How far masturbation in moderately healthy persons living without normal sexual relationships may be considered normal is a difficult question only to be decided with reference to individual cases.  As a general rule, when only practiced at rare intervals, and faute de mieux, in order to obtain relief for physical oppression and mental obsession, it may be regarded as the often inevitable result of the unnatural circumstances of our civilized social life.  When, as often happens in mental degeneracy,—­and as in shy and imaginative persons, perhaps of neurotic temperament, may also sometimes become the case,—­it is practiced in preference to sexual relationships, it at once becomes abnormal and may possibly lead to a variety of harmful results, mental and physical.[345]

It must always be remembered, however, that, while the practice of masturbation may be harmful in its consequences, it is also, in the absence of normal sexual relationships, frequently not without good results.  In the medical literature of the last hundred years a number of cases have been incidentally recorded in which the patients found masturbation beneficial, and such cases might certainly have been enormously increased if there had been any open-eyed desire to discover them.  My own observations agree with those of Sudduth, who asserts that “masturbation is, in the main, practiced for its sedative effect on the nervous system.  The relaxation that follows the act constitutes its real attraction....  Both masturbation and sexual intercourse should be classed as typical sedatives."[346]

Gall (Fonctions du Cerveau, 1825, vol. iii, p. 235) mentioned a woman who was tormented by strong sexual desire, which she satisfied by masturbation ten or twelve times a day; this caused no bad results, and led to the immediate disappearance of a severe pain in the back of the neck, from which she often suffered.  Clouston (Mental Diseases, 1887, p. 496) quotes as follows from a letter written by a youth of 22:  “I am sure I cannot explain myself, nor give account of such conduct.  Sometimes I felt so uneasy at my work that I would go to the water-closet to do it, and it seemed to give me ease, and then I would work like a hatter for a whole week, till the sensation overpowered me again.  I have been the most filthy scoundrel in existence,” etc.  Garnier presents the case of a monk, aged 33, living a chaste life, who wrote the following account of his experiences:  “For the past three years, at least, I have felt, every two or three weeks, a kind of fatigue in the penis, or, rather, slight shooting pains, increasing during several days, and then I feel a strong desire to expel the semen.  When no nocturnal pollution follows, the retention of the semen causes general disturbance, headache, and sleeplessness.  I must confess that, occasionally, to free myself