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:—