Med ical attitudes to the sexual

disorders of the "normal" male

±n Britain, 1900—1950

Lesley Ann HALL

Thesis submitted for the degree of Doctor of Philosophy

U niversity College London

U niversity of London 1969 ProQuest Number: 10610045

All rights reserved

INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted.

In the unlikely event that the author did not send a com plete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. uest

ProQuest 10610045

Published by ProQuest LLC(2017). Copyright of the Dissertation is held by the Author.

All rights reserved. This work is protected against unauthorized copying under Title 17, United States C ode Microform Edition © ProQuest LLC.

ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106- 1346 2

Abstract

This thesis considers the British medical profession's general scorn and neglect of the sexual dysfunctions experienced by the "normal" male: defined as a man who perceived himself as such, and expected to marry and lead an ordinary married life, with children. The works of medical, and some non-medical, writers, who did take an interest in the subject are discussed. The prevalence of such disorders, and anxiety among men generally about sexual functioning, is illustrated, and set in the context of general perceptions about the nature of male desire which marginalised and pathologised, where they did not wholly ignore, common difficulties experienced by large numbers of men in the course of their sexual activities. Prevailing attitudes of taboo around sexual matters generally are also discussed as bearing upon this neglect, and contributing to doctors' reluctance to delve into the subject. Debates about the control of venereal disease are cited as well as discussions of the functional disorders. It is contended that while doctors were believed, in virtue of their profession, to have particular authority to pronounce on sexual questions, this was a subject dealt with cursorily, if at all, in medical education, and that doctors were as likely as non-doctors to have been influenced by common misconceptions and prejudices. Central to this thesis is a detailed study of the overwhelming response by male readers to the works of marital advice published by Marie Stopes. The difficulties presented to her in the enormous numbers of letters she received from the public, and comments upon doctors expressed to a non-medical expert in this field, are analysed. Consideration is given to the tensions between accepted notions of manhood and individuals' sense of their own experiences. Changing perceptions and attitudes to do with sexuality and marriage during the period under discussion are reviewed. Table of contents

Page

A bstract 2

Acknowledgements 4

Introduction 6

Chapter One: The Victorian Background and the Rise of Sexology 26

Chapter Two: Diseases, Dangers, and Double Standards 66

Chapter Three: "What a Young Man Ought to Know" 106

Chapter Four: Married Love and Enduring Passion 146

Chapter Five: "Young husbands and all those who are betrothed in love" 191

Chapter Six: "The most miserable of all patients" 233

Chapter Seven: "How little we medical men know" 275

Chapter Eight: "I fear a doctor would laugh if consulted" 325

Chapter Nine: World War II: Continuity and Change 366

Bibliography 408 4

Acknowledgements

While engaged In this research I was employed full-time as an archivist at the Wellcome Institute for the History of Medicine. I should therefore like to express my gratitude to the Wellcome Trustees for their provisions for their employees to undertake study for higher degrees. I have been indeed fortunate in having such a stimulating intellectual environment as the Wellcome Institute. Its programmes of seminars, symposia and lectures have made valuable contributions to my own development, as have more informal discussions.

Dr W F Bynum of the Academic Unit at the Wellcome In s titu te has supervised this thesis and I am indebted to him for his initial encouragement and help in defining my thoughts on this topic, as well for his supervision.

I am also extremely grateful to my colleagues of the Wellcome Institute Library whose support and cooperation made it possible to pursue my research. Particular thanks are due to Eric Freeman, Director and Librarian, and especially to Julia Sheppard of the Contemporary Medical Archives Centre for her patience with a preoccupied colleague. Jeanette Lake was most helpful in making available to me relevant printed material from a cataloguing limbo. I should also like to express my thanks to the Library Desk, stack and photocopying staff, and to all my colleagues for their interest and support.

While 1 have been able to pursue much of my research within the Wellcome Institute Library I should also like to thank the following Individuals and Institutions: Dorothy Sheridan and the Tom Harrisson-Mass Observation Archive at the University of Sussex; David Doughan and the Fawcett Library at the City of London Polytechnic; the British Library, in particular the Department of Manuscripts, and especial gratitude to Dr Anne Summers; the Eugenics Society; the Church House Record Centre, Westminster; the Scout Association Archives; the Rare Books and Manuscripts Library, University of Sydney. Miss A G Polden of the Library Association Library provided a most helpful response to a query of mine on public library policies of the 1930s.

Thanks are due to Harry Stopes-Roe who originally approached the Wellcome Institute in 1979 to give a home to those of his mother's papers rejected by the British Library. Cataloguing this collection sowed the seed which turned into this thesis. Mrs J Griffith, the wife of E F Griffith, when approached about her husband's surviving papers, was kind enough to transfer them to the care of the Contemporary Medical Archives Centre, and I received courteous replies, and valuable if negative Information, from His Excellency J F Walker and the Countess of Cork and Orrery respecting the papers of the la te Kenneth Walker.

Valuable opportunities to present for discussion earlier versions of parts of th is th esis were provided by seminars at the Wellcome In s titu te its e lf, under the auspices of the Society for the Social History of Medicine in London and York, by the Cambridge Child Care and Development Group and by the Department of History at the South West Polytechnic Exeter, also in Sydney, Australia through the kind efforts of Dr Milton Lewis and Dr Wayne Hall. Some of the material in this thesis has been published in the form 5 of articles in the Journal of Contemporary History and the Bulletin of thp Society for the Social History of Medicine.

Particular individuals whom I should like to mention with gratitude for useful informal discussions and stimulating reactions to my research and conclusions as well as general support and friendship are Dorothy Porter (both for her enthusiasm and for her contributions to the "pox-box"), Charlotte Mackenzie (and for references I might have overlooked, even if I didn't actually use "a common post-connubial insanity"), Malcolm Nicholson, Naomi Pfeffer, and of course the other "Wellcome In s titu te sexologists" Renate Hauser, Andreas Hill, and Mark Micale. I received welcome encouragement from Roy Porter, Barbara Brookes, Jane Lewis, Professor Jeanne Peterson of the University of Indiana, and Professor R A Soloway of the University of North Carolina. To all those whose interest and support kept me going through the production of this thesis I extend my thanks.

An especial debt is owed to Heather Creaton of the Institute of Historical Research to whose encouraging response I first mooted the possibility of undertaking this research, and who has over the years kept me supplied with references I might otherwise have missed.

I have been sustained throughout the production of this thesis by the companionship of Ray McNamee, whose support has extended to waiting in second-hand book-shops while I scoured the shelves for copies of obsolete sex-manuals, carrying these home, and building book-shelves to hold them.

This thesis is dedicated to my parents, Frederick and Marjorie Hall. 6

Introduction

In the past two decades there has been an upsurge In historical writing about sex in history. Much of this has sprung from the interests of feminist and gay historians and propagandists, although work by historians of demography and the family has also shed light on sexual conduct. Most of this work has looked at women or at "deviant minorities" or at the rise of the b irth control movement. Foucault's famous work on the subject argues that the rise of sexology in the later nineteenth century explicitly categorised the objects of the policing by definition and labelling by this new medicalised (as opposed to religious) discourse around sexual behaviour as the hysterical woman, the onanistic child, the deviant and the

Malthusian couple.1 It is to these groups that most historiographical attention has been paid. Less attention seems to have been given to the pedagogic inculcation of society's sexual standards in the young: a few articles have looked at attitudes to masturbation and the construction of the belief in "masturbatory insanity"2 but the topic has not been studied with the attention that has been given to attitudes to female sexuality and the construction of deviant identities, or to examining changing reproductive behaviour within families.

Unexamined by th is historiographical trend, and often assumed to be monolithic, unchanging, unproblematic, stands the "normal" male. The implication tends to be that sexual discourses operated exclusively for his benefit and that there was no ambiguity or ambivalence in his position, no possible constraint upon him. This thesis examines this apparently unitary and transhistorical figure, to indicate the ways in which "normal male 7 sexuality" was perceived, from the later nineteenth up to the middle of the twentieth century, to point out changes, and to suggest tensions between the ideal set up and the lived experience of men as they perceived it.

The essentialist argument thinks of sex itself as

very "natural"—you do it with little or no equipment and with no clothes on.3 and with regard to the two sexes promulgates a view of the natures of male and female as essentially different and unchanging throughout history and in all different societies. Under this schema

Mary McIntosh has conceptualised it in her discussion of certain themes around the subject of prostitution, "innately, it seems, women have sexual attractiveness while men have sexual urges."A It therefore follows that any attempt to change this order of things given by either God or Nature is doomed to failure. Nature tends, in arguments of this kind to mean either "the way things are" or "the way I think they ought to be".

This notion of a constant natural and transcendent difference between the sexes, often merely an unthoughtout popular belief, still has its defenders. However, it is clear there have been g reat variations throughout history and in different societies of what masculinity and femininity are expected to be and how they have been experienced.8 Even motherhood, often assumed to be the ultimate "natural", has varied according to historical circumstance, as Fildes has shown in her 6tudy of infant feeding, and

Hardyment in her account of changing ideas on child-rearing.* While 8 eschewing therefore the more simplistic arguments of the ’’socialisation" theory of sex-roles, this thesis is located within a conceptualisation of sex-roles as being constructed and experienced within particular historical and social contexts rath er than constant. As Plummer has argued,

[Man] has a biological capacity... which is capable of great variation as he moves and manipulates his symbolic environment.7

The experience of individuals does not necessarily match precisely with the roles prescribed for them at any particular point in time, and it is hoped that this will be established by contrasting the ideology of manhood with actual problems experienced by men.

It is necessary to define the "normal male" as the term is employed in this thesis. Too often he has just been assumed to be someone who is not a woman, someone who is not homosexual, someone who by hie nature is privileged within society as they are not. For the purposes of this thesis, the "normal male" is a man who defines himself as heterosexual, wants to marry and lead a conventional conjugal life, and has no "deviations of object" in his sex-life, beyond, perhaps, the odd mild fetishism. In fact, he is the man who would think of himself as "normal", and for that reason perhaps not puzzle himself much about the wilder intricacies of sexual desire. Havelock Ellis remarked of the male sexual Impulse

To deal with it broadly as a whole seems unnecessary, if only because it is predominantly open and aggressive. Moreover, since the constitution of society has largely been in the hands of men, the nature of the sexual impulse in men has largely been expressed in the written and unwritten codes of social law.0

It should be pointed out that Ellis himself (discussed in greater detail in

Chapter 1) was almost the antithesis of this figure of simple open aggressive desires. It can be demonstrated that this idea of the simplicity 9 and straightforwardness of male desire is part of the constructed package, and that "normality" does not exclude sexual anxiety.

Because of these assumptions about male sexuality, its problems have often been ignored. The one problem that may be voiced is that of the question of control over this potentially dangerous insurgent force, which led to the rise of anti-masturbation literature and other propaganda in favour of male purity in the later nineteenth and the early twentieth century. In spite of Ellis's remark above that written and unwritten social laws are made by men on men's behalf, the question of male purity was one which exercised men as well as women, although it might be supposed that only the latter had any vested interest in controlling male lusts. There was, of course, a certain class dimension to the question of control over male sexuality, control over baser lusts being seen as appropriate and desirable behaviour, or perhaps constituting a form of internalised moral policing,

for the middle classes or would-be respectable, but hardly to be expected of the lowest classes. The control of women was, and still is, often presented under rhetoric of the dangers of arousing masculine lusts by

inappropriate dress or behaviour: Norah March suggested in 1920 th at

There is much to be said in regard to the training of girls, that they should so deport themselves and so dress themselves as to place the minimum of difficulty in the way of masculine restraint.9

This comment can be duplicated in other works. The prostitute was seen as atemptress beguiling men into sin by playing on their vulnerability, a concept discussed in greater detail in Chapter 2. This concept of the rampant nature of male sexuality, and the need for it to be controlled for the good of both sexes by women, i6 still to be found in writers on 10 sociobiology and is at the heart of most essentialist arguments, and sometimes figures as a plea in mitigation in rape cases.

Yet men do suffer from anxieties around their sexuality. In adolescence they may be perturbed or even terrified by spontaneous nocturnal emissions, and worried about the consequences of masturbation, since folk

"wisdom" still carries all sorts of warnings about this practice even if sex manuals have gone from condemnation to reassurance to advocacy:

(1920) Of course you will see that it is very important to a fellow's health that he does nothing to waste this fluid, or to make it come away more than it does naturally. For, the body, to release this fluid, requires a certain amount of nervous energy, and that means a certain fatigue or tiredness follows.10

(1959) Masturbation in itself has no harmful effects, mental, moral or physical. But a sense of guilt caused by masturbation may have serious consequences.11

(1967) Adolescence is a preparation for maturity, and masturbation should be seen as part of that preparation— although in some cases it is an end in its e lf .12

(1978) It is a way of getting sexual pleasure and satisfaction and learning how to love your body. Finally: you don'thave to masturbate if you don't want to.13

Men may be excessively concerned by what they perceive to be some abnormality of the external genitalia: smallness or largeness or lack of symmetry. The statistical frequency of impotence and premature ejaculation still seems to be a well-kept secret: to judge from the tenor of recent books written for general practitioners dealing with sexual problems,14, men with these difficulties continue to feel themselves to be uniquely cursed: "among the most miserable of all patients that the doctor is called upon to treat" as Kenneth Walker described "the young man with a disorder of sex" in 1930.16 And not just young men, either. The sexual problems arising in middle-aged men are equally shrouded in silence, and cause despair. If doctors no longer forbid further child-bearing while 11 withholding mention of birth-control, they are often still reluctant to

discuss the implications for sexual life of certain common conditions, or

of operations such as prostatectomy, or the effects on libido of some

commonly prescribed drugs.

Apart from their perhaps solipsist ic worries, men worry about sexual

difficulties within relationships. During the period under discussion a

major anxiety was birth control, and there is evidence that this was a

matter of concern to husbands as well as wives. Far from leaving the whole

business up to the woman, many men were so concerned that it was the

condom which was the most widely-used form of artificial marital

contraception, while in spite of the dire warnings about the effects of

coitus interrupt us, this continued to be a common practice. Men were not

indifferent to their wives' sexual pleasure, either, and while it could be

argued that this was an essentially egotistical worry; mutually enjoyable

intercourse being more pleasurable, women who enjoy sex will let their

husbands have it more often, and satisfying his partner enhances a man's

self-esteem; there is evidence that thi6 concern was not as selfish as all

that, that men did care for their wives' wellbeing and health over and

above any relation to their own gratification, a theme which will be

developed in Chapter 5.

Men also contract venereal diseases to a far greater extent than women.

Once figures became available following the Public Health Regulations

instituted under the recommendations of the Royal Commission of Venereal

Diseases, 1916 (as discussed in Chapters 2 and 9) the figures for patients

attending the clinics and receiving treatment disclosed that men made up

the vast majority in both categories, and would indicate that male patients constituted approximately three-quarters of the total during the early

1920s.1 e This sex differential was still noticeable in the 1970s, if it was

not as great: the figures are a little skewed by the presence of non-

venereal genital tract conditions such as candidiasis and trichomoniasis

which are more prevalent in the female. All the other conditions

categorised were seen far more often in the male, furthermore the numbers

of male patients who attended the clinics but required no treatment far

exceeded those for women in similar case, an interesting statistic in view

of the fact that women are generally considered to seek medical

consultations far more frequently than men.17 While this thesis

concentrates mainly upon the functional sexual disorders, attitudes to

venereal disease, its causes and prevention, will be examined as a nexus of

attitudes having a much wider bearing on perceptions of sexuality and

gender roles.

The medical profession is still predominantly male, and was male-dominated

to an even greater extent earlier in this century. There has been a great

deal of discussion, both sociological and historical, about the attitudes

and behaviour of male doctors to female patients, particularly in the

fields of gynaecology and obstetrics and psychiatry. Doctors have been

accused of reducing all female disorders to the sexual/reproductive, of

unnecessary interventions, of colonising and controlling the female sex in

the bodies and minds of their patients.10 Some doctors did keep their

female patients in Ignorance: Naomi Pfeffer has discovered how married

women with syphilis contracted from their husbands were not told of the nature of their disease.19 It is impossible to know, now, whether this

information was withheld from a spirit of male solidarity, or in the 13 interests of preserving marital harmony, and it would be interesting to know what doctors did in the presumably considerably less frequent case of men contracting syphilis from their wives. It has been suggested that doctors were far more forthright with men: Jane Lewis believes that male doctors would talk to husbands about birth control but not wives.20 The evidence cited within this thesis, however, would lead the inference that at the period she was talking of most doctors might tell husbands, for example, that their wives should have no more children but not suggest how, apart from abstinence, this might be accomplished, a topic discussed further in Chapter 7.

There is a general assumption that men come off and came off better in medical encounters, that doctors were more at ease with them, treated them more like equals. It is contentious to suppose that the doctor/patient relationship is ever one not involving a considerable imbalance of power.

As Ann Oakley has pointed out

features of femininity... are precisely those features which identify the patient in what most doctors consider to be a good doctor-patient relationship and most patients experience to be the normal doctor-patient relationship.21 and although this is stated in a discussion of the management of childbirth, these attitudes expressive of dominance/submission within the doctor-patient relationship go well beyond such a particular context. This being so doctors may be happier with situations where this is quite explicit in terms of general social relations. There are problems here to do with the nature of the doctor-patient relationship, and it should not be presupposed that there was necessarily any alliance or sympathy between male doctor and male patient on grounds of shared gender: a contemporary

American writer points out 14

the myth that all men patients enjoy special or preferential treatment from doctors because medicine Is a male-dominated institution... the super-professional, super-cool and supercilious physician with the bedside manner of a cobra does not suddenly become Dr Niceguy when he has a man stre tc h out on his examining table.22

The very similarity of sex seems to have been a reason why in certain matters, such as dealing with sexual problems, doctors failed to meet their male patients' needs.

Doctors were supposed, as a result of their medical training, to be privy to a whole body of sexual knowledge from which the lay person was excluded. This myth was promulgated by lay and medical writers alike. As w ill be shown in Chapter 7, formal medical education was in fact remarkably lacking in even the most basic information about normal sexual activity. At a time when syphilis and gonorrhma were extremely prevalent diseases, venereology was not even taught at the undergraduate level.

Doctors shared with their patients preconceptions, Indeed misconceptions and anxieties, about sex which seriously affected their professional efficacy in this field. Modern writing on the treatment of sexual problems reiterates what Walker was saying in the 1930s: that the usual distant authoritative manner has to be discarded. The author William Cooper has written a novel in which the doctor protagonist has made a successful

Harley Street career out of treating sexual problems by reiterating the simple formula "You're not alone: it happens to us all."23

As Pfeffer has pointed out

Whilst medicine highlights the potential for reproductive disorders in women, it makes them invisible in men.24 and she has demonstrated how this has resulted in differential attitudes to sterility in men and in women. The reluctance of doctors to contemplate 15 sexual disorder In the male can have fatal consequences: a recent report in the Times pointed out that

There would rightly be general uproar from women if a general examination by a doctor did not include examination of the breasts; but male patients still don't expect their testicles to be examined by the doctor, despite the fact that testicular cancer is the commonest tumour for men between the ages of 20 and 34, and is increasing.

Although the disease is usually curable if diagnosed in time, this is dependent on an early detection which will not improve until "cancer specialists insist... it becomes routine to examine the genitalia in the young male". Two cases were cited (originally reported in the British

Medical Journal) of young boys in whom this disease was diagnosed only very late after the Initial presentation of symptoms: in one case when the patient was known to have had surgery for undescended testis, these being particularly liable to malignant change. Both patients had undergone hospital treatment for the symptoms before anyone examined their testicles: this is particularly remarkable given that doctors often routinely perform cervical examinations and breast palpations on women presenting with non-gynaecological disorders.26

On a less mortal level, although the situation may have changed now, during the earlier part of the twentieth century doctors were reluctant to perform investigations into male fertility. It was known that an examination of the semen would disclose whether a man was producing viable spermatozoa. Although this is a simple and non-invasive technique, requiring only a microscope and a fresh semen sample, doctors went on performing operations on the female half of infertile couples without ever determining if the failure to conceive were in fact her "fault", or that of her husband (see Chapter 7 for further discussion). 16

An examination of the attitudes and behaviour of doctors towards "normal" men suffering from sexual problems provides a point where male power and medical power impinge upon one another, rather than intersecting in any simple graphic way. Foucault described sexuality as "an especially dense transfer point for relations of power", although rather surprisingly did not cite the doctor-patient relationship in his list of the relationships in which sexuality particularly manifests this characteristic:

Between men and women, young people and old people, parents and offspring, teachers and students, priests and laity, and administration and a population.2®

The consideration of the interaction between (male) patient and (male) doctor over a crisis to do with the operation of sexual functioning raises fruitful questions about the construction of male sexuality within society and about the medical profession itself.

The material upon which this thesis is based is multifarious. In order to find out what attitudes were in circulation about male sexuality works of description and prescription emanating from various sources have been consulted. However works of fiction and imaginative literature have been excluded (at least, literature which sets out specifically to be such).

Primarily this is because of the serious methodological problems involved in the use of this latter type of material as a guide to actual social practice and beliefs, and the conventions of continuing Victorian prudery also means that in the sexual sphere novels are particularly likely to be misleading. Pornography has also been omitted from consideration, although it has been used for example in the work of Steven Marcus and Coral

Lansbury,27 as an indicator of attitudes despite its very obvious fantasy components. This thesis concentrates on publications which set out to be 17 informative, "serious” works about sex rather than deliberately arousing pieces of erotica. This is not to ignore the fact that many of the works discussed were greeted with as much horror as if they had been pornographic, and were even described as such, and that some of them were disseminated through a shadow-world of unrespectable publishers and shops which were also in the business of purveying pornography.

There are serious methodological problems to the use of advice literature as a guide to conduct, as Mechllng has pointed out in the case of child- rearing manuals.2® However, fortunately a large number of the le tte r s survive which were written to Marie Stopes, the popular writer on sex, from 1918 u n til her death in 1958, by readers of her books such as

Married Love, or those who had heard of her name in connection with the subject, for example as a result of her much-publicised libel-case against

Dr Halliday Sutherland. These show, as discussed in later chapters, the immense Impact her works had on those who read them, and the questions raised in their minds to which they sought further answers. Over 45% of her correspondents were male. Although the correspondence generated by

Stopes' work was international in its spread, the letters used as evidence in this thesis have been those from British citizens resident in the United

Kingdom, serving in various parts of the Empire, or working overseas.

Letters from the Dominions and Eire have also been cited because of the cultural similarities. Letters from the USA, continental Europe, and the non-European citizens of the Empire have been excluded. Letters from women pertaining to the problems of their husbands or male friends have in some cases been drawn upon. 18

While this collection appears to be unique at least in terms of size <60 archive boxes containing over 300 files held in the Contemporary Medical

Archives Centre, Wellcome In s titu te for the History of Medicine: also a small sample kept with the Stopes papers at the British Library, amounting to several thousand actual letters), an endeavour has been made to keep a check on it and supplement the information by pursuing letters written to other authors on similar topics. In most cases these were destroyed by their recipients, or lost: Isabel Hutton in her autobiography mentions that she received numbers of letters in connection with her work The Hygiene of

Marriage:

The book passed almost unnoticed for some years, having only a small circulation, though it was surprising how many people wrote to me of their problems... each of them I answered to the best of my ability, for the problems were many, diverse and unexpected.29 but it would appear that these did not survive. This is similarly the case with the papers of Kenneth Walker. Helena Wright's biographer states that she worked (during Wright's lifetime) on a copious collection of "documents le tte rs and papers" preserved by Wright.30 However, no case m aterial or correspondence were among the Wright papers offered by her sons to the

Contemporary Medical Archives Centre in 1984 following her death. A little correspondence survives among the papers of E F Griffith, founder of the

Marriage Guidance Council and author of Modem Marriage and Birth Control.

The Scout Association archives include a handful of letters written to

Baden Powell relating to the sexual advice given in Rovering to Success.

The papers of Norman Haire in Sydney University Library do not contain case records or correspondence from the general public. Some material in the papers of the Eugenics Society, in particular the correspondence on vasectomy, has been useful. Letters to the National Society for the

Prevention of Venereal Disease, 1938-1944, from the general public, were 19 almost exclusively concerned with questions of prophylaxis of venereal disease.

Tributes paid to the work of Stopes found in autobiography and memoirs have been cited, though a complete search of the relevant texts for the period has not been possible, especially as the mores as to what is and is not publishable have changed so radically. Thus writers looking back to the

1920s and 1930s from the 1970s and 1980s had a freedom in dealing with their sexual life and attitudes which earlier would not have been possible, except in a private diary or correspondence with close friends.

While there was no British survey undertaken of the magnitude of the

Kinsey survey in the USA, or even comparable to the earlier projects of a similar nature conducted in the USA by Dickinson, Davis and others,31 inspired by Kinsey a rather less grandiose project was undertaken by Mass

Observation after the Second World War. The findings were never published in their entirety. The survey was questionnaire based and therefore depends very much on the questions asked for what can be got out of it, and does not really reveal problems rather than attitudes, but has been of considerable use, in particular some of the auxiliary materials gathered in connection with it have proved valuable. Shortly afterwards Eustace

Chesser, author of Love without Fear and other works of sexual advice, did a huge survey on the sex life of the Englishwoman. This massive and useful survey, with its breakdown into age cohorts, while it lacks direct evidence about the Englishman, does give some indications of his attitudes, performance and marital difficulties. 20

Sex education literature and the works of social purity and hygiene organisations were pursued. The Shield, published by the Association for

Social and Moral Hygiene, proved a valuable resource. This periodical emanated from a purity organisation which adhered to the ideals of

Josephine Butler in her campaign for the abolition of the Contagious

Diseases Acts. Unlike some other bodies in this field, it opposed any legislation which aimed to penalise prostitutes as a particular group, and constantly promoted the single moral standard. It thus combined a certain liberalism with its high social and moral ideals. The records of the White

Cross League, a religious organisation founded in the later nineteenth century to improve male morality and uphold the single standard of sexual conduct, held among the Church House Archives, Westminster, contained the publications of this body but little correspondence. The Eugenics Society

Library (now transferred to the Wellcome Institute Library) included a valuable collection of pamphlet literature. The Fawcett Library at the City

Polytechnic, although primarily devoted to the history of women, was also a rich repository of material relevant to this thesis. Many works, though of wide circulation in their day, could only be tracked down among the collections of the British Library, and some of them were still kept under the rubric of "Cupboard", a restriction which may be due, by this era, to the rarity of the volumes and not their presumed obscenity.

For attitudes of the medical profession the British Medical Journal. The

Lancet, and other professional periodicals have been consulted. They are invaluable sources in that they not merely published the latest developments in the field but provided in their correspondence columns a forum for debate between widely differing viewpoints. The British Journal of Venereal Diseases, while most of its contents were of purely technical 21 and professional interest to venereologists, displayed an abiding concern with social, psychological and legal implications of these diseases. Works written to instruct the profession on how to deal with patients presenting sexual difficulties have been used, and contrasted with those written to enlighten the general public. Numbers of doctors wrote to Marie Stopes, and in 1922 she attempted a survey on the use of birth control by members of the profession, which though statistically problematical, is suggestive.32 The Mass Observation surveys also incorporated attem pts to differentiate between the attitudes of the medical and other professions and those of the general public.

Material on quack and patent remedies has been gleaned from various sources. The Mass Observation Archive has already been mentioned, and the

"Medico-Political14 Group files of the British Medical Association now in the Contemporary Medical Archives Centre a t the Wellcome In s titu te were a useful repository of material.

Recent debates on sexuality and its history have also been studied as well as medical sociological works on the doctor-pat lent relationship.

The th e sis commences by looking at the prevailing ideas about sexuality up to the outbreak of the First World War, both the ideas usually associated with the Victorian era which were still current, and those being promulgated by the new generation of sexologists. The second chapter deals with the anxieties aroused by the problem of venereal disease, and the allied question of prostitution, up to the end of World War 1. The Royal

Commission on Venereal Diseases set up in 1913, and reporting in 1916, and 22

the effects of the First World War on attitudes to VD and sex generally are also discussed. The third chapter examines the various routes by which differing forms of sexual information percolated through to young men, both informally, and more formally through the growing development of sex education. The particular horror around masturbation is discussed. The

fourth chapter describes the explosion of marriage advice literature and more general works on sex in the wake of Marie Stopes' Married Love.

considers the continuing restrictions on the availability of such books,

and discusses what, if any, impact this literature had on its readers and whether it affected their behaviour at all. In chapter five changing

concepts and ideals of marriage are presented, with particular reference to evidence from the letters received by Stopes from men on problems to do with marriage and relating to their wives. In chapter six the problems

presented by Stopes* numerous male correspondents re latin g more

particularly to male sexual dysfunction and anxiety are examined. The next

chapter looks at doctors and sex, both general attitudes and less common

ones, and the state of medical knowledge and education on sexual matters.

The following chapter considers the interactions between doctors and their

male patients seeking advice for problems to do with sex. The final

chapter describes the impact of the Second World War, the effects of the

consequent sudden rise in the declining VD rate, surveys by Mass

Observation and others on sexual subjects, and what changes, if any, in

general social attitudes, had taken place in the previous fifty years. 23

Introduction: Notes

1. Foucault, Michel, The History of Sexuality Volume I: An Introduction. (translated by Robert Hurley), first published in France as La Volonte det / savoir. Editions Gallimard 1976, Allen Lane 1979, Penguin Books paperback 7 edition, Harmondsworth Middlesex, 1981, pp 104-105

2. Hare, E H, "Masturbatory Insanity: the history of an idea", Journal of Mental Science 1962 Vol 108, pp 1-25; MacDonald, Robert H, "The frig h tfu l consequences of onanism: notes on the history of a delusion", Journal of the History of Ideas. 1967, Vol 28, pp 423-431; Engelhardt, H Tristram, Jr, "The Disease of Masturbation: values and the concept of disease", Bulletin of the History of Medicine. 1974, Vol 48, pp 234-248; Comfort, Alex, The Anxiety Makers: Some curious preoccupations of the medical profession. Nelson, London 1967, pp 69-113, Chapter 3, "The Rise and Fall of S elf- Abuse"

3. McIntosh, Mary, "Who Needs Prostitutes? The ideology of male sexual needs", in Smart, C and B, Women, sexuality and social control. Rout ledge and Kegan Paul, London, 1978, pp 53-64, re f to p 55

4. ibid. p 54

5. One of the classic works on this subject from an anthropological perspective is Margaret Mead's Male and Female: A Study of the Sexes in a Changing World, first published in the USA 1950, Pelican paperback edition 1962. Gagnon. John H, and Simon, William, Sexual Conduct: The Social Sources of Human Sexuality. Aldine Book Co, Chicago, 1973, Hutchinson, London 1974, is perhaps the most often cited sociological work of the social interactionist school. For some recent discussions on sexual diversity, see, e g, Schlegel, Alice, ed, Sexual Stratification: A Cross-cultural View. Columbia University Press, New York, 1977; Howells, Kevin, ed, The Psychology of Sexual Diversity. Basil Blackwell, Oxford, 1984, paperback edition, 1986; Caplan, Pat

6. Fildes, Valerie, Breasts Bottles and Babies: A History of Infant Feeding. University of Edinburgh, 1986; Hardyment, Christina, Dream Babies: Child Care from Locke to Spock. Jonathan Cape Ltd, London, 1983

7. Plummer, Kenneth, Sexual Stigma: An Interact io n ist account. Rout ledge and Kegan Paul, London and Boston, 1975, p 37

8. Ellis, Havelock, Analysis of the Sexual Impulse: Love and Pain: The Sexual Impulse in Women. Studies in the Psychology of Sex Volume III, F A Davis Co Ltd, Philadelphia, 1910, Random House, New York, omnibus edition, 1936, p 189

9. March, Nor ah, Toward Racial Health: A Handbook for Parents. Teachers and Social Workers on the Training of Boys and Girls (with a foreword by J Arthur Thomson), George Routledge and Sons Ltd, London, 1915, 4th edition, 1920, p 175

10. ibid. pp 261-262 24

11. Davies, Maxine, Sex and the Adolescent: A Guide for Young People and Their Parents (Foreword by Dr Eustace Chesser), Heinemann, London, 1959, p 47

12. Chesser, Eustace, Unmarried Love: Sexual Wisdom for the Single. Jarrolds, London, 1965, Corgi paperback edition 1967, p 47

13. Cousins, Jane, Make It Happy. Virago, London, 1978, p 31

14. Freedman, G R Sexual Medicine. Edinburgh, 1983; Fairburn, C G, Dickson, M G, Greenwood, J, Sexual Problems and Their Management. Edinburgh, 1983; Bancroft, J, Human Sexuality and Its Problems. Edinburgh, 1983

15. Walker, Kenneth M, Male Disorders of Sex. Jonathan Cape, London, 1930, P 7 16. Harrison, L W, 'The Public Health Services and Venereal Diseases", B ritish Journal of Venereal Diseases. 1925, Vol 1 no 1, pp 12-22, tab le on p 13

17. "DHSS: Sexually transmitted diseases: Analysis of the total number of new cases at the clinics in England only during the quarter ended 31 December 1972"; from a file in the Birth Control Campaign archives held in the Contemporary Medical Archives Centre at the Wellcome In s titu te for the History of Medicine, CMAC: SA/BCC/E.54 "Press-cuttings: venereal disease; news, 1972-1974"

18. Ehrenreich, Barbara, and English, Deirdre, For Her Own Good: 150 Years of the Experts' Advice to Women. Doubleday, New York, 1978, Pluto Press, London, 1979; Corea, Gena, The Hidden Malpractice: How American Medicine Mistreats Women. Harper and Row, New York, updated edition 1985; Showalter, Elaine, The Female Malady: Women Madness and English Culture. 1830-1980. Pantheon Books, New York, 1985, Virago, London, 1987. A critiq u e of th is approach to the history of medical treatment of the problems of women was put forward by Parsons, Gail Pat, in "Equal Treatment for All: American Medical Remedies for Male Sexual Problems: 1850-1900", Journal of the History of Medicine and Allied Sciences. 1977, Volume 32, pp 55-71; see also Charlotte Mackenzie's review of The Female Malady in Social History of Medicine. 1989, Vol 2 no 1, pp 103-105.

19. Hutton, Lady Isabel, Memories of a Doctor in War and Peace. Heinemann, London, 1960, mentions this from her own experience as a young doctor before the F irst World War, pp 88-89; the subject is discussed by Naomi Pfeffer in "Pronatalism and Sterility", unpublished PhD thesis, University of Essex, 1987, p 275, from an analysis of gynaecological case records of certain London hospitals between the wars.

20. Lewis, Jane, Women in England 1870-1950: sexual divisions and social change. Wheat sheaf, Brighton, 1984, p 117

21. Oakley, Anne, Telling the Truth about Jerusalem: A Collection of Essavs and Poems. Basil Blackwell, Oxford, 1986, p 58

22. Julty, Sam, "Men and Their Health—A Strained Alliance”, in New Men New Minds: Breaking Male Tradition, edited by F Abbott, The Crossing Press, Freedom, California, USA, 1987, pp 107-109 25

23. Cooper, William, You're Not Alone: A Doctor’s Diary. Macmillan, London 1976

24. Pfeffer, Naomi, "The Hidden Pathology of the Male Reproductive System", in Homans, Hilary Ced), The Sexual Politics of Reproduction. Gower, Aldershot, Hants, 1985, pp 30-44

25. The Times (London), 15th October 1987

26. Foucault, op cit. p 103

27. Marcus, Steven, The Other Victorians: A Study of Sexuality and Pornography in Mid-Nineteenth Century England. Weidenfeld and Nicholson, London, 1966, Book Club Associates edition, 1970; Lansbury, Coral, The Old Brown Dog: women, workers and vivisection in Edwardian England. University of Wisconsin Press, Madison, Wisconsin, 1985

28. Mechling, Jay, "Advice to Historians on Advice to Mothers", Journal of Social History. 1975-1976, Volume 9, pp 44-57

29. Hutton, Lady Isabel, op cit. p 217

30. Evans, Barbara, Freedom to Choose; The Life and Work of Dr Helena Wright. Pioneer of Contraception. Bodley Head, London, 1984

31. Davis, Katherine B, Factors in the Sex Life of Twenty-two Hundred Women. Harper and Bros, New York, 1929; Hamilton, G V T, A Research in Marriage. A & C Boni, New York, 1929; Dickinson, Robert L and Beam, Lura, A Thousand Marriages. Williams and Wilkins, Baltimore, 1932; Terman, L, Psychological Factors in Marital Happiness. McGraw-Hill, New York, 1939

32. Marie C Stopes papers in the British Library Department of Manuscripts, Additional Manuscripts 58562 26

Chapter One

The Victorian Legacy and the Rise of Sexology

The attitudes towards sexuality which were prevalent in the earlier twentieth century did not spring into being fully-fledged in 1900. The ideas of the Victorians continued to be important for a very long while, notions of sexuality promoted by Victorian writers held as received ideas, the way things were, "natural". Moreover, many of the works discussed in the earlier part of this chapter continued to be published and circulated well into the twentieth century, well after one might have suppose them outdated and obsolete. These ideas were also Important because so much twentieth century sexual rhetoric deliberately set out to counteract

"Victorianism". In this chapter the growth of the medical-scientific discourse is discussed, and its relationship to ideas about sexuality put forward by non-medical writers.

The figure who is usually taken to epitomise Victorian attitudes to sexuality is William Acton, MRCS. There has been considerable debate about this controversial figure, and how typical his views about sexuality were, particularly as embodied in The Functions and Disorders of the

Reproductive Organs in Youth. Adult Age and Advanced Life, considered in their Physiological. Social and Psychological Relations, first published in

1857. There has been a good deal of revisionism of the notion of his significance which Steven Marcus put forward in The Other Victorians.1 F B

Smith, for example, has suggested in The People’s Health* that Acton was on the lunatic fringe and that this was widely thought at the time. More 27 recently M Jeanne Peterson in an article in Victorian Studies3 has

contended that his ideas were far less influential and far less typical, in

particular within the medical profession, than those of Sir James Paget,

which w ill also be discussed.

Acton cannot be thus readily dismissed: he was a far more significant and

typical figure than these revisionists would like to believe. Smith and

Peterson, along with Peter Gay, are among the historians who have recently

been trying to rehabilitate the sexlife of the Victorians.A While it is

important to realise that not all Victorian marriages were characterised by

wives who closed their eyes, opened their legs, and thought of England, and husbands who informed their wives that ladies did not move, and this recent work is valuable in eroding these ancient polemical stereotypes, it risks setting up new and equally misleading generalisations about the

Victorians. These historians tend to minimise the very real sexual

anxieties and inhibitions that existed, quite probably even in the happiest

marriages.

Acton's influence and significance have been mostly, except in Marcus's

work, either promoted or dismissed on the basis of his statements about decent women seldom desiring sexual gratification on their own behalf, and

submitting only from the desire of maternity and to please their husbands,

a view which accords with received ideas about the sexless passivity of

the Victorian female. It is true that it would be perfectly possible to

find the promulgation of exactly contrary beliefs in contemporary medical

literature (as distinct from the pornography cited by Marcus) but Smith exaggerates the significance of a few statements widely separated in time and the experience of a few not necessarily typical individuals. Smith, like 28

Gay, has also tended to concentrate on proving that the Victorian woman was not the sexless "angel in the house" of popular mythology, and was not expected to be. This concentration upon women, while largely ignoring the ideology around male sexuality—apart from the occasional nod to the

"double standard" and its presumed prevalence—suggests that the male, as sexual being, has not been regarded as problematic. His sexuality is taken as a given and supposed less plastic than that of the female to the changing tides of ideology and social pressure. Acton, however, problematised the male: it was his control over his own sexuality which

Acton perceived as the crucial problem and not, or only incidentally, keeping all but an excluded pariah class of women chaste for motherhood.

It is surely symptomatic that it was Acton who was singled out by the later sexologist Havelock Ellis as the epitome of what was both typical and wrong with Victorian attitudes to sex.® It can be argued that he was in a very real sense Ellis's predecessor, a revolutionary innovator initiating a serious medical debate on sex, less antithetical to Ellis than is usually supposed. If Acton was explicitly prescriptive whereas Ellis's stated intention was description, the dichotomy was not so absolute as it seems. Ellis was perhaps more prescriptive than he pretended, while Acton believed himself to be describing the way things were, and making recommendations for conduct on that basis. They both received credit, even acclaim, for their serious moral intent, courage and sincerity in taking on tabooed subjects. One might compare the way their works were dealt with by their colleagues and received by the medical press. Acton's project was seen by contemporaries as somewhat daring, as the Lancet reviewer said "Mr

Acton has never feared to touch pitch."® Even Sir James Paget, who has 29 been depicted by Peterson as Acton's antithesis, paid tribute to him in an obituary:

Let it be remembered to his honour, that he practised honourably in the most dangerous of specialities; that he wrote decently on subjects not usually decent, and that he never used the opportunities which his practice offered for quackery or extortion.7

Acton himself commented in the preface to the Third Edition of Functions

and Disorders on its "flattering reception by the profession" and

acknowledged

The frank and loyal spirit in which my professional brethren, and with one exception, the periodical press, recognised the difficulty of the question, and appreciated my attempt to treat it as it requires.®

Ellis's reception by the medical profession will be discussed below.

As Marcus pointed out, the main subject of Acton's Functions and Disorders

was not women at all: there are two passages, a very small proportion of

the whole, which might be taken to be about the female sexual response, or

lack of it. The rest is entirely about the male sexual organs, their

functions and disorders, mainly disorders. One of the reasons Acton

discussed the female response at all was to reassure anxious males that

they would not be expected to perform superhuman sexual feats within

marriage. He regarded female frigidity as a great assisting factor in the

avoidance of marital excesses (which according to Acton could be just as

deleterious as solitary excesses) because he admitted that there was

nothing very exciting or stimulating about making love to an unresponsive

partner:

As all that we have read and heard tends to prove that a reciprocity of desire is... necessary to excite the male, we must not be surprised if we learn that excesses in fertile married life are comparatively rare.® 30

Acton was concerned with the dangers sexuality presented to the male. Sex in the male was a dangerous force which had to be held in check; any indulgence might, probably would, lead to enslavement in sensual habits which were not only morally bad but physiologically dangerous. He was not thinking, at least not specifically, of the dangers of consorting with potentially diseased prostitutes, although he also wrote on Prostitution and was an advocate of the Contagious Diseases Acts. What he was worried about was the waste of the vital spermatic fluid by whatever means.

Over indulgence (even in legitimate marriage) could lead to the wasting disease of spermatorrhoea. Although part of hi6 argument against indulgence involved moral discipline, and within its own terms was fairly logical (a man who had been wont to gratify his urges by self-abuse was undermining his self-discipline and therefore was less likely to be able to resist other temptations), the main force of Acton's arguments depended on the belief, by no means unique to him, in the physiologically deleterious effect of seminal losses. He was also concerned about the debilitating effects of sexual pleasure, which he feared too Intense to be experienced safely with any frequency.

He recognised the difficulty of continence: a healthy normal man had natural healthy urges. At one point in The Functions and Disorders of the

Reproductive Organs it would seem that he was arguing that nocturnal emissions were nature's way of coping with the stresses of continence, a natural outlet

I believe that such emissions, occurring once in every ten or fourteen days, are in the nature of a safety valve, and even conducive to health in persons who do not take enough exercise, and live too well... It is only when they occur repeatedly and leave symptoms of prostration with other ill consequences that they require our attention.10 31

However, he also seemed to imply that they were the resu lt of semi­

conscious impure thoughts emerging during sleep, and gave means by which

they could be controlled, for example, by the sufferer training himself to

wake up before emission occurred and eschewing as far as possible

anything that might stimulate sensations best left in quiescence. If

sexlessness was the ideal for Victorian womanhood, it was also the most

desirable state for the man. His sexual desires should be so subdued that

they were expressed, consciously, only under his will in legitimate

marriage for the purposes of reproduction. The very occasional relief in

the celibate by nocturnal emissions was often depicted as excusable,

analogous as a discharge of bodily waste products to menstruation in the

woman, and occurring, ideally, cyclically on a similar time-scale.

Was Acton really, as Smith has suggested11, way out on the lunatic fringe?

Cominos,12 on the other hand, has suggested that Acton was on the whole a

moderate, with his approval of some limited indulgence of the sexual

impulse within marriage as actually conducive to health (in the male at

least), and belief that the sexual act was beneficial to the individual

beyond its reproductive aspect:

The marriage state is the best and most natural cure for sexual suffering of many a human being. It is in itself a state conducive, when well regulated, not only to increased happiness but long life... The moderate gratification of the sex passion in married life is generally followed by the happiest consequences to the individual.13

How typical of opinion in the medical profession and generally was he?

Marcus does not discuss this, but takes him as a "given", the

representative of Victorian medical orthodoxy. Peterson is inclined to doubt that he was.1* 32

She cites Sir James Paget’s Clinical Lecture on "Sexual Hypochondriasis"15 as a counter to the Actonian thesis. Paget, while insisting on the necessity for continence, and the doctor's duty to refuse to prescribe fornication, was quite emphatic that masturbation did not in fact do any harm, at least no more than any other indulgence if carried to excess, and certainly did not lead inevitably to the lunatic asylum. Paget held this belief even though he wished that he

could say something worse of so nasty a practice; an uncleanliness, a filthiness forbidden by God, an unmanliness despised by men.

But it would seem that Paget was very much a voice of commonsense crying in the wilderness, that the medical profession, if one can generalise at all, if it did not necessarily subscribe completely to Acton's shock-horror warnings, was still convinced of the physical as well as the moral evils of self-abuse, the dangers of excessive losses through any kind of indulgence.

After all, Paget's Clinical Lectures, of which "Sexual Hypochondriasis" was only one, went into no more than two editions. Functions and Disorders was a great deal more successful as a publication, going on being reprinted well after Acton's death. Dr James Copland's Dictionary of Practical

Medicine (1858, "Pollution" pp 441-448), a more general guide than Acton's sp ecialist work, was equally vehement about the dangers of "pollutions", in particular those produced by "manustupration", To this cause he attributed the lesser life-expectancy and greater morbidity of those who remained unmarried.16 That his views had considerable and enduring circulation is perhaps evidenced by the British Medical Journal's 1881 citation of Copland as an authority upon the deleterious effects of self-abuse (with which the writer did not altogether concur).17. As for the significance of Acton himself (as a medical writer on sex and not as a straw-man for historians of Victorian sexuality), apart from the typicality of his views, as late as 33

1930 tribute was being paid to Acton's pioneering efforts: in the Lancet review of Kenneth Walker's Male Disorders of Sex, the reviewer commented

We should have liked to have seen the name of Acton, the British pioneer in this subject, mentioned.1®

Given the size, expense, and pretensions of Acton's book it cannot have had anything like the sale of Samuel La'mert's work Self-Preservation: A

Medical Treatise on Nervous and Physical Debility. Spermatorrhea. Impotence and Sterility, with Practical Observations on the Use of the Microscope in the Treatment of Diseases of the Generative System, which went into numerous editions during the 1850s and 1860s, i.e. contemporaneously with the publication of Functions and Disorders. This work, which seems to bear all the stigmata of a work of quackery, was in fact the production of someone entitled to refer to himself quite legitimately as a doctor, until being struck off the register for, among other things, publishing Self-

Preservation. described as "an indecent and unprofessional treatise".

La'mert was a Licentiate of the Society of Apothecaries, a member of the

London Hospital Society and an MD of the Royal University of Erlangen in

Bavaria.1® But although he employed similar rhetoric to Acton's about his mission; that there was a dangerous conspiracy of silence around problems of sex, and that a doctor who dealt with them risked his reputation, this rather sleazy little work does not inspire a lot of confidence in La'mert's disinterested devotion to the relief of suffering ignored by the profession as a whole. It was self-published, and at the end La'mert printed numerous testimonials from those who had undergone treatment at his Bedford Square consulting room, with advertisements for it (he preferred that patients visited him in person but was prepared to advise by post). It is not astonishing that its publication led to La'mert's deletion from the recently 34 established Medical Register in 1863 (his appeal to the Court of Queen's

Bench was a test case of the General Medical Council's power). The result of the case was no more than popular wisdom would expect of the Victorian medical profession and judiciary, especially given the understandable touchiness of doctors about their professional status, their desire to dissociate themselves from quacks. A concern with the problems of sex was one of the hallmarks of the quack: naturally the production of such a work would be condemned. It is p articu larly remarkable that one of the charges against La'mert was that he had falsely associated his son, a Licentiate of the Royal College of Physicians of Edinburgh, with this work by claiming him as Joint author both on the title page and in advertisements; the inclusion of th is charge suggests that Lima Abraham La'mert, with his

Edinburgh qualification, was anxious to dissociate himself from his less well-qualified father and his somewhat dubious practice. Also noteworthy is the point that La'mert's advertising as such did not form part of the case against him: only the "indecent and unprofessional nature" of his treatise and his misrepresentations as to its authorship.20

Yet in the previous year, in the same medical journal that published the account of La'mert's appeal, the following remarks had appeared:

By his readiness to deal with the diseases of the reproductive organs in all their most questionable forms and social relations, he has shown a boldness for which Duchatelet is one of the most respectable authorities... Mr Acton has undertaken to identify himself with all the aspects of the sexual question, and it must be said that he has discussed them in this work with honesty, boldness, and manifest good Intent.

The review concluded by mentioning the desirability of such matters being

"wrested from the hands of quacks" and "being discussed by men of honour probity, and intelligence".21 This had been a theme of The Lancet for some years in its reviews of earlier editions of Acton's The Functions and 35

Disorders of the Reproductive Organs*** and also in its review of a

lesser-known work, Marris Wilson's On Diseases of the Vesiculg Semlnales

and their Associated Organs, with Special Reference to the Morbid

Secretions of the P ro static and U rethral Mucous Membrane.*3 Wilson's

studies in this subject had been published as a series of articles in the

Lancet during 1856 and 1857, under the t i t l e "Contributions to the

physiology, pathology, and treatment of Spermatorrhea" prior to the

publication of this monograph.2,4 Wilson expressed the hope that

By directing inquiry to the mysterious agencies which have hitherto surrounded this most terrible moral and physical disease, much will have been accomplished, both for the science of medicine, and for the benefit of the unfortunate victims of sperm atorrhea.25

It is therefore not the case that the Victorian medical profession ignored

or necessarily despised the question of male sexual disorders.

It might therefore be supposed that there must have been great

differences in the messages being promulgated by the respected Mr Acton,

MRCS, and the despised La'mert with his mere Licentiate of the Society of

Apothecaries and rather dubious continental MD. But what the latter

actually said was almost exactly the same as Acton; the appalling risks

male sexuality involved. Like Acton, he made the following appeal:

Let moderation in the enjoyment of the highest physical pleasure be the motto of the married as well as of the single. The most powerful and healthy body with which man was ever blessed, could not sustain without permanent damage, more than a very prudent and well-regulated amount of intercourse2®

and went on to warn, just like Acton, of the perils of overindulgence in

these heady pleasures in the intoxicating days of early wedlock.

He even used the rhetoric common in the medical press

that the subject has been generally neglected and avoided by regularly educated practitioners in this countryt and until very 36

lately, entirely consigned to the care ofunqualified empirics27

This differed very little from the opinion of the Lancet reviewer on the first edition of The Functions and Disorders of the Reproductive Organs that

The only way by which some of the most important functional ailments affecting humanity can be rescued from the grasp of the most disgusting and villainous quackery, and treated with benefit to the patient, is by the scientific and conscientious practitioner openly taking them under his own charge.2®

A theme which was reiterated in the 1862 review of the third edition:

That the entire practice relating to what are called "secret diseases" should be wrested from the hands of quacks is most desirable. This is only to be effected by the subject being discussed by men of honour, probity, and intelligence; these men expose that most wicked and destructive of all kinds of charlatanry, which preys upon the mind, the body and the e sta te of its victims.2®

Acton and La'mert, as writers exclusively on sexual subjects, and Copland in his more general work, were only some exemplars of the high level of male sexual anxiety during the Victorian era. Perusal of the medical press during the later nineteenth century reveals recurring attacks by the profession on the purveyors of quack pamphlets and remedies, who were, it is clear, preying on prevalent fears about sexual weakness and anxieties about sexual functioning.30 A great deal of paper was being devoted to profitable works addressed to this anxiety, and fears of sexual debility were a steady source of income.

The quacks, presumably, were well aware of the existence of the anxieties on which they preyed, and thus perhaps had a more realistic perception than the profession of the sexual problems, real or imagined, of the man in the street. They knew what would sell and were prepared to advertise 37 their wares. Even when the medical profession was exhorted to give counsel to the sexually distressed, as in the series of Lancet leaders on the subject in 1870,31 there was of course no suggestion that they should make this service widely known. And in the absence of a belief that this problem would be sympathetically dealt with by a regular doctor, patients continued to turn to quacks. The Lancet reviewer of The Functions and

Disorders noted in 1857

the strange and paradoxical feeling of the sufferers themselves to prefer confiding... to the advertising imposters who publish books full of sec rets3*

It is popularly supposed that the remedies prescribed by the Victorian medical profession for self-abuse and spermatorrhoea were brutal in the extreme, to the point where the idea might have encouraged sufferers rather to seek out alternative methods. Certainly The Lancet, in 1870, recommended in cases of sexual debilitation that

it is necessary to guard the penis for a time against improper manipulation. This is best done by keeping up slight soreness of the body of the organ, either by blistering liquid or tissue, tartar-emetic ointment, nitrate of silver, or any other suitable application. The soreness should be sufficient to render erection painful.33 and cauterisation might be generally recommended for "over-sensitivity" of the organ. But remedies which made erection uncomfortable were not only the province of the orthodox profession. The device which was attacked in

The Lancet in 1857 under the heading "The Spermatorrhea Imposture":

The patient... stated that he had been suffering from some time past from spermatorrhea, that he had been undergoing the treatment of various advertisers, and that the last expedient which had tried was what he said was called "the American remedy", which had been recommended to him as an in fa llib le cure... It consisted of a ring of common metal, with a screw passing through one of its sides, and projecting into the centre, where it had a button extremity. This was to be applied to the "part affected" at bed-time... From what he said as to the recommendations which he had received of the treatment... it is probable that it has been extensively used.3* 38 was applied by the su ffe re r in the belief that it was for his own good.

Such devices were not necessarily not imposed, as has often been suggested in sensational discussions of the Victorian horror of masturbation, by doctors upon victimised patients. The horror was not merely felt by the profession but was widespread in popular belief, and as can be deduced from the above, applied not merely to deliberate self-abuse but to involuntary seminal emissions as well. Such stringent remedies, savouring of the punitive, may even have been particularly acceptable to guilty sufferers. (Some desperate remedies resorted to as late as the 1920s and

1930s for this self-perceived ailment are mentioned in Chapter 5.)

What surprises in reading Victorian works of advice about sex is the similarity of the assumptions shared by the medical profession, writers who represented fringe and unorthodox beliefs such as phrenology, medical herbalism, and hydropathy, and outrightly commercially motivated quack writers. They were all worried about the same things, it was a rare voice that proclaimed spermatorrhoea to be a factitious ailment or masturbation innocuous. The prolific American phrenological writer 0 S Fowler, while promoting the importance of mutual conjugal delight,

Normal fulfilment Cof the conjugal act] carries with it a feeling of moral elevation, consecration and sanctity unequalled.

Mutual participancy is Nature's Law.3* was as ferocious as any on the problem of self-abuse, regarding it as a positive plague

Masturbation outrages Nature's ordinances more than any or all the other forms of sexual sin man can perpetuate... Millions are ruined by it before they enter their teens.3* 39

One of the most stringent of writers on sex was T L Nichols, an American hydropathic practitioner latterly settled in the UK, in Esoteric

Anthropology.37 Compared to him, as Cominos pointed out,3® Acton did indeed look like a moderate on questions of sexual frequency and the permissibility of coitus which might not result in reproduction. But whereas Acton was a member in good standing of a respectable profession,

Nichols was a hydropathic practitioner. He was also tainted with a "free- love" stigma,33 although the 1873 and subsequent British editions of

Esoteric Anthropology omitted the condemnations of marriage and its abuse, and the free-love rhetoric, of earlier American editions. Havelock Ellie believed, looking back from 1936, that Esoteric Anthropology was

"considered a respectable source of information on these secrst subjects", though also, in most families, "kept locked up in a bedroom drawer."-40 A contemporary opinion, however, was that of the judge in the Adelaide

B artlett murder case, 1886, who condemned it as "garbage".41 It might be possible, given Nichols' emphasis on coitus only at potentially reproductive times of the female cycle, that his careful calendrlcal details could have been employed in the very opposite way to the one he intended (just as abort if acient pills were marketed with a large warning that they should not be taken in cases of suspected pregnancy). However, in common with his contemporaries, his assumptions about the relation between ovulation and menstruation were the antithesis of those not finally established until

1929 by Ogino and Knaus, and anyway he believed "amative exciteCment]" in itself productive of ovulation. The general burden of his teaching was that

every mode of prevention, other than living in chastity, is an evident violation of nature.42

While seeming to concede that sexual intercourse should be a mutually pleasurable act he was more concerned to give hints for the maintenance of 40 continence, considered that many women in the corrupt state of modern life were incapable of sexual enjoyment, and moreover made the rather terrifying comment that

women are sometimes deeply injured in their nervous systems by the efforts of their husbands to make them participate in, and so heighten, their enjoyments.43

For men, "after fifty, sexual pleasures are very exhausting. They often bring on paralysis or apoplexy."44

Comminated in Esoteric Anthropology under the general heading of

secularist philanthropists... openly advocating universal prostitution, concubinage and promiscuity'4®

George Drysdale, the Malthusian writer of Elements of Social Science, was surely on the radical fringe. Although a doctor and a self-proclaimed radical, he was sufficiently anxious about his professional status to publish the earlier editions of this work anonymously. This work, first published anonymously in 1854 and constantly reissued up until the time of

World War I, is remembered for its advocacy of "preventive intercourse", its recommendation of early marriage with the use of contraceptive measures. Drysdale's view of sexuality was the therefore perhaps to be expected one, antithetical to the Actonian belief that sex was a dangerous force requiring constant vigilance to keep it In check. For Drysdale, sexual problems were the results of the unnatural restraints put on the indulgence of natural urges by society. In his scheme of things, it was celibacy which led to those ailments which other authorities attributed to indulgence.4® One of Drysdale's arguments in support of his thesis was that prolonged continence during the years of youthful vitality led relentlessly to the evils of masturbation, a practice which he, unlike

Paget, regarded as e ssen tially pernicious.47 It was th is work by Drysdale 41 which alarmed the youthful Havelock Ellis by its predictions of spermatorrhoea as the dire sequel to nocturnal emissions.

Drysdale's views on the solitary vice, for all his radical beliefs, differed

little from those of the Hon E Lyttelton, cleric and headmaster of Eton,

who wrote prolifically on the problems of children, sex education and the

moral dangers of school life, warning that

The least defilement in boyhood enormously increases the difficulty of continence in manhood.

Of all the sins to which a boy is tempted at school, the most prevalent, the most alluring, the most enduring and the most deadly in its effects is impurity. 60

Drysdale warned similarly against "injurious habits of self-pollution",

which he believed laid, during the dangerous period of puberty, the

foundations of lingering disease.S1 However, for Drysdale, there was a

necessity of [the generative organs] having due exercise from the time of their maturity, which takes place at puberty, till that of their decline.*2

and abstinence, in his view, led to pernicious results which he believed

far more prevalent than the much more widely warned against ev ils of

excess, since there existed natural checks upon unbridled excesses. His

major authority on the dangers of spermatorrhoea was Lallemand, much cited

by writers whose general ideological bent was far removed from that of

Drysdale.

Like other writers, from Samuel La'mert to the anonymous reviewers and

leader-writers of the Lancet. Drysdale attributed much of contemporary

sexual suffering to the neglect of sexual problems by the medical

profession, whereby such problems became the purlieu of quacks.63 He

contended that so common were the 42

pernicious feelings of delicacy prevailing on sexual subjects, [that] physicians generally neglect to enquire into the history, past and present, of the genital organs in each patient... and thus do sexual diseases constantly escape detection, though they may be at the root of all the symptoms. ®A

Elements of Social Science, frequently reprinted well into the twentieth century, must have had a considerable circulation. As Ellis stated, with considerable charity given his own unfortunate experience with the work:

It was by no means in every respect a s c ie n tific or sound work, but it certainly had great influence, and it came into the hands of many who never saw any other work on sexual topics.15®

It would appear to have escaped the fate of becoming involved in legal action which befell such other works advocating contraception as Knowlton's

Fruits of Philosophy, reprinted by Drysdale's fellow-Malthusians Charles

Bradlaugh and Annie Besant,®® with his own editorial emendations, and H A

A llbutt's Wife's Handbook.®7 This may have had something to do with the fact that Elements was largely a work of philosophical, medical and political justification for the limitation of families by artificial means rather than a birth-control tract as such.

While the appeal of books such as Esoteric Anthropology was probably, as

Ellis remarked, "as a desirable source of information" on "these secret subjects",®8 matters of sex and conjugality were discussed among other more general problems relating to health, in the context of a hydropathic approach to human well-being. Other works were being issued during the later nineteenth century which set out specifically and exclusively to discuss the problems of sex and marriage. Two examples of these were

Sexual Physiology and Hygiene by R T Trail, MD,®9 and Confidential Talks with Husband and Wife by L B Sperry, AM, MD,®° both of which originated, like Nichols' work, in the USA, were published in the UK, and went into 43 numerous editions well into the twentieth century. In their emphasis on the marriage relationship and its right conduct they could be regarded as the precursors of the marriage manual as it had evolved by the 1920s.

Some themes can already be perceived emerging.

One of these was the importance of the wedding night, and the dangers that lay in wait there: Sperry warned

Many men also have found it one of the most delicate and important events in their own lives... Now is the time for the husband to show him self a man, instead of a selfish sensualist or a careless and ungovernable brute.®1

Another was the notion of sexual intercourse as an important part of the married relationship separate from its generative function:

the "total abstinence" admired by theorists ("except when pregnancy is desired") is apt to lead to indifference and formality, not to say actual coldness and irritation... An occasional sexual connection... unquestionably cultivates affectionate mutual regard and unselfish devotion according to Sperry;®2 and Trail agreed that

normally exercised, no act of an intelligent being is more holy, more humanising, more ennobling.®3

However, the problem of how much of th is could be perm itted was s t i l l one that taxed these writers: Sperry conceded

A moderate amount of sexual indulgence... is not perceptibly injurious to the normal husband or wife... but it is difficult to determine the exact limits of moderation.®* and would have Inclined to agree with Trail that

Between love and lust it may not always be easy to draw the line of demarcation... With the great masses of the people the only rule of conduct is appetite, and this is to a great extent morbid.®®

This idea of restraint had the concomitant idea that it was the husband who stood in more need of cultivating the trait: "it is seldom that sexuality should be nursed or cultivated in a man" was Sperry*s advice;®® 44 and if Trail believed that "married men are not always as sensual in character, nor as cruel in disposition, as they seem", he went on to deprecate the fact that

With many, sexual intercourse becomes a habit... and they indulge in it... reckless and thoughtless of its consequences to themselves or to their wives.®7

It followed from the above that, as Trail said

whatever may be the object of sexual intercourse... it is very clear that it should be as agreeable as possible to both parties... there shall be no sense of discord, no feeling of repugnance.®®

However, given this, both writers implied what Sperry actually stated:

it is not necessary to describe in detail the proper position for copulation, or the exact methods of procedure in exercising the sexual function.®®

It can be seen, therefore, that while adumbrating a new ideology of marriage relations, these writers still forbore to give any exact physiological instructions for rendering the act mutually pleasurable.

There was an assumption that providing the act were not abused or perverted, that the couple were in good health and not vitiated by the

corruptions of modern life, it would naturally be agreeable to both.

Indeed, there were reiterated warnings against the dangers of excess and sexual gluttony, citing their injurious effects; though these warnings may

be seen as connected to the constant cautions to the husband about the dangers of abusing his wife and injuring her health through selfishness and overindulgence.70 45

By the 1890s sex was gradually being more widely recognised as a legitimate subject for scientific study. Some years before the issue of the first volume of his own Studies in the Psychology of Sex. Havelock Ellis undertook to edit a series of small volumes intended to present aspects of contemporary scientific advance in a way accessible to the average intelligent reader: the Contemporary Science Series.71 Possibly by sheer coincidence, the first volume in this series was The Evolution of Sex by

Patrick Geddes and J Arthur Thomson. The biological approach of th is work looked at human sexuality in terms of "the fundamental unity underlying the Protean phenomena of sex and reproduction", but in spite of the authors' claim in the preface that they took up "an altered and unconventional view upon the general questions of biology",72 their attitudes towards the two sexes and their differences, and the implications of their work on ideas pertaining to sexual conduct, would seem to place them on a far less radical section of the spectrum to E1116 himself. Their work, being a cheap, and deliberately accessible volume, doubtless had a far wider circulation than Ellis's massive Studies, and moreover, probably accorded far more closely with prevalent ideas.

Underlying all their arguments was the belief in "the divergent evolution of the sexes", which they expressed in terms of "anabolic" or constructive and conservative energies, assigned by them to the female, and "katabolic" or disruptive and destructive energies, assigned by them to the male. To illustrate this thesis they drew examples from all of organic creation, in order to prove that "what was decided among the prehistoric protozoa cannot be annulled by Act of Parliament."73 It seemed to them

An average truth throughout the world of animals—The preponderating passivity of the females, the predominant activity of the males.7A 46

This alluded, in fact, to the cochineal insect, and was further illustrated by a description of the threadworm. The implications of this for humanity were:

strenuous spasmodic bursts of activity characterise men, especially in youth and among the less civilised races.75

the less nutritive, and therefore smaller, hungrier and more mobile organism... we call the male.76

as we should expect from the katabolic temperament, it ^ males which are especially liable to exhaustion... the temporarily exhausting effect of even moderate sexual indulgence is well known, as well as the increased liability to all forms of disease while the individual energies are thus lowered.77

a deep difference in constitution expresses itself in the distinctions between male and female, whether these be physical or moral.76

It is equally certain that the two sexes are complementary and mutually dependent... each is higher in its own way, and the two are complementary... It is generally true that the males are more active, energetic, eager, passionate and variable... The more active males, with a consequently wider range of experience, may have bigger brains and more intelligence... being usually stronger, have greater independence and courage... The stronger lust and passion of males is likewise the obverse of predominant katabolism... greater cerebral variability and therefore more originality... Man thinks more, woman feels more.76

Geddes and Thomson's views on evolution led them to look upon the neo-

Malthusian arguments for the limitation of offspring with some sympathy:

The survival of a species or family depends not primarily upon quantity, but upon quality. The future is not to the most numerous populations but to the most individuated.60 not merely for this consideration but for humanitarian reasons. However, their attitude to the employment of artificial birth control was ambivalent:

To many doubtless the adoption of a method which admits of the egoistic sexual pleasures, without the responsibilities of childbirth, would multiply temptations... On the other hand, it seems probable that the very transition from unconscious animalism to deliberate prevention of fertilisation, would tend 47

in some to decrease rather than increase sexual appetite.®1

Their own solution was

one of temperance... a large measure of that self-control which must always form the organic basis of the enthusiasm and idealism of lovers... a new ethic of the sexes... as a discipline of life.®2 and a social, as opposed to an individual, approach to the problem.

Thus, although these two authors declared that

It is now full time to re-emphasise, this time of course with all scientific relativity instead of a dogmatic authority, the biological factors of the case. ®3 their appeal to science did not seem to take them so very far from the teachings of "dogmatic authority".

The new sexology of the 1890s, however, is usually far more often associated with the development of discourses around the pathological and the deviant rather than the "normal", or with the appeal to the dictates of nature (as these were perceived in the light of post-Darwinian evolutionary biology) made by Geddes and Thomson. Opinions on this development differed. The British Medical Journal reviewer in 1893 said of

Krafft-Ebing's Psvchopathia Sexualis:

We have taken some time to consider whether to notice this book or not... There are many morally disgusting subjects which have to be studied by the doctor and by the jurist, but the less 6uch subjects are brought before the public, the better... the book may be valuable as a book of reference, but it is altogether one not to be left about for general reading.®*

In 1898 The Lancet commented upon the seizure and prosecution of Havelock

Ellis's Sexual Inversion

while we admit that the subject of sexual inversion has its proper claims for discussion we are very clear as to the propriety of limiting that discussion to persons of particular attainments... it is especially Important that such matters should not be discussed by the man in the street, not to 48

mention the boy and girl in the street.

Even though

A book written solely in a spirit of scientific enquiry into a subject which, though odious in itself, has yet to be faced, cannot possibly be included under the head of indecent lite ra tu re nevertheless

such a book may become indecent if offered to the general public with a wrong motive.6*®

The British Medical Journal, while more sympathetic towards Ellis in its comments:

It is true that no attempt has been made to advertise the book in any general way or to expose it for sale otherwise than in a technical sense. There is certainly nothing about the book itself, either . in its appearance or the manner in which the subject is treated, to pander to the prurient mind. also made the usual proviso that "the subject is extremely disagreeable" while conceding that it was

one of those unpleasant matters with which members of the medical profession should have some acquaintance.®®

Most of the medical discussion in the nineteenth and early twentieth century about sex was prefaced with similar rhetoric: that it was necessary to talk about thi6 horrible subject in order to be aware of its dangers, and that discussion was to be confined to the profession Itself.

In a multiple review of a group of books on sexuality and sexual problems in the British Medical Journal in 1902, however, the translation of the tenth edition of Psvchopathia Sexualis was described as

the most repulsive of a group of books of which it is the type... the reader is not spared the minutest and the most nauseous detail... we should prefer that the book should convey solace by being put to the most ignominious use to which paper can be applied.

The reviewer then proceeded, holding his nose, to consider Volumes I and II of Ellis's Studies in the Psychology of Sex: 49

many of the facts accumulated by Mr Ellis... are not interesting in themselves... they have... the additional disadvantage that they are in themselves disgusting and nauseous.

However, the reviewer was prepared to admit

it does not become members of the medical profession to object to dealing with filth for the purpose of elucidating a scientific principle or obtaining a valuable datum

and he went on to admire what he considered to be Ellis’s integrity and

honesty of purpose:

his scientific and explanatory discussions... are serious and honest attempts to deal with his subject... we must admit his honesty of purpose, and regret that it is not turned to better account.®7

It would seem that far from being stigmatised Ellis (once the Sexual

Inversion furore had died down) was regarded with a certain esteem by

fellow-members of his profession: in the same volume of the British

Medical Journal his book The Criminal was accorded a very favourable

review.®® In 1910, the Lancet’s reviewer could be found recommending Sex in

Relation to Society "to the medical world and to serious students of social

problems", and stating that

Mr Havelock E llis has become a scholar in his peculiar field, and has given the dignity of scholarship to a very delicate and difficult subject, and this is the proper method of treatment.

However, he did have considerable reservations about E llis's

recommendations to contemporary British bridegrooms about sexual

technique:

Even though ardent young husbands are apt to be too hasty and too clumsy in the introduction of their wives to the mysteries of the marriage bed, it is doubtful if the refinements in the ars amandi detailed in this chapter are desirable for general adoption.®®

E llis, like Acton before him, had become the acceptable medical man who had

taken on the unlovely task of dealing with sexual matters, to be held up 50 against quacks and foreigners like Krafft-Ebing. Studies in the Psychology of Sex were clearly the result of serious scholarly labours, and were produced in limited, expensive and hard to obtain editions, after the scandal over Sexual Inversion, even if Ellis also wrote works of a more popular nature.

Havelock Ellis (1859-1939), a man of considerable eccentricity and polymathic learning, had received what seemed to him a revelation of his life's work, to elucidate the mysteries of sex, while employed as a school­ teacher in a remote area of Australia. He regarded gaining a medical qualification as the necessary first step, a wise tactical move, and therefore returned to England to study medicine. After much trial he obtained the minimum qualification necessary for legitimate medical practice, the Licentiate of the Society of Apothecaries, in 1889, and abandoned practice after a very short time in order to devote himself to his life's work.30 He must be one of the few Licentiates of the Society of

Apothecaries ever to have become a Fellow of the Royal College of

Physicians, which honour he was awarded in 1938 shortly before his death.®1 This was doubtless partly due to the changing climate of sexual discussion by the 1930s:

CIt is] a measure of our change in outlook when we compare it [the prosecution of Sexual Inversion] with the respect now shown to the memory of Havelock Ellis.®2 by which decade the medical press was recommending Ellis's short compendium Psychology of Sex for use as a textbook in medical schools.®3

However, although, as J A Ryle wrote to the Lancet in 1943

Havelock Ellis was condemned in his earlier years for outspoken writings on sex, but those days are past and before he died he was acclaimed throughout the world as a philosopher in these matters to whom we owe a great debt.

Ryle went on to ask the pertinent question 51

How many practitioners, how many teachers of medical students, I wonder, have read his Psychology of Sex or Sex in Relation to Societyt or given serious thought to the teaching which in turn they might have given to others had they taken the trouble to inform themselves better in regard to one of our greatest problems in human betterment and social hygiene?3*

Ellis was a retiring man who found the adverse publicity associated with the confiscation of Sexual Inversion a devastating blow. While he had wide and international contacts of friendship and common interest, this early set-back led him to withdraw from engagement in public controversies and to devote himself to the work of scholarship. His own sex-life seems to have been somewhat unorthodox; he was a urolagnist and while he had numerous amorous friendships with women, besides being married twice (the first time to the predominantly lesbian Edith Lees) it would appear that none of these were fully consummated before, at the age of 59, a time of life when most men tend to find their sexual powers fading, he achieved full congress with his second (common-law) wife. Nevertheless (or perhaps as a result) he seems to have exercised a charismatic effect over the women who associated with him, many of them intellectuals and social reformers in their own right.9®

Besides his monumental Studies in the Psychology of Sex. Ellis produced volumes of essays and travel writings and literary work; he was the editor of the Mermaid Series of te x ts of Elizabethan and Jacobean dram atists. His

Studies9® were a vast compilation of material drawn from an enormous variety of sources, from medical writings, the researches of anthropologists, the work of biologists, literature from many countries, and the self-disclosures of individuals about their own sexual experiences.

If this work could be said to have one underlying theory it was that all 52 sexual behaviour lay somewhere upon a continuum, that the "perverse” was often the exaggeration of normal tendencies, and that one of the highest virtues was liberal toleration for difference. Thus in spite of Ellis's sympathies towards such contemporary movements as eugenics he was very chary of anything in the nature of compulsory measures.

Like his friend and colleague Edward Carpenter, Ellis was someone who explicitly associated himself with a "progressive" sexual programme, and was a founder member of the British Society for the Study of Sex

Psychology. This movement was more concerned about the sexual rig h ts and wrongs of women and the amelioration of the harsh legal system vis-a-vis persons of "deviant" desires than it was about the normal male, whose

I sexual impulse had been described by Ellis as predominantly open and| aggressive", its nature and needs inscribed "in the written and unwritten codes of social law."97 To a great extent the normal male was perceived as being part of the problem, depicted as insensitive and clumsy, his 6exual technique compared to an ape endeavouring to play the violin.

However, while Ellis is mainly remembered for his contribution to studies of the sexually anomalous and his depiction of the vast range of sexual behaviour, a number of his works also dealt with problems affecting the

"normal". In his essays and pamphlets he dealt with subjects such as marriage, eugenics, motherhood, in a fashion pointing to the philosophy of a changed and more egalitarian relationship between the sexes which lay behind most of the marriage manuals of the 1920s and 1930s. Two volumes of the Studies in particular bore on matters which might be assumed to affect most men, though Volume IV, The Sexual Impulse, dealt mainly with that of the female, Ellis's comments on that of the male have already been 53

quoted in the Introduction. In Auto-Erotism, part of Volume I of Studies in

the Psychology of Sex, first published in 1899 (as Volume II), Havelock

E llis turned a radically c ritic a l gaze on the received wisdom concerning

masturbation, and commented

It seems to me that this field has rarely been viewed in a scientifically sound and morally sane light, simply because it has not been viewed as a whole. We have made it difficult so to view it by directing our attention on the special group of auto-erotic facts—that group included under masturbation— which was most easy to observe and which in an extreme form came plainly under medical observation in insanity and allied conditions... The nature and evils of masturbation are not seen in their true light and proportions until we realize that masturbation is but a specialized form of a tendency which in some form or in some degree affects not only man but all the higher animals.s,e

Ellis went on to explode many of the contemporary myths surrounding auto­

erotic practice: that it was inevitably physically, mentally, or morally

debilitating, that it was a uniquely human trait, and that it was a sad

side-effect of civilisation:

To whatever extent masturbation may have been developed by the conditions of European life, which carry to the utmost extreme the concomitant stimulation and repression of the sexual emotions, it is far from being, as Mantegazza has declared, one of the moral characteristics of Europeans. It is found among the people of nearly every race of which we have any intimate knowledge, however natural the conditions under which men and women may live.99

He was by no means alto g eth er in favour of deliberate m asturbatory

practices, considering that they might

[produce] a divorce... between the physical sensuous impulse and the ideal emotions100

a possible outcome which Sigmund Freud also suggested might eventuate

since

in the phantasies that accompany satisfaction the sexual object is raised to a degree of excellence which is not easily found in real life.101

Ellis also echoed numerous writers on the subject by attributing, at least

to the persistent and habitual masturbator, the traditional 54

morbid heightening of self-consciousness without any co­ ordinated heightening of self-esteem.102

Yet he also suggested that boys might well be more inclined than girls to internalise very negative attitudes towards masturbation, through encountering prevalent attitudes that it was an "unmanly" practice, and by coming across terrifying quack literature

Volume VI of the Studies. Sex in Relation to Society. 1910, was the one in which Ellis, as much a6 he ever did, summed up his own views on the problems of sexuality, within the context of society as it existed at the time. As has been noted above, the volume met with critical approval. The comment of the Lancet reviewer on the subject of "refinements of thears ama/id-T'103 in the recommendations to bridegrooms may have raised hopes of something much spicier than can actually be found in the relevant chapter: in comparison with marriage advice manuals of even a decade later this chapter seems tame indeed, almost as obfuscatory as Sperry or Trail as far as practical recommendations go. 55

It was in this work that Ellis gave a description of the English (middle- class) male's attitude to erotic matters which was far more subtle than the usual description of him as an ape endeavouring to play the violin, while nevertheless making it quite clear why this accusation was so often made:

They have been taught to be strenuous and manly and cleanminded, to seek by all means to put out of their minds the thought of women or the longing for sensuous indulgence. They have been told on all sides that only in marriage is it right or even safe to approach women. They have acquired the notion that sexual indulgence and all that appertains to it is something low and degrading, at the worst a mere natural necessity, at the best a duty to be accepted in a direct, honourable and straightforward manner. No-one seems to have told them that love is an art.lc,A

Reading this, it is no longer surprising that Marie Stopes could claim to have discovered a positive epidemic of premature ejaculation among middleclass British men.los One thing particularly notable about Ellis's writings here is his concern about the relationship, as opposed to earlier

Victorian writers who tended to regard the male as a creature whose prime aim was to preserve himself from unduly wasting vital bodily fluids, a kind of self-contained and isolated mechanism.

The most radical thinker on sexual matters at this period was undoubtedly

Sigmund Freud. His Three Lectures on the Theory of Sexuality1 og were an epoch-making contribution to the study of the subject, however, it is by no means clear how influential this particular work of his was in Britain. The

Three Lectures do not seem to have been reviewed in the British Medical

Journal or the Lancet e ith e r on th e ir f ir s t appearance in 1905 in German, or later, when English translations were published.

Freud began the first lecture, on "The Sexual Aberrations" with a description of popular received ideas of the sexual instinct: 56

...absent in childhood* to set in at the time of puberty in connection with the process of coming to m aturity and to be revealed in the manifestations of an irresistible attraction exercised by one sex upon the other; while its aim is presumed to be sexual union.

His own conclusion, however was,

that these views give a very false picture of the true situation.107

and further on, in a footnote, he went so far as to maintain

From the point of view of psychoanalysis the exclusive sexual interest felt by men for women is also a problem that needs elucidating and is not a self-evident fact based upon an attraction that is ultimately of a chemical nature.10®

This was, still is, so extremely contrary to received ideas and attitudes

it is perhaps not surprising that later writers, while making a token

obeisance to Freud's great work in elucidating the mysteries of the psyche,

far from wrestling with the implications of this notion of sexuality,

applied "Freud" like icing to the same old cake. Weeks has suggested

not that Freud was buried but that his work became encrusted with the immensely strong, biologically orientated theories of sex u ality .10®

in the process of the assimiliation of his ideas within British traditions.

Freud's ideas on innate bisexuality, his conflation of the "perverse" with

the "normal", his recognition that

the sexual instinct and the sexual object are merely soldered together11°

(in spite of such continued allegiance to biological determinism as his

comment that "the sexuality of most male human beings contains an element

of aggressiveness*'") are so different from the accepted discourses, so

subversive in their implications, that, while his work was recognised as

important, perhaps the only way it could have been assimilated at all was by undergoing mutation and misrepresentation. 57

Freud's teachings and those of his school in general were regarded with a good deal of suspicion by the British medical establishment, and it is, indeed, something of a clich6 that the ideas of psycho-analysis were not accepted in any great degree until they were found of use in the abreactive treatm ent of shell-shock during World War I. Even then, W H R

Rivers, in his ground-breaking article in the Lancet in 1917 on the uses of psychoanalysis and Freud's concepts, explicitly deplored the overemphasis on sex and its role in the aetiology of neurosis, which he attributed rather to over-enthusiastic disciples than Freud himself.112

Freud's ideas continued to come in for a certain amount of derision. At the

79th Annual Meeting of the Medico-Psychological Association in August

1920, at which a number of speakers paid trib u te to the work of Freud and the therapeutic value of psychoanalysis, Sir Robert Armstrong-Jones

declared his belief that Freudism was dead in England today. When that system first came to light he regarded it as probably applicable to life on the Austrian and German fro n tiers, but not to virile, sport-loving open-air people like the British.

But even the speakers who praised Freud tended to deny to

sex tendencies... anything like the universality claimed by Freud's disciples. though Dr R G M Ladell, while he agreed

That on first becoming acquainted with Freudianism it seemed repulsive... went on to maintain th at

on proceeding to study it and on submitting oneself to analysis one was forced to the conclusion that Freud was justified in his contention that these tendencies did exist.113

Freud's writings were of course copiously cited by Ellis. In their 1914

Home University Library volume on Sex Geddes and Thomson displayed an acquaintanceship with his ideas.11* Arthur Cooper, author of Sex 58

Disabilities of the Male (1908), in later editions referred to works by

Freud.1 1B By the 1920s watered-down Freudianism made its appearance in popular manuals of sex education and advice, in combination with the old elements found in such works, which sat uneasily with the new Jargon of

"repressions1'. A certain lip-service was paid to his doctrines without consideration of their profounder implications.

By about 1920, therefore, there was a multitude of differing ideas about sex in the air. The old ideas conveniently epitomised by the name of

William Acton were by no means dead. Writers such as Ellis and Freud were known to a few at least, though how wide a circulation their ideas, as opposed to popular notions of their views, had is a very moot question, and it is indeed likely that they were more appreciated among certain sections of the lay public than among the medical profession. There was a new emphasis on mutual pleasure in marriage, and an idea abroad that sex in marriage was perhaps not simply something to be indulged either infrequently for the purposes of reproduction, or more frequently for the gratification of the husband alone. The decline of the birth-rate from about 1870 suggested th at by some means or other married couples were limiting their families. The social role of woman was changing. World War I had produced profound alterations in society. The discovery of Salvarsan gave a new therapeutic optimism to the possibility of curing, as opposed to merely preventing, venereal diseases. While "Victorianism" was very far from being dead, new ideas about sexuality which had been known and discussed in certain limited circles from the 1890s were gaining a far wider currency. 59

Chapter One: Notes

1. Marcus, Steven, The Other Victorians: A Study of Sexuality and Pornography In Mid-Nineteenth Century England. Weidenfeld and Nicholson, London 1966; 1970 Book Club Associates edition, pp 1-33, Chapter One "Mr Acton of Queen Anne S treet, or, The Wisdom of our Ancestors”

2. Smith, F B, The People’s Health. 1830-1910. Croom Helm, London, c. 1979, Section 4, Adults, Part 4, "Venereal Diseases, Contraception and Sexuality", pp 294-315

3. Peterson, M Jeanne, "Dr Acton's Enemy: Medicine Sex and Society in Victorian England", Victorian Studies. 1986, Vol 29 no 4, pp 569-590

4. Smith, op cit; Peterson, op cit; Gay, Peter, Education of the Senses: The Bourgeois Experience. Victoria to Freud. Volume I. Oxford University Press, New York, 1984; also Smith, F B, "Sexuality in Britain, 1800-1900: Some Suggested Revisions", in Vicinus, M, A Widening Sphere: Changing Roles of Victorian Women, pp 182-198; Peterson, M Jeanne, "No Angels in the House: The Victorian Myth and the Paget Women", American H istorical Review. 1984, Vol 89 no 3, pp 677-708

5. in E llis, Havelock, The Erotic Rights of Women and The Objects of Marriage. British Society for the Study of Sex Psychology, Publication no 5, London, 1918, p 9

6. The Lancet. 1862, i, 518

7. Proceedings of the Royal Medical and Chirurgical Society of London. 1876, Vol VIII no 1, pp 74-76

8. Acton, William, The Functions and Disorders of the Reproductive Organs in Youth. Adult Age and Advanced Life, considered in their Physiological. Social and Psychological Relations. John Churchill, London, 1857, 3rd edition 1862, p vii

9. ibid. p 98

10. ibid. p 138

11. Smith, The People's Health, p 295

12. Cominos, Peter T, "Late Victorian Respectability and the Social System", International Review of Social History. 1963, Vol 8, pp 18-48, 216- 250

13. Acton, op cit. p 74

14. Peterson, "Dr Acton's Enemy"

15. Paget, Sir James, "Sexual Hypochondriasis", Clinical Lectures and Essays. Longmans Green, London, 1875, 2nd edition, 1879, pp 275-298

16. Copland, James, A Dictionary of Practical Medicine: comprising general pathology, the nature and treatment of diseases, morbid structures and the disorders especially incidents to climates, to the sex, and to the different 60 epochs of life. Longmans, London, 3 vols in 4 1844-1858, "Pollutions", pp 441-448

17. British Medical Journal. 1881, ii, 904

18. The Lancet. 1930, i, 1187

19. La’mert, Samuel, Self-Preservation; A Medical T reatise on Nervous and Physical Debility. Spermatorrhoea. Impotence and Sterility, with Practical Observations on the Use of the Microscope in the Treatment of Diseases of the Generative System. London, c. 1850s-1860s, "64th edition" "Published by the Author and sold at all Booksellers": contains credentials pertaining to La'mert's career and qualifications. His licence (1833) to practice as an apothecary is to be found in the registers of Licentiates of the Society of Apothecaries held in the Guildhall Library, ref Guildhall Mss 8241/6, 8241B/1; he had qualified through apprenticeship

20. BML 1863, i 567, ii 586-587; The Lancet 1863, ii, 634-635

21. The Lancet. 1862, i, 518-519

22. ibid. 1857, i, 556-557

23. Wilson, Marris, On Diseases of the Vesicula Seminales and th eir Associated Organs, with Special Reference to the Morbid Secretions of the P rostatic and U rethral Mucous Membrane. London, 1856; reviewed in The Lancet. 1856, i, 289-290

24. The Lancet. 1856, ii, 215-217, 300-303, 482-484, 643-644, 1857, i, 376-377

25. ibid. 1856, ii, 644

26. La’mert, op cit. p 23

27. ibid. Introduction, p ix

28. The Lancet. 1857, i, 556-557

29. ibid. 1862, i, 518-519

30. for example, The Lancet. 1870, i, 880, 889, ii, 89-90, BMJ. 1879, i. 823-824

31. The Lancet 1870, ii, 89-90, 124-124, 159-160, 224-225

32. ibid. 1857, i, 556-557

33. ibid. 1870, ii, 159

34. ibid. 1857, ii, 537

35. Fowler, 0 S, Creative and Sexual Science; or. Manhood. Womanhood and their mutual interrelations; Love, its laws, power, etc; selection, or mutual adaptation; courtship, married life and perfect children: their generation, endowment, paternity, maternity, bearing, nursing and rearing; together with 61 puberty, boyhood, girlhood, etc. sexual Impairments restored, male vigour and female health and beauty perpetuated and augmented, etc. as taught by phrenology and physiology. New York, 1870, later edition (published by 0 S Fowler), n.d. c 1900, pp 603, 620

36. ibid, pp 801-804

37. Nichols^ T L, E soteric Anthropology (The Mysteries of Man) A comprehensive and confidential treatise on the structure, functions, passional attractions, and perversions, true and false physical and social conditions and the most intimate relations of men and women. Anatomical, physiological, pathological, therapeutical and obstetrical. Hygienic and Hydropathic. From the American Stereotype Edition. Revised and Rewritten. Published by Dr Nichols at the Hygienic In stitu te , Museum St, London WC, n d Cc. 18733

38. Cominos, op cit

39. Nissenbaum, S, Sex. Diet and Debility in Jacksonian America: Sylvester Graham and Health Reform. Westport, Connecticut, and London, 1980, pp 158 173, discusses Nichols and his wife Mary Gove Nichols in the context of health reform and free love movements in the USA, and explores the contradictions inherent in their "free love" stance.

40. E llis, Havelock, review a rtic le in Reynolds News. 26 Apr 1936, E F Griffith's press-cuttings scrapbook, CMAC: PP/EFG/A.41; he expressed a similar opinion about the dissemination of this work among the more respectable part of the population in Eonism and Other Supplementary Studies. Vol VII of Studies in the Psychology of Sex, F A Davis Co, Philadelphia, 1928, p 156

41. Hartmann, Mary, Victorian Murderesses: A True History of Thirteen Respectable French and English Women Accused of Unspeakable Crimes. Schocken Books, 1977, Robson Books paperback, London, 1985, mentions th is on p 185, and that Adelaide Bartlett had actually consulted Mary Gove Nichols, p 200. I am indebted to Heather Creaton of the Institute of Historical Research, London, for drawing my attention to the part played by the Nicholses and Esoteric Anthropology in one of the most famous of Victorian murder cases.

42. Nichols, op cit. p 115

43. ibid. p 120

44. ibid. p 119

45. ibid. p 114

46. Drysdale, George, Elements of Social Science: or physical sexual and natural religion, an exposition of the true cause and only cure of the three primary social evils: poverty, prostitution, and celibacy, by a doctor of medicine. E Truelove, London, 1854 (anonymously), G Standring, London, 1905 pp 80-81

47. ibid. pp 78, 87 62

48. Grosskurth, Phyllis, Havelock Ellis: A Biography. Allen Lane, London 1980, p 39

49. Lyttelton. Hon E, The Causes and Prevention of Immorality in Schools. Social Purity Alliance, printed for private circulation, 1887, p 15

50. ibid. p 18

51. Drysdale, op cit. pp 77-78

52. ibid. p 78

53. ibid. p 88

54. ibid. p 125

55. Ellis, Havelock, Sex in Relation to Society. Studies in the Psychology of Sex, Vol VI, Philadelphia, 1910, William Heinemann Medical Books, London, 1937, War Economy edition, 1946, p 356

56. Knowlton, C, F ruits of Philosophy: An essay on the population question, new edition, with notes (first published in the USA 1847) edited by G Drysdale, printed by Charles Bradlaugh and Annie Besant, the Freethought Publishing Co, London, C18771; for an account of the trial of this work see Chandrasekhar, S, UA Dirty Filthy Book": The writings of Charles Bradlaugh and Annie Besant on reproductive physiology and birth control, and an account of the Bradlaugh-Besant trial. Berkeley, California, 1981

57. Allbutt, H A, The Wife's Handbook; How a Woman Should Order Herself during Pregnancy, in the Lying-In Room, and After Delivery. With Hints on the Management of the Baby, and Other M atters of Importance Necessary to be Known by Married Women. W J Ramsay, London, 1886; for an account of the trial see BMJ. 1889, i, 270, ii, 1162-1163, 1221-1222. In spite, or perhaps because, of this notoriety, this work had gone into over 40 editions by the time of the F irst World War, and was s till, according to Himes, Norman E, The Medical History of Contraception. Williams and Wilkins Co, Baltimore, 1936, widely available in the 1930s, p 326n

58. vide supra, note 40

59. Trail, R T, Sexual Physiology and Hygiene: An exposition practical, scientific, moral, and popular of some of the fundamental problems in sociology. 1st edition c. 1888, T D Morison, Glasgow and Simpkin, Marshall, Hamilton and Kent Co, London, 1908

60. Sperry, Lyman Beecher, Confidential Talks with Husband and Wife: A Book of Information and Advice for the Married and the Marriageable. Oliphant Anderson and Ferrier, London and Edinburgh, 1900

61. Sperry, op cit. pp 105-106

62. ibid. p 119

63. Trail, op cit. p 226

64. Sperry, op cit. p 113, 63

65. Trail, op cit. p 222

66. Sperry, op cit. p 119

67. Trail, op cit. p 232

68. ibid, p 234

69. Sperry, op cit. p 110

70. e.g. ibid. pp 117-120: Trail, op cit, p 226

71. Grosskurth. op cit. pp 114-115 72. Geddes, Prof. Patrick, and Thomson. J Arthur. The Evolution of Sex. The Contemporary Science Series, edited by Havelock Ellis, Walter Scott, London 1889. Introduction to the 2nd edition, 1901, p v (the f ir s t edition only said "such unity as our present knowledge renders possible").

73. ibid (1st edition, 1889), p 267

74. ibid. p 17

75. ibid. p 18

76. ibid. p 117

77. ibid. p 257-258

78. ibid. p 267

79. ibid. pp 270-271

80. ibid. p 295

81. ibid. p 296

82. ibid. p 297

83. ibid. p 269

84. BMJ 1893, i. 1325-1326; Kraf ft-Ebing, Richard von, Psvchopathia Sexualis: with especial reference to the antipathetic sexual instinct. A medico-forensic study, f ir s t published in German, 1886, f ir s t English edition 1893, numerous subsequent editions, Staples Press, London, 1965 (based on 12th German edition)

85. The Lancet. 1898, ii, 1344-1345. "The Question of Indecent L iterature"

86. BMJ, 1898, ii, 1466

87. BMJ, 1902, i. 339-340

88. BMJ, 1902, i, 1154

89. The Lancet. 1910, i, 1207 64

90. cf Grosskurth. op cit

91. Lives of the Fellows of the Royal College of Physicians ("Munk's Roll"), Vol V, p 121, and obituaries in the BMJ, 1939, ii, 203-204, and The Lancet. 1939, ii, 164-165, 229

92. The Lancet. 1939, ii, 164

93. The Lancet. 1933, i, 1348; BMJ, 1933, i, 1057

94. The Lancet. 1943, i, 415

95. cf Grosskurth, op cit; she is inclined to doubt that Ellis achieved the full consummation of his relationship with Francoise Delisle, but Arthur Calder-Marshall, in Havelock Ellis: A biography. Rupert Hart-Davis, London 1957, seems to accept Mme D elisle's account. The exact nature of E llis's sexual failings is by no means clear; Grosskurth, p 285, suggests that he suffered from a combination of "incomplete development", and perhaps premature ejaculation, and would apparently imply that his high-pitched voice was the sign of hormonal deficiencies.

96. Studies in the Psychology of Sex: Volume I: The Evolution of Modesty: The Phenomena of Sexual Periodicity: Auto-Erotism. Leipzig and Watford, 1899, F A Davis Co, Philadelphia 1900, 3rd edition 1910, Random House, New York, omnibus edition, Volume I, 1936 Volume II: Sexual Inversion (with J Addington Symonds), London, Wilson and Macmillan, 1897 (withdrawn), F A Davis Co, Philadelphia, 1901, 3rd edition 1915, Random House, New York, omnibus edition, Volume I, 1937 Volume III: The Analysis of the Sexual Impulse: Love and Pain: The Sexual Impulse in Women. F A Davis Co, Philadelphia, 1903, Random House, New York, omnibus edition, 1937 Volume IV: Sexual Selection in Man. F A Davis Co, Philadelphia, 1905, Random House New York, omnibus edition, 1937 Volume V: Erotic Symbolism: The Mechanism of Detumescence: the Psvchic State in Pregnancy. F A Davis Co, Philadelphia, 1906 Volume VI: Sex in Relation to Society. F A Davis Co, Philadelphia, 1910, f ir s t English Edition, William Heinemann Medical Books, 1937, War Economy edition, 1946 Volume VII: Eonlsm and Other Supplementary Studies. F A Davis Co, Philadelphia, 1928

97. E llis, Havelock, Analysis of the Sexual Impulse: Love and Pain: The Sexual Impulse in Women, p 189

98. E llis, Havelock, The Evolution of Modesty; The Phenomena of Sexual Periodicity; Auto-Erotism., p 98

99. ibid. p 166

100. ibid. p 261

101. Freud, Sigmund, "'C ivilised' Sexual Morality and Modern Nervous Illness", first published in German 1908, English translation, Standard Edition, 1959, included in Civilisation. Society and Religion. Pelican Freud Library 12, Harmondsworth Middlesex, 1985, pp 33-55; ref to p 51 65

102. E llis, Havelock, The Evolution of Modesty: The Phenomena of Sexual Periodicity: Auto-Erotism, p 263

103. The Lancet. 1910, i. 1207

104. Ellis, Havelock, Sex in Relation to Society, p 310

105. Stopes, Marie, Enduring Passion: Further New Contributions to the Solution of Sex Difficulties being the continuation of Married Love. GP Putnams Sons, London 1928, 2nd edition 1929, p 76

106. Freud, Sigmund, Three Lectures on the Theory of Sexuality ('The Sexual Aberrations", "Infantile Sexuality", "The Transformations of Puberty"), first German edition, Leipzig and Vienna, 1905, English translation by James Strachey for the Standard Edition. 1952, included in On Sexuality. Pelican Freud Library 7, Harmondsworth Middlesex 1977

107. ibid. p 45

108. ibid. p 57n

109. Weeks, Jeffrey, Sex. Politics and Society: The regulation of sexuality since 1800 (Themes in B ritish Social History), Longmans Group Ltd, London, 1981, p 156

110. Freud, Three Lectures. 59

111. ibid. p 71

112. The Lancet. 1917, i, 912-914

113. The Lancet. 1920, ii, 404

114. Geddes, Prof. Patrick, and Thomson, J Arthur, Sex. Home University Library, Williams and Norgate, London, 1914, pp 118, 138, 144, 150

115. Cooper, Arthur, The Sexual Disabilities of Man and Their Treatment. H K Lewis, London, 1908, 3rd edition 1916, pp 78, 182 66

Chapter Two

Diseases* Dangers, and Double Standards

In the previous chapter various ideas on sex and in particular on the nature of male sexuality, prevalent during the later nineteenth century, were discussed. These ideas did not exist within a vacuum: they were generated within a social context in which venereal diseases were rampant and widespread and in which prostitution was rife. It was not until the turn of the century that syphilis and gonorrhoea could be reliably diagnosed and it was not until 1909 that Paul Ehrlich produced a cure for syphilis with the discovery of Salvarsan. Prior to this treatment of syphilis had used mercury, which although it did sometimes effect a cure if applied early enough after contracting the disease, had side-effects which were extremely deleterious. It was however inefficacious in the treatment of gonorrhoea. Syphilis was the more serious disease, being implicated in many mortal conditions, and afflicting the children of the victim with congenital syphilis. Even so it was not until the discovery of the causative organism, the spirochaete, and the rise of the Vasserman diagnostic test, that it became apparent how widespread the long-term effects of syphilis were as its relationship to such conditions as General

Paralysis of the Insane arising many years after the initial infection was finally established. The morbidity arising from syphilis was perceived as not merely an individual but as a national problem. Gonorrhoea, though apparently less serious, was almost certainly more widespread, and apart from its effect upon its victims, was implicated as a major cause of sterility in women, many of whom were unaware that they had been infected by their husbands. The prevalence of these diseases was greater among 67 the male population than the female, according to such statistics as the

Royal Commission on Venereal Diseases, 1913-1916, was able to discover.

This imbalance was largely due to the double standards of sexual morality, according to which sexual laxity was excusable in men, and even a physiological necessity, but chastity in women was imperative. The concomitant of this was the existence of a class of socially shunned prostitutes to cater for "male lusts" who were often depicted as reservoirs of disease polluting society.

In this chapter, the attitudes to the male embodied in ideas about venereal disease and prostitution from the repeal of the Contagious

Diseases Acts to the years immediately after the First World War will be considered, along with changes in social attitudes.

The venereal diseases were stigmatised complaints. Many voluntary hospitals would not admit patients suffering from them,1 and T J Wyke in an article on the Manchester and Salford Lock Hospital between 1818 and

19172 has indicated that even in the eighteenth century this was so, and that there was an unwillingness among subscribers to hospitals to contribute for what were perceived as "undeserving" cases, although the

"innocently" infected might be admitted as in-patients for treatment.

Friendly Societies usually refused to pay sickness benefits to subscribers with venereal disease.3 Wyke has pointed out that the Annual Reports of the Manchester Lock Hospital, founded specifically for sufferers from venereal disease, were explicit about the attitudes to the diseases which affected the public image of the Lock Hospital:

Many people considered the disease as self-inflicted, a justified penalty for sexual immorality and that those infected were not 68

worthy of charitable assistance.A

It is clear that these attitudes were in existence well before the

Victorian era. Attempts were made to de-stigmatise the enterprise by emphasising that the hospital dealt with non-venereal skin diseases as well, and by stressing that reformative attempts were made in connection with female in-patients: these would chiefly have been prostitutes, and

there were close connections between the Manchester Lock Hospital and the

Manchester and Salford Asylum for Female Penitents. It is however clear

that the stigma associated with these diseases also affected male sufferers and the provisions for their treatment.

It may be queried, as Wyke has done, whether the treatment in Lock

Hospitals had any therapeutic benefits at all. Syphilis is characterised by

long asymptomatic stages and a patient whose gonorrhoea has passed the

stage of acute symptoms can continue infectious. One of the arguments put

forward in criticism of the medical efficacy, as opposed to the ethical

aspect, of the Contagious Diseases Acts, pointed to the difficulty of

diagnosis of venereal diseases and the impossibility of determining

whether a case was infectious, particularly since this was especially hard

to discover in women.

The Contagious Diseases Acts <1864, 1866, 1869) and the agitation against

them have been extensively discussed by h isto rian s.6 They were regarded at

the time as giving the sexual double standard the force of law by setting

up a system which endeavoured to provide clean prostitutes for members of

the armed forces by the compulsory inspection of women alleged to be

prostitutes in certain designated garrison and naval towns. It should be

borne in mind, however, that this provision was aimed specifically at 69 maintaining in fighting health a group of the population which consisted almost entirely of unmarried men drawn from the lower social classes, a group in itself often stigmatised in that "going for a soldier" tended to be perceived as a disgrace.15 Fears of what might happen if this dangerous group did not have its sexual needs provided for focussed on unbridled anarchy and the dangers to respectable women if suitable outlets for the

"brutal and licentious soldiery" were not supplied.

Furthermore, almost as soon as the acts were passed, in spite of the somewhat surreptitious way this was done, there was considerable opposition which did not come from one sex alone. Men too, on grounds of moral outrage as well as the protection of civil liberties, objected to this state regulation of immorality; objections which did not come only from the middle and educated classes but from working men. It would therefore seem that there was far from monolithic support in Victorian

Britain for the idea of a double standard of sexual morality and the notion that prostitution was a necessary social evil to be granted official legal recognition.

The Contagious Diseases Acts attempted to deal with the problems of venereal disease by endeavouring to control the source, as prostitutes were perceived. The Acts were inspired by the regulationist systems which existed in continental Europe, but as has been pointed out above, were only, even at their height, in force in certain designated towns, and bore almost exclusively upon women of the working classes. While there was considerable medical support for this mode of containing the problem, which was seen as conforming to the public health model, doubts were expressed as to the medical soundness of providing for the treatment of only one 70 partner in the sexual transaction. Historians of Victorian sexuality have often cited the statement of the 1871 Royal Commission on the Contagious

Diseases Acts that

We may at once dispose of [any recommendation] founded on the principle of putting both parties to the sin of fornication on the same footing by the obvious but no less conclusive reply that there is no comparison to be made between prostitutes and the men who consort with them. With the one sex the offence is committed as a matter of gain; with the other it is an irregular indulgence of a natural impulse.7 but this opinion should not be taken as monolithic or uncontested. In the previous chapter the emphasis placed by many writers on the importance of male continence has been demonstrated, and there were many men who in their own lives specifically rejected this assumption of the double standard: the physician Hermann Weber (1828-1918) wrote in his book On

Longevity and means for the prolongation of life that

In my youth I have been intimately acquainted with a small band of young men who recognised the unsatisfactory social position of women as compared to that of men, and especially so in regard to sexual relations. They considered it unjust that young, unmarried men were allowed to have free sexual intercourse with women without losing their position in society, while a young woman after such a lapse would be expelled from it. They, therefore, resolved to be as chaste as they expected their future wives to be. I have reason to know that these men have carried out their resolution.®

(It is not however clear whether he was referring to his youth in Germany, or his experience in England to which he came in his twenties). However, whatever the feelings of individuals or particular groups within society it is true that the double standard was enshrined in law not only by the

Contagious Diseases Acts but in the Divorce Law of 1857, under which a husband could divorce his wife for a single act of adultery whereas a woman had to prove aggravated adultery—adultery plus bigamy, cruelty, desertion, incest, rape or unnatural offences—in order to obtain a decree. 71

It is clear that a much higher premium was placed upon female than upon male chastity.

However, while fornication might not exile a man from decent society, it would not appear that venereal diseases in the male were regarded as any less of a stigma or less shameful than they were in women. Voluntary and teaching hospitals did not discriminate by gender when banning venereal patients from their wards.5* Flexner, however, in Prostitution in Europe mentioned an unnamed London Hospital whose ru les precluded the treatm ent of unmarried women with venereal disease while permitting that of unmarried men—he does not explicitly say, but it seems implicit from the context, that this referred to in-patient treatment, and so may have been motivated by a consideration for the feelings of the other female in­ patients. Anyway it would appear to have been very much an exception from the usual total exclusion of such cases.10

The subject of venereology was not taught as part of the undergraduate medical syllabus,1 1 but could be acquired only by postgraduate study.

Harrison suggested that

The financial rewards of private practice in venereology were large indeed: I have heard that one large teaching hospital in London was founded by a surgeon on the large fortune he acquired from his VD p a tie n ts.12

Enormous though these rewards might be, medical p ractitio n ers tended to shrink from the stigma of the quack that hung about the treatment of venereal diseases. Because the diseases were not admissible to voluntary hospitals for gratuitous treatment, and because most Friendly Societies , would not pay sick benefit for venereal afflictions,13 (although in some cases they were certificated euphemistically so that benefit could be 72 applied for),14 many cases must have either gone untreated or been attended to by unlicensed practitioners of various kinds, as the Royal

Commission in its Report of 1916 acknowledged:

The fear of disgrace and the consequent desire for concealment necessarily render the sufferer from venereal disease specially liable to attempt self-treatment, or to entrust his treatment to persons who are in no way qualified to deal with the disease.1®

It was not merely inability to pay which led individuals to seek unqualified assistance: as the Royal Commission on Venereal Diseases pointed out "the upper classes resort to quacks as readily as the poor",1® which was attributed to "shame or because they are misguided by advertisement or misleading recommendations."17 This prevalence of quack treatment of venereal disease had been confirmed by the Report as to the

Practice of Medicine and Surgery by Unqualified Persons in the United

Kingdom presented to Parliament by the Local Government Board in 1910.

This had discovered that

In many of the great towns the treatment of venereal diseases is largely in the hands of unqualified persons.

This was expanded upon:

Chemists, qualified and (more frequently) unqualified, and herbalists undertake this class of work. Many so-called specialists in venereal diseases have sprung up... [they] often acquire a great reputation, though entirely ignorant of medicine1 s

Individual Medical Officers of Health in their reports to the Local

Government Board on the situation in their localities deplored the "faulty diagnosis and treatment" this state of affairs brought about.

No details were given of the kind of treatment such practitioners supplied.

It may well have been more gentle than sufferers from gonorrhoea would have received from their orthodox medical practitioner: L W Harrison was of the opinion that 73

In Gonorrhoea I believe that prior to 1909 more damage was being done by the treatment than by the disease. Silver nitrate and organic compounds of silver were the great standby, and the strengths of the former were really terrible.19 a contention borne out by the comments of R V Rajam in his article on

"Progress in the Treatment and Control of Venereal Diseases":

Local treatment of [gonorrhoea] held the field during this period with irrigations using a multitude of chemicals, instillations of concentrated dye-stuffs, and vigorous instrumentations of the poor long-suffering urogenital mucous membrane... the cure was long, laborious and painful and a sensitive patient after having gone through the whole gamut of therapeutic procedures would never think of contracting the infection again.20

Harrison commented on the prevalence of u reth ral s tric tu re consequent upon this heroic practice.21

E T Burke, writing in the 1920s on the problems of venereal diseases, commented

Until within very recent times the subject lay in the gutter, battened on only by the quack and the charlatan... in Great Britain the subject has scarcely been taught in medical schools: it has been too often regarded as a "side-line" to other specialities, tinkered at by all and sundry, from chemists in back-streets to dermatologists.22

In Treatment of Venereal Disease in General Practice which he published in the following year, he echoed the above

Venereology has but recently emerged from the fog of quackery and charlatanism 23 and exhorted the removal of "the last vestige of quackery and medievalism

from this branch of science". According to Burke

The vast majority of syphilitics come in the first instance to the general practitioners. Whether he is always able to recognise them as such is a different matter.2A

It is not clear how far Burke was describing the situation by the 1920s when the public agitation about venereal diseases, and the effects of the war, might have made this state of medical ignorance obsolete. It might 74 also be contested whether syphilitics would normally resort to their general practitioners, at least if knowingly consulting him about this disease.

Folk myths about venereal diseases and their cure persisted: the most noxious of these was the belief that these afflictions could be cured by intercourse with a virgin. In the Lancet in 1884 a case was reported of a man with primary and secondary syphilis, with an indurated ulcer on his penis, raping a girl of fourteen "with the object of being cured of his disease."25 This superstition would have appeared to have still been in currency well into the twentieth century, being mentioned in evidence to the Royal Commission of Venereal Diseases in 1913 by J E Lane of St Mary's and the London Lock Hospitals:

A certain superstition exists that if a man has contracted venereal disease and he can have connexion with a virgin he will transmit that disease to her and himself escape free; the idea has existed for a very long time, I am afraid.26

These beliefs may have lingered on perhaps longer than equivalent beliefs in the case of other diseases because of the secrecy and shame in which venereal diseases were shrouded. Cases when cited seem always to deal with a man raping a young g irl: the commerce does not seem to have gone the other way.

While anxiety persisted about venereal diseases and their effect upon the nation as a whole, it was not until the early twentieth century that medical science began to offer positive hope that something could be done, beyond attempts at social control such as existed in the regulationist states on the Continent and as embodied in the discredited Contagious 75

Diseases Acts. The efficacy of such preventive measures was seriously doubted.

However, th is did not mean that there were no attem pts to formulate a public policy on the subject even if these did not meet with success. Upon the publication of the Final Report of the Royal Commission in 1916, E B

Turner, who had been involved in attem pts to get a Royal Commission set up for approaching twenty years, contributed an article to Science Progress.

1916-1917, looking back over these attempts, which had begun by informal contacts between concerned members of the medical profession and workers in allied philanthropic fields in 1896.27

In 1897 a memorial was drawn up, with the advice of prominent rescue workers and medical men, to obtain the appointment of a Royal Commission to investigate the prevalence and effect of venereal diseases in the

United Kingdom: the notion gained by the individuals who were working at close quarters with the problem being that they were far more widespread than was commonly imagined. A meeting was held in 1898 to bring together representatives of all those concerned in the problem, and a resolution in support of the memorial was passed. This, signed by representatives of eight rescue associations, ninety-six women engaged in social work, seventy-two men of all classes and fifty-two members of the medical profession, was presented to the Prime Minister, Lord Salisbury, in 1899.

No action was taken: Salisbury considered that "public opinion was not sufficiently informed and enlightened", and Turner believed, in retrospect, that he was subject to the influence of those who opposed such an enquiry from fears of a revival of the Contagious Diseases Acts in an extended 76 form, a belief that the problem was in decline, and an idea that anyway they should be fought on moral and religious grounds.

However, according to Turner, those who sought an enquiry into the subject

(which was all that they originally demanded) were most, if not all, as opposed to the re introduction of the Contagious Diseases Acts as their opponents. Their aspirations looked to the inclusion of men in any scheme, on grounds of both justice and efficacy, while they made no suggestions as to the registration or licensing of vice, nothing like the CD Acts which had been aimed at returning women to health for the continued pursuit of

"an evil life". They emphasised that the scheme was "to protect the innocent from contagion" and check the spread of these diseases. This emphasis on the unjust burden being placed upon the innocent was often made at this period when pleading for a wider consciousness of the ravages of sexually transmitted diseases: "the innocent" in this context meaning the wives and children of ("guilty") infected men (infection in children, when not congenital, was, it should be noted, usually attributed to the spread of infection through the use of common towels and household implements, not sexual abuse). Innocent were also those who had acquired the disease through sharing a cup or an innocent social kiss with a sufferer, and those medical and nursing personnel who had contracted the diseases in the course of treating the diseased. It is not clear how many cases were in fact "innocently" contracted either non-sexually or through legitimate marital intercourse, or whether this emphasis was a propaganda move to counteract the stigma which hindered discussion of, and the provision of facilities for, the means of controlling venereal diseases. 77

An important point to note here is that the "guilty" sufferer by the turn of the century was, it would seem, far more often perceived as male, conveying disease to the innocent women and children of his family, as opposed to a contaminated prostitute infecting healthy young male bodies.

This agitation for investigation into venereal disease in the United

Kingdom took place in a context of growing international concern about the problem: strong resolutions, proposed by the British Medical Association, were passed at the Brussels International Medical Congress in September

1899 calling for full enquiry into their causes and prevalence. How little was definitely known and how meagre were the existing mechanisms for discovery was plain from Colonel Long's 1898 "Suggested Terms of Reference for Enquiry re Venereal Diseases": first of which was to ascertain "how great the evil is now", followed by the need to collect evidence on the prevalence of the various forms of venereal disease, to discover what arrangements were already in existence. Only then did Long proceed to the necessity of devising means to prevent or limit the spread of these diseases, and to moot the p o ssib ility of some form of n o tificatio n of contagious sufferers, which would not render doctors liable under the laws of libel for communicating such information.

Further meetings took place and resolutions were passed: the problem was not merely one which agitated the medical profession alone, a 1903 meeting was chaired by the Bishop of Stepney, subsequently Archbishop of York. The

Interdepartmental Committee on Physical Deterioration in its Report of

1904 recommended that a Commission of Enquiry into the prevalence and effects of Syphilis be set up—stimulated by anxieties about national deterioration. It was not until a couple of years later that the discovery 78 of the Wasserman te st, consequent upon the discovery of the spirochaete in

1905 indicated how long-term in its effects syphilis could be. Political upheavals thwarted attempts to present another Memorial to the Prime

Minister upon the desirability of appointing a Royal Commission of enquiry.

In 1911 a Royal Commission on the Poor Laws recommended that the powers of detention of workhouse authorities already applied to sufferers from other contagious diseases should also be extended to the venereally infectious. However, a Memorial urging more widespread action by the Local

Government Board, while sympathetically received by the President, of the

Board, was "duly pigeon-holed". Oddly enough, Turner did not mention, in his summary of the progress towards the Royal Commission of 1913-1916, that the Local Government Board did indeed institute an official inquiry into the problem of venereal disease. Admittedly this was undertaken by a Dr R

W Johnstone "in the midst of other official duties", and in fact it appeared after the press agitation described below, since in the discussion of th is report by Public Health in November 1913, it was remarked that

signs are not wanting that public opinion is ripe for a frank discussion of the question. and mentioned that the Government had promised to institute an inquiry.

Public Health seconded Johnstone's recommendations that the priorities were to improve facilities for early diagnosis and treatment of the venereally infected, and were particularly anxious to rid these diseases of the stigma which hung around them and prevented effectiv e action. Even so the emotive expressions "innocent and guilty" were still deployed, hard upon the statement that "the hospital is not directly concerned with moral issues", and it was emphasised how great a proportion of the cases,

especially among women attending hospital for the diseases have been infected apart from irregular relationship.30 79

In 1913, with an International Congress due to meet in London that year, and without waiting for the results of this investigation by the Local

Government Board, Sir Malcolm Morris and others with strong feelings on the venereal disease problem, having decided on the basis of past experience that approaching politicians and Government departments was a exercise in futility, concluded that

the only way to get a chance of obtaining a full inquiry was to startle and impress the "man in the street" in order than public pressure should be brought to bear on the Government, so that, yielding to panic and clamour, that should be granted which was denied to reason, evidence and argument.

A manifesto, laying out a "plain unvarnished statement of the facts" was published in the Morning Post over many well-known names as well as those of nearly every doctor who held an official position. "These tactics succeeded to perfection": the matter was openly discussed by the press and the agitation for an inquiry spread even to those who had once opposed the idea. The International Congress passed strong resolutions on the subject, and when Parliament next rose the Prime Minister announced the appointment of a Royal Commission.31

The Royal Commission, chaired by Lord Sydenham, spent several years in hearing copious evidence on the present state of the prevalence of venereal disease and the provisions for its diagnosis and treatment, as well as recommendations as to what should be done to combat the "terrible p eril to our Imperial race". In 1916 it produced its fin al report. It was clear that the hopes held out by the Wasserman test and Ehrlich's discovery of the Salvarsan treatment had not yet been fulfilled, largely because there were not the structures necessary to put into practice the now existing means of early diagnosis and treatment. Even such facilities as there were concerned with the treatment of venereal diseases had not 80 necessarily taken advantage of these medical advances. Outside London, and not automatically even there, the vast proportion of hospitals did not routinely undertake Wasserman testing, according to Johnstone's report. although by the time of the Final Report of the Royal Commission it would seem that there had been an increase in laboratory provision in voluntary hospitals. Pathological provisions for Poor Law Authorities and in most sanitary areas under the Public Health Authorities lagged behind even this.3^ Salvarsan being a very new therapeutic agent, there were controversies as to how, and who by, it should be administered. The general conclusion was that

The medical practitioners of this country are, from the nature of the case, to a large extent unfamiliar with the newer methods of diagnosis and treatment, and the evidence we have received suggests that, in the past, many of them have in fact failed to appreciate the importance of these diseases.33

It was concluded that such was the national importance of these diseases that only State action could adequately deal with them. Mindful of the particular problems which were involved with venereal diseases, the

Commission insisted

It is of the utmost importance that this institutional treatment should be available for the whole community and should be so organised that persons affected by the disease should have no hesitation in taking advantage of the facilities for treatment which are offered.3-* that is, it was clear th at it was e sse n tial to get away from the old stigmatising and punitive attitudes to sufferers embodied in the creation of Lock Hospitals and the statutes of voluntary hospitals excluding venereal patients, or the creation of different classes of "innocent" and

"guilty" implicit in the Contagious Diseases Acts. The Report of the Royal

Commission, in the in te re st of public health rath er than human rig h ts, advocated no distinction between the sexes, between "good" and "bad" women, 61 or between the classes In making its recommendations for tackling the problem.

This indeed was extremely widespread: the Royal Commission suggested that as many as 10% of the urban population had syphilis and an even greater proportion gonorrhoea. It was particularly noteworthy that these diseases appeared to be proportionately much more common among the male than the female population, even given the great difficulty of diagnosis in the female. However, as the Royal Commission pointed out, accurate s ta tis tic s on venereal diseases were, because of the stigma, very hard to come by, although the probability was that they were far more prevalent than official statistics, for example of causes of death, would indicate.3S

As a result of the implementation of the Royal Commission's recommendations, venereal diseases began to decline. This decline was noticeable by the early 1920s in spite of the increase in cases which had resulted from the War, and in spite of the fact that improvements in recognition and recording would have tended to show an increase. However, as Sir Arthur Newsholme, formerly the Principal Medical Officer of the

Local Government Board, pointed out in an article on the figures given in the R egistrar-G eneral's Annual Review of England and Wales for 1924: "This shows a dramatic reduction from the year 1918 onwards" in the number of deaths registered as due to syphilis. As he pointed out, most cases of death from syphilis occurred in infancy, and deaths in infancy would

"respond fairly quickly to diminution of infection". Attendances of patients at venereal clinics, as recorded by the Chief Medical Officer of the

Ministry of Health, had increased remarkably between 1917 and 1925, almost certainly due to the improved facilities and the publicity they had 82 received. He believed that the statistics indicated the overwhelming success of the measures introduced according to the recommendations of the Royal Commission, and while wider changes in social conduct were necessary for the complete eradication of venereal diseases, they were under control at last.33

It is somewhat ironic that shortly after the appointment of a Royal

Commission had been achieved, World War One broke out, and brought the problem of venereal diseases forcibly to the fore, even as national preoccupation changed to a war mentality. The situation respecting the detection and treatment of these diseases in members of the armed forces already involved different provisions to those obtaining in civil life. Its prevalence was easier to detect and treatment, once indicated, compulsory.

Harrison, however, suggested that this treatment might not be particularly efficacious or in line with current advances even prior to the introduction of Salvarsan, involving the use of mercury treatment in ways which

Harrison believed failed to eradicate the disease, and heroic measures against gonorrhoea leading to eventual s tric tu re .37 However, at the time of the Royal Commission, and owing to the e ffo rts of men like Colonel Lambkin

(1858-1912) and Harrison himself, it was agreed that the facilities for early diagnosis and treatment were better developed than in civil life.

However, it would seem th at the system in existence was placed under considerable stress by the outbreak of war. Adler wrote 'The army's well- organised service was not working"33 a remark which is apparently contradicted in The History of the Great War: Medical Services; Diseases of the War Chapter 3, "Venereal Diseases" in which it was stated that 83

The rates for the whole British Army, including Dominion forces, compare favourably with the rates for the three previous peace years 1911-19 IS39 and statistics given of the rates of admission per 1000 per annum of all troops. These actually declined from 60.5 in 1911 to 36.7 in 1916 with a slight rise in the following two years. But this relative decline does not reflect the absolutely larger numbers of men involved, given the increase in the numbers of the armed forces once the nation was at war, even prior to the introduction of conscription. This latter move also made the risks of contracting venereal diseases a particularly sensitive subject.

According to the History of the Great War. 400,000 cases of venereal disease were treated in the course of the war, 4th August 1914 to 11th

November 1918, and gonorrhoea greatly outnumbered syphilis and other afflictions, comprising 66% of the total. Syphilis represented only about a quarter of the cases.4-0

There were of course enormous variations by theatre of war and whether the troops were in the front line or not. While venereal diseases were regarded by the authorities, understandably, as wholly a bad thing, the men themselves, or some of them, seem to have taken a d ifferen t view, deliberately courting infection to avoid the trenches.41

The official History of the Medical Services in the Great War pointed out that (regardless of the stigma of the disease) sexually transmitted diseases posed medical officers particular problems:

In all other infectious diseases the medical services endeavour to prevent infection reaching the personnel of an army but with venereal diseases the situation was different:

The causes are well known, and officers and men, knowing how infection is contracted, individually take the risk.42 84

Their control was important not only because of the enormous amount of wastage of man-power they caused at a time of national emergency, but because they

incurred the likelihood of permanent damage to the individual, infection to others, and an heritage which might stain an innocent life.43

It was recognised, or perhaps assumed, that war conditions were unusually favourable for encouraging the spread of these diseases:

There can be no doubt that during war the sexual instinct is stimulated in both sexes, and gratification of the impulse is more easily obtained. Personnel have more money to spend and there is a tendency towards slackening of moral principles.AA

It is safe to say that social conditions operated strongly during the war in favour of a high venereal rate.*5

Fischer and Dubois, in their sensationalist pseudo-scientific study Sexual

Life during the World War (1936), constructed a whole book entirely around this contention. Their evidence, though startling, is perhaps too startling altogether to convince one either of their serious scholarly intent or of the validity of th e ir arguments.-46, Wilhelm Stekel, in his massive two volume study on Impotence in the Male attributed much post-war sexual dysfunction to the effects of the war, but apart from commenting on the unexpectedly large number of military men he treated for impotence in his practice, had little to say about the effects of war on sexual activity for the duration of the conflict itself.-47

Means of reducing the prevalence of venereal diseases among the troops varied. Exhortations to sexual continence, most famously Lord Kitchener's address to the British Expeditionary Force, were sometimes employed. With the inception of the National Council of Combatting Venereal Diseases and the training of special lecturers, such exhortations, given a medical rather than a purely moral basis, may have had some effect. Particularly in 85

France reliance was placed on the provision of "maisons toler^es", ie licensed brothels, and Bridget Towers has suggested in her article on

"Health Education Policy, 1916-1926: Venereal Disease and the prophylaxis dilemma" that this met with the approval of a British class leadership which continued in the b elief that "army morale was contingent on sexual activity. "AS She has also pointed out that th is was not necessarily regarded by the Medical Corps as the most effective course of action, since by that time many Medical Officers were committed to a medical approach to the problem rather than one of social control.

There still remained grounds of dissension over what actually constituted the most effective medical preventive approach to venereal diseases in the fighting forces, complicated by the pressures of influential groups on the

Home Front. Public opinion, for example, forced the closing of licensed brothels for the troops, but only as late as 1918. Early treatment of the potentially infected was one recommendation: this involved setting up an ablution area where treatment could be given as soon as possible after exposure. The American and Dominion forces placed reliance upon the issue of prophylactic packs, containing preventives and equipment for self­ disinfection. This was allied to far stronger punitive measures against those who did become infected in sp ite of these provisions. Next to th is the policies pursued by the British do indeed appear "laissez-faire", even haphazardly ad hoc, and certain medical officers were articulate in their demands that th is new model should be adopted.419 There were of course vast differences between individual medical officers: a letter to the

B ritish Medical Journal in December 1919 suggested th at the failu re adequately to prevent venereal diseases might be attributable to temporary medical officers drawn from civil life who 86

have little faith from lack of experience, others who consider the "punishment fits the crime”, others who have conscientious objections to lecturing on the subject, and still others too tired to do so.60

These opinions on temporary medical officers came under attack: one temporary surgeon lieutenant claimed

I made it my business to collect opinions on the results of prophylactic treatment in the navy from as many "permanent" senior medical officers as possible. Their opinions varied, and none were as dogmatic as his... I and many other temporary medical officers... have been handicapped in some instances by the lukewarm support or even apathy shown by some of our senior medical officers.®1

Another former temporary medical officer in the same issue contended that

probably they might allot some of their failures to their own permanent officers, who are maybe "too tired" to preach the doctrines of preventive medicine.62

These intra-professional rivalries cannot have conduced to efficiency.

Nevertheless, there was a considerable difference between the number of cases among B ritish Troops and those from the Dominions: the O fficial

History would suggest that the Tommy on leave would go home, and if he had any kind of sexual activity this would be with a girlfriend; certainly a "careful enquiry in 6ome thousands of cases" amongst British troops showed that

Over 60 per cent of the infections resulted from intercourse with women who were not prostitutes in the ordinary sense of the word.63

The Dominion soldier, however, would seek the bright lig h ts of the wicked city and succumb to the wiles of prostitutes: according to the Official

History about 60% of infections in Australian soldiers were due to professional prostitutes, "perhaps due to the higher pay of the soldiers."64 It would also appear, perhaps for the same reason, that the actual number of exposures to infection was considerably higher for 87

Dominion troops; investigations at the time suggested that the risk of infection from "illicit sexual intercourse without precautions" was around

3%.5S

What is clear is that even when more stringent controls were called for in this wartime ambience, they were tending to focus more and more on the man himself rather than policing his potential partners, even when control of prostitution was also part of the package. It would seem probable also that care was taken to ensure, in the light of the epoch-making recent developments, that medical officers were better trained in the diagnosis and current treatment methods than had previously been the case. The

National Council for Combatting Venereal Diseases secured special instruction in the subject for temporary RAMC officers (presumably the assumption was the regular Officers already knew)se though doubtless the content of such instruction was affected by the particular moral biases of the NCCVD. This body, while promoting early treatm ent provision, was extremely anxious not to appear to be encouraging fornication through the distribution of prophylactic packets.Newsholme suggested that the decline in deaths from syphilis had already begun previous to the implementation of the measures recommended by the Royal Commission, because of the arrangements within the armed forces for the detection and treatment of large numbers of men who, but for the war, would not have come within th e ir purlieu. While many more men had been exposed to infection because of the War,

Never was there a period... when those infected received treatment as satisfactory and complete as that of these war years.se 88

One question which inevitably arises from the consideration of venereal disease, is that of who was giving it to whom. It has already been mentioned that the figure of the innocent wife infected by her unchaste husband, her life blighted, her children born congenitally diseased, had become more prominent in arguments about these diseases. It is commonly supposed that under the "Double Standard" of sexual morality most men who were not married, and many who were, habitually made use of the sexual services of prostitutes, and that there was an absolute dichotomy between the type of women with whom men indulged their carnal urges and the women whom they sought in marriage. It is hard to get a picture of the way prostitution operated, but there is some evidence that far from being a once and ever fall, it was an option into which women drifted and drifted out again under the pressure of economics or changing circumstances This was argued by Acton in Prostitution. 1857, and

Walkowitz similarly has suggested that the Contagious Diseases Acts actually led to a delineation of the prostitute as a particular type of women whereas hitherto prostitution had been a stage or phase in a woman's life, not a career.ss* Flexner, in Prostitution in Europe was also inclined to consider that for many women prostitution was a temporary expedient. However, his description of the forces which might come to ensnare a woman to keep her within the profession suggest that considerable pressures militated against this possibility.®0

What are needed are more studies like that of Frances Finnegan in Poverty and Prostitution, which looks in great detail at the way prostitutes came into the public eye in York, appearing before the courts, being reported by the newspapers, and simply through visibility in the streets. Her study is limited but not vitiated by being confined to almost the lowest class of 89 street women, whose customers were drawn almost exclusively from working class men. Most of her subjects would appear to have been those who continued as prostitutes over a period of years, and who fell foul of the law.®1 P ro stitu tio n at a more refined and discreet level would be much harder to study, endeavouring as it did to avoid the rigours of the law which affected "common prostitutes" and therefore not coming into contact with the official record, and probably being less visible to the general public. In countries where a separate branch of "morals police" existed such a study might be more feasible, though even then the vast problem of clandestine and covert prostitution would not necessarily be recorded.®2 In

England, while it is clear that women were arrested by the police for being prostitutes, and this was their perception of the occurrence, in theory they were subject to laws relating to disorderly conduct and the causing of nuisance which were of universal application.®3 Contemporary observers, however, were of the opinion that the prostitute conducting her trade with discretion was nevertheless far more likely to be arrested than a man blatantly making himself offensive to female passers-by:

those laws under which 6000 women a year and some few men are fined or imprisoned on police evidence only for alleged annoyance of persons of the opposite sex... probably the total charges brought against men for annoying women merely by accosting them is not more than 100 or 150 in the course of two or three years, whereas 6000 unfortunate women are arrested every year for alleged annoyance of men.®”4

Even harder than trying to reconstruct the historical existence of the prostitute is the attempt to reconstruct the prostitute’s customer.

Commentators have often cited evidence to show that during the nineteenth century it was regarded as acceptable and inevitable for all men to patronise prostitutes, and that this was so trivial an occurrence that it was strongly believed that it should not be penalised. Perhaps too much 90 reliance has been placed upon the pronouncements of upper-class legislators and high-court judges relating to prostitution, where class bias combined with gender prejudice to designate fourteen-year old working class girls as "harpies" preying on the naive Oxbridge sons of privilege.

This was particularly apparent in Parliamentary debates on the Criminal

Law Amendment Act of 1885 concerning the raising of the age of consent.

These have been described in detail by Helen Ware in her 1969 thesis on

"The role recruitment and regulation of prostitutes in Britain", in which she has indicated that most MPs did not think that it should be criminal to have intercourse with a girl of fourteen and that, while the public were concerned about this issue, their legislators were not, fearing rather that the B ill would

jeopardise masculine liberties for the sake of protecting slum girls who were already corrupted by their environment.es

It was feared that these dreadful designing harpies would "trump-up" stories in order to blackmail young men and boys. Similar opinions were expressed during debates on the Criminal Law Amendment (White Slave

T raffic) Bill of 1912. Great horror was expressed at the notion of making male importuning a criminal offence, while the young prostitute was described as "the temptress, she leads him into mischief."ee Meanwhile there was a great outcry in favour of instituting flogging as a punishment for "bullies" living off prostitutes' earnings. Receiving money from a prostitute was apparently perceived as a far worse offence than purchasing her sexual favours. Similar attitudes recurred yet again in House of Lords

Debates on the Criminal Law Amendment B ill of 1920: The Shield commented upon Lord Dawson's supposition that

a young man, even up to the age of twenty-five, is powerless against the "allurements" of a girl under seventeen.

The Shield pointed out the class bias inherent in these attitudes: 91

At sixteen they [“daughters of the poorer classes"! have been expected to resist the "allurements" of the richest and most experienced men of all ages, yet men like Lord Dawson have apparently seen no hardship or injustice in that.e7

(Lord Dawson, a physician, spoke out well before most of the profession in favour of birth control: he was, it is clear, not without other prejudices it might have been thought belonged to a by-gone age).

While it was sometimes remarked in lite ra tu re emanating from Continental sources that the first dose of gonorrhoea was regarded as a young man's rite de passage,ee British medical literature does not reflect any such insouciant acceptance of the need to "sow wild oats", indeed, the rhetoric quoted above about lower-class female temptresses might be taken to imply that their "victims" were innocent young men devoted to the pursuit of chastity u n til irre s is tib ly solicited. However, although it was rarely explicitly stated that men required sexual outlets and that prostitutes were necessary for this purposes there was

a false standard of manhood... ta c itly given and accepted, the "wild oats" doctrine... winked at or jestingly repudiated, and when our young men respond to this environment and follow the powerful promptings of their sex nature, we assert that this is inevitable.*5'3 something which it is very hard to calibrate from published sources.

Ware has indicated in the Appendix to her thesis cited above that by 1800 it was no longer a matter of boast in Britain to have contracted a venereal disease.70 Differences between British and Continental practices were recorded by Flexner in his survey of Prostitut ion in Europe during the early years of the twentieth century,71 and while they may indicate nothing more than a greater furtiveness and subterfuge perhaps indicative of traditional British hypocrisy in matters sexual, it would certainly seem 92 that by the early 1900s prostitution in Britain was less blatant than in the European cities where it was regulated, but also exceedingly prevalent in clandestine form. Flexner was inclined to believe that the state of

London had greatly improved as a result of the trend of public opinion against overt manifestations of prostitution: he quoted W A Coote, the moral reformer, as describing the contrast to the state of affairs forty years previously "London today... is an open-air cathedral."72 Flexner, while finding that London was by no means perfect from the moral point of view, nevertheless compared it favourably with Continental cities where regulation was in force.

However, the assumption that if men indulged, they indulged with prostitutes and not with nice girls of their own class, was extremely prevalent. So prevalent that in the works of sex education emerging in the early years of the twentieth century, girls were warned about provocative dress and behaviour not because of the danger these presented to the preservation of their own virtue, but because they might so inflame their men friends that the latter would be driven into the arms of p ro stitu te s.73

The question of the prostitute and her public visibility was thrown into glaring prominence once more with the advent of World War I. The anxieties around the rate of venereal diseases and the problem of their prevalence in the armed forces have already been discussed above. It is clear that some authorities regarded the prostitute as a necessary comcomltant of combat, even when licensed brothels were not set up to provide for military necessity. The provision of licensed brothels, it was suggested by 93 the Association for Moral and Social Hygiene, inculcated in serving soldiers the notion that they were entitled to sexual indulgence and that this was indeed necessary, even if no explicit statements were made to th is e ffe c t.7* An in terestin g point made in the pages of The Shield was that men soon came to find the atmosphere in these establishments

too sordid, and the transaction too mechanical and degrading for men to tolerate long.75 and the women in them so "horribly brutalised in manner and appearance" as a result, that

[they] soon cease to be attractive to the men who are to be got only to visit the regulated house... he will prefer to go to other houses, where the women are at least a grade higher.'76

In the brothel near the convalescent camp near Cayeux-sur-mer, Somme, 15 women were visited by 360 men per day, which gives somecredence to this view. Rather than the degradation of the circumstances leading them to eschew sexual indulgence altogether, the implicit permission conceded by these provisions encouraged the men to seek the same indulgence in more aesthetic circumstances, though still with prostitutes, but not those subject to any form of regular medical examination and licensing:

Men are encouraged and incited to form vicious habits when brothels are provided for their use, but the habit having been formed, they endeavour to gratify it elsewhere.77

But these expedients took place, if not at the Front itself, in areas dominated by the military, and in another country. Far greater anxiety was generated well beyond the pages of social hygiene journals by the efflorescence of florid prostitution in Britain itself. This was said to cause particular offence to the Dominions troops passing through London and other cities, who had never encountered such open vice in their lives.

Anxiety was expressed about the impact this would have on the families at 94 home who learnt of the moral danger into which their boys had been plunged. Young men, the pick of colonial manhood and prepared to fight in the war to end wars, were apparently wholly impotent in the face of female blandishments.

In 1916 the Lancet commented that

Young men living in the m ilieu in which soldiers do live, and stirred by an unwonted spirit of adventure, must make exceedingly easy game for the tem ptress.70

But although subsequently conceding that in the "larger social view" these women were "more sinned against than sinning" the Lancet nevertheless believed that there was a "most urgent duty" upon the community at large to protect the young men who were prepared to give their lives for their country from the moral and medical dangers which assailed them. Sir Arthur

Conan Doyle, in a le tte r to the Times in February 1916, asked more vehemently

Is it not possible in any way to hold in check the vile women who prey upon and poison our soldiers in London... these harpies carry off the lonely soldiers to their rooms, make them drunk often with the vile liquor they keep there, and finally inoculate them, as likely as not, with one or other of those diseases which... have had free trade granted to them among us.70

The Reverend F B Meyer made sim ilar pro testatio n s:

Many soldiers have confessed to us that they hardly dare venture into the public thoroughfares in certain parts of London because of the temptations with which they are assailed by certain women and girls.00

As Alison Neilans of the Association for Social and Moral Hygiene commented

One can only infer that most of the men who have come from far and wide to protect the Empire are totally incapable of protecting themselves from the solicitations of women and girls. and she went on to cite an article in the Pall Mall Gazette on this problem the tenor of which was that 95

when a woman solicits a man it is depravity, but when a man yields to the solicitation it is merely human nature.®1

Neilans might be considered to be expressing the point of view of a female social worker, but M H Mason, apparently a woman engaged in social work, expressed very contrary views in an article in the Nineteenth Century in

1917.6,2 While conceding that

It is not generally known how often perfectly respectable women walking quietly along are annoyed by men in the streets.

Mason nevertheless placed far more emphasis on the way woman "persecuted" men with their solicitations, some of these dreadful creatures being

girls apparently of only 12 or 13, painted, got up, and with all the manners and phrases of professionals.

Not only boys but "older men" were in desperate need of protection from

"persistent and unavoidable temptation". Mason was aware that many of these "flappers" were not "vicious or intentionally immoral" but 6imply looking for a good time. One problem which would appear to have been new during the First World War was that of the "amateur", the young woman who was free with sexual favours not necessarily for direct financial reward but in repayment for being taken out and given presents, or simply to

"have fun". Mason thought that girls who "habitually misconducted themselves unpaid" ought to be placed in institutions of detention such as were already provided for professional prostitutes. The underlying assumption in this article was quite clearly that men were helpless to resist the determined advances of these trollops.

This recognition of the intrusion into debates about promiscuity of women who could not be legitimately described as prostitutes (though the term

"amateur prostitute" for a girl behaving promiscuously remained in 96 currency at least until the 1960s) undermined arguments about the control of venereal disease by controlling overt prostitution. The preference for women who at least appeared not to be of the prostitute class was even attributed to the campaign against venereal disease with its emphasis on the dangers of consorting with prostitutes.03 It was cited in arguments around the problem of prophylaxis against venereal disease, since men were apparently reluctant to use this when indulging with a casual but non­ professional partner, regarding it as somewhat of a slur upon her: a Dr J

McWalter writing to the British Medical Journal contended that

it became almost a point of honour not to use the preventive appliance, as conveying a doubt as to the ladies' chastity or at least immaculateness.

However, although one might imagine the word of a "specialist sanitary officer to a district comprising 20,000 soldiers" to be authoritative his baffling comment that

Those who did use the appliances provided by the packet system consistently gradually acquired a taste for unnatural vice suggests certain deep prejudices inclining to the vitiation of his arguments. It was sometimes remarked, even in the pages of journals such as The Shield that, however deplorable, these often transient sexual relationships of a non-pecuniary nature were on a higher moral level than the resort to prostitutes. There was a feeling abroad that the fastidious man would prefer not to indulge in a crude financial transaction, which indeed would tend to reflect badly on his ability to obtain gratuitous female companionship. While this development might be decried as involving a lowering of women to the moral standard of men, rather than the raising of the latter to the former, there is considerable evidence that this significant social change had begun taking place by the end of World War

I. It may have existed ra th e r less as an actu al phenomenon than as a myth, 97 but it would point to a growing public sense of the lack of acceptability of male resort to prostitutes, irrespective of any legal changes:

There is a growing feeling of disgrace in respect of sexual relations which are not even excused by a passing personal attraction.®5

Our young men are feeling the pressure of an awakening social conscience in regard to prostitution, and they are developing excellent powers of resistance to the crude appeal of the professional streetwalker.®®

These ideas of changing attitudes put forward by The Shield were corroborated by Sir Arthur Newsholme in the course of his remarks about the declining rate of syphilis:

It may be... that prostitution is decreasing, while more stable irregular unions are partially taking their place... I do not regard it as improbable that there has been actual decrease in sexual irreg u la rities, in some measure at least.®7

There is some evidence about attitudes towards prostitution by the 1920s among the correspondence received by Marie Stopes from male readers in the wake of the publication of her book Married Love, early in 1918. These attitudes would presumably have been formed in the early years of the century. Even though she was obviously an advocate of monogamy subsequent to chaste youth as the ideal of sexual conduct, her correspondents manifested considerable honesty in writing to her about the less acceptable facets of sexual behaviour. Some men actually described pre­ marital sexual relations with prostitutes:

When I was at the University at home I used occasionally to go with prostitutes.

I first had sexual intercourse when I was not quite 22, a harlot, but the amount of "life" it put into me I cannot explain.

I had union with several prostitutes in Montreal about 3 years ago.®®

Other men, though not explicit about the status of their partners in sin, 98 described having had a "wild life" or leading a "bachelor life"®® or having led a promiscuous life, but did not mention the status of their partners.

Others told of having had liaisons with "girlfriends" even "C?married] women of intelligence and imagination."®0 Some of them seemed to have regarded a certain amount of sexual activity as a normal course for the male:

I have had the usual sexual history of men.

I am 31 and have led a fairly normal and I suppose promiscuous bachelor existence.®1

Others however were explicit about their revulsion from prostitution as an acceptable outlet for male passions:

The idea of going to p ro stitu te s was always repugnant to my ideas because I could not bring myself to the idea of sleeping with a girl whom I did not love and who did not love me.

I hated the idea of buying relief.

I have never been with a prostitute.

I have never had any physical connection with any female I would never think of such a thing outside marriage.

Of course the usual advice is to seek the prostitute but I do not want to do that.

I have never yet indulged in "bought love" as you term it.®2

Reasons for refraining from sexual activity were not always idealistic:

I most sincerely hope to enter the married state clean and free from all the usual diseases.

[I] have never had union with a woman, being always somewhat afraid of the experience.®3 although many of Stopes's readers were profoundly idealistic about sex and marriage; this will be discussed further in Chapter 4. A number of correspondents, admittedly this was in the post-war period when certain moral conventions, it is popularly supposed, were loosening their 99 stranglehold, admitted to having had intercourse with fiancees or steady girlfriends. This was often presented, however, for perhaps obvious reasons, as being an unusual and spontaneous lapse rather than pursued habitually. It tended to be mentioned in the context of anxiety over the occurrence of pregnancy.

The changes to the "Double Standard" which would appear to have been coming about by the beginning of the 1920s were embodied by the amendment, after long protest, of the Divorce Law so that it provided the same grounds for the dissolution of marriage to both husband and wife.

While the 1923 Matrimonial Causes Act, which made simple adultery a grounds for divorce, was subject over the following years to much

criticism, partly due to its enshrining the concept of guilty and innocent parties, and partly due to its exclusion of other grounds, it nevertheless

abolished a major gender inequity in the evaluation of sexual misconduct

in marriage.

It is thus clear that, Double Standard or not, sexual activity was

perceived as a hazardous pursuit for the British male. Even if it was

sometimes considered a necessity, it was seen as being one which involved

considerable risks of contagion. While informal advice may have involved

warnings about personal prophylaxis, or instructions as to how to

recognise a "clean" prostitute, on an official level the problems of being

seen to be condoning or even encouraging fornication were ever-present.

For all the mentions in medical literature about unscrupulous quacks or

even members of the profession who might recommend fornication as

beneficial to the health of young men, it is practically impossible to 100 discover any published work containing such recommendations. The dangers was sufficiently well known: even Drysdale, cited in the previous chapter, pointed out that in the current corrupt state of sexual morals such sexual outlets as were available to young men were almost certainly diseased members of a degraded class of women. The need to provide young men with sufficient knowledge to enable them to perceive and evade dangers but without providing so much as to corrupt them was a matter of concern from the middle of the nineteenth century. The next chapter discusses the various ways in which young men might come into contact with sexual information of different kinds, intended to preserve them from the ever­ present dangers sex threatened. 101

Chapter Two: Notes

1. Roval Commission on Venereal Diseases. Final Report. Cd 8189, 1916, §137-138

2. Wyke, T J, "The Manchester and Salford Lock Hospital, 1818-1917", Medical History. 1979, Vol 19, pp 73-86

3. ibid. and RC on VD. Final Report. §134

4. Wyke, op cit. p 76

5. Walkowitz, Judith R, Prostitution and Victorian Society: women, class and the state. Cambridge University Press, Cambridge and New York 1980; McHugh, Paul, Prostitution and Victorian Social Reform. Croom Helm, London c. 1980

6. Trustram, Myna, Women of the Regiment; marriage and the Victorian Army. Cambridge University Press, Cambridge and New York, 1984; even the legitimate wives of soldiers were stigmatised.

7. Thomas, Keith, "The Double Standard", Journal of the History of Ideas. 1959, Vol 20, pp 195-216

8. Weber, Hermann, On Longevity and means for the prolongation of life. Macmillan, London, 1903, 5th edition edited by F Parkes Weber 1919, pp 235-236

9. Harrison. L W, "Those were the days! or Random notes on Then and Now in VD", Bulletin of the Institute of Technicians in Venereology. Cn d ?1950s], pp 1-7

10. Flexner, Abraham, Prostitution in Europe, first published by the Bureau of Social Hygiene, New York, 1913, Abridged edition, Grant Richards Ltd, London, 1919, p 276

11. Harrison, op cit; Adler, Michael, "The terrible peril: a historical perspective on the venereal diseases", British Medical Journal. 1980, ii, 202-211

12. Harrison, op cit. p 1

13. Wyke, op cit: Departmental Committee on Sickness Benefit Claims under the National Insurance Act. Cd 7687, 1914, §134-141

14. ibid. §141

15. RC on VD. Final Report. §188

16. ibid

17. ibid. §133

18. Local Government Board, Report as to the Practice of Medicine and Surgery by Unqualified Persons in the United Kingdom. Cd 5422, 1910, p 15 102

19. Harrison, op cit. p 5

20. Rajam, R V, “Progress in the Treatment and Control of Venereal Diseases", The A ntiseptic. 1954, Vol 5 no 4, pp 345-366, re f to p 356

21. Harrison, op cit. p 1

22. Burke, E T, Scourges of Today (Venereal Disease. Cancer. Tuberculosis and Alcoholism). The S cientific Press, London, 1926, p 11

23. Burke, E T, Treatment of Venereal Disease in General Practice. The Scientific Press, London, 1927, p iv

24. ibid. p x

25. The Lancet. 1884, i, 963

26. RC on VD. F irst Report: Appendix; Minutes of Evidence (1913-1914). 1914, Cd 7475, §2822

27. Turner, E B, “The History of the Fight Against Venereal Disease", Science Progress. 1916-1917, Vol 11, pp 83-88. The account which follows of the movement to get a Royal Commission on Venereal Diseases set up summarises this essay by Turner.

28. Public Health. 1913, Vol 25, p 51

29. ibid (I am indebted to Dorothy Porter for this reference)

30. Turner, op cit

31. RC on VD. Final Report. §127-132

32. ibid. §136

33. ibid §143

34. ibid. §144

35. ibid. §10-11

36. Newsholme, Sir Arthur, "The Decline in Registered M ortality from Syphilis in England. To what is it due?", Journal of Social Hygiene. 1926, Vol 12 no 9, pp 514-523

37. Harrison, op cit

38. Adler, op cit

39. History of the Great War Based on Official Documents: Medical Services: Diseases of the War. Volume II, Chapter III "Venereal Diseases"

40. ibid. p 118

41. Adler, op cit. no supporting reference, possibly anecdotal 103

42. History of the Great War, p 72

43. ibid. p 74

44. ibid. p 78

45. ibid. p 121

46. Fischer, H C, and Dubois, E X, Sexual Life during the World War. Francis Aldor, London, 1937

47. Stekel, Wilhelm, Impotence in the Male: the psychic disorders of sexual function in the male. <2 vols), 1st published in German 1927, authorised English version by Oswald H Boltz, John Lane, London, printed in the USA, 1941, Vol II, Chapter 18, "War and Impotence", p 175 et seq

48. Towers, Bridget, "Health education policy, 1916-1926: Venereal Disease and the Prophylaxis Dilemma", Medical History. 1980, Vol 24, pp 70-87, p 77

49. See the debate in The Nineteenth Century between Sir Bryan Donkin and Sir Francis Champneys: Donkin, "The Fight against Venereal Infection", Sept 1917, Vol 82, pp 580-595; Champneys, "The Fight against Venereal Infection: A reply to Sir Bryan Donkin", Nov 1917, Vol 82, pp 1044-1054; Donkin, "The Fight against Venereal Infection: A Rejoinder", Jan 1918, Vol 83, pp 184-190; Champneys, "The Fight against Venereal Infection:A fu rth ar reply to Sir Bryan Donkin", Mar 1918, Vol 83, pp 611-618. There was also considerable correspondence on this topic in the BMJ during 1919 and 1920

50. BMJ, 1919, ii, 832

51. BMJ, 1920, i, 61

52. BMJ, 1920, i, 62

53. History of the Great War, p 121

54. ibid. p 121

55. ibid. p 120

56. ibid. p 121

57. Towers, op cit; Adler, op cit

58. Newsholme, op cit. p 521

59. Acton, William, P ro stitu tio n . 1st published London 1857; new edition edited by Peter Fryer, MacGibbon and Kee, London, 1968. pp 61-74; Walkowitz, op cit. Chapter 10, "The making of an outcast group: p ro stitu te s and working women in Plymouth and Southampton", pp 192-213

60. Flexner, op cit. pp 70-71, 146-149

61. Finnegan, Frances, Poverty and Prostitution: A study of Victorian prostitutes in York. Cambridge University Press, Cambridge and New York. 1979 104

62. cf Flexner, op cit: much of his argument against the regulation of prostitution was based on figures demonstrating the enormous amount of clandestine prostitution which was rife in regulationist states.

63. Johnson, G W, "The Injustice of the S olicitation Laws", The Shield. 1920-1922, 3rd Series no 3, pp 267-269; "Woman, where are thine accusers?", ibid. pp 307-309

64. ibid. p 307

65. Ware, H R E "The role, recruitm ent and regulation of p ro stitu te s in Britain, 1800-1969", unpublished University of London PhD thesis, 1969, p 303

66. ibid. pp 446, 466

67. The Shield 1920-1922, 3rd Series Vol 3, p 116

68. cf Stekel, op cit. Vol I, p 170 and Flexner, op c it. pp 40-41, for mentions of this attitude

69. Arthur, Dr R, "Some Aspects of the Venereal Problem", The Shield. 1916-1917, Series 3 Vol 1, pp 302-308, ref to p 308

70. Ware, op cit. p 626

71. Flexner, op cit. passim, as part of his overall comparison between abolition and regulation as means of controlling prostitution

72. ibid. p 233

73. see, eg, Hall, Winfield Scott MD, assisted by Hall, Jeannette Winter, Sexual Knowledge: In plain and simple language: sexology or knowledge of self and sex for both male and female: especially for the instruction of youths and maidens, young wives and young husbands, all fathers and all mothers, school-teachers and nurses, and all others who feel a need of proper and reliable information on Sex Hygiene. Sex Problems and the best wav and the best time to impart sexual knowledge to boys and girls about to en ter into manhood and womanhood. International Bible House: Philadelphia, 1913, T Werner Laurie, London, C19263, pp 184-185, and March, Norah, Toward Racial Health: A Handbook for Parents. Teachers and Social Workers on the Training of Boys and Girls, with a foreword by J Arthur Thomson, George Routledge and Sons Ltd, London 1915, 4th edition, revised, 1920, p 175, for such warnings

74. "British Troops in France: provision of tolerated brothels". The Shield. 1916-1917, Series 3 Vol 1, pp 393-397; "The Maisons TolerGes", The Shield. 1918-1920, 3rd series Vol 2, pp 53-64

75. The Shield Series 3 Vol 1, p 397

76. ibid. Series 3 Vol 2, p 58

77. ibid. Series 3 Vol 1, p 397

78. The Lancet. 1916, i, 305 105

79. cited in Neilans, A, "The Protection of Soldiers", The Shield. 1916— 1917, Series 3 Vol 1, pp 216-223, re f to p 218

80. cited in ibid. p 218

81. ibid. p 219

82. Mason, M H, "Public Morality: some constructive suggestions", The Nineteenth Century. 1917, Vol 82, pp 185-194

83. Neilans, Alison, "Has Moral Teaching Failed?", The Shield. 1920-1922, 3rd Series Vol 3, pp 257-265, re f to p 262

84. BMJ, 1920, i, 273

85. White, Dr Douglas, "The Sexual Basis of Human Society", The Shield. 1923-1925, 3rd series Vol 4, pp 129-134, ref to p 133

86. "The Double Moral Standard in the Law", The Shield. 1926-1929, 3rd Series Vol 5, pp 13-20, re f to p 17

87. Newsholme, op cit. p 522

88. Marie C Stopes papers in the Contemporary Medical Archives Centre at the Wellcome Institute for the History of Medicine, Correspondence "ML- GEN"; CMAC: PP/MCS/A.252 FVW, (Indian Civil Service), A. 193 RP, A.94 RSF, see also A.67 GHG, A.205 HWP, A.220 WS

89. CMAC: PP/MCS/A.121 Lt Cdr CMDH, A. 168 Capt EMcK

90. CMAC: PP/MCS/A.88 FWF, A. 109 Major DLG (Sudan)

91. CMAC: PP/MCS/A. 129 FH, A. 109 Lt Cdr JRG, (RN)

92. CMAC: PP/MCS/A.246 HFW, A.63 C, A.183 RCM, A.168 AMMcK, A.144 AJ, A.213 FR, and see also A.73 AD, A.71 D

93. CMAC: PP/MCS/A. 144 AJ, A.208 AWR 106

Chapter Three

"What a Young Man Ought to Know11

It has been shown in the previous chapters that in the later nineteenth and beginning of the twentieth centuries male sexual activity outside marriage (and even inside) was perceived as threatening assorted dangers.

Sexually transmitted diseases were the inevitable concomitant of a double standard whereby a pariah class of prostitutes was regarded as a necessity for the satisfaction of male lust while safeguarding the chastity of respectable women. Before the discovery of reliable methods of prevention and cure these diseases posed an enormous threat both to the individual and to society at large. Besides this danger of disease, the resort to prostitutes was attended by other feared dangers such as robbery and blackmail. In Chapter One it has been pointed out how perilous sexual activity as such was conceived of as being to the male, depleting to his vital energies, quite apart from the dangers of disease or social stigma.

It therefore came to be considered not merely prudent but a matter of urgent necessity that boys and young men should be made aware of the enormous dangers to th e ir continued healthy manhood which assailed them on every side.

In this chapter the various means by which sexual knowledge and sexual warnings were conveyed to young men will be considered, and the content of such information. Also dealt with in this chapter is the miasma of horror surrounding masturbation, a practice all but universal in the adolescent male, at least in societies where marriage and/or reciprocal sexual activity is delayed or forbidden, but at this period regarded with almost 107 equal revulsion to the sexually transmitted diseases, to the extent that many considered that fornication was a less deleterious course, and even a necessary curative measure against the perils of onanism.

It is clear that it was extremely hard for young men to retain that untouched innocence about sexual matters which was assumed to be innate in their sisters. Although authorities such as Sir James Paget did comment upon the encounter in medical practice with men whose sexual ignorance was such that they had failed to consummate their marriage or even re a lise of what th is consisted,1 on the whole it was unlikely that a boy in growing up would avoid a ll mention of sex (a d ifferen t m atter from acquiring practical competence in the act, it must be pointed out).

A major source of the transmission of sexual information or misinformation was talk between young males. In the rhetoric of self-conscious proponents of the need for sex-education about the importance of providing "clean and healthy" sex instruction for young men this probably mutual exchange of bits and scraps of knowledge or speculation was usually transformed into

"corrupt companions" tainting the innocent child:

The great majority of boys... have imbibed their ideas from the coarser of their companions... very few boys escape... the acquisition of degraded ideas on the subject of sex.2

Neither should you speak about these subjects; nor should you listen to other boys speaking about them... you will be more than likely to meet boys who have never been taught the importance of what we have told you. If you speak with them on these matters they will surely tell you what they have happened to have learned, and this is generally untrue.3

Normal children are almost certain to get sexual information no later than the early adolescent years, and usually from unreliable and vulgar sources.-* 108

Many parents even now fail to realise that their children, especially their boys, may acquire a most undesirable knowledge, and may become accustomed to impure ideas and d irty jokes before they leave the preparatory or elementary school.®

You may possible find that many of your friends have not had all these things properly explained to them like you have, and they may talk about them in such a way that you will feel is wrong and unclean.®

Scraps of information or misinformation are liable to be whispered in a lewd and vulgar manner from one to the other among young people.7

In the absence of any other mode of gaining information on the subject, this was often the only resource many men had.

In letters received by Marie Stopes her correspondents occasionally mentioned that they had picked up such sexual information as they had had prior to reading her book from such suspect sources, which they tended to describe in terms which suggested the aura of the unpleasant and furtive or coarse which hung about talk of this kind:

What I had heard from the usual talk one had to get accustomed to in the Army.

I married 8 years ago with only a very limited knowledge of sexual matters—mostly gathered from smutty tales, or talks with men one meets on the daily path.

I have certain knowledge which is more or less common property but the sources from which I acquired it are such that I have grave doubts as to the advisability of making use of it.®

While much was made in the rhetoric of the medical press and of sex educators of the "contamination" that came to boys and young men through quack and obscene literature, or through the corrupt discourse of undesirable companions feeding them with smutty misinformation, some learnt of sex more directly and in a context which might be defined as abusive. Writers of texts on sex education often mentioned the dangers to children of sexual corruption by servants: 109

Boys are abused by ignorant and libidinous nurses, who play with their organs, both to gratify their own sensuality, and to keep the children quiet.9

Doctors testify to the hideous fact that children are taught this habit in the nursery.10

Harm is done to very young boys sometimes by their nurses, who teach them habits of abuse.1 1

Risks are not confined to children of the poor, overcrowded localities only, for, among the more luxuried classes, children who are left too much to the care of thoughtlessly chosen servants, perhaps of undesirable moral natures, are frequently led astray.12

The motivation for this behaviour was not always perceived as being sexual on the part of the servants involved, it was sometimes explained as a pernicious but ignorant means of soothing a fractious child:

Even nurses, sometimes, in ignorance of the terrible evil and sad consequences of their act, practice this destructive habit upon very young children for the purpose of diverting their thoughts, so that they will not cry, or in order that they may be quieted and fall asleep.13

He had first—as far as he could remember, at about six—had his private parts excited by his nurse, who apparently did this to put an irritable child into a good temper!1*4

Medical information tells us that only too frequently are children mishandled by untrustworthy nurses and servants, who, in this way, endeavour to soothe a crying or troublesome charge.15

This might be assumed to be a piece of paranoid myth-making generated by fantasies to do with members of lower social classes (similar to those cited in the previous chapter about p ro stitu tes). However, a few of Marie

Stopes's correspondents did describe experiences of sexual behaviour by servants: given the youthful age at which most of these incidents were described as occurring seduction does not seem to be an appropriate term, suggesting as it does a kind of droit de seigneur initiation, a rite of passage. There was nothing romantic in accounts such as the following: 110

When very young I was taught the exquisite but pernicious soul and body destroying sin of masturbation by a servant girl who used to play with my sexual organs.

From the age of 4 owing to a nursemaid I got into the solitary vice habit.

When about 12 years of age a maid of ours, then about 20 years of age, caused me to have intercourse with her before I knew anything about such things.

As a young child of six I was often looked after by a young neighbour aged about 16. One day she exposed herself to me with a great display of detail.

I attribute my weakness to having connections with a servant maid two and three times daily over a long period before I reached puberty.1*

However, none of the victim s of these a ssau lts appear to have perceived these assau lts as a means of placating and soothing them.

Others described incidents at school which would seem to have involved force and reluctance rather than mutual explorations in adolescence:

In my case degraded at the age of six at a high-class boarding- school

I was at a public school and self-abuse was more or less thrust on me in my sleep by a m aster!17

Others, describing learning self-abuse in adolescence at school, were not always explicit as to the role of their peers in the matter, the way they expressed it might simply mean that it was then they acquired the habit. A few did mention advice or example from others as a factor:

I was told by grown-up men that it was good for me and that kind of thing made a man of one.

Acting on the advice of other young boys I began to relieve myself in this artificial manner.

I then learnt from elder boys that pernicious and shameful h ab it.1 e

This would suggest that there was in existence a male sub-culture of communications about sexuality, but apart from fleeting references such as Ill this it is very hard to discover of what these communications actually consisted. A M Edge, Physician to the Salford Lock Hospital, cited in the

White Cross League pamphlet "The Testimony of Medical Men" (as to the harmlessness, even healthfulness, of chastity), referred to the "poisonous advice which he too often receives from others a little older than himself".'3 Drs Schofield and Vaughan-Jackson mentioned the danger of

men who take an evil delight in telling young boys about themselves, and telling them in such a manner as to encourage them to commence or continue this injurious habit. They will say "It w ill do you no harm," or "It w ill make a man of you", or make some such untrue remark.20 but since they went on warn that these men "will lead you further, and towards more injurious and disgusting practices", which appears to be a covert warning against homosexual advances, it is not clear if this warning was based on observation or paranoia. (They recommended th at if anyone made such suggestions the reader of their work ought to be prepared to "punch his head.") This idea of corruption and degradation may be misleading however: one correspondent writing to Marie Stopes reported that at one time he had been much troubled by strong desires but hated the idea of "buying relief" and had been told by his brother that

I could obtain release by applying friction to the penis with the hand and this I did every now and then... I have always understood it is quite harmless.21

The outbreak of war in 1914 and the subsequent introduction of conscription must have exposed numbers of men to discussions on sexual topics they would not necessarily previously encountered and might even have avoided. Some writers commented on the impossibility of avoiding the general coarseness of male talk once in the army, so that "decent kindly men [were] taken and crushed and stamped into the Army mould" as Stephen 112

Graham put it in A Private in the Guards, published in 1919. In th is work he deplored

[the] learning to be impure. It is only a strong character that can resist the infection of impurity. Inevitably you do or think things which are obscene and brutal, and many go and do the sort of things they say and think.2*

An inquiry into The Armv and Religion, reviewed by the Shield in the same issue as the volume by Graham, also mentioned the "constant flow of filth y language, the drunkenness, and, more especially, the immorality." Army chaplains were cited as claiming

In matters of sex I think the men are very lax... impurity is the gravest problem... they argue that sexual indulgence is natural and therefore legitimate... their minds are pretty filthy... their talk is pretty often disgusting.23

The bad example set by older men was remarked upon from a very d ifferen t level in the hierarchy of rank, by Brigadier-General F D Crozier in A Brass

Hat in No-Man's Land.2*

The reputedly greater aggressiveness of prostitution during the war years has been discussed in the previous chapter, along with the provision in certain theatres of war of licensed brothels for military use, a facility which some men might not have encountered previously. Above a ll there were, supposedly, lectures on hygiene which, since one of the major health anxieties of the war was the venereal disease rate, would have dealt with problems of sex. These were not all-embracing in giving every member of the forces at least the knowledge of the existence of these diseases: one man wrote to Marie Stopes in 1921

I was in the Navy during the War and knew nothing of the horrors of th is scourge. I was caught by bad company and contracted gonorrhoea in August 1918.2S

What might seem from other writings on the subject to have been an unprecedented torrent of information about the sexually-transmit ted 113 diseases had clearly passed this man by. Another of Stopes's correspondents admitted to have encountered some form of instruction but

many of the lectures etc one ever hears in the service on "dangers" etc rather pass over my head.2e

The recently initiated debate about venereal diseases and the controversies over the prophylaxis question generated their own problems:

A gentleman who is in close touch with some 280,000 workmen and trade-unionists... said that the working men had got so confused by the discussions and differences among members of the profession as to prophylaxis and early treatment that they had come to the conclusion that the medical profession knew nothing whatever about this diseases, and that they therefore preferred to follow the advice and take the treatment of their own quacks and h e rb a lists.27

One might note here the continuing persistence of superstitions such as that of curing venereal disease by "passing it on" to a virgin.

It might be supposed that a certain amount of surreptitious word of mouth communications about sex were common to adolescents of both sexes, but it is plain that there were forms of information to which young men were far more likely to be exposed. The s tre e ts themselves were regarded as a potent source of danger for young men. Men—respectable men, that is—were believed to be in far greater peril from temptations and solicitations than women of the same class. Innocence in women was assumed to be its own best protection and of course men were often obliged to go into "social spaces" where women of their own class would never have intruded. Night­ time stre e ts , for example, had a su fficien t reputation to condemn any young woman who might be found out upon them unchaperoned. It was argued that streets needed to be kept free of prostitutes for the sake of the young male. It has been suggested that nobody thought the worse of men resorting to prostitutes, but this fear of laying temptation in the way of 114 young men could Indicate that this was perhaps not altogether the case.

Furthermore there would seem to have been sufficient stigma attached to the activity that men who had been robbed in the course of a transaction with a prostitute were apparently reluctant to press charges, and if fornication were assumed to be a physiological necessity one would have imagined that no grounds for fears of blackmail would have existed. Unless the fear was of that other great male paranoid anxiety, the spurious accusation of rape?

But it was not only the activity of the direct market for sex in public areas which was perceived as a menace to the young man. The s tre e ts held other perils. The medical press fulminated against the pernicious habits of quacks, and certainly there is evidence for their persistence in attempting to drum up custom for their dubious remedies. It might take a certain amount of effort and expense for a young man to get his hands upon a book but quack pamphlets were not merely free, they were often hard to avoid:

There are few cap itals where more tem ptation and more indecency of literature are permitted in the streets than in this metropolis.2®

Medical men have repeated—nay, almost constant—evidence brought under their eyes of the ruin wrought by a peculiarly pernicious class of quack literature, which, in spite of recent legislation and of the efforts of the police, continues to circulate.2®

Any youth walking in a London street some thirty years ago [written 19293 ran the risk of having thrust into his hand a pamphlet describing the terrible results of "solitary vice" and, urging him to seek treatment from some pernicious quack.30

"Handbills, pamphlets and advertisements" would have been hard to avoid, given this aggressive marketing technique. Their dissemination was doubtless met by curiosity and a desire for enlightenment: as the British

Medical Journal pointed out in 1885, in its discussion of the 115

"objectionable mode in which sexual knowledge generally gets access to the mind... through the corrupting medium of lewd jest or obscene print."

Instead of condemning th is phenomenon out of hand, the (anonymous) commentator enquired

Why do the young so often regard an obscene work or print with such fearful but such irresistible curiosity? Not from mere depravity, as we often assume, but because they are thus unconsciously seeking information which they have a right to possess... Sexual knowledge is not wrong... but our mistaken methods of secrecy have undoubtedly the most unfortunate e ffe c t.31

The quacks were playing upon the understandable curiosity of the young in order to encourage their own trade.

Another device used by quacks was that of the "anatomical museum". One of these was still in existence, if not flourishing, in Blackpool in the 1950s, when a group of doctors complained to the British Medical Association

Ethics Committee about it. They considered that "being next to the chamber of horrors" placed the exhibition in a "horrific setting" and that it contained "gross misrepresentation of fact tending to terrify and mislead the public", the more so as many of the models and displays dated from around 1860 or so and there was no attem pt to suggest that they, and the information presented by the legends, were not up to date. More interesting, perhaps, from the point of view of what these exhibitions were like and the impression they were likely to convey to vulnerable minds was

a series of models of genitalia and other parts of the body alleged to show the signs of Venereal Disease. Some of these appear to be grossly exaggerated and inaccurate. Mixed up with these are others illustrating catalogue references to masturbation.

A copy of the catalogue was enclosed with this letter, and indeed "Face of on old bachelor; a confirmed onanist. He became idiotic and rapidly sank into second childhood" was juxtaposed with "Face of a man shewing the evil 116 effects of secondary symptoms of syphilis" and "Twenty models of the human face... showing secondary symptoms syphilis and gonorrhoea" was next to an exhibit of "Onanism in man, showing its dreadful effect on the organ of generation."32 These images, mingled as they were with representations of operations, horrifying examples of childbirth, and monstrosities, must have created very gruesome associations with sex. Such museums were often run as a "come-on" and a front by purveyors of spurious remedies for factitious ailments. In an article in the British Medical Journal in 1879 this connection was made apparent. Discussing the confiscation of certain obscene quack pamphlets at the instigation of the Society for the

Suppression of Vice, it was noted that the defendants at the subsequent trial were "only hired servants of the principal offender, the proprietor of a notorious museum", This museum, described as "for twenty-five years a disgrace and scandal to the metropolis", had been closed down by the efforts of the aforementioned Society, which had managed a similar coup against "a similar so-called museum, kept by an individual who called himself 'Dr Hunter', in one of our largest provincial towns."33

Besides these devious devices of surreptitious quacks, some chemists were also criticised for the displays in their windows of advertisements and articles "for weak and nervous men", as well as works on "popular medical social sexual science", and contraceptive devices.34

As well as these street devices of the quacks, there were other means by which they intruded even into homes: they advertised widely in newspapers.

These were not only the lower sort of periodicals: the British Medical

Journal deplored

the advertisements... inserted far too freely, and with too little sense of responsibility, by newspapers of a respectable, 117

nay, even of a valuable and respected character. Religious newspapers, daily evening papers of high class and aim, cheap and highly popular social journals, do not hesitate to print advertisements of which the mischievous pretences are transparent or very thinly veiled.

How thinly veiled the import of these advertisements was, was demonstrated by the fact that one particularly objected to was sufficiently incautiously worded that "there was ground for proceedings under the Act of last year for an offence against public propriety."*5

In contradistinction to the plaints cited above about quacks and corruption in the streets, which would seem to continue a long tradition of seeing the city as a haven for corruption and vice, writers complaining in The

Lancet in 1870 of newspaper advertisements saw these as particularly pernicious in the provinces and in rural areas. A letter to the Editor enclosed a country newspaper containing specimens of advertisements of "a most objectionable character" and propounded the theory that

it is from the remote country districts that the advertising quack draws his best hauls... Londoners as a rule know to whom and where to go.3e

An editorial comment would seem to substantiate this claim:

a fair sample of others that are to be found in too many country, and a few of the most degraded of the London, papers... in London th eir game is wellnigh played out 37 and another correspondent agreed that "provincial newspapers are clearly the greatest offenders in this respect.,,3a The subsequent series of articles in The Lancet, however, simply pleaded for doctors to take more interest in treating cases of "functional disorders of the male generative system"33 rather than arguing for the introduction of any kind of general sex education. "Country newspapers" were indicted once more over thirty years later by T S Clouston in Clinical Lectures on Mental Diseases, in the chapter on "The Insanity of Masturbation." Of these, Clouston wrote 118

those shameful quack advertisements put into the country newspapers... with just enough concealment to make them suggestive... they aggravate the miseries of those who are suffering from the minor effects of this vice by keeping them constantly before their minds; they suggest evil thoughts to those who might be free from them, and they fatten the vilest of mankind.40

It is interesting to note that Clouston believed these scare-mongering advertisements to be as potent (though no greater) a cause of insanity as masturbation itself.

A selection of such advertisements from periodicals circulating in

A ustralia around 1907 appealed to "the weak, nervous and debilitated" sufferers from "nervous weakness, loss of strength and energy", offering

"health strength and vigour restored in four weeks", "a simple means of self-cure", "speedy cure", "strong men made from weaklings", "weak men made strong." They spoke of "Strength; How lost, how regained" (with a picture of a lion). In almost all cases they offered as a come-on a pamphlet free for the sending: "write for the book today, it is free", "an interesting book for young men... sent free on application", "drop us a line and we will forward our treasure-book", "Free Book! send us the following coupon and let us post our Illustrated Book to you... It contains 96 pages of good reading and sound advice."41 Similar advertisements were to be found in the British Press:

How to preserve strength and retain the powers To the inexperienced. The married or those contemplating marriage. No other work contains so much helpful or sensible advice and invitations to "write for book on lack of vigour variocele and all urinary complaints", as well as "Treatment that cures. Exhaustion, lost energy, variocele and premature decay."42 119

The British Medical Journal, in the aforementioned diatribe against

"Dangerous Quack Literature" in 1892 declared that literature such as these pamphlets touted by advertisers

identifies, with diabolical ingenuity the ordinary and frequent symptoms of "lassitude", "debility", "loss of memory", "low spirits" etc, especially common in adolescents and nervous dyspeptic or hypochondriac young men, with serious maladies and personal faults of conduct or habit. They fill the minds of such readers with dire despondency and erroneous fears, and by describing what are often physiological phenomena incidental to adolescence as evidences of deep-seated mischief, fraught with peril to mind and body, they thus make confirmed invalids and hopeless patients of those who only need a little sound lecturing or gentle remonstrance, or cheery reassurance.

The inspiration for this commentary on the pernicious influence of quack literature about sexual debility was the suicide of a young man, a 21-year old butcher in Westminster, who had had a "varied selection" of pamphlets of which it was said at the inquest

a young man reading them might think he was suffering from every disease imaginable... no doubt the deceased had worried himself by reading the pamphlets.

Convinced that there might be many suicides as a result of such literature, the British Medical Journal also pointed out that there were doubtless

countless cases of protracted misery, alarm and depression from mental anxiety amongst young men of less educated and wealthy classes at a time of life and under circumstances when such suffering greatly prejudices their careers.

In the absence of more openly circulated and less commercially motivated information about sex, young men might be readily persuaded to 6end for the gratuitous pamphlets so generously offered by advertisers.

It is clear that the average man might well have picked up various kinds of sexual information and myth without putting himself to any great effort to obtain it, in fact he might find it hard to avoid unless leading an 120 exceptionally sheltered life. It would have been hard for him to be totally unaware, for example, of notions to do with "sexual debility and male weakness" and their apparent prevalence, or to be completely ignorant of the existence of prostitution.

It came to be believed, therefore, that the menaced young man was in need, far more so than his sheltered sisters, of warnings against the dangers which might a ssa il his developing manhood. The movement for some kind of sex education, in the form of warnings against dangers, would seem to have emerged round about the 1880s, with the development of various social purity organisations emerging out of the movement to repeal the Contagious

Diseases Acts, and the furore caused by W T Stead's articles in the Pall

Mall Gazette. "The Maiden T ribute of Modern Babylon", a ll of which factors led to the passing of the Criminal Law Amendment Act, with its raising of the age of consent and its criminalisation of male homosexual activities.

While in religious and educational circles anxieties about masturbation in a religious and moral context had been prevalent for some time, it would seem to be only by around the 1880s that the medical profession became vocally anxious about the enormous prevalence in schools of what had long been perceived as a profoundly injurious (if never explicitly named) habit.

The British Medical Journal published in 1881 an editorial "A Grave Social

Problem" which summarised existing debates and made various suggestions.

The writer urged that a middle path should be steered:

We must guard, in the first place, against the exaggerations of some of the earlier medical authors, who narrated, in connection with the practices to which we refer, a series of results so manifestly out of harmony with fact, that public opinion fell a ready prey to the second, and denied both the frequency of the 121

evil and the permanently bad effects which it produced.AA an apparently balanced view which did not, however, exclude descriptions of the problem, never explicitly named, as "certain forms of vice", "the evil",

"these practices", "bad habits", as "a parasite which has so deeply eaten its insidious way into the heart of [the public school] system." The air of scientific rationality which the writer appeared to be trying to create was constantly being undermined by comments about "the natural, if unfortunate, repugnance" with which medical men would view the subject, and the general sense that while this was an attempt at opening up discussion of a tabooed subject, very little was actually being said. Not surprising, perhaps, when explicit warnings such as those found in the pages of Acton and other writers on the specific subject were considered to have "a certain unsavoury suggestiveness" and it was considered that it would be very hard to give warnings "without entering into repulsive and suggestive detail." This caveat in spite of the recognition in the very first paragraph that

the vague and mysterious warnings of parents and guardians may directly tend to the suggestion of evils which might otherwise have remained unknown.

It is clear that there was already a tension in existence between the perception of an urgent need to warn of impending dangers and the fear of putting undesirable ideas into formerly untouched minds.

This tension was demonstrated in the differing responses given in the

Lancet and the British Medical Journal in August 1885 to "the publicity recently given to the subject of sexual sins", "recent painful disclosures."

The British Medical Journal spoke out against the

complete ignorance regarding the sexual organs and the sexual functions which is permitted, and indeed, sedulously fostered, by 122

the ordinary education which boys and girls receive in this country.

While applauding the "delicacy of thought and expression" characteristic of the English people in such matters, the British Medical Journal was

convinced that this secrecy, this "conspiracy of silence" has gone too far, and that it is productive of serious evils.

It argued that "the stealthy approaches of vice are favoured by the existing system" which by leaving young people in ignorance led them to

"seek illum ination from some unhallowed source." However while some authorities urged that instruction in sexual matters was for parents to give, the British Medical Journal raised the objection that "probably a majority of parents are not well fitted to undertake such a duty", lacking a suitable vocabulary in which such information might be conveyed. The writer also considered that the suggestion that the duty be delegated to the family medical practitioner "would be highly disagreeable to members of the profession." The solution proposed was to teach "elementary anatomy and physiology" as a integral part of children's education, so that

when the suitable age arrives, the structure and functions of the sexual organs might be taken as the natural sequel of the previous portions of the course. In this way, the necessary knowledge would enter the mind naturally and simply, with no false shame on the one hand and no fillip to the imagination on the other.

This scientific and rational approach to the subject would, it was averred,

"remove the unwholesome fascination which our present habit of secrecy imparts.

The Lancet, a week later, took issue with the arguments propounded by the

British Medical Journal. It represented the voice of those who believed that little good cause was served by the publication of "hideous and revolting details in newspapers of the coarseness and selfishness of 123 individual scoundrels." They "regardtedl with suspicion those who think to promote these virtues by publications of vice", fearing that there were those who would thus "be drawn helplessly into the fascinating vortex." It was, the Lancet agreed, desirable that

public law do more than it has done, and a ll that it can do, for the protection of the young, not of one sex, but of both sexes.

But the remedy, in this argument, would come from "the cultivation of purity." The Lancet took exception to the recommendation of the study of anatomy and physiology as the solution to the problem:

There is no question on which a knowledge of anatomy and physiology is so little likely to be helpful as this... They are essentially moral and religious questions.

While law should protect the innocent, and filth be cleared from the streets and from literature, it was in the cultivation of purity and unselfishness that The Lancet placed its hopes. The pursuit of knowledge of sexual functioning was, in their eyes "bestdeferred.The Lancet did not engage with the British Medical Journal’s argument that innocence and ignorance lent themselves to entrapment and seduction, most especially of young girls.

Whatever the views of the medical profession, which it can be seen were far from monolithic upon the subject, other interest groups concerned with the promotion of social purity believed that a higher standard of this would not be attained by a continuation of the "conspiracy of silence."

Bodies such as the White Cross League and the Alliance of Honour produced numerous pamphlets specifically aimed at the inculcation in men of a high and single standard of chastity. While these were on the whole directed towards youths and young men rather than boys, the same problems were the ones concerned. True Manliness by "JEH" (the purity worker Jane Ellice 124

Hopkins) reached a large audience, according to Edward Bristow in Vice and

Vigilance over one million copies had been sold by 1909,*7 and this presumably does not include its further circulation as one of the papers drawn together in The Blanco Book, a compilation of White Cross League pamphlets produced for issue to troops.

True Manliness.*151 as its title suggests, aimed to inculcate an ideal of the true male as pure and chivalrous. This was partly done by vivid metaphoric depiction of the dangers men faced, with a description of the crossing of a mountain glacier by a narrow path, and partly by emphasising the struggle which the maintenance of continence required. Man was "an intelligent being mounted on a spirited horse" which he had to master. The dangers of ignorantly abusing the developing sexual function were threefold: such abuse would damage the maturing organism; the sexual faculties were designed for occasional, not continuous use and did not need to be called into action until this was legitimate; and they were not for selfish enjoyment but intimately connected with the good of future wife and family. Knowing this, would the young man

run the risk of tainting your blood and making it a fountain of corruption, till you have to loathe your body, the temple you have made into a charnel-house, reeking with the very breath of the grave. or would he

play the man, and fight against everything low and beastly, determined that your life shall have no shameful secrets in it.

Given th is choice, what would he choose:

You are conscious of strong impulses surging within you, conscious of a forbidden pleasure within your reach, forcing itself on your notice in ways that you cannot help.

But, even in the face of such innate temptations 125

you know what is rig h t, what is manly, what is noble, what is true to your nature.

Adhering to a high moral standard of conduct would accrue benefits, however, beyond the mere spiritual self-satisfaction of self-discipline, for

"stored-up passion” would create "splendid energy." The religious and moral messages were blended with the medical, including exhortations to stay away from quacks but to seek the help of reputable medical men if necessary. Occasional nocturnal emissions were reassuringly described as

"Nature's method of re lie f." This work, though couched in religious rhetoric, is notable for its directness and its getting straight to the problems at issue, even if it was sometimes hard to detect whether fornication or masturbation was being subsumed under the description

"dirty, shameful, secrets in your life": perhaps they were being regarded as simply differing aspects of the general problem of impurity.

In another publication of the White Cross League, The Testimony of Medical

Men was brought in to prove that there was nothing medically deleterious in continence and that it was itself conducive to health. Acknowledging that

Young men in the early prime of life often suffer really keen d istre ss and that the struggle for continence was just that, readers of this work were nevertheless warned away from "the many banks of festering slime" which lay in wait to "tear and rend the unhappy being who is driven against them", and reminded that "this is the only warfare where victory is won by flight."*49

True Manliness suggested that in spite of "the devil's lie, 'that... no man is really pure"' in fact 126

every pure man knows that he is only one of a great multitude in England and America wearing "the white flower of a blameless life". There are scores and scores of men all around you who are just as pure as any woman.so

This was not a position often taken by the purity lobby. In Lyttelton's The

Causes and Prevention of Immorality in Schools <1887), he was appalled by the prevalence of the solitary vice and impurity generally:

Of all the sins to which a boy is tempted at school the most prevalent, the most alluring, and the most enduring and deadly in its effects is impurity—and it is the only one not warned against as a matter of course.51

The "two great causes" he believed, were "curiosity and dirty talk",52 and the only effective preventive measure was warning against this uniquely awful sin.53

In 1894 the British Medical Journal reiterated its plea for the sexual enlightenment of young people in commenting upon a symposium in The New

Review on "The Tree of Knowledge", and how far it was necessary to preserve girls in innocence. Some contributors, perhaps naturally, believed that modern girls knew all too much already, but the

general drift of the opinions [was] strongly in favour of knowledge, although there is much divergence as to how or when it is to be imparted, and this is where the difficulty comes.

While the debate was prim arily on the problems of g irls Thomas Hardy, the novelist, remarked that "Innocent youths should... also receive the same instruction... it has never struck me that the spider is invariably male and the fly invariably female" (an opinion he vividly embodied in Jude the

Obscure), and the British Medical Journal concurred:

There can, we think, be little doubt that much unhappiness and a great deal of illness would be prevented if young people of both sexes possessed a little accurate knowledge regarding th e ir sexual relations... Knowledge need not necessarily be nasty.54 127

Certainly there was enough of a public perception of the need to instruct young people in these delicate matters for there to be increasing numbers of publications produced during the 1890s and 1910s, directed either at parents and guardians or young people themselves. What the actual demand for these was is hard to estimate since so many were privately printed by purity or youth organisations, and purchased in bulk by similar bodies, and the constraints of commercial publishing did not apply. Certainly vast q u an tities were produced and distributed. However, the success of books such as the "Self and Sex" series published by Dr Sylvanus Stall, an

American divine, which had wide sales in Britain, suggests that such a demand did exist beyond any mere imaginings about a rising tide of impurity threatening the nation.

Stall’s works were in their way typical examples of the kind of literature that was coming to be produced on th is subject. Their very title s became a kind of general description of it: "What a Young Boy/Young Man/Young

Husband/Man of Forty-Five Ought to Know." The gradation by phase of life was also typical, it was assumed that certain kinds and levels of knowledge were appropriate to certain ages. It might be noted here that the age at which warnings should be given was moving backwards to an earlier stage, as, presumably, it came to the awareness of purity workers that "bad habits" were often acquired prior to the surges of puberty: something which had been commented on by the B ritish Medical Journal in

1881: "bad habits have usually been acquired at preparatory schools."®5

Warnings aimed towards boys of an earlier age had to be couched rather less directly and with more circumlocution than had been regarded as appropriate in True Manliness or in Lyttelton’s pleas against impurity in 128 schools. It was surely at this period that the slow ascent of the evolutionary ladder (which was used by Geddes and Thomson as cited in

Chapter One) came to be employed in sex education literature and thus associated it with "the birds and bees":

The service they render in sex education is manifest. To come plump onto an anatomical or physiological explanation of the human sexual relation might conceivably shock and scandalise. To reach it at the end of an outline study of the sexual aspects of plant, bird and animal life is far more tolerable.®®

The beauties of nature and the natural reappeared with cliched regularity in these works. The spirochaete and the gonococcus, in this context, do not seem to have counted as part of "nature", which was always described as beautiful and benign, provided it was not abused or perverted.

Stall, in What a Young Boy Ought to Know, which was written in the formula of chats to a young boy called Harry, began with 47 pages on "God's purpose in endowing plants, animals and Man with reproductive organs."®7

After that he moved straight on to the danger of abusing the reproductive organs: this was the outcome of the existence of that organ which differentiated man from the animals, his hand:

Man is possibly the only animal which persistently pollutes and degrades his own body, and th is would not have easily been possible if God had not given him hands, which He designed should prove useful and a means of great help and blessing to him in his life upon the earth.5®

The dangers to "the moral intellectual and physical powers" of

polluting their bodies, by handling and toying with their sexual member in such a way as to produce a sensation, or feeling, which may give a momentary pleasure, but results in the most serious injuries.B® were gone into in much detail. There was certainly not much room for doubt about what vice Stall was attacking. While not offering a quack's remedies,

Stall's account of the deleterious effects of self-abuse very much echoed 129 those of quacks, as he threatened "idiocy... early decline and death... consumption... total mental and physical self-destruction" as the outcome of the practice. If a boy lived to manhood and managed to become a father, the "inferior quality" of his "sexual secretion" would manifest itself in his offspring.®0

Stall's prescriptions for the avoidance of falling into this pernicious habit, and for recouping strength if it had been succumbed to, involved life-style rather than patent remedies: wholesome light diet, healthy exercise, early rising, hard beds, the pursuit of mental improvement, cold baths, etc. Similar warnings were to be found in the next volume in the series, What a Young Man Ought to Know, which dealt also with the threats of venereal diseases and the problems of the courtship period.®1

While these earliest widely-circulated books emanated from the USA, and had a considerable influence in Britain, more local productions came to be issued after the turn of the century. Purity was also a concern of writers whose works were not exclusively dedicated to the purpose of sex education. It is arguable that the works of Lord Baden-Powell, Scouting for

Boys and Rovering to Success, reached a far wider audience than any more narrowly directed works. In the early editions of Scouting for Boys remarks on "Continence" were reserved for the appendix of "Notes for Instructors".

Baden-Powell was in favour of dealing with this problem in a frank and open manner, giving "clear and plain-spoken instructions." Self-abuse, according to "BP",

brings with it weakness of head and heart, and, if persisted in, idiocy and lunacy.®2

However, in la te r editions th is warning was taken out of the appendix and given directly to the scouts themselves: 130

There is one temptation that is pretty sure to come to you at one time or another and I want just to warn you against it.53

In Rovering to Success, addressed to an older age group, "Women" were among the "Rocks you are likely to bump on" but the problems dealt with under this heading dealt as much if not more with masturbation and the problems of continence as with actual relationships with women during this

"rutting season" of growing into manhood.6-* Readers were reminded that

"The Germ is a Sacred Trust for carrying on the race", and recommended to

"[keep] the organ clean and bathed in cold water every day" as the best precaution against excessive nocturnal emissions or the temptation to self-abuse.6,5 Baden-Powell also warned against venereal diseases,

sure, sooner or later, to overtake those who indulge their sex desires unwisely but also

very easily caught—even from a kiss or from drinking out of a cup used by an infected person.6,6.

Such warnings about the ease of catching sexually transmitted diseases by apparently innocent means were commonly found in sexual education literature at this period.

Baden-Powell was not influenced, over the years during which his works continued to be republished, by any consideration of changes in the medical debates upon sexuality. His breezy common-sense tone stayed the same, as did his ideas of the deleteriousness of masturbation, though he was clearly convinced of the possibility of recuperation, if not too far gone, by leading a healthy scouting life. Other, more sophisticated writers in the field of sex education were, by the time of the F irst World War, uneasily aware of theoretical developments tending to undermine many of 131 the beliefs embodied in their work. Some of them bravely, showing how up to date they were, incorporated the name of Freud into their writings.

A certain lip-service to Freud could be found, for example, in the fourth edition of Towards Racial Health: A Handbook for Parents. Teachers, and

Social Workers on the Training of Boys and Girls, published in 1920, Norah

March declared, in a footnote, We are indebted to the work of Professor Freud of Vienna for great illumination of this field of sex psychology.67 and referred to

this unconscious sexual life, the existence of which Freud is leading us to appreciate.66

Nevertheless her work was imbued with the b elief in an inborn "racial instinct" which did not readily blend with the libidinal theory of sexual development. Her views on the distinct and separate natures of the two sexes rested more on the work of Geddes and Thomson than on a reading of the Three Lectures on Sexuality (which did not appear in her list for further reading), as she argued in terms of the differing role of the father and the mother in reproduction resulting in the male instinct being direct and the female diffused, as a natural outcome of evolution. As a corollary to this, there was a detailed chapter on the use of nature study

towards inducing a reverent and responsible attitude towards questions of sex and parenthood.69

(So reverent and responsible an attitude was induced by nature study, that when two University lecturers in botany married in 1911, the marriage was dissolved several years later on the grounds of non-consummation and the wife of the couple wrote a best-selling book so that other .couples might escape the ignorance which had blighted her own life: see Chapter 4).

March's prescriptions for discouraging "sexual laxity and distress" in the growing boy similarly had a familiar ring: 132

[He] should absolutely free himself from the dominion of eroticism... the male mental attitude should be pure and cool enough to refrain from susceptibility... the more frequently he exerts his will-power to triumph, the more easily will it act for him in the day of sudden emergency.

However,

should he fail to exert self-discipline... the mental habit so formed will become so detrimentally strong as to overwhelm any effort of will to preserve mental and emotional serenity.7”0

While the stress here may be laid on mental attitude rather than physical measures the underlying attitude on the need for and the struggle involved in control was still there. March did not ignore, either, the usual physical prescriptions prophylactic against incontinence, reiterating the usual exhortations about early rising, hard beds, wholesome diet, cold baths, etc.

It should be clear, therefore, that in many ways the paramount sexual sin inveighed against by sex educators was masturbation, perhaps naturally in view of the fact that they were addressing themselves to an age-group for which it was far more likely a temptation than actual fornication. The horror in which the practice was held, however, extended well beyond this concern for youth in danger.

Anxieties about masturbation had several roots: it was regarded as a disgusting and sinful habit, it wa6, as described in Chapter One, widely regarded within the medical profession as depleting to health, and it could also be the first step in a course of impurity leading to fornication, disease and death, by eroding self-discipline and self-control: as E

Lyttelton put it in The Causes and Prevention of Immorality in Schools

The least defilement by hand enormously increases the d iffic u ltie s of continence in manhood.7’1 133

Opinions, even, or particularly, among the medical profession, varied, and

in the White Cross League pamphlet "The Testimony of Medical Men" some of

these experts echoed Lyttelton in considering masturbation the high-road

to a career of assorted debauchery:

the precocious indulgence of boyhood may... ripen into the ungovernable passion of manhood and become responsible for the support of prostitution.72

I believe that it is th is commencement of ev il which leads to so much debauchery after school life is over.73

the early and restrained [sic] indulgence of the passions... will lead the unhappy sufferer to seek relief in unlawful and perilous expedients, which... become the parent of other ills far more difficult to bear than the salutary rule of self- re s tra in t.74 whereas others believed that once succumbed to, the vice of masturbation would its e lf become an over-riding obsession:

the habit of solitary sin, learned and contracted at school, and not discontinued even in later and more mature years, until at last it has become the one absorbing and uncontrollable passion of life .75

However, although the importance of eschewing self-indulgence in so lita ry

vice in order to build up self-discipline to resist later temptations was

often emphasised, an enormous weight was given to the deleteriousness of

masturbation itself. This was regarded by many authorities as far more

physiologically harmful than actual copulation (excluding the risks of

contracting disease). This would seem to be only partly due to a belief

that it could be far more readily pursued to "excess" than fornication,

since the opportunity, as it were, was always to hand. It was regarded as

especially dangerously depleting to the vital forces of the adolescent at a

time when these were needed for the maturing process. 134

So much more harmful was it supposed to be than fornication that copulation was often supposed to be the specific remedy against it

(provided that impotence had not already supervened as a result). However, it is exceptionally hard to find doctors actually recommending this as the answer, in spite of the reiteration in purity literature of warnings against medical men advocating fornication as essential for male health. It is true that Drysdale could be regarded as doing this, but as his recommendations were part of a wider social programme involving radical changes in the relations of the sexes, it would be hard to contend that he was suggesting that young men should resort to prostitutes.

However, one elderly man (aged 76 in 1924) wrote anonymously to Marie

Stopes with the following account:

The doctor... strongly advised me to drop masturbation. He even suggested certain houses where I might meet women of a better class, and advised the use of sheaths or injections... The doctor even advised woman as a lesser evil than the risk of disease in masturbation.7®

This was perhaps the more astonishing because this advice seems to have been prof erred during treating the patient for "a clap". A retired naval surgeon from New Zealand wrote to Stopes around the same time arguing the case for "licensed houses", on the basis that masturbation was increasing in prevalence as reflected by physical deterioration, evidenced by the growing numbers of cases of variocele seen in candidates for the

Canterbury (NZ) police over a period of forty years. He described his experience in the Navy of the "bluejacket's" horror of masturbation which led them to duck any young sa ilo r found indulging, then putting him to bed with a woman in the next port reached. He claimed that "the number of young men crippled by masturbation is appalling."77 These are, however, hardly evidence of widespread prescription of such remedy by the medical 135 profession, especially as these remarks were conveyed in private communications, and by men of a previous era. Nevertheless, as late as

1920, a Dr J Charsley Mackwood, MC, presumably a young man since according to the Medical Directory he had qualified in 1910, and one who had both served as a temporary RAMC officer in the War and been a Medical Officer to the Admiralty, wrote to the British Medical Journal during the on-going debate about venereal disease prevention and prophylaxis, suggesting that the campaign to make the horrors of sexually transmitted disease more widely known

succeedts] so well that the convert practices self-abuse rather than risk infection. The late Dr Charles Mercier would have classified this last as a crime against humanity.70

It might be argued that opinions about the ill-effects of masturbation were simply effusions by the medical profession and that all the diatribes reprobating the practice had little enough effect upon the average young man. This is to ignore the fact that masturbation was equally represented as pernicious by "underground" sexual advice. It also assumes that coming into contact either with purity leaflets or quack pamphlets had no effect upon individuals, and that they could ignore a climate of opinion which blamed masturbation for a variety of ailments from warts on the fingers to impotence, consumption, convulsions, insanity and death falling upon the individual himself, as well as the corruption of his posterity.

If it might be doubted whether these awful warnings had any effect upon those who encountered them, there is some evidence for the anxiety about the topic beyond that of the persistence of quacks in exploiting this field. Bristow, in Vice and Vigilance, points out that many- of the individuals and organisations involved in the field of sex education 136 received "a heavy burden of correspondence with young men."73

Unfortunately these letters no longer survive: a very few of what must surely have been a far larger collection of letters received by Baden-

Powell are to be found among his papers held by the Scout Association.

Most of these are fairly inexplicit:

It [Rovering to Success] has bucked me wonderfully, cleared my darkened mind, and s e ttle d a lot of l i t t l e troubles which I before did not discuss owing to the delicacy of their nature.

Breezy wholesome manliness, and tit] does not merely warn against dangers and unwholesome development.

In confidence I can tell you that in the past I have been greatly troubled with the "Rock" women which you so strongly refer to in your book. I mean self-abuse only I put it under this heading... of course one does not realise the danger at the time.

I have very nearly fallen once already... and may I say how great a help your book is, as it puts it all so clearly? It is just this question of the last clause of the Scout Law ["Pure in thought word and deed"! which is rather a difficulty—as to know how to deal with it.

My greatest "rock" was the attempting to curb my natural desires which at times were so strong that through weakness I gave in... now I am just beginning to look men in the face again.30

Marie Stopes received many letters from men who were extremely anxious about masturbation, either because of fears that they had damaged themselves or because of their inability to break the habit. Sufferers (and it is clear that in their own eyes it was suffering) from the habit often described it in extremely pejorative terms:

The beastly thing.

This beastly habit.

That pernicious and shameful habit self-abuse.

Utterly loathsome cravings.

I was a slave to the vile practice of masturbation. 137

A terrible craving to give way to self-abuse.

The exquisite but pernicious soul and body-destroying sin of masturbation.

All my troubles are due to masturbation.

The abominable habit of masturbation... I have been a weak and miserable rotter.

This vile thing.

Cl] got into the terrible evil of self-abuse.6,1

Such pejorative terms suggest a considerable internalisation of prevalent attitudes towards the solitary vice. Its negative connotations were further revealed in descriptions of the habit as having been picked up from "bad company”, "undesirable and debased characters", "a ro tten set".®2 Even when descriptions of the habit were less hysterical than those quoted above, it was described as "folly",®3 a "mistake",®-4 even a "•disease"', something of which the su fferer was a victim.®®

One or two of her readers did voice some scepticism about how horrendous the effects of self-abuse might be:

I know it should be discouraged but all boys do it and nothing ever happens.®® and some considered it a "lesser evil"®7 than fornication:

I was told and I believed, that the only possible alternative to this was to go with prostitutes, and that this alternative was more degrading than the other.

I hated the idea of buying relief from women but my brother... told me that I could obtain release by applying friction to the penis by my hand... I have always understood it was quite harmless.

I feel sure tit3 is not so harmful as generally thought but is obviously unpleasant and undesirable.®®

This point was also made by one of Baden-Powell's correspondents, writing about his son's difficult struggle for continence: 138

Other men knowing his weak point have told him that fortnightly self-abuse was not inconsistent with a pure life—schoolmaster, doctor and parson have all told him this.®9

This commonsensical approach to the problem, that occasional regulated indulgence in self-abuse was better than a resort to fornication, may possibly have had considerable currency. However, such a statem ent in published works is very hard to find: the view of Dr W F Robie, in Rational

Sex Ethics, c. 1918,

Its occasional indulgence is much less harmful than occasional intercourse, on account of the dangers of venereal disease.90 must have been almost unique at the time, although by the 1930s such a concession became more commonplace in works of sexual advice. Among

Stopes's correspondents, it is interesting to note that this expedient was advocated by two of the clergymen who wrote to her, rather than doctors: one, conceding that "it cannot be discussed in public prints", suggested that if masturbation

is only availed of for relief and self-regulation (like the bowels, as an eminent London man once said to me) say once a week or in 10 days, I not only see no sin or fault in this but an act of self-denial, of escape, and probably of unselfishness towards another. It is certainly better than either seducing a girl, or availing of prostitutes.91 a point of view with which Stopes was inclined to agree. Another clergyman while admitting that

I know it is injurious to often rub "stuff" out of my penis by hand and I have never done it regularly. added that "I can never see it harmful or wrong occasionally."92

This point of view contrasts with the tales of those men who were so horrified by their practice of self-abuse that they sought fornication as a cure:

Do you think in my case it would be wrong to go to a prostitute? 139

I thought to have connections with a woman would cure me.

Before I was married I used to have unions three and four times a night, two or three times a week with d ifferen t g irls in the hope of curing myself but it was of no use.33

Mentions of the acquisition of information from friends and companions has already been cited: at least two of Stopes's correspondents related that their reading of works of sex education had opened their eyes to the dangers of their habit:

Somehow I got hold at the age of 19 of a book called "What a Young Man Ought to Know". Having read it, and with a violent assertion of will-power, I overcame the vice of masturbation, and have kept free from it ever since.

It was while I was recuperating from th is illn e ss that I noticed a book advertised (Knowledge A Young Man Should Have). It was not u n til I read that book that I realised what harm I had been doing to myself through self-abuse.3A

Stopes's works, of course, appeared after the First World War at a period when, theoretically, ideas about the dangers of masturbation were growing less ferocious and there was even an increasing tendency to argue that the guilt and shame aroused by purity literature and quack horror stories were more productive of damage than onanism itself. Sir T S Clouston's remarks on the dangers of quack scare advertising as equally productive of insanity as the vice itself have been cited above. He did not, however, therefore consider the habit innocuous.

Fear of the possible ill-effects of masturbation persisted, and much of the lite ra tu re cited above continued to circu late up to the Second World War at least, while the underground tales of sexual mythology must have gone on producing their own horrors. Since the pernicious belief about curing venereal disease by intercourse with a virgin would appear to have been still current at least up to the time of World War II, being mentioned in 140 order to be dismissed in instructional literature, it seems probable that the life of other myths was equally persistent.

The young man of the later nineteenth and early twentieth century was likely to have acquired, somehow, some form of information about sex. It is plain that there was some kind of informal male culture which might provide some form of instruction, though th is would very likely have been full of myths and not necessarily particularly reassuring. Quack scare literature defining non-pathological manifestations of male sexuality as the signs of radical disease was omnipresent. It must have provoked widespread anxiety and was not so alien from the general medical perceptions of the dangers of sex as the profession sometimes liked to suppose. Purity literature exhorted to a complete suppression of all sexual instincts and insisted that the only licit place for the exercise of the sexual instinct was within marriage. The influence of such ideas upon individual males must have varied very widely, and the ideas themselves differed so radically, that their effect on actual behaviour is extremely hard to calibrate. However, it would seem th at it would have been very hard for a man wholly to avoid the fears and misconceptions and anxieties around sexual activity embodied in information emanating from very differing sources of advice. 141

Chapter Three; Notes

1. Paget, Sir James, "Sexual Hypochondriasis", Clinical Lectures and Essays. Longmans Green, London, 1875, 2nd edition, 1879, pp 275-298

2. Scharlieb, Mary, and Sibly, F A, Youth and Sex: Dangers and Safeguards for G irls and Boys. London, [19133, p 48

3. Schofield, Dr A R and Vaughan-Jackson, Dr P, What A Bov Should Know. Cassell, London, 1913, pp 27-28

4. Bigelow, M A, Sex Education: A series of lectures concerning knowledge of sex in its relation to human life. Macmillan, New York, 1916, p 14

5. Scharlieb, M, How to Enlighten Our Children: A Book for Parents. Williams and Norgate, London, 1918, p 8

6. March, Norah, Toward Racial Health: A Handbook for Parents. Teachers and Social Workers on the Training of Boys and G irls, with a foreword by J Arthur Thomson, George Routledge and Sons Ltd, London, 1915, 4th edition, revised, 1920, Appendix I, p 262

7. Stopes, Marie C, Sex and the Young. G ill Publishing Co, London, 1926, p 11

8. Marie C Stopes papers in the Contemporary Medical Archives Centre at the Wellcome In s titu te for the History of Medicine, correspondence "ML- GEN", CM AC: PP/MCS/A.32 HMB 1921, A.57 JC 1918, A.135 WH 1919

9. Nichols. T L, Esoteric Anthropology (The Mysteries of Man) A comprehensive and confidential treatise on the structure, functions, passional attractions, and perversions, true and false physical and social conditions and the most intimate relations of men and women. Anatomical, physiological, pathological, therapeutical and obstetrical. Hygienic and Hydropathic. From the American Stereotype Edition. Revised and Rewritten. Published by Dr Nichols at the Hygienic Institute, Museum St, London WC, Cc. 18733, p 280

10. Lyttelton. Hon E, The Causes and Prevention of Immorality in Schools. Social Purity Alliance, printed for private circulation, 1887, p 12

11. Schofield and Vaughan-Jackson, op cit. p 53

12. March, op cit. p 24

13. Stall, Sylvanus, What a Young Boy Ought to Know. Self and Sex Series, Vir Publishing Co, Philadelphia and London, 1897, p 85

14. Scharlieb and Sibly. op cit. p 56

15. March, op cit. p 54

16. CMAC: PP/MCS/A.220 WS, A.43 PAB (a missionary), A. 146 BJ, A.210 L-Bdr LR, A.64 C

17. CMAC: PP/MCS/A.l 15 HPH, A.244 WPW 142

18. CMAC: PP/MCS/A. 107 CHG, A. 132 HPH, A. 157 ML

19. Barnett, Arthur T, "The Testimony of Medical Men", in The Blanco Book. The White Cross League, London, 1913, pp 217-248, re f to p 224

20. Schofield and Vaughan-Jackson, op cit. p 50

21. CMAC: PP/MCS/A.63 C

22. cited in a review in The Shield. 1919-1920, 3rd Series Vol 2, p 228

23. The Shield. 1919-1920, 3rd series Vol 2, p 231

24. Crozier, Brig-Gen F D, A Brass Hat in No-Man's Land: a personal record of the European War. Jonathan Cape, London, 1930, p 90

25. CMAC: PP/MCS/A. 166 IMacL

26. CMAC: PP/MCS/A.60 2nd/Lt ERFC (RAF)

27. B ritish Medical Journal. 1919, ii, 360

28. The Lancet. 1885, ii, 350

29. BMJ, 1892, ii, 753

30. The Lancet. 1929, i, 1202-1203

31. BMJ, 1885, ii, 303-304

32. British Medical Association Groups files in the Contemporary Medical Archives Centre at the Wellcome In stitu te for the History of Medicine, "Medico-Political" files, CMAC: SA/BMA/C.483 "Birth Control and Indecent Advertisements: correspondence, c. 1929-1955"

33. BMJ, 1879, i, 823-824

34. CMAC: SA/BMA/C.429 "Patent Medicine: Documents used by Dr Crosse in the compilation of evidence to be presented before the Select Committee, 1912"

35. BMJ. 1892, ii, 753

36. The Lancet. 1870, i, 889

37. The Lancet. 1870, i, 880

38. The Lancet. 1870, ii, 72

39. The Lancet. 1870, ii, 89-90, 124-125, 159-160, 224-225

40. Clouston, Sir T S. Clinical Lectures on Mental Diseases. J A Churchill, London, 1883, 6th edition 1904, "The Insanity of Masturbation", pp 535-546, re f to pp 538-539 143

41. CMAC: SA/BMA/C.436 “Patent Medicines: A ustralian Commission on Secret Drugs 1907“

42. CMAC: SA/BMA/C.429, cited above

43. BMJ, 1892, ii, 753

44. BMJ, 1881, ii, 904

45. BMJ, 1885, ii, 303-304

46. The Lancet. 1885, ii. 350-351

47. Bristow, Edward, Vice and Vigilance: purity movements in B ritain since 1700. G ill and Macmillan, Dublin, 1977, p 138

48. HJEH" (Hopkins, J Ellice), “True Manliness", in The Blanco Book. White Cross League, 1913, pp 115-143

49. Barnett, "The Testimony of Medical Men", pp 244, 246-247

50. "True Manliness", pp 133-134

51. Lyttelton, op cit. pp 16

52. ibid. p 14

53. ibid. pp 16, 27

54. BMJ, 1894, i, 1266-1267

55. BMJ, 1881, ii, 904

56. Northcote, Rev H, "Sex and Nature Study", The Shield. 1920-1922, 3rd series Vol 3, pp 323-326, re f to p 325

57. S tall, op c it. pp 25-72

58. ibid. pp 80-81

59. ibid. pp 82-83

60. ibid. p 113

61. Stall, Sylvanus, What a Young Man Ought to Know. Self and Sex Series, Vir Publishing Co, Philadelphia and London, 1897; revised and reprinted as late as 1929

62. Baden-Powell, Lord, Scouting for Boys: A Handbook for Instruction in Good Citizenship. C Arthur Pearson, London, 1908, 2nd impression, p 279

63. ibid. 10th edition, 1922, p 209

64. Baden-Powell, Lord, Rovering to Success: A Book of Life-Sport for Young Men. Herbert Jenkins Ltd: London, 1922, 13th printing, n d, p 103 144

65. ibid. p 104

66. ibid. p 107

67. March, op cit. p 33

68. ibid. p 35

69. ibid. p 97

70. ibid. p 175

71. Lyttelton, op cit. p 15 72. Barnett, "The Testimony of Medical Men", F Le Gros Clark, p 223

73. ibid. Clement Dukes, p 224

74. ibid. J J Nason, p 239

75. ibid. C G Wheelhouse, p 226

76. CMAC: PP/MCS/A. 1/25

77. cited in Hall, Ruth, ed, Dear Dr Stopes: Sex in the 1920. Andre Deutsch, London, 1978, p 97

78. BMJ, 1920, i, 130

79. Bristow, op cit. p 147

80. Baden-Powell papers held in the Scout Association archives, "Rovering to Success correspondence" c. 1922, ref TC/2

81. CMAC: PP/MCS/A.228 AGS, A.245 MW, A. 157 ML, A. 168 AMM, A. 183 JM (in India), A. 17 CH, A.220 WS, A. 128 JSH, A. 157 FJL, A.244 WPW, A.64 GWC

82. CMAC: PP/MCS/A.44 B, A.54 C, A.32 B

83. CMAC: PP/MCS/A. 176 MM, A. 183 WN, A. 107 GHG

84. CMAC: PP/MCS/A.232 CT

85. CMAC: PP/MCS/A.239 CW

86. CMAC: PP/MCS/A.248 Sgt HTW (in India)

87. CMAC: PP/MCS/A. 109 Major GCGG

88. CMAC: PP/MCS/A.200 JP, A.63 C, A.42 Lt-Col WWB (RAMC, India)

89. Baden-Powell papers in the Scout Association archives, as cited above, note 80

90. Robie, W F, Rational Sex Ethics: a physiological and psychological study of the sex lives of normal men and women. R G Badger, Boston, [19183, 145

Brandon Library paperback edition, North Hollywood California, 1966, p 102, see also pp 294-296, where he describes masturbation as "a minor evil... which works no harm on the re s t of society”

91. "An Old Priest", cited in Ruth Hall, op cit. p 65

92. ibid. p 72

93. CMAC: PP/MCS/A.241 CW, A. 176 MM, A.33 WWDB (New Zealand)

94. CMAC: PP/MCS/A.32 JJB, A. 107 CHG (A ustralia) Chapter Four

Married Love and Enduring Passion

It has been shown in the previous chapters that sex was more and more being considered a subject which should not be left to nature to sort out.

If it had always been a topic on which doctors were meant to be an authority, it was being conceded that information should be made available to the laity, however much certain areas should remain an exclusively medical concern. Anxieties about disease, hereditary or acquired, and about national fitness, anxieties aroused by changing social mores, were leading to new ways of thinking about sex. Some of these were already emerging prior to the F irst World War: but it was only a fte r 1918 that there was the sudden efflorescence of a new form altogether of the marriage manual.

This doubtless owed something to the growing awareness that birth control was a possibility, and an increasing belief, which took some time to be accepted by the medical establishment, that it was an acceptable practice for married couples. Obtaining reliable information was still a problem, and contraception still had an aura of the sleazy which many found deterrent. During the 1920s this changed. The idea that sex within marriage performed other functions than the purely reproductive, while not new, gained a much wider currency. In order that it might fulfil its other potential function of consolidating the married couple's relationship, physically, emotionally, spiritually, new guidelines were needed, for the achievement of a mutually satisfying physical relationship between husband and wife did not necessarily come "naturally". 147

In 1918 a palaeobotanist named Marie Stopes published at her own expense

(or, rather, at that of her soon-to-be fianc6 Humphrey Verdon Roe) a small volume entitled Married Love: A New Contribution to the Solution of Sex

Difficulties, with prefaces by Jessie Murray, one of the first British psycho-analysts, Professor E H Starling, the physiologist, and Father

Stanislaus St John, a Catholic priest (this latter was withdrawn from later editions as Stopes became notorious for her advocacy of birth control).

The story which is generally accepted about the origins of th is work, and which was promoted by Stopes herself, was that, as she said in her own preface,

In my first marriage I paid such a terrible price for sex- ignorance that I feel that knowledge gained at such a cost should be placed at the service of humanity.1

In 1911 she had married Reginald Ruggles Gates, a Canadian botanist. Some years later, concerned that she had not yet become pregnant, she embarked on a course of investigation among the works held in the "Private

Cupboard" at the British Museum, which led her to conclude that her marriage had never been consummated. There could hardly be stronger evidence in contradiction of the prevalent contemporary thesis that nature study was a sound basis for sex education. For all their expertise in the subject of plant reproduction, Stopes and Ruggles Gates seem to have failed to make any useful connections to human mating.2

Stopes proceeded to seek a decree of annulment, which was granted in 1916.

A statement by Gates deposited in the British Library Department of

Manuscripts by his widow contradicts Stopes' account, although it appears to have been written many years after the event and to contain certain implausibilities: it would certainly have been very hard for a woman not 148 demonstrably still a virgin to obtain a decree of annulment on the grounds of non-consummation, if not altogether impossible. However, it is also clear from Stopes' biography that she was capable of a considerable degree of self-delusion, and that if she had managed to convince herself that on any level meaningful to her the marriage was a failure, she would have believed implicitly that it was no real marriage. Gates married again

(twice) but had no children by either of these unions, although included with his statement in the British Library is a medical report on a sperm- test he had done during the 1930s which would seem to indicate that he was fe rtile .3

Whatever the truth about this tragic union, which will surely never be known now, according to Stopes it led to the writing of Married Love.

However, since 1913 at least she had entertained hopes of performing 6ome work of great service to humanity (apart from her scientific researches) and determined that it should be "bi-sexual... not, like the women's movement, unisexual" although she was a supporter of the suffrage movement, retained her maiden name subsequent to marriage a t a time when this was extremely uncommon, and agitated for reforms in the tax laws relating to married women. She had been Involved with contemporary movements for sexual reform, and in 1915 had met the American b irth control a g ita to r Margaret Sanger in the company of Havelock E llis. While learning from Sanger about methods of contraception (though the two women subsequently fell out) her response to reading Ellis's own Studies in the

Psychology of Sex was to remark that it was "like breathing a bag of soot: it made me feel choked and dirty for months."* The emphasis in her own works was on the normal, the natural, the healthy, the clean: as she stated in the preface to Married Love 149

In this book average, healthy, mating creatures will find the key to happiness which should be the portion of each... I hope it may save some others years of heartache and blind questioning in the dark.®

Married Love went through 5 editions and sold 17,000 copies in the first year alone® (it outsold, according to B Melman Woman and the Popular

Imagination in the 1920s (London 1988), most of the b est-sellin g fiction of the era). It was received with a certain degree of enthusiasm by the medical press: the Lancet described it as "an extremely sensible little book... is really needed as a public adviser"7 and the British Medical

Journal paid tribute to Stopes' "literary skill, sympathetic insight, idealism, and more than common courage." The reviewer went on to give her the accolade that

Not withstanding the vast output of books on sex in recent times, Dr Stopes has, we think, proved that something remained to be said on the subject if the right person could be found to say it in the right way... [We] commend it to medical men and women, and through them to those of the general public who in their judgement are likely to profit by its teaching.®

By 1925 sales of Married Love had passed the half-m illion mark, and achieved the million in the early 1950s. These figures do not include

English language editions for the USA, Australia, Canada and India, or translations into 14 foreign languages and Braille.9 There is some evidence that copies were circulated among friends and relatives, so the total number of readers must have been much higher. It was the most successful of her works but the others also sold well. Wise Parenthood: A Sequel to

Married Love. A Book for Married People, with an introduction by the novelist Arnold Bennett, had sold over half a million copies by 1930, had gone into 25 editions by 1951, and was translated into 12 languages. It is, however, interesting to contrast its reception (as an explicit manual about 150 birth control) by the medical press with that of Married Love cited above: both the Lancet and British Medical Journal greeted this second work of

Stopes with resounding silence. Her shorter work on birth control, the pamphlet A Letter to Working Mothers. On How to have Healthy Children and

Avoid Weakening Pregnancies (subsequently P ractical Birth Control) must have had a great deal more readers: it was so cheap that some clinics, district nurses, and also owners of rubber-goods shops, bought up large quantities to sell or distribute free. Stopes geared her approach to different groups: she has often been Jeered at for the recommendation in

Wise Parenthood that the cap be inserted "when dressing in the evening."10

But th is book was addressed to the rath er more m iddle-class readership which had already devoured Married Love: A L etter to Working Mothers was slanted much more clearly to the circumstances and reading abilities of over-stretched working-class women. Stopes had a considerable awareness of differing audiences, proved by the phenomenal response to her articles in

John Bull, which produced a flood of letters from poor women, many of which were later published under the title Mother England. Other successful works by Stopes were Radiant Motherhood: A Book for Those Who are Creating the Future (1920) and Enduring Passion. Further New

Contributions to the Solution of Sex Difficulties being the continuation of

Married Love (1928).

Stopes' ideas had wide currency and her very name became a by-word for sex-advice and birth control. This was helped rather than hindered by the widely publicised libel suit between her and the Catholic doctor Halllday

Sutherland who had written a book attacking birth control in which he accused her of opening the Mother's Clinic in Holloway in order to experiment on poor women. He alleged 151

ordinary decent instincts of the poor are against these practices... the poor are the natural victims of those who seek to make experiments on their fellows. In the middle of a London slum a woman who is a doctor of German Philosophy (Munich) has opened a birth control clinic.

In spite of the very limited circulation which this work attained, Stopes took Sutherland to court, an action which gained her even more publicity than hitherto and generated a considerable increase in her correspondence and in the sales of her work.11

The enthusiastic and personal response of her readers (who represented a wide social mix) was a tte ste d to not merely by the sales of her works but by the fact that they wrote to her in great numbers. As she wrote in

Enduring Passion (1928)

Ten years have passed with such amazing rapidity that it seems in some ways but a few weeks since, by publishing th at book [Married Love] I le t loose upon my shoulders an avalanche of demand, enquiry and appeal from humanity for ju st th at deeper probing of marriage which I postulated.12

These letters to her survive in quantity, alongside, in many cases, carbon copies of her replies or at least notes for her secretaries, which demonstrate her own continued interest in helping couples to attain her ideals of Married Love. This mass of correspondence forms a rich and unique source for the study of sexual ideas and attitudes in the 1920s and

1930s, providing an invaluable key to the question of reader response to works of this kind.13

The reasons for the success of Stopes’ works, Married Love in particular, are not hard to find. It is clear from the response of her readers that she was writing in the right place at the right time, that she was attuned to the spirit of the age in her descriptions of what many couples sought for from marriage and were failing to find. Married Love was also short, 152 something that could be read in one evening, and got straight to the

problems of human marital sexuality in Western society without climbing

the evolutionary ladder and covering the globe first. It also advocated,

though without giving details (Wise Parenthood dealt more explicitly with

the matter), the use of artificial birth control, a radical departure in

books of this kind. Earlier works had made a token gesture to the need of

some couples to restrict their families by recommending the safe period, usually based on biblical formulae and thus even less reliable than the

present-day rhythm method. But Stopes* message that sexual fulfilm ent for

both partners was necessary to marriage, independently of reproduction,

clearly struck profound chords in her readers, male and female. Above all

it was technically helpful in explaining what to do to obtain pleasure in

the sexual act: the writer Naomi Mitchison remarked in her autobiography:

It seems incredible now that this book was such an eye-opener. Why had none of these elementary techniques occurred to either of us before?

and attributed to it **a marked increase of happiness."1A Mitchison herself

was brought up in a s c ie n tific family (her father was Professor J S

Haldane the physiologist and her brother the geneticist J B S Haldane) and

conducted genetic experiments with guinea-pigs from an early age, but as

with Stopes, the academic knowledge she had about plant and animal

reproduction was little help in the marriage bed.

The clim actic moment was presented by Stopes (and other contemporary

writers in the genre), as something approaching a mystical experience: she

used terms such as "subtle spiritual alchemy", "the initiate of love's

mysteries", and imagery of tides and waves15 pervaded her explicit

accounts of the sexual organs and act. It followed that heavy pressure was

laid on the man to continue the act for as long as it took for his wife to 153 become fully aroused and completely satisfied; Stopes suggested at least twenty minutes.161 But it was not merely restraint in the act of coitus that was urged: Stopes' disciplines for marital "erogamy" also required restraint in the old sense:

Without the discipline of self-control there is no lasting delight in erotic feeling. The fullest delight, even in a purely physical sense, can be attained only by those who curb and direct their natural impulses.17

Similar ideas had been promulgated by Havelock Ellis in Sex in Relation to

Society, in the chapter on "Chastity”,10 in which he advocated periods of abstinence as a vital component of the highest kind of sex-life. Like

Acton, though for different reasons, Stopes advocated fortnightly unions

(to coincide with the woman's "love-tides"): and like Acton she anticipated that more than one act would take place at these times. Not because of the need for a "thorough emptying" of the seminal vesicles, but to take advantage of the woman's passions at th e ir h eig h t.19 The reward she promised—the pinnacles of mutual sexual ecstasy—was rather more alluring a prospect than the hygienically recommended ejaculation of the Actonlan husband into his unresponsive wife, though possibly more productive of performance anxiety. This emphasis on periodic restraint, however, links her to forebears who would surely have dissociated themselves from the other components of Stopes' message to humanity.

Stopes was not, of course, the only successful writer of sexual advice at th is period. Numbers of works followed Married Love in providing the sexual advice which so many readers sought. So many books on the subject were published, some of them exceedingly ephemeral, that it is impossible to discuss them all. The account which follows therefore generalises from 154 a sample, which seems fairly representative, of books all of which had a considerable following, went into several editions, and continued to be reissued over a period of many years.

Coming out very shortly after Married Love. Wise Wedlock: the whole truth; a book of counsel and instruction for all who seek for happiness in marriage by Dr G Courtenay Beale,20 was alleged by Stopes to be more or

less a plagiarism of her own work. She also believed "G Courtenay Beale" to be a pseudonym concealing a syndicate.21 Certainly no doctor of that name appears in the Medical Register; and passages in Wise Wedlock echoed the phraseology and general tenor of Stopes' work suspiciously closely. For example

In the shared rapture of union between two beings who desire each other with every strand and fibre of their natures, the b arrier between body ahd s p irit is done away; in the supreme glow of a supreme sense of b liss there comes to pass a glorious fusion of individualities... a subtle mutual interpenetration.22

would seem to be a paraphrase of Stopes'

When two who are mated in every respect burn with the first of the innumerable forces within them, which set their bodies longing towards each other with the desire to interpenetrate and to encompass one another, the fusion of joy and rapture is not purely physical.23

While his passage which alleged

in her the sex-tide ebbs and flows, sinks and rises, and it is for him to observe the "signs of the times", not difficult to read for the vigilance of love, which will proclaim that her tide is at the full.24' seems to derive from Stopes' chapter "The Fundamental Pulse" with its

theory of the "sex-tides" in women. "Beale" asserted the existence of

fortnightly rhythm of sexual desire in women, an idea particularly associated with Stopes: Havelock Ellis's discussion of the question, in

Volume VII of the Studies, paid tribute to her formulation of this idea,2* 155 which was also recognised by the reviewers in the Lancet and British

Medical Journal as one of her most distinctive contributions to the subject.2* It is hard to imagine where else "Beale" would have found this notion. However, it is also possible that "Beale" was expressing ideas which were less Stopes* own property than part of the climate of the time, and that this was the reason for these echoes. A later edition of Wise

Wedlock received the accolade of an introduction by Norman Haire, the

Harley Street sexologist, in which he stated

I now consider it to be one of the best, if not the best, of its kind available in English.27

It was still being reissued well into the 1940s.

"Beale's" medical status remains uncertain: Isabel Hutton, however, was a woman doctor who took the daring step in 1923 of publishing a work of m arital advice, The Hygiene of Marriage.28 under her own name. It would appear from her autobiography that her career in psychiatry had been terminated by her marriage, since most salaried medical appointments, at both national and local levels, were at that date subject to a marriage bar where women doctors were concerned.29 Her work, like Stopes', grew from her own experience:

I... evolved something that stemmed from my own past ignorance and difficulties. though also out of

the questions patients had asked me throughout the years.

Her aim was to w rite a book which was

simple, realistic, and containLedl essential information that is not instinctive with the human species.30

The Hygiene of Marriage certainly achieved this, and, though never one of the most notorious works in this field, enjoyed a certain modest success, 156 being reprinted several times. Dr Hutton's comments on the response of her readers have already been cited in the Introduction. Hutton acknowledged in her autobiography the generous critiques the work received from her colleagues in the medical press: both the Lancet and the British Medical

Journal pronounced it to be a work which "could with advantage be recommended by medical p ractitioners."31 She h erself was of the belief

that it was "the first of its kind to be written by a medical doctor",33 and hoped that her professional colleagues would recommend it to th eir patients. This indeed seems to have been the only publicity the book had.

Nevertheless numbers of people wrote to Dr Hutton about their problems,

though unlike Stopes she does not seem to have preserved this correspondence.33

Perhaps Stopes' major competitor in the field was Theo. Van de Velde, Dutch gynaecologist's, famous work Ideal Marriage.3A He also published other

works of less far-reaching popularity. In 1949 Eustace Chesser wrote that

Van de Velde on Ideal Marriage is still handed to the enquiring husband as confidently as Mrs Beeton on Cookery has been passed to innumerable wives.35

This work, even though the sale of the e a rlie r B ritish editions was

re stric te d to members of the medical profession,36 was extremely and

enduringly popular, being reissued regularly well into the 1960s, and a

paperback edition appearing as la te as 1984. In his work The Sex

Researchers. E M Brecher entitled his chapter on Van de Velde "He Taught a

Generation How to Copulate." As at 1970, the date of Brecher's work, the

English translation of Ideal Marriage: its physiology and technique, first published by William Heinemann in 1928 (though Brecher gives the date

1930), had gone into 43 printings and sold 700,000 copies approximately.

(The dustwrapper of the 1962 reissue bears the legend "300,000 copies sold 157 of this edition": there seems to have been no revised edition subsequent to the first, only reprintings). It was more popular perhaps in the USA, selling over half a million copies between 1945 and 1970 (no figures being available 1930-1945).37

The British doctor, Eustace Chesser, although influenced by Van de Velde in his own writings, was somewhat critical of him and his all-pervading influence. He maintained, contrary to Brecher's allegations, that

The plain fact must be faced that thousands of people, after studying his huge inventory of sexual pleasures, all of them carefully inscribed "normal", have found nothing but disappointment in their quest of the promised ideal... nine readers out of ten have felt cheated.30 and also considered that

[Van de Velde] is almost blindly followed by the majority of writers on sexual technique.3'3

However, the original readers, not to mention its English tran slato r, the feminist Stella Browne, must have found the emphasis on the necessity for mutual sexual pleasure in marriage, and the detailed instructions for achieving it, remarkable and valuable enough for them to ignore, or at least take in their stride, the appalling misogyny and dire pseudophilosophical waff lings about love, marriage, manhood, womanhood, etc, which pervade the work.

With all his verbosity, Van de Velde deployed a remarkable taciturnity on the subject of male dysfunction. That male potency could sometimes fail or prove inadequate in normal circumstances was a matter ignored by the

Dutch sexologist: indeed, he remarked that "genuine impotence... is distinctly morbid",AO and dealt only with the temporary impotence due to over-exertion and fatigue. Premature ejaculation he barely alluded to at 158 all: "These cases are on the borderline of disease."'11 There was little indication in Van de Velde's work that marital sexual failure could be due to anything but the remediable defects of the husband's erotic technique or stubborn frigidity on the wife's part: male sexual inadequacy was

so serious and complex a condition... that its treatment is a matter for the medical specialist.'12

Helena Wright was a woman doctor who, after an early career as a medical missionary in China, returned to England and became involved in the birth control movement.Her experiences at the North Kensington Women's

Welfare Clinic, one of the birth control clinics set up independently of

Marie Stopes, may have led to the writing of her two short lucid books The

Sex Factor in Marriage (1930) and More About the Sex Factor in Marriage

(1947 '>.AA She acknowledged a debt to Van de Velde, but she would appear to have picked out what was useful and helpful in his work while om itting his excessive verbiage and personal idiosyncrasy. Both these works were much reprinted, up to the 1960s, a special edition of The Sex Factor being produced for the use of the National Marriage Guidance Council and the

Family Planning Association. Most remarkable in her work was her continued emphasis on the importance of the clitoris in female arousal and satisfaction, throughout the period when many writers were insisting that the only "right" orgasm was the vaginal, and deprecating clitoral stimulation as immature.

A writer who tended to promulgate this belief was E F Griffith:

The act of penetration initiates an entirely new situation and brings an entirely different part of the sexual mechanism into play... It is improbable that a really satisfactory union can be obtained unless the second stage lasts sufficiently long to enable the woman to achieve an orgasm, by which I mean a vaginal orgasm, and not simply a clitoral one.*® 159 in his work Modern Marriage. originally Modern Marriage and Birth Control. first published by Victor Gollancz in 1935, and in print for nearly forty years, with some changes of publisher. Griffith was a general practitioner who came to sex advice through involvement with the establishment of birth control clinics and sex education centres, and was a founder of the

Marriage Guidance Council.

These four writers were all doctors. Hutton and Wright both employed a plain direct factual style, possibly as a reaction to the floweriness of

Marie Stopes' works, although a good deal of the underlying ideas were the same,' or extremely similar. The idiosyncrasies of Van de Velde's style have been mentioned already.

A Havil's The Technique of Sex: towards a better understanding of sexual relationship <1939: "the sale of this book is restricted to adult persons.")*7 is still obtainable. It is a short book with a rather misleading title, since it contains only one chapter which might be said to be p articu larly about technique: 11 pages on "The Sex Act". The re st of the book consists of brief summaries of information on the anatomy, physiology and psychology of sex, chapters on pregnancy and labour, contraception, abortion, venereal disease, prostitution, and impotence and sterility:

impotence and sterility are due to defects in the construction of the body, due to defects brought on by illness, or due to a lack of knowledge.*®

The reasons for the continuing popularity of this extremely slight work are rather hard to fathom. The author purported to be

a young medical man especially interested in the study of Obstetrics and Gynaecology, who has worked at his subject in England, America, and on the Continent of Europe. Where he has given information, therefore, it has not always been derived from English sources.*® 160

However, no-one of the name Havil appears in contemporary Medical

Registers and Directories, although it is always possible that the name was a pseudonym assumed for the purpose of publishing a work on so sensitive a subject. Dr Maurice Newfield, a perfectly respectable medical man, chose to use the nom-de-plume "Michael Fielding" when publishing a short work for lay readers on birth-control: Parenthood: Design or

Accident.50

Eustace Chesser's chatty and exhortatory Love without Fear51 came out in

1941 and was reprinted 4 times in the ensuing 18 months in spite of war stringencies. It went on being reissued well into the 1980s, and was still on sale in the Family Planning Association bookshop in 1988. As fa r as promoting Love without Fear went, Chesser was outspoken about the need for reliable methods of birth control, and gave information on getting advice. He did create a climate of permission (for married couples) for the deliberate pursuit of sexual pleasure, for attention to foreplay, for experimenting with different positions. But this in itself became something of an imperative:

Too many people le t love's joys largely escape them. They are unwilling to make an effort to retain them. Any effort demanded is amply ju stifie d .52

Similarly he was reassuring about masturbation, claiming that guilt about the habit was more pernicious than the habit itself, though he continued

But, on the other hand, care must be exercised not to develop a habit of masturbating frequent ly.53

Chesser, a doctor, wrote prolifically on matters of sex and psychology, but most of his works appeared subsequent to 1950. 161

All these works shared in the major shift, which took place early in the twentieth century, and can be seen in the works of, for example, Havelock

Ellis, in the conceptualisation of the problem of control over the insurgent force of male sexuality. Men were depicted as, though ardent, clumsy and impetuous, Balzac's image of the orangutan trying to play the violin6* being constantly invoked, and Griffith characterised the average man as follows: He behaves so frequently like a bull in a china shop, and his conceit prevents him from seeing what a mess he has made of things... a man has to revise his whole outlook before he is in any way fitted to be a suitable mate.66

No longer was it simply a matter of control over the emission of the vital seminal fluid. Perhaps simplistically it could be said that the notion of continence, and re stra in tfrom performing the sexual act changed to a concept of restraint within the act itself, with a new emphasis on the desirability of mutual pleasure. The male was supposed to contain his urges for as long as it took to arouse the female with foreplay, and then, subsequent to intromission, to continue the act for as long as it took for the elusive female orgasm to be achieved. Helena Wright wrote

a man may become a worthy lover only with patience, knowledge and practice... It is necessary to have an atmosphere of peace and leisure; hurried love-making cannot be successful.645 and Griffith confirmed

The ideal is to make the relationship last sufficiently long to provide both partners with mutual orgasm, real emotional relief and a sense of refreshm ent.67

One of the few dissenters from the emphasis on male self-control was

"Courtenay Beale", who asserted

There is plenty of room... for sexual restraint, even within married life, but hardly in the conjugal act itself, where spontaneity is of the essence of the function's wholesome performance; to hold up the climax, which in the nature of things would supervene with imperious force of its own accord, means the imposing of a severe and probably injurious strain upon the nerves and the emotions alike, at the very time when 162

both are already being considerably taxed.5,13

On the whole, however, these works assumed that once a man was aware of the need to control the insurgent spontaneity of his own desires, he would be both willing and capable of doing so. When Marie Stopes came, ten years after publishing Married Love, to issue the sequel, Enduring Passion

(1928),53 for couples who had already been married some time, she found it necessary to give considerable space, a chapter apiece, to the subjects of

"The Undersexed Husband" and "Premature Ejaculation", as a resu lt of the vast amount of problems she had encountered from correspondence with her readers, as discussed in Chapters 5 and 6.

According to some writers, even before a man came to marry, self-abuse might have vitiated his powers and rendered him unfit for marriage and fatherhood, even if it were no longer regarded as the cause of total physical mental and moral wreck:

The sex organs are as susceptible to habit as any other part of the body, and they may become so accustomed to some p articu lar method of self-relief that enjoyment of the normal sex-act may become d iffic u lt to estab lish .60

The general tendency of masturbation is to accustom the reaction to a harsher and cruder type of stimulus... For this reason he may find, what many unfortunate men have found after marriage, that the normal stimulus of normal union does not suffice to bring on the natural crisis of orgasm.61

However, on the whole, whatever sex education lite ra tu re warning boys continued to allege, these works tended to reassure their readers that masturbation would not necessarily unfit them for marriage. This was one of the most notable changes in sexual advice literature between 1914 and

1950 and w ill be discussed fu rth er in Chapter 9. 163

Male lack of control, impetuosity and clumsiness, were depicted as imperilling the marriage right from the wedding night, unless the man could put some kind of restraint upon himself. Advice writers recounted fearsome tales of marriages ruined from the first night by male insensitivity meeting female ignorance:

There have been not a few brides whom the horror of the first night of marriage with a man less considerate has driven to suicide or insanity... That girls can reach a marriageable age without some knowledge of the realities of marriage would seem incredible were it not a fact... When girls so brought up are married it is a rape for the husband to insist on his "marital rights" at once... such a beginning must imprint upon her consciousness the view that man's animal nature dominates him.62

Fatal blunders are often committed and irreparable mischief done in the first night, Many a delicately-organised, highly-strung woman never gets over her horror of what to her appears the revelation of male brutality such as she never expected to e x ist.63

If a man is not specially gentle and considerate in the early days of marriage he will endanger the happiness of the whole of his married life; he will also endanger the health of his wife, not only at the time, but in the years that follow.6*

It is hopelessly wrong for the husband to regard the wedding night solely, or even primarily, as merely an occasion for his own own sexual gratification...The clumsy, brutal claiming of "marital rights" by the husband frequently gives rise to inability on the wife's part to enjoy sexual pleasure.66

Most writers, however, did not put this wedding night carelessness down to sheer malice or deliberate brutality. Hutton remarked

It is very rare for a man to use force intentionally, but he may be too impetuous without realising it.66 and Stopes believed

The men who consciously sacrifice their wives are in a minority. Most men act in ignorance.67 while "Beale" maintained

The brute who has no consideration for the feelings of a woman —and that woman his new-made wife—is happily very rare.6®

/ 164

The general tenor of wedding night advice was in these terms of cautions to the husband. His own anxieties, doubtless exacerbated by such warnings, were less often addressed: possibly there was a fear of putting ideas of failu re into men's minds. Nevertheless, the image presented was one of the rampant impetuous male who needed to curb his insurgent desires if the marriage were not be wrecked from the outset. Few writers mentioned, as

Isabel Hutton did, that Temporary inability to obtain erection, and so perform the marital functions, is of fairly frequent occurrence in the early weeks of marriage. Few know that this may happen in perfectly normal and healthy men, and they are consequently very anxious and imagine that there is something seriously wrong... Many a man fears, long before the wedding ceremony, that he will not be able to consummate the marriage... A frequent cause of this trouble is that a man may be afraid of inflicting pain upon his bride.es*

(Her views were borne out by the anxieties correspondents expressed to

Marie Stopes, discussed in the following two chapters). The likelihood of a disparity in the speed of male and female sexual reactions in the early days of wedlock was more often ventilated:

Inexperienced men find it difficult not to come to the climax too soon. In the course of time, and with the establishment of habit, they are able to lengthen the interval before the climax.70

This Clack of female satisfaction] is not very surprising when it is realised that... the inexperienced man has to ejaculate after very short "play".71

Once this traumatic beginning had been safely passed, the couple had to aim for "Mutual Adjustment." The perfect sexual act was envisaged as coitus culminating in mutual orgasm more or less simultaneously

Digital stimulation of the clitoris... is a rudimentary act... far removed from the mutual, synchronised, mature form of sexual intercourse.72

No couple should be content until they have learnt how to experience orgasm together.73 165

There is real harmony only when ejaculation and the woman's orgasm take place at the same time, and to arrive at this harmony may take time, patience, and understanding.7*

Both partners should, in coitus, concentrate their full attention upon one thing: the attainment of simultaneous orgasm.75

This meeting of a belief in the sexual rights of women with continuing

commitment to an idea of femininity as essentially passive and responsive, rather than spontaneously desirous and active, of female desire as something which had to be carefully awoken and cultivated, laid the burden of ensuring happy conjugality squarely on the male. His desire was seen as much less fugitive and complex than that of his partner:

A man in good health does not need nearly so much stimulation as a woman to bring him to the point where he can satisfy his desires, providing he is really attracted.7e

In spite of all declarations concerning his tendency to thoughtless selfish

clumsiness, the man was perforce cast in the role of initiator:

He, and no-one else, is the cause of the non-responsiveness he deplores in his wife. He does not know that the possibilities of passion, which with him lie always near the surface, in her case are covered by many strata... through which he must learn to penetrate ere he can hope to kindle the spark that will flash an answer to his spark.77

It is the husband who must educate her to this end, and he must remember that in doing so the health and happiness of their married life is at stake. Tenderness, tact, gentleness and patience during the early months, together with the essential knowledge, will colour the whole married life.7®

[Men are! naturally educators and initiators of their wives in sexual matters.7®

Usually at the beginning the man is the initiator, the women the willing recipient; the husband, understanding his wife's nature, has the joy of arousing her gradually, of creating in her an ardour equal to his own. A woman's body can be regarded as a musical instrument awaiting the hand of an artist. Clumsiness and discord will produce nothing but discord, knowledge and skill evoke responses of limitless beauty.®0 166

He must seek to arouse her desire, and in doing so help to overcome her timidity and resistance... They [most women] have to learn how to enjoy voluptuous pleasure. Their husbands have to be their guides.31

Few writers dared mention that male arousal was anything but a given response, not needing any encouragement: again Isabel Hutton was unusual here in suggesting that

The wife must be ready to help her husband if his reactions are slow and if he be tired and unable to achieve erection easily. She must master the subject of love-play, and learn what helps sexual response in him.32

And although, in Enduring Passion. Stopes took issue with the long-time married faced with problems of male dysfunction or disinclination, she did not recommend a more aggressive approach on the part of th e ir wives. On the whole the exhortations given to wives laid more stress on an attitude of responsiveness rather than activity:

No amount of skill and tenderness on the husband's part can be successful unless the wife is willing to be aroused.33

The initial advances are usually made by the man, but it is most misleading to suggest that the woman is merely a passive partner. One the contrary, love being a mutual relationship in which both take part, she has a good deal to contribute to the relationship at the right time... by kissing, by touch, and by active cooperation during coitus.3A

However, only once the delicate period of initiation and adjustment had taken place could a man even begin to hope for a little more reciprocity, or have any of the responsibility for managing the couple's sex life taken

from him. But, provided he had made no irreparable mistakes in the early years of marriage, the time might eventually come when

It is the wife's turn to take the initiative... These times are the wife's opportunity to show her many-sided nature, when she may woo her husband and charm him out of his fatigue.3®

Much of this new phase of writing about sex, more or less begun by

Married Love, might be seen as replacing one set of anxieties with a new 167 set. There was a new emphasis on getting it right, in the right place: which was within monogamous marriage, with sim ultaneous orgasm.

Increasingly, there was a differentiation between the right kind of female orgasm (the vaginal) and the wrong kind (the clitoral). Few writers were as practical and non-judgemental on this subject as Helena Wright:

Theoretically it might be said that the ideal type of female sensation is concerned with the vagina alone, but that idea is seldom realised... Many wives are unable to reach the climax because their husbands fail to realise that rhythmic friction of the clitoris is necessary right up to the end of the act.as

The quotations from Eustace Chesser previously cited reveal the ambivalence found in these works and the possibility inherent in much of th is lite ra tu re that fresh anxieties might be aroused. However, the case of the young man who claimed that he had been precipitated into a nervous breakdown through reading Enduring Passion’s allegations that masturbation might "coarsen the nerves" and lead to impotence, appears to have been a unique response, and the lengthy correspondence he had with Stopes revealed considerable indications of his instability.®7 This school of writing about sex did not employ the punitive and guilt-inducing medico- moral framework which was characteristic of so much Victorian and

immediately post-Victorian sex advice (as opposed to more generally philosophical works on sexuality). Its agenda was to encourage a more positive approach to sex within marriage, and while no doubt, given the charged nature of the subject, any prescriptive writings on sex may induce anxiety, this was no explicit part of the programme of these writers.

How easy was it for people to obtain works on sex, and how informative were such works as they could readily obtain? Certain book6 and pamphlets 168 were distributed widely through religious organisations and youth movements, but it is unlikely that anyone in search of information about the sexual act would have found them at all helpful. Enticingly titled works on marriage and sex turned out, on consultation, to be strong on the sexlife of the amoeba and/or bizarre marriage customs in exotic parts of the world and remarkably laconic about the average couple on the Clapham omnibus.0® Walter Gallichan remarked in The Poison of Prudery, admittedly in the course of making a polemical point,

I have known several parents and young men who have expressed their disappointment with the inadequacy of the general run of cheap popular books on sex matters.®®

In 1933 the Lancet also expressed a certain discontent with the books on sex available at the time:

In the course of the last five years there has appeared an increasing number of books by writers, often unqualified for the task, on the many aspects of the psychology of sex. Several of these books have been translated into English from foreign languages... The numerous books which have appeared on this subject are mostly open to criticism on various grounds: if written by timid but well-meaning persons, slightly nervous of their reputations, they are overladen with apologies for dealing with the topic of sex at all, and much space is devoted to begging the reader to purge himself of prejudice; if written with the object of amusing and shocking the reader, they may abound in dubious anecdotes and advocate ultra-modem views on sexual reform; if written by religious persons the argument may be conducted in semi-theological language, which the medical reader does not always find helpful; or if the role of mentor be assumed to a young and innocent reader, the tone of the book may be patronising or heavily loaded with adjectives.

The reviewer concluded by recommending Havelock E llis's Psychology of Sex. not necessarily for public consumption, but as fulfilling the need for "a manual on the subject for [medical] students."®0

During the 1920s and 30s, as described above, numerous book6 came to be published for the lay public, intended for sale in respectable bdokshops instead of the sleazy rubbergoods shops of backstreets and big cities. 169

However, one or two of Marie Stopes* correspondents complained of the sordid outlets in which they had been obliged to purchase her works :

I am sorry to say I felt it is being offered to the public in the wrong kind of shop... I heard of the work quite by accident and was directed to rather an "unsavoury" little establishment which some men and most women would h e sita te to enter. I mean the kind of place with a window devoted to cheap rubber goods and pornographic fiction... your book was probably one of the most healthy in the place. (1919)

the popularity of your works with booksellers of that type shows that there must be something amiss, something not of the highest. (1924)91

Since even ten years later a correspondent was reporting that his suggestion to the local public library that Stopes* works be bought "was instantly vetoed",5,2 it is not surprising that many readers had to obtain copies of them from less reputable sources.

But even when stocked by reputable booksellers, works on sex were regarded as not for every eye: many were published with a warning that they were issued for the medical and allied professions and serious students of the subject only.93 Gallichan, in The Poison of Prudery, recounted the following tale:

When I wished to buy a copy of Dr Wilhelm Stekel's two volumes of "Sexual Frigidity in Women"... I had to obtain a letter from a medical man, professing that he desired to purchase the volume. Such a situation is ludicrous. A life-long student of sexual psychology, and the writer of twelve books on the subject, is not permitted to buy the work of another psychologist.9*

It is not clear how pervasive a custom this was, assuming the incident to have occurred in the first place. One of Stopes* readers, however, recounted a similar incident

Not long ago I went to Denny's, Strand, to get your book "Contraception" but after a long and deliberate conversation in the office, the assistant declared that he had orders to sell the book only on production of a medical or law degree certificate. although he then added 170

As I thought this is only a personal affair and neither your nor the publisher's instructions (an advertisement in "Nature") I went to Lewis's, Gower S treet, where I obtained the book, of course, without any difficulty whatever. (1923)'3S

Even as late as the 1940s a work like Love without Fear bore on the dust flap the proviso that

The author has w ritten th is book for those who are married or about to be married, and in this connection the bookseller's cooperation is requested.3e

In spite of this, Love without Fear was prosecuted as "an alleged obscene book" in 1942, as described in more d e tail in Chapter 9.

It is almost impossible to find out how far such gestures of restriction were a mere matter of form, and how far they did operate as a barrier to the dissemination of these works. After all, the sales figures for the books discussed above, and the fact that they were constantly reprinted, suggests that people did manage to bring themselves to buy them by some means or other. The numbers of copies of works of sexual advice in circulation is indicated to a certain extent by the numbers of them that continue to turn up in second-hand bookshops. It would be helpful to know what policies were in force in public libraries respecting the purchase of and conditions of access to books on sexual matters. Correspondence with the Library Association Library on this latter question indicates that only by research into the minutes of Local Authority Library Committees could this question be resolved,5,7 a task beyond the scope of this thesis.

Certainly some libraries were keeping works on sex locked up in the

Librarian's Office well into the 1970s, even in Central London.3® Policies presumably varied widely: one case has already been cited of a library refusing to purchase Stopes' works, but in 1934, during the prosecution of material sent out to advertise Dr Norman Haire's Encyclopedia of Sexual 171

Knowledge, the Chairman of the Public Library of the Bromley Borough

Council produced a list of books available in that library on matters of sex education. He alleged that there was nothing in Haire's work which was not available from th is source.5,3

It cannot be denied that there was a continued association between the

informative sex manual and pornography throughout this period. It seems probable that many people obtained their books of marital advice from rubber-goods shops or “surgical stores", perhaps by sneaking into those in an area where they were not known, or by means of mail-order ("in plain wrapper"), a ll of which had somewhat sleazy connotations.

The continuing stigma attached to books about sex can be seen in the

adoption of pseudonyms by those publishing them. This has been discussed

above in the section on "A HavilH,s Technique of Sex. Among those

legitimately entitled to call themselves "Doctor", as opposed to those who

awarded themselves a spurious medical qualification to lend authority and a presumed respectability to their works, besides Newfield, publishing as

"Michael Fielding", Norman Haire, who published several works under his own name, also used the nom-de-plume "Wyckham Terris", though this pseudonymity may also have had to do with restrictions against advertising

by doctors.

Isabel Hutton recounted in her autobiography the trepidation with which she set out to get The Hygiene of Marriage published. One of her colleagues, while believing her endeavour valid, was convinced that she would "wear a crown of thorns" as a result. Another merely felt "the public should not know too much", but a third encouraged her. Solicitors to 172 whom she showed the work, while not explicit, seemed to fear it unprintable; the Oxford University Press would not take the work and

"thought it would be very d iffic u lt to place." Even a fte r the work had been accepted by Heinemann's Medical Publications, Hutton

had many a spasm of apprehension in the watches of the night and imagined street posters announcing "Suppression of Woman Doctor's Marriage Book". Heinemann's showed great courage in publishing in that year of 1923 [the year of the Stopes/Sutherland libel easel, for there was a real risk of its being suppressed with ignominy.

Although, as mentioned above, the book received favourable mention in the medical press (including "a long amusing poem suitable only for medical eyes" in St Thomas's Hospital Medical School magazine)

Publicity there was none of any kind... The book was not advertised in the Press nor did any of the lay papers or periodicals acknowledge it, though the editor of one of the most popular daily newspapers wrote to me, "We are sorry, but you must know that we never touch sex stuff".100

A question that must be asked is, of course, whether these works had any impact on th e ir readers. People bought them, and presumably, read them.

Were they affected by them? Certainly those who wrote them believed they were, as did those who aimed to restrict or censor sexual information. But did these books influence behaviour? Did they reflect accepted norms?. Or were they, as Jay Mechling has argued for advice on childrearing, a literary genre whose relation to actual conduct is tenuous to say the le a st? 101

Mechling's article is useful and provocative, and his contention that the prescriptions contained in such works cannot be taken as descriptive of actual practice is surely a valid warning to those using such material. 173

Considerable reservations could be made, however: for example about his

blanket use of the term "official” advice, which suggests that this was some government propaganda being forced on the populace. Advice manuals were works originating from heterogeneous interest groups, that people went out and bought on their own initiative. Many advice-books, and this may well be true in the field of child-rearing as well as of sex, seem to have been published almost in defiance of what was seen as medical monopoly and conspiracy of silence, to enlighten the public. Though as has

been shown in discussing the attitudes of Victorian doctors, alternative

practitioners, and quacks, to certain sexual problems, writings which appear to be coming from very d ifferen t places may yet share underlying assumptions. Whatever the differences perceived by a contemporary, the similarities are often more striking to a present day observer.

Certainly Mechling was right to emphasise that one cannot use advice books

in a vacuum as an h isto ric a l resource for revealing actual conduct at the

time of their issue. It is clear that the very production of such works,

impinging, as they do, on matters often supposed "natural" to humanity, raises interesting questions about the kind of society within which such a manifestation takes place. Nevertheless, it cannot be contended, as

Mechling would seem to argue, that the writing and reading of such works merely constituted a kind of intellectual exercise, without any influence upon behaviour.

It is fortunate that it is possible to study the reactions of a large group of readers to a popular work of sexual advice. Immediately upon the

first publication of Married Love Stopes began to receive letters. This was in spite of the fact that her publishers had had so little confidence in 174

the book’s success that she had had to pay for it to be printed, and that

the first editions, due partly to this attitude on the publisher's part and

partly to war restrictions, were very small. If Stopes' correspondents from

the poorest classes were mostly interested in the prevention or

termination of pregnancy, her ideals of marriage found a ready response

among members of the respectable working classes, the expected middle

class readers, officers of the armed forces, members of the Indian and

other colonial services, and even the aristocracy (but although she sent a

copy of Married Love to the Princess Elizabeth in 1947 on the occasion of

her marriage to Prince Philip, there is no record that it was read).

Letters of praise and admiration massively outnumbered those of

condemnation and criticism , which tended to be anonymous: those who

supported Stopes signed th e ir names.

There is some evidence that a handful of men found Stopes' flowery style

off-putting. A Mrs VR wrote to Stopes in 1934 suggesting that men

find the facts in your books most interesting and helpful, but they do not like your style as it is too emotional for them... I wonder if you have ever thought of w riting some concise unemotional guide for men.

Stopes replied to this as follows:

My experience is that there are such things as men and men. Married Love was first appreciated and praised in the very words "but it is a new gospel of hope and happiness" by men, old, middle-aged, young.102

Such criticisms of her works as Stopes received tended to concentrate on her advocacy of birth control and her recommendation of a philosophy of marriage which did not advocate continence and restraint as necessarily the highest conjugal good:

A man who does not try to control and subordinate his (unnatural) sensual Inclinations Is committing a very grave 175

offence... He is an enemy to posterity... Lust, Lust, Lust!!! such departures expose the lamentible [sic] extent to which humanity has sunk in depravity!103

But by far the most common response was outright praise and

congratulation, expressed in such fulsome phraseology as the following:

the perfect frankness and the clean wholesome manner of giving intimate details

probably doing more good than any book published during the la st century or two.

indicates something higher than mere animal gratification of desire.

your book with its insight and sympathy has gone right to the root of most of our difficulties.

I don't think I have ever read a book that has given me such pure pleasure before.

lifting the sacrament of love from the unhappy atmosphere with which it is so often surrounded.

I have read many books on the sex question and its difficult problems but none written in such beautiful language, unfolding the joy of complete married life as a glorious thing rather than a sordid fact.

We pray that God may richly bless your gloriously straightforward endeavours to further the wondrous beauty of really happy married life.10A

Many of her correspondents praised the "cleanness" as well as the lucidity

and beauty which they found in her works:

your remarkably frank yet perfectly delicate study... its seriousness and tone would silence the ribald jest.

nowadays one is nauseated by the amount of sex "muck" in everyday life—to read your books is like a breath of fresh air.

every decent feeling man must thank you for the frankness and courage with which you have dealt with aspects of life usually most unfortunately kept "veiled" in a kind of miasmatic haze.

the nice ideas she has and the delicate and beautiful language she uses in her books.

Married Love is especially pleasing by its lucidity, its candour and its practical idealism in comparison with the suggestion of 176

semi-pruriency and semi-religiosity which hangs about books of the "Self and Sex" type.

a book at once so necessary, explicit, delicate and of such high motive.

cannot thank you enough for giving the uninitiated the benefit of your experience and scientific knowledge in such a clean and straightforw ard manner.

I wish to thank you from the bottom of my heart for the good work you have done by w riting such an honourable clean and upright book for the benefit of mankind.

the clever tactful way you have treated a very difficult subject which in coarse hands might have been made repulsive.

the book is w ritten so frankly and yet so "nicely" that no-one could possibly be harmed by reading it.

so plain and straightforward yet untouched by the vulgarity which characterises other books of the same sort.10®

The courage needed to produce such a work was recognised in the descriptions of her books as "courageous and beautiful",106, "sorely needed but... which nobody seems to have had either the ability or the courage to publish",107 the gratitude expressed for the "love and courage you have shown", "your courage and kindness to humanity", "the fearless spirit in which you have issued your books."10® Her works, especially Married Love. seem to have struck her first readers as with the light of revelation:

it tells so much that is left out by other books that make a pretence of dealing with the subject.

I can safely say that it has opened my eyes and taught me more than a lifetime's groping could possibly have taught me.

your book has taught me lots of things of which I had not the least idea.

it has opened my eyes and I have been married ten years.

the great joy and liberation of spirit the reading of your book Married Love has brought... your glorious gift of expressing the hitherto inexpressible.

it has thrown a flash of light on many things we did not understand. 177

clarified much that had been for years shrouded in fog and misunderstanding.103

Many wished that it had been available to them earlier in their married life: "only wish it had been available seven years ago", "would that

[Married Love] had appeared fifteen years ago", "wish I had read it 25 years ago", "if only [your books] had been given into our hands just after marriage", "might have altered the whole course of my married life", and similar sentiments were expressed by many readers: the longest period given was 40 years previous.11 °

So remarkable was the impact which Stopes' works had on her early readers that many of them were anxious to share the experience with others.

Married Love was said to "adorn our bookshelves", "will occupy an honoured place in our home"111 (therefore was not hidden in corset-drawers, like

Aristotle's Masterpiece or Esoteric Anthropology), and was handed about among friends and given openly as a wedding present by close relatives, even from parent to child, in one case by a father-in-law described as "a particularly clean-minded parson."112 Such comments as the following were typical:

We have decided to present a copy to each of our children as they marry.

We have already ordered half a do2en copies for presentation to suitable friends.

I Intend to help in future by sending a copy of your book to any of our acquaintances about to marry.

We shall take pleasure in spreading the good news among our friends.113

A not uncommon comment was that it should be in the hands of all young couples about to marry:

1 have always avoided "sex books" but a friend made me buy [Enduring Passion]. It has but one fault, namely that it isn't so 178

cheap that every man and woman in the country can have a copy of it!

if these books were read by all who are about to be married and those that are already there would be many more happy unions.11A and some readers went as far as to say, with Major LR

No marriage certificate should be issued without a copy of your book11s

Stopes* books seem to have been able to break through the taboo on open discussion of sex matters and to initiate discussion among groups of male friends and even in army and air-force messes:11®

in conjunction with several other married men I am most interested in your works.

I have lent the book to several married brother officers who are one and all deeply impressed by it.

This letter is the outcome of many serious conversations with some friends of mine, a ll of whom, owing to several years having been spent in the Army, have come up to the University at a more mature age than was usual hitherto, three of them are engaged and the perusal of your works has made them deeply sensible of their responsibilities as future husbands and fathers.

what a help [Married Love] has been to a great number of officers during the last few years. It has shown them the dangers and pitfalls and how to avoid them.117 though this was not always the case. Capt BH, of the Indian Army, commented, a fte r praising Stopes* “fearless s p irit"

Living as I do in messes and clubs, chiefly masculine gatherings, I know something of the manner in which they have been met, and the criticism and remarks they have invoked... As you will know, in such gatherings these are sometimes not a bit pleasant.11 e

Above all, Stopes' books opened up a channel of communication between married (and engaged) couples:

we have both read your works about wooing and the necessity for tender embraces and caresses prior to the sex act. 179

I must give your book to my wife to read.

[Married Love] does open one's eyes and wife to as [sic] read the book.

my wife and I have both read your book which is very fine.

now a fte r reading your book we re a lise what is wrong in our lives.

both my sweetheart and myself find it difficult to follow your book "Contraception".

We talked matters over, and read your book Enduring Passion. My wife then persuaded me to write this letter.

I have just read your book Married Love and am sending another copy to my wife.

we tended to scorn the notion of literature on the subject until Married Love was given u s.11 3

Moreover several men mentioned sending a copy of her book to their fiancees.120 Not all men, however, took this attitude: in spite of his own positive reaction to reading Married Love. Capt BH declared

frankly, [I] should not wi6h the woman whom 1 shall marry to read some p arts of them; it may sound illo g ical, of the old era of ignorance—but I think any normal healthy-minded young man feels similarly.121

Michael Gordon, in a paper on changing trends in marital advice literature in the USA, 1830-1940, has suggested that the growing concern with technique and foreplay during the 1920s and 30s was

a form of ritual magic. That is to say, as the sexual rights of women gained acceptance, sexual intercourse probably became a more anxiety-laden area for men, and hence, it is not surprising that we see this new concern with technique.122

However, whatever motive drove men to take an interest in developing their love-making technique, the evidence would seem to suggest that works such as Stopes', or Van de Velde's Ideal Marriage, aided marriages not by providing husbands with a compendium of e ro tic s k ills but by opening up 180 communication within the couple. E L Packer in a 1947 article on "Aspects of Working Class Marriage" was of the opinion that

Reading text-books on sex technique has not proved helpful in correcting sexual maladjustment unless both husband and wife have read the book, and have been able to discuss it together.

In support of this contention Packer adduced the case of a marriage which had reached the point of a consideration of separation. The husband

came to realise that his part in copulation was deficient in skill, and to remedy this he bought a number of manuals on sex education for marriage. There was no confidence between man and wife at this time, and and he did not attempt to impart any of his newly acquired knowledge to his wife before coition. During coition his wife maintained the reserve which was customary, and the maladjustment persisted.123

This hypothesis can also be supported by Moya Woodside's remarks upon the greater willingness to discuss sex among the younger couples in a survey undertaken by her in the 1940s, and their more sexually satisfactory marriages, which did not seem to depend upon any increased sexual knowledge or expertise on the husband’s part.12*

In The Sex Researchers. E M Brecher has suggested that the success of

Ideal Marriage was due to its availability at a time when there was little else on sexual technique for the ordinary reader, and that it had the power to

open up communication between spouses and lovers on precisely the topics of concern: the sensations, perceptions, and emotions arising before, during, and after coitus.125

Its importance did not necessarily relate to any carrying out of his recommendations in grim detail. This was also true of Married Love, to judge by readers' comments, and the testimony of Naomi Mitchison in her autobiography:

Married Love... seemed to me to have the answers to some of my own troubles if Dick too would read it and put some of it into 181

practice... [It] must have made an immense difference to the happiness and well-being of thousands of couples.12S

Perhaps what mattered was less what the particular book was than the

channel it opened up for married couples to talk about sex. In many cases

it must have been only works like Married Love or Ideal Marriage which

provided couples with a vocabulary in which to talk about such matters.

The wholesale adoption of Stopes' language and concepts by her readers,

which can be seen in their comments cited above and in the following

chapters, suggests that before reading her works they had had little or no

way of articulating their thoughts and feelings on the subject, or at least

no way that seemed decent and permissible, suitable for use within such a

relationship. The role played by advice manuals in providing an

opportunity, and possibly an acceptable vocabulary, for conjugal

discussions of sex, is borne out by the type of enquiries which Marie

Stopes received from her grateful readers.

It is clear that readers were influenced by Stopes' work not merely to

reconsider their married lives but to attempt to change them on the basis

of her recommendations. Presumably many of the readers who did not write

to her had found her writings sufficiently clear and helpful to work

matters out for themselves. Works of autobiography or memoirs by

contemporaries reinforce this impression.127 After all, it was those who had problems not readily solved by her lucid instructions who wrote to her. Some wrote simply to convey appreciation and gratitude, but most

correspondents had some further question that they wanted to ask: for

elucidation of passages which seemed unclear to them ("not only her arms

should embrace her husband"), to ask for further advice (the twenty-minute 182 prescription seems to have been beyond many husbands), the best methods of birth control (not dealt with in detail in Married Love) and where they could be obtained. She may have aroused new anxieties (that 20 minutes again) but she also allayed fears which her correspondents had hardly known they had, or been silently tormented by for years. A number of her correspondents specifically mentioned as influential, in a negative way, works of guidance for young men, and two or three actually cited Sylvanus

S ta ll's What a Young Man Should Know.123

There are questions to be asked about advice and the relationship of the advised person to the advisor. Work has been done on the way patients in terp ret, or m isinterpret, and act on or do not act on, advice given by doctors in the course of medical consultations. This has shown that quite major misunderstandings take place, and that non-compliance with instructions, even over apparently simple matters such as how a drug should be taken, occur in a statistically remarkable number of cases.12® It was certainly possible for readers to misread or misunderstand works of advice: however, unlike a medical consultation, a book can be gone back to and re-read, and discussed with a partner and even, from the evidence of

Stopes' correspondents, with family and friends. And, as Kenneth Walker remarked in Marriage (1951), *the reading of a book does not demand an act of courage",130 which for most people the communication of sexual difficulties requires.

Looking at the correspondence Stopes received (and in some cases people did write back reporting on the effect of taking the advice she had given them), it can hardly be doubted that her books did have an effect on people, did modify both their idea of what the conjugal relationship should 183 be and what they did about it. But people only took out what they were ready for: her books were in the right place at the right time. What people wrote to her also modified her own works: in Enduring Passion she wrote that it was the correspondence she had received after writing Married Love which made her aware of "the wide prevalence of premature ejaculation" among the British middle-classes, and which therefore led her to deal with this problem in more detail 131

It can be seen from the foregoing that the sex manual was a widespread phenomenon in the 1920s and 1930s, and that in sp ite of the d iffic u ltie s and embarrassments of obtaining such works they sold in large quantities.

As the author of a recent humorous work on the sex manual pointed out, though without accounting for it, these works "enjoyed... huge sales and an extraordinary influence."13^' The evidence provided by Stopes* correspondence indicates that they did indeed have a considerable influence on their readers, even if their actual descriptions of the relations between the sexes cannot necessarily be taken as acceptable historical evidence. In the next two chapters will be considered the problems actually presented by that figure depicted by the manuals as an ape with a violin, the British husband. 184

Chapter Four: Notes

1. Stopes, Marie, Married Love. A New Contribution to the Solution of Sex D ifficulties. With a Preface by Dr Jessie Murray, and le tte r s from Professor E H Starling FRS, and Father Stanislaus St John, SJ, A C Fifield, London, 1918 (la te r editions by GP Putnam's Sons Ltd London), 4th edition, 1918, Author's Preface, p x iii

2. Hall, Ruth Marie Stopes. A biography. Andre Deutsch, London, 1977

3. British Library Department of Manuscripts: Additional Manuscripts 59848

4. Hall, op cit 5. Stopes, Married Love. Author's Preface, p xiii

6. Eaton, Peter, and Warnick, Marilyn, Marie Stopes: A Checklist of Her Writings. Croom Helm, London 1977; Melman, B illie, Woman and the Popular Imagination in the 1920s. Macmillan, London, 1988, p 3

7. The Lancet. 1918, ii, 886

8. British Medical Journal. 1918, i, 510

9. Eaton and Warnick, op cit

10. Stopes, Marie, Wise Parenthood. The Treatise on Birth Control For Married People. A Practical Sequel to "Married Love." with an Introduction bv Arnold Bennett. G P Putnam's Sons Ltd, London, 1918, 11th edition 1923, p 31

11. Hall, op cit. pp 237, 242, also Hall, Ruth, ed, Dear Dr Stopes: Sex in the 1920s. Andre Deutsch, London 1978, Appendix, pp 216-217

12. Stopes, Marie, Enduring Passion. Further New Contributions to the Solution of Sex Difficulties being the continuation of Married Love. GP Putnams Sons, London, 1928, 2nd edition 1929, p 20

13. Hall, Lesley A, "The Stopes Collection in the Contemporary Medical Archives Centre of the Wellcome In s titu te for the History of Medicine", Bulletin of the Society for the Social History of Medicine. June 1983, no 32, pp 50-51, also typescript handlist to the collection (CMAC: PP/MCS) compiled by the same

14. Mitchison, Naomi. You May Well Ask: A Memoir 1920-1940. Victor Gollancz Ltd, London, 1979, Flamingo paperback edition 1986, pp 69-70

15. Stopes, Married Love, pp 28, 49, and passim

16. ibid. p 95

17. ibid. p 98

18. Ellis, Havelock, Sex in Relation to Society. Studies in the Psychology of Sex, Vol VI, F A Davis, Philadelphia, 1910, William Heinemann Medical 185

Books, London, 1937 1946 (War Economy), Chapter V, "The Function of Chastity", pp 95-118

19. Stopes^ Married Love, p 56

20. Beale, "Dr" G Courtenay, Wise Wedlock: The Whole Truth; A book of Counsel and Instruction for All Who Seek for Happiness in Marriage. Health Promotion Ltd, London, 2nd edition Cc. 19223

21. CMAC: PP/MCS/A.22 includes correspondence "Re Dr Courtenay Beale" in which Stopes voiced her suspicions as to "Beale " in the light of the fact that she had been unable to track him down in order to serve upon him a writ for plagiarism. There is an account in the Mass Observation Archives, held at the University of Sussex, among the "Sex Survey" materials, (late 1940s), of an attempt to find out more specific details about a "doctor" author of popular sex advice manuals which failed to prove either his medical qualifications or, indeed, his very existence; Tom Harrisson-Mass Observation Archive at the University of Sussex A.9 "Sex Survey", file 4/G "Report on Sex: Miscellaneous and unsorted draft material". This was also mentioned in England, Leonard, "A British Sex Survey", in Pillay, Dr A and Ellis, Albert (eds).Sex Society and the Individual: Selected Papers, revised and brought up to date, from Marriage Hygiene (1934-1937) and the International Journal of Sexology (1947-1952). The International Journal of Sexology, Bombay, 1953, pp 360-367, re f to p 365

22. Beale, op cit. p 58

23. Stopes, op cit. p 77

24. Beale, op cit. p 88

25. E llis, Havelock, Eonism and other supplementary studies. Studies in the Psychology of Sex Volume VII, F A Davis Co, Philadelphia, 1928, IV, "The Menstrual Curve of Sexual Impulse", pp 213-236, reference to Stopes* adumbration of the theory on page324; Ellis, while prepared to believe that some such curve did exist, was Inclined to believe that the tides of desire in individual women were more idiosyncratic than Stopes seemed to suggest.

26. BMJ, 1918, i, 510; The Lancet. 1918, ii, 886

27. Beale, "Dr" G Courtenay, Wise Wedlock: The Whole Truth: A book of Counsel and Instruction for All Who Seek for Happiness in Marriage, with an Introduction by Norman Haire, The Wales Publishing Co, London, new revised edition, 1944, p 5 (there seems remarkably little difference between this and earlier editions)

28. Hutton. Isabel E, The Hygiene of Marriage. William Heinemann Medical Books Ltd, London 1923, 4th edition 1933

29. Hutton, Lady Isabel, Memories of a Doctor in War and Peace. Heinemann, 1960, pp 213-214

30. ibid. pp 214-215

31. BMJ, 1923, ii, 286 186

32. Hutton, Memories of a Doctor, p 217

33. ibid

34. Van de Velde, Th. H, Ideal Marriage; Its Physiology and Technique. fir s t published in Dutch 1926, English tran slatio n , William Heinemann Medical Books Ltd, London, 1928, 39th impression 1962

35. Chesser, Eustace, Sexual Behaviour; Normal and Abnormal. London Medical Publications Ltd, 119493, pp 16-17

36. According to a review in The Lancet. 1929, ii, 177

37. Brecher, Edward M, The Sex Researchers. Andre Deutsch, London 1970, pp 82-103

38. Chesser, op cit. p 17

39. Chesser, Eustace, Love without Fear: A Plain Guide to Sex Technique for Every Married Adult. Rich and Cowan Medical Publications, London, 1941, July 1942 edition, p 67

40. Van de Velde, op cit. p 238

41. ibid. p 165

42. ibid. p 248

43. for details of Helena Wright's career see Evans, Barbara, Freedom to Choose; The Life and Work of Dr Helena Wright. Pioneer of Contraception. Bodley Head, London, 1984

44. Wright, Helena, The Sex Factor in Marriage: A book for those who are or are about to be married, with an introduction by A Herbert Gray, Williams and Norgate Ltd, London, 1930, 2nd edition 1937; Wright, Helena, More About the Sex Factor in Marriage: A Sequel to The Sex Factor in Marriage. Williams and Norgate, London, 1947, 2nd edition 1954

45. G riffith, Edward F, Modern Marriage, with forewords by Lord Horder, Canon Pym, and Claud Mullins (originally published by Victor Gollancz as Modern Marriage and Birth Control. 1935) Methuen and Co Ltd, London, 1946, p 149

46. for details of Griffith's life and career see his autobiography, The Pioneer Spirit. Green Leaves Press, Upton Grey, Hampshire, 1981

47. Havil, Anthony, The Technique of Sex. Towards a b e tte r understanding of the Sexual Relationship. Wales Publishing Co, London, 1939

48. ibid. p 105

49. ibid. p 10

50. "Fielding, Michael" (Newfield, Maurice, pseud). Parenthood: Design or Accident: a Manual of Birth Control. Labour Publishing Co, London, 1928, 4th edition, Williams and Norgate, London, 1944. Accounts of Newfield's career 187 which mention this pseudonymity may be found in obituaries in The Eugenics Review. 1949, Vol 41 no 3, and The Lancet. 1949, i i 353

51. Chesser, Love without Fear, note 39 above

52. ibid. p 85

53. ibid. p 98

54. Balzac, Honors de, The Physiology of Marriage, f ir s t published in France, 1826, English edition, privately printed, London 1904, p 56-58: "comparing the majority of husbands to this orang-outang trying to play the violin."

55. G riffith, Modern Marriage, p 194

56. Wright, The Sex Factor, p 68

57. G riffith, Modern Marriage, p 148

58. Beale, op c it. p 87

59. Stopes, Marie, Enduring Passion. Further New Contributions to the Solution of Sex Difficulties being the continuation of Married Love. GP Putnams Sons, London, 1928, 2nd edition 1929

60. Wright, The Sex Factor, p 83

61. Stopes, Enduring Passion, p 67

62. Stopes, Married Love, p 22

63. Beale, op cit. p 69

64. Hutton, The Hygiene of Marriage, p 49

65. Chesser, Love without Fear, p 61

66. Hutton. The Hygiene of Marriage, pp 49-50

67. Stopes, Married Love, p 39

68. Beale, op c it. p 75

69. Hutton, The Hygiene of Marriage, p 54

70. Wright, The Sex Factor, p 74

71. Havil, op c it. p 40

72. Hutton, The Hygiene of Marriage, p 67

73. Wright, The Sex Factor, p 74

74. Havil, op c it. p 40 188

75. Chesser, Love without Fear, p 58

76. Havil, op cit. p 39

77. Beale, op cit. p 83

78. Hutton, The Hygiene of Marriage, p 64

79. Van de Velde, op cit. p 6

80. Wright, The Sex Factor, pp 67-68

81. Chesser, Love without Fear, pp 66-67

82. Hutton, The Hygiene of Marriage, pp 65-66

83. Wright, The Sex Factor, p 68

84. Griffith, Modern Marriage, pp 155-156

85. Wright, The Sex Factor, p 76

86. ibid. pp 72-73

87. Marie C Stopes papers in the Contemporary Medical Archives Centre at the Wellcome Institute for the History of Medicine, correspondence "ML- GEN", CMAC; PP/MCS/A.79

88. eg Geddes, Prof. Patrick, and Thomson, J Arthur, The Evolution of Sex. The Contemporary Science Series, edited by Havelock Ellis, Walter Scott, London 1889; Geddes, Prof. Patrick, and Thomson, J Arthur, Sex. Home University Library, Williams and Norgate, London 1914; Herbert, Mrs S, Sex- Lore; A Primer on Courtship. Marriage and Parenthood. A & C Black Ltd, London 1918; Cokkinis, A J, The Reproduction of Life: a handbook of the science of reproduction in nature and man. Bailliere and Co, London, 1926

89. Gallichan, Walter, The Poison of Prudery; An Historical Survey. T Werner Laurie, London, 1929, p 151

90. The Lancet. 1933, i, 1349

91. CMAC: PP/MCS/A.216 Lt LS 1919, A. 184 JFM 1924

92. CMAC: PP/MCS/A.223 MWS c. 1930s

93. e.g Hirschfeld, Dr Magnus, Sexual Anomalies and Perversions: Physical and Psychological Development and Treatment. A summary of the works of the la te Professor Dr Magnus Hirschfeld. compiled a6 a humble memorial by his pupils. Torch Publishing Co Ltd, London, Cc. 19361, "A Textbook for Students, Psychologists, Criminologists, Probation Officers, Judges and Educationists'*; Ryley Scott, George, Scott's Encyclopaedia of Sex: A Practical Encyclopaedia arranged in alphabetical order, explanatory of everything pertaining to sexual physiology, psychology and pathology. T Werner Laurie Ltd, London, 1939, "The sale of th is book is re s tric te d to members of the Medical and Legal Professions, Scientists, Anthropologists, Psychologists, Sociologists, Criminologists and Social Workers" 189

94. Gallichan. op c it. p 147

95. CMAC: PP/MCS/A.158 JL, 1923

96. Chesser, Love without Fear. July 1942 edition, inside dust jacket

97. I am indebted to Miss A Polden of the Library Association Library for information on this point.

98. Personal information from Mrs P Baker, formerly archivist at Westminster Public Library, and librarians of my acquaintance

99. BMJ, 1934, ii, 95

100. Hutton, Memories of a Doctor, pp 216-217

101. Mechling, Jay, "Advice to Historians on Advice to Mothers", Journal of Social History. 1975-1976, Volume 9, pp 44-57

102. CMAC: PP/MCS/A.210 Mrs VR

103. CMAC: PP/MCS/A.180 GYM 1923

104. CMAC: PP/MCS/A.183 SCM, A.112 FRG, A.120 Major HH-K, A.173 NM, A.173 Lt RPH, A. 179 DOEM, A. 151 ERK, A.297 Rev CAB

105. CMAC: PP/MCS/A.131 GFH, A.140 HACJ, A.146 EYJ, A.62 C, A.239 ACW, A.230 CT, A. 189 GLN, A.221 PEMR, A. 114 Col HHH, A. 118 Capt WPH, RAMC, A. 160 SL (a schoolmaster)

106. CMAC: PP/MCS/A.134 CGH

107. CMAC: PP/MCS/A.235 WT

108. CMAC: PP/MCS/A.94 EGF, A. 194 EP, A. 135 Capt BH Indian Army

109. CMAC: PP/MCS/A.248 LW, A.235 Lt-Col DCT, A.208 Capt JR, A.205 WJP, A. 190 FN, A. 185 JM, A. 110 WGG

110. CMAC: PP/MCS/A. 173 AJM, A.120 JH, A.250 JHW, A.240 JHW, A.246 RHW, A. 123 ARH (Carlton Club)

111. CMAC: PP/MCS/A. 114 ACH, A. 165 HL

112. CMAC: PP/MCS/A. 117 GPH

113. CMAC: PP/MCS/A.239 Mrs AEW, A.246 HPW, A.197 EWP, A.165 HL1; and see also A. 130 JH (Capt RAF), A,30 ELE, A.237 ELW, A.222 EAS, A. 198 EWP

114. CMAC: PP/MCS/A.239 TSW, A.254 HJY

115. CMAC: PP/MCS/A.208 Major LR

116. CMAC: PP/MCS/A.201 HBP (RAF) 190

117. CMAC: PP/MCS/A.228 MS, A. 118 Capt WPH, A. 152 HEK, A.248 Capt AW (RAMC)

118. CMAC: PP/MCS/A. 135 Capt BH

119. CMAC: PP/MCS/A. 188 F, A.109 Major JG, A.112 Pte WG, A.124 SJH, A.128 FJH, A. 174 Cpl HM (RAF), A. 185 AGM, A.202 WJP, A. 182 CKM,

120. e g CMAC: PP/MCS/A. 160 SL, A. 136 Capt LDAH (RGA), A. 129 FH

121. CMAC: PP/MCS/A. 135 Capt BH

122. Gordon, Michael, "From an Unfortunate Necessity to a Cult of Mutual Orgasm: Sex in American Marital Education Literature 1830-1940", in Henslin, J, ed, Studies in the Sociology of Sex. Appleton-Century Crofts, New York, 1975, pp 53-77, re f to p 7 In

123. Packer, E L, "Aspects of Working Class Marriage", Pilot Papers: Social Essays and Documents. March 1947, Vol 2 no 1, pp 92-104

124. Woodside, Moya, "Courtship and Mating in an Urban Community", Eugenics Review. 1946, Vol 38 No 1, pp 29-39

125. Brecher, op c it p 102

126. Mitchison, Naomi, All Change Here: Girlhood and Marriage. The Bodley Head, London 1975, p 157

127. eg. ibid. and her later autobiographical volume, You May Well Ask op cit; Asquith, Lady Cynthia, Diaries 1915-1918. London 1968, p 477, in which she described a "fairly obscene hair-combing arising from a discussion of Dr Stopes* Married Love" with Lady Diana Manners, later Cooper, who was "quite a missionary" about the book (I am Indebted to Heather Creaton for this citation). Charlotte Mackenzie has drawn my attention to the fact that even Virginia Woolf was aware of the widespread popularity of Stopes* works, mentioning the circulation among the "younger generation" of the works and ideas of "Mary tsic] Stopes" in a letter to Molly Macarthy of 19th January 1923.

128. e g CMAC: PP/MCS/A.32 JJB, A. 107 CHG (A ustralia)

129. Pendleton, D and Hasler, J (eds), Poet or-Pat lent Communication. Academic Press, London and New York, 1983; Byrne, P S, and Long,BEL, Doctors Talking to Patients. HMSO, London, 1976, depicts what miscommunications can take place in the course of a consultation.

130. Walker, Kenneth M, Marriage: A book for the married and about to be married. Seeker and Warburg for the British Social Hygiene Council, London, 1951, p 1

131. Stopes, Enduring Passion, p 76

132. Rusbridger. Alan, A Concise History of the Sex Manual. 1886-1986. Faber and Faber, London, 1986, pp 11-12 191

Chapter Five

"Young husbands and all those who are betrothed in love”

The previous chapter showed the unflattering picture of the average male presented in sexual advice literature. How far was this merely a polemic construct, and did it bear any relationship to the actual experience of men? Havelock Ellis considered that

It is not easy to form a clear picture of the erotic life of the average man in our society.

In spite of this difficulty he believed that the average man in general failed to realise the profounder possibilities of sexual congress because his ideas in the erotic sphere were reducible to two:

(1) He wishes to prove that he is ”a man” and he experiences what seems to him the proof of virility in the successful attainment of that proof; (2) he finds in the same act the most satisfactory method of removing sexual tension and in the ensuing relief one of the chief pleasures of life.1

Deleterious a6 such an attitude was for the wife of such a man, it also provided the man himself with a very impoverished sexual life. Little would seem to have changed in this respect within thirty years or so of Ellis's remark. An anonymous writer (very probably Dr Joan Malleson) of a leaflet on "Difficulties commonly encountered among men", produced for the Family

Planning Association around the 1940s, stated at the very beginning

It is not at all unusual to find an apparently normal man who is quite limited in what he feels to be "proper" during sexual intercourse; this limitation will tend to lessen his own sexual satisfaction and also may lead him to misjudge seriously his wife's feelings and necessities.2

In this chapter evidence is considered relating to the experiences of men within the marital relationship. 192

A number of writers in a sociological mode took up the notion of male selfishness and crassness within a specifically class context. It was one of the main points made by M Leonora Eyles in The Woman in the Little

House.3 This book set out to reveal the sufferings of poor working-class women, of which she believed male lack of consideration in the sexual sphere to be one of the greatest: she began the chapter with a comment

6he claimed to have heard from five different women

I shouldn't mind married life so much if it wasn't for bed­ time.A

She set this in a context of the general atmosphere of sexual shame and ignorance, and pointed out that it was more "ignorance than unkindness" that led husbands to misuse their wives:

The working man has theories, usually formed by and coincident with his desires... the prevalent idea among men, from what women tell me, is that continence is wrong... Cthe man] makes the exercise of the sex function a nightly occurrence... most working-class men seem to think that the use of preventives is bad for them.

Eyles surmised that

This continual pandering to an impulse robs it of thrill or pleasure... He is spoiling hie own pleasure also. He is making what should be a feast into a dreary penance.®

These remarks obviously have a strong middle-class bias, in which perhaps the failings of the working class male were exaggerated. The attitude, however, was common enough: Wilhelm Stekel <1868-1940) the Viennese psychoanalyst, in his monumental work on Impotence in the Male implied that it was the more intelligent, cultivated man who because of his higher ideals and aspirations in the sexual sphere was more likely to suffer from dysfunction, and to worry about his sexual adequacy. Marie Stope6, rightly or wrongly, believed that premature ejaculation a6 a problem w&6 most prevalent among 193

British men of the professional and upper classes... I have little evidence of its existence as a "problem" in the homes of the manual workers, and incline to think it much rarer than among the "black-coated". Among Public School and University men it is one of the marital difficulties oftenest brought to my notice.®

Her remarks addressed specifically to working class women, in A Letter to

Working Mothers, concentrated not on recipes for obtaining mutual conjugal bliss but on how to avoid debilitating pregnancy.

An a rtic le by Moya Woodside, "Courtship and Mating in an Urban Community", published in the Eugenics Review in 1946,7 drew on a field-work study of marriage in Britain, and "in civilian life our subjects had belonged to the artisan and working classes." Like M L Eyles, though her study was perhaps more grounded in statistical methodology than Eyles', she concluded "Women suffer most", while

Men find their sex lives satisfactory. If any complaint is made, it is usually on the score of "coldness" or lack of interest of their partners.

In spite of the general level of male satisfaction, Woodside nevertheless concluded that

sexual maladjustment is widespread. Ignorance, far from ensuring bliss, has meant embarrassment, fear and misery. Men are lacking in the rudiments of erotic technique, and have been brought up to think that frankness in such matters is improper. an a ttitu d e she illu s tra te d by citin g the comment of a "middle-aged brewer's drayman" that "I respect my wife. I would never talk Intimate to her", and the case of a man of 38, seventeen years married, with five children, who "didn't know" if his wife enjoyed intercourse. Woodside pointed out in her conclusions that this was a small sample, that the material was incomplete, and that the war-time situation was abnormal. 194

E L Packer (a probation officer) in "Aspects of Working-Class Marriage"

(1947), presented a similarly grim picture of the subject,' |

The attitude of the man's rights and wifely duties is still encountered in many working-class marriages. Although in law a husband is not entitled to seize his rights by force in order to render him conjugal rights, in practice it frequently happens.

Packer remarked that

Lecturers in sex education have found that children assume that sexual intercourse is forced on the woman by the man Although Packer claimed that "[copulation] becomes a weapon whereby the partners in the marriage can attack each other", the example of this hostile use cited turned on a husband who refused to practice withdrawal

(his wife being in serious danger from further pregnancies) in the course of a matrimonial disagreement, and no equivalent female example appeared.

A case of wifely adultery with an Indian peddler mentioned in another context would not seem to have constituted a gesture of revenge. The double bed was condemned by Packer as a force

which has contributed to the failure to achieve sexual harmony... continuous physical contact in time is productive of boredom and satiety . even in the absence of cases of enuresis, the adverse effects of which were recounted.6 While Woodside drew some moderately cheerful conclusions from the willingness of the younger couples she interviewed to discuss sex with one another, Packer emphasised the state of divorce and upheaval, though with the proviso that this might be a transitional stage towards marriage with more equal rights and responsibilities.

It was perhaps easier for middle-class social observers to study and comment upon working-class habits and practices than those of their own class. The self-study of Mass Observation (to be considered in Chapter 9) involved individuals surveying themselves rather than simply presenting 195

themselves as the subject of others’ studies, although they also acted as observers of social phenomena. However, while Mass Observation noted differences between the (predominantly middle-class) Panel and the general

public whose views they sought, it could well be argued that the Mass

Observation Panel members were in no way typical members of the middle-

c lasses.

Most writers who mentioned any class dimension when discussing male

sexual attitudes and behaviour seem to have proceeded, implicitly if not

explicitly, on the basis of certain preconceptions, either of the greater

effeteness of the middle-class male or of the coarseness and brutality of

his working-class counterpart. While as a very crude generalisation it

could be said that Marie Stopes' correspondents from the lower social

classes were more concerned about the prevention of unwanted pregnancy,

and the more middle class with the quality of the marital relationship,

th is was in no way an absolute dichotomy. Just as members of the middle

class were anxious about too many and too frequent pregnancies, men of

the working class were concerned about their marital relationship and the

well-being of their wives.

Marie Stopes specifically dedicated Married Love to "Young husbands, and

all those who are betrothed in love." Of the vast correspondence that

eventuated, approximately 45% of all her letters came from men, suggesting

that her work did not only appeal to women suffering from too many

pregnancies or neglected sexual desires.9 Nearly all the correspondence she

received indicated a positive response to her works, very little of it was

condemnatory or even mildly critical. The torrents of praise which were 196 expressed have been cited in the previous chapter, as well as the occasional reservation. It is clear that most of its male readers, at least the ones who were sufficiently impressed one way or another to put pen to paper on the subject, regarded her work as a welcome revelation, a shaft of lig h t into an area of murky darkness.

Stopes' grateful readers did not merely write to convey their gratitude for her works. In most cases the fulsome praise was a preamble to a request for further elucidation of matters touched on in her works, or for advice on some personal problem upon which it was assumed that she, being an authority on sexual questions, might be able authoritatively to pronounce.

Among the problems put to her by her male readers there was a dichotomy, by no means absolute, between those men who were writing as solitary beings about a problem which seemed to them of purely individual concern, and those who wrote about problems as part of an existing or potential mutual relationship, or Indeed as spokesman for the conjugal couple. What is perhaps astonishing, given the construction of the male in so much of the literature as insensitive, egotistical, clumsy, selfish, was how many of the men who wrote to Stopes did fall into the second category. A study of these letters undermines any simplistic assumptions about the relationship of the sexes within marriage during the period in which Stopes' writings were most influential. This may of course reflect the particular type of man to whom Stopes' works would have appealed, but given the wide circulation of her works it is possible that this type of man was perhaps more commonly to be found than might have been supposed. Very few of her correspondents wrote in terms such as the following, dissenting from the 197 tendency of Stopes' work to privilege women: a Mr CEFM in 1925 voiced the charge that

[Married Love] is a book written by a woman for the benefit of women exclusively... its gospel is sacrifice by the man. while Mr JG, in 1926, was convinced that

there are a great many women (my wife is one of them) who are so devoted to their husbands that they are quite satisfied and delighted when they know that they are giving joy and pleasure to their loved ones and are indifferent whether they experience orgasm or not.10

But most of Stopes' male readers, it would seem, did not regard the possibility of sexual mutuality in these terms and were anxious to achieve it.

It should be remembered that Stopes was writing during a period during which the very concept of marriage was apparently undergoing re- evaluation. She was by no means the only writer propounding a new philosophy of marriage, which, while continuing to emphasise the differences between the sexes, was speaking for a new egalitarianism within marriage. "Companionate marriage" was given a specific meaning by the American Judge Ben Lindsay as an agreed and not necessarily permanent chlldfree liaison between "consenting adults",11 but was often taken as a shorthand way of expressing thi6 new ideal in which partners in marriage were to be companions and comrades, a definite reaction against what was set up as the "Victorian" patriarchal household. Husbands and wives were to be lovers, the husband was encouraged to favour his wife having interests beyond the home, and to lend a hand in the domestic sphere. This was a philosophy found as much, if not more, in religious writers and lay authors as in medical texts—Van de Velde for example was rather a 198

"separate spheres" man, and even Kenneth Walker expressed himself firmly about the proper roles of man and wife.12

There is some confirmation for this view of a new spirit among married couples in autobiographies of those living during the period. While one might dismiss the domestic and conjugal arrangements of the Mitchison household or within the menage of VftFA Br-tttAta Aftd GftflrgA GAltUty AS described in their autobiographical accounts, as being confined to

"advanced" artistic and bohemian circles, a similar arrangement catering

for the needs of both partners was set up by Dr Isabel Hutton and her husband, an Army officer, who seems to have been well in advance of the authorities who refused to employ Dr Hutton as soon as they discovered her to be married.13 At a very different social level an army private who wrote to Stopes in 1919 expressed the sentiment "my wife whom I wish to be my friend and wife and companion."1,4

Writers on the marriage relationship did not always or even usually suggest that a wife's outside Interest should necessarily be a career or a

Job, and marriage bars in many professions often meant that this was an

impossibility. Nevertheless the idea was growing that the marriage relationship was not best served by the wife's interests and perspective being limited to the four walls of her home, nor was it improved by a male authoritarianism associated with Victorian patriarchs.

Men who wrote to Stopes on the whole demonstrated a considerable concern for their wives, or women with whom they were emotionally involved. Many had general queries relating to the health and well-*being of their wife or fiancee or girlfriend: usually involving "women's problems." Presumably as 199 the woman In question was reluctant to seek medical advice men wrote to

Stopes for advice about painful and heavy menstruation,16 as well as other problems connected with the menstrual period:

My wife... for a few days preceding each monthly "period" becomes violent and dangerous.16

(a rare reference to the pre-menstrual syndrome), a girl of 18 who had never menstruated and had other health problems, a fiancee whose scanty periods led to worries about her fertility, a wife who had not had periods for years, a wife who was "poorly" during her period, and a fiancee suffering from something like fits during her "poorly times."17

Similarly there were some queries about mysterious "discharges":

I write to you on behalf of my wife, who is troubled with what she terms "the whites".16 as well as some about the loss of figure following childbirth,16 pain after intercourse,20 and ovarian inflammation.21 A number of questions related to matters to do with fertility: the case of the female friend with small undeveloped breasts—would she be able to breastfeed;22 how old could a woman be and still safely conceive a first child;23 would an appendectomy render a woman sterile;2* would earlier use of an abortifacient affect child-bearing capacity.26 Nor were men insensitive to the suffering child­ birth caused women:

I was home on leave when my kiddy was born and so I know what terrible agony my wife had to endure... If I thought my darling had to go through that every 2 years or so I think I should try to stay on foreign service until she was past child-bearing.26

In some cases it was the general state of the wife's health which gave cause for concern, as in the case of the man whose wife was in a

frig h tfu lly enemic Csic] condition and is a nervous wreck.27

In one case a man ascribed this ill-health to his own past actions, without 200 actually stating what these were,2® and in several letters the wife's poor state of health was attributed to sexual problems within the marriage.2®

Queries about marital relations where one or both partners had tuberculosis or a bad heart suggest the reluctance of doctors to advise or patients to enquire on such a sensitive topic.30

It is possible that some of these men may have been moved to write less from concern for their wives as out of the selfish desire to have a healthy one, if it is possible to differentiate the selfl6h from the altruistic motive in this way. While presumably the correspondents wished to present themselves to Stopes as caring husbands, need one doubt statements such as

My one aim in life is to give my wife all she deserves and if you cannot help re the points raised I do not know where to turn for help.31 given that other men were prepared to state the suffering that their wife's indifference to or refusal of sex caused them:

It's the problem of the "cold and unresponsive" wife... it puts me in the greatest despair for the best part of my days... I find it slowly dragging me down to underhand and disgusting thoughts... torture I endure and have withstood for 4# years.32

Claire Davey has pointed out, in a study of letters specifically relating to birth control addressed to Stopes,33 that they present information which cannot be gleaned from other studies made during the inter-war years, and which individuals conducting surveys thought too sensitive even to enquire about. Her suggestion is that, for whatever reason, Stopes' correspondents were unusually honest about their sex-lives, especially respecting the use of methods of family limitation, including abortion. 201

The problem of birth control is and was often seen as something concerning women alone. Some writers, for example Leonora Eyles and E L Packer as cited above, perpetuated the notion of men reluctant to use birth control or even opposed to its use as diminishing their control over their wives.

The idea of men as indifferent to, if not wholly hostile to, the use of reliable methods of birth control or at least methods which did not leave control in their own hands, cannot be substantiated from the letters which men wrote to Marie Stopes, and this conclusion is confirmed by Claire

Davey's a rtic le . Numbers of them, alerted to the existence of methods more reliable and less nerve-wracking than coitus lnterruptus and le6s aesthetically obnoxious than the sheath, wrote to Stopes for further details and the names of reliable suppliers. It is clear from these letters that many couples had already been doing something to avoid pregnancy: coitus interruptus,

I have been married 12 years and have always used the withdrawal method with success.

I don't see any way to limit conception except by interrupted coitus. This I plead guilty to.

I... have been reduced to withdrawing which I know to be bad for both and am becoming semi-impotent.3* using sheaths

Only by total abstinence or using rubber specialities can we avoid a child annually. This latter method fails to give pleasure to either.

One seems to be so conscious of their presence that as aesthetic methods they are not very desirable.

Condoms are very unpleasant.

From my point of view [the sheath! renders the "sex act" sordid and destroys the aesthetic side entirely.

Rubber check pessaries (male) remind me of one having a bath with top hat and spurs on.3S 202 chemical pessaries such as "safety cones",30 about the general reliability of which there was much doubt

Is there any truth in the statement that by law there must be at least one harmless and ineffective pessary in every box sold?

1 am informed that so many per cent of check pessaries have to be made defective else the Government do not allow their sale.37

Douching was also known of:

the sexual act takes place, and in all such cases the woman has to get up and wash out the bad-smelling liquid the man has injected into her.30 and the occasional, usually inaccurate, concept of a safe period:

There is only danger I understand when or about the menses.30

One man wrote to Stopes (though he did not say he used this expedient himself):

I was a short time since in the flat in London of a fashionable cocotte... had a talk and was informed that middle-aged married men came to cocottes as a means of keeping down their progeny! So you see that there are other means of birth control!*0

While some correspondents queried whether b irth control were "not a form of prostitution",*1 this is presumably not what they meant. Some couples simply refrained from actual penetration, managing to satisfy themselves by "other means" which appears to have meant mutual masturbation or intracrural intercourse:

Our nearest relations consisted of weekly and bi-weekly love- play in the course of which we both reached high pitches of excitement but never once was intercourse attempted, altho* at times greatly desired.*2 or a practice described as "extra-vaginal intercourse."*3 Anal intercourse as a contraceptive alternative was extremely seldom considered by Stopes' correspondents, being mentioned only a couple of times.** 203

The occasional very bizarre notion of a contraceptive method was put forward by Stopes' correspondents: in one case dependent on a total misconception about the reproductive system. The letter itself does not survive, but Stopes replied

In reply to your question about rendering of the navel air-tight as a possible means of preventing conception I may say I never heard anything more ridiculous in my life. It is an absolutely preposterous notion.

Another strange method was mentioned by a correspondent who stated that he had encountered it in a work entitled The Marriage of Happiness (he was also enquiring about a recent sex-change case which might indicate an interest in the sexually bizarre). The work suggested that the husband should suckle his wife's breasts to maintain lactation and keep away the menstrual flow:

We married men know that the suckling time is practically a safe period so far but it is a bit too real for the man to do this.*6

While it is thus clear that the idea of birth control was not a new one to many of Stopes' readers, nevertheless numbers of them still felt reluctance or repugnance at the concept:

such means and devices are rather abhorrent to me.

like many others I have always shrunk from enquiring into these m atters.

we neither of us understand... the actual practical method of preventing conception... the idea of wearing artificial means of prevention tends to make us question the rightness of union apart from children.

I want to maintain our love without degrading it by impure means.

Chow to have union] without any risk of conception and without employing any artificial contraceptives, which my friend abhors. (A Balliol man, for "a friend.") 204

my wife and I are anxious to resume cohabitation but without the risk of any more children... but wish to avoid the use of contraceptives.

The usual means... are somewhat d is ta ste fu l.4,7 and one man shrank from the idea of birth control "as from sodomy",4,0 while a naval Lieutenant-Commander claimed that employing a birth control device "shocked my sense of delicacy even more I think than hers."AS*

Another man sought "methods of course that would be scientific and consistent with decorum and prevention."60 Because of the ambivalent feelings that were aroused by the subject of birth control, some correspondents found it necessary to give their respectable credentials for venturing to enquire about it:

my reason for seeking the information is not morbid curiosity. I am a married man with one child.

I have become convinced that the practice of self-control in this respect without the use of some artificial appliance, must in time prove injurious to one or the other.

I do not want the information from a selfish motive but for my wife's.

the ever present fear of a woman and the mental agony of a man lest she should have been "caught" is one of the foundations of marital unhappiness. The ecstasy of union is clouded by the subsequent torment.

Cl am] a householder and a family man of limited means and deeply interested in the subject.61

This sense of a necessity to prove one's worthiness to be given contraceptive advice has been substantiated by Claire Davey, who cites working class women who described themselves as having already "done their duty" in bearing children.62

In a few cases, far from birth control being seen a6 the wife's province and none of the husband's concern, the husband seems to have been forcing a method upon the wife which 6he was relu ctan t to employ: 205

[My wife] said [the female check pessary] was distasteful and took away the romance of everything... the more I think of this m atter the more I think it looks selfish on the woman's part especially if coitus interruptus really does harm to the man.

I took my wife to you in order to be fitted for an occlusive cap (very much against her will) as I considered it would be a more efficient and beneficial method of birth control.

I simply cannot persuade her to... adopt the preventive measures recommended by you. At present I simply cannot afford to indulge in parenthood... After three years of married life I am still compelled to be satisfied with the use of a thick preventative.53

However most men seem to have been ra th e r more sen sitiv e to th e ir spouse's feelings, one man writing to Stopes for advice "since my wife

feels th at the method recommended would be repellent",SA and others stressing the deleteriousness of coitus interruptus from the woman's point of view

I have to practice coitus interruptus which is most unsatisfactory from my wife's point of view and therefore from mine because my climax is reached as a rule just as the pleasure for her is about to begin.

withdrawal leaves the wife "in the air" as you say.SB

For many couples the only way that they could conceive of to limit births was to abstain, usually from all kinds of sexual activity

We tried for some years a life of pretty rigid abstinence and it didn't work and only brought a decrease in happiness.

Consequently we have had no union ever since the child was conceived over 5 years ago.

[we] have been holding off from our great mutual experience. (St John's College Cambridge)

I have by the greatest exercise of self-denial kept our family down to three, without any artificial checks but it has been a very great trial.

My wife and 1 have been married three years and we have not had a union, because we do not want children yet.®* 206

Some men felt that practising abstention had other benefits besides the obvious:

Prior to reading your book I was of the opinion that the one and only course was total restraint and you must admit that it has one great advantage—it enables the man to prove to his loved one that in his desire for marriage there are no selfish or secondary motives, and for that very reason I cling to the idea.67

A few of her readers mentioned the practice of "karezza" or prolonged

intercourse without male ejaculation, a practice which was supposed to have profound spiritual/mystical benefits for the couple as well as having been advocated by certain nineteenth century writers (Noyes of the Oneida

Community, A Stockham) for its non-reproductive aspect. Most of Stope6' correspondents had come across the notion in her own works and were writing for further information; only a few seemed to have been practising

it and even less found it satisfactory or at all coming up to descriptions of its benefits.6® Stopes* own comment was

In my opinion an average, 6trong and unimaginative Englishman is not likely to achieve success in this type of union, but more sensitive and artistic temperaments and those in which the vitality is not excessive undoubtedly can do so... Whole communities are known to have practised such control successfully and healthily, though I do not know of more than a few British men who have done so.6®

Even more than birth control, abortion has often been regarded as a particular female concern, indeed, part of a women's "underculture", a practice that went on hidden from the male world. While the vast majority of requests for abortion advice received (much to her horror) by Stopes came from women, a significant number were addressed to her by men, suggesting that it wa6 an issue in which both members of the couple were 207

Interested, even if the brunt of anxiety and suffering would naturally have been experienced by the woman.

Most of the abortion requests addressed to Stopes by men concerned

unwanted pregnancy occurring within marriage, where there were too many

children or conceptions following too closely upon one another or the wife suffering from ill health. This does not differ greatly from the requests

from women. Panic in some cases set in very early, after one act which had

taken place unprotected or with contraceptive failure,60 while others wrote when the woman was already several months along in pregnancy.61 Some wrote in very veiled, circumlocutory terms which contrasted with the explicitness of others. The use of folk remedies was mentioned in some

le tte rs:

I have heard that a medicine of some kind is allowed to be given to stop things at the early stages.

Are we doing wrong in taking these pills?

My wife has been trying Vegetable Tablets and also syringing herself.62

but the general ignorance, when it came to practicalities, of what could be

done, is very apparent:

We are ignorant of how to deal with such cases.

the problem how to effect menstruation in my wife, who is overdue by about a fo rtn ig h t.63

Presumably it was those couples who did not have access to any network

which might have put them in touch with an abortionist who wrote to

Stopes, but in at least one case the husband wrote

My wife will not speak to anyone.64. 208

Many of these couples were agitated by the prospect that pregnancy had occurred after a single act of Intercourse, or after one Incomplete or

inadequately contracepted act:

On the 9th, the sex act, we are both afraid to say, was Indulged.

I have been keeping company with a young lady for a considerable time and nothing happened between us until I lost control of myself on March 9th—the result is that the girl is in a certain condition.

I have always been as careful as I possibly could whenever we had any intercourse not to go too far and although we have two children I can truthfully say we have never yet had one proper full union together. My wife never has any orgasm herself and seems to take if I go near her... she [has] accidentally caught again.

Cl] fear that intercourse has been achieved while we were both in a somnolent state.66

The terror and sense of disgrace which affected couples who were faced with undesired pregnancy in or out of wedlock was eloquently described

I am afraid I shall lose her if she has another child and she is so frightened herself. I feel afraid to go out to work and leave her. I would give all I possess to have her right again.

A time of great trouble for me and my young lady... we have got ourselves into very great trouble... may I appeal to you to help us out of the disgrace that has come upon U 6 . . . it has been like this for three months ever since we made the great mistake and I was wondering if it is possible for you to do anything for us... it is our only hope—just one little ray of light in our darkened lives. I am sure I can never face the terrible ordeal— I know I am a coward.66

An associated anxiety sometimes expressed in letters to Stopes was the ease with which conception might take place even without full Intercourse: readers wrote to ask how long sperm would survive outside the body,67 could conception be caused by the deposit of spermatozoa on the labia,

through cloth,60 and could a woman get pregnant from a single drop of sperm.60 One man wrote on behalf of "a friend” who had been practising 209 digital stimulation on his girlfriend, through her clothes, and was worried that he might be transferring sperms to her on account of his practice of masturbation.70 A particularly convoluted contingency was described by one enquirer:

If an ejaculation takes place during the night, and the body is subsequently washed in a bath the next morning, is there any possibility of live spermatozoa remaining in the bath-water, and is there any chance of these spermatozoa impregnating a woman who may happen to use the bath afterwards?71

One young man, surprised by the number of couples he knew who had had to get married in the previous eighteen months, and the number of hasty

/ marriages noticed by his fiancee who worked in the Registrar's Office, wrote

It is inconceivable to my fiancee and myself that they would have had intercourse such as we understand is necessary from your books... Is it possible that an "accident" could have such serious results, by this I mean, supposing for example they were in an embrace, the fellow "became excited", could thi6 soak through their clothing or anything like that. If this is possible I would submit that as so many are running such a grave risk, it would be worthy of mention in one of your volumes... I would like to observe that if conception can take place so easily then life for engaged couples is unbearable, if however it is necessary for complete intercourse then it is true that "still waters run deep".72

One young man brought up in a remote country district of Ireland had no such technical worries concerning fears of getting girls pregnant: he had feared that if one talked too much with girls God sent a child.73

Men brought many other marital anxieties to Stopes besides those to do with anxieties over pregnancy. In spite of all their perturbation at the prospect of conception occurring Inconveniently, men also expressed the desire for fatherhood:

[I am] ardently desirous of becoming a father.

I have strong desires and aspirations re parenthood. 210

We are both awfully keen on having some topping children.

We would like to have three children; at what Intervals should these be born and what books can you recommend on child education and upbringing?74

However, most le tte rs which concerned the question of fatherhood were to do with anxieties about its desirability in the particular case of the writer. Some men, intending to marry their cousins, feared that this meant that they should not risk having children.75 There was also anxiety about potentially hereditary disorders on one or other side of the family: tuberculosis,76 fits,77 club-foot,7® and deafness.7® Some men feared that they had permanently unfitted themselves for marriage and parenthood through masturbation.®0

Worries about problems in marriage and being a satisfactory husband often began well before the wedding, sometimes even without a prospective bride in view. Numbers of men, young and some less young, wrote to Stopes concerning their anxieties about marriage. While some of these involved questions of actual sexual competence, and will be discussed in the next chapter, and others were to do with birth control, many of the men who wrote to Stope6 displayed a concern for their wife to be and an idealism about the potential of the conjugal relationship which was expressed for them by Stopes h erself in Married Love:

The young man is often even more sensitive, more romantic, more easily pained about all ordinary things, and he enters marriage hoping for an even higher degree of spiritual and bodily unity than does the girl or woman.®1 and this spirit of idealism was echoed by several of her correspondents:

I'm in a quandary, how 1 should act when I'm married, I'm extremely passionate but do not want to do anything that would hurt her sense of the aesthetic—I want her to be really happy.

There must be innumerable thousands of husbands like myself who wish the marital embrace, that mystical beauty of body and soul, to contain the fullest possible joy for their wives. 211

Cthe need to] keep unbroken the subtle threads of spiritual joy and beauty in the consummation of the perfect union.

It was ten weeks where my affection was sorely tried against human passion but I thought then and now that her happiness was most important.02

Many of them took a certain pride in having kept themselves clean for their future wife:

Previous to my first marriage [aged 31] I can honestly say I had led absolutely a life free from vice.

I am a young man of 25 years of age, who is to be married soon, and who, I am proud to say, will be able to offer his wife, himself, uninitiated in sexual intercourse.

I have not ever known in that sense anyone but my wife as I look upon those m atters as sacred.

For her sake during the long and hard years of boyhood, youth and manhood (I am now 35) I kept myself clean, looking ever forward to the complete joy of marriage.

Cl] went to the altar with what I call "clean hands".

I am some 32 years old and have not had sex experience before, being anxious to keep myself for the love that is given and not bought.

Simply it had always been one of my ideals that I should be able to feel that I had been married in the state in which I expected my wife to be.

Passionate devotion has never caused me to over-ride an almost sacred regard for her.03

Some men, though, had less Idealistic reasons for refraining from sexual activity:

I most sincerely hope to enter the married state clean and free from all the usual diseases.

[I] have never had union with a woman, being always somewhat afraid of the experience.

I had no experience before marriage... I think I had no 6ex impulse or ideas or knowledge at all until in my late 30s.

When we were married both of us were Ignorant... I hadn't taken much interest in that sort of thing.0* 212

It is hard to quantify the prevalence of premarital intercourse and how acceptable it was assumed to be. Attitudes towards prostitution expressed by Stopes' correspondents have already been quoted in Chapter 2. Others, however, it i6 clear, were having or had had sexual intercourse with the woman they were intending to marry, though this was not always directly stated but can be deduced from statements such as Nmy young lady 16 in trouble."®® Others, though this disaster had not occurred, nevertheless expressed a sense of guilt over the occurrence of sexual relations prior to marriage.®6 It would therefore seem that the young man who declared that

we have been like most normal couples I presume (that is) guilty of having intercourse.®7 was possibly less "normal" than he supposed. Another young men was adamant in his determination to "stem the flood of our natural desires", because

I love her 60 deeply it would break my heart if any premarital event took place.®®

Given the worries about the consequences of Intercourse, and the number of cases in which premarital Indulgence had alerted the man to a state of premature ejaculation:

I thought to have connections with a woman would cure me [of masturbation] but it did not. Because, in the first place, I could not get properly erected, and in the second place my stren g th was spent in a few moments.®9 anxieties about the sexual relationship can be seen to have commenced well before marriage took place.

A surprising number of correspondents wrote about unconsummated marriages, some of which had existed in this state for an extremely long period: 213

I am 54 years of age my wife being 48 and although we have been married many years, union between us has never been possible.

We have been married just over 12 years and yet... through a number of difficult circumstances which I will first very briefly indicate—we have not been able to consummate our marriage.90 and other lengthy periods mentioned included 5, 9, and 10 years.91 In other cases the couple had been married a fairly brief time before consulting

Stopes:

Although we have been married only 3 weeks, we are both unhappy and distressed to find that physical union is impossible.

Everything has gone wonderfully except for the fact that we have been unable to experience our first coitus [married 1 month].92 but most left it at least a little longer before worrying: two, four or six months seem more usual,93 and a number of couples who wrote with th is problem had been married between 1 and 3 years:

The position is that we have been married 3 years and have as yet been unable to effect coition.

Surprising as it may seem our union has not yet been consummated [in 2 years 9 months].

So far [in two and a half years] there has been no marital relation between U 6 .

I have been married for one year and have not as yet been able to have sexual intercourse.94-

Not all correspondents were specific about the time during which they had been suffering from this difficulty:

We have not yet had a normal sex union.

We are both healthy and clean-minded but up to now we have made a complete mess of things.

When we come together I have never succeeded in making entry... I am a strong working fellow.

Entry being so very difficult and it took so little trying on my part to cause such pain.99 214

Some failures in consummation appear to have arisen following deliberate abstention for contraceptive purposes, reasons of the wife's general health, or her ignorance.9® One writer (a woman) said that "the happy

companionship of our bodies seemed sufficient" but soon found that her husband wanted union, which they were unable to achieve.97

Even if a man succeeded in consummating his marriage without difficulty

there were still many problems which he might encounter. Many men wrote

to Stopes about problems connected with ensuring that their wives were as satisfied with the sexual side of marriage as they were themselves:

After nearly 5 years of marriage my wife still appears to be frigid and to scarcely ever desire sex union... I am so anxious to make her happy.

1 am seldom able to satisfy my wife when we do have intercourse... my wife is a very pure-minded woman and 1 deeply regret that I am not able to satisfy her.

My greatest wish is to make her happy—we are very happily married and are in every way suited to each other but when we have union she is very rarely satisfied.

Never has she been fortunate enough to be satisfied.

For the whole of that time Cll years] I have been unable to stir her to any passionate interest in our love.

How is it in the power of the husband when holding physical union with his wife to ensure that she receives the full orgasm and thus the full benefit of union?

1 really want to give some pleasure to a good wife.

My wife can obtain no actual climax to the sexual act. Not by any stretch of the imagination can she be called frigid—on the contrary she is extremely passionate before and during the act but however long it lasts she is left feeling unsettled.

Although I obtain pleasure every time I unite with my wife she has had pleasure only twice during this period... I would do anything if only I could help her.9® 215

In some of these cases they had not realised, until reading Married Love. that there was a problem:

I have not realised till now that I haven't given my wife the satisfaction to which she has a right.

You speak of "rousing a woman's body and soul" and you say th at this takes time. My wife states that she has never had this experience... I should be very grateful for any hints as to how to produce the effect which you describe.

I do not believe she has reached anything like the ecstasy portrayed in your book.

You argue the necessity of the climax of one with the climax of the other. I have long felt the necessity of this mutual state but must admit the inability... will you please tell me how to arrive at this perfect state in the accomplishment of which I consider my duty to my wife.39

Stopes' correspondents described the torment that this was to them, as well as how distressing for their wives:

She fired me to the extent that I was rarely master of myself and it all seemed to mean so little to her... I seemed bound to give myself up entirely and yet to have no power to fire her in the same way. To my personal esteem alone it was a bitter blow... I fe lt it for her too.

To speak plainly, my wife can obtain no pleasurable sensation whatever from sexual union... I find it almost repugnant to take advantage of what is hardly more than generosity on my wife's part, she feels that she is missing what is her due.

The only thing that troubles me is th at when we have sexual intercourse my wife never receives that pleasure which we expect... it makes me feel such a cad, when I desire th is pleasure, and she does not.

I feel it rather badly when I turn away satisfied and see her laid there "just left" as you might term it...I feel my wife's position rather keenly.

When I found I could not awaken the desire in her it made me feel so selfish and mean.100

Men sought various solutions to this problem: some of them asked how they could identify the "love-tides" described in Married Love 216

I am asking you to le t me know the dates of these moments when she may have these welling desires.

What noticeable outwards Indications does a wife give when she is at her high tides or desires bodily union with her husband.101 others asked for literature to give them guidelines which they had not found in Married Love

Can you not tell me of any literature on the subject which goes into details of the techniques, etc, of the sex act.

Would it be too much to ask of you for further enlightenment of the above, to recommend a book showing how th is could be controlled.102 while others were Interested in the possibilities of aphrodisiacs:

In short if you could advise me of some way of rousing her with the aid of drugs etc, I think it might help a lot. I have studied her periods and courted then as advised by you but it has no effect.

Are aphrodisiacs advisable please? and if so, which are the best to use?103

However, few of these concerned husbands fe ll into the mechanical- adjustment way of describing their problem used by Mr GL: "Can you tell me how to get this remedied?",10A or the man who hoped that an operation would improve his wife's sexual responsiveness.10®

This widespread phenomenon of female lack of arousal and satisfaction in the conjugal act is les6 surprising when it is realised how very hesitant most of these men were about using even the most ordinary forms of tactile stimulation: one recently married man of 48, not altogether lacking in experience, wrote to Stopes, thanking her for the help Married Love had been to him:

But for your advice I should not have hazarded preliminaries, for fear of shocking my wife and giving her the feeling that I was treating her as a mistress.10®

A number of the men who wrote to Stopes for help with the problem of 217 their wives' lack of satisfaction were aware that clitoral stimulation made a considerable contribution to the achievement of this elusive state:

Cl] Just lay down beside my wife and cuddled her while I worked gently with my fingers round about the opening with slight pressure until my wife completed her orgasm.

The ordinary act does not seem to touch the seat of pleasure in her at all.

After my own orgasm... I help my wife to achieve her orgasm by digital manipulation.

As far as I can judge the seat of the most acute and gratifying sensation is far way too high up (not in depth in vagina) to receive the motions necessary to give orgasm from actual union.

You say that a woman should have a paroxysm when relations take place between husband and wife. My wife is unable to experience this unless I cause it with my finger.107

However most of them were extremely troubled about the use of th is expedient, efficacious though it was, fearing th at it might be somehow

impermissable, harmful, or revolting to the woman:

Whether it is right or not to do so by fondling with the hand?... what is—perhaps vulgarly, termed "feeling"—or, is this too indecent to the nicely minded woman.

Quite by chance my wife and I discovered that considerable stimulation and excitation was afforded her prior to the sex act by some digital stimulation of the clitoris... the thought remains in our minds that perhaps this digital excitation of the clitoris prior to union may savour of perversion or prove harmful.

I have often adopted the plan of remaining idle myself until I have worked up her enthusiasm with the aid of a little external friction. I am afraid this may not be good for her.

Are most women not likely to object to this form of stim ulation?1oe

and several suggested that there was something somehow superior or more

natural about an orgasm achieved without this intervention:

Although Mrs H has an orgasm artificially we haven't succeeded really.

My wife is therefore though always "satisfied" not so deeply thrilled as I would like her to be. 218

Our inability to reach the crisis together in the natural way.

My young wife is now never satisfied in the normal way.10*

But it was only seldom that a man objected on his own account to this practice:

I can make her get the feeling by tickling her with my finger but this does not satisfy me.110

Numbers of men of course, awakened to the possibility of female arousal and satisfaction by reading Stopes' works, were anxious to learn how these phenomena could be detected:

What natural signs should a woman exhibit that 6he ie in a totally tumescent state?111 though one man (writing from the Carlton Club), before he realised the existence of female orgasm, when his wife had one, "was frightened and thought it was some so rt of f it." 112

Some men, however, wrote to Stopes to tell her that her works had confirmed principles and practices which they had managed to discover for themselves over years of marriage:

I find that I have carried out the majority of the practice which it [Married Love! lays down, and these things seemed to come to me as second nature.

Things have worked out themselves to the same conclusions as you draw.

[We] read Married Love with great interest, the more because it so fully confirmed our own practice.

We were children as far as knowledge was concerned and yet I must have approached her as you would have advised, for years after she was grateful to me for the way I acted then. I did what seemed natural.

Many of your observations we had marked out for ourselves in 18% years very intimate married life. 219

We had "muddled through" to almost exactly the idea you describe.113

Even such basic issues as how frequently marital intercourse should take place would appear to have been provocative of considerable anxiety. It was a question often included in letters requesting premarital advice or along with other questions and quite often the assumption was made that there was some kind of acceptable standard:

I am a young man of thirty contemplating marriage and I cannot decide in my mind what is usually considered the normal amount of intercourse per month between a married couple.11A

Some men were anxious not in terms of accepted propriety in the matter or out of concern for their wives but for fear of damaging their own well­ being:

You... suggest (what appears to me to be extraordinary) that in most cases an average would be 5 or 6 times a week... I would not doubt the desire for union as frequently as this but I cannot help thinking that the desire must be suppressed if one wishes to maintain one's health.

It seems to me to be quite possible to give the reins to the sex Impulse at the expense of health and efficiency.115

This echoes the anxieties more often expressed in nineteenth century literature of sexual advice about the depleting effect of sexual activity upon the male.

The subject of the correct or acceptable positions for sexual intercourse generated a considerable number of enquiries to Stopes. Her phrase in

Married Love that "not only her arms should embrace her husband"116 was

frequently cited with a request for explication. It often occurred along with other queries in letters of premarital enquiry.11T These questions were less to do with a search for variety and exotic stimulation, though in some cases this seems to have been part of the motive for enquiring: 220

How can I possibly convince my rather Puritan little wife that there are "more positions than one" and that "not only the arms should embrace"?11® than with an attempt to find a position which worked, which was comfortable for both partners and led to satisfaction for both:

My wife does not assume a position which allows of simple access on my part to her. I do not seem to get full entry.

My wife is of medium size and perhaps a little frail. I myself am a largely built man. I have found that my unions with my wife are marred by her feeling my weight unduly, particularly on the thighs... I fear I must seem very stupid in being unable to solve this problem myself, but I must confess that my love and respect for my wife fill me with a horror of ill-informed experiment.

What positions other than face to face would you recommend in view of my previous remark as to the apparent seat of sensation, as likely to give increased gratification to the woman?

Now that I am cured [of hasty ejaculation] we feel that we could be in connections for any length of time... but the ordinary position... is much too tiring and exhausting for her.

In some cases, however, even the most basic position seemed to be in some doubt:

Would it be asking too much of you to explain fully what the usual position is, how men and women should entwine themselves.

Although I have read several books on the subject 1 have never yet learnt what is considered the natural position to adopt during union.

Would it therefore be too much to ask you to just mention the principal positions in which sex union may be accomplished?120 while others, though they were aware of the so-called missionary position had never heard of or thought of other possibilities:

this difficult subject of the ideal position for sexual union.

I must confess I never thought of any but the usual position which suits me but as you say another position might be better.

In what position besides face to face should the act be done, will you kindly explain to me some of the various positions.121 221

These difficulties were perhaps not so remarkable when it would appear that many married couples indulged in intercourse clothed and in the dark, or so it can be deduced from some of the letters Stopes received:

Can you tell me what proportion of married women refuse to allow their husbands to see them nude?

Though I beg her for coitus just once with both of us naked she completely shrinks from it, even in firelight or dark.

A naked woman is the most beautiful thing in the world, being one's own wife should make her more beautiful... if a woman realised how much her husband liked to see her naked and admire her in that state there would be fewer unhappy marriages to record.122

Other problems sometimes raised by Stopes' readers were to do with sexual activity continued into later life, after the wife's menopause:

We are sixty years of age and occasionally like intercourse but of course there is not the cumus [sic] or saliva of former days and often the entrance and passage are difficult.123 or with sexual activity during pregnancy, either its permissibility,12,4 or the p ra c tic a litie s to do with positions.12®

Numbers of men wrote to Stopes expressing distress about various aspects of their married relationship. Some of these have been already cited above in connection with the difficulties of consummation and achieving mutual satisfaction, and problems to do with birth control. Often, in spite of the obvious strains that they described, these men were careful to declare that apart from the particular problem they sought remedy for, they had happy marriages and were contented with their wives.

Those who found that their wives were Indifferent to sex were sometimes less contented with the overall relationship. While in some cases it seems to have been a question of simply wanting their wife to be a little more sexually active:

Whilst I admire her body mine "leaves her cold". She never "handles" me and I never receive those kisses and caresses that I am anxious to bestow on her.

You refer to the playing of an active part by the woman during the sex act and you speak of certain movements she should make... by what in stin ct can she know those movements which w ill most readily promote mutual felicity?126 in most cases the lack of interest of which they complained was far more profound:

She herself believes that in common with most girls of her class she is incapable of experiencing sexual desire or sensation.

I am somewhat of a passionate nature and my wife is not. I tell her that the sensual side was left out when she was created. Still I am deeply in love with her and ardently desire her.

My wife seems quite incapable of any sexual feeling or desire. I have done my utmost to awake this feeling, but have failed to do so.127

They did not hesitate to describe the suffering this indifference caused them:

I am one I suppose of thousands of ordinary middle-class husbands... I ought to be happy but I am not... it's the problem of the "cold and unresponsive" wife... it puts me in the greatest despair for the best part of my days... I find it slowly dragging me down to underhand and disgusting thoughts... torture I endure and have withstood for years.

As I am fairly virile her attitude causes me pain and unhappiness.126 but what would seem apparent from the tenor of many of these le tte r s was that these men were not simply deploring the deprivation of intercourse subsequent upon their wives' attitude but the degraded quality of intercourse itself when performed with a reluctant and unresponsive partner:

I do not force it but general attitude is "I am your wife I must submit". 223

I think she must have married, as I feel so many women must, with the fixed idea that it was her duty to submit at all times to the whim of her husband’s desire... consequently after a time neither she nor I took any real pleasure in the sexual union.

So many Englishwomen look upon sexual intercourse as abhorrent and not as a natural fulfilment of true love... rock on which so many marriages are split... women often show their cruelty through their coldness.

Mine is a nature which cries out for that deep mutual love and passion, that intimate understanding and tender sympathy you so well describe; and it has withered up by being in an atmosphere of too low a temperature.

My wife has not the slightest bit of feeling for intercourse which while she never refuses me, as you will understand, one cannot enjoy it to the full extent if their partner as it were hasn't any interest in it.

Loving wives know that it is expected of them and submit or offer themselves from a sense of duty but you will know that there is no satisfaction in that.

[She] seems to be guided by a sense of duty... which I regret to say I am finding just a little nauseating.123

Nevertheless, few of the marriages of Stopes' readers and correspondents seemed to have reached the stage of outright breakdown. In some cases one partner might be engaged in an adulterous affair:

A very dear friend... [who! has been a far greater influence for good than wrong in my life has given me all that a woman can to the man she loves. but this was the exception rather than the rule, though some men stated that the stress caused by restraint either for contraceptive purposes or on account of their wives' coldness was driving them to consider seeking satisfaction elsewhere:

Before long—and much against my will—I will be compelled the seek satisfaction elsewhere.131

At least one man found his escapades with other women completely inexplicable:

Some six months ago I did a thing which I can never expect my wife to overlook. I made some attempt to take liberties with a 224

maid in my fath er's employ. What made me do It I cannot say, I must have been mad. I must say that even before my wife found this out she suspected I was fond of other girls. I admit I did flirt but no more than that... CI3 have offered to undergo an operation so that I shall never want that sort of thing again. Can you tell me if a doctor will do this for me... I am prepared to do anything if only I can keep my wife that is all I ask.132 while another wrote recounting the story of his marriage which had included his wife bearing three children by two different men, besides one of his own, all regarded as legally his, a tale told without any condemnation of his w ife.133 The following le tte r seems to have been almost a unique case:

My wife... has made purchases by post from your clinic... the advice and help you gave us should have been a path to happiness but owing to my wife's abuse of it, it has led to anything but happiness. I'm writing to ask you, not to supply her with any more goods, unless the application comes from me, and will you please send me a copy of what purchases my wife has made since March of th is year.13*

(Stopes refused to betray the confidentiality of the clinic).

The vast majority of the men who wrote to Stopes would seemed to have been committed to their marriages and emotionally bonded to their wives.

They often entered marriage with an idealism as to its potential for their happiness which could lead to deep disillusionment, but also to a determination to get the best they could out of the relationship for the couple and any family they might have. While many of them did come to realise upon reading Stopes' works that they had been clumsy and inept, on the whole the type of man to whom these books appealed would seem to have been less unthinkingly selfish than many writers gave him credit for.

The enthusiastic response evoked by Stopes's writings, and the desire for 225 instruction evinced by her correspondents, confirmed the opinion of one of them that

the male Cis3 not such a selfish beast if he only knows.136 226

Chapter Five: Notes

1. Ellis, Havelock, The Plav-Function of Sex. British Society for the Study of Sex Psychology Publication no 9, London, 1921, p 5

2. Family Planning Association "Difficulties commonly encountered among men", c. 1940s, cited in "Medica" (Malleson, Dr Joan, pseud). Anv Wife or Any Husband; A Book for Couples who have met sexual d iffic u ltie s and for doctors. William Heinemann Medical Books, London, 1950, pp 25-29.* In th is book she mentions that the pamphlet quoted is one of a series which "have stood the te s t of time" (p 18); a copy among the Marie Stopes collection of pamphlets and ephemera held in the Official Publications Library of the British Library is undated but bound with other materials dating from the late 1940s/early 1950s (Vol 2/32). Among the Family Planning Association archives held in the Contemporary Medical Archives Centre at the Wellcome In stitu te for the History of Medicine, there is a file, CMAC: SA/FPA/A.3/5 "Ancillary Services: Marital Difficulties, Advice on, 1948", which mentions "Dr Malleson's leaflets" on this subject and the possibility of obtaining a grant from the Home Office Departmental Committee on Grants for the Development of Marriage Guidance to have more of them printed. No actual copies of them appear to survive in this archive.

3. Eyles, M Leonora, The Woman in the L ittle House. Grant Richards, London, 1922, Chapter 7, "The Sex Problem", pp 129-151

4. ibid. p 129

5. ibid. pp 139-141

6. Stekel, Wilhelm, Impotence in the Male: the psychic disorders of sexual function in the male. <2 vols) 1st published in German 1927, authorised English version by Oswald H Boltz, John Lane, London, printed in the USA, 1940, Vol I, p 57 ("with increasing intelligence... the psychic disturbances of potency become more numerous"); Stopes, Marie, Enduring Passion. Further New Contributions to the Solution of Sex Difficulties being the continuation of Married Love. GP Putnams Sons, London, 1928, 2nd edition 1929, p 76

7. Woodside, Moya, "Courtship and Mating in an Urban Community", Eugenics Review. 1946, Vol 38 No 1, pp 29-39

8. Packer, E L, "Aspects of Working Class Marriage", Pilot Papers: Social Essays and Documents. March 1947, Vol 2 no 1, pp 92-104. This sh o rt-liv ed periodical was edited by Charles Madge, one of the founders of Mass Observation, discussed in Chapter 9. In his editorial comments on this volume he described "Mr Packer" as "an experienced probation officer."

9. Stopes, Marie, Married Love. A New Contribution to the Solution of Sex Difficulties. With a Preface by Dr Jessie Murray, and letters from Professor E H Starling FRS. and Father Stanislaus St John. SJ. A C Fifield, London, EC4 (la te r editions by GP Putnam's Sons Ltd London) 1918, 4th edition, Aug 1918, p iv; for accounts of her correspondence, see Hall, Lesley A, 'The Stopes Collection in the Contemporary Medical Archives Centre of the Wellcome In s titu te for the History of Medicine", B ulletin of the Society for the Social History of Medicine. June 1983, no 32, pp 50-51; 227

Hall, Ruth, ed, Dear Dr Stopes: Sex in the 1920s. Andre Deutsch, London 1978, Statistical Appendix compiled by Christopher Stopes-Roe, pp 215-218

10. Marie C Stopes papers in the Contemporary Medical Archives Centre at the Wellcome Institute for the History of Medicine, correspondence "ML- GEN", CMAC: PP/MCS/A.180 CEFM, A. 113 JG

11. Lindsey, Judge Ben B and Evans, Wainwright, The Companionate Marriage. Boni and Liveright, New York 1927; the concept is discussed (from a radical feminist perspective with which I do not wholly agree) in Simmons, Christina, "Companionate Marriage and the Lesbian Threat", Frontiers, 1979, Vol 4 no 3, pp 54-59 (I am indebted to Barbara Brookes for this reference)

12. for examples, see Gray, Rev A Herbert, Men. Women, and God: A Discussion of Sex Questions from the Christian Point of View. Student Christian Movement, London 1923; Royden, A Maude, Sex and Commonsense. Hurst and Blackett, Ltd, London t?1920s], 8th edition; Borden, Mary, The Technique of Marriage. William Heinemann Ltd, London 1933; Marriner, Dr Margaret, First Aid to Marriage. ("A successful marriage should be an enchanted garden, in which two people can play together long after childhood has passed": note on cover), Williams and Norgate, London, 1933; as well as Stopes, op cit. For the views of Van de Velde and Kenneth Walker, see Van de Velde, Th. H, Ideal Marriage: Its Physiology and Technique, first published in Dutch 1926, English translation William Heinemann Medical Books Ltd, London, 1928, 39th impression 1962, and Walker, Kenneth M, Marriage: A book for the married and about to be married. Seeker and Warburg for the B ritish Social Hygiene Council, London, 1951

13. Mitchison, Naomi, You May Well Ask: A Memoir 1920-1940. Victor Gollancz Ltd, London, 1979, Flamingo paperback edition 1986; B rittain , Vera, Testament of Youth: An Autobiographical Study of the Years 1900-1925. Victor Gollancz Ltd, London, 1933, cheap edition 1948; B rittain, Vera, Testament of Experience: An Autobiographical Story of the Years 1925-1950. Victor Gollancz Ltd, 1957, Virago Press paperback 1979; Hutton, Lady Isabel, Memories of a Doctor in War and Peace. Heinemann, London, 1960

14. CMAC: PP/MCS/A. 112 Pte WG

15. e g, CMAC: PP/MCS/A.250 GHW, A.544 EY, A. 193 DAP, A. 117 DCH, A. 120 FJH, A.44 B, A. 105 NG

16. CMAC: PP/MCS/A. 188 BNN

17. CMAC: PP/MCS/A. 164 AL, A.77 EAE, A.42 WAB, A.6 A, A.98 AHG

18. CMAC: PP/MCS/A.248 PW, see also e g, A.67 PLC, A.223 RWS

19. CMAC: PP/MCS/A. 189 HEN, A.73 FD

20. CMAC: PP/MCS/A.88 FK, A.26 CAB, A.208 HR

21. CMAC: PP/MCS/A. 70 D

22. CMAC: PP/MCS/A. 191 EN 228

23. CMAC: PP/MCS/A. 140 CGJ, A. 150 HJK

24. CMAC: PP/MCS/A.98 HG

25. CMAC: PP/MCS/A. 146 THJ

26. CMAC: PP/MCS/A. 44 RB

27. CMAC: PP/MCS/A.240 JWW

28. CMAC: PP/MCS/A. 41 FB

29. CMAC: PP/MCS/A.87 WRF, A.89 ABF, A.89 SF, A.5 A, A.26 CAB, A.27 CB, A. 114 Major WdeHH

30. CMAC: PP/MCS/A.202 AHP, A. 158 Capt HLM, A.28 CB

31. CMAC: PP/MCS/A.218 Sgt ES

32. CMAC: PP/MCS/A. 113 G

33. Davey, Claire, "Birth Control in B ritain duringthe Inter-War Years: evidence from the StoDes corresDondence". Journal ofFamily History. 1988. Vol 13, no 3, pp 329-345

34. CMAC: PP/MCS/A.209 AR, A. 198 CKP, A. 168 Capt EM

35. CMAC: PP/MCS/A.208 GHR, A. 171 GEM, A. 146 EYJ, A. 145 AJJ, A.46 JB

36. CMAC: PP/MCS/A. 187 Lt-Cdr RN

37. CMAC: PP/MCS/A.247 Capt JWW, A.206 HFR

38. CMAC: PP/MCS/A.243 ABW

39. CMAC: PP/MCS/A.234 MT

40. CMAC: PP/MCS/A. 128 EH

41. CMAC: PP/MCS/A. 14 HLA

42. CMAC: PP/MCS/A. 113 HFG, see also e g, A.50 IC, A.39 B, A.41 B

43. CMAC: PP/MCS/A.202 WP

44. CMAC: PP/MCS/A. 15 SSA, A.66 GSC

45. CMAC: PP/MCS/A. 189 FSN

46. CMAC: PP/MCS/A.237 CW

47. CMAC: PP/MCS/A.235 Lt-Col DCT, A.211 RHR, A. 153 AK (and wife), A. 140 TSJ, A. 155 PL, A. 148 EHK, A. 117 WABH

48. CMAC: PP/MCS/A. 15 A 229

49. CMAC: PP/MCS/A. 187 Lt-Cdr RN

50. CMAC: PP/MCS/A.249 CGW

51. CMAC: PP/MCS/A. 135 WH, A. 139 JSI, A. 128 FH, A. 131 GFH, A. 11 GA

52. Davey, op c lt

53. CMAC: PP/MCS/A. 196 TRP, A. 153 KSK, A.238 EJW

54. CMAC: PP/MCS/A. 189 AGN

55. CMAC: PP/MCS/A. 168 Lt-Col WSMN, A. 145 EYJ

56. CMAC: PP/MCS/A. 183 Capt RCM, A. 148 RHK, A.238 HE, A. 147 CEGJ, A.89 ABF

57. CMAC: PP/MCS/A. 140 SJ

58. e g, CMAC: PP/MCS/A.28 CB, A.30 JB, A.56 RC, A.68 JHC, A. 100 G, A.98 WG, A. 109 G, A. 161 KWL, A.213 WAR

59. Stopes, Married Love. 12th edition, revised, 1923, Appendix, Note III, p 190

60. CMAC: PP/MCS/A. 178 JM, A. 160 AEL, A.160 WJL, A.163 DL, A.109 RFG, A.74 D, A.65 FFC

61. CMAC: PP/MCS/A. 174 EENM, A.89 F

62. CMAC: PP/MCS/A. 179 WEM, A. 166 BWMcM, A.89 F, see also A.222 AGES

63. CMAC: PP/MCS/A. 182 GM, A.160 AEL

64. CMAC: PP/MCS/A. 182 GM

65. CMAC: PP/MCS/A. 178 JM, A. 196 EHP, A. 182 GM (skilled working-class), A.163 DL, see also A. 155 AWL, A. 108 EWG, A. 123 EH, A.32 B

66. CMAC: PP/MCS/A. 182 GM, A. 174 EENM

67. CMAC: PP/MCS/A.230 BGT

68. CMAC: PP/MCS/A.231 WFT

69. CMAC: PP/MCS/A.232 FST

70. CMAC: PP/MCS/A. 168 AMcI

71. CMAC: PP/MCS/A. 173 EJM

72. CMAC: PP/MCS/A. 169 JWMacL

73. CMAC: PP/MCS/A. 166 MMcA

74. CMAC: PP/MCS/A.89 JTF, A.232 CT, A. 115 2/Lt GH, A.238 F/Lt CMGW 230

75. CMAC: PP/MCS/A.221 WES, A.232 RSST, A.58 WC, A.64 HAC, A.35 FB, A. 173 Capt EM

76. CMAC: PP/MCS/A.250 GEW, A.70 FED, A.2 A, A. 172 AAM, A.206 JR

77. CMAC: PP/MCS/A. 180 HBM, A.98 AHG, A. 190 FAN

78. CMAC: PP/MCS/A.67 C

79. CMAC; PP/MCS/A.230 AWT

80. CMAC: PP/MCSA.182 JRPM, A. 17 WDB

81. Stopes, Married Love. 4th edition 1918, p 9

82. CMAC: PP/MCS/A.246 Lt SLW (RAMC), A. 173 AJM, A.230 CT, A.50 CC

83. CMAC: PP/MCS/A.183 PM, A.161 KGL, A.232 CT, A.126 BDFH, A.42 WAB, A.70 RCD, A.220 Capt JS, A.211 AER

84. CMAC: PP/MCS/A. 144 AJ, A.208 AWR, A.223 JPS, A.237 HW

85. CMAC: PP/MCS/A. 130 WH, see also A. 174 EENM, A. 108 EWG, A.66 C, A.85 F, A. 169 GDMcL

86. see CMAC: PP/MCS/A.67 C, A.233 DLLT

87. CMAC: PP/MCS/A.28 AB

88. CMAC: PP/MCS/A. 160 SL (schoolmaster)

89. CMAC: PP/MCS/A. 176 MM, see also A.252 FVW, A.67 GHG

90. CMAC: PP/MCS/A.222 AFS, A.250 CCW

91. CMAC: PP/MCS/A. 180 GM, A. 152 Mrs CEK, A. 147 Mrs MJ

92. CMAC: PP/MCS/A. 185 AGM, A. 179 JFM, see also A.70 RCD

93. CMAC: PP/MCS/A.213 FR, A.76 FE, A.60 FJC, A. 104 TRG, A.92 CAF, A.208 Mrs DR, A.252 GJW, A.223 JPS, A.126 FH

94. CMAC: PP/MCS/A.223 RWS, A.241 GCAW, A.202 Mrs MP, A. 142 CJ

95. CMAC: PP/MCS/A.28 BFB, A.80 SGE, A. 179 EJM, A.252 GSY

96. CMAC: PP/MCS/A.297 Rev GKA, A.241 GCAW, A. 197 JP

97. CMAC: PP/MCS/A. 174 Mrs FM

98. CMAC: PP/MCS/A.238 RRW, A.239 WLW, A.226 TWS, A.226 TWS, A.220 BAMS, A.220 EHS, A.297 Rev CAB. A.202 RP, A. 193 Capt JP, A.160 LL

99. CMAC: PP/MCS/A.222 HOS, A.248 GJW, A.222 GNFS, A.208 Pte RWR see also A. 150 GK, A. 133 ACH, A. 138 GSL, A.66 C 231

100. CMAC: PP/MCS/A.220 Capt JS, A.220 DHS, A.218 2/Lt PES, A. 158 HL, A. 158 S/sgt PL (India)

101. CMAC: PP/MCS/A. 169 MMcL, A. 166 JHMcB

102. CMAC: PP/MCS/A. 140 MWJ, A. 124 Cpl AH (Royal Engineers)

103. CMAC: PP/MCS/A. 167 LWMacD, A.232 WET, see also A.98 WG, A. 122 Lt Cdr CMDH

104. CMAC: PP/MCS/A. 157 GL

105. CMAC: PP/MCS/A.219 TS

106'. CMAC: PP/MCS/A. 129 FH

107. CMAC: PP/MCS/A. 161 HHL, A.248 GMW, A.211 FWR, A. 183 Capt RCM, A. 164 NAL

108. CMAC: PP/MCS/A.220 JLS, A.88 F, A. 134 LHH, A.205 Lt Col LMP, RAMC and see also A.229 Capt PJT, A.201 HCP, A. 172 FJM, A.72 D

109. CMAC: PP/MCS/A. 119 EACH, A.253 WBY, A.226 JS, A.206 GMR

110. CMAC: PP/MCS/A. 167 LWMacD (in India)

111. CMAC: PP/MCS/A. 197 JWP, see also A.165 HGL, A.20 GSB, A.22 B, A.44 B, A. 132 FHH

112. CMAC: PP/MCS/A. 123 ARH

113. CMAC: PP/MCS/A.218 Lt PES, A.237 Lt Col EGW, A.146 FWJ, A.196 AFP, A.43 B, A. 103 IWG

114. CMAC: PP/MCS/A.233 RST, see also A.212 Pte AKR, A. 131 JMH

115. CMAC: PP/MCS/A. 136 CH, A. 134 LJH

116. Stopes, Married Love. 12th edition, p 92: th is passage does not appear in the 1918 edition and may well have been Inserted following the many revelations of sexual ignorance Stopes received.

117. e g , CMAC: PP/MCS/A. 196 EP, A. 197 AHP, A. 121 JH, A. 132 HPH

118. CMAC: PP/MCS/A.220 JLS

119. CMAC: PP/MCS/A. 103 ECG, A.248 JCW, A. 183 Capt RCM, A. 109 JMGG

120. CMAC: PP/MCS/A.194 RTP, A.162 MCHL, A.250 WW

121. CMAC: PP/MCS/A. 196 IDP, A.202 RP, A.160 JRL

122. CMAC: PP/MCS/A.44 LAB, A.97 G, A. 112 Major FRG

123. CMAC: PP/MCS/A. 189 AN 232

124. CMAC: PP/MCS/A.157 Major FWL, A.209 Capt RMR, A.114 AEH

125. CMAC: PP/MCS/A. 160 JRL, A.114 TEH

126. CMAC: PP/MCS/A.56 RC, A. 156 THL

127. CMAC: PP/MCS/A. 194 RP, A. 198 CHP, A. 132 AJH, and see also A. 170 EHMN, A. 132 WH, A. 134 JFH A. 165 CGL

128. CMAC: PP/MCS/A. 113 G, A.238 RRW

129. CMAC: PP/MCS/A.110 SEG, A.118 Capt WPH (RAMC), A.2U Lt Col WKR (Ceylon), A.245 LDW, A. 180 WAM, A. 157 CEL, A.64 C

130. CMAC: PP/MCS/A.245 LDW, see also A. 167 LWMacD

131. CMAC: PP/MCS/A.238 EJW

132. CMAC: PP/MCS/A.250 KW

133. CMAC: PP/MCS/A. 103 FG

134. CMAC: PP/MCS/A. 120 S/sgt EJH

135. CMAC: PP/MCS/A1/1 233

Chapter Six

"The most miserable of a ll patients"

There Is an assumption, even today, that male sexuality is not subject to the problems and complications which are understood to be an intrinsic part of female sexual functioning. The very male organs are regarded as less complex and less liable to malfunction than those of the female, whereas, as Naomi P feffer has shown in "The Hidden Pathology of the Male

Reproductive System", this is an illusion which is maintained in part by labelling, so that the functioning of the male organs is represented in terms of health and that of the female organs in terms of pathology, and in part by an immense ignorance of how, in fact, the male organs work,1 the mechanisms of spermatogenesis being far more mysterious than the process of ovulation. This designation of the male as unproblematic means that in the 1980s as in the 1930s doctors find that their male patients presenting with problems of sexual dysfunction regard themselves as uniquely cursed, "among the most miserable of all patients that a doctor is called upon to treat", as Kenneth Walker depicted "the young man with a disorder of sex."2 In this chapter those writings which did touch on the problems of male sexual dysfunction will be considered, in the context of the difficulties which actual individual men wrote about to Marie Stopes and their response to her writings. It should be noted that although problems specifically to do with conjugal relationship have been dealt with in the previous chapter, it is not always possible to dichotomise problems in this way, and the difficulties of functioning discussed in this chapter were often perceived as particularly harrowing because of their repercussions upon married life. 234

That men had problems which were not simply those of maintaining control over an impetuous and insurgent force was a fact which had received some recognition even in the nineteenth century. Sir James Paget in "Sexual

Hypochondriasis" had described the anxieties and problems which any doctor might encounter among his patients,3 while quacks preyed on the fears of men anxious about their manhood or fearful that through "excess" they had wrecked their powers (see Chapter 3). The dissolution of Ruskin's marriage on the grounds of non-consummation was a high Victorian cause-celebre, and that other Great Victorian Carlyle was also widely supposed to have had a mariage blanc. Even so, such advice as was given to men was along the lines of restraining their desires outside of marriage and indulging them only with caution within lt, as discussed in Chapters 1 and 3.

In spite of this assumption that male sexuality was a force which only the pressures of civilisation succeeded in keeping within the bounds necessary % to prevent the overthrow of society itself (a point of view which is mooted in the 1980s by some thinkers of the "New Right"), in spite of this, it was recognised by those who had had the opportunity to discover the experiences of individuals that matters were really somewhat different.

Krafft-Ebing and Havelock Ellis described all sorts of bizarre and flamboyant perversions, nearly all of them ascribable solely to the male.

In 1964 Anthony Storr wrote

Fetishism is a deviation which is almost entirely confined to the male sex.4, and he ascribed this partially to the conclusions reached by Kinsey that

the human male is sexually responsive to a far wider range of stimuli than the female, and seems also to be more easily conditioned by these stim uli.5 but also to 235

the reassurance which the fetish gives, and the way in which it enables a man who is frightened of the opposite sex and uncertain of his masculine potency to overcome his fears.®

That is, where fetishism has not grown to exclude normal coital activity, it acts as a form of magic against male anxieties about sexual arousal and functioning. Even in the "liberated" era fetishism remained a male province, and such deviations used in arguments for the continuing existence of prostitution, given the need for such unfortunates to find a partner ready to indulge their quirks.7

But besides these flamboyant oddities of sexual behaviour there was a vast amount of q u ieter desperation: Freud commented

To the uninitiated it is scarcely credible how seldom normal potency is to be found in a husband... what a degree of renunciation, often on both sides, is entailed by marriage, and to what narrow limits married life—the happiness that is so ardently desired—is narrowed down.®

This had already gained occasional recognition within the medical profession: in 1870 an anonymous writer in the Lancet gave warnings against advising men with "questionable powers" to marry:

Family practitioners will know how large a number of uterine maladies are directly traceable to ill-assorted unions. although the writer had no compassion for the victims of sexual weakness:

The men who are the subjects of sexual weakness are, as a rule, inexpressibly nasty... in the interests of society it would be better to emasculate him at once than to hand over to him the health, happiness and honour of a woman to be used as remedial agents in his behalf.9

The psychological rather than physiological aetiology of such dysfunction, attributed by the above writer to the effects of long-continued masturbation and excesses, was remarked upon by Sir James Paget:

Though the physical causes of impotence and great decrease of sexual power may be thus numerous, yet from all these causes together the cases are less frequent than those due to nervous 236

disorder or to mental defect; and the impotence which is complained of or dreaded without any real reason is more common s t i l l . 10

A venereologist, F W Lowndes of the Liverpool Lock Hospital, in 1883 touched upon the problems of sexual hypochondriasis as distinct from the specific problem of venereal hypochondriasis in which the patient believed himself to have contracted a disease which he did not, in fact, have. He attributed their fears of a disorder of sex to "previous excessive intercourse or self-abuse".11 In D Hack Tuke's Dictionary of Psychological

Medicine. Vol II, 1892, under the heading of "Marriage and Insanity" he mentioned that "young men think of the loss of power and fear they are impotent" during the approach to marriage. He went on

On the man's part the idea of impotence may have become so dominant that no congress is possible, and it is such cases in which true obsession arises. Instead of the fear of impotence, some idea connected with the wife, either as to her purity or as to her local physical formation, may completely prevent congress, and this may lead to suicidal attempts. Probably most of the suicides which take place soon after marriage are due to ideas of impotence.12

Vecki, author of a much reprinted work on impotence, f ir s t issued in

1888,13 practised in the USA but would appear, on internal evidence cited in the book, to have had his origins in Central Europe and to have served as a military doctor in the Austro-Hungarian Army.1* Thus his experience would seem to have spanned the Old World and the New: he believed th at

Impotence besides being a very serious disease is also of frequent occurrence.1® and th at

This ideal condition of virility is somewhat rare with men following the customary manner of life of our days, and in any given case it will generally last for but a short time.1®

While he believed that new instruments such as the urethroscope were illuminating lesions causative of states of sexual dysfunction previously 237 attributed to neurasthenia, he was also convinced of the prevalence of cases of psychogenic impotence with no apparent clinical cause;

Comparing the number of psychically impotent with those that are affected with real impotence, we shall find that the former constitute a large portion of those applying for relief.17"

He stressed that it was essential to treat all patients presenting with sexual problems "psychically" as well as physically, and that unless the doctor gained the patient's confidence very little could be done.

The British doctor Arthur Cooper (from a background in, apparently, venereology),1® in The Sexual Disabilities of Man. first published in 1908 and appearing in a second edition in 1910, commented that

Impotence... has been from time immemorial a matter of anxiety to a vast number of mankind... it is quite common for medical advice to be sought respecting the copulative power.19 and he reiterated this belief that impotence, or the fear of it, was no new thing

Psychical impotence probably dates from the time when man first began to think about himself, and evidences are to be found in the writings of all ages.20

However, he was inclined to believe that premature ejaculation was on the increase and a consequence of the strains of modern life:

These cases of early ejaculation without assignable cause, may perhaps mean that under the nervous stress of modem life the sexual centres are becoming more impressionable and more quickly responsive to stimulation, and thus that the duration of the sexual act may be tending to become gradually sh o rter.21

Like other writers, he tended to assign sexual problems to the intelligent and cultivated:

It would be a great mistake to suppose that those who suffer from sexual troubles, fancied or real, are always to be found among the idle, the worthless and the profligate. On the contrary, though mostly neurotic or of neurotic stock, many are honourable men of high intellectual capacity and culture holding positions of responsibility and trust... what are commonly called youthful indiscretions, if abandoned, are not incompatible with 238

the attainment of success and even eminence.122

He described the likely subject of a case of sexual disorder as "a young man perhaps highly educated and of more than average intellectual power" with a history of "some previous sexual irreg u larity ."23 The class from which, presumably, his patients were drawn from and for whom he was writing can perhaps be deduced from his prescription in cases of wedding- night impotence: "a single glass of good champagne taken shortly beforehand will usually be enough."2* Unusually he mentioned the role of others in the aetiology of impotence:

The not uncommon case of a man fancying himself impotent because he is not so vigorous as some friend is—or says he is, for these boasters exaggerate greatly.25

Although these examples cited would suggest that male sexual difficulties were a constant problem which was likely to appear before the doctor far more often than might be suspected, twentieth-century, post-World War I w riters seemed sometimes to imply that th is was a new phenomenon, produced by the strains and tensions of modern life in the aftermath of the Great War. Wilhelm S tekel's work on Impotence in the Male- although published in German in 1927 was not tran slated into English u n til 1940

(some years later than his similarly massive work on frigidity in women, which was published in English in 1936).26, A review in the Lancet of that year described the book's message as

Love inadequacy is increasing alarmingly among men... because of the diverse inhibitions with which love in a civilised man has to struggle.27

While th is work of Stekel's was not available in English u n til th is date, it does seem to have been read and cited by other specialist writers on the problems of male sexuality and therefore to have been Indirectly if not directly influential on British writers on the problem. 239

Stekel <1868-1941), born in Vienna, was originally a general practitioner in a working class area. Among the earliest group of Freud's disciples, he subsequently separated from Freud and abandoned the practice of psychoanalysis in its classical form, seeking shorter methods of treatment.

In 1938 he came to England and in 1941 he died, it would seem by his own hand.2® In Impotence in the Male he maintained that

The percentage of relatively impotent men cannot be placed too high. In my experience hardly half of all civilised men enjoy normal potency. Nowadays ejaculatio praecox is no longer a disorder; it is the regular accompaniment of civilisation.2®

He considered that

We are not dealing with rare cases and exceptions but with widespread disorders which are characteristic of our age.30

He discounted the belief that in ancient times men were more potent and instinctual, and put the prevalence of sexual disorder down to the fact that "love is becoming more and more deep and profound", with the result that "in men the struggle between the brain and the spinal cord is much more severe."31 Unlike the writers who called in the healthy natural life of the country to contrast it to the debility of the cities and urbanised civilisation, Stekel contended that

The sexual energy of city inhabitants— when it is normal— exceeds that of the peasant... in some individuals the potency is enhanced by increased intelligence.32

He also contradicted popular wisdom about the superior manliness of the m ilitary:

most of my impotent men have been officers... even my cases in civil practice include numerous soldiers who complained of failing and inadequate potency, and felt quite disconcerted by their weakness, since they were always supposed to be blessed with an unusually good sexual power.33

The whole work, a ll two volumes, presents the male sexual impulse as fragile indeed:

there is hardly another physiological process which can be so easily disturbed by inhibitory ideas as the act of erection.3* No man can say that he is absolutely certain of his potency.3S caught between the instincts, the reflexive actions of the spinal cord, and the higher aspirations induced by intellect and culture.

Dr Siegfried Placzek, a Berlin neurologist, in The Sexual Life of Man

<1929) remarked that

Imaginary obstacles of the most varied descriptions react on the capacity for coitus far more than is generally believed.3®

In the History of Urology prepared under the Auspices of the American

Urological Association in 1933, while the significance of physical lesions and the necessity for "thorough study and examination through the urethroscope" were emphasised, nevertheless the statistical prevalence of the functional disorders in urological practice, and the frequent lack of

"correlation between the clinical phenomena and the urethroscopic picture" were pointed out. The authors recommended th at more serious consideration be given to psychotherapy in such cases.37 Even in a speciality whose major interest was in the physical lesions of the male genito-urinary system the functional nature of many of the disorders they encountered was recognised.

Dr6 Costler and Willy, and others, in the Encyclopaedia of Sexual

Knowledge, published in London in 1934 under the general editorship of

Norman Haire, also made readers aware of the insecurity of male desire:

The anomalies which can occur in the male genital system are consequently numerous and varied.36

All unfavourable conditions can induce impotence... Men in general are very sensitive on the subject of their potency... a man, once persuaded that he is incapable of a normal erection, becomes Impotent through auto-suggestion.39 241

The specific problem that struck Marie Stopes by its almost epidemic prevalence was premature ejaculation* a wide-spread phenomenon brought to her attention as a result of reading the letters generated by Married

Love, and which she therefore dealt with in more detail in Enduring

Passion. Like Stekel, she regarded it as a "civilisation disease", and differentiated lt from "the ordinary haste and carelessness used by too many quite normal men in the marital act."*° She described complete impotence as "rare, but less rare than is generally imagined."*1

Kenneth Walker, in Male Disorders of Sex (first published in 1930), wrote in the Introduction in such a way as to imply that medical men might well frequently encounter problems of sexual disturbance. These complaints fell inconveniently between the specialisms of neurology and urology, while the busy general practitioner might dismiss them as trivial and non-life- threatening. Walker would seem to have been implying that the problem was not that doctors did not encounter such cases but that very few had the knowledge to deal with them, even if they had the time to give to them. He acknowledged that these disorders were common, far more so than was popularly believed:

"First night impotence"... such cases as this are commoner than i6 usually supposed... There are many men who are frightened of sex.*2

Kinsey's evidence in his famous Sexual Behaviour in the Human Male

(1948),*3 while applying to a sample taken wholly from within the USA, tended to confirm the assumption that lower-class men, while lacking in sexual subtlety, suffered much less than more refined males from problems of sexual functioning: he concluded that "most cases of impotence... are to be found among upper level, educated males."** However, Kinsey did not 242 regard premature ejaculation as a problem, but considered speedy reactions to be an intrinsic part of male response:

For perhaps three-quarters of all males, orgasm is reached within two minutes after the initiation of the sexual reaction, and for a not inconsiderable number of males the climax may be reached within less than a minute or even within ten or twenty seconds after coital entrance. Occasionally a male may become so stimulated... that he ejaculates before he has effected genital union. and characteristic of the lower class male:

At lower educational levels it is usual for the male to try to achieve an orgasm as soon as possible after effecting genital union.

He concluded

the idea that the male who responds quickly in a sexual relation is neurotic or otherwise pathologically involved is, in most cases, not justified scientifically.

He even went on to invert traditional thinking on the subject:

It would be difficult to find another situation in which an individual who was quick and intense in his responses was labelled anything but superior.■** and considered it a problem solely from the point of view of the woman in the relationship, a notion not fully substantiated from other sources which would indicate that many men found their prematurity frustrating rather than satisfying, a cause for complaint: this was suggested by a contemporary American psychiatrist, Edmund Bergler, who maintained that

"Ejaculatio praecox represents the most frequently encountered of all psychogenic potency disturbances." He went on to point out that this conclusion was based on the number of patients who presented themselves desperately seeking help for their condition: "psychiatrists do not 'snatch' prematurists off the street... and out of sheer malice declare these people to be sick."*6 243

It is arguable that male insensitivity was not solely a working-class attribute, and that problems of sexual functioning were not exclusively a bourgeois defect, indeed might be found also among the le66 privileged social strata. Kinsey's evidence would seem to bear this out, suggesting that premature ejaculation, or at least an extreme rapidity in attaining a sexual climax, was as prevalent among the lower classes as among the middle classes, if not more so. He would seem to be arguing that the middle-class male took this, to Kinsey, perfectly normal behaviour and turned it into a problem, in the context of the middle-class tendency to have much wider notions of what constituted sexual satisfaction, both for the male and for his partner, and that it was not perceived as a problem by the lower class male. Vecki, however, made the relevant point in his work on Sexual Impotence that

Most of the sexually weak persons who take medical advice are of the intelligent and well-to-do class of society.*7 which must surely represent the general class-bias in medical consultation.

Working class men may have hesitated to consult a medical man, for reasons of economics or from shame and embarrassment, and sought instead a solution to their problems in folk remedies or patent medicines, which, as indignant medical observers were wont to point out, were sold in great quantities (see Chapter 3).

Some British observers of working class sexual mores have been quoted and discussed in the previous chapter. It would seem that the working-class male was seen, both by Kinsey and in the United Kingdom, as being more

"male", in the sense of unthinking, spontaneous and selfish in his desires.

The criticism of him on th is score by Eyles, Woodside and Parker was therefore consistent with attacks on the impetuous and clumsy male in 244 literature on sex generally. Kinsey however rather valorises these qualities as lacking in the effeteness he purported to find among American middle-class males with their plethora of non-coital "outlets"

(masturbation, petting, homosexual contacts), their concern over foreplay and their greater liability to sexual anxiety. Some national differences in notions of "manliness" as well as differing class biases may be involved here, as well as the difference between female and male observers.

The evidence of the writers cited above would tend to suggest that male sexual anxiety and dysfunction were not phenomena generated solely by the tensions of twentieth century life and the growing demand for a recognition of the sexual rights of women. Even in the 1980s it is sometimes suggested that the increasing assertiveness of women is unmanning the other sex, with deleterious effects on the relationships between them. However, the unsuspected prevalence of these disorders commented upon by the w riters cited, from the middle of the nineteenth century to the mid-point of the twentieth, would suggest that some form of male sexual dysfunction has been a constant concomitant of civilised existence.

The belief expressed by the various writers cited above in the prevalence of male sexual dysfunction is borne out by the number of enquiries Marie

Stopes received concerning these difficulties. It is not easy to quantify this prevalence, since 6ome correspondents were not very clear about exactly what the difficulty was, and problems might be subsumed under queries relating to birth control methods, requests for help in unconsummated marriages, or pleas for advice over giving wives equal 245 sexual satisfaction. Also it is not always possible to differentiate types of dysfunction, and as Kenneth Walker pointed out

If we care to make a preliminary subdivision of these cases into those in which the main symptom is weakness of desire and of erection, and those in which it is irritability and premature ejaculations... we must realise that the division is an arbitrary one and not really fundamental. Irritability and weakness may be different manifestations of the same disease and are often found at different times in the same patient.Ae

Irritability, or premature ejaculation, distressed many men who suffered from it but on the whole they did not classify it as impotence pure and simple:

My trouble is that ejaculation takes place simultaneously with erection... I am 42 years of age and strong and healthy and am not in any way impotent.4,9 perhaps because the functions of erection and ejaculation were felt to be there, if somewhat over-hasty in their actions. Like the writer cited above, many of the men who wrote to Stopes complaining of this disorder were anxious to point out that they were not weaklings in the general sense, but were "a big man and strong",60 "above the average in physical fitness",B1 "organically healthy",Bs "well-built, athletic, physically very strong",B3 "athletic",BA "hard and fit",BB "healthy and possessed of no defect physically that I know of."ee

Far from being untroubled by this problem of hasty ejaculation except from the point of view of obtaining pleasure and satisfaction for their wives, men often described this over-urgency as being unproductive of pleasure for themselves:

Neither of us ever feels that satisfaction in the closest embrace which instinct and reason tell me should be the ca6e.

No doubt accounts for something lacking in my married life.

This is no good either for myself or for my wife. 246

I am unable to control the ejaculation so as to enjoy the perfect orgasm you speak about.

Mere physical relief for me devoid of all pleasure and love.

From my own point of view I get practically no satisfaction or relief either... each unsuccessful union leaves me more disgusted with myself and depressed.67 though in some cases this personal unhappiness about the condition may have been due to the "growing feeling of inferiority and ineffectiveness" expressed by one man.6® The fear was also expressed that

It causes me to desire, I am afraid, more than is temperate, because I never do get proper satisfaction.6®

It should be pointed that in many cases what these men were describing was not just an inability to contain their orgasm for the twenty minutes recommended by Stopes for the achievement of the perfect conjugal orgasm:

til do not understand how a man after penetration can control himself for 20 minutes and at the same time bring on the crisis in the woman.60 but an extreme precipitancy which often occurred even before intromission had taken place:

In the case where this occurs almost immediately on entry what would you suggest?

Ejaculation before complete entry.

So hasty is the ejaculation that it frequently occurs before entry is possible, and neither of us benefit.

I have never been able to keep back the semen during the act, in fact when first married and even now ejaculation would take place before I could nearly penetrate.

In the endeavour to find the opening the excitement provokes a discharge.61

It was a sad irony that several of them described the act of wooing or their wives' own responsive desire as being responsible for these disasters: 247

When my wife desires I thrill so terrifically that I find I eject before I have been with my wife many seconds.

I find that in my case by the time my wife i6 tumescent I have reached such a state of sexual excitement that ejaculation takes place before we have had a union.

When I follow your instructions regarding the preparation by wooing, ejaculation frequently occurs before the act of union can be commenced.

When I feel she does want [connection] I explode in a couple of minutes or so.62

Some of them had tried to control their hasty reactions by will-power, something which did not, it would seem, enjoy a great deal of success:

I've tried to "put my mind" to restraining the ejaculation, but it just happens—not even 2 or 3 minutes being vouchsafed to the act of union.

I have willed myself to wait, often, but might as well try to dam a torrent with brushwood.

I am unfortunately one of those men who apparently have no power to control the ejaculation and this normally takes place with me within half a minute of insertion.63 but others did not see how this could even be feasible:

I do not see how once penetration has begun this can be possible, as, seeing that it is actually possible to experience a reaction through a mere embrace without any actual union taking place, surely the arrival of the climax is bound to be beyond the man's control.

Is not excessively hasty ejaculation due to a congenital irritability of the nerves, and is it not incurable?66

In one or two cases mention was made of the (rather counter-productive) use of abstention in the hopes of improvement, in one case at medical suggestion.66 Others had made some kind of approach to an individual solution, but these adjustments were not always satisfactory:

[I] have found th at on some occasions when I do not allow myself to become emotionally excited, a certain amount of movement and a moderately satisfactory union is possible. But quite a small degree of excitement results in premature ejaculation. 248

My best time Is In the morning when lt Is not kind to wake a woman up. Besides I don't think morning Is the best time.

Have you any experience as to whether lt is harmful or otherwise for the man to wear a small rubber band Just sufficiently tight to allow only a portion of the fluid to escape. Does any harm arise from the portion that has been so to speak stirred up but not ejected.66

One of Stopes1 suggestions for men troubled by premature ejaculation was to pause and then attempt a second union on the same occasion, since the initial sensitivity might be somewhat abated. But even when a man found himself capable of a second erection and another union this was not always regarded as a happy solution, some men fearing that this might lead to debility,67 and others still being upset at their inability to control their first hasty ejaculation.6® Quack remedies were a possible resort, but one in which little confidence was expressed:

Is [there] any possibility that the tablets advertised could be of use—or are they a complete swindle?6® though some of Stopes' readers had found some benefit in following her prescription of the application of a lotion to render the glans less exquisitely sensitive. She mentioned this in reply to letters evoked by

Married Love, and included instructions on how to make it up in Enduring

Passion.70. Reactions received were:

Rather less than a month's use of your lotion effected the most remarkable improvement.

I have found some benefit from the use of the lotion you describe in your book Enduring Passion for premature ejaculation.71 though it would be hard to estimate how far the benefits were psychological, a question which could also be asked about the glandular preparations Stopes la te r came to recommend.72

One reader remarked that 249

Your book brought great comfort in hearing alone that it is a more or less common complaint.73 and it is clear that many men had only realised that their problem was not aunique curse and might even be treatable on reading Stopes's works— particularly Married Love:

You refer to husbands being cured of too hasty ejaculation. This has always been my trouble.

You refer to husbands being cured of the habit of too rapid ejaculation.

You write of husbands being cured of premature ejaculation... how exactly is the cure brought about?

You say that husbands have been cured of this but not how.7-* and one even remarked:

If some of us men knew how to overcome this difficulty no doubt many of us would take steps to cure it, after all we are the victims of our own natures.75 though only one seemed to have discussed the problem with other men:

I am aware from intimate conversations with other men that it is a common trouble amongst them.76

He did not state if these confessions were generated by the discussions of

Married Love described in the previous chapter. Another expedient recommended by Stopes for couples with this predicament was for the husband to induce his wife's orgasm manually, so that she was not left "in the air" as so many feared she would be. This suggestion may have contributed to alleviating "performance anxiety" by giving explicit permission for an act about which many individuals felt dubious (as discussed in the previous chapter).

The converse problem, that of retarded ejaculation, was either very much rarer or bothered Stopes' readers to a much lesser degree, since very few of them consulted her on this problem. The fact that the problem received 250 no mention in the 1930 edition of Walker's Male Disorders of Sex would suggest that if it were not rare, it was not a problem much found in the consulting room. In one case presented to Stopes, a couple had been indulging in "love-play" but not intercourse. When they attempted to

"commence intercourse" the husband found that

I am not able to ejaculate—or shall I say, I presume I am unable... the wooing is done by me on each and every occasion but to me (although ardent) there does not come the passion— not even the old passion before we had union at all.

Since it would appear that some form of copulation was nevertheless taking place this cannot be regarded as a simple case of impotence.7”7. Another case was that recounted to Stopes by the wife of a "universally abstemious, hard-working and self-controlled" man:

The man is unable (on nearly every occasion) to reach any climax or ejaculate any semen; erection and union occur quite easily but nothing further. This leaves both with a feeling of dissatisfaction and in "mid-air" as it were.70

One man, while continuing subject to the nocturnal emissions he had experienced every few weeks prior to his marriage, found that

Whenever we have sexual intercourse instead of the sexual excitement increasing more and more until it culminates in the unmistakable emission of semen and the collapse of the penis... the excitement gradually dies down leaving the penis still erect until finally (after say about half an hour) the only thing seems to be to withdraw, feeling somewhat unsatisfied.79

While premature ejaculation was p articu larly a problem among the newly married, impotence, in terms of the failure or uncertainty of actual erection, would seem to have been perhaps more a problem of the middle- aged:

I find that the last few months my power of erectlbillty is waning so much that penetration is not possible. [Aged 60]

We are deeply devoted to each other and my wife more anxious for the pleasures of the bed than ever but alasf... I'm very rarely able to get an erection. [Aged 54] 251

In the last 2 years I have been faced by excessive physical fatigue for no apparent cause and a gradual decrease of sexual prowess now beginning to amount to impotence. [Aged 433

I am a married man 58 years of age and now find myself unable to enjoy the sexual relation with my wife properly.

At the age of 50 while otherwise in abounding health I am finding a deplorable weakness in our sex unions.

A lack of power in that direction which has been growing on me lately. [Aged 513®°

It was not a question of the total disappearance of desire in all cases:

The desire is keen but the reaction is sluggish.

I still feel amorously disposed but find that my erections are defective and lack the rigidity of former days. [Aged 503°1 though some men did describe the waning of desire as such:

She is 42 and as virile as ever. Unfortunately I have lost all desire. [Aged 453

I am beginning to become one of the "under-sexed husbands" a6 quoted in your Enduring Passion.

I have no pains or trouble, just my normal self, but no desire for the opposite sex. [Aged 29, widower3a2

It is not always easy to differentiate between the cases of men who regretted the passing of their virility for their own sakes and those who regretted it on behalf of their wives:

It is very humiliating to me and while my wife bears sympathetically with it, I fear she is disappointed.

My wife being well-sexed suffers as a result. [Man aged 403

I'm not able to do her justice although we lie every night in each o th er's arms. [Aged 543

This is having a very serious effect on my wife's nerves. [Aged 503

I have never felt for the last twelve years that I really did my duty by my wife. [Aged 503®3

However, few of the men who wrote about th is problem and possible solutions expressed it in quite this way: 252

I am badly In need of something to make me able to face up to my wife. [Man aged 55 3® A

Some men attributed this failing to prior indulgence in masturbation.*

This is brought about 1 expect from unwise habits contracted in youth and even carried on after my married life.®6 one or two to the prolonged practice of coitus interruptus.®6, or to a general state of fatigue or stress:

A marked tendency to impotence which I can only ascribe to nervous debility.®7 or simply the expectation of failure after one episode

A sudden unusual impotence and since then doubt as to the a b ility to succeed. [Aged 57]®®

But often they were unable to account for it:

I have not led a fast life nor in our early married life did we exceed the usual limit. My general health is good... PS I rarely touch stimulants.

I have not abused myself in any way and cannot account for it.®®

Stopes was able to reassure enquirers that some flagging in sexual performance was a frequent experience in men of middle years, and that providing that the sufferer did not fret himself into a state of anxiety about "declining powers" all might be well.

The above difficulties of premature ejaculation and Impotence involved the disturbing lack of congruence between desire and performance in those who suffered from them. Those who found that lack of interest in sex, or "sex anaemia"90 was growing upon them with advancing years nevertheless had some idea of what it was that they were missing. It might therefore be imagined that men who experienced little interest in sex and lacked desire might therefore not consider themselves to have a problem. This was not 253 always the case. Sometimes a man who felt infrequent desire rather than none at all might marry:

My worry is that I feel I am slightly undersexed, at any rate in relation to the sex activities of my wife. Normally we have union every 3-4 weeks... I am sure it would be to her happiness if we had union more frequently, and incidentally, it would also be to my own happiness.311 but it would seem clear that this man did at least enjoy sex when he

found himself capable of it. Other men seem to have been suffering from something more like sexual anaesthesia:

I have always suffered a tremendous lack of desire and virility... The times that I have had intercourse have been more or less satisfactory for her, but for me rather an effort as I find all the time myself trying to create desire which is not there, for her or anybody, and this has naturally given me an inferiority complex. Were this not so, I would still lack my "manhood"... I have always fe lt that perhaps my glands were lacking.

Does it not seem strange that our union, though I succeed in giving my wife intense pleasure, 1 myself go through the act without any sensation whatever? [Aged 50, Just married, for the first time!

I cannot enjoy the sex act... listlessness... I feel no physical reaction but ejaculate immediately upon entry.92

Engaging in sexual activity, therefore, was not so very simple an undertaking for the male as some w riters seemed to suggest. Even if he were totally oblivious to the needs to his partner and his obligations towards her, he was still likely to find that the act was not an automatic and pleasurable success.

The concept of "spermatonrhoa" does not seem to have continued in prevalence into the 1920s: although one or two of Stope6' correspondents did use the word to describe their disorder92 this was not very common. 254

However, the belief in the weakening e ffe c ts of undue seminal losses s t i l l persisted to create misery in large numbers of young men. It was often not realised that, as Walker pointed out “involuntary nocturnal emissions occur in the normal male from puberty onwards."9*

There is some evidence for the persistence of the belief that even within legitimate marriage the expenditure of semen was depleting, a few of

Stopes' correspondents touched on this worry, and one man wrote to a member of the Eugenics Society after reading a newspaper article on Male

Sterilisation:

I am a married man of 53 years & I find that the after effects of going with my wife always weakens me & I believe that if I was sterilised I would not want this desire & I would benefit from th is & become stronger.95

This anxiety was considered by E F G riffith (author of Modem M arriage) in an unpublished fragment among his later writings after he had undergone analytical psychotherapy and become a Jungian analyst: "it still seems to worry many a man today; his fear of ejaculation" but while he recognised that the reason given for this was that

he has been told by parent or teacher that the seminal fluid possesses some particular and vital function; that every time he ejaculates he loses strength and vitality.

Griffith hypothesised that the real cause for the anxiety lay deeper:

At this moment he loses conscious control; he surrenders himself to the woman.95 a notion which it is hard to parallel in the works of any contemporary writer, although perhaps Stekel's description of the conflicts between the almost reflex action of instinct and the demands of culture with the inhibitions of the brain may be saying something similar about the terror of submission to a force beyond the control of the higher faculties.

According to the American psychologist G Stanley Hall, in his massive work 255 on Adolescence (1904), the peculiar horror and terror aroused by spontaneous nocturnal emissions could be attributed to the fact that

masturbation is felt to be controllable and the victim feels that he can stop at any time, but spontaneous emissions give a sense of being powerless in the hands of fate. Free will is lost and the youth feels helplessly possessed by automatism.97 so that this, combined with the secrecy with which the occurrence was surrounded, made the sufferer an easy victim of the quack.

The notion that involuntary seminal losses could be deleterious accounted for much of the anxiety which was expressed around masturbation and nocturnal emissions by men who wrote to Marie Stopes. The influence of current beliefs pertaining to masturbation, conveyed both informally through the conversation of school companions and work-mates, and more formally through exhortatory works on the subject, as described by Stopes' readers, has been discussed in Chapter 3 in connection with the general question of sex education and its influence. Such losses were not only believed to be depleting in themselves, it was feared that they were a symptom of, or led eventually to, impotence.

Stopes* readers certainly expressed extreme perturbation at spontaneous emissions of semen. Some men experienced these in the course of sleep and in connection with dreams:

1 had dreams which caused similar occurrences and these became so frequent that I lay the case before a doctor.

Is there any treatment (otherwise than physical drill) for men with a too frequent (natural ejaculation) which affects them adversely (during dreams)?

[Dreams] which re su lt in unconscious and often very painful emission... seriously drained my health, greatly weakened my memory and left a continual dread of their constant recurrence. 256

I had become a physical and mental wreck, for voluptuous dreams and night losses had added their effect.9® and one man who had averaged an ejaculation every night for over thirty years wrote to Stopes for advice about this which he believed to be weakening."

Other young men were especially frightened by the fact that, during the course of prolonged engagements, they experienced spontaneous emissions in the waking state:

the emissions always occur quickly, and complete discharges eventually, when I embrace and kiss my young lady.

I get an erection whenever my girl kisses me and if we have a long kiss and she is on my knee I often get a discharge. [Former Army officer, educated at Rugby]100 or the recurrence of nocturnal emissions after these had disappeared:

Lately I have felt a sexual longing when sitting on the couch with my fiancee... Since feeling the sexual longing I have occasionally had a discharge of semen when asleep although up till lately I have not had a single discharge for years.101

The anxieties caused by the sexual arousal consequent upon courtship and often prolonged but chaste engagements were sometimes severe: one young man was so horrified by the sexual feelings aroused by his fiancee that upon going to the front during the First World War he "almost hoped I should never return alive",102 and another young man, a school-teacher, found that his bi-monthly meetings with his fiancee meant that "I begin to get nervously excitable and fatigued and sensual in thought."103 The strain of lengthy engagements sometimes provoked questions similar to the following:

Do you consider it wrong, either from a physical or a moral point of view, for two such persons to give each other relief— provided that actual intercourse does not take place?1OA

Stope6 did not believe this latter expedient to be a desirable course of 257 action; her usual suggested remedy to young people in this state was to marry and to use birth control until they could start a family (she also tended to advocate the wife working until such time as economics permitted ch ild - bear ing).

Connected to these anxieties around sexual manifestations was the host of fears which many of Stopes1 correspondents expressed to do with masturbation. Few of Stopes' correspondents elaborated any details about their practice of the habit, except in terms of frequency or how long continued: but one man described:

The sins of my youth were onanism committed with a lady's corset wrapped around a pillow.1 os

Another confessed that

I in the first place purchased [Married Love] in order to satisfy these promptings [i.e. to masturbationl. but underwent a conversion through reading it:

I hope I shall be able to cure myself of I now realise utterly loathsome cravings ... with your aid I have now realised that there is something fuller and deeper behind it than mere sa tisfa c tio n .106

Another described his chosen method of self-gratification by rubbing against the bed-sheets.107

The attitudes expressed towards the habit by Stopes* correspondents have already been cited in Chapter 3, both the very prevalent horror and disgust and the occasional scepticism about its ill-effects. Certainly it was often presented to Stopes as something of which the sufferer was a victim:

The feeling of impotence to free myself.

The urge got a great hold on me until finally I was unable to hold myself in. 258

I formed the habit of masturbation years ago, could not break it when I wanted.

I used to be edected [sic] to this.10® and in some cases was said to have been begun or picked up in ignorance of its dangers:

[My] lack of knowledge of the consequences.

From the age of 18 (I am now 28) until 2 months ago I was foolish enough to masturbate.

So in my ignorance I abused myself, not realising the damage I was doing.

[I] was denied such knowledge as a boy, abused myself, was never warned and for 20 years was deprived of my manhood's rights.

I did not know the dangers of it and became, I suppose, fascinated and practised it for about three years.

It is only now that I seem to be able to control myself after having learned about the evil consequences attendant on this practice.

A weakness which I fell into as a child and which my Victorian parents never noticed or warned me against.109

Men described the feelings and symptoms which they experienced as a result

This has given me a great feeling of nervousness, shame and remorse.

When I was about 22 1 had a nervous breakdown and the doctor who attended me said case was taken just in time and that I was on the verge of P etit Mai... It was not u n til I read th at book that I realised what harm I had been doing to my health through self-abuse.

[My] nervous system [is] all to pieces.110 while others believed it had had deleterious effects upon the organ itself, either by restricting its growth:

My penis is far too small... this I realise... is due to abuse.111 or by causing precisely the opposite effect: 259

"Too frequent erection", a certain "flabbiness" and possible "overenlargement'* of the male organ, due probably to youthful indulgence in solitude.112

Variocele was widely supposed to be another effect:

CI3 was for twenty years deprived of my manhood's rights, I wa6 operated on, in Africa, for variocele.

My le ft te stac le Csic] became swollen and in 1914 I was operated on for variocele.113

At least one of Stopes' correspondents believed it to have caused the traditional penalty of insanity:

Eventually nature's desire and masturbation turned me insane in my opinion, [working class!11* and one produced a compendium which reads like a quack pamphlet's warnings on the subject

As a result I am very pale and awfully depressed, I cannot interest myself in anything, 1 am unfit for my work, sometimes 1 feel so depressed that I wish I was dead. I am perfectly certain that my present condition is due to my awful folly as described above... My chief ailments are:- increasing headaches, aching eyes, and I have a throbbing in my body that seems to make my whole being give a l i t t l e automatic jump, the jump keeping exact time with my pulse and veins, the throbbing is greatly pronounced near the temple and ears. CA clerk in a railway company!11 s

Another man was so convinced of the deleterious effect of masturbatory practices that he wrote, at the age of 29, to declare that all his troubles were due to self-abuse carried on for a period of five months at the age of 17, since when he had abandoned the habit.11® Eczema between the legs,117 and a dripping of urine after passing water11® were also attributed to the habit.

Others, while noticing no particular adverse effects upon themselves, were concerned that it might have a disastrous effect on their abilities within marriage, or even affect any children they might father:

Would it hinder me in married life as regards being responsible for children as I hope to be some day when means permit.

/ 260

Would not dream of having children should I marry—which seems impossible.

I am now wondering if it is the cause of my ineffective efforts.

[I was] completely in ignorance that harm would result when I m arried.119

Fears around the loss of semen caused by an inability to control the spontaneous eruption of sexual desire led some men to beg for a remedy for this ailment, as they perceived it:

Now will you tell me if vasectomy will cure my loss of semen, for I confess that even yet I get at intervals the terrible craving to indulge in this sin, and sometimes have nocturnal losses.

Efforts to prevent it—extra clothing at night, tying up hand6 in gloves, all to no effect.120

Circumcision was sometimes thought to be a potential remedy:

Would you advise me to be circumcised... If you advise circumcision could I do it myself as I don't wish to approach a doctor on the subject as I am thoroughly ashamed of myself.121

However, few of those who wrote to her mentioned quack remedies: one said that he had been recommended to take "Damaroids",122 another enquired of

Stopes if there were "any prescription"123 for his trouble, and another asked "is there any treatment (otherwise than physical drill)?"12* Anti­ mast urbational devices such as have been described in Chapter 1 do not seem to have been in use. Stopes' usual response to such cries for help was to be reassuring, although she also advocated trying to give up habits of masturbation by cutting down and regulating its use. She was inclined to be scathing about such commonly prescribed remedies as bromides. While there was the young man given to fear for his sexual powers by Stopes' remarks about the potential of masturbation to coarsen the nerves and vitiate the male response) as already mentioned in Chapter 4),12Bher advice 261 both in her books and to her readers in correspondence was more likely to soothe and encourage than scare.

It can therefore be seen from the above that masturbation was a practice which for many men was surrounded by guilt and fears, which extended to cover emissions which were not voluntarily produced. The use of the term

"pollutions" to describe these would seem to have embodied the emotions they raised. So adverse were the feelings about these phenomena that even the sexual feelings roused by contact with an intended wife were sometimes perceived as frightening as well as sinful.

While the anxieties discussed above were to do with the inability of men to control the activities of their genital organs, other anxieties focussed upon the physical conformation of the organs. Men wrote to Stopes for reassurance that they were "normal", or for means by which they could remedy the matter if they were not.

It is perhaps not surprising that the most frequent cause of worry in this respect was the fear that the sexual organ was too small:

My sexual organ is very much smaller than my wife's and she can scarcely feel me at all. Is there a method by mean6 of which my sexual organ can be enlarged without injury?

I wish to know whether there is any treatment for an under­ developed sexual organ.

I have reason to believe... that my organ of sex is slightly below normal.

I am rather shy and have never discussed the subject actually with anyone but I think my genital organs are below the average size. My erected penis is approx 5)6" long and 1)6" in diameter. 262

Compared with the other men I was equal and more so in physique but my penis is far too small compared with the rest of my body.

I am smally made by nature... [is there] any means known to medical science by which I can increase the size of my congenital [sic] organ.

My private part should be bigger than it is.

I have been laughed at because... my penis has been much smaller than the average... I have taken measurements and normally it is nearly 4" and at other times it is about 5&" long.126.

Others however feared that excessive largeness would have an adverse effect on marital relations,127 and in some cases failure to consummate was put down to such disproportion.12®

Variocele also provoked requests for information:

What is the best treatment for variocele? Is it detrimental to marriage?123 also what were perceived as abnormalities of the testicles:

Both my tisticles [sic] were badley injured matter formed and they had to be lanced to let matter out... do you think I should not marry. Would my children be healthy if I was to have any.

[Dysentery] seems also to have affected my sex organs in particular my testes (I think that is the correct expression) in that they seemed to shrink to considerably le6S than their normal siz e .130 in particular, cases where one testicle remained undescended.131

Circumcision seems to have aroused a variety of anxieties:

Is circumcision really of any moral value, or is it merely a custom delivered to us from the east?

I was never circumcised as a baby and as a consequence on entering my wife "bare" the loose skin at the end of the penis is easily pushed back out of place (except where the skin is grown onto the side of the penis).132

In contrast to this attribution of problems to long foreskins which had not been circumcised, a Mr F stated

with regard to control of ejaculation in my opinion circumcision has a great bearing on this method as I am speaking from 263

personal experience having been served by th is inhuman operation... I find that men who have not been circumcised can control ejaculation more than men who have and I firmly believe this business is done solely to increase the population.133 and one man, although he had already been circumcised in childhood, sought advice as to the advisability of having it done again.13A Another believed that the odd growth of his foreskin was the reason for his childless marriage.133 The case of the man who was prepared to circumcise himself as a cure for masturbation and emissions has been cited above.

Other worries had to do with the presence of blood in the semen:

I have had emissions during sleep which have been deeply stained with blood.133 a brown spot on the head of the penis,137 a clear secretion from the penis,133 spots inside the penis,133 and large blue veins. 1AO

Prostate troubles agitated a number of men. In some cases this anxiety seems to have been aroused by reading Stopes* own works, in particular

Change of Life in Men and Women, in which she deplored the insufficient attention given by the medical profession to this problem.1*1 Although this may have contributed to the arousal rather than the allaying of worry, one man, whose heart condition made an operation out of the question, had been given hope by reading her work that amelioration might be gained without surgery.1** Another, who had just had a prostatectomy, complained that he felt very run down and weak and asked Stopes for her advice.1 *3 Certainly the idea of the operation was frightening for men: one, a doctor himself, wrote to Stopes of his fear of such intervention and described a failed catherisation.1 ** 264

Very few men wrote to Stopes concerning venereal disease: perhaps this was a problem with which they felt the medical profession was adequate to cope. A few of her correspondents did mention it: one believed that the cause was intercourse during menstruation.1,4® Another described suffering from a discharge after having Hsex union with a strange woman"1,46, for which he feared that the treatm ent he was g ettin g from his doctor was incorrect. In spite of the fact that Stopes' works appeared in the final months of a major war during which the problems of sexually transmitted diseases had come to be a matter of public concern (see Chapter 2), very few men wrote to her in terms similar to the following:

I was in the Navy during the war and knew nothing of the horrors of th is scourge. I was caught by bad company and contracted gonorrhoea in August 1918. Since then my life has been cleanly led.147 and in fact most men seemed aware of the connection between resorting to prostitutes and contracting venereal diseases, giving this as a reason for not seeking th is remedy for the stra in s of continence. However, certain misapprehensions did exist: one man wrote to Stopes that he had believed the gonorrhoea he had suffered from some years previously had cured itself spontaneously, but now he feared, as he was courting his recently widowed childhood sw eetheart, th at th is was not so and he probably s t i l l had the disease.1

Stopes' correspondents did not write to her, either, with phobic fears of having contracted venereal disease, a condition which according to venereologists was far from rare, and according to one of them at least was found "mainly in men."1,4® Presumably individuals who feared th is would take their presumed symptoms to a clinic or their own doctor. It seems probable that a certain number of functional or neurotic disorders were 265 seen in venereal disease clinics in patients who were not suffering from

infections. During the 1930s the British Journal of Venereal Disease published the occasional paper on impotence or the psychological after­ effects of venereal disease, as well as syphiliphobia, by experts such as

Kenneth Walker.lso In 1958 Dr Ambrose King noted th at increasing numbers of individuals attended clinics for advice and did not require treatment, and suggested that this demonstrated public confidence in the service, as well as th e ir "usefulness in preventing psychogenic disease."161 However, the remark of a Mr Hamish Nicol in discussion upon Kenneth Walker's paper on "Impotence" should be borne in mind as perhaps more typical of a venereologist's perception of sexual problems:

He had but few cases of impotence in his practice; most of his patients were of the opposite kind—it was difficult to persuade them to control themselves.162

Stopes did not receive confessions pertaining to the more bizarre sexual variations: far from being fetishists of the exotic kind detailed in the pages of Krafft-Ebing or Havelock Ellis Stope6* correspondents were more likely to enquire as the permissibility of spouses seeing one another in the nude,163 or to make comments such as:

I'd love her to slip on a pretty slip or brassiere for me yet she has no idea of the joy it would give me.1BA

However, the expectation of a sympathetic hearing which she aroused in her readers did lead to a few men writing to her on the subject of their homosexuality. One man, who had been led to read Edward Carpenter's Love's

Coming of Age by learning of its existence in the pages of Married Love. declared it to be "one of the greatest revelations of my life" and wondered "if only Dr Marie Stopes would write a book on the subject."1 BB

Another asked for her opinion as to whether 266

perpetual restriction of the sex side Cisl as harmful for the homosexualist as it is for the normal man?1®® and another felt able to confess to her

I am a man but I am equally sure... that there is another side to my nature which is effeminately inclined.1®7

As a matter of interest, the men who mentioned when writing to her that

they had undergone seduction or “degradation" while at school,ise usually mentioned this in connection with problems to do with masturbation, not as having initiated them into a lifetime of homosexual inclination.

The major source of anxiety for most men, at least those who wrote to

Stopes, was clearly of dysfunctions affecting the actual 6exual union. A

good deal of the worry around masturbation, emissions and defects of the

genitalia had to do with fears of unfitness for marriage and fatherhood.

The importance which many men placed on the marital relationship and the

success of the sexual relation within it has already been demonstrated in

the previous chapter. Failures in potency were not simply failures in

"manhood" in the ab stract, but threatened a relationship which men valued.

It is also clear that both these dysfunctions, and the anxiety caused by

them, were remarkably prevalent. 267

Chapter Six; Notes

1. Pfeffer, Naomi, "The Hidden Pathology of the Male Reproductive System" in Homans, Hilary, (ed), The Sexual Politics of Reproduction. Gower, Aldershot, Hants, 1985, pp 30-44

2. Walker, Kenneth M, Male Disorders of Sex. Jonathan Cape, London, 1930, P 7 3. Paget, Sir James, "Sexual Hypochondriasis", Clinical Lectures and Essays. London, 1875, 2nd edition 1879, pp 275-298

4. Storr, Anthony, Sexual Deviation. Penguin Books, Harmondsworth Middlesex, 1964, p 49

5. ibid. p 52

6. ibid. p 54

7. North, Maurice, The Outer Fringe of Sex: A Study in Sexual Fetishism. Forum Studies in Sexual Behaviour, The Odyssey Press, London, 1970, reprinted 1981, a study of rubber fetishists, indicates some of the problems encountered by these men. It would seem from this work that very few women take part in this deviation except for mercenary reasons or else for the gratification of an addicted partner.

8. Freud, Sigmund, "'Civilised' Sexual Morality and Modem Nervous Illness", 1st published in German 1908, Standard edition 1959, in Pelican Freud Library 12; Civilisation Society and Religion.Harmondsworth Middlesex, 1985, p 53

9. The Lancet. 1870, ii, 225

10. Paget, op cit. p 289

11. British Medical Journal. 1883, ii, 564

12. Tuke, D Hack, Dictionary of Psychological Medicine. (2 vols) J A Churchill, London, 1892, Vol II, "Marriage and Insanity", p 776; I am indebted to Charlotte Mackenzie for bringing thi6 reference to my atten tio n

13. Vecki, Victor G, Sexual Impotence. W B Saunders, Philadelphia and London, 1899, 5th edition 1915

14. ibid: described on title page a6 a consultant at Mount Zion Hospital, San Francisco, and mentions his service with the Croatian Government examining conscripts, p 96

15. ibid. p 26

16. ibid. p 28

17. ibid. p 350 268

18. It is hard to discover any biographical details about Arthur Cooper save for the very basic information to be found in the Medical Directory. He flourished c. 1870-1930, practising in London u n til 1920, when he retired to Harrogate. His early publications were on venereal disease (he published Syphilis and A Student's Manual of Venereal Disease in collaboration with Berkeley Hill) but by the turn of the century his attention seems to have been directed more towards the functional disorders. Besides publishing his book on the Sexual Disabilities of Man. he made a contribution to the British Medical Journal in 1914

19. Cooper, Arthur, The Sexual Disabilities of Man and Their Treatment. H K Lewis, London, 1908, 2nd edition, 1910, p 3

20. ibid, P 118

21. ibid, P 140

22. ibid, P 94

23. ibid, P 127

24. ibid. P 152 25. ibid. p 160

26. Stekel, Wilhelm, Impotence in the Male: The psychic disorders of sexual function in the male. (2 vols), 1st published in German 1927, authorised English version by Oswald H Boltz, John Lane, London, printed in the USA, 1940; Stekel, Wilhelm, F rigidity in Woman in Relation to her Love Life (2 vols), German edition 1926, Liveright Publishing Co, New York, 1936

27. The Lancet. 1940, i, 552

28. Information derived from The Lancet. 1941, ii, 56, and m aterial collated in the Wellcome Institute Library Readers' Queries file, RQ 14

29. Stekel. Impotence.

30. ibid, Vol II, p 276

31. ibid, PP !-2 32. ibid, Vol I, p 47

33. ibid, Vol I, p 55

34. ibid, Vol I, p 95

35. ibid. Vol II, p 25

36. Placzek, Dr Siegfried, The Sexual Life of Man: An Outline for Students. Doctors and Lawyers. Berlin, 1929, English tran slatio n by L S Morgan, John Bale, Sons and Danielsson, London 1931, p 136 269

37. History of Urology, prepared under the Auspices of the American Urological Association, Williams and Wilkins Co, Baltimore, 1933: Walther, H W E, "Neuroses and Functional Disorders of the Genito-urinary Tract", Vol II, pp 43-44

38. Costler, A, Willy, A and Haire, Norman, Encyclopaedia of Sexual Knowledge, Encyclopaedic Press, London, 1934, 2nd edition, 1952, p 293

39. Ibid. pp 295-296

40. Stopes, Marie C, Enduring Passion. Further New Contributions to the Solution of Sex Difficulties being the continuation of Married Love. GP Putnams Sons, London, 1928, 2nd edition, 1929, Chapter V, pp 75-84

41. ibid. p 54

42. Walker, op cit. p 40

43. Kinsey, Alfred C, Pomeroy, Wardell B, and Martin, Clyde E, Sexual Behaviour in the Human Male. W B Saunders Co Ltd, Philadelphia and London, 1948

44. ibid. p 545

45. ibid. p 580

46. Bergler, Edmund, "Premature Ejaculation", in Pillay, Dr A and Ellis, Albert (eds), Sex Society and the Individual: Selected Papers, revised and brought up to date. from Marriage Hvpiene (1934-1937) and The International Journal of Sexology (1947-1952). The International Journal of Sexology, Bombay, 1953, pp 58-63

47. Vecki, op cit. p 375

48. Walker, op c it. p 37

49. Marie C Stopes papers in the Contemporary Medical Archives Centre at the Wellcome In s titu te for the History of Medicine, correspondence "ML- GEN", CMAC: PP/MCS/A.231 FJW

50. CMAC: PP/MCS/A.237 Lt Col EGW

51. CMAC: PP/MCS/A.183 CM

52. CMAC: PP/MCS/A.152 FGK

53. CMAC: PP/MCS/A.146 Mrs BJ

54. CMAC: PP/MCS/A.109 SG, and see also A. 115 2nd/Lt GH

55. CMAC: PP/MCS/A.69 FD

56. CMAC: PP/MCS/A.146 HPJ 270

57. CMAC: PP/MCS/A.213 GR, A.208 HR, A.202 RP, A. 193 Capt RFP (RN), A. 164 JL-W, A. 127 Lt SGH

58. CMAC: PP/MCS/A.68 C

59. CMAC: PP/MCS/A.213 GR

60. CMAC: PP/MCS/A.222 Major AFS

61. CMAC: PP/MCS/A.234 VRT, A.235 FJT, A.213 FR BSc, A.202 RP, A.70 D

62. CMAC: PP/MCS/A.199 RP, A.204 GWP, A. 187 HJN, A.215 TR

63. CMAC: PP/MCS/A.237 Lt Col EGW, A.208 Pte RWR, A. 114 Major WdeHH (Royal Engineers)

64. CMAC: PP/MCS/A.190 Capt BCN, A. 146 EYF

65. CMAC: PP/MCS/A.194 EP, A. 120 JH

66. CMAC: PP/MCS/A.183 CM, A.202 RP, A. 181 DVM

67. CMAC: PP/MCS/A.235 FJT

68. CMAC: PP/MCS/A.239 AJW

69. CMAC: PP/MCS/A.183 CM

70. Stopes, Enduring Passion, p 81

71. CMAC: PP/MCS/A.109, JMGG, A.201 WEP, see also A.216 KAS, A. 183 CM, A.66 JEC

72. Stopes, Enduring Passion. Appendix A HA Few Examples of Useful Prescriptions", pp 201-208

73. CMAC: PP/MCS/A.109 JMGG

74. CMAC: PP/MCS/A.237 Lt Col EGW, A.234 VRT, A.208 Capt JR, A.208 Capt MR

75. CMAC: PP/MCS/A.202 Capt CHB-P

76. CMAC: PP/MCS/A.155 JL

77. CMAC: PP/MCS/A.113 HFG

78. CMAC: PP/MCS/A.158 Mrs EML

79. CMAC: PP/MCS/A.176 FGM

80. CMAC: PP/MCS/A.225 WHS, A. 174 GAM, A. 138 AI, A. 109 EG, A. 128 CCH, A.80 HE

81. CMAC: PP/MCS/A.209 SR, A. 168 HM 271

82. CMAC: PP/MCS/A.157 FALt A. 146 JRJ, A.98 SG

83. CMAC: PP/MCS/A.225 WHS, A.233 AWT, A. 174 GAM, A. 128 CCH, A. 176 JGM

84. CMAC: PP/MCS/A.131 WCH

85. CMAC: PP/MCS/A.109 EG, see also A. 157 ML, A.89 F (aged 35), A.37 W-B, A.64 GWC, A88 FWF

86. CMAC: PP/MCS/A.176 JGM

87. CMAC: PP/MCS/A.165 FLL see also A.142 Cdr ACJ (RN), A.9 A, A.67 C

88. CMAC: PP/MCS/A.171 GM aged 57, see also A. 166 JMcB, A. 147 HK (unemployed builder's labourer aged 49)

89. CMAC: PP/MCS/A.174 GAM, A. 168 HM

90. CMAC: PP/MCS/A.9 A

91. CMAC: PP/MCS/A.241 Capt MKW

92. CMAC: PP/MCS/A.239 TSW, A. 165 WHL, A.210 Lt-Cdr LR

93. e g, CMAC: PP/MCS/A.205 AWP

94. Walker, op c it. p 113

95. Eugenics Society archives in the Contemporary Medical Archives Centre at the Wellcome In s titu te for the History of Medicine, CMAC: SA/EUG/C.181

96. Papers of E F Griffith held in the Contemporary Medical Archives Centre at the Wellcome Institute for the History of Medicine, CMAC: PP/EFG/B.22 "Notes for a Lecture on the Devouring Mother"

97. Hall, G Stanley, Adolescence: Its psychology and its relations to physiology, anthropology, sociology, sex, crime, religion, and education. Appleton, London and New York, 1904, p 457

98. CMAC: PP/MCS/A.146 BJ, A. 180 HBM, A. 197 EWP, A.220 WS, see also A. 107 JHG, A. 70 JD

99. CMAC: PP/MCS/A.71 D

100. CMAC: PP/MCS/A.146 BJ, A.118 SNC-H, see also A.54 HC, A.65 C,A.132 HDH, A. 138 LR-I, A. 165 HGL, A.92 F, A.230 LT

101. CMAC: PP/MCS/A.157 WAL

102. CMAC: PP/MCS/A.65 C

103. CMAC: PP/MCS/A.240 JW

104. CMAC: PP/MCS/A.254 NHY

105. CMAC: PP/MCS/A.136 RLH 272

106. CMAC: PP/MCS/A.168 AMM 1927

107. CMAC: PP/MCS/A.15 JFA

108. CMAC: PP/MCS/A.183 JM, A. 132 HPH, A.245 MW, A. 126 JGH

109. CMAC: PP/MCS/A.252 AEW, A.222 PDS, A.222 JHS (a soldier stationed in Egypt), A. 194 TCP, A. 176 MM, A. 123 HPH, A. 117 CH

110. CMAC: PP/MCS/A. 126 JGH, A. 107 CHG, A.64 GWC

111. CMAC: PP/MCS/A.222 JHS (soldier serving in Egypt)

112. CMAC: PP/MCS/A.208 AWR

113. CMAC: PP/MCS/A. 194 TCP, A.89 F

114. CMAC: PP/MCS/A.65 C (working class)

115. CMAC: PP/MCS/A. 189 WN

116. CMAC: PP/MCS/A. 128 JSH

117. CMAC: PP/MCS/A.228 AGS

118. CMAC: PP/MCS/A.232 EB

119. CMAC: PP/MCS/A.239 CW, A.220 WS, A.63 C, A.80 SGE, see also A.252 AEW, A.222 PDS, A. 183 JM, A. 120 OLH, A. 107 CHG, A.43 PAB

120. CMAC: PP/MCS/A.220 WS, A.228 AGS

121. CMAC: PP/MCS/A.239 CW, see also A. 132 LACH (RAF)

122. CMAC: PP/MCS/A. 189 WN

123. CMAC: PP/MCS/A. 176 MM

124. CMAC: PP/MCS/A. 180 HBM

125. CMAC: PP/MCS/A.79 AE

126. CMAC: PP/MCS/A.239 WLW, A.242 ABW, A.251 HW, A.222 PDS, A.222 JHS, A.211 BR, A. 131 AWH, see also A.31 OB, A.27 RGLB, A.10 RA, A.66 JEC, A.55 HC, A.93 RHF, A. 105 JG, A.99 GHG, A. 157 RL

127. e g, CMAC: PP/MCS/A.248 Sgt HTW, A. 120 OLH, A. 126 FH, A.97 G-F, A.70 RCD

128. CMAC: PP/MCS/A. 126 FH

129. CMAC: PP/MCS/A. 180 HBM, see also A. 193 DAP, A.89 F, A. 13 GAA

130. CMAC: PP/MCS/A.223 WFS, A.219 WS, see also A.38 B

131. CMAC: PP/MCS/A. 74 FD, A. 41 HGB 273

132. CMAC: PP/MCS/A.109 ECG, A.235 GT, see also A.226 RJS, A.99 GHG, A.66 C

133. CMAC: PP/MCS/A.88 F

134. CMAC: PP/MCS/A.68 C

135. CMAC: PP/MCS/A. 13 WRA

136. CMAC: PP/MCS/A.222 AFS, see also A.297 Rev LS

137. CMAC: PP/MCS/A. 147 GBJ

138. CMAC: PP/MCS/A.80 THE

139. CMAC: PP/MCS/A.65 C

140. CMAC: PP/MCS/A. 13 GAA

141. e g* (CMAC: PP/MCS/A.231 HT, A.302 Rev SS, A. 146 DEJ 142. CMAC: PP/MCS/A.69 DC

143. CMAC: PP/MCS/A. 141 EDFJ

144. CMAC: PP/MCS/A.205 Dr WPP

145. CMAC: PP/MCS/A.146 HAJ

146. CMAC: PP/MCS/A. 209 WR

147. CMAC: PP/MCS/A. 166 IMacL

148. CMAC: PP/MCS/A.202 JP

149. Bradbrook, R, "The VD Phobia", Bulletin of the Institute of Technicians in Venereology Ltd. [n d, c. 1950s], pp 7-8

150. Walker, Kenneth M, "Impotence", BJVD. 1931, Vol 7 no 4, pp 289-299; Walker, Kenneth M, "Gonorrhoea and its psychological casualties", BJVD. 1934, Vol 10, pp 202-205; Hadfield, J A, "The Nature and Cause of Phobias, with Special Reference to Syphilophobia", BJVD. 1938, Vol 14, pp 119-133: Hamish Nicol, in the discussion on this latter paper, declared that he "had never had a woman patient suffering from gonophobia or syphilophobia", p 133, although this was not the experience of other speakers.

151. King, Ambrose, "These Dying Diseases: Venereology in Decline?", The Lancet. 1958, i, 651-657

152. BJVD. 1931, Vol 7, p 297

153. CMAC: PP/MCS/A.41 DB, A.97 G

154. CMAC: PP/MCS/A.56 RC

155. CMAC: PP/MCS/A.240 CDW 274

156. CMAC: PP/MCS/A. 159 PL

157. CMAC: PP/MCS/A. 174 CTM

158. e g, CMAC: PP/MCS/A. 115 HPH, A.244 WPW, A.232 CT, A. 157 ML, A.65 C 275

Chapter Seven

"How little we medical men know”; doctors and sexual matters

There hae always been a complacent supposition among the medical

profession (and shared by others) that medical training constitutes an

essential preliminary to a true understanding of the mysteries of sex, and

that doctors are uniquely qualified to assist those troubled in these

matters. According to the Lancet in 1889

Ours is a very responsible profession. Young men are looking to us as men looked to the old type of priests who combined moral and medical functions.1

In 1931 the Reverend T W Pym contended that

[The educator] cannot speak of the physical side of sex in that matter of fact manner which we find and envy in those who profess the science of medicine.2

while in 1935 the British Medical Journal was of the opinion that

No walk in life engenders more sympathy with human frailty than does the practice of medicine.3

It has been, and often still is, assumed that years of studying the

intricacies of the human organism give doctors a particular and peculiar

advantage in the sexual realm. However, recent w riters have pointed out, in

textbooks for the general practitioner faced with sexual problems in the

surgery,

[Most doctors] preferred to avoid the subject rather than reveal th e ir embarrassment, ignorance and therapeutic impotence."*

the doctor either didn’t know how to help them, or just didn't want to know about th e ir problems.®

And as a leader in the Lancet in 1988 remarked, more i6 known about the

HIV virus than what people actually do in the privacy of th e ir bedrooms.® 276

The Lancet remarked In Its obituary of Havelock Ellis,

He might have become another Edward Carpenter had he not made up his mind that a study of medicine was essen tial to him in clearing up the problems of sex.7 implying th at only by th is means could E llis have become a major sexologist. Ellis, it may be noted, acquired after great struggle the

Licentiate of the Society of Apothecaries, the most basic means of entrance into the profession, and only practised for a few months before retiring into a life of scholarship. The Fellowship of the Royal College of

Physicians which he received shortly before his death was granted under a

Special Regulation, and he must be among the few, if not the only, LSA, to receive this accolade.® It is not clear if his medical training gave him any particular help apart from providing him with respectability and credibility in the eyes of his professional colleagues. As Marie Stopes proved, it was possible for a layperson of intelligence and application to discover far more about the problems of sex and the state of current knowledge on the subject than mo6t doctors, and to uncover a mass of sexual ignorance and suffering which doctors had ignored or believed negligible.

Ellis himself was extremely critical of his professional peers' dealing with problems of sex: furthermore reviewers of his works concurred, tending to pay tribute to the valuable contributions Ellis's indefatigable scholarship had made to illuminating this murky subject for the benefit of other p ractitio n ers, as already discussed in Chapter 1. In his 1933 summary volume on the subject, The Psychology of Sex. E llis began by remarking in the Preface

Medical education displays at this point a vacuum which is altogether lamentable. For my gynaecological teachers the processes of sex in health and disease were purely physical... It might be supposed that great progress has been made since 277

those remote days. Here and there, no doubt, there has. But I have no evidence that the progress in any country is widespread or pronounced.®

He went so far as to state "ancient superstitions still prevail in our medical schools",10 and to contend

The physician is often less well informed than his patients, and not seldom the victim of false traditions and antiquated prejudices.11

Ellis's remarks about the state of enlightenment of doctors on problems of sexuality are by no means outmoded, as demonstrated by the correspondence in the British Medical Journal which led to a leader entitled "Intolerance

1980s Style" and the letters which followed it (on the subject of a small and discreet advertisement for the Gay Medical Association). Opinions were expressed which would not have seemed out of place at the time of the furore over the publication of Ellis's Sexual Inversion in the aftermath of the Wilde t r i a l .12

Ellis was not alone in this view of the medical profession as by and large unfitted, as well as (or perhaps therefore) reluctant, to give counsel to the sexually suffering. W H R Rivers, in hie defence of "Freud's Psychology of the Unconscious" in 1917, suggested that the emphasis, (which he deplored) by some of Freud's followers on the "cruder side of sexual life" was a

reaction from the timidity and prudery of the great mass of the medical profession in relation to sexual matters.13

Norman Haire, the Harley Street gynaecologist, wrote in 1923 that

Unfortunately the majority of persons in these professions have not escaped the general ignorance and prejudice in respect of matters relating to sex, and are therefore not in a position to sympathise with, and help, those who may wish to confide in them.1 A

In the course of the agitated correspondence in the British Medical Journal 278

In 1932 engendered by the proposal of the B ritish Social Hygiene Council to set up an advisory bureau on Preparation for Marriage, J W Astley

Cooper pointed out

While I am aware that the average general practitioner has not hitherto given these matters the attention they deserve, I doubt whether he has given them less attention than has the average specialist in those branches of medicine [gynaecology, neurology, psychiatry] above indicated.16

Reviewers of The Psychology of Sex (1933) considered that

It would appear most desirable that instruction on this subject should be imparted to senior medical students.16

Creditable though these statements were, they seem to have had little influence on the training of doctors, in spite of Haire's 1920s optimism that

The doctor of the future will have a greater knowledge of sex- matters than has the doctor of today. Every Medical School will have its chair of Sexual Science... every large city will have its Institute of Sexual Science... The medical student will be trained in sexology, and part of his training will deal with contraception.17

His optimism was echoed by a Dr K who wrote to Marie Stopes commenting

when I attended one of your doctors’ demonstrations [on birth control methods] I was interested to find that the audience consisted chiefly of us younger practitioners so that presumably in the future doctors will not be so apathetic and ignorant about this subject.10

But th is does not seem to have been borne out by events: in 1944 E F

Griffith wrote to the British Medical Journal to complain that

More and more couples are coming for help, and yet it is no uncommon thing to find cases which are mishandled, and no constructive advice is given... over and over again one hears patients say that their doctors are not interested in these m atters.19 and in 1949, in a comment on the Goodenough report on medical schools, the

Lancet remarked

Patients often complain that, of all the problems they bring to the doctor, those arising out of sexual abnormality or sexual 279

ignorance find the least satisfactory reception, although the commentator (almost certainly Alex Comfort) went on to describe the doctor as "the one person who might be expected to provide

informed advice." However, whatever the ideal, the author was forced to

admit

the newly qualified doctor today is no better off, so far as the teaching given him is concerned, than his counterpart of 1914. Indeed, he often shares all the prejudices of his time.20 although this Lancet comment did not go as far as Comfort's article on

"Sex Education in the Medical Curriculum" published in the International

Journal of Sexology in the following year, in which he contended

Sex education of the public in England has almost certainly outstripped sex education of doctors, and the patient with a specifically sexual problem is very often willing to discuss it with anyone except his own medical adviser.21

Some years later, in 1957, Bernard Sandler conducted a survey of forty-

seven medical schools to discover what sex education was being given, to

which he obtained thirty-six replies, twenty-four from Britain. He

concluded

Most doctors who acquire any knowledge of sex by the time they graduate, do so, not by organised instruction but rather by personal enterprise.22

The deficiencies of medical education in producing doctors able to deal

with sexual problems without embarrassment and helpfully to their patients

were still being pointed out in the early 1970s, when it was proposed, and

finally enacted, to make contraception freely available under the National

Health Service,23

It is something of a sad reflection on the unavailing efforts of the

pioneers in this field to read, in the Journal of the Royal College of 280

General Practitioners. 1979, a review of E Trimmer's Basic Sexual Medicine describing psycho-sexual medicine as "this new branch of the profession",2"1 eighty-two years after the publication of the first volume of Studies in the Psychology of Sex, and nearly fifty years after the Lancet and the

British Medical Journal were recommending Ellis's Psychology of Sex as a valuable textbook for a profession a member of which, Ellis himself contended, could no longer

fail to have [the subject of sex! brought before him. He cannot, like his predecessors, conventionally ignore its existence, or feel that its recognition would be resented as impertinent or indecorous.25

Clifford Allen's assertion in the Preface to his 1962 Textbook of

Psychosexual Disorders that

Psychosexual diseases are now an acceptable part of the corpus of respectable medicine.25 would seem to have been premature.

This neglect of sex education for doctors may have had its roots, as

argued by both Ellis and Comfort, in the fact that many doctors seldom if

ever encountered psycho-sexual problems, due to the reluctance of patients

to take such troubles to their medical adviser

for fear of a reproof or a rebuff [rather] than out of lack of confidence in his doctor's technical knowledge.27

(a subject which will be discussed in more detail in the following

chapter). Another possible problem was of what this sexual education, beyond the strictly physiological data, should consist, given that sex is

an area of human activity particularly fraught with ethical problems, and

that opinions on desirable sexual behaviour differ widely. A contribution

to debate on the subject in the British Medical Journal in 1958 by

R Thompson contended that 281

Sex education which is based on utterly wrong premises is probably worse than no education at all. It is proverbially much more difficult to teach a person who has been badly taught than one who knows nothing about the subject.2®

As E llis had commented in 1933

Morals are in perpetual transition. Much that is regarded as moral today, or at all events as permitted, was fifty years ago regarded as immoral, and was not openly permitted. In harmony with the change in the moral situation, distinguished physicians, with a full sense of responsibility, today openly publish advice in matters of sex which not so very long ago they could not have ventured to give even in private.2®

Fluctuations in moral standards can have made it no easier on the level of

actual practice to determine what sexual instruction should be given to

doctors, if it were to be given at all.

Marie Stopes herself was not a medical doctor, though of course many of her readers thought she was. The reaction of the profession to her works

was mixed. When Married Love f ir s t appeared in 1918, the reviews in the

medical press praised it and recommended it as a guide which could be

safely given to "the married and those about to marry, provided they are

normal in body and not afraid of facing facts" containing "things which are

commonly accepted as sound physiology... which thousands of people would

be happier for knowing."30

However, some doctors were ardent supporters of the Roman Catholic

Halliday Sutherland in the court case over his alleged libel of Stopes,

even though they did not share his faith, and he found medical witnesses,

including a female doctor, to support his case.31 But others were

recommending her books to their patients, asking her advice on

birthcontrol, and pleading to come to her clinics to learn. Some of them

even wrote to her for advice on their own problems: for example, young men

who were about to marry 282

You must know how abysmally ignorant even a medical man like me is in these matters

Although I know anatomy and physiology being a medical student my knowledge of psychology especially of women is very crude.32 as well as the long-married medical men who, reading her books, confessed

I was utterly ignorant of how the sex impulse acts in the average healthy woman

I find these things puzzling. How to obtain mutual satisfaction is the point.

I knew little or nothing of the abstruse problems of sex... Thus I was incompletely equipped... to enter the married state.

Having spent nearly thirty years in the practice of medical psychology I did not think that anyone could teach me anything about myself, but I was mistaken.33

As aresult Stopes had no illusions about the state of sexual ignorance which prevailed among the medical profession. In 1920 she wrote to

Havelock Ellis

I often seriously contemplate publishing "Letters to Marie Stopes", every one containing a pretty revelation of doctors' incompetence!

However, she refrained from doing so, since

such a number of medical men are friendly, and I do not want to hurt their feelings.3A

Numbers of the doctors who wrote to Stopes made the same point as E llis,

Haire and Comfort (who might have been supposed to have some professional

interest in encouraging a greater interest in sexual problems among their

fellows), deploring the state of medical education in this respect:

Our Assistant MOH here in Chesterfield told me that the books now in question supplied the missing link in the education of a medical student.

Although I am a physician 95% of what I read in your book is new to me, and I am certain that the knowledge obtained with be of great benefit to me in my practice.

Medical men have about as small a chance of acquiring such information as have the general public. 283

Many doctors are unaware of the Intricacies of the sex act.

Although a medical man myself I must confess to a most woful [sic] ignorance of all essential points bearing on a subject of such importance.

I have frequently to advise patients upon the subjects dealt with in your books, and am only too aware of how little we medical men know with any degree of authority how to deal with such enquiries.

Although a practitioner of 12 years and a married man with 4 children it has taught me many things that I did not know before of which many of our profession are ignorant.

Too little of anything is taught in our medical schools on such subjects, and yet who needs more than the medical man to know about the psychology of men and women in relation to each other, seeing that he is the one who is most often consulted.36

In the efflorescence of books written for the lay public about sex during the 1920s and 1930s, there were a number by doctors. However because of the nature of the subject some of the writers who described themselves as doctor seem to have had a very tenuous claim to the title, e.g. "Dr

Courtenay Beale", whom Stopes contended was a syndicate and not a single individual at all (see Chapter 4). Others, because of the stigma associated with the subject, also the ban on advertising by doctors, took pen-names, such as "Michael Fielding" which was the pseudonym of Dr Maurice Newfield.

In Parenthood: Design or Accident, a work intended to be a simple handbook for the lay public, he was, remarkably, less than reassuring about doctors:

anyone who cares to read the polemics against birth control written by doctors will find that in most of them the argument has nothing whatever to do with medicine.36

Remarkable, because of the difference between what could be said within the profession and what could be said to the public, as evinced by the comments on the work of Havelock E llis. Kenneth Walker, who could be scathing about doctors in works intended for his professional colleagues: 284

As a rule a doctor gains what psychological knowledge he possesses after he has qualified by experience rather than by systematic study. Unfortunately, there are those who never gain any insight into the psychology of their patients and who even fail to realize that this is necessary... they spend their lives treating diseases rather than people... Such men should never on any account undertake the treatment of impotence.37

was more reassuring in works written for the general public, advising them

to consult their family doctor in any case of difficulty in Marriage.33

However, while in Love. Marriage and the Family he conceded th a t the

"family doctor is a much better choice" than a local clergyman when seeking pre-marltal advice, he did admit that

Some family doctors, though excellent in every other way, show very little interest in sex problems and have had no experience in how to deal with them. Having satisfied themselves that there is nothing physically wrong with the candidates for marriage, they are likely to assure them that there is no need for them to worry, and then with wishes for a long and happy married life the interview is brought to an end.

and went on to suggest that while

The family doctor's reassurance is an excellent remedy for lesser degrees of anxiety... When... any doubt exists in the practitioner's mind he would be well advised to pass on the responsibility of deciding whether marriage is advisable or not, to a p sy ch ia trist.33

Many members of the profession were appalled at the rising tide of advice

on sexual m atters:

Our ancestors, and generally speaking, all plants and animals, have conducted their mating without specialist advice for so long a period that the question arises whether people who require this ought to marry at all.40

The need for this type of literature, which deals with sex and the ars amorls. does not at once seem apparent to those whose practice lies along different lines, among relatively normal people. What useful function it fulfils we are at a loss to understand, but we would be interested to know whether some of our colleagues who sponsor such work consider it to be a serious contribution to science.141

Isabel Hutton referred into her autobiography to the reaction of her then 285 boss, the psychiatrist Sir Frederick Mott, to her projected publication of

The Hygiene of Marriage;

[He] did not approve of the book and was not greatly interested. He was getting on in years and felt that the public should not know too much; married couples having got along all these years without any skilled instruction, could well do without such a book.42

This response was not only found among those who might be dismissed as fossilised reactionaries. In a review article devoted to several works on sex in the New Statesman. January 1935, Harry Roberts, while admitting

that books such as these are being published in great numbers shows th at they meet a public demand... at least part... comes from those who are seeking for information necessary to their happiness... to which they are entitled. went on to demur that

The case for broadcasting the revelations of the pathological laboratory and the mortuary is not so obvious... as a doctor, I am called upon to contemplate and handle many things that I think are unpleasant and unclean—things from contact with which the general public is rightly exempt.

And he continued

They discuss..."the technique of the physical relationship". Who are they who need this instruction? Is "loss of appetite and potency" so widespread that information must be circulated as to means whereby desire may be artificially restored and simulated?*3

Roberts was a fascinating figure, a socialist, a pro-suffragist, a doctor who actually chose to work in the slums of the East End of London and became a widely-beloved figure there, a man who moved in intellectual and literary circles, had been a neighbour of Ellis, and one of whose publications was a selection from the writings of Edward Carpenter.** In this review he was talking about works which purported to provide fairly basic information about the sexual act for the newly or about to be married. Textbooks written for the profession had been mentioning for some 286 time that many barren marriages were the result of simple non- eonsummation, and that some of the couples concerned did not even realise that this was the case.*5 It is hard to see why these works should have merited Roberts's opprobrium, which evokes the imagery employed by the anonymous British Medical Journal reviewer of Psvchopathia Sexualis in

1902 (cited in Chapter 1).

One might have thought that Roberts, like many doctors, and particularly practising where he did, would inevitably have encountered in the course of his practice the kind of elementary sexual problems that books like these set out to assist, and would have realised the kind of suffering

that existed: non-consummated marriages, marriages which too many pregnancies too quickly eroded (indeed Roberts was an advocate of

legalising abortion on medical grounds for the overburdened working

mother),*5 problems of sexual anxiety. As one doctor with an East End

practice wrote to Stopes: "I am convinced that something must be done,

knowing the East End as I do."*7

Roberts did not, however, explicitly state what so many doctors alleged,

that it was a subject to be confined to the profession, that these matters

should be discussed only within the privacy of the consulting room by

trained doctors. This was the response of Lord Dawson to E F Griffith when

asked to contribute to the journal Marriage Hygiene:

There is too much written about this subject already, and it is getting out of proportion. It 6hould be handled by the medical profession or by societies in which doctors take a steady though quiet part. Contraception should be handled quietly by means of clinics, or, on the research side in laboratories.*® 287 an opinion which Dawson had already expressed to Marie Stopes in 1922:

I would have preferred that knowledge as to the applications of birth control should be conveyed by doctors to their patients rather than by books in general circulation... I fully admitted that doctors do not give the information and some of them are incapable of giving it. My chief reason for writing that sentence was to make doctors fulfil their proper role.AS*

Even so, of the books that were written by doctors during this period, at

least as many if not more seem to have been directed towards enlightening

the lay-public as educating the profession. That the profession was in need of education is not merely apparent from the letters received by

Stopes and the enormous sales of sex-advice literature, but from reviews of works intending to educate general practitioners and indeed the general

public in dealing with this murky topic, as has been shown by the citation

of reviews of the works of Stopes and Hutton in Chapter 4. As early as

1908 Arthur Cooper's Sex D isabilities in the Male was greeted with

enthusiasm by the Lancet:

A book for which a large number of practitioners, puzzled and harassed by a class of cases of extreme difficulty, may well be be grateful... [It] affords a pleasant comparison with certain turbid continental outpourings.50

The prevalence of the male functional disorders was recognised in works

written specifically for urologists, for example, an American work

published in Baltimore in 1933, prepared "Under the Auspices of the

American Urological Association", in which it was remarked that

Nocturnal emissions are an endless source of worry to many of our patients... Premature ejaculations should be grouped with those symptoms so commonly brought to the attention of urologists.

Prescriptions for treatment included 288

Massage to these structures, deep urethral Instillations, dilatations with sounds or dilators, physiotherapeutic procedures, intravenous administration of supportive agents, the prescribing of effective tonics.

though also "educational propaganda in the dissemination of knowledge

regarding sex hygiene." While believing that

The advent of the cysto-urethroscope and the pan-endoscope have opened up vistas undreamed of a quarter-century ago.®1

for the investigation of hitherto concealed lesions and pathological

developments deep within the male genitalia, the authors of this work had

to acknowledge

The neuroses and psychoses coincident with inflammatory conditions of the urethra in the male... not infrequently persist after the initial lesions are completely cured. and that there were not necessarily any "apparent correlations between the

clinical phenomena and the urethroscopic picture",®2 as a result of which

they concluded

Psychotherapy should be more seriously considered by urologists in treating such patients with otherwise negative findings.®3

In contrast to the invasive methods of treatment advocated by the

urological specialists, a Berlin neurologist writing during the 1920s on

the problems of "Psychically-caused impotence in men" considered that

All local treatment is superfluous, occasionally dangerous, and mostly harmful.®A

and ascribed any success these measures might achieve to the action of

suggestion. Siegfried Placzek attributed impotence itself to auto­

suggestion: he also remarked that

Imaginary obstacles of the mo6t varied description react on the capacity for coitus far more than is generally believed.®®

It can be seen therefore, that specialists in these very different

specialisms, from different countries and medical traditions, with very 289 different views on the causation of functional sexual disorders and the therapeutic means to be employed in their treatment, were nevertheless convinced that such problems were extremely prevalent, far more so than commonly supposed.

Twenty years after Cooper's book appeared, during the 1930s and 1940s the works of Kenneth Walker were conceded to be filling a • gapj in

1939, reviewing Sexual Disorders of the Male, the B ritish Medical Journal remarked

A book on this subject is very necessary for the general practitioner and the medical student... as a rule the practitioner is quite helpless and is driven to the prescription of either bromide or strychnine without even the confidence in his administrations which might make for good suggestions.se

It was functional disorders which accounted for the major percentage of male sexual difficulties presented in consultation, as shown by the fact

that though, in Walker's 1923 work Diseases of the Male Organs only the

short final chapter, almost a mere appendix, 16 pages out of 230, dealt

with the functional disorders,in 1930 his Male Disorders of Sex was

devoted almost exclusively to the functional disorders, and was republished

and revised several times during the 1930s and 1940s; later editions, with

the collaboration of E B Strauss, Physician to the Tavistock Clinic, under

the title Sexual Disorders of the Male.se

Walker was a genito-urinary surgeon, although he did not fit the usual

notion of the successful consultant specialist. Born in 1882, and therefore

almost a generation junior to Havelock E1116, he had a brilliant early

career, training at St Bartholomew's Hospital where he qualified in 1906

with the Conjoint diploma, graduating in medicine and surgery at Cambridge 290 in the following year, and becoming a Fellow of the Royal College of

Surgeons in 1908. He decided to specialise in genito-urinary surgery, and held a lectureship at Barts. However, in sp ite of the g litte rin g professional rewards accruing to him, he chose to spend three years practising in South America. He had a distinguished war-time career. On demobilisation he was appointed urological surgeon to the Royal Northern

Hospital as well as holding a post as consulting surgeon at Barts. He was very well thought of in this speciality, and according to an obituary tribute in the Lancet, "attended upon the highest in the land." However, as th is w riter also commented, he was "more of a philosopher than most surgeons are."®9 Far from dealing simply with the technical problems within his specialised field, Walker

became more and more interested in the personal and social problems of medical practice both for the doctor and the p atien t.60

According to the The Lancet, the "keynote of Walker’s teaching and the rule

of his practice" was that

Modern developments had given us... a thousand nostrums for the body, but no word of comfort for the suffering sp irit. Nevertheless, the distinction between mind and matter, between the psychological and the physical, between the functional and the organic, had broken down, there was no clear-cut division between the two, and the doctor could no longer afford to turn aside from the spiritual difficulties of his patients.61

He was Influenced by the thinking of Gurdjieff and Ouspensky, and also

wrote children's books. Noted for his casualness of appearance, he had

interests extending far beyond the usual boundaries of medicine, and

brought to the subject an eclectic, introspective and questioning approach,

which, however, was firmly rooted in a pragmatic sense of what would and

would not work in particular case6. It can be seen that although his

career described a very different pattern to that of Ellis, Walker was

equally a man of independent spirit, unwilling to rest on the security of 291 received ideas, a professional maverick unlike his own description of many surgeons

Preoccupied with the machinery of the body they forget about the existence of the mind and s p ir it.62

The development of Walker's ideas on male sexual problems can be clearly traced through his textbooks on the subject written for the profession. It has already been noted that most of his early, 1922, work Diseases of the

Male Organs was devoted to actual diseases and malformations of the male genitalia, with only a short final chapter on the functional disorders. By

1930 Walker had realised that these were sufficiently prevalent to justify a whole book on Male Disorders of Sex, concentrating on the functional ailments and stressing the psychosomatic aetiology of most of them.

However, perhaps not surprisingly in view of h is background in urological surgery, he quite often recommended physical treatment of various kinds which by the time he came to w rite the much revised version which appeared under the title Sexual Disorders of the Male in collaboration with

E B Strauss of the Tavistock Clinic, he had come to think worked, if at all, as "magic", by suggestion. Even in cases where there was some actual

lesion, he had concluded, the psychological attitude of the doctor was of paramount importance. He maintained the view that there was no treatment

for Impotence as such, only the successful treatment of individual patients.63

While he considered the causation of much male sexual dysfunction to lie

in prevailing social attitudes towards sex and sexual morality, he recognised that merely recommending throwing off old ways of thinking and admitting the power of the sexual drive was an over-simplistic solution. 292

To advise a course of action which would contravene deeply held moral and social beliefs, as opposed to those held unthinkingly, superficially, and as a matter of social convenience rather than true conviction, would be disastrous: recommending copulation to someone who believed fornication sinful would only create further problems, while failing to cure existing sexual neurosis.

The success of Walker's textbooks, which went into several editions and were widely praised in the medical press, suggests that his ideas must have obtained considerable currency among at least a part of the medical profession. His more popular books of sexual advice and theory disseminated them widely among the lay public. Yet in spite of Walker's prolific writing on the subject, it seems from the works of the 1970s and

1980s mentioned above, that each generation of doctors is faced once more with the problem of male functional disorder, and believes that this is new, a problem which has never been discussed before.

The functional and psycho-sexual disorders, however, as Walker made clear, are after all vague and hard to define, problems which cannot be simply treated by the routine prescription of drugs or devices. Perhaps in matters in which they felt more therapeutically competent, in which some material help could be given, doctors were better able to deal with problems bearing on sexual behaviour?

By the 1920s the medical profession was having to come to terms with the growing demand for, indeed growing use of, birth control. It has been shown by various historians that attempts to limit the size of families by 293 diverse means had been growing more widespread from about the 1870s.es

This had largely taken place outside the medical profession: the general feeling within it probably supported C H F Routh rather than H A Allbutt or G Drysdale, given that Allbutt was struck off the Medical Register for publishing The Wife's Handbook at a price which made it available to the poor. The impropriety of his action was remarked upon in the British

Medical Journal in 1889:

Mr H A Allbutt might have ventilated his views without let or hindrance from professional authority had he been contented to address them to medical men instead of to the public.ee although it is by no means clear that his reception would have been favourable had he done this. The subject itself was regarded as thoroughly reprehensible. In Routh's condemnation of contraception in the 1879 paper

"On the Moral and Physical Evils likely to follow if practices intended to act as Checks to Population be not strongly discouraged and condemned",®7 he was extremely careful to point out that he had been induced to open th is discussion only at the desire of "some distinguished members of the profession", claiming that he felt "the responsibility of having one's notions misconstrued", but was nevertheless "ready to fulfil a manly and generous part." In the course of his diatribe he stated

It is almost defilement even thus cursorily to allude to these vile practices... sexual fraudulency, conjugal onanism. but nevertheless the medical man's duty, in order to point out the dangers.

It seems clear that the very mention of the subject, even in outright condemnation, was regarded with suspicion.

It been noted for some while, by the early twentieth century, in connection with the general decline in family size, that doctors, like most middle- class professionals, had smaller than average families. This led to 294 suspicions that they were practising what they would not prescribe. In

1922 Marie Stopes circulated a questionnaire on contraceptive practices to members of the medical profession. One hundred and twenty-eight completed forms survive, also a few which were torn up or otherw ise defaced by indignant recipients.45,15* While this is clearly a statistically unsatisfactory sample, some useful and suggestive impressions may be gleaned from these returns. Doctors as much as their patients seemed to be still seeking for a satisfactory and reliable method. Several of the respondents claimed abstention for greater or lesser periods as the only method of deliberate limitation employed. One couple had abstained for fifteen years following the birth of their only child. None of them had any belief in one method as superior to the rest. Scepticism was expressed about the "safe period”:

What are "safe periods"?

Personally I do not recognise safe periods

Dare not tru s t this.

Since even today, in the light of the knowledge of the relationship between ovulation and m enstruation established by Ogino and Knaus in 1929, the safe period is still regarded as "Vatican roulette", it is not surprising that, using biblical injunctions and the Mosaic Law, it was found such an unsatisfactory method of restricting conceptions in the early 1920s. Whether by chance or design, however, most of the respondents to this survey had small families.

Norman Haire, who, besides having a Harley Street practice, was the Medical

Officer of the Walworth Women’s Welfare Centre, a birth control clinic set up shortly after Stopes' Mothers' Clinic, divided the profession into three camps on the subject of b irth control

(1) Those who are definitely in favour of birth control, (2) those who are definitely against it, and <3) those who hold a 295

middle posit ion.es*

With the paucity of available information about reliable methods, even doctors who believed in principle in artificial birth control, in general or

in particular cases, might have been reluctant to make specific recommendations. In response to Stopes1 survey, Sir Arbuthnot Lane, eminent surgeon and founder of the New Health Society, suggested that the people most likely to be able to answer questions about contraceptive practice were retail chemists:

I learned more from talking to the manager of Bell and Croydon than you can learn from corresponding with all the doctors and parsons in England.70

He may have been mistaken about the reception seekers for birth control information and devices met from retail chemists, at least those who prided themselves on running a respectable business: one of Stopes' correspondents who had sought to purchase birth control supplies from a

local chemist claimed that he was regarded "as if I were a libertine",71, and others described their reluctance to go to local retailers. One of

Stopes* medical correspondents found that

A number of patients however feel a diffidence about ordering the appliances in their native town.72

that is, presumably, even with medical authority to do so.

The association of birth control and sexual matters generally with retail chemists and worse still "rubbergoods shops” did not endear the topic to doctors, sensitive as they were to questions of professional dignity. In

the 1950 a rtic le by Alex Comfort on "Sex Education in the Medical

Curriculum", he cited the case of a couple seeking help for an

unconsummated marriage:

the husband had twice consulted his doctors, only to be told that the surgery was not a rubber goods shop.73 296

In 1936, in The Medical History of Contraception. Norman Himes remarked that

The subject of the commercial dissemination of contraceptive knowledge has received almost no study in recent years.

This could still be said; very little work has been done on this subject.

Commercial en terp rise was the main means by which the use of contraceptives was disseminated. Himes noted th at, even in 1936, by which time the medical profession was taking cognisance of the demand, "the traffic in the business must be very considerable", although he had no exact s ta tis tic s .75

While many people in the early twentieth century obtained means of birth control from retail chemists, rubbershops, barbershops and by mailorder through small advertisements in magazines, there was also an increasing demand upon the medical profession to supply advice on the limitation of births. Partly th is demand came from within the profession its e lf. The issue had some similarities to the problem of quack pamphlets on sex; it was felt that this subject, distasteful as it was, should be in doctors' hands and not exploited for commercial gain. However, besides possibly genuine fears concerning the health hazards of the devices used, there was what can only be described as a moral panic about the permissibility of any use of artificial methods of birth control. While this applied mainly to their use for reasons of economic pressure within the family (or simple selfishness and sensual indulgence as this was often described), there was also doubt about the use of artificial methods even when pregnancy was contraindicated for medical reasons. 297

This attitude was allied to eugenic concerns about the population, its threatened decline and its quality. A number of the medical respondents to

Stopes' questionnaire on birth control, and her other correspondents, expressed a feeling that while birth control might be permissible and even necessary in the case of the over-burdened working-class woman, it was a very different matter among the middle classes, with their notoriously small families. One, although he did not use birth control himself, had prescribed quinine pessaries in cases of economic hardship and for maternal health,76 and another thought

Your ideas are splendid: I have considerable experience of the poor "prolific" wife.77

One remarked "knowing the East End as I do", he was convinced that

"something must be done",7® but another, while perceiving a need among the poor, was concerned about the selfishness of the better-off.7® Some, while favouring contraception in "special individual cases", "suitable cases",

"lots of cases in which it should be recommended", were opposed to

"indiscriminate practice of control",or any suggestion that birth control should be "popularly broadcast."®0 Similarly, Harry Roberts believed that the legalisation of abortion under conditions favouring the overworked poor mother exhausted from multiple pregnancies would be justified by humane considerations, while dissociating himself from Stella Browne's stance that it should be available to all women as an essential prerequisite of their emancipation.®1 This idea of the "deserving" and the

"selfish" still lingers in debates around abortion although birth control is no longer considered in these terms.

In July 1923 The P ractitio n er brought out a special issue on Contraception, presumably in the wake of the furore caused by the work of Marie Stopes, 298 since the timing of this production coincided with her widely publicised libel suit against Dr Halliday Sutherland. A number of the papers referred, though not by name, to Stopes, in their allusions to

popular handbooks... by women with no medical qualification. 03

the promulgation of birth control methods to every boy and girl who had half-a-crown to spend at a bookseller s.03

non-medical "doctors" who write erotic treatises on birth control conveying misleading information in a highly stimulating form.0*

The general opinion of the eminent physicians who contributed to this volume was that birth control resembled a toxic drug which ought to be meted out, if employed at all, by the doctor only in medically suitable cases

Marie Stopes' libel suit against him), claimed that

Abstinence from sexual relationships is the method as a rule advised by the medical profession.00

Several of the contributors claimed that the use of birth control inhibited eventual fertility, as well as causing general illhealth and an erosion of the proper feelings between man and wife. No distinction was made between particular methods in causing such deleterious effects, although these opinions were given with the solemn weight of scientific authority.

Occasionally the concession was made that the safe period might be recommended, but u n til the work of Ogino and Knaus, establishing a safe period was a matter of individual guesswork or applying the injunctions of

Leviticus; and no-one seemed to recognise that the safe period would vary from woman to woman according to the length of her menstrual cycle. 299

These articles were to be found side by side with papers by E C Pritchard and Norman Haire, who, unlike their colleagues, had actually had the advantage of seeing numbers of patients who had been using contraceptives, over a period of time, without ill-effects. Both of them took a view of the problem as being that of deciding on the best and safest method. Pritchard actually stated

I do not believe it is possible or desirable to suppress knowledge of any kind among an intelligent and educated people; ignorance of sex-physiology is not a virtue.

He also said, contradicting the heavy guns of his colleagues

I have myself known married people to employ this method Cuse of the check pessary] for many years without apparent detriment of health or alienation of affections, further it has not interfered with subsequent conception.®6

Pritchard also admitted that he had given up prejudices and preconceptions of his own on the matter, and that since his remarks to the National Birth

Rate Commission of 1918-1920, observation in actual clinical experience had changed his opinions to the ones expressed in the Practitioner article.

This contribution by Pritchard was the more remarkable as in the same year he wrote to Marie Stopes describing himself as "a very half-hearted adherent to the b irth control movement. I am ra th e r s ittin g on the hedge."

He attributed his caution in the matter to a need to avoid "givling] offence to susceptible fellow workers" tin the child welfare movement].®7

His contribution in the Practitioner, however, if only by contrast with the others, would seem to designate him as very much on the side of birth control.

Time was on Pritchard's and H aire's side. Ten years la te r The P ractitio n er ran another special Birth Control issue. In thi6 there was precisely one anti-birth control paper, "The Ethics of Birth Control" by E A Barton, and 300 in the introduction to the issue by Lord Horder this was specifically singled out as being

a little inconsistent in some places, as, indeed, it is certainly opposed to known facts in others.se

Barton asserted that

at my clinic... it frequently happened that on asking a mother the number of her family she was unable to tell me, she had lo st count.09 a remark that strikes one as improbable in the extreme, not to say patronising. Letters to Stopes from mothers of large families stated in great detail the number of their pregnancies, live births, miscarriages, stillbirths, and children died young. This was in spite of the obvious low level of literacy apparent in the letters. The following comments from the letters from poor women to Stopes, following her article in John Bull (not published by her in Mother England) are representative:

I've had no less than 16 children (2 sets of twins) and I have 14 children living now (my first set of twins being premature 22 years ago). I have 9 under 14 and 5 over 16 years.

I am the mother of 6 children, 5 living, oldest 10 years of age, baby 18 months.

I'm the mother of 10 now and eight living out of them, the oldest 18 and the youngest 4 months.

15 children, 12 born alive but only 10 livelng now. There is only 12 months between some of them, two years is the longest.90

These women were also very specific about the ages of their children, their dates of birth, and their illnesses. It is of course possible that the women visiting E A Barton's clinic were intimidated into inarticulacy by their surroundings and his air of authority: the medical sociologist Anne

Oakley recounts an amusing anecdote of an occurrence observed at an ante­ natal clinic. The doctor remarked to a patient that she had a girl and a boy already: two girls, she replied; oh yes, he said, checking on her record 301

card, girls.91 If this could happen during the 1970s it is not surprising

that Barton’s poor mothers were confused.

The rest of the papers in the Practitioner 1933 issue were however full of

practical advice, and arguments for the benefits of birth control, and the explosion of myths such as that it caused sterility (couples who used birth control often delayed attempts at conception until their fertility had declined somewhat with age, but their relative infertility was not a direct consequence of employing contraceptives). However, when Himes declared in The Medical History of Contraception that there was a

"diffusion downward of contraceptive knowledge, a democratising process",92 he took a view of the role of the medical profession in the dissemination of useful information on the limitation of births which it is hard to substantiate. A J Cronin's Andrew Manson, doctor-hero of the best-selling novel The Citadel, was, one hopes, atypical. He considered the local minister's tentative enquiries about contraception

in a cold distaste. He said carefully: "Don't you re a lise th at there are people with a q u arter of your stipend who would give their right hand to have children. What did you get married for?" His anger rose to a sudden white heat. "Get out—quick—you—you dirty little man of God!"®3

Cronin would appear to have approved this general stance: there is no indication of any contrast between the minister and, for example, the over­ burdened mothers who presumably existed in this fictional Welsh mining village. Norman Haire's depiction (in More Medical Views on Birth Control.

1928) of the kind of scene that took place when "a married couple consult a doctor who is opposed to birth control" rather resembles Cronin's fictional scene. In the course of the little drama recreated by Haire the doctor fulminates 302

You cannot thwart nature with impunity! Birth Control is an affront to Nature and an offence against her laws!! and the scene concludes

Exeunt the married couple with a very proper sense of guilt, while the doctor puts the three guineas in his pocket with the righteous air of one who has done his duty nobly and well.9*

This might be supposed an exaggeration for Haire's own polemic purposes, if it were not so similar to the reports made by Stopes's correspondents.

These had many grim tales to tell respecting their attempts to seek advice on birth control from their doctors. A number reported outright refusal to give such advice

He refused to advise me on the subject, perhaps because he was uncertain himself.

He refused me the necessary advice.

We endeavoured to obtain the assistance from our doctor but were politely told that prevention was not in accordance with the medical profession.

He flatly refused to enter into any discussion on birth control, and in addition said a few choice words of his own, with the re su lt th at my wife came away very much upset.

My doctor is the oldfashioned sort who warned me not to use preventives you know the so rt.

There is unfortunately the opposition of a class of medical men—one such in our own Instance has refused the assistance indicated in Wise Parenthood.99 and others told of receiving dire warnings:

We have been told by a doctor that the use of preventive methods may endanger the probability of children when we do want them.99

Others, according to those who had consulted them, held vague or contradictory ideas about methods of birth control and their advice could not be relied on:

My doctor knows nothing or very little on the subject. 303

I have spoken to three different doctors, and they appear to have little knowledge of the subject, or are prejudiced, or in too great hurry to be bothered.

Two family doctors are willing to accept fees for the statement that they do not know [when the safe period falls]!

I have asked two family doctors for information in respect to an auxiliary preventive but have had no satisfactory answer.

I have found that a medical man is useless in this respect.

I feel that the opinion of a single medical man who is not an expert places or leaves one in a very doubtful position.

He knew of the sheath, but the small pessary seemed unfamiliar to him. Anyhow he gave me no help, save that he suggested union only during the time least likely to have consequences.®7

Some doctors were sufficiently aware of their deficiencies in this field to advise their patients to write to Stopes:

My doctor gave me your address.

I have been recommended by my doctor to write to you to enquire the name of the "satisfactory cap" mentioned in your article in the British Medical Journal of Nov 19th.

I am directed to write to you through Dr P— whose treatment I am under.®®

Much more common, however, were cases in which a medical man advised his patients that they should have no more children, without either stating whether childbirth or coitus as such was the deleterious exertion to be avoided, or making any mention of birth control. This euphemistic approach is enshrined in the piece of medical folklore recounting the tale of the girl who is told by her doctor, following a severe attack of rheumatic fever, that marriage will kill her. She is discovered many years later the happily unmarried mother of a flourishing family.®® Stopes's correspondence contained many letters requesting advice on birth control, with explanations like the following for their reasons for seeking it:

My doctor told me my wife should not have any more children. 304

Quite naturally I asked him to give me such information as would enable me to carry out his instructions [that his wife was not to have any more children for several years] but the answers were so vague that I was left after the interview in much the same position as before it took place.

Our doctor advised me strongly at this time that it would be very unwise for her to have any more children at this time on account of her health, he did not, however, give me any practical advice.

After my wife's last confinement our doctor definitely said "No more" but left us entirely in the dark as to how this was to be achieved.

Our doctor has told my wife that it will not be good for her to have any more children.

The doctor strongly advises her to have no more babies but does not give her any idea how he suggests thi6 should be accomplished.

The doctor told my wife after her second child was born [they had five] not to have any more children, but not giving her any good advice, only that there are plenty of "preventatives" on the market.

Our doctor said it would be better if she had no more children, But he did not tell us how to prevent them.100

Although the editor of The Practitioner acknowledged in his introduction in

1923 that the works of Stopes (unnamed but id en tifiab le as such) contained for the medical profession "practical information of which they had hitherto been ignorant" they also, according to him, included "a great deal of which they might legitimately disapprove."101 This presumably meant her advocacy of birth control, since neither the British Medical Journal, or the

Lancet, which had greeted Married Love with a certain degree of enthusiasm, had taken any notice whatsoever of the publication of Wise

Parenthood. Doctors themselves wrote in great numbers to Stopes for advice on how to advise their patients, and for permission to attend classes at her clinic on contraceptive methods.102 Few doctors, however, seem to have been prepared to come out in print expressing gratitude for the work she 305 was doing, though Norman Haire did pay tribute to her in the introduction to Some More Medical Views on Birth Control

Marie Stopes is one of the most distinguished women of our age. Brilliantly clever, of world-wide repute as a palaeontologist, she, more than anyone else—except, perhaps, Margaret Sanger— has made it possible for decent people to take part in an open discussion of birth control. Without her campaign of publicity it would have been impossible for medical men and women to speak and write frankly on the subject as we can today.103

While recognising her importance as a publicist for the cause they shared, he had no hesitation in taking issue with certain of her specific recommendations, and moreover, was careful to point out that she was a doctor of philosophy and science, not medicine.

Sir Maurice Abbot-Anderson, who claimed in the 1923 issue of The

Practitioner that

as regards the effective application of this instrument Cthe check pessary], it is only necessary to the doctor to endeavour for himself to fix one of these appliances in position. Unless expert, this is no easy matter.1 OA was presumably not among the doctors, who, recognising their own deficiencies in the area, were flocking to Stopes's clinics to undergo instruction. His attitude was probably far from unique: a Dr G, writing to

Stopes in 1935, remarked that

I do not myself see that the apparatus to be provided for the doctors for the business is too complicated... It is I think only the excuses made by men who do not want the job and th is I expect is mainly from ignorance.106

Such attitudes, however they originated, may explain why nearly twenty years after Abbot-Anderson's diatribe, when knowledge about contraceptives was far more widespread and available from reputable sources, some doctors still advised their female patients about methods without even making a physical examination, let alone fitting them, or so E F Griffith maintained:

When are doctors going to discontinue the habit of advising women about contraception without examining them, or of fitting 306

them ineffectively when they do examtine] them? They would never treat an eye condition so haphazardly. Why do they, therefore, the sex organs?106

At least these doctors reprehended by Griffith were doing something towards advising their patients about birth control, however inadequate: in

1954 H C McLaren wrote to the British Medical Journal deprecating the continuing practice of "family physicians" telling women or their husbands that further pregnancies would be life-endangering, and laying down

a ban on further conception... not supported by detailed instruction on contraceptive technique. The woman or her husband is simply given a grim warning and left to work out some method of b irth control.107

In Love Marriage and the Family, published in 1957, Kenneth Walker similarly observed that

There are many gynaecologists and gynaecological hospital clinics which show no in te re st at a ll in contraceptive measures and dislike being bothered with enquiries on the subject. Many women patients have reported that although they have been warned at a hospital clinic that it would be very unwise for them to become pregnant again, no advice is given them as to how this catastrophe can be avoided.106

Certainly doctors received no training in birth control methods as part of th e ir medical school curriculum .103 In the same year, 1922, that she surveyed the contraceptive practices of the medical profession, Stopes also inquired of medical schools what teaching, if any, they provided on the su b ject.110 None of them did, in sp ite of the assertion to the contrary of one M 0 Callaghan in reply to an enquiry about an article he had contributed to Health and Strength under the pseudonym "Physiologist". He claimed that sex hygiene and related matters were being taught and discussed throughout the medical curriculum, so that

the young student or p ractitio n er now knows much more than the older generation did.111 307

He then specified that only by submitting to a full medical training could his questioner (Stopes* secretary on her behalf) expect to become fully informed on these matters. Callaghan does not seem to have been a doctor: if at any time a medical student he must have failed to qualify, as the name does not appear in the Medical Directory.

Certainly the response of Stopes* correspondents to her work bears out the contention that this was an area in which medical education was deficient: apart from those who applied in large numbers for courses of instruction at her clinics, or wrote for information on the suppliers of the appliances she approved, many also commented explicitly on this lacuna in their training. One doctor gave an account of receiving instruction on birth control only in the context of a lecture on medical jurisprudence, juxtaposed to a warning against criminal abortion. He added that

I learnt much more on the subject in the Army, but have often thought that it is more than a mistake that we medical men are compelled to find such knowledge through the worst possible channels instead of being given the facts and claims on both sides of the question.112

This perhaps alluded to information gleaned in the course of dealing with the prevention and treatment of venereal diseases among the troops.

Another doctor declared that even these unsavoury contacts with the subject had been missing from his medical education:

During the whole of my University training for my profession the subject of control of conception was never mentioned.113 while many must have found with another of her correspondents that

until I read your book Contraception I was hopelessly ignorant of all matters pertaining to that valuable but neglected branch of medicine.114- 308

Doctors were not exempt from such current superstitions as the belief in the existence of one defective pessary or condom in every packet,11® which one doctor was said to have stated was in accordance with an Act of

Parliament.116 Few of them, it is to be hoped, were quite so misinformed as one T W Hill, to whom Stopes wrote in reproach for publishing a book in which it was, erroneously, stated that the law prohibited the spread of birth, control knowledge and advice. Her letter was dated 1933, that is, three years after an Ministry of Health circular made it possible for birth control to be prescribed by local government Mother and Child Welfare

Clinics, however much this permissive measure was circumscribed by local prejudices, and however initially furtive the attitude of the Ministry to this provision (it was only due to Stopes and other birth control activists that the measure received any publicity).117

Birth control was an issue which involved all sorts of social and emotional aspects affecting doctors' responses to the subject; one was alleged to have stated that

the! could understand a man overmastered by desire raping a woman; but could not understand any man being so low and vicious as deliberately to make use of any anti-conceptional method.110 though it is not clear in context whether this was stated as a professional opinion during a consultation. There was considerable ambivalence as to whether contraception should be a medical concern at all.

Linda Gordon has discussed the way birth control was the subject of medical takeover in the USA, but this was a question of who should run clinics and control their services: she points out that individuals encountering individual doctors doubtless met ranges of response not dissimilar to those experienced by Stopes' British correspondents.11* 309

While birth control might be dismissed as not part of the appropriate sphere of the doctor, other matters to do with fertility and reproduction did impinge more obviously upon medical expertise. Sterility, for example, was seen as very much falling within the medical purlieu. How did doctors react to couples coming to them asking for assistance in ending their barrenness?

According to Stopes* correspondents most doctors regarded this as the wife's "fault" and their reaction was to suggest that she undergo surgery.

This may not have been of much value even in cases where the woman was accountable for the failure to conceive, it could be argued that surgery was seldom the answer and in some cases, because of the formation of adhesions in the abdominal cavity, would have been likely to make conception even less probable. The male factor in a sterile marriage, however, could be discovered readily by non-invasive means, examining his semen to see if it were potent.

However, many doctors seem to have failed to d iffe re n tia te between sexual potency and fertility in the man: Kenneth Walker remarked

Confusion on this subject is very common amongst laymen, and occasionally even doctors fail to distinguish in their minds between the conditions.120 although he was perhaps optimistic in stating

The doctor... no longer starts with the assumption that the wife is to blame. He knows that in a certain number of cases it is the infertility of the husband that is responsible for his wife's failure to conceive, and that for the proper solution of the problem an examination of both is required.121

Many doctors, it would appear, were unwilling to accept that responsibility

for barrenness might lie with the husband or be the result of factors affecting both members of the couple. This neglect of the male in 310 questions of sterility still continues, according to a report in The Times.

20 April 1988, "Anguish of the Sterile Husbands" on a paper given by Dr R

Snowden at a medical conference at Leeds, in which he stated

Few men were given advice and many were encouraged to deny their infertility. "In some cases wives pretend that it is they who are infertile as a smoke-screen for the inadequacies of th e ir husbands."122

Some doctors seem not to have been aware of the possibility of performing investigations upon semen: a Mr B wrote to Stopes in 1931 that only a fte r several operations on his wife did the doctor test his semen, and had not even known that this was possible.123 Similarly a Mr HHB declared

The doctor at my suggestion has made a sperm test... I get the impression that he is a little out of his depth in this m atter.12‘* and one woman reported that her husband had seen two doctors neither of whom had suggesting examining his semen: the husband, although said to object to going to a doctor for a sperm test, was

strongly of the opinion that medical men know little about sex troubles.125

According to Mrs AMG, to whom Stopes had suggested that a test should be performed on her husband's semen,

the doctor is quite convinced that is is my fault I cannot have a baby. He says that very occasionally it is the man's fault but in the great majority of cases the female is to blame... £ it was] her duty to undergo the operation first and then if nothing happened he would te s t him six months afterw ards.126

Some doctors were unwilling to do anything to assist infertile couples:

We had a talk with our own doctor but he appeared unwilling to speak about it so we did not pursue the matter further.

I then asked the doctor about the matter I am now submitting to you but he was not at all disposed to give me information.

Both my wife and myself have at different times seen our doctors and they say there is no apparent reason for it.127 311

While in some cases it might have been the man's own reluctance to

undergo even so non-invasive an investigation which influenced the doctor's decision, only one of Stopes' correspondents actually admitted "I feel shy

to ask a doctor to examine my seminal fluid" and even he claimed "but with

you I feel different."123 Others in fact had tried to get their doctors to

perform the examination, but as the remarks cited above indicate, most doctors were either ignorant of this test or reluctant to perform it.

This may have been because they had little idea of what to do if the man's

sperm count did turn out to be below par: one woman wrote to Stopes

My husband was told to go for a six months holiday without me, eat oysters and drink stout and probably things would come rig h t.129

This sounds like a folk remedy rather than the latest in scientific medical

thinking. Another man's "well-known London specialist" had in fact tested his seminal fluid and found very few live spermatozoa, but

gave neither counsel or advice and made no suggestion as to how lack of fertility might be treated.130

Confusion between the two separate capacities of potency and fertility was

also demonstrated by doctors' notions on the subject of vasectomy:

correspondents writing to the Eugenics Society for information about the

operation reported such attitudes as the following:

He was horrified... it was obvious to me that he was entirely unfamiliar with the modern method... he would not have it that the man would not be affected in some very serious way.131

The family doctor Insists that all sorts of mental and physical upset will follow a double vasotomy in a man of twenty-one.132

and Stopes* correspondents had similar experiences: one said that his doctor alleged that vasectomy would make him "a sexless, or useless."133 312

However, even when doctors did not come out with such misleading statements, it was a common thing to find

my own medical man unable to help me in this matter.13it

I have broached the matter of sterilisation to both my Panel Doctor and the local Tuberculosis Officer but on each occasion nothing resulted from the conversation.13S

neither [of two doctors] know about vasectomy, although young and up to date are entirely ignorant.

He would not give me any information as he does not approve of st er ilisat ion.13e

In contrast to the notion that vasectomy weakened sexual power, there was also current the notion that it was a viable treatment for sexual weakness. Members of the lay public believed it might act as a cure for masturbation or a prophylactic against debilitating sexual excesses:

I am a married man of 53 years & I find that the after-effects of going with my wife always weakens me & I believe that if I was sterilised I would not want this desire & I would benefit from th is & become stro n g er.137

In Male Disorders of Sex Kenneth Walker mentioned that b i-la te ra l vaso­ ligature had been recommended as a procedure and performed in "severe and unresponsive" cases of nocturnal emissions; but as he pointed out

Whilst it cuts off the secretion coming from the testicles, tit] does not affect that supplied by the prostate and vesiculae, so that emissions may still persist after it has been carried o u t.130

However, he did believe th at the "treatm ent of sexual weakness by vaso­ ligature restCed] on a more solid experimental basis" than the use of testicular grafting to cure sexual abnormality.139 The procedure was performed as a "rejuvenation" operation in the belief that an increase in the production of the sex hormone by the interstitial cells of the testicles could be brought about by putting out of action their other 313

function, spermatogenesis. Following the work of Steinach and his pupil

Lichtenstern

the operation was soon exploited by uncritical and unprincipled medical men who saw in it a harvest in the sunshine provided by the lay press. The inevitable reaction followed. Vaso-ligature has come to be regarded as a "stunt" by the greater part of the profession, and a method of treatment that used properly might have taken its place in therapeutics has fallen into disrepute.140

Walker actually surveyed the value of the operation from this aspect, and

was of the opinion, on the basis of this investigation, that

When it is carried out with success its action is by suggestion rather than through any physical change produced in the organs of sex.141

By the time he came to write Sexual Disorders in the Male he was even

less inclined to ascribe any organic value to the operation:

Any operation on the genital organs specifically performed with the intention of increasing potency is likely to have a good re s u lt.142

The reasons behind the misconceptions which existed about male

reproductive capacity and its relationship to sexual potency are delineated

in Naomi P feffer's a rtic le "The Hidden Pathology of the Male Reproductive

System."143 In this she has argued that, rather as Havelock Ellis saw the

male sexual Impulse as a simple matter, the medical profession has been

inclined to suppose that male reproductive systems "operate with

mechanical ease and efficiency with few detrimental effects",144 a view

she suggests has even influenced feminists in their discussions of female

reproductive pathology. She shows how language describing the male organs

implies that their natural state is one of uncomplicated health:

Consider the following chapter headings in a book entitled Systemic Pathology (Payling Wright and Symmers, 1966): Chapter 26: The Male Reproductive System Chapter 27: Gynaecological Pathology14* 314 and that whereas there exists a plethora of negative descriptions pertaining to the female reproductive system there are no equivalents for discussing disorders of the male organs. As she states

Implicit in the medical definitions and unchallenged by feminists, is the assumption that the male reproductive system is structurally efficient, and that its functions proceed smoothly... whilst medicine highlights the potential for reproductive disorders in women, it makes them invisible in men.1 AS

In further support of her argument, she adduces the way that when discussing the quality of semen, only positive terms are used, and that the measure of fertility is expressed as numbers of sound and motile sperm, not as a percentage of defective spermatozoa.

The fact is, she suggests, that "far less is known about the male reproductive system than about the female",1A7 research having concentrated on the reproductive biology of the female. As a result,

"reproductive structure and function in the male can be represented in simple terms."1 Ae The corollary of this is that there is no medical speciality specifically concerned with the male reproductive system; any trouble with the male reproductive organs is deal with by urologists. She points out that there is no evidence that they are any "more sympathetic or understanding of sexual problems than gynaecologists."1

She illustrates the way writers on male fertility have characterised the sperm: "individual, independent actors" with "independent purposeful existence"; and suggests that the way sperm are judged in a laboratory rests on "the assumption that only a nicely-shaped, active and purposeful sperm can fertilise an egg."150 It is perhaps not a coincidence that the qualities attributed to the healthy sperm are very similar to those 315 supposed to belong to the "normal” man, although, as Mary Ellman has wittily remarked, far from resembling individualistic heroes, spermatozoa

"move in jostling masses, swarming out on signal like a crowd of commuters

from the 5:15."1B1

As a result of the attitudes to the male reproductive system which Pfeffer describes, it is perhaps not to be wondered at that

treatment for male fertility is not based upon clearly understood principles, but on empirical treatment, such as vitamins and hormones, which are used on a "try it and see" basis and acknowledged to be ineffective,1®2

Her evidence for this is an article in a textbook on The Infertile Couple

published in 1980. The neglect of the male contribution to in f e r tility • is borne out by the Times report cited above:

Men who cannot become fathers are the forgotten figures on the sidelines of artificial reproduction procedures... Infertile husbands were often neglected while the wives received intensive treatment and support from doctors and scientists... "Often it is the husbands who suffer most".1®3

Problems to do with sex, it has been demonstrated, have tended to meet a

barrier of doctors’ reluctance and ignorance when brought into the

consulting room. This would appear to be still more the case, even today,

for problems specific to male patients. Where one might perhaps expect a

degree of sympathy, even empathy, from doctors who are, themselves, mainly

men, what one seems to find is a shrinking away from the entire subject,

and its complete neglect in their professional education. The works of

Cooper and Walker in their day went into several editions, yet one finds

the continual re-emergence of the theme that male sexual dysfunction is

terra incognita^ a new problem facing contemporary doctors. It cannot be 316 that only now are men bringing this problem to their doctors, when Cooper,

Walker and their reviewers, urologists and neurologists, all of these proclaimed male functional disorders to be among the most common problems seen in the consulting room. The next chapter considers the attitudes of the male patient with a sexual problem to the prospect of consulting a doctor, and what happened if he did get himself into the doctor's surgery. 317

Chapter Seven: Notes

1. The Lancet. 1889, i, 1042

2. Pym, Rev T W, "The Need of Education in Questions of Sex", B ritish Medical Journal. 1931, ii, 186-190, ref to 186

3. BMJ, 1935, ii, 511

4. Fairburn, C, Dickson, M G and Greenwood, J, Sexual Problems and Their Management. Churchill Livingstone, Edinburgh, 1983, Introduction by J Bancroft, p i

5. Freedman, G R, Sexual Medicine. Churchill Livingstone, Edinburgh, 1983, p 107

6. The Lancet. 1988, i, 31

7. The Lancet. 1939, ii, 164

8. see Chapter 1, note 91

9. Ellis, Havelock, Psychology of Sex; The Biology of Sex—The Sexual Impulse in Youth—Sexual Devlation--The Erotic Symbolisms—Homosexuality— Marriage—The Art of Love. William Heinemann Medical Books Ltd, London, 1933, 12th impression 1948, p v

10. ibid. p vi *

11. ibid. p 2

12. BMJ, 1985, ii, 1747

13. The Lancet. 1917, i, 913

14. Haire, Norman, Hymen, or the Future of Marriage. E P Dutton and Co, New York, 1928, p 11

15. BMJ, 1932, i, 864

16. BMJ, 1933, i, 1057

17. Haire, op c it. p 80

18. Marie C Stopes papers in the Department of Manuscripts, British Library, "Physicians: British Isles", Add Mss 58570

19. BMJ, 1944, i, 540

20. The Lancet. 1949, i. 744

21. Comfort, Alex, "Sex Education in the Medical Curriculum", International Journal of Sexology. 1950, Vol 3 no 3, pp 175-177

22. The Lancet. 1957, i, 832 318

23. Press reports germane to this issue are to found among the archives of the Birth Control Campaign held in the Contemporary Medical Archives Centre at the Wellcome In s titu te for the History of Medicine, CMAC: SA/BCC/E.42 "Press-cuttings: sex education” c. 1972-74

24. Journal of the Roval College of General P ractitioners. 1979, Vol 29, p 440, review by Malcolm Ay le t t

25. cited in the The Lancet. 1933, i, 1348

26. Allen, Clifford, Textbook of Psvchosexual Disorders. Oxford University Press, London, 1962, p ix

27. Comfort, op cit

28. BMJ, 1958, ii, 1415

29. Ellis, op cit. p 5

30. BMJ, 1918,i, 510, The Lancet. 1918, ii 886

31. Hall, Ruth, Marie Stopes: A Biography. Andre Deutsch, London, 197-7, Chapter 13 "The Great Trial"*, pp 213-241; Box, Muriel , The T rial of Dr Stopes. Femina Books, London, 1967, contains a fu ll tran scrip t of the proceedings

32. Marie C Stopes papers in the Contemporary Medical Archives Centre at the Wellcome In s titu te for the History of Medicine, correspondence "ML- DRS", CMAC: PP/MCS/A.294 V, A.246 SLW (Lt RAMC)

33. ibid. "ML-DRS" and le tte rs from medical men filed among "ML-GEN", CMAC/PP/MCS/A.280 AFR, A.205 Lt Col MLP, A.287 DSR; BL Add Mss 58571 RMcDL

34. CMAC: PP/MCS/A.265

35. BL Add Mss 58568 BCB; CMAC: PP/MCS/A.267 F, A.278 RML, A.282 M, A.283 JHM, A.260 SvSB, A.256 ECB, A.87 VLF

36. "Fielding, Michael" (Newfield, Maurice pseud). Parenthood: Design or Accident: a Manual of Birth -Control. Labour Publishing Co, London, 1928, 4th edition, Williams and Norgate, 1944, p 197

37. Walker, Kenneth M, Male Disorders of Sex.Jonathan Cape, London, 1930, p 65

38. Walker, Kenneth M, Marriage: A book for the married and about to be married. Seeker and Warburg ior the British Social Hygiene Council, London, 1951, pp 33-37

39. Walker, Kenneth, Love. Marriage and the Family. Odhams Press Ltd, London, 1957, pp 75-76

40. L etter from W J Logie, BMJ. 1932, i, 959

41. L etter from H M Walker and A Morris Jones, BMJ. 1934, i i 88 319

42. Hutton, Lady Isabel, Memories of a Doctor in War and Peace. Heinemann, London, 1960, p 215

43. Roberts, Harry, a group review of works of sexual advice, entitled "Sex, Marriage, and Love" in The New Statesman. 12th January 1935, pp 36- 37; included in E F Griffith's press-cutting scrapbook, CMAC: PP/EFG/A.40. A somewhat different version of this article appears under the title "The Sex Obsession" in Roberts, Harry, Euthanasia and other aspects of life and death. Constable and Co, London, 1936

44. see Stamp, W, Doctor Himself: An unorthodox biography of Harry Roberts. Hamish Hamilton, London, 1949, and ob itu aries in The Lancet. 1946, ii 774-775, and BMJ, 1946, ii, 797, 878

45. Dulberg, Joseph, S terile Marriages: The various causes which produce childlessness and how to combat them: including chapters on sexual hygiene of married life: normal and abnormal menstruation: the menopause (change of life): miscarriage: signs of pregnancy: sterility, male and female: impotence and its various causes: twilight sleep, and other allied subjects. T Werner Laurie, London, [1920], p 15; Jackson, Margaret H, Malleson, Joan, Stallworthy, John and Walker, Kenneth M, Problems of Fertility in General Practice. Hamish Hamilton Medical Books, London, 1948, Chapter 2 "Coital Problems", pp 8-21

46. Browne, F W Stella, Ludovici, A M, and Roberts, Harry, Abortion (3 essavs). G Allen and Unwin, London 1935

47. BL Add Mss 58569, CELL

48. E F Griffith papers in the Contemporary Medical Archives Centre at the Wellcome Institute for the History of Medicine, CMAC: PP/EFG/A.5 "Marriage Hygiene: EFG's correspondence", 1935. Griffith was for a while the English editor of this journal which was published from Bombay

49. BL Add Mss 59567

50. The Lancet. 1908, ii, 1373

51. History of Urology, prepared under the Auspices of the American Urological Association, Williams and Wilkins Co, Baltimore, 1933; Walther, H W E, "Neuroses and Functional Disorders of the Gen it o-urinary Tract", Vol II, pp 38-39

52. ibid. p 43

53. ibid. p 44

54. Placzek, Dr Siegfried, The Sexual Life of Man: An Outline for Students. Doctors and Lawyers, tran slated by L S Morgan, John Bale, Sons and Danielsson, London, 1931, p 137

55. ibid. p 136

56. BMJ, 1939, ii, 608

57. Walker, Kenneth M, Diseases of the Male Organs. London, 1922 320

58. Walker, Kenneth M, Male Disorders of Sex. Jonathan Cape, London, 1930; Walker, Kenneth M, Sex Difficulties of the Male: a new and completely revised edition. Jonathan Cape, London, 1934 (described in a notice in the BMJ. 1934, i, 431, as "really a second edition of Male Disorders of Sex."): Walker, Kenneth and Strauss, Eric B, Sexual Disorders of the Male. Hamish Hamilton Medical Books, London, 1939, are a ll very su b stan tially the same book issued with revisions and changes of title

59. The Lancet. 1966, i, 300

60. Ross, Sir J P, and Lefanu, W R, Lives of the Fellows of the Royal College of Surgeons, 1965-1973. Pitman Medical, London, 1981, p 377-378

61. The Lancet. 1966, i, 300

62. Walker, Kenneth M, The Circle of Life: A Search for an A ttitude to Pain. Disease. Old Age and Death. Jonathan Cape, London, 1942, p 123

63. Walker, Male Disorders. Chapter IV, "Treatment of Impotence", pp 48-69

64. ibid. pp 110

65. Banks, J A, Prosperity and Parenthood: A Study of Family Planning among the Victorian Middle Classes. Rout ledge and Paul, London, 1954; McLaren, Angus, Birth Control in Nineteenth Century England. Croom Helm, London 1978, p 116 for s ta tis tic s of population decline; Soloway, Richard A, Birth Control and the Population Question in England. 1870-1930. University of North Carolina Press, Chapel H ill and London, 1982

66. BMJ, 1889,ii, 88

67. Routh, C H F, On the Moral and Physical Evils likely to follow if practices intended to act as Checks to Population be not strongly discouraged and condemned, originally given as a paper before the Obstetrical section of the British Medical Association, and first published in the Medical Press and Circular. October 1878, reprinted from the same, London, 1879

68. BL Add Mss 58562

69. Haire, Norman, (ed), Some More Medical Views on Birth Control. Cecil Palmer, London, 1928, p 12; th is book was w ritten as a counterblast to Merchant, Sir James, Medical Views on Birth Control. M Hopklnson and Co, London, 1926, a work containing exclusively the views of doctors opposed to birth control; my own copy of Haire's work is actually inscribed to Marchant by Haire, "with compliments".

70. BL Add Mss 58566

71. CMAC: PP/MCS/A.204 KAP

72. CMAC: PP/MCS/A.266 FE

73. Comfort, op cit 321

74. Himes, Norman E, The Medical History of Contraception. Williams and Wilkins Co, Baltimore, 1936, p 327

75. ibid. p 326

76. BL Add Mss 58562 "MD"

77. ibid. Dr A

78. BL Add Mss 58569 CELL

79. ibid. EMcK

80. BL Add Mss 58568 EBT; CMAC: PP/MCS/A.263 WED, A.266 FE

81. Browne et al, op cit. cited in Brookes, Barbara, Abortion in England. 1900-1967. Croom Helm, London, 1988

82. The P ractitioner. July 1923; Introduction, "Contraception", p 2

83. ibid; Whitehouse, Beckwith, "The Problem of Birth Control", pp 43-48, re f to p 44

84. ibid: Haire, Norman, "Contraceptive Technique: A Consideration of 1400 Cases", pp 74-90, ref to p 90. It is interesting to note how fervently Haire dissociates himself from Stopes, given that his paper is one of the two which do not u tte rly condemn any notion of a r tif ic ia l b irth control.

85. ibid: Mcllroy, A Louise, "The Harmful Effects of Artificial Contraceptive Methods", pp 25-35, ref to p 27

86. ibid: Pritchard, Eric C, "Birth Control", pp 56-61, refs to pp 56, 61

87. BL Add Mss 58569

88. The P ractitioner. 1933, no 783, Vol 131, Lord Horder, "Birth Control: an Introduction", pp 221-227, re f to p 222

89. ibid, Barton, E A, "The Ethics of Birth Control", pp 239-246, ref to p 242

90. CMAC: PP/MCS/A.322 Mrs RD, A.322 ED, A.322 SD, A.322 JD

91. Oakley, Anne, Telling the Truth about Jerusalem: A Collection of Essavs and Poems. Basil Blackwell, Oxford, 1987, p 76

92. Himes, op c it. p 330

93. Cronin, A J, The Citadel. Victor Gollancz Ltd, London, 1937, cheap edition, 1942, p 143

94. Haire, Some More Medical Views, p 25

95. CMAC: PP/MCS/A.246 HPW, A.49 AGC, A. 196 HAP, A.238 FEW, A.212 HCR, A.57 JC 322

96. CMAC: PP/MCS/A.121 JH

97. CMAC: PP/MCS/A,48 AHRB, A.90 JAF, A. 127 Sgt HJH, A. 197 LBP, A. 131 RPH, A.62 C-R, A.213 FR

98. CMAC: PP/MCS/A.76 JE, A.220 JMS, A. 198 CP

99. The Lancet. 1988, i, 1217

100. CMAC: PP/MCS/A. 198 EWP, A.74 D, A.94 GF, A. 109 HRG, A. 167 CSMcC, A. 187 Lt-Cdr RN, A.221 GR, A.210 JR

101. The Practitioner. 1923, "Introduction", p 2

102. A very large proportion of the correspondence to be found in both the Stopes Collection in the Contemporary Medical Archives Centre, in the section "ML-DRS", CMAC: PP/MCS/A.256-296, and among the Stopes papers in the British Library Department of Manuscripts, Add Mss 58568-58571, "Physicians, British Isles, General", consists of routine requests of this nature.

103. Haire, Some More Medical Views, p 18

104. The Practitioner. 1923, Abbot-Anderson, Sir Maurice, "Birth Control as seen by an Open Mind", p 12

105. CMAC: PP/MCS/A.269 Dr 0

106. Griffith papers, CMAC: PP/EFG/A.34, "Letters to Press and Reviews", draft of letter to BMJ. 8th June 1944

107. BMJ, 1954, i, 817

108. Walker, Love. Marriage and the Family, p 172

109. Hutton, Memories of a Doctor, pp

110. Stopes' correspondence with medical schools, 1922, is to be found in BL Add Mss 58569

111. CMAC: PP/MCS/A. 123 M 0 Callaghan to H J Bagge (Stopes' secretary)

112. CMAC: PP/MCS/A.283 M

113. CMAC: PP/MCS/A.287 R

114. CMAC: PP/MCS/A.274 J

115. CMAC: PP/MCS/A.278 RML

116. CMAC: PP/MCS/A.64 A

117. CMAC: PP/MCS/A.273 TWH; he was the author of The Health of England. 1933, which Stopes otherwise commended. According to the Medical Directory he was a Medical Officer of Health, which makes this misapprehension of his all the more remarkable. For information about the Ministry of Health 323 circular Memo 153/MOW and its im plications for the b irth control movement see Hall, R, Marie Stopes. p 269, and Leathard, Audrey, The Fight for Family Planning. Macmillan. London, 1980, pp 48-50.

118. CMAC: PP/MCS/A. 146 EYJ

119. Gordon, Linda, "The P o litics of Birth Control, 1920-1940: The Impact of Professionals", in Women and Health: The Politics of Sex in Medicine. edited by E Fee, pp 151-175

120. Walker. Male Disorders, p 24

121. ibid, p 141

122. The Times. London. 1988, 20th April

123. CMAC: PP/MCS/A. 36 1B

124. CMAC: PP/MCS/A. 38 1HHB

125. CMAC: PP/MCS/A. 127 Mrs MH

126. CMAC: PP/MCS/A. 112 Mrs AMG

127. CMAC: PP/MCS/A. 152 JK, A.232 CT, A.242 RLW

128. CMAC: PP/MCS/A. 132 HPM

129. CMAC: PP/MCS/A. 155 Mrs EML

130. CMAC: PP/MCS/A.299 Rev JD

131. Eugenics Society archives in the Contemporary Medical Archives Centre, Wellcome In s titu te for the History of Medicine, CMAC: SA/EUG/D.211, "Voluntary Sterilisation: Enquiries about operation" SFC

132. CMAC: SA/EUG/D.212 F

133. CMAC: PP/MCS/A.77 E

134. CMAC: SA/EUG/D.210

135. CMAC: SA/EUG/D.211, 0

136. CMAC: PP/MCS/A.28 CEB,A.48 TB

137. CMAC: SA/EUG/C.181, see also CMAC: PP/MCS/A.220 WS

138. Walker, Male Disorders, p 121

139. ibid. p 76

140. ibid. p 77

141. ibid. p 78 324

142. Walker and Strauss, Sexual Disorders, p 137

143. P feffer, Naomi, "The Hidden Pathology of the Male Reproductive System", in Homans, Hilary, (ed), The Sexual Politics of Reproduction. Gower, Aldershot Hants, 1985, pp 30-44

144. ibid. p 30

145. ibid. p 33

146. ibid. pp 31-32

147. ibid. p 33

148. ibid. p 34

149. ibid. p 36

150. ibid. p 40

151. Ellmann, Mary, Thinking About Women. Macmillan, London 1968, pp 13-14

152. Pfeffer, op cit. p 42

153. The Times. London, 1988, 20th April 325

Chapter Eight

"I fear mv doctor would laugh if consulted”

It has been demonstrated that, while there was a prevalent assumption that doctors were uniquely well-informed about sexual matters, in fact they were both ignorant and subject to various misconceptions to do with the subject, even when it was not a question of vague and hard to define functional disorders. However, whatever the actual deficiencies of medical knowledge in this sphere, it might be supposed that the lay person believed doctors to be particularly well-informed and competent. It may be argued that in spite of their deficiencies of knowledge in this matter, doctors had, as a result of their training, a sympathy with the sufferers which might stand them in good stead in the absence of any tried and tested treatment for their problems. According to the British Medical

Journal in 1935,

No walk in life engenders more sympathy with human frailty than does the practice of medicine.1

However, in its review of E llis's Psychology of Sex a couple of years earlier, the British Medical Journal had cited, without contradiction, and with the implication of agreement, Ellis's belief that

Where sexual anomalies are concerned, patients complain that the practitioner has shown no comprehension of their sexual difficulties or peculiarities, either brushing them aside or treating them as vicious.2

It was perhaps because of the growing availability of sexual information and the increasing possibility of publicly discussing such matters, that in

1949 the Lancet was prepared to maintain

Patients often complain that, of all the problems they bring to the doctor, those arising out of sexual abnormality or sexual ignorance find the least satisfactory reception.3 326

This chapter looks at the encounter between male patients and doctors over the sexual problems of the former.

Many men did not consult their doctors at alL In the 1850s Samuel La'mert, in Self-Preservation (and since he had a flourishing if rather dubious practice dealing with sexual problems, he presumably had some knowledge of the subject) commented that the family physician "is precisely the la st man to be consulted or confided with the secret",-4 and nearly a hundred years later Alex Comfort remarked

The patient with a specifically sexual problem is very often willing to discuss it with anyone except his own medical adviser.5 an opinion confirmed by J B W rathall Rowe's le tte r to the B ritish Medical

Journal in 1944, statin g

My experience has been that people will ask their next-door neighbours or their friends or the chemist about these matters, anyone in fact but the only person whose knowledge is sufficiently thorough [sic] to explain things properly.6

Recent work by the o ral h isto rian Steve Humphries on sexual practices before World War II includes the reminiscences of the proprietor of a rubbergoods shop in the provinces.7 The somewhat idyllic view presented of the shop as a haven for the sexually ignorant, a provider of a necessary social service, should perhaps be regarded with a little scepticism. Most of the profits were surely made from the sales of "remedies" for

"debility" and abort if acient preparations of dubious efficacy. However it is also possible that just as the back street abortionist was perhaps unjustly maligned as filthy and rapacious, these shops may not always have been the squalid and swindling dens of iniquity and pornography they were 327 usually made out to be. In her research into "The Woman Abortionist" for which she interviewed women in Holloway Prison on that account, Woodside discovered that they resembled not at all the stereotype of the filthy and greedy exploiter, and although they took payment, were living in such poor circumstances that they were hardly getting rich as a result of their criminal activities. Their important social function was demonstrated by the support they received from their neighbours during their trial and imprisonment, and from the other prisoners.® It is therefore possible that many individuals found in rubber-goods shops a place in which they could ask for the help they hesitated to seek from their doctors, and that they received there advice at least as helpful as they might have obtained from a more orthodox source.

Some doctors themselves might note

the fact remains that young people often find it easier to talk to a strange doctor. They are shy with the one who knows a ll about them.® just as La'mert had referred to confessions the family doctor never heard owing to the patients' reluctance to take such sensitive topics to him. But th is was not necessarily taken by doctors as a reflectio n on medical competence per se in the field. Such a seeking of advice from alternative, even stigmatised sources may have been perceived by the actual sufferers as a preferable course of action to consulting a doctor perceived as being of a different and superior social class, and less provocative of anxiety.

James McCormick, Professor of Community Health at T rinity College Dublin, has commented that

Those disadvantaged in terms of status and social class still feel the need to behave in ways that will be approved by their doctors, because lacking that approval their prospect of gaining their objectives is substantially diminished. This need to be approved extends beyond behaviour to matters of dress and 328

personal cleanliness.10

Approaching one's doctor for help on such a tabooed subject as sex, would therefore be particularly productive of anxiety given the stigma surrounding it. And as McCormick has pointed out, this

need to be thought well of by the doctor is not confined to those whose status or class is different, and it stems, in part at least, from the supplicant posture.11

Even for men who might have regarded themselves as the social equals or even superiors of doctors the strain of consulting one with a sexual difficulty was considerable. In Enduring Passion. Marie Stopes wrote of the positive epidemic of premature ejaculation response to her works had disclosed among "British men of the professional and upper classes." She added that

often they are the very men who would never be suspected of any lack of normal sex capacity even by their medical attendants.12

Stopes' correspondents who wrote of their reluctance to consult a doctor or of the humiliation they had encountered in doing so included admirals, high-ranking army officers, and members of the "twice-born" Indian Civil

Service. These were not men likely to be easily intimidated or to automatically feel any sense of inferiority. The impression gained is that they had found going over the top or governing the Empire a far less harrowing and taxing experience than exposing a less than ideal sex-life to their medical practitioners.

There was certainly a general reluctance to consult doctors on problems relating to sexuality: the great majority of Marie Stopes' correspondents made no mention at all of having consulted, or even considering consulting, a doctor. They had been moved to write to Stopes by reading her books or through having heard of her work at the time of the Sutherland libel suit. 329

Married Love or her other works had revealed to them that the difficulties and problems they had been encountering in sexual matters did not need to be endured with resignation. Having been told that their troubles were not either the natural course of events or a peculiar and unique personal failing, but were common difficulties and capable of remedy, they wrote to the author of this revelation for further assistance. It may be argued, however, that the group writing to Stopes was a self-selecting sample attracted to her writings precisely because of her lack of unquestioning belief in the contemporary medical profession, and that they were not by any means representative, nor did their opinions constitute a valid criticism upon the way doctors dealt with sexual problems.

However, Kenneth Walker described "the young man with a disorder of sex" as

probably amongst the mo6t miserable of all the patients that a doctor is called upon to treat. The consciousness of sexual impotence brings with it a feeling of intense humiliation. The sufferer stands degraded not only in his own eyes but in the eyes of the world; he is robbed of every illusion and left without hope or purpose.13 and the reluctance disclosed by Stopes* correspondents to even contemplate consulting their doctor suggests that the very prospect was attended with this consciousness of personal unworthiness. As Walker also stated

A man suffering from impotence is deeply ashamed and wounded. Loss of virility seems to him a disgrace. He feels that he is inferior to his fellows... In such circumstances the efforts of his medical advisers are handicapped from the start.1*

Writers on medical sociology have shown how the doctor-pat lent encounter is an emotionally fraught one for the patient even when the consultation does not involve so degrading an ailment. Irving Zola, in a study of "non- compliance" has remarked that 330

the doc tor-pat lent encounter is perhaps the most anxiety-laden of all lay-expert consultations. Rarely does someone go for a re-affirmation of a good state. At best, they are told that they are indeed in good health and thus a previous worry should be dismissed. More likely they learn that a particular problem is not as serious as they feared... Seeking a doctor's help is a relatively infrequent response to symptoms... Delay is the statistical norm. Fear and anxiety the psychological ones.1®

Some of Stopes* correspondents, aware of something wrong prior to encountering her works, had contemplated consulting a doctor but had been unable to bring themselves to that point. It does not seem to have been the expense aspect which deterred them, since this was seldom mentioned:

"I am not trying to avoid the payment of a doctor's fee"16 was an almost unique comment, though one or two considered that they could not afford' a specialist or that, although competence was essential, any specialist would have to be "inexpensive."17 and another declared

Of course I had to give up trying to right myself as I could not afford it.16

Others remarked bitterly on doctors' willingness to take fees for giving unhelpful advice and regarded doctors as financially exploiting their patients: in the previous chapter the plaints of those who consulted doctors and paid fees to be told that the doctor did not know of any reliable method of birth control have been cited. One man wrote to Stopes giving a detailed account of what he perceived as a racket being operated by several doctors whom he encountered in the process of seeking a remedy for the sterility of his marriage, passing him from one to another for various tests and treatments, all of them, in his view, in collusion to extract the maximum profit from a desperate patient.19 Panel patients sometimes seemed to feel that with this humble status they could not expect to take up a doctor's valuable time with their sexual problems: 331

I am only a panel patient and as you are doubtless aware doctors have neither the time nor in many cases the inclination to advise on such m atters.

I have a panel doctor but... should not care to approach him in th is m atter.20

However, even those who were accustomed to pay doctors for th e ir services displayed a good deal of hesitation over consulting a medical practitioner upon sexual matters. The expense involved in consulting a registered medical practitioner does not seem to have constituted a prime consideration among Stopes' correspondents for writing to her, and many expressed a willingness to pay her for advice or a personal consultation.

Some people did not have a regular doctor to consult:

We have only resided in CX] since February last, and as we have not yet become acquainted with any local doctor I thought it best to get in touch with you direct.21

1 have a panel doctor but have never had occasion to visit him.

1 have not seen any doctor for six months.

I shrink from the idea of calling on the nearest practitioner.22 and from the tenor of their letters many of those who wrote to Stopes would seem not to have had one single doctor to whom they went for all their problems, since they wrote not of "my" or "our" doctor but of "a" or

"any" or "a local" doctor whom they might consult but would rather not.

This whole correspondence rather tends to contradict the cosy image of by­ gone medical practice with its reassuring figure of the friendly family doctor, sympathetically concerned for his patients and with an intimate knowledge of their lives, to whom they turned in every crieis.

Many men simply felt a shyness about raising the matter at all:

I cannot for the life of me ask this question of any doctor out here [the Malay States] as have never seen one about that (or about any disease) so am extremely shy about it. 332

These are things about which one cannot ask a doctor.

They would probably put me off by some incomprehensible jargon (you know what doctors are!) or else take a pitying attitude at my lack of knowledge.

I have never had the courage to speak to my doctor about it.

It is so difficult to see a doctor without being misunderstood.

I write as I have not got the nerve to interview a doctor on so intimate a point.

Neither I nor she—feel able to talk about it even to a doctor.

When the doctor examined me I would not tell him the trouble.

I have tried to muster sufficient courage to go to a local doctor but somehow I cannot do it.23

Some voiced doubts as to whether their doctor would give them a sympathetic hearing:

I hesitate to ask my family doctor owing to his orthodox ideas.

It is no good asking a doctor

Not being sure of sympathetic hearing I do not care to consult our own doctor.

One is somewhat chary of applying to medical men and the like for advice on such a delicate point.

I am not sure that a doctor would appreciate my difficulty.2-*

Others specifically stated their reasons for writing to Stopes rather than seeking a doctor's advice: in some cases her sex seems to have led them to regard her with expectations of sympathy:

I would rather confide in a woman like you after reading your book than any man... somehow I feel could not t e ll any doctor what I feel I could tell you...I would much rather meet you than one of your doctors.

The idea of explaining my difficulty to another man is somehow very distasteful.25 although at least one felt some hesitation upon precisely this account:

I feel somehow more at ease, writing to you, in spite of your sex, than discussing the matter with the usual medical men.2S 333

The sympathy which they perceived either from the fact of her sex or from the evidence of her books, and in apparent contrast to their expectations of doctors, was an important factor.

It is only the extraordinarily sympathetic manner in which you have dealt with these subjects that makes me explain what I would never dream of telling an ordinary practitioner.

I prefer to write to you... than consult my own medical practitioner both because I feel that you will deal with the matter more sympathetically and on account of other reasons which I need not go into here.27

At least one correspondent gave the following reason:

I feel it would somehow be less difficult to unburden myself to you, a total stranger, than to someone I know slightly.2® while others expressed some prejudice against doctors and their advice:

I ask you this question in preference to our... doctor because I have most faith in your teachings.

I don't want to address you—as doctoi— as I don't want—a doctor's advice.

I know that Cmy wife] is very much prejudiced against doctors and not without reason. I myself think many of them not the equals of experienced old women.2®

Some writers were explicitly cynical about the capabilities of doctors to deal with such sensitive matters:

There are things about which one cannot ask a doctor, even if the doctor knew anything about it when asked.

I prefer to seek your specialised advice.

I do not feel like going to my medical man on the matter, and am afraid he (and others) know little of these subjects.

The usual medical practitioners... seldom have any practical advice to give.30

Some correspondents, however, were not so much generally disillusioned with doctors as dubious about the competence of those immediately available to them to help in such delicate cases: 334

I shrink from the idea of calling on the nearest practitioner, who might be dense and lacking in understanding.

Our present doctor is good, but he is not the man to whom I could turn in a case of sexual trouble.

I could not think of consulting any of our local doctors on this particular question, as I am of the opinion that they are nearly as ignorant as most other people on the subject.

I would go to a local doctor about the matter if I had any confidence in them.31

This was sometimes put down to the particular geographical location in which the writer found himself. Some men purported to believe, very likely with some justice, that they were residing somewhere where they could not expect to find a doctor in touch with the latest sexological developments:

As my medical practitioners are Army doctors, who have probably little knowledge of the subject, and as I do not know of a suitable civilian practitioner to go to in Shanghai...

I have no confidence whatever in any local practitioner here for it is only a remote country district.

There is not one doctor in this country town whom I could honestly expect sound advice from.

I live right away up in the north east of Scotland where doctors who give advice on sexual matters are hard to find.

We are now living right out in the wilds of Cornwall... neither of us care to mention the subject to our doctor—and we very much doubt if he would be able to enlighten us if we did.32

This desire not to consult local doctors was sometimes motivated by fears of gossip and social embarrassment:

I do not like to consult any of the doctors here as it is a small place and talkative.

They do not feel that they could consult a doctor, partly because they do not wish to go to a local one.

I live in a very small place in India and I do not care to go to our only doctor because everyone knows everyone else.33 335

It was not merely the ‘'local" practitioners who were scorned, for the above reasons, but the "ordinary" doctor in general (which may have had to do with the feelings men had, according to Walker as cited above, about the rarity and intractability of sexual disorders)

I do not believe the ordinary medical man knows enough to help.

The ordinary medical man, not having made any special study of this matter is unable to give any useful advice.

What I would never dream of telling an ordinary practitioner.

I feel that my difficulty is not one that can be dealt with by an ordinary doctor.

I despair of getting anything helpful from a regular family physician.

The ordinary medical man is not likely to be helpful.

I do not imagine the average practitioner is likely to be much help.

I do not put any confidence, I am afraid, in the ordinary practitio n er on th is m atter.

I consider the Doctor [MCS] a 100 years ahead of her time and if I consulted an ordinary doctor he would not approach the difficulty in the same way.

I want of course to put myself only in competent hands,and am doubtful whether the ordinary family doctor could achieve the desired result.

The ordinary family physician is not much use.3*

While all these reasons for not consulting the doctors available to them may have been deliberate or unconscious mechanisms for not doing so, a corollary to the distrust of the average practitioner was a belief that somewhere there was a doctor who was capable to dealing with sexual difficulties to the patient's satisfaction. Stopes' enquirers were sometimes seeking a doctor whose thinking was along the lines they found and responded to in her works: 336

I wish to seek the advice of a physician. At the same time I realise that all medical men do not hold your views.

Some doctor who approved of your work would command my confidence.

I should be most grateful if you could put me in the way of a medical man in London to whom I could go with some chance of gaining understanding treatment and possibly some such help as you prescribe.3S but others were simply in search of the name of a "qualified" specialist:

I should be glad if you would be good enough to recommend me to someone who could give me the advice I require.

I would be very grateful if you would advise me as to whom I could consult about it.

If you would be so kind as to recommend me the name of an inexpensive but really competent (male) specialist on sexual questions.

I would rather apply to a doctor I knew dealt with such complaints.

Cl] am anxious to go straight to a specialist who can advise treatm ent.

What I should like is a quiet talk with someone who is able to advise sympathetically and who specialises in these matters.

I am... w riting to you to ask if you would recommend to me an up-to-date doctor... I should be very obliged if you would recommend a good doctor, if possible within easy reach.

I am quite ignorant of the name of any specialist in such m atters.36

The desire to take their problems to a stranger may indeed have been one reason for people to avoid consulting their usual practitioner. One couple, suffering from problems in their marriage, had actually been to see a doctor "in a strange town", where "he looked on us as a newly married couple."37 However, from the correspondence cited above it would seem that those who wrote to Stopes were perhaps even more concerned about the incapacity of the medical practitioners available to them to deal 337 authoritatively with sexual problems. It was not just Stopes and her correspondents who were critical of the way the medical profession handled sexual matters. The criticisms of the sexual ignorance of the medical profession by Havelock Ellis, Kenneth Walker, Norman Haire, E F Griffith, and Alex Comfort have already been cited in the previous chapter, and substantiated by the comments found in reviews of their works and in correspondence, in the Lancet and British Medical Journal. Private comments about the profession and the lacunae within its education made to Stopes by doctors have also been quoted.

Even if a man got himself into the consulting room he still faced problems. Millais Culpin, Professor of Medical and Industrial Psychology at the London School of Hygiene, in the opening talk in a discussion of

"Sexual Problems in General Practice" averred

The first sex problem in practice, he said, was the practitioner himself. Just as there were practitioners temperamentally incapable of evaluating psycho-neurotic symptoms and who therefore never heard them, there were practitioners who, by their attitude, warned off any attempt to seek their advice on sex difficulties. Any doctor who was unable to ask a question about details of sex life without lowering his voice had better leave the whole subject alone. A practitioner who said he had never met a case of sexual perversion confessed to a personal inhibition.3®

In the course of the same meeting of the Chelsea Clinical Society, Dr

Joseph Geogehan stated that

The doctor got to know of these things through being more than a mere doctor... The best thing that the general practitioner could do was to be kind, and to send the patient to somebody who understood the subject better.3®

This depiction of the way the average general practitioner deflected, perhaps not even consciously, enquiries to do with sexual difficulties, is confirmed by the reminiscences of Dr George Day, who much later became

Consultant Physician to the Samaritans. Describing himself as a young 338 doctor in the later 1920s and early 1930s, he wrote

When I spotted the conversation veering in that direction I went cold and adroitly steered it elsewhere. I was both intolerant and ignorant. My medical education had not prepared me for that sort of thing.AO

Alex Comfort's comment that patients "suffered in 6ilence... for fear of a reproof or a rebuff",-41 was prefigured in the comment in the Lancet during the previous year that

Hostility towards such problems ["of sexual abnormality or sexual ignorance"], and to those who bring them, remains sufficiently common among doctors to prevent the patient from discussing them with the one person who might be expected to provide informed advice.-42

(certain similarities of phraseology suggest that the note from which this extract has been taken was also by Comfort, though published anonymously).

It is not clear, from the statements of Stopes* correspondents cited so far, if any of them had in fact ever got so far as the doctor's consulting room and been deterred by his chilly and off-putting manner from mentioning their sexual difficulties.

Apart from expressing their disillusionment with or lack of faith in the medical profession, the men who wrote to Stopes also recounted discouraging experiences they had had in the consulting room. They deplored the receptions they had met with, substantiating the fears of those who described their hesitation in even seeking help for that reason.

Some doctors were said to have displayed a perfunctoriness and lack of interest from which their patients shrank

They only asked a few perfunctory questions.

My doctor seems to treat the matter very lightly.

Before marriage I consulted a doctor who treated the subject with such indifference that it rather disgusted me. 339

I was informed that there was nothing that could be done for me, and that he advised me not to marry.

CHel treated the matter rather lightly I thought.*3

Other doctors were not perceived as sympathetic, particularly (as mentioned above), in contrast to Stopes herself:

I didn't feel the atmosphere sympathetic.

I always feel you have the great sympathy and "understandingM which the average medical man lacks.**

Numbers of men complained that they had actually been treated with scorn by the medical men they consulted. While it is possible that they were misinterpreting what might have been attempts to reassure the patient by not taking his problem too seriously, the following comments suggest that this rather hearty approach was not appreciated:

He quite missed my point and treated the matter as a joke and the only result was we had a row, and I shouldn't care to face the experience again. CA Commander in the Royal Navy]

Doctors whom he has consulted have made light of the whole thing.

Both went to no pains to hide their scorn for me and my complaint.

I consulted the best doctor available and explained the whole position to him. He examined me and appeared to laugh at my fears.CA mining engineer employed in India]

I have approached my own doctor, an Edinburgh man, but he either seems not to know anything about it, or rather laugh6 at it.

Questions on the subject are apt to receive rather heavy-handed replies from the General Practitioner.

He even ridiculed the idea of my thinking I was impotent... I went to another and he only laughed at me.

The ordinary doctor smiles and makes a joke of difficulties in the way I mean... I went to the old Family Doctor... but he made light of it.*s 340

Even if doctors were not actually offensive to their patients when dealing with these matters, it would seem from the experience of Stopes's readers that they were seldom at all helpful:

He is not at all helpful.

I consulted a local doctor on the subject but obtained absolutely no advice of any use whatsoever from him.

Doctors don't seem to consider the matter much.

I have found that a medical man is useless in this respect.

Certain sexual difficulties, which an ordinary Medical Practitioner has been unable Ctol overcome.

You are quite right in saying men cannot get any help from their own family medical advisers.

I have consulted my doctor and he says he is unable to help me.*e and according to the men who had futilely consulted them, as ignorant or more so than themselves:

I decided he probably knew less about marriage than I did.

I am convinced he does not know why, neither has he studied the subject as you have.

The surgeon who operated on me... although very free with me in conversation, could not give me any idea what caused this trouble, and I can see that they are not at all clear on this subject.

The Army doctors are worse than useless... I must have real expert advice.

Your remarks re how little most medical men know of your subject are astoundingly true.

I have already consulted our family doctor, himself a married man, without gaining light or guidance obviously for the reason that he had none to give.

I have already consulted my own doctor on the subject but he seems to know practically nothing about it.47 341

It can be seen, therefore, that there is little in the Stopes correspondence to substantiate boasts such as the following made in the

Lancet in 1901:

Most of what CEllis] has written will be familiar to medical men because of the confidences that have been reposed in them.*4® or the assumptions underlying practitioners' complaints about

the undesirability of undermining a patient's confidence in the ability of the family doctor, who, best of all, knows the constitution of his own patients.*®

It might have been hoped that even if doctors had no particular remedies

to provide to sexual sufferers, they could have provided sympathetic listening, reassurance, and created such confidence in their healihg abilities that even their ineffectual bromides and tonics would have had a potent placebo effect. This does not seem to have been the case at all: in a review of Walker and Strauss, Sexual Disorders of the Male, in 1939 it was remarked:

as a rule the practitioner is quite helpless and is driven to the administration of either bromide or strychnine without even the confidence in his administrations which might make for good suggestion.150

Stopes' correspondents were bitter about their actual experience of doctors' lack of sympathy and inability to inspire confidence in their

therapeutic competence. Some doctors were inclined to dismiss the matter with references to "nature" or the healing qualities of time;

All the doctor can say is that is natural.

My doctor merely suggested waiting on developments.

He went to a doctor who told him he was quite normal.

[Doctors] say there is no apparent reason for it.

My medical men... both think these things should be "left to nature", say I shall "find out in due course". 342

Doctor says don't worry... condition natural... some men start chasing flappers and small boys.

As to this state of semi-impotency he says time is a great healer.®1

Some doctors did at least make some kind of physical examination, although not all of them bothered:

I consulted a doctor but, I was not examined physically.®2 but it is clear that a reassurance about their general state of fitness did not set these men's minds at rest at all:

Although he examined me most thoroughly he was unable to find anything wrong with me.

Two reliable doctors... pronounce me perfect organically.

Three different doctors, all of whom seem to confine their examination to the physical condition and all with the 6ame finding, i.e. "physically sound" but none offer any real advice on the point at issue.

My panel doctor... after examination could find nothing wrong with me. He suggested I might be a little "rundown" in general health.

I was assured that I was quite normal, except for my nervous system which was in a bad state... marriage would be beneficial.

Surgeon said "that I was quite normal and that there was nothing to fear."

Three doctors... are all perfectly satisfied with my condition and health.®3

If the doctor bothered to prescribe at all, the medicaments given, according to the recipients, were perfectly useless. The very variety of things given suggests the therapeutic desperation of the medical men concerned, although few men underwent so poly-pharmaceutical a course of treatment as the following, to such little avail:

They prescribed various things. I took Easton Syrup steadily for six months. I took 5000 tabloids of Hormotone at the rate of three a day and I have taken Iron Jelloids and all kinds of tonics and nothing seems to have any effect at all. (A mining 343

engineer serving in India]15,4

In some cases tonic preparations were prescribed:

One suggested the use of strychnine, which I have taken for some months.

The ordinary doctor seems satisfied with giving a tonic and saying it will probably be alright.

All I could get out of him was a tonic for nerves, phosphates or something I think, but it made no difference.

On each occasion he prescribed a tonic, which after long trial made no difference.

The only thing he did was to prescribe me a tonic.®® or sometimes a bromide:

No <4) prescribed bromide saying my husband's sexual centres were too excitable—no benefit.

I have consulted my physician who prescribed bromide but the effect was so slight as to be negligible.®6

Some (possibly the more up-to-date ones) employed "glands" and "hormones" but with no greater success:

The Gland Specialist said that I could be cured by injections of prostate gland extract, I paid 3 gns for the interview and 12 injections cost me 6 gns.

He also gave me a prescription for Hormones and Chalones.

He treated me with "hormones" without much success it seems.®7

It can be seen that injections were administered by some doctors, but to little effect:

All he did... was prescribe injections of "Testogan" with which I carefully followed his instructions but without any result.

I told him my case and was under his treatment for about 2 months, during which time he gave me about a dozen Injections and a tonic.®6 though these seemed to have been combined with more usual medication.

Some correspondents mentioned apparently patent preparations given them by doctors, for example, "Testogan", mentioned above, also 344

Two of them gave me pills (aphrodyne [sic]) [?or a mishearing of aphrodisiac] to take but they did not seem to have any effect at all.

[I] consulted a Harley Street specialist who advised me to take Homoir [? sic] a French preparation.69

A surprising number of cases did not mention what kind of medicine it was they were given, whether it had been meant to have a tonic effect or a calming one: all they recorded was that the medicine did not have the desired effect:

They simply give me medicine which does no good.

He gave me medicines and pills and treatment but to no effect.

He ordered me a course of phisic [sic] and tablets for about 8 weeks... th is is some time ago but I am s t i l l the same.

I have been to a doctor who gave me tablets and am sorry to say that they have not done the necessary.

The medicine doctors gave me did not help at all.60

Other doctors, in what seems to have been therapeutic desperation, recommended circumcision:

The doctor told me that I had an unusually tight foreskin, that it would have been better if I had been circumcised but that he did not think it was really necessary, although he added that it would of course be better.

I was circumcised as I wanted to leave nothing unturned.

One said circumcision may cure him.61

One doctor at least recommended cytoscopic examination, though the man to whom this was suggested remarked that "the doctors are not agreed",6a and another was recommended to see a certain Dr W

for the "Tapelights"[sic] the idea being to see inwardly.63 though what the presumed benefit of this was is not clear. Norman Haire was reported to have given one man electrical treatment but "without effect",6* and another was prescribed 345

Electrical treatment to lower part of back and crutch—no b en efit* *

The same patient had also been recommended, by another doctor, to try

Cold hip baths morning and evening—result failure.

Another of the doctors seen by the same man made the suggestion

to make the attempt not on retiring at night but in the morning or daytime, and that [his wife] should take the position on top.

If the patient were unmarried the doctor might have the solution to his problems in advocating marriage:

When I was 21 I remember mentioning some little trouble to my doctor and he told me "marriage was all I needed."

They both suggested that I should marry again and said that they were convinced that if I did so I would immediately see an improvement.

He has consulted 2 or 3 doctors... one said circumcision may cure him and another said marriage might.

I have consulted my doctors...and have been told... that I ought to get married.

I was told that marriage would be beneficial.

They advised me to get married.66

This of course not a feasible diagnostic option when dealing with the

problems of married men, which might indeed have only arisen as a result of marriage.

Surprisingly few doctors seem to have recommended "having a woman" to

their patients as a solution to their problems (however, see also Chapter

3 and the idea that fornication was both preferable to masturbation and a

cure for it). The response of Stopes' correspondents to those who did

suggests that they were not a group of patients seeking medical authority

for fornication: one patient would seem to have been after this; 346

A doctor in Egypt and one in Stockholm both said I should do so soon Chave connection] or I should go mad but English doctors have always gravely warned me against women unless I marry... any English doctors I have approached on the subject have given me rather evasive advice.67 but others were frankly appalled that their medical man should suggest any such thing:

So I went to see a doctor... and in the end he told me the only thing that would do any good was to take N ature's remedy, well, that is all very well for him to say so, but 1 could not bring myself to do so, for you see, I have the pleasure of being engaged to one of the best of girls.

He refused to tell me any remedy, except to say, jokingly I think, you'd better get a woman.

I have asked for information from a doctor of my own sex, who merely advised me to spend a night with a prostitute.

My doctor says find someone else, just what most men would, but I thank god I am in this not like other men. Chis wife was undergoing medical treatment making Intercourse impossible.]

Have been told... th at I. want a woman.

Dr W lectured me a long time. He 6aid I had very strong sex and that we had got to face the fact that "nature takes no notice of morality".6®

But on the whole, it is apparent that doctors faced with a man suffering from a sexual disorder did little more at best than make reassuring noises, if that. It would seem that reassurance was not enough, for many of the correspondents who complained of the treatment they had received from their doctor nevertheless wrote in a way that would suggest that the doctor had tried, however ineptly, to convey some kind of reassurance: all the doctors who were accused of having treated their patients' problems

"lightly" may have been endeavouring to set their minds at rest by making out that it was not quite the major tragedy they perceived it as. Zola has suggested in his writing on non-compliance in the doctor-pat lent relationship that 347

"Not to worry" i6 perhaps the most over-worked and useless advice In the English language... On the one hand It did communicate...that... [the] condition was not medically serious, It also contained an implicit put-down... for being bothered by something that turned out to be "nothing".69

The medical sociologist Ray Fitzpatrick has also commented on the counter­ productive nature of this exhortation:

The firm "don't worry, it's quite normal" from the doctor does not necessarily produce reassurance and indeed may well be counterproductive in its insensitivity.70

Kenneth Walker wrote, dealing specifically with men having sexual problems

On no account must it ever be said that there is nothing wrong. This is the most certain method of losing a patient's trust.71

The futility of such reassurances is substantiated by the accounts given by Stopes' correspondents: it is clear that many of them had precisely bsen given such empty exhortations "not to worry" which had done no good whatsoever, leaving them feeling if anything worse. Statements such as the following, given subsequent to a course of treatment, cannot have conduced to any great optimism

He said I must hope for the best but keep my mind off it, and eventually I may come alright.72

McCormick, analysing the doctor-pat lent relationship, has pointed out that doctors, by hedging their bets, actually undermine statements intended to reassure:

"there is nothing to worry about" is often qualified by "but I would like you to take these pills—have an x-ray—see one of my colleagues".73 and that their reassurances, for lack of sensitive probing, may be directed at the wrong target (for example all those assurances that patients were in perfect physical condition). 348

It is true that a few of Stopes' correspondents dissented from this tide of fear and condemnation of doctors and reported that they had found their own, or particular, practitioners helpful and reassuring:

[My doctor! put me in touch with a Harley Street specialist, who consented to see me without a fee.

I mentioned this affair to my local doctor, who seemed concerned about it, later he sent me to a specialist.

Some years ago we obtained help from a doctor at Norwood, a specialist we think in this matter.

The doctor was very optimistic and said he would cure him in a month.

I saw a local doctor whose general ability I have no reason to doubt. His advice was that it was quite common and no harm resulted.

One medical man with whom I discussed the question gave it as his opinion that the sufferer from this habit need fear no serious physical results."74

However, it is clear that however helpful and reassuring these doctors had

been, they had not produced the results their patients had wanted from

them, leaving them still in a sufficiently anxious state to seek Stopes'

advice. In some cases the help doctors actually gave was a recommendation

to their patients to consult Stopes' own writings: the response of medical

men to her work and their praise for her books has been documented in the

previous chapter. It is clear that their praises were not altogether idle

since Stopes' correspondents did report that their doctors had advised

them to read her books:

At my doctor's suggestion have just read your Married Love and much wish I had done so before.

On the advice of a doctor (when he ascertained we had no children) I purchased Married Love.

[My doctor] recommended me to read Married Love which I did, and I have also read Wise Parenthood.

I asked my doctor, and he advised me to read your book.

I was given your other 2 books to read by my doctor. 349

I broached the matter to our doctor, who advised me to read your Wise Parenthood.76

But several of these writers alluded to a "doctor friend" who had helped them in th is way:

I am about to be married and read these books on the advice of a young doctor friend.

Acting upon advice of a doctor friend of mine I read Married Love.

A doctor friend advised her to get the books and send them along to me if she thought fit.76 suggesting that the advice was not given in the course of a formal medical consultation, but as from friend to friend. It is surely of some significance that doctors could think of no more helpful thing to do than to prescribe the reading of works by a notorious lay woman.

It can be seen from the above that many men were reluctant to consult their doctors, and would only contemplate such a course when reassured of the credentials of any medical man they might consult, while others were completely deterred by one encounter with an unsympathetic or unhelpful practitioner. But still others seem to have shopped around, fruitlessly, for relief from their sexual problems. The issue is raised here of the lack of trust these men placed in the opinions and advice of the doctors they saw: medical authority did not seem to have been able to satisfy them. Some simply wrote in such a way as to indicate that they had not been contented with the opinion of a single medical man:

I find general practitioners and even specialists very unhelpful I am sorry to say.

The doctors I have been to never really come to the point. 350

Not being satisfied with one doctor I went to another.7"7 while others enumerated more specifically the exact number they had consulted:

I twice consulted doctors about 7 years ago.

Four doctors have been consulted with no benefit.

I have seen two medical men in the last few years on the m atter.

I have [been] to two reliable doctors.

He has recently seen 3 different doctors.

I mentioned the matter to my Panel doctor... further examination and treatment by two or three medical men have produced no improvement.

I have asked two family doctors for information.

I have been to 3 doctors of my own sex.

I have seen 3 doctors.

I have been examined by 4 doctors.

He has consulted 2 or 3 doctors at various times.7®

Yet others seem to have lost count among the "severalM, "various", and even

"numerous" practitioners they consulted:

I have enquired of several doctors as to such a cure.

I tried to gain advice from several doctors.

I have consulted numerous local doctors in different parts of the country.

I sought advice from various doctors previous to our marriage, as I was in doubt as to my fitness for it.7®

Writing to Stopes was in itself a form of shopping around,- of seeking help which the medical profession, in the person of one or more of its members, had failed to supply. Remarks such as the following betray the lack of confidence doctors' counsel on sexual matters inspired in their patients:

The opinion of a single medical man who is not an expert places or leaves one in a very doubtful position. 351

I have heard of a doctor in Belfast who will [they] tell me give me a definite and decided answer, a thing I have been unable to get up to date.®0

It seems likely that some of these correspondents would have been very hard to satisfy: one man claimed that he still felt anxious and deformed in spite of reassurances from several medical men that having one testicle undescended would not affect his sexual performance,®1 and others not only wrote of the numbers of doctors they had already consulted but bombarded

Stopes with demands for a definite answer or reassurance which she, no more than the doctors, was able to give. One young man had a copious correspondence with Stopes in the early 1930s, showering her with lengthy letters while simultaneously consulting several other doctors (including

Kenneth Walker), and concurrently spending some time as a psychiatric in­ patient. It can be deduced from his letters, and those to Stopes from the doctors concerned with his case, that he was a considerably disturbed and rather manipulative individual, trying to play the various specialists he consulted off against one another. The case cannot be regarded as at all typical, but this man took to a bizarre extreme the common worry among men that excessive masturbation could lead to impotence: he alleged that

Stopes* remarks in Enduring Passion concerning masturbation and fitness for marriage had precipitated his nervous breakdown.®2 There were some patients whom it was unlikely that any doctor could have helped.

Nevertheless, most of Stopes* correspondents were presenting her with problems for which it seem6 reasonable that they could have expected some kind of help from their doctor. A few even mentioned unsatisfactory behaviour from their practitioners in cases involving venereal disease: one man had accidentally made his wife pregnant while suffering from uncured 352 syphilis contracted during the war:

I have put the case to my doctor—as you know they are always retisent Csicl to tell you anything concerning this.03

A woman with syphilis contracted prior to her marriage had not been told that was what she had or that she should avoid having children,04 while a man suffering from gonorrhoea and under doctor's treatment thought it

"seems to be getting worse.H0S Those seeking for information about 6exual conduct while suffering from some other complaint were also badly served: one woman with a husband who had tuberculosis wrote to Stopes

Perhaps it is not advisable for my husband to have sexual intercourse while he is suffering from this complaint. He was examined by a specialist last week but he did not mention the m atter at a ll.06 and in other cases the advice given was too vague to be of much help: a man with heart disease was told by the "heart specialist"

If we married to have no children and to avoid any abuse of sexual intercourse, as undue straining would have serious consequences for him.07

This tendency of doctors to lack explicitness in dealing with sexually- related matters had already been documented in the previous chapter in the discussion of their ambiguous statements concerning "no more children."

It would therefore seem that the average lay perception of doctors' capacity to assist in matters of sexual dysfunction was not particularly flattering to the profession, and that this was in many cases borne out by patients' experience if they did get themselves into a consulting room.

While it has already been shown in Chapter 7 how doctors sought assistance in learning about birth control from Marie Stopes, they seem, with some exceptions such as Capt AW of the Royal Army Medical Corps 353

I as a Doctor am often consulted about the chapter on sleep, especially by those who have been continent before marriage. They say that their reaction Is so quick that they are quite unable to bring satisfaction by one connection. Can you give me any information about the curing of thi6 condition or refer me to any authority on the matter... CI3 don't feel competent to give the necessary advice myself.ee to have been less ready to ask her for help in dealing with the cases of sexual dysfunction among men which they came across in the course of their practice. A few at least were aware of the magnitude of the problem:

Hundreds of women have come to me and hundreds of men and I did not know how to put things right... the ignorance of some men is appalling.

tl am] struck by the frequency of sexual neuroses that affect happiness in married life. There seems to be a widespread disorder among young men.

I have often been consulted by young married men and men about to be married.99 but one doctor, working in a military hospital in 1919 and seeing many neurasthenia cases, presumably put the number of cases of premature ejaculation about which he reported being consulted down to the effects of shell-shock.®0 Other doctors wished to know how to advise their patients on the desirable frequency of marital intercourse:

A matter on which doctors at clinics are constantly being asked far- information isth isi how often may intercourseoccur consistently with the man and woman both keeping their working capacity.

I have been asked in my practice how often conjugal intercourse should happen where both parties are healthy and mutually affectionate but desire in this matter to be temperate. Before expressing an opinion I wanted the opinion of someone with wider experience along this line.91

Stopes realised from the bulk of her correspondence on the matter that there were problems she could not refer back to just any doctor: as she said in Enduring Passion

Few men in such circumstances consult an experienced medical practitioner; and if they do they are not sure of getting the 354

help they need. There are few medical practitioners experienced enough In all the subtleties of such a case to be really helpful. The tendency of most men toward another male In this predicament Is to laugh or be incredulous. If a medical man who Is consulted and is convinced that something is amiss does not quite know what to prescribe, he need not be ashamed to be unable to advise successfully regarding the cure, for such physiological needs of mankind have been but little studied or discussed, save by a few experts.92 a considered opinion presumably based upon the comments she had received from her readers, and which she had become conscious of very early on.

Quite soon after the publication of Married Love, in 1919, she contacted Dr

E B Turner, whose name had been suggested to her by Sir Amand Routh. She wrote

[Married Love] has brought me an immense correspondence from people who have not got the assistance they need from practising doctors, and who wish me to help or cure them. One particularly difficult type to handle is that of the man, deeply in love, but for a variety of reasons, suffering from excessively premature ejaculation. In very few cases do I feel that by correspondence I can do anything to assist them, and I do not give interviews. I shrink from thrusting them back into the arms of the profession in general, as in a number of cases they have already despaired of medical help.

Turner replied to Stopes as follows:

I cannot say that I do specialise in such cases, but I happen to have seen and come across a good many. You can lay down no absolute rule of treatment for general application. Each case requires most careful consideration on its own merits... I always see if there is any physical reason for it, and go thoroughly over the nervous system, and try and put right anything which may be a cause. I lay down rules for each person as to diet, exercise, bathing, etc. In some cases I have found surgical procedures necessary such as circumcision... They are all difficult cases but I have had fair results, on the whole.93

This way of dealing with the problem, which must have derived much of its efficacy from the giving of time and attention to the patient and by doing so convincing him that he was not the degraded weakling he supposed himself, was similarly advocated by Kenneth Walker. In Male Disorders of

Sex he stated 355

It le no exaggeration to say that [psychological treatment] is the pivot on which the whole treatment of impotence revolves. Even when an organic lesion exists the psychological handling of the patient is of importance, since he is almost certain to be suffering from certain fears and lack of confidence... In the commoner form of primary impotence the psychical treatment is the chief weapon in the therapeutic armament.

Walker went on to discuss the handling of the individual case as it presented itself, and noted

It is more than likely that the patient has already sought medical help and been told that there is nothing the matter with him, or else has been given some pills with the assurance that all will be well. As a consequence he comes full of suspicions which must be allayed before any help can be given.

It was therefore essential for the doctor to "overcome his patient's distrust and despair." This required time and patience:

[The doctor] must be prepared to listen patiently to a history that may have very little bearing on the case, but the mere recital of which will bring to the patient some feeling of re lie f.

He urged an attitude of open-minded tolerance, and an attempt at empathy with the patient and his sufferings:

The doctor must not make the common error of judging him from his own standpoint. He must realize than no statement he may make is to be treated as ridiculous, no feeling he describes as unworthy of being considered. For the time being he must make every effort to place himself in the patient's position so that he may Judge everything from that particular angle.**

While emphasising the primary importance of the psychological approach,

Walker did not minimise the value of physical investigations,

Not only that the existence of any physical factor may be excluded, but also that the patient may realise that his case is being dealt with thoroughly. It is more than probable that to his way of thinking the trouble is due to a physical defect, and unless he knows that he has been carefully examined he will never listen to any suggestion that organically he is sound.**

While less dazzled than the American urologists cited in the previous chapter by the vistas opened up by developing technology for physical 356 investigation of the male genitalia, Walker considered that posterior urethroscopy "will have a marked psychological effect."

While arguing for a pat lent-cent red approach to the treatment of sexual incapacity, Walker was also conscious of the difficulties that lay in the doctor's way. He was aware that

In all probability the patient's ideas on the subject of his weakness will be false... it is difficult for some men to understand that their impotence is psychological rather than physical. They will cling to the idea that something is wrong with the organs of sex.9® and cautioned against ever declaring that "there is nothing wrong." While his general line was a therapeutic optimism, he also warned the doctor treating such cases that

Relapses must be expected, and the strain on the doctor's patience is likely to be severe.97

Twenty years before Walker, Arthur Cooper had also indicated to the practitioner, in The Sexual Disabilities of Man. that these cases were by no means straightforward to deal with. Like Walker he advocated that

the first thing to do is to enquire carefully into the patient's general state, both physical and mental.9® and by the time he came to issue the third, revised and enlarged edition of his work, he found it necessary to add

in all cases with the exception perhaps of those due solely to mechanical causes, it is of the first importance that the doctor should gain the full confidence of the patient if treatment is to be successful. Whoever thinks these cases can be cured by the mere writing of a prescription had better leave them alone altogether.99

It is noteworthy that remarks respecting the necessity of the patient having faith in hie doctor "and if he have faith in his doctor, recovery may usually be looked for in the end",100 only appear in the third edition 357 of Cooper's work: it is possible that as a result of the earlier editions of Sexual Disabilities he came to see an unusually large number of cases of sexual difficulties, including those for which other doctors had been unable to do anything. This hypothesis would seem to receive some substantiation from Cooper's comments in the third edition on the use of drugs:

Although I have prescribed some of the drugs on occasion I have learned more about them from patients, so many of whom I find have already tried one or other of them without benefit.101

Cooper had come, by this time, to the conclusion that

Suggestion... is of special importance in the treatment of functional sexual disorders, and if it is to have the desired effect it is essential that the patient have faith in the man who suggests... the aim should be so to combine suggestion with other treatment that they mutually help and enforce one another.102

He did not, however, go so far as Walker, who was inclined to consider that physical treatment was most likely to work as "magic" pure and simple:

Electricity in any form appeals to a patient's imagination. It is a magic force, and since functional troubles are particularly amenable to magic, electricity may be very useful.103

Like Walker and Turner, Cooper was aware that there was no panacea, and that "treatment must be adapted to each case after careful consideration of the circumstances."1 °*

It is perhaps not surprising that doctors were reluctant to involve themselves with such cases. McCormick cites research by G V Stimson on what general practitioners considered to be troublesome patients. They regarded the presentation of a vague, psychological illness, hard to diagnose and manage and unlikely to get better, as constituting trouble.

Patient behaviour which included the taking up of time, the vague presentation of the problem, neither trusting the doctor nor accepting 358 limits to his skill, a critical attitude and lack of cooperation, indicated the difficult patient. If the general social competence of men presenting sexual disorders was high and therefore in their favour in the doctor's eyes, the very nature of their complaint must have marked them as unhappy, insecure, inadequate, and possibly malingerers as well.los As patients, therefore, they would have been unwelcome to doctors.

As cases they would demand an investment of time and atten tio n which a busy doctor might find it hard to spare, for a therapeutic outcome he might well consider uncertain. Being unable to prescribe an immediate remedy might also tend to undermine a doctor's faith in himself. McCormick has suggested that

The scientific physician concerned primarily with diagnosis and to a lesser extent with its corollaries of treatment and cure is apt to see his role as confined within relatively narrow boundaries... Hi6 inability to cure is a reproach rather than a challenge: it is in conflict with his role; he tends to believe that he has nothing to offer.10*

As G Freedman remarked in Sexual Medicine, published in 1983, on the subject of the management of sexual dysfunction:

The knowing, clever, doctor has to be discarded... this rather naked position poses a threat to many doctors used to being able to provide answers through their specialised knowledge and s k ills .107

In 1932 the B ritish Medical Journal published some remarks by Dr W J Mayo, given at the Mayo Clinic, world-famous surgical centre:

Having himself [the doctor] a disciplined mind and being in good health, he may be be disposed to regard with some degree of contempt the emotional reactions of the patient... The trained physician, in his natural contempt for sham and make-believe, is perhaps apt to forget that he is dealing not with a cool logical, self-controlled individual, but with one disturbed by uncertainties and doubts and fears; part of the treatment is to banish these, and the agency for the purpose is the attitude of the doctor. If thi6 attitude is not appropriate to the situation, how can success be expected?100 359

This ideal of the doctor divided him sharply from the patient: the doctor had a disciplined mind, good health, logic, self-control, all of which the patient lacked. If banishing the patients' fears was even part of surgical

treatment, how much more so would thi6 be the case with functional disorders?

Edward Shorter has argued, in Bedside Manners.109 that the ris e of the

"scientific physician" took place after World War II, subsequent to the development of antibiotics. On the basis of the experiences reported by

Stopes' correspondents, his assumption that, before the actual therapeutic effectiveness this development gave doctors, they were far better at

listening and giving their patients the placebo effect of the doctor's authority does not seem easy to substantiate. Certainly Mayo presents the doctor of the early 1930s as likely to be Impatient, in his cool scientific

superiority, of the more emotional reactions of his patient. The doctor of

the twenties if he had no actual remedies for impotence had diagnostic

tools such as his posterior urethroscope: if this new scientific device

revealed no lesion he was apt to Inform the patient that there was

"nothing wrong."

Freedman, in Sexual Medicine.110 appears to imply that the desire of male

patients for assistance with sexual difficulties is a new, post-war, even

perhaps peculiarly post—1960s phenomenon. This assumption might seem to

confirm Shorter's arguments, although Freedman does not explicitly contrast

the modern doctor's "scientific" authority, so helpless in the face of these disorders, with the old-fashioned "listening" model of a physician. The evidence cited in this chapter, however, would suggest that male anxiety

about sexual dysfunction is no new disorder, neither is the hope of 360 medical assistance a result of the rise of any new faith in medical treatment. Doctors of the past do not seem to have been any more sympathetic to their patients presenting such problems than they are today, while there seems to be little foundation for any assumption that this is an area in which "progress" has been made.

Doctors, being men, and middle-class professional men of the class Stopes found peculiarly subject to the "civilised disease" of premature ejaculation, might have found it particularly difficult to maintain this sharp division from the patient who presented himself with a disorder of sexual functioning. Especially if this patient were himself of a similar status in society, turning the medical gaze upon him may perhaps have been too much like looking into a mirror for the average doctor to feel confident and at ease in dealing with the problem. The defensive retreat into a brusque medical authoritarianism must have been a constant temptation, and one to which, from the plaints of Stopes' correspondents, many doctors succumbed. One way or another, the sexually dysfunctional male was not the kind of patient presenting the kind of problem with which doctors felt most comfortably equipped to deal. 361

Chapter Eight: Notes

1. British Medical Journal. 1935, 11, 511

2. BMJ, 1933, 11, 1057

3. The Lancet. 1949, 1, 744

4. La'mert, Samuel, Self-Preservation? A Medical Treatise on Nervous and Physical Debility. Spermatorrhea. Impotence and Sterility, with Practical Observations on the Use of the Microscope In the Treatment of Diseases of the Generative System. "64th edition, published by the author, available from a ll booksellers", London, 1850s/1860s, pp 60-61

5. Comfort, Alex, "Sex Education In the Medical Curriculum", International Journal of Sexology. 1950, Vol 3 no 3, pp 175-177, ref to p 175

6. BMJ, 1944, 1. 636

7. Humphries, Steve, A Secret World of Sex: forbidden fruit, the British experience 1900-1950. Sidgwick and Jackson, London, 1988, p 60

8. Woodside, Moya, "Illegal Abortion: The Woman Abortionist", a paper given at a Family Planning Association Conference on Abortion in Britain held 22nd April 1966; found in Abortion Law Reform Association archives in the Contemporary Medical Archives Centre at the Wellcome In s titu te fo r the History of Medicine, CMAC: SA/ALR/D.16

9. BMJ, 1944, i, 731

10. McCormick, James, The Doctor: Father Figure or Plumber. Croom Helm, London, c.1979, p 26

11. ibid. p 27

12. Stopes, Marie, Enduring Passion. Further New Contributions to the Solution of Sex Difficulties being the continuation of Married Love. GP Putnams Sons, London, 1928, 2nd edition 1929, p 76

13. Walker, Kenneth M, Male Disorders of Sex. Jonathan Cape, London, 1930, P 7 14. ibid. p 50

15. Zola, Irving K, "Structural constraints in the doctor-pat lent relationship: the case of non-compliance", in Eisenberg, L, and Klelnmann, A, The Relevance of Social Science for Medicine. D Reidel Publishing Co, Dordrecht, Boston and London, 1981, pp 241-252, re f to p 244

16. Marie C Stopes papers in the Contemporary Medical Archives Centre at the Wellcome In s titu te for the History of Medicine, correspondence "ML- GEN", CMAC: PP/MCS/A.85 F

17. CMAC: PP/MCS/A.45 RB, A.215 BR

18. CMAC: PP/MCS/A.98 SG 362

19. CMAC: PP/MCS/A.29 FB

20. CMAC: PP/MCS/A.152 JK, A. 149 TJK

21. Eugenics Society papers in the Contemporary Medical Archives Centre at the Wellcome Institute for the History of Medicine, CMAC: SA/EUG/D.211 "Voluntary Sterilisation: enquiries about operation", P

22. CMAC: PP/MCS/A.149 TJK, A. 165 FLL, A.45 RB

23. CMAC: PP/MCS/A.66 C, A.69 FD, A.32 HMB, A.213 GR, A.37 W-B, A. 105 GFG, A. 107 WEG, A. 121 FH, A. 139 AWI

24. CMAC: PP/MCS/A.28 ASHB, A. 112 Major G, A. 187 JNN, A.229 GT, A.253 FVW

25. CMAC: PP/MCS/A.99 GHG, A. 183 CM

26. CMAC: PP/MCS/A.189 GLN

27. CMAC: PP/MCS/A.130 HPBH, A. 153 JBK

28. CMAC: PP/MCS/A.50 IC

29. CMAC: PP/MCS/A.74 FD, A. 196 TRP, A.235 MST

30. CMAC: PP/MCS/A.69 FD, A.230 LT, A.225 WJS, A. 189 GLN

31. CMAC: PP/MCS/A.45 RB, A. 103 G, A.246 RW, A. 106 FG

32. CMAC: PP/MCS/A.241 Capt MKW, A. 157 FJL, A. 157 DGL, A. 157 GL, A. 158 Capt (retired) HML

33. CMAC: PP/MCS/A.168 HM, A. 171 VM, A.248 Sgt HTW

34. CMAC: PP/MCS/A.70 RCD, A.31 0B, A. 130 HBPH, A.68 C, A.28 BJB, A. 107 WGR, A.208 Lt-Col CR, A. 116 MWH, A. 117 JBH, A.211 AR, A. 128 Lt FMPH

35. CMAC: PP/MCS/A.114 Major WdeHH, A. 117 NWH, A. 173 JHM

36. CMAC: PP/MCS/A.207 WGR, A.208 Lt Col CR, A.215 BR, A.149 TJK, A.165 FLL, A.245 ETW, A.245 MW, A.211 AR

37. CMAC: PP/MCS/A.121 FH

38. Professor Millais Culpin "Address to the Chelsea Medical Society: Sexual Problems in General Practice", The Lancet. 1935, i. 1277

39. ibid

40. G H Day, "Point of View: The Samaritans and the Medical Profession", The Lancet. 1983, ii, 1478

41. Comfort, op clt. p 176

42. The Lancet. 1949, i, 744 363

43. CMAC: PP/MCS/A.65 C, A. 146 HPJ, A. 115 2/Lt GH, A.221 RS, A.32 B

44. CMAC: PP/MCS/A.199 EEP, A. 183 LM

45. CMAC: PP/MCS/A.208 Cdr MR (RN), A.80 Mrs EE, A.128 JSH, A.200 JP, A. 176 JGM (Buenos Aires), A. 179 OODEM, A.250 DOCW, A.202 RP

46. CMAC: PP/MCS/A.67 AC, A.231 Cdr SET, A.89 FPF, A. 131 RPH, A.206 DAR, A.40 RJB, A. 122 FLH

47. CMAC: PP/MCS/A.199 EEP, A.41 FB, A. 121 FH, A.128 Lt FMPH, A. 172 Cdr FLM, A.173 NM, A. 181 JM

48. The Lancet. 1901,1 , 108

49. BMJ. 1932, i, 687

50. BMJ. 1939, ii, 608

51. CMAC: PP/MCS/A.80 THE, A. 132 AH, A. 173 Mrs EM, A.242 RLW, A.223 JPS, A.67 C, A.233 SRT

52. CMAC: PP/MCS/A. 113 HFG

53. CMAC: PP/MCS/A.222 AFS, A. 142 CMJ, A. 146 Mrs BJ, A. 172 AHM, A, 185 AGM, A.221i RS, .A.296 Rev GKA

54. CMAC: PP/MCS/A.200 JP

55. CMAC: PP/MCS/A. 142 CMJ, A.233 AWT, A.202 RP, A.221 AMS, A.222 AFS

56. CMAC: PP/MCS/A.208 Mrs DR, A. 187 HJN

57. CMAC: PP/MCS/A. 197 Rev LA, A.98 VWG, A. 103 G

58. CMAC: PP/MCS/A. 176 JGM (Buenos Aires), A.250 DOCW

59. CMAC: PP/MCS/A.297 Rev GKA, A. 122 Major HM

60. CMAC: PP/MCS/A.45 FCB, A.82 E, A.98 FG, A.222 JS, A.89 FPF

61. CMAC: PP/MCS/A.252 GJW, A.221 RS, A.87 MF

62. CMAC: PP/MCS/A.297 Rev LA

63. CMAC: PP/MCS/A.98 SG

64. CMAC: PP/MCS/A.98 VWG

65. CMAC: PP/MCS/A.208 Mrs DR

66. CMAC: PP/MCS/A.212 FH, A.250 DOCW, A.87 MF, A.205 HWP, A. 185 AGM, A. 166 MMcA

67. CMAC: PP/MCS/A.78 E 364

68. CMAC: PP/MCS/A.82 E, A. 19 DHB, A.43 B, A. 165 DML, A.205 HWP, A. 166 MMcA

69. Zola, op clt. p 247

70. Fitzpatrick, Ray, "Lay Concepts of Illness", in Fitzpatrick, Ray, Hinton, John, Newman, Stanton, Scambler, Graham, and Thompson, James, The Experience of Illness. Tavistock Publications, London and New York, 1984, pp 11-31, re f to p 28

71. Walker, Male Disorders, p 64

72. CMAC: PP/MCS/A.98 SG

73. McCormick, op cit. p 59

74. CMAC: PP/MCS/A,70 RCD, A.98 SG, A.107, WG, A.112 Miss EG, A.222 PDS, A. 104 EOG

75. CMAC: PP/MCS/A.228 RS, A. 189 GLN, A. 182 DSM, A. 129 FH, A. 117 RH, A.46 B

76. CMAC: PP/MCS/A.89 JTF, A.146 BJ, A.131 JMH

77. CMAC: PP/MCS/A.223 JPS, A. 162 Sub-Lt FL, A.250 DOCW

78. CMAC: PP/MCS/A.65 C, A.208 Mrs DR, A.128 JSH, A. 142 CMJ, A.146 Mrs BJ, A. 172 AHM, A. 197 LBP, A. 197 EWP, A.297 Rev GKA, A.297 Rev LA, A.87 Mrs MF

79. CMAC: PP/MCS/A.208 Capt JR, A.216 Lt ES (RAF), A.45 FCB, A. 185 AGM

80. CMAC: PP/MCS/A.62 C-R, A. 151 Major CESK

81. CMAC: PP/MCS/A. 45 HGB

82. CMAC: PP/MCS/A.79 AE

83. CMAC: PP/MCS/A. 107 EG

84. CMAC: PP/MCS/A.244 AW

85. CMAC: PP/MCS/A.209 WR

86. CMAC: PP/MCS/A. 162 Mrs VBL

87. CMAC: PP/MCS/A. 110 Miss EG

88. CMAC: PP/MCS/A.248 Capt AW (RAMC)

89. Marie C Stopes papers in the Department of Manuscripts at the British Library, Add Mss 58568, IJ; CMAC: PP/MCS/A.275 K, A.256 S ir TB

90. BL Add Mss 58568 Capt C, Moss Side Military Hospital

91. BL Add Mss 58569 DMM; CMAC: PP/MCS/A.284 P

92. Stopes, Enduring Passion, p 60 365

93. BL Add Mss 58565 Dr E B Turner from MCS and Dr E B Turner to MCS: this reply Is actually not next to Stopes' letter, but has been filed at the end as an undated item; on internal evidence, however, it is clearly Turner's response to her request.

94. Walker, Male Disorders, p 60

95. ibid. p 61

96. ibid. pp 61-62

97. ibid. p 64

98. Cooper, Arthur, The Sexual Disabilities of Man and Their Treatment. H K Lewis, London, 1908, 2nd edition, 1910, p 146

99. Cooper, Arthur, The Sexual Disabilities of Man and Their Treatment. H K Lewis, London, 1908, 3rd edition, 1916, p 136

100. ibid. p 146

101. ibid. p 161

102. ibid. p 162

103. Walker. Male Disorders, p 56

104. Cooper, op cit. 3rd edition, p 143

105. McCormick, op cit. pp 29-30

106. ibid. p 15

107. Freedman. G R. Sexual Medicine. Churchill Livingstone. Edinburgh. 1983. p 76

108. BMJ. 1932, i, 1044

109. Shorter. E Bedside Manners: the troubled history of doctors and patien ts. Simon and Schuster, New York, c.1985

110. Freedman, op cit. p 107 366

Chapter Nine

World War II. Continuity and Change

The 19406 provide a useful point at which to stand in order to consider

the changes (or lack of change) occurring in sexual mores since the last great international conflict. It is possible to see, from contemporary debates, to what extent anxieties to do with sexual conduct and sexually

transmitted disease remained similar to those of thirty years earlier, and

to what extent changes, partly brought about by World War I, had changed

the terms of these debates. Although it was still deplored that a

"conspiracy of silence" reigned respecting these dangerous diseases, it was

during the War that they came to be the subject of advertisements in newspapers and radio broadcasts pointing out the perils of such diseases

and warning against them. The "conspiracy of silence" itself might have

been the natural result of the radical decline in the number of cases

reported: until the outbreak of war sent the figures spiralling upwards

once more. However, the 1940s saw an upsurge of therapeutic optimism

respecting these ailments with the emergence of antibiotic drugs. The

professional prostitute was seen as a less significant vector in the

dissemination of venereal diseases than the "amateur" and the increase in

general promiscuity. The anxiety about eugenics and national deterioration

characteristic of the years preceding the Great War had been replaced,

during the 1930s, by a more general fear about the declining population of

Britain, but this was connected with the wider public acceptability of the

discussion of birth control and the dissemination of birth control clinics

(even if the umbrella organisation found it strategically desirable to

change its image from Birth Control to Family Planning). The 1930s and 367

19408 saw the rise of various forms of social survey, and while there was often hesitancy about applying these research methods to the touchy area of sexual attitudes and behaviour (although even prior to Kinsey a number of surveys on such topics had been conducted in the USA),1 by the early

1950s some survey data was in existence on the subject. Even in 1942

Eustace Chesser's Love without Fear could be the subject of a prosecution

for obscenity; however, the result was his acquittal and praise for his work, not the humiliation that had accrued to Havelock Ellis as a result of the Sexual Inversion case. Works of sex advice and education were tending more and more to eschew the notion that masturbation was an invariably deleterious practice. Writers contended that worry and guilt were far greater dangers than the habit itself; ideas on the perils of self-abuse, however, were still in circulation.

Following the recommendations of the 1916 Royal Commission, provisions had come into being for the treatment of venereal diseases in Britain which aimed to make it as freely and readily available as possible. In theory, at least, it

eschewed anything that might discourage the patient from seeking and continuing treatment, including cost, compulsion, reporting, case finding, and lack of consideration.2

193 clinics had been established by 1925 (142 in voluntary hospitals and

51 in institutions directly controlled by public health authorities), funded

75% from central government sources, forming part of public health administration, and creating a new professional medical group in the medical officers serving in them.3 This widespread provision has hardly changed: although there were 230 clinics by the 1960s this is more likely to be related to changes in health administration areas than to any real 368 increase in provision.-4 By the mid 1920s therefore the country was covered by a network of publicly provided centres for the treatment of venereal diseases, employing a new and articulate Interest group. 293 of these joined together to form the Medical Society for the Study of Venereal

Diseases in 1925.s

A perusal of the British Journal of Venereal Disease, the organ of the new professional body of venereologists, shows that in spite of this apparently generous provision of facilities for the control and cure of venereal disease, more or less from the inception of this journal in 1925 medical officers employed in the venereal disease service were deploring the conditions under which they worked and the ways in which the spirit and even the letter of the Act were being breached. They complained that as a specialism they had all the lowly status that Mpox doctors" had always fallen heir to, in spite of the newly scientific status diagnostic and therapeutic developments might have added to their role. They constantly bewailed the inconvenient premises in which they were supposed to conduct clinics, usually in basements, cramped in space, lacking laboratory facilities, and often providing very inadequate privacy for patient consultations, a complaint still being voiced in 1950:

We work in unhygienic cellars, or inconvenient corners of hospitals. In our relations with colleagues and laity we are often considered to be outcasts. If we are honest we do not make money but only a very modest competence. By our colleagues we are often ignored until they wish to get rid of unpopular patients.®

This was in spite of the fact that the venereal department could boast of curing the majority of the patients who attended it. Appointments committees, venereologists complained, in spite of having a body of specialists at their disposal, were wont to appoint to venereal clinic 369 posts doctors lacking in any qualification, except, possibly, some experience as an army medical officer. Opposition was to be found even within hospitals: in his paper on "Collaboration between the Venereal

Disease and Other Departments", C Mills pointed out the stigma attached to venereal work which led specialists in related departments to specify their unwillingness to be associated with it. During the subsequent discussion he mentioned the excessive segregation measures imposed upon VD patients by administrators, who seemed to think it "necessary to close all the doors and windows of the room where a VD patient had been and fumigate it",7, and a Dr Price mentioned difficulties caused through encountering opposition by nursing staff.® This "sanctimonious a ttitu d e of mind" found among the nursing profession was mentioned again in 1944 by H Nichol during a discussion on papers "Is a New Deal in the Control of Venereal

Disease Necessary?", and another discussant commented on the "ill-defined position" of male VD nursing orderlies, who were not admitted to the State

Register in spite of their skills.®

However, in sp ite of a ll th is continuing evidence of the low esteem, even stigma, which was associated with the care of venereal diseases, this system was extensively patronised by those suffering from, or fearing that they suffered from, venereal disease. As early as 1919 over one million patients were seen in a year (a massive increase over 1918, but it is to be supposed that prior to demobilisation many men—the majority of patients—would have been receiving treatment under forces provisions).10

Langford Adam6 in the above cited thesis suggests, from a study of the distribution of arsenical drugs (which were supplied free for doctors with private patients as well as to public clinics) that the great majority of known syphilis cases were treated through free local authority clinics 370 rather than private practice.11 Indeed, in 1932 H Wansey Bayly wrote to

The Lancet to complain that

The venereal specialist sees ruin staring him in the face, as with the universal financial stringency more and more patients go to clinics who do not properly belong to the hospital class, and who can even with their reduced incomes well afford a moderate fee for private treatment.

As Wansey Bayly had been a founder-member of the Society for the

Prevention of Venereal Disease one might have thought he would have welcomed any development which led to such a take-up of treatment: however, in spite of his earlier pronouncements that the matter was one of medical prophylaxis, and moral considerations were an irrelevant intrusion upon a sanitary problem, he could now be found fulminating that

the curious position obtains that the only diseases in which, in the great majority of cases, infection is due to a voluntary act of the patient are also the only diseases accepted at clinics for treatment without any inquiry as to the patient's income or financial ability to pay for private treatment.

Because of this, he contended, "the practice of many venereal specialists

has decreased almost to vanishing point" because of the "unnecessarily

large and numerous VD clinics" being maintained at public expense.12 This

kind of plaint could not be found in the pages of the British Journal of

Venereal Diseases, since most the contributors seemed to be involved in

public rather than private practice and to be far more concerned about the

failures of the state-funded system than the success which Dr Wansey

Bayly claimed for it. Francis Louis, of St Peter's (Whitechapel) Hospital,

wrote in response to Bayly's outcry that "it is in the interest of the

nation that venereal disease be wiped out", pointing out that Bayly's

argument implied

the unavoidable position that it is in the interests of the venereal disease specialists that venereal disease should not be exterminated.13 371

The decline In venereal diseases subsequent to the institution of a voluntary non-compulsory system providing free confidential and expert treatm ent became apparent within a decade or so. Between 1920 and 1923, although attendances at venereal disease clinics Increased (1,488,514 to

1,605,617), numbers of actual cases declined significantly: syphilis from

42,805 to 23,927, and gonorrhoea from 40,284 to 30,908, an overall decline of nearly 30,000 cases.1A This was widely supposed to be the result of the introduction of free confidential clinics, although in the same issue of the British Journal of Venereal Diseases as the article citing these

figures F G Crookshank contended that

The now rapid diminution of venereal disease is, in my view, not really due at all to the work of venereal clinics and the like... it is due to the fact that...an entirely new social code has been set up... allowCing] intercourse between the sexes to occur without the attendant circumstances of dirt shame and furtiveness, and without entailing social disability.1®

Whilst other authorities might have included these changing social mores

as a contributory cause they certainly would not have assigned them the

epidemiological significance given them by Crookshank, no venereologist but

a psychiatrist and a founder of the Medical Society for Individual

Psychology, the main British body advancing the views of Alfred Adler.16

It was suggested by W Derwent R Thompson in a paper published in the

British Journal of Venereal Diseases in 1936 on the medico-legal aspects

of the diseases, that "many patients" were still deterred from attending

clinics through fear of discovery, driving them back into the arms of

chemists and quacks. This was not a point of view often mooted in the

pages of this journal, and indeed in the discussion on Thompson's paper Dr

Laetitia Fairfield argued that patients in fact trusted the promises of 372 confidentiality held out by the system, and th at th is was shown by the success of the clinics, calculated on the numbers of patients using them.17

In 1937, with the introduction of sulphonamides, "it was commonly said that that venereology would soon cease to exist as a special subject."1® and certainly these drugs caused a revolution in the treatment of gonorrhoea,1® for which there had been no specific, equivalent to salvarean and the allied arsenicals in syphilis. Even in the 1930s the treatment for gonorrhoea had usually consisted of

a fearsome series of dilatations, applications of caustic, antiseptic, and astringent chemicals, and instrumental investigation of various types.20

It would seem that a drug treatment for gonorrhoea which did not demand the instrumental skills formerly needed in the treatment of this ailment sent numbers of patients back to private practitioners:

The advent of sulphonamides has depleted attendances for gonorrhoea as more patients seek, and are able to find, treatment in private.21

However, it was very shortly after the first use of the sulpha drugs that the problem of the emergence of resistant strains of bacteria became apparent, tempering the initial therapeutic optimism about their potential.22 In syphilis, the number of early cases seen in clinics in 1939 was under 5000, a decline of over 45% since 1931; there had been something of a peak in the early 1930s as a result of economic recession and mass unemployment. Congenital syphilis showed a steady decline, probably due to the efforts made in ante-natal clinics.23 The most radical break-through in treatment, however, was the discovery of penicillin, which had the major advantage over the arsenicals that treatment did not have to be continued over a lengthy period. The introduction of penicillin

treatment did not occur however until 1944; even when it became available 373 it would appear th at there was some prejudice against its use for the treatment of venereal disease,2* and the allotment of penicillin for cases of syphilis was allocated sixth place on the priority list, except in the case of infection proven resistant to the standard arsenical or bismuth

treatment.2®

As in 1914, the outbreak of war showed an almost immediate upsurge in the number of infections reported. It is interesting to note that this upswing, at least in cases of syphilis, was mirrored in Sweden, a n eu tral country,

in the tripling of numbers of cases of fresh infection between 1937 and

1943.26 This would suggest that an atmosphere of stress and tension may have contributed to conditions encouraging the spread of these diseases

(as noted above, the trade depression of the early 1930s 6aw an increase

in cases in Britain) separately from the particular problems created within

a nation on a war footing.

Within the Armed Forces mechanisms did already exi6t to deal with the problem: but even so:

Venereal disease was found to be the most difficult of all diseases to control owing to the restrictions imposed on preventive measures by public opinion and to the manner in which i t was contracted.27

Information was supposed to be disseminated to all servicemen about the risks involved and the provisions for treatment but of patients admitted with the ailments "many denied ever having had a lecture on the subject",2® and R Lees, Adviser, later Consultant in Venereal Diseases to

the Middle East and subsequently the Central Mediterranean Forces remarked

that

almost all the officers and men arriving in the Middle East Theatre were almost completely ignorant of the practised 374

methods of prevention of venereal disease.23

Lees also commented on the lack of planning for the prevention or treatment of venereal diseases and the inadequate facilities provided for him as Consultant Venereologist. However measures of' prevention and fo r treatment were introduced: condoms were issued as a prophylactic measure and educational films acquired from the USA* lectures were given and poster campaigns initiated. With the possibility of antibiotic treatment

for uncomplicated cases, men with gonorrhoea could be treated in their units or in the field.30

In 1943 a regulation was passed under the Defence (General) Regulations to

provide for the notification of known carriers, that was, an individual reported by more than one person as their contact with the disease. While avoiding the obvious discrimination of earlier attempts to control

prostitution, this measure bore more punltively upon women than upon men.

In the first six months of its operation 64 women had been informed

against but only 2 men; Dr Edith Summerskill, commenting in Parliament

upon these statistics, suggested that women were more reluctant than men

to inform upon their partners.31 The "easy woman" was perceived as a

reservoir of infection, much as the prostitute had once been, and was

accorded a similar stigma, although it was also sometimes recognised that

"irresponsible youths who default as soon as their signs and symptoms

abate do much to spread disease”,32 and that there were men "engaged in

industry and many kinds of war work who come under no compulsion" to

undergo examination and treatment such as applied to men serving in the

Forces.33 375

Anxiety about the incidence of venereal disease led to a publicity campaign to increase public awareness of these diseases, their transmission and the provisions for treatment. The taboo on mentioning these diseases in the press and on the radio was breached,34 although not wholly. Complaints were made in the Lancet about the "mistaken sense of delicacy" which had led to expurgation of the original text of press advertisements, changing "precision" to "vaguer general statements", and deleting the popular names of "pox" and "clap" identifying the diseases, interposing, the Lancet suggested "a barricade of unfamiliar terms."3S

Other new departures in the venereal disease field included the evolution of contact-tracing by social workers attached to clinics, and a greater interest in the problem of "the defaulter", who, failing to continue with a course of treatment, remained infectious.36 This was connected with a developing concern about the type of person who contracted venereal disease: by the later 1940s this was to a great extent seen, at least in professional journals, as someone who was neurotic or inadequate rather than sinful or unfortunate.37 Lt-Col T A Ratcliffe took the argument

further. From the observation that the most marked Increase in the Army incidence of venereal disease occurred in the immediate post-war period, he proceeded to a survey of the troops in South East Asia Command. On the basis of hi6 findings he suggested that the venereal disease rate in a military unit was an accurate register of its morale, high morale being correlated with few cases of VD.3S Not all experts agreed, however: in the discussion of ED Wittkower's paper on "The Psychological Aspects of

Venereal Disease" a number of them argued in somewhat old-fashioned style to claim that it was "fighting soldiers of the finest type", "fine physical specimens", "magnificent specimenCs]" who contracted the diseases, either 376 because promiscuity was "an entirely natural reaction, especially under conditions of soldiering" or because these fine specimens were "subjected to more temptations than the ordinary soldier."39

This new Interest in the male who contracted venereal disease, as opposed to the woman who gave it to him, was perhaps one more sign of changes in social customs around sexual behaviour. Nevertheless, there was still considerable stigmatisation of the "promiscuous amateur" who had replaced the professional prostitute as the scapegoat for venereal infections. The

Shield continued to point out the way that regulations apparently applying to both sexes fell more heavily on women, even though this was not actually inscribed in the regulation. In 1942 it pointed out that in the debates around compulsory treatment for habitual infectors these were

usually perceived as either professional prostitutes or the "vicious female amateur."'40

The decline in professional prostitution and the rise of the "amateur" has already been discussed in Chapter 2. "Prostitution... becomes promiscuity" was certainly the perception of the venereologists writing in the British

Journal of Venereal Diseases, though some of the evidence for this would appear to be anecdotal. One writer in 1928 considered that chancroid, par excellence an indicator of professional prostitution was dying out, while gonorrhoea and syphilis took its place.411 G L M McElligott, writing on "The

Venereal History: Truth or Fiction" in 1932, suggested than men were very seldom truthful concerning the status of their partners:

Young men tend to deny having had anything to do with a prostitute, regarding it as a slight on their attractions that it be thought that they had to pay for what they wanted, while the elderly man, brought up to regard prostitutes as the only "fair 377

game" w ill often make out that his consort was one, though in fact she may turn out later to have been his housekeeper or an old acquaintance.*42

This apparent change varied by social group: in a study of "The Problem of

Venereal Disease in the Mercantile Marine", H M Hanschell pointed out that the great majority of cases, as might be expected in such a mobile group, were the result of mercenary transactions.43 (It might be noted that in the discussion of th is paper Dr Wansey Bayly commented that they were dealing with a class of "the strong virile type, men who would not be dissuaded from satisfying their sexual instinct."44).

Certainly the comments about this change in sexual habits would suggest that there was a perception th at male pride had become invested in not having to pay for sexual favours, and to regard having to do this as a disgrace. Ratcliffe noted that

many men who for ethical, aesthetic, or other reasons, would not approach a prostitute will willingly expose themselves to risk with a "girl-friend".

He suggested that once a soldier had "walked out" with a casually-met girl for a few weeks, he would have unprotected intercourse with her in the belief th at she was "safe"43; as Robert Sutherland commented, citin g th is,

Presumably they imagine that having passed such a test she must have withstood indefinitely the overtures of all their predecessors.46

Ratcliffe further considered that this activity, however deplorable and hygienically dangerous was "a stage higher in the level of normal social adjustment" than patronising prostitutes.47 It was also, however, regarded as an insidious danger to national health: Lord Dawson of Penn in a House of Lords debate contended that

The so-called amateurs were most dangerous because they were likely to give disease where it was least expected. But there 378

was an Increasing number of venereal infections among girls of good repute, who would no doubt later become mothers.49

However, while it might be true, as The Shield contended in 1938 th at

men's morals are better; they are more responsible and their relations with women are les6 sordid than in the old days49 and that

Crude prostitution is falling into disuse in the better walks of life; its place is being taken by liaisons of a more or less affectional character.®0 prostitution was still rife as almoners and social workers found when endeavouring to trace contacts.®1 It was pointed out that while numbers of the women involved in promiscuous liaisons were not full-time prostitutes they were either supplementing their income or acquiring gifts in kind by this means. It was alleged that the

older prostitute has a more professional attitude towards disease and will, if warned of possible infection, attend for examination or treatment which did not apply to feckless younger women who did not regard prostitution as a career.®2 Colonel J E Gordon of the Office of the Chief

Surgeon, US Army, however, writing in The Lancet on "The Control of

Venereal Diseases: an epidemiological approach" in 1944, declared that it was a myth that the prostitute "knew how to take care of herself", and

that prostitutes, because of the number of their exposures, were almost certain to contract and transmit venereal disease and thus were far more risky partners.®3

The Shield continued to point out the weight of inequitable responsibility

laid on young girls in court cases involving intercourse with under-age girls (since 1922 "reasonable cause" to believe the girl over 16 had been accepted as a sufficient defence): 379

we wish judges would not encourage people to think that decent men are morally defenceless creatures against the wiles of unscrupulous girls under 16, and that their seduction by the girl, even if they themselves are over 30, is mainly the girl's iniquity.** and in 1942, with the current agitation over the "vicious amateur" as the prime agent in the communication of venereal diseases, reiterated this argument, with examples of the leniency Judges showed towards men in such cases.**

Men were certainly not innocent victims in sexual transactions; Tyneside almoners and social workers pointed out the disproportionate numbers of referrals to contacts which involved certain pubs known to be "picking-up" places. Not all of the men involved were as discriminating about casual partners as some of the rhetoric might suggest; a considerable proportion seen in one Tyneside clinic had been too drunk on the occasion of infection to remember anything at all about their partner.**

It is supposed now, and was often said at the time, that sexual matters had come to be far more acceptable as a topic for general discussion following the end of World War I. As Douglas White, writing in The Shield in 1933 commented:

The change of attitude on the subject of sex since the beginning of the present century has been remarkable. In 1900 it was impossible for any book to be published dealing openly with sexual subjects... no simple books or pamphlets on the anatomy, physiology or psychology of sex were available.

Bridegrooms of that era, he considered, had had no means of instruction except "school, college or workshop companions, or through previous illicit experience."*7 On the whole White thought the "open chatter" of the twentieth century an improvement upon the silence of the nineteenth. 380

However, in spite of the apparent flood of literature being published aiming at enlightenment in sexual matters (and some of the problems about the actual accessibility of such literature have already been discussed in

Chapter 4), some individuals still gained much if not most of their

information on sex from the "school, college, or workshop companions" mentioned by White. During the 1930s men continued to write to Marie

Stopes with such comments as the following:

naturally I had an idea, but it was obtained from the crude and unreliable source of workshop and barrack-room talk, both of which were and are so indecent that I left sex alone, [soldier serving in Egypt, 1937]

What sexual knowledge 1 did gain was just "picked up” from bad sources, was very fragmentary and largely quite wrong. [1935]

Living as I do in the Navy 1 have naturally heard these subjects discussed freely, perhaps too freely, but never by persons with a technical knowledge. [19351s® which differ very little from comments expressed in letters to her very shortly after the publication of Married Love (see Chapter 3).

Shortly after the war, Mass Observation, inspired by learning of the Kinsey survey in the USA, undertook a "Sex Survey" in the United Kingdom. Mass

Observation had been set up in 1937 by the anthropologist Tom Harrlsson

in order to produce "an anthropology of ourselves" that is, the people of

Britain. Besides accumulating diaries and reports by volunteer observers upon contemporary social phenomena it also undertook investigations into particular topics using full-time investigators and canvassing the opinions of "the man in the street".®® The Sex Survey was one of these. Its aims and methods were somewhat different to those of Kinsey. It was hoped to discover "what people's feelings really are towards sex morality in this country" (rather than Kinsey-style investigations into sexual behaviour), and although reliant upon teams of investigators these worked on the basis 381 of a questionnaire, rather than the famed interviews of Kinsey and his colleagues.60 The results of the survey were written up but never published in extenso. The typescript "Report on Sex" is held in the Mass

Observation Archives, as are the completed questionnaires, around 3000, not including pilot surveys and the survey "Leaders of Opinion" (clergymen, doctors and teachers), but incorporating the replies of members of the

Mass Observation "Panel" (individuals who undertook to record their own views and to observe public opinion for the work of Mass Observation) who were perhaps both more middle-class in general social standing and more unorthodox in attitudes than would be completely representative of general feelings.

An outstanding discovery made by Mass Observation in researching this subject was

the contrast between our own initial expectation of inhibition, embarrassment and rebuff—and the friendly and cooperative manner with with our questions were answered.

Only 1% of the street sample refused to continue responding once they had learnt of the survey's emphasis upon sex. One woman, however, was reported to have terminated the interview with the remark "We never mention the word sex in the class of society I belonged to." One problem that was noted was the tendency of respondents to try and give a "correct" reply; but certainly preconceptions to do with the reticence of the British were not fulfilled. Respondents regarded the subject as important—with "the constant insistence that 'sex is natural'" though it also appeared that there was a conflict between thi6 view of sex as natural and healthy and fears of "uncontrolled" sex.61 382

In the finished “Report", in the chapter on "Discovering Sex",. the

"haphazard, surreptitious passing on of information" was noted, while "as many as one in twenty claimed marriage as their sex instructor." The conclusion drawn was that

Most of the people who are grown up today "picked up" th e ir sex knowledge—off the street-corner, from workmates, from other children, from whatever literature, "respectable" or otherwise, they could lay their hands on, or just by keeping their eyes and ears open.6*

Such information was often extremely bitty: "knowledge of one aspect may or may not be accompanied by ignorance of another", and in some cases respondents had not in fact realised until a relatively late age that there was anything to learn (most startlingly in the case of a midwife who had not realised the role of fathers). In a statistical breakdown of sources reported (and some respondents gave more than one), 25% said they had

"picked it up", 13% that they had learned from other children, 12% that it

"came naturally" or by experience, 11% (probably mostly girls) had been instructed by their mothers, 8% had found out through reading, 6%

(probably more likely to have been mostly boys) had been told by their fathers, 6% by a teacher, 6% learnt from workmates, 5% by getting married,

4% in the Armed forces, and 10% from other sources. The older respondents were more likely to have claimed knowledge of "natural" origin.63

A number of respondents, when describing Information picked up from school or work-mates or in the Forces, were as pejorative in their remarks as

Stopes* correspondents cited above:

I also found out the nastier things from youths around my own age.

In the Army I discovered how beastly some men are. Their conversation and bragging of their exploits made unpleasant something which should between two people in love be the fulfilment of their love and passion. 383

From smutty sto ries.

From all sorts of people in a most repulsive and incorrect manner. The damage was done before I found the right literature.

Schoolmates' dirty stories.®4

Through smutty jokes and conversation. Rather pleasant but also rather dangerous.

As small boy, had entirely wrong information imparted by schoolf riend.6®

I never at any time heard anything about sex but what was smutty and sordid.6®

One man, describing the "wrong way" he had learnt about sex, detailed the usual tale of schoolboy smut and added "finally by deliberately having sexual intercourse",®7 which would appear rather rare, although numbers seem to have learnt in marriage or engagement what they had not previously known. Deliberately requesting information was very uncommon, though one man did say he had found out "by enquiry"60 and another by going to the public library and "askiing] for a book on it."60 Most however seem to have learnt from whatever sources became available to them; those who did seek information from books were often restricted to such works as they could lay hands on.

Of the 8% who claimed to have found out from reading, the things read covered a very wide field, ranging from the Bible, to daily papers, encyclopaedias, dictionary, household medical books, Shakespeare, Bertrand

Russell, Aldous Huxley, Freud, Havelock Ellis, and Marie Stopes. At least one cited L N Fowler the nineteenth century phrenological writer. Among the works or authors cited more than one or two times were the Bible,

Havelock Ellis, Marie Stopes, Freud, Kenneth Walker, and books generally on natural history and biology. The report noted that there were significant 384 differences between the street sample and the National Panel group of Mass

Observers in their returns on this point. The Report also mentioned that there had been collected during the survey a mass of information and literature likely to fall into "unspecialised hands", and that this was mostly on the ill-effects of masturbation. The report, being no doubt thoroughly up to date with the latest thinking on the subject (see below, pp 394-395, for a discussion of changing ideas about masturbation), pointed out that there was little rational basis for believing masturbation to be particularly deleterious.70

In terms of gender differences in this field, the survey concluded "Men appear to have experienced fewer troubles, on the surface at least", and they seemed

to be more complacent about their lack of sex instruction; perhaps in any case street-corner bandying of sex facts is more open and casual amongst boys—or perhaps men are less willing to admit to sex doubts and difficulties.71 a view which could perhaps be substantiated from Stopes's correspondence, with the numbers of men who wrote to her reiterating how hard they would find it to tell their troubles to anyone else, how reluctant they were to consult doctors (see Chapters 5, 6, and 8). However willing respondents were to discuss their general attitudes, it may well be that the face-to- face questionnaire method of the survey would have deterred any discussion of personal fears and problems.

Based on research conducted by the psychiatrist Eliot Slater and psychiatric social worker and researcher Moya Woodside, Patterns of

Marriage: A Study of Marriage Relationships in the Urban Working Classes

(London 1951) reported on a investigation of 200 families carried out 385 between 1943 and 1946. While th is survey was re stric te d by the method of selection (two groups, one of soldiers who succumbed to neurotic illness while in army service and another of soldiers hospitalised for non-neurotic ailments) and was small, S later and Woodside believed th e ir sample to be

"fairly representative... of Londoners of working and lower middle-class, married, and between the ages of twenty-two and forty-seven."7,2 Like Mass

Observation, they found a certain complacency amongst men:

Men seemed to be less troubled on the subject and took it much more for granted. Sexual adaptation was in fact far more successful... Time and again, things were said to be "all right", and further enquiry was blocked.7”3

It might be supposed, giving the increasing acceptability of, and debate about, birth control described in earlier chapters, that no-one could have avoided knowing exactly what th is was by the 1940s: but Mass Observation uncovered a number of misunderstandings in the responses to the questions on this subject: some respondents thought the term had something to do with anaesthesia in childbirth,and this unfamiliarity with the precise meaning of the expression was also noted by Eliot Slater and Moya

Woodside, in Patterns of Marriage, though they did not find any misapprehension of quite this kind. What they did discover was that

many do not realise that coitus interruptus (withdrawal) is in fact a form of contraception, regarding "birth control" as something chemical or mechanical, while others confuse contraception with abortion.76 a conclusion borne out by such reported comments as that of "Mrs D", who said that "they don't use birth control as 'there's no need* but also says her husband is 'careful'."7,6 However, in sp ite of th is semantic confusion,

Mass Observation found that men and women on the whole agreed about its desirability,77 and certainly on studying the questionnaires themselves no comments can be found comparable to those addressed to Stopes detailed in 386

Chapter 5 expressing reservations and even revulsion about the entire concept. A particular change was that

Doctors... are inclined to consider the necessity of birth control from the more practical angles of health and finance and as such to approve.7®

Marriage, it was discovered, in particular by "the man in the street", was regarded as

a purely mundane personal arrangement designed for people's comfort and happiness—an arrangement, however, which is easily capable of going wrong.7®

In more general consideration of sex and its psychology, the consensus was that it was "natural, but only insofar as it is also reasonably orthodox."

Little fundamental objection to sex itself was expressed (though a few respondents did so), any reservations being to do with "infringement of conventional ethics." There was however a recurrent notion (expressed by one in five people) of the harmfulness of sex if "overdone", though it was not clear whether this meant excessive sexual activity or too much mental preoccupation with the subject. "A considerable amount of anxiety" was focussed on the fear of "sex 'getting a hold on you'", and the dangers of over-indulgence.®0 It came out under the discussion of responses on the subject of "Abnormalities" that men were not only more wary of the dangers of contracting venereal disease, but

they are also more inclined to dwell on the consequences of over-frequent sex relations.®1

This view would appear to be somewhat inconsistent with that expressed in the chapter on commercial sex and prostitution, that "the man's need of the prostitute is more widely recognised" than the prostitute's need to pursue her trade, although it was conceded that prostitution "kept the streets safe", protecting "decent women" from assault.® 2 However, there was not 387 necessarily any contradiction between these two views: on the one hand men seem to have been conceived as having imperious desires demanding occasional urgent gratification, but undue indulgence in sex beyond this perceived as dangerous, just as there might be imagined a distinction between natural appetite for food and gluttonous over-indulgence. It should perhaps be noted that in a list of common superstitious beliefs about venereal diseases known to American workers in the field, there was one, that "it is possible to catch gonorrhoea by excessive copulation 0a strain')."®3

Anxieties around male sexuality were returned to in notes among the miscellaneous unsorted draft material with this "Report", in which there was a comment upon

the advertisements in sex interest periodicals... aimed at a market anxious about their loss of "youthful vigour".... a glance through almost any of the current sex interest magazines shows offers of literature on birth control, proferred cures for sexual difficulties and fears... and finally, the glandular advertisements.®*

A quantity of material relating to proprietary medicine and tonics presumably accumulated during the course of the survey is to be found with this collection. Anxiety to do with the 06 I S of male vigour and the development of sexual debility, even if not referred to by male respondents, would not seem to have diminished over a period of fifty or so years, although the means for treating it seem to have changed with changing fashions and ideas; by the 1940s "glands" and "hormones" were being touted as the remedy.®®

Other works which mentioned the dissemination of sexual advice and considered its effects upon marriage which were in preparation at a 388 similar time to the Mass Observation survey were Slater and Woodside's

Patterns of Marriage, which has already been cited above, and Eustace

Chesser’s The Sexual. Marital and Family Relationships of the English Woman

(London 1956) reporting upon surveys carried out in 1954. Both of these mentioned the contribution made to marital adjustment by sexual advice lite ra tu re . S later and Woodside commented

Books on sex have helped, and create a mental background which favours attempts at a planned adaptation.®® and mentioned examples of books being exchanged between the couple.

Chesser's results would seem to be remarkably confirmatory of the important part such literature played (it should be remembered that his results pertained to women, but certain social changes affecting both sexes can be generalised from his findings):

The highest proportion of those who experience a lot of satisfaction (one-half) is among those who obtained their sex education mainly from books and pamphlets.®7 and extrapolated

Such reading may have helped to allay fears and anxieties and was, presumably, the expression of a desire to know more in order to find greater enjoyment in the sexual relationship; it might also have suggested more satisfactory sexual techniques.®®

In contrast, and very interestingly, he discovered that the group of women manifesting the least satisfaction with their sexual life within marriage was that which had obtained such sex education as they had had from other children, from which he concluded

It would appear that the degree of sexual satisfaction in adult life is significantly influenced in many cases by the way in which sex education is gained in adolescent years.®9

This may have borne some relation to social class, but Chesser had most significantly found that that there was a noticeable difference between the older and younger age groups in the matter of discussion of sexual 389 matters either between women friends or with boy-friends. Two-fifths of the women born before 1904 had discussed sex with other women, and one- seventh with boy-friends. Three fifths of those bom after 1914 had discussed sex with other women, and over one-fifth of those born after

1924 with boy-friends.

It would therefore seem that there is some evidence for a degree of greater sexual openness having come about by the 1950s, in terms of the availability of literature and its perusal and a great readiness to discuss the subject in ways that were not to do with "street-corner smut", both within marriage and between friends.

However, this apparent "progress" should perhaps be qualified, although it is not necessary to discount it entirely. It has been mentioned above and in Chapter 4 that Eustace Chesser's Love without Fear, a serious marriage manual written by a practising doctor (specialising in gynaecology and psychology), was the subject of prosecution for obscene libel in 1942, after 5000 copies had already been sold and even though it was very largely made up of quotations from works already in circulation. In a discussion of the case in a more general essay on "Recent Developments in the Law of Criminal Libel",90 Alec Craig commended the defendants' choice of trial by Jury over summary trial. In the latter case conviction was almost certain, especially if the Director of Public Prosecutions was behind the case. The penalties, however, were comparatively light, particularly if a plea of guilty were entered. With trial by Jury conviction might mean heavy penalties; but, as Craig pointed out

there is always just a chance that a jury may be impressed by a man's sincerity or bring a healthy man-in-the-street knowledge 390

of life to bear on the case.91

This difference between orthodox views of authority figures and those of the ordinary person in such matters was commented upon elsewhere. Mass

Observation both in its survey on sex and in earlier investigations on venereal disease found that the general public were usually a great deal less prudish and far readier to take an interest in the topic than legislators and opinion-makers tended to believe.92 It may be recalled that for many years, following the repeal of the Contagious Diseases Acts, the

Government and its departments had been reluctant to re-open the debate on venereal disease for fear of public opinion (as discussed in Chapter 2), an anxiety which it would appear was somewhat misguided.

While the sty le of Love without Fear was, as Craig described it "hortative and rather startling... calculated to impress itself on ordinary men and women without any special knowledge of the subject or remarkable scholastic achievement"93 making it an accessible and readable work upon the subject, at 12/6 it was by no means cheap, as Chesser himself declared during the trial "a price... which will, one hopes keep it out of younger people's hands, such as typists and others."9* It was specifically directed towards the married and those about to be, and Chesser hoped that it would be recommended by other medical men to their patients.

Chesser was able to plead that he had seen in his practice an enormous amount of suffering caused by sexual difficulties, as much or more in the industrial town of Salford as in his subsequent London practice.9* The

Common S erjeant's summing up was, Craig said, "a lucid, dispassionate and authoritative statement of the law of obscene libel."9* This Included, summarising the defence position, such analyses as 391

Their first defence is that at this time, in the year 1942, it is ridiculous and absurd to suggest that the discussion of sex and sex relationship in a book is obscene... all this hush-hush and secrecy with regard to sex and sex relationship have done a great deal of harm, as anyone who has had any experience as a doctor knows.®'7’

He drew the jury's attention to the price of the book and the fact that "it can be bought at reputable booksellers' shops like Harrods and W H

Smith's", and that Chesser was hardly making a fortune from its sales.33

The testimony of three doctors

Nevertheless in subsequent editions Chesser made some changes in the book omitting certain passages and examples which had been the subject of particular objections by the prosecution.100. Even so, the July 1942 edition (that is, issued subsequent to the trial) of Love without Fear still contained such passages as the following which had aroused comment:

In some continental licensed brothels, large numbers of girls are ordered by the "madame" to parade before prospective customers... These girls are never naked. Often they wear a silken sash which hides one breast but leaves the other exposed... long silk stockings and high-heeled shoes.101 and the descriptions of homosexuality, lesbianism and sado-masochism.103

The question of distribution and the danger of such works finding their way into the wrong hands was discussed during the Chesser trial, being raised in fact by the Foreman and another of the Jurors.103 Such questions were involved in other cases discussed by Craig in his essay; in one case respecting a privately-run lending library in the West Country, which was 392 circulating a book specified as for the medical profession and students of physiology without any such limitation as to the borrowers to whom it was lent, and without making sure that these were over twenty-one. A request on the order form for a declaration of this was suggested by the judge to be Man additional inducement to adolescents."1 In other cases, the plea was made th at customers included "a number of doctors and clergymen",

"medical men and psychologists", and such mitigating factors as the shop being "in a quiet street well away from the front" supplied, also the precautions [taken] to prevent young people obtaining the books."10®

This would suggest that it was not necessarily easy for those who wanted to obtain books on sexual matters, for however worthy a reason, to do any such thing. Among the additional materials found with the Mass Observation

Sex Survey there was the catalogue of The Direct Book Supply Co of London

NW9, a mail-order lending library, operating c. 1950.10® Intending subscribers to this "Exclusive Library" were warned that it was intended solely for the

PERSONAL use of members of the professions, psychologists, social workers, students of psychology and responsible adults, for the purpose of serious study. and a declaration to this effect had to be signed. The books offered were some of them, it was stated , "VERY SCARCE".

The books offered were a very bizarre but perhaps quite revealing selection. They included books which were serious works of sexology by

Havelock E llis, Wilhelm Stekel, etc, sexual advice manuals by Marie Stopes,

Eustace Chesser, Norman Haire, Van de Velde and other standard writers, anthropological classics such as Malinowskis Sex and Repression in Savage

Society and Margaret Mead's Coming of Age in Samoa, and banned novels 393

(now recognised as major works of literary merit) such as Joyce's Ulvsses and D H Lawrence's Ladv Chat ter lev's Lover. Positively a social service to the enquiring serious reader? Maybe. However these worthy efforts were to be found in close proximity to works of a more specialised appeal, not merely the ’’Leafless Eves' Library'1 but such works as Tortures and

Torments of the Christian Martyrs. The History of Torture throughout the

Ages. The Whip and the Rod. Slavery in the Roman Empire, and other works described as "special reference to stimulation by punishment","of absorbing interest to students of torture and flagellation", "some of the finest chapters ever written on corporal punishment at sea" (Herman Melville's

White-Jacket). Other books promised "many strange illustrations" or to be

"curious".

Besides this association with books at least verging upon the, if not wholly, pornographic, works of seriously intended instruction and aid were mixed up willy-nilly with those which might possibly be regarded as part of the problem they had been written to combat and which had been in circulation for a great many years. For example, The Superb Virility of

Manhood by Bemarr Macfadden, first issued during the 1890s and containing detailed accounts of the dangers of male debility, Huhner's (misspelt as

Hunter) Disorders of the Sexual Function in the Male, first published before World War I, Gardner's nineteenth century tre a tis e on The Conjugal

Relationship as to Health. R T Trail's contemporaneous Sexual Physiology and Hygiene, and Walling's gruesome Sexology107 were all listed in the catalogue without any comment as to their age or reliability as guides.

Readers did not necessarily come to these with any realisation that they were (or should be) "amusing museum relics", as Cyril Bibby, in Sex

Education (1946), described just such a book—John Thompson's Man and hie 394

Sexual Relations: embracing the Evils and Remedies of a Misguided Youth.

Manhood and Married Life—which had come into his hands in 1943.1c,e

One change that had definitely taken place in sex education literature by the 1940s was a radical alteration in the advice given concerning masturbation. As opposed to the stringent warnings against it and the dire tales of its awful effects (such as could be found in the works mentioned above circulated by the Direct Book Supply Co), the standard opinion in works for young people at the period under discussion was that the old- fashioned works of scare-mongering did far more harm than the habit its e lf: as Cyril Bibby wrote in Sex Education

The trouble is not so much in the habit of masturbation... as in the mental conflict which may arise from its condemnation.109 a point of view with which Eustace Chesser concurred

It has no ill-effects, physical or mental—except those bruises which may be caused to the young mind when the child... is made to have a feeling of guilt and shame.110 and which was, in fact, more or less a commonplace by th is period. Similar comments could be found in the pamphlet Sex Education for Children by C P

Blacker, General Secretary of the Eugenics Society and issued by that body:

The habit causes no physical harm provided that it is practised in moderation. Some boys who have begun to masturbate, when told that this leads to insanity, are so frightened as to be able to break it off; others are equally frightened but cannot break it off. These frequently suffer greatly in mind.111 and in the Home University Library’s volume on Sex: its meaning and purpose (1951) by W E Sargent, discussing the subject from a religious

(Christian) angle, it was stated that:

Masturbation has no physical, consequences that can be called injurious, any more than a happy normal intercourse hae. The harm done is psychological—through worry and through habit. If people have collected wrong ideas about masturbation—ideas which arouse their feelings of guilt and make them think they 395

have committed the unpardonable sin, or that they have damaged their brain and may some day have to go into a mental hospital —they will certainly be greatly worried.112

The distinguished American physiologist George Corner, in Attaining Manhood

(first published in Great Britain in 1953), also agreed that

Such stupid falsehoods have often caused tragic mental suffering on the part of boys who had little or nothing to worry about or be ashamed of. Modern physicians know th at occasional self-excitement is not harmful... Serious worry over the possible sinfulness of it, or violent efforts to repress it on the part of people in whom the desire is almost irresistible, can do much more harm than the act its e lf .113

The constant reiteration of this reassurance would suggest that notions of the harm caused by masturbation were still prevalent, and this is perhaps not surprising. Not only were books detailing the horrendous results of the practice still in circulation, it seems probable that myths on the subject were among those retailed between young boys in their search for knowledge on the subject. Bibby, in Sex Education, gave examples of the k inds of questions children and adolescents at various stages were likely to ask, given the opportunity to do so, and among these he included

Boys <13-15 years): Does self-abuse make you lose blood? I ditto: Lose strength, lose weight, etc.] Does masturbation cause insanity? [ditto :Consumption, venereal disease, paralysis, pimples, etc.] If you do it, will you be able to marry?11A

Reassurances were also given about nocturnal emissions:

Unfortunately there is a foolish tradition that spontaneous emissions are harmful. Quack doctors who publish advertisements writer about such emissions as "nocturnal pollutions" or "loss of manhood", thus trying to frighten people into patronizing their useless remedies.116

[Boys] should be told that this is quite natural and in no way harmful. It is not a sign of weakness nor i6 it in any way weakening.116 396

This is simply a sign that Nature is beginning to work in you. She is, if you like, "testin g out" the apparatus she has made... when this happens to you... there is nothing to worry about.117

Nothing could be more natural than these emissions—yet they are a nightmare of worry to many millions of young boys. Unreasonable feelings of guilt are often experienced.11®

It should not however be supposed that these reassuring writers altogether approved of the practice of masturbation:

It is not wrong, but for certain reasons it is something you might make an effort to do without... masturbation may be regarded as quite "normal", but it is wise and healthy to consider the reasons for doing your best to refrain.119

Despite all this, one cannot say that masturbation Is a desirable practice.120

The worst than can be said of masturbation is that it is childish; and who wants to be guilty of childish things?121

The mind and body must be kept under reasonable discipline. For this reason sensible boys and men will avoid as far as possible unnecessary sexual stimulations.122

Another change in sex education was the disappearance, to some extent, of the "birds and bees" method of dealing with it. As Blbby suggested, in discussing the "so-called 'biological approach'",

The child was not asking about amphibians or angiosperms, it was asking about humans—and it has a right to expect that its question will be answered. Certainly its attention should from time to time be directed to the reproductive mechanisms of other creatures, but not as a substitute for answering its q ueries.123

Blacker, while suggesting that this method was good for collective instruction of children, concurred that it was not

always the best way of answering the simple questions which naturally arise in the minds of young children. When the child asks these it usually wants a straight answer; it does not want a le ctu re.12*

However, it had not disappeared entirely: both Corner and Chesser in th e ir 397 works (intended for perusal by actual adolescents) spent some pages on the evolution of sexual reproduction, and on heredity. The account was nevertheless far briefer, a mere introductory summary, than it had been in analogous works published earlier in the century.

Another topic which was less discussed was the problem of prostitution.

Although, according to Blacker, this was still Hso common in large towns

that boys and girls living in them are sure to learn about it some

time",12B warnings were more likely to be given about general promiscuity.

Chesser, in Grow up—and Live, in which “prostitution" was not even mentioned in the index, nevertheless warned against "careless sexual relations" and the "rather fast girl" who let herself be picked up.12*

Bibby, while commenting on the g reater awareness of venereal disease among

young people as a result of massive public health publicity campaigns

during the war,127 spent more time on the problem of "petting" than on the

question of prostitution, which he believed (like so many other

authorities) to be far less significant than it had once been wont to be,

having been to a great extent replaced by freely-chosen casual affairs.12*

Comer likewise considered sexual temptation far more likely to present

itself to contemporary young men in the form of

in plain language, Intimate contact which may go to any length from relatively mild caresses to actual sexual union.129

than in the guise of the predatory harlot.

In conclusion, therefore, it may be argued that by the time the National

Health Service came into being sex in Britain was an area less fraught

with horror and stigma than it had been in 1900. However, i t should be 398 borne in mind that although venereal disease services were Included under the National Health Service (and in the universality of their provisions may be regarded as a precursor) birth control provision was still largely the province of the Family Planning Association, a voluntary organisation.

Training courses in contraceptive methods were run by this body, which was also responsible for testing the reliability of the various devices available. The general attitude of the medical profession towards the prescription of birth control well into the 1950s and even 1960s has been discussed in Chapter 7. While there was continuing governmental emphasis on the importance of the family and marriage, which was expressed in certain areas of social policy, the Marriage Guidance Council, again, was a voluntary body dealing with the actual marital problems of individual couples. Divorce, while easier to obtain, becoming more socially acceptable, and available on somewhat wider grounds than had been provided for in

1923, still involved concepts of "guilt" and "innocence". Case-law in the

Bourne judgement had indicated that doctors performing abortions to preserve a woman's health were within the law. With the advent of antibiotics it seemed that venereal disease was at last a defeated enemy.

Changes in attitudes to sex had on the whole been beneficial, lessening the shame and horror with which the subject had been surrounded, and increasing the possibility of open discussion on sexual topics. The roles of the sexes had not, however, been radically redefined. If the double standard was in retreat, the male was still expected to be the pursuer and initiator. Debates about the vaginal versus the clitoral orgasm, though perhaps more anxiety-provoking for women, must have had the effect of arousing worries in men about the capacity of their performance to produce the "mature" variety. Male sexual problems were still something that men 399 found it hard to mention and which still, because of this secrecy with which they were surrounded, provided a thriving market for the producers of remedies such as "Damaroids". While it was often commented, even by purity workers, that casual liaisons were on a moral level above the resort to prostitutes, they must have laid on the man more of a burden to be sexually competent than the purchase of an ’'outlet" for male desires would involve. Furthermore, overt street-prostitution was still regarded as sufficiently widespread and problematical in the 1950s to lead to the appointment of the Wolfenden Committee to investigate and make recommendations, leading to legislation.

The possible improvement in the quality of life created by the decline in venereal disease, the rise of birth control, and access to sources of sexual information which . were neither mercenary nor furtive and superstitious, should not be dismissed, even though there must be reservations and qualifications as to how far it went and how great the benefits were. If too much can be claimed for the significance of sex In human life, it is nevertheless true that it can be a potent source of happiness or misery for the Individual and the couple. Clean air, good drains, adequate nutrition and an unpolluted food supply are usually regarded as good things for the communities which enjoy them, if not the whole source of human happiness and well-being. The same may surely be said of conditions which make it possible for more individuals within a community to have (an admittedly hard to quantify) less worried, more enjoyable sexual life.

Nevertheless, it is by no means apparent that the medical profession had moved so very far since the turn of the century. Sexual disorders were 400 still neglected in the medical curriculum and many doctors still disdained to give birth control advice. The existence of the common male dysfunctions, and their prevalence in the community, was still a well kept secret, and even in 1989 the B ritish Medical Journal has commented upon the neglect of the problems of the prostate which affect so high a percentage of men once they reach their middle years.'30 "Private clinics" advertise in quality newspapers offering treatment for impotence and premature ejaculation (the naming of the problems, instead of subsuming them under the name of "male weakness", is perhaps an advance?),131 suggesting that, if not a product of the strains of modem life, these problems continue to exist, and that sufferers feel chary of taking them to their general practitioners. In a witty essay "If Men Could Menstruate" by the American feminist Gloria Stelnem she has advanced the conceit that if men rather than women had periods enormous attention and financial resources would be given to problems such as dysmenorrhea.132 The operation of power within society is not quite so clear-cut as this, as has been indicated in this study of attitudes towards uniquely male problems, especially where these carry the connotation of some kind of failure or inadequacy, and if men menstruated, it seems entirely probable that common wisdom and that of the massed ranks of the medical profession would concur that Real Men don't have period pains. 401

Chapter Nine; Notes

1. such as Davis, Katherine B, Factors in the Sex Life of Twenty-two Hundred Women. Harper and Bros, New York, 1929; Hamilton, G V T, A Research in Marriage. A & C Boni, New York, 1929; Dickinson, Robert L and Beam, Lura, A Thousand Marriages. Williams and Wilkins, Baltimore, 1932; Terman, L, Psychological Factors in M arital Happiness. McGraw-Hill, New York, 1939

2. Langford Adams, Paul, "Health of the State: British and American Public Health Policies in the Depression and World War II", unpublished dissertation for the Doctorate of Social Welfare, University of California Berkeley, 1979, Chapter 7, "Reforming Morals and Making Fornication Safe: Venereal Disease Control in Wartime", pp 326-367, ref to p 328

3. Harrison, L W, "The Public Health Services and Venereal Diseases", B ritish Journal of Venereal Diseases 1925 Vol 1 no 1, pp 12-22; Newsholme, Sir Arthur, "The Decline in Registered Mortality from Syphilis in England. To what is it due?", Journal of Social Hygiene. 1926, Vol 12 no 9, pp 514-523

4. figures from Adler, Michael, "The terrible peril: a historical perspective on the venereal diseases", British Medical Journal. 1980 ii, 206-211

5. P residential Address by Dr W ilfrid S Fox, BJVD. 1926, Vol 2, pp 59-64, re f to p 59

6. Lees, Robert, "VD—Some random reflections of a venereologist", BJVD. 1950, Vol 26 no 4, p 157-163, re f to p 157

7. Mills, C, "Collaboration between the Venereal Disease and Other Departments", BJVD. 1934, Vol 10, pp 233-248, re f to p 248

8. ibid. p 246

9. Orpwood Price, I N, and Burgess, J A, "Is a New Deal in the Control of Venereal Disease Necessary?" <2 papers and discussion), BJVD. 1944, Vol 20, pp 19-30, re f to pp 28-29

10. Harrison, op cit. p 13

11. Langford Adams, op cit. pp 327

12. The Lancet. 1932, i, 1229

13. The Lancet. 1932, i, 1279-1280

14. Metcalfe Chambers, W, "Prostitution and Venereal Disease", BJVD. 1926, Vol 2 no 5, pp 68-75 re f to p 72

15. Crookshank, F G, "Medico-Legal Problems in Relation to Venereal Disease", BJVD. 1926, Vol 2 no 5, pp 36-58, re f to pp 40-41

16. Lives of the Fellows of the Royal College of Physicians. London ("Munk's Roll"), Vol IV, 1826-1925, pp 567-568 402

17. Thompson, W Derwent R, "The Medico-Legal Aspects of Venereal Diseases", BJVD. 1936, Vol 12, pp 88-108

18. King, Ambrose, 'These Dying Diseases: Venereology in Decline?", The Lancet. 1958, i, 651-657, re f to p 651

19. Dalrymple-Champneys, Sir Weldon, 'The Epidemiological Control of Venereal Disease", BJVD. 1947, Vol 23, pp 101-108, ref to 102

20. Lees, op cit. p 158

21. "Scotland versus VD", The Lancet. 1944, i, 668

22. Dalrymple-Champneys, op cit. p 102; Lees, Robert, "Venereal Diseases in the Armed Forces Overseas <1)", BJVD. 1946, Vol 22, p 149-158, ref to p 155; Campbell, D J, "Venereal Diseases in the Armed Forces Overseas (2)", BJVD. 1946, Vol 22, pp 158-168, re f to p 159; History of the Second World War: United Kingdom Medical series: The Army Medical Services: Administration II. edited by F A E Crew, HMSO, London, 1955, p 236

23. contribution by L W Harrison to discussion of Dalrymple-Champneys, op cit. p 108; Burgess, J A, "Is there a New Deal in the Control of Venereal Disease", op cit. p 24, pointed out the great regional variations in routine testing of pregnant women for latent syphilis

24. Campbell, D J, op c it. p 159

25. The Army Medical Services: Administration II. p 238

26. The Lancet. 1944, ii, 17, "Legislative Control of Venereal Disease"; in the discussion on Dalrymple-Champneys, op cit. p 106, L W Harrison pointed out that in spite of the oft-repeated exhortations to follow the compulsionist example of the Scandinavian countries in treating venereal disease, statistics such as this did not bear out the superiority of such measures.

27. The Armv Medical Services: Administration II.d 231

28. ibid, p 232

29. Lees, Robert, "Venereal Diseases in the Armed Forces Overseas", p 155

30. The Armv Medical Services: Administration II.p 234

31. The Lancet. 1944, i, 167

32. The Lancet. 194,. ii, 18

33. The Shield. 1942, 5th series no 9 (2), p 58

34. The Lancet. 1942, ii, 577

35. The Lancet. 1943, i, 276 403

36. e g Frazer, A D, T h e Problem of the Defaulter", BJVD. 1932, Vol 8, pp 56-58, and In 1935, Vol 11, a series of papers on p articu lar classes of defaulter

37. Watts, Major G 0 Wilson, Major R A, "A Study of Personality Factors among Venereal Disease Patients", Canadian Medical Association Journal. 1945, Vol 53, pp 119-122

38. Ratcliffe, Lt-Col T A, "Psychiatric and Allied Aspects of the Problem of Venereal Disease in the Army", Journal of the Royal Army Medical Corps. 1947, Vol 89, pp 122-131

39. Wittkower, E D, The Psychological Aspects of Venereal Disease", BJVD. 1948, Vol 24, pp 59-67

40. "Compulsory Methods and the Treatment of Venereal Diseases", The Shield. 1942, 5th series 9 <2>, pp 55-58

41. Stokes, Prof John H, T h e Future of Syphilis" BJVD. 1928, Vol 4 no 4, pp 274-289, re f to p 275

42. McElligott, G L M, The Venereal History: Truth or Fiction?", BJVD. 1932, Vol 8, pp 292-297, re f to p 294

43. Hanschell, H M, The Problem of Venereal Disease in the Merchant Marine", BJVD. 1929, Vol 5 no 3, pp 202-208

44. Ross, A 0, "The Problem of the Treatment of Venereal Disease in the Mercantile Marine", with discussion on this and the above paper by Hanschell, BJVD. 1929, Vol 5, pp 210-228, re f to p 220

45. R atcliffe, op cit. p 125

46. Sutherland, Robert, "Some Individual and Social Factors in Venereal Disease", BJVD. 1950, Vol 26, pp 1-15, re f to p 3

47. R atcliffe, op cit. p 125

48. The Lancet. 1942, ii, 737

49. The Shield. 1938, 5th se rie s 6 <3>, p 125

50. White, Douglas, The Basis of a New Moral Appeal", The Shield. 1939, 5th series 7 <1), pp 1-4, ref to p 2

51. "The Social Aspect of the Venereal Diseases"; Johns, Hilda M, "Contact Tracing", BJVD. 1945, Vol 21 pp 17-21

52. ibid: Wailes, Margaret A, "Contact Tracing and the Prostitute", BJVD. 1945, Vol 21, pp 15-17, re f to p 16

53. Gordon, Col J E, The Control of Venereal Disease: An Epidemiological Approach", The Lancet. 1944, ii, 711-715

54. The Shield. 1937, 5th series 5 (3), p 99: "Notes of the Quarter: 'Dangers to Men'" 404

55. The Shield. 1942* 5th se rie s 9 (1), pp 3-7; "Notes of the Quarter"

56. "The Social Background of Venereal Disease: a report on an experiment in contact tracing and an investigation into social conditions: Tyneside experimental scheme in venereal disease control* October 1943 to March 1944", BJVD. 1945 no 21, pp 26-34

57. White* D, in The Shield. 1933, 5th series 2(1), p 34

56. Marie C Stopes papers in the Contemporary Medical Archives Centre at the Wellcome In s titu te for the History of Medicine, correspondence "ML- GEN", CMAC: PP/MCS/A.222 HJS, A.88 FWF, A.83 KLE

59. for a b rief account of Mass Observation and its work, see Calder, Angus, and Sheridan, Dorothy, (eds), Speak for Yourself: A Mass Observation Anthology 1937-1949. Oxford University Press, 1985

60. Tom Harrisson-Mass Observation Archive at the University of Sussex: "Sexual Behaviour 1929-1950", A.9 "Sex Survey 1949"; file 5/D, "Organisational material"

61. ibid. file 3/B "Report on Sex: Chapter One: Sex Surveyed"

62. ibid. file 3/C "Report on Sex: Chapter Two: Discovering Sex"

63. ibid

64. ibid: completed questionnaires, file 10/A

65. ibid: completed questionnaires, file 10/B

66. ibid: completed questionnaires, file 10/C

67. ibid: completed questionnaires, file 10/C

68. ibid: completed questionnaires, file 10/A

69. ibid: completed questionnaires, file 10/B

70. ibid. file 4/G "Report on Sex: Miscellaneous and Unsorted Draft M aterial"

71. ibid. file 3/C "Report on Sex: Chapter Two: Discovering Sex"

72. S later, Eliot and Woodside, Moya, P atterns of Marriage: A Study of Marriage Relationships in the Urban Working Classes. C assell and Co, London, 1951, p 21

73. ibid. p 167

74. Mass Observation, A.9 "Sex Survey 1949" file 3/E, "Report on Sex: Chapter Four: Birth Control"

75. S later and Woodside, op c it. p 194

76. ibid. p 206 405

77. Mass Observation, A.9 "Sex Survey 1949" file 3/E "Report on Sex: Chapter Four: Birth Control"

78. ibid

79. ibid. file 3/F "Report on Sex: Chapter Five: Marriage"

80. ibid. file 4/C "Report on Sex: Chapter Nine: The Psychology of Sex"

81. ibid. file 4/F "Report on Sex: Early draft chapters, discarded; Chapter Fifteen; Vanguards and Resistance Movements"

82. ibid. file 4/B "Report on Sex: Chapter Eight: Prostitution"

83. Regenburg, B H, and Durfee, R A, "Venereal Disease and the Patient", Journal of Social Hygiene. 1934, Vol 20 no 8, pp 369-377

84. Mass Observation, A.9 "Sex Survey 1949", file 4/G Report on Sex: Miscellaneous unsorted draft material and notes"

85. ibid. file 16/G "Advertising and Publications: Proprietary Medicines and Tonics"

86. S later and Woodside, op c it. p 173

87. Chesser, Eustace, Maizels, Joan, Jones, Leonard, and Emmett, Brian, The Sexual. Marital and Family Relationships of the English Woman (with the assistance of an Advisory Committee comprising Professor F A E Crew, Professor Alexander Kennedy, Kenneth Walker, Doris Odium, Canon Hugh Walker), Hutchinson's Medical Publications Ltd, London, 1956, Chapter 14, §22, p 177

88. ibid. Chapter 14, §23, p 177

89. ibid. Chapter 14, §21, p 177

90. Craig, Alec, "Recent Developments in the Law of Obscene Libel", in Pillay, Dr A , Ellis, Albert (eds), Sex Society and the Individual: Selected Papers, revised and brought up to date, from Marriage Hygiene <1934-1937) and the International Journal of Sexology (1947-1952). The International Journal of Sexology, Bombay, 1953, pp 302-327

91. ibid. p 303

92. Mass Observation, A.9 "Sex Survey 1949", file 3/B "Report on Sex: Chapter One: Sex Surveyed", and Mass Observation VD surveys of 1942-1943, "Sexual Behaviour", file s 1/A-G

93. Craig, op cit. p 302

94. ibid. p 306

95. ibid. p 304

96. ibid. p 307 406

97. ibid. p 311

98. ibid. p 312

99. ibid. pp 313-314

100. ibid. p 314

101. Chesser, Eustace, Love without Fear; A Plain Guide to Sex Technique for Every Married Adult. Rich and Cowan Medical Publications, London, 1941, [revised edition] July 1942, p 26

102. ibid. Chapter XI "Byways of Sex" and Chapter XII "Painful Pleasures, pp 105-124

103. Craig, op cit. p 307

104. ibid. p 315

105. ibid. pp 315-320, passim

106. Mass Observation, A.9 "Sex Survey 1949", file 16/A "Advertising And Publications: Published M aterial on Sex"

107. MacFadden, Bernarr A, The V irile Powers of Superb Manhood: How Developed. How Lost. How Regained. Physical Culture Publishing Co, New York, 1900; Huhner, M, A Practical Treatise on Disorders of the Sexual Function in the Male and Female. F A Davis Co, Philadelphia, 1916, 3rd edition, 1929; Gardner, A K, The Conjugal Relationship as regards Personal Health and Hereditary Well-Being Practically Treated. USA c. 1890, T D Morison Glasgow/Simpkin Marshall Hamilton and Kent, London, 1894; T rail, R T, Sexual Physiology and Hygiene: An exposition practical, scientific, moral, and popular of some of the fundamental problems in sociology. T D Morison Glasgow/Simpkin Marshall Hamilton and Kent, London, 1888, 1908 edition; Walling, Prof W H, Sexology. The Puritan Publishing Co, Philadelphia, 1902

108. Bibby, Cyril, Sex Education: A Guide for Parents. Teachers and Youth Leaders. Macmillan and Co Ltd, London, 1946, p 128

109. ibid. p 109

110. Chesser, Eustace, Grow Up—and Live. Penguin Books, Harmondsworth Middlesex, 1949, reprinted 1951, p 237

111. Blacker, C P, Sex Education for Children. The Eugenics Society, London, [n d, c. 1940s]

112. Sargent, W E, Sex: its meaning and purpose. (Teach Yourself Book), English U niversities Press Ltd, London, 1951, reprinted 1969, p 67

113. Comer, George W, A ttaining Manhood. A Doctor Talks to Boys about Sex, with an introduction by Dr Eustace Chesser, British edition, George Allen and Unwin, London, 1953, reprinted 1959, p 57

114. Bibby, op c it. p 157 407

115. Corner, op cit. p 55

116. Blacker, op c it

117. Chesser. Grow up— and Live, P 235 118. Bibbv. op cit. p 125

119. Chesser. Grow up—and Live. P 237 120. Bibbv. op cit. p 129

121. Sargent, op cit. p 69

122. Corner, op cit. p 58

123. Bibbv. op cit. p 150

124. Blacker, op cit

125. ibid

126. Chesser. Grow up—andLive. P 247 127. Bibbv. op cit. p 169

128. ibid, p 22

129. Corner, op cit. p 68

130. Chisholm, Prof G D "Benign Prostatic Hyperplasia: the best treatment", BMJ. 1989, ii, 215-216

131. e g, in The Observer. June and July 1989

132. Steinem, Gloria, "If Men Could Menstruate", in Outrageous Acts and Everyday Rebellions. Holt, Rinehart and Winston, USA, 1983, Jonathan Cape, London, 1984, Flamingo paperback edition 1984, pp 337-340 408

Bibliography

Primary sources

Manuscript sources

In the Contemporary Medical Archives Centre, Wellcome In s titu te for the

History of Medicine, London:

Papers of Marie C Stopes (1880-1958), series "ML-GEN", "ML-DRS", and "ML-CLERGY", PP/MCS/A

Papers of Dr E F Griffith (1895-1988), PP/EFG

Files of the British Medical Association, 'Medico-Political* series, SA/BMA/C

Records of the Eugenics Society, SA/EUG

Papers of the National Society for the Prevention of Venereal Disease, SA/PVD

Archives of the Family Planning Association, SA/FPA

Records of the Birth Control Campaign, SA/BCC

Archives of the Abortion Law Reform Association, SA/ALR

In the British Library Department of Manuscripts:

Marie C Stopes Papers: "Physicians [British Isles]*', Additional Manuscripts 58561-58571

Professor R Ruggles Gates (1882-1962), Add Mss 59848

In the Tom Harrisson-Mass Observation Archive, University of Sussex:

Mass Observation "Sexual Behaviour" boxes

In the Church House Record Centre, Westminster:

Records of the Church of England Purity Society 409

In the Scout Association Archives:

Papers of Lt-Gen Lord Baden Powell (1857-1941); Rovering to Success correspondence, ref TC/2

In the Rare Books and Manuscripts Library, U niversity of Sydney:

Papers of Dr Norman Haire (1892-1952)

Parliamentary Papers

Report as to the Practice of Medicine and Surgery by unqualified persons

in the United Kingdom, 1910, Cd 5422

Select Committee on Patent Medicines 1914 (414)

Departmental Committee on Sickness Benefit Claims under the National

Insurance Act, Cd 7687, 1914

Royal Commission on Venereal Diseases.—

F irst Report, Cd 7474, 1914

Appendixes and Minutes of Evidence (1913-1914), Cd 7475, 1914

Final Report, Cd 8189, 1916

Appendixes and Minutes of Evidence, Cd 8190, 1916 410

Journals

British Medical Journal (BMJ)

The Lancet

British Journal of Venereal Diseases (BJVD) founded 1925

The Shield; Journal of the Association for Moral and Social Hygiene

Primary Published Sources

Abbot-Anderson, Sir Maurice, "Birth Control as seen by an Open Mind", The

Practitioner. July 1923, pp 6-13

Abercrombie, R, Abercrombie's Two Popular Medical Referees in one volume

First edition-combined/contents of the First Part: the Solvent Process.

Curative remedies for diseases of the chest, dropsy, tumours, cancer. etc/Contents of the second Part; the Self-Doctor and Household Medical

Referee, published by the author, London, 1883

— On the speedy and permanent cure of the diseases of the generative organ ...by a new Internal and painless electrodic process. The Aid of

Medicine Superseded. Addenda: prescriptions for the cure of general ailments and other interesting medical information in the New Self-Doctor and Medical Referee.... T Williams, London, 1891 411

Acton, William, The Functions and Disorders of the Reproductive Organs in

Youth. Adult Age and Advanced Life, considered in th e ir Phvslo logical.

Social and Psychological Relations. John Churchill, London, 1857, 3rd edition, 1862

P rostitution. London, 1857, new edition edited by Peter Fryer,

MacGibbon and Kee, London, 1968

A llbutt, H A, The Wife's Handbook. How a Woman Should Order Herself during

Pregnancy, in the Lying-In Room, and After Delivery. With Hints on the

Management of the Baby, and Other M atters of Importance Necessary to be

Known by Married Women. W J Ramsay, London, 1886

Allen, Clifford, Textbook of Psychosexual Disorders. Oxford University

Press, London, 1962

A risto tle’s Works. Medical Knowledge. The Works of A risto tle the Famous

Philosopher, containing his complete masterpiece and family physician, his

Experienced Midwife. His book of Problems and His remarks on Physiognomy.

London Cn d, c 18903, and other editions, also n d, of C19th-C20th

Arthur, Dr R, ’’Some Aspects of the Venereal Problem”, The Shield. 1916-

1917, Series 3 Vol 1, pp 302-308

Baden-Powell, Lord, Scouting for Boys: A Handbook for Instruction In Good

Citizenship. C Arthur Pearson, London 1908, 2nd impression

— ibid. 10th edition, 1922 412

Rovering to Success: A Book of Life-Sport for Young Men. Herbert

Jenkins Ltd, London, 1922

Balzac, Honors de, The Physiology of Marriage, first published in France,

1826, English edition, privately printed, London, 1904

Barnett, Arthur T, "The Testimony of Medical Men", in The Blanco Book. The

White Cross League, London, 1913, pp 217-248

Barton, E A, "The Ethics of Birth Control", The Practitioner. 1933, no 783,

Vol 131, pp 239-246

Beale, "Dr" G Courtenay, Wise Wedlock. The Whole Truth; A book of Counsel and Instruction for All Who Seek for Happiness in Marriage. Health

Promotion Ltd, London, 2nd edition, Cc. 19223

ibid. with an Introduction by Norman Haire, The Wales Publishing Co,

London, new edition revised, 1944

Bergler, Edmund, "Premature Ejaculation", in Pillay and Ellis (eds), Sex

* Society and the Individual, pp 58-63

Bibby, Cyril, Sex Education: A Guide for Parents. Teachers and Youth

Leaders. Macmillan and Co Ltd, London, 1946

Bigelow, M A, Sex Education. A Series of Lectures concerning knowledge of sex in its relatio n to human life. Macmillan, New York, 1916 413

Blacker, C P, Sex Education for Children. The Eugenics Society, London, [n d, c. 1940s]

Borden, Mary, The Technique of Marriage. William Heinemann Ltd, London,

1933

Bradbrook, R, "The VD Phobia”, Bulletin of the Institute of Technicians in

Venereology Ltd. tn d, c. 1950s3, pp 7-8

"British Troops in France: provision of tolerated brothels", The Shield.

1916-1917, Series 3 Vol 1, pp 393-397

Brittain, Vera, Testament of Youth: An Autobiographical Study of the Years

1900-1925. Victor Gollancz Ltd, London, 1933, cheap edition 1948

— Testament of Experience: An Autobiographical Storv of the Years 1925-

1950. Victor Gollancz Ltd, 1957, Virago Press paperback, 1979

Browne, F W Stella, Ludovici, A M, and Roberts, Harry, Abortion (3 essays).

G Allen and Unwin, London 1935

Burgess, J A, "Is a New Deal in the Control of Venereal Disease Necessary?"

BJVD. 1944, Vol 20, pp 19-30

Burke, E T, Scourges of Today. (Venereal Disease. Cancer. Tuberculosis and

Alcoholism). The S cientific Press, London, 1926 414

— Treatment of Venereal Disease In General Practice* The Scientific

Press, London, 1927

Campbell, D J, "Venereal Diseases in the Armed Forces Overseas (2)", BJVD.

1946, Vol 22, p 158-168

Carpenter, Edward, Love's Coming of Age. A Series of Papers on the Relation of the Sexes. George Allen and Unwin Ltd, London, 1896, 13th edition, 1930

Champneys, Sir Francis, "The Fight Against Venereal Infection: A reply to

Sir Bryan Donkin", The Nineteenth Century. Nov 1917, Vol 82, pp 1044-1054

"The Fight Against Venereal Infection: A fu rth er reply to S ir Bryan

Donkin", The Nineteenth Century. Mar 1918, Vol 83, pp 611-618

Chesser, Eustace, Love without Fear: A Plain Guide to Sex Technique for

Every Married Adult. Rich and Cowan Medical Publications, London, 1941, revised edition, July 1942

— Sexual Behaviour: Normal and Abnormal. London Medical Publications Ltd,

C19493

— Grow Up—and Live. Penguin Books, Harmondsworth Middlesex, 1949, reprinted 1951

— Unmarried Love: Sexual Wisdom for the Single. Jarrolds, London, 1965,

Corgi paperback edition, 1967 415

Chesser, Eustace, Maizels, Joan, Jones, Leonard and Emmett, Brian, The

Sexual. Marital and Family Relationships of the English Woman, (with the assistance of an Advisory Committee comprising Professor F A E Crew,

Professor Alexander Kennedy, Kenneth Walker, Doris Odium, Canon Hugh

Walker), Hutchinson's Medical Publications Ltd, London, 1956

Clouston, Sir T S, Clinical Lectures on Mental Diseases. J A Churchill,

London, 1883, 6th edition, 1904

Before I Wed, or young men and marriage. Questions of Sex Series,

Cassell and Co, London, 1913

Cokkinis, Apollo John, The Reproduction of Life: A handbook of the science of reproduction in nature and in man. B ailliere and Co, London, 1926

Comfort, Alex, "Sex Education in the Medical Curriculum", International

Journal of Sexology. 1950, Vol 3 no 3, p 175-177

"Compulsory Methods and the Treatment of Venereal Diseases", The Shield.

1942, 5th se rie s Vol 9 (2), pp 55-58

Cooper, Arthur, The Sexual Disabilities of Man and Their Treatment. H K

Lewis, London, 1908, 2nd edition, 1910

— ibid. 3rd edition, 1916 416

Copland, James, A Dictionary of Practical Medicine, comprising general pathology, the nature and treatment of diseases, morbid structures and the disorders especially Incidents to climates, to the sex, and to the different epochs of life. Longmans, London, 3 vols in 4 1844-1858

Corby, Henry, "Birth Control and Economy", The P ractitioner. July 1923, pp

62-73

Corner, E M, Male Diseases in General Practice: An Introduction to

Andrology. Oxford Medical Publications, 1910

Comer, George W, Attaining Manhood: A Doctor Talks to Boys about Sex.

Introduction by Dr Eustace Chesser, first published in the USA, George

Allen and Unwin, London, 1953, reprinted 1959

Costler, A, Willy, A and Haire, Norman, Encyclopaedia of Sexual Knowledge.

Encyclopaedic Press, London, 1934, 2nd edition, 1952

Cousins, Jane, Make It Happy; What Sex Is All About. Virago, London, 1978

Craig, Alec, "Recent Developments in the Law of Obscene Libel", in Pillay and E llis

Cronin, A J, The Citadel. Victor Gollancz Ltd, London, 1937, cheap edition

1942

Crookshank, F G, "Medico-Legal Problems in Relation to Venereal Disease",

BJVD. 1926, Vol 2 no 5, pp 36-58 417

Individual Sexual Problems. Psyche Medical Miniatures, London, 1931

Crozier, Brig-Gen F D, A Brass Hat in No-Man's Land: a personal record of the European War. Jonathan Cape, London, 1930

Dalrymple-Champneys, Sir Weldon, "The Epidemiological Control of Venereal

Disease", BJVD, 1947, Vol 23, p 101-108

Davies, Maxine, Sex and the Adolescent. A Guide for Young People and Their

Parents (Foreword by Dr Eustace Chesser), Heinemann, London, 1959

Davis, Katherine B, Factors in the Sex Life of Twenty-Two Hundred Women.

Harper and Bros, New York, 1929

Dickinson, Robert L and Beam, Lura, A Thousand Marriages. Williams and

Wilkins, Baltimore, 1932

Donkin, Sir Bryan, "The Fight against Venereal Infection", The Nineteenth

Century. Sept 1917, Vol 82, pp 580-595

"The Fight Against Venereal Infection: a rejoinder", The Nineteenth

Century. Jan 1918, Vol 83, pp 184-190

"The Double Moral Standard in the Law", The Shield, 1926-1929, 3rd Series

Vol 5, p 13-20 418

Drysdale, George, Elements of Social Science, or physical sexual and natural religion. an exposition of the true cause and only cure of the three primary social evils: poverty, prostitution, and celibacy, by a doctor of medicine. E Truelove, London, 1854 (anonymously), G Standring, London, 1905

Dulberg, Joseph, Sterile Marriages. The various causes which produce childlessness and how to combat them; including chapters on sexual hygiene of married life; normal and abnormal menstruation: the menopause (change of life): miscarriage: signs of pregnancy; sterility, male and female:

Impotence and its various causes; twilight sleep, and other allied subjects.

T Werner Laurie, London, C19203

E llis, Havelock, The Evolution of Modesty: The Phenomena of Sexual

Periodicity: Auto-Erotism. Studies in the Psychology of Sex Volume I,

Leipzig and Watford, 1899 (as Volume II), F A Davis Co, Philadelphia, 1900,

3rd edition 1910, Random House, New York, omnibus edition, Vol I, 1937

(with J Addington Symonds), Sexual Inversion. Studies in the Psychology of Sex Volume II, Leipzig and Watford, 1897 (as Volume I), F A Davis Co,

Philadelphia, 1901, 3rd edition, 1915, Random House, New York omnibus edition, Vol I, 1937

— Analysis of the Sexual Impulse: Love and Pain; The Sexual Impulse in

Women. Studies in the Psychology of Sex Volume III, F A Davi6 Co,

Philadelphia, 1903, Random House, New York omnibus edition, Vol I, 1937 419

— Sexual Selection In Man. Studies in the Psychology of Sex Volume IV, F

A Davis Co, Philadelphia, 1905, Random House, New York omnibus edition, Vol

I, 1937

— Erotic Symbolism; The Mechanism of Detumescence: The Psychic S tate in

Pregnancy. Studies in the Psychology of Sex Volume V, F A Davis Co,

Philadelphia, 1906

— Sex in Relation to Society. Studies in the Psychology of Sex Volume VI,

F A Davis, Philadelphia, 1910; William Heinemann Medical Books, London,

1937, War Economy edition 1946

Eonism and other supplementary studies. Studies in the Psychology of

Sex Volume VII, F A Davis Co, Philadelphia, 1928

— Psychology of Sex. The Biology of Sex— The Sexual Impulse in Youth—

Sexual Deviation—The Erotic Symbolisms—Homosexuality—Marriage—The Art of Love. William Heinemann Medical Books Ltd, London, 1933, 12th impression

1948

— The Erotic Rights of Women and The Objects of Marriage. British

Society for the Study of Sex Psychology, Publication no 5, London, 1918

— The Plav-Function of Sex. British Society for the Study of Sex

Psychology, Publication no 9, London, 1921

England, Leonard, "A British Sex Survey", in Pillay and Ellis (eds), Sex.

Society and the Individual, pp 360-367 420

Exner, M J, The Sexual Side of Marriage. Unwin Books, London, 1932, reprinted 1969

Eyles, M Leonora, The Woman in the L ittle House. Grant Richards, London,

1922

Commonsense About Sex. Victor Gollancz, London, 1933

"Fielding, Michael", (Newfield, Maurice pseud). Parenthood; Design or

Accident; a Manual of Birth Control. Labour Publishing Co, London, 1928, 4th edition, Williams and Norgate, 1944

Fischer, H C and Dubois, E X, Sexual Life during the World War. Francis

Aldor, London, 1937

Flexner, Abraham, P ro stitu tio n in Europe, f ir s t published by Bureau of

Social Hygiene, New York, 1913, abridged edition, Grant Richards Ltd,

London, 1919

Fowler, 0 S, Creative and Sexual Science: or. Manhood. Womanhood and their mutual interrelations; Love, its laws, power, etc: selection, or mutual adaptation: courtship, married life and perfect children: their generation, endowment, paternity, maternity, bearing, nursing and rearing: together with puberty, boyhood, girlhood, etc. sexual impairments restored, male vigour and female health and beauty perpetuated and augmented, etc. as taught by phrenology and physiology, published by 0 S Fowler, New York, 1870, later edition, Cn d. c 19003 421

Frazer, A D, "The Problem of the Defaulter", BJVD. 1932, 8, pp 56-58

Freud, Sigmund (trans Strachey, James), Three Essavs on the Theory of

Sexuality, in On Sexuality. Pelican Freud Library 7, first published in

German, Vienna and Leipzig, 1905, English tran slatio n , 1952, Penguin Books,

Harmondsworth Middlesex, 1977

— "'Civilised' Sexual Morality and Modern Nervous Illness", in Civilisation

Society and Religion. Pelican Freud Library 12, first published in German

1908, Standard edition, 1959, Harmondsworth Middlesex, 1985

Gallichan. Walter, Letters to a Young Man on Love and Health. T Werner

Laurie, London, 1919

Sexual Apathy and Coldness in Women. T Werner Laurie, London, Cl9273

— The Poison of Prudery; An Historical Survey. T Werner Laurie, London,

1929

Gardner, A K, The Conjugal Relationship, as regards Personal Health and

Hereditary Well-Being Practically Treated, c. 1890, USA, T D Morison

Glasgow/ Simpkin Marshall Hamilton and Kent, London, 1894

Geddes, Prof Patrick and Thomson, J Arthur, The Evolution of Sex. The

Contemporary Science Series, edited by Havelock Ellis, Walter Scott, London,

1889, 2nd edition, 1901

— and — Sex. Home U niversity Library, Williams and Norgate, London, 1914 422

Gordon, Col J E, "The Control of Venereal Disease: An Epidemiological

Approach", The Lancet. 1944, ii, 711-715

Gould, S, EBP (Medical h erb alist), A Brief T reatise on Venereal Disease and

Spermatorrhea, its Cause and Cure. (For Private Circulation Only. Entered at

Stationers' Hall.) Manhood. How Lost, by Acquired Diseases: How Regained, by

Vegetable Compounds. [?The author, ?Bradford3 [c. 19103

"A Graduate", A Lecture to Young Men on the Preservation of Health and

Personal Purity of Life. (Pulvermakers World Famed Galvanic Belt Co),

H Renshaw, London, 7th edition, 1892

Gray, Rev A Herbert, Men. Women, and God. A Discussion of Sex Questions from the C hristian Point of View. Student C hristian Movement, London, 1923

Sex Teaching. National Sunday School Union, London, [19293

Griffith, Edward F, Modern Marriage, with forewords by Lord Horder, Canon

Pym, and Claud Mullins. Originally published by Victor Gollancz as Modern

Marriage and Birth Control. 1935, Methuen and Co Ltd, London, 1946

— The Pioneer S pirit. Green Leaves Press, Upton Grey, Hampshire, 1981

Hadfield, J A, "The Nature and Cause of Phobias, with Special Reference to

Syphilophobia", BJVD. 1938, Vol 14, pp 119-133

Haire, Norman, Hymen, or the Future of Marriage. E P Dutton and Co, New

York, 1928 423

(ed), Some More Medical Views on Birth Control. Cecil Palmer, London,

1928

— "Contraceptive Technique: A Consideration of 1400 Cases", The

Practitioner. July 1923, pp 74-90

Hall, G Stanley, Adolescence: Its psychology and its relations to physiology, anthropology, sociology, sex, crime, religion, and education.

Appleton, London and New York, 1904

Hall, Gladys, Prostitution: A Survey and A Challenge. Williams and Norgate,

London, 1933

Hall, Winfield Scott MD, assisted by Hall, Jeannette Winter, Sexual

Knowledge: In plain and simple language: sexology or knowledge of s e lf and sex for both male and female: especially for the instruction of youths and maidens, voung wives and young husbands, all fathers and all mothers, school-teachers and nurses, and all others who feel a need of proper and reliable information on Sex Hygiene. Sex Problems and the best way and the best time to impart sexual knowledge to boys and girls about to enter into manhood and womanhood. International Bible House, Philadelphia, 1913,

T Werner Laurie, London, Cl926]

Hamilton, G V T, A Research in Marriage. A & C Boni, New York, 1929

Hanschell, H M, "The Problem of Venereal Disease in the Merchant Marine",

BJVD. 1929, Vol 5 no 3, pp 202-208 424

Harrison, L W, "The Public Health Services and Venereal Diseases", BJVD.

1925 1 (1), pp 12-22,

"Those were the days! or Random notes on Then and Now in VD", Bulletin of the Institute of Technicians in Venereology Cn d c. 1950], pp 1-8

Havil, Anthony, The Technique of Sex; Towards a better understanding of the

Sexual Relationship. Wales Publishing Co, London, 1939

Heape, Walter, Preparation for Marriage. Questions of Sex Series, C assell and Co, London, 1914

Herbert, Mrs S, Sex-Lore: A Primer on Courtship. Marriage and Parenthood.

A & C Black Ltd, London, 1918

Himes, Norman E, The Medical History of Contraception. Williams and Wilkins

Co, Baltimore, 1936

Hirschfeld, Dr Magnus, Sexual Anomalies and Perversions: Physical and

Psychological Development and Treatment. A summary of the works of the la te Professor Dr Magnus Hirschfeld. compiled as a humble memorial by his pupils. Torch Publishing Co Ltd, London, tc. 19363

History of the Great War Based on Official Documents; Medical Services:

Diseases of the War Volume II. HMSO, London, 1923

History of the Second World War; UK Medical Series. The Army Medical

Services: Administration II. edited by F A E Crew, HMSO, London, 1955 425

History of Urology (2 vols), prepared under the Auspices of the American

Urological Association, Williams and Wilkins Co, Baltimore, 1933

Horder, Lord, "Birth Control: an Introduction", The P ractitioner. 1933, no

783, Vol 131, pp 221-227

Huhner, M, A Practical Treatise on Disorders of the Sexual Function in the

Male and Female. F A Davis Co, Philadelphia, 1916, 3rd edition, 1929

Hutton, Isabel E, The Hygiene of Marriage. William Heinemann Medical Books

Ltd, London, 1923, 4th edition 1933

Memories of a Doctor in War and Peace. Heinemann, London, 1960

Jackson, Margaret H, Malleson, Joan, Stallworthy, John and Walker,

Kenneth M, Problems of F e rtility in General Practice. Hamish Hamilton

Medical Books, London, 1948

"JEH" (Hopkins, J Ellice), "True Manliness", in The Blanco Book. White Cross

League, London, 1913, pp 115-143

Johns, Hilda M, "Contact Tracing", BJVD. 1945, Vol 21 pp 17-21

Johnson, G W, "The Injustice of the S o licitatio n Laws", The Shield. 1920-

1922, 3rd Series no 3, pp 267-269

King, Ambrose, "These Dying Diseases: Venereology in Decline?", The Lancet.

1958, i, 651-657 426

Kinsey, Alfred C, Pomeroy, Wardell B, and Martin, Clyde E, Sexual Behaviour in the Human Male. W B Saunders Co Ltd, Philadelphia and London, 1948

, — , — and Gebhard, Paul H, Sexual Behaviour in the Human Female.

W B Saunders Co Ltd, Philadelphia and London, 1953

Knowlton, C, F ru its of Philosophy: An essav on the population question, new edition with notes, edited by G Drysdale, printed by Charles Bradlaugh and

Annie Besant, The Freethought Publishing Co, London, C18773

Krafft-Ebing, Richard von, Psychopathia Sexualis. with especial reference to the antipathetic sexual instinct. A medico-forensic study, first published in German, 1888, f ir s t English edition 1893 and numerous others, Staples

Press, London, 1965 (based on 12th German edition)

La’mert, Samuel, Self-Preservation: A Medical Treatise on Nervous and

Physical Debility. Spermatorrhea. Impotence and Sterility, with Practical

Observations on the Use of the Microscope in the Treatment of Diseases of the Generative System. "64th edition Published by the author, available from a ll booksellers", London 1850s/1860s

Lees, Robert, "Venereal Diseases in the Armed Forces Overseas (1)", BJVD.

1946, Vol 22, p 149-158

«VD—Some random reflectio n s of a venereologist", BJVD. 1950, Vol 26 no

4, pp 157-163 427

Levine, Milton I and Seligmann, Jean H, The Wonder of Life; How we are born and how we grow up. George Rout ledge and Sons Ltd, London, 1941

Lindsey, Judge Ben B and Evans, Wainwright, The Companionate Marriage, Boni and Liveright, New York, 1927

Ludovici, Anthony M, Woman: A Vindication. Constable and Co, London, 1923, re-issu ed 1929

Man: An Indictment. Constable and Co, London, 1927

Lyttelton, Hon E, The Causes and Prevention of Immorality in Schools. Social

Purity Alliance, printed for private circulation, 1887

MacAndrew, Rennie, Encyclopedia of Sex and Love Technique. Wales Publishing

Co, London, [19411

McElligott, G L M, "The Venereal History: Truth or Fiction?", BJVD. 1932, Vol

8, pp 292-297

MacFadden, Bernarr A, The V irile Powers of Superb Manhood. How Developed.

How Lost. How Regained. Physical Culture Publishing Co, New York, 1900

Mcllroy, A Louise, "The Harmful Effects of Artificial Contraceptive

Methods", The P ractitioner. July 1923, pp 25-35

"The Maisons Toler6es: Association of Moral and Social Hygiene, Report of

Public Annual Meeting", The Shield. 1918-1920, 3rd series Vol 2, pp 53-64 428

March, Norah, Toward Racial Health. A Handbook for Parents. Teachers and

Social Workers on the Training of Boys and Girls, with a foreword by J

Arthur Thomson, George Rout ledge and Sons Ltd, London. 1915, 4th edition revised, 1920

Marchant, Sir James (ed), Medical Views on B irth Control. M Hopkinson and

Co, London, 1926

Marriner, Dr Margaret, First Aid to Marriage. Williams and Norgate, London,

1933

Mason, M H, "Public Morality: some constructive suggestions", The Nineteenth

Century. 1917, Vol 82, pp 185-194

"Medica", (Malleson, Dr Joan, pseud). Any Wife or Any Husband: A Book for

Couples Who Have Met Sexual Difficulties and For Doctors. William Heinemann

Medical Books Ltd, London, 1950

Metcalfe Chambers, W, "Prostitution and Venereal Disease", BJVD. 1926, Vol 2 no 5, pp 68-75

Meyer, Rev F B, (For Men Only) A Holv Temple: Words to Young Men on

Puritv. S W Partridge and Co, 12th edition, (58,000), London, [ 19093

Mills, C, "Collaboration between the Venereal Disease and Other

Departments", BJVD. 1934, Vol 10, pp 233-248 429

Napheys, G H, The Transmission of Life: Counsels on the Nature and Hygiene of the Masculine Function. C H C Watts and Co, Philadelphia, 14th edition,

1876

Nature’s Revelations for the Married Only. Printed for Private Circulation

Only, E lectric Life Invigorator Co, G W Ventnor, The Limes, Painswick Rd,

Gloucester, C719043

Neilans, A, "The Protection of Soldiers", The Shield. 1916-1917, Series 3

Vol 1, pp 216-223

— "Has Moral Teaching Failed?", The Shield. 1920-1922, 3rd Series Vol 3, pp 257-265

Newsholme, Sir Arthur, "The Decline in Registered M ortality from Syphilis in England. To what is it due?", Journal of Social Hygiene. 1926, Vol 12 no

9, pp 514-523

Nichols, T L, Esoteric Anthropology (The Mysteries of Man) A comprehensive and confidential treatise on the structure. functions. passional attractions, and perversions, true and false physical and social conditions and the most intimate relations of men and women. Anatomical. physiological, pathological, therapeutical and obstetrical. Hygienic and

Hydropathic. From the American Stereotype Edition. Revised and Rewritten. published by Dr Nichols at the Hygienic Institute, Museum St, London WC, tc

18733 430

Northcote, Rev H, "Sex and Nature Study", The Shield. 1920-1922, 3rd series

Vol 3 pp 323-326

Orpwood Price, I N, "Is a New Deal in the Control of Venereal Disease

Necessary?", BJVD» 1944, Vol 20, pp 19-30

Packer, E L, "Aspects of Working Class Marriage", Pilot Papers: Social

Essays and Documents. Mar 1947, Vol 2 no 1, pp 92-104

Paget, Sir James, "Sexual Hypochondriasis", in Clinical Lectures and Essays.

Longmans Green, London, 1875, 2nd edition, 1879, pp 275-298

Pillay, Dr A and Ellis, Albert (eds), Sex Society and the Individual;

Selected Papers, revised and brought up to date, fromMarriage Hygiene

(1934-1937) and The International Journal of Sexology (1947-1952). The

International Journal of Sexology, Bombay, 1953

Placzek, Dr Siegfried, The Sexual Life of Man. An Outline for Students.

Doctors and Lawyers, first English edition 1923, 2nd English edition, tran slated by L S Morgan, John Bale, Sons and Danielsson, London, 1931

The P ractitioner. July 1923, "Contraception"

no 783, 1933, "Birth Control"

Pritchard, Eric C, "Birth Control", The Practitioner. July 1923, pp 56-61 431

Pym, Rev T W, "The Need of Education in Questions of Sex", B ritish Medical

Journal. 1931, ii, 186-190

Rajam, R V, "Progress in the Treatment and Control of Venereal Diseases",

The A ntiseptic. 1954, Vol 5 no 4, pp 345-366

Ratcliffe, Lt-Col T A, "Psychiatric and Allied Aspects of the Problem of

Venereal Disease in the Army", Journal of the Royal Army Medical Corps.

1947, Vol 89, pp 122-131

Regenburg, B H and Durfee, R A, "Venereal Disease and the Patient", Journal of Social Hygiene. 1934, Vol 20 no 8, pp 369-377

Roberts, Harry, Euthanasia and other aspects of life and death. Constable and Co, London, 1936

Robie, W F, Rational Sex Ethics, a physiological and psychological study of the sex lives of normal men and women. R G Badger, Boston, [19183, Brandon

Library paperback edition (together with Further Investigations). North

Hollywood C alifornia, 1966

Ross, A 0, "The Problem of the Treatment of Venereal Disease in the

M ercantile Marine", BJVD. 1929, Vol 5, pp 210-228 432

Routh, C H F, On the Moral and Physical Evils likely to follow If practices intended to act as Checks to Population be not strongly discouraged and condemned, originally given as a paper before the O bstetrical section of the British Medical Association, and first published in the Medical Press and Circular. October 1878, reprinted from the same, London, 1879

Royden, A Maude, Sex and Commonsense. Hurst and Blackett, Ltd, London,

[19223, 8th edition, Cn dl

Ryley Scott, George, A History of Prostitution from Antiquity to the

Present Day. T Werner Laurie, London, 1936, Revised and Illustrated limited edition, Torchstream Books, 1954

— The Sex Life of Man and Woman. A Practical Contribution to the

Solution of the Problems. Difficulties and Dangers connected with Sex. Love and Marriage as they affect every man and every woman. T Werner Laurie,

1937, Torchstream Books, London, 1946

— Scott's Encyclopaedia of Sex: A Practical Encyclopaedia arranged in alphabetical order, explanatory of everything pertaining to sexual physiology, psychology and pathology. T Werner Laurie Ltd, London, 1939

— Sex Problems and Dangers in Wartime. A Book of Practical Advice for

Men and Women on the Fighting and Home Fronts. T Werner Laurie Ltd,

London, 1940 433

— Modern Birth Control Methods: with an Appendix on the F acilitatio n of

Conception, with a Foreword by the late Sir W Arbuthnot Lane, Library of

Modern Sex Knowledge, no 7, Torchstream Books, London, Cn d3

Sargent, W E, Sex; its meaning and purpose. Teach Yourself Book, English

U niversities Press Ltd, London, 1951, reprinted 1969

Scharlieb, M, How to Enlighten Our Children: A Book for Parents. Williams and Norgate, London, 1918

and Sibly, F A, Youth and Sex. Dangers and Safeguards for Girls and

Boys. T C and E C Hack, London, [19133

Schofield, Dr A R and Vaughan-Jackson, Dr P, What A Boy Should Know.

Questions of Sex Series, C assell, London, 1913

Slater, Eliot and Woodside, Moya, Patterns of Marriage; A Study of Marriage

Relationships in the Urban Working Classes. C assell and Co, London, 1951

"The Social Aspect of the Venereal Diseases", BJVD. 1945, Vol 21, pp 12-34

"The Social Background of Venereal Disease: a report on an experiment in

contact tracing and an investigation into social conditions: Tyneside experimental scheme in venereal disease control, October 1943 to March

1944", BJVD. 1945 no 21, pp 26-34 434

Sperry, Lyman Beecher, Confidential Talks with Husband and Wife. A Book of

Information and Advice for the Married and the Marriageable, first published in the USA, Oliphant Anderson and Ferrier, London and Edinburgh,

1900

Stall, Sylvanus, What a Young Boy Ought to Know. Self and Sex Series, Vir

Publishing Co, Philadelphia and London, 1897

What a Young Man Ought to Know. Self and Sex Series, Vir Publishing

Co, Philadelphia and London, 1897

What a Young Husband Ought to Know. Self and Sex Series, Vir

Publishing Co, Philadelphia and London, 1897

What a Man of Fortv-Five Ought to Know. Self and Sex Series, Vir

Publishing Co, Philadelphia and London, 1901

Stekel, Wilhelm, F rigidity in Woman in Relation to her Love Life (2 vols),

German edition 1926, Liveright Publishing Co, New York, 1936

Impotence in the Male; The psychic disorders of sexual function in the male (2 vols), authorised English version by Oswald H Boltz, 1st published in German 1927, John Lane, London, printed in USA, 1940

Stokes, Prof John H, "The Future of Syphilis", BJVD. 1928, Vol 4 no 4, pp

272-289 435

Stone, Hannah and Stone, Abraham, A Marriage Manual: A P ractical Guide-Book of Sex and Marriage; English edition edited and with an Introduction by

Michael Fielding* Victor Gollancz in Association with John Lane the Bodley

Head, London, 1936

Stopes, -Marie, Married Love. A New Contribution to the Solution of Sex

D ifficulties. With a Preface by Dr Jessie Murray, and le tte rs from

Professor E H Starling FRS. and Father Stanislaus St John* SJ. A C Fifield,

London, EC4 (la te r editions by GP Putnam's Sons Ltd London), 1918, 4th edition, 1918

ibid. 12th edition (296th thousand), 1923

Wise Parenthood. The T reatise on Birth Control For Married People. A

Practical Sequel to "Married Love", with an Introduction by Arnold Bennett.

G P Putnam's Sons Ltd, London, 1918, 11th edition, 1923

— Sex and the Young. G ill Publishing Co, London, 1926

— Enduring Passion. Further New Contributions to the Solution of Sex

D ifficu lties being the continuation of Married Love. GP Putnams Sons,

London, 1928, 2nd edition, 1929

— Change of Life in Men and Women. GP Putnam, London, 1936

Sutherland, Robert, "Some Individual and Social Factors in Venereal

Disease", BJVD. 1950, Vol 26, pp 1-15 4-36

Terman, L, Psychological Factors in M arital Happiness. McGraw-Hill, New

York, 1939

Thompson, W Derwent R, "The Medico-Legal Aspects of Venereal Diseases",

BJVD. 1936, Vol 12, pp 88-108

Trail, R T, Sexual Physiology and Hygiene. An exposition practical, scientific, moral, and popular of some of the fundamental problems in sociology, first published in the USA c. 1888, T D Morison, Glasgow/

Slmpkln, Marshall, Hamilton and Kent Co, London, 1908

Tuke, D Hack, Dictionary of Psychological Medicine (2 vols), J A Churchill,

London^ 1892

Turner, E B, "The History of the Fight Against Venereal Disease", Science

Progress. 1916-1917, Vol 11, pp 83-88

Van de Velde, Th. H, Ideal Marriage. Its Physiology and Technique, first published in Dutch 1926, William Heinemann Medical Books Ltd, London, 1928,

39th impression, 1962

— Sex Hostility in marriage: its origin, prevention and treatment, first published in Dutch 1928, Heinemann Medical Publications, London, 1931

Vecki, Victor G, Sexual Impotence. W B Saunders, Philadelphia and London,

1899, 5th edition, 1915 437

Wailes, Margaret A, “Contact Tracing and the Prostitute", BJVD. 1945, Vol

21, pp 15-17

Walker, Kenneth M, Diseases of the Male Organs. Oxford Medical

Publications, London, 1923

Male Disorders of Sex. Jonathan Cape, London, 1930

— Sex Difficulties of the Male: a new and completely revised edition.

Jonathan Cape, London, 1934

and Strauss, Eric B, Sexual Disorders of the Male. Hamish Hamilton

Medical Books, London, 1939

— The Circle of Life; A Search for an Attitude to Pain. Disease. Old Age

and Death. Jonathan Cape, London, 1942

Marriage. A book for the married and about to be married. Seeker and

Warburg for the B ritish Social Hygiene Council, London, 1951

Love. Marriage and the Family. Odhams Press Ltd, London, 1957

— "Impotence", BJVD. 1931, Vol 7 no 4, pp 289-299

— "Gonorrhoea and its psychological casualties", BJVD. 1934, Vol 10, pp

202-205

Walling, Prof W H, Sexology. The Puritan Publishing Co, Philadelphia, 1902 438

Walther, H W E, "Neuroses and Functional Disorders of the Gen it o- urinary

Tract", in History of Urology. prepared under the Auspices of the American

Urological Association, Williams and Wilkins Co, Baltimore, 1933

Watts, Major G 0 and Wilson, Major R A, "A Study of Personality Factors among Venereal Disease Patients", Canadian Medical Association Journal.

1945, Vol 53, pp 119-122

Webb, Dr Helen, Life and Its Beginnings. Questions of Sex Series, Cassell and Co Ltd, London, 1913

Weber, Hermann, On Longevity and means for the prolongation of life.

Macmillan, London, 1903, 5th edition edited by F Parkes Weber, 1919

White, Dr Douglas, "The Sexual Basis of Human Society", The Shield. 1923-

1925, 3rd series Vol 4, pp 127-134

"The Basis of a New Moral Appeal", The Shield. 1939, 5th se rie s Vol 7

(1), pp 1-4

The White Cross League, The Blanco Book. London, 1913

Whitehouse, Beckwith, "The Problem of Birth Control", The Practitioner. July

1923, pp 43-48 439

Willis, W N, Wedded Love or Married Misery? To the married and those about to marrv containing "A vigorous protest against the contra-conceptive propaganda of Mrs Marie Stopes. which the author vehemently contends is against the best interests of the Empire, The sound logic and authenticated scientific facts which are brought to bear on behalf of the author’s standpoint provide a sane and incontrovertible argument”. published by the Author, Waterloo Road, London, [19203

Wilson, Marris, On Diseases of the Vesiculae Semin ales and th e ir Associated

Organs, with Special Reference to the Morbid Secretions of the Prostatic and U rethral Mucous Membrane. Tallant and Allan, London, 1856

Wittkower, E D, "The Psychological Aspects of Venereal Disease", BJVD. 1948,

Vol 24, pp 59-67

"Woman, where are thine accusers?", The Shield. 1920-1922, 3rd Series no 3, pp 307-309

Woodside, Moya, "Courtship and Mating in an Urban Community", Eugenics

Review. 1946, Vol 38 No 1, pp 29-39

Wright, Helena, The Sex Factor in Marriage. A book for those who are or are about to be married, with an introduction by A Herbert Gray, Williams and Norgate Ltd, London, 1930, 2nd edition, 1937

More About the Sex Factor in Marriage: A Sequel to The Sex Factor in

Marriage. Williams and Norgate, London 1947, 2nd edition, 1954, 2nd impression 1959 440

Secondary sources

Unpublished Theses

Holtzmann, Ellen M, "Marriage, Sexuality and Contraception in the British

Middle Classes 1918-1939: the correspondence of Marie Stopes" Rutgers

University, the State University of New Jersey (New Brunswick), PhD, 1982

Langford Adams, Paul, "Health of the State: British and American Public

Health Policies in the Depression and World War II", unpublished dissertation for the Doctorate of Social Welfare, University of California

Berkeley, 1979, Chapter 7, "Reforming Morals and Making Fornication Safe:

Venereal Disease in Wartime", pp 326-367

Pfeffer, Naomi, "Pronatalism and Sterility, 1900-1950" University of Essex

PhD, 1987

Ware, Helen R E, "The Role Recruitment and Regulation of Prostitution in

Britain from the middle of the Nineteenth Century to the Present Day"

University of London PhD, 1969

Secondary Published Sources

Abbott, F (ed), New Men. New Minds: Breaking Male Tradition. The Crossing

Press, Freedom, California, USA, 1987 441

Adler, Michael, "The terrible peril: a historical perspective on the venereal diseases", BMJ. 1980, ii, 206-211

Bailey, Victor and Blackburn, Sheila, "The Punishment of Incest Act 1908: A

Case Study of Law Creation", Criminal Law Review. 1979, pp 708-718

Bancroft, J, Human Sexuality and Its Problems. Churchill Livingstone,

Edinburgh, 1983

Banks, J A, Prosperity and Parenthood: A Study of Family Planning among the

Victorian Middle Classes. Rout ledge and Paul, London, 1954

— Victorian Values: Secularism and the Size of Families. Rout ledge and

Kegan Paul, London and Boston, 1981

Barker-Benfield, G J, The Horror of the Half-Known Life: Male Attitudes to

Women and Sexuality in nineteenth-century America. Harper and Row, New

York, 1976

Boswell, John, "Towards the Long View: Revolutions, Universals and Sexual

Categories", Salmagundi. 1982-83, Vol 58-59, pp 89-113

Box, Muriel (ed), The T rial of Dr Stopes. Femina Books, London, 1967

Brake, Mike (ed), Human Sexual Relations: A Reader: Towards a redefinition of sexual p o litics. Penguin Books Ltd, Harmondsworth Middlesex, 1982 442

Branson, N and Heinemann, M, B ritain in the 1930s. Weidenfeld and Nicholson,

London, 1971

Brecher, Edward M, The Sex Researchers. Andre Deutsch, London, 1970

Bristow, Edward, Vice and Vigilance; purity movements in B ritain since 17QQ.

G ill and Macmillan, Dublin, 1977

B rittan, Arthur, M asculinity and Power. Basil Blackwell, Oxford, 1989

Brod, Harry

Brookes, Barbara, Abortion in. England. 1900-1967. Croom Helm, London, 1988

Bullough, Vern, Sex Society and History. Science History Publications, New

York, 1976

— and Bullough, Bonnie, Sin Sickness and Sanity; A History of Sexual

A ttitudes. New American Library, New York, 1977

Byrne, P S and Long,BEL, Doctors Talking to P atients. HMSO, London, 1976

Calder, Angus and Sheridan, Dorothy (eds), Speak for Yourself: A Mass

Observation Anthology 1937-1949. Oxford University Press, 1985

Calder-Marshall, A, Havelock Ellis; A biography. Rupert Hart-Davis, London,

1957 443

Caplan, Pat (ed), The Cultural Construction of Sexuality. Tavistock

Publications, London and New York, 1987

Cassel, Jay, The Secret Plague; Venereal Disease in Canada. 1838-1939.

University of Toronto Press, Toronto, 1987

Chandrasekhar, S, HA Dirty Filthy Book1*; The writings of Charles Bradlaugh and Annie Besant on reproductive physiology and birth control, and an

account of the Bradlaugh-Besant trial. Berkeley, California, 1981

Chapman, Rowena and Rutherford, Jonathan

masculinity. Lawrence and Wishart Ltd, London, 1988

Christ, Carol, "Victorian Masculinity and the Angel in the House", in

Vicinus, M, A Widening Sphere; Changing Roles of Victorian Women.

pp 146-162

Comfort, Alex, The Anxiety Makers; Some curious preoccupations of the

medical profession. Nelson, London, 1967

Cominos, Peter T, "Late Victorian Respectability and the Social System",

International Review of Social History. 1963, Vol 8, pp 18-48, 216-250

Connell, R W, Gender and Power: Society, the Person and Sexual Politics.

Polity Press, Cambridge, 1987

Cooper, William, YouVe Not Alone: A Doctor’s Diary. Macmillan, London, 1976 444

Corea, Gena, The Hidden Malpractice; How American Medicine M istreats Women.

Harper and Row, New York, updated edition 1985

Darmon, Pierre (trans Keegan, Paul), T rial bv Impotence: V irility and

Marriage in pre-Revolutionarv France, first published in France as Le

Tribunal de L'Impuissance. Editions du Seuil, Paris 1979, Chatto and Windus

The Hogarth Press, London, 1985

Davey, Claire, "Birth Control in Britain during the Inter-War Years: evidence from the Stopes correspondence", Journal of Family History. 1988,

Vol 13 no 3, pp 329-345

Easthope, Antony, What a Man*s Gotta Do. The Masculine Mvth in Popular

Culture. Paladin, Grafton Books, London, 1986

Eaton, Peter and Warnick, Marilyn, Marie Stopes: A Checklist of Her

Writings. Croom Helm, London, 1977

Ehrenreich, Barbara and English, Deirdre, For Her Own Good: 150 Years of the Experts* Advice to Women. Doubleday, New York, 1978/ Pluto Press,

London, 1979

Ehrenreich, Barbara, The Hearts of Men: American Dreams and the Flight from

Commitment. Anchor Press Doubleday, New York/Pluto Press, London, 1983

Eisenberg, L and Kleinmann, A, The Relevance of Social Science for Medicine.

D Reidel Publishing Co, Dordrecht, Boston and London, 1981 445

Ellmann, Mary, Thinking About Women, Macmillan, London, 1968

Engelhardt, H Tristram, jr, "The Disease of Masturbation: values and the concept of disease", B ulletin of the History of Medicine. 1974, Vol 48, pp 234-248

Evans, Barbara, Freedom to Choose: The Life and Work of Dr Helena Wright.

Pioneer of Contraception . London, Bodley Head, 1984

&

Fairburn, C G, Dickson, M G and Greenwood, J, Sexual Problems and Their

Management. Churchill Livingstone, Edinburgh, 1983

Fee, Elizabeth, (ed), Women and Health: The Politics of Sex in Medicine.

(Policy Politics Health and Medicine Series), Baywood Publishing Co Inc,

Farmingdale New York, 1983

Feminist Review, Sexuality: A Reader. Virago, London, 1987

Fildes, Valerie, Breasts Bottles and Babies: A History of Infant Feeding.

University of Edinburgh, 1986

Finnegan, Frances, Poverty and Prostitution: A study of Victorian prostitutes in York. Cambridge University Press, Cambridge and New York,

1979

Fitzpatrick, Ray, Hinton, John, Newman, Stanton, Scambler, Graham and

Thompson, James (eds), The Experience of Illness. Tavistock Publications,

London and New York, 1984 446

Fitzpatrick, Ray, "Lay Concepts of Illness”, in Fitzpatrick, Hinton, Newman,

Scambler and Thompson

Foucault, Michel, (trans Hurley, Robert), The History of Sexuality Volume I:

An Introduction, first Published in France as La Volonte de savoir..

Editions Gallimard, 1976, Allen Lane 1979, Penguin Books, Harmondsworth

Middlesex, 1981

(trans Hurley, Robert), The Use of Pleasure: The History of Sexuality

Volume II. first published in France as L'Usage des Plaislrs. Editions

Gallimard 1984, Random House, New York, 1985, Viking, London 1986, Penguin,

Harmondsworth Middlesex, 1987

(trans Hurley, Robert), The Care of the Self; The History of Sexuality

Volume III, first published in France as Le Soucl de Soi. Editions

Gallimard, 1984, Pantheon Books, New York, 1986

Freedman, G R, Sexual Medicine* Churchill Livingstone, Edinburgh, 1983

Gagnon, John H and Simon, William, Sexual Conduct: The Social Sources of

Human Sexuality. Aldine Book Co, Chicago, 1973, Hutchinson, London, 1974

Gay, Peter, Education of the Senses: The Bourgeois Experience. Victoria to

Freud. Volume I. Oxford University Press, New York, 1984

Gillis, John, For Better. For Worse: British Marriages. 1600 to the Present.

Oxford University Press, New York and Oxford, 1985 447

Git tins, D, Fair Sex; family size and structure 1900-1939. Hutchinson,

London, 1982

Gordon, Linda, "The P o litics of Birth Control, 1920-1940: The Impact of

Professionals", in Fee (ed), Women and Health: The Politics of Sex in

Medicine, pp 151-175

Gordon, Michael, "From an Unfortunate Necessity to a Cult of Mutual Orgasm:

Sex in American Marital Education Literature, 1830-1940", in Henslin, J (ed)

Studies in the Sociology of Sex. New York, 1975, pp 53-77

Graves, Robert and Hodge, Alan, The Long Weekend: A Social History of Great

B ritain 1918-1939. Faber and Faber, London, 1940, 2nd impression 1950

Grosskurth, Phyllis, Havelock E llis: A Biography. Allen Lane, London, 1980

Hall, Lesley A, "The Stopes Collection in the Contemporary Medical Archives

Centre of the Wellcome Institute for the History of Medicine", Bulletin of

the Society for the Social History of Medicine. June 1983, no 32, pp 50-51

"'Somehow very distasteful': doctors, men and sexual problems between

the wars", Journal of Contemporary History. 1985, Vol 20 no 4, pp 553-574

— "From Self-Preservat ion to Love without Fear: medical and lay writers

of sex advice from William Acton to Eustace Chesser", Bulletin of the

Society for the Social History of Medicine. Dec 1986, no 39, pp 20-23

Hall, Ruth, Marie Stopes: A Biography. Andre Deutsch, London, 1977 448

(ed), Dear Dr Stopes; Sex in the 1920s. Andre Deutsch, London, 1978

Hardyment, Christina, Dream Babies; Child Care from Locke to Spock. Jonathan

Cape Ltd, London, 1983

Hare, E H, "Masturbatory Insanity: the history of an idea", Journal of

Mental Science 1962, Vol 108, pp 1-25

Harrison, Brian, "Underneath the Victorians", Victorian Studies. 1967, Vol

10, pp 239-262

Hartmann, Mary S, Victorian Murderesses: A True History of Thirteen

Respectable French and English Women Accused of Unspeakable Crimes.

Schocken Books, 1977, Robson Books, London, 1985

Heath, Stephen, The Sexual Fix. Macmillan, London, 1982

Henslin, James, (ed). Studies in the Sociology of Sex. Appleton-Century

Crofts, New York, 1975

Higonnet, M R, Jenson, J, Michel, S and Weitz, M C (eds), Behind the Lines:

Gender and the Two World Wars. Yale University Press, New Haven and

London, 1987

Hoch, Paul, White Hero. Black Beast: Racism. Sexism and the Mask of

Masculinity. Pluto Press, London, 1979 449

Holtzmann, Ellen, "The Pursuit of Married Love: Women's A ttitudes Towards

Sexuality and Marriage in Great Britain, 1918-1939", Journal of Social

History, 1982, Vol 16, pp 39-52

Homans, Hilary, (ed), The Sexual Politics of Reproduction. Gower, Aldershot

Hants, 1985

Howells, Kevin, (ed), The Psychology of Sexual Diversity. Basil Blackwell,

Oxford, 1984, paperback edition, 1986

Humphries, Steve, A Secret World of Sex: forbidden fruit, the British experience 1900-1950. Sidgwick and Jackson, London, 1988

Jeffreys, Sheila, The Spinster and Her Enemies: Feminism and Sexuality

1880-1930. Pandora Press, London, 1985

Julty, Sam, "Men and Their Health—A Strained Alliance", in Abbott, F (ed),

New Men New Minds: Breaking Male Tradition. The Crossing Press, Freedom,

California, USA, 1987

Kaufman, Michael (ed), Beyond Patriarchy: Essays by Men on Pleasure. Power,

and Change. Oxford University Press, Toronto and New York, 1987

Lansbury, Coral, The Old Brown Dog: women, workers and vivisection In

Edwardian England. University of Wisconsin Press, Madison, Wisconsin, 1985

Leach, William, True Love and Perfect Union: The Feminist Reform of Sex and

Society. Basic Books Inc, New York, 1980 450

Leathard, Audrey, The Fight for Family Planning. Macmillan, London, 1980

Ledbetter, Rosina, A History of the Malthusian League. 1877-1927. Ohio

S tate University Press, Columbus Ohio, 1976

Lewis, Jane, Women in England 1870-1950: sexual divisions and social change. Wheatsheaf, Brighton, 1984

McCormick, James, The Doctor: Father Figure or Plumber. Croom Helm, London,

Cc. 19793

MacDonald, Robert H, "The frightful consequences of onanism: notes on the history of a delusion", Journal of the History of Ideas. 1967, Vol 28, pp 423-431

McGregor, 0 M, Divorce in England: A Centenary History. Heinemann, London,

1957

McHugh, Paul, P ro stitu tio n and Victorian Social Reform. Croom Helm, London,

Cc. 19803

McIntosh, Mary, "Who Needs Prostitutes? The ideology of male sexual needs", in C and B Smart, Women, sexuality and social control. Rout ledge and Kegan

Paul, London, 1978, pp 53-64

McLaren, Angus, Birth Control in Nineteenth Century England. Croom Helm,

London, 1978 451

— Reproductive Rituals: The perception of fertility In England from the sixteenth century to the nineteenth century. Methuen, London and New York,

1984

Mangan, J A and Walvin, J, Manliness and Morality: m iddle-class m asculinity in Britain and America 1800-1940. Manchester University Press, 1987

Marcus, Steven, The Other Victorians; A Study of Sexuality and Pornography in Mid-Nineteenth Century England. Weidenfeld and Nicholson, London, 1966,

Book Club Associates edition, 1970

Marriner, Gerald L, MA Victorian in the Modern World: The 'Liberated' Male's adjustment to the New Woman and the New Morality", South Atlantic

Quarterly,, 1977, 76, 190-203

Mechling, Jay, "Advice to Historians on Advice to Mothers", Journal of

Social History. 1975-1976, Volume 9, pp 44-57

Mead, Margaret, Male and Female; A Study of the Sexes in a Changing World.

USA, 1950, Pelican paperback, Harmondsworth Middlesex, 1962

Melman, Billie, Woman and the Popular Imagination in the 1920s. Macmillan,

London, 1988

Metcalf, Andy and Humphries, Martin (eds), The Sexuality of Men. Pluto

Press, London, 1985 452

Mitchison, Naomi, All Change Here: Girlhood and Marriage. The Bodley Head,

London, 1975

— You Mav Well Ask: A Memoir 1920-1940. Victor Gollancz Ltd, London,

1979, Flamingo paperback edition, 1986

Mort, Frank, Dangerous Sexualities; Medico-moral politics in England since

1830. Routledge and Kegan Paul, London and New York, 1987

Nissenbaum, S, Sex. Diet and Debility in Jacksonian America; Sylvester

Graham and Health Reform. Greenwood Press, Westport, Connecticut, and

London, 1980

North, Maurice, The Outer Fringe of Sex: A Study in Sexual Fetishism. Forum

Studies in Sexual Behaviour, The Odyssey Press, London, 1970, reprinted

1981

Oakley, Anne, Telling the Truth about Jerusalem: A Collection of Essays and

Poems. Basil Blackwell, Oxford, 1987

Padgug, Robert A, "Sexual matters: on conceptualising sexuality in history",

Radical History Review. 1979, Vol 20, p 3-23

Parsons, Gail Pat, "Equal Treatment for All: American Medical Remedies for

Male Sexual Problems, 1850-1900", Journal of the History of Medicine and

Allied Sciences. 1977, Volume 32, pp 55-71 453

Peckham, Morse, "Victorian Counterculture", Victorian Studies. 1974, Vol 18, no 1, pp 257-276

Pendleton, D and Hasler, J (eds), Poet or-Pat lent Communication^ Academic

Press, London and New York, 1983

Peterson, M Jeanne, The Medical Profession in Mid-Victorian London,

University of California Press, Berkeley, California, Cc. 19783 4

"Dr Acton's Enemy: Medicine Sex and Society in Victorian England",

Victorian Studies. 1986, Vol 29 no 4, pp 569-590

"No Angels in the House: The Victorian Myth and the Paget Women",

American H istorical Review^ 1984, Vol 89 no 3, pp 677-708

Pfeffer, Naomi, "The Hidden Pathology of the Male Reproductive System", in

Homans (ed), The Sexual Politics of Reproduction, pp 30-44

Plummer, Kenneth, Sexual Stigma: An Interact io n ist account. Rout ledge and

Kegan Paul, London and Boston ,1975

Ray, Joyce M and Gosling, F G, "American Physicians and Birth Control",

Journal of Social History. 1985, Vol 18 no 3, pp 399-411

Reynaud, Emmanuel (trans Schwartz, Ros), Holv V irility: The Social

Construction of Masculinity, first published in France as La Sainte

V irility. Editions Syros, Paris, 1981, Pluto Press, London, 1983 454

Robinson, Paul, The Modernization of Sex: Havelock Ellis. Alfred Kinsey.

William Masters and Virginia Johnson. Harper and Row, New York and London,

1976

Rowbotham, Sheila and Weeks, Jeffrey, Socialism and the New Life: the personal and sexual politics of Edward Carpenter and Havelock Ellis. Pluto

Press, London, 1977

Rusbridger. Alan, A Concise History of the Sex Manual. 1886-1986* Faber and

Faber, London, 1986

Schlegel, Alice (ed), Sexual Stratification: A Cross-cultural View. Columbia

University Press, New York, 1977

Seidler, Victor J, Rediscovering Masculinity; Reason Language and Sexuality.

Rout ledge, London, 1989

Shelp, Earl E (ed), Sexuality and Medicine Vol I: Conceptual Roots. D Reidel

Publishing Co, Dordrecht/Boston/Lancaster/Tokyo, 1987

Shorter, E, A History of Women*s Bodies. Basic Books, New York, 1978, Allen

Lane, London, 1983

— Bedside Manners: the troubled history of doctors and patients, Simon and Schuster, New York, 1985

Showalter, Elaine, The Female Malady; Women Madness and English Culture.

1830-1980. Pantheon Books, New York, 1985/Virago, London, 1987 455

Simmons, Christina, "Companionate Marriage and the Lesbian Threat",

Frontiers. 1979, Vol 4 no 3, pp 54-59

Smart, C and Smart, B (eds), Women. Sexuality and Social Control. Rout ledge and Kegan Paul, London, 1978

Smith, F B, The People’s Health. 1830-1910. Croom Helm, London, c.1979

— "Sexuality in Britain, 1800-1900: Some Suggested Revisions", in

Vicinus, M, A Widening Sphere: Changing Roles of Victorian Women. pp 182 198

Snitow, Ann, Stansell, C hristine and Thompson, Sharon (eds), Desire: The

p o litics of sexuality. Virago, London, 1984

Soloway, Richard A, Birth Control and the Population Question in England.

1870-1930. University of North Carolina Press, Chapel Hill and London, 1982

Stamp, W, Doctor Himself: An unorthodox biography of Harry Roberts. Hamish

Hamilton, London, 1949

Stearns, Carol Z and Stearns, Peter N, "Victorian Sexuality: Can Historians

Do It Better?", Journal of Social History. 1985, Vol 18, no 4, pp 625-634

Steinem, Gloria, Outrageous Acts and Everyday Rebellions. Holt, Rinehart and

Winston, USA, 1983, Jonathan Cape, London, 1984, Flamingo paperback edition,

1984 456

Stevenson, John, The Pelican Social History of Britain; British Society

1914-1945. Penguin Books, Harmondsworth Middlesex, 1984

Storr, Anthony, Sexual Deviation. Penguin Books, Harmondsworth Middlesex,

1964

Theweleit, Klaus, Male Fantasies I; Women, floods, bodies, history, trans

Conway, Stephen with the collaboration of Carter, Erica, and Turner, Chris,

Originally published as Mannerphantasien Volume I Frauen. Fluten. Korper.

Geschicht. by Verlag Roter Stern, 1977, Foreword by Barbara Ehrenreich,

University of Minnesota/ Polity Press, Cambridge, 1987

Thomas, K, "The Double Standard", Journal of the History of Ideas. 1959, Vol

20, pp 195-216

Thompson, F M L, The Rise of Respectable Society: A Social History of

Victorian B ritain 1830-1900. Fontana, London, 1988

Tolson, Andrew, The Limits of Masculinity. Tavistock Publications, London,

1977

Towers, Bridget A, "Health education policy, 1916-1926: Venereal Disease

and the Prophylaxis Dilemma", Medical History. 1980. Vol 24, pp 70-87

Trust ram, Myna, Women of the Regiment: marriage and the Victorian Army.

Cambridge University Press, Cambridge and New York, 1984 457

Vance, Carole S , Pleasure and Danger; Exploring Female Sexuality.

Rout ledge and Kegan Paul, Boston and London, 1984

Vicinus, M

Indiana University Press, Bloomington, Indiana, 1977

Walkowitz, Judith R, Prostitution and Victorian Society; women* class and the s ta te . Cambridge University Press, Cambridge and New York, 1980

Walters, Margaret, The Nude Male; A New Perspective. Paddington Press, New

York and London, 1978

Weeks, Jeffrey, Sex. P o litics and Society: The regulation of sexuality since

1800. (Themes in B ritish Social History), Longman Group Ltd, London, 1981

Sexuality and its Discontents: Meanings. Myths and Modern Sexualities.

Routledge and Kegan Paul, London, 1985

— Sexuality. Ellis Horwood Ltd, Chichester/Tavistock Publications, London and New York, 1986

Wyke, T J, "The Manchester and Salford Lock Hospital, 1818-1917", Medical

History. 1979, Vol 19, pp 73-86

Zilbergeld, Bernard with the assistance of Ullman, John, Men and Sex : A

Guide to Sexual Fulfilment. Little Brown and Co, New York, 1979, Fontana,

London, 1980 458

Zola, Irving K, "Structural Constraints in the doctor-pat lent relationship: the case of non-compliance", in Eisenberg, L, and Kleinmann, A (eds), The

Relevance of Social Science for Medicine, pp 241-252