Physicians have traditionally been suspicious of the pleasure women have had in masturbation. In the 18th and 19th centuries the "mechanical and iniquitous excitations" of masturbation were thought to cause all manner of disorders. Doctors thought they saw serious somatic symptoms of the practice: sunken eyes with black bags under them, pallor, general weakness and a host of sexual manifestations that one physician described as necessarily culminating, eventually in a massive spasmodic system failure, a sort of death by orgasm.

Sewing machines, particularly the kind with two foot treadles operated alternately, were thought by many 19th-century physicians to be the cause or the means of masturbation in women, a concern expressed also about the bicycle. One writer thought the power of the sewing machine was such that heterosexual women could be turned into lesbians by "excessive work" on them.

E. H. Smith, in the Pacific Medical Journal of 1903, published a guide to detecting masturbation by examination. A woman with one labium longer than the other, he asserted, had caused this "hypertrophy" by masturbating on that side. Passing a "mild faradic current" through the urethra was another way of determining whether women were too sexually sensitive.

Nonetheless, physicians came to recognise the power of masturbation in relieving some symptoms of female patients. In 1903 Samuel Howard Monell summarised doctors' need to be able to treat their hysterical patients by masturbating them to orgasm. "Pelvic massage in gynaecology has brilliant advocates who report wonderful results, but when practitioners must apply the skilled technic with their own fingers the method has no value to the majority." For physicians in this line of work the vibrator was a godsend:

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"Special applicators (motor driven) give practical value and office convenience to what is otherwise impractical," concluded Monell.

Samuel Spencer Wallian, extolling the virtues of "rhythmotherapy" with a vibrator in 1906, asserted that in manual massage the physician "consumes a painstaking hour to accomplish much less profound results than are easily effected by the vibrator in a short five or ten minutes."

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The rest-cure physician Sir Weir Mitchell was an advocate of such practices; but in 1877 he warned fellow doctors that "the early use of massage is apt in some nervous women to cause increased nervousness and even loss of sleep", though "very soon the patient begins to find the massage soothing and to complain when it is omitted".

(Taken from The Technology of Orgasm)