Jean Stengers and Anne van Neck: Masturbation: The History of a Great Terror, translated by Kathryn A. Hoffmann. New York: Palgrave, 2001. ISBN 0312224435

A fact cunningly concealed by the copyright page of this book is that it was originally published in 1984, and has not been significantly updated. Appending less than half a page alluding to the exclusion of questions about masturbation from the British National Sexual Attitudes and Behaviour Survey of the early 1990s, and to the 1994 dismissal of Joycelyn Elders as US Surgeon-General for advocating masturbation as safe sex, is hardly adequate. Since 1984 there have been a number of significant articles on the history of masturbation specifically, a discursive explosion in the history of sexuality more generally, illumination of the world of eighteenth century medical ideas and practice and doctor/patient relationships, studies of medical quackery, and research on the history of childhood, as well as work on the history of masculinity (since men were always the major target of masturbation panic), all of which surely need to be taken into account when writing a history of this 'great terror'.

Even for 1984 it was old-fashioned. A name notable by its absence from the citations is that of Michel Foucault. While it may be refreshing to think that a francophone work on onanism could be produced eight years after the publication of Histoire de la Sexualité (Paris: Gallimard, 1976) without feeling it necessary to mention it, this underscores the relatively untheorised and unanalytical nature of Stengers and Van Neck's account. There is none of the reflexivity found in E. H. Hare's seminal article ('Masturbatory Insanity: The History of an Idea', Journal of Mental Science, 108, 1962) on masturbatory insanity or Alex Comfort's The Anxiety Makers: some curious preoccupations of the medical profession (London: Nelson, 1967), both of which used the medical discourse of the evils of self-abuse as a salutary warning to the medical profession (and indeed the public) to think critically about contemporary accepted 'truths' concerning health and illness. Many of Stengers' arguments are presentist and Whiggish: a characteristic statement is 'Tissot had been taken for a man of science because physiology was still in its infancy in his day' (p. 110).

The book deals almost exclusively with 'high', medical, opinions on masturbation. Occasional quacks and fringe practitioners (such as the phrenologist O.S. Fowler) are mentioned and towards the end survey and literary evidence of individual attitudes among the general public are adduced. There is no mention of the rise of the social purity/social hygiene movement at the end of the nineteenth century, which while it was responsible for disseminating such terrorising tracts as Rev. Sylvanus Stall's What a Young Boy/Young Man Ought to Know, may paradoxically have contributed to the decline in belief in the pernicious effects of masturbation, or at least of the view that it was the ultimate sexual evil. Social purity emerged from the Abolitionist movement against regulated prostitution, which rejected the idea that sexual intercourse was a necessity for male health: this led by the early twentieth century at least to suggestions that while masturbation was bad, it was less deleterious than fornication, whether this involved seducing decent women or exploiting prostitutes. This point of view was supported by changing medical understanding of the venereal diseases during the later nineteenth century, in particular the revelation of the long-term pernicious effects of gonorrhoea in women, and the responsibility of syphilis for such tertiary manifestations as general paralysis of the insane, and for congenital disorders in offspring. Fornication was coming to seem not such a healthy alternative to the evils of self-abuse. The role of commerce in keeping masturbation anxiety alive is also neglected. By the 1880s Henry Maudsley and Thomas Clouston, previously leading hard-liners on the subject of masturbatory insanity, were attributing adverse mental effects not to the actual practice but to the terror inculcated by 'quack literature', which was very widely disseminated.

This book has some value in that it provides a continental European slant on a subject which has been perhaps more thoroughly explored in the Anglo-American context, and undermines arguments that would attribute worries over masturbation to a Protestant world-view. Such fears were clearly much more widely dispersed throughout Europe. What is not explored however, are the subtle differences between countries and regions in the concerns manifested and the measures recommended. There is an allusion to the early introduction of infibulation as a remedy in Germany, and the primacy of masturbatory insanity in British writings, but the work of René Spitz ('Authority and Masturbation', Psychoanalytic Quarterly, 21, 1952) on national variations is not taken up and expanded upon, although his article is cited.

Lesley A Hall, Wellcome Library for the History and Understanding of Medicine, London

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