“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.