are much greater than those attendant on mere ablution, especially in cold water. The cases in which an operation may be required on the prepuce are for the surgeon's decision.'

ever cause.

The foregoing remarks will have already suggested the propriety of carefully guarding against unnecessary manipulation from whatChildren should be early taught not to play with the external organs; without giving any reason, they may be desired to keep their hands away, which will in most cases be sufficient, if there is no physical exciting cause. The smallest sign, however, of the existence of any such cause should never be neglected. If, for instance, a child wets his bed, which is generally almost the first indication the parents have of the presence of irritation, the organs should be examined, and the boy's other habits watched. The irritation is only too likely to determine blood to the part, and the unpleasant symptoms, moreover, show a nervous susceptible temperament, which always requires careful watching.

Circumcision is never likely to be introduced among us, and there is no doubt that cleanliness will suffice in most cases to remove all ill effects arising from the existence of the prepuce; but that the prepuce in man (at least in civilized life) is the cause of much mischief, medical men are pretty well agreed. It affords an additional surface for the excitement of the reflex action, and, in the present state of society, aggravates an instinct rather than supplies a want. In the unmarried, it additionally excites the sexual desires, which it is our object to repress; and, although it is possible that it may increase the pleasure derived from the act of sexual congress, there is no evidence that Jews, and those who have undergone circumcision, do not enjoy as much pleasure in the copulative act as the uncircumcised;-at any rate, the former do not complain.

1 In a state of nature the foreskin is a complete protection to the glans penis; nevertheless, to the sensitive, excitable, civilized individual, the prepuce often becomes a source of serious mischief. In the East, the collection of the secretions between it and the glans is likely to cause irritation and its consequences; and this danger was perhaps the origin of circumcision. That the existence of the foreskin predisposes to many forms of syphilis, no one can doubt; and, which is more to our present purpose, I am fully convinced that the excessive sensibility induced by a narrow foreskin, and the difficulty of withdrawing it, is often the cause of emissions, masturbation, or undue excitement of the sexual desires, which it becomes very difficult for the sufferer to endure.

In advanced age the prepuce may be necessary to copulation. Without it there might be a difficulty in exciting the flagging powers; but those powers should never be excited at that time of life. All men require restraint, not excitement. The old require repose. The organs of animals are generally differently formed from those of man, and in them, not unfrequently, the prepuce, besides protecting the delicate glans penis from injury, seems requisite to enable the intromittent organ of the male to be brought into an

erect state.

One cause that, I am convinced, can and does excite sexual feelings in children, I would strongly protest against, as at once dangerous and unnecessary. I refer to the infliction of floggings on the nates. Of late years this form of punishment has gone out of vogue in some quarters; but, in the large public schools, it is urged by very many persons that flogging cannot be dispensed with. This may or may not be so. But I am sure that it ought, if employed at all, to be applied to the shoulders, and not to the nates. The medical objections to this latter practice have not, probably, been stated; and, I think, its ill effects are not sufficiently known. That it has a great influence in exciting ejaculation, no one can doubt. Jean Jacques Rousseau, in his "Confessions," admits that this was his first incitement to masturbation, as the flogging administered by his female guardian first gave him sensual feelings. His words are:

"J'avais trouvé dans la douleur, dans la honte même, un mélange de sensualité qui m'avait laissé plus de désir que de crainte de l'éprouver derechef par la même main. Il est vrai que, comme il se mélait sans doute à cela quelque instinct précoce du sexe, la même châtiment reçu de son frère ne m'eut point du tout paru plaisant." ("Confessions," Partie I, livr. 1, 1719–1723.)

The sex, however, of the inflictor of this indecorous punishment has little to do with the feelings it may excite, as the effect is purely reflex and physical. That it has such an effect on the nervous system which supplies the generative organs, there is unfortunately abundant evidence. I am almost ashamed to say there are vile old wretches who, to excite emission, have recourse to this means of stimulating their flagging powers. This fact alone should induce those concerned in the education of youth, if flogging is still to be practiced, to see that it is applied on the shoulders, and not on the nates, of youths.

The reader will already have divined the danger against which all these minute precautions, even at the tenderest age, are thus strongly recommended. The tendency of all irritation or excitement of the generative system, either mental or physical, is to induce the youngest child to stimulate the awakened appetite, and attempt to gratify the immature sexual desires which should have slept for years to come. In a state so artificial as that of our modern civilization, the children of our better classes are sadly open to this temptation. An enervated sickly refinement tells directly on the children that are at once its offspring and its victims, begetting precocious desires, too often gratified by the meanest and most debasing of all vices. Of this melancholy and repulsive habit as it appears in, and affects young children, I shall say something here. Its effects in after-life will be dealt with hereafter.

CHAPT. II.-MASTURBATION IN CHILDHOOD.

This term, like the word Chiromania, can properly be applied only to emission or ejaculation produced by titillation and friction of the virile member with the hand: and in the course of the next few pages, such will be the meaning of the term. Use has, however, given it a larger signification, and it may be, and often is, now used to express ejaculation or emission attained by almost any other means than that of the natural excitement arising from sexual intercourse. This practice in a young child may arise in a variety of ways. The commonest is of course the bad example of other children. In other cases again, vicious or foolish female servants suggest the idea.1 In such sexually-disposed children as have been described, the least hint is sufficient, or indeed they may, even

1 I have heard of a vile habit which some foreign nurses have (I hope it is confined to the continent) of quieting children when they cry by tickling the private parts. I need hardly point out how very dangerous this is. There seems hardly any limit to the age at which a young child can be initiated into these abominations, or to the depth of degradation to which it will fall under such hideous teaching. Books treating of this subject are unfortunately too full of accounts of the habits of such children. Parent Duchâtelet mentions a child, which, from the age of four years, had been in the habit of abusing its powers with boys of ten or twelve, though it had been brought up by a respectable and religious woman. ("Annales d'Hygiène Publique," tome vii, parte 1832, p. 173.)

without any external information, invent the habit for themselves. This latter origin, however, is rare in very early life.

As to the frequency of the habit at present among children, or even boys at school, I have been unable to obtain any very reliable information. Patients from whom, in the confessional of the consulting-room, the truth on such subjects is oftenest learnt, speak rather of what existed in their day. On the whole, I am disposed to think that in most public schools, the feeling is strongly against these vile practices. Still, every now and then facts leak out, which show that even into these establishments evil influences sometimes find their way, and the destructive habit may take root and become common. In private schools, however, which are to a great extent free from the control of that healthy public opinion that, even among boys, has so salutary an effect, there is too much reason to fear that this scourge of our youth prevails to an extent which will not be known, with any certainty, till years hence the sufferers from early vice are seeking medical relief, too often, alas! in vain. It is for us now to consider what preventive steps can be taken to lessen if not remove the evil; that it exists among children, even now, to a frightful extent, I have only too abundant. reason to know. And that schools are still subject to it is pretty evident from much information I have had, of which the letter printed at page 40, from one who has had unequaled opportunities of knowing what goes on in schools, is a sample.

I cannot venture to print the accounts patients have given me of what they have seen or even been drawn into at schools. I would fain hope that such abominations are things of the past, and cannot be now repeated under more perfect supervision and wider knowledge of what is at least possible.

THE SYMPTOMS which mark the commencement of the practice are too clear for an experienced eye to be deceived. As Lallemand remarks: "However young the children may be, they get thin, pale, or irritable, and their features become haggard. We notice the sunken eye, the long cadaverous-looking countenance, the downcast look which seems to arise from a consciousness that their habits are suspected, and, at a later period, that their virility is lost. It may depend upon timidity acquired or inherited. I wish by no means to assert that every boy unable to look another in the face, is or has been a masturbator, but I believe this vice is a very fre

quent cause of timidity. These boys have a dank, moist, cold hand, very characteristic of great vital exhaustion; their sleep is short, and most complete marasmus comes on; they may die if their evil passion is not got the better of; nervous symptoms set in, such as spasmodic contraction, or partial or entire convulsive movements, together with epilepsy, eclampsy, and a species of paralysis accompanied with contractions of the limbs." (Vol. i, p. 462.)

Provided the vicious habit is left off, or has not been long practiced, nature in the boy soon repairs the mischief, which appears to act principally on the nervous system,' for in very young boys no semen is lost. If, however, masturbation is continued, nature replies to the call of the excitement, and semen, or something analogous, is secreted. Occasionally, the emission gives pleasure, and there is then great danger of the habit becoming confirmed. The boy's health fails, he is troubled with indigestion, his intellectual powers are dimmed, he becomes pale, emaciated, and depressed in spirits; exercise he has no longer any taste for, and he seeks solitude. Let those who would read an eloquent and able description of the symptoms, consult J. J. Rousseau's "Confessions," p. 366. At a later period the youth cannot so easily minister to his solitary pleasures, and he excites his organs the more, as they flag under the accustomed stimulus. He becomes shy and timid, particularly in the presence of women. There is a case related by Chopart, of a shepherd boy who was in the habit of passing a piece of twig down the urethra, in order to produce ejaculation, when all other means had failed.

PROGNOSIS.-Evil as the effects are, even in early childhood, the prognosis of the ailment, looking on it as an ailment, is not, in children, unfavorable. Lallemand observes: "In respect to the evil habit in children, it is easy to re-establish the health, if we can prevent the little patient masturbating himself, for at this period

1 Lallemand admits that in children it is not the loss of semen which can produce the usual effects of spermatorrhoea, but that the symptoms must depend upon the influence exercised on the nervous system, what he terms the ébranlement nerveux épileptiforme, the loss of nervous power which follows over-excitement, tickling, or spasmodic affections in young and susceptible children, and which may produce such a perturbation of the nervous system as to occasion even death. He gives an instance of this, which he attributes to the effect produced on the brain by repeated convulsive shocks similar to those which susceptible subjects receive when the soles of the feet are tickled. (See Lallemand, p. 467-8.)