THE INSANITY OF MASTURBATION, 
BY C. B. BURR, M. D., Pontiac, Michigan. 
Assistant Physician Trt the Eastern Michigan Asylum. 
Reprinted from The Physician and Surgeon, Ann Arbor, Michigan. THE INSANITY OF MASTURBATION* 
BY C. B. BURR, M. D., Pontiac, Michigan. 
Assistant Physician iji the Eastern Michigan Asylum. 
A careful study of the symptomatology of mental disease 
develops the fact that cases of insanity having for their origin 
a like cause possess distinctive characteristics in common. 
This becomes the more clearly apparent in proportion as our 
investigation is more painstaking, and the scrutiny of symp- 
toms more minute. The exciting causes of disease, the sur- 
roundings which favor its development, the age at which it 
makes its appearance, the general condition and circumstances 
of the patient, are believed not only to determine in a general 
way the form of disease, but also what its particular manifes- 
tations are to be, the character of delusions, and most unques- 
tionably the curability or hopelessness of the malady. 
Thus we have the insanity of pubescence, the insanity of 
adolescence, the insanity of the climacteric period, insanity 
from constitutional disease, and various other forms, each one 
presenting definite traits and diagnostic features. This associ- 
ation of cases in accordance with their natural history consti- 
tutes the clinical grouping of mental disease, and through it 
the alienist is furnished a useful and important classification. 
Of the different types of insanity, none presents more uni- 
form and distinctive symptoms than the one under considera- 
tion. The association of the habit of masturbation with insan- 
ity is shown by many striking signs which, if noticed at all, are 
frequently ascribed by the friends of patients to causes other 
than the true one. 
Thus a mother observes that her son is growing quieter, 
more reserved, and low spirited, and that his health seems 
failing. He is indisposed to go out, and remains much by 
himself; is disinclined to see people, takes little interest in 
ordinary matters, and may be found deeply absorbed in read- 
ing, or lost in thought. Frequently it is the bible which 
engrosses his attention, or a religious experience is expressed, 
and it is thought that a spiritual awakening is taking place. 
As he grows pale, nervous, and languid, his malady is thought 
to be due to over-study, and his condition enlists the sympathy 
and warmest solicitude of others. As this deep reserve, how- 
ever, is in many instances but an exaggeration of natural char- 
acteristics, the apprehension of friends as to any mental failure 
in the patient are not excited. It is some sudden, rash, impul- 
*Read before the State Medical Society at its annual meeting in 
Ypsilanti in 1882. 2 
sive act, which leads them to suspect that something is wrong 
with his head, and even then they are loth to admit the exis- 
tence of any serious mental disorder. 
It is strange how often it is that the very flower of the fam- 
ily is stricken in this manner. “He was always a thoughtful, 
studious, amiable boy,” his friends say; “was not rough like 
his companions, took very little interest in their sports, and 
was always devoted to his books.” VV. C., a boy of twenty- 
two, who was arrested for an attempt to shoot his father, but 
released from custody on the ground of insanity, and placed 
in the asylum, was thus described by his mother: “He was 
brought up in Sabbath school and day school more or less 
until nineteen years of age; was always very fond of reading, 
and but for the unkindness of his father at the age of fourteen 
or fifteen would have learned the printers’ trade or telegraph- 
ing, and to-day have ranked among men as he wanted to, but 
no encouragement was given him in that direction, and here is 
the climax. He has seemed very reflective of late, and I have 
thought religion had something to do with his thoughts.” She 
adds, also, that she hopes he will be led to salvation. Notwith- 
standing the high tribute from his mother, this patient’s char- 
acteristics were found to be of the most unpleasant kind. He 
was irritable, vain, self-conceited, aggressive, and very belliger- 
ent. His suspicion was so great that at first he would not reply 
to any question, and resented attempts at familiarity. Two 
days after his admission he made assaults upon some feeble 
patients, and required to be removed from a quiet to a dis- 
turbed ball. He would walk about the hall with his hands 
raised, and making a strange noise, as if engaged in some relig- 
ious exercise. He had hallucinations of hearing, was unap- 
preciative of his condition, and was often rambling and inco- 
herent in his conversation. He was obstinate and willful, and 
sought opportunities to annoy others. He addressed his fellow 
patients in a harsh, disagreeable tone, and elbowed the feebler 
ones about. At night he would disturb the hall by jumping in 
and out of bed, and whistling at the window. On one occasion 
while out walking, he clambered into a passing wagon, grabbed 
the lines, whipped up the horses, and drove some distance 
before the owner of the team could regain control of them. 
On another occasion he required removal from one hall to 
another, for committing an act of great indecency in a room. 
Full three months after admission, after having been composed 
and self-controlled for quite a long period, he made a brutal 
and violent assault upon an attendant while his back was 
turned. After being under treatment six months, this patient 
was removed at the request of his mother, who always felt 
that his detention in an asylum was a great hardship and 
injustice. 
N. E., who was brought to the asylum after having pro- 
cured a knife for the purpose of killing his mother, whom he 
thought was a devil, was always spoken of as a pattern of pro- 
priety, both by her and by his sisters. He was said to be 3 
genial, amiable, industrious, and successful in his undertak- 
ings. This boy had periods of great irritability, was suspici- 
ous, vain, very self-conceited, and inclined to hold himself 
aloof from others. He entertained religious delusions, and 
believed that the knife he had sharpened to kill his mother 
with was predestined for that purpose. 
Another patient who had made repeated assaults upon his 
father and mother, and shown great irritability if opposed, was, 
previous to his attack, “always retiring in tastes and unlike 
other boys.” 
A male, aged fourteen, who inherited a strong predisposi- 
tion to mental disease, and was admitted to the asylum suf- 
fering from acute mania, was spoken.of as a bright, studious, 
good boy, of kind disposition and pleasant manners, and free 
from bad habits. This patient, during convalescence, ascribed 
his entire trouble to vicious habits. 
It is a most striking fact that those patients as a rule who 
suffer from mental disease in consequence of this vicious indul- 
gence, possess an inherited tendency to nervous disorders. It 
would seem that the habit of masturbation operated toward the 
overthrow of the intellect chiefly in those cases where the ner- 
vous constitution is in some way defective, or abnormally sus- 
ceptible to this and other exciting causes of insanity. As 
illustrative of this point, an analysis of cases may be of interest. 
Of the thirty-five patients admitted to the Eastern Michigan 
Asylum, since the first day of October, 1880, in whom mastur- 
bation was the undoubted cause of insanity, twenty-seven are 
found to inherit a predisposition to nervous or mental .disease; 
in three cases such tendency cannot be positively stated, 
though the presumption is that it exists; five only are exempt 
from any hereditary taint as far as known. 
Melancholia and 'dementia are the most frequent types of 
disease from this cause which are seen in asylums. Symptoms 
are continually changing however, and transitions from one 
state to another constantly occur. Thus in many cases, brief 
periods of mild excitement alternate with those of comparative 
composure, the length of the interval of quiet being dependent 
to a great extent upon the habits of the patient. 
The tendency of all mental disease from this cause is toward 
irritable dementia, and perfect recovery is exceptional, this 
depending so largely as it does upon the ability of the patient 
to restrain morbid tendencies and correct .vicious habits. Self- 
control is in many cases so nearly destroyed by the degrading 
vice that such cooperation is impracticable. 
The excitement observed in connection with this form of 
insanity is of a purposeless character; is characterized by mis- 
chievous acts, erotic impulses, wanton deeds of violence, and 
destructive propensities. These patients mark the walls, de- 
stroy their clothing, are untidy in habits, lawless and exces- 
sively difficult to look after. In some instances mania assumes 
a chronic form, and periods of immunity from excitement are 
brief and imperfect. 4 
The opposite condition, that of melancholia, is characterized 
by hallucinations, emotional disturbance, the existence of relig- 
ious delusions, and a disposition to pray and confess sin. It is 
difficult to say just what the relation is between the abuse of 
the sexual organs and the development of the religious (?) 
nature, but this connection has been observed by all who are 
familiar with mental disease. Patients of this class read the 
scriptures diligently, talk on spiritual subjects, are given to 
praying and exhorting, and have much to say on the subject 
of morality. They deeply deplore their past sins, and allude 
to errors of youth, but point to the spotless purity of their 
Eresent lives, and are strong in professions of rectitude. It has 
een held that these religious delusions originate in the fear of 
punishment for violation of nature’s laws. (Skae mentions the 
prevalence of the belief that the unpardonable sin has been 
committed). For relief from this burden of guilt, consolation 
is sought in scripture reading and religious exercises, and the 
morbid fervor thus engendered eventually leads the patient 
to the opposite extreme. He believes himself highly moral, 
and superior to his associates and surroundings. Maudsley 
says:— 
“Very remarkable is it what a strain of exalted sentiment 
and lofty idealism is professed in some of these cases; the world 
is too coarsely selfish and rudely practical for their fine sensibil- 
ities and nice aspirations, and notwithstanding that they are 
sunk in a degrading self indulgence, and perhaps emasculated 
by it, they will pour out loftily-pitched moral sentiments, and 
take it hotly to task in high conceited fashion for its low aims 
and gross ways.” 
Emotional states prevail in this class of cases, and attacks 
resembling hysteria in the female are not uncommon. The 
patient takes to bed, or falls in a lifeless manner to the floor; 
he has a feeble pulse, relaxed skin, and dilated pupils. There 
is either a feigning of unconsciousness, or complete absence of 
self-control, weeping, shouting, and active lamentation. This 
condition is ascribed to nervous exhaustion from over-stimu- 
lation of the sexual organs. It may be followed by a paroxysm 
of maniacal excitement. 
The vanity and egotism of these patients are phenomenal. 
This is a noteworthy sign of mental failure, and increases with 
impairment of intellect. Many imagine themselves possessed 
of great gifts, and dwell with pride on their varied accomplish- 
ments. Some delight in a display of oratorical powers, others 
write poetry or compose music. There is a strong tendency to 
speak of the opposite sex, and the average lunatic of this class 
imagines himself possessed of boundless powers of fascination. 
These characteristics were exemplified to a marvelous degree in 
the following case: A male, aged twenty-six was admitted to 
the asylum about one year ago. His father says that he 
exhausted himself by study at the age of eighteen, and that 
his mind “went to pieces” then. He did not suffer from brain 
fever, but was confined to his bed and seemed to be out of his 5 
head. When he got up he was left irritable and peculiar, 
unable to devote himself to any regular occupation or study, 
and without much purpose. At the end of a year he quarreled 
with a sister, and procuring money went to Kansas without the 
knowledge of his family. There he gained a bare subsistence, 
and at the end of eighteen months came home, ragged and 
wretched. His mind upon his return seemed much more 
active; he applied himself diligently to the study of law, and 
at the age of twenty-one was admitted to the bar. For some 
time he was associated in business with an older lawyer, and 
did pretty well in the way of making collections and practicing 
in the bankruptcy courts. In a year and a half he became 
impressed with an undue sense of his own importance, and 
established himself independently. In the course of a year 
his library was sold under a chattel mortgage to satisfy his 
rent. With the loss of his library he gave up, and for three 
years previous to his admission, did nothing for his own sup- 
port. In Detroit he connected himself with one of the churches, 
and was quite a devoted attendant, but notwithstanding this 
his moral nature was very defective. His bearing while in the 
society of young ladies was objectionable, and on one occasion 
he narrowly escaped a cowhiding from an irate father, whose 
daughter he had insulted. There was, no doubt, progressive 
mental failure during these three years, but a relative, upon 
whom he depended for support, did not recognize the fact, and 
ascribed his growing irritability, indolence, and unpleasant 
characteristics to viciousness and sheer laziness. Finally this 
relative concluded he could care for him no longer. From 
Detroit he went to a neighboring city where his parents resided. 
There he made himself very obnoxious to young ladies by 
forcing his society upon them. He had a practice of staring at 
them in church, or at public entertainments, which was offen- 
sive in the extreme. He was addicted to poetry writing, and 
inflicted his productions upon whomsoever would accept. He 
had a scheme for “connecting water ways,” and for “lake im- 
provement,” and made himself a great nuisance by his impor- 
tunities to persons to purchase stock. Finally it became 
rumored that he was looking for the “girl who had jilted him,” 
with a revolver, and being considered dangerous to be at large, 
he was placed in the asylum. When admitted he was suffer- 
ing from a nervous disorder of the heart, and was reduced phy- 
sically. He complained of pain in the back, suffered from 
constipation, believed that the bones of the spinal column were 
decaying, and thought that with every act of defecation por- 
tions of the spinal marrow escaped. He had many other 
delusions, among which was one that an explosive bullet had 
been administered to him in his food. He was listless, per- 
formed no active labor, and was indifferent to exercise. His 
vanity was excessive, his conversation was almost entirely 
about himself, and very self-laudatory; his poetry was reeled 
off to his auditors without mercy, and he delighted in display- 
ing what he chose to believe was a highly cultivated voice. He 6 
devoted much time to personal adornment, and would spend 
hours prinking and smirking before a mirror. In public gath- 
erings he would face full about and stare at the ladies. During 
the first few months he seemed to improve, but this change was 
not a permanent one, and in six months material impairment 
of mind had taken place. He grew more irritable, wore a surly 
look, and complained of a feeling of great confusion. To his 
attendant he confessed without shame that his habits were 
improper at night, and ocular evidence corroborated his state- 
ment. It was also reported at this time that he was seen by a 
fellow patient exposing his person at the window. One even- 
ing he was cautioned by the physician in charge against such 
practices, whereupon he grew highly indignant. An hour 
afterwards he approached an attendant, who was standing in a 
group with others, and dealt him a murderous blow on the 
head with a chamber. The assault was made without provo- 
cation. Pie had previously been on the best of terms with this 
attendant, and no words whatever had been exchanged between 
them that evening; neither had the attendant reported any- 
thing to his discredit, and this the patient well knew. 
The sense of shame gradually becomes obscured and even- 
tually is lost. Disgusting acts are committed, indecent expo- 
sures of person and improper advances are made, and open 
indulgence in the vicious habit is not uncommon. Women 
frequently entertain delusions appertaining to the union of the 
sexes. Many believe themselves to be married, others engaged. 
Others again allege that men have been improperly intimate 
with them. They all possess very susceptible affections, and 
in many instances a disappointment in love has been the 
assigned cause of insanity. No less than four female patients 
of this class, at present under treatment in the asylum, have 
delusions of this character. 
Two cases have been received showing well marked suicidal 
tendencies. Such, however, are comparatively rare. One case 
was that of a male, aged nineteen, who had been a close stu- 
dent and aspired to be a school teacher. He had been a victim 
of this habit for a number of years, and had been the prey of 
quacks and impostors, who had excited his extreme apprehen- 
sion, and kept constantly before him the bugbear of impotence. 
One of these quacks had advised a complete renovation of the 
system by a restricted diet. He adopted the starvation plan, 
and became so much reduced physically that at the time of 
admission he weighed but seventy-five pounds. He had been 
much disposed to wander about alone, and just previous to 
admission had attempted self-mutilation by cutting his tongue. 
He had religious delusions, and was disinclined to eat. With 
physical improvement his mind grew better, and at the end of 
six months he was discharged “ recovered.” 
The other case was that of a female, aged twenty-five, 
who inherited a strong predisposition to mental disease. She 
had been failing in mind for upwards of a year, her malady 
being ascribed by her friends to disappointed affections. She 7 
had imagined herself drugged and ruined, and claimed that 
she had been offered some indignity by a young man. She 
had twice attempted suicide, once by throwing herself into the 
river, and again by cutting her throat. This patient has 
become very degraded in habits, and her mind is greatly im- 
paired. She entertains all her former delusions, is impulsive, 
violent, and disposed to make sudden assaults. Her prospects 
for recovery are very poor indeed. 
Auditory and visual hallucinations are frequently found. 
In one case hallucinations of hearing were so intense and unre- 
mitting, as to almost completely destroy the comfort of the 
patient, and render him at times abject and miserable. Perse- 
cution from these evil spirits, as he was wont to style them, 
was occasionally so severe as to cause him to lose all self-con- 
trol, to scream, and to cry out in agony. On one occasion he 
wrote to his father that “it is bother, bother, bother, all the 
time,” and added, “insanity is a queer thing; persons who 
are not afflicted know not how much they suffer or how they 
feel. I have had spells come over me to strike people with 
my fists, or break the windows, but they were of short dura- 
tion.” 
Another patient imagined that people made faces at him. 
He also heard himself mocked and accused of crime, and 
believed that a conspiracy was formed against him, to thwart 
him in all his undertakings. He had many other symptoms 
appertaining to this form of insanit}', was irritable and exces- 
sively vain, and imagined himself a very superior person. 
The tendency to the commission of sudden acts of violence 
has been alluded to, as a striking characteristic of this variety 
of mental disease. It has been illustrated in the cases men- 
tioned, and instances might be multiplied. An hallucination 
or delusion (as in the case of N. E., who thought his mother a 
devil) may furnish the motive for an assault, or the attack is 
of an explosive character, is wanton, outrageous, and due to 
excessive irritability from sexual exhaustion, as in several of 
the cases quoted. 
A patient was recently admitted to the asylum, whose case 
may be of interest in this connection. Some of the particulars 
recorded are doubtless familiar to certain members of the soci- 
ety. The patient, a male, aged twenty-nine years, was born in 
Germany and probably inherited from his mother a susceptible 
organization. He served three years in the army, then learned 
a trade and supported himself by his own exertion until five 
years ago, at which time he became deranged. He describes 
a sensation coming upon him then like a lightning stroke, 
which prostrated him temporarily, and gave him a severe pain 
in the back. In all probability he has never been well in mind 
from that time to the present. Soon after the attack he fell in 
love but did not marry—he says because he had no means. 
He has been in America most of the time for the past four 
years; has resided with a relative and worked at his trade. 
His mind has been unsettled, however. One year ago, in Jan- 8 
uary, he again became anxious to marry. This, and other 
symptoms of mental disorder, induced his friends to send him 
to Germany for a six-months’ sojourn. One month ago he met 
on the street of one our cities a lady whom he had formerly 
seen in a vision, and whom he recognized as his “double life.” 
Procuring a pistol he visited this lady’s house, and demanded 
of her that she marry him. Upon her refusal so to do, he shot 
at her three times. For this deed he was arrested, but his 
insanity being undoubted, he was committed to the asylum. 
His manner is that of one who has been insane for a long time, 
and is the subject of persistent delusions. He had at first a 
restless, suspicious expression of contenance, but was quite 
communicative. His conversation is extravagant. Although 
he admits he has had little schooling, he believes with a better 
knowledge of the English language he would be the first law- 
yer in the land. He has no appreciation of his condition, and 
considers himself perfectly sound in body and mind. He has 
had many visions. In one of them a female appeared and took 
improper liberties with his person. 
The physical symptoms associated with this form of mental 
disease are attributable to the general impaired state of the ner- 
vous svstem, particularly of the vaso-motor system. We find 
pain in the back and limbs, disorders of circulation, irregular 
action of the heart, dilated pupils, wet hands and a coated 
tongue. Disorders of sensation are occasionally observed. The 
patient complains of languor, lassitude, and a feeling of general 
weakness. He is indisposed to exercise. Constipation and 
general derangement of the secretions are more or less con- 
stantly present. 
In the above paper J have endeavored to call attention 
to the delusions and peculiar manifestations which I regard 
as characteristic of this form of insanity. In brief these are: 
(1) An intense vanity and self-love; 
(2) Extreme selfishness and disregard for others; 
(3) Religious delusions and perverted moral sentiments; 
(4) Delusions referable to the sexual system; 
(5) Hallucinations of sight and hearing of a certain definite 
character; 
(6) Emotional disturbances; 
(7) Homicidal impulses and a disposition to commit sudden 
acts of violence; and 
(8) Certain physical disorders referable to an impaired state 
of the nervous system. 
About ten per cent, of all patients under treatment at the 
Eastern Michigan Asylum, suffer from this form of mental dis- 
ease. This I believe to be a much smaller percentage than is 
generally supposed. 
While it is true that among the insane this vice is not infre- 
quent, in many instances it is indulged in consequence of the 
impairment of will power from disease, and is regarded as one 
of the results rather than a cause of mental infirmity. Cases 
of this character I have excluded in the ahove-estimate.