^ • ■■<£■■■" AMERICAN FOUNDATOTORHOMOEOPATHY ;-4d;j ■V.l • ;;-r - .* -A "' » f :. .'.> » * » TI&RARY. AMERICAN FOUNDATION FOR HOMOEOPATHY A TREATISE ON THE DISEASES PRODUCED BY ONANISM, MASTURBATION, SELF-POLLUTION, AND OTHER EXCESSES. BY L. DESLANDES, M. D., MEMBER OF THE EOYAL ACADEMY OF MEDICINE AT PARIS. AND OTHER LEARNED SOCIETIES. TRANSLATED FROM THE FRENCH, WITH MANY ADDITIONS. «Secott& HMtfott. BOSTON: OTIS, BROADERS, AND COMPANY. 1839. LIBRARY AMERICAN FOUNDATION FOR HOMOEOPATHY 7ici Entered, according to an Act of Congress, in the year 1838, by OTIS, J3ROADERS & COMPANY, In the Clerk's Oliice of the District Court of Massachusetts. PREFACE. To those who would complain of the publica- tion of a work upon the delicate subject, to which the following pages refer, we would remark, that the evil here depicted, is one of great magnitude. This cause of disease is often entirely overlooked even by medical men, either from false notions of delicacy, or because their attention has not been drawn by fearful experience to cases which are ascribable merely to onanism. The patient is unconscious of his danger, and perseveres in his vicious habit—the physician treats him symp- tomatically, and death soon closes the scene. " Many a young man," remarked a physician, who had seen much of disease from this cause, " many a one hns come to me, totally unconscious that his criminal act was sapping to the very foundation his health and strength." To call the attention of medical men to this source of disease, and to point out to such per- 3 4 sons not of the profession as may meet with this book, and who indulge in this habit, the fatal precipice to which they wend their way, has been the object of publishing it here. How very, many cases of consumption, that disease which annually destroys its thousands, could, if the truth were known, be referred to this cause! How many minds have been ruined by self-in- dulgence ! If any apology were needed for this publica- tion, it may be found in the last annual report of the State Lunatic Asylum of Massachusetts, which states that of the number of insane receiv- ed at that institution during the last year, no less than thirty-two lost their senses from this cause. CONTENTS. PART I. EFFECTS OF VENEREAL EXCESSES. Chapter 1. Danger attending venereal excesses. § 1. Power of the genital organs when at rest. § 2. Power of the genital organs when excited. § 3. Power of the genital organs when in action. Chaptfr 2. Circumstances which render the act OF venery more or less injurious to the con- stitution and to the health. § 1. Circumstances connected with the act of ve- nery which render it more or less injurious. § 2. Circumstances foreign to the act of venery which render it more or less injurious. § 3. Influence which the general state of the func- tions at different ages and the particular state of some of them at different periods of life, may have on the consequences of the act of venery. Chapter 3. Symptoms and diseases resulting from venereal excesses. § 1. General symptoms of venereal excesses. § 2. Disease? resulting from venereal excesses. 6 PART II. RULES OF PRESERVATION AND TREATMENT RELATIVE TO VENEREAL EXCESSES. Chapter 1. Means of preservation with reference to venereal excesses. § 1. First indication. To prevent the desire of onan- ism. § 2. Second indication. To take away from those who wish to masturbate the power of doing so. Chapter 2. Mode of repairing the injury arising from venereal excesses. vbd*A>k>A, 'fowj^*L Ob ONANISM AND OTHER ABUSES. cY\j^-Wk PART FIRST. EFFECTS OF EXCESS IN VENERY. Can the power possessed by man of indulging in the act of venery be abused? or, in other words, can any injury arise to the health or constitution, by in- dulgence in this act. It is sufficient to observe, that the affirmative has never been doubted by any author, that no medical man has ever been found at any time, or in any country, so deficient in intelligence as to doubt that venereal enjoyments were attended by ve- nereal excess, and no one has ever disputed that mas- turbation or coition may be injurious. The act of venery, then, may be followed by bad effects. But is it so, and to what extent? This question is the only one which has been debated, the only one to be debated. Let then those, who think that vene- real indulgences are followed only by the remembrance of them, know, that deceived by their desires, and per- haps by their necessities, they are rushing blindly to- ward a fatal precipice, which is to be sure at a greater or less distance from them, but which however exists, and to which those who do not take warning will arrive more quickly. It is generally thought that venereal excesses, par- ticularly those of masturbation, contribute in a con- siderable proportion to the ills of suffering humanity. 8 Some even consider this cause of disease, as one of the most fatal and active. "In my opinion,".says Reveille-Parise, "neither the plague, nor war, nor small-pox, nor similar diseases, have produced results so disastrous to humanity as the pernicious habit of onanism: it is the destroying element of civilized so- cieties, which is constantly in action, and gradually undermines the health of a nation." {Revue Medi- cate, April, 1828, p. 93.) No one has disputed the dangers of this kind of excess. Many authors, how- ever, have thought, that writers had exaggerated on this subject. Thus Montegre says that " the bad con- sequences (although they do exist) attending prema- ture indulgences have sometimes been exaggerated. (Dict.des sc. med. vol. vi. p. 100.) Georget's opinion is similar. According to him, (Physiologie du sys- tems nerveux vol. i.) most authors and Tissot among others have much exaggerated the effects of mastur- bation. It will be seen, with how much reserve these au- thors speak. The injury arising from this habit, say they, is very great, but il has been overrated. Let us now examine upon what grounds they and others have been led to consider these fears as too great: we shall see by what reasoning they have been gov- erned, and if they are correct. Montegre was struck by the instances of individuals who were addicted to onanism from early childhood, and who, however, in the prime of vigour and health, had attained an age to which men do not generally arrive, or to whom advanced age comes loaded with troubles. But do we not see old soldiers who have always escaped bullets? Now what do these facts prove except that such individuals exist? It has also been stated, that influenced with what they have read in books, which contain the most formidable cases, as those only are printed, many physicians have attribu- ted too much importance to the diseases caused by onanism. But admitting this, may we not conclude also, that many severe affections which it produces are uot referred to it ? That in attending cases of 9 dorsal consumption, epilepsy, paralysis, loss of sight, &c, less dangerous diseases are oyerlooked, and that their origin is not suspected? How often, for in- stance, are we ignorant of the true cause of these af- fections whose characters are constantly changing, which are seen every day, which at first produce un- easiness, but with which one soon becomes familiar; which are not the symptoms of a disease having its name and place among other diseases, so much as the indication of constitutional affections, which appear from a variety of influences, and are referred to each one of them. And yet this kind of affection, as we shall state hereafter, is that presented most frequently by individuals addicted but for a short time to ona- nism, who indulge in it but seldom, or whose consti- tution resists this kind of excess. Appeal has been made also to direct observation; the number of those who have fallen victims to ona- nism has been cited. It has been said, call to mind every thing which has occurred to you in the course of a long practice, you will doubtless find deplorable and even numerous instances of the diseases attend- ing onanism ; but does this number approximate that of the individuals who abandon themselves to this vice? There are few persons who are not addicted to masturbation; very well, are there many whose constitutions are impaired and whose health is de- stroyed? It is admitted that premature and too fre- quent and too often repeated indulgences may injure and sometimes have caused great detriment, yet those who live through them are very numerous, and the distance between the use and abuse of the act of venery, is greater than is generally admitted. This manner of counting the dead and wounded has something specious in it, but it is defective in this respect, that it takes no account of what has escaped observation, and cannot be estimated. Every prac- titioner has undoubtedly seen more cases of mastur- bation than he has seen victims to this habit. But how many circumstances have prevented him from seeing all the diseases which are caused by this habit, 10 or have prevented him from referring these diseases to their true cause? We have already mentioned the influence which his previous reading and occupation have on this subject; to this cause of errour, we may add others. How numerous are the affections which are borne in silence and which never come under the notice of a physician. How numerous too the prac- titioners who avoid the trouble of referring to the im- mediate or remote causes of the diseases which are observed by them, and who confine themselves simply to their treatment, without tracing them to their source. How often too are diseases resulting from onanism attributed to causes with which they have no con- nexion, to causes which were indicated by persons who knew no better, or even by the patient who believed himself to be interested in giving wrong statements. How frequently also does the practition- er exclude himself from obtaining information, by ab- staining from making suggestions to the parents, which all hear with displeasure, and repel with indig- nation. How often, also, does he refrain from asking necessary questions, for fear of wounding the moilesty of the young patient, of teaching him a thing of which perhaps he is ignorant, or at least of exciting in him a dangerous curiosity! Finally how frequently are his doubts removed by the art with which those who indulge in onanism, even when young, know how to conceal a habit at which they blush in secret. Now is it reasonable to expect, that the physician when surrounded by so many causes of errour, should go into statistical details and estimate from them the sum total of the ills produced by onanism and other excesses of a similar character? This method would undoubtedly lead to taking a part for the whole and consequently to forming too narrow an opinion of the evil. Many authors having followed this course, and having considered the evils which are unobserved by them as only imaginary, have not denied the dangers and inconveniences of venereal excesses, but have supposed that they exist less frequently than is really the case. 11 I do not wish to call in question the utility of ob- servations, or to pretend that they must be neglected. I only wish to say that in attaching to them too much consequence we are led to false conclusions which may inspire a dangerous security. The physician who commits this fault, reasons as does the onanist, who being unable to distinguish, either in his com- rades or in himself, the effects of his pernicious habit, concludes that it is an innocent practice and that it may be indulged in unreservedly. The principal utility of observing the diseases caused by masturba- tion is to determine ichat are the maladies produced by onanism and what is the relative frequency of each of them. We can also certainly form an opin- ion, from that which is shown by observation, in regard to that which escapes us. But it is only by induction, that the extent of the evils caused by vene- real abuses can be estimated. The bad effects pro- duced by these abuses, can be estimated only by con- sidering what they may produce. It is only afte studying the genital system in its relations with other organs, and considering the influence it exercises upon them, that we can pronounce in regard to the mala- dies and infirmities and dangers of all kinds which attend the abuse of the genital system. We proceed to this subject first. We shall then state what is known from direct observation in regard to the differ- ent affections which result from venereal excesses. CHAPTER I. OF the dangers which may follow venereal EXCESS. To abuse oneself by onanism, by coition, is to abuse the organs which serve for the execution of these acts. The genital organs in the female are, the vulva, clitoris, vagina, uterus, fallopian tubes and ovaries. Those in the male are the penis, the semi- nal passages and the testicles. These organs are then placed in such a state that they become a source of disorder and of disease to the rest of the body. Now, 12 what is their power in this respect? Can they do much injury ? This is the question now to be ex- amined. The injury which the genital organs can do to the rest of the body when they are abused, is the natural consequence of the influence exercised when they are not abused! This injury is in a direct ratio with this influence; it is by this then that it must be measured. In fact, it is clear that if the different organs have in the ordinary state different degrees of power, they must, when they do injury, exercise it in different de- grees. Let us then attempt to estimate the influence possessed by the genital organs. If it be demonstra- ted that when these organs are in a state of rest, of excitement, or in use, their influence on the other functions is considerable, some opinion may be formed as to what may be their influence when abused. It must be admitted that organs, which have a powerful effect on all parts of the body, which regulate all the others, which cannot feel, act, and perform their func- tions without the others taking part in what takes place in them, it must be admitted I say, that when such organs are made instruments of disorder, the bad con- sequences which follow may be very great. The genital organs may be observed in three states; the first state is that of rest. They then merely live, present no special sensation and do not proceed to the act of venery. In the second state they become the seat, the focus of more or less vivid sensations, and which have for a special character to invite and to constrain with more or less power to the act of vene- ry. In animals, this state is called rutting: in our species, it has no special name, except when existing to a very great degree, and then it constitutes a dis- ease, termed Satyriasis or nymphomania; I shall call it tl e state of e.vcitem,ent. The third is that of ac.ii n: it is the state in which the genital organs are, whei. they perform their special functions, when they accon plish the act of venery. They then do not simply live as in the first state, or feel as in the sec- ond ; but they act, and afterward return to one of the 13 preceding states, and particularly to the first: they rest. These are the three aspects under which we shall examine these organs. To render our remarks more intelligible, we will give a few definitions. The power of bringing the genital organs into a state of action is the venereal power: this when put in action is the act of venery. If this act results from the con- currence of the two sexes, it is coition. If it be caused by solitary manipulation, it then receives divers names; the terms most used are masturbation, or onanism. The act of venery, whether it does or does not result from the concurrence of the two sexes may or may not be injurious. When it is injurious in any degree there is then venereal excess, abuse of the genital organs. This sense is the only one attached in this book, to this mode of expression: for if in a moral and religious point of view the simple fact of coition in some cases and of onanism in every case be a vice, an excess, an abuse, the physician should apply these terms only to cases where the health is injured. § 1. INFLUENCE OF THE GENITAL ORGANS CONSIDERED IN A STATE OF REST. It might be thought that when these organs are at rest, when they are neither used nor abused, when the venereal sense is as it were asleep in them, and they seem occupied only with their own development, and nutrition, it might seem I say that these organs take little or no part in what is going on around them: but this is a mistake. We shall see that this dull life which then occupies them is sufficient to make them a powerful focus of action; that all the other organs owe to them a part of their mode of existence their form and substance. By this we can judge of what the genital system is capable, when excited, and when by the hand or otherwise it is brought to the highest degree of activity. Consider him who was born an eunuch, the man who has never had genital organs, whose body, mind, and heart are developed without their influence: 2 14 compare him with other men and see in what, he is deficient: for his physical moral and intellectual rela- tions will of course be deficient in all that depends on the genital organs. This study will reveal to you their power, and will point out to you the difference between a man in whose development they have assisted, and one in whose development, the genital organs have taken no part. Eunuchs are very seldom tall: they are frequently short and sometimes very short. A woman fifty-two years old, who had no uterus, and whose genitals were presented to the academy of medicine by M. Renaul- den, was only three and a half feet high. The limbs of eunuchs when they are not percolated with white fluids, are generally thin and badly developed. Their bones have neither their usual size nor form, as has been remarked by many observers, particularly by M. Mojon of Geneva. (Alibert, Nouv. El. de (herapeu- tique, 3d edition, vol. ii., p. 115.) This defect in growth is much more remarkable in the larynx. This organ which generally acquires two-thirds of its size at puberty, remains as in infancy, and the voice pre- serves that shrillness which it has in young people, but becomes a little stronger because the chest en- larges. The different tissues are not only less de- veloped, but some are not developed at all. Thus in eunuchs the beard and the hairs on the pubis are de- ficient; their skin remains as free from hairs as in early youth. The genital organs then have a power- ful effect on nutrition, because when they are deficient, the growth is defective or ceases entirely. This in- fluence is manifested also by the characters presented by the different tissues after the action of the genital arts ceases. To understand these characters, we ave only to compare the flesh of animals who have been castrated with that of those who are perfect; for example the flesh of the ox with that of the bull, that of the capon with that of the rooster &c. In the eunuch these characters are no less marked. His organization is in a measure stationary. When an adult, he preserves in great part the physical attributes 15 of youth, and then when these are lost, those of old age, and not those of manhood, present themselves. It is the genital organs then which in a perfect man, give colour to the skin, give to the flesh more consist- ence and firmness and which gradually take up from the cellular tissue those white fluids, which prevent us from seeing the prominences of the bones and muscles. The organization of the eunuch is then un- finished, imperfect. The organs which should have appeared at the period of puberty are not seen: others acquire only a part of their growth: all retain a part of those characters which they ought properly speak- ing to lose and do not obtain those which belong to them. These facts are highly important. The study of them demonstrates the extent of the derangement caused by venereal excesses: for the organs abused by the onanist and libertine, are those which take so active and special a part in the internal economy of all our tissues: which stamp them with the sealof virility, of which the eunuch always remains desti- tute. Consider the eunuch now in his life of relation: look in him for the thought, activity, and sensibility of the man. In these respects also how much he is deficient; he is inactive, indifferent, and destitute of energy. The lymphatic temperament is marked in him by his insensibility, his apathy, no less than by the delicacy of his flesh, and the whiteness of his skin. He has preserved from infancy the disposition given by feebleness, to be excited by the least cause: hence he is timid and pusillanimous and cowardly. Devoid of any internal feeling which renders the soul gay, he is morose and wearisome. He is desti- tute of those feelings which attach man to man and render one capable of attachment, love, and devotion. He lives, he vegetates only for himself: he is a per- fect egotist: if he has any sentiments they are those of envy or hatred : in fact they are repulsive senti- ments : but most frequently he has none or they are very slight. The crimes of the eunuch come in fact less from the sentiments he has, than from those he 16 has not. His mind, like his body and heart, remains a perfect waste. Hi9 intelligence is but moderate and he is never known to conceive or execute great ideas. This picture is not drawn from the imagination; it is the result of long continued observations at all periods, in all places, and upon all kinds of eunuchs. One of them observed by M. Bedor embodied in himself the principal features of this picture. He was an eunuch from birth who had become a conscript. His appear- ance was humble and languishing; his eyes were downcast and averted; he was very timid and cow- ardly, was afraid of dead bodies, and of darkness. He admitted that he had never been attached even to any member of his family: but he was also incapable of dislike. He was not pleased with musick, and had no idea of singing: finally he was insensible to all enjoyment. He did not however complain of his situation. His intelligence was very slight, his con- versation was obscure and incorrect, and he was so incapable of being instructed that although he had lived in the barracks a year he had none of the moral habits of the soldier. {Journal de med. chir. et phar. vol. xxv. p. 75.) Such is the eunuch. The operator in mutilating him mutilated his heart, his senses, his mind. The development of the moral and intellectual faculties then like that of the body is connected with the ex- istence of the genital organs. Deprive a child of a limb of his four limbs, that is of the half at least of his frame, and he will continue to be developed, the same as if no part had been taken from him. But take away the testicles, and all his tissues, all his faculties will bear indelible marks of this mutilation. These organs alone then have much more power than the four extremities. It is with these, with this power, that the onanist trifles from childhood, without hes- itation and without moderation. Is it necessary now to follow this train of reasoning to show that his course of conduct is dangerous? It is also to the in- fluence exercised by the genital organs on other parts that the sexes owe their peculiar differences. Their 17 organization, influenced by a different genital appara- tus, presents a different mode of existence, action and sensation. Thus the sexual characters are slightly marked at birth, become distinct as the genital organs develope themselves, suddenly enlarge at the period of puberty, exist in the greatest degree when these parts have come to their perfect state, and lose their energy in old age. The destruction of the testicles in the male and of the ovaries in the female prevents the regular development, or even alters the special distinctions of sex. We have already seen that this destruction renders man effeminate: we will add that it renders the female more masculine, and gives her characters, which in the natural order of things belong exclusively to the male. This conclusion is drawn from facts which seem authentic, and it is strength- ened too by the fact that when the activity of the genitals is destroyed by age, the voice becomes rough, resembling that of the male, the upper lip and chin are covered with hairs, the moral character acquires more firmness, the taste and habits are much modified and approximate those of the male. A similar thing occurs in animals according to Dumeril. {Diet, des 8C. med., art. continence, p. 118. It is not only by comparing the sexes that we see that different genital organs have a different action, but it follows also from observing those doubtful beings termed hermaphrodites. In these individuals the genital organs disturbed in their regular develop- ment, present doubtful appearances and belong at the same time to the two sexes. In these individuals the organization being influenced in another manner is developed differently. Faithful to these organs which generally impress in the body the seal of sex, the general state of the body becomes equivocal like them and presents a mixture in different proportions of the male and female attributes. Thus in a girl whose history is stated by Beclard. and who among other imperfections of the external genital organs which rendered her sex doubtful, presented a complete clo- sure of the vulva, and a clitoris so much developed IS that it resembled a penis, the larynx and voice were like those of a youth: the upper lip, the chin and cheeks presented a white beard, long and coarse hairs covered the lower extremities and surrounded the anus; finally the proportions of the trunk and limbs and the formation of the pelvis resembled those of man. {Bull, de la Faculte de med. vol. iv. p. 273.) It would be easy to refer to similar facts which have been frequently recorded. The general state of the economy, then, is somewhat connected with that of the genital parts, varies like them and takes part in the changes which they undergo. Hence it is aston- ishing to see libertines and onanists render them- selves effeminate, and demoralize their constitution by using these parts in such a manner as to fatigue and change them: and to observe women robbing themselves in the same manner of their beauty, the delicacy of their form and the charm of their voice. When man has attained his perfect development, the bonds which unite the genital organs to the rest of the body become less apparent and probably less intimate than before: they however are not destroyed. Castration certainly does not deprive the adult of all the characters, of all the faculties which had been de- veloped by puberty: but it modifies them very much. The beard has been known to come out after the loss of the testes as if its existence were connected with theirs, as an effect is with its cause. The intellectual faculties particularly lose much of their energy, when the genital organs are removed. Those persons who have been mutilated not unfrequently become melan- choly and finally commit suicide. {Orfila, Leqons de medicine legale, 1823, p. 126.) A remarkable case of enervation was observed by Richerand, in some soldiers whose testes had been shot away in action. Among other cases, he mentions a soldier who had previously been celebrated for his activity and valor, and who, after his mutilation took an aver- sion to any violent exercise, and to gain his livelihood, applied himself to such labours as are carried on by females, particularly to sewing gloves. {Richerand, 19 nosographie chirurgicale, 2nd edition, vol. iv. p. 292.) Compare these facts with what takes place when age, that great operator, extinguishes the prin- ciple of virility. When one is old, is he as affection- ate, as sensible, as devoted, as intelligent, as he was in youth? do not the general characters of an eunuch gradually come upon him ? The genital organs then, even when in repose, regulate in more than one re- spect and at every period of life, the rest of the human body. But it is particularly before and during puberty that these organs deserve the most serious attention, for then they possess the most power. This power com- mences with them, and like them increases every day. Thus the tastes, the characters, the inclinations, and generally all which distinguishes the sexes in a moral and physical point of view, are marked from infancy. That poverty of body of heart and of spirit which characterizes eunuchism, is seen in young eunuchs, in those for instance who are born destitute of genital organs. The soldier whose case is stated by Bedor, always presented that indifference and languor com- mon to eunuchs; he always avoided all trials of skill at wrestling, running, leaping and finally all youthful exercises, and as we have already remarked, never ex- hibited attachment to any one, even to his parents. The influence of the sexual organs then commences with life. But it does not attain all its intensity until puberty. At this period, which in our climate commences from the twelfth to the sixteenth year, a little sooner in females than in males, the genital organs have the most vitality. Until that time they are developed slowly and almost imperceptibly; they suddenly in- crease with great activity, and their growth is not arrested till they have arrived at perfection. This is not the place to enter into details as to the labour which then takes place in them: we will merely remark that the change is often.so intense as to present all the characters of inflammation. It is then admissible that in such a state these organs should exercise on 20 the economy a much more powerful action than be- fore, when their development was imperceptible, and also than they do afterward, when they have only to preserve themselves. This in.fact is proved by ob- servation. At no period of life, does the body grow as rapidly as during puberty. The researches of Quetelet and Villerme on the weight and height of men at different ages, {Annates $c. p. 26) leave no doubt on this subject. Thus the annual increase in the weight of the body which until the period of pu- berty was only from three to three and a half pounds, suddenly rises to five and six pounds when this period commences, and gets to be twelve pounds when it is at the summum of intensity. And it is worthy of re- mark that in females who arrive at the age of puberty about two years earlier than males, this increase of growth also commences two years sooner. A similar fact is observed in those monsters who present in early infancy traces of virility: in them the mass of the body is in a direct ratio with the development of the genital system; hence their height and weight are enormous. This is proved by a great number of facts related by authors and particularly by Moreau, Fages, J. G. Smith, Gedike, Meckel, Dupuytren, &c. Let us now compare these facts with those pointed out when speaking of eunuchism, and it will be shown that the power of the genital organs in its nutrition follows in its variations those which they experience: that the general growth conforms to theirs, that if one advances the other does, and if one be imperfect, the other is imperfect. This increase in the activity of the nutritive pow- ers during puberty, is not shown simply by the in- crease of the substance of the body, it manifests it- self by other symptoms. More heat is generated in the tissues, as is indicated particularly by the facility with which individuals at the age of puberty resist cold, and by the interesting remark of duetelet and Smitz, that the summer of all seasons of the year is most fatal to them. Ailments of every kind too show in most subjects, that the influence of the genital 21 organs on all parts of the body may be so great as even to derange the functions: of this character are pains, heaviness in the head, vertigos, redness of the face, numbness in the limbs, dulness and oppression, palpitations of the heart, bleeding from the nose, pain- ful engorgements of the lymphatic ganglions, differ- ent inflammations, &c. ccc. Finally the body re- sponds like an echo, to all that takes place in the gen- ital system. Need we say that nothing of the kind takes place in eunuchs. The active development of the genital parts exer- cises an equal influence on the functions of the life of relation, in the faculties of sensation, action, and thought. These faculties, which are so feeble in the eunuch are extremely active during puberty. This is the age of muscular activity and agility. If those who are growing up, sometimes are reluctant to take exercise, this feeling of reluctance depends on a hy- peremia of the nervous centres, which soon disap- pears. Numerous different and generally transient sensations, denote the part which the nervous system takes in what passes in the genital system; and this is proved also by the frequency of convulsive and spasmodic affections at this period of life. The moral susceptibility is then still more exalted than the phys- ical susceptibility. The mind directed and controlled by the most vivid, most varied, and most transient im- pressions, takes up and lays aside the most opposite opinions, and adopts the most hazardous enterprises. This disposition has existed to so great a degree as even to constitute a kind of monomania, so transient as to be almost imperceptible, and during which crimes, (particularly that of arson) were committed. This fact rests on the authority of Osiander, Henke, of the faculty of medicine at Leipsick, of Marc and of many other authors. {See Marc's memoir omncen- diary monomania, Annates d'hyg. October, 1833.) But the mental state resulting from the change of puberty is characterized particularly by the readiness with which one shares the affections of others, par- takes of their sympathies, and sympathizes with them. 22 This is the moment of generous ideas, or as is re- marked by those, whose minds no longer feel the action of organs which have become mute, the period of illusions. How much experience ought not the mind to gain when passing through this moral tem- pest? Is it astonishing then to find weak minds and cold hearts among eunuchs ? Being deprived of these organs which at the period of puberty give so marked an impulse to the system, they do not feel it: the most active of all moral excitants is absent. Judge from this of its power, and yet it is this stimulant which is so much abused by the onanist. Let us resume our remarks. We have seen by comparing the eunuch to the perfect individual, the male to the female, and the hermaphrodites to those persons whose genitals are perfect, that the genital organs, from the simple fact of their existence, exercise a well marked influence on the physical intellectual and moral constitution of individuals. We have also seen by comparing the period of life when the genital organs are actively developed, with that when they are simply preserved, that the influence which has been spoken of, is exercised with a variable degree of intensity, and is in a direct ratio with the vital activity which exists in these organs. We may then state as a positive truth, that the genital system modifies ex- tensively the action and sensation of all our organs, and modifies it in proportion as it is itself excited. This fact stated, the question whether venereal ex- cesses can or cannot do much injury is resolved. We may, a priori, affirm, that when the genital organs pass from a state of repose to that of excitement, and from this to a state of action, their influence on the other organs is always in an increasing ratio. To prove this requires no new facts. This action and this progressive increase of power, result, inevitably from the comparisons we have made. Life is so-mys- terious and on the other hand, coition is so transient, that what takes place in the tissues during its con- tinuance is concealed from view: but we may be cer- tain that something takes place in them, that some 23 disf'irbar.ce there occurs and that the disturbance is greater during the act of venery than during the pre- ceding states. This act then exerts more influence than it appears to exert, as it affects all parts of the or- ganization. If when the genital system appears at rest, it exercises so much influence on the vitality of the other organs, what must be its power when the vene- real sense is excited in it, antl further when this sense b carried by masturbation or coition to the greatest degree of excitement. How much then must these secret functions be modifitd, whose exercise is so in- timately connected with that of the genital organs! Certainly those who say that the possible consequen- ces of venereal excesses are exaggerated, have not taken this view of the subject. § 2. POWER OF THE GENITAL ORGANS CONSIDERED IN A STATE OF EXCITEMENT. When these organs are in a state of excitement, they present a greater degree of excitement than at any of the phases of the state of repose, not even excepting that of puberty. We may say that they have passed from the chronic to the acute state. They not only be- come the seat of a vivid and special sense, but they also presentakind of turgescence of erethism, and I will say of very remarkable inflammation. They swell, become firm and redder, hotter, and moister: their sensibility becomes extreme. Their power ought certainly to be increased in proportion to the distance between this state and the one of repose. This excitement however is so transient, and the functions on which it reacts are so mysterious, that a great part of its immediate influence cannot be estimated. For in order to mark the action of the genital organs on the mode of exis- tence on the action of the different tissues we must compare individuals to individuals, that is a whole life with a whole life, or at least we must compare two long portions of the same life. On this point the study of the state of repose, of that state which is incomparably the most common, has been useful to us, for we have arrived at facts, by considering their remote conse 24 quences, which at the moment of their production, con- stantly escape. The state of excitement however does not manifest itself solely by the sensations which attend it. Different signs show that the rest of the economy feels that the power of the genital organs is increased. In fact when this state is well marked, the heat of the other parts of the body is increased. The eyes are more brilliant: the colour of the complexion is more lively, the pulse is quicker, and the patient experiences a kind of febrile agitation which in satyriasis and nymphomania, that is, in the greater degrees of human venery, presents the characters of a highly marked fever. The secretions also undergo important modifications, which are but slightly marked in man, but are easily recognised in a great number of animals, who exhale during the period of heat, a strong and most generally a disagreeable odour. The function of nutrition also suffers from this state: thus if it appears too frequent- ly, or is continued too long, the embonpoint disap- pears, the flesh becomes dry, and the body exhibits that leanness which is seen so frequently in those who are extremely salacious. But, I repeat, a great part of the influence exercised upon the nutritive func- tions by the'genital organs when in a state of excite- ment would be overlooked, if only the phenomena mentioned were taken into account. In fact these phenomena are only those which fall directly tinder the notice of the senses, and we believe that their number and proportions would increase infinitely, if the observer could directly inspect the tissues closely. But the most striking fact in the state of excitement is the development of a special sense, the venereal sense. This fact characterizes this state and it effaces the others to such an extent that it seems to form it alone. We shall not attempt to describe the genital sense: a sense cannot be described. We may how- ever ask what is required? Even as hunger impels to eat and thirst to drink, this sense impels to the act of venery. It is the bond which brings the two sexes toward each other, which unites them and which 25 makes, in the words of the disciples of a new belief, a perfect individual of the male and female. This sense may be only feebly excited, and then may have only a rnoderare degree of power. But when it is exalted, the chain with which it binds the free will is of incalculable power. The male dreams of the female: the latter of the male. One of the opposite sex is continually present to the mind and eyes and imagination. Individuals and forms which at other times appear by no means remarkable, now seem per- fect and excite transports of admiration. Riches and honors are no longer esteemed, and even life itself is considered as not worth possessing. All necessities have disappeared before one only. Hunger and thirst are no longer felt. In fact it is a state of delir- ium. All the senses are concentrated in one: it com- mands them and receives from them, like a blind master, all the illusions which they present to it: and then fatigued by this violent state and exhausted by its excess, even when not satisfied, it is as it were ex- tinguished. Such is the power of the genital organs, those organs which are abused by the onanist. Who then can question the physical evils with which its abuse may be attended. § 3. POWER OF THE GENITAL ORGANS CONSIDERED IN A STATE OF ACTION. If the individual either by legitimate modes or otherwise, wishes to satisfy his desires, the state of excitement becomes changed to one of action, and the genital organs then arrive at their greatest degree of power. All parts of the genital system are interested, and combine their actions: the testes prepare the semen: the excretory ducts convey it: the prostrate gland and the muciparous follicles secrete their spe- cial humours, and the mucous fluids flow to the sexual parts. The erectile tissue, which forms the whole of the glans, the cavernous bodies, the clitoris, and most of the external and internal labia, the vagina &c, so- licits to itself and retains the blood, becomes swelled by as much as it can contain, hardens and enlarges to 26 the utmost of its capacity. At the same time the geni- tal sense passes rapidly throughallthe degrees of excite- ment : and finally arrives at that point beyond which it cannot extend: every muscle, every mature fibre in the genital system is then convulsed: the seminal vesicles', the muscles surrounding the urethra and those which are attached to the anus contract with violence, and the semen, the loss of which causes so much exhaustion even when discharged involuntarily, is convulsively expelled. The scene now changes: the genital apparatus, lately so full of life now becomes flaccid: the scro- tum becomes loose and pendent, and a sensation of torpor, of fatigue, of chill follows. The convulsive motions are succeeded by a kind of paralysis, and all attempts at new excitement are vain. During this tumult and after this crisis, the general state of the patient conforms in every manner to that of the genital system. Thus the face reddens, the neck swells, the veins become filled; the skin is now burning and now moistened with sweat, the heart beats with rapidity; in fact there is a state of fever, which almost justifies us in placing the act of venery among diseases. At the same time the nervous centres, the cerebrum, the cerebellum, the spinal mar- row, experience a very powerful impression. As the state progresses, consciousness is lost, and the subject is as it were in a state of delirium. The will is sus- pended, and the muscles are not controlled by it, but by the nervous centres which are so much irritated. Thus the trunk and limbs are agitated by involuntary mo- tions and chills. This disturbance increases until the crisis arrives, when the convulsion affects the genital system; a fit of epilepsy as it were ensues: the sight becomes dim, the trunk stiffens and the neck is thrown back: and finally this state might be regarded as a violent access of disease if the beginning and end of it were not known. Now however the individual is changed: his face has lost its color, his limbs are stiff, without motion and as it were paralyzed: the head is painful, the 27 mind is slow and the limbs are incapable of the least effort. The hearing is dull, the sight is deranged, and the external senses impart to the brain only imperfect impressions. The pulsations of the heart are feeble, the pulse is small, the veins are collapsed and the eyelids are livid. The soul is left in a state of lan- guor and sadness and becomes as it were melan- choly. This picture although giving the principal points is far from being complete; in order to be perfect it should include that which is not as well as that which is seen. If the simple labor which takes place in the genital organs at puberty, is sufficient to modify ma- terially the functions of nutrition, functions which when deranged give rise to many diseases, what must be in this respect the influence of the venereal act, and a fortiori of venereal excesses. This influence, like that exercised by this act on the nervous system cannot be appreciated at the moment it is produced, for it is not immediately perceptible. An idea of this can be gained only in two modes: one consists in measuring the long intervals which exist between a state of repose and that of action: we then say that if the first can modify to such an extent the texture of these organs, their powers of sensation and of action, how great must be the power of the second. In this manner we reason in this instance. In the other mode an opinion may be formed by re- marking the physical alterations and functional disor- ders which have been the consequence of them. This kind of proof which we shall soon examine will not fail us. We shall then see that the diseases affect- ing the nervous system, that system which is power- fully disturbed during coition, are not the only ones resulting from venereal excesses. We shall see that all alterations of tissue, every physical disorder, may be caused by them: and thus we shall complete the proof of this fact that the act of venery not only pro- duces that convulsive state which is so powerful while it continues but that it also exercises on all parts of the body an action which is extremely powerful and 28 is also the source of many evils. When we think of the power of the act of venery, and consider that it may be indulged in as often as an individual chooses, and that if the legitimate mode of indulgence, the concurrence of the sexes is denied, the individual may abuse himself; when we reflect we say on all this, we may fearlessly assert that most of the inconveniences and diseases afflicting the human species, arise from venereal excesses. We have hitherto considered masturbation and coition abstractedly and as if there were no circum- stances to change the influence they exercise. But is this always the case? Are there not individuals who are rendered indisposed by a single act of venery ? Are there not others who can repeat this act with im- punity at near intervals and for a long period of time? Farther is its influence always the same? Are there not circumstances which render it more or less in- jurious and dangerous at different periods of life? And now what are the circumstances and the causes of all the differences we have mentioned ? This sub- ject will be considered in the next chapter. CHAPTER II. CIRCUMSTANCES WHICH RENDER THE ACT OF VENERY MORE OR LESS INJURIOUS TO THE CONSTITUTION AND HEALTH. These circumstances are of two kinds: some de- pend on the act itself: others are independent of it and depend most frequently upon the disposition in which the economy is at the moment of its occur- rence. Let us study in succession these two orders of circumstances. § 4. CIRCUMSTANCES CONNECTED WITH THE VENEREAL ACT WHICH RENDER IT MORE OR LESS INJURIOUS. We have seen in the preceding chapter that the in- fluence of these organs is much greater the more vivid their excitement is: that, for instance, this in- fluence has more intensity during the state of excite- 29 ment than during that of repose: finally that its great- est degree is felt in the act of venery. The natural consequence of these facts is that the greater the ex- citement of the genital organs during this act, the stronger must be the impression caused by it. We may then say that its power of doing injury, other things being equal, is in direct ratio with the force and duration of the excitement which attends it. And further this result is proved by observation. Compare the two sexes together: the female pre- sents instances of venereal excess, much less fre- quently than the male. Whence is this difference? Is it not because the genital sense in females is much less susceptible of excitement than in males, and therefore the act of venery causes them much less fatigue? I know that this fact has been disputed: and it is asserted that the female is fully as sensual as the male; and that if females show their feelings less, it is because they are controlled by custom. I know also that the reluctance of females to submit to the approach of the male is ascribed to a kind of ten- der coquetry which tends to increase the ardor of the former. Finally, the rednesss of the genital organs of females during the period of heat, has been mentioned as proving the intensity of their sensations. {Marc, Diet, des Sc. med., art. Celib. etc.) But these argu- ments cannot be maintained in opposition to that which daily experience proves to be true, viz., that as a general fact, females are much less addicted to the pleasures of love than males, and experience less fatigue during sexual intercourse. The inferiority or perhaps the advantage which fe- males have over males in this respect, depends on the passiveness which they naturally exercise in the act of generation: and hence their desires are less strong. The state of manners justifies their reserve in this re- spect, and points out a physiological fact, or rather they are the consequence of it. As to the pretended coquetry of animals, I do not believe in it strongly ; and in regard to that of females I believe that it has caused more to err than their desires. If the venereal 3* 30 passion be equahy developed in the two sexes, why s onanism more common in males than in females, notwithstanding certain conditions ought to produce a contrary state of things? And farther do not many wives yield themselves to the caresses of their hus- bands, without desire and without enjoyment? and yet this indifference does not prevent conception, for the sensation of love is not with them, as with the male, an indispensable condition of the work of gene- ration. Finally would there be any prostitutes, if coition caused in females the same exhaustion as in the male? Females then are indisputably less sen- sual than males; and when this fact is taken in con- nexion with the circumstance that women are less frequently victims of venereal excesss, does not this tend to prove, that, other things being equal, the act of venery is, as before stated, less injurious, in pro- portion, as the sensations attending it are less vivid? Perhaps this explains why females generally live lon- ger by two or three years, than males, notwithstand- ing the pains and dangers of pregnancy, parturition and lactation: and this fact may be deduced accord- ing to Sir John Sinclair, from the registers of mortal- ity of different countries, and from the rent tables which have been kept in Holland for a hundred and twenty-five years. Farther, it is well ascertained that every thing which contributes to give more force and duration to the sensations attending the act of venery, also increases the fatigue and disorder which follow it. Coition taken in its simplest sense, and consider- ed only as an excretion of semen, undoubtedly causes much less injury than if it occurs with other sensa- tions. Thus intercourse with public women and generally with those who do not excite strong sensa- tions is generally attended with less derangement, as Hunter has remarked, than if accompanied with vio- lent passion. Some authors however as Sanctorius and Tissot have advanced a contrary opinion; but they have evidently confounded the state of the mind with that of the body. When the, soul is possessed of a violent passion, the ardors of love continue a 31 longer time, are not so soon satisfied: but does it fol- low from this that the body presents more resistance. Certainly not, but only that the pernicions effects are felt less at the time; although at a later period they will be perceived. One reason why masturbation is more pernicious than coition arises from the state of mind during the two acts. The onanist, and here we allude only to those who have some ideas of sexual intercourse and love, having no material object which is the beginning and the end of its pleasures, the imagination must supply and invent it. This mental labor renders the sensations stronger and the body more disposed to feel them. Added to these, the onanist is desirous of pro- longing his feeling, and having under his control cer- tain circumstances which in sexual intercourse hasten the denouement, he retards it. Thus with fatal skill he gives to this destructive vice all the power it can possess, and experiences all the evil which this vice can cause. § 4. CIRCUMSTANCES INDEPENDENT OF THE ACT OF VENERY, WHICH RENDER IT MORE OR LESS INJURIOUS. The economy is not equally affected by venereal excesses in all individuals at all periods of life. There are some circumstances which make it neces- sary for masturbation or ^coition to be more or less fre- quently repeated in order to be injurious. Hence if we wish to know the real influence of these acts, these circumstances must be considered. These are numerous but they are not all known. Two individ- uals indulge in onanism: one becomes ill in a few weeks: but the other resists the pernicious habit lon- ger. These two individuals were certainly in differ- ent states, as the event proves. This fact however was indicated previously by no circumstance: their age, constitution and manner of living before this were similar: in fact the reason why they were af- fected so differently cannot be told. The difference here presented by two individuals may be observed in 32 the same person, when considered at different epochs and periods of life. He will resist the excess of mas- turbation and coition to a greater degree at some times than at others, although the circumstances on which these differences depend are not known. There are then unknown circumstances which have an effect on the consequences arising from onanism. These re- marks are highly important and seem to be well un- derstood ; and it is clear that there is no possible se- curity for the onanist: in vain does he look for en- couragement by comparing himself to others, or by remarking of a comrade: "if he had been as healthy as I am, his health would still be good, he would not have died:" or by saying "why should I fear what I have indulged in so long with impunity." This mode of reasoning is out of the question when the truth of the preceding remark is admitted, and it is then im- possible for a person to deceive himself; and the rea- son that so many abuse themselves is because they think themselves stronger than others. Besides these circumstances, there are some which are well known and which contribute more or less to render the act of venery more detrimental. These circumstances consist first, in the general state of the functions at different ages and in the peculiar state of some of them at different periods of life; second, in a coincidence of action between the act of venery, and other causes of disease; third, in the alterations which the constitution may have already suffered, and in the disposition existing to contract certain dis- eases; fourth, finally in the state of the diseases with which the patient is afflicted, when he indulges in the act of venery. Influence which the general state of the functions has at different ages, and which the peculiar state of some of them at different periods of life may have on the consequences of the act of venery. Life is composed of three very distinct periods. In the first, the body is developed and formed: it is a period of progress: while it continues, the organs gain in force and substance: it terminates when they 33 have arrived at their greatest degree of perfection: and this generally lakes place about the twTenty-fifth year. During the second period man uses the organs as they are formed and constituted. The only process which takes place in them is one of reparation, of re- newal : this is the period of maturity: it generally terminates about the fiftieth year. The third period is the opposite of the first: it. is the period of decline. There is, during this latter period, a progressive dete- rioration of the strength and of the tissues. It termi- nates with life. Thus a state of development, that of maturity, and that of decline are "the three a"speets under which life presents itself. Let us trace the ef- fect of venereal excesses in these different phases of action. First period. No animal, and particularly no one of the vertebrated animals can procreate on entering the world. The genital organs doubtless exist at that time, but their form is rudimentary, which proves that they are incapable of doing much. These organs do not acquire the power of fulfilling their special func- tions, until a more advanced period of life, which period varies in different species of animals, but is nearly the same in all individuals of the same species. Until this time there is no secretion of prolific semen in the male, nor creation of oyales in the female: the procreative power does not exist. Man is no exception to this common rule; his gen- ital organs, although distinct, are scarcely developed at the moment of birth. The penis in males, the nymphae and clitoris in females appear it is true to have a certain size, but this size does not depend on the development of the true spongy, erectile tissue of these parts. The genital apparatus continues to grow, although slowly during infancy, but it does not be- come filled for reproduction until after the rapid devel- opment seen at puberty. Hence in man, as in all an- imals, the power of reproduction does not exist until after some portion of life has elapsed. What is this portion? why does not the power come earlier or later? this is of but little importance: existence is 34 necessary a certain time before it appears. But as God has made nothing useless in this world, we may fearlessly assert that those who before the age for pro- creation, excite in themselves the feelings attending this faculty, do an unnatural act and one which is ne- cessarily pernicious. Thus a priori, and by the application of general laws all premature indulgences are reproved. This opinion is confirmed by the study of the human body in the first third of its existence. This period of life is marked by two facts of the highest importance. It is then that the organs form, that they become perfect in substance, extent, and texture. It is then also that they acquire in action and in the power of receiving impressions the characters which form their special constitution, that is, the state which considered at the same time in all the organs, composes what is called the temperament. During Infancy and in youth, the formation of the substance of the body and of its con- stitution, is going on. Let us compare with this pro- cess, on the regularity of which the health, and well- being of the individual depends, let us compare, we say venereal indulgences, or rather masturbation, for this alone is then possible; we shall then see why the generative faculty was not born with us, and why the precocious excitement of the genital sense is attended with so much danger. The first result of this excitement is to hasten the material and sensitive development of the genital or- gans. The preternatural size which masturbation gives to the penis in children is so remarkable that this alone is often sufficient to reveal this habit. Farther this excitement not only awakens the venereal sense long before the legitimate period of its appear- ance, but it acquires so much power that the youngest persons brave all connective means to satisfy it. Here then we have a system of organs forcing their development forward at the expense of the other organs. This state undoubtedly causes derangement and if we compare the genital organs with those which have the least sensibility, we may form aa 35 opinion of the consequences of it. If we reflect on the symptoms attending dentition which are often severe; or those depending on too rapid growth of the bones, and then measure the great difference between the vitality of the osseous and genital systems, we can form an idea of the injury caused by the prema- ture enlargement of the genital apparatus. Although there may be no real disease, yet the wasting of the body, the enervation which results from excessive growth are often sufficient to give to a young man the appearance of an onanist. If such feelings arise simply from the osseous sys- tem, what must we expect when onanism, with its train of moral and of sensual feelings, forces the gen- ital organs to take part in the efforts of growth. The power which is then impaired is the same which we have seen extend over all parts of the organization, that, whose action when regular, contributes so much to make each tissue perfect, in fact that which when removed gives to man the characters of an eunuch. Now consider onanism as possessing this power and using to do injury all the energy which it possesses to do good; what limits shall be assigned to its inju- rious effects? and yet some authors question them. Many general phenomena of puberty also appear pre- maturely, when premature indulgences call them into development. Thus the beard appears on the chin, the pubis is covered with hairs, the voice assumes a deeper tone, and the first indications of virility show themselves much earlier than is proper. These symp- toms serve to trace the aberrations which onanism causes in the formation of the organs. This vice too does not surely hasten or retard; it deranges: for the derangement of the functions is not generally mani- fested by irregularities in formation, aspect, and tex- ture, but by material alterations, by diseases. Hence why inflammations of all kinds, and numerous organ- ic affections result, as observation proves, sooner or later from anticipated pleasures: now as the suscep- tibility of the organs varies in individuals, and as in one, the hearty in another the lungs, the stomach s of sub-tance. There are individuals however who remain thin and dried up through life, in consequence of abusing them- selves while young. The loss of strength generally follows the loss of flesh and returns also with it. At first debility only follows the act temporarily, but afterward it continues longer: new emissions of semen take place, and even before the subject of them has regained the strength exhausted by a previous indulgence. In the morning he rises from his bed with difficulty: during the day he is idie, stupid, and indolent, and pursues his avo- cations without any spirit. If he goes up stairs, or ascend* a hill, his heart beats forcibly, and he pant3 very much. This debility, if the cauae agitation was so great, that the patient could not rest in bed, nor sit without support. Twenty-five leeches were applied to the lumbar re- gion, and these drew about twelve ounces of blood. The trembling diminished, and the patient could soon rise and walk without a stick, and in fact without as- sistance. From this time, he felt no pains nor trem- bling, and he left the hospital eight days afterward. Dr. Bertini has since seen him, and he was well. {Revue Med., Dec. 1825.) The tetanic form of the disease of the spinal mar- row has rarely been observed as arising from onanism. Tissot saw a case of it in a young man:—" The dis- ease commenced with rigidity of the neck and spine; this extended successively to* all the limbs; and the patient, for some time before death, was obliged to lie in h-ed on his face, unable to move either his feet or hands. All motion was impossible; and he was 89 obliged even to be fed. He lived several weeks in this sad state; and died, or rather sunk away, almost without suffering." Paralysis, which is the consequence of myelitis, or of any other affection of the spinal marrow, has been seen much more frequently than tetanus, in onanists. It is most generally confined to the lower parts of the body ; but if the disease be seated in the cervical portion of the spinal marrow, the four extremities may be paralyzed. This was seen in the case of a young man who was under the care of Dupuytren, in Sep- tember, 1833:— This young man was twenty years old: he was very much addicted to masturbation, and his disease could be attributed to no other cause. This affection had existed for two years, when the patient entered Hotel Dieu. The attack of paralysis had been sudden, like a clap of thunder: the patient had lost the use of his limbs suddenly. The muscles of the neck were paralyzed, and the head fell in any direction: a short time before, however, the patient had recovered the flower of sustaining it. The paralysis of the four imbs, also, varied in degree, alternately increasing and diminishing. After the patient entered the hospi- tal, it was not equal on both sides: thus, he had some power over his left arm, but not over his right arm. Both the upper limbs, also, were atrophied, or wasted : those of the right side more so, however, than those of the left. Many remedies had been tried for this patient, but without success. At the time the case was published, purgatives and inoxas were proposed. Dupuytren remarked to his pupils, that the situation of the myelitis corresponded in this young man to the cervical vertebra:; and that, if it ascended a little, and extended to the origin of the diaphragmatic nerve, it would cause death. He regarded the passion for mas- turbation, which existed in this young man, as the probable cause of this myelitis; and, consequently, of an atrophy of the anterior roots of the spinal nerves. {LunceUe Franrai.se, 1833, p. 339.) The disorganization, also, occupied an elevated por- S* 90 tion of the spinal marrow, in the following case stated by Tissot:—"I was called upon," says he, "to visit in the country a man, forty years old, who had been very strong and robust, but who had indulged excessively in sexual commerce and in wine, and who had been often engaged in athletic exercises. He began to be affected, a few months since, by a weakness in his legs, which made him totter in his walk, as if drunk. He sometimes fell, when walking on a plane; he could not descend the stairs without much difficulty; and hardly dared to leave his apartment. His hands trembled very much; he wrote with very great diffi- culty, and very badly; but he dictated with ease, al- though his speech, which had never been very fluent, began to be less so. His memory was still good ; and the only ground for suspecting a lesion in his mind was the want of attention at the jeu de dames, and the change of countenance. His appetite was good, and he slept well; but it was difficult for him to turn in bed. It occurred to me that his gallantries, and a too free use of wine, were the first causes of the disease; and that his athletic exercises, in which he had been fre- quently engaged, were the origin of the particular affection of the muscles. The season was not favor- able for the use of remedies; but it was necessary to attempt to arrest the progress of the disease. I ad- vised frictions of the whole body with flannels, and some tonics. I directed the doses to be increased, and to add also the use of the cold bath, at the commence- ment of summer. In a few weeks, the trembling of the hands seemed to be a little diminished. A con- sultation was had in the month of April: the disease was attributed to his having written some months, two years since, in a chamber recently plastered. Warm baths—oily frictions, with diaphoretic and anti- spasmodic powders, were employed without benefit. In the month of June, in a second consultation, he was advised to visit the medicinal spring of Leuk, in Valais. On his return, the trembling and stiffness had increased. From this time, (Sept. 1760, to Jan. 1764.) I saw him 91 but three or four times. In 1762, he procured from Frankfort the remedies mentioned in the English treat- ise, Onania, which were of no use. He consulted a foreign physician the last year with as little success. The disease has slowly, but daily progressed ; and for several months before death, his legs were too weak to support the weight of his body. He could not move his hands nor arms without help; his speech was so embarrassed, and his voice so feeble, that it was diffi- cult to understand him; the extensor muscles of the head allowed it to fall continually on the chest; he had constant pains in the loins; his sleep and appetite were sensibly diminished. During the last few months of his life, there was much difficulty in swallowing; after Christmas? there came on an irregular fever, and his eyes were singularly dim; when I saw him in the month of January, he passed the whole day and most of the night reclining on a sofa, with his feet in a chair, with a domestic constantly in attendance near him, in order to change his position, raise his head to feed him, and to listen attentively to all he said. As he approached the period of his dissolution, he was obliged to articulate letter by letter, which was written down as it was pronounced. Seeing that I gave him no encouragement, as I only employed some palliatives for his fever and oppression, and actuated by a desire of living, he sent one of his friends to tell me the cause to which he attributed all these symptoms, viz., masturbation; that he commenced this infamous practice several years since; had continued it as long as possible; and that he had perceived his difficulties increase, in proportion to his indulgence in it. He confirmed this statement a few days afterward ; and it was this which induced him to use the remedies recommended in Onania.'1 This case shows us paralysis confined at first to the abdominal limbs, but extending afterward to the upper part of the body. We find a similar case of this pro- gression, in a case related by Olivier, of Angers:— " M—, of a sanguine temperament, of a strong con- stitution, and of a lively and gay character, had always 92 enjoyed good health until seventeen years eld, when he unfortunately became addicted to masturbation. He soon languished, and grew debilitated. Having. however, conquered this fatal habit, his strength grad- ually returned, and a proper regimen soon restored him to his former vigor. When twenty years old, he per-' ceived a marked debility in the motions of the articu- lation of the right foot; but this disappeared: he was then affected twice with blenorrhagia, the last attack of which continued for several months. "When twenty-five years old, he again indulged in masturbation, and similar symptoms to those first pre- sented soon appeared : the lower extremities, also, be- came weakened; at times, also, the sensibility of the skin was obtuse, and even lost; but it soon reappeared. Under the influence of remedies, the weakness in the limbs diminished slightly. M— could walk three quarters of an hour without resting, but he could not stand longer; his legs, which Avere evidently wasted, refusing to sustain him. He was extremely costive; and since the last attack of blenorrhagia, the excretion of urine Avas painful. " This affection remained stationary for several years, and then became more serious: the patient was now twenty-nine years old. At this period, the para- plegia became complete. He could not walk, nor even support himself on crutches; his lower limbs Avere often stiff; both arms, also, were at times insensible; and sometimes the sense of touch was blunted. The wasting away had increased ; the excretion of urine was often involuntary, and the constipation Avas habit- ual. He was somewhat benefited by Halle's prescrip- tions, consisting in frictions with cantharides, and douches to the spine; but the next year the evil in- creased, the sensibility in the hands diminished, and there was difficulty in moving the right hand. " Eighteen months afterward, the lower extremities became perfectly paralyzed : they were less Avarm than the rest of the body ; yet. when cold water was applied to them, it produced a burning sensation. The right arm, forearm, and hand, often felt fatigue: its motions 93 were less free, and the patient sometimes found it dif- ficult to write. The limb of the opposite side was not affected. The disease of the bladder, Avhich had ex- isted for several years, was also increased. " Paralysis, during the folloAving years, progressed slowly, but constantly. The arm of the right side lost its motion entirely; the forearm was flexed upon it, and retained this position. At a later period, the fin- gers became stiff, crooked, and they continued to be so flexed, that a tampon of linen Avas placed on the palm of the hand, to prevent the nails from lacerating the skin. A singular symptom, also, appeared : if the in- ternal part of the thigh was gently rubbed, the limbs extended quickly, as if by a galvanic shock, and then resumed their first position, which was that of a per- manent state of semiflexion. The paralysis finally affected the left upper extrem- ity, which had hitherto been free from it; at the same time, the respiration became more difficult, the voice more feeble, and speech more painful, so that the pa- tient choked, after talking a few moments. These different symptoms, and those described above, gradu- ally became intense; and at the time this case was recorded, the patient was still alive—but in a most lamentable situation. Very severe pains supervened in the right side ; the limbs were frequently convulsed ; the constipation was obstinate; the urine passed invol- untarily : the intellectual faculties, however, remained unaffected; and the patient, who was then fifty years old, proved, by his easy and agreeable conversation, that, notwithstanding his unfortunate situation, he had lost none of his natural gayety of character." ( Traiie de la moelle epiniere, &c„ vol. ii., p. 594.) The lower part of the medulla alone was affected in an individual whose case is mentioned by Tissot. In another case related by Weszpremi, the spinal marrow and brain were affected. The patient, who was thirty years old, complained of pains along the spine, especially when he stooped. His legs Avere so weak, that he could scarcely stand erect for a moment; nis memory was considerably weakened, and he seemed 94 stupid; his sight was also affected, and he was ex- tremely thin. This man, having long denied the cause of his disease, finally confessed it. After some months, his health was restored. (Observ. Med., p. 175.) The disease is not always confined to the spinal marrow, and its membranes: it frequently extends to the parts adjacent, and particularly to the vertebrae. The latter are then destroyed ; and the disease de- scribed by Pott, and which takes his name, appears. Sabatier was aware of the influence of masturbation on the bony part of the vertebral column. " The most terrible and most frequent results of onanism," says he, in a letter to M. A. Petit, "are nodosities of the spine. My opinion has always been regarded as unfounded, on account of the youth of the patients; but I was enlightened by the admission of some of my patients, that many were guilty of this thing before their sixteenth year." This fact, which was afterward stated by Boyer, in his lectures, is now no longer doubted. The relation, however, between the caries of the bodies of the vertebrae in onanists, and ihe affection of the medulla, or of its membranes, had not been observed; it had not been remarked that this latter always precedes caries, which in this case is only the result of the extension of the primitive dis- ease. The facts which are to be stated will prove this to be true. L. E. G., twenty-one years old, a turner, of a lymph- atic temperament, of a slender and delicate constitu- tion, addicted to masturbation from childhood, expe- rienced, at the beginning of February, 1825, a slight pain in the epigastric region, difficulty of digestion, and constipation: he also had laborious breathing, caused by palpitations, which were much increased by walking, and particularly by going up stairs. On entering the hospital la Pitie, April 28th, 1S25, this young man presented all the symptoms of a hypertrophy of the left cavities of the heart: these phenomena, which diminished after a feAv days, were followed by symptoms of enteritis and peritonitis, which were attributed to excesses in eating. During 95 the continuance of this latter affection, the patient complained of uncommon debility in the abdominal limbs. These symptoms disappeared; and Avhen it was expected to see ihe patient convalescent, he was affected Avith complete paraplegia. He lost the use of his legs: they, however, retained their sensibility. As motion in them was lost, this sensibility was even increased; for the patient cried whenever he was touched, or Avhen the position of the lower limbs was changed. The bladder was soon paralyzed, and the sound was used, which caused inflammation of this or- gan. A broad and deep eschar, followed by ulcera- tion, laid bare the whole posterior part of the pelvis. From this time, the symptoms increased more and more, and the patient died the 11th of August, about six weeks after the first symptoms appeared. On opening the body, a softened tubercle was found on the surface of the right hemisphere of the brain ; the body of the third dorsal vertebra was slightly changed', the corresponding portion of the dura ma- ter presented a cancerous degenerescence, which ex- tended from the body of the third dorsal to that of the fifth cervical vertebra. The bodies of all the vertebrae connected with this alteration were whitish, and slightly softened. The tissue of the spinal marrow was softened, especially on the level with the seventh cervical and first three dorsal vertebrae: the softening occupied the anterior cords, which were of a grayish Avhite color; the posterior cords were slightly softened but only on a level with the first three dorsal vertebrae The lungs were healthy and crepitating; the right contained superiorly a small softened tubercle. Tin heart was healthy: its size was normal; the left cav- ities possessed their usual size and thickness. Traces of inflammation were found in the peritoneum, intes- tines, and bladder. {Journal de Physiol. Experim. July, 1S25.) In this case, avp see in a measure the mode in which caries of the vertebrae is produced. This caries is only at its commencement; the vertebrae are affected super- ficially, and in those parts only which correspond to 96 the diseased portions of the dura mater and medulla. There are none of the io al symptoms of Poll's dis- ease—no collapse of the vertebral column—no gibbos- ity ; yet the paraplegia appeared, as in the cases where these alterations exist: it resulted, then, from ihe soft- ening of the medulla, or the alteration of its mem- branes. If a little time had elapsed, and several spi- nous processes had deviated from their true direction, this paralysis would have been attributed to ihe com- mencement and progress of this deviation. These relations between the state of the medulla and that of the vertebrae have been alieady remarked by several authors. M. Latour, in a memoir inserted among those of the Society of Emulation, has sought to establish that paraplegia, in Pott's disease, resulted from a primitive alteration of the medulla. Janson has since expressed a similar opinion. Cases have also been published by Louis, which leave little doubt on this subject. {Mem. and Recherchcs, 1826, p. 410.) One symptom in the preceding case, which deserves to be noted, is the difficulty of respiration, the palpita- tions, and other symptoms which led to the belief that the heart was diseased. On opening the body, how- ever, this organ was found'perfectly healthy. Similar phenomena are often seen in onanists: it would there- fore be wrong to consider them always as signs of an organic alteration of the heart and large vessels. In the following case, the vertebrae were more changed. The spinal column was gibbous: but this was preceded by paraplegia, and other symptoms of myelitis. This case was published by M. Dalande- terie:— A shoemaker, twenty-four years old, of good consti- tution, Avho has always enjoyed good health, contracted the habit of masturbation at the age of sixteen years, and became so addicted to it, that he indulged seven or eight times a-day: his strength soon diminished, and he lost flesh and his color. After an interruption, caused by an acute disease, the patient resumed his fatal habit with the same earn- estness. He finally became sd weak; languid^ and 97 pale, that he was discharged from military service, in which he was inscribed. A little while afterward, this young man, who had never shown any symptoms of scrofula, presented scrofulous engorgements in the groins and axillae, and swellingSj with caries, in several phalanges of the fin- gers. At the same time, a singular phenomenon ap- peared : the hair, which was chestnut colored, came off; on groAving again, it appeared of several colors: but after coming off once or twice, it resumed its natu- ral shade. The patient continuing to indulge in onanism, finally became extremely weak, and was obliged to keep his bed. Marked symptoms of myelitis now appeared. The patient gradually lost the use of his lower limbs: first they became weak, and showed a disposition to be crossed ; but finally wasted away, and lost the power of motion. He was now obliged even to be turned in bed, as he could not move. The articulation of (he feet and knees became stiff and inflexible, and his legs were so much retracted, that the end of the foot ouly touched the ground, when the patient was Flaced in an erect position. The sensibility of the imbs, also, was as much affected as their motions; they were cold, numb, and even when pinched they Avere not painful. The general languor was increased every day. He suffered from thirst, dyspepsia, pains in the stomach, rumblings, night sweats, &c. At this period, the patient quitted a woman with whom he had lived for a year, and who, having but little incli- nation for coition, caused him to indulge in masturb- ation. The erections Avere frequent, powerful, short, and ahvays terminated with a more or less abundant dis- charge of mucus from the urethra—perhaps, also from the prostrate gland; or even the discharge might be of thin semen. After a while$ the ejaculations were composed, instead of semen, of a half-clotted, blackish or veloAvish blood: sometimes, as much as a table- spoonful was lost. These emissions were always pain- ful, and were followed by extreme prostration. 9 98 For some time, the patient was in this sad state, when he experienced a crawling sensation, like that caused by ants, descending along the back: he expe rienced, in the same region, a severe and fatiguing pain, which extended into the ribs and loins. These symptoms subsided ; but at the lower part of the dorsal region appeared a hard tumor, which at first was small; but it gradually enlarged, as long as the patient con- tinued to masturbate. This tumor was evidently formed by the curve of the spine, and the projection of three spinous processes. In three months, the patient was improved by the use of rnoxas and of antiscrofulous remedies, by a suitable regimen, and particularly by abstaining from onanism, for which he had conceived not only disgust, but even a horror. The abdominal limbs regained their strength, heat, and sensibility; the patient could walk on crutches, and could even stand erect for a few moments, and could take a few steps unaided. In this case, which is remarkable in more than one respect, the symptoms of myelitis preceded the curve of the spine, and then disappeared, although the spine did not regain its primitive rectitude. The debility, numbness, retraction, and paralysis of the limbs, ap- peared long before the pain in the back, after which the curve in the back began to appear; and then these limbs regained their sensibility, force, and motion, while the gibbosity remained always the same. This curve, then, could not be the cause of the paraplegia, because the latter appeared first, and the spine remained curved after the paralysis was removed. The devel- opment of symptoms apparently scrofulous, in a man more than twenty years old, who had hitherto pre- sented nothing analogous, and Avhose parents were healthy; the loss of his hair; the affection of the seminal passages, and the state of the genital organs, &c, &c.—facts to which Ave shall recur hereafter—all contribute to render this case interesting. We shall see, in the following case, also related by M. Dalandeterie, an instance of vertebral caries in an onanist:— 99 A cook, forty-five years old, of bad constitution, but having always enjoyed robust health, indulged in mas- turbation, although not to very great excess. Eighteen months before his case was published, he perceived pains and weakness in the loins, frequent colics, often followed by brownish dejections, and sometimes by obstinate constipation. He suffered, too, from flatu- lency ; and in the left haunch there was a pain, which increased or diminished with this flatulence. The patient, notwithstanding the progress of these symptoms, continued to masturbate. Debility and pains in his loins extended into the abdominal limbs, and increased so much, that he was obliged to keep his bed: he could only lie on his left side; but in this position his motions were easy. The diminution in the natural heal, the livid color of the skin, the soft- ness and flaccidity of the flesh, debility, loss of sleep and of flesh, thirst, constipation, &c, were added to the symptoms already mentioned. At the same time, a hard, indolent tumor, the size of a pullet's egg, was formed at the lower part of the dorsal region. This tumor, which did not enlarge, evidently resulted from the prominence of the spinous processes, and consequently from a curve in the spine, which Avas doubtless caused by a softening of the bodies of the vertebrae. Nearly at the same period, there was developed, at the loAver part of the sternum, a hard, indolent tumor; the color of the skin Avas unchanged: it gradually be- came the size of a nut, suppurated, and assumed the appearance of a scrofulous ulcer. The lymphatic ganglions of the neck, which were somewhat swelled, now returned to their natural size. The treatment Avas similar to that used in the former case, and was attended with the same result: the strength, bodily heat, and appetite returned. Finally, the patient was able to Avalk with crutches; and could stand, unsup- ported, for a k\v moments. The circumstances in this case are not detailed with sufficient accuracy, to enable us to follow exactly the cause of the symptoms. We Avould remark, however, 100 that one of these seen first was the neuralgic pains, which extended from the loins into the lower extremi- ties. Now, as this symptom belongs to irritation of the medulla or its membranes, more than to their com- pression, there is reason to think that this irritation preceded the curve of the spine. In this patient, also, as in the preceding case, the affection of the marrow had not so much influence in causing the destruction of the bodies of the vertebrae, as a disposition to caries —a disposition which was evidently increased by onanism, and which appeared at the same time in several bones. The following case, from Meyrieu, is not sufficiently detailed, to affect in any manner the question, how caries of the vertebrae is produced in onanists; but it is interesting, as it shows that the disease may extend to the soft parts which cover or are adjacent to the affected vertebrae. L—, twenty-two years old, was moderately tall with a narrow chest, and had never enjoyed good health, particularly for the six years preceding the time when he entered the prison at Bicetre, when he indulged in the disgusting practice of onanism. In the course of January, 1819, he was affected with gen- eral numbness, with frequent cough and expectoration of mucus: these symptoms were occasioually attended with slight fever. When admitted to the infirmary, the 1st of February, he complained, in addition to the symptoms already mentioned, of a violent pain in the posterior part of the neck. A slight swelling was seen at the level of the first and second cervical vertebrae, and pressure on that part was painful; the head Avas bent to the left side, and remained motionless; the thoracic and^abdominal limbs were numb; and deglu- tition was painful. Local resolvent frictions, blisters, and moxas were used. The 15th of February, he was affected with hemoptysis, Avhich yielded in two days to the use of bleeding and astringents. The vertebral disease, however, generally made progress, like that of the chest, which seemed to relax. In July, the thoracic limbs were perfectly paralyzed; and in Au- 101 gust, this was true also of the abdominal limbs. At this period, the head Avas absolutely immoveable; the phthisis seemed as yet in the second degree. Finally, the patient died suddenly, from moving his head, while the attendants were changing him. Post-mortem Examination. The soft, parts of the fiosterior region of the neck were changed to a whitish, ardaceous substance; the right condyle of the occipi- tal bone was carious: there was also a deep caries of the upper part of the right lateral mass of the first vertebrae, and of the odontoid process. The transverse and odontoid ligaments were degenerated and soft- ened; and the medulla oblongata presented a kind of strangulation, resulting from the compression caused by the left posterior part of the edge of the occipital foramen: in fact, there was a dislocation of this bone, on the first vertebrae. The cerebrum was unaffected ; the right lung was tuberculous, and very small; that of the left side was also tuberculous, but was larger. The peritoneum presented some marks of inflammation. In the preceding cases, the caries of the vertebrae was not attended with a congested abscess. The fol- lowing case, published by Leveque Lasource, will pre- sent to us this symptom, which is so common in this disease:— N— O— Avas addicted to onanism, from tAvelve to eighteen yeais of age; but could not renounce this fatal habit, although reminded of its danger by a curve in the spine, and by other symptoms. When received at la Charite Hospital, in 1806, beside a well marked gibbosity, he presented a congested abscess at the upper and inner part of the thigh. Two cauteries were applied to the sides of the vertebral prominences: these suppurated freely, but did no good. The abscess was punctured in several places. This young man, who could-not survive, left the hospital; so that the organic changes produced by his disease could not be verified. {Jour, de Med., Chir. and Phar.; vol. xvii., p. 261.) The same author has related another case, which terminated more fortunately :—A child, seven or eight 9* 102 years old, addicted to masturbation, entered at la Char- ite, affected with gibbosity and paralysis of the lower limbs. During the month he stayed in the hospital, several cauteries were applied around the tumor, which suppurated; tonics and strengthening medicines were administered internally. He left, perfectly cured of the paralysis, and of the other symptoms caused by the affection of the medulla; but the deformity result- ing from the prominence formed by the spinous pro- cesses of the vertebrae continued. Three years after, this child, who had abstained from this bad habit, had experienced no relapse. We have seen, in several of the preceding cases, that permanent contractions of the lower limbs re- sulted, in onanists, from affections of the spinal mar- row. Guersent, also, admits the possibility of essential contractions—that is, those which do not result from a disease of the nervous centres. According to this practitioner, these kinds of contractions are seen most frequently in those nervous children who indulge in bad habits, like that of masturbation. The following case has been considered by him as an instance of this affection:— D— E—, five years old, and addicted to masturba- tion, after passing a part of the winter at the Hospital des Enfans, to be treated for scrofulous engorgements of the glands of the neck, Avas sent to the country in the spring. He had been there about three months, when he was suddenly affected with a contraction of the lower extremities. Examined the 5th of July, he complained neither of pain in the head nor spine. The digestive passages were in very good state ; there was no derangement in the circulation or respiration; the muscles of the loAver extremities were permanently rigid : the tension, however, was more marked in the adductors; for the patient constantly kept his kneps crossed. There was no deviation in the vertebral column. Different remedies Avere employed, but with- out success; except a little improvement under the use of carbonate of iron. The legs and thishs of the patient could be flexed and extended with the hands; 103 but he could neither flex them when extended, nor ex- tend them when flexed. This child was cured in a singular manner. His state was as described, when, at the beginning of September, he Avas affected with symptoms of roseola. The contraction of the lower extremities disappeared, when the fever came on. The eruption went through its course, and the contraction of the limbs did not return. Thus, this disease, which had resisted several efficacious reme- dies, disappeared before another disease. The loss or debility of the external senses, particu- larly those of hearing and sight, when this state is the consequence of venereal excesses, often result, as may be seen in several of the cases above stated, from a disease of the brain. This organ was probably dis- eased in the old man whose case was mentioned by Reveille Parise. This man was desirous of living with a young Italian girl, whose temperament was extremely ardent. He paid for his imprudence by blindness, which occurred in eight days, and which was followed by death. Sometimes, however, the eye alone is diseased : at least, the pathological state which it presents is unattended by any symptoms indi- cating an affection of the brain or its membranes. Many libertines present only an irritation of the con- junctiva and of the edge of the eyelids. It is a sort of chronic ophthalmia; their eyes are red, watery, fa- tigued, painful; and they cannot engage in the even- ing in any occupation, such as reading, which requires the attention to be confined to one object. Sometimes, a severe and deep-seated pain proves that, beside the outer parts of the eye, the interior of this organ is the seat of a severe irritation. Hoffmann has seen several cases of this. He cites that of a young man, who in- dulged in onanism from the age of fifteen to that of twenty-three. " His eyes and head were so Aveak," says he, "that these organs were often affected Avith violent spasms, during the emission of semen. When- ever he attempted to read, he experienced a sensation similar to that of "drunkenness: the pupil was consid- erably dilated, and excessive pains were felt in the 104 eye. The eyelids were glued together every night; the eyes were also watery ; and there was, at the tAvo angles, a collection of whitish matter. These irrita- tions, especially when seated within the eye, may be followed by the loss of sight. Dr. Juengken, professor of clinical ophthalmology at the Berlin faculty, and who has published an excellent Avork on the diseases of the eye, indicates, Avhen speaking of amaurosis re- sulting from masturbation, that the pupil assumes a peculiar form, Avhich is found only (says this professor) in those individuals habitually addicted to this vice. In these cases, the pupil, instead of being in the cen- tre of the eye, is removed upward, but does not lose its roundness: the upper part of the iris seems nar- rower, and contracted on its ciliary edge. This symp- tom has been mentioned, also, by Dr. Sichel, as occurring in certain scrofulous ophthalmias: iritis then exists. Photophobia, which is a greater or less aver- sion to light, resulting from the.pain which it occasions in the eye, has been indicated, by Sanson, as some- times preceding amaurosis, caused by too frequent a loss of semen. All authors agree in placing venereal excesses, and particularly those from masturbation, among the causes of amaurosis. They are so unanimous on this point, that Ave shall cite no authorities. They generally agree to regard amaurosis, in onanists, as produced by the exhaustion caused by diurnal or nocturnal pollu- tions. Beer, and many others, assimilate, in this re- spect, the loss of semen to that of other fluids; and compares venereal excesses, especially those from onanism, with cholera, diarrhoea, &c, as a cause of amaurosis. This idea of exhaustion probably led Scarpa to remark, that amaurosis, resulting from pre- mature abuses of masturbation or coition, must gen- erally be regarded as incurable. This prognosis may be made, we believe, in regard to most cases of amau- rosis. Dr. Buzzi has published, with four other cases of amaurosis, Avhich were cured, that of an individual in whom it had been produced by masturbation. It, however, yielded, on the abandonment of bad habits, 105 to the moderate use of good wine, combined with milk diet. Dr. Rognetta, in a memoir on the causes of amau- rosis, insists on the opinion that onanism produces this disease, by exhau-ting the sensibility of the body. He compares this habit to decay. " Nothing," say3 he, "enervates the body so much as loo frequent emis- sions of semen, especially when they are caused by the hand : the spasm which attends them throws the body into all the infirmities of old age. The retina and optic nerve then gradually lose their sensitive faculty, which finally becomes extinct. Those who masturbate are affected with amaurosis, like decrepit old men." Rognetta adds, that he has the notes of several cases of amaurosis, which had resisted all rem- edies, and which Avere caused entirely by the luxuria manuensis. He relates the history of a young eccle- siastic, nineteen years old, a native of Palermo, whose sight became very weak. This unfortunate young man had been in the habit of masturbating seven times a-day: he was also prone to sodomy. Rognetta ad- vised him to leave off this bad habit, and to return to his native place and take cold baths. Sanson, also, places voluntary and involuntary pol- lutions among the asthenic causes of amaurosis: he, however, regards these pollutions as sometimes caus- ing irritation of the retina. He assimilates them, as do many other authors, to all abundant discharges of fluids. The following case has been considered by him as one of asthenic amaurosis, produced in this manner:—A notary's clerk, twenty-four years old, ex- perienced for a year a progressive debility in his sight He had labored much at night, by lamp-light, and attributed his disease to this cause ; but another, which had contributed to the development of the amaurosis, was the excesses of this young man, in onanism and coition. Venereal disease, which he had contracted, might also contribute to this bad result. The pupil Avas dilated ; the iris was immoveable; the eye was Eerfectly clear; and the retina, of a dull color, could e seen through the pupil. An antivenereal treatment, 106 purgatives, emetics, and blisters around the organ, &c, produced no effect. In my opinion, blindness from amaurosis, being not so much a disease as a symptom, or rather the con- sequence, of many other diseases, is not, in onanists, the result of exhaustion, of asthenia, any more than the debility and paralysis of the lower extremities are, when the spinal marrow is diseased. Besides, what difference does it make, how the sight is lost in onan- ists? the most essential thing to be known is, that they can lose it. This unfortunate circumstance is to be dreaded by those Avhose sight is much affected du- ring the act of venery, and who remain, as it Avere, in a mist for a few moments after this act. Thus, am- aurosis was predicted in a public girl, whose case is mentioned by Hoffmann, and Avhose sight Avas obscured Avhenever she had connexion with men. She finally became blind. {De morbis ex nirn.. ven., § 26.) The sight is rarely lost suddenly: it commonly fades aAvay gradually; and the onanist, if he can understand this Avarning, may, by abandoning his bad habits in time, pieserve the vigor he still possesses; and, sometimes, even may recover what he has lost. • The weakness and loss of sight, and the other af- , fections of the eye already mentioned, are not the only ones which may arise from excessive onanism or coition: the muscles of the eye may also be affected. Lorry was, Ave believe, the first to notice this fact. "The eyes," says he, "are affected Avith convulsive and spasmodic motions, after venereal excesses, rather than Avith blindness." He states, that strabismus may be caused by onanism. We have before stated the case of a young man, whose eyes were affected with violent spasms at the moment of a discharge of semen. Demours has observed similar facts. " Masturbation," says he, "affects the optic nerves, and also acts on the motor nerves of the eye." He admits that he can see no reason for this. The same author mentions vene- real excesses among the different causes of partial par alysis of the muscles of the eye. We have already mentioned the wandering pains, 107 which frequently affect onanists; we have also alluded to those which depend on an affection of the spinal marrow. We have reason to think, from our own ob- servations, and the statements particularly of English authors, that the number of pains dependent on an affection of the spinal marrow is much larger than is generally thought: Ave think, that most of the pains termed rheumatic, particularly those affecting the trunk and the limbs, are neuralgic; and that most of these neuralgias proceed from an irritation of the me- dulla or its membranes. We do not say that the spinal cord is always affected then, as in those cases of my- elitis which attend paralysis and death: Ave think that it is affected in some'manner; and that these pains, which are commonly so severe, and frequently so gen- eral—sometimes attended with tumefaction, but more frequently without it—which are felt in the course of these nerves, are the usual consequences of this affec- tion. Hence, it is not surprising, that the act of venery, which excites the nervous system so much—which has so marked an action on the spinal marrow, has fre- quently predisposed to neuralgic or rheumatic pains, and has directly caused or increased this kind of pains. It is well ascertained, and many authors—particularly Hoffmann—have remarked, that those who indulge in onanism, during youth, are more subject to these pains than others. The act of venery, even when indulged in to a moderate extent, generally increases their vio- lence. I have often seen attacks of neuralgia super- vene immediately after coition. It was an affection of this kind Avhich Avas felt by the onanist Avho wrote to Tissot, that he felt in his face a pain similar to that caused by applying a great number of pins. Individuals who have braved the usual causes of rheumatism Avith impunity, not unfreqnently become vulnerable to these causes after venereal excesses. M. Villeneuve relates the case of a stonecutter, who had loug been exposed to changes of weather without inconvenience, and Avho was violently attacked with rheumatism after unusual venereal excesses. He also mentions the case of a groom, who had long slept m a 108 damp and narrow stable without suffering, but who was attacked with rheumatism the winter after his marriage. Saucerotte has seen a similar case: it was that ol a man who had constantly braved the changes of weather, and who was affected with rheumatism after indulging in women and wine. The same author has established, in the memoir where this fact was reported, that muscular rheumatism is only a variety of neuralgia. Among the proofs which he gives of it, he states that many authors, as Barthez, Scudamore, Chaussier, Olivier, and Ferrus, have placed venereal excesses among the causes of neuralgias and those of rheumatism. Most authors have considered these excesses as one of the predisposing causes of gout. Hippocrates, probably, entertained the same idea, if we may judge from these two aphorisms:—" Eunuchi neque podagra labor ant, neque caluescunt. Puer podagra nan ten- talur ante vetiereorum usum,P Sydenham also re- garded excessive indulgence in venereal pleasures as tending to produce gout. Guilbert remarks, that even hereditary gout is neither a disease of infancy nor of youth: he admits, however, that venereal excesses may produce it before the time it generally appears. Roche exclaims against this opinion: he thinks that venereal excesses can only cause attacks of gout. He says— "What influence have masturbation and venereal excesses in producing gout? According to men of the world, and even to some physicians, they are the most fruitful source of this infirmity : and yet on what facts doe3 this opinion rest? On this, that several gouty people have been great libertines in their youth. But how many chaste persons, and how many prelates, too, are attacked by this cruel disease? On the other hand, are there not as many, and even more libertines among the poor, than among the rich ? and yet, in gen- eral, they are not-Attacked by the gout. Finally, the ihameful vice of onanism is observed most frequently among the young; and we have already said that gout is a disease of matyhood and old age. Hence^ it is 109 wrong to attribute to this order of causes a part of the influence which it has not, and cannot have, in pro- ducing gout. Here, doubtless, has been committed the error which has been several times pointed out: attacks of gout have frequently been known to super- vene after venereal excesses or masturbation; and it has been concluded lhat these causes concur power- fully in producing the disease itself. Good living and gormandizing are, we repeat, the real—the only sources of gout: sobriety, frugality, are the best preservatives from it." This last phrase shows clearly the origin of Roche's opinion. It is evident that he denies the influence attributed to venereal excesses, in the production of gout, only to sustain a favorite theory. Roche cer- tainly never would have said, that there is more liber- tinism in the lower than in the higher walks of life, if he had not been preoccupied with the desire of proving that good living is the cause of gout, to the exclusion of every other cause. It may be asserted, that one mode of living predisposes to the gout more than another; and we will agree with every author, that this disease appears particularly in individuals who are well fed; but Ave cannot admit, that the pos- sible action of certain influences, as that of venereal excesses, should be denied. Impressed, however, Avith the vast extent of the influence of venereal excesses, and with the uncertainty of its limits, we prefer to allow, with all authors, that venereal excesses, like many other known and unknown causes, may predis- pose to gout. This opinion seems to be more logical than that sustained by Roche with his usual ability. Roche, also, in accordance Avith other authors, re- gards venereal excesses as injurious to those affected with gout. " The indulgence in venereal pleasures," says Barthez, "should seldom be permitted to those affected Avith gout; for they should abstain from Aviiat- eA'er weakens or exhausts. Coste, who has written on gout, is much more formal. <: A gouty person," says he, " should choose between living apart from his wife, and being cured of his disease; or caressing her, and 110 rendering his disease incurable. Whenever a goaty person sees a female," he adds, " if young, a new root to his disease sprouts forth ; and if he be old, he drives a nail into his coffin." This opinion differs from that of Pietsch, who maintains that gout arises from the absorption of vitiated semen, which is retained by con- tinence in the seminal vesicles. Can venereal excesses cause hemorrhoidal affec- tions? For want of facts on this subject, we would remark, that these excesses may contribute to develop these affections, and particularly the exacerbations to which they are subject. This was Montegre's opin- ion: he admitted, that the nervous debility which re- sulted from the abuse of the genital organs, generally favored the occurrence of fluxes, motions which occur most frequently in people subject to hemorrhoids; and also, that in those females who have hemorrhoidal tumors on the rectum or vagina, the abuse of coition may excite inflammation of these tumors. Montegre, however, thinks that excessive continence has a more detrimental effect on those affected with hemorrhoids than the contrary. He thought that the irritation which extreme continence causes in the seminal vesicles and adjacent parts, may excite a hemorrhoidal paroxysm: hence, he regards the act of venery as generally use- ful to persons affected with hemorrhoids, provided it is confined within certain limits. On this opinion, we would say, that if the irritation of the seminal pas- sages may extend to the adjacent passages, venereal excesses which produce this irritation may also cause inflammation of the hemorrhoidal tumors much more frequently than continence. This is the opinion of Begin, also, who mentions, among the direct causes of hemorrhoids, " excesses in venereal pleasures—ex- cesses Avhich are always attended with a state of org- asm and vascular fulness in the genital system, and in all the parts connected with it; and particularly in the lower region of the rectum, which receives the same vessels in the neck of the bladder, the prostrate gland, and the seminal vesicles, in the male, and in the uterus and vagina in the female. Ill We may believe, from the enervating action of mas- turbation, that the development of scrofula may be excited or favored in those young patients who are, addicted to it. Few proofs of this, however, are found in authors; and it is rare to find records of scrofulous symptoms in the histories of those onanists which have been published. It, however, would be absurd to conclude, from this silence, that the coincidence of these symproms and the ordinary effects of onanism never occur, or that this habit cannot call into action a disposition to disease. But we must admit, that if masturbation be an active cause of this disease, this fact would have been noted more frequently. Further: Certain circumstances seem to indicate, that onanism must be but little favorable to the devel- opment of scrofula. First, onanism renders the limbs thinner, dries them, then deprives them of those white fluids with which the flesh of scrofulous persons is generally infiltrated. Next, since in these latter the sensibility is as it were blunted, and the susceptibility is slight, onanism tends to excite them. Besides, one of the most common effects of the action of the geni- tal organs, at puberty, is the disappearance of scrofu- lous engorgements and other symptoms, if they exist. Sometimes, the normal development of the genital apparatus excites in those who have arrived at puberty the swelling of the lymphatic ganglions of the neck, axillae, and particularly of the groins: but in this case, these ganglions are painful, and present a kind of in- flammatory state, analogous to that which is attempted to be produced when they are affected with scrofulous engorgements. Cabanis has well described what then takes place:—"From the time," says he, "that the evolution of the genital organs commences, there is a general motion in the whole lymphatic apparatus; the glands of the groins, the mammae, those of the axillae, and neck, swell: they often become painful. It is not only in girls that the mammae swell; in young men, I have frequently seen them form tumors, which seemed inflammatory: they have often been consid- ered as such by ignorant quacks. This symptom gen- 112 erally causes uneasiness in those who experience it: but this depends not so much on the pain, (Avhich sometimes impedes the free motions of the body,) as on the influence of this new action—the commotion caused in the imagination by the new system." This state of the lymphatic system would be, as is seen, rather antithetic, than analogous to what is seen in scrofulous patients. Farther: we have only to com- pare the eunuch with him who has vigorously passed through puberty, to see that the action of the genital organs is not adapted to favor the development of this affection. The act of venery often causes, also, ganglionary swellings; but they do not resemble scrofulous en- gorgements, more than those which arise from the in- fluence of puberty. " The first essay of venereal pleas- ures," says Cabanis, "is often necessary to complete the development of the genital organs: thus, the gen- eral swelling of all the parts where the glands are sit- uated, especially of the bosom, of the anterior face of the neck, is often the consequence of this great com- motion. The characters which manifest this swelling are much more remarkable in females; hence, per- haps, 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 ex- citement in the lymphatic system, it ought to be still more manifest when a part of this system is already inflamed. This is confirmed by a fact stated by Lordat, in the bulletin of the scientific society of Montpelier. It relates to a young woman, in whom the jugular glands being swelled, a few days after her marriage, increased or diminished in size, according as she yielded to her husband's embraces or not. Thus, then, if we consider the genital organs, either during the acute period of their development, or when the act of venery is indulged in, we see that they extend their action to the lymphatic apparatus, as they do to the other systems; but in a manner which seems the 113 reverse of that reputed to favor the production of scrofula. Symptoms, however, analogous to those caused by scrofula, have been known to occur where there is evidence of venereal abuses. Two cases, which we have already quoted from M. Dalandeterie, are in- stances 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 Avere regarded as scrofulous, and which were soon followed by ulcer- ation and caries. The patient experienced no pain; and only felt an intolerable itching. The lymphatic ganglions of the groin and axillae were permanently swelled; and the bodies of several vertebrae became, as we have seen, vaffected with caries. The other patient, who was forty-five years old, presented an advanced case of myelitis, and caries of the vertebrae, when there formed, at the lower part of the sternum, a hard and indolent tumor, Avhich 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 sAvelled 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 vertebrae 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 dis- ease, the development of which was but slightly fa- vored by the age of the patients, as a tubercular affec- tion—that is, a disease Avhich might be developed at every period of life. We think that tubercles were 10* 114 developed, in the phalanges, in the first case; and in the sternum, in the second; that these tubercles soft- ened, and suppurated; and thus Avere formed the appa- rent scrofulous ulcers presented by these individuals. Probably, a similar circumstance occurs in the verte- brae, the bodies of which are destroyed; for distin- guished 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 onan- ism. 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, Avho 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 masturba- tion, 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 re- sults from numerous well ascertained facts," say Four- nier and Begm, "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 diffi- cult and hurried. Almost all these individuals con- tract chronic catarrhs, or more serious affections of the pulmonary organs; and finally perish, in a complete state of phthisis." Broussais, also, places among the 115 causes of phthisis pulmonalis, "erotic spasms, no mat- ter in what manner they are excited." We have seen this affection, more frequently than any other, resulting from onanism. Among other in- stances, 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 ex- pense of government, in a public school. He was then sixteen years old; and his health, which had pre- viously been good, now failed. He became pale, lan- guished, 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 there- fore 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 sus- picions 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 Avhich the patient at first did not attend. This was the first symptom indicating an affection of any particular or- gan. This cough soon became more frequent; and, by means of auscultation, we found that the respira- tion, at the summit of one of the lungs, was imperfect. At this time, the patient avoAved to his father his de- plorable habit. This had been contracted at school; it had been indulged in for two years; and of late, 116 much more frequently than before. His danger was fully pointed out to him ; parents, friends, physicians, all conjured him to abandon this secret vice. Treat- ises 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 con- sumption had progressed very far. Deep abscesses successively formed in his lungs; the expectoration soon became purulent and excessive. Night sweats and diarrhoea followed ; and the patient died in a ter- rible state of marasmus and exhaustion. In 1829, we prescribed for a young man, whose ca- reer 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 Avas seven or eight years older than her husband, and did not suffer much. He, however, soon became affected with cough, attended with bloody ex- pectoration. When consulted, we informed the patient of his danger, unless he changed his mode of living. Our advice was not followed; and shortly after, hem- orrhage from the lungs supervened so abundantly and obstinately, that notwithstanding the most active treat- ment, he died in eight days. The young man, too, mentioned by Tissot, was also doubtless affected with phthisis. " He came to Mont- pelier to pursue his studies; but was affected Avith phthisis, from excessive onanism: and I remember that his cough was so hard and constant, that all those who were near him Avere 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 dis- eases, caused by masturbation. This habit causes disease, by cherishing and by cultivating special dis- positions. Thus, the onanist born of consumptive parents, whose chest is narrow, with a long neck and 117 •hin limbs, and who presents symptoms of scrofula, is more liable to be affected with phthisis or consump- tion. This was the case with a young man. as men- tioned by Rozier. This patient was evidently scrofu- lous, and many members of his family had been af- fected Avith the disease. He remained, however, pretty well until he was eighteen years old, when, in conse- quence of a contusion in one of his legs, he became affected with an ulcer, which Avas 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 in- creased, and he was aware of the dangers of onanism, he continued to indulge. Many physicians were con- sulted ; but he did not mention his bad habit. The affection of the lungs continued ; his sleep was inter- rupted ; 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 Avas 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 exer- cise; are subject to stifling, &c. These symptoms, the existence of which cannot always be explained by that of any organic alteration in the heart or lungs, finally assume, in some individuals, the characters attributed to nervous asthma. The authors who have written on this subject, have all classed venerea) ex- cesses 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 ven- 118 ereal pleasures by young persons, excesses of the table in old men, &c.—contribute, as powerfully as individ- ual predispositions, to produce this disease." Jolly remarks, in nearly similar language:—"Venereal ex- cesses and masturbation," says this distinguished phy- sician, " 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 ven- ereal 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, Avhether excited or not by an organic lesion, as consisting in a spasm of the glottis; or, as Reises- sen 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, fre- quent, 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 affec- tion. We have seen dilatations of the left ventricle of the heart, which evidently arose from this cause. " In some cases," says Fournier and Begin, "palpita- tions, 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, notwith- standing 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 men- 119 tioned. The patient experienced for a long time diffi- culty of breathing; which increased on Avalking, and especially on going up stairs. These symptoms Avere 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 my- elitis; and on opening the body, the heart was found perfectly healthy, of its normal size, and presented nothing unusual in the extent of its cavities, or in the thickness of their parietes. Among the diseases of the heart which may be caused by venereal excesses, there is one in particular mentioned by Blaud. He thinks that too frequent coition predisposes to polypi of the heart. He main- tains, that the act produces its effects, either by weak- ening 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 ?he cardac 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, tney 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, Ave 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 Avas depressed at the loAver part of the stern- um; 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; 120 the extremities of the long bones, particularly those Avhich form the elbows and knees, Avere very much enlarged ; the legs were thrown out, and their muscles were scarcely developed ; their eyes were sunken ; their countenances pale and Avhite; 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 Aveak, physically and morally, and became imbecile long before they died." Dr. Rich- ard, cited by Petit, has also seen considerable deform- ity of the ribs, resulting from onanism. Tissot placed this habit first among the causes of rachitis. M. Lon- yer 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, not- withstanding their excesses, and all the symptoms of extensive alteration. It follows, also, from the re- searches of Villerme and Q,uelelet, 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 Aveight is quadruple of Avhat it was in preceding years. Do not these rea- sons authorize us to think, that if premature excesses have any influence on the height of man, this action is less than is generally imagined? Besides rachitis, caries, and tubercles, which have been mentioned, are the bones ever affected with any 121 other disease, in consequence of venereal indulgence?? 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. Hav- ing attempted, a feAv 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 circum- stances, 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. Hip- pocrates gives the history of a young man of Meliboea, 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 with- out being attacked Avith fever, which continued several days. Tissot, in 1761 and 1762, knew two very healthy, strong, and vigorous young men, Avho were attacked, one the day after, and the other the second night of their marriage, with a very violent fever, pre- ceded by no chill, pulse quick and hard, Avakel'ulness, 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 Avine was in part the procuring part of these symptoms; but I was of a different opinion in regard to the second. They 122 were cured at the end of two days. This circumstance added to the character of the disease, leaves no doubt of the cause. Sauvages admits, after Dellon, that a typhus of ex- hausted persons exists. The Portuguese term patients affected with this malady, esfalfados. The exhaustion caused by immoderate indulgence in venereal pleas- ures, says this author, is very common among the In- dians. 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 Avritten on the dis- eases of warm climates, have mentioned the too fre- quent repetition of the act of venery among the causes of these typhus affections, Avhich have been termed febris ardens, cansus, yellow fever, &c. In tem- perate climates, adynamic ataxic fevers, &c, and very severe acute diseases, have often been knoAvn to occur from excesses in venery, or from masturbation. If satyriasis and nymphomania have been regarded as rare diseases, it is only because the meaning of these terms has been too confined to embrace numer- ous cases Avhich, however, have the greatest analogy with those diseases to which these terms are applied. Generally, these persons are considered as affected with satyriasis and nymphomania, who are irresistibly impelled to coition, and resort, to satisfy their desires, to the most indecent actions, and to the most direct provocations. Thus defined, these diseases are rare; and most practitioners have never seen them. But if satyriasis and nymphomania be regarded as an unusual state of heat, by which one is led to desire and to practise not only coition, but the act of venery in any mode, then the scene enlarges, and these affections deserve to be placed among those which are observed most frequently. We shall adopt the latter sense. In our view, male and female onanists are affected with satyriasis and nymphomania, as much as those to whom these terms 123 are generally applied. In both, the sense of venery. existing to an unusual extent, affects the mind, and incites to dangerous actions, repugnant both to modesty and reason. Onanists do not, like other persons af- fected with satyriasis, expose their persons, and solicit Avith 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, how- ever, 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 nympho- mania depends on the power the venereal sense has over the will. These affections do not exist in those with Avhom it is optional whether they shall indulge in onanism or not, nor in those who can refrain fiom coition. Thus, then, a person may masturbate, with- out being affected Avith 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 Avell educated, and although he well knew the dangers of his habit, yet he could not refrain. His good resolu- tions Avere formed only to be broken. He died. In a young woman whom we attended, the struggle with her passions terminated more favorably. It was 124 not the desire of preserving her life, which induced her to leave off her bad habits; but the wish of con- forming to the will of her father. Her constitution was already considerably affected, Avhen 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 Avas extremely mild and docile, and made every effort to please and obey him. It Avas 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 Avhich she might be most effectually prevented from abusing herself. The ven- ereal sense gradually became subdued, and confined within the proper limits. And thus, this habit—or, rather, the nymphomania, which Avas 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 manoeuvres. We have already mentioned some remarkable instances of this state. The following may serve as the type of the greatest degree of nymph- omania. 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 manoeuvres. 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. {Dirt, des Sc. Med.; vol. xxxvi., p. 566.) Onanism is not only a direct cause of satyriasis and 125 of nymphomania; it may leave in the genital organs a certain disposition, which, if cherished, may degen- erate into one of these affections. The following case, published by Duprest-Rony, seems to us to be an in- stance of this:— A young man, twenty years old, of a strong and al- most athletic frame, but who had been enfeebled by onanism, abandoned himself, from the age of fifteen to eighteen years, to this destructive habit. He in- dulged in this habit even while in the bath, and some- times 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; Lis memory and other mental faculties were restored. His parents now placed him with a merchant. He entered upon his new occupations with zeal and activ- ity ; but receiving marks of attachment from the mer- chant 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 grati- tude, 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 Avas 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 hus- band 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 as- tonishment of the supposed Theseus. He resolved to 11* 126 send the young man away. This cured the delirium: but the erections and seminal emissions continued. The stomach and intestinal tube became inert. The patient's appetite was good; but as soon as he ate food, pains occurred in the epigastric region, and un- easiness in the rest of the body. The disease finally yielded to the combined use of antispasmodics and tonics. And noAv, 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, masturb- ation may leave in the genital organs an irritability of a different kind, the results of which are not less dis- agreeable. A case of this presented itself in a young female, whom we attended. While at board, she in- dulged freely in onanism. She was married when seventeen years old; and then expected legally to en- joy Avhat had seemed to her the extreme of pleasure. She was disappointed, however: marriage was only the source of uneasiness and pain. She Avas perfectly insensible to the caresses of her husband—or, rather, in submitting to them, she experienced the most dis- agreeable 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, Avhich caused great anxiety. This lady's sus- ceptibility, also, was very great; and she constantly complained of some of the attendants of hysteria. She presented every appearance of a lymphatic tempera- ment. During her youth, too, she had been affected with symptoms of scrofula, from which even now she is not entirely free, although twenty-tAvo years old. Dq not these circumstances, not generally coexistent with extreme sensibility, prove, that the extreme irri- tability 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 or- 127 gans have been excited: sometimes, too, it occurs in old men. Coelius Aurelian, (lib. iii., ch. 18,) relates, that an old man was affected with priapism for sev- eral 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 remem- brance 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 con- tinues until these dangerous resources fail, which hap- pens, 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 ex- tent of insensibility which the penis may attain, or of delirium which may affect a man, who, having ex- hausted 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, 128 while tending his flocks in the solitude of the mount- ains. By a continuation pf 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, at- tended with a sensation of pleasure, followed by a copious emission. He had recourse to his new dis- covery 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, un- able 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 lime, he one day in- troduced his bit of wood so carelessly, that it slipped from his fingers, and dropped into the bladder. Ex- cruciating 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 di- visions, that this conformation was not congenital from his birth; obliged the patient to give him an ac- count of his life, which he did, with the details which have been related. This wretch was cut, as for the stone—recovered of the operation—but died three months after, of an abscess in the right side of the chest; his phthisical state having been evidently 129 brought on by the practice of onanism, carried on nearly forty years." Whatever may be the degree of degradation attend- ing onanism, we do not think it possible to adduce a second instance of such a mutilation. Gallien's un- happy idea of introducing a foreign body into the urethra, has often occurred to others, who had availed themselves, but unsuccessfully, of the ordinary re- sources of masturbation. These unfortunate people have always been obliged to call in medical advice, either on account of the diseases caused by their dan- gerous manoeuvres, or—much more frequently—by the symptoms to Avhich they fall victims, through their carelessness. In fact, the implements used often es- cape 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 Avill give a few instances of this kind of acci- dent. 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 Avhich Avas crooked like a hook, to obtain, probably, more exquisite pleasure. One day, while indulging in this singular manoeuvre, he sud- denly felt severe pain. The membraneous portion of the canal was ruptured. The unfortunate man made several attempts to Avithdraw the wire; but the hook, which had entered the soft parts, rendered it impos- sible. 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 exer- cised this force till the ring was nearly broken, but the iron was still in its place. He now expected death; but the suffering Avas so great, that he was obliged to call a physician; and Dr. Fardeau, of Saumur, visited him. The penis, and also the skin of the scrotum, was enormously tumefied: all the tissues which are inserted 130 in the penis were also swelled, hot, and painful. The belly began to be puffy, and the urine was suppressed ; the face was red, and the eye filmy ; the mind began to be affected; the pulse was hard, frequent, and corded. Dr. Fardeau grasped the loose portion of the wire, pulled upon it slightly, and immediately found that the other end was arrested by an immoveable ob- stacle. 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.) Saraille 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 instru- ment 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 cir- cumstance 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 Ho- tel Dieu, at Clermont, stated in his lectures, that a vine-dresser used a vine-stalk for this purpose. Dn- 131 ring an emission of semen, he dropped the stalk, which entered the urethra, and passed into the bladder, where it caused symptoms which required the operation of lithitomy. 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, Mor- gagni, 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 sensi- bility preserved in the genital organs : they finally cause chronic diseases of the urethra and bladder. These organs, when constantly irritated by applica- tions 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 re- mained in the places where it has been introduced, with a view to imitate the natural process better. Sa- batier 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 pa- tient to withdraw it. After oiling the parts well, the handle was slipped down as far as theglans; but here scarifications were required, to diminish the engorge- ment, before the penis could be liberated. After this, 132 escars sloughed off, which were followed by cicatrices, which rendered the part deformed, although a sound was introduced into the urelhra, to prevent this result. The same author relates tnat 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 lock- smith 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 ihe hole in the bottom of the tub, made for ihe removal of the Avater. The glans soon became so much sAvelled, that he could not withdraw it. His cries brought him as- sistance ; but it was not easy to remove him from the fetters he had forged for himself. {Diet, 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 pe- nis was filed, and thus taken from him. It would oc- cupy too much room, to enumerate all the facts of this kiud which have been noted by practitioners; but a common accident, and which has been seen several times by Dupuytren, is the ligature of the penis by a •thread or wire. Some young men, and even adults, have bound the penis in fits of erotic delirium, so that the knot could not be loosed ; and a circular section has been made in the skin, and the urethra even has been opened and cut. It is evident, that, in these cases, the only thing to be done is to divide the thread, to dress the wound, and then to introduce a gum-elastic 133 sound, in order to prevent the formation of an urinary fistula, or of an accidental hypospadias. Another kind of strangulation—which is much less serious, however, than those we have mentioned—may result from masturbation and coition, in those individ- uals where the opening of the prepuce i3 too narrow. This prolongation of the skin, after being drawn violently back behind the corona glandis, strangles the penis, as Avould be done by a foreign body, and cannot be brought again to its primitive situation: there is then a paraphimosis. All authors Avho have treated of this affection, have placed among the causes of it that which we have mentioned. We have seen seve- ral instances of this character. I will cite that of a young boy, seven or eight years old, in whom this ac- cident was produced during masturbation. The glans was tumefied, and the prepuce formed a large fold around it. The frightened parents sent for our assist- ance. Methodical and long continued pressure soon brought things to their proper state. Herpes prepatialis, another affection of the prepuce, may arise from the constant excitement of this part. Fortunately, this eruption is a slight disease, and gen- erally terminates in a week or two, even without med- ical 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, whilivh 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 to- gether, 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 gonorrhoea. It, however, results from an unusual excitement of the mucous membrane, lining the glans and urethra. Now, if the simple excite- ment of the venereal sense can cause such an effect, Avhat might not be expected from excesses in coition or masturbation 1 Thus, these causes are mentioned, 12 134 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 masturba- tion, who had been affected for more than six months with a gonnorrhoeal discharge, which had been ne- glected because it occasioned no suffering. The mat- ter 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 ex- posed to contract disease; and Closs, therefore, con- sidered this blenorrhea as the result of masturbatidh, 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 sus- picions and reproaches. It is said, too, that excesses indulged in by persons whose genital organs are per- fectly sound, may produce in one or both of them a more or less intense blenorrhea. Cullerierand 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 ob- served 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 re- quires the same treatment. Inflammation of the urethra may become very in- tense, and extend to the bladder, particularly when venereal excesses coexist Avith intemperate habits: the discharge of urine may then be interrupted, and consequently all the symptoms of dysuria and strang- ury may supervene. Chronic catarrh of the bladder 135 is often observed, also, in those individuals who have abused the pleasures of love. Montegre, speaking of a kind of cystitis, which he terms vesical hemorrhoids, mentions among its causes venereal excesses, and particularly those repeated tit- illations, 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 fre- quent 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 ad- hered to the pot de chambre. The prostatic portion of the urethra was cauterized, but without success. Lallemand thought that there was a morbid develop- ment of the middle lobe of the prostate gland. In an- other 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 Avere developed under the influ- ence 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 af- fected 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 ex- cesses in coition or masturbation? We have more than once seen this disease in young onanists. Sainte Marie, also, pl?ces 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. 136 May not the relations between these two affections extend to the causes which determine them? One of the most common causes of excesses in ve- nery is, the involuntary loss of semen. This disease, which has been termed spermatorrhaia, involuntary pollution, may also arise from other causes; but as it results most frequently from excesses in masturb- ation 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 re- mote consequence of a voluntary action, and the im- mediate result of involuntary contractions. The ven- ereal 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, en- tirely independent of the will, terminates it. This crisis occurs sooner or later. It may even be quick- ened 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 leratores ani muscles— are the powers by which the semen comes into the urethra. The ejaculation is caused by the muscles of the perinoeum, and particularly by the bulbo-cav- ernosus muscle. The swelling and hardness of the corpus cavernosum furnish this muscle with a point of resistance, which enables it to compress more effi- ciently the semen with which the urethra is filled; and the straightening of this canal, by the erection, renders the expulsion of this fluid more easy. All these motions take place by jerks; and, we repeat it, convulsively, without the aid of the will. • The involuntary excretion of the semen, the morbid pollution, may take place sometimes in the manner described, sometimes in another mode. In the first 137 case, it differs from Avhat occurs in the normal state, only not being preceded by those acts which are per- formed 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 con- vulsed, as is proved by the excessive weakness of the venereal sensation. And, secondly, one of the indis- pensable conditions of the ejaculation—erection of the penis—does not exist. There are, then, two kinds of involuntary pollutions; one which is convulsive, and the other which is not so.. Between these two kinds, there are intermediate degrees, in which sperm- atorrhoea partakes more or less of one or the other. These degrees often mark the passage from convulsive spermatorrhoea 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 indi- viduals who present habitually an insensible Row of this fluid. Involuntary pollutions have been distinguished until now in another manner: they have been divided into diurnal and nocturnal. These distinctions are founded only on accessory circumstances. What difference does it make, whether the pollutions occur by night or by day, provided they are similar in other respects? If, on the contrary, there are more essential differences, Avhy not give to them the importance they demand? Farther: is not convulsive spermatorrhoea, like that which is not convulsive, seen both at night and day? These are the reasons why we have sought to distin- guish these affections more logically, and which have led us to propose the new distinction just mentioned. Convulsive spermatorrhoea may occur in all individ- uals, and under the influence of a great many causes, without being necessarily a disease. After excessive '12* 138 continence, it may even prove a salutary crisis. This pollution has a pathological character, when it is re- peated 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 sperm- atorrhoea; and from this circumstance it is called noc- turnal pollution. The temperature of the bed, and lying on the back—circumstances Avhich favor the warmth and excitement of the IcAver 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 re- marks 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 slain, and the state of fatigue, weakness, aud malaise attending it. A lascivious dream, however, generally attends a pollution. These dreams are not, as is gen- erally thought, the cause of the pollution: if they ex- ist, 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 characier, which has been pointed out by many writers. The individual is rarely placed in voluptuous circum- stances, 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. 139 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 ^veiled and bluish; the patient is sad and stupid. Finally, he presents physically and morally the conse- quences of an abuse of venery. It may readily be im- agined, that the periods of spermatorrhoea render the exhaustion more rapid than the voluntary excesses al- ready 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 pro- duces a more general excitement, in which these or- gans 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 formid- able to those onanists who are reformed. Inspired by the sentiment of self-preservation, warned by the suf- ferings, counsels, and by reading, they have resolved to abandon for ever the manoeuvres 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 Avhich exercised such absolute control over him: but his organs, which have been irritated, continue the work which he wished to interrupt. He is imitated— he despairs. Let him be of good cheer; when the will perseveres, it generally triumphs. I attended an 140 onanist, who was suddenly converted by reading the work of Tissot, and who experienced all the troubles to which we have alluded. He was constantly tor- mented by the remembrance of the past night, and the fear of that which wras 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 aAvake, as soon as he was assailed by dreams. By his will, however, he finally succeeded; and he had the power of Avatching himself during sleep. His pollutions gradually became less frequent, and finally disappeared entirely. This is generally the case where all bad habits cease. Convulsive spermatorrhoea 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 in- stance of it may be seen in the case of satyriasis stated by M. Duprest-Rony. Whenever this young man be- held 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 Avhich the pa- tient ejaculated fourteen times in a few hours. But this affection was not in consequence of venereal ex- cesses, and the emission of semen presented nothing more extraordinary than other cases of priapism. Di- urnal convulsive pollution is seldom accompanied, in individuals exhausted by abuses of masturbation and coition, with a perfect erection. The size of the penis increases, but it does not become hard. The semen is then emitted only to a short distance, if there be any ejaculation. The least cause, the slightest touch, is sufficient to excite this. Thus, in a man thirty years old, whom Tissot has mentioned, after Boerhaave, the semen escaped whenever there was a commencement, of an erection, for it was never complete; and instead of being expelled forcibly, it oozed out drop by drop. The patient became impotent. This symptom (adds 141 Tissot) is very frequent among those who are ex- hausted, 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 fol- lowed 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 spermatorrhoea assumes then, as it were, a bastard character in onanists: it occupies an intermediate place between proper convulsive spermatorrhoea, such as occurs during sleep, and the non-convulsive sperm- atorrhoea, which we shall mention directly. There is a phenomenon very similar to this bastard spermatorrhoea, and which shows itself when the pa- tient is inclined to indulge in coition or masturbation: the emission of semen takes place on the commence- ment 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 se- men not admitting it to be perfect. Sometimes, erec- tion is radically impossible, and prevents the ejacula- tion. 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 impo- tent, because the power of procreating requires erec- tion and ejaculation. In persons affected with spermatorrhoea, the seminal fluid must preserve its normal characters. It is gener- ally thinner, less opaque, and similar to serum: some- times it resembles a fetid sanies or corrupt mucus; in other cases, the seminal vesicles are evidently affected. Sometimes, blood is exhaled from these vesicles, and 142 is even ejaculated. We have already stated instances of this emission. Tissot, also, has published a case of it. It was a young man, less than sixteen years old, who indulged in onanism to such an extent, that blood was finally emitted, instead of semen. This emission was soon followed by excessive pains, and an inflammation of all the genital organs. We must remark, that blood never seems to be discharged, un- less the pollution is excited directly: this, at least, would seem to follow from the cases stated, and par- ticularly from one mentioned by Dalandeterie. The erections (said he) always terminate Avith a more or less abundant flow of mucus—perhaps, also, of pros- tatic fluid, or even of a very diluted semen. In ejacu- lations excited by the hand, a semi-clotted, blackish blood comes, instead of semen: sometimes, a teaspoon- ful 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 con- traction of the ejaculatory muscles, with erection of the penis, and sensations of venery. We have also seen, that the semen may be discharged, although the erection of the penis, the sensation of venery, and the convulsive contraction of the ejaculatory muscles is slight, and almost nothing. When this exists to a still greater degree, we have non-convulsive spermatorrhoea, or diurnal involuntary pollution, as it is called: here there is no erection, convulsion, nor ejaculation ; there is no feeling of venery ; the semen flows, instead of being expelled; and there is no feeling of pleasure attending this discharge. 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, Ave shall enlarge on the subject. This pollution for a long time Avas confounded with all the discharges from the urethra, which were blended under the term gonorrhoea. 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 143 Marie, and Lallemand, place its existence, however, beyond a doubt. The first ideas on this kind of sperm- atorrhoea may be referred to the earliest periods of medicine. It was known to Hippocrates, who has mentipned {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.raisonee, 1693, p. 164,) that men Avho 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 ex- cretion 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 pollu- tion, is valuable. This dissertation was printed in 1782, at Goettingen. 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 pollu- tion 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 144 semen constantly by a continual excretion of this fluid, like females subject to lencorrhea ; 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 gonorrhoea in which the semen is continually escaping drop by drop. He, however, doubts the existence of this last affec- tion, and remarks that authors are very much confused on the subject. Nor would a pollution which Avas in- voluntary, and during the hours of waking, be consid- ered 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, Avho, having been addicted to onanism in his youth, was affected with involuntary pollutions if a blister Avas 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 Avith 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 ex- istence 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 pe- nis 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, 145 and especially while at stool, are, according to Wich- mann, specific characters of involuntary diurnal pol- lution. 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 appe- tite, however, continues—even increases, and some- times 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 in- dulged. As the stomach and most of the other vis- cera do not perform their functions properly, the more that is eaten the more the belly is tumefied, by the re- laxation of the digestive organs. This swelling is attended with a painful feeling of anxiety, which ex- ists 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 sub- stance concealed in the body, and consuming the flesh. The patient has no pain, excepting that obtuse, com^ pressive pain, which is referred to the hypochondria, and which depends on the swelling of the weak intes- tines. If you add to the characters the absence of fever, and of the ordinary causes of exhaustion, you 146 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, draAvn 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 dis- ease must be referred to this cause alone. The symp- toms 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 dispar- agement of the patient, whose state requires opposite remedies. Farther: it is clear, that the disease of which Ave 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 hyp- ochondriac: in fact, different symptoms led to the be- lief that the disease was situated in the hypochondria. The loss of strength—the languor of digestion, al- though 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 restless- ness of character—and, finally, a certain Aveakness of intellect—seemed to justify the diagnosis. He had formerly indulged with females, and had been affected 147 with venereal disease, to which he attributed his pres- ent 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 over- looked. " 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 attrib- ute 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 obser- vation Avas 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 prema- ture 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 blenorrh- oea, 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 Avould not be followed with consumption, and other symptoms of phthisis. In fact, onanism does uot always give rise to this pollution. If this were 148 the case, the number of onanists affected with con- sumption 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 some- times produces involuntary diurnal pollution, we ought to investigate if it does not exist in those Avho 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 discov- ered this cause of consumption, I knew a young man, thirty years old, who had been addicted to masturba- tion 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 149 travelled for a long time, and had received advice from several French physicians. He went to the Spa wa- ters, 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 con- tinued 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 advan- tages of a large fortune, which rendered him the vic- tim of a precocious abuse of pleasure, of a kind of pre- mature depravity. Wich'mann'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 Ave 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 emit- ted 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 Avhen 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. Wich- mann had admitted the existence of a discharge from the prostate gland, which ought not to be confounded 13* 150 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 thep 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 in- dulging in desires, or after erections which have not been followed by the act of venery. Sainte Marie con- siders 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 hypochon- dria, of slow nervous fevers, of consumptions, were kept up by this kind of gonorrhoea, to which the pa- tients, unable to observe themselves, had paid no at- tention. 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 conti- nence of days or weeks, an exciting or substantial regi- men, 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 pol- lution 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 Wich- mann." Wichmann said nothing in regard to the organic conditions of the diurnal pollution: he merely stated 151 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 mar- row. We will quote this passage:—Diurnal pollu- tion (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 or- gans. 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 emis- sion of urine. Involuntary diurnal pollution is here only a symptom: it occurs, because the genilal 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 fecund- ation—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 gen- ital organs of life, explains, on the other hand, the Avasting of parts which respond to this sensitive centre —the thinness of the loins, thighs, and lower extrem- ities—the debility—the paralysis of these extremities —the obstinate constipation, complained of by the pa- tients, and which is similar to that of old men, yield- ing only to the employment of stimuli—the formica- tions 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 trochan- iters. We might easily pursue this subject, and ex- tend it to the most general symptoms of consumption, as deep melancholy, weakness and slowness of the pulse, disposition to faint, and all those marked symp- toms which assimilate this disease to sIoav nervous fever; hut this would estrange us from the principle we seek to establish—which is, that diurnal pollution 152 is sometimes the cause, and sometimes only the symp- tom, of dorsal consumption. Wichmann has treated only of the first: the second is connected with a gen- eral 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 diur- nal pollution described by this latter, and which he considers as arising either from relaxation or from irri- tation of the testicles and seminal passages—he ad- mits, we say, a blenorrhcea of the prostate gland, the characters of which, as stated by him, are precisely similar to those of diurnal pollution. Blenorrhcea 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 particu- larly during the day, and without venereal desire. This disease is soon followed with general debility or weakness: this exhaustion is attended with emacia- tion of the body, and is followed by death, if the pa- tient 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 indi- viduals, except when they go to stool; and that hard- ened 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 spermatorrhoea: one with loss of semen and of the prostate fluid ; the other, produced by constipation. He remarks—Persons who are habit- ually 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 then- procreative power is 153 lost. Others attribute it to old blenorrhocas, Which have struck in, as it is said. All, generally, are terri- fied at the effect; and quacks have often profited by its existence, to persuade patients that they were af- fected 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 rec- tum on the seminal vesicles, and may be removed by removing the constipation. This was the state of science, when Lallemand de- voted himself to the study of the diseases of the urin- ary 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 reten- tions of urine, produced by chronic inflammation of the prostatic portion of the urethra, the irritation ex- tends 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 ejacu- lation is very sudden: nocturnal pollutions are fre- quent—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 spermatorrhoea has general effects, analogous to those Avhich 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 Avhich caused it—and relates cases of this character. Do not the remarks of this practitioner, compared with our remarks on convulsive spermatorrhoea, and partic- ularly on the different states Avhich the semen may 154 present in this affection—do they not establish clearly, that in many, perhaps in most cases of spermatorrhoea, there is not relaxation, weakness of the seminal vesi- cles and ejaculatory ducts, but irritation or inflamma- tion of these parts ? It would, then, seem well established, that the se- men may be discharged without pleasure, without erection, and without ejaculation; and that this dis- charge 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 es- cape spontaneously, without solicitation; and that when such a case has been suspected, the fluid dis- charged was not probably semen; and that, farther, if this kind of spermatorrhoea exists, it must be very rare. Swammerdam, Hunter, and Haller, have ex- pressed 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 spermatorrhoea are only blenorrhoeas, is still very prevalent. Descamps, physician at Castilliones, hav- ing brought before the Medical Society, in 1821, two cases of spermatorrhoea, the consequences of masturb- ation ; 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 155 by all the symptoms which are referred to it, it is evi- dent 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 conse- quently mistaken. The same maybe 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, com- pressed the remote parts of the urethra, so that not a drop of semen was lost. The fatigue, however, fol- lowing efforts of this kind was very great, notwith- standing these exertions. Finally, the strength di- minished, and the person wasted away as much as if the semen had been discharged. {Diet, des Sc. Med., Art. Masturbation.) There is frequently some derangement in the func- tions of the testicles, in those who have lost the geni- tal sense, where the penis is no longer capable of erection, or Avho 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, Avhich extend along the cord. These symp- toms sometimes assume an evidently neuralgic char- acter; and it may readily be imagined, that, in indi- viduals affected with wandering pains, excesses in venery may fix them in these parts. This has been remarked in gout. Halle 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 constitute* 156 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 Avas 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 re- ceived a bloAv on this part, nor had he been affected with blenorrhcea; but he admitted, that for five years he had been addicted to onanism, and that a day sel- dom 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 ex- cessively for many years; that, when twenty years old, in consequence of external violence, he was af- fected 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 onan- ists. This fact is also confirmed by Breschet, in his memoir read at the Academy of Sciences, Jan. 13th, 1834. He thinks that circosele and varicosele are by 157 no means diseases of adult and old age, but that they are seen most frequently in young men. These affec- tions seem to him to be caused most particularly by venereal excesses. He adds, that the varicose tumors of the bursae, 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 omit- ted 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 fre- quently than in males. By too frequent titillation, the clitoris may become enormously large. This cause (says Bouillaud) may determine schirrous en- gorgement, or even a cancerous degenerescence of this organ. The most frequent alteration, however, of the genital organs of the female, which may be thus pro- duced, is an inflammation of the membrane which lines the vulva and vagina. This inflammation is con- stantly indicated by a more or less abundant leucor- rhceal discharge, and often by swelling, redness, and pain. When this discharge continues, which is often the case, it occasions in young females symptoms analo- gous to these of diurnal pollution. The complexion loses its color, and becomes yellowish; the eyes are constantly suffused, and the countenance is sad; the paiients are feeble and careless; they generally expe- rience gnawing sensations in the epigastric region} and, thinking that these are occasioned by hunger, are constantly eating. Sometimes, the appetite is vora- cious, and the digestive powers are preserved; but these are commonly soon altered. Severe and con- stant pains are often felt in the back and epigastrium; the body wastes 3 and a short, dry, and frequent cough, 14 158 renders the patient, parents, and sometimes the phy- sician, anxious as to the state of the chest. Add to these symptoms those already described, when speak- ing of the general effects of masturbation, and you have the state most frequently presented by girls ad- dicted 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 ve- nery. May a too frequent return of this symptom have any influence on the health? The only remarks on the subject, to our knoAvledge, are to be found in Swediaur. He says, Avhen speaking of diurnal pollu- tion—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 symp- toms of the tabes dorsalis, described by HippocTates, as a disease of the male. Even the lungs begin to feel this disease. She, hoAvcver, 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 ai the facts, we should find that the cause of fluor albus in adults was either recent or former abuses. Whenever Ave have addressed females on the subject, to ascertain this fact, our con- jectures have been verified. This has frequently been the case Avith servant girls. We have seen several, who Avere so weakened by fluor albus, and the irrita- tion of the sexual parts, thai they have been obliged to quit their situations, being unable to do their duty. We Avill 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. 159 Besides, all authors who have spoken of leucorrL and blenorrhoea in .females, have mentioned excesse. in masturbation and coition as among their most fre- quent causes. It would be easy to adduce general evidence and special cases in support of this proposi- tion ; 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 coi- tion. 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 absti- nence, was but imperfectly followed: she was so ad- dicted to onanism, that, although she indulged law- fully, and was the mother of several children, she con- tinued 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 p olapsus uteri, or a falling of the Avomb: the neck of he uterus was almost at the vulva. This displacement, which is the 160 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 manoeuvres. 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 at- tempted to verify this assertion, by examining numer- ous cases, but they have obtained no marked result; which is not surprising, considering the number of causes, which, especially in hospitals, render such in- vestigations useless. The influence of excessive in- dulgence, 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 hus- band, although they Avere 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^iffect 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, howevt r, be very careful in their pleasures, as this slight accicent indicates a bad state of the system, 161 and one which should be mistrusted. Sometimes-, blood appears on return of coition, when females have not indulged for a long lime. Rondelon cites an in- stance 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 for- tiori from its abuse, during or just before the menstrual period. Very serious hemorrhages have often occur- red in consequence of excessive copulations. Tissot states—In 1746, a girl, twenty-three years old, submit- ted 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. {Diet, 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 ab- sorb substances applied to it, ho irritation of the uterus and vagina renders them unfit for impregnation. Thus, then, libertinism, instead of adding, as Ave might think, to the chances of fecundation, acts in a contrary manner. Marc remarks, that tAvo hundred public girls do not produce more than two or three children annu- ally. Farther: it seems well ascertained, that if these girls resume a regular life, they again become fruitful. The English, wishing to people Botany Bay, trans- ported there a large number of public women. Those who Avere sterile in their own country proved fruitful, when subjected to the rigid laAvs of marriage. Is it not notorious, too, that among the public girls, those 14* 162 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 mar- riage—that is, when the congress of the sexes is most frequent, and causes the most irritation. Villerme 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 dete- rioration 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 sur- geon of the last king of Poland, attributes the extreme physical debility of the Polish Jews to these prema- ture 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 re- course to artificial means to procure a semblance of coition. Accidents of a similar character have hap- pened to girls; and they have been obliged to call in surgeons to their assistance. There are numerous in- stances, where foreign bodies have been introduced into the vagina, and particularly into the urethra, and 163 could not be withdrawn. We shall mention some of them. Pamard has reported that of a girl, thirty-one years old,Avho 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 withrawn, 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 hav- ing entered very deeply, fell into the bladder. Faure Avas called, and was obliged to cut for it, to extract it. Rigal Avas 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 blad- der. 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, (accord- ing to Morand's report,) was called to a girl twenty years old, \vho had introduced into the urethra a tooth- pick, 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, Avhen, by accident, it became engaged in the sound. Wishing to withdraAv it, and finding some resistance, he introduced his finger into the vagina, and ascertained whence it proceeded. By skilful ma- nipulation, 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 sel- 164 dom 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 de- rangement in the vulvo-uterine passage. On examin- ation, 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, pre- vented its disengagement. After much effort, how- ever, the body was removed; and it proved to be a pomatum-pot, which had been introduced by its base. {Additions a la Med. Operat., de Sabatier; vol. iv., p. 96.) PART SECOND. RULES OF PRESERVATION AND TREATMENT RELATIVE TO VENEREAL EXCESSES. There are two indications, which embrace every thing relating to venereal excesses. The first is, to prevent the bad effects; the second, to remedy them. To preserve, to recruit, is what these excesses require. Hence, some of the remedial measures must be hygi- enic, and others therapeutic. To these, we shall de- vote two chapters of this second part. CHAPTER I. PRESERVATIVE MEANS RELATIVE TO VENEREAL EXCESSES. The preservative rules which relate to venereal ex- cesses present fundamental differences, as to the suc- cess and facility of their application, according as reference is made to the act of masturbation or coition. Let us point out these differences. Coition is an act, the mode and purport of which, considered in a scientific point of view, are legitimate; and which, consequently, is lawful, so long as the constitution and health are unimpaired. Hence, it should not be prohibited, except when abused—that is, when indulged in too often, or under circumstances which render it injurious. Except in these cases, it may be permitted, or even advised. When it is for- bidden, the advice is generally understood, as it is commonly addressed to adults, children having neither the power nor the opportunity to indulge in coition. 166 This advice may be easily folloAved, as the individual who indulges in coition to excess, may find it abso- lutely impossible to indulge: in fact, means to satisfy his taste can only be found by the concurrence of an- other. Hence, it is only necessary to shun this con- currence, to render this kind of excess impossible. To address one's self to the reason of an adult—or, rather, of a young man—and to create for him, if he cannot create for himself, obstacles to sexual relations, these are the only two preservative indications which abuses of coition require. We have discharged the first, or have stated the mode of fulfilling it, by men- tioning the bad consequences attending these abuses, and by making known the circumstances which ren- der the act of venery injurious to those addicted to it. Hence, Ave shall not return to the subject. The sec- ond indication can find no place in a book, and conse- quently will not detain us. Our remedies, then, as to preservation, will apply exclusively to onanism. In a subsequent page, when we are treating of the restora- tive remedies, the distinction here laid doAvn between this habit and coition will disappear; and we can then treat of all venereal excesses conjointly. Although coition, if confined within certain limits, and under certain circumstances, may not be forbid- den, this is not the case with masturbation. This lat- ter indulgence has nothing legitimate in it; and nothing respectable—nothing which can palliate the veto of the physician. We are aware that onanism is not al- ways necessarily followed by any inconvenience or danger; but, practically, this distinction disappears. But onanism, Avithout regard to the mode, its frequence, or the individuals or circumstances under which it oc- curs, may always be considered an abuse, and, conse- quently, be earnestly proscribed. This view of the subject rests on two facts: one is fundamental, and applies to all individuals, without distinction of age, sex, or constitution; the other re- lates only to those who are addicted to onanism, be- fore they are perfectly formed and constituted. The first of these motives is founded on this, that when 167 this practice is not actually bad, it may constantly be suspected of becoming so. When onanism once com- mences, it is difficult to say how far it will extend. The taste for it, and the facility of indulging in it at night, and often in the day, cause this habit to be in a measure indulged in without limits. It becomes so soon imperious, and the despotism it exercises is so absolute, that Ave ought always to attempt its preven- tion. It should be regarded as a scourge, and be treated as such, without Avaiting for the bad effects which may result from it. This course is still more neces- sary, when children, young patients, and individuals who have not attained their growth, are interested. When maturity arrives, the evil is possible; before it happens, it is probable, and often certain. Farther: our remarks on precocious enjoyments prevent our re- curring to the subject. Before speaking of the preservative means, a ques- tion presents itself. How can it be told Avhen these means may be used? or, in other words, what are the signs which indicate that an individual is an onanist, or may become so ? The suspicion may extend very far: in fact, every age is exposed to it, as onanism is pos- sible from early life to old age: it, however, belongs to the age before puberty. A great many young girls and boys masturbate: hence, this maybe suspected of »very one. This habit is less frequent, but it is far from being rare. The precautions to prevent onanism, and constant vigilance, should then be exercised con- stantly towards children and young people—in fact, toAvards all Avho are not of mature age. This rule is an important one; and cannot be neglected, Avithout exposing one to danger and to deep regrets. It would be desirable to ascertain the existence of onanism before its effects appear; but this is seldom the case. There is in children a kind of instinct which leads them to conceal this manceuA're, although they have not learned that it is an illicit act. The art with Avhich they elude vigilance is often inconceivable. Watch where the child goes. Have an eye to him who seeks solitude—who remains a long time alone, 168 and who cannot give a good account of himself. Be watchful about the periods of lying down and of rising. At this time, the onanist may be detected in the act. His hands are never out of bed, and his face is often hidden under the bed-clothes. Soon after lying down, he appears sound asleep: this circumstance, which always causes distrust in the experienced man, is one of those which contribute the most to inspire the pa- rents with a feeling of security. The affectation of sleep in the young person may serve to detect him. When approached, he is frequently found red, and covered with sweat, although neither the temperature of the chamber, the weight of bed-clolhes, nor any other cause, can explain this state: at the same time, the respiration is more hurried, the pulse is fuller, harder, and more frequent; the veins are larger, and the heat is greater, than usual; in fine, there is that kind of fever, of general turgescence, which usually attends the act of venery. When the young person is disturbed suddenly, his hands, if he has not had time to remove them, will be found on or near the genital organs. The penis, also, may be found in a state of erection; or you may even find marks of recent pollution, which might be known by the peculiar odor arising from the semen, and which comes from the soiled fingers. Have an eye to those young persons, whose hands, when in bed, or during sleep, are in the position described : they are onanists, or will become so. The same is true in those Avho frequently have erections of the penis. This erection, and this attitude, are certainly not positive signs of onanism ; but they are the probable, or precursory signs of it: they should not, then, be neglected. The stains of semen, on the bed-clothes or dress, may also increase suspicion. When the patients are very young, they are not very evident, the fluid which they emit not having the characters of real semen: the traces which it leaves, however, are too remarkable, not to cause sus- picion as to their origin. In those who have attained the age of puberty, there would be nothing equivocal: the only question then would be, that they might be 169 produced by involuntary pollution. On this topic, we would remark, that this pollution seldom occurs before the age of fifteen or sixteen years, and is seldom fre- quent" before twenty. When involuntary discharges of semen are frequent in young persons, you may be assured that they are the indirect results of onanism: hence, there is reason to regard stains of semen as positive proofs of onanism, when the patients have not attained the age of puberty ; and as more probable signs of this habit, when older, if these stains be frequent. A loss of color, or an earthy tint of the countenance —a violet appearance of the eyelids—a languid ex- pression of face—an air of fatigue and nonchalance, when the patient rises from bed—a difficulty in getting Up_are all signs Avhich may lead to the discovery of this pernicious habit. Here we might trace the physi- cal state produced by onanism, if this had not already been done. Unfortunately, it is consumption which sounds the alarm ; and this disease must be advanced, too,.before the parents seek the cause. Sometimes, the true cause is overlooked, and all remedies are di- rected to an imaginary one. We will admit, hoAvever, that it is not always easy to refer the wasting caused by masturbation to its real origin. A young man, al- though not addicted to onanism, may lose his strength, grovv thin, and present, both morally and physically, the characters belonging to this habit: this effect is often produced by intestinal Avorms, by dentition, pu- berty, by a too rapid growth of the body, &c.; and likewise by some chronic diseases of the stomach, in- testines, liver, lungs, heart, dec. Hence, we should not be too quick to attribute to masturbation a state which may be produced by other causes. The prac- titioner who would pronounce too precipitately that a patient indulged in onanism, would commit an error which might be serious in more than one respect. When a young patient presents signs of consump- tion, there is cause to suspect that onanism is the cause of it; and modes may be used to ascertain whether this be the case. Sometimes, the patient is watched, as has already been stated. Sometimes, we attempt 170 to discover if any other cause has produced consump- tion; and Avhen this cause is not found, the existence of onanism is supposed. The patient, for instance, presents all the symptoms of exhaustion, and these in- crease. We inquire if this state may not result from a want of nourishment, or from improper food—from hard Avork—from long watching—from melancholy, &c.; if it may not be caused by a disease about which the patient is silent, or by one of those maladies Avhich produce effects similar to those of masturbation. Noav, if the gradual sinkings of the patient cannot be ex- plained by any of these causes; if he is weak, pale, thin, &c.; if, notwithstanding abundant and nutritious diet, a moderate degree of labor, the absence of all chagrin, &c.; if he presents no sign of disease—or, rather, if the first symptoms of diseases which he Avould present are not manifested until after the ap- pearance of those of consumption; farther, if these diseases are too slight to have caused this state; if they cannot explain the numerous and varied symp- toms observed, and particularly the countenance, the character of which is so significant, that it alone often reveals onanism: then we may consider, if not as cer- tain, at least as very probable, that the patient is a vic- tim to this habit, and Ave must act accordingly. But, of all the proofs, it is most important to obtain an avowal of the habit from the patient. First, it removes all doubt; then it renders the action of the physician more frank, and consequently more effica- cious. He is no longer fearful of wounding his feel- ings—of compromising his character, by shoAving a wrongly founded suspicion; of awaking the attention of the young patient to a subject of which he was ignorant, or of teaching it to him. Advice, remon- strances, punishments, and all the moral remedies, are noAv easily applicable; and if therapeutic or coercive measures are called for, the patient can no longer deny their utility, and reject their use. Finally, an avowal places the physician, parents, instructers—in short, all who have authority over the patient—in a position to proceed directly to their aim, and thereby attain it. 171 An avoAval never takes place spontaneously: to ob- tain it is difficult. With males, one need not be so particular; but we must be careful with females. On this topic, no positive advice can be given: much must be left to the tact of the practitioner. We will only add, that Ave have more than once simply given advice; and we could see, from the manner in which it was received, that our conjectures were right. The physi- cian, however,, should always attempt to acquire the confidence of the onanist, to- place him at his ease. They have no frankness Avhen a person is stern, or when a moral lecture is expected. The physician should confine himself to his profession. In his eye, onanism should be regarded as a cause of disease—as a cause similar to an excess of labor, bad regimen— in fact, like any influence which might prove injurious lo the health. If he should moralize, he would prob- ably be debarred from that confidence Avhich would enable him to give advice, and prescribe the resources of the art. Masturbation is often overlooked, because it is thought that the hand is a necessary agent in producing it: this is far from being the case; as it may be indulged in, by both sexes, without the aid of the hands. When this is suspected, it is soon discovered, by the manners, face, and silence of the onanist: there is something unusual in the appearance of the patient, Avhich is readily observed; and generally, also, the thighs are crossed, or, at least, are pressed closely together. To prevent the development of the habit, and, when it is developed, to arrest it, are the two indications prescribed by hygeia. These tAvo indications may be embraced in one—that of preventing the occurrence of onanism. If, for instance, you have before you the case of two individuals, one of whom is not addicted to onanism, while the other may be, you should pre- vent one from continuing, and the other from com- mencing it. In the two cases, the means used have the same tendency; only when you wish to prevent the habit commenced, you have need of more efforts than in the first case, where it does not exist. These 172 means are, then, preventive—essentially preventive; for, whatever may be their mode of action, they all tend to prevent the act. Although the prevention of onanism, and the arrest of the habit, are apparently different, yet we shall state the mode of attaining this double result, to avoid repetitions. In masturbation, we must consider three things—the desire, the will, and the poAver. Onanism is not pos- sible, where these three conditions do not exist: there is no wish without desire; and the latter is often com- pletely mastered by the former, and both present no result, if there be no possibility of indulging. Hence, to prevent masturbation, and to arrest it, the desire, the wish, the power to indulge, must, not exist. These are, as it has been seen, three distinct indications. It is sufficient to attain one of them. It is easily seen, that by appeasing the desire, the will is aided; and the obstacles opposed would be more efficacious, the less vivid the desire, and the weaker the will. It is, there- fore, sufficiently understood, that the three indications we have mentioned, although very distinct, require each of them special means, the attainment of one of which renders that of the others useless, while they all can and may be pursued conjointly. § 1. FIRST INDICATION. TO PREVENT THE OCCURRENCE OF THE DESIRE TO MASTURBATE, TO PREVENT ITS RE- TURN, AND TO ABRIDGE ITS POWER. The desire of masturbation is very distinct from venereal desires, which may be felt without experi- encing the other. This desire is special: it is that of onanism, and no other. The influences, also—the re- sult of which is more or less proximate, and which is to excite the genital sense—are only the indirect and predisposing causes of onanism. The direct and ef- ficient causes are those which lead to the indulgence of it, and the preferring of it to coition. Consequently, two indications relate to the desire of masturbation: one consists in preventing the exaltation of the vene- real sense, or in appeasing it; and the second, in pre- 173 venting or destroying the special causes of the desire of onanism. We proceed to study these two indica- tions in succession. 1. Rules relative to the general or indirect causes of onanism.—The genital sense, and, consequently, the venereal desires, may be felt too vividly and too early, in consequence of different circumstances, which may be divided into two groups. Some belong to the human body, and consist in certain innate acquired arrangements of the organization, in consequence of which the venereal sense presents more or less sus- ceptibility. Others consist in different influences, as education, food, climate, kind of life, &c.; which may act on the sensibility in general, and particularly on that of the genital system. We will begin with the rules connected with the former. Of the innate or acquired causes of venereal ex- citement, and of the rules of preservation connected with them.—Some individuals seem, as it were, marked by their organization, to become victims of venereal excesses. In them, the genital sense is excited, and exercises great power, long before the usual period of its manifestation. In others, on the contrary, this sense is not excited until late: in fact, it is so slight, that even this excitement may be doubted. In the present state of the science, these differences can by no means be accounted for. In many cases, however the great development of certain Organs, the increase of their vitality or their diseased'state exercise consid- erable influence on the strength and precocity of the venereal sense. Gall, and the phrenologists of his school, place am ativeness in the cerebellum. They consider this organ as the legislator of the sexual parts, the seat of physi- cal love; and assert that the differences in the mass and vitality of this portion of the brain, correspond exactly to the differences of the intensity of the geni- tal desires. We will proceed to mention the different facts on which these physiol'ogists formed their opinion. Comparative anatomy furnishes them with no argu- ment worthy of mention: in fine, facts contradictory 15* 174 to Gall's opinion may be derived from numerous classes of animals who have been deprived of their cerebel- lum, and yet have exercised the act of reproduction. This opinion applies only to man, and the mammalia resembling him. The relation between the develop- ment of the cerebellum and that of the genital organs, has furnished a more plausible reason : it has been adduced as an argument, that, in the encephalon, the fibres of the cerebellum are the last to appear distinctly; and this organ is not perfect, till from the age of eighteen to twenty-six years. A remark of Soemmering, also, has been adduced, to show that the cerebellum, at the period of puberty, is to the cerebrum as one to five, while in infancy it is only as one to seven. We have already seen that the genital sense is more powerful in males than in females. But it is said positively, that the cerebellum is commonly smaller in females than in males. Phrenologists have also sought to establish a reci- procity of action between the genital organs and the cerebellum, by means of the results of castration, and also the influence which the development of the cere- bellum may have on the testicles. Castration, (say they,) while it opposes the development of the sense of venery, prevents the cerebellum from gaining the size it would otherwise have attained. Observe, too, how much broader the neck in the bull is, than in the ox. They have also advanced, that if castration oc- curs only at a period when the cerebellum acquires its development, the genital sense may survive this ope- ration ; that, in some cases, it may reduce this organ to a state approximating atrophy; that the removal of one testicle from an animal, whatever may be its spe- cies, may produce atrophy, or some alteration in the lobe of the cerebellum, on the side opposite to the tes- ticle removed. They have added, that the alteration of the cerebellum had caused a wasting of the testi- cles; and that, in the cases where one of the lobes only was disorganized, the testicle of the opposite side was alone affected. According to Gall and his disciples, the size of the cerebellum is discerned ex- 175 temally by the size and breadth of the nucha. They remark, that this part of the skull is generally more convex in males than in females—in entire ani- mals, than in those who have been castrated—in early life, and in those individuals who are distinguished for their salacity, more than in those who are not sus- ceptible to the pleasures of love. Larrey pointed out to Gall a soldier, whose antipathy to females amounted to mania: the sight of a female caused in him violent convulsions, and almost fury. Spurzheim saw a sim- ilar instance in England. Now, in both of these in- dividuals, the cerebellum was but slightly developed. The portraits of Newton, Charles XII., and Kant, according to Gall, by the narrowness of the neck, show that the organ of which we were speaking was but slightly developed in these great men, who history states had but little relish for venereal pleasures. Dis- positions diametrically opposite, on the contrary, co- exist with an enlarged volume of the brain. The following is related by Gall:— " A highly intellectual lady was affected from infancy with very passionate desires; and her careful educa- tion alone saved her from those excesses to which she was exposed by her violent temperament. When ar- rived at a more advanced age, she was left to herself. She attempted every mode to satisfy her burning pas- sions ; but enjoyment seemed only to irritate her. She Avas frequently almost in a state of mania. In despair, she left her house, quitted the city, and took refuge with her mother, in a desolate country, where the want of exciting objects, and the utmost severity, and the cares of gardening, prevented the evil. After a time, she returned again to a large city, was again threatened with relapse, and took refuge a second time with her mother. On returning, she came to see me at Paris, and complained to me in great despair. ' On every side, I see images of luxury—in every place—at table, and even in my sleep, the demon pursues me. I shall either be mad, or die.' " I told her briefly the natural history of the instinct of propagation. I called her attention to the form of 176 her neck. Although her head was very large, yet the diameter of the nucha exceeded the distance from ear to ear. She formed an idea of the cause of her state. I advised her to visit her mother again; to vary her occupations, so as to diminish the activity of her cere- bellum ; to apply leeches to the nucha, to diminish the irritation of this organ ; to avoid all stimulating meats and drinks, &c. &c. "I have seen at Paris," says the same author, "a boy, five years old, who seemed sixteen, in respect to his corporeal strength. His genital organs Avere per- fectly developed; his beard was strong; his voice was rough and hoarse: in short, he presented all the signs of virility." Dr. Gall was struck, also, Avith the development of the cerebellum in a boy ten years old, who had been detained in a house of correction at Leipzick, for hav- ing violated a young girl. He had also seen at Paris a young mulatto, less than three years old, who was remarkable in the same respect. He made advances, not only to young girls, but to women, and urged them to consent to his desires. His sexual organs, with the exception of long-continued erections, exhibited nothing remarkable. As he was surrounded by girls who indulged him, he died of consumption before he was five years old. His cerebellum was unusually developed; the rest of the head was of the common size. Gall has related other instances of the kind. A case published by Dr. Chauffard, of Avignon, de- serves to be stated here. This physician accompanied the prefect in 1823, in his tour to the departments, to examine those young men who wished to be discharged from military service. A stout farmer, with coarse beard and hair, and disagreeable odor, was undressed, being, as it Avas said, affected with a disease which he dared not name. It Avas at the close of December; the season was cold, and the room very chilly. No sooner was he undressed, than the penis began to swell. He was confused—he blushed—he turned his back to the assistants. He could not avoid the pria- pism ; nor, finally, an emission of semen, Avhich took 177 place without a sensible diminution in the size of this organ. This man was ignorant and stupid, but he answered questions correctly. He said he was always tormented by continual erections, often followed by seminal emissions. He even admitted that he was accustomed to solicit them. His neck was short, broad, and thick; the posterior portion of the occipital bone presented a very marked slope: finally, the cere- bellar portion of the cranium was very prominent, and much developed. This man was reformed. {Jour. unic. des Sc. Med., December, 1828.) We have also observed a very remarkable development of the poste- rior part of the skull, in a boy eight years old, who was addicted to masturbation for several years, and whose penis was almost constantly in a state of erec- tion. This prominence so elongated the antero poste- rior diameter of the cranium, that the mother found it difficult to fit caps to his head. One of Gall's most distinguished pupils, Dr. Voisin, has tested phrenology, in a visit recently made to the convict galley, at Toulon. Renaud, the Director, informed of the scientific purpose of the visit of this physician, allowed him to examine the cerebral organs of 350 thieves, forgers, or homicides; among whom he had designedly distributed 22 other convicts, con- demned for rape, requesting M. Voisin to discover them from this number, by examining the posterior part of the head. This gentleman picked out 22, 13 of whom only were condemned for violence. Thus, then, he had selected nine who were not guilty of this crime; and, on the contrary, had allowed to escape him nine who had been committed. Now, the nine wrongly selected were libertines, whom the Director admitted required to be constantly watched; and the nine, on the contrary, whom he had not detected, were guilty by accident, or when intoxicated: with them, libertinism was only accidental, and not organic. A few experimental proofs have been invoked, in support of Gall's opinions of the cerebellum. We will cite a remark made by Series, as to those bulls killed by striking them on the back of the neck. " The 178 penis, in those where the cerebellum Avas injured, oscil- lated very evidently during the experiment." The same gentleman observed a Arery marked erection in a young norse, who was killed by plunging a knife into the cerebellum. Segalas has produced the same effect in Guinea pigs, by pushing a stylet into this organ. The principal proofs, however, have been drawn from the action of the diseased cerebellum on the gen- ital apparatus. Thus, the erection of the penis in those who die by hanging, has been attributed, by Gall, to the affection of the cerebellum in this kind of death. Cruvelhier has contested this explanation. He.thinks it may be explained by the stasis of the venous blood. " Respiration," says he, " is retarded, in consequence of the medulla oblongata; and hence results a semi- asphyxic state, favorable to erection. In hanging, there may be an affection of the cervical part of the medulla; and priapism has been observed more than once in lesions of this part." Phrenologists have also shown, that this symptom often follows the application of a blister or seton to the neck. Another fact, to show the connection of the cerebellum with the genital ap- paratus, is that of a soldier, whose generative powers had disappeared, after the fleshy scalp of the occiput had been removed by the blow of a sabre. We doubt whether similar cases to this, which was observed by Larry, have often occurred; although Dr. Bischoff has advanced, that Avounds of the back of the head, and blows on this part, have often been followed by inflam- mation of the genitals. Peculiar excitement of these'organs has more than once attended a disease of the cerebellum. We have already mentioned this fact; and the cases stated were selected as those where the affection of the cerebellum might be considered as produced by venereal excesses. In those now to be mentioned, the genital excitement is, or seems to be, the consequence of this affection. Erection of the penis, with or without pollutions, has several times been noticed as a symptom of apo- plexy of the cerebellum. This phenomenon may have been observed in some cases of this affection which 179 we have cited. Serres was the first one to call atten- tion, to this phenomenon, in his Memoir on Apoplexy of the Cerebellum, inserted in the Journal of Experi- mental Physiology; the principal facts of which have been adduced in his work on the comparative anatomy of the brain. One fact is, that of a man, forty-six years old, who died with violent apoplexy of the cerebellum, during which satyriasis and ejaculation appeared, with swelling of all the genital organs. Similar cases, Avhich it is unnecessary to state here, might be added. One of them was observed by Falret. " The priapism AAras presented to my observation with a very remark- able circumstance. The patient had been affected with apoplexy, and presented a complete paralysis of the left side of the body. Different nervous symptoms indicated that there was also great irritation of the encephalon or its membranes. This man, although half frantic, made amorous proposals to the female who attended him, and presented a semi-erection of the penis: this part, instead of being straight, presented a concavity, which looked towards the side not para- lyzed. I regret that I could not examine the cadaver of this individual. The affection of the genital organs, in apoplexies of the cerebellum, might probably have been noticed in many cases, if it had been sought after. It has not been noted, in any of the cases analyzed by Andral. Cruvelhier, also, has never noticed priapism, in a case of apoplexy of the cerebellum which he has seen; but he adds, that he would not dare to say that it has never existed—at least, temporarily. In fact, it may easily escape observation. Hydrocephalic patients often show a great passion for venereal indulgences. Gall, in noticing this re- mark, observes, that of all the parts of the encephalon, this is the least changed in these individuals. Chauf- fard has seen a hydrocephalic patient, fourteen to fif- teen years old, Avith an enormous head, who Avas ad- dicted to masturbation, and spoke of the pleasures he derived from it. An acute or chronic irritation of the cerebellum, or of its envelopes, may cause, venereal symptoms more 180 than the alterations just mentioned. In a cadaver, brought from the hospital Bicetre to the amphitheatre, where the penis and testes were considerably swelled, the whole of the cerebellum was inflamed. One of the most interesting facts of this kind was reported by Chauffard. It was that of a man, fifty-three years old, of pleasant manners and mild character, who, in fall- ing, struck his head against the bed-post. The infe- rior occipital region became inflamed; and subse- quently, the habits of the patient were much changed: he became affected with satyriasis, and was so sala- cious, that he persecuted his wife and daughter, and all the females around him. This man, hitherto pious and modest, gradually became affected with the most violent erotic delirium, and finally committed the most indecent acts. During the next three months, this state increased; but, at the same time, his strength and intelligence failed. Finally, one day, after a vio- lent fit of anger, occasioned by the refusal of his wife to listen to him, he became convulsed. The pain left the back part of the head, and affected the top of it. The left side of the body noAV began to be paralyzed; and the satyriasis was replaced by religious delirium, with constant mumbling of prayers. The patient died eight days afterward. According to Chauffard, at first, there was an affection of the cerebellum. When the state of the patient was changed, the organ of venera- tion was affected: this organ corresponds to the cen- tral posterior and superior part of the frontal bone, where the patient finally felt severe pain. Was not the cerebellum, also, affected, in the fol- lowing case reported by Sainte Marie:—"A merchant of Lyons, an educated and honorable man, seemed to be cured of an inveterate venereal affection, for which he had undergone a course of treatment with mercury. He,'however, complained of restlessness, heat in the throat, pains in the occiput and nucha, and frequent erections. In 1812, after domestic troubles, he became affected with furious delirium. This state lasted three days, and terminated in priapism; during which, the patient had fourteen emissions in a few hours. This 181 singular crisis resulted in a perfect calm: extreme debility, hoAvever, remained, which soon yielded to tonics and analeptics. Two years and a half afterward, this disease reappeared, under the influence of these same causes, and with similar symptoms. The ter- mination was the same. There was a slight return of it after two years ; but, this time, the patient escaped with slight erections, without much loss of semen. Facts of a similar character have induced several authors to attribute satyriasis and nymphomania ex clusively to an innate or accidental state of the cere- bellum. "The material condition of satyriasis," says Voisin, "resides in the encephalon; and in all cases, the derapged manifestation of it depends on the nature and preponderating power of the cerebellum, or on those moral and intellectual causes which have favored the development of this organ—or, rather, on the ex- ternal circumstances which at the moment of disease have brought it violently into action." On the other hand, the localization of physical love in the cerebel- lum has been violently contested by excellent observ- ers, particularly by Flourens and Bouillaud, who con- sider as the special function of this organ its presidence over locomotion. Bouillaud, particularly, has attempted to establish, by analyzing the observations of Gall and Seires, that they are not so conclusive as these authors asserted, and that they may be interpreted differently. Chauffard thinks that Gall has gone too far, and that his remark, that physical love and erections should not be attributed to the presence of the semen and the irritation which it causes, should be qualified by using the term exclusively. We also think, that, thus altered, Gall's remark would be more just. The cerebellum has certainly a powerful action on salacity; but we shall see that each part of ihe genital apparatus exer- cises one equally great; and that, consequently, the organic principle of the state of rutting, and of vene- real excesses, cannot be sought for solely in the en- cephalon. In consequence of Gall's opinions, many authors, among whom we will mention Chauffard, Voisin, and 16 182 Londe, have thought it necessary, in order to subdue too great a degree of amativeness, to make applications directly to the cerebellum. Some attempts have seemed to justify this view of the subject. Sainte Marie says, that a physician of Lyons has cured invet- erate nocturnal pollutions, by applying ice to the occi- put and nucha before going to bed. A man, thirty years old, had three or four seminal emissions every night, which Lallemand had tried in vain to cure, by cauterizing the ejaculatory canals. Gensoult ap- plied leeches and ice to the nucha: the pollutions were arrested, as if by magic. Serres. Avho reports this case, adds, that, since the publication of his memoir on cer- ebellar apoplexy, he has seen two cases of apoplexy, Avhere erections appeared during the paroxysms. Both Avere cured by applying leeches and emollient cata- plasms to the nucha. Miii'ht not narcotics be applied, endermically, near the cerebellum, to subdue the onan- istic satyriasis? Might not belladonna, opium, &c, introduced in this manner, be used with advantage? Might not, also, the hair of the head be kept short, especially behind, and rest on a pillow of hair, instead of feathers? Setons and blisters, also, should be ap- plied to the neck, in onanists, only with the utmost care; and they should be removed as soon as they are considered indispensable. Besides the irritation caused near the cerebellum, the influence of the cantharides is to be guarded against. We have already stated, that there is a reciprocity of action between different organs: if there be one which exercises a marked influence on the other, the latter will in turn affect the former. This may be proved by the cerebellum, which sometimes becomes diseased after abuses of the genital organs, and some- times communicates to these organs the over-excite- ment which is accidentally seated in it: the spinal ' marrow, also, confirms the fact. Willis, who, before Gall, had sought to localize in the nervous centres the faculty of reproduction, had designated the spinal marrow as the organ of this fac- ility. Numerous observations, and many experiments, 1S3 have lately given some credit to this opinion. Segalas, who produced erections of the penis in Guinea pigs, by introducing a stylet into the cerebellum, caused ejaculations by pushing this instrument into the spinal column, near the lumbar region. Serres repeated this last experiment, and the result was similar: he there- fore concluded that the lower part of the spinal mar- row acts on the secretory and excreting seminal appara- tus, as the cerebellum acts on the genital sense. We shall see, also, that this opinion is too positive, as the lesions of the medulla exert a marked action on erec- tion of the penis and the venereal sense, besides the influence on the ejaculation attributed to it by Serres A case, reported by Lenhossek, seems to establish, that compression and atrophy of the spinal marrow may oppose the development of the genital organs. This patient was twenty-four years old: he was thin, wasted, and his height was that of an individual twelve years of age. Neither his face nor genital system pre- sented the characters of puberty. This individual died suddenly; and it was found, that in consequence of a malformation of the first and second cervical vertebrae, the diameter of the occipital foramen was contracted one half. The medulla oblongata had been com- pressed in this part, and its development was impeded. Might not the singular disease, observed by Larrey in Egypt, and afterward in Paris, be referred to an affec- tion of the spinal marrow? Here the testicles gradu- ally wasted; the patient lost the power of feeling vene- real sensations, and also that of erections; the lower extremities shrunk aAvay, and tottered; the face was discolored; the digestive powers and intellectual fac- ulties were deranged. Does not this coincidence, of a considerable weakening of the lower extremities and the wasting of the testicles, indicate that this latter has been the consequence of an affection of the spinal marrow ? Dupuytren long since established the fact, that pria- pism was caused by a lesion of this organ. Numerous instances of this are found in Olivier's work on the spinal marrow: they prove, that every part of the me- 184 dulla, but particularly the cervical portion, when in- jured, may cause an erection of the penis. Potain, Rcnauldin, and Hedelhofer, have stated similar facts. This last author saw a man who fell upon his sacrum, and instantly had an emission. Professor Fages was in the habit of mentioning the following case in his lectures:—"An aid-de-camp of General Dumourier was affected with complete paralysis of the lower ex- tremities, in consequence of a fall from his horse. This paralysis was attended with a great decree of priapism, which encumbered him very much, and caused retentions of urine, which were treated by the most active refrigerants. Going through Montpelier, on his way to Balaruc, he rested several days at the military hospital, where it became expedient to sound him.- In order to do this, it was necessary to uncover the whole body, to expose it for some time to the cold air, and to apply to it cold water; and, even then, the sound had to be used promptly, otherwise erections Avould soon have supervened, merely by touching the penis, and by the presence of the sound in the urethra. The baths of Balaruc almost cured the paralysis; and as motion returned to the lower extremities, the pria- pism disappeared." Do not these facts show that the spinal marrow has a marked influence on the genital organs. We have already mentioned the opinion of Sainte Marie, who regards involuntary pollutions as sometimes the cause and sometimes the result of affections of the spinal marrow. May not an original or accidental state of this organ be, in some subjects, the indirect cause of venereal excesses? Remark the influence of a recum- bent position, in producing voluptuous dreams and emissions of semen. Does not this singular effect de- pend on the heat of the spinal marrow caused by this position? This is possible, particularly if you con- sider the advantages derived in involuntary pollution, priapism, and satyriasis, from douches of cold water along the vertebral column, particularly on the lumbar and sacral regions, and also from the application of ice to these parts. Sainte Marie has sometimes ar- 185 rested the spasm of the genital organs by frictions on the sacrum with bladders full of ice. We thin*, then, there are cases where these remedies may be used suc- cessfully to combat the habit of masturbation. Nar- cotic frictions and endermic applications may be made along the vertebral column, as we have said, when speaking of the cerebellum. In vigorous patients, leeches and cups may be applied to the loins. We will not allude here to the remedy recommended by many old authors, of'a sheet of lead to the kidnies, for this cannot produce the refrigerant effect expected from it. The organic conditions of venereal desire are con fined neither to the cerebellum nor spinal marrow: they may exist, also, in all parts of the genital system, as we shall demonstrate. A considerable part of this system is formed of a tissue termed the erectile, on account of its power of swelling, hardening, and becoming erected. It con- stitutes the whole of the cavernous bodies—the glans, which is the loose extremity of these bodies—the spongy part of the urethra—the clitoris—and a consid- erable portion of the vulva and vagina. The part taken by this tissue in the work of generation, would indicate that it is affected in amatory desires, and that its state must exercise some influence upon them; which is demonstrated by the facts we shall mention. There is no vice in the human species without its representative in some class of animals. Thus, the inclination to theft, to destroy, &c, are found in some species existing to a great degree. So. too, with lux- uriousness. There is a class of apes—the dog-faced —which represent it. It is impossible to form an idea of the lasciviousness of these animals, which is man- ifested at sight not only of a female of their own class, but at that of a woman: they show by their looks, gesture, and voice, that they are excited. They are extremely jealous at sight of a man. They indulge in coition to great excess; and if this be impossible, they abuse themselves. How does their organization differ from that of other animals?—in the cerebellum?—in 16* 186 the spinal marrow ? No: but according to Desmoulins, by the enormous mass of erectile tissue Avhich they have. This tissue abounds not only around the sexual organs, but is found in the haunches and pubis. In the face, it is not confined as in us to the lips, but it covers the face, and there presents a brilliancy of color which exceeds that of the vulva and glans in our spe- cies. It should be remembered that the kunocephali do not exhibit this lasciviousness until puberty, when this tissue is developed, and assumes its brilliant colors. Here, then, are animals, in Avhom the erectile tissue evidently performs the part attributed by phrenologists exclusively to the cerebellum. Why may not the same thing exist in our species? Are not the penis and clitoris, generally speaking, much larger in those who have a marked propensity for the pleasures of love? Is not their erection the most constant sign of the activity of the venereal sense? Is not the erectile tissue developed at puberty, at the same time with this sense, and does it not collapse in old age? Finally, does not the genital sense exist at its highest degree in the glans—the clitoris—that is, in ihe organs formed entirely of this tissue? There is, then, reason to seek the principle of mas- turbation in this tissue, and to this remedies should be applied. This is done in a vigorous and healthy patient by blood-letting, and by applying leeches or cups around the sexual parts. Lotions and cold appli- cations to these parts, and cold hip-baths, act in the same manner; and as they do not contribute to the exhaustion, they are employed more frequently. Sainte Marie recommends that the genital organs of individ- uals affected with spermatorrhoea should be covered with bladders of pounded ice, Avhich should be removed as often as it melts. This remedy seems more effica- cious and convenient than the application of wet sponges or linens to the parts. It might also be used in those onanists who will consent to it. The same indication is fulfilled by forbidding children to be washed in warm water, and by causing them to use 187 hard cushions to sit on; and likewise, by keeping the pelvis lightly covered, and the clothes large enough to allow the air to circulate freely around the genital organs. The cold injections, in girls, may also be somewhat useful. There is also another remedy which is applicable to parts formed of erfectile tissue, and which we shall mention—viz., their removal. Some nations are accustomed to practise upon their female children a kind of circumcision, which consists in cutting off several parts of the vulva. This custom is very ancient, and exists particularly in Egypt, Ethio- pia, around the Persian Gulf, and in several parts of central Africa. What portions of the vulva are cut off? Many authors think that these are the nympbse, clitoris, and even the hymen. In fact, Niebuhr has given a colored plate of the sexual organs of an Egyp- tian girl, eighteen years old, drawn by the painter Baurenfiend, the original of which is in the library at Gottingen, in which the parts just named seem to have been extirpated. Sonnini, who has examined two young Egyptian girls, one of whom had been circum- cised for two years, while the operation was performed on the other in his presence, states, contrary to Nie- buhr's opinion, that this operation has reference to the interior of the vulva, and is confined to the excision of a thick, flabby, and fle-hy excrescence, covered with skin, which in several African races rises above the commissure of the external labia; the length of this was only six lines, in the two girls observed by him, but it may be four inches long, at the age of tAventy-five years. As the opinion of Niebuhr agrees with that of all authors who have lived in these countries, the facts observed by Sonnini are exceptions, rather than the rule. Hence, it appears, that in many nations it is the custom to remove from the females a considerable portion of the erectile tissue, which is found around their sexual organs. What is the origin of this singular custom? Is it to remove in infancy, from the vulva of the girls, cer- tain prominences which, at a later period, might prove inconvenient? Has this custom been established with 188 a view to cleanliness? May it not be, to take away the power of self-abuse? Whatever may be the rea- son of its existence, its effect is to deaden the venereal sense, by removing a portion of the surfaces in which it is situated. This seems positively established, by the testimony of Niebuhr, and many others. If this be so, may not the removal of the internal labia and of the preputial portion of the clitoris—espe- cially if these parts are large—be attempted, in order to avoid a more extreme thing, Avhich we shall men- tion directly. Might not this removal blunt, if it did not deaden, the propensity to solitary enjoyments, and render the other remedies employed more efficient? Although we have but little confidence in this opera- tion, yet, Avhen we consider that a superficial cauteri- zation of the nympha? and clitoris has cured nympho- mania, as will be stated hereafter, we can conceive that the excision of the internal labia may in some cases present a chance of success. Farther: this ope- ration is not very painful—is easily performed—and cannot, even under the least favorable circumstances, be attended with any inconvenience, except that of being useless. It certainly would not be practised generally if it caused severe pains, or was followed by bad consequences. In Africa, it is performed by the females of Said, who use a razor. And it should be remembered, too, that it is not children Avho sub- mit to this operation; but girls eight or ten years old, as may be seen in the travels of Niebuhr and Sonnini. The exquisite sensibility of the clitoris, and the size it commonly presents in lascivious females — that which it acquires in those Avho masturbate, or Avho are affected with nymphomania—have led to the opin- ion, that voluptuous desires are situated exclusively in this organ, and that its removal will extinguish them. Levret was, we believe, the first Avho conceived the idea of curing nymphomania by this operation. Du- bois performed it on a young girl, Avho was so addicted to onanism, that she Avas almost in the last stages of marasmus. Aware of the danger of her situation, and yeU too Aveak, or too much under the control of volup- ISO tuousness, she could not resist. In vain were her hands and limbs tied: she rubbed herself against the bed, and thus procured excessive discharges. Her parents applied to Dubois, who proposed amputation of the clitoris. This was assented to. The organ was removed by one stroke of the knife: the hemor- rhage was arrested by the actual cautery, and the girl recovered her health and strength. Richerand, who has reported this case, considers the operation per- formed on this young girl as the most efficient remedy in such a case. If the idea of cauterizing the vessels is di-agreeable to the patients, the vessels of ihe cli- toris might be tied, as are those of the penis after am- putation. {Nosog. Chirurg., second edition, 1308; vol. iv., p. 326.) The following, which is similar to the preceding, but more remarkable in some respects, was published in the Journal of Surgery, by Graefe:— "The subject of this case Avas born in 1807, and grew very well, till the age of fourteen months, Avhen she became ill: for eight days, she was affected alter- nately Avith constipation, diarrhoea, and vomiting. She remained sick till she Avas two years old, and did not Avalk till she was four. She, however, never learned to talk, and exhibited symptoms of idiocy. This id- iocy resisted the most varied treatment, progressively increased, and the patient was finally reduced to a state below the brute. She swallowed her feces, and passed hour after hour in a corner, her tongue lolling from her mouth. " The most experienced physicians considered her case as hopeless. A physician at Berlin undertook to cure her. She was now fourteen years old. He re- marked first in her a strong inclination to onanism: she indulged in this practice night and day. In this, there Avas a curative indication, which the physician embraced immediately. It seemed evident to him that masturbation prevented the development of the intel- lectual faculties. Hence, she Avas prevented from sit- ting doAvn; and the head was cauterized, to obtain revulsion by the pain. The wound from this opera- 190 tion did not suppurate till after six weeks. Cold effu- sions were applied to the wound, and a solution of antimony was injected inio it. These remedies Avere followed by a slight degree of amendment. Douches and emetics were then used, but in vain. Finally, when the patient was fifteen years old, her physician resolved to extirpate the clitoris. The operation was performed June 20, 1822, by Professor Graefe, of Ber- lin. The wound soon cicatrized ; and the good effects of the process exceeded all expectations. The dispo- sition to onanism was removed ; the mind became ex- panded; and the education of the patient commenced. In three years, she could talk, read, Avrite, and even play a few tunes on the piano—to be sure, rather im- perfectly ; but still she might be regarded as being in the way of recovering from her long and cruel disease." The details of this case are not sufficient to estab- lish whether idiocy was the cause or effect of onanism. We may conclude, however, from the result, that it was at least in great part the consequence of this habit. It, however, was necessary to put a stop to the onan- ism before the idiocy disappeared. Farther, this case shows the extent of the restorative power of nature, when it is no longer impeded by masturbation. It also shows, by the good effects arising from removing the clitoris, that it would be wrong to think, as several authors, and particularly Voisin, have asserted, that nymphomania always depended on an affpction of the cerebellum. Powerful and the most energetic revul- sives had been applied to this latter organ, but unsuc- cessfully. It Avas not the first time the remedies had been used. Villeneuve long since recommended the application of caustics to the iegs, and of cups around the genital organs, with extensive scarifications, to appease venereal desires. The two following facts were communicated by Biett. The first is that of a lady, thirty-five years old, who became affected with nymphomania, after long absence from her husband. After many unsuccessful efforts to cure this disease, extirpation of the clitoris was decided upon. The operation was not easy, and 191 there was considerable hemorrhage, requiring the ap- plication of ligatures. In a few weeks, the patient recovered. The success of this operation induced Biett to ad- vise a similar one in the following case:— "Mademoiselle C***, ten years old, of strong con- stitution and good muscular developments, had been addicted to onanism since she was two years old. She was taught it by her nurse, who remarked that she Avas quieted, when crying, by titillating the clitoris, in which she was soon imitated by the patient. The habit finally caused great moral and physical degene- ration. At first, the cause of her wasting aAvay was unknown; but when it Avas discovered, the parents tried every mode to break her of it. Their vigilance Avas in vain—she still continued it. Her mind re- mained unaffected, but not so Avith her physical consti- tution. Mechanical means Avere now employed: the apparatus of Lafont was applied, but without success; and there was danger of her becoming idiotic. Her parents, after long hesitation, decided to have the clitoris removed. The operation was performed June 26, 1834, with perfect success. The patient became restored, and her voluptuous feelings di-appeared." Many have scruples in regard to this operation. They ask whether it is right to nip the enjoyments of love in the bud, &c. These considerations seem to me only to impose circumspection in respect to the operation, and to show that the operation never should be employed until all other remedies have been tried. But when life is to be saved, or the mind is to be pre- served, then we ought not to hesitate. We then do, as in amputating a limb—Ave sacrifice a part for the whole. Nor is it demonstrated, that the venereal sense is for ever extinguished, by removing the clito- ris. This organ is noi the exclusive seat of venerea] sensations, as we have already seen, and shall see again. Hence, it may be feared, for this reason, that the operation may not be successful. In fact, only the prominent part of the clitoris is cut off: a large portion Of the cavernous bodies remains. If the operation is 192 performed before puberty, perhaps by developing their tissue, this feeling may extend at this period of life: but, even then, if these chances of reparation did not exist—if it were certain to destroy all sexual desires —still this operation ought to be performed; as, with- out these feelings of love, a female may become a good mother, and a devoted wife. Our remarks on the cerebellum, spinal marrow, and erectile tissue, may apply to all parts of the genital apparatus; as each part may be a direct cause of ven- ereal excitement, and consequently an indirect cause of venereal excesses. This is certainly true of the mucous membrane, which lines the genito-urinary pas- sages. Every one knows that acute inflammation of the interior of the urethra often causes painful erec- tions, and which may attend a deformity of the penis; and hence the term chordee is applied to these blenor- rhoeas. We have seen, when speaking of diurnal pol- ' lution, that chronic inflammations of this canal may be followed by losses of semen. The presence of a stone in the bladder usually causes an itching and tickling at the end of the penis, which has sometimes been the beginning of bad habits. If, after excesses of the table, coition is indulged in to excess, it is be- cause the abuse of wine and liquors stimulates the mucous membranes, and particularly those of which we are speaking—excites their action, and new desires arise. Is it not on the special character possessed by cantharides, of inflaming the urinary passages, that the violent satyriasis caused by this remedy depends? The phenomena we have mentioned are seen much more frequently in females than in males, as the mu- cous membrane of the genital organs is much more extensive and more exposed to the action of external agents in the former. We have known several cases of nymphomania to be caused by herpetic affections, which were seated within the, vulva. Biett knew a case of it in a female, sixty years old, affected with prurigo of this part. Trousseau has known similar cases. Hence, the irritations of the vulva, attended with itching, have been considered by many author* 193 among the causes of onanism. Eczema, when it has extended to the vulvo-vaginal mucous membrane, has been known to induce this habit violently in females. Ascarides, which have escaped from the anus, have often caused violent itching, and afterward a venereal excitement, which was followed by the same result. P>ck has known these worms to produce nymphoma- nia in a female seventy years old. Bitter injections into the vagina were followed by the evacuation of a great number of these animals, and by the cessation of the symptoms. The remarks of many authors on the salacity of individuals afflicted with herpetic eruptions must apply particularly to those who are afflicted with pruriginous di lases of the skin around or near the genital organs. The excitement then extends to these organs, and awakes in them the sense of venery; a similar result may attend irritation of the inner surface of the rec- tum. Wichmann thinks, and a case published by i-jt. M.irie confirms the opinion, that simply the presence of ascarides in this instance may cause discharges of semen. Hemorrhoidal irritation has sometimes pro- du-e I them. Thus Wichmann relates the case of an individual, in whom hemorrhoids caused an obstinate diarrhoea during the day, and frequent polio nous at night. Nymphomania has been produced by drastic enemata, and particularly by those made of graliola. It is not uncommon to see symptoms of inflamma- tion appear at the same time or successively in differ- ent mucous membranes. The membrane lining the genital organs is not more exempt from this, than others. The heat which patients feel in the genital parts, the redness and swelling Avhich are there devel- o,)(>I, are generally the only symptoms Avhich then he- come known to.ihe physician. But there is another, tiie excitement of the venereal sense, which often es- capes him ; either because the patients are too young to explain it, or because a natural feeling prompts them to conceal it. Hence this symptom is frequently uiviotieed, except in rare cases, where it exits to a great degree, and presents characters analogous to those of 191 satyriasis and nymphomania. Dr. Desportes was we believe the first one to point out a certain relation be- tween venereal excitement and different catarrhal af- fections among which he has particularly mentioned the aphthous inflammation of the pharynx termed by Guersent angina pultacea. M. Desportes has knoAvn attacks of at least eight cases of this angina to be preceded by a vivid excitement of the reproductive system, an excitement which is sometimes manifested by an irritation, which although not exactly the vene- real appetite, is analogous to it, and causes in the pa- tient an evident feeling of distrust, inquietude, and chagrin. As this phenomenon has presented itself as a precursory symptom in at least one half of the cases of angina pultacea observed by him, he regards it as an index of the imminent invasion of this disease. He also thinks and with reason, that this phenomenon may, in young patients, become a cause of masturba- tion, and even in some cases, may pervert momentar- ily the ideas and sentiments, so as to impel individ- uals to the commission of acts reputed criminal or culpable. This opinion of Desportes is supported by eight facts. The most remarkable is that of a lady seventy years old, in whom the angina pultacea, was preceded for about a month with vivid and frequent venereal desires: they became so irresistible, that notwithstanding her religious opinions, she forgot her- self so far as to relieve her ardor by onanism. Desportes has attempted to explain this singular feeling, by the connexion of the nerves of the neck with certain, parts of the encephalon, the commence- ment of the spinal marrow. He might, we think, have explained this more naturally, by observing that the genital excitement, instead of appearing simulta- neously with the affection of the pharynx, disappear- ed simply from the appearance of the latter. Thus, in one of these patients, a man of fifty years old' whose habits were chaste, and Avho was suddenly af- fected Avith unusual venereal desires and priapism, the-e symptoms ceased, when after twenty days, an angina appeared^ which was followed by an eoatma 195 which affected the hairy scalp, and the parts behind the ears. In another of the cases reported by Despor- tes, the genital excitement Avhich appeared during convalescence from pleuro pneumonia, was suddenly replaced by an inflammatory irritation of the digestive passages, and particularly of the inner membrane of the mouth. Is it not evident that the irritation was transmitted in these cases from one membrane to an- other. If, however, Despertes has erred in the man- ner in which the genital excitement is produced, he deserves credit for pointing out a symptom which merits the attention of practitioners. The irritation of the internal integuments of the genital parts, is not only, as this physician has thought, a precursory sign of that of the pharynx. It may show itself during the continuance of an inflamma- tion of any other portion of the mucous membranes, or it may even follow this inflammation. Dr. Miram- beau has communicated to me two cases which con- firm this fact. The first is that of a boy who Avas af- fected after a chill, with a very obstinate gastroenter- itis. This disease was nearly terminated, when the mucous surface of the penis became the seat of a very severe irritation, which was soon attended with satyr- iasis. Things came to such a pass that his hands were obliged to be tied to keep him from those manip- ulations Avhich he had never indulged in before. The subject of the second case was a girl nine years old, who presented the same circumstances as in the pre- ceding case. She also was obliged to be tied. This fit continued in these two cases, from ten to twelve days. Hence irritation of the mucous membrane which lines the genito urinary passages may alone cause venereal excitement, and consequently onanism, in- dependent of any affection of the nervous centres. This fact is highly essential on account of the impor- lant indications which may be deduced from it. Aware of the possibility of its existence, the physi- cian will be more attentive to discover this irrita- tion ; he will find it more frequently and may in a de- 196 gree prevent a fatal habit: he will also carefully re move every cause of irritation from the mucous integ- ument of the genital parts and discuss as promptly as possible the inflammations Avhich may be developed there. The mode of doing this is by attending to the following rules. To keep the sexual parts perfectly clean by repeated ablutions: to forbid all excesses of the table, and the use of such food and drinks as tend to render the urine more irritating, and the genito uri- nary mucous surface more irritable ; hence to discard the use of wine, liquors, coffee, tea, spices, beer, par- ticularly that made strong with hops: to allay irrita- tions of the interior of the rectum, around the anus or those affecting the integuments around the genital or- gans. When children complain of itching around the anus, you must ascertain whether this be not caused by ascarides which is easily done by inspect- ing the parts and the feces : no means should be spared to get rid of these worms when they exist:* and final- ly the most efficient remedies should be used to cure the itching of the genitals as soon as this affection commences. Ozanam communicated to the academy of medicine August 12, 1823, a very acute case of nymphomania which had resisted antispasmodics, narcotics, cold baths, &c.; and which was finally cured by applying to the internal labia and clitoris a solu- tion of four grains of nitrate of silver in an ounce of water. There was a marked inflammation of the parts to which this was applied. {Rev. Med., Sept. 1828.) In 1833, we employed successfully another remedy, for a lady thirty-four years old and subject to nervous affections. She experienced a feeling of heat and irritation in the vulva and vagina which caused her excessive trouble. Solutions and injections of an * The injection into the rectum of a strong decoction of pomegranate root will destroy these ascarides. These injec- tions should be repeated noon and night, and in five or six days the end is attained. Should these animals be found in the vagina, the same decoction should be used. 197 infusion of the wild cherry-tree, produced no relief. The introduction into the vagina of a pledget of lint moistened wilh a solution of the extract of belladon- na, (one grain to the ounce,) had a better effect. Dif- ferent symptoms indicated the absorption of this drug into the system and the irritation disappeared. But it returned a few days after, and we then advised the application of ice within the vagina which relieved her, and finally brought about a permanent cure. The irritation of the uterus in this lady might have bad more or less influence in producing these distress- ing symptoms. Venereal desires, and nymphomania may in fact also depend upon the state of this organ. The excitement preceding and attending the period of menstruation, renders females much more lascivious. This phenomenon is much more marked in the small number of animals Avho menstruate: it always coex- ists in them with the period of rutting. This remark- able fact, which has long been known, of asses and monkeys, has lately been ascertained to exist in the roussettes by Camot and Lesson, and in the genette by Cuvier. Farther inflammations and diseases of the uterus have often been observed in those affected with nymphomania. Helwiel relates the history of a lady, who, after being for a long time indifferent to conjugal pleasures, became extremely salacious. She died some lime afterward, and on opening the dead body, fibrous tumours were found in the tissue of the uterus, and hydaleds in the ovaries. Calmeil found in a monomaniac, who was most furiously addicted to onanism, and Avho had a perfect hymen, that the os tincoe and a part of the neck of the uterus were of a violet colour, and Avere softened and ulcerated. This author observes that generally, when deranged fe- males imagine themselves pregnant, or that they have been violated, are finally known to think of their gen- ital organs, there is commonly some lesion of the ute- rus (Diet, des Sc. Med., art. Alienes.) In the cases which have been mentioned, the affection of the uterus was not so much the cause as the result of the excesses which bad been committed, but this cannot 17* 19S be said of those cases where Lisfranc has seen cau- terization of the neck of the uterus to be followed in the genital organs with a kind of erethism which is attended with void desires. Is not this an experimen- tal proof, that an irritation of the uterus may produce an exaltation of the venereal sense. T; is excitement from congenital or accidental dis- positions, may affect the ovaries; to prove this we have only to consider that their development exactly follows that of the venereal sense : that at forty-five years they begin to diminish in size, and finally they disappear: their removal or destruction too is always attended with the extinction of venereal desires. The respective size of the veins and arteries of the ovaries has been mentioned by some authors as a cause of salacity: the amorous ardor of animals, say they, is much greater, when the veins of the ovaries are smaller and feAver than the arteries. Haller found that the last-named vessels were very much devel- oped in a female whose temperament was extremely amorous. Different alterations in the ovaries have been found in those affected with nymphomania. Bosset, Blancard, Vesalius, Riolan, Mangel, Dimmei- broede, Riviere, Lieutaud &c. have observed cases of this. De Blegnay states that one of the girls con- fined at the Salpetriere, and who had been affected several times with furor uterinus, was once seized so violently that it was necessary to tie her. This un- fortunate girl perished by suffocation, while strug- gling to extricate herself. On opening the dead body the left ovary and Fallopian tube were found much diseased. The removal of the ovaries has been performed successfully to appease excessive uterine ardor; a swineherd, irritated by the conduct of his daughter, extirpated these organs and thus extinguished her passions. The ovaries however have been extirpated several times on account of disease. The operation has been performed on several women and with suc- cess by Dr. Sacchi of Italy, and Dr. D. L. Rogers of New York. The usual effects in those who are for- 199 tunate enough to survive, are a Avasting of the mam mae and a perfect indifference to the act of venery (Bulletin therapeutique, vol. iv., p. 313.) We need not make many remarks on the effects ot castration in the male to show the influence of the testes on the development and vivacity of lascivious desires. We know that it has been asserted that these desires may remain after the loss of these or- gans. In support of this opinion have been quoted Galen, Juvenal, Brantome and many other authors, particularly Fianck, who states that four eunuchs in a city had so many intrigues with females, that the police were obliged to interfere. {Diet, des Sc. Med., vol. iv. p. 269.) But these facts only prove that eu- nuchs may indulge in pretended coition and that they preserve some sparks of the fire which is generally seated in the testicles. Most authors have attributed the action of these organs in the sense of venery, to the fluid secreted by them, to the semen. They say that this fluid awakes this sense either by the qualities it assumes, when accumulating in the testicles or seminal vesicles, or because it is carried by absorption to all parts of the body. This opinion is certainly much too positive: but in the present state of science, can we, as do many authors, assert that it has no foundation? The qualities of the semen may cer- tainly vary much, as may be proved by the presence or absence of the spermatic animalcula?. It is enter- tained for instance, that these animalculse, do not ap- pear before puberty, and that they are not to be found in old age, that they disappear during sickness, and that in many animals, in most birds for instance, they occur only during the season of mating {Dumas, Diet, class, d'hist. nat., art. generation.) The ve- nereal sense becomes imperious, Avhen the individual secretes real semen, and this sense may be felt in old men, after semen is no longer formed. The fulness of the seminal vesicles cannot be absolutely neces- sary for venereal desires, because these organs do not exist in birds, in many cold-blooded animals and in some of the mammalia. Are these persons in whom 200 the testicles, instead of descending into the bursoe as usual about the seventh month of fetal life, remain in ihe abdomen, are these persons, Avho are termed crysoichides more addicted than others to sensual pleasures? This has been asserted by many authors, and particularly by Monro and Hunter. They cer- tainly are not less so. Poliniere has related a case of a person of this character 17 years old Avhom he saw at Brest in 1812, and Avho indulged most immoderate- ly in venereal pleasures contrary to the advice of his physicians. Death soon put an end to his career. The sensuality attributed to the crysorchides has been explained by the greater degree of heat expe- rienced in the testicles, when they remain in the ab- domen. Be this as it may, the excitement of these organs probably exalts the sense of venery. When the state of excitement is very marked, they swell and become more sensible: these symptoms how- ever are much more marked in animals during the period of rutting, than in our species. Accidental irritations of the testicles have sometimes also caused an unusual excitement of the sense of venery. Mo- reau attended for a long time a man advanced in age, who consulted him particularly for pollutions at- tended with amatory dreams. These symptoms which were very distressing constantly occurred, Avhenever the fibrous membrane of the testicles was affected with chronic rheumatism. From our remarks, we can conceive thnt extirpa- tion of the testicles Avould be a powerful remedy in fact the most efficient of all remedies, to quell lasciv- ious desires, and to put an end to venereal excesses. Hence individuals have been known to sacrifice these organs, and thus to rid themselves of a salacity which rendered them unhappy. Baldassar relates the his- tory of a man on whom he tried every remedy, and finally found nothing better than fa*ting and prayers. "Not recovering under these remedies," says this author, "he wished the operation of castration to be performed, but I thought it inexpedient. The patient however pressed me very earnestly, and sought to win 201 over to his views by presents those who opposed his wishes. He even piomised me an ambling poney of remarkable beauty, if I would consent to perform it." Reduced to despair some individuals lave even cas- trated themselves. Origen, it is Avell known, mutila- ted himself, in order to extinguish the warmth of his temperament. This operation has been performed by surgeons and with happy results. A surgeon of Bern- stadt was less fortunate : he removed the testes of a man 73 years old, in consequence of the unusual de- sires he experienced. The operation was not attend- ed with the expected result. (Sprengel, Hist, de la •med., vol. ix.) Hence this remedy is not infallible. We will add that it is far from being without danger, particularly in those individuals who are already ex- hausted by excesses. Farther, the operation is not confined, as in amputation of the clitoris, to the ex- tinction of the venereal sense: it takes away the procreating power, and causes that moral and physi- cal deterioration Avhich is seen in eunuchs, even Avhen they have lost their testicles after puberty. These therefore are reasons why this operation should not be performed ; an operation which is disapproved of by most authors. We will except however Simon, who advises as a last resource in those affected with onanism to press upon or tie the vas deferens or the spermatic artery ; for it is better, said he, that the patient should live a eunuch, than that he should in- evitably perish. (Hygiene de la jeunesse, p. 174.) Some practical conclusions may be drawn from the fact? we have mentioned. Thus in some patients, cold lotions or applications of ice to the scrotum, and of leeches around it, may be used with advantage. Young patients also should have these parts clothed lightly. Diseases affecting various parts by their action on the organs mentioned, that is on the cerebellum, spi- nal marrow and the genital system, may cause a kind of a state of rutting and thus become the occasion of venereal excesses. For instance an unusual A-enereal^ excitement is sometimes a forerunner of an attack of 202 g~v.x, AA'Mch may be explained by considering that the i .i>ion of the local symptoms of this di-ease, is u-ual!v preceded by the irritation of several mucous membranes. Does not the salacity which all authors have mentioned as being peculiar to phthisical per- sons depend on th" part Avhich the genito-urinary iiembr me takes in the general excitement of the mu- cous membranes which is so common in the tubercu- lous affection of the lungs? Pathological anatomy ha thrown no light on the subject. Of forty patients all*-ried with phthisis, where the prostate gland, sem- inal ve,icles. and vasa deferentia were carefully ex- amined by Louis, three only presented an alteration of these parts; this consisted in the deposition of a quantity of tuberculous matter in the pro-tate gland : in one of them this matter was found in the seminal ve icles and vasa deferentia. (Recherches analo- patli. snrla phthisie, 1825, p. 132.) Louis says noth- ing in regard to the amatory passions of these indi- viduals. The affection of the genito-urinary mucous mem- brane, accounts also for the venereal sensations which many authors have mentioned as a symptom of the elephantiasis of the Greeks, otherwise termed lepra tubercularis. The frequency of this symptom Avas so remarkable, that ihe ancients confounded elephantiasis with satyriasis. Sonnini saw at Cana, in the island of Camlia, a great many individuals of both sexes, affected with this kind of leprosy. They were con- fined according to custom, in barracks without the walls of the city, and there they indulged in the most unbri- dled licentiousness. Even the old men were very las- civious. He gives an instance of a leper who, on the night of his death, indulged his desires. Niebuhr speaks of another leper who carried away by his ardor, imparted his disease to a Avoman of Bagdad, who was admi'.ted with him into the lazaretto of that city. Vidal and Joannis assert that they have seen this libido in those Greek sailors affected with elephantiasis. Au >r these proofs, it required some boldness to deny the possibility of this symptom, which to us seems 203 easily explained. Consider the nature of elephantiasis: while it aff'cts the skin, it extends to the mucous membranes, whpre Ave find tubercles, ulcerations, soft- enings, &e. Why should ihe membrane, lining the genito-urinary passages, he exempt from these altera- tions ? Is it not then probable that this membrane Was diseased in some way or other, in those individuals affected with libido? We can easily imagine, too, that as these alterations cannot be constant in lepra tubercularis, the symptom of Avhich Ave are speaking must often be deficient, which explains Avhy different authors who have observed cases of elephantiasis, particularly Alibert. Rayer and Cazenave, have not met with it. An affection of the genital organs may produce results completely opposite to libido: it may arrest the development of the genital organs Avhen it appears before puberty. The individuals then present the marked characters of eunuchs, Avhich has been observed by Adam*, (Obs. on morbid poisons.) and probably Pallas, who asserts that the Tartans affected Avith elephantiasis, are averse to the pleasures of love. Farther, in lepra tubercularis, the sexual parts are often, and according to Alibert, most jrenerally affected; this would necessarily extinguish all venereal desires. This probably was the case in the patient mentioned by Cazenave, in whom the testicles, glands and prepuce were found converted into a lardaceous tissue; and where, too, the corpora cavennosa were destitute of blood, and presented an evident hypertrophy of their septa. It often happens that the genital sense is exalted, because it is the only one, or nearly so, which contin- ue*. This is frequently seen in idiots, and in those affected with dementia. The imbecils, if left to them- selves, "says Esquirol." sometimes at the period of pimerty become affected with onanism, nymphomania, or hysteria. Idiots also often indulge in the most un- restrained masturbation. This can readily be imagined : these individual* are in a measure isolated by the de bility or weakness of their sen*es and intelligence. As they receive no external impressions, those which 204 are inherent, exercise unlimited power. The internal senses are then much more regarded, because they speak alone. That which is in others only a desire, becomes in idiots a want: hence there are many who seem to live, merely to eat, drink, and indulge in li- centiousness. When speaking of the effects of onan- ism on the mental faculties, we have shown that the venereal sense becomes heightened, as these other fa- culties are weakened. This fact may be rematked, whatever may have been the cause of derangement: for many individuals become affected with onanistic satyriasis, because they are imbecile or idiotic. Fi- nally, idiocy may be the effect and cause of onanism. Sometimes the disease appears first, sometimes the habit—but as soon as they exist they strive continually to increase, and Ave are unable to say Avhich of the two exercises the stronger influence on the other. Our remarks on idiocy are equally applicable to cre- tinism, Avhich is a variety of this affection. The cre- tins, though small, goitrous, hideous and imbecile, are extremely salacious, and this feeling is allayed by in- tercourse between them, or by onanism. A remarkable fact which has been observed twice, once in a cretin and once in an idiot, may throw some light on the or- ganic causes of the inverse progress folloAved by the external and internal senses in this kind of patients: it is the hypentrophy of the ganglionnary nervous sys- tem,. One of these cases is recorded by M. Schiffner. He found, on the cadaver of a cretin, that the ganglions of the great sympathetic nerve, situated along the ver- tebral column, were unusually large. The sympathetic nerve of the left side, on a level with the 6th vertebra presented a ganglion the size of a hen's egg. Before this case of Schiffner. in 1819, Cayre also, in a thesis on idiotism, had mentioned the excessive development of the ganglionuary system, in one born an idiot. The cervical ganglions were three times their usual size ; those of the thorax Avere larger than in the healthy state, and this was the case also with the semilunar ganglions. We have seen that individuals appear much more 205 lascivious, as they become more stupid and insensible; venereal sensuality often developes itself under very different circumstances. It may be only an episode, and sometimes it is an effect of the general suscepti- bility. A person is lascivious, because he is alive to vivid impressions ; because the genital organs, like the rest of the economy, are easily excited, and their ex- citement is vividly felt. This disposition occurs often in hypochondriac and hysterical people; that is, in in- dividuals who are so susceptible as to be habitually sick. They are easily excited, and have nocturnal pollutions froiri the slightest cause. The genital or- gans, also like the others, may become affected by an irritation which is seated at a greater or less distance from them; for instance, in the stomach, lungs, skin, &c. Those persons Avho are affected with cutaneous diseases, which cause itching, are generally extremely lascivious. Symptoms similar to priapism and satyri- asis, appear in numerous diseases. Nervous or flatulent colics have often been known to produce a similar ef- fect. A woman observed in 1833, at Hotel Dieu, in the ward of Bouillaud, and whose case is reported by Donne, (Revue Med., June, 1833,) presented a pheno- mena, Avhich, notwithstanding its strangeness, is ex- plained by what we have said. She was thirty years old, of a strong constitution, and hysterical. After an attack of acute rheumatism affecting the wrist, her hand became exquisitely sensible, and the slightest friction upon it, procured for the patient all the sensa- tions arising from coition. This aberration of the sen- sibility disappeared with the last traces of the rheu- matic inflammation, and the part regained its natural state. A highly respectable man, Dr. Mirambeau, communicated to us the case of a child Avho procured similar sensations by pulling his umbilicus. His health suffered so much in consequence of this singular habit, that coercive measures were employed to check it. We must remark, however, that notwithstanding the sensation* mentioned, this patient presented no erection nor any other phenomena in the genital organs, similar to those of the act of venery 18 206 Of the things which may produce venereal excite- ment, and of the modes of preservation which are connected with them. These things are all those which are capable of increasing the sensibility in gen- eral and particularly that of the organs of venery: the means are, the influences which may be used to act in a contrary direction. The venereal desire may develope itself at all sea- sons. The most favorable to its appearance, how- ever, is spring. This fact was well known to the ancients: but it did not rest on a scientific foundation till recently. The confirmation of this fact is owing to the statistical labors of Villerme in France and oi Q.uetelel and Smits in Belgium. Villerme proposed to establish, from the register of births, ihe periods of the year when conceptions occur most frequently. He arranged the months in the fol- lowing order. May, June, April, July, February, March, December, January, August, November, Sep- tember, October. Hence the three months when there are the most conceptions are April May and June, and those in which there are the feAvest are September. October, and November. Hence it is in spring, at that period of the year when vegetation sprouts forth and when the trees are covered with foliage, when most animals seek their mates, that pregnancy is most common : while in autumn, that season in which vegetable life is as it were extinguished, is also the period when the human race labors least at reproduction. The results obtained by Q,uetelet and Smits, conform entirely with the above. It now remains to know whether the difference between spring and autumn arises from there being less procreative exertion or whether con- ception or impregnation at thai time are more easy. To resolve this question Villerme consulted the criminal calendar to ascertain at Avhat period of the year there were the mo-t attempts at rape: and he found that it was the same as that when the most conceptions occnr, that is in the spring. The same result was obtained by Quetelet and Smits. May 207 not these crimes be more common in the spring be- cause then men have more opportunity of being guilty, as at that time females may be found alone and loosely clothed, in the woods and distant places? But these same circumstances exist in the months of Au- gust and September, and yet the respective number of these crimes diminishes in these tAvo months. Nor can this greater number of pregnancies be attributed to the fact that more marriages are contracted at one period of the year than at another, for the maximum and minimum of births can be referred in every country and at all times, with but few limitations to the same periods, while the maximum, and minimum of marriages in different countries present great and numerous differences. We may then consider it sas determined that man is subject to a certain extent to a kind of periodical heat, which returns every year in the spring. It is not the heat of weather which produces this phenomenon, for if this were the case, it would ap- pear in July and August rather than in April and May : but it is the return of early warmth. Perhaps this phenomenon also arises from influences hoav un- known, which would contribute in early spring to the vernal resurrection of organized beings. The slight variations in the period of heat in men, in different climates, confirms Avhat has been said as to the action of spring. Villerme having compared the different parts of^F ranee, of Europe and even of the two hem- ispheres, found that the maximum of conceptions is, like this season,more precocious in warm than in cold climates. There is then a period of the year Avhen man is more disposed to indulge in these excesses and when his desires should be more carefully controlled. We have already seen that AVichmann regards the spring as a cause why diurnal pollutions are more active and frequent; ihe same mav be said of nym- phomania. In a female Avhose hi-tory has already been given and who Avas affected with this disease, the period of the greatest degree of salacity extend- ed from the beginning to the end of this season. 208 There is another observation which at first seems only of a moderate degree of importance-but which may present practical deductions of great interest. Villerme has found that ihe maximum and minimum of conceptions are much less marked in the cities than in the country, and still less so in the large cities. This fact confirms our remarks on the influence of seasons, for it shows that this influence is less, the more individuals are exposed to it. It shows too how far the salacity of men may be influenced by his mode of living. This remark has long been made in regard to animals: the period of rutting ceases to be marked periodically when they pass from a savage to a do- mestic state. We have now to learn in what manner a retired life acts on the venereal sense. Another ob- servation of M. Villerme seems to us to throw light on this topic. The law of maximum and minimum. A'-hich has just been treated of, presents a remarkable exception which is seen in cold countries as Sweden, Finland, St. Petersburgh, &c. In these countries, exceptions occur most frequently in the months of December and January, in short in winter. Different causes have been supposed to account for this exception : there is hut one however, which will explain it well—that is the manner in which the inhabitants of these coun- tries are clothed during the cold season. By means of dress and warmth they then create an artificial cli- mate by which they are enabled to resist the rigor of that in which they dwell. The whole body is enveloped in numerous thick and Avarm garments, which fit accurately, envelope it exactly and preserve for the body its natural temperature : placing these individuals in a position analogous to that of vegeta- bles which are hastened in their growth by manure. Farther they preserve in their dwellings a degree of temperature which Avould be insupportable in a tem- perate climate. In fact if the inhabitants of the polar regions should keep civil registers of births, their ex- amination Avould doubtless demonsrtate that in these rude climates, the fine season is not that of amours. 209 It is well known that puberty in these countries is more precocious, as is the ca-e under the tropics. Thus the Samoid women menstruate at the age of 11 years and are often mothers at 12. (Klingstadt, Memoire sur les Samoides, pp. 41. & 43.) 'This is not to be wondered at Avhen Ave consider that they live in subterranean caves, where there is a stifling heat produced by throwing Avater on redhot stones. Dwellings then in cold countries may be considered as hot houses which act on man as they do on vege- tables. These facts established, let us consider their con- sequences; do they not prove, that an artificial cli- mate may develope the venereal sense prematurely or too vividly ? That on the coming of winter a young man ought not to be clothed too warm? That too many quilts should not be put on the bed at night? That the cold should be braved ? That we should forbid too long a continuance in warm rooms? These prin- ciples are deduced naturally from observations on the seasons. It is unnecessary to say, that these rules, good as they are, are more particularly applicable to those who are suspected or convicted of masturbation. In our preceding remarks we have paid regard only to the temperate zones of the two hemispheres, that is, to those countries where there are four distinct sea- sons nearly equal in length. But if we approach the equinoctial line, those regions of the globe where the year is divided into a very long summer and a very short winter, the influence of seasons is effaced by that of clim,ate. We shall not repeat in this place all that has been said in regard to the precocity of the in- habitants of warm countries, their ardor in love, the excesses to which they are addicted, the rapidity with which they grow old; all these facts are well known. But Ave will make a remark which seems to us impor- tant: if the habitual and long continued action of solar heat, hastens the appearances of the venereal sense, and gives it so much power, Avhy will not the continued action of any other heat, for instance of clothing, dwelling*, baths, &c, produce a similar re- 210 suit? It seems to us that the admission of the first fact necessarily implies the other. Thus whether we regard the influence of seasons exerted around us, or that of climates which are far distant, we always ar- rive at the conclusion that by a delicate education, and by taking care to preserve children from the slight- est cold, we hasten the excitement of their sensual feelings, to which they are more liable to become vic- tims. Hence in prescribing a change of scene for a young man addicted to onanism, we should be care- ful not to expose him to hot climates. Are there any emanations which have the power of deadening the venereal sense? From a case already mentioned, and which we owe to M. Villerme, we might suspect that emanations from stagnant waters have this effect: but it is probable that if procreation is less active in marshy countries during the most un- healthy seasons, it is because the number of sick is greater. It is well known that notwithstanding all emanations, the venereal sense may be very preco- cious, and may lead whole communities to indulge in excesses : we might cite as instances the inhabitants of the marshy parts of the Landes of Bordeaux, and the Solognese. The power which certain odors have of exciting to desire is by no means doubtful, at least so far as animals are concerned. Most of the mammalia at the period of rutting, exhale certain emanations which serve to inform the male at a distance of the presence of a female and to excite in him the desire of copula- tion. Even in the insect kingdom some facts exist which cannot be accounted for except on the principle of odorous effluvia. Thus if we shut up in a perfectly close box a female bombyx, we shall soon see males flying around it, who cannot be guided there by the sense of sight. Does any thing similar occur in the human family ? Many authors assert the affirmative. "Odors," says Cabanis, "act powerfully on the nervous system: they incite it to all pleasurable sensations: they communicate to it this slight disturbance which seems to be inseparable from it, and this because they 211 exercise a special influence on the organs which are the seat of the most vivid pleasure granted us by na- ture. In infancy, the influence of smell is but slight: in old age, it is feeble: it is most active at the period of youth which is that of love." (Rapports du phys. an morale de Vhomme, vol. I, p. 222.) Among many nations even in remote antiquity, voluptuous females excited their visiters to desire by the cosmetic use of different perfumes, particularly by musk. This sub- stance has been said to be capable of producing even nocturnal pollutions. (Luc. Lebrozchus, Hist. Moschi, ch. 24, p. 153.) On the other hand, we read that Henry IV. thought that the natural odor of the sexual parts was more powerful than any cosmetics. Not- withstanding these testimonials and many others of a similar character, which might be adduced, we be- lieve that in our species, where the sense of smell has bo little influence compared to what it has in animals, that odors have but a slight effect in exciting to sexual pleasures. We think it prudent however to forbid the abuse of cosmetics in young people. Irritation of the skin, particularly in the neighbor- hood of the sexual parts, may act on them as we have seen, and produce venereal desires. Debauched lib- ertines have frequently sought pleasure in this, and have sometimes lashed themselves with thongs, or other instruments of torture. In the time of Nero, the art of invigorating the virile powers with green nettles was known and practised. Many authors have stated details on this topic which may be found in the treatise of Melbourne, {Deflagrorum usu in re venerea, Lugd. Batav. 1643,*) and an article by Virey. (Diet, des Sc. Med., art. Flagellation.) The pleasures of flagellation, however, also have their limits: it has therefore been prescribed to deaden carnal desires, as well as to excite them. Mote than one saint has flagellated himself * This learned work is dedicated to the Bishop of Lubeck, and has this motto:— "Delicias pariunt veneri audelia rlagra Dum nocet, ilia juvat: dum juvet, ecce nocet." 212 with this hope. In order that it should be efficacious, it should be used with severity. It can easily be imagined that this remedy may have a very different effect from that proposed. Castigation, and also the denuding of the body, Avhich is necessary, often have an effect on children, indicated by the erec- tion of the penis. Young persons sometimes desire this punishment. The sensations caused by it have been so strong, as to be followed by an immediate emission. How many children have become addicted to onanism, in consequence of this imprudent punish- ment ! how often has the fatal habit of onanism been encouraged by it! These consequences have been pointed out by many authors. Pic de la Mirandole, Rhodoginus, &c, have related instances of it. The fol- lowing is from Serrurier. " One of my school-fellows," says he, "found an indescribable pleasure in being whipped : he took every occasion to provoke the master, who never pardoned an offender, but had him scourged, by individuals to whom this duty was committed. This same school-fellow declared that he was sorry when ihe punishment was ended, because then the pollution was not complete. What has been the con- sequence of this horrid discovery. The unhappy per- son became addicted to onanism. Reduced to the lowest stage of consumption, in consequence of the habitual loss of semen, his death presents us a picture of depravity, and an instance of the danger to which one is exposed by this fatal passion." Castigation is much more to be dreaded when practised by one of an opposite sex from that of the patient. Even young children notice this difference. Rousseau, describing the effect produced on him by being punished by Mad- emoiselle Lambercier, says, he was then eight years old, "For a long time she confined herself to threats, and the threat of punishment seemed very dreadful to me; but after it was performed, I found it less terri- ble than I expected ; so much so, that it required all my natural sweetness to prevent me from seeking a return of the punishment, by averting it: for I found in the pain, and even in the shame, a mixture of sen- 213 suality which had left rather a desire, than a fear to be punished by the same hand. The same punishment from the hand of her brother would doubtless have been less agreeable." Rousseau having exposed him- self a second time to punishment, it was seen by a certain sign, that this chastisement did not produce the desired effect: he therefore escaped afterward. Thanks to his temperament, Rousseau did not contract, at that dangerous period, a habit which would have extinguished, at tneir source, those admirable faculties which were afterward developed. The importance of separating the sexes in schools can be seen from the preceding remarks: this is done in many institutions, and should be practised in all. The rod, too, should also be excluded from families, and physicians should explain to families the double danger of a loss of modesty, and of exciting the senses. Certain articles of clothing may excite the skin, cause an itching, and thus produce effects similar to those of flagellation. Haircloth and sackcloth, with which some orders of monks are now clothed, have contributed, it is said, together with the mode of life to that reputation for incontinence possessed by some orders of friars. A want of cleanliness has also had the same effect. Be this true or not, it is wise to avoid the use of flannels next the skin, particularly in young patients, and around the pelvis. Hence Avoollen pan- taloons should always be lined. The importance of keeping the sexual organs clean, has already been pointed out; the same remarks apply to the Avhole body. This cleanliness must be maintained by lotions and baths. The former ought generally to be cold: this rule is seldom contra-indicated. As to baths, we would remark that hot baths ought seldom to be prescribed for onanists and for young persons generally, because of the excitement which they cause. Tepid baths should also be used with care, as they render one sus- ceptible and delicate. Cold baths ought always then to he preferred, when the season and health of the pa- tients permit. There are other rules to be mentioned hereafter. 214 The venereal appetite may be much modified by food and drinks. This passion and the excesses with which it is attended may be connected Avith the diet used. Hence when we attempt to cure a young per- son of onanism a good selection of food and drink is very essential. It is therefore important to state the dietetic conditions by which the venereal appetite is excited or depressed. Sine cerere et Baccho friget Venus is an old proverb, which hoAvever is too obsolete. Generally speaking abundance of good food is more favorable to venereal desires than a contrary mode of diet. This may be seen on a large scale by comparing years of plenty with those of scarcity. We can then remark how injurious periods of public distress are to the pro- creative power. This has long been observed, but has now been demonstrated beyond a doubt, by the patient researches of Villerme. He has ascertained from several statistical tables of population in France, that at the period of the revolution when the duty was re- moved from wine, salt, &c, Avhen the laborers found themselves unusually prosperous, when they indulged in feasts and celebrations, in short, lived better, the number of births evidently increased. Eleven tables were examined by Villerme, and to this remark—he found but one exception. On the contrary, when the diet of the people is poor and insufficient, the number of conceptions diminishes and never resumes its level till abundance is restored. It would even seem that after the period of scarcity has passed away, it still continues to exercise an extraordinary degree of energy. These facts were very manifest after the bad har- vest of 1816: the number of conception*, proportion- ally speaking was less, from November 1816 to Sep- tember 1817, especially during the months of April, May, June, and July, than in other years. (Ann.d'hyg. pnbl., Jan. 1S34.) Similar observations have been made in animals: it is remarked thai the period of heat supervenes when they are best fed, and that gen- erally they are much moie productive when they are 215 domesticated than when in a wild state, where they are often liable to long fasts. Hence there is reason for prescribing fasting to deaden carnal passions. Villerme has remarked that in all those catholic coun- tries of which he has seen statistics, Lent, as it is now observed, and particularly as it was formerly kept, seems to exercise an unfavorable influence on generation. The facts which have been mentioned may be ex- plained in several ways: first by the action of plenty and scarcity on the health of the public. Probably in times of scarcity, a state of things is observed analo- gous to what is seen in marshy countries during the reign of epidemics. The action of abundance on the power of procreation may be explained also by the direct influence of the labor of digestion on the organs where the venereal sense is located. It is known that amorous desires are often developed directly after ta- king food. Nocturnal pollutions sometimes occur di- rectly after lying down. Serrurier speaks of a ma- niac who had seminal emissions on taking food after long abstinence. (Diet, des Sc. Med., vol. xliv. p. 116.) Farther the effect alluded to may be produced as is readily imagined, more easily and forcibly Avhen the excitement attending the labor of digestion is ex- cessive when for instance, the repast has been great^ composed of many exciting and stimulant articles of food and of good wine or with a small quantity of alcoholic drink*. Those individuals who are subject to pollution, feel the direct influence of these circum- stances/ Beside the immediate effect mentioned, a warm and analeptic diet hy giving the body an increase of ex- citement and force, mav render amorous de-ires more frequent and vivid. Thus the habitual free u*e of meats, game, pork, ragout*, spices, heavy wines. li- quors, coffee, &c, must be considered as an indirect cau>e of venereal excesses, particularly if the persons who live on this regimen do not counteract its effects by actiA'e exercise. The u-e of vegetables, especially those which are not very nutritious, have coutrary ef- 216 fects. This remark must not be considered too ob- solete. A debilitating diet and excessive salacity sometimes coexist: The Landes of Gironde are a striking instance of this ; their diet is very miserable ; they live on vegetable soups made wiuV rancid lard ; broihs of meal, of coarse bread, and water, pure or acidulated at most with vinegar, &c. Hence they are extremely thin, are dark and sallow, and have an appearance of unhealthiness: this however does not prevent their indulgence in love, to which they are extremely addicted. Different articles of food have been mentioned as contributing more than any others to excite the genital powers. Among them are found fishes. It would seem that this quality has long been attributed to them ; this opinion however has not been received by moderns with much credit until it was admitted doubt- ingly by Montesquieu. (Del Vesprit des lois, Book xxiii. ch. 15.) Many authors have admitted this to be fact on the authority of this great man, and then in- stead of investigating whether it was true or not have attempted to assign the reasons for it. Thus the pro- lifick virtue of fish has been said to depend on the aro- matics and other condiments with Avhich they are pre- pared ; on their seasoning: on the phosphorus con- tained in their flesh and more particularly in their milt: and by this fact, that populations on the sea- coast live almost exclusively on fish. This has been carried stili farther : the parts of fishes which furnish the most of the seminal material have been deter- mined : and this property has been ascribed to the milt, either because the semen is here secreted, or on account of the phosphorus which Fourcroy and Vauque- lin have discovered in it. Some fishes however are thought to induce venereal passions more than others. We have attempted to find the origin of this opin- ion in regard to fish but without success. In fact it has not the support of popular notoriety which arises insendbly from daily observation. Thus Benoiston has proved directly by statistical facts that fecundity is not greater among the inhabitants o£ maritime 217 coasts than among those who live in other places. (Bulletin de Ferussac, Jan., 1827 ) Villerme has noticed that in Greenland and among the Esquimaux, who live principally on fi-h, qii sea-calves, that is, aliments, containing these oily part*, Avhichare regard- ed as so prolific, women have rarely more than two or three children during their life. Besides if fi-h has the property ascribed to it, Avhy i* it that during Lent, that period of the year when this form of food is most used, the procreative power should be most inactive; a fact which is proved from documents col- lected in almost every country by the laborious inves- tigations of Villerme. (Annates d'hygienepubl., Jan. IS.il.) Hence it is extremely improbable that fi-h possesses this property, which it is important to estab- lish in order not to discard from the regimen of youth, an article of diet which being both nutritious and slightly stimulating, is well adapted to prevent gen- ital excitement or to subdue it. Many other ariicles of food beside fish have been regarded as aphrodisiac. Many insecteating reptiles, a bird called torcol and numerous insect* of which it is Useless to speak. Eggs have also been regarded as having the same property, and also truffles, mush- rooms, artichoke*, celery, cocoa and all its prepara- tions, onions and condiments as ginger, pepper, and vanilla, and finally certain fruits as strawberries, ap- ricots, peaches, pineapples, &c. Among the articles which Ave have named there are certainly some which being heating and exciting, may cause desire although containing nothing more specific than a great many substance* which are esteemed as antiapbrodisiac, because being cooling and soothing they may produce the opposite effect. Among these latter, we find milk, Avhich, according to Ste. Marie, generally contributes less to form the semen than most other articles of food. Among these also we may mention fresh vegetables and particularly the sorrel, pur-lain, lettuce, endive, cucumber, mushroom, melons, ceo. To these may be added the flesh of youug auinials, chicken, larub, veal, &c, and also 218 cooling drinks, as orgeat, lemonade, ccc. The regi- men best adapted for appeasing all carnal desires con- sists as we have seen in an antiphlogistic diet Avhich is composed of thbse fluids or solids Avhich when in- troduced into the stomach are digested and assimilated with the slightest possible degree of excitement and heat. This regimen is that which should be pre- scribed to those patients who possess a certain degree of vigor and wish to protect themselves against urgent and dangerous desires. Different medicines have also been prescribed for the same purpose: many of them act in the same manner as the articles of food Ave have mentioned: of this character are tisans of marshmallows, violets, barley, emul-ions, water distilled from lettuce, purslin, &c.: of a similar character are iced drinks, ice given internally, and even prepared ices. To calm the ex- citement of the genital organs drugs having a positive influence on the nervous system are also administer- ed. Thus camphor given alone or in combir.ation Avith nitre has often been prescribed for this purpose. The special action of this article on the urinary pas- sage*, leads to the belief that in some cases it may be useful. Primrose and St. Basil have boasted of the internal use of cicuta for moderating too ardent de- sires. Opium and its preparations have been prescribed for the same purpose. The use of this article by the Orientals and its effects upon them render us rather suspicious of it; there may be cases however in which it is useful. Belladonna deserves more confidence. Dr. Powell, in the London medical magazine for April, 1824. relates the case of a young girl 27 years old, who for more than three years experienced twice a month and even more frequently violent attacks of a libidinous hysteria: her cure Avas attributed to a potion compo-ed in part of the tincture of belladonna, which was u-ed to such an extent as to produce dilatation of the pupils. The results obtained by Chaussier, and by many other*, from applying belladonna to the neck of the uterus either to combat rigidity in labor or to al- leviate puerperal convulsions, lead us to thiuk that 219 medicine may prove efficacious in satyriasis and nym- phomania. Thridace also may be tried in thee cases, and Angelot has related a ca*e of spermattorrhcea supervening in consequence of excesses at the table which was cured by this remedy. Distilled cherry- tree water also might be added which Louyer Vil- lermay indicates as useful in nymphomania. Boracic acid, formerly termed the sedative salts of Homberg, has also been recommended to subdue am- orous passions. This is true likewise of nitre, which, under this name, or that of Sal Prunelle and mineral crystal, has been much esteemed as an antiaphro- disiac. The use of this remedy according to Baldas- sar cured the man, who demanded so earnestly the re- moval of his testes, and whose case has already been mentioned: this salt was used because Prevatius, a physician at Pavia, having administered it to a man for an affection of the bladder rendered him impotent. The hemp and the Avillow have also been recom- mended: Etmuller believes particularly in the action of this latter; and recommends the extract of its leaves, and the sap obtained from its young branches in spring. (Trait du bon choix des medicamens, 1710, Lyons.) But among all drug*, those Avhich are the longest known, and which Avere most esteemed, are the a gnus caslus or vitex, and the nenuphar. Human credulity is severely taxed, to believe Avhat has been said as to the virtues of these articles. The Greek women, ac- cording to Dioscorides, slept during the festivals of Ceres, on the leaves of the agnus castus to preserve their cha-tity. Amaud de Villeneuve states that an infallible mode of preserving the breast from all men's attempts, is to carry a knife, the h ndle of which is made of this wood. Even now its let. /es and seeds are used both externally and internally in monasteries to support more easily the rigors of celibacy. At pre- sent, however, no one believes in its virtues. The same is true of the nenuphar. Its reputation, as soothing the genital organs, belong* to the early periods of sci- ences. It is mentioned in Dioscorides and Galen, and 220 its history is as fabulous as that of the agnus-castus. The li-t of antiaphrodisiacs would terminate here, if Montegre had not mentioned a tree called mairkonsia, Avhich grew in the East Indies, and Avhich was used by some fakirs to render themselves impotent. Every day those children, who are designed to be fakirs, swallow a small roll of its leaves : the dose is gradu- ally increased, and at the age of twenty-five, the effect is irrevocably produced. This tree is yet to be known by scientific men. (Diet, des Se. Med., Art. Conti- nence.) Besides those articles which act as stimulants on the genital organs specially, these latter are excited by whatever tends to increase the sensibility in general. A great degree of susceptibility, and a moderate devel- opment of the venereal sense, may co-exist, and are often found combined: but this only proves lhat the genital apparatus may escape certain influences, and not respond to the excitements which are impressed on it. Tb'Js, whatever tends to develop, or to diminish the sensibility of a subject, must be considered not as necessarily modifying that of the genital organs, but as having the power to modify it, and as exercising this power in mauy cases. Now if Ave consider that the abuses of the genital organs arise most generally, because the sensibility of these organs has been excited too soon, or too vividly, we can imagine that a very great degree of suscepti- bility may predispose to these abuse*, andj that conse- quently, to prevent and repress them, Ave must attenl to every thing which favors the development of .ne genital organs. The power of sensation, like that of thought and action, is in many respects jusi what it is formed. Th' education, lhat is, the cultivation of these three luculties, may then give the senses a pre- cocious language, and become indirectly a principle of excess. It may also, when properly directed, be a powerful means of preventing any excess. Let us see then how education act*, and how it is directed. It. is only by exerci*e that the faculties are cultivated. It would be very wrong, however, to suppose that each 221 one of them has an individual existence, and by use may be developed separately, and independent of the others. The human faculties seem to have a certain extent of poAver in common, which they divide in such a manner that one cannot increase except at the ex- pense of the others. An individual who possesses ex- cessive sensibility, rarely enjoys a great degree of muscular vigor. Those men who are noted for mus- cular strength, are seldom distinguished for the bril- liancy of their intellect. Education then acts in two ways: directly, by developing the faculties which it exercises, and indirectly, by opposing the progress of those Avhich it neglects. Whatit gives to one, it takes from another: it is boih a positive, and a negative power. As to the modes of directing it, they act by regulating the use of the three faculties during the period of life when they are forming. This is not the place to say how far education should be carried, so that, in a physical, intellectual, and moral point of view, it should be good: we seek only to determine Avhat it ought to be, in order that a too vivid, or too precocious a facility to receive impressions, may not become the causes of venereal excesses. It is not among the working classes, that those sub- ject to hysteria and hypochondria, are most numerous. The fatigue of body, when constant, dulls the senses. On the other hand, whatever enervates, renders one susceptible to excesses. These facts, which are gene- rally known, and are confirmed by daily observation, ought to shoAVthe influence of exercise and rest on the venereal passion. Onanism is arrested in those chil- dren, much more readily, who are extremely active and always in exercise, than in those who are sedentary. The period of puberty, this emancipation of the genital organs, is later, by two or three years, in those individ- uals who take just enough of repose to rest them from fatigue, than in those who take exercise simply because wearied of repose. Other things being equal, the adult Avho depends upon his daily labor for his bread, thinks Less of sexual pleasures than the idler. Helvetius (de Vhomme sect. 10, notei,) attributes the lascivious tastes 222 of the Asiatics to their idleness, and the indifference of the Canadians to the pleasures of love, to the fa- tigues experienced by hunting and fishing. Villerme has attempted to shoAV by statistics the influence of great labor on conceptions, but has not accomplished it. He, however, is disposed to regard the influence of fatigue on the sexual feelings, as the cause of the enormous difference said to have been observed in the Antilles, between the fecundity of the black slave*, and that of the whites. He remembers to have read, that in 1798, at St. Domingo, three marriages of blacks produced only two children, while each union between whites produced three children. It may be seen from the preceding remarks to what extent exercise is useful to young children. Unfortu- nately, the intellectual and moral necessities of our age cause physical education to be sacrificed in many respects. How many desires must necessarily be cher- ished, by confining the physical activity of young peo pie, chained down as it Avere, hour after hour. How many men of mind have protested against the brief period of recreation allowed in our schools. Mr. Taillefer has done this in an excellent work published in 1824,on the improvement to be introduced in schools. This is true, also, of Pavet de Courtailles and Simon, (Hygiene des Colleges, and, Hygiene de lajeunesse,) and in America bv Dr. A. Brigham. of Hartford, whose work entitled, The Influence of Mental Cidlivation upon Health, is full of judicious precept and sound logic. Gymnastic exercises, which are now beginning to be generally used in boys' schools, and to be adopted in some seminaries for young ladies, compensate in some measure for their enervating education. Simon (of Metz) asserts that masturbation, formerly so destruc- tive in the Orphan Asylum at Berne, has been expelled from it by introducing exercises. He adds, too, that this scourge has also disappeared from the schools of Switzerland, since mutual instruction was introduced, which, as is Avell known, obliges children to change their position frequently. A very active life may remedy a too great degree of 223 lasciviousness. Hunting, particularly, has been rec- ommended for this purpose. 'Diana nas been re- garded as the enemy of Love,' say* Rousseau, "and tne allegory is just: the languor of love only comes from sweet repose. Violent exercise extinguishes the tender emotion*." Rullier has known hunting to pro- duce in a man forty years old, Avho was passionately addicted to it, a true anaphrodisia, Avhich disappeared Avhen the patient adopted, in accordance Avith the ad- vice of his physician, another mode of life. Some ex- ercises, however, produce a contrary effect, viz: those which excite the genital organs directly. Riding in a carriage, especially if it jolts much, and still further riding on hor-eback, may act in this manner. This effect was known to the ancient authors. Aristotle speaks of it. All those accustomed to riding know that the motions of the horse often produce an erection, and sometimes an involuntary emission of semen. A similar occurrence may take place from riding in a car- riage. Serrurier has known this to happen in himself. The sitting posture, when long continued, excites the genital organs. Simou thinks so; because this atti- tude, by the pain and obstruction which it causes to the circulation, brings the blood to the lower parts of the trunk, and keeps it there: hence, it exposes the young man to excitement of the genital organ*, and to engorgements of the spermatic cord : even hemorrhoids appear in tho*e who ride and sit much. This author concludes by condemning the custom, in schools, ol keeping the students sitting the greater part of the day. He thinks that the number of hours spent in school shoulJ be less, and that the students should study as many of their lessons as possible, in the erect posture. He recommends, also, that the seats should be so con- structed as not to generate much heat, as do those whii'h are stuffed. The action of intellectual labor is extremely analo- gous to that of muscular exertion. Persons whose minds are much occupied, who are devoted to their studies, are generally but slightly sensual in their feel- ings. There are some literary men who thus have be- 224 come p.ematurely impotent. On the other hand, indi- viduals whose minds are naturally dull and heavy, the imbecils and idiots, are frequently remarkable for their extreme salacity. The cultivation of the intellect then is not in itself a predisposing cause of venereal abuses, hut it may become so indirectly, either by the physical inaction which it demands, or by the nature of the ideas it excites. We have spoken of the former, and will now consider the latter. The moral influences, that i*, those which are im- pressed on the senses through the medium of the intel- lect, often predispose young patients to the abuses of which we are treating. The action of these influences is direct: it is by the impressions which they develop, that they may give to the senses the power of holding a language, and of exercising a precocious influence. They are particularly to be dreaded when they address the instinct of propagation, and excite it before the organized system is perfectly developed. The moral education also, that education which consists in keep- ing from the young certain impressions, does not act until their time has come, and must be considered as one of the most efficacious modes of preventing the premature abuse of venereal pleasures. Notions of love may, when acquired too soon, excite in the soul a sensation which is first vague, then more precise, and which only requires an opportunity to be- come a fatal passion. Thus the reading ofrornanc.es, and books which always interest the soul in love scenes which are painted in bright colors, ought to be strictly forbidden to young people. The same is true of the- atrical representations. Here love is in a measure materialized : we see the persons who are animated by this passion : they express themselves in a manner to make one really think they feel it: they attempt by every kind of coquetry to deceive and delude the pub- lic, and even to excite desires. Art lends her aid to eloquence and gesture to move the heart, and the fear of failing to enlist the feelings, often induces the actor to overstep the bounds of nature, and then he repre- sents libertinism, not love. Conceive of the effect 225 which this must produce upon one Avho is uninitiated, who is tnu* a* it were, intioduced into a new world: the venereal sense becomes excited sooner ihan it ought, to be, and desires demand to be sati-fied before the body has attained its strength, and con-equeutly before legitimate pleasures are practicable or allowable. Balls, parties, and assemblies, all opportunities of seeing the world in its gayest and most attractive at- tire, are dangerous to youth. Generally speaking, the habitual intercourse of ihe two sexes ought to be avoid- ed as much as possible. In a report made to the In- dustrial Society of Malhouse. as to the number of hours which children ought to labor daily, the evening labor which brings the different sexes together in the workshops, is mentioned as a great source of trouble. One advantage of schools is, that the different sexes are kept distinct. In families, and we do not except those which are models of morality, the opportunities of intercourse between boys and girls are too frequent. Certain emotions, of an obscure character at first, are felt: curiosity is ex'ited, and soon the secret of soli- tary indulgence is found. Young persons may also, under their paternal roof, acquire dangerous notions in regard to the material differences between the sexes, and other facts which are the consequence of them. " I do not see," says Rousseau, "but one mode of pre- serving in children their innocence ; which is. that all those around should respect and love it." Unfortu- nately, the smallness of dwelling houses in cities, and other necessities, particularly that of Avatching their offspring obliges parents to keep their children near them, and their curiosity being always on the alert, often leads them to unfortunate discoveries. Abbe Chappe has stated the manner in which the Samoides live in their huts, as an active cause of libertinism. The*e individuals do not use beds, but lie, almost naked, on straw and on benches. The children wit- ness much that should be concealed from them ; be- come loose in their morals, and hence they have to be married early to prevent excesses. {Travels in Si- beria, Vol.i.) If accidental observations in the mott 226 moral families may be attended with the results just mentioned, what must be the consequence of constant depraved manners; their empire is so great at this age when the mind is unexperienced, and is always ready to adopt the impressions of the moment. In pity then to youth, let every magistrate prevent the publicity of immodesty and vice ; do not let prostitution be sanctioned by the laAV: for when our sons and daughters are liable to find out in an instant what we have so carefully concealed from them, the responsibil- ity should rest not simply on those unfortunate beings who follow such a course of life, but also on the part of those who having the power to prevent it, close their eyes, and permit, or even authorize it. Rules relating to the direct and special causes of onanism. The habit of onanism may have three ori- gins: it may be, 1st, that the individual discovers it spontaneously ; 2d, that the vice may be taught him ; 3d, that being unable to satisfy his desires for coition, he seeks a resource in onanism. We have already seen that an unusual irritation of the genito-urinary mucous membrane may develop ve- nereal excitement capable of causing satyriasis and nymphomania. This irritation may also act in another manner. The itching it occasions may cause the hands to be carried to the genital organs ; unknown sensa- tions are produced, and masturbation is accidentally discovered. We see by this how necessary it is in young patients to protect these parts from all sources of itching. Sometimes, loo, a knowledge of this vice comes from accident. Hence children at an early age should be taught habits of modesty ; all handling of the genital organs should be prohibited. Children should not be allowed to keep their hands in their pockets. Neither should they be left alone long: the necessity of observing, which is so vivid at their age, is exer- cised on themselves, when they find nothing else to interest them, and they sometimes make dangerous observations. It is in bed particularly that this evil is most liable to happen; hence they should be taken from their beds as soon as they awake, and the hour of 227 rest should not long precede that of sleep. Many children have been led to onanism by their efforts to re-ist the wish to urinate. The pressure exercised on the penis by pressing the thighs firmly against each other, has excited sensations which they have attempt- ed to re-produce. We mention this cause of onanism as being much more common than is generally sup- posed. There is another cause. Avhich is much more rare, but which deserves to be linown : domestic animal*, as cats and dogs, have sometimes licked the sexual parts of young children, particularly girls, and have excited a sense which ought to sleep. Hufeland pub- lishes a remarkable case of this character in support of some peculiar views on venereal disease, and adds that Ruggieri some years before, published in the medical journals, a case where, by the licking of a dog, ulcers of a bad character were developed in the genitals of two old maids. (Bibliot. Med., May, 1821, p. 250.) Most frequently, however, the habit of or .ni*m arises from direct provocation, from instruction. Some- times this provocation can be attributed only to impru- dence. Thus nurses sometime* titillate the genital or- gans in children to stop their cries. We have already stated, from Biett, the in-tance of a young girl who had thus contracted this bad habit, and who was cured by the amputation of the clitoris : this case arose prob- ably only from ignorance. Sometimes, hoAvever, ser- vants teach their masters' children from wilfulness. One should be particularly careful of female servants, as it is to them that young children are generally en- trusted. Male domestics are generally to be feared, only for those young persons who are near the age of puberty. The wish to please their young master, often induces them to give the most disgusting lessons. Most frequently, however, these lessons come from their associates, the older boys teaching those who are younger. If among young patients onanism is practised for it- self, it is afterward only an apology for the want of more legitimate enjoyments. Celibacy, in adults, is 229 with some few exceptions the only cau*e of onanism. This practice, and others still more revolting, are com- mon among monastic orders, as the consequence and punishment of vows made contrary to the laws of na- ture. Polygamy, the quasi celibacy to which the fe- males of many countries submit, also causes great de- rangements in the system. A kind of consumption has been described to which the Turkish Avomen are subject, and which can be traced to no other cause. (Journal, de Med., Vol. 44, p. 539.) It is in piison*, nowever, where there is no moral feeling, that this vice is most prevalent. Villerme remarks, that the amount of this vice in prisons, is almost incredible. Young and old abandon themselves to it so freely, that the physicians of the prisons of the department of the Seine, attribute the frequency of pulmonary consump- tion, of cramps in the stomach, muscular debility, Aveakness of sight, and of the intellectual faculties, to this cause alone. This physician considers onanism as one of the causes of the excessive mortality existing in the depots of mendicity. (Diet, des Sc. Med., art. Prison.) Sailors also often abandon them«elves during their long voyages to I hi* vice. Many adults, and particu- larly female*, seek in solitary indulgence a compensa- tion for the restraints imposed on them by laAvs and customs. Even animals indulge. Montegre has pub- lished some interesting details on this subject. (Diet. des Sc. Med., art. Continence.) We have said that onanism is performed so easily that it is much more to be feared than sexual inter- course. If then the physician has to choose between the two, he ought not to hesitate. In human things we cannot always choose between an injury and a benefit. Sometime* the selection is between a greater and a lesser evil. We may then Avithout detriment to physical and moral laws, counsel the young man Avho indulges in onanism, to gratify his feelings in a less dangerous manner. This also was Rous*eaii's opinion. He says, in his Emile, " If a tyrant mint conquer you, I would prefer to yield you to that from 229 which you can be released most easily : and you can be Aveaned from females more readily than from your- self." The physician in these cases should recom- mend marriage. This advice, too, is sanctioned by experience. Many young men after indulging in sexual intercourse, have commenced onanism ; despising the latter, after exer- cising the former. "We have known a lather," say Fournier and Begin, "who finding his son disobeyed his advice, married him, and with success." The same remedy has often been tried, and with good effect. A single coition has often sufficed to appease excessive ardor in females, and we.could state several cases of nymphomania which have been thus immediately cured. Pregnancy also has been followed by the same results: this fact Avas known to the ancients, and is mentioned in a work ascribed to Hippocrates. Pana- rolus, Matthew de Grado, and others, have related cases of females affected with nymphomania, who are never calm except during pregnancy. The following fact, observed by Esquirol, shows the inlluence of coi- tion and pregnancy on the genital system. A strong and healthy girl, of good family, nineteen years old, became affected with hysteria, with violent and almost constant convulsions. After a long and ineffectual course of medical treatment, this young woman disap- peared from her father's house, and all inquiries for her Avere in vain. After a few months, E-quirol. pas- sing in the evening through a noted and dissipated quarter of Paris, was stopped by a female, whom he recognised to be his patient. On inquiring Avhat she was doing, she answered, " Getting well." For eigh- teen months this girl was a prostitute of the lowest order. She miscarried twice, and finally returned to her father's house perfectly well. This woman is now married, a mother, and extremely circumspect in her conduct." (Diet, des Sc. Med., art. Continence.) § 2. SRCOND INDICATION To resist the desire of onanism. When a desire can be satisfied, and is not, it is be- 20 230 cause the will is enchained, or this is distracted by circumstances more powerful than desire. Thus then it is possible to inspire an individual with certain fears, or by distracting his thoughts to make his will resist his desires. The fear of God and his ministers may have great influence over the minds of many, and preserve strict continence. The fear of confession has often, to our knowledge, produced a denial of desire in young per- sons. At the present day, however, this latter influ- ence cannot be depended on much, and confessors, by their imprudent questions, have often excited curiosity in hearts yet innocent. The fear of transgressing the rules of modesty taught in youth, restrains some individuals. Others abstain because they fear the correction and reproaches of a father, and think on the shame Avith which they would be covered were their secret known. Chastise- ment has sometimes had the effect of rendering the guilty ones very circumspect. But of all fears, that which has produced the most effect on onanists, is the fear of disease and death. Onanists rarely believe what is told them by parents and others, as to the dangers of their course, but place more credit on Avhat they read in books ; and of these, Tissot is the only one which possesses much reputa- tion. It has been much read, and although attended with great good effects, it has not always been useful. Many think its statements exaggerated, and therefore injurious. We have knoAvn it to fail entirely of its desired purpose, and to cause deplorable effects. On the whole, hoAvever, it has done much good, which it would be unjust not to acknowledge. At the same time, we must say, that a knowledge of the reproaches against Tissot, and the desire to avoid them, have had no influence over a word of the present treatise. In composing it we have been actuated by a desire to tell the truth, and have more than once remarked that we must not judge of the common effects of onanism by the cases Avhich have been published, as those only which are very severe, appear in print. We have also 231 said that the most common effects of onanism consist rather in certain vitiations of temperament, than in di-ease* having a precise form, and a distinct place in the sy-tems of nosology. We have also shown how rapidly the health is generally restored when indulg- ence in onanism ceases. But this Avas done not to exercise any influence over the minds of those avIio might read the book, but simply to do justice to the truth. The Avord of a physician may frequently hoAvever produce a change in the patient; more frequently lhan the reading of a book. He should not hesitate to speak boldly, for if it be requisite he can aftenvard modify his opinion. The effect of an opinion as fol- lows, "In three months you Avill be a dead man" is often very great. The onanist trembles and becomes pale: his heart beats quickly, his strength fails. Do not regret it, it is not by encouragement that you Avill save him from himself. Add however that in a lew months he Avill be a well man, provided he will re- nounce his bad habits. These Avords of hope Avill console him and encourage him to resist his evil de- sires. Frequently hoAvever the impression caused by this language is soon effaced. In this case another remedy must be sought for. The language and tone of the physician too should vary according to the per- son addressed; but he should ahvays present the cer- tainty of death if the vice is continued, and that of re- lief if it be arrested. Sometimes the onanist leaves his old habit very gradually, a course Avhich is recommended by Swe- diaur. This course may be pursued for two reasons: the first is that it is more easy to quit this habit by degrees than to break it off violently: the second that it is not always prudent to leave off habits suddenly even if they are bad. Persons have sometimes been blinded by being taken from their dungeons too sud- denly. When a young man hoAArever finds himself unable to resist the force of his desires notwithstanding the perusal of books and the advice of his physician 232 there is still one resource, which is the sight of an onani-t dying. Approach and look at him: he was recently healthy and his prospects bright. He in- dulged in onanism: see what he is now; friends and physicians remonstrated with him but in vain ; he would listen to nothing, he believed nothing. Now however he believes, but it is too late, for in a few days his earthly career will be closed. If terror does not affect him who witnesses this doleful picture you cannot produce it. A surgeon named Bertrand aware of the [lower of this mode of instruction constructed in wax two figure* Avhich represented onani-ts of both sexes. These figures Avere exhibited to those sus- pected of indulging in onanism and produced it is said very btnefieient effects. 'I'he ancients and Ave will cite Avicenna, and Paul of Egina, recommend that Ave should attempt to ex- cite in ihe minds of those addicted to this vice an in- terest about external objects. Distraction is then a mode which may be usefully recommended to those onanists over whom their desires have not much power. Travelling, study, recreation, in fact every thing which can give the mind a strong and new di- rection, should be recommended, and may have the effect of distracting the onanist from his bad habit. §' 3. THIRD INDICATION. Remove from those who have the wish to mas- lurbale the power of doing so. Masturbation is pos- sible only under the two following conditions: first there must b : an opportunity to indulge in secret; next there must be a possibility of indulging. Hence by frustrating these conditions Ave can prevent ona- nism, the Avishes of the onanist to the contrary not- withstanding. The opportunities for.onanism are all embraced under one term, isolation. It is necessary for the onanist to be alone. Hence Avatchfulness, that pre- caution Avhich makes the young man constantly ob- serves, which exposes him every moment to detection and consequently to shame, to reproaches and to pun- 233 ishment for his fault, is a powerful means of prevent- ing it. Watchfulness should be particularly practised over young people, when they are undressed, in bed, in ihe bath or in the privy. Hence the young patient should undress, go to bed and rise under your inspection. If this be not sufficient, he should share your bed. This measure is frequently the only way to prevent ona- nism. In large boarding schools there should be no private rooms: the sleeping chambers should be ex- tensive, and a lamp, which would give sufficient light to assist your watchfulness, but not enough to prevent sleep, should burn in it all night. The masters and those avIio have charge of the pupils ought to examine in silence at different hours and the most perfect quiet should exist in the apartment. Here too the hours of retirement and of rising should be calculated accord- ing to the ages, so that the suspected or guilty might never go to bed except to sleep. Be watchful of those Avho stay long in privies: those however wilh ample accommodations are not so dangerous as those which are single. In some schools the doors of the privies are open at the top, so that an adult can look into them. Need we add that persons who are suspected should be watched in the bath. Onanism is executed Avith the hand and thighs on the sexual parts or by rubbing these parts against ex- ternal bodies. Different modes have been proposed to obviate and prevent these. The most simple of all is to oldige the children to keep their hands out of bed. This plan when it can be observed is often suf- ficient, particularly in boys. Besides this we knew of only one remedy, the purpose of Avhat can be con- cealed, viz., the application of a cold cataplasm to the sexual parts, a plan we have recommended several times. Pavet de Courtielle proposes the use of a chemise reaching below the feet and which is draAvn together at the bottom: this remedy may be effica- cious. The remedies Avhich remain to he treated of are essentially coercive: hence the chance of success is smaller the older and stronger the patients are. 90* 234 The hands may be tied to keep them from the sex- ual organ*, and the feet al*o mav be lied so as to keep the thighs separated. The child too maybe placed in a straight waistcoat fastened behind, which may force the arms to rest on the chest. Different apparatus has been contrived also to keep the thighs asunder. One is composed of thick pieces of cork which are attached to the inside of the ihighs. Drawers open- ing behind are sometimes used : these serve to im- prison the lower part of the trunk. A kind of truss is sometimes usea to preserve the sexual parts from external contact. The principal piece of this is of metal, either silver or tin: for fe- males its form is triangular, and for boys it represents a sort of mould, in which the penis and scrotum may be placed: the bandage is kept in place by springs, like those of herniary bandages. To add to the secu- rity of this apparatus it is sometimes applied to a dress which opens only behind. In young and feeble children these means are exceedingly efficacious, as experience has proved. The art of the onanist has even sometimes evaded these bandages. The follow- ing case occurred in the practice of Reveille Pariset; a little girl 7 years old, whose health failed every day having been detected in onanism, her mother instead of reproaching her, gave her to understand that it was the custom to apply a bandage to girls of her age. This bandage was fitted very accurately and attained the purpose desired; the health of the child being rapidly established. Soon however the syjniptoms re- appeared and more violently than before. The band- age was examined and it was found to be undisturbed. She however was Avatched and it Avas found lhat she used a quill for the purposes of onanism, which-she slipped in under the bandage. After this, the mother stayed with her daughter all the time, and by her vig- ilance the child was saved. These mechanical bandages have other inconve- nience* Avhich limit their use. First they cannot be employed in boarding schools as ihey become the sub- ject of remark; and then they keep up in the genital 235 organs a constant heat, irritation and moisture. The edges of the principal piece also may cause deep ex- coriations. For all this, however they are often use- ful and ought not to be neglected. CHAPTER II. OF THE MODE OF REPAIRING THE INJUEIE3 ARISING FROM VENEREAL EXCESSES. In therapeutics we proceed m two ways ; sometimes tracing the symptoms to their cause, we attempt to destroy this cause in the organ in which it is situated, and sometimes Ave attend only to symptoms. The same plan is applicable to the abuses of the genital organs, which as we have already seen forms a real disease. The most efficient Avay to arrest the evil caused by these abuses, is to stop them. When this is done, order is established very rapidly. Hence the pre- serva.ive means are in our view better than any reme- dial measures. Often however, when these excesses have been Irequently repeated and long continued, the genital organs continue Avithout provocation the work which wub commenced by onanism. Thus involun- tary pollutions keep up and increase a degree of ex- haustion and other complaints which would otherwise disappear. In this case the treatment to be followed is to arrest the pollutions. These generally result, as Ave have said, from an inflammation of the seminal passages analogous to that existing in the urethra in blenorrhcea. This fact has lately been demonstrated anatomically by Lallemand and M. Davila. Hence the treatment of involuntary spermattorrhcea resem- bles in many respects that of chronic catarrh. The following are the principal remedies to be employed. First must be placed cold applications to the genital organs; of these pure water and ice are more general- ly and successfully employed. In using the-e, Coe- lius Aurelian employed sponge*. Wichmann wet clotns, and Ste. Marie, Avho preferred ice, used a blad- der. Cold washes and affusions to the part and cold 236 douches to the perineum, and hipbaths and seabaths have also been used. Lallemand Avho repudiates enemata too hot or warm thinks lhat those which are cold may be useful. Sulphurous baths have likewise been employed by Lallemand, in the manner described in his Avork in diseases of the genito-urinary organs. Davila in his thesis relate* instances cured in this mode, and also the case of a young man avIio was cured of a diurnal pollution by introducing into the urethra a sound, which was retained there as long as the patient could bear it. Lallemand entertains the same opinion, and has also employed acupuncture and he says with success. He has known patients who after the application of needles between the pos- terior parts of the bursoe and the anus, have passed three or four months without pollutions. Some practitioners have succeeded by directing their remedies to the cerebellum and the spinal mar- row. Many medicines have been administered internally for losses of semen. Those most in repute are the preparations of iron and quinine, either separately or together. Ferruginous waters, particularly those of Spa, and the oxides of iron, have often been used. Wichmann recommends several glasses of Spa water every morning combined Avith some preparation of cinchona: Serrurier has related a case shoAving the efficacy of this treatment. Lallemand thinks that cinchona and generally all remedies Avhich contain lannin, only benefit temporarily. Many authors also disapprove of the use of astringents and tonics in spermattorrhoca, attributing to them among other in- conveniences, that of causing constipation. Many narcotic substances have also been used. We have related a case where thridace has succeed- ed. Belladonna also might be useful. In a patient mentioned by Serrurier, opium seems to have exas- perated the complaint. Davila however thinks that opiates have been prescribed with success: but he dreads the constipation which they generally cause. Other remedies as the mineral acids, phosphoric 237 lemonade, lime water, some preparations of lead, magnesia, ipecac, &c. have been used. Might not ad- vantage be derived from the use of balsam copaiva and pulverized cubebs in some cases of spermator- rhoea. We have already made some remarks on regimen, when speaking of the mode of avoiding or calming the venereal sense, and our rules for restoring individuals exhausted by onanism, will be stated hereafter. The object of the treatment stated is to remedy the disease, caused by the loss of semen. A mode has been proposed by Wender to prevent this physically ; this con-ists in the compression of the canal of the urethra: it is accomplished by means of a pair of for- ceps made of flexible wood, six to seven inches long, and from twelve to eighteen lines thick. This forceps is used by passing the penis between its two branches, one being above, and the other below; the two ex- tremities are then lied with a cord. In this manner the penis is compressed and slightly confined ; Avhich i* sufficient, says Wender, to remove all voluptuous sensation from this part, and to arrest the pollution. He has given the details of a case obtained by these means, and by the proper administration of tonics. Wender's forceps may have several inconveniences, and may frequently fail of the proposed end. But has it not been too much ridiculed, and is it not susceptible of improvement? Serrurier thinks that the idea may be turned to advantage, and Reveille Pariset assures us lhat be has used it twice in cases of pollution, and with success. (Revue. Med., April, 1823, p. 94.) Having mentioned the course to pursue in order to reach the seat of the disease, that is, the voluntary and involuntary pollutions, let us now speak of their ef- fects. One of two things must happen; either these pollutions pursue their work, or finally the economy becomes insensible to their action. The first supposi- tion is that least favorable to success : the physician prescribes for effects Avhile the cause continues to act; he doctors, as it i* called, for symptoms ; and it is the same as if one should attempt to cure gastritis or pleu- 233 riti*, Avithout attending to the pleura or stomach.* This, however, is no reason for abstaining completely from treatment. We may also sometimes retard the prog- ress of the disease, or calm any painful and disquieting symptom. The physician has a much better prospect of success, when there is no longer a habit to destroy the health, and when no pollutions occur. We shall not attempt in this place to give the treatment proper for the different diseases which may be produced by onanism. Myelitis, dementia, amaurosis, epilepsy, &c, &c, whether caused by onanism or not, require special remedies, which are stated in works which treat of these affections. We Avould remark, however, that Avhen these diseases are caused by onanism, it is perfectly futile for the physician to attempt to treat the disease, unless the habit of self pollution be arrested. In this place we Avill only mention that consumption, that exhaustion, in fact, that deterioration, which we have described in the third chapter of our first part. Onanistic deterioration presents two very distinct phenomena: 1st, the consumption of the strength; 2d, the excitement of the senses. Thus, then, to restore the strength without increasing, and even, if possible, to diminish the general disposition to receive impres- sions, are the two indications to be fulfilled. But before commencing, it is well to remember that this cannot be done in a feAv days. A disease which is gradual in its appearance is removed in the same manner. The physician who Avould attempt to hurry it by employing active remedies, would soon exhaust the system. The best mode of reparation is found in diet: the body must be recruited by food, and inasmuch as only those things are nutritious which are digested, the first rule to be observed is, that all the conditions of good digestion are properly observed. Inasmuch as these conditions present nothing special in respect to onan- ists, we shall be very brief, referring to our previous remarks on this subject. It must first be considered, that in patients accustomed to onanism the digestive functions are always deranged, or are liable to be so. 239 The slightest error in diet may aggravate this state considerably; Avhich is, in itself, an evil, and may add to the trouble of cure. Hence, if the rules of a good regimen should always be vigorously observed, this necessity is still more imperious when patients indulge in onanism. Every article of food which is difficult to digest should be forbidden, and among articles which can be digested, those should be selected which contain the most nourishment, and are the least exciting. Thus condiments, which are but slightly nutritious, and are very exciting, ought never to be used, unless they are indispensably necessary to digestion, and then only in very small quantities. Milk is very nutritious, and does not excite ; it should therefore be preferred by all those who are exhausted. If cow's milk be found dif- ficult of digestion, asses' milk and that of woman has been recommended. But if this article be difficult of digestion, it should be prohibited, for then it is injuri- ous. The flesh of young animals, particularly veal and poultry, is good ; but beef and mutton is still bet- ter, for they contain more nutritious matter in a smaller compass. These articles, Avhen roasted or broiled, are better than Avhen boiled. Fresh fish is generally a suitable article of food: Ave allude to those kinds which are easily digested, as shad, perch, &c. Soup*, espe- cially those of beef, turtle, and the different broths, should always, in order to be digested, be mingled with solid articles of food, and should even take their place, if these latter cannot be digested. Farinaceous substances, and especially bread, rice, potatoe, &c, are very suitable, because they are nutri- tious, and but slightly stimulant; but they are often bad to digest. The rule little and often, is the rule to follow, in regard to the division of food. The patient has always taken too much food: if he feels perfectlysatisfied, or if he experiences any inconvenience after it, the quan- tity of nourishment should be so regulated that nothing of this kind could occur. The meal* should be taken frequently, only because they are small. We prefer to 240 give broth warm, or more frequently still, cold, by spoonfuls, and have seen a benefit from it. Drinks are not very nutritious, and generally stimu- late much. Those which are given to strengthen, only do so for a few moments. They excite, and do not nourish. If the patient takes them to quench thirst, he should take as little as possible, for they also must be digested. In this respect wines may be useful. To choose among them, the experience of the patient must be consulted. A general rule governs the use of drinks at meals, viz: to attain the proposed end with the smallest quantity of drink. Very dry wines, liquors, coffee, tea, &c, ought not lo be permitted, unless abso- lutely necessary to'digestion. The use of Selzer water, and particularly of Spa water, may be very advantage- ous. Very cold drinks are often the only ones suitable to the stomach. Medicines have often been administered, either to strengthen the system, or to re-establish the digestive powers. Of these, the most useful are preparations of iron, quinine, and bitters. It is possible to improve the digestive organs with these drugs, and also with others; but this is not the place to give the treatment of dis- eases which are marked by difficulty of digestion. I know that some tonics may be used with great advan- tage, especially if they are given in such doses as to have no direct and immediate effect, particularly if their local action on the stomach and intestines be not too powerful. Very cold baths, like every remedy capable of hav- ing an intense effect, should be forbidden to patients exhausted by onanism. But if the baths are simply cold, and particularly if they are taken in running water, or in the sea, they may strengthen the constitu- tion. Dry, or aromatic frictions on the limbs, or along the vertebral column, are useful. The exercise should be moderate exercise, for too much fatigue exhausts tlit: strength, instead of increasing it, and might excite or ha-ten the development of one of the diseases pro- duced by onanism. A pure and dry air, like that breathed in hilly countries, may also have a favorably influence on the economy generally, or on digestion. APPENDIX. The preceding pages may seem to many of onr readers more particularly adapted to France; and it may be presumed that onanism is not so frequent in America. This however is a mistake: an able writer in that valuable periodical, the Boston Med. and Surg. Journal, Avhen treating on the subject remarks as follows:— " The pernicious and debasing practice of Mastur- bation is a more common and extensive evil with youth of both sexes, than is usually supposed. The influence of this habit upon both mind and body, se- vere as it has been considered, and greatly as it has been deprecated, is altogether more prejudicial than the public, and, as is believed, even the medical pro- fession, are aAvare. A great number of the evils Avhich come upon the young at and after the age of puberty, arise from mas- turbation, persisted in. so as to waste the vital ener- gies and enervate the physical and mental poAvers of man. Not less does it sap the foundation of moral Erinciples, and blast the first budding of manly and onorable feelings which were exhibiting themselves in the opening character of the young. Many of the weaknesses commonly attributed to growth and the changes in the habit by the important transformation from adolescence to manhood, are just- ly referable to this practice. This change requires all the energy of the system, greatly increased as it is at this period of life, which 242 if undisturbed Avill bring about a vigorous and heal thy condition of both the mental and physical powers " If masturbation be commenced at this period, it cannot fail to interrupt essentially this important pro- cess ; and if continued, will inevitably impress im- becility on the constitution, not less apparent in the body than the mind, preventing, as it will not fail to do, the full development of the poAvers of both. "The individual becomes feeble, is unable to labor with accustomed vigor, or to apply his mind to study ; his step is tardy and weak, he is dull, irresolute, en- gages in his sports with less energy than usual, and avoids social intercourse; when at rest he instinctive- ly assumes a lolling or recumbent posture, and if at labor or at his games takes every opportunity to lie down or sit in a bent and curved position. The cause of these infirmities is often unknoAvn to the subject of them, and more generally to the friends; and to labor, or study, or growth, is attributed all the evils which arise from the practice of this secret vice, which if persisted in will hardly fail to result in irre- mediable disease or hopeless idiocy. The natural consequence of indulgence in this, as in most other vices, is an increased propensity to them. This is particularly true of masturbation. In my intercourse with this unfortunate class of individuals, I have found a large proportion of them wholly ignorant ot the causes of their complaints, and if not too far gone the abandonment of the habit has, after awhile, re- moved all the symptoms and resulted in confirmed health. " One young man, now under my care, was first arrested in his career by reading the chapters on the subject in the Young Man's Guide. For many months, he has totally abstained from the practice, and yet he is feeble, depressed, irresolute, and unable to fix his attention to any subject, or to pursue any active employment. But he is steadily convalescing, and Avill doubtless recover. "If the symptoms above enumerated do not lead in any way to a discontinuance of the habit, other symp- 243 toms more formidable, and more difficult of cure, will present themselves. The back becomes lame and weak, the limbs tremble, the digestion is disturbed, and costiveness or diarrhoea, or an alternation of them, take place. The head becomes painful—the heart palpitates—the respiration is ea-ily hurried—the mind is depressed and gloomy—the temper becomes irrita- ble—the sleep disturbed, and is attended by lascivious dreams, and not unfrequently nocturnal pollutions. Wilh these symptoms ihe pulse becomes small, the extremities coid and damp ; the countenance is down- cast, the eye Avithout natural lustre; shamefacedness is apparent, as if the unfortunate viclim was conscious of his degraded condition. " The stomach often rejects food, and is affected with acidity, and loathing; the nervous system be- comes highly irritable; neuralgia, tabes dorsalis, pul- monary consumption, or fatal marasmus, terminate the suffering, or else insanity and deplorable idiocy are the fatal result. Long before such an event, the mind is enfeebled, the memory impaired, and the power of fixing the attention wholly lost. These are symptoms which should awaken our attention to the danger of the case, and which should induce us to sound the alarm, and if possible arrest the victim from the inevitable consequences of persisting in the habit. " In females, leucorrhcea is often induced by mas- turbation, and I doubt not incontinence of urine, stran- guary, prolapsus uteri, disease of the clitoris, and many other diseases, both local and general, which have been attributed to other causes. "It is often difficult to obtain information on the subject of masturbation. Where it is suspected by the physician, the friends are wholly ignorant on the subject, and the individual, suffering, is not ready to acknowledge a practice Avhich he is conscious is filthy in the extreme, although he may have had no sus- picions of its deleterious influence upon his health. "It is not sufficient lhat Ave know the consequences of masturbation, for these are often irremediable dis- ease; Ave ought to know the symptoms of its com- 244 mencement, of the incipient stages of those diseases which result from it, as well as the influence Avhich the moderate practice of it will have upon the phys- ical and mental stamina of the man—for it is not too much to say that the practice cannot be followed by either sex, even in a moderate way, without injury, especially by the youmg. "JMalure designs that this drain upon the system should be reserved to mature age, and even then that it be made but sparingly. Sturdy manhood, in all it; vigor, loses its energy and bends under the too fre- quent expenditure of this important secretion; and no age or condition will protect a man from the dan- ger of unlimited indulgence, legally and naturally ex- erci-ed. " In the young, however, its influence is much more seriously felt; and even those who have indulged so cautiously as not to break down the health or the mind, cannot know how much their physical energy, menial vigor, or moral purity, have been affectad by the indulgence. " Nothing short of total abstinence can save those who have become the victims of it. In this indul- gence, no half way course will ever subdue the dis- ease, or remove the effect of the habit from the sys- tem. Total abstinence is the only remedy. If the constitution is not fatally impaired—if organic dis- ease ha* not taken place, this remedy will prove effec- tual, and must be adopted, especially in all cases in which the effects are visible, or the consequences can- not fail to be ultimately fatal. "This means of cure may be seconded by others, which may be found necessary to remove the effects upon the physical system. Suffice it to remark here, that total abstinence, in an aggravated form of mas- turbation, is not easily effected. Slight irritation will pro luce an expenditure of the secretion quite involun- tary, and spontaneous emissions and nocturnal pol- lution may for a long time prolong the danger, and prevent that renovation of the powers which Avould 245 otherwise be the result of the good resolution of the victim of the habit. "No cause is more influential in producing insanity, and, in a special manner, perpetuating the disease, than masturbation. The records of the institutions give an appalling catalogue of cases attributed to this cause; and yet such records do not show nearly all the cases which are justly ascribable to it. For it is so obscure, and so secret in its operation, that the friends in almost all cases are wholly ignorant of it. It is in a few cases only, Avhere the practice of the vice be- comes shamefully notorious, that friends are willing to allow its agency in the production of any disease, par- ticularly insanity; and yet no cause operates more di- rectly upon the mind and the feeling. The mental energies are prostrated by the habit in innumerable cases, long before the delusions of insanity appear. Indeed there are many cases, in which insanity does not intervene between the incipient stages of that mental and physical imbecility, which comes early upon the victim of masturbation, and the most deplor- able and hopeless idiocy, in which it frequently results. " This is perhaps peculiar to this cause of idiocy. I know of no other Avhich does not produce the ravings and illusions of insanity, or the gloomy musings, agi- tations and alarms of melancholy, before the mind is lost in idiotism. But the victim of masturbation pass- es from one degree of imbecility to another, till all the poAvers of the system, mental, physical and moral, are blotted out forever! '• This is not, however, always the case. In some in- dividuals there is all the raving of the most furious mania, or the deep and cruel torture of hapless melan- choly, before the mind is obliterated and the energies of the system forever prostrated. " There are other circumstances attendingthe insanity from masturbation, which render this the most distress- ing form of mental disease. I allude to the difficulty ofbreaking up the habit while laboring under this malady. When insanity is once produced by it, it is nearly hopeless, because the cause of disease is re 21* 246 doubled and generally perpetuated. The libidinous desires are greatly increased, and the influence of self restraint cannot be brought sufficiently into action to prevent the constant, daily, and I might say almost hourly recurrence of the practice. Thus the cause is perpetuated ; and in spite of every effort, the disease increases, the powers of body and mind fail together, and are lost in the most deplorable, hopeless, disgust- ing fatuity ! Aud yet the practice is not abandoned. All the remaining energies of animal life seem to be concentrated in these organs, and all the remaining power of gratification left is in the exercise of this no longer secret, but loathsome and beastly habit. " Those cases of insanity arising from other knoAvn causes, in which masturbation is a symptom, are ren- dered more hopeless by this circumstance. It is a counteracting influence to all the means of cure em- ployed, either moral or medicinal, and coinciding as it does with whatever other causes may have had an agency in producing disease, renders the case. almost hopeless. Of ihe number of the insane that have come under the observation of the writer (and that number is not small,) few, very few have recovered, who have been in the habit of this evil practice ; and still fewer, I might say almost none, have recovered, in which insanity or idiotcy has followed the train of symptoms enumerated in a former paper, indicating the presence of the habit, and its debilitating influence upon the minds and bodies of the young. " Most of ihe cases of insanity from this cause com- mence early in life; even confirmed and hopeless idiocy has been the melancholy consequence, before the victim had reached his twentieth year. - "Of eighty males, insane, that have come under the observation of the writer, and who have been particu- larly examined and watched, with reference to ascer- taining the proportion that practised masturbation, something more than a quarter were found to practise it; and in about 10 per cent., a large proportion of which are idiotic, the disease is supposed to have arisen from this cause. 247 "Would it be believed, if it should be said that the proportion will not vary essentially in the other sex 1 On a former occasion I observed that the absolute abandonment of the practice, even in those whose minds were unaffected by insanity, was not ahvays easily effected. If no voluntary practice is continued, the habit may be so far established, and the suscepti- bility to the complaint be so great, that slight irritation will produce it, and that often for a long time after the danger is fully appreciated, and the victory over the propensity achieved so far as cautiously avoiding known and intentional indulgence. Nocturnal pollu- tion and invo.unlary emissions come from slight causes and trifling irritation, but perpetuate for a long time all the train of unhappy influences that have been hereto- fore detailed. The unfortunate subject of this detest- able vice, whose mental energy is unimpaired, and whose moral feelings are susceptible of impression, can be persuaded to abandon it, if the danger is set before him in its true light; but hundreds can bear me testimony that the effects of it are long felt, and the involuntary excitement produced by dreams, lascivious companions, Avarin beds, and improper intercourse Avith corrupt society, has for a long time after had its influ- ence in retarding complete recovery to health. With the insane we can have no such hopes, and no such prospects of cure. They will rarely form resolutions on the subject, and still'more rarely adhere to them. Reason, the balance wheel of the mind, being denied them, they are obnoxious to the influence of all the propensities in a high degree. " After the practice of masturbation, as a voluntary habit, i* entirely suspended, long and persevering ef- forts will be required to remove the effects from the system, and restore it to vigor and soundness. The individual himself must exercise great self-denial, and resolve to persevere with the means and overcome all obstacles that may be in his Avay, however formidable and difficult. The regimen to be adopted must be fctrictly adhered to on all occasions. As the inebriate v. 0....J piob.iLly never conquer his appetite for alcohol.c 248 drink if he indulged once a month only—so in this habit, the occasional indulgence will tlwart the whole plan of cure. The diet should be simple and nutri- tious ; the exercise should be moderate and gentle; in- dulgence in bed should not be allowed, and the indi- vidual should always sleep alone. A mattress is belter than a soft bed. He should rise immediately upon waking, and never retire till the disposition to sleep comes strongly upon him. The cold bath is a valuable remedy; a sea bath is better, and the shower bath often superior to either. " Narcotics, if there is a high degree of irritability in the system, are valuable remedies, of which conium, belladonna, hyoscyamus, nux vomica, and opium, may be used under different circumstances, combined or singly, according to the effects. Blisters and issues on the pudenda or perineum, promise well, and the different preparations of bark and iron, and other min- eral tonics, should be used till all the effects of the habit are removed, till the propensity is fully conquer- ed, and the constitution-is restored to health and vigor." Among the cases which occurred in the practice of this gentleman, are the following:— "A respectable young gentleman, of one of the learned professions, was out of health for a long pe- riod ; his head and eyes suffered exceedingly, and he was in a state little short of insanity. He placed him- self under the care of one of the most eminent men in the metropolis, and followed his prescriptions a year, but without benefit. He then called upon another, who asked him whether he was addicted to masturba- tion, to which he answered in the affirmative. The advice given him was principally to abstain from the indulgence, and his health gradually improved, and is now re-established. "B. D., aged 20, had had ill health for a year or more ; he Avas pale, feeble, nervous—lost his resolution —had no appetite—took to his bed most of the time, and became dull, almost speechless, and wholly ab- stracted and melancholy. His brother Avas his physi- cian "but not ascertaining the cause of his symptoms, 249 he gained no advantage over the disease, and the un- happy young man was constantly losing strength and flesh. After a while he came under the care of the Avriter. He was in the most miserable condition con- ceivable ; emaciated, feeble, pallid—had night sweat*, diarrhoea, or costiveness, total loathing of all food ; his heart beat, his head was painful, and he felt no desire, and would make no effort, to live. Suspecting mas- turbation, I found, upon strict inquiry and watching, that my suspicions were well foqnded. I pointed out the danger of the practice, assured him that it was the cause of all his sufferings, and that he might be re- stored to usefulness and health again if he would strictly adhere to the course prescribed for him. He took bark and ir*on alternately for a long time, pursued a course of gentle exercise and invigorating diet, and gave up at once the vicious indulgence. After a long time he wholly recovered, and is now a healthy and valuable citizen. " P. W., aged 27, called for advice in the summer of 1831, having had ill health for some eighteen months or two years. He complained of confusion of the head and pain in the eyes, indigestion, palpitation of the heart, and difficulty of respiration. His sleep was dis- turbed, his temper irritable, and he felt dissatisfied with himself, and greatly inclined to gloom and melancholy. He complained of listlessnessand indisposition to any bodily efforts, and of inability to fix his mind upon any subject, or give his attention to any business. His hands were cold, countenance pale and dejected, pulse frequent, and his whole system in a slate of great ir- ritation. It was ascertained that for two or three years he had been in the daily habit of masturbation. For eight or nine months last past, he has discontinued it; he is, however, occasionally subject to nocturnal emis- sion, which has thus far interfered with his recovery; but he is better, and under the use of tonic remedies, exercise and generous diet, feels confident of recovery, having regained his spirits and appetite. " H. F., aged 20. Avas for a long time in the habit of masturbation. He was for years confined to the house, 250 and much of the time to his bed. By long indulgence the habit had become irresistible, and the consequences truly deplorable. His mind was as fickle and capri- cious as that of an infant, and his health was wholly prostrated. For five or six years he was the most wretched being imaginable. Nocturnal pollutions, spontaneous emission, and all the evils resulting from unrestrained indulgence, were presented in this truly unhappy young man. He had been apprized of the danger which the continued practice would bring upon him, and was sensible that all his trials had their ori- gin in this vice ; and yet the propensity had become so strong that he could not resist it, and if he did, the consequences had become such that little benefit was derived from his good resolution. In his intercourse with his friends he Avas covered with shame and con- fusion, and seemed to feel conscious that every indi- vidual that he met with knew, as well as himself, the height and the depth of his degradation. In this con- dition, in a fit of desperation, he attempted to emascu- late himself, but succeeded in removing one testicle only. After he recovered from the dangerous wound Avhich he inflicted, he began to get better, and after two years he recovered his health and spirits. He has since, at the age of 45, married a very clever woman, and they live in peace and harmony. H.----, a young man 20 years of age, had been feeble and dejected for two years. He was pale, tor- pid, irresolute, and shamefaced in the extreme—so much so, that I could not catch his eye during a sitting of an hour. He complained of his head, of short breathing and palpitation of the heart, and of extreme debility. His extremities were cold and damp, his muscular system remarkably flabby, and his snail-like motions evinced great loss of muscular strength. His father, who accompanied the young man, said that he had consulted many physicians without benefit. The moment that he came into my room I was strongly im- pressed that he was the victim of this solitary vice. I questioned him sometime without ascertaining the cause of disease. His father was wholly ignorant, and 251 the physicians had not suspected it, or inquired con- cerning it. I requested a private interview—told him the danger of such habits, the importance of ascer- taining the true cause of disease, and my suspicions that he was in this habit, and that if so, he would soon fall a victim to its influence. He then acknowledged that he was in the daily practice of masturbation, and had been for three years—that he often also had spon- taneous emission, &c. He had never suspected that it had any influence upon his health. "The symptoms Avhich follow masturbation, viz. nocturnal pollution and spontaneous emission, often continue after the victim of the vice is made sensible of the danger of voluntary indulgence. These require distinct and separate consideration. In some cases they become very obstinate; and in spite of every ef- fort, continue to make such a Avaste of vital energies as to prevent a recovery of the health—and the new form of disease continuing, the same fatal results fol- low Avhich take place from a continuance of the habit. The local irritability of the organs of generation often become so great, that the ordinary evacuations of the bowels and the bladder produce an emission ; and even lascivious ideas, riding on horseback, or other equally slight irritation, has the same effect. Such cases re- quire the utmost care, to afford any chance of re- covery. "In addition to the common remedies prescribed for the effects of masturbation—as bark, iron, silver, the cold bath and shower bath, &c, which are valuable remedies for this local, as well as for the general de- bility attending the habit—other remedies, of a more stimulating character, and that have a more direct local effect upon these organs, are also indicated. Of these, tincture of lytta, bals. copaiva, and nitrate of silver, may be named. The strong tinct. of lytta, (made of pulv. lytta, 1U oz. alcohol, lbj.) may be taken in doses of from 10 to 20 drops, increasing, so as to produce a slight irritation of the uretiira, and continued in such doses as will keep up this effect without occasioning actual pain. The dose should be repeated three or 252 four times a day, generally. The very best effects often result from the use of this remedy. " Balsam of copaiva, if ihe urethra is irritable, may be a valuable remedy. Nitrate of silver is also both useful as a general remedy, and as having some local action on these organs. From one to four grains may be taken daily, combined with a little opium, to pre- vent irritation of the stomach and bowels. "In leucorrhcea, which too frequently arises from this cause, these remedies promise much; and when prescribed in efficient doses, often effect a cure, Avhat- ever may have been the cause of the disease. It is not too much to say, that no one cause more frequently affects the health of females, and lays the foundation of fatal disease, than severe and long continued leu- corrhcea; and yet, if attended to early, it is easily cured. It ought, however, even if slight, never to be neglected." Many cases similar in character to those already stated, and confirming the foregoing observations, have been transmitted to us by Dr. A. Sidney Doane, and Prof. J. W. Francis, both of New York. Our limits, however, forbid their insertion. NATIONAL LIBRARY OF MEDICINE 'I >' mi ' WW ,! '«;