Medical students, when listening to lectures graphically picturing disease of the genital organs from sexual debauch, all have each and every form, with the rare and peculiar sequelæ. They consult the professor in whom they repose the most confidence, only to receive the assurance that nothing is the matter, only a little weakness which will soon of itself subside.
In treating of sexual neurasthenia I can but confine myself to that functional derangement caused, directly or indirectly, by the supposed lack of endurance of the genital organs and the coëxisting nervous weakness.
The fact that nearly all young men have at some period polluted, gives them a cause to fear that any nervous debility discovered may be caused by their early indiscretions. In this they are deceived, and only putting their minds at ease will dispel, often, the cause of this perpetuation. I am often consulted by literary men, who only need rest to be free from this languor. A zealous divine consulted me, with the impression that he was afflicted with some organic nervous disease or brain disease. After examining him closely, and assuring him that he had only a nervous weakness of a functional character, he thought best to confess all by saying that he had been “wild” in his youth, and he was laboring under great fear that he was beginning to feel its latent influence upon his brain. I again assured him that it was entirety impossible for him to become in any manner afflicted with a brain disease.
The transitory character of all neurasthenic symptoms is quite sufficient to distinguish this from organic disease. On one day the patient feels badly, with some signs of organic neurosis; but the next day he has forgotten that group of symptoms, and another is complained of; or he may be free and light, and in bright spirits; but whenever he feels weak and languid, the first thing he thinks of is his early indiscretion.
Neurasthenia Caused by Sexual Excess and Domestic Infelicity—Case.—Mrs. M., the mother of two children, passed through four abortions, came lately from Chicago to this city and, perchance, became my patient, when I learned her history. She had sustained a fracture of the left parietal bone and suffered some from compression. The specula was removed in Chicago. The injury was caused by a heavy glass, hurled by her husband in a fit of jealous rage. She is fleshy, weighing 135 pounds, and rather short; has some time been given to drink, to cover domestic infelicity; her face is florid, and on the least excitement becomes purple and ecchymosed in spots; she feels, sometimes, as if she would faint; often has vertigo, tingling in feet and hands, sickness at the stomach; she never cramps, but often cries, feels languid all the time, and lies in bed the most of the day; pulse normal, sometimes a little intermittent; tongue natural and bowels regular; no belt sensation; no tenderness in the cord; no bladder trouble.
Her husband compelled her to submit to his embraces three or four times on Sunday and every night during the week; and this had been practiced, with only menstrual intervals and when too sick to submit, for six years. She is peevish and fretful, and suffering from general exhaustion.
There are many manifestations of neurasthenia, when the cause has been from the sexual; prominent among which is irritability, exhaustion, and sleeplessness following sexual congress; nervous headache with black line under both eyes the next day; creeping sensation and itching of the skin, without any abnormal appearance to cause it; formication, numbness of the hands and feet, flushed face, tenderness and pains that are transitory: all without any detection of organic disease; not but what such symptoms exist in organic disease, but they are more permanent, when they do exist, and can be associated with some assurance. I have had my mind on the point of naming and searching for numerous organic and spinal and cerebral affections, when the patient would multiply antagonistic symptoms so rapidly that I have often concluded that my patient had a new and serious combination of lesions.
Organic disease generally has a set of signs and phenomena entirely in accordance with structures involved; but neurasthenic symptoms are most commonly such as are antagonistic to any two forms of neurosis.
A greater variety of symptoms exists in neurasthenia than any organic disease. Symptoms of one organic disease are common one day, and of another the next day; and though the two organic manifestations were wholly different, the patient on the third day will perceive them all combined and aggravated.
Not all cases of neurasthenia can be attributed to the genital organs. In my experience cases, arising from sexual irritation and other causes, are very evenly divided. I have often been convinced of genital irritation being caused from neurasthenia; but as I have intended the more to discuss sexual neurasthenia, in Neurasthenia from Genital Irritation, I shall be compelled to leave the subject with only having mentioned its bearing on sexual irritation as a cause.