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Treating masturbation, 1895 |
The temptations of surgeryIn 1895 the Medical Record (not a crank publication, but an authoritative and mainstream journal) published an article by Dr Edgar Spratling, who explained why circumcision was the most effective tactic against the "octopus grasp" of masturbation. In the process he revealed how much surgeons like him enjoyed performing the operation. Note his remark (in paragraph 4) that the objective of most anti-masturbation devices was to immobilise the foreskin, revealing the assumption of the times that masturbation was essentially the manipulation and sliding of the foreskin. He had a far more effective and irreversible means of stopping that. Masturbation in the adultMasturbation being in itself a habit fraught with dangers to its devotee just in proportion as the nervous stamina of the individual is lacking, one would naturally think with horror of its octopus-like grasp within the walls of every institution intended for the care and treatment of those unable mentally or morally to stand on an equality with his free fellow-man. And well may those in whose care the insane are placed regard it as the arch enemy, for hand in hand with its boon companion, sodomy, it stalks through every ward, entangling its victims more hopelessly with each passing night.In women the road to cure is an endless and monotonous journey, for nothing short of ovariotomy will be found to deserve even the term palliative; clitoridectomy, anatomically and physiologically, could be but a failure, blistering only cruelty. Among men the case is not so hopeless, for there anatomy is partly in the operator's favour. Of the treatments we might speak of blistering the glans penis, but only to condemn it as an uncalled-for cruelty; the possible beneficial effect is so transient, while the untoward effect is so lasting upon the patient mentally in the way of a feeling of resentment, that it is doubtful if one could ever justify such a proceeding. The various kinds of apparatus that are intended to prevent the mobility of the foreskin are one and all to be let alone as unsatisfactory and unsuccessful, if not actually mischievous, by concentrating the patient's attention to that locality. Preventing the opportunity for the practice is simply out of the question. Castration is not to be considered for many and very obvious reasons. Complete section of the dorsal nerves of the penis (as I have previously advocated) is a rational proceeding, but rather too radical for constant routine practice. The cases require the greatest care in the selection for this operation, and even then with all due care one will generally have to encounter the most strenuous objections and later the bitterest reproach and condemnation from the patients and from their relatives – though the object sought may have been obtained. In all cases, taken as they come, circumcision is undoubtedly the physician's closest friend and ally, offering as it does a certain means of alleviation and pronounced benefit, granting as it does immunity from after-reproach. Those cases in which the glans presents a moist, semi-oily appearance, with papillae strikingly developed about the corona, long thickened foreskin, pliant and giving, large and often tortuous dorsal veins, go to make up a picture that is exceedingly tempting to the surgeon's scissors. The whole operation, when the scissors and continuous suture are used, takes only four to six minutes – and time is a great consideration, especially in the case of the insane, even though local anaesthetics may be used. To obtain the best results one must cut away enough skin and mucous membrane to rather put it on the stretch when erections come later. There must be no play in the skin after the wound has thoroughly healed, but it must fit tightly over the penis, for should there be any play the patient will be found to readily resume his practice, not begrudging the time and extra energy required to produce the orgasm. It is true, however, that the longer it takes to have an orgasm, the less frequently it will be attempted, consequently the greater the benefit gained. Tubes, rings, clamps and directors, devised as aids in circumcision, are worse than useless on account of the time involved in their manipulation, and also because they necessitate the use of a knife instead of scissors, thus inducing more haemorrhage, and most likely necessitating interrupted sutures instead of the continuous. We may not be sure that we have done away with the possibility of masturbation, but we may feel confident that we have limited it to within the danger lines, which is the primary object sought, as we are from the outset striving for the hygienic, not the moral, benefit – the latter is usually too far from our reach to even consider. The younger the patient operated on the more pronounced the benefit, though occasionally we find patients who were circumcised before puberty that require resection of the skin, as it has grown loose and pliant after that epoch. Mental depression following circumcision is practically unknown, and the only patients in whom there is any but the most pronounced physical gain are those above fifty years old. And we might note, too, that after that age masturbation seems to have very little influence on the health, the patient seemingly having passed the period at which the drain can do much harm. Many of the boys and younger men begin to show marked gain in weight and even in mental activity within ten days after the operation. generally the patients do not object to the operation when its nature and object are fully explained to them; indeed, some of the most intelligent insist on its being done, acknowledging their inability to free themselves from their habit voluntarily. Edgar J. Spratling, "Masturbation in the adult", Medical Record, Vol. 48, 28 September 1895, p. 442-3 A century of circumcision to control masturbation in infants, children and adultsHere is a random selection of quotes from the 1870s to the 1970s, showing that, for over a century, the medical profession cited discouragement of masturbation as one of the major benefits of circumcision.M.J. Moses, "The value of circumcision as a hygienic and therapeutic measure", New York Medical Journal 14, October 1871, 368-74 Discusses prevention of masturbation as the first of several reasons for circumcision: "From time immemorial medical men have been consulted by parents and desired to prescribe for children whose haggard faces and extreme nervous irritability have caused them alarm and anxiety. The practised eye of the surgeon sees beyond the veil which shadows the case and recognizes the ravages which solitary vice is making upon the nervous system of the little sufferer. Examination of the case most frequently reveals a long, contracted and irritated prepuce, the presence of which accounts for the initial cause of the trouble. ... "I refer to masturbation as one of the effects of a long prepuce; not that this vice is entirely absent in those who have undergone circumcision, though I never saw an instance in a Jewish child of very tender years, except as the result of association with children whose covered glans have naturally impelled them to the habit." Edgar Spratling, "Masturbation in the adult", Medical Record 48, 28 September 1895, 442-3 Prevention of masturbation a sufficient reason for circumcision: "In all cases [of masturbation], taken as they come, circumcision is undoubtedly the physician's closest friend and ally, offering as it does a certain means of alleviation and pronounced benefit .... Those cases in which the glans presents a moist, semi-oily appearance ... long thickened foreskin, pliant and giving, large and often tortuous dorsal veins, go to make up a picture that is exceedingly tempting to the surgeon's scissors. ... To obtain the best results one must cut away enough skin and mucous membrane to rather put it on a stretch when erections come later. There must be no play in the skin after the wound has thoroughly healed, but it must fit tightly over the penis, for should there be any play the patient will be found readily to resume his practice, not begrudging the time and extra energy needed to produce the orgasm. It is true, however, that the longer it takes to have an orgasm, the less frequently it will be attempted, and consequently the greater the benefit gained." M. Clifford, Circumcision: Its Advantages and How to Perform it (London: Churchill, 1893), 6-8 "The glans penis is very vascular, and is well supplied with nerves ... and the slightest irritation is sufficient to cause a great deal of discomfort. It is not uncommon to see a child dragging at the foreskin as a consequence. As age advances the habit of masturbation is very frequently to be attributed to it. But after circumcision the glans penis is always dry .... It loses much of its acute sensitiveness, and all unnatural irritation being guarded against, the mind is not directed towards the sexual organs, and a decided check is put to one of the vices only too commonly practised in early manhood. ... The cleanliness and chastity which circumcision undoubtedly promotes is probably the reason why the operation has been performed for so many centuries, and may also account for its acquiring a religious significance." Compare Brian Morris: "The concept ... that circumcision was used in this era to prevent masturbation is in fact a falsehood that has been promoted by anti-circumcision groups. The real reason was that it prevented smegma, itching and so on, and thus stopped males scratching their genitalia. The fact that such excessive attention to a penis to relieve the irritation might have led to arousal and thus masturbation was purely coincidental. The Victorians cited many of the same medical conditions associated with uncircumcised penises as do people today." Brian Morris, In Favour of Circumcision (Sydney: UNSW Press, 1999), 57 Ernest G. Mark, "Circumcision", American Practitioner and News 31, 1901, 231 Lessened tendency to masturbation: "Another advantage of circumcision ... is the lessened liability to masturbation. A long foreskin is irritating per se, as it necessitates more manipulation of the parts in bathing. ... This leads the child to handle the parts, and as a rule, pleasurable sensations are elicited from the extremely sensitive mucous membrane, with resultant manipulation and masturbation. The exposure of the glans penis following circumcision ... lessens the sensitiveness of the organ." G. Frank Lydstone, Sex Hygiene for the Male (Chicago 1912), 158-9 Prevention of masturbation the principal reason for circumcision: "Circumcision is a most commendable practice. ... Circumcision promotes cleanliness, prevents disease, and by reducing over-sensitiveness of the parts tends to relieve sexual irritability, thus correcting any tendency which may exist to improper manipulations of the genital organs and the consequent acquirement of evil sexual habits, such as masturbation." Abraham Wolbarst, "Universal circumcision as a sanitary measure", Journal of the American Medical Association 62, 10 January 1914, 92-97 Prevention of masturbation was the fourth of seven reasons Wolbarst gave as to why circumcision was a medico-moral imperative for the twentieth century: "It is a well known fact that the foreskin is a frequent factor in the causation of masturbation, not alone in children but in adults as well. This has been amply proved by the fact that circumcision has become recognised as a most effective remedy in these cases." N.B. Morris and Co still cite Wolbarst as an authority for the contention that the foreskin should always be removed as a precaution against penile cancer. William J. Robinson MD, "Circumcision and masturbation", Medical World 33, October 1915, 390 Prevention of masturbation a sufficient reason for circumcision: "There are a hundred arguments in favour of circumcision, but to speak of them all in detail would require a book or at least a good-sized essay. At this time I wish to touch merely upon one point, the relation of the prepuce to masturbation. "I am convinced that the prepuce is one of the great factors in causing masturbation in boys, and many cases of masturbation cannot be treated successfully until the prepuce is removed. Here is the dilemma we are in: If we do not teach the growing boy to pull the prepuce back and cleanse the glans there is danger of smegma collecting and of adhesions and ulcerations forming, which in their turn will cause irritation likely to lead to masturbation. If we do teach the boy to pull the prepuce back and cleanse his glans, that handling alone is sufficient gradually and almost without the boy's knowledge to initiate him in to the habit of masturbation. "While masturbation is not the terrible calamity that it was once thought to be, and while we recognize the fact now that most children recover from it without permanent effects, still we want to avoid everything possible that may be a factor in the cause of masturbation, and the prepuce unquestionably being such a factor, it should come off. Therefore, once more, off with the prepuce!" Alan F. Guttmacher, "Should the baby be circumcised?", Parents Magazine 16, September 1941, 26, 76-78 Prevention of masturbation was the second of five reasons Guttmacher gave as to why the baby should be circumcised: "It [circumcision] does not necessitate handling of the penis by the infant's mother, or the child himself in later years, and therefore does not focus the male's attention on his own genitals. Masturbation is considered less likely." Compare Brian Morris: "The fact that such excessive attention to a penis to relieve the irritation might have led to arousal ... " "Excessive attention"??! -- how very Victorian! Campbell's Urology, 1970 "Parents readily recognise the importance of local cleanliness and genital hygiene in their children and are usually ready to adopt measures to adopt measures which may avert masturbation. Circumcision is usually advised on these grounds." M.F. Campbell, "The male genital tract and the female urethra", in M.F. Campbell and J.H. Harrison (eds), Urology, 3rd edn (Philadelphia: W.B. Saunders, 1970), Vol. 2, 1836 Only in America! |