A Treatise on the Diseases Produced By Onanism, Masturbation, Self-Pollution, and Other Excesses.

by L. Deslandes

§ 2. DISEASES ARISING FROM VENEREAL EXCESSES.

There are but few diseases which have not been observed as occurring after venereal excesses. The influence of the genital organs is so great, and extends so perfectly to all points of the organism, that the slightest morbid disposition of the latter is favored by its action. Capable of fecundating all the germes of the diseases which occur, the abuse of the genital organs produces all those which may happen in the body. Hence, we must not be astonished to see venereal excesses mentioned in enumerating the direct or indirect causes of most of them. We should certainly sometimes be embarrassed to justify this indication by positive proofs; for we do not know all that exists, and written science does not represent all that has been seen: but, as we know that a powerful influence only requires to exist with a morbid arrangement, to make of it a disease, the knowledge of this fact alone authorizes us to place venereal excesses, which have so injurious an effect, among the productive causes of most affections of the body.

Those diseases which are the consequence of this cause generally have a special mark, which depends not only upon the fact, that in a great many cases it continues to act when they are developed, and therefore deranges their course; but which results also particularly from the presence among their symptoms of those which belong particularly to venereal excesses. Hence, if, in consequence of these excesses, an individual should be affected with phthisis, epilepsy, a chronic disease of the brain, spinal marrow, caries of the vertebræ, &c., the patient will present, besides the special symptoms of these different affections, the signs of consumption already mentioned by us, and which are generally the consequences of the prolonged abuse of masturbation, or of coition; he will become thin, his strength will be exhausted, his eyes will be sunken, and present a dark ring beneath them; his countenance will be melancholy and suffused; his digestion will be deranged; he will suffer from wandering pains, from trembling, and from spasms; his mind will become enfeebled; and, finally, he will show many of the phenomena which we have described as general symptoms of venereal excesses. In these cases, there is, properly speaking, a complication of the special disease which they have produced, and of this other disease resulting as we have seen before, from the abuse of the genital organs. There are, at the same time, the general effects of this abuse, which may be seen in all those who are the victims of it, and the special characters of diseases which might have arisen from some other cause. The practitioner who should be unacquainted with these facts, in regard to which we find nothing precise in authors, would be liable to mistakes which would render him liable to errors of prognosis and of treatment.

The instances of individuals who have died of apoplexy, either of the cerebrum or cerebellum, during coition, are by no means rare. We can readily imagine, that if there be a marked disposition to this disease, and that if it be disposed to come on, the derangement in the respiration and circulation produced by the venereal action might hurry it. This has happened more than once during the digestion of a full meal. Most old men who have died during coition, have been affected with apoplexy. Hence, authors have generally placed venereal excesses among the causes of this affection.

We will mention Cœlius Aurelian, Areltœus, Lomnius, Tissot, Pinel, Cruveilhier, Londe, &c. Henry Van Hers mentions a man, forty years old, who was attacked with apoplexy while with his wife, the first night of his marriage. The attack, however, could not have been very severe, as it yielded readily to treatment: but the patient indulging in the pleasures of love a few days after his recovery, was again attacked, and died. (Dict. des Sc. Med., art. Apoplexie.) Hoffmann mentions one. It was that of a soldier, who died in the act of coition. It was found, on opening his body, that blood was effused in the brain. Serres’ work on the comparative anatomy of the brain states a similar instance. It is that of a man, thirty-two years old, who became affected with apoplexy during coition, and after drinking more freely than usual. Firm erection of the penis, which continued nearly until death had closed the scene, was added to the violent symptoms of apoplexy. The cerebrum was healthy; but the median lobe of the cerebellum exhibited traces of severe irritation; and the substance of the cerebellum was broken in several places; and small abscesses, filled with blood, were grooved along the superior vermicular process.

In some individuals, apoplexy supervenes so soon after venereal excesses, that we might reasonably anticipate that they contributed to its invasion. Thus, a steward, forty-nine years old, whose case is mentioned by Andral, fell down in the street, on coming from a house of ill-fame. He was immediately carried to the Maison de Santé, near, where he died shortly afterward. On opening his body, two apoplectic lesions were found; one in the right hemisphere of the cerebellum, the other in the left hemisphere of the cerebrum.

In coition, a marked congestion of blood takes place toward this organ. It is fair to presume, that such an act frequently repeated may predispose to an attack of apoplexy, which is decided sooner or later under the action of different causes. It is a fact, however, that this affection occurs frequently in those individuals who are accustomed to indulge in venereal pleasures. Serres reports the case of a man who indulged frequently, and who was attacked with apoplexy soon after a day passed in a house of ill-fame. He died two days afterward, presenting, among other symptoms, the erection of the penis, and an abundant discharge of semen. Post mortem examination showed, as in the preceding cases, apoplexy existing in the cerebellum. A similar case was reported by Dr. Guiot. It was that of a man, fifty-two years old, who was much addicted to women, and who, after several times suffering from cerebral congestions, was affected with mania. His genital organs were very much developed, and he was frequently affected with pollutions. He died, finally, of congestion, with hemiplegia, in twelve hours. Among the symptoms presented, were remarked erection of the penis, and as it were automatic motions of masturbation.

Deep and chronic lesions have been observed in the encephalon of onanists, much more frequently than acute diseases. We published, in 1817, a case of chronic arachnitis, which seemed to depend on this cause. The patient was a boy seven years old, who entered the Hospital des Enfans, at the beginning of the preceding year. This child, who was much addicted to masturbation, was usually affected with convulsions during this act. He finally became idiotic. He was extremely repugnant to take exercise, and he remained very quiet. His strength failed, his limbs wasted away, and finally he became affected with almost total blindness. The hearing, and generally the external and internal senses were also much weakened. Galvanism and other remedies were employed in vain. The patient died; and on opening the cadaver, we found a very marked inflammation of the portion of the meninges which follows the course of the superior longitudinal sinus. The surface of the brain, also, appeared to some assistants to be inflamed. In another patient, whose history is stated by Desruelles, in his memoir on the effects of onanism, the substance of the brain was affected. There was paralysis of the left arm, convulsions of the right arm and of the muscles of the face. On opening the cadaver, an encysted abscess was found in the hemisphere of the brain, on the side opposite to the paralysis, and corresponding to the convulsed limbs.

Chronic alterations have frequently been found in the cerebellum of onanists. They have been mentioned by some as the cause, by others as the effect of onanism. But even admitting that in some cases these alterations may have been the beginning of this habit, this fact shows the bond which unites the genital organs and the cerebellum, and renders more probable the influence which they may exercise upon it. In fact, when the disease of one organ deranges the functions of another, we may be satisfied that an opposite result is possible. Farther, it would be impossible, in most of the cases of which we speak, to distinguish whether the cerebral affection or the masturbation had precedence. The only thing positively known is their coincidence; and this latter has appeared too frequently not to attract attention. We will mention several instances of it.

A female, addicted at an early age to the pleasures of venery, finally indulged in prostitution; she was at the same time addicted to onanism, and at last became affected with nymphomania. Ashamed of her situation, she submitted to cauterization of the clitoris, but without any good result. She finally died; and we found chronic irritation, with induration of the middle lobe of the cerebellum. Small sinuses, with callous edges, indicated that an inflammation had existed for a long time in this organ.

Gall (in his treatise on the functions of the brain, Vol. III., p. 314) has given us the history of a boy, three years old, who was strongly addicted to onanism, and in whom two thirds of the cerebellum was found to be suppurated.

A young man, nineteen years old, was so much addicted from his infancy to masturbation, that all mechanical means were tried in vain to conquer this fatal habit. It was even proposed to scarify the penis, in order that his motions might be prevented by pain. All attempts were in vain; and this unfortunate young man, exhausted by continual losses of semen, died three months after entering Hotel Dieu, in the most complete state of marasmus. He had often experienced attacks of epilepsy. On opening the dead body, we found in his cerebellum an encephaloid tumor the size of a nut, which had began to soften.

A girl ten years old, addicted to masturbation, and of a melancholy temperament, complained for four months of severe pains in the head. These pains increased to such a degree, that for the last three weeks of her life she was constantly crying. She was finally carried to the Hospital des Enfans. The only additional information obtained in regard to her was, that the patient was bedridden for twelve days—that she was affected with vomiting of bile, followed by somnolence—that for three days she had ceased to speak, or answered with difficulty—that she constantly kept her hand to her head, which was thrown back. During the last four days, she was comatose: there was a slight degree of strabismus, and dilatation of the pupil. A post-mortem examination showed inflammation, with purulent infiltration of the arachnoid membrane, at the upper part of the cerebellum. The substance of the brain presented tubercles and a softening.

Combette has related a case, which to our knowledge is unparalleled; viz., complete destruction of the cerebellum in a girl eleven years old, who was addicted to onanism. In place of this organ was found a gelatiniform membrane, attached to the medulla oblongata by a peduncle of a similar character. The genital organs of this girl presented evident marks of her habit: the finger could easily be introduced into the vagina; the hymen was absent; the external labia were of a bright red colour, and seemed to have been frequently irritated. All that is known of this patient, who died at the Hospital des Enfans, in 1831, is reduced to a few facts. She was born healthy and well-made, although she was slight; and her physical and intellectual development was slow, and very imperfect. On entering the Foundling Hospital the 13th of January, 1830, she was feeble and ricketty, had but little intelligence, and seemed indifferent to surrounding objects. She answered questions with difficulty and hesitation. Her legs, although feeble, still supported her; but she fell frequently. She was in the full possession of all her senses: her appetite was good. Her health suffered more the following months, and she was finally obliged to remain constantly in bed. Her constitution then appeared impaired, and she was as it were stupified. She was depressed, and complained neither of pleasure nor pain; if questioned, she merely answered yes or no. She laid constantly on her back, her head turned to the left, and she moved her limbs with great difficulty. She soon became affected with a continual diarrhœa; and she died fifteen months after entering the hospital, in a state of complete exhaustion. What was the effect of masturbation in this case? Was it the cause or effect of the malady, which had disorganized the brain? This habit certainly had a great deal to do with it. (Revue Medicale, April, 1831.)

To these facts others might easily be added, where the affection of the brain was manifest, although not verified by a post mortem observation: thus, in the following case mentioned by Serrurier, the epilepsy, loss of sight, and the destruction of the intellectual faculties, certainly indicated a deep lesion of the brain. “I always remember with horror,” says this author, “the frightful picture presented by a young soldier, after frequent indulgence in onanism, and of nocturnal pollutions, which were more violent and copious after each epileptic fit. This young man was in a perfect state of marasmus: his sight was lost entirely; he was perfectly imbecile, and even the calls of nature were unanswered by him. His body exhaled a particularly nauseous odour; his skin was livid; his tongue trembled; his eyes were sunken, his teeth decayed; and his arms were covered with ulcers, which indicated a scorbutic affection. This state continued for six months, when the melancholy man died, having struggled for a long time against death, which finally terminated his sufferings.”

In the preceding case we can remark, in addition to the symptoms of the cerebral affection, the symptoms of the exhaustion of the cachexy, presented by individuals who have been reduced very low by onanism. A similar state is seen in the following case related by Tissot. Here the encephalic affection, to judge of it by the throwing back of the neck, and the violent pains experienced by the patient in this part, seemed to be situated in the cerebellum, medulla oblongata, or in those parts of the arachnoid membrane which are near them.

L. D—— was by profession a watchmaker. He had lived prudently, and had enjoyed a good state of health, till he was about seventeen years of age. At this period, he gave himself up to masturbation, which he repeated every day, sometimes even to the third time; and the ejaculation was always preceded and followed by a slight insensibility, and a convulsive motion in the extending muscles of the head, which drew it very much back, whilst the neck was extremely swelled. A year had not elapsed, before he began to feel a great weakness after every act. This notification was not sufficient to rescue him from his filthy practices: his soul, already devoted to this base habit, was incapable of forming any other idea, and the repetition of his crime became every day more frequent, till such time as he was in a state which gave reason to apprehend his death. Too late grown wise, the evil had already made so great a progress, that he was incurable; and the genital parts were become so easily irritated, and were so weak, that it was no longer necessary that this unhappy youth should be an agent, in order to shed his seed. The slightest irritation immediately procured an imperfect erection, which was constantly followed by an evacuation of this liquor, which daily increased his weakness. This spasm, of which he was not before sensible but in consummating the act, and which ceased therewith, was now become habitual, and frequently attacked him without any apparent cause, and in so violent a manner, that during the whole period of the fit, which sometimes lasted fifteen hours, and never less than eight, he felt such violent pains in the back part of the neck, that he did not scream out, but absolutely howled; and all this while it was impossible for him to swallow either solids or fluids. His voice was become hoarse; but I did not observe that it was more so while the fit continued. He entirely lost his strength, and was obliged to give up his profession, being altogether incapacitated: thus overwhelmed with misery, he languished, almost without any assistance, for some months; and was the more to be pitied, as what memory he had remaining, and which he was at length entirely bereft of, only served him to take an incessant retrospect of the cause of his misfortunes, which were increased by all the aggravating horrors of remorse. I heard of his situation, and went to him; I found a being that less resembled a living creature than a corpse, lying upon straw, meager, pale, and filthy, casting forth an infectious stench; almost incapable of motion, a watery palish blood issued from his nose; saliva constantly flowed from his mouth: having a diarrhœa, he voided his excrement in the bed without knowing it: he had a continual flux of semen; his sore, watery eyes were deadened to that degree, that he could not move them: his pulse was very small, quick, and frequent: it was with great difficulty he breathed, reduced almost to a skeleton in every part, except his feet, which became œdematous. The disorder of his mind was equal to that of his body; devoid of ideas and memory, incapable of connecting two sentences, without reflection, without being afflicted at his fate, without any other sensation than pain, which returned with every fit, at least every third day. Far below the brute creation, he was a spectacle, the horrible sight of which cannot be conceived, and it was difficult to discover that he had formerly made part of the human species. I had immediate recourse to the assistance of strengthening remedies, in order to remove these violent spasmodic fits, which so dreadfully brought him back to sensibility only by pain: I contented myself with having given him some ease in this respect, and I discontinued administering remedies, which could not ameliorate his condition; he died at the end of a few weeks, in June, 1757, his whole body having become dropsical.

In a case related by Bouteille, surgeon-general of the hospital at Lyons, most of the symptoms resulting from the cerebral affection existed in the right side of the body, and consequently indicated an affection of the opposite side of the cerebrum. The patient was a young girl twelve years old, whose constitution was weak and irritable, and very slightly developed—doubtless, on account of the enervating habit of onanism, in which she had indulged for several years, and which her mother’s vigilance could not prevent. Just after recovering from a severe illness, which yielded readily to remedies, this young girl was very much terrified, which had a great deal of influence upon her, as she was extremely sensitive; her sensibility being increased by the weak state of her nervous system, produced by onanism. Soon after, she was affected by slight convulsive motions in the right foot and arm, accompanied by a disagreeable pain in the right knee and in the sole of the foot of the same side. Notwithstanding the use of remedies, the disease increased, and she was soon unable to carry her food to her mouth, her arm was so much agitated. The appetite was variable, and the pulse was regular. Sometimes, and contrary to her usual custom, the patient was silent; sometimes she was extremely lively, and even foolish; sometimes her ideas were incoherent, and she often indulged in tears.

Headache and dizziness were perceived, but they soon yielded. At a later period, the sight and hearing of the right side were considerably weakened: at the same time, the pain in the sole of the foot, knee, and part of the right hand became more intense, and the difficulty of walking increased. After a time, the disease seemed to improve a little: the convulsive motions abated; the intelligence and memory returned, as before the disease; but the sight and hearing remained as they were. An active mode of treatment was now used: electricity formed the principal remedy. The patient was finally cured. Need we remark, that in all probability the fright was only the occasion which excited the development of a disease already prepared for by the onanism. (Traité de la chosée, p. 352.)

The convulsive form, the epileptic, is one of those assumed most frequently by the cerebral diseases produced by masturbation; we can easily conceive of this by remembering, that what takes place in the act of venery has, as we have already seen, a striking analogy with an attack of epilepsy: hence the ancients termed the act of coition, a short fit of epilepsy. It is unnecessary to state here the numerous testimonials found in authors, in regard to the influence of onanism as a cause of epilepsy. This influence is a fact mentioned and assented to by all. We shall relate a few examples.

There are some individuals who are so susceptible, and present so great a disposition to epilepsy, that they have a regular attack of it whenever they indulge in the act of venery. Didier knew a merchant of Montpelier, of whom this was true. Similar cases are related by Galen, Van-Hers, Tissot, Hoffmann, Haller, and many other authors. A similar thing is observed even in animals. Alfred Menard had a strong watch-dog, who was affected with epilepsy whenever he coupled with a slut. These attacks were characterized by convulsions, and a loss of consciousness: their duration varied, and was always connected with the ardour of the animal, who never was affected except under the circumstances mentioned. (Revue medicale, March, 1825.)

Epilepsy sometimes supervenes directly after the excesses which cause it. Cole, cited by Esquirol, relates the case of a female, who became epileptic three days after marriage: but venereal abuses generally act slowly, and prepare the body for an attack of epilepsy, which this or some other cause excites. Esquirol relates the case of a young man, twelve or thirteen years old, who early in life was addicted to masturbation, and became extremely nervous, although strong and robust: at fifteen years of age he was affected with epilepsy. These attacks came on at the moon’s first quarter, and were very sudden: the patient fell down, uttered loud cries, and was generally convulsed: his eyes were open, fixed, and injected: the pupils were very much dilated: and when the fit passed off, he remained exhausted the rest of the day. This young man, like most onanists, was extremely susceptible, fretting upon the slightest pretext. After six months of treatment, the attacks became less frequent: at the end of a year they ceased. This young man might have been considered cured, but the pleasure of seeing his mother, from whom he had been separated for two years, caused a relapse: the same remedial means were again employed, and with success. He has, since that, entered into business, and has travelled extensively: his nervous system is strengthened: he married when twenty-seven years old, and has continued in good health.

Another curious fact has been communicated to us by the celebrated Dr. Goupil. A little boy, only eighteen months old, who had been put out to nurse, returned home with the habit of masturbation. At first, his parents thought but little of this; but when two years old, he was affected with an epileptic form of disease, characterized by loss of consciousness, convulsions of the muscles of the face and eyes, stiffness of the limbs, and sometimes he fell down. These fits becoming more and more frequent, Dr. Goupil was consulted. The patient was now three years and a half old, and still continued his bad habit. He was constantly sad, morose, and stupid. The doctor, not being at first aware of the cause, employed different medicines, but unsuccessfully: he then discovered the cause, and tried mechanical modes. He put on the boy, at night, a kind of strait jacket, by which his arms were kept crossed in front of the chest; and during the daytime, he was watched carefully. These means succeeding but imperfectly. Dr. Goupil employed another strait waistcoat, which was laced behind, and was furnished in front with a silver apparatus, to contain the genital organs, and having only an opening for the urine. This new obstacle did not answer as well as was expected, and the child sometimes escaped all vigilance: but as this was rare, he soon gained flesh, and also his strength and vivacity. The fits of epilepsy gradually became less frequent. This boy is now from nine to ten years old; enjoys good health; and, with the exception of a remarkable loss of memory, retains no trace of former indiscretions.

These two cases show how far the system can be restored, when the cause which disturbs it ceases to act. The following, which was communicated by Zimmerman to Tissot, proves the same thing; but it also shows how soon a return to the bad habit destroys the good effects resulting from its abandonment.

“I have seen,” says Zimmerman, “a man, twenty-three years old, who became epileptic, after debilitating his body by frequent masturbation. Whenever he had nocturnal pollutions, a fit of epilepsy ensued; and the same thing occurred after masturbation—from which, however, he did not abstain, notwithstanding the bad symptoms with which it was followed. After the fit had subsided, he felt very severe pains in the kidneys, and around the coccyx. Having, however, abstained from his manipulations for some time, the pollutions disappeared; and we had hopes of curing the epilepsy, the attacks of which were less frequent. He had regained his strength, appetite, sleep, and color, after resembling a cadaver; but having returned to his bad habits, which were always followed by fits, he was found dead in his chamber one morning, bathed in blood.”

Another convulsive affection, St. Vitus’ dance, has sometimes been caused by onanism. Marc Ant. Petit has published a case of it, which was communicated by Dr. Morelot. It is as follows:—A young girl, eight years old, became remarkably thin: her lower limbs were agitated by extraordinary motions, which were extended to the upper limbs. She soon lost all control over them. The twitching in the muscles of the face and eyes was excessive; the patient could not continue in her bed, and she was confined to a large chair. Her attending physician thought that this might be attributed to the presence of worms, and gave several anthelminthics, but without success. Dr. Morelot was consulted at this period, and thought that he could perceive the effects of a bad habit: he soon became convinced of its existence. By means of great watchfulness on the part of her parents, the use of cold baths, musk, and camphor, she was radically cured.

Mental derangement is often the prevalent symptom in diseases of the brain, produced by excess of masturbation or coition. We have already spoken of idiocy; but this is by no means the only change observed in consequence of these excesses. Every variety of affection of the mind may be caused by them, as is proved by statistics collected by several authors, in insane asylums. Yet these abstracts are far from presenting the truth. “So many circumstances combine,” says Esquirol, “to embarrass the discovery of causes of mental alienation, that the one mentioned, like other causes, must often be unascertained by physicians.” According to this sagacious observer of all the forms of mental alienation, mania is produced least frequently by venereal excesses. He adds, that maniacs, during the duration of the periods of access, are less addicted, generally, than other deranged persons to masturbation; but when they do indulge, this act must be considered as a bad symptom, since it constitutes an insurmountable obstacle to the cure: it destroys the strength, and finally produces in the patients stupidity, phthisis, marasmus, and death.

Dementia is, perhaps, the kind of derangement most frequently observed after masturbation. I saw a remarkable instance of this disease in a young man, twenty years old, who, indulging in these excesses for several years, gradually lost his mental faculties, became averse to even his relatives and dearest friends, and finally fell into a most perfect state of dementia. The relative frequency of this form of mental alienation in onanists has been pointed out in France by Esquirol, and in Norway by Holst. (Annales d’hygiene publ. December, 1830.)

Holst has remarked, that paralysis, that fatal symptom which so frequently attends all varieties of derangement, particularly monomania and dementia, is observed particularly in those insane who are addicted to onanism, and to other venereal excesses. This remark is confirmed by the two facts, that paralysis is much less common in females than in males, and that onanism produces mental alienation much less frequently in the former than in the latter. Thus, of 256 persons, admitted at the asylum at Charenton, during 1826-7-8, there were 44 men, in whom derangement could be attributed to libertinism or to onanism, while the same was true of only 3 women. Dr. Holst has shown that a similar proportion exists between the deranged of the two sexes in Norway. This relation, however, must not be considered as strictly correct; for females, being generally very reserved in their disclosures, onanism probably passes undiscovered in them more frequently than it does in men. It is well ascertained, that one twentieth of the deranged at Salpetrière, is composed of public women, who are for the most part affected with dementia and paralysis. Now, consider that masturbation is much more frequently a cause of derangement among the rich than among the poor. (Dict. des Sc. Med., vol. xvi., p. 179.) And remark, too, that at the Charenton asylum, where only persons in easy circumstances are received, there are proportionally more patients with paralysis than at Bicetre, the population of which is composed of men, belonging to the poorest classes of society.

We have only to consider the phenomena which attend and usually follow the venereal act, to infer that the spinal marrow may frequently be affected in consequence of the abuse of that act. Agitation, the involuntary contractions of the muscles, particularly of those surrounding the pelvis, and the tetanic spasm with which they are affected at the time of the ejaculation of the semen; the cramps which frequently attend it; the general feeling of pain, fatigue, and debility, which follows it—a feeling which is always more perceptible in the loins and lower part of the body, than elsewhere, indicate the powerful impression made on the spinal marrow, and the part which it takes in all going on. This participation is also demonstrated by different pathological facts, and by the results of experiments which we shall mention, when treating of the influence exercised by affections of the spinal marrow, as the cause of venereal excesses.

The local symptoms of the medulla, in onanists, consist in different and more or less acute sensations felt along the vertebral column. At first, these sensations do not appear until after the act of venery, and pass off; they then continue a longer time; and finally become constant. The pain is generally of a dull character—inconvenient, rather than severe—which obliges the patient, when sitting or standing, to change his position frequently; and it is generally less perceptible, or even disappears, when the patient assumes a horizontal position. Sometimes there is a feeling as if of ants crawling over the body, descending from the head along the spine: this symptom was first noticed by Hippocrates. Sometimes, these sensations have a special character, which each patient expresses in his own manner: thus, a man who indulged night and morning, for two years, in coition, complained to me that he felt beatings constantly between his shoulders. Others say that they have a knot in the back. The pains in the spine are sometimes very severe; sometimes they are extremely sharp. Onanists, and individuals affected with pollutions, most generally complain of their loins.

The frequent occurrence of the symptoms mentioned in persons exhausted by venereal excesses, has caused the terms consumption, phthisis dorsalis, and tabes dorsalis, to be applied to the state which they then present.

The other symptoms of the affection of the spinal marrow are more or less severe pains—more or less distinct sensations of cold, of numbness, and formication in the limbs, particularly in the lower extremities; cramps; constant trembling, or convulsive motions in these parts; a kind of tetanic stiffness; gradual debility of the lower half of the body; and, finally, paraplegia. We shall find these symptoms, in addition to the other effects of masturbation, in cases to be mentioned.

Pains in the loins and extremities were very marked in an individual of whom Serrurier remarks as follows:—“A patient whom I attended was reduced to a most dreadful state of marasmus, in consequence of nocturnal pollutions, determined by venereal excesses. I prescribed a tonic mode of treatment, and varied it in every form; but the patient died, after four months of frightful pains in the loins and articulations.” There was apparently, in this case, an affection of the lumbar part of the medulla, or of its membranes. A similar malady existed, probably, in a man whose case was published by Hattè, and who was affected, in consequence of excesses in coition, with a lumbago, which alternated with satyriasis. There is no doubt, in regard to the affection of the spinal marrow, in the following case related by Van Swieten:—“For three years” says he, “I used all the aids of medicine for a young man, who, in consequence of onanism, was affected with general wandering pains—with a sensation, sometimes of heat, sometimes of cold, which was extremely unpleasant, over the whole body, but particularly in the loins. After a time, these pains diminished slightly; and then the thighs and legs were so cold, that although these parts, on being touched, seemed to preserve their natural heat, yet he was constantly warming himself at the fire, even during the warmer days of summer. I observed, particularly, a constant rotation of the testicles in the scrotum; and the patient felt a similar motion in the loins, which was very troublesome to him.”

Was the spinal marrow perfectly healthy in the onanist who wrote to Tissot the following:—“My nerves are extremely weak. My hands have no strength: they tremble constantly, and perspire freely. I have violent pains in my stomach, arms, and legs; and sometimes in the kidneys, chest,” &c. Persuaded, also, from a great many cases, that most of the pains termed rheumatic are neuralgic, and that many neuralgias depend on an affection of the spinal marrow; I think there is reason to suspect this affection, whenever it is found in onanists.

The following case, related by Dr. Bertini of Turin, presents, as a principal symptom, convulsive trembling of the lower extremities. The disease commenced, as is frequently the case, under the influence of an accidental cause; but when this had occurred, the patient presented for a long time symptoms of an affection of the medulla; and it is evident that their origin must be ascribed to onanism.

The patient was twenty-eight years old, and of a lymphatic-bilious temperament. When twelve years of age, he became addicted to masturbation, and then began to perceive tremblings in the arms and legs, vertigo, and pains in the head. He continued his fatal habit till twenty-two years old. At the beginning of August, 1824, he was attacked with a tertian intermittent, but for this he took no medicine. On the 20th of the same month, while cutting wood in Sesia, and while in a profuse perspiration, he went in swimming. He soon felt a sensation of shivering, followed by cold, spasms, vertigo, pain in the head, and thirst; aversion to food, difficulty of respiration, sensation of oppression in the sacrolumbar region, constipation, pains, and trembling in the lower extremities. These latter symptoms became so urgent, that the patient was obliged to have advice. In this state, he was carried to the hospital of Vercelli; and in a few days he was bled eleven times, and drastic purgatives were administered without success. A month afterward, he left the hospital; and since that time, the man has become a beggar and an object of public commiseration. The 18th of October, at which time he came under the charge of Dr. Bertini, he presented the following symptoms: he had no fever, nor pains in the head, nor derangement in the intellectual faculties; but he had a pain in the two sides of the sacrolumbar region, which was increased by pressure. The patient complained, also, of a kind of formication in the legs and feet, which parts, as also the rest of the body, trembled constantly: the agitation was so great, that the patient could not rest in bed, nor sit without support. Twenty-five leeches were applied to the lumbar region, and these drew about twelve ounces of blood. The trembling diminished, and the patient could soon rise and walk without a stick, and in fact without assistance. From this time, he felt no pains nor trembling, and he left the hospital eight days afterward. Dr. Bertini has since seen him, and he was well. (Revue Med., Dec. 1825.)

The tetanic form of the disease of the spinal marrow has rarely been observed as arising from onanism. Tissot saw a case of it in a young man:—“The disease commenced with rigidity of the neck and spine; this extended successively to all the limbs; and the patient, for some time before death, was obliged to lie in bed on his face, unable to move either his feet or hands. All motion was impossible; and he was obliged even to be fed. He lived several weeks in this sad state; and died, or rather sunk away, almost without suffering.”

Paralysis, which is the consequence of myelitis, or of any other affection of the spinal marrow, has been seen much more frequently than tetanus, in onanists. It is most generally confined to the lower parts of the body; but if the disease be seated in the cervical portion of the spinal marrow, the four extremities may be paralyzed. This was seen in the case of a young man who was under the care of Dupuytren, in September, 1833:—

This young man was twenty years old: he was very much addicted to masturbation, and his disease could be attributed to no other cause. This affection had existed for two years, when the patient entered Hotel Dieu. The attack of paralysis had been sudden, like a clap of thunder: the patient had lost the use of his limbs suddenly. The muscles of the neck were paralyzed, and the head fell in any direction: a short time before, however, the patient had recovered the power of sustaining it. The paralysis of the four limbs, also, varied in degree, alternately increasing and diminishing. After the patient entered the hospital, it was not equal on both sides: thus, he had some power over his left arm, but not over his right arm. Both the upper limbs, also, were atrophied, or wasted: those of the right side more so, however, than those of the left. Many remedies had been tried for this patient, but without success. At the time the case was published, purgatives and moxas were proposed. Dupuytren remarked to his pupils, that the situation of the myelitis corresponded in this young man to the cervical vertebræ; and that, if it ascended a little, and extended to the origin of the diaphragmatic nerve, it would cause death. He regarded the passion for masturbation, which existed in this young man, as the probable cause of this myelitis; and, consequently, of an atrophy of the anterior roots of the spinal nerves. (Lancette Française, 1833, p. 339.)

The disorganization, also, occupied an elevated portion of the spinal marrow, in the following case stated by Tissot:—“I was called upon,” says he, “to visit in the country a man, forty years old, who had been very strong and robust, but who had indulged excessively in sexual commerce and in wine, and who had been often engaged in athletic exercises. He began to be affected, a few months since, by a weakness in his legs, which made him totter in his walk, as if drunk. He sometimes fell, when walking on a plane; he could not descend the stairs without much difficulty; and hardly dared to leave his apartment. His hands trembled very much; he wrote with very great difficulty, and very badly; but he dictated with ease, although his speech, which had never been very fluent, began to be less so. His memory was still good; and the only ground for suspecting a lesion in his mind was the want of attention at the jeu de dames, and the change of countenance. His appetite was good, and he slept well; but it was difficult for him to turn in bed.

It occurred to me that his gallantries, and a too free use of wine, were the first causes of the disease; and that his athletic exercises, in which he had been frequently engaged, were the origin of the particular affection of the muscles. The season was not favorable for the use of remedies; but it was necessary to attempt to arrest the progress of the disease. I advised frictions of the whole body with flannels, and some tonics. I directed the doses to be increased, and to add also the use of the cold bath, at the commencement of summer. In a few weeks, the trembling of the hands seemed to be a little diminished. A consultation was had in the month of April: the disease was attributed to his having written some months, two years since, in a chamber recently plastered. Warm baths—oily frictions, with diaphoretic and anti-spasmodic powders, were employed without benefit. In the month of June, in a second consultation, he was advised to visit the medicinal spring of Leuk, in Valais. On his return, the trembling and stiffness had increased. From this time, (Sept. 1760, to Jan. 1764,) I saw him but three or four times. In 1762, he procured from Frankfort the remedies mentioned in the English treatise, Onania, which were of no use. He consulted a foreign physician the last year with as little success. The disease has slowly, but daily progressed; and for several months before death, his legs were too weak to support the weight of his body. He could not move his hands nor arms without help; his speech was so embarrassed, and his voice so feeble, that it was difficult to understand him; the extensor muscles of the head allowed it to fall continually on the chest; he had constant pains in the loins; his sleep and appetite were sensibly diminished. During the last few months of his life, there was much difficulty in swallowing; after Christmas, there came on an irregular fever, and his eyes were singularly dim; when I saw him in the month of January, he passed the whole day and most of the night reclining on a sofa, with his feet in a chair, with a domestic constantly in attendance near him, in order to change his position, raise his head to feed him, and to listen attentively to all he said. As he approached the period of his dissolution, he was obliged to articulate letter by letter, which was written down as it was pronounced. Seeing that I gave him no encouragement, as I only employed some palliatives for his fever and oppression, and actuated by a desire of living, he sent one of his friends to tell me the cause to which he attributed all these symptoms, viz., masturbation; that he commenced this infamous practice several years since; had continued it as long as possible; and that he had perceived his difficulties increase, in proportion to his indulgence in it. He confirmed this statement a few days afterward; and it was this which induced him to use the remedies recommended in Onania.”

This case shows us paralysis confined at first to the abdominal limbs, but extending afterward to the upper part of the body. We find a similar case of this progression, in a case related by Olivier, of Angers:—

“M—, of a sanguine temperament, of a strong constitution, and of a lively and gay character, had always enjoyed good health until seventeen years old, when he unfortunately became addicted to masturbation. He soon languished, and grew debilitated. Having, however, conquered this fatal habit, his strength gradually returned, and a proper regimen soon restored him to his former vigor. When twenty years old, he perceived a marked debility in the motions of the articulation of the right foot; but this disappeared: he was then affected twice with blenorrhagia, the last attack of which continued for several months.

“When twenty-five years old, he again indulged in masturbation, and similar symptoms to those first presented soon appeared: the lower extremities, also, became weakened; at times, also, the sensibility of the skin was obtuse, and even lost; but it soon reappeared. Under the influence of remedies, the weakness in the limbs diminished slightly. M— could walk three quarters of an hour without resting, but he could not stand longer; his legs, which were evidently wasted, refusing to sustain him. He was extremely costive; and since the last attack of blenorrhagia, the excretion of urine was painful.

“This affection remained stationary for several years, and then became more serious: the patient was now twenty-nine years old. At this period, the paraplegia became complete. He could not walk, nor even support himself on crutches; his lower limbs were often stiff; both arms, also, were at times insensible; and sometimes the sense of touch was blunted. The wasting away had increased; the excretion of urine was often involuntary, and the constipation was habitual. He was somewhat benefited by Hallé’s prescriptions, consisting in frictions with cantharides, and douches to the spine; but the next year the evil increased, the sensibility in the hands diminished, and there was difficulty in moving the right hand.

“Eighteen months afterward, the lower extremities became perfectly paralyzed: they were less warm than the rest of the body; yet, when cold water was applied to them, it produced a burning sensation. The right arm, forearm, and hand, often felt fatigue: its motions were less free, and the patient sometimes found it difficult to write. The limb of the opposite side was not affected. The disease of the bladder, which had existed for several years, was also increased.

“Paralysis, during the following years, progressed slowly, but constantly. The arm of the right side lost its motion entirely; the forearm was flexed upon it, and retained this position. At a later period, the fingers became stiff, crooked, and they continued to be so flexed, that a tampon of linen was placed on the palm of the hand, to prevent the nails from lacerating the skin. A singular symptom, also, appeared: if the internal part of the thigh was gently rubbed, the limbs extended quickly, as if by a galvanic shock, and then resumed their first position, which was that of a permanent state of semiflexion.

The paralysis finally affected the left upper extremity, which had hitherto been free from it; at the same time, the respiration became more difficult, the voice more feeble, and speech more painful, so that the patient choked, after talking a few moments. These different symptoms, and those described above, gradually became intense; and at the time this case was recorded, the patient was still alive—but in a most lamentable situation. Very severe pains supervened in the right side; the limbs were frequently convulsed; the constipation was obstinate; the urine passed involuntarily; the intellectual faculties, however, remained unaffected; and the patient, who was then fifty years old, proved, by his easy and agreeable conversation, that, notwithstanding his unfortunate situation, he had lost none of his natural gayety of character.” (Traité de la moelle epinière, &c., vol. ii., p. 594.)

The lower part of the medulla alone was affected in an individual whose case is mentioned by Tissot.

In another case related by Weszpremi, the spinal marrow and brain were affected. The patient, who was thirty years old, complained of pains along the spine, especially when he stooped. His legs were so weak, that he could scarcely stand erect for a moment; his memory was considerably weakened, and he seemed stupid; his sight was also affected, and he was extremely thin. This man, having long denied the cause of his disease, finally confessed it. After some months, his health was restored. (Observ. Med., p. 175.)

The disease is not always confined to the spinal marrow, and its membranes: it frequently extends to the parts adjacent, and particularly to the vertebræ. The latter are then destroyed; and the disease described by Pott, and which takes his name, appears. Sabatier was aware of the influence of masturbation on the bony part of the vertebral column. “The most terrible and most frequent results of onanism,” says he, in a letter to M. A. Petit, “are nodosities of the spine. My opinion has always been regarded as unfounded, on account of the youth of the patients; but I was enlightened by the admission of some of my patients, that many were guilty of this thing before their sixteenth year.” This fact, which was afterward stated by Boyer, in his lectures, is now no longer doubted. The relation, however, between the caries of the bodies of the vertebræ in onanists, and the affection of the medulla, or of its membranes, had not been observed; it had not been remarked that this latter always precedes caries, which in this case is only the result of the extension of the primitive disease. The facts which are to be stated will prove this to be true.

L. E. G., twenty-one years old, a turner, of a lymphatic temperament, of a slender and delicate constitution, addicted to masturbation from childhood, experienced, at the beginning of February, 1825, a slight pain in the epigastric region, difficulty of digestion, and constipation: he also had laborious breathing, caused by palpitations, which were much increased by walking, and particularly by going up stairs.

On entering the hospital la Pitié, April 28th, 1825, this young man presented all the symptoms of a hypertrophy of the left cavities of the heart: these phenomena, which diminished after a few days, were followed by symptoms of enteritis and peritonitis, which were attributed to excesses in eating. During the continuance of this latter affection, the patient complained of uncommon debility in the abdominal limbs. These symptoms disappeared; and when it was expected to see the patient convalescent, he was affected with complete paraplegia. He lost the use of his legs: they, however, retained their sensibility. As motion in them was lost, this sensibility was even increased; for the patient cried whenever he was touched, or when the position of the lower limbs was changed. The bladder was soon paralyzed, and the sound was used, which caused inflammation of this organ. A broad and deep eschar, followed by ulceration, laid bare the whole posterior part of the pelvis. From this time, the symptoms increased more and more, and the patient died the 11th of August, about six weeks after the first symptoms appeared.

On opening the body, a softened tubercle was found on the surface of the right hemisphere of the brain; the body of the third dorsal vertebra was slightly changed; the corresponding portion of the dura mater presented a cancerous degenerescence, which extended from the body of the third dorsal to that of the fifth cervical vertebra. The bodies of all the vertebræ connected with this alteration were whitish, and slightly softened. The tissue of the spinal marrow was softened, especially on the level with the seventh cervical and first three dorsal vertebræ: the softening occupied the anterior cords, which were of a grayish white color; the posterior cords were slightly softened but only on a level with the first three dorsal vertebræ The lungs were healthy and crepitating; the right contained superiorly a small softened tubercle. The heart was healthy: its size was normal; the left cavities possessed their usual size and thickness. Traces of inflammation were found in the peritoneum, intestines, and bladder. (Journal de Physiol. Experim. July, 1825.)

In this case, we see in a measure the mode in which caries of the vertebræ is produced. This caries is only at its commencement; the vertebræ are affected superficially, and in those parts only which correspond to the diseased portions of the dura mater and medulla. There are none of the local symptoms of Pott’s disease—no collapse of the vertebral column—no gibbosity; yet the paraplegia appeared, as in the cases where these alterations exist: it resulted, then, from the softening of the medulla, or the alteration of its membranes. If a little time had elapsed, and several spinous processes had deviated from their true direction, this paralysis would have been attributed to the commencement and progress of this deviation. These relations between the state of the medulla and that of the vertebræ have been already remarked by several authors. M. Latour, in a memoir inserted among those of the Society of Emulation, has sought to establish that paraplegia, in Pott’s disease, resulted from a primitive alteration of the medulla. Janson has since expressed a similar opinion. Cases have also been published by Louis, which leave little doubt on this subject. (Mem. and Recherches, 1826, p. 410.)

One symptom in the preceding case, which deserves to be noted, is the difficulty of respiration, the palpitations, and other symptoms which led to the belief that the heart was diseased. On opening the body, however, this organ was found perfectly healthy. Similar phenomena are often seen in onanists: it would therefore be wrong to consider them always as signs of an organic alteration of the heart and large vessels.

In the following case, the vertebræ were more changed. The spinal column was gibbous: but this was preceded by paraplegia, and other symptoms of myelitis. This case was published by M. Dalandeterie:—

A shoemaker, twenty-four years old, of good constitution, who has always enjoyed good health, contracted the habit of masturbation at the age of sixteen years, and became so addicted to it, that he indulged seven or eight times a-day: his strength soon diminished, and he lost flesh and his color.

After an interruption, caused by an acute disease, the patient resumed his fatal habit with the same earnestness. He finally became so weak; languid, and pale, that he was discharged from military service, in which he was inscribed.

A little while afterward, this young man, who had never shown any symptoms of scrofula, presented scrofulous engorgements in the groins and axillæ, and swellings, with caries, in several phalanges of the fingers. At the same time, a singular phenomenon appeared: the hair, which was chestnut colored, came off; on growing again, it appeared of several colors: but after coming off once or twice, it resumed its natural shade.

The patient continuing to indulge in onanism, finally became extremely weak, and was obliged to keep his bed. Marked symptoms of myelitis now appeared. The patient gradually lost the use of his lower limbs: first they became weak, and showed a disposition to be crossed; but finally wasted away, and lost the power of motion. He was now obliged even to be turned in bed, as he could not move. The articulation of the feet and knees became stiff and inflexible, and his legs were so much retracted, that the end of the foot only touched the ground, when the patient was placed in an erect position. The sensibility of the limbs, also, was as much affected as their motions; they were cold, numb, and even when pinched they were not painful. The general languor was increased every day. He suffered from thirst, dyspepsia, pains in the stomach, rumblings, night sweats, &c. At this period, the patient quitted a woman with whom he had lived for a year, and who, having but little inclination for coition, caused him to indulge in masturbation.

The erections were frequent, powerful, short, and always terminated with a more or less abundant discharge of mucus from the urethra—perhaps, also from the prostate gland; or even the discharge might be of thin semen. After a while, the ejaculations were composed, instead of semen, of a half-clotted, blackish or yellowish blood: sometimes, as much as a tablespoonful was lost. These emissions were always painful, and were followed by extreme prostration.

For some time, the patient was in this sad state, when he experienced a crawling sensation, like that caused by ants, descending along the back: he experienced, in the same region, a severe and fatiguing pain, which extended into the ribs and loins. These symptoms subsided; but at the lower part of the dorsal region appeared a hard tumor, which at first was small; but it gradually enlarged, as long as the patient continued to masturbate. This tumor was evidently formed by the curve of the spine, and the projection of three spinous processes.

In three months, the patient was improved by the use of moxas and of antiscrofulous remedies, by a suitable regimen, and particularly by abstaining from onanism, for which he had conceived not only disgust, but even a horror. The abdominal limbs regained their strength, heat, and sensibility; the patient could walk on crutches, and could even stand erect for a few moments, and could take a few steps unaided.

In this case, which is remarkable in more than one respect, the symptoms of myelitis preceded the curve of the spine, and then disappeared, although the spine did not regain its primitive rectitude. The debility, numbness, retraction, and paralysis of the limbs, appeared long before the pain in the back, after which the curve in the back began to appear; and then these limbs regained their sensibility, force, and motion, while the gibbosity remained always the same. This curve, then, could not be the cause of the paraplegia, because the latter appeared first, and the spine remained curved after the paralysis was removed. The development of symptoms apparently scrofulous, in a man more than twenty years old, who had hitherto presented nothing analogous, and whose parents were healthy; the loss of his hair; the affection of the seminal passages, and the state of the genital organs, &c., &c.—facts to which we shall recur hereafter—all contribute to render this case interesting.

We shall see, in the following case, also related by M. Dalandeterie, an instance of vertebral caries in an onanist:—

A cook, forty-five years old, of bad constitution, but having always enjoyed robust health, indulged in masturbation, although not to very great excess. Eighteen months before his case was published, he perceived pains and weakness in the loins, frequent colics, often followed by brownish dejections, and sometimes by obstinate constipation. He suffered, too, from flatulency; and in the left haunch there was a pain, which increased or diminished with this flatulence.

The patient, notwithstanding the progress of these symptoms, continued to masturbate. Debility and pains in his loins extended into the abdominal limbs, and increased so much, that he was obliged to keep his bed: he could only lie on his left side; but in this position his motions were easy. The diminution in the natural heat, the livid color of the skin, the softness and flaccidity of the flesh, debility, loss of sleep and of flesh, thirst, constipation, &c., were added to the symptoms already mentioned.

At the same time, a hard, indolent tumor, the size of a pullet’s egg, was formed at the lower part of the dorsal region. This tumor, which did not enlarge, evidently resulted from the prominence of the spinous processes, and consequently from a curve in the spine, which was doubtless caused by a softening of the bodies of the vertebræ.

Nearly at the same period, there was developed, at the lower part of the sternum, a hard, indolent tumor; the color of the skin was unchanged: it gradually became the size of a nut, suppurated, and assumed the appearance of a scrofulous ulcer. The lymphatic ganglions of the neck, which were somewhat swelled, now returned to their natural size. The treatment was similar to that used in the former case, and was attended with the same result: the strength, bodily heat, and appetite returned. Finally, the patient was able to walk with crutches; and could stand, unsupported, for a few moments.

The circumstances in this case are not detailed with sufficient accuracy, to enable us to follow exactly the cause of the symptoms. We would remark, however, that one of these seen first was the neuralgic pains, which extended from the loins into the lower extremities. Now, as this symptom belongs to irritation of the medulla or its membranes, more than to their compression, there is reason to think that this irritation preceded the curve of the spine. In this patient, also, as in the preceding case, the affection of the marrow had not so much influence in causing the destruction of the bodies of the vertebræ, as a disposition to caries—a disposition which was evidently increased by onanism, and which appeared at the same time in several bones.

The following case, from Meyrieu, is not sufficiently detailed, to affect in any manner the question, how caries of the vertebræ is produced in onanists; but it is interesting, as it shows that the disease may extend to the soft parts which cover or are adjacent to the affected vertebræ.

L—, twenty-two years old, was moderately tall, with a narrow chest, and had never enjoyed good health, particularly for the six years preceding the time when he entered the prison at Bicetre, when he indulged in the disgusting practice of onanism. In the course of January, 1819, he was affected with general numbness, with frequent cough and expectoration of mucus: these symptoms were occasionally attended with slight fever. When admitted to the infirmary, the 1st of February, he complained, in addition to the symptoms already mentioned, of a violent pain in the posterior part of the neck. A slight swelling was seen at the level of the first and second cervical vertebræ, and pressure on that part was painful; the head was bent to the left side, and remained motionless; the thoracic abdominal limbs were numb; and deglutition was painful. Local resolvent frictions, blisters, and moxas were used. The 15th of February, he was affected with hemoptysis, which yielded in two days to the use of bleeding and astringents. The vertebral disease, however, generally made progress, like that of the chest, which seemed to relax. In July, the thoracic limbs were perfectly paralyzed; and in August, this was true also of the abdominal limbs. At this period, the head was absolutely immoveable; the phthisis seemed as yet in the second degree. Finally, the patient died suddenly, from moving his head, while the attendants were changing him.

Post-mortem Examination. The soft parts of the posterior region of the neck were changed to a whitish, lardaceous substance; the right condyle of the occipital bone was carious: there was also a deep caries of the upper part of the right lateral mass of the first vertebræ, and of the odontoid process. The transverse and odontoid ligaments were degenerated and softened; and the medulla oblongata presented a kind of strangulation, resulting from the compression caused by the left posterior part of the edge of the occipital foramen: in fact, there was a dislocation of this bone, on the first vertebræ. The cerebrum was unaffected; the right lung was tuberculous, and very small; that of the left side was also tuberculous, but was larger. The peritoneum presented some marks of inflammation.

In the preceding cases, the caries of the vertebræ was not attended with a congested abscess. The following case, published by Levêque Lasource, will present to us this symptom, which is so common in this disease:—

N— O— was addicted to onanism, from twelve to eighteen years of age; but could not renounce this fatal habit, although reminded of its danger by a curve in the spine, and by other symptoms. When received at la Charité Hospital, in 1806, beside a well marked gibbosity, he presented a congested abscess at the upper and inner part of the thigh. Two cauteries were applied to the sides of the vertebral prominences: these suppurated freely, but did no good. The abscess was punctured in several places. This young man, who could not survive, left the hospital; so that the organic changes produced by his disease could not be verified. (Jour. de Med., Chir. and Phar.; vol. xvii., p. 261.)

The same author has related another case, which terminated more fortunately:—A child, seven or eight years old, addicted to masturbation, entered at la Charité, affected with gibbosity and paralysis of the lower limbs. During the month he stayed in the hospital, several cauteries were applied around the tumor, which suppurated; tonics and strengthening medicines were administered internally. He left, perfectly cured of the paralysis, and of the other symptoms caused by the affection of the medulla; but the deformity resulting from the prominence formed by the spinous processes of the vertebræ continued. Three years after, this child, who had abstained from this bad habit, had experienced no relapse.

We have seen, in several of the preceding cases, that permanent contractions of the lower limbs resulted, in onanists, from affections of the spinal marrow. Guersent, also, admits the possibility of essential contractions—that is, those which do not result from a disease of the nervous centres. According to this practitioner, these kinds of contractions are seen most frequently in those nervous children who indulge in bad habits, like that of masturbation. The following case has been considered by him as an instance of this affection:—

D— E—, five years old, and addicted to masturbation, after passing a part of the winter at the Hospital des Enfans, to be treated for scrofulous engorgements of the glands of the neck, was sent to the country in the spring. He had been there about three months, when he was suddenly affected with a contraction of the lower extremities. Examined the 5th of July, he complained neither of pain in the head nor spine. The digestive passages were in very good state; there was no derangement in the circulation or respiration; the muscles of the lower extremities were permanently rigid: the tension, however, was more marked in the adductors; for the patient constantly kept his knees crossed. There was no deviation in the vertebral column. Different remedies were employed, but without success; except a little improvement under the use of carbonate of iron. The legs and thighs of the patient could be flexed and extended with the hands; but he could neither flex them when extended, nor extend them when flexed. This child was cured in a singular manner. His state was as described, when, at the beginning of September, he was affected with symptoms of roseola. The contraction of the lower extremities disappeared, when the fever came on. The eruption went through its course, and the contraction of the limbs did not return. Thus, this disease, which had resisted several efficacious remedies, disappeared before another disease.

The loss or debility of the external senses, particularly those of hearing and sight, when this state is the consequence of venereal excesses, often result, as may be seen in several of the cases above stated, from a disease of the brain. This organ was probably diseased in the old man whose case was mentioned by Réveillé Parise. This man was desirous of living with a young Italian girl, whose temperament was extremely ardent. He paid for his imprudence by blindness, which occurred in eight days, and which was followed by death. Sometimes, however, the eye alone is diseased: at least, the pathological state which it presents is unattended by any symptoms indicating an affection of the brain or its membranes. Many libertines present only an irritation of the conjunctiva and of the edge of the eyelids. It is a sort of chronic ophthalmia; their eyes are red, watery, fatigued, painful; and they cannot engage in the evening in any occupation, such as reading, which requires the attention to be confined to one object. Sometimes, a severe and deep-seated pain proves that, beside the outer parts of the eye, the interior of this organ is the seat of a severe irritation. Hoffmann has seen several cases of this. He cites that of a young man, who indulged in onanism from the age of fifteen to that of twenty-three. “His eyes and head were so weak,” says he, “that these organs were often affected with violent spasms, during the emission of semen. Whenever he attempted to read, he experienced a sensation similar to that of drunkenness: the pupil was considerably dilated, and excessive pains were felt in the eye. The eyelids were glued together every night; the eyes were also watery; and there was, at the two angles, a collection of whitish matter. These irritations, especially when seated within the eye, may be followed by the loss of sight.” Dr. Juengken, professor of clinical ophthalmology at the Berlin faculty, and who has published an excellent work on the diseases of the eye, indicates, when speaking of amaurosis resulting from masturbation, that the pupil assumes a peculiar form, which is found only (says this professor) in those individuals habitually addicted to this vice. In these cases, the pupil, instead of being in the centre of the eye, is removed upward, but does not lose its roundness: the upper part of the iris seems narrower, and contracted on its ciliary edge. This symptom has been mentioned, also, by Dr. Sichel, as occurring in certain scrofulous ophthalmias: iritis then exists. Photophobia, which is a greater or less aversion to light, resulting from the pain which it occasions in the eye, has been indicated, by Sanson, as sometimes preceding amaurosis, caused by too frequent a loss of semen.

All authors agree in placing venereal excesses, and particularly those from masturbation, among the causes of amaurosis. They are so unanimous on this point, that we shall cite no authorities. They generally agree to regard amaurosis, in onanists, as produced by the exhaustion caused by diurnal or nocturnal pollutions. Beer, and many others, assimilate, in this respect, the loss of semen to that of other fluids; and compares venereal excesses, especially those from onanism, with cholera, diarrhœa, &c., as a cause of amaurosis. This idea of exhaustion probably led Scarpa to remark, that amaurosis, resulting from premature abuses of masturbation or coition, must generally be regarded as incurable. This prognosis may be made, we believe, in regard to most cases of amaurosis. Dr. Buzzi has published, with four other cases of amaurosis, which were cured, that of an individual in whom it had been produced by masturbation. It, however, yielded, on the abandonment of bad habits, to the moderate use of good wine, combined with milk diet.

Dr. Rognetta, in a memoir on the causes of amaurosis, insists on the opinion that onanism produces this disease, by exhausting the sensibility of the body. He compares this habit to decay. “Nothing,” says he, “enervates the body so much as too frequent emissions of semen, especially when they are caused by the hand: the spasm which attends them throws the body into all the infirmities of old age. The retina and optic nerve then gradually lose their sensitive faculty, which finally becomes extinct. Those who masturbate are affected with amaurosis, like decrepit old men.” Rognetta adds, that he has the notes of several cases of amaurosis, which had resisted all remedies, and which were caused entirely by the luxuria manuensis. He relates the history of a young ecclesiastic, nineteen years old, a native of Palermo, whose sight became very weak. This unfortunate young man had been in the habit of masturbating seven times a-day: he was also prone to sodomy. Rognetta advised him to leave off this bad habit, and to return to his native place and take cold baths.

Sanson, also, places voluntary and involuntary pollutions among the asthenic causes of amaurosis: he, however, regards these pollutions as sometimes causing irritation of the retina. He assimilates them, as do many other authors, to all abundant discharges of fluids. The following case has been considered by him as one of asthenic amaurosis, produced in this manner:—A notary’s clerk, twenty-four years old, experienced for a year a progressive debility in his sight. He had labored much at night, by lamp-light, and attributed his disease to this cause; but another, which had contributed to the development of the amaurosis, was the excesses of this young man, in onanism and coition. Venereal disease, which he had contracted, might also contribute to this bad result. The pupil was dilated; the iris was immoveable; the eye was perfectly clear; and the retina, of a dull color, could be seen through the pupil. An antivenereal treatment, purgatives, emetics, and blisters around the organ, &c., produced no effect.

In my opinion, blindness from amaurosis, being not so much a disease as a symptom, or rather the consequence, of many other diseases, is not, in onanists, the result of exhaustion, of asthenia, any more than the debility and paralysis of the lower extremities are, when the spinal marrow is diseased. Besides, what difference does it make, how the sight is lost in onanists? the most essential thing to be known is, that they can lose it. This unfortunate circumstance is to be dreaded by those whose sight is much affected during the act of venery, and who remain, as it were, in a mist for a few moments after this act. Thus, amaurosis was predicted in a public girl, whose case is mentioned by Hoffmann, and whose sight was obscured whenever she had connexion with men. She finally became blind. (De morbis ex nim. ven., § 26.) The sight is rarely lost suddenly: it commonly fades away gradually; and the onanist, if he can understand this warning, may, by abandoning his bad habits in time, preserve the vigor he still possesses; and, sometimes, even may recover what he has lost.

The weakness and loss of sight, and the other affections of the eye already mentioned, are not the only ones which may arise from excessive onanism or coition: the muscles of the eye may also be affected. Lorry was, we believe, the first to notice this fact. “The eyes,” says he, “are affected with convulsive and spasmodic motions, after venereal excesses, rather than with blindness.” He states, that strabismus may be caused by onanism. We have before stated the case of a young man, whose eyes were affected with violent spasms at the moment of a discharge of semen. Demours has observed similar facts. “Masturbation,” says he, “affects the optic nerves, and also acts on the motor nerves of the eye.” He admits that he can see no reason for this. The same author mentions venereal excesses among the different causes of partial paralysis of the muscles of the eye.

We have already mentioned the wandering pains, which frequently affect onanists; we have also alluded to those which depend on an affection of the spinal marrow. We have reason to think, from our own observations, and the statements particularly of English authors, that the number of pains dependent on an affection of the spinal marrow is much larger than is generally thought: we think, that most of the pains termed rheumatic, particularly those affecting the trunk and the limbs, are neuralgic; and that most of these neuralgias proceed from an irritation of the medulla or its membranes. We do not say that the spinal cord is always affected then, as in those cases of myelitis which attend paralysis and death: we think that it is affected in some manner; and that these pains, which are commonly so severe, and frequently so general—sometimes attended with tumefaction, but more frequently without it—which are felt in the course of these nerves, are the usual consequences of this affection. Hence, it is not surprising, that the act of venery, which excites the nervous system so much—which has so marked an action on the spinal marrow, has frequently predisposed to neuralgic or rheumatic pains, and has directly caused or increased this kind of pains. It is well ascertained, and many authors—particularly Hoffmann—have remarked, that those who indulge in onanism, during youth, are more subject to these pains than others. The act of venery, even when indulged in to a moderate extent, generally increases their violence. I have often seen attacks of neuralgia supervene immediately after coition. It was an affection of this kind which was felt by the onanist who wrote to Tissot, that he felt in his face a pain similar to that caused by applying a great number of pins.

Individuals who have braved the usual causes of rheumatism with impunity, not unfrequently become vulnerable to these causes after venereal excesses. M. Villeneuve relates the case of a stonecutter, who had long been exposed to changes of weather without inconvenience, and who was violently attacked with rheumatism after unusual venereal excesses. He also mentions the case of a groom, who had long slept in a damp and narrow stable without suffering, but who was attacked with rheumatism the winter after his marriage. Saucerotte has seen a similar case: it was that of a man who had constantly braved the changes of weather, and who was affected with rheumatism after indulging in women and wine. The same author has established, in the memoir where this fact was reported, that muscular rheumatism is only a variety of neuralgia. Among the proofs which he gives of it, he states that many authors, as Barthez, Scudamore, Chaussier, Olivier, and Ferrus, have placed venereal excesses among the causes of neuralgias and those of rheumatism.

Most authors have considered these excesses as one of the predisposing causes of gout. Hippocrates, probably, entertained the same idea, if we may judge from these two aphorisms:—“Eunuchi neque podagra laborant, neque caluescunt. Puer podagra non tentatur ante venereorum usum.” Sydenham also regarded excessive indulgence in venereal pleasures as tending to produce gout. Guilbert remarks, that even hereditary gout is neither a disease of infancy nor of youth: he admits, however, that venereal excesses may produce it before the time it generally appears. Roche exclaims against this opinion: he thinks that venereal excesses can only cause attacks of gout. He says—

“What influence have masturbation and venereal excesses in producing gout? According to men of the world, and even to some physicians, they are the most fruitful source of this infirmity: and yet on what facts does this opinion rest? On this, that several gouty people have been great libertines in their youth. But how many chaste persons, and how many prelates, too, are attacked by this cruel disease? On the other hand, are there not as many, and even more libertines among the poor, than among the rich? and yet, in general, they are not attacked by the gout. Finally, the shameful vice of onanism is observed most frequently among the young; and we have already said that gout is a disease of manhood and old age. Hence, it is wrong to attribute to this order of causes a part of the influence which it has not, and cannot have, in producing gout. Here, doubtless, has been committed the error which has been several times pointed out: attacks of gout have frequently been known to supervene after venereal excesses or masturbation; and it has been concluded that these causes concur powerfully in producing the disease itself. Good living and gormandizing are, we repeat, the real—the only sources of gout: sobriety, frugality, are the best preservatives from it.”

This last phrase shows clearly the origin of Roche’s opinion. It is evident that he denies the influence attributed to venereal excesses, in the production of gout, only to sustain a favorite theory. Roche certainly never would have said, that there is more libertinism in the lower than in the higher walks of life, if he had not been preoccupied with the desire of proving that good living is the cause of gout, to the exclusion of every other cause. It may be asserted, that one mode of living predisposes to the gout more than another; and we will agree with every author, that this disease appears particularly in individuals who are well fed; but we cannot admit, that the possible action of certain influences, as that of venereal excesses, should be denied. Impressed, however, with the vast extent of the influence of venereal excesses, and with the uncertainty of its limits, we prefer to allow, with all authors, that venereal excesses, like many other known and unknown causes, may predispose to gout. This opinion seems to be more logical than that sustained by Roche with his usual ability.

Roche, also, in accordance with other authors, regards venereal excesses as injurious to those affected with gout. “The indulgence in venereal pleasures,” says Barthez, “should seldom be permitted to those affected with gout; for they should abstain from whatever weakens or exhausts. Coste, who has written on gout, is much more formal. “A gouty person,” says he, “should choose between living apart from his wife, and being cured of his disease; or caressing her, and rendering his disease incurable. Whenever a gouty person sees a female,” he adds, “if young, a new root to his disease sprouts forth; and if he be old, he drives a nail into his coffin.” This opinion differs from that of Pietsch, who maintains that gout arises from the absorption of vitiated semen, which is retained by continence in the seminal vesicles.

Can venereal excesses cause hemorrhoidal affections? For want of facts on this subject, we would remark, that these excesses may contribute to develop these affections, and particularly the exacerbations to which they are subject. This was Montegre’s opinion: he admitted, that the nervous debility which resulted from the abuse of the genital organs, generally favored the occurrence of fluxes, motions which occur most frequently in people subject to hemorrhoids; and also, that in those females who have hemorrhoidal tumors on the rectum or vagina, the abuse of coition may excite inflammation of these tumors. Montegre, however, thinks that excessive continence has a more detrimental effect on those affected with hemorrhoids than the contrary. He thought that the irritation which extreme continence causes in the seminal vesicles and adjacent parts, may excite a hemorrhoidal paroxysm: hence, he regards the act of venery as generally useful to persons affected with hemorrhoids, provided it is confined within certain limits. On this opinion, we would say, that if the irritation of the seminal passages may extend to the adjacent passages, venereal excesses which produce this irritation may also cause inflammation of the hemorrhoidal tumors much more frequently than continence. This is the opinion of Begin, also, who mentions, among the direct causes of hemorrhoids, “excesses in venereal pleasures—excesses which are always attended with a state of orgasm and vascular fulness in the genital system, and in all the parts connected with it; and particularly in the lower region of the rectum, which receives the same vessels in the neck of the bladder, the prostate gland, and the seminal vesicles, in the male, and in the uterus and vagina in the female.”

We may believe, from the enervating action of masturbation, that the development of scrofula may be excited or favored in those young patients who are addicted to it. Few proofs of this, however, are found in authors; and it is rare to find records of scrofulous symptoms in the histories of those onanists which have been published. It, however, would be absurd to conclude, from this silence, that the coincidence of these symptoms and the ordinary effects of onanism never occur, or that this habit cannot call into action a disposition to disease. But we must admit, that if masturbation be an active cause of this disease, this fact would have been noted more frequently.

Further: Certain circumstances seem to indicate, that onanism must be but little favorable to the development of scrofula. First, onanism renders the limbs thinner, dries them, then deprives them of those white fluids with which the flesh of scrofulous persons is generally infiltrated. Next, since in these latter the sensibility is as it were blunted, and the susceptibility is slight, onanism tends to excite them. Besides, one of the most common effects of the action of the genital organs, at puberty, is the disappearance of scrofulous engorgements and other symptoms, if they exist. Sometimes, the normal development of the genital apparatus excites in those who have arrived at puberty the swelling of the lymphatic ganglions of the neck, axillæ, and particularly of the groins: but in this case, these ganglions are painful, and present a kind of inflammatory state, analogous to that which is attempted to be produced when they are affected with scrofulous engorgements. Cabanis has well described what then takes place:—“From the time,” says he, “that the evolution of the genital organs commences, there is a general motion in the whole lymphatic apparatus; the glands of the groins, the mammæ, those of the axillæ, and neck, swell: they often become painful. It is not only in girls that the mammæ swell; in young men, I have frequently seen them form tumors, which seemed inflammatory: they have often been considered as such by ignorant quacks. This symptom generally causes uneasiness in those who experience it: but this depends not so much on the pain, (which sometimes impedes the free motions of the body,) as on the influence of this new action—the commotion caused in the imagination by the new system.” This state of the lymphatic system would be, as is seen, rather antithetic, than analogous to what is seen in scrofulous patients. Farther: we have only to compare the eunuch with him who has vigorously passed through puberty, to see that the action of the genital organs is not adapted to favor the development of this affection.

The act of venery often causes, also, ganglionary swellings; but they do not resemble scrofulous engorgements, more than those which arise from the influence of puberty. “The first essay of venereal pleasures,” says Cabanis, “is often necessary to complete the development of the genital organs: thus, the general swelling of all the parts where the glands are situated, especially of the bosom, of the anterior face of the neck, is often the consequence of this great commotion. The characters which manifest this swelling are much more remarkable in females; hence, perhaps, the old physicians, and even some moderns, have stated the sudden swelling of the neck in young girls as a sign of defloration. But it is wrong to consider this as a general and certain sign: it is certainly not one.” If the act of venery can produce such an excitement in the lymphatic system, it ought to be still more manifest when a part of this system is already inflamed. This is confirmed by a fact stated by Lordat, in the bulletin of the scientific society of Montpelier. It relates to a young woman, in whom the jugular glands being swelled, a few days after her marriage, increased or diminished in size, according as she yielded to her husband’s embraces or not. Thus, then, if we consider the genital organs, either during the acute period of their development, or when the act of venery is indulged in, we see that they extend their action to the lymphatic apparatus, as they do to the other systems; but in a manner which seems the reverse of that reputed to favor the production of scrofula.

Symptoms, however, analogous to those caused by scrofula, have been known to occur where there is evidence of venereal abuses. Two cases, which we have already quoted from M. Dalandeterie, are instances of this. The first relates to a young man, twenty-four years old, whose health, before he was addicted to masturbation, had been good; and whose parents, so far as could be ascertained, had never been diseased with scrofula, and had never presented any disposition to the disease. First, he was affected with numbness in the little finger of the right hand, and the ring-finger of the left hand; the articulations swelled, and formed in these parts tumors, which were regarded as scrofulous, and which were soon followed by ulceration and caries. The patient experienced no pain; and only felt an intolerable itching. The lymphatic ganglions of the groin and axillæ were permanently swelled; and the bodies of several vertebræ became, as we have seen, affected with caries.

The other patient, who was forty-five years old, presented an advanced case of myelitis, and caries of the vertebræ, when there formed, at the lower part of the sternum, a hard and indolent tumor, which soon became apparently a scrofulous ulcer. The pus from this ulcer was ichorous, and the edges were of a violet red, swelled and hard; and the soft parts adhered to the subjacent bones. The lymphatic ganglions of the neck swelled for some time, but they then returned to their natural state. M. Dalandeterie adds, that these two cases have been selected from many other similar or analogous facts: hence, he considers caries of the vertebræ as having then been the consequence of a scrofulous principle, which was developed by onanism.

If, however, we carefully analyze these facts, we shall find that they do not indicate a scrofulous disease, the development of which was but slightly favored by the age of the patients, as a tubercular affection—that is, a disease which might be developed at every period of life. We think that tubercles were developed, in the phalanges, in the first case; and in the sternum, in the second; that these tubercles softened, and suppurated; and thus were formed the apparent scrofulous ulcers presented by these individuals. Probably, a similar circumstance occurs in the vertebræ, the bodies of which are destroyed; for distinguished observers, especially Delpech, have regarded Pott’s disease as a tubercular affection of the body of these bones. The cases of Dalandeterie would prove only that onanism favors the development of tubercles. Unfortunately, they are not the only cases, as we shall see, which establish this fact.

Consumption, or phthisis tubercularis, is, in fact, one of the diseases caused most frequently by onanism. The act of venery—that power which has so much influence on the internal life of the tissues, and on the respiratory organs, and which, to use Rullier’s expression, seems to agitate the lungs—is commenced in most onanists exactly at that age when the chest enlarges in every direction, and which phthisis seems to prefer. “How many young persons,” says Portal, in his work on phthisis pulmonalis, “have been victims to their unhappy passion? Physicians find those every day, who remain imbecile, or who are so enervated, physically and morally, that they barely drag along a miserable existence: others die with marasmus; and many with phthisis pulmonalis.” In another work, the same author relates the case of a young person, seventeen years old, who was addicted to masturbation, and who fell a victim to this disease. This young person, who had became much deformed, was affected with raising of blood, and soon died of phthisis. “It results from numerous well ascertained facts,” say Fournier and Begin, “that those persons who indulge in onanism are generally remarkable for the imperfect development of their thorax, and for the promptitude with which the least exercise renders respiration difficult and hurried. Almost all these individuals contract chronic catarrhs, or more serious affections of the pulmonary organs; and finally perish, in a complete state of phthisis.” Broussais, also, places among the causes of phthisis pulmonalis, “erotic spasms, no matter in what manner they are excited.”

We have seen this affection, more frequently than any other, resulting from onanism. Among other instances, we would mention that of a young man, who died in 1833. This young man sustained himself so well in public debate, that he was placed, at the expense of government, in a public school. He was then sixteen years old; and his health, which had previously been good, now failed. He became pale, languished, and grew thin; and this, too, although his appetite was keen, and his digestion excellent. Having my suspicions, and having communicated them to the patient, and also to other persons who could enlighten me, we were led to believe, from the answers made to me, that the too rapid growth of the body was the only cause of the state presented by the patient; and his state varied so little from that of health, that the young man assured me that he was very well. I therefore simply directed him to take more exercise, and to be more free in his diet. His loss of flesh, however, and paleness continuing, his parents felt anxious about him. I examined his organs separately: I could find none presenting any marks of disease, or which could explain the general state of the patient. My first suspicions then returned; but on questioning him, the same answers were given. The patient, who had already seen an instance of the bad effects of onanism, in the person of his younger brother, seemed deeply impressed with the danger of his habit. He, however, continued to lose strength. One day, after taking more violent exercise than usual, he fainted away. At the same time, a dry cough supervened, to which the patient at first did not attend. This was the first symptom indicating an affection of any particular organ. This cough soon became more frequent; and, by means of auscultation, we found that the respiration, at the summit of one of the lungs, was imperfect. At this time, the patient avowed to his father his deplorable habit. This had been contracted at school; it had been indulged in for two years; and of late, much more frequently than before. His danger was fully pointed out to him; parents, friends, physicians, all conjured him to abandon this secret vice. Treatises on onanism were placed in his hands; and every attempt was made to arouse in him the feeling of self-preservation. He was terrified; but the power of the habit was so great, that he did not leave it off till consumption had progressed very far. Deep abscesses successively formed in his lungs; the expectoration soon became purulent and excessive. Night sweats and diarrhœa followed; and the patient died in a terrible state of marasmus and exhaustion.

In 1829, we prescribed for a young man, whose career was much more rapid. He had always enjoyed excellent health; and his parents exhibited no marks of consumption. Having married a very pretty widow, he indulged himself with her very freely at night, while during the day both were assiduously engaged. The female was seven or eight years older than her husband, and did not suffer much. He, however, soon became affected with cough, attended with bloody expectoration. When consulted, we informed the patient of his danger, unless he changed his mode of living. Our advice was not followed; and shortly after, hemorrhage from the lungs supervened so abundantly and obstinately, that notwithstanding the most active treatment, he died in eight days.

The young man, too, mentioned by Tissot, was also doubtless affected with phthisis. “He came to Montpelier to pursue his studies; but was affected with phthisis, from excessive onanism: and I remember that his cough was so hard and constant, that all those who were near him were incommoded by it. He was frequently bled; doubtless, with a view to his relief. On consultation, he was ordered to go home, and take turtle soup; and two hours after, he died.”

It is with phthisis, as with most of the other diseases, caused by masturbation. This habit causes disease, by cherishing and by cultivating special dispositions. Thus, the onanist born of consumptive parents, whose chest is narrow, with a long neck and thin limbs, and who presents symptoms of scrofula, is more liable to be affected with phthisis or consumption. This was the case with a young man, as mentioned by Rozier. This patient was evidently scrofulous, and many members of his family had been affected with the disease. He remained, however, pretty well until he was eighteen years old, when, in consequence of a contusion in one of his legs, he became affected with an ulcer, which was a long time healing. After it was cured, however, he remained in good health, and was lively, animated, and intelligent; but when twenty-five years old, he commenced indulging in onanism. He soon felt oppression at the chest, and cough; and although the affection of his chest increased, and he was aware of the dangers of onanism, he continued to indulge. Many physicians were consulted; but he did not mention his bad habit. The affection of the lungs continued; his sleep was interrupted; hectic fever supervened; his cheeks were tinged with an unnatural color; and his expectoration was grayish and purulent. The patient then decided on avowing his habit. Rozier attempted, in the most touching and persuasive manner, to induce him to abandon it; but in vain. Consumption continued to progress; and he was soon unable to talk, to move, or to make the least motion, without danger of suffocation. After remaining in this horrid state three years, the patient died.

We have already remarked several times, that the respiration in onanists is frequently affected. Their breath is often short; they pant on the slightest exercise; are subject to stifling, &c. These symptoms, the existence of which cannot always be explained by that of any organic alteration in the heart or lungs, finally assume, in some individuals, the characters attributed to nervous asthma. The authors who have written on this subject, have all classed venereal excesses among its most frequent causes. “Individuals of a nervous temperament,” says M. Ferrus, “seem most particularly liable to it. But the influence of certain bad habits—as masturbation, the abuse of venereal pleasures by young persons, excesses of the table in old men, &c.—contribute, as powerfully as individual predispositions, to produce this disease.” Jolly remarks, in nearly similar language:—“Venereal excesses and masturbation,” says this distinguished physician, “have appeared in some cases to produce asthma. And if some authors think that too much importance is attached to this cause, they may readily appreciate its value by observing the effects of the venereal orgasm on the pulmonary circulation.” Daily observation proves that persons affected with asthma have generally used the goods of this life freely. To admit that venereal excesses often prepare for or excite an attack of asthma, we have only to regard an attack of asthma, whether excited or not by an organic lesion, as consisting in a spasm of the glottis; or, as Reisessen and Cruvelhier think, of the ramifications of the bronchi.

Our remarks on asthma may apply to diseases of the heart and large vessels. The frequent repetitions of an act which render the emotions so powerful, frequent, and tumultuous, has often produced or increased aneurismatic dilatations of this organ; the thickening of its parietes, or other diseases, of the parenchyma, or of the vessels which leave it and go to it. Thus, the abuse of onanism, and of the pleasures of love, holds a high place on the list of causes of this affection. We have seen dilatations of the left ventricle of the heart, which evidently arose from this cause. “In some cases,” says Fournier and Begin, “palpitations, and even considerable lesions of the heart and large vessels, could have no other cause, in patients whose vigorous constitutions have long resisted the destructive practice of onanism, and who, notwithstanding their excesses, have attained an advanced age.” This last remark is particularly just. These diseases are by no means so immediately dangerous as is generally believed. The principal symptoms of diseases of the heart may exist, although this organ may not be materially altered. A remarkable instance of this may be seen in one of the cases already mentioned. The patient experienced for a long time difficulty of breathing; which increased on walking, and especially on going up stairs. These symptoms were so marked, that on entering the hospital, he exhibited all the symptoms of a hypertrophy of the left cavities of the heart. Four months after his entrance into the hospital, the patient died of the consequences of myelitis; and on opening the body, the heart was found perfectly healthy, of its normal size, and presented nothing unusual in the extent of its cavities, or in the thickness of their parietes.

Among the diseases of the heart which may be caused by venereal excesses, there is one in particular mentioned by Blaud. He thinks that too frequent coition predisposes to polypi of the heart. He maintains, that the act produces its effects, either by weakening the motive powers of this organ, which they over-excite momentarily; or by causing too great an accumulation, and consequently a congestion of blood, in the cardiac cavities. This last fact seemed to him to be proved, by the oppression, the congestion in the head, and the palpitations, which attend coition.

If venereal excesses may cause diseases of the heart, they may increase those which exist. They may also, by causing the rupture of an aneurism, produce instant death. But having already treated of these effects, we shall not return to the subject.

Rachitis, and particularly alterations in the height, have been named by many authors among the ordinary effects of premature indulgences. We have already given, from Portal, the remarkable case of a young girl, who, indulging in excesses of onanism, became humpbacked, and then consumptive. In six months, the curve of the vertebral column progressed rapidly; the chest was depressed at the lower part of the sternum; there was a deep hollow in the epigastric region, while the abdomen was prominent. The same author has observed other similar cases. “I have seen,” says he, “four or five of these unfortunate creatures, from fifteen to eighteen years old, in whom the back was very convex, and the abdomen seemed pressed into the chest; the extremities of the long bones, particularly those which form the elbows and knees, were very much enlarged; the legs were thrown out, and their muscles were scarcely developed; their eyes were sunken; their countenances pale and white; and their voices acute. Any one, to judge of their ages by their looks, would think that they were not more than twelve years old. They were extremely weak, physically and morally, and became imbecile long before they died.” Dr. Richard, cited by Petit, has also seen considerable deformity of the ribs, resulting from onanism. Tissot placed this habit first among the causes of rachitis. M. Lonyer Villermey, also, regards onanism and involuntary pollutions as an active source of deviations in height. On the other hand, Dr. Laguerre, a gentleman who has attended to rachitic persons a good deal, tells us that the habit has been observed by him only once, as a cause of spinal deformity.

It has also been advanced, that premature enjoyment may arrest the growth of the body, and consequently prevent it from attaining its normal height. We do not deny the possibility of such a result. We have seen many onanists, however, grow very rapidly, notwithstanding their excesses, and all the symptoms of extensive alteration. It follows, also, from the researches of Villermé and Quetelet, that the mean height of man is generally greater in the city than in the country; and yet, in the former, masturbation is more frequent. We can see, too, by comparing the increase in weight to that in length, during the first twenty years, that the development of the genital organs exercises much more influence on the mass of the body, than on its height: thus, between the ages of four and fifteen years—that is, during the period of puberty—the annual increase of weight is quadruple of what it was in preceding years. Do not these reasons authorize us to think, that if premature excesses have any influence on the height of man, this action is less than is generally imagined?

Besides rachitis, caries, and tubercles, which have been mentioned, are the bones ever affected with any other disease, in consequence of venereal indulgences? The only case in point is that already mentioned,(p. 85) as reported by Serrurier, of a man who was reduced to a complete state of marasmus, in consequence of venereal excesses and nocturnal pollutions. In this man’s case, a remarkable circumstance occurred. Having attempted, a few days before death, to rest himself from the fatigues of the bed, by spending a few hours in the easy chair, he fractured the bone of his right thigh at its centre, merely by attempting to cross the right thigh on the left. Might not this disease, which is very rare, and is termed friability of the bones, be also caused by the excesses we have mentioned?

These excesses, if accompanied by those of the table, or if indulged in under unfavorable circumstances, may be followed by acute, as well as by chronic affections, and particularly by fevers of a bad character. This result of excessive enjoyments is frequent; and cases of it have been seen by almost every physician. It was known to the ancients. Hippocrates gives the history of a young man of Melibœa, who, after indulging in women and wine, was attacked with all the symptoms of typhus fever. Bartholin knew a person, recently married, who was attacked, after conjugal excesses, with an acute fever, attended with great depression, sinking, nausea, immoderate thirst, &c. This patient was cured by rest and tonics. Hoffmann, who states this case, also mentions that of a man, who never indulged in venereal excesses without being attacked with fever, which continued several days. Tissot, in 1761 and 1762, knew two very healthy, strong, and vigorous young men, who were attacked, one the day after, and the other the second night of their marriage, with a very violent fever, preceded by no chill, pulse quick and hard, wakefulness, many slight convulsive motions, very great inquietude, and dry skin. The appearance of the second was very much altered, and he was troubled with dysuria. He first thought that an intemperate use of wine was in part the procuring part of these symptoms; but I was of a different opinion in regard to the second. They were cured at the end of two days. This circumstance added to the character of the disease, leaves no doubt of the cause.

Sauvages admits, after Dellon, that a typhus of exhausted persons exists. The Portuguese term patients affected with this malady, esfalfados. The exhaustion caused by immoderate indulgence in venereal pleasures, says this author, is very common among the Indians. It is a continued fever, in which the pulse is sometimes full and strong, sometimes weak, and almost imperceptible. The urine is sometimes very red, but transparent; the skin is hot and dry; and there is watchfulness, nausea, and violent thirst.

Farther: All authors who have written on the diseases of warm climates, have mentioned the too frequent repetition of the act of venery among the causes of these typhus affections, which have been termed febris ardens, causus, yellow fever, &c. In temperate climates, adynamic ataxic fevers, &c., and very severe acute diseases, have often been known to occur from excesses in venery, or from masturbation.

If satyriasis and nymphomania have been regarded as rare diseases, it is only because the meaning of these terms has been too confined to embrace numerous cases which, however, have the greatest analogy with those diseases to which these terms are applied. Generally, these persons are considered as affected with satyriasis and nymphomania, who are irresistibly impelled to coition, and resort, to satisfy their desires, to the most indecent actions, and to the most direct provocations. Thus defined, these diseases are rare; and most practitioners have never seen them. But if satyriasis and nymphomania be regarded as an unusual state of heat, by which one is led to desire and to practise not only coition, but the act of venery in any mode, then the scene enlarges, and these affections deserve to be placed among those which are observed most frequently.

We shall adopt the latter sense. In our view, male and female onanists are affected with satyriasis and nymphomania, as much as those to whom these terms are generally applied. In both, the sense of venery, existing to an unusual extent, affects the mind, and incites to dangerous actions, repugnant both to modesty and reason. Onanists do not, like other persons affected with satyriasis, expose their persons, and solicit with voice and gesture those of the other sex: their deranged and delirious imaginations pursue another course. What need have they of the other sex? Their inclinations lead them to solitary indulgence. Their thoughts and actions, however, are not less vile than those of others affected with satyriasis; but they are indulged in secret. Hence, between the satyriasis of books and that of onanists, there is only a difference of form: the foundation is the same. Admit, however, that it be desirable to distinguish this satyriasis from the former, and to give it a special name; is it not better to consider them only as two varieties of the same affection, one of which impels to onanism, the other to coition?

The degree of onanistic satyriasis and of nymphomania depends on the power the venereal sense has over the will. These affections do not exist in those with whom it is optional whether they shall indulge in onanism or not, nor in those who can refrain from coition. Thus, then, a person may masturbate, without being affected with satyriasis. This is the case, when the sentiment of self-preservation is sufficiently strong to resist desires, when the persons yield readily to reprimands and punishments. Satyriasis may be considered as existing to some extent in the onanist, if he cannot refrain. This was the case with a young man, whose history is given by Begin and Fournier. From early puberty, he was addicted to masturbation; and when eighteen years old, he presented some of the bad effects of this habit. This young man was endowed with a brilliant mind: but, although well educated, and although he well knew the dangers of his habit, yet he could not refrain. His good resolutions were formed only to be broken. He died.

In a young woman whom we attended, the struggle with her passions terminated more favorably. It was not the desire of preserving her life, which induced her to leave off her bad habits; but the wish of conforming to the will of her father. Her constitution was already considerably affected, when the cause of it was discovered. The father of this young girl told her how much pain and shame her bad habit caused him, and requested her to abstain from it. She was extremely mild and docile, and made every effort to please and obey him. It was in vain: but whenever she was inclined to masturbate, the fault was confessed as soon as committed. Coercive measures were finally resolved upon. The patient not only consented to have her hands tied every night, but requested it, and even stated the manner in which she might be most effectually prevented from abusing herself. The venereal sense gradually became subdued, and confined within the proper limits. And thus, this habit—or, rather, the nymphomania, which was the result, and also the cause of it—was cured.

Satyriasis and nymphomania, arising from onanism, are most intense, when the persons affected with it can no longer conceal their feelings, but indulge openly in vile manœuvres. We have already mentioned some remarkable instances of this state. The following may serve as the type of the greatest degree of nymphomania. The patient was a little girl less than three years old, who indulged freely in onanism. Neither caresses, entreaties, threats, nor punishments, could correct her. The child grew, however. But at the sight of any pleasant object, she abandoned herself to her manœuvres. At the period of the crisis, she seemed almost entirely to have lost her sight and hearing. Threats and punishments finally restrained her, while in the presence of her parents; but when alone, she still continued her bad habits. This state resisted all remedies. When married, the legitimate sources of enjoyment took the place of the passionate indulgences to which she had been accustomed from infancy. She finally became pregnant, and died in labor. (Dict. des Sc. Med.; vol. xxxvi., p. 566.)

Onanism is not only a direct cause of satyriasis and of nymphomania; it may leave in the genital organs a certain disposition, which, if cherished, may degenerate into one of these affections. The following case, published by Duprest-Rony, seems to us to be an instance of this:—

A young man, twenty years old, of a strong and almost athletic frame, but who had been enfeebled by onanism, abandoned himself, from the age of fifteen to eighteen years, to this destructive habit. He indulged in this habit even while in the bath, and sometimes to the extent of fifteen times in a day. His constitution was enfeebled; his mind was affected; his memory impaired. In accordance with the advice of some prudent people, this young man renounced this fatal habit. During the next two years, he was perfectly continent. His constitution resumed its vigor; his memory and other mental faculties were restored. His parents now placed him with a merchant. He entered upon his new occupations with zeal and activity; but receiving marks of attachment from the merchant and his wife daily, he imagined that she was in love with him. On his side, the passion was returned. Actuated by the fear of violating the duties of gratitude, and the desire of possessing this lady, who was neither young nor pretty, his situation daily became more embarrassing. Whenever she looked at him, erections took place, and there was a discharge of semen. During the night, he had frequent pollutions. His faculties now became deranged: this derangement supervened after reading the Phedra of Racine. He identified himself so closely with the characters of this piece, that he supposed himself to be Hippolyte, and considered his mistress to be Phedra, and her husband as Theseus. More amorous than Hippolyte, and no less virtuous, he threw himself one day at the feet of Theseus, and said, “Theseus! the crime is not yet consummated—your wife is not yet guilty. I have hitherto resisted her prayers—her tears: but I am no longer master of myself; and if she is not removed from my presence, I must yield.” Great was the astonishment of the supposed Theseus. He resolved to send the young man away. This cured the delirium: but the erections and seminal emissions continued. The stomach and intestinal tube became inert. The patient’s appetite was good; but as soon as he ate food, pains occurred in the epigastric region, and uneasiness in the rest of the body. The disease finally yielded to the combined use of antispasmodics and tonics. And now, this young man, who has been married for five or six years, enjoys fine health. (Diss. sur le Satyriasis. Paris, an xii.)

Instead of the disposition just mentioned, masturbation may leave in the genital organs an irritability of a different kind, the results of which are not less disagreeable. A case of this presented itself in a young female, whom we attended. While at board, she indulged freely in onanism. She was married when seventeen years old; and then expected legally to enjoy what had seemed to her the extreme of pleasure. She was disappointed, however: marriage was only the source of uneasiness and pain. She was perfectly insensible to the caresses of her husband—or, rather, in submitting to them, she experienced the most disagreeable sensations. A painful state of spasms and convulsions then affected her, which continued several hours after the cause had ceased to act. We were called to her several times at night, to relieve this state, which caused great anxiety. This lady’s susceptibility, also, was very great; and she constantly complained of some of the attendants of hysteria. She presented every appearance of a lymphatic temperament. During her youth, too, she had been affected with symptoms of scrofula, from which even now she is not entirely free, although twenty-two years old. Do not these circumstances, not generally coexistent with extreme sensibility, prove, that the extreme irritability of the uterine system is to be ascribed to her self-abuse?

Priapism, which signifies permanent erection of the penis, without pleasure, and even in some cases with pain, sometimes follows indiscretions. This has been seen particularly in young children, whose genital organs have been excited: sometimes, too, it occurs in old men. Cœlius Aurelian, (lib. iii., ch. 18,) relates, that an old man was affected with priapism for several months. The erection was firm, like a horn, but not very painful. Finally, it yielded.

The genital organs may, from too much excitement, lose their sensibility, and waste. The manipulations, which at first were followed with the desired result, become unable to excite the genital sense. They may sometimes cause the erection of the penis, and even excite a painful or inconvenient priapism; but they cannot renew the fountain of enjoyment. The remembrance of past pleasures remains; and the onanist, disturbed by their recollection, torments his blunted organs. Obtaining no satisfaction from the modes formerly employed, he now resorts to others, which are sometimes dreadful. His hand which is now armed with some instrument, no longer confines itself to the surface: the surface no longer feels. He now ventures inside, and shrinks from nothing. This continues until these dangerous resources fail, which happens, because they also lose their effect, or because of the severe accidents with which they are sometimes attended.

The following case from Chopart, on diseases of the urinary passages, shows the almost incredible extent of insensibility which the penis may attain, or of delirium which may affect a man, who, having exhausted his faculties by excesses, still remains a slave to his passions:—

“A shepherd of Languedoc, Gabriel Gallien, about the age of fifteen, became addicted to onanism, and to such a degree, as to practise it seven or eight times in a day. Emission became at last so difficult, that he would strive for an hour, and then discharge only a few drops of blood. At the age of six and twenty, his hand became insufficient: all he could do, was to keep the penis in a continual state of priapism. He then bethought himself of tickling the internal part of his urethra, by means of a bit of wood, six inches long; and he would spend in that occupation several hours, while tending his flocks in the solitude of the mountains. By a continuation of this titillation for sixteen years, the canal of the urethra became hard, callous, and insensible. The piece of wood then became as ineffectual as his hand. At last, after much fruitless effort, G., one day in despair, drew from his pocket a blunt knife, and made an incision into his glands, along the course of the urethra. This operation, which would have been painful to any body else, was, in him, attended with a sensation of pleasure, followed by a copious emission. He had recourse to his new discovery every time his desire returned. When, after an incision into the cavernous bodies, the blood flowed profusely, he stopped the hemorrhage, by applying around the penis a pretty tight ligature. At last, after repeating the same process, perhaps a thousand times, he ended in splitting his penis into two equal parts, from the orifice of the penis to the stratum, very near to the symphisis pubis. When he had got so far, unable to carry his incision any farther, and again reduced to new privations, he had recourse to a piece of wood, shorter than the former: he introduced it into what remained of the urethra, and exciting at pleasure the extremities of the ejaculatory ducts, he provoked easily the discharge of semen. He continued this about ten years. After that long space of time, he one day introduced his bit of wood so carelessly, that it slipped from his fingers, and dropped into the bladder. Excruciating pain and serious symptoms came on. The patient was conveyed to the hospital at Narbonne. The surgeon, surprised at the sight of two penes of ordinary size, both capable of erection, and in that stage diverging on both sides; and seeing, besides, from the scars, and from the callous edges of the divisions, that this conformation was not congenital from his birth; obliged the patient to give him an account of his life, which he did, with the details which have been related. This wretch was cut, as for the stone—recovered of the operation—but died three months after, of an abscess in the right side of the chest; his phthisical state having been evidently brought on by the practice of onanism, carried on nearly forty years.”

Whatever may be the degree of degradation attending onanism, we do not think it possible to adduce a second instance of such a mutilation. Gallien’s unhappy idea of introducing a foreign body into the urethra, has often occurred to others, who had availed themselves, but unsuccessfully, of the ordinary resources of masturbation. These unfortunate people have always been obliged to call in medical advice, either on account of the diseases caused by their dangerous manœuvres, or—much more frequently—by the symptoms to which they fall victims, through their carelessness. In fact, the implements used often escape into the bladder; and then the acute suffering and fear of death oblige them to reveal what they had formerly concealed, and to undergo an operation which is always painful, and which is not exempt from danger.

We will give a few instances of this kind of accident. An innkeeper, near Saumur, was in the habit, like Gallien, of titillating the urethra, by introducing foreign bodies. He used an iron wire, seven or eight inches long, the end of which was crooked like a hook, to obtain, probably, more exquisite pleasure. One day, while indulging in this singular manœuvre, he suddenly felt severe pain. The membraneous portion of the canal was ruptured. The unfortunate man made several attempts to withdraw the wire; but the hook, which had entered the soft parts, rendered it impossible. Overcome by suffering and shame, he wished to get rid of it; and with this view, he rounded the loose part of the wire into the form of a ring, proposing in this manner to pull upon it more firmly. He exercised this force till the ring was nearly broken, but the iron was still in its place. He now expected death; but the suffering was so great, that he was obliged to call a physician; and Dr. Fardeau, of Saumur, visited him.

The penis, and also the skin of the scrotum, was enormously tumefied: all the tissues which are inserted in the penis were also swelled, hot, and painful. The belly began to be puffy, and the urine was suppressed; the face was red, and the eye filmy; the mind began to be affected; the pulse was hard, frequent, and corded. Dr. Fardeau grasped the loose portion of the wire, pulled upon it slightly, and immediately found that the other end was arrested by an immoveable obstacle. He then examined the parts attentively; and found, to his astonishment, that the hook was fixed in the inner edge of the ischiatic tuberosity. An oblong incision was now made over this part, the hook seized, and the wire was withdrawn through the perineum. The patient was relieved, and finally was completely restored. (Lancette Fr., October 13th, 1831.)

Saraillé has reported a similar case. The patient was fifty years old, and called this surgeon the 18th of October, 1813. He stated that a sailing needle, about four inches long, had unfortunately slipped into the urethra; and the point had become fixed upward, near the root of the penis. After suffering for eight days, during which the presence of this body excited frequent erections, Lallemand operated, and extracted it.

Many individuals have been similarly affected. They have all imagined that they could extract the instrument they used, when some unforeseen accident has deprived them of it. A young man, nineteen years old, whose case is mentioned by Louis Senn, made use of the stalk of a plant, which he introduced into the urethra. It broke; and after much suffering, the operation for stone was employed to extract it, and the calculi which had formed around it. A similar circumstance happened to a man, thirty-eight years old, a patient of Rigal’s. This man introduced into his urethra the stalk of a sword lily, (gladiolus communis.) This stalk broke, fell into the bladder, and after two months of pain and danger, the operation for stone was employed to extract it. It was two inches long; and was already covered with a saline concretion, one or two lines thick. Bonnet, formerly surgeon at Hotel Dieu, at Clermont, stated in his lectures, that a vine-dresser used a vine-stalk for this purpose. During an emission of semen, he dropped the stalk, which entered the urethra, and passed into the bladder, where it caused symptoms which required the operation of lithotomy. The foreign body extracted was three inches long, and three lines thick. Would it be believed, that Civiale has extracted from the bladder of a man, by means of lithotrity, a bean, which was introduced eleven months before, and which gave rise to all the symptoms of stone? A volume might be filled with facts of a similar character. Many may be found in the Ephemerides Curiosorum, Memoirs of the Royal Academy of Sciences, those of the Royal Society of Medicine, and of the Academy of Surgery; in the works of Chopart, Deschamps, Lamotte, Tolet, Morgagni, Van Swieten, Morand, Pouteau, &c.

The dangers of these practices are not simply those which are stated in the facts already mentioned; nor are they confined to exhausting the rest of the sensibility preserved in the genital organs: they finally cause chronic diseases of the urethra and bladder. These organs, when constantly irritated by applications which in individuals not entirely exhausted are always painful—these organs inflame; indurations, ulcerations, and strictures, form in the urethra; after which supervene all the symptoms of acute and chronic blenorrhea, detentions of urine, and catarrh of the bladder.

Venereal delirium has led other individuals to use processes no less ridiculous, and equally as dangerous. The penis of those who are thus unfortunate has remained in the places where it has been introduced, with a view to imitate the natural process better. Sabatier has related the case of a young man, who had passed his penis through the handle of a key. The handle had been pushed far towards the pubis, and the penis had swelled so as to conceal it from sight: the swelling was also increased by the efforts of the patient to withdraw it. After oiling the parts well, the handle was slipped down as far as the glans; but here scarifications were required, to diminish the engorgement, before the penis could be liberated. After this, escars sloughed off, which were followed by cicatrices, which rendered the part deformed, although a sound was introduced into the urethra, to prevent this result.

The same author relates that a young man had passed his penis into a copper ring: this, however, was fortunately divided with a pair of strong scissors. Another used a rough iron ring for this purpose. The penis puffed out, above and below this ring. A locksmith was called in, to file it off, which could only be done by placing small bits of wood between the penis and the iron ring. Much time was required to remove it. In the same manner—that is, by filing—a ring was removed from another patient, where gangrene had threatened to appear.

One of the most horrid cases of this kind on record, is that of a young man, who, on taking a bath, indulged in masturbation, by placing his penis into the hole in the bottom of the tub, made for the removal of the water. The glans soon became so much swelled, that he could not withdraw it. His cries brought him assistance; but it was not easy to remove him from the fetters he had forged for himself. (Dict. des Sc. Med., vol. xxi., p. 167.)

Many similar cases have occurred in Dupuytren’s practice. One was that of a young man who came to the clinical lecture at Hotel Dieu, having the socket of a candlestick, in front of which the glans was enormously tumefied. Being unable, by any effort, to remove it, the cylindrical portion surrounding the penis was filed, and thus taken from him. It would occupy too much room, to enumerate all the facts of this kind which have been noted by practitioners; but a common accident, and which has been seen several times by Dupuytren, is the ligature of the penis by a thread or wire. Some young men, and even adults, have bound the penis in fits of erotic delirium, so that the knot could not be loosed; and a circular section has been made in the skin, and the urethra even has been opened and cut. It is evident, that, in these cases, the only thing to be done is to divide the thread, to dress the wound, and then to introduce a gum-elastic sound, in order to prevent the formation of an urinary fistula, or of an accidental hypospadias.

Another kind of strangulation—which is much less serious, however, than those we have mentioned—may result from masturbation and coition, in those individuals where the opening of the prepuce is too narrow. This prolongation of the skin, after being drawn violently back behind the corona glandis, strangles the penis, as would be done by a foreign body, and cannot be brought again to its primitive situation: there is then a paraphimosis. All authors who have treated of this affection, have placed among the causes of it that which we have mentioned. We have seen several instances of this character. I will cite that of a young boy, seven or eight years old, in whom this accident was produced during masturbation. The glans was tumefied, and the prepuce formed a large fold around it. The frightened parents sent for our assistance. Methodical and long continued pressure soon brought things to their proper state.

Herpes praeputialis, another affection of the prepuce, may arise from the constant excitement of this part. Fortunately, this eruption is a slight disease, and generally terminates in a week or two, even without medical treatment.

Persons who indulge in lascivious ideas, are often affected with a discharge from the end of the penis—and this though there has been no masturbation—of a viscid, whitish mucus, which leaves on the linen spots similar to those produced by the white of an egg. The edges of the meatus urinarius may also be glued together, by the drying of this mucus. This discharge, which has been described by John Hunter, is not a disease, although it has all the appearance of it; and it keeps some people in constant fear, lest they have contracted gonorrhœa. It, however, results from an unusual excitement of the mucous membrane, lining the glans and urethra. Now, if the simple excitement of the venereal sense can cause such an effect, what might not be expected from excesses in coition or masturbation? Thus, these causes are mentioned, whenever the causes of balanitis and blenorrhagia are alluded to. All authors agree on this subject; and if but few cases are brought forward in support of this opinion, it is because the subject has not been disputed. The following is found in a dissertation of Closs. The patient was a young man addicted to masturbation, who had been affected for more than six months with a gonorrhœal discharge, which had been neglected because it occasioned no suffering. The matter of the discharge, however, becoming acrid, green, and yellow, he was obliged to ask medical advice. He protested, under oath, that he had never been exposed to contract disease; and Closs, therefore, considered this blenorrhea as the result of masturbation, in which the patient had indulged even before puberty.

This symptom is seen still more frequently after excesses in coition, especially if attended with excesses in drinking, as Lallemand has remarked, or if one has cohabited with a female whose genital organs were very small. It has often been observed in the newly married, and has sometimes occasioned unmerited suspicions and reproaches. It is said, too, that excesses indulged in by persons whose genital organs are perfectly sound, may produce in one or both of them a more or less intense blenorrhea. Cullerier and Ratier say, that they have verified this fact several times. Can such a blenorrhea be communicated? Cassan, in the Bulletin Universel of Ferussac, has inserted a note, in which he states that many of the facts observed in man and animals, particularly of the genus Bos, prove, that blenorrhea, which is simply the result of venereal excesses between healthy individuals, easily assumes a contagious character, and is attended with symptoms analogous to those of syphilis, and requires the same treatment.

Inflammation of the urethra may become very intense, and extend to the bladder, particularly when venereal excesses coexist with intemperate habits: the discharge of urine may then be interrupted, and consequently all the symptoms of dysuria and strangury may supervene. Chronic catarrh of the bladder is often observed, also, in those individuals who have abused the pleasures of love.

Montegre, speaking of a kind of cystitis, which he terms vesical hemorrhoids, mentions among its causes venereal excesses, and particularly those repeated titillations, which keep the genital organs in a state of semi-orgasm, which is not terminated by any crisis.

Lallemand reports the case of an individual, who, being addicted to venereal excesses, experienced frequent desire to urinate, and found it difficult to empty his bladder. Finally, unable to pass water without the use of a sound, he learned to introduce it himself. This was not difficult, although the bladder could not be emptied without it. The urine was turbid, thick, and deposited a great deal of glairy mucus, which adhered to the pot de chambre. The prostatic portion of the urethra was cauterized, but without success. Lallemand thought that there was a morbid development of the middle lobe of the prostate gland. In another patient, whose history is given by this excellent observer, excessive masturbation appeared to have predisposed to a chronic inflammation of the genito-urinary organs, which were developed under the influence of the abuse of coition. (Obs., &c., p. 440.)

It is easily seen, that if coition and masturbation may cause all these inflammations, so, too, they may sustain and increase them. The pleasures of love, therefore, should be strictly forbidden to persons affected with diseases of the genito-urinary passages. Acute inflammation of the urethra, blenorrhagia, has often been known to pass to a chronic state by a single act of venery; which, says Lewedrain, may even cause this change several months after the apparent termination of acute blenorrhagia.

May an incontinence of urine be produced by excesses in coition or masturbation? We have more than once seen this disease in young onanists. Sainte Marie, also, places it among the symptoms of daily involuntary pollution; and Lallemand has remarked, that most individuals affected with this pollution had been subject, in their infancy, to incontinence of urine. May not the relations between these two affections extend to the causes which determine them?

One of the most common causes of excesses in venery is, the involuntary loss of semen. This disease, which has been termed spermatorrhœa, involuntary pollution, may also arise from other causes; but as it results most frequently from excesses in masturbation or coition, we shall devote particular attention to it.

Let us consider the mode in which the excretion of semen takes place in the normal state. It is the remote consequence of a voluntary action, and the immediate result of involuntary contractions. The venereal sense is excited voluntarily, either by copulation, or by applying the hand: this excitement is carried to as great an extent as possible; and then a crisis, entirely independent of the will, terminates it. This crisis occurs sooner or later. It may even be quickened or retarded by the will, which may excite or modify the venereal sense; but when it does take place, it is always by involuntary contractions—that is, by a true convulsion.

This last action has two well marked periods. In the first, the semen passes from the seminal vesicles into the urethra; in the second, this liquid is violently expelled. The contraction of the seminal vesicles—and perhaps, also, that of the levatores ani muscles—are the powers by which the semen comes into the urethra. The ejaculation is caused by the muscles of the perinœum, and particularly by the bulbo-cavernosus muscle. The swelling and hardness of the corpus cavernosum furnish this muscle with a point of resistance, which enables it to compress more efficiently the semen with which the urethra is filled; and the straightening of this canal, by the erection, renders the expulsion of this fluid more easy. All these motions take place by jerks; and, we repeat it, convulsively, without the aid of the will.

The involuntary excretion of the semen, the morbid pollution, may take place sometimes in the manner described, sometimes in another mode. In the first case, it differs from what occurs in the normal state, only not being preceded by those acts which are performed voluntarily by man. Secondly, the semen is excreted without any convulsive effort; it flows like the tears, the saliva, the bile. The semen comes into the urethra, and escapes from it merely because it is there. There is no ejaculation: and this is easily conceived of; for the genital organs are not sufficiently excited, to cause the ejaculatory powers to be convulsed, as is proved by the excessive weakness of the venereal sensation. And, secondly, one of the indispensable conditions of the ejaculation—erection of the penis—does not exist. There are, then, two kinds of involuntary pollutions; one which is convulsive, and the other which is not so. Between these two kinds, there are intermediate degrees, in which spermatorrhœa partakes more or less of one or the other. These degrees often mark the passage from convulsive spermatorrhœa to that which is not convulsive; for the latter has generally been preceded by the former. We shall see hereafter, that the existence of one of these affections does not forbid that of the other; and that the ejaculation of semen is possible in some individuals who present habitually an insensible flow of this fluid.

Involuntary pollutions have been distinguished until now in another manner: they have been divided into diurnal and nocturnal. These distinctions are founded only on accessory circumstances. What difference does it make, whether the pollutions occur by night or by day, provided they are similar in other respects? If, on the contrary, there are more essential differences, why not give to them the importance they demand? Farther: is not convulsive spermatorrhœa, like that which is not convulsive, seen both at night and day? These are the reasons why we have sought to distinguish these affections more logically, and which have led us to propose the new distinction just mentioned.

Convulsive spermatorrhœa may occur in all individuals, and under the influence of a great many causes, without being necessarily a disease. After excessive continence, it may even prove a salutary crisis. This pollution has a pathological character, when it is repeated too often, or under unfavorable circumstances; and then it produces the same result as excesses in coition or masturbation, and generally occurs only in individuals already enfeebled by this kind of excess. Sleep is the most favorable state for an attack of spermatorrhœa; and from this circumstance it is called nocturnal pollution. The temperature of the bed, and lying on the back—circumstances which favor the warmth and excitement of the lower part of the spinal marrow—may also cause the convulsive excretion of the semen. But another cause of it is, that during the sleep of the external senses, the internal senses have control, and have more power, because the action of the others is completely suspended. Cabanis remarks this fact, in saying that the genital organs do not participate in the repose of the external senses, but seem to be more excitable when these are asleep. We consider, that what takes place then is analogous to what is observed in idiots, who, deaf, blind, and dead to all the feelings of relation, abandon themselves to every excess, to satisfy a sense, the excitement of which in them often amounts to constant satyriasis.

If the sleep be very profound, pollution may take place without the consciousness of the patient, or, at any rate, without his remembrance of it. When he wakes, the loss of semen is then discovered only by its stain, and the state of fatigue, weakness, and malaise attending it. A lascivious dream, however, generally attends a pollution. These dreams are not, as is generally thought, the cause of the pollution: if they exist, it is because the venereal sense, which is excited, speaks for itself, even as hunger, thirst, or any internal sensation may do. These dreams have a peculiar character, which has been pointed out by many writers. The individual is rarely placed in voluptuous circumstances, where his imagination places him during his waking hours; but he is surrounded by females who are hideous and repelling, and whom he is as it were compelled to enjoy.

In fact, these pollutions fatigue more than those which are excited voluntarily. On rising, the patient experiences a general and more or less distinct feeling of feebleness and of suffering. His loins and limbs seem as if he had taken a long walk, or as if they had been bruised; the countenance is pale; the eyelids are swelled and bluish; the patient is sad and stupid. Finally, he presents physically and morally the consequences of an abuse of venery. It may readily be imagined, that the periods of spermatorrhœa render the exhaustion more rapid than the voluntary excesses already commenced. If, contrary to custom, the onanist remains one night without pollution, the organs which he permits to rest supply the unaccustomed activity. Happy is he, when these symptoms do not seem to him an evidence that this flow of semen is necessary. Every thing which specially excites the genital organs, as lascivious thoughts, voluptuous sights, riding, a soft and warm bed, &c., and also every thing which produces a more general excitement, in which these organs participate, as wine, liquors, coffee, spices, &c.; are so many causes which combine with the direct provocations of the patient, to multiply the causes by which he is excited.

The nocturnal pollutions, however, are not formidable to those onanists who are reformed. Inspired by the sentiment of self-preservation, warned by the sufferings, counsels, and by reading, they have resolved to abandon for ever the manœuvres which they know to be dangerous. This resolution they will be able to keep: they, however, anxiously demand if they are not too late. The genital organs rebel against the decision. How melancholy must be the state of the patient! He sees, in perspective, sufferings, even a death, which seems to be inevitable. To avoid it, he had made a sacrifice; he has abandoned those tastes which exercised such absolute control over him: but his organs, which have been irritated, continue the work which he wished to interrupt. He is irritated—he despairs. Let him be of good cheer; when the will perseveres, it generally triumphs. I attended an onanist, who was suddenly converted by reading the work of Tissot, and who experienced all the troubles to which we have alluded. He was constantly tormented by the remembrance of the past night, and the fear of that which was to come. He slept on a coarse bed; and always enveloped the privy parts with linen, wet with vinegar and water, before going to sleep; promising himself to awake, as soon as he was assailed by dreams. By his will, however, he finally succeeded; and he had the power of watching himself during sleep. His pollutions gradually became less frequent, and finally disappeared entirely. This is generally the case where all bad habits cease.

Convulsive spermatorrhœa is not very common, while a person is awake: it then rarely presents the purely convulsive character, with perfect erection, and distinct ejaculation, that is seen in a healthy emission of semen. This state, however, is possible: an instance of it may be seen in the case of satyriasis stated by M. Duprest-Rony. Whenever this young man beheld his mistress looking at him, erection took place, and ejaculation followed. He, however, had refrained from masturbating for two years, and had regained in a great measure his former strength. M. Sainte Marie has reported a case of priapism, during which the patient ejaculated fourteen times in a few hours. But this affection was not in consequence of venereal excesses, and the emission of semen presented nothing more extraordinary than other cases of priapism. Diurnal convulsive pollution is seldom accompanied, in individuals exhausted by abuses of masturbation and coition, with a perfect erection. The size of the penis increases, but it does not become hard. The semen is then emitted only to a short distance, if there be any ejaculation. The least cause, the slightest touch, is sufficient to excite this. Thus, in a man thirty years old, whom Tissot has mentioned, after Boerhaave, the semen escaped whenever there was a commencement of an erection, for it was never complete; and instead of being expelled forcibly, it oozed out drop by drop. The patient became impotent. This symptom (adds Tissot) is very frequent among those who are exhausted, and it contributes to continue the exhaustion. The slightest excitement causes the commencement of an erection, which is followed by an emission. We have seen a similar phenomenon in one of the patients of M. Dalandeterie. There were frequent painful erections, of short duration, which always terminated by a more or less abundant discharge of fluid. These kinds of pollutions were always painful, and were followed by extreme prostration. It is evident, from the remarks we have quoted, that there was no ejaculation in this patient; and probably, also, the erections, though painful, were imperfect. Daily convulsive spermatorrhœa assumes then, as it were, a bastard character in onanists: it occupies an intermediate place between proper convulsive spermatorrhœa, such as occurs during sleep, and the non-convulsive spermatorrhœa, which we shall mention directly.

There is a phenomenon very similar to this bastard spermatorrhœa, and which shows itself when the patient is inclined to indulge in coition or masturbation: the emission of semen takes place on the commencement of the act of venery. It is a quasi involuntary pollution. In this case, which is by no means rare, the erection is not complete, simply because there is not time for it to be so, the premature emission of semen not admitting it to be perfect. Sometimes, erection is radically impossible, and prevents the ejaculation. This was the case with the onanist who wrote to Tissot, that the semen would flow, but there was no ejaculation. Farther: when there is no erection, either because this is impossible, or because the semen is discharged prematurely, the person becomes impotent, because the power of procreating requires erection and ejaculation.

In persons affected with spermatorrhœa, the seminal fluid must preserve its normal characters. It is generally thinner, less opaque, and similar to serum: sometimes it resembles a fetid sanies or corrupt mucus; in other cases:, the seminal vesicles are evidently affected. Sometimes, blood is exhaled from these vesicles, and is even ejaculated. We have already stated instances of this emission. Tissot, also, has published a case of it. It was a young man, less than sixteen years old, who indulged in onanism to such an extent, that blood was finally emitted, instead of semen. This emission was soon followed by excessive pains, and an inflammation of all the genital organs. We must remark, that blood never seems to be discharged, unless the pollution is excited directly: this, at least, would seem to follow from the cases stated, and particularly from one mentioned by Dalandeterie. The erections (said he) always terminate with a more or less abundant flow of mucus—perhaps, also, of prostatic fluid, or even of a very diluted semen. In ejaculations excited by the hand, a semi-clotted, blackish blood comes, instead of semen: sometimes, a teaspoonful is discharged. This is always attended with pains, and followed by great prostration.

We have seen that involuntary pollution may take place, like voluntary pollution, by the convulsive contraction of the ejaculatory muscles, with erection of the penis, and sensations of venery. We have also seen, that the semen may be discharged, although the erection of the penis, the sensation of venery, and the convulsive contraction of the ejaculatory muscles is slight, and almost nothing. When this exists to a still greater degree, we have non-convulsive spermatorrhœa, or diurnal involuntary pollution, as it is called: here there is no erection, convulsion, nor ejaculation; there is no feeling of venery; the semen flows, instead of being expelled; and there is no feeling of pleasure attending this discharge.

This affection may arise from different causes. It is owing most frequently to venereal excesses; and, as but little is known in regard to it, we shall enlarge on the subject. This pollution for a long time was confounded with all the discharges from the urethra, which were blended under the term gonorrhœa. A contrary opinion was then adopted, and the existence of the disease was denied in toto. The remarks of several authors, and particularly of Wichmann, Sante Marie, and Lallemand, place its existence, however, beyond a doubt. The first ideas on this kind of spermatorrhœa may be referred to the earliest periods of medicine. It was known to Hippocrates, who has mentioned (De Morbis, lib. ii., sect. 5) one of the principal symptoms, the loss of semen, during the emission of urine, and of feces, when describing the tabes dorsalis which affects libertines and those lately married. Celsus, also, (De Medicina, lib. iv., ch. 28,) has admitted that there may be loss of semen, without pleasure, without voluptuous dreams, and which may be followed by a fatal consumption. After this, we find no mention of the disease for a long period. Tauvry says positively, (Naw. Anat. raisonnée, 1693, p. 164,) that men who abuse themselves are liable to have emissions of semen on the slightest compression of the seminal vesicles, when they pass urine or feces. Morgagni admits that the semen may escape without any pleasurable sensation, as happens from the effect of an injection which is too warm, and from the excretion of hardened feces; but he adds, that the fluid discharged may come in some from the prostate gland, in others, from the seminal vesicles. There is much uncertainty on this point of science among authors, many of whom have considered as spermatic most of the discharges from the urethra. The dissertation of Wichmann, however, on the subject of diurnal pollution, is valuable. This dissertation was printed in 1782, at Gœttingen. In it, Wichmann states, first, the characters which distinguish diurnal from nocturnal pollution. The first occurs when the patient is awake, and without his experiencing erection or desire. He is unconscious of it; and this circumstance, with the absence of any swelling of the corpora cavernosa, and of all venereal ardor, serves to distinguish this pollution from the flow of the fluid of the prostate gland, or from a loss of semen, which takes place in some persons when they are excited by desire. To these characters, Wichmann adds another, drawn from the mode in which the excretion of semen takes place. In diurnal pollution, (says he,) men do not lose their semen constantly by a continual excretion of this fluid, like females subject to leucorrhea; but they ejaculate, at a single time: and this circumstance has rendered the term pollution applicable to this disease. He does not consider, as a diurnal pollution, the gonorrhœa in which the semen is continually escaping drop by drop. He, however, doubts the existence of this last affection, and remarks that authors are very much confused on the subject. Nor would a pollution which was involuntary, and during the hours of waking, be considered as a diurnal pollution, if the evacuation of semen had been caused by any aphrodisiac substance. And on this topic, he relates the case of a man, who, having been addicted to onanism in his youth, was affected with involuntary pollutions if a blister was applied to him, if he perceived the odor of cantharides, or even spoke of them.

According to Wichmann, the semen never escapes with the urine: thus, it is not a seminal discharge which comes from persons affected with external or internal hemorrhoids, who pass off with their urine a milky fluid. He, however, admits, with Hippocrates, that the straining of persons at stool often occasions, in those affected with diurnal pollution, the discharge of a greater or less quantity of semen. When the existence of this affection is suspected, we must attempt to ascertain its truth; and for this purpose, the patient should be made to urinate freely; and then, in passing the feces, he should sit in such a manner that the penis may be outside, and one can see all that escapes from it in the efforts at stool. In a diurnal pollution, there is rarely as much semen lost as in a nocturnal pollution. The disease is quite as serious, if it be semen which escapes—if it occurs once a-day, and even more frequently; and at the lightest effort to stool, and without any pleasure, to inform one of the risk which is run.

Thus, then, involuntary emissions of semen, while the patient is awake, without erection, without pleasure, and while the patient is ignorant of it; an emission which takes place, not drop by drop, but at one time, and especially while at stool, are, according to Wichmann, specific characters of involuntary diurnal pollution.

The general effects of this diurnal pollution, as he has often observed them, are those seen in onanists. He remarks:—When you see a man extremely thin, pale, stupid, enervated, complaining of great debility, especially in the thighs and loins, lazy in his actions, and with sunken eyes, you have reason to suspect this cause.

Patients in this state never complain of any absolute pain. Their digestive powers are ruined: the appetite, however, continues—even increases, and sometimes becomes voracious. After taking food, they seem to have more strength; but this advantage is soon paid for, by the inconveniences resulting from digestion—especially if that variable appetite be too much indulged. As the stomach and most of the other viscera do not perform their functions properly, the more that is eaten the more the belly is tumefied, by the relaxation of the digestive organs. This swelling is attended with a painful feeling of anxiety, which exists in these unfortunates at other periods of the day, and impels them to avoid society. They are more disposed to sorrow than to joy—that is, the news of an unfortunate event brings with it more sorrow than that of a happy event causes pleasure. In them, as in onanists, there is a want of intelligence; they are stupid; natural sleep does not refresh them; the memory and sight are particularly debilitated. And this is the state of things, until the patient becomes affected with phthisis. At first, neither moral causes, nor affections of the soul, nor disappointment, can be suspected. There is apparently no viscus affected; nor can we ascribe the disease to any deleterious substance concealed in the body, and consuming the flesh. The patient has no pain, excepting that obtuse, compressive pain, which is referred to the hypochondria, and which depends on the swelling of the weak intestines. If you add to the characters the absence of fever, and of the ordinary causes of exhaustion, you may be persuaded that diurnal pollution exists—that it is the hidden cause of all the symptoms. This is a general description of the disease, drawn up from a considerable number of cases which we have observed.

Wichmann, also, remarks the resemblance between individuals affected with diurnal pollution and those affected with phthisis pulmonalis. Experience has taught me, (says he,) that in many patients who have been considered as affected with true phthisis, the disease must be referred to this cause alone. The symptoms of diurnal pollution are not very dissimilar to those of the first period of phthisis pulmonalis, at this purely spasmodic period, which I should be tempted to term insidious, if I considered merely the difficulty and uncertainty of the diagnosis at this period. The cough which then attends some patients, also, leads physicians to dread phthisis: or, rather, consumption, arising from diurnal pollution, assumes so much the characters and form of this disease, that one is disposed to treat it by the ordinary method, to the great disparagement of the patient, whose state requires opposite remedies. Farther: it is clear, that the disease of which we speak must infallibly terminate in phthisis, if it be not soon arrested.

In 1772, Wichmann observed internal pollution for the first time. The case was that of a young man, over twenty years of age, who for a long time had been affected with spasms. “He was manifestly in a state of cachochymia, and of wasting away. The physicians whom he had consulted before he came to me judged, from these appearances, that he was hypochondriac: in fact, different symptoms led to the belief that the disease was situated in the hypochondria. The loss of strength—the languor of digestion, although the appetite was not lost—the paleness of the countenance—the sadness and pusillanimity which led him to seek solitude—the vivid redness which rushed over his cheeks in conversation—his restlessness of character—and, finally, a certain weakness of intellect—seemed to justify the diagnosis. He had formerly indulged with females, and had been affected with venereal disease, to which he attributed his present state. Although there was not the slightest trace of these old affections, the physician, misled by the false conjectures of the patient, had kept him for a long time on mercurial preparations, by which the symptoms were aggravated, the true cause being overlooked.

“Mercury was then abandoned for tonics; and the ferruginous waters were employed, with the idea that the patient suffered from hypochondria. But this was no better than the former treatment; and the patient begged me to take charge of him. I could not attribute the extreme thinness which existed to the remnant of an imperfectly cured venereal affection, nor to the usual cause of exhaustion and fever. I then asked the patient if he indulged with females, or in onanism; or if he was affected with involuntary loss of semen. He almost swore to the contrary. I then told him of his obligation to speak the truth, and assured him that I should not prescribe for him until he was attentively examined. Some days after, he came to me again, and told me that he had been affected with something like loss of semen. I satisfied myself that the observation was correct. The cause of the evil being known, the treatment was simple. In a few months, the patient was restored to health; and this happy effect of the remedies proved that we had attacked the origin of the evil.

“This young man had probably indulged in premature excesses: in fact, this is the most usual cause of involuntary pollution. All the patients observed by me, (says Wichmann,) were from twenty-five to forty years old. All were addicted to the pleasures of love, or to onanism; or had become affected with blenorrhœa, by intercourse with diseased women.

“I am led to believe,” (adds he,) “that the effects of onanism would not be so pernicious, were it not for this diurnal pollution; that without it, this shameful habit would not be followed with consumption, and other symptoms of phthisis. In fact, onanism does not always give rise to this pollution. If this were the case, the number of onanists affected with consumption would be very great. The number of men addicted to this vice from early childhood is immense; for we do not know a greater scourge than this social corruption. From the fact, too, that onanism sometimes produces involuntary diurnal pollution, we ought to investigate if it does not exist in those who have renounced this pernicious habit. Advice to them would be useless, inasmuch as, having renounced this vice, they do not suspect the enervating cause which destroys them. About eighteen years ago, before I had discovered this cause of consumption, I knew a young man, thirty years old, who had been addicted to masturbation from the time he was ten years old, and who learned this pernicious habit from his preceptor. He died, after experiencing all kinds of infirmities, with extreme debility of all his physical and moral faculties. He acknowledged his error, and that for a long time he had renounced his bad habit; but his late return to continence did not save him. Now, I feel confident that this shameful habit had brought on an involuntary diurnal pollution, which caused his death.”

Wichmann remarks, that it is at the commencement of the fine season of spring that the patients are most conscious of their situation. They owe this increase of their ills (says he) to that general procreative faculty which becomes more active in all animated beings at this period of the year. The more full the vesicles of semen, the more liable are patients to lose it. We must also remark, that most patients secrete prolific semen, and preserve their procreative power. This, however, requires the patient to have the faculty of erection; for, otherwise, he would be impotent. This was the case with an individual, whose case is stated by Henry Van-Hers.

A young man of rich family, and who had arrived at puberty, consulted this physician, avowing, that from the time he was ten years old, he had enjoyed frequent intercourse with young girls, who had excited him by their lascivious touches; adding, that from this period the power of erection had disappeared. He had travelled for a long time, and had received advice from several French physicians. He went to the Spa waters, and there his case was examined by Van-Hers. The sensibility and weakness of the genital organs were so great, that on the slightest touch, and without any desire for coition, or any sensation, there was a discharge similar to thin milk. This excretion continued both night and day, whenever he passed urine, or on the least rubbing of his shirt. A great many remedies had already been tried. Van-Hers regarded the disease as incurable, but the young man would not listen to his advice; and being very rich, he continued to travel in Italy, France, England, and Germany, in the hope of recovering his lost virility. He consulted many physicians. He then had recourse to quacks; and even tried the powers of magic: but all in vain. After six years of travel, he returned to Van-Hers, regretting that he had not taken his advice. The young man then returned home, deploring the advantages of a large fortune, which rendered him the victim of a precocious abuse of pleasure, of a kind of premature depravity.

Wichmann’s dissertation was but little known in France, when Sainte Marie undertook its translation; and not only this, but added many important notes, which have shed new light on diurnal pollution. Wichmann had said, as we have seen, that patients affected with this disease ejaculated the semen. This expression was inexact, and has been rectified by M. Sainte Marie. The patients (said he) do not ejaculate the semen; but it runs away from them: it is not emitted with force. The characters which it presents had briefly been alluded to by Wichmann: his translator has stated them more clearly. According to him, the semen which runs away in diurnal pollution is paler, thinner, and more watery, than that which escapes when the act is attended with pleasure. Its odor, also, is fainter; and the stains it leaves on the linen are slight, superficial, and not very apparent. Wichmann had admitted the existence of a discharge from the prostate gland, which ought not to be confounded with diurnal pollution. Sainte Marie has attempted to point out the characteristics of this discharge. Those in whom it exists, (says he,) find the glans moistened in the morning when they rise with an unctuous substance: if they then compress the urethra from the root to the end of the penis, they press out some drops of a greenish, gluish, and slightly fetid fluid. They thus lose a little of this fluid after indulging in desires, or after erections which have not been followed by the act of venery. Sainte Marie considers it as probable that the mucus of the urethra then mixes with the fluid of the prostate gland, and forms a part of the discharge.

This author confirms Wichmann’s remarks on the general effects of diurnal pollution. He says, “Since I read his treatise, I have found this pollution in diseases of languor, which I could not attribute to a special or primitive alteration of any organ; and I have discovered, that a great many cases of hypochondria, of slow nervous fevers, of consumptions, were kept up by this kind of gonorrhœa, to which the patients, unable to observe themselves, had paid no attention. I have known several individuals, who have been affected with this diurnal pollution for a long time, without experiencing any marked derangement in their health: to them, it was an inconvenience; rather than a disease. But in these cases, diurnal pollution is not habitual: it only occurs when continence of days or weeks, an exciting or substantial regimen, long exercise on horseback or in a carriage, have accumulated semen in its reservoirs, or have irritated specially the genital organs: then the least effort to expel the feces causes the seminal vesicles to pour forth the surplus of fluid which they contain. Let not this state inspire too much security. Diurnal pollution is commenced: it is not yet serious; but it may progress, return every day at each evacuation, and finally produce all the bad results noticed by Wichmann.”

Wichmann said nothing in regard to the organic conditions of the diurnal pollution: he merely stated that this affection was the result of debility. M. Sainte Marie, on this point, makes many interesting remarks. He considers diurnal pollution as sometimes the cause, and sometimes the effect, of dorsal consumption; and he considers this to be an affection of the spinal marrow. We will quote this passage:—Diurnal pollution (says Sainte Marie) is sometimes only an effect; the origin of which must be sought after in a serious and primitive alteration of an important system of organs. Thus, we must reason, for instance, in respect to dorsal consumption. It is said, that one remarkable symptom of this disease is an abundant discharge of watery semen, which comes sometimes at each emission of urine. Involuntary diurnal pollution is here only a symptom: it occurs, because the genital organs do not receive, from the spinal marrow, the nervous and well regulated influence which they require to perform their functions properly. Hence, the super-abundant secretion of semen—its unfitness for fecundation—the relaxation of the seminal vesicles, which allow it to escape so readily—the atony of the scrotum—the inconvenient pulling of the spermatic vessels—the weakness of the erections—impotence, &c., &c. The same state of the organs which deprives the genital organs of life, explains, on the other hand, the wasting of parts which respond to this sensitive centre—the thinness of the loins, thighs, and lower extremities—the debility—the paralysis of these extremities—the obstinate constipation, complained of by the patients, and which is similar to that of old men, yielding only to the employment of stimuli—the formications along the back—the incontinence of urine—the gangrenous eschars, which at a more advanced period of the disease form on the sacrum, hips, and trochanters. We might easily pursue this subject, and extend it to the most general symptoms of consumption, as deep melancholy, weakness and slowness of the pulse, disposition to faint, and all those marked symptoms which assimilate this disease to slow nervous fever; but this would estrange us from the principle we seek to establish—which is, that diurnal pollution is sometimes the cause, and sometimes only the symptom, of dorsal consumption. Wichmann has treated only of the first: the second is connected with a general disease, and cannot be studied separately. These remarks of Sainte Marie will be admitted to be much more important, if compared with our remarks on the abuse of the genital organs on the spinal marrow, and with what we shall say hereafter on the power which this has on the same organs.

Swediaur, who was acquainted with and approved of Wichmann’s work, admits, in addition to the diurnal pollution described by this latter, and which he considers as arising either from relaxation or from irritation of the testicles and seminal passages—he admits, we say, a blenorrhœa of the prostate gland, the characters of which, as stated by him, are precisely similar to those of diurnal pollution. Blenorrhœa of the prostate gland (says he) is a morbid discharge of the mucus from this gland, sometimes mingled with the fluid of the seminal vesicles. It occurs particularly during the day, and without venereal desire. This disease is soon followed with general debility or weakness: this exhaustion is attended with emaciation of the body, and is followed by death, if the patient delays consulting a well-educated physician, as is too often the case; or if the proper remedies are not used in time. He admits, also, that the discharge from the prostate gland does not occur in some individuals, except when they go to stool; and that hardened feces, in passing through the rectum, press the prostate gland more firmly. The discharge is clear mucus, and of a particularly nauseous odor. Cullerier describes two kinds of spermatorrhœa: one with loss of semen and of the prostate fluid; the other, produced by constipation. He remarks—Persons who are habitually costive often see a few drops of semen ooze from the penis, while they are at stool. We have been consulted several times for cases of this kind. Some regard it as resulting from a relaxation, a debility of the genital organs: they imagine that their genital powers are lost, and that their procreative power is lost. Others attribute it to old blenorrhœas, which have struck in, as it is said. All, generally, are terrified at the effect; and quacks have often profited by its existence, to persuade patients that they were affected with an inveterate venereal disease, and thus to dispose of their remedies. This effect arises, as every one knows, from the pressure of the feces in the rectum on the seminal vesicles, and may be removed by removing the constipation.

This was the state of science, when Lallemand devoted himself to the study of the diseases of the urinary passages, and enriched it with many important remarks. As, in acute inflammations of the urethra, the irritation sometimes extends, following the course of the seminal passages to the testicles; so, in retentions of urine, produced by chronic inflammation of the prostatic portion of the urethra, the irritation extends more or less to the seminal vesicles and testicles, producing in the former normal contractions, and in the latter an excessive secretion, whence would result a spermatic flux. In patients thus affected, the ejaculation is very sudden: nocturnal pollutions are frequent—or, rather, the semen is expelled during the emission of urine, and of the feces. It is also more liquid, less odorous, and in short less elaborated than usual. In many patients, the venereal desires are nearly extinct; the erections are feeble, imperfect, or even impossible. This spermatorrhœa has general effects, analogous to those which have been attributed to other pollutions: the patients become timid, idle, indifferent to all which is not connected with their disease; all the functions of the economy languish, and are deranged; and, finally, both body and mind are degraded.

Lallemand has known all the phenomena which we have described to disappear, on curing the retention of urine—or, rather, the disease of the urethra which caused it—and relates cases of this character. Do not the remarks of this practitioner, compared with our remarks on convulsive spermatorrhœa, and particularly on the different states which the semen may present in this affection—do they not establish clearly, that in many, perhaps in most cases of spermatorrhœa, there is not relaxation, weakness of the seminal vesicles and ejaculatory ducts, but irritation or inflammation of these parts?

It would, then, seem well established, that the semen may be discharged without pleasure, without erection, and without ejaculation; and that this discharge may give rise to accidents analogous to those observed after all free discharges of this fluid, arising from any cause whatever. This fact, however, has been contested by different authors. Boerhaave says positively, that he has never known the semen to escape spontaneously, without solicitation; and that when such a case has been suspected, the fluid discharged was not probably semen; and that, farther, if this kind of spermatorrhœa exists, it must be very rare. Swammerdam, Hunter, and Haller, have expressed a similar opinion: the latter admits that a discharge may take place from the penis, under the circumstances mentioned above; he thinks, also, that this discharge comes from the prostate gland and seminal vesicles. But the fluid which escapes is only the mucus secreted by these parts—it is not semen; and unless opinions had been made up from wrong evidence, wrong consequences, it would not have been attributed to it. At present, the opinion that all cases of spermatorrhœa are only blenorrhœas, is still very prevalent. Descamps, physician at Castilliones, having brought before the Medical Society, in 1821, two cases of spermatorrhœa, the consequences of masturbation; Chantourelle, who was the reporter, raised some doubts, which the society seemed to admit, as to the nature of the discharge, thinking it was mucous, rather than spermatic. We, however, are disposed to think, that when the subject of diurnal pollution is better understood, it will be observed more frequently, and then its existence will not be denied. It is with the hope of contributing to this result, that we have dwelt so long on the subject.

If the imperceptible loss of semen may be followed by all the symptoms which are referred to it, it is evident that those authors who have advanced that the emission of semen should be counted as nothing in the influence of the act of venery, and that the nervous disturbance which attends it is the only cause of its consequences—those authors, we say, who assert this, have advanced too positive an opinion, and are consequently mistaken. The same may be said of those who ascribe the danger of venereal excesses simply to the discharge of urine. It is well ascertained, that those individuals who have carried the act of onanism to such an extent as to procure enjoyment without losing semen, have finally became diseased, and their constitution has been impaired. Instances of this might be cited. Fournier and Begin mention that of a young man, who, at the moment of ejaculation, compressed the remote parts of the urethra, so that not a drop of semen was lost. The fatigue, however, following efforts of this kind was very great, notwithstanding these exertions. Finally, the strength diminished, and the person wasted away as much as if the semen had been discharged. (Dict. des Sc. Med., Art. Masturbation.)

There is frequently some derangement in the functions of the testicles, in those who have lost the genital sense, where the penis is no longer capable of erection, or who are affected by one or other of the pollutions mentioned by us. But these organs may be affected more evidently. In many onanists, these parts are extremely tender, or more or less vivid pains are felt, which extend along the cord. These symptoms sometimes assume an evidently neuralgic character; and it may readily be imagined, that, in individuals affected with wandering pains, excesses in venery may fix them in these parts. This has been remarked in gout. Hallé and M. Guilbert observed, in a middle-aged man addicted to excesses of this character, a severe pain in the left testicle, unattended by swelling, which extended to the whole surface of this organ: this pain followed an attack of articular gout. Irritation of the testicles sometimes constitutes an attack of orchitis—that is, an inflammation, which, among other consequences, may be attended with the loss of these parts. Brodie has published two cases of this character. The first was that of a young man, thirty years old, who entered St. George’s Hospital in 1805, affected with pains in the left testicle. This testicle was soft, flabby, and one third smaller than that of the opposite side. The patient had never received a blow on this part, nor had he been affected with blenorrhœa; but he admitted, that for five years he had been addicted to onanism, and that a day seldom passed without his indulgence. Before wasting away, the testicle had been the seat of a swelling, which had been preceded by severe pains. These pains had continued to be felt, and the disease was attended with such a degree of moral depression, that the countenance of the patient assumed a sombre and melancholy character. This young man was treated by various remedies, but he left the hospital uncured. The other patient, on applying to Mr. Brodie, in 1820, was thirty-one years old. Here the two testicles were wasted, and the patient was impotent. This man stated that his intercourse with females began when he was fourteen years old; that he had indulged excessively for many years; that, when twenty years old, in consequence of external violence, he was affected with severe inflammation of the testicles; that this inflammation had been completely cured; and that the wasting of the testicles had commenced some time afterward. In three years, the testicles had shrunk to their present size. (London Med. and Phys. Journal, October, 1826.)

According to Morgagni, the too frequent return of venereal ideas will produce varicocele and hydrocele. Some authors, also, place venereal excesses among the causes of the first of these two diseases, and also of circosele. We have seen several cases of varicose dilatation of the spermatic cord and testicle in onanists. This fact is also confirmed by Breschet, in his memoir read at the Academy of Sciences, Jan. 13th, 1834. He thinks that circosele and varicocele are by no means diseases of adult and old age, but that they are seen most frequently in young men. These affections seem to him to be caused most particularly by venereal excesses. He adds, that the varicose tumors of the bursæ, and the organs they contain, are not only very troublesome, causing severe pain in the cord, but that in some patients they cause extreme melancholy.

One consequence of onanism, which has been omitted by Deslandes, may be stated here. We allude to the smallness of the genital organs. In several severe cases of onanism, which have fallen under the notice of Dr. A. Sidney Doane, of New-York, this important feature has been observed. The same fact has been remarked by Professor John W. Francis, of New-York; Professor Otto, of Germany; and by other eminent pathologists.

Excesses in masturbation and coition, in females, cause affection of the several organs much more frequently than in males. By too frequent titillation, the clitoris may become enormously large. This cause (says Bouillaud) may determine schirrous engorgement, or even a cancerous degenerescence of this organ. The most frequent alteration, however, of the genital organs of the female, which may be thus produced, is an inflammation of the membrane which lines the vulva and vagina. This inflammation is constantly indicated by a more or less abundant leucorrhœal discharge, and often by swelling, redness, and pain. When this discharge continues, which is often the case, it occasions in young females symptoms analogous to those of diurnal pollution. The complexion loses its color, and becomes yellowish; the eyes are constantly suffused, and the countenance is sad; the patients are feeble and careless; they generally experience gnawing sensations in the epigastric region; and, thinking that these are occasioned by hunger, are constantly eating. Sometimes, the appetite is voracious, and the digestive powers are preserved; but these are commonly soon altered. Severe and constant pains are often felt in the back and epigastrium; the body wastes; and a short, dry, and frequent cough, renders the patient, parents, and sometimes the physician, anxious as to the state of the chest. Add to these symptoms those already described, when speaking of the general effects of masturbation, and you have the state most frequently presented by girls addicted to this habit.

As females have no testicles, nor organs which, like the testicles in the male, serve to prepare and excrete the semen, they cannot have seminal pollutions: they, however, like men, are subject to voluptuous dreams, and then there may be a secretion, analogous to that which exists in them at the moment of the act of venery. May a too frequent return of this symptom have any influence on the health? The only remarks on the subject, to our knowledge, are to be found in Swediaur. He says, when speaking of diurnal pollution—I have seen, although much more rarely, similar diseases in the other sex. I have under treatment, at this moment, a female, twenty-eight years old, who, since her miscarriage, a year and a half ago, suffers from frequent involuntary nocturnal pollutions, excited by libidinous dreams, and attended with all the symptoms of the tabes dorsalis, described by Hippocrates, as a disease of the male. Even the lungs begin to feel this disease. She, however, has been cured.

Inflammation of the external organs of generation, and the fluor albus, resulting from it, is most generally, at least in young girls who have not arrived at puberty, a consequence of onanism. We are convinced, too, that if it were possible to arrive at the facts, we should find that the cause of fluor albus in adults was either recent or former abuses. Whenever we have addressed females on the subject, to ascertain this fact, our conjectures have been verified. This has frequently been the case with servant girls. We have seen several, who were so weakened by fluor albus, and the irritation of the sexual parts, that they have been obliged to quit their situations, being unable to do their duty. We will even say, that the most sincere of these girls have given me such information as to their habits, that we suspect most of this class of onanism.

Besides, all authors who have spoken of leucorrhœa and blenorrhœa in females, have mentioned excesses in masturbation and coition as among their most frequent causes. It would be easy to adduce general evidence and special cases in support of this proposition; but this would be useless.

For the same reasons, we may state, that diseases of the uterus may very frequently be determined by these excesses, and more particularly by those of coition. Daily observation proves that acute and chronic inflammations of the body and neck of the uterus frequently appear in those females who have indulged in premature enjoyments.

We have attended, for more than ten years, a lady affected with chronic metritis, arising from this cause. This lady had began to masturbate before she was eleven years old. She soon became affected with fluor albus, from which she has never been free since. When eighteen years old, she married a vigorous man, and then became addicted to another kind of excess. She now experienced constant pains in the loins, lower part of the belly, and in the groins: she was also troubled with a disagreeable feeling of fatigue in the upper part of the thighs, and experienced as it were a weight, as if something was constantly trying to escape from the sexual parts. The neck of the uterus, instead of retaining its usual situation, proved on examination to be almost at the external orifice of the vagina. Our advice, as to moderation and abstinence, was but imperfectly followed: she was so addicted to onanism, that, although she indulged lawfully, and was the mother of several children, she continued in this habit. It may readily be imagined that she did not derive much benefit from my advice: in fact, the symptoms mentioned above, and many others, still continue. Similar cases are related by other authors, and have fallen under the notice of almost every practitioner.

In this case, there was evidently prolapsus uteri, or a falling of the womb: the neck of the uterus was almost at the vulva. This displacement, which is the usual consequence of inflammations of the body of the uterus, very often results, like it, from venereal excesses. This fact has been noticed by all writers on this subject. Schirrous and cancerous affections of the neck of the uterus, also, arise from this cause. Cullerier remarks, that uterine affections in females are loo frequently the sad and cruel consequence of solitary manœuvres. Richerand, after stating that premature or too frequent indulgence is a cause of cancer of the uterus, says, that of forty-seven females affected with this disease, eleven had indulged with males before the period of puberty, seven at this period, and most of them were barren. He adds, that those public girls who escape venereal disease generally die of cancer of the uterus. Bayle and Cayol have attempted to verify this assertion, by examining numerous cases, but they have obtained no marked result; which is not surprising, considering the number of causes, which, especially in hospitals, render such investigations useless. The influence of excessive indulgence, in producing such a disease, is very great. A short time since, we were called to a lady, who had a slight syphilitic ulceration of the neck of the uterus. She, however, still admitted the embraces of her husband, although they were painful, and were followed by a discharge of blood. The parenchyma of the neck, around the ulceration, was gradually engorged: it became schirrous, then cancerous, and the patient finally died. Probably, coition had great influence in developing this disease. Such a thing might happen frequently; for Ricord has shown, that superficial ulcerations of the neck of the uterus are frequent. The cancers which affect these parts, in public women, are, probably, often produced in this manner.

In the lady whose case has been mentioned, the act of coition produced a discharge of blood from the vulva. We have seen cases of a similar character, where the neck of the uterus presented no evidence of organic alteration to the touch. Females in whom this occurs should, however, be very careful in their pleasures, as this slight accident indicates a bad state of the system, and one which should be mistrusted. Sometimes, blood appears on return of coition, when females have not indulged for a long time. Rondelon cites an instance of this. It occurred in a lady from whom her husband had been absent for three years: at the end of this period, he returned. The frequency of coition the first night caused excessive uterine hemorrhage. A similar accident may result from this act, and a fortiori from its abuse, during or just before the menstrual period. Very serious hemorrhages have often occurred in consequence of excessive copulations. Tissot states—In 1746, a girl, twenty-three years old, submitted to the embraces of six Spanish dragoons, at a house near the gates of Montpelier. She died the next day, from excessive hemorrhage of the uterus. A similar case has been related by Virey. We know (said he) that a public woman, who submitted in one night to twenty-one soldiers, the next day died, with hemorrhage of the uterus. This was a dark, thin woman, in the flower of her age. (Dict. des Sc. Med., vol. xiv., p. 339.) Onanism causes in young women, and even in children, a discharge of blood from the vulva. This fact was mentioned by Duges. The blood lost is then never abundant, and the occurrence is by no means serious.

The irritation produced or kept up by too frequent coition, is very often the cause of sterility. Even as, generally speaking, an inflamed surface refuses to absorb substances applied to it, so irritation of the uterus and vagina renders them unfit for impregnation. Thus, then, libertinism, instead of adding, as we might think, to the chances of fecundation, acts in a contrary manner. Marc remarks, that two hundred public girls do not produce more than two or three children annually. Farther: it seems well ascertained, that if these girls resume a regular life, they again become fruitful. The English, wishing to people Botany Bay, transported there a large number of public women. Those who were sterile in their own country proved fruitful, when subjected to the rigid laws of marriage. Is it not notorious, too, that among the public girls, those who bear children are not those most frequently liable to become mothers? De Chanes, physician at Macon, has established, by statistical researches, that but few conceptions take place in the early months of marriage—that is, when the congress of the sexes is most frequent, and causes the most irritation. Villermé has ascertained the same to be true in the early days, and even the early weeks, after marriage. Hence, this learned physician regards the fecundity of copulations as being inversely as their frequency. It may, then, be stated as a fact, that females may become barren, in consequence of venereal abuses.

These abuses are not only injurious, as opposing reproduction, but they also injure, by causing a deterioration of the human family. Marc asserts, that the few children born of prostitutes rarely have the strength and health of those born in lawful wedlock; and that the mortality of the former is fifty per cent greater than of the latter. Too early marriages are attended with results similar to those arising from libertinism. Aristotle mentioned this fact. Delafontaine, first surgeon of the last king of Poland, attributes the extreme physical debility of the Polish Jews to these premature marriages. Marc says—It is proved, that the physical strength of the child depends, in the main, on the mother, rather than on the father; and this is confirmed, too, by referring to domestic animals. The height of the pony depends on the mare, rather than on the stallion. Mules, too, furnish a striking proof of this. The eggs of pullets, whatever may be the size of the cock, are much smaller than those of hens. Farther: it is well known, that females who become mothers before attaining their strength, generally give birth to small children, which are raised with difficulty.

We have seen in a former page, that men had recourse to artificial means to procure a semblance of coition. Accidents of a similar character have happened to girls; and they have been obliged to call in surgeons to their assistance. There are numerous instances, where foreign bodies have been introduced into the vagina, and particularly into the urethra, and could not be withdrawn. We shall mention some of them. Pamard has reported that of a girl, thirty-one years old, who used an ivory whistle, three inches and a half long, and five lines round in its centre. This she introduced, not into the vagina, but into the urethra. One day, it entered so far, that she could not remove it. After many efforts, it was withdrawn, with polypus forceps. Another girl, seventeen years old, was less fortunate. She was in the habit of introducing a large piece of wood into the urethra. This instrument having entered very deeply, fell into the bladder. Faure was called, and was obliged to cut for it, to extract it. Rigal was obliged to do the same, to relieve a young girl, twenty years old, who used a wooden needle-case in masturbating. Needles and pins have often escaped into these passages. Morgagni asserts that it is by no means unfrequent in Italy for the lascivious girls to introduce into the urethra the golden pins worn in their hair, and that they sometimes fall into the bladder. This they conceal for a long time; but they are finally obliged, through pain, to confess their fault. Moinichien mentions a Venetian girl, whom Molinetti relieved of a golden needle, which had slipped from the hand into this organ. In 1751, Lachese, (according to Morand’s report,) was called to a girl twenty years old, who had introduced into the urethra a toothpick, which she had lost; and after two months, it was extracted. A happy circumstance favored Lamotte in a similar case. An old maid had introduced into the bladder a very large pin. Having sounded several times very patiently and attentively, Lamotte finally felt the pin distinctly. He sounded for the fourth time, when, by accident, it became engaged in the sound. Wishing to withdraw it, and finding some resistance, he introduced his finger into the vagina, and ascertained whence it proceeded. By skilful manipulation, he now succeeded in withdrawing it. These symptoms usually happen only in those who are imprudent, and who introduce into the urethra an instrument designed for an adjacent passage. The vagina is so short and large, that foreign bodies seldom remain in it. For such a thing to take place, certain conditions are requisite, which are not very common. This, however, is possible; and many cases of it are recorded. The following is mentioned by Dupuytren. A female consulted him for some derangement in the vulvo-uterine passage. On examination, a foreign body was felt, the nature of which could not at first be determined. The patient refused to give any information on the subject: by examining, however, it was found that the body presented a large opening or deep cavity. The tumefied walls of the vagina covering the edges of the kind of vessel, prevented its disengagement. After much effort, however, the body was removed; and it proved to be a pomatum-pot, which had been introduced by its base. (Additions à la Med. Operat., de Sabatier; vol. iv., p. 96.)

PART SECOND.

RULES OF PRESERVATION AND TREATMENT RELATIVE TO VENEREAL EXCESSES.

There are two indications, which embrace every thing relating to venereal excesses. The first is, to prevent the bad effects; the second, to remedy them. To preserve, to recruit, is what these excesses require. Hence, some of the remedial measures must be hygienic, and others therapeutic. To these, we shall devote two chapters of this second part.

CHAPTER I.
PRESERVATIVE MEANS RELATIVE TO VENEREAL EXCESSES.

The preservative rules which relate to venereal excesses present fundamental differences, as to the success and facility of their application, according as reference is made to the act of masturbation or coition. Let us point out these differences.

Coition is an act, the mode and purport of which, considered in a scientific point of view, are legitimate; and which, consequently, is lawful, so long as the constitution and health are unimpaired. Hence, it should not be prohibited, except when abused—that is, when indulged in too often, or under circumstances which render it injurious. Except in these cases, it may be permitted, or even advised. When it is forbidden, the advice is generally understood, as it is commonly addressed to adults, children having neither the power nor the opportunity to indulge in coition. This advice may be easily followed, as the individual who indulges in coition to excess, may find it absolutely impossible to indulge: in fact, means to satisfy his taste can only be found by the concurrence of another. Hence, it is only necessary to shun this concurrence, to render this kind of excess impossible. To address one’s self to the reason of an adult—or, rather, of a young man—and to create for him, if he cannot create for himself, obstacles to sexual relations, these are the only two preservative indications which abuses of coition require. We have discharged the first, or have stated the mode of fulfilling it, by mentioning the bad consequences attending these abuses, and by making known the circumstances which render the act of venery injurious to those addicted to it. Hence, we shall not return to the subject. The second indication can find no place in a book, and consequently will not detain us. Our remedies, then, as to preservation, will apply exclusively to onanism. In a subsequent page, when we are treating of the restorative remedies, the distinction here laid down between this habit and coition will disappear; and we can then treat of all venereal excesses conjointly.

Although coition, if confined within certain limits, and under certain circumstances, may not be forbidden, this is not the case with masturbation. This latter indulgence has nothing legitimate in it; and nothing respectable—nothing which can palliate the veto of the physician. We are aware that onanism is not always necessarily followed by any inconvenience or danger; but, practically, this distinction disappears. But onanism, without regard to the mode, its frequence, or the individuals or circumstances under which it occurs, may always be considered an abuse, and, consequently, be earnestly proscribed.

This view of the subject rests on two facts: one is fundamental, and applies to all individuals, without distinction of age, sex, or constitution; the other relates only to those who are addicted to onanism, before they are perfectly formed and constituted. The first of these motives is founded on this, that when this practice is not actually bad, it may constantly be suspected of becoming so. When onanism once commences, it is difficult to say how far it will extend. The taste for it, and the facility of indulging in it at night, and often in the day, cause this habit to be in a measure indulged in without limits. It becomes so soon imperious, and the despotism it exercises is so absolute, that we ought always to attempt its prevention. It should be regarded as a scourge, and be treated as such, without waiting for the bad effects which may result from it. This course is still more necessary, when children, young patients, and individuals who have not attained their growth, are interested. When maturity arrives, the evil is possible; before it happens, it is probable, and often certain. Farther: our remarks on precocious enjoyments prevent our recurring to the subject.

Before speaking of the preservative means, a question presents itself. How can it be told when these means may be used? or, in other words, what are the signs which indicate that an individual is an onanist, or may become so? The suspicion may extend very far: in fact, every age is exposed to it, as onanism is possible from early life to old age: it, however, belongs to the age before puberty. A great many young girls and boys masturbate: hence, this maybe suspected of every one. This habit is less frequent, but it is far from being rare. The precautions to prevent onanism, and constant vigilance, should then be exercised constantly towards children and young people—in fact, towards all who are not of mature age. This rule is an important one; and cannot be neglected, without exposing one to danger and to deep regrets.

It would be desirable to ascertain the existence of onanism before its effects appear; but this is seldom the case. There is in children a kind of instinct which leads them to conceal this manœuvre, although they have not learned that it is an illicit act. The art with which they elude vigilance is often inconceivable. Watch where the child goes. Have an eye to him who seeks solitude—who remains a long time alone, and who cannot give a good account of himself. Be watchful about the periods of lying down and of rising. At this time, the onanist may be detected in the act. His hands are never out of bed, and his face is often hidden under the bed-clothes. Soon after lying down, he appears sound asleep: this circumstance, which always causes distrust in the experienced man, is one of those which contribute the most to inspire the parents with a feeling of security. The affectation of sleep in the young person may serve to detect him. When approached, he is frequently found red, and covered with sweat, although neither the temperature of the chamber, the weight of bed-clothes, nor any other cause, can explain this state: at the same time, the respiration is more hurried, the pulse is fuller, harder, and more frequent; the veins are larger, and the heat is greater, than usual; in fine, there is that kind of fever, of general turgescence, which usually attends the act of venery.

When the young person is disturbed suddenly, his hands, if he has not had time to remove them, will be found on or near the genital organs. The penis, also, may be found in a state of erection; or you may even find marks of recent pollution, which might be known by the peculiar odor arising from the semen, and which comes from the soiled fingers. Have an eye to those young persons, whose hands, when in bed, or during sleep, are in the position described: they are onanists, or will become so. The same is true in those who frequently have erections of the penis. This erection, and this attitude, are certainly not positive signs of onanism; but they are the probable, or precursory signs of it: they should not, then, be neglected. The stains of semen, on the bed-clothes or dress, may also increase suspicion. When the patients are very young, they are not very evident, the fluid which they emit not having the characters of real semen: the traces which it leaves, however, are too remarkable, not to cause suspicion as to their origin. In those who have attained the age of puberty, there would be nothing equivocal: the only question then would be, that they might be produced by involuntary pollution. On this topic, we would remark, that this pollution seldom occurs before the age of fifteen or sixteen years, and is seldom frequent before twenty. When involuntary discharges of semen are frequent in young persons, you may be assured that they are the indirect results of onanism: hence, there is reason to regard stains of semen as positive proofs of onanism, when the patients have not attained the age of puberty; and as more probable signs of this habit, when older, if these stains be frequent.

A loss of color, or an earthy tint of the countenance—a violet appearance of the eyelids—a languid expression of face—an air of fatigue and nonchalance, when the patient rises from bed—a difficulty in getting up—are all signs which may lead to the discovery of this pernicious habit. Here we might trace the physical state produced by onanism, if this had not already been done. Unfortunately, it is consumption which sounds the alarm; and this disease must be advanced, too, before the parents seek the cause. Sometimes, the true cause is overlooked, and all remedies are directed to an imaginary one. We will admit, however, that it is not always easy to refer the wasting caused by masturbation to its real origin. A young man, although not addicted to onanism, may lose his strength, grow thin, and present, both morally and physically, the characters belonging to this habit: this effect is often produced by intestinal worms, by dentition, puberty, by a too rapid growth of the body, &c.; and likewise by some chronic diseases of the stomach, intestines, liver, lungs, heart, &c. Hence, we should not be too quick to attribute to masturbation a state which may be produced by other causes. The practitioner who would pronounce too precipitately that a patient indulged in onanism, would commit an error which might be serious in more than one respect.

When a young patient presents signs of consumption, there is cause to suspect that onanism is the cause of it; and modes may be used to ascertain whether this be the case. Sometimes, the patient is watched, as has already been stated. Sometimes, we attempt to discover if any other cause has produced consumption; and when this cause is not found, the existence of onanism is supposed. The patient, for instance, presents all the symptoms of exhaustion, and these increase. We inquire if this state may not result from a want of nourishment, or from improper food—from hard work—from long watching—from melancholy, &c.; if it may not be caused by a disease about which the patient is silent, or by one of those maladies which produce effects similar to those of masturbation. Now, if the gradual sinkings of the patient cannot be explained by any of these causes; if he is weak, pale, thin, &c.; if, notwithstanding abundant and nutritious diet, a moderate degree of labor, the absence of all chagrin, &c.; if he presents no sign of disease—or, rather, if the first symptoms of diseases which he would present are not manifested until after the appearance of those of consumption; farther, if these diseases are too slight to have caused this state; if they cannot explain the numerous and varied symptoms observed, and particularly the countenance, the character of which is so significant, that it alone often reveals onanism: then we may consider, if not as certain, at least as very probable, that the patient is a victim to this habit, and we must act accordingly.

But, of all the proofs, it is most important to obtain an avowal of the habit from the patient. First, it removes all doubt; then it renders the action of the physician more frank, and consequently more efficacious. He is no longer fearful of wounding his feelings—of compromising his character, by showing a wrongly founded suspicion; of awaking the attention of the young patient to a subject of which he was ignorant, or of teaching it to him. Advice, remonstrances, punishments, and all the moral remedies, are now easily applicable; and if therapeutic or coercive measures are called for, the patient can no longer deny their utility, and reject their use. Finally, an avowal places the physician, parents, instructors—in short, all who have authority over the patient—in a position to proceed directly to their aim, and thereby attain it.

An avowal never takes place spontaneously: to obtain it is difficult. With males, one need not be so particular; but we must be careful with females. On this topic, no positive advice can be given: much must be left to the tact of the practitioner. We will only add, that we have more than once simply given advice; and we could see, from the manner in which it was received, that our conjectures were right. The physician, however, should always attempt to acquire the confidence of the onanist, to place him at his ease. They have no frankness when a person is stern, or when a moral lecture is expected. The physician should confine himself to his profession. In his eye, onanism should be regarded as a cause of disease—as a cause similar to an excess of labor, bad regimen—in fact, like any influence which might prove injurious to the health. If he should moralize, he would probably be debarred from that confidence which would enable him to give advice, and prescribe the resources of the art.

Masturbation is often overlooked, because it is thought that the hand is a necessary agent in producing it: this is far from being the case; as it may be indulged in, by both sexes, without the aid of the hands. When this is suspected, it is soon discovered, by the manners, face, and silence of the onanist: there is something unusual in the appearance of the patient, which is readily observed; and generally, also, the thighs are crossed, or, at least, are pressed closely together.

To prevent the development of the habit, and, when it is developed, to arrest it, are the two indications prescribed by hygeia. These two indications may be embraced in one—that of preventing the occurrence of onanism. If, for instance, you have before you the case of two individuals, one of whom is not addicted to onanism, while the other may be, you should prevent one from continuing, and the other from commencing it. In the two cases, the means used have the same tendency; only when you wish to prevent the habit commenced, you have need of more efforts than in the first case, where it does not exist. These means are, then, preventive—essentially preventive; for, whatever may be their mode of action, they all tend to prevent the act. Although the prevention of onanism, and the arrest of the habit, are apparently different, yet we shall state the mode of attaining this double result, to avoid repetitions.

In masturbation, we must consider three things—the desire, the will, and the power. Onanism is not possible, where these three conditions do not exist: there is no wish without desire; and the latter is often completely mastered by the former, and both present no result, if there be no possibility of indulging. Hence, to prevent masturbation, and to arrest it, the desire, the wish, the power to indulge, must not exist. These are, as it has been seen, three distinct indications. It is sufficient to attain one of them. It is easily seen, that by appeasing the desire, the will is aided; and the obstacles opposed would be more efficacious, the less vivid the desire, and the weaker the will. It is, therefore, sufficiently understood, that the three indications we have mentioned, although very distinct, require each of them special means, the attainment of one of which renders that of the others useless, while they all can and may be pursued conjointly.