We must also remember that we have to
distinguish between the _post_ and the _propter_, and that it is
quite possible that neurasthenic persons are specially
predisposed to masturbation. Bloch is of this opinion, and
remarks that a vicious circle may thus be formed.
On the whole, there can be little doubt that neurasthenia is
liable to be associated with masturbation carried to an excessive
extent. But, while neurasthenia is probably the severest
affection that is liable to result from, or accompany,
masturbation, we are scarcely yet entitled to accept the
conclusion of Gattel that in such cases there is no hereditary
neurotic predisposition. We must steer clearly between the
opposite errors of those, on the one hand, who assert that
heredity is the sole cause of functional nervous disorders, and
those, on the other hand, who consider that the incident that may
call out the disorder is itself a sole sufficient cause.
In many cases it has seemed to me that masturbation, when practiced in
excess, especially if begun before the age of puberty, leads to inaptitude
for coitus, as well as to indifference to it, and sometimes to undue
sexual irritability, involving premature emission and practical impotence.
This is, however, the exception, especially if the practice has not been
begun until after puberty. In women I attach considerable importance, as a
result of masturbation, to an aversion for normal coitus in later life.
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