been long and greatly indulged, no permanent evil effects may be observed to follow.”  Naecke, again, has declared ("Kritisches zum Kapitel der Sexualitaet,” Archiv fuer Psychiatrie, 1899):  “There are neither somatic nor psychic symptoms peculiar on onanism.  Nor is there any specific onanistic psychosis.  I am prepared to deny that onanism ever produces any psychoses in those who are not already predisposed.”  That such a view is now becoming widely prevalent is illustrated by the cautious and temperate discussion of masturbation in a recent work by a non-medical writer, Geoffrey Mortimer (Chapters on Human Love, pp. 199-205).

The testimony of expert witnesses with regard to the influence of masturbation in producing other forms of psychoses and neuroses is becoming equally decisive; and here, also, the traditions of Tissot are being slowly effaced.  “I have not, in the whole of my practice,” wrote West, forty years ago, “out of a large experience among children and women, seen convulsions, epilepsy, or idiocy induced by masturbation in any child of either sex.  Neither have I seen any instance in which hysteria, epilepsy, or insanity in women after puberty was due to masturbation, as its efficient cause."[332] Gowers speaks somewhat less positively, but regards masturbation as not so much a cause of true epilepsy as of atypical attacks, sometimes of a character intermediate between the hysteroid and the epileptoid form; this relationship he has frequently seen in boys.[333] Leyden, among the causes of diseases of the spinal cord, does not include any form of sexual excess.  “In moderation,” Erb remarks, “masturbation is not more dangerous to the spinal cord than natural coitus, and has no bad effects";[334] it makes no difference, Erb considers, whether the orgasm is effected normally or in solitude.  This is also the opinion of Toulouse, of Fuerbringer, and of Curschmann, as at an earlier period it was of Roubaud.

While these authorities are doubtless justified in refusing to ascribe to masturbation any part in the production of psychic or nervous diseases, it seems to me that they are going somewhat beyond their province when they assert that masturbation has no more injurious effect than coitus.  If sexual coitus were a purely physiological phenomenon, this position would be sound.  But the sexual orgasm is normally bound up with a mass of powerful emotions aroused by a person of the opposite sex.  It is in the joy caused by the play of these emotions, as well as in the discharge of the sexual orgasm, that the satisfaction of coitus resides.  In the absence of the desired partner the orgasm, whatever relief it may give, must be followed by a sense of dissatisfaction, perhaps of depression, even of exhaustion, often of shame and remorse.  The same remark has since been made by Stanley Hall.[335] Practically, also, as John Hunter pointed out, there is more probability of excess in masturbation than in coitus.  Whether, as some have asserted, masturbation involves a greater nervous effort than coitus is more doubtful.[336] It thus seems somewhat misleading to assert that masturbation has no more injurious effect than coitus.[337]