It Is Not Always a Sign of Partial Insanity

An interesting 1860s article found in Google Books, on the subject of female 'self-abuse'. Note the mention of 'measures injudiciously or too frequently employed, however honestly, by a medical attendant' ... masturbation as medical treatment, which would later by automated by 'massage' devices.

Self Abuse in Women.—Dr. Horatio R. Storer has an article n the Western Journal of Medicine, on this subject, in which he enunciates opinions which are a disgrace to the profession of medicine and a libel on the women of America. The following is his statement:
    "Now I venture to say at the outset, that self abuse in women is not of rare occurrence; that it prevails alike in those who are married and who are unmarried; in the young, and in the old; that it is not necessarily a vice, nor primary, but that it may be the result of physical causes, and therefore is amenable to moral than to physical treatment; that it is not always a sign of partial insanity, its effect or its cause; that while far less frequently than in the male, productive of extreme nervous exhaustion, it is even more frequently than in him productive of partial or extreme nervous irritation, explaining many of the cases of so-called hysteria; and that in many instances the habit initiates from no normal or abnormal longing of the woman's own heart, from no direct or indirect physical sensation upon her part, from no endeavor to simulate previous sexual intercourse had with husband or lover, but from manual caresses conferred by some half-timid man, or from the measures injudiciously or too frequently employed, however honestly, by a medical attendant, or from certain legitimate and very common employments of life, such for instance, as the use of the sewing-machine. I have space but for a few words as to the causation of self abuse in women. The greater portion of my remarks I shall endeavor to devote to its rational treatment.
      "It may be permitted me here to say, that the views that I shall present are the result, not of thought alone, but of many hundreds of confessions, and many years observation of sick women. I acknowledge freely that the statements of women concerning sexual matters are often to be received with extreme caution, but I would call attention on the other hand to the fact that here, as elsewhere, a single positive case outweighs very many negative ones. With reference to the frequency of the habit to which I am alluding, it is as with the somewhat co-relative question of the frequency of criminal abortion. Both of them are matters of very delicate character ; concerning both of them, physician and patient would gladly preserve silence, were it not that by this means the evils referred to with all their train of deplorable results, would be sure to proceed unchecked. The frequency of unjustifiable abortion, is now recognized by every medical man, and reform is rapidly taking place. Ten years ago, howerer, the situation was very different. Upon my directing the attention of the profession to the matter in a paper read before the Suffolk District Medical Society at Boston, I think in 1856, I presented tables based upon confessions made to me within a given time by patients, said patients being married well to do in life, and professing, for the most part, to hold by the tenets of religion. In answer to my paper, the evidenee of which was irresistible, one of our oldest and most influential physicians, at that time Professor in Harvard University, felt called upon to express his astonishment and doubt, in as much as during some forty years or more of practice, he had never known a single case of criminal abortion.   The method of adjustment of our diverging experience I commend to the attention of all who may suppose that self abuse is comparatively unknown among women. My statements to the Society, as I have said, were based upon the confessions of patients. I asked the gentleman if, during his long experience, he had ever questioned a woman if her abortion had been an intentional one. "I consider, Sir, that I should have insulted her by so doing," was the reply. To obtain positive evidence in these matters, the physician must seek it; obtained, as I have said, the experience of the seeker will outweigh that of all who cross over and pass on the other side, without inquiry."
   It is probable that there are some cases of self abuse in woman, but these are very rare. I have taken occasion to make inquiry in such quarters as would be most likely to give definite information, in regard to two classes. The one had been for many years a teacher in a female college, the other was a noted courtezan, and for a dozen years the keeper of a house of prostitution. The answers were in both cases alike, "self abuse in women is of rare occurrence." The sexual orgasm is rarely strong in women, say in not more than ten per cent., and even in these cases, it is frequently associated with a strong will. It is my experience that such opinions grow out of a prurient imagination. As to the " many hundreds of confessions," which establish the fact of self abuse in women beyond peradventure, it sounds fishy for one small young man, and we would like to hear from some of his Boston confreres on the same subject. It is barely possible that the virtuous land of the pilgrims offers an exception in this respect, to more favored portions of our country."

Eclectic Medical Journal, 1867