotions as well as physical organs, was potentially pathologic.³

To date, the golden rule of health had been moderation in all things. For Graham, even moderation had to be practiced in moderation, for abstinence was usually his rule. His was a Victorian philosophy that was the antithesis of the 20th century's “Playboy philosophy”: if it feels good, Graham might have said, don't do it! Those who did do it, who ate meat, drank whisky, or chewed tobacco, were condemned to suffer stimulation-induced inflammation in the immediately affected organ that could pass through the nervous system to all other parts of the body.

SEX AS A THREAT TO HEALTH AND SANITY

Because sex was the most stimulating activity of all (even Graham knew that), it was considered the most dangerous. Some forms of sex, nevertheless, were more dangerous than others. Least risky was the marital variety, the form established by the Creator for replenishing the earth. If enjoyed no more than once a month, connubial commerce was free of threat—so long as the partners were young and in robust health. There was such a thing as “marital excess,” and it led to injury. Even so, it entailed less danger than the “social vice” of premarital or extramarital sex. Lest his readers foolishly suppose that 1 orgasm was much like another, Graham reminded them that adultery involved additional excitements. Both in the violation of a social taboo and the prolonged anticipation and final realization of coupling with a new body, one experienced stimulation far beyond anything to be found in the marital bed; to Graham's mind, the great virtue of marital sex was that it so soon became boring.⁴

Far more treacherous was the “solitary vice,” masturbation, which had been thought of as somewhat less rousing than the real thing. Graham, however, pointed out that as a solitary activity, the practice of masturbation was likely to start at an earlier age and to occur more often than partnered sex. Most important, the lack of a partner meant resorting to fantasy and the conjuring of erotic scenes and lewd images that surely stirred the brain to a fever pitch. (By this analysis, lusting in the heart was physiologically equivalent to lusting in the flesh.) Because the brain's inflamed state could be transmitted to any organ or tissue of the body through the nervous system, all manner of disease could follow. But with sexual solitaire, the climax—rather the culmination—was insanity. “This general mental decay,” Graham warned, “continues with the continued abuses, till the wretched transgressor sinks into a miserable fatuity, and finally becomes a confirmed and degraded idiot, whose deeply sunken and vacant glassy eye, and livid, shriveled countenance, and ulcerous, toothless gums, and fetid breath, and feeble broken voice, and emaciated and dwarfish and crooked body, and almost hairless head—covered, perhaps, with suppurating blisters and running sores—denote a premature old age—a blighted body—and a ruined soul!”^5(pp25-26)

“CURING” MASTURBATION BY CIRCUMCISION AND CLITORIDECTOMY

The linking of ruined soul to blighted body reveals the moralistic basis of Graham's concept of pathology. It is no coincidence that the level of physical injury ascribed to each type of sexual practice is directly correlated to the level of immorality of each: the naughtier you were, the more you could expect to suffer. That kind of correlation made eminent sense to the Victorian mind, and as products of Victorian culture, physicians were hardly immune to such analyses.^6,7,8 An American doctor who blasted “the sin of self-pollution” as “the vilest, the basest, and the most degrading that a human being can commit,” one that should make a boy “ashamed to look into the eyes of an honest dog,” was the same person who as late as the 1880s was still citing masturbation as a frequent cause of tuberculosis, heart disease, epilepsy, and insanity, and urging parents to make unannounced nighttime raids on their children's rooms to catch youthful masturbators in the act and then to cure their prey with cauterization of the clitoris or circumcision without benefit of anesthesia.⁹ Circumcision was, in fact, recommended by more than a few medical experts as masturbation therapy (“a tight or long foreskin is a frequent cause of the habit”),^9(p327) and it was advised for both sexes. “The clitoridectomies of Baker Brown” alluded to by Robertson were the remedy applied to female masturbation by London's Isaac Baker Brown for several years in the 1860s.^10,11

MASTURBATION FALLS FROM FAVOR

Masturbation served for decades as a useful catchall diagnosis for all manner of medical complaints of uncertain etiology. During the late 19th century, however, it fell from favor as investigations in psychiatry and sexology made it clear the practice was nearly universal. As Robertson recognized, if masturbation truly did cause insanity, the capacity of state asylums would have to be increased from 5,000 to 500,000—he apparently felt it unnecessary to add that many of the inmates would be physicians.

Table 1.

Excerpts from The Transactions of the Medical Society of the State of California, 1898

RELATION EXISTING BETWEEN THE SEXUAL ORGANS AND INSANITY, WITH ESPECIAL REFERENCE TO MASTURBATION

By J W Robertson, MD

Livermore, Cal.

“Of all sexual conditions complicating insanity, none occupy the importance either in the professional or lay mind that masturbation holds. It is a vice of most frequent occurrence amongst our sane population, and it is almost universally practiced by the insane. That masturbation alone, in the normal individual, produces insanity is certainly not true; for were this the fact, the accommodations of our asylums would have to be so increased as toehold at least 500,000 rather than the 5,000 insane credited to ourState.” “There should be a sharp distinction drawn between the masturbation of insanity and insanity produced by masturbation, or the so-called masturbational insanity. Even when masturbation is most persistent, there is no ground for positively claiming it as a causative factor; this we term the `masturbation of insanity.' It is frequently merely the first symptom observed.” “Dr Hoisholt, of Stockton, said that he heartily agreed with DrRobertson in what he had said as to the popular belief in masturbation being a cause of insanity, and also as to the many mutilations that had been made with the excuse of helping to remedy the condition of alienation by removing the ovaries, clitoris, etc. He was of the opinion that more education on the part of the general practitioner of medicine, as to the proper relation existing between insanity and the sexual organs, in the question of cause and effect, was certainly desirable. While, as stated by Dr Robertson, we very commonly find masturbation accompanying insanity, we very rarely can say that the vice has been to any extent the cause of the insanity itself. It is more often the result than the cause, popular superstition to the contrary.”

Figure 1.

Sylvester Graham, America's first health reformer. Illustration from Graham S. Lectures on the Science of Human Life. New York: Fowler & Wells; 1858.