The generative centres are particularly damaged by the constant congestion of the genitals. The frequent stimuli keep the lumbar centres in a condition of constant irritation. The nervous system, presiding over the function of erection, thus becomes worn out and exhausted, and the nerves do not respond even to the strongest stimulations, which would otherwise set them in action. In this way, the centres get accustomed, so to say, of not responding any longer with erection to the proper stimuli, or in other words, the consensualism between the genital nerves and their centres is broken.
Hence, besides the harm done to the nerves by the general debility, there is great damage done to the genital nerves and centres by the break in the chain of the reflex mechanism. In no other sex-activity, except in actual copulation, are the generative organs in such a constant and intense excitement as in dalliance with individuals of the other sex, no other erotic stimuli create such libidinous turgescence of the organs and such a high degree of sex-tension, exciting with rapture the higher centres, no other excitations cause such a consumption of nerve power as this gratification of the impulse of contrectation by tactile manoevres. The erections of penis and clitoris are vigorous and violent. The organs are set in a state of expectancy for the final act. If the act is not terminated within a certain limited time, the state of expectancy cannot last for ever. The mode of action is limited in length of time. Except in the abnormal state, known as priapism, the duration of erection is relatively short in the normal individual. Its beginning is synchronous with the onset of the material congestion and nervous tension of the genital parts, and its subsidence should normally be synchronous with ejaculation. If the latter be prevented, erection has to cease sooner or later, even when congestion and tension remain unabated. Hence after long and lasting amorous caresses the erections fail.
If these manœuvres are often repeated, the excitations finally do not effect the proper response, and erection fails from the outset. The strong and continuous stimulations render the nerves and their centres inert in reaction and weak in power. The centres of erection and ejaculation become blunted, the inhibitory centres get very sensitive, and erection cannot be provoked. When the nerve centres presiding over the function of erection get into the habit of not responding to the highest excitations of the tactile stimuli, they do not respond even to the stimulations concarnationis. The cooperating nerve-apparatus has been affected, and a perverted innervation is created. The close interdependence of the mechanism of erection and the centres is removed, and an abnormal reflex-excitability is produced. The consensualism between the corpora cavernosa and the centre of erection is interrupted.
Before the indulgence in frustrate caresses has become a habit, i. e., in the beginning of the practice, erections are vigorous and of considerable duration. But the duration diminishes with each repetition. After a few months or years of these nerve-destroying practices, according to the patient’s nervous constitution, there is no response by erection even to the strongest stimuli. The consentaneous action, which, otherwise, connects the excitement of the organs with erection and completion of the act, does not take place. This lack of consensualism on the part of the several factors which go to make up the orgasm leads finally to complete impotence.
Continence, if long continued, has been claimed to be the cause of impotence. But there is no valid reason for this belief. To prove the harmfulness of continence, an analogue is brought forward between the atrophy of a muscle in enforced idleness and the injury to the sex organs in enforced abstinence. But the proof is somewhat feeble. The essential organs of generation are not muscles but glands, and who has ever heard of a tear gland atrophying for lack of crying. Furthermore, abstinence does not condemn the generative organs to absolute rest. Every individual, especially when abstinent, has frequently nocturnal erections through the entire period of his sexual activity, and there is no reason why such erections should not keep the genitals in the required exercise and should not prevent the alleged atrophy. As far as the exercise to prevent atrophy is concerned, nocturnal erections ought to be of the same service as erections followed by intromissions. The nocturnal erections seem to be even more harmless. The engorgement of the colliculus is less pronounced in these erections. Micturition, on awakening with an erection, is immediately possible, while there is a pronounced inability of micturition after an erection and ejaculation either through initu aut stupro manu.
The histories of patients are cited to prove the deleterious effects of total abstinence. Cases are known of alleged abstinent neurasthenics, on the point of a complete breakdown, who recovered perfect health after marriage. But even this proof cannot stand a closer scrutiny. Who can prove the total abstinence of these patients? The layman is prone to regard the actual intromission only as sexual activity. If he has abstained from this final phase, he considers himself abstinent. But chastity is not continence by any means. Absolute continence is abstinence not only from the gratification of the impulse of detumescence concarnatione, but also from that of contrectation, i. e., from mental and tactile caresses and from all other abnormal practices. We must distinguish between chastity and abstinence. Those who are chaste out of fear of venereal infection or for lack of opportunity are not always abstinent. They are just the individuals who are indulging immoderately in mental erethism or even masturbation.
The mere assertion of the patient that he never indulged in unnatural practices does not count. The patient’s veracity is very questionable. All venereal troubles seem to exert an inhibitory influence upon the truth-centres. The propensity of the masturbator to conceal the truth is notorious. If such a patient claims that he has never masturbated, it is likely that he is still practising it. A special psychical element, associated with this habit, prompts the majority of patients to gross and intemperate prevarication.
But even if such a “rara avis,” who has abstained from actual manusturpation, should exist, still mental erethism cannot entirely be excluded. The elicitation of a history of mental erethism is connected with great difficulty. Masturbation with these patients means only the indulgence in manual practices; the voluptuous day-dreams are considered of no account, and the peculiar type of mendacity prevents them from revealing the truth even to him, upon whom they called to consult.
Hence the loss of sexual power in these patients may not have been effected by continence but, on the contrary, by continual erethism. The examination of such patients really shows, as a rule, the prostatic urethra in a state, which is usually caused by prolonged erethism. After marriage, with its regulated sexual activity and the removal of the inclination to the wild erotic fancies, the neurasthenia is soon cured, not because the patient has given up abstinence, as interpreted by the anti-abstinence advocates, but, on the contrary, because he has now become real abstemious from the excesses of mental erethism. Hence the cure of neurasthenia by marriage is no proof against sexual abstinence. The patients who seek medical advice for their neurasthenic troubles may be those who have only abstained from coition but have freely and immoderately indulged in the unnatural modes of sensualism, whence their troubles originated. The real continent individuals who avoid any kind of erotic practices remain sound and healthy and do not require medical help. Their cases remain hence unknown to the profession.
If total abstainers from every kind of sexual erethism should sometimes become neurasthenic, this fact would not prove yet that the nervous trouble was caused by total abstinence from the gross sexual gratification. Even the man about town may become neurasthenic for lack of the gratification of the impulse of permanent mating. The apologists of promiscuous intercourse forget or are ignorant of the fact that the impulse of permanent mating in normal men and women cannot be satisfied by promiscuity. The craving for a permanent mate, home and family unconsciously demands gratification even from him who leads a promiscuous sexual life. If this impulse is not gratified, as in cranky old bachelors or hysterical old maids, it may lead to severe attacks of neurasthenia. Such cases will not be cured by the association with venal women or by promiscuous sensuality, but they may be cured by a permanent mate, home, and family life. Hence the cure of the total abstainer from his nervousness by marriage is again no proof against total abstinence. The cause of the trouble may have been the unsatisfied impulse of permanent mating which has been now satisfied by marriage. Promiscuous relations would not have cured the neurasthenia, but marriage with its accompanying emotional tones.