Swediaur, who was acquainted with and approved of Wichmann’s work, admits, in addition to the diurnal pollution described by this latter, and which he considers as arising either from relaxation or from irritation of the testicles and seminal passages—he admits, we say, a blenorrhœa of the prostate gland, the characters of which, as stated by him, are precisely similar to those of diurnal pollution. Blenorrhœa of the prostate gland (says he) is a morbid discharge of the mucus from this gland, sometimes mingled with the fluid of the seminal vesicles. It occurs particularly during the day, and without venereal desire. This disease is soon followed with general debility or weakness: this exhaustion is attended with emaciation of the body, and is followed by death, if the patient delays consulting a well-educated physician, as is too often the case; or if the proper remedies are not used in time. He admits, also, that the discharge from the prostate gland does not occur in some individuals, except when they go to stool; and that hardened feces, in passing through the rectum, press the prostate gland more firmly. The discharge is clear mucus, and of a particularly nauseous odor. Cullerier describes two kinds of spermatorrhœa: one with loss of semen and of the prostate fluid; the other, produced by constipation. He remarks—Persons who are habitually costive often see a few drops of semen ooze from the penis, while they are at stool. We have been consulted several times for cases of this kind. Some regard it as resulting from a relaxation, a debility of the genital organs: they imagine that their genital powers are lost, and that their procreative power is lost. Others attribute it to old blenorrhœas, which have struck in, as it is said. All, generally, are terrified at the effect; and quacks have often profited by its existence, to persuade patients that they were affected with an inveterate venereal disease, and thus to dispose of their remedies. This effect arises, as every one knows, from the pressure of the feces in the rectum on the seminal vesicles, and may be removed by removing the constipation.
This was the state of science, when Lallemand devoted himself to the study of the diseases of the urinary passages, and enriched it with many important remarks. As, in acute inflammations of the urethra, the irritation sometimes extends, following the course of the seminal passages to the testicles; so, in retentions of urine, produced by chronic inflammation of the prostatic portion of the urethra, the irritation extends more or less to the seminal vesicles and testicles, producing in the former normal contractions, and in the latter an excessive secretion, whence would result a spermatic flux. In patients thus affected, the ejaculation is very sudden: nocturnal pollutions are frequent—or, rather, the semen is expelled during the emission of urine, and of the feces. It is also more liquid, less odorous, and in short less elaborated than usual. In many patients, the venereal desires are nearly extinct; the erections are feeble, imperfect, or even impossible. This spermatorrhœa has general effects, analogous to those which have been attributed to other pollutions: the patients become timid, idle, indifferent to all which is not connected with their disease; all the functions of the economy languish, and are deranged; and, finally, both body and mind are degraded.
Lallemand has known all the phenomena which we have described to disappear, on curing the retention of urine—or, rather, the disease of the urethra which caused it—and relates cases of this character. Do not the remarks of this practitioner, compared with our remarks on convulsive spermatorrhœa, and particularly on the different states which the semen may present in this affection—do they not establish clearly, that in many, perhaps in most cases of spermatorrhœa, there is not relaxation, weakness of the seminal vesicles and ejaculatory ducts, but irritation or inflammation of these parts?
It would, then, seem well established, that the semen may be discharged without pleasure, without erection, and without ejaculation; and that this discharge may give rise to accidents analogous to those observed after all free discharges of this fluid, arising from any cause whatever. This fact, however, has been contested by different authors. Boerhaave says positively, that he has never known the semen to escape spontaneously, without solicitation; and that when such a case has been suspected, the fluid discharged was not probably semen; and that, farther, if this kind of spermatorrhœa exists, it must be very rare. Swammerdam, Hunter, and Haller, have expressed a similar opinion: the latter admits that a discharge may take place from the penis, under the circumstances mentioned above; he thinks, also, that this discharge comes from the prostate gland and seminal vesicles. But the fluid which escapes is only the mucus secreted by these parts—it is not semen; and unless opinions had been made up from wrong evidence, wrong consequences, it would not have been attributed to it. At present, the opinion that all cases of spermatorrhœa are only blenorrhœas, is still very prevalent. Descamps, physician at Castilliones, having brought before the Medical Society, in 1821, two cases of spermatorrhœa, the consequences of masturbation; Chantourelle, who was the reporter, raised some doubts, which the society seemed to admit, as to the nature of the discharge, thinking it was mucous, rather than spermatic. We, however, are disposed to think, that when the subject of diurnal pollution is better understood, it will be observed more frequently, and then its existence will not be denied. It is with the hope of contributing to this result, that we have dwelt so long on the subject.
If the imperceptible loss of semen may be followed by all the symptoms which are referred to it, it is evident that those authors who have advanced that the emission of semen should be counted as nothing in the influence of the act of venery, and that the nervous disturbance which attends it is the only cause of its consequences—those authors, we say, who assert this, have advanced too positive an opinion, and are consequently mistaken. The same may be said of those who ascribe the danger of venereal excesses simply to the discharge of urine. It is well ascertained, that those individuals who have carried the act of onanism to such an extent as to procure enjoyment without losing semen, have finally became diseased, and their constitution has been impaired. Instances of this might be cited. Fournier and Begin mention that of a young man, who, at the moment of ejaculation, compressed the remote parts of the urethra, so that not a drop of semen was lost. The fatigue, however, following efforts of this kind was very great, notwithstanding these exertions. Finally, the strength diminished, and the person wasted away as much as if the semen had been discharged. (Dict. des Sc. Med., Art. Masturbation.)
There is frequently some derangement in the functions of the testicles, in those who have lost the genital sense, where the penis is no longer capable of erection, or who are affected by one or other of the pollutions mentioned by us. But these organs may be affected more evidently. In many onanists, these parts are extremely tender, or more or less vivid pains are felt, which extend along the cord. These symptoms sometimes assume an evidently neuralgic character; and it may readily be imagined, that, in individuals affected with wandering pains, excesses in venery may fix them in these parts. This has been remarked in gout. Hallé and M. Guilbert observed, in a middle-aged man addicted to excesses of this character, a severe pain in the left testicle, unattended by swelling, which extended to the whole surface of this organ: this pain followed an attack of articular gout. Irritation of the testicles sometimes constitutes an attack of orchitis—that is, an inflammation, which, among other consequences, may be attended with the loss of these parts. Brodie has published two cases of this character. The first was that of a young man, thirty years old, who entered St. George’s Hospital in 1805, affected with pains in the left testicle. This testicle was soft, flabby, and one third smaller than that of the opposite side. The patient had never received a blow on this part, nor had he been affected with blenorrhœa; but he admitted, that for five years he had been addicted to onanism, and that a day seldom passed without his indulgence. Before wasting away, the testicle had been the seat of a swelling, which had been preceded by severe pains. These pains had continued to be felt, and the disease was attended with such a degree of moral depression, that the countenance of the patient assumed a sombre and melancholy character. This young man was treated by various remedies, but he left the hospital uncured. The other patient, on applying to Mr. Brodie, in 1820, was thirty-one years old. Here the two testicles were wasted, and the patient was impotent. This man stated that his intercourse with females began when he was fourteen years old; that he had indulged excessively for many years; that, when twenty years old, in consequence of external violence, he was affected with severe inflammation of the testicles; that this inflammation had been completely cured; and that the wasting of the testicles had commenced some time afterward. In three years, the testicles had shrunk to their present size. (London Med. and Phys. Journal, October, 1826.)
According to Morgagni, the too frequent return of venereal ideas will produce varicocele and hydrocele. Some authors, also, place venereal excesses among the causes of the first of these two diseases, and also of circosele. We have seen several cases of varicose dilatation of the spermatic cord and testicle in onanists. This fact is also confirmed by Breschet, in his memoir read at the Academy of Sciences, Jan. 13th, 1834. He thinks that circosele and varicocele are by no means diseases of adult and old age, but that they are seen most frequently in young men. These affections seem to him to be caused most particularly by venereal excesses. He adds, that the varicose tumors of the bursæ, and the organs they contain, are not only very troublesome, causing severe pain in the cord, but that in some patients they cause extreme melancholy.
One consequence of onanism, which has been omitted by Deslandes, may be stated here. We allude to the smallness of the genital organs. In several severe cases of onanism, which have fallen under the notice of Dr. A. Sidney Doane, of New-York, this important feature has been observed. The same fact has been remarked by Professor John W. Francis, of New-York; Professor Otto, of Germany; and by other eminent pathologists.
Excesses in masturbation and coition, in females, cause affection of the several organs much more frequently than in males. By too frequent titillation, the clitoris may become enormously large. This cause (says Bouillaud) may determine schirrous engorgement, or even a cancerous degenerescence of this organ. The most frequent alteration, however, of the genital organs of the female, which may be thus produced, is an inflammation of the membrane which lines the vulva and vagina. This inflammation is constantly indicated by a more or less abundant leucorrhœal discharge, and often by swelling, redness, and pain. When this discharge continues, which is often the case, it occasions in young females symptoms analogous to those of diurnal pollution. The complexion loses its color, and becomes yellowish; the eyes are constantly suffused, and the countenance is sad; the patients are feeble and careless; they generally experience gnawing sensations in the epigastric region; and, thinking that these are occasioned by hunger, are constantly eating. Sometimes, the appetite is voracious, and the digestive powers are preserved; but these are commonly soon altered. Severe and constant pains are often felt in the back and epigastrium; the body wastes; and a short, dry, and frequent cough, renders the patient, parents, and sometimes the physician, anxious as to the state of the chest. Add to these symptoms those already described, when speaking of the general effects of masturbation, and you have the state most frequently presented by girls addicted to this habit.
As females have no testicles, nor organs which, like the testicles in the male, serve to prepare and excrete the semen, they cannot have seminal pollutions: they, however, like men, are subject to voluptuous dreams, and then there may be a secretion, analogous to that which exists in them at the moment of the act of venery. May a too frequent return of this symptom have any influence on the health? The only remarks on the subject, to our knowledge, are to be found in Swediaur. He says, when speaking of diurnal pollution—I have seen, although much more rarely, similar diseases in the other sex. I have under treatment, at this moment, a female, twenty-eight years old, who, since her miscarriage, a year and a half ago, suffers from frequent involuntary nocturnal pollutions, excited by libidinous dreams, and attended with all the symptoms of the tabes dorsalis, described by Hippocrates, as a disease of the male. Even the lungs begin to feel this disease. She, however, has been cured.