Part 1 — CHAPTER III. SYMPTOMS AND DISEASES CAUSED BY VENEREAL EXCESSES. (continued 3)

This affection may arise from different causes. It is owing most frequently to venereal excesses; and, as but little is known in regard to it, we shall enlarge on the subject. This pollution for a long time was confounded with all the discharges from the urethra, which were blended under the term gonorrhœa. A contrary opinion was then adopted, and the existence of the disease was denied in toto. The remarks of several authors, and particularly of Wichmann, Sante Marie, and Lallemand, place its existence, however, beyond a doubt. The first ideas on this kind of spermatorrhœa may be referred to the earliest periods of medicine. It was known to Hippocrates, who has mentioned (De Morbis, lib. ii., sect. 5) one of the principal symptoms, the loss of semen, during the emission of urine, and of feces, when describing the tabes dorsalis which affects libertines and those lately married. Celsus, also, (De Medicina, lib. iv., ch. 28,) has admitted that there may be loss of semen, without pleasure, without voluptuous dreams, and which may be followed by a fatal consumption. After this, we find no mention of the disease for a long period. Tauvry says positively, (Naw. Anat. raisonnée, 1693, p. 164,) that men who abuse themselves are liable to have emissions of semen on the slightest compression of the seminal vesicles, when they pass urine or feces. Morgagni admits that the semen may escape without any pleasurable sensation, as happens from the effect of an injection which is too warm, and from the excretion of hardened feces; but he adds, that the fluid discharged may come in some from the prostate gland, in others, from the seminal vesicles. There is much uncertainty on this point of science among authors, many of whom have considered as spermatic most of the discharges from the urethra. The dissertation of Wichmann, however, on the subject of diurnal pollution, is valuable. This dissertation was printed in 1782, at Gœttingen. In it, Wichmann states, first, the characters which distinguish diurnal from nocturnal pollution. The first occurs when the patient is awake, and without his experiencing erection or desire. He is unconscious of it; and this circumstance, with the absence of any swelling of the corpora cavernosa, and of all venereal ardor, serves to distinguish this pollution from the flow of the fluid of the prostate gland, or from a loss of semen, which takes place in some persons when they are excited by desire. To these characters, Wichmann adds another, drawn from the mode in which the excretion of semen takes place. In diurnal pollution, (says he,) men do not lose their semen constantly by a continual excretion of this fluid, like females subject to leucorrhea; but they ejaculate, at a single time: and this circumstance has rendered the term pollution applicable to this disease. He does not consider, as a diurnal pollution, the gonorrhœa in which the semen is continually escaping drop by drop. He, however, doubts the existence of this last affection, and remarks that authors are very much confused on the subject. Nor would a pollution which was involuntary, and during the hours of waking, be considered as a diurnal pollution, if the evacuation of semen had been caused by any aphrodisiac substance. And on this topic, he relates the case of a man, who, having been addicted to onanism in his youth, was affected with involuntary pollutions if a blister was applied to him, if he perceived the odor of cantharides, or even spoke of them.

According to Wichmann, the semen never escapes with the urine: thus, it is not a seminal discharge which comes from persons affected with external or internal hemorrhoids, who pass off with their urine a milky fluid. He, however, admits, with Hippocrates, that the straining of persons at stool often occasions, in those affected with diurnal pollution, the discharge of a greater or less quantity of semen. When the existence of this affection is suspected, we must attempt to ascertain its truth; and for this purpose, the patient should be made to urinate freely; and then, in passing the feces, he should sit in such a manner that the penis may be outside, and one can see all that escapes from it in the efforts at stool. In a diurnal pollution, there is rarely as much semen lost as in a nocturnal pollution. The disease is quite as serious, if it be semen which escapes—if it occurs once a-day, and even more frequently; and at the lightest effort to stool, and without any pleasure, to inform one of the risk which is run.

Thus, then, involuntary emissions of semen, while the patient is awake, without erection, without pleasure, and while the patient is ignorant of it; an emission which takes place, not drop by drop, but at one time, and especially while at stool, are, according to Wichmann, specific characters of involuntary diurnal pollution.

The general effects of this diurnal pollution, as he has often observed them, are those seen in onanists. He remarks:—When you see a man extremely thin, pale, stupid, enervated, complaining of great debility, especially in the thighs and loins, lazy in his actions, and with sunken eyes, you have reason to suspect this cause.

Patients in this state never complain of any absolute pain. Their digestive powers are ruined: the appetite, however, continues—even increases, and sometimes becomes voracious. After taking food, they seem to have more strength; but this advantage is soon paid for, by the inconveniences resulting from digestion—especially if that variable appetite be too much indulged. As the stomach and most of the other viscera do not perform their functions properly, the more that is eaten the more the belly is tumefied, by the relaxation of the digestive organs. This swelling is attended with a painful feeling of anxiety, which exists in these unfortunates at other periods of the day, and impels them to avoid society. They are more disposed to sorrow than to joy—that is, the news of an unfortunate event brings with it more sorrow than that of a happy event causes pleasure. In them, as in onanists, there is a want of intelligence; they are stupid; natural sleep does not refresh them; the memory and sight are particularly debilitated. And this is the state of things, until the patient becomes affected with phthisis. At first, neither moral causes, nor affections of the soul, nor disappointment, can be suspected. There is apparently no viscus affected; nor can we ascribe the disease to any deleterious substance concealed in the body, and consuming the flesh. The patient has no pain, excepting that obtuse, compressive pain, which is referred to the hypochondria, and which depends on the swelling of the weak intestines. If you add to the characters the absence of fever, and of the ordinary causes of exhaustion, you may be persuaded that diurnal pollution exists—that it is the hidden cause of all the symptoms. This is a general description of the disease, drawn up from a considerable number of cases which we have observed.

Wichmann, also, remarks the resemblance between individuals affected with diurnal pollution and those affected with phthisis pulmonalis. Experience has taught me, (says he,) that in many patients who have been considered as affected with true phthisis, the disease must be referred to this cause alone. The symptoms of diurnal pollution are not very dissimilar to those of the first period of phthisis pulmonalis, at this purely spasmodic period, which I should be tempted to term insidious, if I considered merely the difficulty and uncertainty of the diagnosis at this period. The cough which then attends some patients, also, leads physicians to dread phthisis: or, rather, consumption, arising from diurnal pollution, assumes so much the characters and form of this disease, that one is disposed to treat it by the ordinary method, to the great disparagement of the patient, whose state requires opposite remedies. Farther: it is clear, that the disease of which we speak must infallibly terminate in phthisis, if it be not soon arrested.

In 1772, Wichmann observed internal pollution for the first time. The case was that of a young man, over twenty years of age, who for a long time had been affected with spasms. “He was manifestly in a state of cachochymia, and of wasting away. The physicians whom he had consulted before he came to me judged, from these appearances, that he was hypochondriac: in fact, different symptoms led to the belief that the disease was situated in the hypochondria. The loss of strength—the languor of digestion, although the appetite was not lost—the paleness of the countenance—the sadness and pusillanimity which led him to seek solitude—the vivid redness which rushed over his cheeks in conversation—his restlessness of character—and, finally, a certain weakness of intellect—seemed to justify the diagnosis. He had formerly indulged with females, and had been affected with venereal disease, to which he attributed his present state. Although there was not the slightest trace of these old affections, the physician, misled by the false conjectures of the patient, had kept him for a long time on mercurial preparations, by which the symptoms were aggravated, the true cause being overlooked.

“Mercury was then abandoned for tonics; and the ferruginous waters were employed, with the idea that the patient suffered from hypochondria. But this was no better than the former treatment; and the patient begged me to take charge of him. I could not attribute the extreme thinness which existed to the remnant of an imperfectly cured venereal affection, nor to the usual cause of exhaustion and fever. I then asked the patient if he indulged with females, or in onanism; or if he was affected with involuntary loss of semen. He almost swore to the contrary. I then told him of his obligation to speak the truth, and assured him that I should not prescribe for him until he was attentively examined. Some days after, he came to me again, and told me that he had been affected with something like loss of semen. I satisfied myself that the observation was correct. The cause of the evil being known, the treatment was simple. In a few months, the patient was restored to health; and this happy effect of the remedies proved that we had attacked the origin of the evil.

“This young man had probably indulged in premature excesses: in fact, this is the most usual cause of involuntary pollution. All the patients observed by me, (says Wichmann,) were from twenty-five to forty years old. All were addicted to the pleasures of love, or to onanism; or had become affected with blenorrhœa, by intercourse with diseased women.

“I am led to believe,” (adds he,) “that the effects of onanism would not be so pernicious, were it not for this diurnal pollution; that without it, this shameful habit would not be followed with consumption, and other symptoms of phthisis. In fact, onanism does not always give rise to this pollution. If this were the case, the number of onanists affected with consumption would be very great. The number of men addicted to this vice from early childhood is immense; for we do not know a greater scourge than this social corruption. From the fact, too, that onanism sometimes produces involuntary diurnal pollution, we ought to investigate if it does not exist in those who have renounced this pernicious habit. Advice to them would be useless, inasmuch as, having renounced this vice, they do not suspect the enervating cause which destroys them. About eighteen years ago, before I had discovered this cause of consumption, I knew a young man, thirty years old, who had been addicted to masturbation from the time he was ten years old, and who learned this pernicious habit from his preceptor. He died, after experiencing all kinds of infirmities, with extreme debility of all his physical and moral faculties. He acknowledged his error, and that for a long time he had renounced his bad habit; but his late return to continence did not save him. Now, I feel confident that this shameful habit had brought on an involuntary diurnal pollution, which caused his death.”

Wichmann remarks, that it is at the commencement of the fine season of spring that the patients are most conscious of their situation. They owe this increase of their ills (says he) to that general procreative faculty which becomes more active in all animated beings at this period of the year. The more full the vesicles of semen, the more liable are patients to lose it. We must also remark, that most patients secrete prolific semen, and preserve their procreative power. This, however, requires the patient to have the faculty of erection; for, otherwise, he would be impotent. This was the case with an individual, whose case is stated by Henry Van-Hers.

A young man of rich family, and who had arrived at puberty, consulted this physician, avowing, that from the time he was ten years old, he had enjoyed frequent intercourse with young girls, who had excited him by their lascivious touches; adding, that from this period the power of erection had disappeared. He had travelled for a long time, and had received advice from several French physicians. He went to the Spa waters, and there his case was examined by Van-Hers. The sensibility and weakness of the genital organs were so great, that on the slightest touch, and without any desire for coition, or any sensation, there was a discharge similar to thin milk. This excretion continued both night and day, whenever he passed urine, or on the least rubbing of his shirt. A great many remedies had already been tried. Van-Hers regarded the disease as incurable, but the young man would not listen to his advice; and being very rich, he continued to travel in Italy, France, England, and Germany, in the hope of recovering his lost virility. He consulted many physicians. He then had recourse to quacks; and even tried the powers of magic: but all in vain. After six years of travel, he returned to Van-Hers, regretting that he had not taken his advice. The young man then returned home, deploring the advantages of a large fortune, which rendered him the victim of a precocious abuse of pleasure, of a kind of premature depravity.

Wichmann’s dissertation was but little known in France, when Sainte Marie undertook its translation; and not only this, but added many important notes, which have shed new light on diurnal pollution. Wichmann had said, as we have seen, that patients affected with this disease ejaculated the semen. This expression was inexact, and has been rectified by M. Sainte Marie. The patients (said he) do not ejaculate the semen; but it runs away from them: it is not emitted with force. The characters which it presents had briefly been alluded to by Wichmann: his translator has stated them more clearly. According to him, the semen which runs away in diurnal pollution is paler, thinner, and more watery, than that which escapes when the act is attended with pleasure. Its odor, also, is fainter; and the stains it leaves on the linen are slight, superficial, and not very apparent. Wichmann had admitted the existence of a discharge from the prostate gland, which ought not to be confounded with diurnal pollution. Sainte Marie has attempted to point out the characteristics of this discharge. Those in whom it exists, (says he,) find the glans moistened in the morning when they rise with an unctuous substance: if they then compress the urethra from the root to the end of the penis, they press out some drops of a greenish, gluish, and slightly fetid fluid. They thus lose a little of this fluid after indulging in desires, or after erections which have not been followed by the act of venery. Sainte Marie considers it as probable that the mucus of the urethra then mixes with the fluid of the prostate gland, and forms a part of the discharge.

This author confirms Wichmann’s remarks on the general effects of diurnal pollution. He says, “Since I read his treatise, I have found this pollution in diseases of languor, which I could not attribute to a special or primitive alteration of any organ; and I have discovered, that a great many cases of hypochondria, of slow nervous fevers, of consumptions, were kept up by this kind of gonorrhœa, to which the patients, unable to observe themselves, had paid no attention. I have known several individuals, who have been affected with this diurnal pollution for a long time, without experiencing any marked derangement in their health: to them, it was an inconvenience; rather than a disease. But in these cases, diurnal pollution is not habitual: it only occurs when continence of days or weeks, an exciting or substantial regimen, long exercise on horseback or in a carriage, have accumulated semen in its reservoirs, or have irritated specially the genital organs: then the least effort to expel the feces causes the seminal vesicles to pour forth the surplus of fluid which they contain. Let not this state inspire too much security. Diurnal pollution is commenced: it is not yet serious; but it may progress, return every day at each evacuation, and finally produce all the bad results noticed by Wichmann.”

Wichmann said nothing in regard to the organic conditions of the diurnal pollution: he merely stated that this affection was the result of debility. M. Sainte Marie, on this point, makes many interesting remarks. He considers diurnal pollution as sometimes the cause, and sometimes the effect, of dorsal consumption; and he considers this to be an affection of the spinal marrow. We will quote this passage:—Diurnal pollution (says Sainte Marie) is sometimes only an effect; the origin of which must be sought after in a serious and primitive alteration of an important system of organs. Thus, we must reason, for instance, in respect to dorsal consumption. It is said, that one remarkable symptom of this disease is an abundant discharge of watery semen, which comes sometimes at each emission of urine. Involuntary diurnal pollution is here only a symptom: it occurs, because the genital organs do not receive, from the spinal marrow, the nervous and well regulated influence which they require to perform their functions properly. Hence, the super-abundant secretion of semen—its unfitness for fecundation—the relaxation of the seminal vesicles, which allow it to escape so readily—the atony of the scrotum—the inconvenient pulling of the spermatic vessels—the weakness of the erections—impotence, &c., &c. The same state of the organs which deprives the genital organs of life, explains, on the other hand, the wasting of parts which respond to this sensitive centre—the thinness of the loins, thighs, and lower extremities—the debility—the paralysis of these extremities—the obstinate constipation, complained of by the patients, and which is similar to that of old men, yielding only to the employment of stimuli—the formications along the back—the incontinence of urine—the gangrenous eschars, which at a more advanced period of the disease form on the sacrum, hips, and trochanters. We might easily pursue this subject, and extend it to the most general symptoms of consumption, as deep melancholy, weakness and slowness of the pulse, disposition to faint, and all those marked symptoms which assimilate this disease to slow nervous fever; but this would estrange us from the principle we seek to establish—which is, that diurnal pollution is sometimes the cause, and sometimes only the symptom, of dorsal consumption. Wichmann has treated only of the first: the second is connected with a general disease, and cannot be studied separately. These remarks of Sainte Marie will be admitted to be much more important, if compared with our remarks on the abuse of the genital organs on the spinal marrow, and with what we shall say hereafter on the power which this has on the same organs.

Swediaur, who was acquainted with and approved of Wichmann’s work, admits, in addition to the diurnal pollution described by this latter, and which he considers as arising either from relaxation or from irritation of the testicles and seminal passages—he admits, we say, a blenorrhœa of the prostate gland, the characters of which, as stated by him, are precisely similar to those of diurnal pollution. Blenorrhœa of the prostate gland (says he) is a morbid discharge of the mucus from this gland, sometimes mingled with the fluid of the seminal vesicles. It occurs particularly during the day, and without venereal desire. This disease is soon followed with general debility or weakness: this exhaustion is attended with emaciation of the body, and is followed by death, if the patient delays consulting a well-educated physician, as is too often the case; or if the proper remedies are not used in time. He admits, also, that the discharge from the prostate gland does not occur in some individuals, except when they go to stool; and that hardened feces, in passing through the rectum, press the prostate gland more firmly. The discharge is clear mucus, and of a particularly nauseous odor. Cullerier describes two kinds of spermatorrhœa: one with loss of semen and of the prostate fluid; the other, produced by constipation. He remarks—Persons who are habitually costive often see a few drops of semen ooze from the penis, while they are at stool. We have been consulted several times for cases of this kind. Some regard it as resulting from a relaxation, a debility of the genital organs: they imagine that their genital powers are lost, and that their procreative power is lost. Others attribute it to old blenorrhœas, which have struck in, as it is said. All, generally, are terrified at the effect; and quacks have often profited by its existence, to persuade patients that they were affected with an inveterate venereal disease, and thus to dispose of their remedies. This effect arises, as every one knows, from the pressure of the feces in the rectum on the seminal vesicles, and may be removed by removing the constipation.

This was the state of science, when Lallemand devoted himself to the study of the diseases of the urinary passages, and enriched it with many important remarks. As, in acute inflammations of the urethra, the irritation sometimes extends, following the course of the seminal passages to the testicles; so, in retentions of urine, produced by chronic inflammation of the prostatic portion of the urethra, the irritation extends more or less to the seminal vesicles and testicles, producing in the former normal contractions, and in the latter an excessive secretion, whence would result a spermatic flux. In patients thus affected, the ejaculation is very sudden: nocturnal pollutions are frequent—or, rather, the semen is expelled during the emission of urine, and of the feces. It is also more liquid, less odorous, and in short less elaborated than usual. In many patients, the venereal desires are nearly extinct; the erections are feeble, imperfect, or even impossible. This spermatorrhœa has general effects, analogous to those which have been attributed to other pollutions: the patients become timid, idle, indifferent to all which is not connected with their disease; all the functions of the economy languish, and are deranged; and, finally, both body and mind are degraded.

Lallemand has known all the phenomena which we have described to disappear, on curing the retention of urine—or, rather, the disease of the urethra which caused it—and relates cases of this character. Do not the remarks of this practitioner, compared with our remarks on convulsive spermatorrhœa, and particularly on the different states which the semen may present in this affection—do they not establish clearly, that in many, perhaps in most cases of spermatorrhœa, there is not relaxation, weakness of the seminal vesicles and ejaculatory ducts, but irritation or inflammation of these parts?

It would, then, seem well established, that the semen may be discharged without pleasure, without erection, and without ejaculation; and that this discharge may give rise to accidents analogous to those observed after all free discharges of this fluid, arising from any cause whatever. This fact, however, has been contested by different authors. Boerhaave says positively, that he has never known the semen to escape spontaneously, without solicitation; and that when such a case has been suspected, the fluid discharged was not probably semen; and that, farther, if this kind of spermatorrhœa exists, it must be very rare. Swammerdam, Hunter, and Haller, have expressed a similar opinion: the latter admits that a discharge may take place from the penis, under the circumstances mentioned above; he thinks, also, that this discharge comes from the prostate gland and seminal vesicles. But the fluid which escapes is only the mucus secreted by these parts—it is not semen; and unless opinions had been made up from wrong evidence, wrong consequences, it would not have been attributed to it. At present, the opinion that all cases of spermatorrhœa are only blenorrhœas, is still very prevalent. Descamps, physician at Castilliones, having brought before the Medical Society, in 1821, two cases of spermatorrhœa, the consequences of masturbation; Chantourelle, who was the reporter, raised some doubts, which the society seemed to admit, as to the nature of the discharge, thinking it was mucous, rather than spermatic. We, however, are disposed to think, that when the subject of diurnal pollution is better understood, it will be observed more frequently, and then its existence will not be denied. It is with the hope of contributing to this result, that we have dwelt so long on the subject.

If the imperceptible loss of semen may be followed by all the symptoms which are referred to it, it is evident that those authors who have advanced that the emission of semen should be counted as nothing in the influence of the act of venery, and that the nervous disturbance which attends it is the only cause of its consequences—those authors, we say, who assert this, have advanced too positive an opinion, and are consequently mistaken. The same may be said of those who ascribe the danger of venereal excesses simply to the discharge of urine. It is well ascertained, that those individuals who have carried the act of onanism to such an extent as to procure enjoyment without losing semen, have finally became diseased, and their constitution has been impaired. Instances of this might be cited. Fournier and Begin mention that of a young man, who, at the moment of ejaculation, compressed the remote parts of the urethra, so that not a drop of semen was lost. The fatigue, however, following efforts of this kind was very great, notwithstanding these exertions. Finally, the strength diminished, and the person wasted away as much as if the semen had been discharged. (Dict. des Sc. Med., Art. Masturbation.)

There is frequently some derangement in the functions of the testicles, in those who have lost the genital sense, where the penis is no longer capable of erection, or who are affected by one or other of the pollutions mentioned by us. But these organs may be affected more evidently. In many onanists, these parts are extremely tender, or more or less vivid pains are felt, which extend along the cord. These symptoms sometimes assume an evidently neuralgic character; and it may readily be imagined, that, in individuals affected with wandering pains, excesses in venery may fix them in these parts. This has been remarked in gout. Hallé and M. Guilbert observed, in a middle-aged man addicted to excesses of this character, a severe pain in the left testicle, unattended by swelling, which extended to the whole surface of this organ: this pain followed an attack of articular gout. Irritation of the testicles sometimes constitutes an attack of orchitis—that is, an inflammation, which, among other consequences, may be attended with the loss of these parts. Brodie has published two cases of this character. The first was that of a young man, thirty years old, who entered St. George’s Hospital in 1805, affected with pains in the left testicle. This testicle was soft, flabby, and one third smaller than that of the opposite side. The patient had never received a blow on this part, nor had he been affected with blenorrhœa; but he admitted, that for five years he had been addicted to onanism, and that a day seldom passed without his indulgence. Before wasting away, the testicle had been the seat of a swelling, which had been preceded by severe pains. These pains had continued to be felt, and the disease was attended with such a degree of moral depression, that the countenance of the patient assumed a sombre and melancholy character. This young man was treated by various remedies, but he left the hospital uncured. The other patient, on applying to Mr. Brodie, in 1820, was thirty-one years old. Here the two testicles were wasted, and the patient was impotent. This man stated that his intercourse with females began when he was fourteen years old; that he had indulged excessively for many years; that, when twenty years old, in consequence of external violence, he was affected with severe inflammation of the testicles; that this inflammation had been completely cured; and that the wasting of the testicles had commenced some time afterward. In three years, the testicles had shrunk to their present size. (London Med. and Phys. Journal, October, 1826.)

According to Morgagni, the too frequent return of venereal ideas will produce varicocele and hydrocele. Some authors, also, place venereal excesses among the causes of the first of these two diseases, and also of circosele. We have seen several cases of varicose dilatation of the spermatic cord and testicle in onanists. This fact is also confirmed by Breschet, in his memoir read at the Academy of Sciences, Jan. 13th, 1834. He thinks that circosele and varicocele are by no means diseases of adult and old age, but that they are seen most frequently in young men. These affections seem to him to be caused most particularly by venereal excesses. He adds, that the varicose tumors of the bursæ, and the organs they contain, are not only very troublesome, causing severe pain in the cord, but that in some patients they cause extreme melancholy.

One consequence of onanism, which has been omitted by Deslandes, may be stated here. We allude to the smallness of the genital organs. In several severe cases of onanism, which have fallen under the notice of Dr. A. Sidney Doane, of New-York, this important feature has been observed. The same fact has been remarked by Professor John W. Francis, of New-York; Professor Otto, of Germany; and by other eminent pathologists.

Excesses in masturbation and coition, in females, cause affection of the several organs much more frequently than in males. By too frequent titillation, the clitoris may become enormously large. This cause (says Bouillaud) may determine schirrous engorgement, or even a cancerous degenerescence of this organ. The most frequent alteration, however, of the genital organs of the female, which may be thus produced, is an inflammation of the membrane which lines the vulva and vagina. This inflammation is constantly indicated by a more or less abundant leucorrhœal discharge, and often by swelling, redness, and pain. When this discharge continues, which is often the case, it occasions in young females symptoms analogous to those of diurnal pollution. The complexion loses its color, and becomes yellowish; the eyes are constantly suffused, and the countenance is sad; the patients are feeble and careless; they generally experience gnawing sensations in the epigastric region; and, thinking that these are occasioned by hunger, are constantly eating. Sometimes, the appetite is voracious, and the digestive powers are preserved; but these are commonly soon altered. Severe and constant pains are often felt in the back and epigastrium; the body wastes; and a short, dry, and frequent cough, renders the patient, parents, and sometimes the physician, anxious as to the state of the chest. Add to these symptoms those already described, when speaking of the general effects of masturbation, and you have the state most frequently presented by girls addicted to this habit.

As females have no testicles, nor organs which, like the testicles in the male, serve to prepare and excrete the semen, they cannot have seminal pollutions: they, however, like men, are subject to voluptuous dreams, and then there may be a secretion, analogous to that which exists in them at the moment of the act of venery. May a too frequent return of this symptom have any influence on the health? The only remarks on the subject, to our knowledge, are to be found in Swediaur. He says, when speaking of diurnal pollution—I have seen, although much more rarely, similar diseases in the other sex. I have under treatment, at this moment, a female, twenty-eight years old, who, since her miscarriage, a year and a half ago, suffers from frequent involuntary nocturnal pollutions, excited by libidinous dreams, and attended with all the symptoms of the tabes dorsalis, described by Hippocrates, as a disease of the male. Even the lungs begin to feel this disease. She, however, has been cured.

Inflammation of the external organs of generation, and the fluor albus, resulting from it, is most generally, at least in young girls who have not arrived at puberty, a consequence of onanism. We are convinced, too, that if it were possible to arrive at the facts, we should find that the cause of fluor albus in adults was either recent or former abuses. Whenever we have addressed females on the subject, to ascertain this fact, our conjectures have been verified. This has frequently been the case with servant girls. We have seen several, who were so weakened by fluor albus, and the irritation of the sexual parts, that they have been obliged to quit their situations, being unable to do their duty. We will even say, that the most sincere of these girls have given me such information as to their habits, that we suspect most of this class of onanism.

Besides, all authors who have spoken of leucorrhœa and blenorrhœa in females, have mentioned excesses in masturbation and coition as among their most frequent causes. It would be easy to adduce general evidence and special cases in support of this proposition; but this would be useless.

For the same reasons, we may state, that diseases of the uterus may very frequently be determined by these excesses, and more particularly by those of coition. Daily observation proves that acute and chronic inflammations of the body and neck of the uterus frequently appear in those females who have indulged in premature enjoyments.

We have attended, for more than ten years, a lady affected with chronic metritis, arising from this cause. This lady had began to masturbate before she was eleven years old. She soon became affected with fluor albus, from which she has never been free since. When eighteen years old, she married a vigorous man, and then became addicted to another kind of excess. She now experienced constant pains in the loins, lower part of the belly, and in the groins: she was also troubled with a disagreeable feeling of fatigue in the upper part of the thighs, and experienced as it were a weight, as if something was constantly trying to escape from the sexual parts. The neck of the uterus, instead of retaining its usual situation, proved on examination to be almost at the external orifice of the vagina. Our advice, as to moderation and abstinence, was but imperfectly followed: she was so addicted to onanism, that, although she indulged lawfully, and was the mother of several children, she continued in this habit. It may readily be imagined that she did not derive much benefit from my advice: in fact, the symptoms mentioned above, and many others, still continue. Similar cases are related by other authors, and have fallen under the notice of almost every practitioner.

In this case, there was evidently prolapsus uteri, or a falling of the womb: the neck of the uterus was almost at the vulva. This displacement, which is the usual consequence of inflammations of the body of the uterus, very often results, like it, from venereal excesses. This fact has been noticed by all writers on this subject. Schirrous and cancerous affections of the neck of the uterus, also, arise from this cause. Cullerier remarks, that uterine affections in females are loo frequently the sad and cruel consequence of solitary manœuvres. Richerand, after stating that premature or too frequent indulgence is a cause of cancer of the uterus, says, that of forty-seven females affected with this disease, eleven had indulged with males before the period of puberty, seven at this period, and most of them were barren. He adds, that those public girls who escape venereal disease generally die of cancer of the uterus. Bayle and Cayol have attempted to verify this assertion, by examining numerous cases, but they have obtained no marked result; which is not surprising, considering the number of causes, which, especially in hospitals, render such investigations useless. The influence of excessive indulgence, in producing such a disease, is very great. A short time since, we were called to a lady, who had a slight syphilitic ulceration of the neck of the uterus. She, however, still admitted the embraces of her husband, although they were painful, and were followed by a discharge of blood. The parenchyma of the neck, around the ulceration, was gradually engorged: it became schirrous, then cancerous, and the patient finally died. Probably, coition had great influence in developing this disease. Such a thing might happen frequently; for Ricord has shown, that superficial ulcerations of the neck of the uterus are frequent. The cancers which affect these parts, in public women, are, probably, often produced in this manner.

In the lady whose case has been mentioned, the act of coition produced a discharge of blood from the vulva. We have seen cases of a similar character, where the neck of the uterus presented no evidence of organic alteration to the touch. Females in whom this occurs should, however, be very careful in their pleasures, as this slight accident indicates a bad state of the system, and one which should be mistrusted. Sometimes, blood appears on return of coition, when females have not indulged for a long time. Rondelon cites an instance of this. It occurred in a lady from whom her husband had been absent for three years: at the end of this period, he returned. The frequency of coition the first night caused excessive uterine hemorrhage. A similar accident may result from this act, and a fortiori from its abuse, during or just before the menstrual period. Very serious hemorrhages have often occurred in consequence of excessive copulations. Tissot states—In 1746, a girl, twenty-three years old, submitted to the embraces of six Spanish dragoons, at a house near the gates of Montpelier. She died the next day, from excessive hemorrhage of the uterus. A similar case has been related by Virey. We know (said he) that a public woman, who submitted in one night to twenty-one soldiers, the next day died, with hemorrhage of the uterus. This was a dark, thin woman, in the flower of her age. (Dict. des Sc. Med., vol. xiv., p. 339.) Onanism causes in young women, and even in children, a discharge of blood from the vulva. This fact was mentioned by Duges. The blood lost is then never abundant, and the occurrence is by no means serious.

The irritation produced or kept up by too frequent coition, is very often the cause of sterility. Even as, generally speaking, an inflamed surface refuses to absorb substances applied to it, so irritation of the uterus and vagina renders them unfit for impregnation. Thus, then, libertinism, instead of adding, as we might think, to the chances of fecundation, acts in a contrary manner. Marc remarks, that two hundred public girls do not produce more than two or three children annually. Farther: it seems well ascertained, that if these girls resume a regular life, they again become fruitful. The English, wishing to people Botany Bay, transported there a large number of public women. Those who were sterile in their own country proved fruitful, when subjected to the rigid laws of marriage. Is it not notorious, too, that among the public girls, those who bear children are not those most frequently liable to become mothers? De Chanes, physician at Macon, has established, by statistical researches, that but few conceptions take place in the early months of marriage—that is, when the congress of the sexes is most frequent, and causes the most irritation. Villermé has ascertained the same to be true in the early days, and even the early weeks, after marriage. Hence, this learned physician regards the fecundity of copulations as being inversely as their frequency. It may, then, be stated as a fact, that females may become barren, in consequence of venereal abuses.

These abuses are not only injurious, as opposing reproduction, but they also injure, by causing a deterioration of the human family. Marc asserts, that the few children born of prostitutes rarely have the strength and health of those born in lawful wedlock; and that the mortality of the former is fifty per cent greater than of the latter. Too early marriages are attended with results similar to those arising from libertinism. Aristotle mentioned this fact. Delafontaine, first surgeon of the last king of Poland, attributes the extreme physical debility of the Polish Jews to these premature marriages. Marc says—It is proved, that the physical strength of the child depends, in the main, on the mother, rather than on the father; and this is confirmed, too, by referring to domestic animals. The height of the pony depends on the mare, rather than on the stallion. Mules, too, furnish a striking proof of this. The eggs of pullets, whatever may be the size of the cock, are much smaller than those of hens. Farther: it is well known, that females who become mothers before attaining their strength, generally give birth to small children, which are raised with difficulty.

We have seen in a former page, that men had recourse to artificial means to procure a semblance of coition. Accidents of a similar character have happened to girls; and they have been obliged to call in surgeons to their assistance. There are numerous instances, where foreign bodies have been introduced into the vagina, and particularly into the urethra, and could not be withdrawn. We shall mention some of them. Pamard has reported that of a girl, thirty-one years old, who used an ivory whistle, three inches and a half long, and five lines round in its centre. This she introduced, not into the vagina, but into the urethra. One day, it entered so far, that she could not remove it. After many efforts, it was withdrawn, with polypus forceps. Another girl, seventeen years old, was less fortunate. She was in the habit of introducing a large piece of wood into the urethra. This instrument having entered very deeply, fell into the bladder. Faure was called, and was obliged to cut for it, to extract it. Rigal was obliged to do the same, to relieve a young girl, twenty years old, who used a wooden needle-case in masturbating. Needles and pins have often escaped into these passages. Morgagni asserts that it is by no means unfrequent in Italy for the lascivious girls to introduce into the urethra the golden pins worn in their hair, and that they sometimes fall into the bladder. This they conceal for a long time; but they are finally obliged, through pain, to confess their fault. Moinichien mentions a Venetian girl, whom Molinetti relieved of a golden needle, which had slipped from the hand into this organ. In 1751, Lachese, (according to Morand’s report,) was called to a girl twenty years old, who had introduced into the urethra a toothpick, which she had lost; and after two months, it was extracted. A happy circumstance favored Lamotte in a similar case. An old maid had introduced into the bladder a very large pin. Having sounded several times very patiently and attentively, Lamotte finally felt the pin distinctly. He sounded for the fourth time, when, by accident, it became engaged in the sound. Wishing to withdraw it, and finding some resistance, he introduced his finger into the vagina, and ascertained whence it proceeded. By skilful manipulation, he now succeeded in withdrawing it. These symptoms usually happen only in those who are imprudent, and who introduce into the urethra an instrument designed for an adjacent passage. The vagina is so short and large, that foreign bodies seldom remain in it. For such a thing to take place, certain conditions are requisite, which are not very common. This, however, is possible; and many cases of it are recorded. The following is mentioned by Dupuytren. A female consulted him for some derangement in the vulvo-uterine passage. On examination, a foreign body was felt, the nature of which could not at first be determined. The patient refused to give any information on the subject: by examining, however, it was found that the body presented a large opening or deep cavity. The tumefied walls of the vagina covering the edges of the kind of vessel, prevented its disengagement. After much effort, however, the body was removed; and it proved to be a pomatum-pot, which had been introduced by its base. (Additions à la Med. Operat., de Sabatier; vol. iv., p. 96.)