University of Virginia Library

10. RESULTS OF SECRET VICE.

The physician rarely meets more forlorn objects than the victims of prolonged self-abuse. These unfortunate beings he meets every day of his life, and listens so often to the same story of shameful abuse and retributive suffering, that he dreads to hear it repeated. In these cases, there is usually a horrid sameness — the same cause, the same inevitable results. In most cases, the patient need not utter a word; for the physician can read in his countenance his whole history, as can most other people at all conversant with the subject.

In order to secure the greatest completeness consistent with necessary brevity, we will describe the effects observed in males and those in females under separate heads, noticing the symptoms of each morbid condition in connection with its description. EFFECTS IN MALES.

We shall describe, first, the local effects, then the general effects, physical and mental.

Local Effects. — Excitement of the genital organs produces the most intense congestion. No other organs of the body are capable of such rapid and enormous engorgement. When the act is frequently repeated, this condition becomes permanent in some of the tissues, particularly in the mucous membrane lining the urethra. This same membrane continues into, and lines throughout, the bladder, kidneys, and all the urinary organs, together with the visiculæ seminales, the ejaculatory ducts, the vasa deferentia, and the testes. In consequence of this

continuity of tissue, any irritation affecting one part is liable to extend to another, or to all the rest. We mention this anatomical fact here as a help to the understanding of the different morbid conditions which will be noticed.

Urethral Irritation. — The chronic congestion of the urethra after a time becomes chronic irritability. The tissue is unusually sensitive, this condition being often indicated by a slight smarting in urination. It often extends throughout the whole length of the urethra, and becomes so intense that the passage of a sound, which would occasion little if any sensation in a healthy organ, produces the most acute pain, as we have observed in numerous instances, even when the greatest care was used in the introduction of the instrument.

Shooting pains are often felt in the organ, due to this irritation. The pain is of a smarting character, and is in some cases most felt at the root, in others, at the head. It often darts from one point to another. Just before and just after urination the pain is most severe.

Stricture. — Long-continued irritation of the mucous membrane of the urethra produces, ultimately, inflammation and swelling of the same in some portion of its extent. This condition may become permanent, and then constitutes real stricture, a most serious disease. More often the swelling is but transient, being due to some unusual excess, and will subside. Sometimes, also, a temporary stricture is produced by spasmodic contraction of the muscular fibers surrounding the urethra, which is excited by the local irritation. This kind of stricture is often met in the treatment of spermatorrhœa.

Enlarged Prostate. — This painful affection is a fre-

quent result of the chronic irritation in the urethra, which the gland surrounds, the morbid action being communicated to it by its proximity. A diseased action is set up, which results in enlargement and hardening. It is felt as a hard body just anterior to the anus, and becomes by pressure the source of much additional mischief. Sometimes the disease progresses to dangerous ulceration. It is attended by heat, pressure, and pain between the anus and the root of the penis.

Permanent enlargement of the prostate is a very serious matter, since it interferes with the proper discharge of urine from the bladder, which ultimately leads to disease of the bladder itself, and may result even in death. This condition is the result of other forms of sexual excess as well as self-abuse.

Urinary Diseases. — The same congestion and irritability extend to the bladder and thence to the kidneys, producing irritation and inflammation of those organs. Mucus is often formed in large quantities; sometimes much is retained in the bladder. Earthy matter is deposited, which becomes entangled in the mucus, and thus a concretion, or stone, is produced, occasioning much suffering, and perhaps death.

We saw, not long since, a case of this kind. The patient was nearly sixty years of age, and had practiced masturbation from childhood. In consequence of his vice, a chronic irritation of the urethra had been produced, which was followed by enlargement of the prostate, then by chronic irritation of the bladder, and the formation of stone. His sufferings were most excruciating whenever he attempted to urinate, which was only accomplished with the greatest difficulty and suffering.

One of the unpleasant results of irritation of the lining membrane of the bladder is inability to retain the urine long, which requires frequent urination, and often causes incontinence of urine.

Priapism. — This same morbid sensitiveness may produce priapism, or continuous and painful erection, one of the most "terrible and humiliating conditions," as Dr. Acton says, to which the human body is subject. The horrid desperation of patients suffering under this condition, is almost inconceivable. It is, fortunately, rare, in its most severe forms; but hundreds suffer from it to a most painful degree as one of the punishments of the transgression of nature's laws; and a most terrible punishment it is.

Piles, Prolapsus of Rectum, etc. — As the result of the straining caused by stricture, piles, prolapsus of the rectum, and fissure of the anus are not infrequently induced, as the following case observed at Charity Hospital, New York, illustrates: —

The patient had a peculiar deformity of the genital organs, hypospadias, which prevented sexual intercourse, in consequence of which he gave himself up to the practice of self-abuse. He had become reduced to the most deplorable condition of both mind and body, and presented a most woe-begone countenance. In addition to his general ailments, he suffered from extreme prolapsus of the rectum, and a most painful anal fissure. His condition was somewhat bettered by skillful surgical treatment.

Extension of Irritation. — Serious and painful as are the affections already noticed, those which arise from the extension of the congestion and irritation of the

urethra to those other organs most intimately connected with the function of generation, are still more dreadful to themselves, and far more serious in their consequences. The irritation extends into the ejaculatory ducts, thence backward into the seminal vesicles, and downward through the vasa deferentia to the testes. These organs become unnaturally excited, and their activity is increased. The testicles form an abnormal amount of spermatozoa; the seminal vesicles secrete their peculiar fluid too freely. From these two sources combined, the vesicles become loaded with seminal fluid, and this condition gives rise to a great increase of sexual excitement.

In cases of long standing, the irritation of the urethra at the openings of the ejaculatory ducts, a point just in front of the bladder, advances to inflammation and ulceration. Here is now established a permanent source of irritation, by which the morbid activity of the testes and seminal vesicles is kept up and continually increased. This condition is indicated by frequent twitching of the ejaculatory and compressor muscles in the perineum. It is also indicated by a burning sensation at the root of the penis after urination, which, in severe cases, amounts to very serious pain.

Atrophy, or Wasting of the Testes. — The first result of the irritation communicated to the testes, is, as already remarked, increased activity; but this is attended by swelling in some cases, more or less pain, tenderness, and after a time, diminution in size.

This degenerative process likewise affects the seminal fluid, which becomes more or less deteriorated and incapable of producing healthy offspring, even while it

retains the power of fecundating the ovum, which it also ultimately loses, if the disease is not checked by proper treatment, when the individual becomes hopelessly impotent, — a happy result for the race; for it prevents the possibility of his imparting to another being his debilitated constitution.

Varicocele. — This morbid condition consists in a varicose state of the spermatic veins. It is almost always found upon the left side, owing to an anatomical peculiarity of the spermatic vein of that side. It has been supposed to be a result of masturbation and its effects, but is certainly caused otherwise in many cases. It is not infrequently found in these patients; but Prof. Bartholomew contends that even in such cases we should "consider its presence, in general, as accidental." Atrophy of the left testicle is often produced by the pressure of the distended veins; but this does not certainly occasion impotence. It sometimes occurs simultaneously on both sides, and certainly greatly aggravates the effects of self-abuse, if it is not itself an effect of the vice.

Nocturnal Emissions. — Seminal emissions during sleep, usually accompanied by erotic dreams, are known as nocturnal pollutions or emissions, and are often called spermatorrhœa, though there is some disagreement respecting the use of the latter term. Its most proper use is when applied to the entire group of symptoms which accompany involuntary seminal losses.

The masturbator knows nothing of this disease so long as he continues his vile practice; but when he resolves to reform, and ceases to defile himself voluntarily, he is astonished and disgusted to find that the

same filthy pollutions occur during sleep without his voluntary participation. He now begins to see something of the ruin he has wrought. The same nightly loss continues, sometimes being repeated several times in a single night, to his infinite mortification and chagrin. He hopes the difficulty will subside of itself, but his hope is vain; unless properly treated, it will probably continue until the ruin which he voluntarily began is completed.

This disease is the result of sexual excesses of any kind; it is common in married men who have abused the marriage relation, when they are forced to temporary continence from any cause. It also occurs in those addicted to mental unchastity, though they may be physically continent. It is not probable that it would ever occur in a person who had been strictly continent and had not allowed his mind to dwell upon libidinous imaginations.

Exciting Causes. — The exciting causes which serve to perpetuate this difficulty are chiefly two; viz., local irritation and lewd thoughts.

The first cause is usually chiefly located in the urethra, and especially at the mouths of the ejaculatory ducts. Distention of the seminal vesicles, with a superabundance of seminal fluid, also acts as a source of irritation. Constipation, worms, and piles have an irritating influence, which is often very seriously felt.

Unchaste thoughts act detrimentally in a twofold way. They first stimulate the activity of the testes, thus increasing the overloading of the seminal vesicles. Lascivious thoughts during wakefulness are the chief cause of lascivious dreams.

Emissions do not usually occur during the soundest sleep, but during that condition which may be characterized as dozing, which is most often indulged early in the morning after the soundest sleep is passed. This fact has an important bearing upon treatment, as will be seen hereafter.

At first, the emissions are always accompanied by dreams, the patient usually awaking immediately afterward; but after a time they take place without dreams and without awaking him, and are unaccompanied by sensation. This denotes an advanced stage of the complaint.

Certain circumstances greatly increase the frequency of the emissions, and thus hasten the injury which they are certain to accomplish if not checked; as neglect to relieve the bladder and bowels at night, late suppers, stimulating foods and drinks, and anything that will excite the genital organs. Of all causes, amorous or erotic thoughts are the most powerful. Tea and coffee, spices and other condiments, and animal food have a special tendency in this direction. Certain positions in bed also serve as exciting or predisposing causes; as sleeping, upon the back or the abdomen. Feather-beds and pillows and too warm covering in bed are also injurious for the same reason.

In frequency, emissions will vary in different persons from an occasional one at long and irregular intervals, to two or three a week, or several — as many as four in one case we have met — in a single night.

The immediate effect of an emission will depend upon the frequency of occurrence and the condition of the individual. If very infrequent, and occurring in a com-

paratively robust person, after the seminal vesicles have become distended with seminal fluid, the immediate effect of an emission may be a sensation of temporary relief. This circumstance has led certain persons to suppose that emissions are natural and beneficial. This point will receive attention shortly.

If the emissions are more frequent, or if they occur in a person of a naturally feeble constitution, the immediate effect is lassitude, languor, indisposition, and often inability to perform severe mental or physical labor, melancholy, amounting often to despair and even leading to suicide, and an exaggeration of local irritation, and of all the morbid conditions to be noticed under the head of "General Effects." Headache, indigestion, weakness of the back and knees, disturbed circulation, dimness of vision, and loss of appetite are only a few of these.

Are Occasional Emissions Necessary or Harmless? — That an individual may suffer for years an involuntary seminal loss as often as once a month without apparently suffering very great injury, seems to be a settled fact with physicians of extensive experience, and is well confirmed by observation; yet there are those who suffer severely from losses no more frequent than this. But when seminal losses occur more frequently than once a month, they will certainly ultimate in great injury, even though immediate ill effects are not noticed as in exceptional cases they may not be. If argument is necessary to sustain this position, as it hardly seems to be, we would refer to the fact that seminal losses rarely occur in those who are, and always have been, continent both mentally and physically. They occur the most infrequently in those who most nearly ap-

proach the standard of perfect chastity; so that whenever they occur, they may be taken as evidence of ill-health or some form of sexual excess. This fact clearly shows that losses of this kind are not natural.

Emissions not Necessary to Health. — If it be argued that an occasional emission is necessary to relieve the overloaded seminal vesicles, we reply, The same argument has been used as an apology for unchastity; but it is equally worthless in both instances. It might be as well argued that vomiting is a necessary physiological and healthful act, and should occur with regularity, because a person may so overload his stomach as to make the act necessary as a remedial measure. Vomiting is a diseased action, a pathological process, and is occasioned by a voluntary transgression of the individual. Hence, it is as unnecessary as gluttony, and must be wasteful of vitality, even though rendered necessary under some circumstances. So with emissions. If a person allows his mind to dwell upon unchaste subjects, indulges in erotic dreams, and riots in mental lasciviousness, he may render an emission almost necessary as a remedial effort. Nevertheless, he will suffer from the loss of nervous energy just the same as though he had not, by his own concupiscence, rendered it in some degree necessary. And as it would have been infinitely better for him to have retained and digested food in his stomach instead of ejecting it, — provided it were wholesome food, — so it would have been better for him to have retained in his system the seminal fluid, which would have been disposed of by the system, and probably utilized to very great advantage in the repair of the tissues.

Eminent Testimony. — An eminent English physician, Dr. Milton, who has treated many thousands of cases of this disease, remarks in a world upon the subject as follows: —

"Anything beyond one emission a month requires attention. I know this statement has been impugned, but I am quite prepared to abide by it. I did not put it forward till I considered I had quite sufficient evidence in my hands to justify me in doing so."

"An opinion prevails, as most of my readers are aware, among medical men, that a few emissions in youth do good instead of harm. It is difficult to understand how an unnatural evacuation can do good, except in the case of unnatural congestion. I have, however, convinced myself that the principle is wrong. Lads never really feel better for emissions; they very often feel decidedly worse. Occasionally they may fancy there is a sense of relief, but it is very much the same sort of relief that a drunkard feels from a dram. In early life the stomach may be repeatedly overloaded with impunity; but I suppose few would contend that overloading was therefore good. The fact is that emissions are invariably more or less injurious; not always visibly so in youth, nor susceptible of being assessed as to the damage inflicted by any given number of them, but still contributing, each in its turn, a mite toward the exhaustion and debility which the patient will one day complain of."

Diurnal Emissions. — As the disease progresses, the irritation and weakness of the organs become so great that an erection and emission occur upon the slightest sexual excitement. Mere proximity to a female, or the thought of one, will be sufficient to produce a pollution,

attended by voluptuous sensations. But after a time the organs become so diseased and irritable that the slightest mechanical irritation, as friction of the clothing, the sitting posture, or riding horseback, will produce a discharge which may or may not be attended by sensation of any kind. Frequently, a burning or more or less painful sensation occurs. After a time, erection no longer takes place. Even straining at stool will produce the discharge, or violent efforts to retain the feces when there is unnatural looseness.

The amount of the discharge may vary from a few drops to one or two drams, or even more. The character of the discharge is of considerable importance. When it occurs under the circumstances last described, viz., without erection or voluptuous sensations, it may be of a true seminal character, or it may contain no spermatozoa. This point can be determined by the microscope alone. The discharge is the result of sexual excitement or irritation, nevertheless, and indicates a most deplorable condition of the genital organs. The patient is sometimes unnecessarily frightened by it, and often exaggerates the amount of the losses, and the symptoms arising from them. However, when a single nocturnal emission occasions such detrimental results, what must be the effect of repeated discharges occurring several times a day, or every time an individual relieves his bowels, urinates, or entertains an unvirtuous thought! If the losses were always seminal, the work of ruin would soon be complete; fortunately, those discharges which are the most frequent are only occasionally of a true seminal character. It is not so, however, as has been claimed by some writers, one at least, that they are

never seminal, as we have proved by repeated microscopic examinations.

Causes of Diurnal Emissions. — The causes of these discharges are spasmodic action of the muscles involved in ejaculation, which is occasioned by local irritation, and pressure upon the seminal vesicles by the distended rectum or bladder. They denote a condition of debility and irritation which may well occasion grave alarm.

In occasional instances, the internal irritation reaches such a hight that blood is discharged with the seminal fluid.

Spontaneous ejaculation as the result of a depraved state of mind is not infrequent in women who give themselves up to evil thoughts. The observations of the author will support the view that this form of disease is more frequent in women than in men. Women whose sexual organs have been weakened by abuse are most likely to suffer in this way, as also from involuntary ejaculation occurring at night.

Internal Emissions. — As the disease progresses, external discharges finally cease, in some cases, or partially so, and the individual is encouraged by that circumstance to think that he is recovering. He soon discovers his error, however, for he continues to droop, even though the discharges apparently cease altogether. This seems a mystery until some medical friend or a medical work calls his attention to the fact that the discharges now occur internally instead of externally, the seminal fluid passing back into the bladder, and being voided with the urine, a microscopic examination of which shows the presence of zoosperms.

An Important Caution. — It is necessary, however,

to caution the reader not to pronounce every whitish sediment or flocculent matter found in the urine to be a seminal discharge, for the great majority are of a different character. They are most frequently simply mucus or phosphates from the bladder. Seminal fluid cannot be distinguished from mucus by any other than a careful microscopic examination. A microscope of good quality, and capable of magnifying at least one hundred and fifty diameters, is required, together with considerable skill in the operator. Quacks have done an immense amount of harm by frightening patients into the belief that they were suffering from discharges of this kind, when there was, in fact, nothing more than a copious deposit of phosphates, which is not at all infrequent in nervous people, especially after eating.

When the condition described does really exist, however, the patient cannot make too much haste to put himself under the care of a competent physician for treatment. If there is even a reasonable suspicion that it may exist, he should have his urine carefully examined by one competent to criticise it intelligently.

Spermatorrhœa. — By many authors, the term spermatorrhœa is confined entirely to this stage of the disease. It is said that in many cases the forcible interruption of ejaculation has been the cause of this unfortunate condition. Such a proceeding is certainly very hazardous.

One more caution should be offered; viz., that the occasional presence of spermatozoa in the urine is not a proof of the existence of internal emissions, as a few zoosperms may be left in the urethra after a voluntary or nocturnal emission, and thus find their way into the urine as it is discharged from the bladder.

Impotence. — In the progress of the disease, a point is finally reached when the victim not only loses all desire for the natural exercise of the sexual function, but when such an act becomes impossible. This condition may have been reached even before all the preceding symptoms have been developed. Ultimately it becomes impossible to longer practice the abominable vice itself, on account of the great degeneration and relaxation of the organs. The approach of this condition is indicated by increasing loss of erectile power, which is at first only temporary, but afterward becomes permanent. Still the involuntary discharges continue, and the victim sees himself gradually sinking lower and lower into the pit which his own hands have dug. The misery of his condition is unimaginable, — manhood lost, his body a wreck, and death staring him in the face.

This is a brief sketch of the local effects of the horrid vice of self-abuse. The description has not been at all overdrawn. We have yet to consider the general effects, some of which have already been incidentally touched upon in describing nocturnal emissions, with their immediate results.

General Effects. — The many serious effects which follow the habit of self-abuse, in addition to those terrible local maladies already described, are the direct result of two causes in the male; viz., —

1. Nervous exhaustion.

2. Loss of the seminal fluid.

There has been much discussion as to which one of these was the cause of the effects observed in these cases. Some have attributed all the evil to one cause, and some to the other. That the loss of semen is not

the only cause, nor, perhaps, the chief source of injury, is proved by the fact that most deplorable effects of the vice are seen in children before puberty, and also in females, in whom no seminal discharge nor anything analogous to it occurs. In these cases, it is the nervous shock alone which works the evil.

Again, that the seminal fluid is the most highly vitalized of all the fluids of the body, and that its rapid production is at the expense of a most exhaustive effort on the part of the vital forces, is well attested by all physiologists.

The nervous shock accompanying the exercise of the sexual organs, either natural or unnatural, is the most profound to which the system is subject. The whole nervous system is called into activity; and the effects are occasionally so strongly felt upon a weakened organism that death results in the very act. The subsequent exhaustion is necessarily proportionate to the excitement.

It need not be surprising, then, that the effects of the frequent operation of two such powerful influences combined should be so terrible as they are found to be.

General Debility. — Nervous exhaustion and the loss of the vivifying influence of the seminal fluid, produce extreme mental and physical debility, which increases as the habit is practiced, and is continued by involuntary emissions after the habit ceases. If the patient's habits are sedentary, and if he had a delicate constitution at the start, his progress toward the grave will be fearfully rapid, especially if the habit were acquired young, as it most frequently is by such boys, they being generally precocious. Extreme emacia-

tion, sallow or blotched skin, sunken eyes, surrounded by a dark or blue color, general weakness, dullness, weak back, stupidity, laziness, or indisposition to activity of any kind, wandering and illy defined pains, obscure and often terrible sensations, pain in back and limbs, sleeplessness, and a train of morbid symptoms too long to mention in detail, attend the sufferers.

Consumption. — It is well recognized by experienced medical men that this vice is one of the most frequent causes of consumption. At least, such would seem to be the declaration of experience, and the following statistical fact adds weight to the conclusion: —

"Dr. Smith read a paper before a learned medical association a few years since, in which he pointed out the startling fact that in one thousand cases of consumption, five hundred and eighteen had suffered from some form of sexual abuse, and more than four hundred had been addicted to masturbation, or suffered from nocturnal emissions."[19] [19] Acton.

"Most of those who early become addicted to self-pollution, are soon afterward the subjects, not merely of one or more of the ailments already noticed, but also of enlargements of the lymphatic and other glands, ultimately of tubercular deposits in the lungs and other viscera, or of scrofulous disease of the vertebræ or bones, or of other structures, more especially of the joints."[20] [20] Copland.

Many young men waste away and die of symptoms resembling consumption which are solely the result of the loathsome practice of self-abuse. The real number of consumptives whose disease originates in this manner can never be known.

Dyspepsia. — Indigestion is frequently one of the first results. Nervous exhaustion is always felt by the stomach very promptly. When dyspepsia is once really established, it reacts upon the genital organs, increasing their irritability as well as that of all the rest of the nervous system. Now there is no end to the ills which may be suffered; for an impaired digestion lays the system open to the inroads of almost any and every malady.

Heart Disease. — Functional disease of the heart, indicated by excessive palpitation on the slightest exertion, is a very frequent symptom. Though it unfits the individual for labor, and causes him much suffering, he would be fortunate if he escaped with no disease of a more dangerous character.

Throat Affections. — There is no doubt that many of the affections of the throat in young men, and older ones, which pass under the name of "clergyman's sore throat," are the direct result of masturbation and emissions.

Dr. Acton cites several cases in proof of this, and quotes the following letter from a young clergyman: —

"When I began the practice of masturbation, at the age of sixteen, I was in the habit of exercising my voice regularly. The first part in which I felt the bad effects of that habit was in the organs of articulation. After the act, the voice wanted tone, and there was a disagreeable feeling about the throat which made speaking a source of no pleasure to me as it had been. By-and-by it became painful to speak after the act. This arose from a feeling as if a morbid matter was being secreted in the throat, so acrid that it sent tears to the eyes when speaking, and would have taken away the

breath if not swallowed. This, however, passed away in a day or two after the act. In the course of years, when involuntary emissions began to impair the constitution, this condition became permanent. The throat always feels very delicate, and there is often such irritability in it, along with this feeling of the secretion of morbid matter, as to make it impossible to speak without swallowing at every second or third word. This is felt even in conversation, and there is a great disinclination to attempt to speak at all. In many instances, in which the throat has been supposed to give way from other causes, I have known this to be the real one. May it not be that the general irritation always produced by the habit referred to, shows itself also in this organ, and more fully in those who are required habitually to exercise it?"

Nervous Diseases. — There is no end to the nervous affections to which the sufferer from this vice is subjected. Headaches, neuralgias, symptoms resembling hysteria, sudden alternations of heat and cold, irregular flushing of the face, and many other affections, some of the more important of which we will mention in detail, are his constant companions.

Epilepsy. — This disease has been traced to the vile habit under consideration in so many cases that it is now very certain that in many instances this is its origin. It is of frequent occurrence in those who have indulged in solitary vice or any other form of sexual excess. We have met a number of cases in which the disease was due to this cause.

Failure of Special Senses. — Dimness of vision, amaurosis, spots before the eyes, with other forms of ocular

weakness, are common results of this vice. The same degeneration and premature failure occur in the organs of hearing. In fact, sensibility of all the senses becomes in some measure diminished in old cases.

Spinal Irritation. — Irritation of the spinal cord, with its resultant evils, is one of the most common of the nervous affections originating in this cause. Tenderness of the spine, numerous pains in the limbs, and spasmodic twitching of the muscles, are some of its results. Paralysis, partial or complete, of the lower limbs, and even of the whole body, is not a rare occurrence. We have seen a number of cases in which this was well marked. Two of the patients were small boys who began to excite the genital organs at a very early age. In one, the paralytic condition was complete when he was held erect. The head fell forward, the arms and limbs hung down helpless, the eyes rolled upward, and the saliva dribbled from his mouth. When lying flat upon his back, he had considerable control of his limbs. In this case, a condition of priapism seems to have existed almost from birth, owing to congenital phimosis. His condition was somewhat improved by circumcision.

In another case, in which phimosis also existed, there was paralysis of a few of the muscles of the leg, which produced club-foot. Circumcision was also performed in this case, and the child returned in a few weeks completely cured, without any other application, though it had previously been treated in a great variety of ways without success, all the usual remedies for club-foot proving ineffectual. Both of these cases appeared in the clinic of Dr. Sayre at Bellevue Hospital, and were operated upon by him.

A few years ago, we observed several cases of spinal disease which could be traced to no origin but masturbation. Two patients were small boys, naturally quite intelligent. They manifested all the peculiarities of locomotor ataxia in older persons, walking with the characteristic gait. The disease was steadily progressing in spite of all attempts to stay it. An older brother had died of the same malady, paralysis extending over the whole body, and finally preventing deglutition, so that he really starved to death.

Insanity. — That solitary vice is one of the most common causes of insanity, is a fact too well established to need demonstration here. Every lunatic asylum furnishes numerous illustrations of the fact. "Authors are universally agreed, from Galen down to the present day, about the pernicious influence of this enervating indulgence, and its strong propensity to generate the very worst and most formidable kinds of insanity. It has frequently been known to occasion speedy and even instant insanity."[21] [21] Arnold.

"Religious insanity," so-called, may justly be attributed to this cause in a great proportion of cases. The individual is conscience-smitten in view of his horrid sins, and a sense of his terrible condition — ruined for both worlds, he fears — goads him to despair, and his weakened intellect fails, reason is dethroned, and he becomes a hopeless lunatic. His friends, knowing nothing of the real cause of his mysterious confessions of terrible sin, think him over-conscientious, and lay the blame of his insanity upon religion, when it is solely the result of his vicious habits, of which they are ignorant.

In other cases, the victim falls into a profound melancholy from which nothing can divert him. He never laughs; does not even smile. He becomes more and more reserved and taciturn, and perhaps ends the scene by committing suicide. This crime is not at all uncommon with those who have gone the whole length of the evil road. They find their manhood gone, the vice in which they have so long delighted is no longer possible, and in desperation they put an end to the miserable life which nature might end in a few months if not thus violently superseded.

Idiocy. — If the practice is continued uninterruptedly from boyhood to manhood, imbecility and idiocy are the result. Demented individuals are met in no small numbers in hospitals and asylums, and out of them as well, who owe to this vice their awful condition. Plenty of the half-witted men one meets in the every-day walks of life, have destroyed the better half of their understanding by this wretched practice.

A Victim's Mental Condition Pictured. — The mental condition of a victim of this vice cannot be better described than is done in the following paragraphs by one, himself a victim, though few of these unfortunate individuals would be able to produce so accurate and critical a portrait of themselves as is here drawn by M. Rosseau, as quoted by Mr. Acton: —

"One might say that my heart and my mind do not belong to the same person. My feelings, quicker than lightning, fill my soul; but instead of illuminating, they burn and dazzle me. I feel everything; I see nothing. I am excited, but stupid; I cannot think except in cold blood. The wonderful thing is that I have sound enough

tact, penetration, even finesse, if people will wait for me. I make excellent impromptus at leisure; but at the moment I have nothing ready to say or do. I should converse brilliantly by post, as they say the Spaniards play at chess. When I read of a Duke of Savoy who turned back after starting on his journey to say, `In your teeth! you Paris shop-keeper!' I said, `That is like me!' "

"But not only is it a labor to me to express, but also to receive, ideas. I have studied men, and I think I am a tolerably good observer; yet I can see nothing of what I do see. I can hardly say that I see anything except what I recall; I have no power of mind but in my recollection. Of all that is said, of all that is done, of all that passes in my presence, I feel nothing, I appreciate nothing. The external sign is all that strikes me. But after a while it all comes back to me." EFFECTS IN FEMALES.

Local Effects. — The local diseases produced by the vice in females are, of course, of a different nature from those seen in males, on account of the difference in organization. They arise, however, in the same way, congestions at first temporary, ultimately becoming permanent, and resulting in irritation and various disorders.

Leucorrhœa. — The results of congestion first appear in the mucous membrane lining the vagina, which is also injured by mechanical irritation, and consists of a catarrhal discharge which enervates the system. By degrees the discharge increases in quantity and virulence, extending backward until it reaches the sensitive womb.

Contact with the acrid, irritating secretions of the

vagina produces soreness of the fingers at the roots of the nails, and also frequently causes warts upon the fingers. Hence the value of these signs, as previously mentioned.

Uterine Disease. — Congestion of the womb is also produced by the act of abuse; and as the habit is continued, it also becomes permanent. This congestion, together with the contact of the acrid vaginal discharge, finally produces superficial ulceration or abrasion upon the neck of the womb, together with other diseases.

Another result of congestion is all kinds of menstrual derangements after puberty, the occurrence of which epoch is hastened by the habit.

Prolapsus and various displacements are produced in addition to these menstrual irregularities. The most common forms of displacement resulting from self-abuse, are retroflexion and retroversion, which are usually accompanied by congestion and enlargement of the womb, catarrh of the lining membrane of the womb, and relaxation of the vagina. When these conditions are present in a young woman, together with the enlargement of the labia and clitoris, they may be looked upon as positive evidence of the existence of the habit. After a large experience in this class of cases, in which an opinion of the nature of the case has been based upon the symptoms named, the author has never found such an opinion erroneous.

Sterility. — Sterility, dependent on a total loss of sexual desire and inability to participate in the sexual act, is another condition which is declared by medical authors to be most commonly due to previous habits of self-abuse. In consequence of overexcitement, the organs

become relaxed, the natural tone is lost, and they become so much depleted that they are unable to respond to the natural stimulus, and the sexual act is not only not accompanied by sensation, but is even attended by disgust and a sense of extreme exhaustion. Among many cases of this sort which have come to the notice of the author, in only one or two has he been unable to trace the abnormal conditions to the practice of self-abuse in early life.

Atrophy of Mammæ. — Closely connected with other local results is the deficient development of the breasts when the vice is begun before or at puberty, and atrophy if it is begun or continued after development has occurred. As previously remarked, this is not the sole cause of small mammæ? but it is one of the great causes.

Pruritis, or Itching Genitals. — This is an affection not infrequent in these subjects. Continued congestion produces a terrible itching of the genitals, which increases until the individual is in a state of actual frenzy, and the disposition to manipulate the genitals becomes irresistible, and is indulged even in the presence of friends or strangers, and though the patient be at other times a young woman of exceptional modesty. In cases of this kind, marked hypertrophy of the organ of greatest sensibility has been observed, and in some cases amputation of this part has been found the only cure.

Nocturnal Ejaculation in Females. — A disorder analogous to nocturnal emissions in the male, occurs in females who have been addicted to this vice. An erotic dream is accompanied by ejaculation, which is followed on the succeeding day by all the unpleasant symptoms of nervous irritability, headache, backache, etc., which are experienced by males subject to seminal losses.

General Effects. — The general effects in the female are much the same as those in the male. Although women suffer no seminal loss, they suffer the debilitating effects of leucorrhœa, which is in some degree injurious in the same manner as seminal losses in the male. But in females the greatest injury results from the nervous exhaustion which follows the unnatural excitement. Nervous diseases of every variety are developed. Emaciation and debility become more marked even than in the male, and the worst results are produced sooner, being hastened by the sedentary habits of these females. Insanity is more frequently developed than in males.

Spinal irritation is so frequent a result that a recent surgical author has said that "spinal irritation in girls and women is, in a majority of cases, due to self-abuse.[22] [22] Davis.

A Common Cause of Hysteria. — This, too, is one of the most frequent causes of hysteria, chorea, and epilepsy among young women, though not often recognized.

A writer, quoted several times before in this work, remarks as follows: —

"This is not a matter within the scope of general investigation; truth is not to be expected from its habitués; parents are deceived respecting it, believing rather what they wish than what they fear. Even the physician can but suspect, till time develops more fully by hysterias, epilepsies, spinal irritations, and a train of symptoms unmistakable even if the finally extorted confession of the poor victim did not render the matter clear. Marriage does, indeed, often arrest this final catastrophe, and thus apparently shifts the responsibility upon other

shoulders, and to the `injurious effects of early marriages,' to the `ills of maternity,' are ascribed the results of previous personal abuse.

"For statistics and further information on this all-important subject, we must refer the reader to the opinions of physicians who have the charge of our retreats for the insane, lunatic asylums, and the like; to the discriminating physicians of the families of the upper classes, — stimulated alike by food, drinks, scenes where ease is predominant, where indolence is the habit, and novel-reading is the occupation, — for further particulars on a subject here but barely alluded to."[23] [23] Gardner. EFFECTS UPON OFFSPRING.

If sterility does not result, children are liable to be "delicate, puny, decrepit, or subject to various congenital maladies, especially of the nervous system, to idiocy from deficient development of the brain, to hydrocephalus, to epilepsy, convulsions, palsy. The scrofulous diathesis, tubercular and glandular maladies, diseases of the vertebræ and of the joints, softening of the central portions of the brain, and tuberculous formations in the membranes, palsy and convulsions, chorea, inflammations of the membranes or substance of the brain or spinal cord, and numerous other affections to which infants and children are liable, very commonly result from the practice of self-pollution by either of the parents previous to marriage. But the evil does not always stop at this epoch of existence; it often extends throughout the life of the offspring, or it appears only with puberty and mature age."

Neglect Dangerous. — Too frequently, the victim of

self-abuse, when he finds himself suffering from the first results of his sin, neglects to adopt any measures for the cure of the disease. Not understanding its inveterate character, he labors under the delusion that it will cure itself in time. This is a fatal mistake. The diseased conditions induced by this vice never improve themselves. Their constant tendency is to increase in virulence and inveteracy. The necessity of taking prompt measures for relief is too apparent to need especial emphasis.