Masturbatory insanity: the history of an idea, revisited.

In the eighteenth century, masturbation was extended from the moral to the medical sphere and conceptualized as being the cause of various deteriorative physical illnesses. In the nineteenth century, psychiatrists accepted that difficult to control masturbation was a feature of many mental disorders. They also believed that masturbation could play a casual role in a specific type of insanity with a distinctive natural history. In 1962, E.H. Hare published an article on the concept of masturbatory insanity that became an important explication of the masturbation and mental illness relationship in the history of psychiatry. Historical research published subsequent to Hare's article suggests several updates to his analysis. Hare did not note that the masturbation and mental illness relationship was promoted to the general public by quacks peddling quick cures. Hare emphasized psychiatrists' condemnatory language only, neglecting the aspiration of psychiatrists to treat disorders caused by excessive masturbation, not punish the sin of masturbation. Hare recognized the importance of hebephrenia and neurasthenia to this history but attributed the decline of masturbation related mental illness in part to the rejection of an irrational, unscientific hypotheses about masturbation's causal role. As an alternative, we suggest that before the causal role of masturbation was widely abandoned, the concepts of hebephrenia and neurasthenia gained a competitive advantage and became primary diagnoses for cases that once would have been conceptualized as masturbatory insanity.

The enigmatic figure of Dr Henry Maudsley (1835-1918).

In spite of his contribution to psychiatry in 19th century Britain, Henry Maudsley remains a mysterious figure, a man mostly known for his donation to the London County Council for the building of the Maudsley Hospital and for The Maudsley Annual Lecture created in honour of his benevolence. Besides Sir Aubrey Lewis' article in 1951 and Michael Collie's attempt in 1988 to construct a biographical study on Maudsley, there does not seem to be any current endeavour to tell the story of his life, whereas Trevor Turner's contribution to the 2004 Oxford Dictionary of National Biography gives a somewhat scathing but unattributed account of Maudsley's personality. This essay attempts to explore his contributions to the Medico-Psychological Association (MPA), the current Royal College of Psychiatrists, his editorship of the Journal of Mental Health (currently named the British Journal of Psychiatry), his literary contributions and his vision for a psychiatric hospital. This essay is an attempt to demystify his figure and to explore some of the rumours and criticisms surrounding his name and the reasons why so little has been written about him. It is also a venture to unravel his complex personality and his intricate philosophy.

Sleep-related erections throughout the ages.

INTRODUCTION: The occurrence of sleep-related erections (SREs) has been known since antiquity. AIM: To highlight historical, theological, and sexual medicine-related aspects of SREs throughout the ages. METHODS: Review of old medical books on male sexual functioning and review of scientific medical and theological articles on SREs from about 1900 on. RESULTS: The cyclic character of SREs was first noted by German researchers in the forties of the 20th century. However, already before the beginning of the Christian era, one knew that men had erections and ejaculations during sleep. In the Middle Ages, SREs were generally considered to be rebellious manifestations of the male body, while it seemed to disobey its owner and showed up its perverted and sinful side. From the fifteenth to the end of the 17th century, severe erectile dysfunction (ED) was ground for divorce. The ecclesiastical court records show that if necessary, the members of the jury sat at the defendant's bedside at night to be able to judge any SREs occurring. Since the 17th century, SREs were considered to be part of masturbation, which could cause many ailments and diseases. Psychoanalyst Stekel acknowledged in 1920 that a morning erection, the last SRE, is a naturally occurring phenomenon in healthy men from infancy to old age. Today, some scientists assume that SREs protect the integrity of the penile cavernous bodies. CONCLUSIONS: Throughout the ages, philosophers, theologians, physicians, members of ecclesial law courts, psychoanalysts, psychiatrists, sexologists, physiologists, and urologists have shown interest in SREs. Obviously, the observations and testing of SREs have a long history, from antiquity to modern sleep labs, in men and in women, in newborns and old adults, by penis rings with sharp spikes to fancy strain gauge devices. Despite all these efforts, the mechanisms leading to SREs and its function are however not yet completely understood.

"A plea for the prostate": doctors, prostate dysfunction, and male sexuality in late 19th- and early 20th-century Canada.

Historical examinations of medical discourse concerning male sexuality have focused on the perceived linkage between masturbation and sexual neurasthenia. However, more tangible conditions such as prostatic hypertrophy were also linked to the sexual misconduct of young and old men. This paper examines both the medical discourse concerning prostatic hypertrophy and how the development of treatment was influenced by contemporary concerns with both sexuality and masculinity. It argues that mainstream doctors moved away from the Victorian preoccupation with the dangers of illicit sexuality and increasingly regarded the restoration of sexual function as being in the best interests of their patients. This view was particularly evident in their quest for an operative method that would cure prostatic hypertrophy while preserving potency.

The relevance of castration and circumcision to the origins of psychoanalysis: 1. The medical context.

In this paper the author outlines and discusses the origins and the decline of castration and circumcision as a cure for the nervous and psychic disturbances in women and little girls between 1875 and 1905. The author argues that the opposition to this medical practice affected the conception of hysteria, promoting a distinction between sexuality and the genital organs, and the emergence of an enlarged notion of sexuality, during the period from Freud's medical education to the publication of the Three Essays on the Theory of Sexuality. The hypothesis is put forward that Freud came directly in contact with the genital theory of the neurosis at the time of his training on the nervous disturbances in children with the paediatrician, Adolf Baginsky, in Berlin, in March 1886. It is hypothesized that this experience provoked in Freud an abhorrence of circumcision 'as a cure or punishment for masturbation', prompting an inner confrontation which resulted in a radical reorganization of the way of thinking about sexuality. It is also suggested that this contributed to Freud developing a capacity to stay with contradictions, something which would become a central quality of the psychoanalytic attitude.

The historical response to female sexuality.

In the past, medical attitudes to female sexuality were grotesque, reflecting the anxiety and hypocrisy of the times. In the medieval world, the population feared hunger, the devil, and women, being particularly outraged and threatened by normal female sexuality. The 19th century attitude was no better as academics confirmed the lower intellectual status of women, particularly if they ventured into education. The medical contribution to this prejudice was shocking, with gynaecologists and psychiatrists leading the way designing operations for the cure of the apparently serious contemporary disorders of masturbation and nymphomania. The gynaecologist, Isaac Baker Brown (1811-1873), and the distinguished endocrinologist, Charles Brown-Séquard (1817-1894) advocated clitoridectomy to prevent the progression to masturbatory melancholia, paralysis, blindness and even death. Even after the public disgrace of Baker Brown in 1866-1867, the operation remained respectable and widely used in other parts of Europe. This medical contempt for normal female sexual development was reflected in public and literary attitudes. There is virtually no novel or opera in the last half of the 19th century where the heroine with "a past" survives to the end. The wheel has turned full circle and in the last 50 years new research into the sociology, psychology and physiology of sexuality has provided a greater understanding of decreased libido and inadequate sexual response in the form of hypoactive sexual desire disorder (HSDD). This is now regarded as a disorder worthy of treatment.

Creencias acerca de la masturbación / Beliefs it brings over of the masturbation

El objetivo de la investigación fue realizar una revisión sobre las creencias acerca de la masturbación. Para ello, se hizo una búsqueda de los trabajos publicados sobre el tema, se analizó y se seleccionó los más relevantes. Los autores exponen que la masturbación era considerada una enfermedad, estudiada por la medicina, especialemnte por la psiquiatría y la psicología. Se concluye que la masturbación es una actividad sexual común en ambos sexos y en algunos casos, se utiliza como técnica terapéutica en las disfunciones sexuales.

The objective of the research was to carry out a revision on the beliefs about the masturbation. For it, a search of the works was made published on the topic, it was analyzed and it was selected the most outstanding. The authors expose that the masturbation was considered an illness, studied by the medicine, especially for the psychiatry and the psychology. It concludes that the masturbation is a common sexual activity in both sexes and in some cases, it is used as therapeutic technique in the sexual disfunctions.

Rethinking the history of female circumcision and clitoridectomy: American medicine and female sexuality in the late nineteenth century.

During the late nineteenth and early twentieth centuries, there was one kind of female orgasm and it was clitoral; there was also only one kind of healthy sexual instinct for a woman and it was for penetrative sex with her husband. When a woman behaved outside of this normality-by masturbating or by not responding to her husband's affections-her sexual instinct was seen as disordered. If healthy women, then, were believed only to be sexual within the marital embrace, what better way to explain these errant behaviors than by blaming the clitoris, an organ seen as key to female sexual instinct? Doctors corrected a clitoris in an unhealthy state using one of four surgeries-removing smegma or adhesions between the clitoris and its hood, removing the hood (circumcision), or removing the clitoris (clitoridectomy)-in order to correct a woman's sexual instinct in an unhealthy state. Their approach to clitoral surgery, at least as revealed in published medical works, was a cautious one that respected the importance of clitoral stimulation for healthy sexuality while simultaneously recognizing its role as cause and symptom in cases of insanity that were tied to masturbation.

["The main cause of his insanity, ... self-pollution". Attributions to illness and the treatment of insanity in the Siegburg Asylum (1825-1878). The case of Georg v. G]. / "Was nun die Haupt-ursache seiner Geisteskrankheit betrifft, ... Selbstbefleckung". Krankheitszuschreibungen und Behandlungspraktiken in der Irren-Heil- Anstalt-Siegburg (1825-1878). Der Fall des Georg v. G.

The 25 year old Georg v. G. is admitted to the respected Prussian Siegburg Asylum in 1835. After six years he is discharged from the Siegburg having been diagnosed "incurably insane". In search of possible causes for the illness, the participants involved in the discussion, his father, doctors and the clergyman, come to the conclusion that it is his continuous "self-pollution" that is to be blamed. Their opinion runs in accordance with the discourse within the medical profession that "self-pollution" among young men is a prominent cause of insanity. The young man's patient record makes it possible to reconstruct the forms of "therapy" which are undertaken to cure his feeble state and to keep Georg from his dangerous habit. His record elucidates the interplay between medical theory and medical treatment. The methods of treatment undertaken in the asylum intended to bring Georg back to reason which includes a disciplined behaviour. His case record also opens up new possibilities for research in the history of psychiatry, as, in contrast to previous results, this patient neither attributed his state to his "immoral" behaviour, nor did he take any notice of the attempts his surroundings underwent to prevent him from continuing his actions.

Pathologizing male sexuality: Lallemand, spermatorrhea, and the rise of circumcision.

Although spermatorrhea as a disease entity and an episode in nineteenth-century medical history has received significant scholarly attention over the past decade, many aspects of its nature, origins, and consequences remain obscure. The aim of this article is to indicate its origins in and links with medical anxiety about masturbation and to discuss the therapies devised to treat the condition. Particular attention is given to the work of Claude-Francois Lallemand and his influence on English doctors, especially William Acton, and the implications of their identification of the foreskin as the major risk factor for childhood masturbation and later spermatorrhea. It is further argued that fear of spermatorrhea was an important factor in the acceptance of circumcision as a valid medical intervention in the late nineteenth century.

The antimasturbation crusade in antebellum American medicine.

The antimasturbation fervor that swept through the English-speaking world during the 19th century raged with particular intensity and unequaled duration in the United States. American medical leaders were convinced that masturbation was the underlying cause of nearly all social problems and diseases. Even after the discovery and general acceptance of the germ theory of disease in the late 19th century, the U.S. medical establishment continued to maintain well into the middle of the 20th century that masturbation was both a pathological act and a cause of mental and physical disease. This article explores the dominant themes in the medical doctrines about masturbation that prevailed in the first half of the 19th century, by examining the case reports of five prominent American physicians: Benjamin Rush, Samuel Bayard Woodward, Alfred Hitchcock, Alonzo Garwood, and Edward H. Dixon.