The patient had a peculiar deformity of the genital organs, hypospadias, which prevented sexual intercourse, in consequence of which he gave himself up to the practice of self-abuse. He had become reduced to the most deplorable condition of both mind and body, and presented a most woebegone countenance. In addition to his general ailments, he suffered from extreme prolapsus of the rectum and a most painful anal fissure. His condition was somewhat bettered by skillful surgical treatment.
[Extension of Irritation].—Serious and painful as are the affections already noticed, those which arise from the extension of the congestion and irritation of the urethra to those other organs most intimately connected with the function of generation are still more dreadful in themselves, and far more serious in their consequences. The irritation extends into the ejaculatory ducts, thence backward into the seminal vesicles, and downward through the vasa deferentia to the testes. These organs become unnaturally excited, and their activity is increased. The testicles form an abnormal amount of spermatozoa; the seminal vesicles secrete their peculiar fluid too freely. From these two sources combined, the vesicles become loaded with seminal fluid, and this condition gives rise to a great increase of sexual excitement.
In cases of long standing, the irritation of the urethra at the openings of the ejaculatory ducts, a point just in front of the bladder, advances to inflammation and ulceration. Here is now established a permanent source of irritation, by which the morbid activity of the testes and seminal vesicles is kept up and continually increased. This condition is indicated by frequent twitchings of the ejaculatory and compressor muscles in the perineum. It is also indicated by a burning sensation at the root of the penis after urination, which, in severe cases, amounts to very serious pain.
[Atrophy, or Wasting of the Testes].—The first result of the irritation communicated to the testes, is, as already remarked, increased activity; but this is attended by swelling in some cases, more or less pain, tenderness, and, after a time, diminution in size.
This degenerative process likewise affects the seminal fluid, which becomes more or less deteriorated and incapable of producing healthy offspring, even while it retains the power of fecundating the ovum, which it also ultimately loses if the disease is not checked by proper treatment, when the individual becomes hopelessly impotent, a happy result for the race, for it prevents the possibility of his imparting to another being his debilitated constitution.
[Varicocele].—This morbid condition consists in a varicose state of the spermatic veins. It is almost always found upon the left side, owing to an anatomical peculiarity of the spermatic vein of that side. It has been supposed to be a result of masturbation and its effects, but is certainly caused otherwise in many cases. It is not infrequently found in these patients; but Prof. Bartholow contends that even in such cases we should "consider its presence, in general, as accidental." Atrophy of the left testicle is often produced by the pressure of the distended veins; but this does not produce impotence. It occasionally occurs simultaneously on both sides, and greatly aggravates the effects of self-abuse, if it is not itself an effect of the vice.
[Nocturnal Emissions.]—Seminal emissions during sleep, usually accompanied by erotic dreams, are known as nocturnal pollutions or emissions, and are often called spermatorrhoea, though there is some disagreement respecting the use of the latter term. Its most proper use is when applied to the entire group of symptoms which accompany involuntary seminal losses.
The masturbator knows nothing of this disease so long as he continues his vile practice; but when he resolves to reform, and ceases to defile himself voluntarily, he is astonished and disgusted to find that the same filthy pollutions occur during his sleep without his voluntary participation. He now begins to see something of the ruin he has wrought. The same nightly loss continues, sometimes being repeated several times in a single night, to his infinite mortification and chagrin. He hopes the difficulty will subside of itself, but his hope is vain; unless properly treated, it will probably continue until the ruin which he voluntarily began is completed.
This disease is the result of sexual excesses of any kind; it is common in married men who have abused the marriage relation, when they are forced to temporary continence from any cause. It also occurs in those addicted to mental unchastity, though they may be physically continent. It is not probable that it would ever occur in a person who had been strictly continent and had not allowed his mind to dwell upon libidinous imaginations.
[Exciting Causes.]—The exciting causes which serve to perpetuate this difficulty are chiefly two; viz., local irritation and lewd thoughts.