Plain Facts for Old and Young Part 22

_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 transgression of nature's laws; and a most terrible punishment it is.

_Piles, Prolapsus of r.e.c.t.u.m, etc._--As the result of the straining caused by stricture, piles, prolapsus of the r.e.c.t.u.m, and fissure of the a.n.u.s are not infrequently induced, as the following case observed at Charity Hospital, New York, ill.u.s.trates:--

The patient had a peculiar deformity of the genital organs, _hypospadias_, which prevented s.e.xual 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 woebegone countenance. In addition to his general ailments, he suffered from extreme prolapsus of the r.e.c.t.u.m and a most painful a.n.a.l 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 in 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 t.e.s.t.i.c.l.es 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 s.e.xual 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 twitchings of the ejaculatory and compressor muscles in the perineum. It is also indicated by a burning sensation at the root of the p.e.n.i.s 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 const.i.tution.

_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. Bartholow contends that even in such cases we should "consider its presence, in general, as accidental."

Atrophy of the left t.e.s.t.i.c.l.e is often produced by the pressure of the distended veins; but this does not produce impotence. It occasionally occurs simultaneously on both sides, and 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 _spermatorrhoea_, 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 his sleep without his voluntary partic.i.p.ation. 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 s.e.xual 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 unchast.i.ty, 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 irritative influence which is often very seriously felt.

Unchaste thoughts act detrimentally in a two-fold 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 in early in the morning after the soundest sleep is pa.s.sed.

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 a greatly increased gravity of the complaint.

Certain circ.u.mstances 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 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 somewhat upon the frequency of occurrence and the condition of the individual. If very infrequent, and occurring in a comparatively 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 circ.u.mstance 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 const.i.tution, the immediate effect is la.s.situde, 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 appet.i.te, are only a few of these.

Are Occasional Emissions Necessary or Harmless?--That an individual may suffer for years an involuntary seminal loss as frequently 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 do not occur in those who are, and always have been, continent both mentally and physically, when such rare individuals can be found. They occur the most rarely in those who the most nearly approach the standard of perfect chast.i.ty; so that whenever they occur, they may be taken as evidence of some form of s.e.xual excess. This fact clearly shows that losses of this kind are not natural.

Emission 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 unchast.i.ty; 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 the voluntary transgression of the individual. Hence, it is as unnecessary as gluttony, and must be wasteful of vitality, even though rendered necessary under some circ.u.mstances. 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 the vital fluid 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 certain of the tissues.

Eminent Testimony.--An eminent English physician, Dr. Milton, who has treated many thousands of cases of this disease, remarks in a work 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 a.s.sessed 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 s.e.xual 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; erection does not take 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 circ.u.mstances 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 s.e.xual 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 true, however, as has been claimed by some writers, one at least, that they are never seminal, as we have proved by repeated microscopic examinations.

Cause of Diurnal Emissions.--The causes of these discharges are spasmodic action of the muscles involved in e.j.a.c.u.l.a.t.i.o.n, which is occasioned by local irritation, and pressure upon the seminal vesicles by the distended r.e.c.t.u.m 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 height that blood is discharged with the seminal fluid.

Internal Emissions.--As the disease progresses, external discharges finally cease, in some cases, or partially so, and the individual is encouraged by that circ.u.mstance 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 pa.s.sing back into the bladder and being voided with the urine. An examination of the urine reveals the presence of cloudy matter appearing much like mucus, or a whitish sediment. A microscopic examination shows this matter to be composed largely of zoosperms, which decides its origin.

An Important Caution.--It is necessary, however, to caution the reader not to p.r.o.nounce 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 criticize it intelligently.

By many authors, the term spermatorrhoea is confined entirely to this stage of the disease.

It is said that the forcible interruption of e.j.a.c.u.l.a.t.i.o.n has been the cause of this unfortunate condition in many cases. 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 s.e.xual function, but when such an act becomes impossible. This condition may have been reached even before all of 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, 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 results 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 s.e.m.e.n 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 p.u.b.erty, and also in females, in whom no seminal discharge nor anything a.n.a.logous 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. It is further believed by some eminent physicians that the seminal fluid is of great use in the body for building up and replenishing certain tissues, especially those of the nerves and brain, being absorbed after secretion. Though this view is not coincided in by all physiologists, it seems to be supported by the following facts:--

1. The composition of the nerves and that of spermatozoa is nearly identical.

2. Men from whom the testes have been removed before p.u.b.erty, as in the case of eunuchs, are never fully developed as they would otherwise have been.

The nervous shock accompanying the exercise of the s.e.xual 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.