Masturbation.—Under this caption will I proceed with the topic of self-abuse; as this term more properly covers the vice of both sexes, as well as of childhood.

The small boy, only four years of age, will often titilate his genitals until the prepuce has become inflamed and swollen. In this undeveloped and delicate condition of the genitalia, more harm may be accomplished than could be imagined. Nurse-girls, sometimes, for the purpose of quieting a child, will titilate its genital organs; which is quite sufficient to lead the child to manipulate its own organs as it goes on in age and development. Often a feeble state of health in the child, will cause the mother to consult a physician; and the genitalia will show signs of irritation; and when the true nature of the difficulty is revealed to the mother, it will be much to her surprise, and often, disgust; and she will not be convinced beyond a doubt until by constantly watching, she has observed actions more convincing than the doctor’s hints.

Boys at school teach each other to perform this manual pollution; and vile servants initiate small boys at a surprisingly early period. I have often gained the confidence of these little ones, and learned things more astounding than amusing. Not long since a boy only eight years of age convinced me, by his confidential description of his little vice, that he realized passion, erection, and as he called it the “goodie feeling” (orgasm); which was evidently the sensation without emission of semen. No small amount of injury is done to the nervous system by the constant titilation of the undeveloped genitalia; and as the habit passes on to the puberty-stage of adolescence, the novelty of the first ejaculation affords great and frequent amusement to the child, and he pursues it as often as he can obtain an obscure corner. This must be the time that the greatest harm is wrought upon the brain and spinal cord. The first five years succeeding puberty, the vice is carried on with great energy in a vigorous youth. Doubtless, the majority of boys have practiced masturbation, to some extent, some time during adolescence, but as they arrive at the age of discretion, become disgusted; or some influential person frightens them, and they quit the practice. Where it has only been an occasional indulgence, no lasting injury has occurred.

Masturbation is practiced among men, not so much to the injury of their physical structure, but it is nevertheless a common vice. Miserly bachelors, hermits, and often widowers resort to self-pollution when financial affairs prevent their visiting houses of ill fame. I am credibly informed that the vice of self-pollution, by the hand, prevails largely among soldiers, as well as in convents, and public schools.

Pollution Among Females.—This is less common in childhood than in the male. Small girls are naturally more modest than small boys: they will not so readily fall into such vices, as they do not readily submit to having their genital organs manipulated; they therefore remain comparatively free until puberty, and often later; and then the habit is not common, but occasionally exists. With the limited opportunities for finding out such things, it will undoubtedly be long before an estimate, as to the extent that it prevails, can be made. I cannot better continue this subject, than by giving a case which is typical of many adult cases that I have observed in this peculiar and delicate role of physician; and it is not a “cooked” case, but one in actual life, which cannot be fully portrayed by type or word:

Mrs. X. visited me professionally; aged 28; mother of three children; been married nine years; spare, dark hair and eyes, rather brilliant; small of stature; retiring and confiding of disposition. She was very neurasthenic and excitable; never hysterical; bowels constipated. I prescribed all kinds of treatment for her during the first six weeks, after which time, as I had failed to find out anything that might be a cause for such a peculiar nervousness, I suggested an examination per vaginam. As soon as my finger reached the orifice of the vagina, I was convinced that my case was a sexual one, as a nervous, passionate shiver ran over her; but she soon controlled herself, and I proceeded with my examination, with the discovery of only slight general irritation. She then gave me the following account of her married life and condition. She was married at nineteen, a robust, vigorous girl. Her husband was amorous and ignorant of her requirements; would soon satisfy his desires and go to sleep, when she had but just become excited; but when her erotic excitement was aroused she had no control of it: would remain wakeful during the entire night, with the husband sleeping, regardless of her condition. She finally learned to use a clothes-pin, by which means she could appease her burning and bring about an orgasm. She says that she could then sleep. She of late had consented to the advancements of a prominent lawyer; but she was conscience-stricken and desired, if possible, to be a “good woman;” but was satisfied that, to be a virtuous woman, she must remain away from her husband, so that her passion never would be beyond her control. I immediately, after her departure, sent for the husband, and informed him how to perform the marital connection, and that, if he desired that his wife should become a well woman, he must adhere to my instructions. He was glad of the information, and was successful in his efforts. She was soon free from her troublesome neurasthenia, and beatitude prevails to this day; and, I believe, she is as virtuous and worthy a woman as a man deserves.

Women use tallow candles, clothes-pins, and other commodious means, such as friction over the pubes, titilations of the clitoris, etc., for the purpose of exciting erotic energy and sexual orgasm. The nervous excitement which is wrought, is not unlike shock, from general causes; yet, when frequently brought about, may produce an over-stimulation, followed by relaxation and general weakness of the nervous system, or a neurasthenia, advancing to hysteria and organic disease of the nervous system. Various devices have been resorted to to overcome the habit of masturbation. Such things may be of service in children, but in adults moral treatment alone is of any value; and as to any appliances and devices I have nothing new to offer. The old means of blistering, tying the hands, etc., may be resorted to with children, by those who have confidence in their efficacy. In adults, matrimony will often do good, when the habit is in its incipiency; but in an advanced stage it is of little benefit.

The great variety of unnatural ways of gratifying the sexual passion is only an evidence of human depravity; and the entailed diseases must be unreservedly studied, that, as much as possible, these abominable conditions may be confined within a certain limit, which should be legally set apart and licensed, that the chaste and elevated portions of society may find protection.

These conditions all exist: there is no remedy to abort or expunge them; and the numerous diseases, growing out of this great depravity and mismanagement of the sexual, must all be duly considered, by the medical man, as predisposing and exciting causes of neurine maladies. To prevent the spread of disease, should be the chief aim of every humane citizen, and more especially the physician. Much is said in regard to means and legislation to prohibit the spread of venereal disease; but the nervous diseases caused by sexual debauch and mismanagement are of equal importance and as devastating to the race.If we can give credence to what Dr. S. W. Gross says, in the May number, 1877, Medical and Surgical Reporter, of Philadelphia, masturbation has, in his cases, caused fifteen out of nineteen cases of urethral stricture, while four were caused by gonorrhoea. I am not aware of any such proportions reported by any other authority, yet I am thoroughly convinced that masturbation has existed in a great majority of cases of urethral stricture, and in many such cases has been a cause, primarily or secondarily. It is not far from true to say, that a large proportion of masturbators, of advanced age, have a general contraction of the entire urethral canal and a diminished dilatability. Purulent discharges and abscesses are not uncommon along the course of the urethra and prostate gland, followed by folicular disintegration and perforation.

The Effect of Sexual Excesses upon the Neural Axis as a Cause of Organic Disease.—“Sexual excesses and Onanism are certainly of no slight significance, at least in the development of a predisposition to tabes.” (Erb.) Again, in speaking of causes in general of spinal disease, the same author says: (P. 147, Ziemssen’s Cyclopoedia, vol. XIII.)