L—, twenty-two years old, was moderately tall, with a narrow chest, and had never enjoyed good health, particularly for the six years preceding the time when he entered the prison at Bicetre, when he indulged in the disgusting practice of onanism. In the course of January, 1819, he was affected with general numbness, with frequent cough and expectoration of mucus: these symptoms were occasionally attended with slight fever. When admitted to the infirmary, the 1st of February, he complained, in addition to the symptoms already mentioned, of a violent pain in the posterior part of the neck. A slight swelling was seen at the level of the first and second cervical vertebræ, and pressure on that part was painful; the head was bent to the left side, and remained motionless; the thoracic abdominal limbs were numb; and deglutition was painful. Local resolvent frictions, blisters, and moxas were used. The 15th of February, he was affected with hemoptysis, which yielded in two days to the use of bleeding and astringents. The vertebral disease, however, generally made progress, like that of the chest, which seemed to relax. In July, the thoracic limbs were perfectly paralyzed; and in August, this was true also of the abdominal limbs. At this period, the head was absolutely immoveable; the phthisis seemed as yet in the second degree. Finally, the patient died suddenly, from moving his head, while the attendants were changing him.
Post-mortem Examination. The soft parts of the posterior region of the neck were changed to a whitish, lardaceous substance; the right condyle of the occipital bone was carious: there was also a deep caries of the upper part of the right lateral mass of the first vertebræ, and of the odontoid process. The transverse and odontoid ligaments were degenerated and softened; and the medulla oblongata presented a kind of strangulation, resulting from the compression caused by the left posterior part of the edge of the occipital foramen: in fact, there was a dislocation of this bone, on the first vertebræ. The cerebrum was unaffected; the right lung was tuberculous, and very small; that of the left side was also tuberculous, but was larger. The peritoneum presented some marks of inflammation.
In the preceding cases, the caries of the vertebræ was not attended with a congested abscess. The following case, published by Levêque Lasource, will present to us this symptom, which is so common in this disease:—
N— O— was addicted to onanism, from twelve to eighteen years of age; but could not renounce this fatal habit, although reminded of its danger by a curve in the spine, and by other symptoms. When received at la Charité Hospital, in 1806, beside a well marked gibbosity, he presented a congested abscess at the upper and inner part of the thigh. Two cauteries were applied to the sides of the vertebral prominences: these suppurated freely, but did no good. The abscess was punctured in several places. This young man, who could not survive, left the hospital; so that the organic changes produced by his disease could not be verified. (Jour. de Med., Chir. and Phar.; vol. xvii., p. 261.)
The same author has related another case, which terminated more fortunately:—A child, seven or eight years old, addicted to masturbation, entered at la Charité, affected with gibbosity and paralysis of the lower limbs. During the month he stayed in the hospital, several cauteries were applied around the tumor, which suppurated; tonics and strengthening medicines were administered internally. He left, perfectly cured of the paralysis, and of the other symptoms caused by the affection of the medulla; but the deformity resulting from the prominence formed by the spinous processes of the vertebræ continued. Three years after, this child, who had abstained from this bad habit, had experienced no relapse.
We have seen, in several of the preceding cases, that permanent contractions of the lower limbs resulted, in onanists, from affections of the spinal marrow. Guersent, also, admits the possibility of essential contractions—that is, those which do not result from a disease of the nervous centres. According to this practitioner, these kinds of contractions are seen most frequently in those nervous children who indulge in bad habits, like that of masturbation. The following case has been considered by him as an instance of this affection:—
D— E—, five years old, and addicted to masturbation, after passing a part of the winter at the Hospital des Enfans, to be treated for scrofulous engorgements of the glands of the neck, was sent to the country in the spring. He had been there about three months, when he was suddenly affected with a contraction of the lower extremities. Examined the 5th of July, he complained neither of pain in the head nor spine. The digestive passages were in very good state; there was no derangement in the circulation or respiration; the muscles of the lower extremities were permanently rigid: the tension, however, was more marked in the adductors; for the patient constantly kept his knees crossed. There was no deviation in the vertebral column. Different remedies were employed, but without success; except a little improvement under the use of carbonate of iron. The legs and thighs of the patient could be flexed and extended with the hands; but he could neither flex them when extended, nor extend them when flexed. This child was cured in a singular manner. His state was as described, when, at the beginning of September, he was affected with symptoms of roseola. The contraction of the lower extremities disappeared, when the fever came on. The eruption went through its course, and the contraction of the limbs did not return. Thus, this disease, which had resisted several efficacious remedies, disappeared before another disease.
The loss or debility of the external senses, particularly those of hearing and sight, when this state is the consequence of venereal excesses, often result, as may be seen in several of the cases above stated, from a disease of the brain. This organ was probably diseased in the old man whose case was mentioned by Réveillé Parise. This man was desirous of living with a young Italian girl, whose temperament was extremely ardent. He paid for his imprudence by blindness, which occurred in eight days, and which was followed by death. Sometimes, however, the eye alone is diseased: at least, the pathological state which it presents is unattended by any symptoms indicating an affection of the brain or its membranes. Many libertines present only an irritation of the conjunctiva and of the edge of the eyelids. It is a sort of chronic ophthalmia; their eyes are red, watery, fatigued, painful; and they cannot engage in the evening in any occupation, such as reading, which requires the attention to be confined to one object. Sometimes, a severe and deep-seated pain proves that, beside the outer parts of the eye, the interior of this organ is the seat of a severe irritation. Hoffmann has seen several cases of this. He cites that of a young man, who indulged in onanism from the age of fifteen to that of twenty-three. “His eyes and head were so weak,” says he, “that these organs were often affected with violent spasms, during the emission of semen. Whenever he attempted to read, he experienced a sensation similar to that of drunkenness: the pupil was considerably dilated, and excessive pains were felt in the eye. The eyelids were glued together every night; the eyes were also watery; and there was, at the two angles, a collection of whitish matter. These irritations, especially when seated within the eye, may be followed by the loss of sight.” Dr. Juengken, professor of clinical ophthalmology at the Berlin faculty, and who has published an excellent work on the diseases of the eye, indicates, when speaking of amaurosis resulting from masturbation, that the pupil assumes a peculiar form, which is found only (says this professor) in those individuals habitually addicted to this vice. In these cases, the pupil, instead of being in the centre of the eye, is removed upward, but does not lose its roundness: the upper part of the iris seems narrower, and contracted on its ciliary edge. This symptom has been mentioned, also, by Dr. Sichel, as occurring in certain scrofulous ophthalmias: iritis then exists. Photophobia, which is a greater or less aversion to light, resulting from the pain which it occasions in the eye, has been indicated, by Sanson, as sometimes preceding amaurosis, caused by too frequent a loss of semen.
All authors agree in placing venereal excesses, and particularly those from masturbation, among the causes of amaurosis. They are so unanimous on this point, that we shall cite no authorities. They generally agree to regard amaurosis, in onanists, as produced by the exhaustion caused by diurnal or nocturnal pollutions. Beer, and many others, assimilate, in this respect, the loss of semen to that of other fluids; and compares venereal excesses, especially those from onanism, with cholera, diarrhœa, &c., as a cause of amaurosis. This idea of exhaustion probably led Scarpa to remark, that amaurosis, resulting from premature abuses of masturbation or coition, must generally be regarded as incurable. This prognosis may be made, we believe, in regard to most cases of amaurosis. Dr. Buzzi has published, with four other cases of amaurosis, which were cured, that of an individual in whom it had been produced by masturbation. It, however, yielded, on the abandonment of bad habits, to the moderate use of good wine, combined with milk diet.
Dr. Rognetta, in a memoir on the causes of amaurosis, insists on the opinion that onanism produces this disease, by exhausting the sensibility of the body. He compares this habit to decay. “Nothing,” says he, “enervates the body so much as too frequent emissions of semen, especially when they are caused by the hand: the spasm which attends them throws the body into all the infirmities of old age. The retina and optic nerve then gradually lose their sensitive faculty, which finally becomes extinct. Those who masturbate are affected with amaurosis, like decrepit old men.” Rognetta adds, that he has the notes of several cases of amaurosis, which had resisted all remedies, and which were caused entirely by the luxuria manuensis. He relates the history of a young ecclesiastic, nineteen years old, a native of Palermo, whose sight became very weak. This unfortunate young man had been in the habit of masturbating seven times a-day: he was also prone to sodomy. Rognetta advised him to leave off this bad habit, and to return to his native place and take cold baths.