Part 1 — CHAPTER III. SYMPTOMS AND DISEASES CAUSED BY VENEREAL EXCESSES. (continued 2)

One symptom in the preceding case, which deserves to be noted, is the difficulty of respiration, the palpitations, and other symptoms which led to the belief that the heart was diseased. On opening the body, however, this organ was found perfectly healthy. Similar phenomena are often seen in onanists: it would therefore be wrong to consider them always as signs of an organic alteration of the heart and large vessels.

In the following case, the vertebræ were more changed. The spinal column was gibbous: but this was preceded by paraplegia, and other symptoms of myelitis. This case was published by M. Dalandeterie:—

A shoemaker, twenty-four years old, of good constitution, who has always enjoyed good health, contracted the habit of masturbation at the age of sixteen years, and became so addicted to it, that he indulged seven or eight times a-day: his strength soon diminished, and he lost flesh and his color.

After an interruption, caused by an acute disease, the patient resumed his fatal habit with the same earnestness. He finally became so weak; languid, and pale, that he was discharged from military service, in which he was inscribed.

A little while afterward, this young man, who had never shown any symptoms of scrofula, presented scrofulous engorgements in the groins and axillæ, and swellings, with caries, in several phalanges of the fingers. At the same time, a singular phenomenon appeared: the hair, which was chestnut colored, came off; on growing again, it appeared of several colors: but after coming off once or twice, it resumed its natural shade.

The patient continuing to indulge in onanism, finally became extremely weak, and was obliged to keep his bed. Marked symptoms of myelitis now appeared. The patient gradually lost the use of his lower limbs: first they became weak, and showed a disposition to be crossed; but finally wasted away, and lost the power of motion. He was now obliged even to be turned in bed, as he could not move. The articulation of the feet and knees became stiff and inflexible, and his legs were so much retracted, that the end of the foot only touched the ground, when the patient was placed in an erect position. The sensibility of the limbs, also, was as much affected as their motions; they were cold, numb, and even when pinched they were not painful. The general languor was increased every day. He suffered from thirst, dyspepsia, pains in the stomach, rumblings, night sweats, &c. At this period, the patient quitted a woman with whom he had lived for a year, and who, having but little inclination for coition, caused him to indulge in masturbation.

The erections were frequent, powerful, short, and always terminated with a more or less abundant discharge of mucus from the urethra—perhaps, also from the prostate gland; or even the discharge might be of thin semen. After a while, the ejaculations were composed, instead of semen, of a half-clotted, blackish or yellowish blood: sometimes, as much as a tablespoonful was lost. These emissions were always painful, and were followed by extreme prostration.

For some time, the patient was in this sad state, when he experienced a crawling sensation, like that caused by ants, descending along the back: he experienced, in the same region, a severe and fatiguing pain, which extended into the ribs and loins. These symptoms subsided; but at the lower part of the dorsal region appeared a hard tumor, which at first was small; but it gradually enlarged, as long as the patient continued to masturbate. This tumor was evidently formed by the curve of the spine, and the projection of three spinous processes.

In three months, the patient was improved by the use of moxas and of antiscrofulous remedies, by a suitable regimen, and particularly by abstaining from onanism, for which he had conceived not only disgust, but even a horror. The abdominal limbs regained their strength, heat, and sensibility; the patient could walk on crutches, and could even stand erect for a few moments, and could take a few steps unaided.

In this case, which is remarkable in more than one respect, the symptoms of myelitis preceded the curve of the spine, and then disappeared, although the spine did not regain its primitive rectitude. The debility, numbness, retraction, and paralysis of the limbs, appeared long before the pain in the back, after which the curve in the back began to appear; and then these limbs regained their sensibility, force, and motion, while the gibbosity remained always the same. This curve, then, could not be the cause of the paraplegia, because the latter appeared first, and the spine remained curved after the paralysis was removed. The development of symptoms apparently scrofulous, in a man more than twenty years old, who had hitherto presented nothing analogous, and whose parents were healthy; the loss of his hair; the affection of the seminal passages, and the state of the genital organs, &c., &c.—facts to which we shall recur hereafter—all contribute to render this case interesting.

We shall see, in the following case, also related by M. Dalandeterie, an instance of vertebral caries in an onanist:—

A cook, forty-five years old, of bad constitution, but having always enjoyed robust health, indulged in masturbation, although not to very great excess. Eighteen months before his case was published, he perceived pains and weakness in the loins, frequent colics, often followed by brownish dejections, and sometimes by obstinate constipation. He suffered, too, from flatulency; and in the left haunch there was a pain, which increased or diminished with this flatulence.

The patient, notwithstanding the progress of these symptoms, continued to masturbate. Debility and pains in his loins extended into the abdominal limbs, and increased so much, that he was obliged to keep his bed: he could only lie on his left side; but in this position his motions were easy. The diminution in the natural heat, the livid color of the skin, the softness and flaccidity of the flesh, debility, loss of sleep and of flesh, thirst, constipation, &c., were added to the symptoms already mentioned.

At the same time, a hard, indolent tumor, the size of a pullet’s egg, was formed at the lower part of the dorsal region. This tumor, which did not enlarge, evidently resulted from the prominence of the spinous processes, and consequently from a curve in the spine, which was doubtless caused by a softening of the bodies of the vertebræ.

Nearly at the same period, there was developed, at the lower part of the sternum, a hard, indolent tumor; the color of the skin was unchanged: it gradually became the size of a nut, suppurated, and assumed the appearance of a scrofulous ulcer. The lymphatic ganglions of the neck, which were somewhat swelled, now returned to their natural size. The treatment was similar to that used in the former case, and was attended with the same result: the strength, bodily heat, and appetite returned. Finally, the patient was able to walk with crutches; and could stand, unsupported, for a few moments.

The circumstances in this case are not detailed with sufficient accuracy, to enable us to follow exactly the cause of the symptoms. We would remark, however, that one of these seen first was the neuralgic pains, which extended from the loins into the lower extremities. Now, as this symptom belongs to irritation of the medulla or its membranes, more than to their compression, there is reason to think that this irritation preceded the curve of the spine. In this patient, also, as in the preceding case, the affection of the marrow had not so much influence in causing the destruction of the bodies of the vertebræ, as a disposition to caries—a disposition which was evidently increased by onanism, and which appeared at the same time in several bones.

The following case, from Meyrieu, is not sufficiently detailed, to affect in any manner the question, how caries of the vertebræ is produced in onanists; but it is interesting, as it shows that the disease may extend to the soft parts which cover or are adjacent to the affected vertebræ.

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.

Sanson, also, places voluntary and involuntary pollutions among the asthenic causes of amaurosis: he, however, regards these pollutions as sometimes causing irritation of the retina. He assimilates them, as do many other authors, to all abundant discharges of fluids. The following case has been considered by him as one of asthenic amaurosis, produced in this manner:—A notary’s clerk, twenty-four years old, experienced for a year a progressive debility in his sight. He had labored much at night, by lamp-light, and attributed his disease to this cause; but another, which had contributed to the development of the amaurosis, was the excesses of this young man, in onanism and coition. Venereal disease, which he had contracted, might also contribute to this bad result. The pupil was dilated; the iris was immoveable; the eye was perfectly clear; and the retina, of a dull color, could be seen through the pupil. An antivenereal treatment, purgatives, emetics, and blisters around the organ, &c., produced no effect.

In my opinion, blindness from amaurosis, being not so much a disease as a symptom, or rather the consequence, of many other diseases, is not, in onanists, the result of exhaustion, of asthenia, any more than the debility and paralysis of the lower extremities are, when the spinal marrow is diseased. Besides, what difference does it make, how the sight is lost in onanists? the most essential thing to be known is, that they can lose it. This unfortunate circumstance is to be dreaded by those whose sight is much affected during the act of venery, and who remain, as it were, in a mist for a few moments after this act. Thus, amaurosis was predicted in a public girl, whose case is mentioned by Hoffmann, and whose sight was obscured whenever she had connexion with men. She finally became blind. (De morbis ex nim. ven., § 26.) The sight is rarely lost suddenly: it commonly fades away gradually; and the onanist, if he can understand this warning, may, by abandoning his bad habits in time, preserve the vigor he still possesses; and, sometimes, even may recover what he has lost.

The weakness and loss of sight, and the other affections of the eye already mentioned, are not the only ones which may arise from excessive onanism or coition: the muscles of the eye may also be affected. Lorry was, we believe, the first to notice this fact. “The eyes,” says he, “are affected with convulsive and spasmodic motions, after venereal excesses, rather than with blindness.” He states, that strabismus may be caused by onanism. We have before stated the case of a young man, whose eyes were affected with violent spasms at the moment of a discharge of semen. Demours has observed similar facts. “Masturbation,” says he, “affects the optic nerves, and also acts on the motor nerves of the eye.” He admits that he can see no reason for this. The same author mentions venereal excesses among the different causes of partial paralysis of the muscles of the eye.

We have already mentioned the wandering pains, which frequently affect onanists; we have also alluded to those which depend on an affection of the spinal marrow. We have reason to think, from our own observations, and the statements particularly of English authors, that the number of pains dependent on an affection of the spinal marrow is much larger than is generally thought: we think, that most of the pains termed rheumatic, particularly those affecting the trunk and the limbs, are neuralgic; and that most of these neuralgias proceed from an irritation of the medulla or its membranes. We do not say that the spinal cord is always affected then, as in those cases of myelitis which attend paralysis and death: we think that it is affected in some manner; and that these pains, which are commonly so severe, and frequently so general—sometimes attended with tumefaction, but more frequently without it—which are felt in the course of these nerves, are the usual consequences of this affection. Hence, it is not surprising, that the act of venery, which excites the nervous system so much—which has so marked an action on the spinal marrow, has frequently predisposed to neuralgic or rheumatic pains, and has directly caused or increased this kind of pains. It is well ascertained, and many authors—particularly Hoffmann—have remarked, that those who indulge in onanism, during youth, are more subject to these pains than others. The act of venery, even when indulged in to a moderate extent, generally increases their violence. I have often seen attacks of neuralgia supervene immediately after coition. It was an affection of this kind which was felt by the onanist who wrote to Tissot, that he felt in his face a pain similar to that caused by applying a great number of pins.

Individuals who have braved the usual causes of rheumatism with impunity, not unfrequently become vulnerable to these causes after venereal excesses. M. Villeneuve relates the case of a stonecutter, who had long been exposed to changes of weather without inconvenience, and who was violently attacked with rheumatism after unusual venereal excesses. He also mentions the case of a groom, who had long slept in a damp and narrow stable without suffering, but who was attacked with rheumatism the winter after his marriage. Saucerotte has seen a similar case: it was that of a man who had constantly braved the changes of weather, and who was affected with rheumatism after indulging in women and wine. The same author has established, in the memoir where this fact was reported, that muscular rheumatism is only a variety of neuralgia. Among the proofs which he gives of it, he states that many authors, as Barthez, Scudamore, Chaussier, Olivier, and Ferrus, have placed venereal excesses among the causes of neuralgias and those of rheumatism.

Most authors have considered these excesses as one of the predisposing causes of gout. Hippocrates, probably, entertained the same idea, if we may judge from these two aphorisms:—“Eunuchi neque podagra laborant, neque caluescunt. Puer podagra non tentatur ante venereorum usum.” Sydenham also regarded excessive indulgence in venereal pleasures as tending to produce gout. Guilbert remarks, that even hereditary gout is neither a disease of infancy nor of youth: he admits, however, that venereal excesses may produce it before the time it generally appears. Roche exclaims against this opinion: he thinks that venereal excesses can only cause attacks of gout. He says—

“What influence have masturbation and venereal excesses in producing gout? According to men of the world, and even to some physicians, they are the most fruitful source of this infirmity: and yet on what facts does this opinion rest? On this, that several gouty people have been great libertines in their youth. But how many chaste persons, and how many prelates, too, are attacked by this cruel disease? On the other hand, are there not as many, and even more libertines among the poor, than among the rich? and yet, in general, they are not attacked by the gout. Finally, the shameful vice of onanism is observed most frequently among the young; and we have already said that gout is a disease of manhood and old age. Hence, it is wrong to attribute to this order of causes a part of the influence which it has not, and cannot have, in producing gout. Here, doubtless, has been committed the error which has been several times pointed out: attacks of gout have frequently been known to supervene after venereal excesses or masturbation; and it has been concluded that these causes concur powerfully in producing the disease itself. Good living and gormandizing are, we repeat, the real—the only sources of gout: sobriety, frugality, are the best preservatives from it.”

This last phrase shows clearly the origin of Roche’s opinion. It is evident that he denies the influence attributed to venereal excesses, in the production of gout, only to sustain a favorite theory. Roche certainly never would have said, that there is more libertinism in the lower than in the higher walks of life, if he had not been preoccupied with the desire of proving that good living is the cause of gout, to the exclusion of every other cause. It may be asserted, that one mode of living predisposes to the gout more than another; and we will agree with every author, that this disease appears particularly in individuals who are well fed; but we cannot admit, that the possible action of certain influences, as that of venereal excesses, should be denied. Impressed, however, with the vast extent of the influence of venereal excesses, and with the uncertainty of its limits, we prefer to allow, with all authors, that venereal excesses, like many other known and unknown causes, may predispose to gout. This opinion seems to be more logical than that sustained by Roche with his usual ability.

Roche, also, in accordance with other authors, regards venereal excesses as injurious to those affected with gout. “The indulgence in venereal pleasures,” says Barthez, “should seldom be permitted to those affected with gout; for they should abstain from whatever weakens or exhausts. Coste, who has written on gout, is much more formal. “A gouty person,” says he, “should choose between living apart from his wife, and being cured of his disease; or caressing her, and rendering his disease incurable. Whenever a gouty person sees a female,” he adds, “if young, a new root to his disease sprouts forth; and if he be old, he drives a nail into his coffin.” This opinion differs from that of Pietsch, who maintains that gout arises from the absorption of vitiated semen, which is retained by continence in the seminal vesicles.

Can venereal excesses cause hemorrhoidal affections? For want of facts on this subject, we would remark, that these excesses may contribute to develop these affections, and particularly the exacerbations to which they are subject. This was Montegre’s opinion: he admitted, that the nervous debility which resulted from the abuse of the genital organs, generally favored the occurrence of fluxes, motions which occur most frequently in people subject to hemorrhoids; and also, that in those females who have hemorrhoidal tumors on the rectum or vagina, the abuse of coition may excite inflammation of these tumors. Montegre, however, thinks that excessive continence has a more detrimental effect on those affected with hemorrhoids than the contrary. He thought that the irritation which extreme continence causes in the seminal vesicles and adjacent parts, may excite a hemorrhoidal paroxysm: hence, he regards the act of venery as generally useful to persons affected with hemorrhoids, provided it is confined within certain limits. On this opinion, we would say, that if the irritation of the seminal passages may extend to the adjacent passages, venereal excesses which produce this irritation may also cause inflammation of the hemorrhoidal tumors much more frequently than continence. This is the opinion of Begin, also, who mentions, among the direct causes of hemorrhoids, “excesses in venereal pleasures—excesses which are always attended with a state of orgasm and vascular fulness in the genital system, and in all the parts connected with it; and particularly in the lower region of the rectum, which receives the same vessels in the neck of the bladder, the prostate gland, and the seminal vesicles, in the male, and in the uterus and vagina in the female.”

We may believe, from the enervating action of masturbation, that the development of scrofula may be excited or favored in those young patients who are addicted to it. Few proofs of this, however, are found in authors; and it is rare to find records of scrofulous symptoms in the histories of those onanists which have been published. It, however, would be absurd to conclude, from this silence, that the coincidence of these symptoms and the ordinary effects of onanism never occur, or that this habit cannot call into action a disposition to disease. But we must admit, that if masturbation be an active cause of this disease, this fact would have been noted more frequently.

Further: Certain circumstances seem to indicate, that onanism must be but little favorable to the development of scrofula. First, onanism renders the limbs thinner, dries them, then deprives them of those white fluids with which the flesh of scrofulous persons is generally infiltrated. Next, since in these latter the sensibility is as it were blunted, and the susceptibility is slight, onanism tends to excite them. Besides, one of the most common effects of the action of the genital organs, at puberty, is the disappearance of scrofulous engorgements and other symptoms, if they exist. Sometimes, the normal development of the genital apparatus excites in those who have arrived at puberty the swelling of the lymphatic ganglions of the neck, axillæ, and particularly of the groins: but in this case, these ganglions are painful, and present a kind of inflammatory state, analogous to that which is attempted to be produced when they are affected with scrofulous engorgements. Cabanis has well described what then takes place:—“From the time,” says he, “that the evolution of the genital organs commences, there is a general motion in the whole lymphatic apparatus; the glands of the groins, the mammæ, those of the axillæ, and neck, swell: they often become painful. It is not only in girls that the mammæ swell; in young men, I have frequently seen them form tumors, which seemed inflammatory: they have often been considered as such by ignorant quacks. This symptom generally causes uneasiness in those who experience it: but this depends not so much on the pain, (which sometimes impedes the free motions of the body,) as on the influence of this new action—the commotion caused in the imagination by the new system.” This state of the lymphatic system would be, as is seen, rather antithetic, than analogous to what is seen in scrofulous patients. Farther: we have only to compare the eunuch with him who has vigorously passed through puberty, to see that the action of the genital organs is not adapted to favor the development of this affection.

The act of venery often causes, also, ganglionary swellings; but they do not resemble scrofulous engorgements, more than those which arise from the influence of puberty. “The first essay of venereal pleasures,” says Cabanis, “is often necessary to complete the development of the genital organs: thus, the general swelling of all the parts where the glands are situated, especially of the bosom, of the anterior face of the neck, is often the consequence of this great commotion. The characters which manifest this swelling are much more remarkable in females; hence, perhaps, the old physicians, and even some moderns, have stated the sudden swelling of the neck in young girls as a sign of defloration. But it is wrong to consider this as a general and certain sign: it is certainly not one.” If the act of venery can produce such an excitement in the lymphatic system, it ought to be still more manifest when a part of this system is already inflamed. This is confirmed by a fact stated by Lordat, in the bulletin of the scientific society of Montpelier. It relates to a young woman, in whom the jugular glands being swelled, a few days after her marriage, increased or diminished in size, according as she yielded to her husband’s embraces or not. Thus, then, if we consider the genital organs, either during the acute period of their development, or when the act of venery is indulged in, we see that they extend their action to the lymphatic apparatus, as they do to the other systems; but in a manner which seems the reverse of that reputed to favor the production of scrofula.

Symptoms, however, analogous to those caused by scrofula, have been known to occur where there is evidence of venereal abuses. Two cases, which we have already quoted from M. Dalandeterie, are instances of this. The first relates to a young man, twenty-four years old, whose health, before he was addicted to masturbation, had been good; and whose parents, so far as could be ascertained, had never been diseased with scrofula, and had never presented any disposition to the disease. First, he was affected with numbness in the little finger of the right hand, and the ring-finger of the left hand; the articulations swelled, and formed in these parts tumors, which were regarded as scrofulous, and which were soon followed by ulceration and caries. The patient experienced no pain; and only felt an intolerable itching. The lymphatic ganglions of the groin and axillæ were permanently swelled; and the bodies of several vertebræ became, as we have seen, affected with caries.

The other patient, who was forty-five years old, presented an advanced case of myelitis, and caries of the vertebræ, when there formed, at the lower part of the sternum, a hard and indolent tumor, which soon became apparently a scrofulous ulcer. The pus from this ulcer was ichorous, and the edges were of a violet red, swelled and hard; and the soft parts adhered to the subjacent bones. The lymphatic ganglions of the neck swelled for some time, but they then returned to their natural state. M. Dalandeterie adds, that these two cases have been selected from many other similar or analogous facts: hence, he considers caries of the vertebræ as having then been the consequence of a scrofulous principle, which was developed by onanism.

If, however, we carefully analyze these facts, we shall find that they do not indicate a scrofulous disease, the development of which was but slightly favored by the age of the patients, as a tubercular affection—that is, a disease which might be developed at every period of life. We think that tubercles were developed, in the phalanges, in the first case; and in the sternum, in the second; that these tubercles softened, and suppurated; and thus were formed the apparent scrofulous ulcers presented by these individuals. Probably, a similar circumstance occurs in the vertebræ, the bodies of which are destroyed; for distinguished observers, especially Delpech, have regarded Pott’s disease as a tubercular affection of the body of these bones. The cases of Dalandeterie would prove only that onanism favors the development of tubercles. Unfortunately, they are not the only cases, as we shall see, which establish this fact.

Consumption, or phthisis tubercularis, is, in fact, one of the diseases caused most frequently by onanism. The act of venery—that power which has so much influence on the internal life of the tissues, and on the respiratory organs, and which, to use Rullier’s expression, seems to agitate the lungs—is commenced in most onanists exactly at that age when the chest enlarges in every direction, and which phthisis seems to prefer. “How many young persons,” says Portal, in his work on phthisis pulmonalis, “have been victims to their unhappy passion? Physicians find those every day, who remain imbecile, or who are so enervated, physically and morally, that they barely drag along a miserable existence: others die with marasmus; and many with phthisis pulmonalis.” In another work, the same author relates the case of a young person, seventeen years old, who was addicted to masturbation, and who fell a victim to this disease. This young person, who had became much deformed, was affected with raising of blood, and soon died of phthisis. “It results from numerous well ascertained facts,” say Fournier and Begin, “that those persons who indulge in onanism are generally remarkable for the imperfect development of their thorax, and for the promptitude with which the least exercise renders respiration difficult and hurried. Almost all these individuals contract chronic catarrhs, or more serious affections of the pulmonary organs; and finally perish, in a complete state of phthisis.” Broussais, also, places among the causes of phthisis pulmonalis, “erotic spasms, no matter in what manner they are excited.”

We have seen this affection, more frequently than any other, resulting from onanism. Among other instances, we would mention that of a young man, who died in 1833. This young man sustained himself so well in public debate, that he was placed, at the expense of government, in a public school. He was then sixteen years old; and his health, which had previously been good, now failed. He became pale, languished, and grew thin; and this, too, although his appetite was keen, and his digestion excellent. Having my suspicions, and having communicated them to the patient, and also to other persons who could enlighten me, we were led to believe, from the answers made to me, that the too rapid growth of the body was the only cause of the state presented by the patient; and his state varied so little from that of health, that the young man assured me that he was very well. I therefore simply directed him to take more exercise, and to be more free in his diet. His loss of flesh, however, and paleness continuing, his parents felt anxious about him. I examined his organs separately: I could find none presenting any marks of disease, or which could explain the general state of the patient. My first suspicions then returned; but on questioning him, the same answers were given. The patient, who had already seen an instance of the bad effects of onanism, in the person of his younger brother, seemed deeply impressed with the danger of his habit. He, however, continued to lose strength. One day, after taking more violent exercise than usual, he fainted away. At the same time, a dry cough supervened, to which the patient at first did not attend. This was the first symptom indicating an affection of any particular organ. This cough soon became more frequent; and, by means of auscultation, we found that the respiration, at the summit of one of the lungs, was imperfect. At this time, the patient avowed to his father his deplorable habit. This had been contracted at school; it had been indulged in for two years; and of late, much more frequently than before. His danger was fully pointed out to him; parents, friends, physicians, all conjured him to abandon this secret vice. Treatises on onanism were placed in his hands; and every attempt was made to arouse in him the feeling of self-preservation. He was terrified; but the power of the habit was so great, that he did not leave it off till consumption had progressed very far. Deep abscesses successively formed in his lungs; the expectoration soon became purulent and excessive. Night sweats and diarrhœa followed; and the patient died in a terrible state of marasmus and exhaustion.

In 1829, we prescribed for a young man, whose career was much more rapid. He had always enjoyed excellent health; and his parents exhibited no marks of consumption. Having married a very pretty widow, he indulged himself with her very freely at night, while during the day both were assiduously engaged. The female was seven or eight years older than her husband, and did not suffer much. He, however, soon became affected with cough, attended with bloody expectoration. When consulted, we informed the patient of his danger, unless he changed his mode of living. Our advice was not followed; and shortly after, hemorrhage from the lungs supervened so abundantly and obstinately, that notwithstanding the most active treatment, he died in eight days.

The young man, too, mentioned by Tissot, was also doubtless affected with phthisis. “He came to Montpelier to pursue his studies; but was affected with phthisis, from excessive onanism: and I remember that his cough was so hard and constant, that all those who were near him were incommoded by it. He was frequently bled; doubtless, with a view to his relief. On consultation, he was ordered to go home, and take turtle soup; and two hours after, he died.”

It is with phthisis, as with most of the other diseases, caused by masturbation. This habit causes disease, by cherishing and by cultivating special dispositions. Thus, the onanist born of consumptive parents, whose chest is narrow, with a long neck and thin limbs, and who presents symptoms of scrofula, is more liable to be affected with phthisis or consumption. This was the case with a young man, as mentioned by Rozier. This patient was evidently scrofulous, and many members of his family had been affected with the disease. He remained, however, pretty well until he was eighteen years old, when, in consequence of a contusion in one of his legs, he became affected with an ulcer, which was a long time healing. After it was cured, however, he remained in good health, and was lively, animated, and intelligent; but when twenty-five years old, he commenced indulging in onanism. He soon felt oppression at the chest, and cough; and although the affection of his chest increased, and he was aware of the dangers of onanism, he continued to indulge. Many physicians were consulted; but he did not mention his bad habit. The affection of the lungs continued; his sleep was interrupted; hectic fever supervened; his cheeks were tinged with an unnatural color; and his expectoration was grayish and purulent. The patient then decided on avowing his habit. Rozier attempted, in the most touching and persuasive manner, to induce him to abandon it; but in vain. Consumption continued to progress; and he was soon unable to talk, to move, or to make the least motion, without danger of suffocation. After remaining in this horrid state three years, the patient died.

We have already remarked several times, that the respiration in onanists is frequently affected. Their breath is often short; they pant on the slightest exercise; are subject to stifling, &c. These symptoms, the existence of which cannot always be explained by that of any organic alteration in the heart or lungs, finally assume, in some individuals, the characters attributed to nervous asthma. The authors who have written on this subject, have all classed venereal excesses among its most frequent causes. “Individuals of a nervous temperament,” says M. Ferrus, “seem most particularly liable to it. But the influence of certain bad habits—as masturbation, the abuse of venereal pleasures by young persons, excesses of the table in old men, &c.—contribute, as powerfully as individual predispositions, to produce this disease.” Jolly remarks, in nearly similar language:—“Venereal excesses and masturbation,” says this distinguished physician, “have appeared in some cases to produce asthma. And if some authors think that too much importance is attached to this cause, they may readily appreciate its value by observing the effects of the venereal orgasm on the pulmonary circulation.” Daily observation proves that persons affected with asthma have generally used the goods of this life freely. To admit that venereal excesses often prepare for or excite an attack of asthma, we have only to regard an attack of asthma, whether excited or not by an organic lesion, as consisting in a spasm of the glottis; or, as Reisessen and Cruvelhier think, of the ramifications of the bronchi.

Our remarks on asthma may apply to diseases of the heart and large vessels. The frequent repetitions of an act which render the emotions so powerful, frequent, and tumultuous, has often produced or increased aneurismatic dilatations of this organ; the thickening of its parietes, or other diseases, of the parenchyma, or of the vessels which leave it and go to it. Thus, the abuse of onanism, and of the pleasures of love, holds a high place on the list of causes of this affection. We have seen dilatations of the left ventricle of the heart, which evidently arose from this cause. “In some cases,” says Fournier and Begin, “palpitations, and even considerable lesions of the heart and large vessels, could have no other cause, in patients whose vigorous constitutions have long resisted the destructive practice of onanism, and who, notwithstanding their excesses, have attained an advanced age.” This last remark is particularly just. These diseases are by no means so immediately dangerous as is generally believed. The principal symptoms of diseases of the heart may exist, although this organ may not be materially altered. A remarkable instance of this may be seen in one of the cases already mentioned. The patient experienced for a long time difficulty of breathing; which increased on walking, and especially on going up stairs. These symptoms were so marked, that on entering the hospital, he exhibited all the symptoms of a hypertrophy of the left cavities of the heart. Four months after his entrance into the hospital, the patient died of the consequences of myelitis; and on opening the body, the heart was found perfectly healthy, of its normal size, and presented nothing unusual in the extent of its cavities, or in the thickness of their parietes.

Among the diseases of the heart which may be caused by venereal excesses, there is one in particular mentioned by Blaud. He thinks that too frequent coition predisposes to polypi of the heart. He maintains, that the act produces its effects, either by weakening the motive powers of this organ, which they over-excite momentarily; or by causing too great an accumulation, and consequently a congestion of blood, in the cardiac cavities. This last fact seemed to him to be proved, by the oppression, the congestion in the head, and the palpitations, which attend coition.

If venereal excesses may cause diseases of the heart, they may increase those which exist. They may also, by causing the rupture of an aneurism, produce instant death. But having already treated of these effects, we shall not return to the subject.

Rachitis, and particularly alterations in the height, have been named by many authors among the ordinary effects of premature indulgences. We have already given, from Portal, the remarkable case of a young girl, who, indulging in excesses of onanism, became humpbacked, and then consumptive. In six months, the curve of the vertebral column progressed rapidly; the chest was depressed at the lower part of the sternum; there was a deep hollow in the epigastric region, while the abdomen was prominent. The same author has observed other similar cases. “I have seen,” says he, “four or five of these unfortunate creatures, from fifteen to eighteen years old, in whom the back was very convex, and the abdomen seemed pressed into the chest; the extremities of the long bones, particularly those which form the elbows and knees, were very much enlarged; the legs were thrown out, and their muscles were scarcely developed; their eyes were sunken; their countenances pale and white; and their voices acute. Any one, to judge of their ages by their looks, would think that they were not more than twelve years old. They were extremely weak, physically and morally, and became imbecile long before they died.” Dr. Richard, cited by Petit, has also seen considerable deformity of the ribs, resulting from onanism. Tissot placed this habit first among the causes of rachitis. M. Lonyer Villermey, also, regards onanism and involuntary pollutions as an active source of deviations in height. On the other hand, Dr. Laguerre, a gentleman who has attended to rachitic persons a good deal, tells us that the habit has been observed by him only once, as a cause of spinal deformity.

It has also been advanced, that premature enjoyment may arrest the growth of the body, and consequently prevent it from attaining its normal height. We do not deny the possibility of such a result. We have seen many onanists, however, grow very rapidly, notwithstanding their excesses, and all the symptoms of extensive alteration. It follows, also, from the researches of Villermé and Quetelet, that the mean height of man is generally greater in the city than in the country; and yet, in the former, masturbation is more frequent. We can see, too, by comparing the increase in weight to that in length, during the first twenty years, that the development of the genital organs exercises much more influence on the mass of the body, than on its height: thus, between the ages of four and fifteen years—that is, during the period of puberty—the annual increase of weight is quadruple of what it was in preceding years. Do not these reasons authorize us to think, that if premature excesses have any influence on the height of man, this action is less than is generally imagined?

Besides rachitis, caries, and tubercles, which have been mentioned, are the bones ever affected with any other disease, in consequence of venereal indulgences? The only case in point is that already mentioned,(p. 85) as reported by Serrurier, of a man who was reduced to a complete state of marasmus, in consequence of venereal excesses and nocturnal pollutions. In this man’s case, a remarkable circumstance occurred. Having attempted, a few days before death, to rest himself from the fatigues of the bed, by spending a few hours in the easy chair, he fractured the bone of his right thigh at its centre, merely by attempting to cross the right thigh on the left. Might not this disease, which is very rare, and is termed friability of the bones, be also caused by the excesses we have mentioned?

These excesses, if accompanied by those of the table, or if indulged in under unfavorable circumstances, may be followed by acute, as well as by chronic affections, and particularly by fevers of a bad character. This result of excessive enjoyments is frequent; and cases of it have been seen by almost every physician. It was known to the ancients. Hippocrates gives the history of a young man of Melibœa, who, after indulging in women and wine, was attacked with all the symptoms of typhus fever. Bartholin knew a person, recently married, who was attacked, after conjugal excesses, with an acute fever, attended with great depression, sinking, nausea, immoderate thirst, &c. This patient was cured by rest and tonics. Hoffmann, who states this case, also mentions that of a man, who never indulged in venereal excesses without being attacked with fever, which continued several days. Tissot, in 1761 and 1762, knew two very healthy, strong, and vigorous young men, who were attacked, one the day after, and the other the second night of their marriage, with a very violent fever, preceded by no chill, pulse quick and hard, wakefulness, many slight convulsive motions, very great inquietude, and dry skin. The appearance of the second was very much altered, and he was troubled with dysuria. He first thought that an intemperate use of wine was in part the procuring part of these symptoms; but I was of a different opinion in regard to the second. They were cured at the end of two days. This circumstance added to the character of the disease, leaves no doubt of the cause.

Sauvages admits, after Dellon, that a typhus of exhausted persons exists. The Portuguese term patients affected with this malady, esfalfados. The exhaustion caused by immoderate indulgence in venereal pleasures, says this author, is very common among the Indians. It is a continued fever, in which the pulse is sometimes full and strong, sometimes weak, and almost imperceptible. The urine is sometimes very red, but transparent; the skin is hot and dry; and there is watchfulness, nausea, and violent thirst.

Farther: All authors who have written on the diseases of warm climates, have mentioned the too frequent repetition of the act of venery among the causes of these typhus affections, which have been termed febris ardens, causus, yellow fever, &c. In temperate climates, adynamic ataxic fevers, &c., and very severe acute diseases, have often been known to occur from excesses in venery, or from masturbation.

If satyriasis and nymphomania have been regarded as rare diseases, it is only because the meaning of these terms has been too confined to embrace numerous cases which, however, have the greatest analogy with those diseases to which these terms are applied. Generally, these persons are considered as affected with satyriasis and nymphomania, who are irresistibly impelled to coition, and resort, to satisfy their desires, to the most indecent actions, and to the most direct provocations. Thus defined, these diseases are rare; and most practitioners have never seen them. But if satyriasis and nymphomania be regarded as an unusual state of heat, by which one is led to desire and to practise not only coition, but the act of venery in any mode, then the scene enlarges, and these affections deserve to be placed among those which are observed most frequently.

We shall adopt the latter sense. In our view, male and female onanists are affected with satyriasis and nymphomania, as much as those to whom these terms are generally applied. In both, the sense of venery, existing to an unusual extent, affects the mind, and incites to dangerous actions, repugnant both to modesty and reason. Onanists do not, like other persons affected with satyriasis, expose their persons, and solicit with voice and gesture those of the other sex: their deranged and delirious imaginations pursue another course. What need have they of the other sex? Their inclinations lead them to solitary indulgence. Their thoughts and actions, however, are not less vile than those of others affected with satyriasis; but they are indulged in secret. Hence, between the satyriasis of books and that of onanists, there is only a difference of form: the foundation is the same. Admit, however, that it be desirable to distinguish this satyriasis from the former, and to give it a special name; is it not better to consider them only as two varieties of the same affection, one of which impels to onanism, the other to coition?

The degree of onanistic satyriasis and of nymphomania depends on the power the venereal sense has over the will. These affections do not exist in those with whom it is optional whether they shall indulge in onanism or not, nor in those who can refrain from coition. Thus, then, a person may masturbate, without being affected with satyriasis. This is the case, when the sentiment of self-preservation is sufficiently strong to resist desires, when the persons yield readily to reprimands and punishments. Satyriasis may be considered as existing to some extent in the onanist, if he cannot refrain. This was the case with a young man, whose history is given by Begin and Fournier. From early puberty, he was addicted to masturbation; and when eighteen years old, he presented some of the bad effects of this habit. This young man was endowed with a brilliant mind: but, although well educated, and although he well knew the dangers of his habit, yet he could not refrain. His good resolutions were formed only to be broken. He died.

In a young woman whom we attended, the struggle with her passions terminated more favorably. It was not the desire of preserving her life, which induced her to leave off her bad habits; but the wish of conforming to the will of her father. Her constitution was already considerably affected, when the cause of it was discovered. The father of this young girl told her how much pain and shame her bad habit caused him, and requested her to abstain from it. She was extremely mild and docile, and made every effort to please and obey him. It was in vain: but whenever she was inclined to masturbate, the fault was confessed as soon as committed. Coercive measures were finally resolved upon. The patient not only consented to have her hands tied every night, but requested it, and even stated the manner in which she might be most effectually prevented from abusing herself. The venereal sense gradually became subdued, and confined within the proper limits. And thus, this habit—or, rather, the nymphomania, which was the result, and also the cause of it—was cured.

Satyriasis and nymphomania, arising from onanism, are most intense, when the persons affected with it can no longer conceal their feelings, but indulge openly in vile manœuvres. We have already mentioned some remarkable instances of this state. The following may serve as the type of the greatest degree of nymphomania. The patient was a little girl less than three years old, who indulged freely in onanism. Neither caresses, entreaties, threats, nor punishments, could correct her. The child grew, however. But at the sight of any pleasant object, she abandoned herself to her manœuvres. At the period of the crisis, she seemed almost entirely to have lost her sight and hearing. Threats and punishments finally restrained her, while in the presence of her parents; but when alone, she still continued her bad habits. This state resisted all remedies. When married, the legitimate sources of enjoyment took the place of the passionate indulgences to which she had been accustomed from infancy. She finally became pregnant, and died in labor. (Dict. des Sc. Med.; vol. xxxvi., p. 566.)

Onanism is not only a direct cause of satyriasis and of nymphomania; it may leave in the genital organs a certain disposition, which, if cherished, may degenerate into one of these affections. The following case, published by Duprest-Rony, seems to us to be an instance of this:—

A young man, twenty years old, of a strong and almost athletic frame, but who had been enfeebled by onanism, abandoned himself, from the age of fifteen to eighteen years, to this destructive habit. He indulged in this habit even while in the bath, and sometimes to the extent of fifteen times in a day. His constitution was enfeebled; his mind was affected; his memory impaired. In accordance with the advice of some prudent people, this young man renounced this fatal habit. During the next two years, he was perfectly continent. His constitution resumed its vigor; his memory and other mental faculties were restored. His parents now placed him with a merchant. He entered upon his new occupations with zeal and activity; but receiving marks of attachment from the merchant and his wife daily, he imagined that she was in love with him. On his side, the passion was returned. Actuated by the fear of violating the duties of gratitude, and the desire of possessing this lady, who was neither young nor pretty, his situation daily became more embarrassing. Whenever she looked at him, erections took place, and there was a discharge of semen. During the night, he had frequent pollutions. His faculties now became deranged: this derangement supervened after reading the Phedra of Racine. He identified himself so closely with the characters of this piece, that he supposed himself to be Hippolyte, and considered his mistress to be Phedra, and her husband as Theseus. More amorous than Hippolyte, and no less virtuous, he threw himself one day at the feet of Theseus, and said, “Theseus! the crime is not yet consummated—your wife is not yet guilty. I have hitherto resisted her prayers—her tears: but I am no longer master of myself; and if she is not removed from my presence, I must yield.” Great was the astonishment of the supposed Theseus. He resolved to send the young man away. This cured the delirium: but the erections and seminal emissions continued. The stomach and intestinal tube became inert. The patient’s appetite was good; but as soon as he ate food, pains occurred in the epigastric region, and uneasiness in the rest of the body. The disease finally yielded to the combined use of antispasmodics and tonics. And now, this young man, who has been married for five or six years, enjoys fine health. (Diss. sur le Satyriasis. Paris, an xii.)

Instead of the disposition just mentioned, masturbation may leave in the genital organs an irritability of a different kind, the results of which are not less disagreeable. A case of this presented itself in a young female, whom we attended. While at board, she indulged freely in onanism. She was married when seventeen years old; and then expected legally to enjoy what had seemed to her the extreme of pleasure. She was disappointed, however: marriage was only the source of uneasiness and pain. She was perfectly insensible to the caresses of her husband—or, rather, in submitting to them, she experienced the most disagreeable sensations. A painful state of spasms and convulsions then affected her, which continued several hours after the cause had ceased to act. We were called to her several times at night, to relieve this state, which caused great anxiety. This lady’s susceptibility, also, was very great; and she constantly complained of some of the attendants of hysteria. She presented every appearance of a lymphatic temperament. During her youth, too, she had been affected with symptoms of scrofula, from which even now she is not entirely free, although twenty-two years old. Do not these circumstances, not generally coexistent with extreme sensibility, prove, that the extreme irritability of the uterine system is to be ascribed to her self-abuse?

Priapism, which signifies permanent erection of the penis, without pleasure, and even in some cases with pain, sometimes follows indiscretions. This has been seen particularly in young children, whose genital organs have been excited: sometimes, too, it occurs in old men. Cœlius Aurelian, (lib. iii., ch. 18,) relates, that an old man was affected with priapism for several months. The erection was firm, like a horn, but not very painful. Finally, it yielded.

The genital organs may, from too much excitement, lose their sensibility, and waste. The manipulations, which at first were followed with the desired result, become unable to excite the genital sense. They may sometimes cause the erection of the penis, and even excite a painful or inconvenient priapism; but they cannot renew the fountain of enjoyment. The remembrance of past pleasures remains; and the onanist, disturbed by their recollection, torments his blunted organs. Obtaining no satisfaction from the modes formerly employed, he now resorts to others, which are sometimes dreadful. His hand which is now armed with some instrument, no longer confines itself to the surface: the surface no longer feels. He now ventures inside, and shrinks from nothing. This continues until these dangerous resources fail, which happens, because they also lose their effect, or because of the severe accidents with which they are sometimes attended.

The following case from Chopart, on diseases of the urinary passages, shows the almost incredible extent of insensibility which the penis may attain, or of delirium which may affect a man, who, having exhausted his faculties by excesses, still remains a slave to his passions:—

“A shepherd of Languedoc, Gabriel Gallien, about the age of fifteen, became addicted to onanism, and to such a degree, as to practise it seven or eight times in a day. Emission became at last so difficult, that he would strive for an hour, and then discharge only a few drops of blood. At the age of six and twenty, his hand became insufficient: all he could do, was to keep the penis in a continual state of priapism. He then bethought himself of tickling the internal part of his urethra, by means of a bit of wood, six inches long; and he would spend in that occupation several hours, while tending his flocks in the solitude of the mountains. By a continuation of this titillation for sixteen years, the canal of the urethra became hard, callous, and insensible. The piece of wood then became as ineffectual as his hand. At last, after much fruitless effort, G., one day in despair, drew from his pocket a blunt knife, and made an incision into his glands, along the course of the urethra. This operation, which would have been painful to any body else, was, in him, attended with a sensation of pleasure, followed by a copious emission. He had recourse to his new discovery every time his desire returned. When, after an incision into the cavernous bodies, the blood flowed profusely, he stopped the hemorrhage, by applying around the penis a pretty tight ligature. At last, after repeating the same process, perhaps a thousand times, he ended in splitting his penis into two equal parts, from the orifice of the penis to the stratum, very near to the symphisis pubis. When he had got so far, unable to carry his incision any farther, and again reduced to new privations, he had recourse to a piece of wood, shorter than the former: he introduced it into what remained of the urethra, and exciting at pleasure the extremities of the ejaculatory ducts, he provoked easily the discharge of semen. He continued this about ten years. After that long space of time, he one day introduced his bit of wood so carelessly, that it slipped from his fingers, and dropped into the bladder. Excruciating pain and serious symptoms came on. The patient was conveyed to the hospital at Narbonne. The surgeon, surprised at the sight of two penes of ordinary size, both capable of erection, and in that stage diverging on both sides; and seeing, besides, from the scars, and from the callous edges of the divisions, that this conformation was not congenital from his birth; obliged the patient to give him an account of his life, which he did, with the details which have been related. This wretch was cut, as for the stone—recovered of the operation—but died three months after, of an abscess in the right side of the chest; his phthisical state having been evidently brought on by the practice of onanism, carried on nearly forty years.”

Whatever may be the degree of degradation attending onanism, we do not think it possible to adduce a second instance of such a mutilation. Gallien’s unhappy idea of introducing a foreign body into the urethra, has often occurred to others, who had availed themselves, but unsuccessfully, of the ordinary resources of masturbation. These unfortunate people have always been obliged to call in medical advice, either on account of the diseases caused by their dangerous manœuvres, or—much more frequently—by the symptoms to which they fall victims, through their carelessness. In fact, the implements used often escape into the bladder; and then the acute suffering and fear of death oblige them to reveal what they had formerly concealed, and to undergo an operation which is always painful, and which is not exempt from danger.

We will give a few instances of this kind of accident. An innkeeper, near Saumur, was in the habit, like Gallien, of titillating the urethra, by introducing foreign bodies. He used an iron wire, seven or eight inches long, the end of which was crooked like a hook, to obtain, probably, more exquisite pleasure. One day, while indulging in this singular manœuvre, he suddenly felt severe pain. The membraneous portion of the canal was ruptured. The unfortunate man made several attempts to withdraw the wire; but the hook, which had entered the soft parts, rendered it impossible. Overcome by suffering and shame, he wished to get rid of it; and with this view, he rounded the loose part of the wire into the form of a ring, proposing in this manner to pull upon it more firmly. He exercised this force till the ring was nearly broken, but the iron was still in its place. He now expected death; but the suffering was so great, that he was obliged to call a physician; and Dr. Fardeau, of Saumur, visited him.

The penis, and also the skin of the scrotum, was enormously tumefied: all the tissues which are inserted in the penis were also swelled, hot, and painful. The belly began to be puffy, and the urine was suppressed; the face was red, and the eye filmy; the mind began to be affected; the pulse was hard, frequent, and corded. Dr. Fardeau grasped the loose portion of the wire, pulled upon it slightly, and immediately found that the other end was arrested by an immoveable obstacle. He then examined the parts attentively; and found, to his astonishment, that the hook was fixed in the inner edge of the ischiatic tuberosity. An oblong incision was now made over this part, the hook seized, and the wire was withdrawn through the perineum. The patient was relieved, and finally was completely restored. (Lancette Fr., October 13th, 1831.)

Saraillé has reported a similar case. The patient was fifty years old, and called this surgeon the 18th of October, 1813. He stated that a sailing needle, about four inches long, had unfortunately slipped into the urethra; and the point had become fixed upward, near the root of the penis. After suffering for eight days, during which the presence of this body excited frequent erections, Lallemand operated, and extracted it.

Many individuals have been similarly affected. They have all imagined that they could extract the instrument they used, when some unforeseen accident has deprived them of it. A young man, nineteen years old, whose case is mentioned by Louis Senn, made use of the stalk of a plant, which he introduced into the urethra. It broke; and after much suffering, the operation for stone was employed to extract it, and the calculi which had formed around it. A similar circumstance happened to a man, thirty-eight years old, a patient of Rigal’s. This man introduced into his urethra the stalk of a sword lily, (gladiolus communis.) This stalk broke, fell into the bladder, and after two months of pain and danger, the operation for stone was employed to extract it. It was two inches long; and was already covered with a saline concretion, one or two lines thick. Bonnet, formerly surgeon at Hotel Dieu, at Clermont, stated in his lectures, that a vine-dresser used a vine-stalk for this purpose. During an emission of semen, he dropped the stalk, which entered the urethra, and passed into the bladder, where it caused symptoms which required the operation of lithotomy. The foreign body extracted was three inches long, and three lines thick. Would it be believed, that Civiale has extracted from the bladder of a man, by means of lithotrity, a bean, which was introduced eleven months before, and which gave rise to all the symptoms of stone? A volume might be filled with facts of a similar character. Many may be found in the Ephemerides Curiosorum, Memoirs of the Royal Academy of Sciences, those of the Royal Society of Medicine, and of the Academy of Surgery; in the works of Chopart, Deschamps, Lamotte, Tolet, Morgagni, Van Swieten, Morand, Pouteau, &c.

The dangers of these practices are not simply those which are stated in the facts already mentioned; nor are they confined to exhausting the rest of the sensibility preserved in the genital organs: they finally cause chronic diseases of the urethra and bladder. These organs, when constantly irritated by applications which in individuals not entirely exhausted are always painful—these organs inflame; indurations, ulcerations, and strictures, form in the urethra; after which supervene all the symptoms of acute and chronic blenorrhea, detentions of urine, and catarrh of the bladder.

Venereal delirium has led other individuals to use processes no less ridiculous, and equally as dangerous. The penis of those who are thus unfortunate has remained in the places where it has been introduced, with a view to imitate the natural process better. Sabatier has related the case of a young man, who had passed his penis through the handle of a key. The handle had been pushed far towards the pubis, and the penis had swelled so as to conceal it from sight: the swelling was also increased by the efforts of the patient to withdraw it. After oiling the parts well, the handle was slipped down as far as the glans; but here scarifications were required, to diminish the engorgement, before the penis could be liberated. After this, escars sloughed off, which were followed by cicatrices, which rendered the part deformed, although a sound was introduced into the urethra, to prevent this result.

The same author relates that a young man had passed his penis into a copper ring: this, however, was fortunately divided with a pair of strong scissors. Another used a rough iron ring for this purpose. The penis puffed out, above and below this ring. A locksmith was called in, to file it off, which could only be done by placing small bits of wood between the penis and the iron ring. Much time was required to remove it. In the same manner—that is, by filing—a ring was removed from another patient, where gangrene had threatened to appear.

One of the most horrid cases of this kind on record, is that of a young man, who, on taking a bath, indulged in masturbation, by placing his penis into the hole in the bottom of the tub, made for the removal of the water. The glans soon became so much swelled, that he could not withdraw it. His cries brought him assistance; but it was not easy to remove him from the fetters he had forged for himself. (Dict. des Sc. Med., vol. xxi., p. 167.)

Many similar cases have occurred in Dupuytren’s practice. One was that of a young man who came to the clinical lecture at Hotel Dieu, having the socket of a candlestick, in front of which the glans was enormously tumefied. Being unable, by any effort, to remove it, the cylindrical portion surrounding the penis was filed, and thus taken from him. It would occupy too much room, to enumerate all the facts of this kind which have been noted by practitioners; but a common accident, and which has been seen several times by Dupuytren, is the ligature of the penis by a thread or wire. Some young men, and even adults, have bound the penis in fits of erotic delirium, so that the knot could not be loosed; and a circular section has been made in the skin, and the urethra even has been opened and cut. It is evident, that, in these cases, the only thing to be done is to divide the thread, to dress the wound, and then to introduce a gum-elastic sound, in order to prevent the formation of an urinary fistula, or of an accidental hypospadias.

Another kind of strangulation—which is much less serious, however, than those we have mentioned—may result from masturbation and coition, in those individuals where the opening of the prepuce is too narrow. This prolongation of the skin, after being drawn violently back behind the corona glandis, strangles the penis, as would be done by a foreign body, and cannot be brought again to its primitive situation: there is then a paraphimosis. All authors who have treated of this affection, have placed among the causes of it that which we have mentioned. We have seen several instances of this character. I will cite that of a young boy, seven or eight years old, in whom this accident was produced during masturbation. The glans was tumefied, and the prepuce formed a large fold around it. The frightened parents sent for our assistance. Methodical and long continued pressure soon brought things to their proper state.

Herpes praeputialis, another affection of the prepuce, may arise from the constant excitement of this part. Fortunately, this eruption is a slight disease, and generally terminates in a week or two, even without medical treatment.

Persons who indulge in lascivious ideas, are often affected with a discharge from the end of the penis—and this though there has been no masturbation—of a viscid, whitish mucus, which leaves on the linen spots similar to those produced by the white of an egg. The edges of the meatus urinarius may also be glued together, by the drying of this mucus. This discharge, which has been described by John Hunter, is not a disease, although it has all the appearance of it; and it keeps some people in constant fear, lest they have contracted gonorrhœa. It, however, results from an unusual excitement of the mucous membrane, lining the glans and urethra. Now, if the simple excitement of the venereal sense can cause such an effect, what might not be expected from excesses in coition or masturbation? Thus, these causes are mentioned, whenever the causes of balanitis and blenorrhagia are alluded to. All authors agree on this subject; and if but few cases are brought forward in support of this opinion, it is because the subject has not been disputed. The following is found in a dissertation of Closs. The patient was a young man addicted to masturbation, who had been affected for more than six months with a gonorrhœal discharge, which had been neglected because it occasioned no suffering. The matter of the discharge, however, becoming acrid, green, and yellow, he was obliged to ask medical advice. He protested, under oath, that he had never been exposed to contract disease; and Closs, therefore, considered this blenorrhea as the result of masturbation, in which the patient had indulged even before puberty.

This symptom is seen still more frequently after excesses in coition, especially if attended with excesses in drinking, as Lallemand has remarked, or if one has cohabited with a female whose genital organs were very small. It has often been observed in the newly married, and has sometimes occasioned unmerited suspicions and reproaches. It is said, too, that excesses indulged in by persons whose genital organs are perfectly sound, may produce in one or both of them a more or less intense blenorrhea. Cullerier and Ratier say, that they have verified this fact several times. Can such a blenorrhea be communicated? Cassan, in the Bulletin Universel of Ferussac, has inserted a note, in which he states that many of the facts observed in man and animals, particularly of the genus Bos, prove, that blenorrhea, which is simply the result of venereal excesses between healthy individuals, easily assumes a contagious character, and is attended with symptoms analogous to those of syphilis, and requires the same treatment.

Inflammation of the urethra may become very intense, and extend to the bladder, particularly when venereal excesses coexist with intemperate habits: the discharge of urine may then be interrupted, and consequently all the symptoms of dysuria and strangury may supervene. Chronic catarrh of the bladder is often observed, also, in those individuals who have abused the pleasures of love.

Montegre, speaking of a kind of cystitis, which he terms vesical hemorrhoids, mentions among its causes venereal excesses, and particularly those repeated titillations, which keep the genital organs in a state of semi-orgasm, which is not terminated by any crisis.

Lallemand reports the case of an individual, who, being addicted to venereal excesses, experienced frequent desire to urinate, and found it difficult to empty his bladder. Finally, unable to pass water without the use of a sound, he learned to introduce it himself. This was not difficult, although the bladder could not be emptied without it. The urine was turbid, thick, and deposited a great deal of glairy mucus, which adhered to the pot de chambre. The prostatic portion of the urethra was cauterized, but without success. Lallemand thought that there was a morbid development of the middle lobe of the prostate gland. In another patient, whose history is given by this excellent observer, excessive masturbation appeared to have predisposed to a chronic inflammation of the genito-urinary organs, which were developed under the influence of the abuse of coition. (Obs., &c., p. 440.)

It is easily seen, that if coition and masturbation may cause all these inflammations, so, too, they may sustain and increase them. The pleasures of love, therefore, should be strictly forbidden to persons affected with diseases of the genito-urinary passages. Acute inflammation of the urethra, blenorrhagia, has often been known to pass to a chronic state by a single act of venery; which, says Lewedrain, may even cause this change several months after the apparent termination of acute blenorrhagia.

May an incontinence of urine be produced by excesses in coition or masturbation? We have more than once seen this disease in young onanists. Sainte Marie, also, places it among the symptoms of daily involuntary pollution; and Lallemand has remarked, that most individuals affected with this pollution had been subject, in their infancy, to incontinence of urine. May not the relations between these two affections extend to the causes which determine them?

One of the most common causes of excesses in venery is, the involuntary loss of semen. This disease, which has been termed spermatorrhœa, involuntary pollution, may also arise from other causes; but as it results most frequently from excesses in masturbation or coition, we shall devote particular attention to it.

Let us consider the mode in which the excretion of semen takes place in the normal state. It is the remote consequence of a voluntary action, and the immediate result of involuntary contractions. The venereal sense is excited voluntarily, either by copulation, or by applying the hand: this excitement is carried to as great an extent as possible; and then a crisis, entirely independent of the will, terminates it. This crisis occurs sooner or later. It may even be quickened or retarded by the will, which may excite or modify the venereal sense; but when it does take place, it is always by involuntary contractions—that is, by a true convulsion.

This last action has two well marked periods. In the first, the semen passes from the seminal vesicles into the urethra; in the second, this liquid is violently expelled. The contraction of the seminal vesicles—and perhaps, also, that of the levatores ani muscles—are the powers by which the semen comes into the urethra. The ejaculation is caused by the muscles of the perinœum, and particularly by the bulbo-cavernosus muscle. The swelling and hardness of the corpus cavernosum furnish this muscle with a point of resistance, which enables it to compress more efficiently the semen with which the urethra is filled; and the straightening of this canal, by the erection, renders the expulsion of this fluid more easy. All these motions take place by jerks; and, we repeat it, convulsively, without the aid of the will.

The involuntary excretion of the semen, the morbid pollution, may take place sometimes in the manner described, sometimes in another mode. In the first case, it differs from what occurs in the normal state, only not being preceded by those acts which are performed voluntarily by man. Secondly, the semen is excreted without any convulsive effort; it flows like the tears, the saliva, the bile. The semen comes into the urethra, and escapes from it merely because it is there. There is no ejaculation: and this is easily conceived of; for the genital organs are not sufficiently excited, to cause the ejaculatory powers to be convulsed, as is proved by the excessive weakness of the venereal sensation. And, secondly, one of the indispensable conditions of the ejaculation—erection of the penis—does not exist. There are, then, two kinds of involuntary pollutions; one which is convulsive, and the other which is not so. Between these two kinds, there are intermediate degrees, in which spermatorrhœa partakes more or less of one or the other. These degrees often mark the passage from convulsive spermatorrhœa to that which is not convulsive; for the latter has generally been preceded by the former. We shall see hereafter, that the existence of one of these affections does not forbid that of the other; and that the ejaculation of semen is possible in some individuals who present habitually an insensible flow of this fluid.

Involuntary pollutions have been distinguished until now in another manner: they have been divided into diurnal and nocturnal. These distinctions are founded only on accessory circumstances. What difference does it make, whether the pollutions occur by night or by day, provided they are similar in other respects? If, on the contrary, there are more essential differences, why not give to them the importance they demand? Farther: is not convulsive spermatorrhœa, like that which is not convulsive, seen both at night and day? These are the reasons why we have sought to distinguish these affections more logically, and which have led us to propose the new distinction just mentioned.

Convulsive spermatorrhœa may occur in all individuals, and under the influence of a great many causes, without being necessarily a disease. After excessive continence, it may even prove a salutary crisis. This pollution has a pathological character, when it is repeated too often, or under unfavorable circumstances; and then it produces the same result as excesses in coition or masturbation, and generally occurs only in individuals already enfeebled by this kind of excess. Sleep is the most favorable state for an attack of spermatorrhœa; and from this circumstance it is called nocturnal pollution. The temperature of the bed, and lying on the back—circumstances which favor the warmth and excitement of the lower part of the spinal marrow—may also cause the convulsive excretion of the semen. But another cause of it is, that during the sleep of the external senses, the internal senses have control, and have more power, because the action of the others is completely suspended. Cabanis remarks this fact, in saying that the genital organs do not participate in the repose of the external senses, but seem to be more excitable when these are asleep. We consider, that what takes place then is analogous to what is observed in idiots, who, deaf, blind, and dead to all the feelings of relation, abandon themselves to every excess, to satisfy a sense, the excitement of which in them often amounts to constant satyriasis.

If the sleep be very profound, pollution may take place without the consciousness of the patient, or, at any rate, without his remembrance of it. When he wakes, the loss of semen is then discovered only by its stain, and the state of fatigue, weakness, and malaise attending it. A lascivious dream, however, generally attends a pollution. These dreams are not, as is generally thought, the cause of the pollution: if they exist, it is because the venereal sense, which is excited, speaks for itself, even as hunger, thirst, or any internal sensation may do. These dreams have a peculiar character, which has been pointed out by many writers. The individual is rarely placed in voluptuous circumstances, where his imagination places him during his waking hours; but he is surrounded by females who are hideous and repelling, and whom he is as it were compelled to enjoy.

In fact, these pollutions fatigue more than those which are excited voluntarily. On rising, the patient experiences a general and more or less distinct feeling of feebleness and of suffering. His loins and limbs seem as if he had taken a long walk, or as if they had been bruised; the countenance is pale; the eyelids are swelled and bluish; the patient is sad and stupid. Finally, he presents physically and morally the consequences of an abuse of venery. It may readily be imagined, that the periods of spermatorrhœa render the exhaustion more rapid than the voluntary excesses already commenced. If, contrary to custom, the onanist remains one night without pollution, the organs which he permits to rest supply the unaccustomed activity. Happy is he, when these symptoms do not seem to him an evidence that this flow of semen is necessary. Every thing which specially excites the genital organs, as lascivious thoughts, voluptuous sights, riding, a soft and warm bed, &c., and also every thing which produces a more general excitement, in which these organs participate, as wine, liquors, coffee, spices, &c.; are so many causes which combine with the direct provocations of the patient, to multiply the causes by which he is excited.

The nocturnal pollutions, however, are not formidable to those onanists who are reformed. Inspired by the sentiment of self-preservation, warned by the sufferings, counsels, and by reading, they have resolved to abandon for ever the manœuvres which they know to be dangerous. This resolution they will be able to keep: they, however, anxiously demand if they are not too late. The genital organs rebel against the decision. How melancholy must be the state of the patient! He sees, in perspective, sufferings, even a death, which seems to be inevitable. To avoid it, he had made a sacrifice; he has abandoned those tastes which exercised such absolute control over him: but his organs, which have been irritated, continue the work which he wished to interrupt. He is irritated—he despairs. Let him be of good cheer; when the will perseveres, it generally triumphs. I attended an onanist, who was suddenly converted by reading the work of Tissot, and who experienced all the troubles to which we have alluded. He was constantly tormented by the remembrance of the past night, and the fear of that which was to come. He slept on a coarse bed; and always enveloped the privy parts with linen, wet with vinegar and water, before going to sleep; promising himself to awake, as soon as he was assailed by dreams. By his will, however, he finally succeeded; and he had the power of watching himself during sleep. His pollutions gradually became less frequent, and finally disappeared entirely. This is generally the case where all bad habits cease.

Convulsive spermatorrhœa is not very common, while a person is awake: it then rarely presents the purely convulsive character, with perfect erection, and distinct ejaculation, that is seen in a healthy emission of semen. This state, however, is possible: an instance of it may be seen in the case of satyriasis stated by M. Duprest-Rony. Whenever this young man beheld his mistress looking at him, erection took place, and ejaculation followed. He, however, had refrained from masturbating for two years, and had regained in a great measure his former strength. M. Sainte Marie has reported a case of priapism, during which the patient ejaculated fourteen times in a few hours. But this affection was not in consequence of venereal excesses, and the emission of semen presented nothing more extraordinary than other cases of priapism. Diurnal convulsive pollution is seldom accompanied, in individuals exhausted by abuses of masturbation and coition, with a perfect erection. The size of the penis increases, but it does not become hard. The semen is then emitted only to a short distance, if there be any ejaculation. The least cause, the slightest touch, is sufficient to excite this. Thus, in a man thirty years old, whom Tissot has mentioned, after Boerhaave, the semen escaped whenever there was a commencement of an erection, for it was never complete; and instead of being expelled forcibly, it oozed out drop by drop. The patient became impotent. This symptom (adds Tissot) is very frequent among those who are exhausted, and it contributes to continue the exhaustion. The slightest excitement causes the commencement of an erection, which is followed by an emission. We have seen a similar phenomenon in one of the patients of M. Dalandeterie. There were frequent painful erections, of short duration, which always terminated by a more or less abundant discharge of fluid. These kinds of pollutions were always painful, and were followed by extreme prostration. It is evident, from the remarks we have quoted, that there was no ejaculation in this patient; and probably, also, the erections, though painful, were imperfect. Daily convulsive spermatorrhœa assumes then, as it were, a bastard character in onanists: it occupies an intermediate place between proper convulsive spermatorrhœa, such as occurs during sleep, and the non-convulsive spermatorrhœa, which we shall mention directly.

There is a phenomenon very similar to this bastard spermatorrhœa, and which shows itself when the patient is inclined to indulge in coition or masturbation: the emission of semen takes place on the commencement of the act of venery. It is a quasi involuntary pollution. In this case, which is by no means rare, the erection is not complete, simply because there is not time for it to be so, the premature emission of semen not admitting it to be perfect. Sometimes, erection is radically impossible, and prevents the ejaculation. This was the case with the onanist who wrote to Tissot, that the semen would flow, but there was no ejaculation. Farther: when there is no erection, either because this is impossible, or because the semen is discharged prematurely, the person becomes impotent, because the power of procreating requires erection and ejaculation.

In persons affected with spermatorrhœa, the seminal fluid must preserve its normal characters. It is generally thinner, less opaque, and similar to serum: sometimes it resembles a fetid sanies or corrupt mucus; in other cases:, the seminal vesicles are evidently affected. Sometimes, blood is exhaled from these vesicles, and is even ejaculated. We have already stated instances of this emission. Tissot, also, has published a case of it. It was a young man, less than sixteen years old, who indulged in onanism to such an extent, that blood was finally emitted, instead of semen. This emission was soon followed by excessive pains, and an inflammation of all the genital organs. We must remark, that blood never seems to be discharged, unless the pollution is excited directly: this, at least, would seem to follow from the cases stated, and particularly from one mentioned by Dalandeterie. The erections (said he) always terminate with a more or less abundant flow of mucus—perhaps, also, of prostatic fluid, or even of a very diluted semen. In ejaculations excited by the hand, a semi-clotted, blackish blood comes, instead of semen: sometimes, a teaspoonful is discharged. This is always attended with pains, and followed by great prostration.

We have seen that involuntary pollution may take place, like voluntary pollution, by the convulsive contraction of the ejaculatory muscles, with erection of the penis, and sensations of venery. We have also seen, that the semen may be discharged, although the erection of the penis, the sensation of venery, and the convulsive contraction of the ejaculatory muscles is slight, and almost nothing. When this exists to a still greater degree, we have non-convulsive spermatorrhœa, or diurnal involuntary pollution, as it is called: here there is no erection, convulsion, nor ejaculation; there is no feeling of venery; the semen flows, instead of being expelled; and there is no feeling of pleasure attending this discharge.