Inflammation of the external organs of generation, and the fluor albus, resulting from it, is most generally, at least in young girls who have not arrived at puberty, a consequence of onanism. We are convinced, too, that if it were possible to arrive at the facts, we should find that the cause of fluor albus in adults was either recent or former abuses. Whenever we have addressed females on the subject, to ascertain this fact, our conjectures have been verified. This has frequently been the case with servant girls. We have seen several, who were so weakened by fluor albus, and the irritation of the sexual parts, that they have been obliged to quit their situations, being unable to do their duty. We will even say, that the most sincere of these girls have given me such information as to their habits, that we suspect most of this class of onanism.
Besides, all authors who have spoken of leucorrhœa and blenorrhœa in females, have mentioned excesses in masturbation and coition as among their most frequent causes. It would be easy to adduce general evidence and special cases in support of this proposition; but this would be useless.
For the same reasons, we may state, that diseases of the uterus may very frequently be determined by these excesses, and more particularly by those of coition. Daily observation proves that acute and chronic inflammations of the body and neck of the uterus frequently appear in those females who have indulged in premature enjoyments.
We have attended, for more than ten years, a lady affected with chronic metritis, arising from this cause. This lady had began to masturbate before she was eleven years old. She soon became affected with fluor albus, from which she has never been free since. When eighteen years old, she married a vigorous man, and then became addicted to another kind of excess. She now experienced constant pains in the loins, lower part of the belly, and in the groins: she was also troubled with a disagreeable feeling of fatigue in the upper part of the thighs, and experienced as it were a weight, as if something was constantly trying to escape from the sexual parts. The neck of the uterus, instead of retaining its usual situation, proved on examination to be almost at the external orifice of the vagina. Our advice, as to moderation and abstinence, was but imperfectly followed: she was so addicted to onanism, that, although she indulged lawfully, and was the mother of several children, she continued in this habit. It may readily be imagined that she did not derive much benefit from my advice: in fact, the symptoms mentioned above, and many others, still continue. Similar cases are related by other authors, and have fallen under the notice of almost every practitioner.
In this case, there was evidently prolapsus uteri, or a falling of the womb: the neck of the uterus was almost at the vulva. This displacement, which is the usual consequence of inflammations of the body of the uterus, very often results, like it, from venereal excesses. This fact has been noticed by all writers on this subject. Schirrous and cancerous affections of the neck of the uterus, also, arise from this cause. Cullerier remarks, that uterine affections in females are loo frequently the sad and cruel consequence of solitary manœuvres. Richerand, after stating that premature or too frequent indulgence is a cause of cancer of the uterus, says, that of forty-seven females affected with this disease, eleven had indulged with males before the period of puberty, seven at this period, and most of them were barren. He adds, that those public girls who escape venereal disease generally die of cancer of the uterus. Bayle and Cayol have attempted to verify this assertion, by examining numerous cases, but they have obtained no marked result; which is not surprising, considering the number of causes, which, especially in hospitals, render such investigations useless. The influence of excessive indulgence, in producing such a disease, is very great. A short time since, we were called to a lady, who had a slight syphilitic ulceration of the neck of the uterus. She, however, still admitted the embraces of her husband, although they were painful, and were followed by a discharge of blood. The parenchyma of the neck, around the ulceration, was gradually engorged: it became schirrous, then cancerous, and the patient finally died. Probably, coition had great influence in developing this disease. Such a thing might happen frequently; for Ricord has shown, that superficial ulcerations of the neck of the uterus are frequent. The cancers which affect these parts, in public women, are, probably, often produced in this manner.
In the lady whose case has been mentioned, the act of coition produced a discharge of blood from the vulva. We have seen cases of a similar character, where the neck of the uterus presented no evidence of organic alteration to the touch. Females in whom this occurs should, however, be very careful in their pleasures, as this slight accident indicates a bad state of the system, and one which should be mistrusted. Sometimes, blood appears on return of coition, when females have not indulged for a long time. Rondelon cites an instance of this. It occurred in a lady from whom her husband had been absent for three years: at the end of this period, he returned. The frequency of coition the first night caused excessive uterine hemorrhage. A similar accident may result from this act, and a fortiori from its abuse, during or just before the menstrual period. Very serious hemorrhages have often occurred in consequence of excessive copulations. Tissot states—In 1746, a girl, twenty-three years old, submitted to the embraces of six Spanish dragoons, at a house near the gates of Montpelier. She died the next day, from excessive hemorrhage of the uterus. A similar case has been related by Virey. We know (said he) that a public woman, who submitted in one night to twenty-one soldiers, the next day died, with hemorrhage of the uterus. This was a dark, thin woman, in the flower of her age. (Dict. des Sc. Med., vol. xiv., p. 339.) Onanism causes in young women, and even in children, a discharge of blood from the vulva. This fact was mentioned by Duges. The blood lost is then never abundant, and the occurrence is by no means serious.
The irritation produced or kept up by too frequent coition, is very often the cause of sterility. Even as, generally speaking, an inflamed surface refuses to absorb substances applied to it, so irritation of the uterus and vagina renders them unfit for impregnation. Thus, then, libertinism, instead of adding, as we might think, to the chances of fecundation, acts in a contrary manner. Marc remarks, that two hundred public girls do not produce more than two or three children annually. Farther: it seems well ascertained, that if these girls resume a regular life, they again become fruitful. The English, wishing to people Botany Bay, transported there a large number of public women. Those who were sterile in their own country proved fruitful, when subjected to the rigid laws of marriage. Is it not notorious, too, that among the public girls, those who bear children are not those most frequently liable to become mothers? De Chanes, physician at Macon, has established, by statistical researches, that but few conceptions take place in the early months of marriage—that is, when the congress of the sexes is most frequent, and causes the most irritation. Villermé has ascertained the same to be true in the early days, and even the early weeks, after marriage. Hence, this learned physician regards the fecundity of copulations as being inversely as their frequency. It may, then, be stated as a fact, that females may become barren, in consequence of venereal abuses.
These abuses are not only injurious, as opposing reproduction, but they also injure, by causing a deterioration of the human family. Marc asserts, that the few children born of prostitutes rarely have the strength and health of those born in lawful wedlock; and that the mortality of the former is fifty per cent greater than of the latter. Too early marriages are attended with results similar to those arising from libertinism. Aristotle mentioned this fact. Delafontaine, first surgeon of the last king of Poland, attributes the extreme physical debility of the Polish Jews to these premature marriages. Marc says—It is proved, that the physical strength of the child depends, in the main, on the mother, rather than on the father; and this is confirmed, too, by referring to domestic animals. The height of the pony depends on the mare, rather than on the stallion. Mules, too, furnish a striking proof of this. The eggs of pullets, whatever may be the size of the cock, are much smaller than those of hens. Farther: it is well known, that females who become mothers before attaining their strength, generally give birth to small children, which are raised with difficulty.
We have seen in a former page, that men had recourse to artificial means to procure a semblance of coition. Accidents of a similar character have happened to girls; and they have been obliged to call in surgeons to their assistance. There are numerous instances, where foreign bodies have been introduced into the vagina, and particularly into the urethra, and could not be withdrawn. We shall mention some of them. Pamard has reported that of a girl, thirty-one years old, who used an ivory whistle, three inches and a half long, and five lines round in its centre. This she introduced, not into the vagina, but into the urethra. One day, it entered so far, that she could not remove it. After many efforts, it was withdrawn, with polypus forceps. Another girl, seventeen years old, was less fortunate. She was in the habit of introducing a large piece of wood into the urethra. This instrument having entered very deeply, fell into the bladder. Faure was called, and was obliged to cut for it, to extract it. Rigal was obliged to do the same, to relieve a young girl, twenty years old, who used a wooden needle-case in masturbating. Needles and pins have often escaped into these passages. Morgagni asserts that it is by no means unfrequent in Italy for the lascivious girls to introduce into the urethra the golden pins worn in their hair, and that they sometimes fall into the bladder. This they conceal for a long time; but they are finally obliged, through pain, to confess their fault. Moinichien mentions a Venetian girl, whom Molinetti relieved of a golden needle, which had slipped from the hand into this organ. In 1751, Lachese, (according to Morand’s report,) was called to a girl twenty years old, who had introduced into the urethra a toothpick, which she had lost; and after two months, it was extracted. A happy circumstance favored Lamotte in a similar case. An old maid had introduced into the bladder a very large pin. Having sounded several times very patiently and attentively, Lamotte finally felt the pin distinctly. He sounded for the fourth time, when, by accident, it became engaged in the sound. Wishing to withdraw it, and finding some resistance, he introduced his finger into the vagina, and ascertained whence it proceeded. By skilful manipulation, he now succeeded in withdrawing it. These symptoms usually happen only in those who are imprudent, and who introduce into the urethra an instrument designed for an adjacent passage. The vagina is so short and large, that foreign bodies seldom remain in it. For such a thing to take place, certain conditions are requisite, which are not very common. This, however, is possible; and many cases of it are recorded. The following is mentioned by Dupuytren. A female consulted him for some derangement in the vulvo-uterine passage. On examination, a foreign body was felt, the nature of which could not at first be determined. The patient refused to give any information on the subject: by examining, however, it was found that the body presented a large opening or deep cavity. The tumefied walls of the vagina covering the edges of the kind of vessel, prevented its disengagement. After much effort, however, the body was removed; and it proved to be a pomatum-pot, which had been introduced by its base. (Additions à la Med. Operat., de Sabatier; vol. iv., p. 96.)