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 thereverse 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 atubercularaffection—that is, a disease which might be developed at every period of life. We think that tubercles weredeveloped, 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 thecauses 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 andthin 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 tonervous 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 venerealpleasures 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 topolypi 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 anyother 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. Theywere 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 termedfebris 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.
Ifsatyriasisandnymphomaniahave 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 termsare 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 wasnot 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 andof 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 tosend 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 organshave 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 evidentlybrought 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 insertedin 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. Duringan 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-elasticsound, 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 bladderis often observed, also, in those individuals who have abused the pleasures of love.
Montegre, speaking of a kind of cystitis, which he termsvesical 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, theinvoluntary loss of semen. This disease, which has been termedspermatorrhœa,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 firstcase, 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 isconvulsive, and the other which isnot 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 intodiurnalandnocturnal. 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 excessivecontinence, 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 anonanist, 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 (addsTissot) 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, andis 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 havenon-convulsivespermatorrhœa, ordiurnal 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.
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 deniedin toto. The remarks of several authors, and particularly of Wichmann, SanteMarie, 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 theirsemen 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, youmay 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 affectedwith 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 werethe 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.”