RC cc ccccgre 1 v : - ^fefijHL C< c c c c ■- ^=- ^ ^-~ i - c » f r O^E : ■ «C PHILADELPHIA 1860. This book will be sent any distance by mail, free of Postage, by Dr. N. B. Liipt, for Twenty -five, Cents; or, six copies for One Dollar, 2 DIPLOMA J, ©-g fc fc A O »— i O o a PS H H GO P-i m -c ©s r ^o T3 <* 3 <* © £ • *> © «« © .C -2 r- ij .-I BD S w .5 ^03* "ft- © Cu — © a S-l >©^c«q g>^« T3 i: <« £ S .© k f m a - © S a 03 §.«mS - ©-d S a *> 9 a - cs £ a>03-| * o O to -%* oa a CS 3 g 3 O 45 - 2 s a ° £' *» a o. . 5 © L) "S 04 ^ § fctto .££*£ o ~ fa ffi 2 g ©--5 ^ © g-ol 03 _ <= p>- ^■r. S O g " — ^ s* -♦— © a: ~ ■a Pm r* c -g o < .2 g • 3 »8 § a s © g q S •*■ ri ** a ja cs jtj BAM ■ o S J ^ "< . » I £ O « < ?~\\\\\\ 5 9 o^ "~.a ^-^ ° t«Afl g? 5 © »T -03 *^ J ooflO mow 03 bO a © © 03 HShJ ^ S S S 3 ^ g m »J h5 i-3 S § » j 3 s s INDEX Explanation of terms and words Page 4 Special remarks ; to single and married 5 Preface; unusually important 7 Special references; to Females, single and married 14 To all readers; secrecy, confidence, fees, etc 15 Letters of inquiry ; how answered, etc 19 Special references; to Males, single and married 25 Spermatorrhea ; Self-abuse — Onanism — Masturbation — Pol- lutions — Involuntary Emissions — their history and pro- gress — causes and effects— hints to Parents — regrets, misery and unhappiness — seduction — caution against marriage... 26-59 Venereal excesses; morbid desires, vanity, etc 59 Seminal emissions; causes and effects 63-69 Spermatorrhea; treatment and advice 69-77 Improper indulgences, among Females 77 Impotency; causes, effects, and advice 79-85 Blenorrhagia — Balanitis — Leucorrhea, or " the "Whites" — villany of Quacks — suspicion, crimination and recrimi- nation—reconciliation — treatment, etc 85-99 Gonorrhea ('• Clap") in the male; symptoms and treatment. 99-112 Quack (Self-styled Doctors), their victims 104, 105 Dr. N. B. Leidy's Specifics; for Gonorrhea . 106 Quack receipts; for Gonorrhoea, caution and danger 107-111 Mercury — Injections— Bougies— bad effects of Ill, 112 Chordee— Phymosis — Paraphymosis— Vegetations— Warts- Excrescences, and their treatment 112-115 Swelled testicles or Orchitis, Varicocele, and treatment... 115-118 Stricture — Gleet— Dr. N. B. Leidy's peculiar treatment 118-127 Gonorrhea in the Female, and treatment — distinguished from Leucorrhcea, or u the Whites," and other discharges. 127-135 Syphilis ( <; Pox"), in all stages, in male and female, and treat- ment \ 135-167 Chancre; primary, its progress and treatment 140 Chancres ; Indurated — Phagadenic — Serpiginous or creep- ing — Gangrenous — Urethral or concealed 144-147 Chancres; in the female 147-149 Buboes; in male and female. 149-152 Herpes preputialis - Itching of the genitals, etc 167-173 Menstruation ; its absence, irregularity, painful, scanty or profuse, decline or change of life, etc. 173-185 Young Females; drugged for Amenorrhoea 176 Female Irregularities; consult Dr. N. B. Leidy 180 Leucorrhea (the ''Whites"); causes, effects and treatment. 185-189 Delicate subjects for Single and Married. , 189 Information desired when first writing 190 Complexion purifier— Tonic and Stimulant 190 Monthly crystalline medicine for Females 191 Restorer and In vigor ator— Syphilitic medicines 192 (3) WORDS AND TERMS EXPLAINED, THAT MANY MAY NOT BE FAMILIAR WITH, AND IN THE MOST SIMPLE MANNER" TO BE MADE IN- TELLIGIBLE. Abrasion; a chafing or rubbing off the surface. Anus ; lower opening of the rectum for escape of faeces. Caries; diseased or mortified condition of bone. Corona glandis ; posterior ridge of the head of the penis. Continence ; total abstinence from sexual intercourse. Diaphoresis; perspiration or sweating. Diaphoretics ; medicines producing perspiration. Dysuria ; difficulty, heat and pain, voiding urine. Ejaculation ; the act of throwing out semen. Eruptions ; a breaking out of sores. Erosions ; sores eating and destroying vital parts. Escharotics ; caustic medicines or applications. Excoriations; superficial destructive sores. Fjeces; excrement or refuse from stomach and bowels. Fundus ; fundament or lower extremity of the rectum. Gangrene ; incipient mortification. Generative; the power of propagation. Genitals; the organs of generation. Glans-penis ; as understood, head of the penis. Hematuria ; voiding bloody urine. Ichorous; thin and watery (applied to humors). Labia; lips or folds of membranes, as applicable to the external female genitals, the pudendum, vulva, etc. Maturity ; of full age when applied to years. Marasm : a wasting away of animal substance. Meatus ; mouth or opening to whatever applied. Micturition; the act of voiding urine. Narcotics ; medicines producing sleep. Necrosis ; dry, gradual mortification of a part. Nodes ; swelling of the periosteum, bones and joints. Os-uteri ; mouth of the womb. Palpitation ; fluttering or beating, as of the heart at times. Perineum ; space between the genitals and anus. Periosteum ; thin membranous covering of the bones. Pledgets ; pieces of linen, lint, or soft rags. Prepuce; loose membrane or covering of the glans-penis. Puberty ; average age or period, capable of propagating. Rectum; lower portion of the large intestines. Scrotum; membranous bag, containing the testicles, etc. Sloughing ; separation of diseased parts. Suppuration; the generation of matter or pus. Tampon; a folded piece of soft linen or muslin. Urethra; canal or passage leading to the bladder. Vagina; passage to the Uterus or womb. Virus; an unhealthy or contagious matter. Vulva : external membranous folds of female genitals. (4) TO THE SINGLE AND MARRIED ! SPECIAL REMARKS FOR THOSE WHO WILL UNDERSTAND. " It is time to burst through the veil of that artificial bashfulness, which has injured the growth, while it has affected the features of genuine purity. Society has suffered enough from that spurious modesty which lets fearful forms of vice swell to a rank luxuriance, father than point at their existence — which coyly turns away its head from the wounds and putrefying sores, that are eating into our system, because it would have to blush at the exposure."— Quarterly Revieiv, 1846. "Truth must ultimately vanquish error, and vindicate its divine origin. There is no truth relating to this life only, so important as that which teaches the means of securing a sound mind in a sound body." Some perhaps in reading the following, may think the remarks rather severe, — but many must feel their force, conscious of their correctness, and feel rebuked for their neglect of others, and for which they, themselves would have censured— aye, cursed those, hav- ing had them in minority, under their care, for neglect, had they been similarly afflicted, from similar causes. There is a culpable neglect, whether through real, false, or as- sumed modesty, or diffidence among physicians, fathers, mothers, guardians, etc., in not directing more particular attention to the changed and unhealthy appearance or conditions of youth of either sex* and in not endeavoring to ascertain the cause; and after finding it out, are doubly censurable, if not taking prompt measures to avert consequences already existing, or which will most certainly ensue. What must be the feelings of parents who see in their sons or daughters a gradual, unmistakeable decline in early age, and not heeding it? — becoming in after years imbecile or idiotic, — destitute of the natural attributes of their sex, — indifferent to society, or aught else, — inanimate, sluggish, solitary and lonely in their ways, — complexions sallow or pale, with wild and sunken eyes, and of ghastly look or appearance, — mere shadows of a human being, — life to themselves a burthen, — objects of pity to all, and sooner or later either become inmates of a lunatic asylum, or commit suicide, unless 1* (5) SPECIAL REMARKS. sooner relieved of their miserable conditions through premature death. After which, follows the shame, mortification, regret, sorrow and remorse o f conscience, of parents for their neglect in thus being instrumental in the sacrifice, perhaps of an only son or daughter. Though others may be censured, having youths under their care, yet not possessing the same paternal feelings for the offspring of others, as much watchfulness on their part is not generally expected. Parents having children of their own ; or others having youths of either sex under their care, say ten years of age and upwards; should furnish this book to them, or place it in their way ; — that, by learning soon as possible the serious consequences of improper habits or associations, they may be timely warned against them; or if guilty, they may be deterred from their continuance. There are numerous ailments and conditions to which either sex is liable, treated of in this book, of which they should have some knowledge, and is but proper and right they should know in advancing to ma- turity, and particularly after, when contemplating matrimony. There is nothing in this small work that can be objectionable; — except to the over fastidious or falsely modest and ignorant, presum- ing much upon their own superabundance of profound and assumed wisdom, discerning judgment, and discriminating sense of delicacy and indelicacy. There are a few subjects that at first may seem a little indelicate, but I would ask, — will not a knowledge of them, and of the serious consequences resulting, cause thousands of both sexes, at all ages, single and married, to be cautious, careful and prudent in their habits, indulgences, and associations, and avoid temptation and danger? If so, and a healthful and moral influence is produced, — who can say, notwithstanding the seeming indelicacy, they are ob- jectionable? How important too will be, information on some subjects in this book, to many, leading to happy results, both before and after mar- riage; when under peculiar circumstances otherwise, the most mis- chievous and serious consequences may have occurred. There are daily and nightly (particularly in large cities or towns) sights exhibited in windows of fashionable stores; and at other places, scenes or representations witnessed by all classes, at all ages, and of both sexes, for the gratification of whose morbid tastes " tens of thou- sands of dollars" are annually expended ; of pernicious tendencies, certainly no moral good or healthful influence; — whilst many of those same persons will, perhaps, condemn " this little book, costing but twenty-five cents," that may save the life of a human being; — relieve doubt, anxiety and suffering,— -promote health,— the mediator between husband and wife, — the harbinger or messenger of peace and happiness, of inestimable and priceless value. PREFACE. Too often is the preface of a work overlooked as unimportant, and not read. The preface to this, however, is deemed of some importance, and, it is to be hoped, will be read by every one. This work, though small, is more comprehen- sive and intelligible, and embraces much more, that is really useful on certain subjects, than is contained in any other work of similar extent, and even in many that are more voluminous and expensive. The language is such that all who can read, and are possessed of an ordinary Eng- lish education, cannot fail to understand ; so that there will be few, it is hoped, who cannot avail themselves of all the benefit or good in- tended to be accomplished by it. Though it may not be considered strictly pro- fessional throughout, nor partakes of that style which members of the Medical Profession look for, the writer would remark, . the work is in- tended in as brief manner as possible, to be made intelligible to all; particularly li the rest of (?) 8 PREFACE. mankind" (apart from the profession), thousands of whom, but for this mode of imparting infor- mation, for various reasons, would never seek Professional aid or advice, but would remain in their ignorance, allowing their sufferings to con- tinue and increase ; and, linger out a longer or shorter period of misery and wretchedness, until relieved by Death. Upwards of twenty-seven years have I been en- gaged in the treatment of the consequences of various habits and abuses, as well as certain special diseases and conditions incident to both sexes at all ages, in hospital and private prac- tice ; and in that time I have had opportunities of ascertaining much in regard to their nature, causes, and character, and from observation and experience learned the most desirable and effec- tual modes of treatment and cure. To a certain extent I am willing to impart the result of my observations and experience to others, besides adding such information as may be useful. It cannot be reasonably expected in so small a volume as this, that minutiae in all that relates to the various diseases or conditions treated of in it, their history, pathology, &c, can be fully entered into or given. PREFACE. 9 It is intended, however, to impart such know- ledge, information, and advice, as may enable many to cure themselves, or accomplish as much as may be possible by one's self, and be relieved to a certain extent. Yet after all that may be said or written, many will be unable, through want of ability or confidence, or through fear of committing some unfortunate error, to under- take the treatment of their own cases ; or cannot, if inclined, because unable to procure such medi- cines or preparations at or near their homes, as may be required or prescribed. There are very many who suffer much and long from various causes, and through diffidence or modesty, fear or shame, add to their suffer- ings, by ignorance of the danger or consequences of certain diseases or habits, and neglecting to seek relief until their situations become distressing and alarming. It is truly deplorable how many youth, of both sexes, hesitate and neglect to seek proper aid or Medical advice early, or so soon as they dis- cover the existence of any symptoms indicating disease, loss of vigor, declining health or strength ; and, when forced or obliged to do so, they often become the victims of Foreign and Native Quacks 10 PREFACE. or Impostors, promising early and prompt relief, and are robbed and deceived by them ; or they are induced to try the numerous Quack nostrums, so boastingly and disgustingly published and puffed in various ways ; but after employing or taking one and another without the expected and promised benefit or cure, they find themselves even in a worse condition than in the beginning, con- stitutionally injured, &c. ; at last to be restored only through the care and advice of some com- petent Physician. The young and timid girl hesitates or fears to, communicate to either of her parents what she suffers, until, after lapse of time, her appearance and declining health attracts attention — but it is ofttimes discovered too late, and instead of en- tering Womanhood in health, possessing vigor and the attributes of Nature, she becomes the almost constant patient of some Medical ad- viser, or is induced to experiment with various preparations recommended by her friends, or Nostrums of Quacks or Empirics, in the vain hope of being restored, until, alas, after years of terrible suffering, and mental agony and anxiety, an early grave ends her career. Very many of both sexes enter into matrimony PREFACE. . 11 with bright prospects, hopes and anticipations of happiness.; but, sooner or later, they are over- whelmed with mortification and misery at dis- covering their gradually declining physical ener- gies or abilities, under circumstances not easily averted or changed. Too often one or another, conscious of defects, or conditions existing which should forbid matrimony at the time, yet unad- visedly enter into it-; after which their condi- tions becoming daily more apparent and mani- fest, they are made miserable and unhappy, and their partners innocently made to suffer also. Youth, as well as the more advanced and aged, single and married, frequently depend too much upon their own judgment in accomplishing cures of certain diseases, &c, that they cannot effect ; although possessed perhaps of much judg- ment in various matters, or information on cer- tain subjects, they should remember they do not know all that pertains to the character, nature, and cure of certain diseases, but often trifle with and injure themselves, adding much to their sufferings, thereby prolonging their recovery even with competent Medical skill. In certain dis- eases, after their primary stages or conditions, it would not be advisable for persons to attempt 12 • PREFACE. treatment of their own cases; where of such nature and character as generally require the result of observation, experience, and skill to cure. To tamper with them would only be to endanger general health and perhaps life. Whilst most respectable, intelligent, and skil- ful Physicians throughout the Union are engaged in general practice, treating all manner or classes of diseases among families, whether in cities, towns, or country, within a circuit of many miles, it is evident they must have a much smaller pro- portion of practice in any special class, than one who for more than twenty-seven years has been known far and near as devoting himself exclusively to the treatment of diseases embraced in such class. From directing my whole atten- tion to such as are made the subject of this work, therefore, together with my observations and experience in many thousand cases for many years, I trust I may, without presumption, claim some precedence. I might fill volumes with the history and character of cases cured by me, but, it is well known, no one peculiarly afflicted or diseased would permit his or her case, either with name, initials, or residence to be published ; and, with- PREFACE. 13 out which, they would be generally thought false and untrue, as are those published by Quacks and Impostors to force belief if possible of their abilities, that they may the more easily impose upon the unthinking, unsuspecting, and too credulous sufferers. The medicines prescribed or directed by me in this book, are mostly of such a character as can be obtained from apothecaries ; except a few which I prepare myself, to be the more certain of their efficacy, and because, as pre- pared by others, they are frequently impure and adulterated, and cannot be relied upon ; besides, several articles employed so successfully by me, I am obliged to import from the East Indies, and are not to be had elsewhere. To avoid mistakes an exact copy should always be made from the book, of the prescription in- tended to be employed, or the printed prescrip- tion be shown the Apothecary. Memory should not be depended upon, as the mistaking of names of medicines may produce mischief; or the quan- tities of several to be compounded together, wrongly proportioned, may change the desired effect entirely. Notwithstanding a few sections of what is so- 2 14 PREFACE. called the " Preface" may be thought by some not in place, nevertheless I have deemed it a fitting place for them, and as the book is in- tended for the good and benefit of its readers, particularly the afflicted and unfortunate, a formal arrangement of some portions is con- sidered unnecessary, and not observed. K B. LEIDY, M. D. SPECIAL REFERENCES FOR FEMALES, SINGLE AND MARRIED. i oung Ladies' suffering and distress, through modesty, fear, and neglect Page 9, 10, 11 Confidence and Secrecy , 15 Mothers, guardians, etc., of young Misses.... 18 Single females contemplating marriage 23, 59 Females, insane from certain causes 33, 34 Mothers, watch your child-nurses 41, 70 No right to sacrifice young girls, or others, in marriage, as a remedy for man 75, 76 To all females, particularly in youth 77, 78, 79 Invaluable information, for single and married, promoting health and happiness of parties. 85 to 99 Domestic trouble, and suspicion avoided 133, 134 Causes of distress and annoyance to females ... 167, 169 Females imposed upon through fraud 179 Of special importance to all females 185 to 189 Peculiar delicate subjects 189 How to remove blotches, etc., from face and neck 190 How to prevent irregularities, etc ... 191 Invigorating medicine 192 TO ALL READERS You are earnestly requested to read the fol- lowing sections carefully ; they will sufficiently explain themselves, as adapted to one and an- other reading; them. All persons Male or Female, young or old, single or married, whether applying to Dr. N. B. Leidy personally, at his private Office, or addressing him by Letter, can rely upon strict confidence and secrecy ; and be the situation of any one what it may, to betray or expose a patient, or any one confiding his or her case with him, would be for him to violate obligations of Institutions to which he is attached, sacred as Holy Writ. Letters, and Packages of Medicine sent by Mail, or forwarded by Express or otherwise, never have any outside imprint or mark, whereby others may know from whence they came or by whom sent. Persons not wishing to be known themselves, or not desiring to address communi- (15) 16 TO ALL READERS. cations in their own names to Dr. Leidy, can address him by any assumed name or initials, and Letters or Packages will be addressed, marked and forwarded as directed. Address all Letters, DR. K B. LEIDY, No 243 North Sixth St., above Race. Philadelphia. Or Box No. 1374, Post Office, Philadelphia. There is much trouble and time con- sumed in answering Letters ; in order to observe inviolable secrecy, an assistant cannot be em- ployed to answer them, neither to give advice, prescribe for, or treat patients — but all must be done by Dr. Leidy himself. Hence, the first Letter from any one addressed him should con- tain a reasonable fee. The writer may use his own discretion as to the amount ; be what it may, he can religiously and honourably rely upon receiving its full value or equivalent there- for, in information, advice, medicine, &c. There are but few who cannot form a nearly correct idea as to what a reasonable fee TO ALL READERS. 17 is, in consideration of the benefit or importance of the information desired ; or, if desiring advice and medicine, judging of the character, nature, extent and duration, whether of short or long standing, of his or her disease or situation, how- ever bad or hopeless ; or whether having been already unsuccessfully treated by others ; or re- sisted usual remedies, &c. , &c. All who sincerely require information, advice, or treatment, are willing to pay for it, and always enclose a fee. Those who think the time and trouble of corres- pondence is but of little moment, or who from idle curiosity address Dr. Leidy, and think his time is theirs, and expect it to be devoted gratuitously to them, cannot expect their Letters to be answered. Thousands have been hereto- fore received, of such character, and destroyed without being answered. Time and trouble of answering Letters, when for others' benefit, should always be paid for, as well as Time em- ployed in manual labor, or for other services. No certificates, names of individuals, or correspondence of patients, are ever published by Dr. Leidy ; hence there need be no fear of ex. posure; but all Letters, &c, are destroyed w T hen 2* 18 TO ALL READERS. no longer necessary for reference during the treatment of a case; or, if specially requested, they will be returned. It will be an act of humanity, if the reader of this book, after having perused it, and having no further use for it, will envelop it in a private manner, and address, or forward it, to some friend or acquaintance who may be known or suspected of being afflicted in some delicate way, and who, through its medium, may be in- duced to seek relief and be restored. Parents, Guardians, Teachers, and all others having charge and care of youth, are re- quested to read this small book themselves ; then judge if it be not a proper one for youth of both sexes. It contains no disgusting pictures or obscene language, that can render it objection- able to being introduced into any family. It will be instrumental in warning thousands of youth and others against evils which might otherwise befall them, and rescue thousands who have already fallen, from a degraded condition, miserable existence, and premature death. LETTERS OF INQUIRY. Numerous Letters of inquiry are sent me by the afflicted and unfortunate of both sexes, in relation to treatment of special, private, delicate, and secret diseases, or situations of a peculiar character, asking various questions, as — Can you relieve me ? Can you cure me ? Is my case curable ? How long will it take ? Can medicine be taken without detection or dis- covery ? Do you employ or give Mercury ? Can you send Medicines by mail or otherwise ? What are your terms or charges ? &c, &c. To answer all in writing (as several thousand are received annually) would be impossible, being obliged to answer all myself because of privacy and secrecy ; I therefore send a printed sheet in reply, (enveloped letter form) of which the fol- lowing is part copy. Giving it place here will render it unnecessary for the readers of it to ad- dress me on the same points ; which will no doubt be satisfactory, and enable all to determine their course. (19) 20 LETTERS OF INQUIRY. Respected I feel sufficient confidence in my own ability and capacity, to say : if I cannot cure you I believe no one else can. I believe there are few cases, however bad, long standing, or that have baffled the skill of others, that are incurable, under proper treatment, if time and opportunity be allowed, with equal care and at- tention on the part of patients. Doctors can only advise, prescribe, or furnish medicine and means of cure, whilst it requires patients to ob- serve the advice, follow instructions, &c. No Physician is superhuman, or can accom- plish a cure in a specific or given time, regard- less of adverse circumstances, Nature's opera- tions, the Divine will, &c. I do assert, however, most positively, that I believe I can cure in as short a space of time as any other, and less than most others ; but no one can be honest in naming a positive fixed time of cure in any case. Never- theless, there are Foreign and Native Quacks and Impostors, having neither reputation or character to lose, without education, skill, or capacity, regardless of all circumstances or con- sequences resulting from wrong treatment, or delay and loss of time to patients, who will pro- LETTERS OF INQUIRY. 21 mise or guaranty to accomplish or cure anything in a few hours, days or weeks, to secure and obtain a fee ; even uftder forfeits (they cannot be made to pay) irrecoverable, and which they know patients would not expose themselves to recover if they could. The fee once obtained, they care not if hours become days, days length- ened into weeks, weeks into months or years — in fact, having extorted and obtained all that is likely to, or can, be obtained from their patients, regardless of their condition, they are abandoned to seek relief elsewhere ; which can only be found, under treatment of a regularly educated, graduated, skilful and experienced Physician. Shuu, therefore, all Quacks and Impostors, if you would not* add to your sufferings ! Shun them if you would not be deceived, robbed and swindled ! Shun them if you value your future happiness! Shun them if you do not wish to be constitutionally injured, and your physical strength and energy affected, or debilitated for life! The choice of a Physician is of the utmost importance, but is difficult, in face of the lying boasts, false pretences and promises, boasted qualifications, and incredible assertions of these 22 LETTERS OP INQUIRY. same Quacks and Impostors ; who, but for the lameness of the Laws in many States, allowing any \t Ignoramus 7 J or " Charlatan" to assume the title of " Doctor," and stick out a " Doctor's Sign" with their own or assumed names,, would be prosecuted or imprisoned for obtaining money under false pretences, and liable to damages for mal-practice and wrong treatment ; increasing the sufferings, and constitutionally injuring, and tampering with the lives of their too credulous and unsuspecting patients. They rely chiefly upon Mercury, in various forms, Pills, Mixtures, Extracts, &c, as "cure alls," or "specifics," in all manner of cases — killing or curing ; the cured are seldom heard of; the dead never, for they are silent in their graves ; their living friends little knowing or suspecting the cause of death. Mercury is not employed by me, and the medicines prescribed or furnished to my patients can be taken without fear or danger from expo- sure to all weather ; without restraint from occu- pation, and in very few cases, indeed, without change in diet, or usual course of living. They are pleasant, agreeable, and easy to take, and without fear of detection by others. They can LETTERS OP INQUIRY. 23 be sent by mail, express, or otherwise, and it is requested that patients will always inform me how they would prefer having them sent. A remittance of any amount, sent by Letter or otherwise, with an explicit description of exist- ing disease or symptoms, will always insure medicine, advice, and instructions to its full value. Should the case of a patient be a bad one, or of a serious nature, or of long standing, the patient will be fully apprized of it, and may be fully assured that, if more remuneration is required, it will be no more than the case will justify ; and may rely upon being honourably and fairly dealt with, and required to pay as reason- ably as can possibly be afforded, and on accom- modating terms. The Single of either sex, whether contempla- ting marriage or not, or the married, if there be anything in their nature, organization, or aught else that may be, or might become, perchance, an impediment to, or interfere with th^ir marital rights, or subject them to exposure should cast off all fear, affectation, or modest/, and consult some competent Physician before His too late. If not convenient to call at my dfice, by writing Letter (enclosing fee), giving a description of 24 LETTERS OF INQUIRY. any one's case or situation, such medicine, ad- vice, or information may be furnished and sent according to directions, as will save much anxiety, exposure, uneasiness, and mortification, or frequently serious consequences, which too often are the lot of many before and after entering into matrimony; and which might have been averted. It may not here be out of place to assert, most positively and without fear of contradiction (ex- cept by a Quack or Impostor, who will say or do anything to carry out a fraudulent object), that I am the only regularly educated graduate Physician of the University of Pennsylvania, of 1833, advertising, and residing in Philadelphia, (for three years previous to graduation, a student of Samuel Jackson, M. D., Professor in said Institution); now more than twenty-five years engaged in Hospital and Private practice, fa treatment of Special Diseases ; and because of my exclusive devotion to their treatment, long experience, ^nd consequent knowledge and ob- servation, acknowledged skill and success, am consulted in critical cases, by the Profession, particularly in Philadelphia, to whom I can proudly refer, and also to Merchants, Hotel LETTERS OF INQUIRY. 25 Proprietors, Publishers, and other citizens, who have known, heard of, and witnessed many re- markable and unexpected cures. Communications confidential. Offices and in- terviews strictly private. Very respectfully yours, etc., N. B. LEIDY, M. D., No. 243 North Sixth St., above Race, Opposite Franklin Square, Philadelphia. SPECIAL REFERENCES FOR MALES, SINGLE AND MARRIED. Youths or young men's suffering and distress, through modesty, fear, and neglect Page 9, 10, 11 Confidence and Secrecy 15 Fathers, guardians, teachers, etc., of youths... 18, 70 Single men contemplating marriage.. 23, 59 Males, insane from certain causes 33, 34 Guilty youths, cautioned and advised 51 Regrets, for past indiscretions, etc 54 Results of man's pride in his virile power 60 Results of fornication and excessive indulgence. 68, 80 Invaluable information, for single and married, promoting health and happiness of parties... 85 to 99 Unjustifiable intercourse during a gleet 122 Causes of distress and annoyance, through dis- ease and insects, etc 167tol73 How to remove pimples and blotches on the face, etc., and stimulate organic powers 190 How to restore and invigorate nature 192 SPERMATORRHEA, AN UNNATURAL FLOW, SOMETIMES EXCESSIVE — LOSS OF SEMEN. Under this head I shall treat of Onanism, Self-abuse, Masturbation, Pollutions, Wet- dreams, and Nocturnal and Diurnal emissions ; first, defining the distinctive meaning of the terms as clearly as possible — though difficult, be- cause so generally employed as almost synony- mous ; in consequence of which they will be pro- miscuously employed — this being unavoidable in treating of Spermatorrhea as the subject head. The word " Spermatorrhea" is derived from the Greek "tfTt^a" (sperma), signifying Semen, and "p" (reo) to flow; by their combination expressive of a discharge or flow of semen — more particularly applied to ejaculations and emis- sions produced in a variety of ways, and by their frequency and excess, resulting in serious local and constitutional effects, which will be hereafter fully described. Lalleraand defines Spermatorrhea to be a very abundant evacuation of Semen, in whatever manner it may take place. By "■ Onanism" is implied the crime or sin of Onan, which will be better understood on refer- (26) SPERMATORRHEA. 2T ence to the 38th chapter of the first book of Moses, called Genesis, more particularly from the 6th to the 10th verses inclusive, as follows : — "And Judah took a wife for Er, his first born, whose name was Tamar. "And Er, Judah 's first born, was wicked in the sight of the Lord ; and the Lord slew him. " And Judah said unto Onan, go in unto thy brother's (Er's) wife, and marry her, and raise up seed to thy brother. " And Onan knew that the seed should not be his, and it came to pass, w r hen he went into his brother's wife, that, he spilled it on the ground, lest that he should give seed to his brother. "And the thing which he did, displeased the Lord, wherefore he slew him also." Thus it would appear the ' ' spilling it on the ground," was the great offence for which Onan was slain. Any further construction of the terms is left to the reader. Onanism is, how- ever, generally understood (though I consider erroneously) as synonymous with self-abuse and Masturbation, and hence the term "Onanism" has arisen, significant of the act. " Self-abuse" is a term not much employed by writers, but is in common use throughout the community ; and by it, is more clearly, and forcibly understood the act to which it is applied ; namely, the abuse of one's self, in producing 28 SPERMATORRHEA. ejaculation and seminal emissions by unnatural means, manual manoeuvres or manipulations, titillation, friction, &c, &c. " Masturbation, " by some writers, is applied to ejaculations or emissions, produced also by unnatural means ; but, by others, synonymous with Self-abuse, with reference to certain acts, and indulgence in unnatural modes, whereby ejaculations and emissions are forcibly produced. By V Pollutions" has been formerly understood emissions produced through manual manoeuvres, and also as applicable to such only — but it is now more generally understood to apply to all emis- sions occurring from whatever cause, during day or night, excited by Abuse, Yenereal excesses, Erotic dreams, Lascivious thoughts, immoral pictures, toying with females, Spermatic ple- thora, irritating causes, &c, &c, with and with- out erection. Pollutions, or otherwise Self-pol- lutions, is also much employed as synonymous with (though improperly) Self-abuse and Mas- turbation. V Wet-dreams" apply more particularly to pol- lutions or emissions occurring through dreams, lascivious, erotic, &c, during sleep. " Nocturnal emissions" signify those occurring at night, and " Diurnal emissions" those occur- ring during the day. SPERMATORRHEA. 29 CAUSES, EFFECTS, AND CONSEQUENCES OF SPERMATORRHEA. Self-abuse, Masturbation, Onanism, and, I may add, Self-pollution, being considered and employed as identical, are among the most prominent and leading causes (though there are others which will also be noticed) of Sperma- torrhea, Seminal emissions, Impotency, &c. ; the consequences and effects of which are not confined to any particular class in society, age or condition ; but affect the virtuous and licentious, the robust, healthy, and strong, as well as the sickly and debilitated. Thousands who suffer are unsuspected, and it is believed more evils are produced through them than all diseases com- mon to mankind combined. The vigor of man- hood is destroyed, and all the natural, physical, and mental powers are more or less impaired, even incapacitated thereby. Seminal Emissions occurring among persons in a healthy condition, because of nature forming, supplying, and secreting a superabundance, (also inducing Spermatorrhea), has the effect of pro- ducing peculiar sensations of a stimulating and exciting character, attended with, and creating strong desires for its escape. Unless relieved by sexual indulgence, nature will relieve herself, and being followed with pleasurable feelings, 3* 30 SPERMATORRHEA. frequently induces in man the unnatural habit of Self-abuse or Masturbation, and if uninitiated as to any particular mode, he will be sure to resort to some method peculiarly his own to effect a repe- tition of those feelings. But, woe to that man ! the initiatory step taken he may find it difficult to retract. Wretchedness, misery, and a pre- mature death is often the result. Let man be warned against thus indulging, and not give way to artificial excitement. Rather, much rather take the chances of marriage under any circum- stances, or consult some competent Medical adviser, before too great frequency of emissions occur. Seminal Emissions, long continued, from what- ever cause, by their frequency exhaust man r s vigour, and much impair his Nervous and vital energy. Such losses produce general prostra- tion of the system, and symptoms similar to a variety of diseases ; namely, of the Heart, Liver,- Stomach, Rectum, Kidneys, Bladder, Urethra; the Dyspepsia, Pneumonia, Nervous derange- ment, &c. Many men suffer much and long, not suspecting the real cause of their general ill health, and their Medical advisers being equally unsuspecting, proceed to treat some special con- dition most apparent from the existing symptoms, whilst the leading cause is unknown and over- looked. Thus, man may be temporarily relieved, but becomes the almost constant patient of some, medical adviser. Wretchedness and disease harass him, and premature death takes place, SPERMATORRHEA. 31 without either dreaming of the real or original cause. That Nervous energy, the mental faculties and physical power of man is dependent upon the supply or deficiency of healthful semen, (as of other secretions), and is impaired by its exces- sive losses, and changes to an unhealthy condi- tion through Spermatorrhea, in whatever manner produced, is evident from the fact, that in all cases coming under my notice, as well as that of others, there exists more or less disturbance of all the functions of the system ; the brain particularly, and affecting the memory, vision, hearing, &c. I have not only seen youth, but persons at a middle age, when unaffected by other influences, at a time when man is considered as having arrived at the period of fullest health and vigor, or in the prime of life, rapidly declining, suffer- ing, not only bodily infirmity, but mental imbe- cility, eventually becoming idiotic and insane, in consequence of it. Confirmatory of the same, a few extracts are made from several celebrated foreign medical authors. Boerhaave thus writes : " The loss of too much semen occasions lassitudes, debilities, and ren- ders exercise difficult ; it causes convulsions, emaciation, and pains in the membrane of the brain ; it deadens the senses, particularly the sight; gives rise to dorsal consumption, indo- lence, and various other disorders therewith con- nected. Patients in this disease grow stupid. 32 SPERMATORRHEA. I never perceived such loss of power brought on by any other cause." Lomnius, another ancient author, says, " Fre- quent emissions of Semen, relax, weaken, dry, enervate the body, and produce numerous other evils, as apoplexies, lethargies, epilepsies, tremb- ling, paralysis," &c. From the same cause, says, Tulpius, a physi- cian of Amsterdam, " Not only the Spinal mar- row wastes, but the whole body and mind becomes languid, and the patient perishes in misery." From the loss of semen, says Hoffman, "the patient not only loses strength, becomes ema- ciated and pale, but the memory is impaired, a continual sensation of coldness affects all the extremities, the sight becomes dim, the voice harsh, and the whole body gradually wasted," &c. Kloekof briefly says, "A too great loss of semen weakens all the solid parts/' &c. Next as regards Idiocy and Insanity as re- sulting from Spermatorrhea, more particularly through Self-abuse, Masturbation, and Onan- ism ; in addition to my own observations and knowledge, I will adduce further proofs, based upon high authorities and facts incontrovertible and undeniable. It is a fact generally known among Physicians and those particularly having opportunities of being informed, and of which the public are not apprised, that a considerable portion of the in- mates of Lunatic or Insane Hospitals and Asy- SPERMATORRHEA. 33 lums, are victims of the baleful and destructive influence and effects of Spermatorrhea. Professor Woodward, formerly presiding over the " Insane Retreat," Connecticut, in a report made to the Legislature of that State, remarked, that over two-thirds of the inmates of that insti- tution were brought there from that cause ; and in a Letter says, "For the last four years it has fallen to my lot to witness, examine, and mark the progress of from ten to twenty-five eases daily, who have been the victims of this debasing habit ; and I aver that no cause whatever which operates upon the human system, prostrates all its energies — mental, moral, and physical — to an equal extent. I have seen more cases of idiocy from this cause alone, than from ail the other causes of insanity. If insanity and idiocy do not result, other diseases, immediately and hopelessly fall in its train, or such a degree of imbecility marks its ravages upon body and mind, as to destroy the happiness of life, and make existence itself wretched and miserable in the extreme. " In one of the annual reports of the Massa- chusetts State Lunatic Asylum, it is stated ; of 191 idiots examined, and known to have prac- tised masturbation, 116 were males and 75 fe- males ; in another 139; and in another 145, males and females. In Pennsylvania and other States, reports not being generally made public, I am aware from private information, of as great pro- portion of idiotic and insane from similar causes. 34 SPERMATORRHEA. During a period of three years, of 256 patients admitted into the asylum of Charenton, from Dr. Deslandes' statement, 44 males and 3 females were insane from Masturbation or excessive sexual indulgence ; Dr. Foville reports 334 cases of insanity, 22 men and 9 women, from similar causes ; and Professor Rech states the dispro- portion of the sexes even greater at the Mont- pelier Lunatic Asylum. Drs. Deslandes and Esquirol think that the proportion as is generally reported between male and female is not so great, and that a fair rela- tive proportion cannot be had, because of the objection females mostly have in giving infor- mation, more frequently concealing than males ; and Lallemand writes, " So remarkable and con- stant a difference cannot arise from any acciden- tal cause, for the number of insane females sur- passes that of males, " &c. Extracts from a re- port presented by Dr. G. S. Howe to the Massa- chusetts Senate, in 1848, on the subject of Idiocy, for the benefit of youth and mankind, cannot be too widely published, and we therefore give them place here. " There is another vice, a monster so hideous in mien, so disgusting in feature, altogether so beastly and loathsome, that, in very shame and cowardice, it hides its head by day, and vam- pyre-like, sucks the very life-blood from its victims by night ; and it may perhaps commit more direct ravages upon the strength and rea- SPERMATORRHEA. 35 son of those victims than even intemperance; and that vice is SELF-ABUSE. " One would fain be spared the sickening task of dealing with this disgusting subject ; but, as he who would exterminate the wild beasts that ravage his fields, must not fear to enter their dark and noisome dens, and drag them out of their lair ; so he, who would rid humanity of a pest, must not shrink from dragging it from its hiding-places, to perish in the light of day. If men deified him who delivered Lerna from its hydra, and canonized him who rid Ireland of its serpents, what should they do for one who could extirpate this monster- vice ? What is the ravage of fields, the slaughter of flocks, or even the poison of serpents, compared with that pollution of body and soul, that utter extinction of reason, and that degradation of beings, made in God's image, to a condition which it would be an in- sult to the animals to call beastly, and which is so often the consequence of excessive indulgence in this vice ? " It cannot be that such loathsome wrecks of humanity as men and women, reduced to drivel- ling idocy by this cause, should be permitted to float upon the tide of life, without some useful purpose : and the only one we can conceive, is that of awful beacons to make others avoid, — as they would eschew moral pollution and death, — the course which leads to such ruin. 36 SPERMATORRHEA. if This may seem to be extravagant language, but there can be no exaggeration, for there can be no adequate description even, of the horrible condition to which men and women are reduced by this practice. There are, among those enu- merated in this Report, some who not long ago were considered young gentlemen and ladies, but who are now moping idiots, idiots of the lowest kind ; lost to all reason, — to all moral sense, — to all shame ; idiots who have but one thought, one w r ish, one passion, — and that is, the further indulgence in the habit which has loosed the silver cord even in their early youth, which has already wasted, as, it were, dissolved the fibrous part of their bodies, and utterly extinguished their minds. " In such extreme cases, there is nothing left to appeal to, absolutely less than there is in the dogs and horses, — for they may be acted upon by fear of punishment ; but these poor creatures are beyond all fear and all hope, and they cumber the earth a while, living masses of corruption. f j If only such lost and helpless wretches ex- isted, it would be a duty to cover them charit- ably with the veil of concealment, and hide them from the public eye, as things too hideous to be seen : but, alas ! they are only the most unfor- tunate members of a large class. They have sunk down into the abyss towards which thou- sands are tending. The vice which has shorn these poor creatures of the fairest attributes of humanity is acting upon others, in a less degree SPERMATORRHEA. 3? indeed, but still most injuriously ; enervating the body, weakening the mind, and polluting the soul. 1 ' A knowledge of the extent to which this vice prevails, would astonish and shock many. It is, indeed, a pestilence which walketh in dark- ness, because, while it saps and weakens all the higher qualities of the mind, it so strengthens low cunning and deceit, that the victim goes on in his habit unsuspected, until he is arrested by some one whose practised eye reads his sin in the very means which he takes to conceal it — or until all sense of shame is forever lost in the night of idiocy, with which his day so early closes. " Many a child who confides everything else to a loving parent, conceals this practice in its innermost heart. The sons or daughters who dutifully, conscientiously, and religiously confess themselves to father, mother, or priest, on every other subject, never allude to this. Nay, they strive to cheat and deceive by false appearances ; for, as against this darling sin, — duty, con- science, and religion, are all nothing. They even think to cheat God, or cheat themselves into the belief that He who is of purer eyes than to behold iniquity can still regard their sin with favor. " Many a fond parent looks with wondering anxiety upon the puny frame, the feeble purpose, the fitful humors of a dear child, and, after try- ing all other remedies to restore him to vigor 4 3$ SPERMATORRHEA. of body and vigor of mind, goes journeying about from place to place, hoping to leave the offend- ing cause behind, while the victim hugs the dis- gusting serpent closely to his bosom, and con- ceals it carefully in his vestment. M The evils which this sinful habit works in a direct and positive manner are not so appreci- able, perhaps, as that which it effects in an in- direct and negative way. For one victim which it leads doivn to the depths of idiocy, there are scores and hundreds ivhom it makes shame- faced, languid, irresolute, and inefficient for any high purpose of life. In this way, the evil to individuals and to the community is very great. " It behooves every parent, especially those whose children (of either sex) are obliged to board and sleep with other children, whether in boarding-schools, boarding-houses, or elsewhere, to have a constant and watchful eye over them, with a view to this insidious and pernicious habit. The symptoms of it are easily learned, and, if once seen, should be immediately noticed. "Nothing is more false than the common doctrine of delicacy and reserve in the treat- ment of this habit. All hints, all indirect ad- vice, all attempts to cure it by creating diver- sions, will generally do nothing but increase the cunning with which it is concealed. The way is, to throw aside all reserve; to charge the offence directly home ; to show up its disgusting nature and hideous consequences in glowing SPERMATORRHEA. 39 colors ; to apply the cautery seething hot, and press it in to the very quick, unsparingly and unceasingly. *' Much good has been done, of late years, by the publication of cheap books upon this subject, They should be put into the hands of all youth suspected of the vice. They should be forced to attend to the subject. There should be no squeamishness about it. " There need be no fear of weakening virtue by letting it look upon such hideous deformity as this vice presents. Virtue is not salt or sugar to be softened by such exposure ; but the crystal or diamond that repels all foulness from its sur- face. Acquaintance with such a vice as this, — such acquaintance, that is, as is gained by having it held up before the eyes in all its ugli- ness, can only serve to make it detested and avoided. 11 Were this the place to show the utter fallacy of the notion that harm is done by talking or writing to the young about this vice, it could probably be done by argument, certainly by the relation of pretty extensive experience. This experience has shown that, in ninety-nine cases in a hundred, the existence of the vice was known to the young, but not known in its true de- formity ; and that, in the hundredth, the repul- sive character in which it was first presented, made it certain that no further acquaintance with it would be sought. "In some families which are degraded by 40 SPERMATORRHEA. drunkenness and vice, there is a degree of com- bined ignorance and depravity, which disgraces humanity. It is not wonderful that feeble- minded children are born in such families ; or, being born, that many of them become idiotic. Out of this class domestics are sometimes taken by those in better circumstances, and they make their employers feel the consequences of suffer- ing ignorance and vice to exist in the commu- nity. There are cases recorded in the appendix, where servant-women, who had the charge of little girls, deliberately taught them habits of self-abuse, in order that they might exhaust themselves, and go to sleep quietly ! This has happened in private houses, as well as in the almshouses ; and such little girls have become idiotic. 1 1 The mind instinctively recoils from giving credit to such atrocious guilt ; nevertheless, it is there with all its hideous consequences : and no hiding of our eyes, no wearing of rose-colored spectacles, — nothing but looking at it in its naked deformity, will ever enable men to cure it. There is no cordon sanilaire for vice ; we cannot put it into quarantine, nor shut it up in a hospital ; if we allow its existence in our neigh- borhood, it poisons the very air which our chil- dren breathe. r f. SPERMATORRHEA. 41 MASTURBATION, &C, DURING INFANCY AND PUBERTY — ITS EFFECTS AND CONSEQUENCES. It will scarcely be believed, but it is never- theless true, that Infancy is not free from the dreadful effects of Masturbation and abuse, not by its own hands, but through those of the nurse. Some nurses, aware of, or discovering that the cries and restlessness of infants may be appeased and quieted by handling the genital organs, are in the habit of doing so ;. little sus- pecting, or ignorant of the consequences which sometimes prove fatal from its effects ; or when not, initiating them in a mode by which they of themselves may induce pleasurable sensations afterward. Long before puberty, at three, four, or five years of age, there exists among some children an instinctive attraction toward the opposite sex, which is often observed and laughed at by parents and others, without sus- picion as to their final tendency. Nurses, chambermaids, and others, too often toy with such in innocent amusement as they suppose, little suspecting the encouragement and in- creased desires they are inducing and adding to their already instinctive and precocious feel- ings. More and more sexual impulses are awakened in them, and in their associations with others of both sexes, familiarities occur and in- 4 * 42 SPERMATORRHEA. crease among them, leading to practices followed too often with serious consequences. HINTS TO PARENTS, &C. Watchfulness of children manifesting greater attachment to nurses, or other domestics, than to their own parents, is recommended strongly ; as among them habits are originated as stated in the preceding section. Particularly do they require and claim the attention of Parents, Guardians, &c, when be- coming pale, haggard in looks, losing flesh, irri- table, having occasional spasms and convulsions, falling into marasmus, &c. Too often do those conditions indicate effects from abuse, but are attributed to worms, teething, or other causes. The lives of numerous infants and children might be saved, were parents and even physicians equally suspicious of causes producing such effects. It would lead to proper inquiry, and induce a differ- ent course of treatment, frequently resulting in entire recovery of many instead of death. Several cases have come under my notice, of children with symptoms and appearances as be- fore described, although other causes had been suspected by their parents. Upon questioning the nurses very closely, they confessed, and discovered what had been done to appease the children : by causing these nurses thereafter to desist from the practice, and by suggestions and recommendations to the parents as to watch- SPERMATORRHEA. 43 fulness and proper nourishment, these chil- dren were afterwards restored to healthy con- ditions. Drs. Deslandes, Chaussier, and others, report similar cases, and Professor Halle men- tions them in his Lectures. Professor M. Lallemand, having written much upon the subject of Spermatorrhea, its causes, effects, &c, and, than whom no other author stands pre-eminent, I shall make some quota- tions from his writings, which will not only con- firm what I have already written, but further add to the information of the reader. After detail- ing the history of numerous cases coming under his notice, he says : " I should observe that in all the cases of which I have just spoken, the children were five or six years of age — at most eight — that they did not show signs of puberty for several years afterwards, and that they were not exposed to the influence of bad example. Their sexual ideas were, therefore, spontaneously developed, several years before development of the genital organs. The same precocity is often observed in children of the other sex. " From these facts an important scientific con- clusion may be adduced: viz., that in many children the genital instinct shows itself with much energy many years before the age of puberty. "A no less important practical precaution presents itself: viz., that the age of puberty 44 SPERMATORRHEA. should not be waited for, in order to surround children with prudent circumspection, and to prevent their curiosity from being gratified. ^ * 5}C * >K "The symptoms arising from masturbation in the child, have been always hitherto confounded with those produced in the adult ; they present certain distinctive characters, however, which require our consideration. However young they may be, children lose flesh and become pale, irritable, morose, and passionate ; their sleep is short, disturbed and broken. They fall into a state of marasm, and at length die if not pre- vented from pursuing their courses. Examples of such a termination are so well known that I forbear to quote them. 11 Analogous symptoms are shown in the adult — follow nearly the same course — and may lead to the same termination — but in infancy more or less nervous symptoms are superadded, which are not found in those who have com- menced the practice after puberty, or which at least are not in the latter case manifested to the same extent. Such are spasms, and partial or general convulsions, eclampsia, epilepsy, and paralysis, accompanied with contraction of the limbs ; these phenomena were present in all the children whose cases I have noticed, and numer- ous similar facts have been published by different authors. SPERMATORRHEA. 45 u In childhood, seminal emissions are never experienced, but nevertheless the patients fall into a state of marasin to which some even suc- cumb. These effects, like those observed under the same circumstances in the female, have in- duced some authors to leave out of their con- sideration the seminal discharges which are pro- duced by the same acts at a later period. They have attributed the debility which follows all abundant discharges of semen, to the nervous excitement and convulsive motions which usually accompany the discharge. The accidents ob- served before puberty are evidently only due to the effects on the nervous system, and the same sensation accompanying voluntary emissions after puberty, it is natural to suppose that the nervous system plays as active a part then, as in childhood. "I have already noticed that the symptoms produced by abuses during childhood, present a spasmodic character ; this character without doubt, is derived from the predominance of the nervous system at that period, rendering children so alive to external impressions. This excessive sensibility also explains the great disorder of the economy, which children suffer, from such manoeuvres. ***** " Every excessive loss of semen also, even vvhen unaccompanied by sensation, is followed 46 SPERMATORRHEA. by debility, and this may be carried so far as to cause death. " There exists then two distinct causes ; ner- vous disturbance and debilitating discharges, and both these act at once, when seminal emis- sions are produced by the influence of the will. It is not to be wondered at, that both these causes should produce nearly the same syrup* toms, because they both weaken the economy. The action of the first on the nervous system is direct and immediate, and the symptoms that result from it are of a more spasmodic character. It is very easy to confound these two causes when they act simultaneously ; but I have just shown that they can be considered separately. The following reason shows the importance of so doing. "Whenever we succeed in entirely putting a stop to the habits of abuse in children, we may make sure of obtaining their return to health, and that very quickly. This I have remarked in all the cases of children that have come under my care. I do not mean to infer that the dis- order done to nutrition during the progress of development is easily repaired, but that the acute symptoms rapidly disappear, and that all the functions are quickly re-established. If the effects' produced are active and serious, they cease very rapidly, as soon as the cause is re- moved, and return to health becomes certain. Unfortunately matters do not follow so simple a course after puberty. SPERMATORRHEA, 47 "What I have just said respecting children, applies equally to females ; this is easily shown by examining the cases in which excision of the clitoris has been performed for the cure of nym- phomania. The state of these unfortunates must have been deplorable indeed, to justify the resort to such means ; yet they recovered rapidly. " Why in these two classes of cases, is the cure certain and the return to health rapid, as soon as the vice has been mastered ? It is, that the cause of the weakness immediately ceases to act on the economy." HISTORY, PROGRESS, EFFECTS, &C, OF SELF-ABUSE, MASTURBATION, AND ONAN- ISM, IN SEVERAL THOUSAND CASES. Instead of citing or describing individual cases, I shall give in a condensed manner, the general character, symptoms, evils, and conse- quences of several thousand cases of Spermator- rhea, seminal weakness, and emissions, impo- tency, &c, the result of Self-abuse, Masturba- tion, and other causes, having come under my notice and observation during treatment the past twenty-seven years; many, on personal applica- tion to me, and very many, through correspon- dence, resident throughout the United States, Canada, and adjoining provinces. 48 SPERMATORRHEA. I adopt this mode of introducing the charac- ter of many cases, because of brevity ; certain portions of the histories, progress, effects, &c, being applicable to one another, confirmed by their own representations personally and by let- ter, and because it is believed readers will be the more assured there are no fanciful sketches of the afflicted and unfortunate, as are so often falsely pictured in long certificates or letters, either anonymous, or with initials and assumed names attached, containing misrepresentations and exaggerations beyond credulity or belief; often written and designed by Foreign and Native Quacks, to alarm and frighten, the more easily to impose upon the too credulous, unsus- pecting, and unthinking. Under this head I shall also add some re- marks and comments, which, I trust, may be of some importance and benefit to all who read them. The greater number of patients vary in age, from fifteen to forty years ; the larger proportion between the periods named. They include youths at boarding and other schools, factories, workshops, and places in cities, towns, and coun- try, were they occasionally congregate for amuse- ment, &c. ; others more advanced, students in seminaries and colleges, or more privately en- gaged in professional studies ; overseers, prin- cipals, and teachers, the learned and the igno- rant, the indolent, inactive, wealthy and retired, mostly in celibacy, or without general employ- SPERMATORRHEA. 49 merit of body or mind ; indeed, it would be diffi- cult for me to name any capacity or position, among whom there cannot be numbered more or less, that I have treated for Spermatorrhea and other effects of the pernicious habits before named — not even excepting females at different ages, single and married. Notwithstanding thousands have fallen into destruction, with a full knowledge of as many thousands having fallen before them, yet the known dangerous and dreadful consequences of Self-abuse, &c, seem to be no barrier to many, learned, well informed and apparently possessing the strongest, most exalted, and highest qualifi- cations of mind, from indulging in practices so disgusting and pernicious. Numerous detailed and lengthened accounts have been, and are daily being received by me in letters, as well as statements made me per- sonally at my office, of the origin or commence- ment of the practice of Self-abuse, Masturba- tion, &c. ; the modes instinctive, initiatory, and instructive, employed to gratify their feelings and curiosities ; the effects from the beginning, and progressive- until affecting different functions of the system, to the time of writing or applying to me ; from all which I shall select such por- tions and here give them, as may be deemed of importance and interest to all readers, whether afflicted and unfortunate, or whether free from the "sin of Onan" or other habits, that they may be at least informed, and extend the benefit 5 50 SPERMATORRHEA. of such information to their companions or others, where it may be needed, and be instru- mental perhaps in saving many from much suf- fering, misery, or destruction. Many ascribe their habits of Masturbation and Self-abuse to association while at play with children at or about similar ages, long before puberty, through instinctive ideas and familiari- ties with one another ; others, through lying with brothers or sisters or strange children, and dur- ing wakefulness toying with each others genitals, tending to arouse pleasurable feelings and sensa- tions ; and others through example and persua- sion, even by elder associates, shown, taught, instructed, and initiated in modes and ways, whereby, in their performance, they would expe- rience and taste the delusive, seductive sweets and peculiar emotions, sensations and pleasures to be derived therefrom. (How fatal to thou- sands in the end, though ignorant in the begin- ning of their baleful and destructive influences !) As to the modes and ways employed, I shall not name or describe them. To the precocious and instinc- tive youth, as well as to numerous others, accident some- times reveals them, or they are taught by others ; while some adopt means to gratify their feelings and desires, peculiarly their own, and original. My object is to dis- courage and deter those already guilty of such horrible and sinful acts, and who are hurrying themselves to a disgraceful, wretched, miserable, and premature fatal end, and not to encourage and allure them on. Many thousands are already on that road ; it would be criminal to point out or describe modes to those who know them not; indeed, in doing so, I should consider myself as accessory to their ruin or death. SPERMATORRHEA. 51 Many, referring to the history of their cases, acknowledge having commenced Masturbation several years before puberty, and notwithstand- ing a consciousness of its effects, observing their growing weakness and loss of strength, changed complexion, from healthy to a pale or sallow hue, loss of flesh, weakness of their joints, nerv- ousness, headache, &c, yet could not, though frequently resolved to do so, abandon entirely the practice. Many say they were induced to continue, because of a change, described by com- panions, from puberty to manhood ; when the ejaculation of semen should take place, and the event be hailed with joy and pride, stepping as it were (under a falsely conceived idea) out of childhood into manhood, and that their gratifi- cations and pleasures would then also be much increased ; in consequence of all which they would be stimulated to greater excesses, and consequently do themselves greater injury. Here readers, if guilty, be advised. Stay your sinful career. At the time when ejaculation of semen first occurs, your strongest resolutions and determination to desist is demanded. If you have regard for, or attach any value to your future health and happiness, now is the time to show it. If you value the respect, sympa- thies and feelings of your parents, brothers, or sisters — desist ! If you desire to mingle in the society of friends or strangers %f both sexes without shame or mortifica- tion — desist ! If you ever anticipate entering into matri- mony — desist ! If you desire to participate in rational pleasures of whatsoever kind, and enjoy or appreciate the beauties of nature so lavishly bestowed and displayed 52 SPERMATORRHEA. around you by a kind Providence — desist ! By all that is sacred and dear to you in this world, now, at this critical time or period, should you desist, for there still remains sufficient of reason, nervous and physical force, to do so if you will ; — if you will not, but on the con- trary persist in your course, and without advice or treat- ment, certain destruction must follow. Where involuntary emissions have not occurred, and they do not until after a continuance of abuse for some time after the period above referred to, recovery and restoration is certain. Recovery is not, however, uncer- tain afterward; but is attended with tediousness and longer time in treatment ; and the chances are more or less in proportion to the frequency, quantity, and charac- ter of the discharges, and the natural, physical, nervous, and constitutional power or organization of individuals. But so long as Spermatorrheal discharges continue, the chances are lessened and the patient goes on from worse to worse. Pause, therefore, before 'tis too late — fail not to re- solve at the moment, or soon after ejaculation of semen first occurs, to desist; for there is certainty then. If the warning be unheeded you may involve your future fate in uncertainty. To aid you at this time too, it will be well to observe some general instructions or advice in another portion of this book, or consult some compe- tent and experienced physician. The most diffident and timid may confidentially address Dr. Leidy, and rely upon friendly and honourable advice. Correspondence by mail, or otherwise, can always be managed to avoid the possibility of exposure or the knowledge of any one. JUiP 01 (A reasonable fee must not, however, be for- gotten, to be enclosed when writing; and there are few but are capable of judging to a certain extent as to what is reasonable, when taking into consideration, trouble and time in writing — giving written advice and instruc- tion, furnishing and sending medicines — and consider- ing also their disease, situation, or condition, of short or long standing, &c). SPERMATORRHEA. 53 Continuing with Self-abuse or Masturbation, its progress, effects, &c, many further represent — that after ejaculation of semen occurs, and habits or practices are continued, nocturnal emissions follow, with and without lascivious and erotic dreams ; sometimes once in two or three weeks ; once, twice, and three times a week — sometimes nightly ; and with many they occur irregularly and at long intervals, generally fol- lowed by palpitation of the heart, nervousness, weakness, and low spirits for a day or more after; and, with many, those feelings constant. Others, having an escape of semen before and after urinating, or passing with the urine ; some- times during stools, particularly when straining, through costiveness, hardened faeces, &c. ; some- times taking place unconsciously during night — observed in the morning upon the night clothes or bed linen. With others the discharges or emissions had changed ; become viscid, opaque, and of a muddy appearance, accompanied by a peculiar odor or smell, and passing off day and night, with and without erections, increasing in frequency and quantity, without the power of restraining them. (ISIP* Discharges of this character are what I would strictly call ' ' pollu- tions;" though, by many, the term is differently applied, even synonymously with Masturbation or Self-abuse). At this stage many represent, dis- gust and horror takes the place of the pleasur- able sensations before experienced ; they become alarmed, and, notwithstanding their resolutions 5 * 54 SPERMATORRHEA. to abandon their habits, they seem almost irre- sistible and impossible ; when abandoned, even for a short period, many describe their misery and suf- ferings as scarcely to be conceived or imagined ; felt only by themselves and known to them only, and those to whom they apply for relief, who, from experience and observation, are sensible of their feelings and situations. Now it is that thousands turn back and think of their past follies and indiscretions, and regret they had not profited by the timely warnings they had, in the gradual and perceptible injury their bodies were sustaining, and in their declining health ; and besides their injurious ten- dencies, learned from reading — the advice of some kind friends, parents, guardians, &c. Alas ! reflection is ^•equently in vain, often too late. Still there is some hope left; but how few, however, even conscious of their situations at this stage, fully sensible of the rapid change going on throughout their whole system, benefit by re- flection — indulgence in their unnatural and filthy pro- pensities seems to overcome all resolution or determina- tion to abandon their practices, and, if possible, recu- perate themselves. The wretched infatuation predomi- nates, and prevails against reason — all power over the passions seems lost — the victim loses all pleasure in society — avoids the company of members of his family and most intimate friends — the sight of his own sisters, mother, or other females overwhelm him with shame, mortification, and remorse — he is disgusted with him- self — finds no comfort or consolation in anything — though pleasures and enjoyments to others surround him, there is none in which he can feel an interest or participate — it is now that he feels isolated in existence — he shuns the world, and fancies all shun him — his mind and body become more and more enfeebled, and lose their power — intellect becomes dull and partially SPERMATORRHEA. 55 suspended, bordering on a state of lunacy; which con- tinuing, sooner or later plunges him into destruction, or a condition from which he can never recover — many, before being entirely deprived of reason, contemplate suicide ; but few commit it, because of a cowardly and innate feeling of intimidation, imagining or picturing to themselves their probable fates in the future, and there- fore they continue in a life of torment and misery until death. Having, in the foregoing, more particularly given the history and progress from the com- mencement of Self-abuse, Masturbation, &c, which produce peculiar results, I will now proceed to the effects or consequences as variously de- scribed by patients, and which are also peculi- arly characteristic and confirmatory of what has been written by others, as well as by my own observations. In many instances, for a few years they enjoy a good appetite, the bowels are regular, they sleep and rest well at night ; maintain a healthy colour and are of robust appearance — but often have flushes of heat and unusual redness of the face. Occasionally giddiness and faintness, heavy and oppressed feelings of the head or brain are expe- rienced, and some nervousness and palpitation of the heart ; but only following indulgence in Masturbation, and subsiding after a time. Many are afflicted with partial impotence, having in- complete erections, and unable to cohabit with the opposite sex with satisfaction or gratifica- tion; frequently wholly impotent and incapable of erections at all, by any means that may be em- §6 SPERMATORRHEA. ployed; the penis shrunken and mnch shrivelled from what it was, and the urine passing slow, sluggish, and without natural force ; the scro- tum, or bag, enlarged, flabby, and hanging loosely, with the appearance upon feeling as if filled with bunches of worms ; or one testicle hanging much below the other, the bag much elongated on one side in consequence, and some- times one or both testicles having disappeared, having escaped from their natural situation alto- gether. Prostration and debility are experienced by many in proportion to the extent of their indul- gences, frequency, and profusion of emissions or pollutions ; gradual wasting of the flesh and loss of strength ; complexions are pale, livid and sallow ; the whole contour of the face is changed ; skin shrivelled ; cheeks hollow ; eyes sunken, with a ghastly, vacant look and expression ; blotches and pimples, dry, scaly, watery, or containing yellowish matter, or a small worm ; covering the face, forehead, and portions of the body ; tremb- ling of the hands; weakness of the knees and other joints ; contractions of the muscles and limbs, affect many. With others the appetite is variable ; bowels irregular ; have a disgust or fancy to certain food or drinks ; voice changes, from being clear and distinct, becoming low, husky, and inclined to stammering ; hearing is dull, with various noises through the head ; memory defective, remembering only incidents or circumstances having occurred within a short SPERMATORRHEA. 5T time ; the eyes are dull and vision dimmed ; sleep light, broken, disturbed by dreams; rest- less and cannot sleep ; or if falling into a doze, startled through nervous and spasmodic action ; lying awake without inclination to sleep, and the mind absorbed with sad and horrible thoughts or forebodings ; palpitation of the heart, almost constant, and much increased through fatigue, sudden alarm, or excitement ; nervousness at all times, and increasing, affecting the mind, eventu- ally the brain, so much so as to produce occasional vertigo, syncope, spasms or convulsions, epi- lepsy, &c. In addition to the effects, as before described, there are many patients who describe feelings peculiar to each one's self, which may be more easily imagined, when, without regard to cir- cumstances, whether poor or wealthy, they would freely give all they possessed if they could be restored to full, natural vigor and capacity of manhood — having indulged to some extent in Masturbation, both before and after puberty, still possessing natural feelings toward the oppo- site sex, mingling and associating with females with fondness and pleasure ; not having been conscious of their ability or power to cohabit with them until too late, forming attachments, and without reflection, proposed, or entered into matrimony. Instances of the following are frequent. An early day is fixed for marriage ; in the mean- time circumstances transpire convincing the in- 58 SPERMATORRHEA. tended husband he is incapable of performing marital rights so soon. At his request a future time is determined upon, relying upon restora- tion through nature and abandonment of his habits. The second appointed time arrives, and he finds himself still incapable. A third period is fixed upon, intending to try some ad- vertised nostrums, or seek medical advice ; he tries the former, but in vain; he next, without making proper inquiry to find out a competent physician, becomes the victim of some Quack Doctor or Impostor, and his condition made no better, perhaps worse ; at last the third ap- pointed day arrives, but not with it the realiza- tions of connubial happiness. He neither ap- prizes the expectant bride previously, nor pre- sents himself at the appointed time, because of fear, shame, and mortification. The engage- ment is broken off for reasons unknown, untold, and mysterious to the intended bride, her family and others. Another, unconscious of his weak- ness or inability, fulfils his promised vow, soon to become sensible of his own condition, and is not only made miserable himself in consequence, but his unsuspecting and confiding partner is plunged into misery and unhappiness also. For a time her feelings, almost indescribable, are suppressed, but eventually bursting with indigna- tion, mortification, disappointment and wounded pride, she either flies to her once happy home, or, filled with horror and disgust at making known the existing state of things to her family or SPERMATORRHEA. 59 friends, becomes the victim of some artful seducer. For this the world, perhaps, would condemn her ; but how deplorable and pitiable her situation ; her own husband the destroyer of her peace and happiness — the author or cause of her guilt and shame. Readers ! if any of you are inclined to matrimony, ponder well and be certain of your abilities before you enter into it. Awful is the position of either sex under circumstances just narrated. None are excusable, if from effects of Masturbation, or from any other cause whatever, (and there are many among both sexes) they are incompetent in forming matrimonial alliances. If aware of any impediments which may be remedied, see they are removed before even proposing marriage. Much suspense, anxiety, mortification, and disappoint- ment, besides indescribable suffering, will be prevented. Better, far better live a life of celibacy, than a connubial life in misery and unhappiness. Dr. N. B. Leicly can always be consulted in such cases, either through cor- respondence or privately, at his Office, with the most implicit confidence and secresy; and many be saved months, years, or a life-time of misery, not only of them- selves, but from involving others also. VENEREAL EXCESSES. Another prominent cause of Spermatorrhea, is the too frequent indulgence in sexual inter- course, usually termed " Venereal Excesses/' whether from natural impulses of the passions, or for certain reasons cohabiting when not de- 4 60 SPERMATORRHEA. manded by the passions, but urged through morbid desires, excitement, or extraordinary stimulus. Lallemand expresses himself so intel- ligibly in reference to the passions of either sex, and describes so clearly the symptoms of Sper- matorrhea as more particularly consequent upon such excesses, that I am induced to quote a few sections from his writings. (i Man feels a desire for the esteem of his fel- low creatures, and particularly that of the female, whose protector he naturally is. It is in her society that he is proud of his physical force, of his intellectual superiority, of his social posi- tion, &c. ; but above all things he is anxious to prove to her his possession of the virile power ; and those men who are the worse provided in this respect, are often the very ones who are most fearful of allowing their feebleness to appear. This tendency to vanity is still further excited by that which predominates in the female under another form ; she sees, in fact, that these re- peated acts prove most incontestably a violent passion ; the most satisfactory proof of the power of her charms. She is too proud of it not to respond by every means in her power; these mutual feelings, both the offspring of vanity, excite one another, and then produce reciprocal demonstrations, which are not based on real wants, and which do not proceed from true passion. Young married persons who have given them- SPERMATORRHEA. 61 selves up without regard to consequences, to the impetuosity of their temperament, feel compelled to support the same system as that on which they commenced ; they are fearful lest coldness and Vinconduite be suspected, and they come to regret their first imprudence, for their at present irritated organs are no longer in that physiologi- cal state which has enabled them for a time to support everything. If I may judge from the details into which some of my patients have entered, venereal ex- cesses have been produced more frequently at the instigation of misconstrued amour propre than by the entrainment of true love." Symptoms. — V Let us suppose that the organs are sound, but exposed to the acts more fre- quently than the real wants of the individual re- quire. These excesses will be the better sup- ported in proportion as they are the first, or as they have not been preceded by any inflamma- tion or irritation of the sexual organs, and as the tissues are in a complete state of integrity. It is thus, in like manner, that we must compre- hend the reputation of novices, for absolute inaction does not fortify the generative system any more than does the contrary ; they are only the more susceptible in proportion as they have been more frequently affected. Provided these excesses are carried further, or that they last long, the excitement augments, and the first symptoms of irritation manifest themselves. Heat in the canal commences, par- 6 62 SPERMATORRHEA, ticularly during the act of making water ; the urine is more abundant than usual, and the de- sire to pass it more frequent, accompanied with a tickling which is sometimes agreeable ; the meatus is more injected than usual, and the in- tensity of pleasure is diminished. At a latter period dysuria comes on, occa- sionally attended with hematuria ; ejaculation takes place with a rapidity that goes on increas- ing ; the semen sometimes contains streaks of blood, at other times it is altogether bloody. The irritation extends to the prostate, or the margin of the anus, and a feeling of weight is felt in the perineum and rectum, accompanied with a spas- modic constriction of the sphincters which pro- duces constipation. The spermatic cords and the testicles become painful and sensitive to the least pressure ; they require the support of a suspensory bandage. ?? From venereal excesses, when long continued, the general health suffers ; consequences similar to some extent, follow as results from self-abuse or Masturbation ; namely, prostration, nervous- ness, impotence, the same repugnance to em- ployment, exercise, and society, &c. The com- pany of females is particularly avoided, because though possessed of natural desires, disposition or inclinations to indulge, yet are incapacitated from contributing to, or participating in former mutual or reciprocal pleasures, or gratifications with the opposite sex. Erections become less complete, the semen scanty, and changing to a SPERMATORRHEA. 63 thin, watery, or semi-transparent fluid, incapa- ble of fecundation. Notwithstanding such con- ditions may be the cause of much regret, shame, and mortification, yet the consequences, ment- ally and physically, from venereal excesses, are not so serious as from Masturbation, &c. ; the effects produced are also much mitigated, or alleviated through active occupation and exer- cise, whilst they are proportionally exaggerated and increased through indolence, and inactivity. SEMINAL EMISSION'S. Seminal emissions from other causes than the preceding- often occur, and from their fre- quency inducing Spermatorrhea, attended or followed with disagreeable and unpleasant con- sequences ; but partial, in comparison to those generally resulting from Masturbation, Self- abuse, or Yenereal Excesses. With many the generative organs are natur- ally delicate, sensitive, and susceptible ; and par- ticularly with persons of strong passions or desires ; aided by their imaginations or thoughts, erections are incited, pleasurable sensations are felt, and ejaculation soon follows. With such emissions will occur, when riding on horseback, through bouncing upon the pommel of the sad- dle ; — also, from being in company with lively, prepossessing, or attractive females, and fond- 64 SPERMATORRHEA. ling or toying with them ; — also from sleeping in beds upon feathers, or otherwise too soft and warm, or lying upon the back or belly ; — also from looking at lascivious pictures, and from reading lascivious and imaginative works, &c. Seminal emissions occurring from these causes, being most common in a majority of instances to persons of delicate constitutions, weakness of the physical energies uf the body, and of the generative organs, they may be invigorated and a more healthful and natural condition produced by means hereafter recommended ; or through the advice, instructions, and aid of competent medical counsel, which should be preferred if circumstances will admit. Among those referred to in the preceding sec- tions, are too often found those, who, after en- tering into matrimony (having up to that period remained continent, abstained previously from sexual intercourse through ideas of virtue and morality, modesty or diffidence, indifference or want of more sensual feelings, or from other causes) sooner or later, discover their inability or weakness; having been ignorant or uncon- scious of it before. There are also direct causes, which, through annoyance, irritation, and stimulus, produce erections, ejaculations or emissions, injurious, and from their frequency and long continuance induce Spermatorrhea. Among them are the following : — SPERMATORRHEA. 65 Ascarides or Seatworms, located around the margin of the anus or seat, and sometimes immediately within ; more particularly common among children, and are exceedingly annoying. Hemorrhoids or Piles, and Diseases of the Rectum, which are not only annoying but very distressing at times. Cutaneous Eruptions around the anus, some- times discharging an ichorous fluid, which, run- ning or spreading over the surface of the sur- rounding parts, the perineum, inside the thighs, scrotum, or bag, &c, produces almost insup- portable itching and irritation. Offensive Secretions, sebaceous or cheese- like, between the glans (head) or neck of glans penis and prepuce (the loose foreskin covering the head and neck of the penis) ; which, be- coming acrid, excoriates the parts, or are covered with small red patches, purple spots or pimples, and causing a pricking and itching of the sur- face, exceedingly disagreeable. Contracted Prepuce, or foreskin ; where ter- minating in a very small pouty opening, barely admitting the escape of the urine, entirely cover- ing the head of the penis, and in consequence of the impossibility of drawing it fyack or over, preventing cleanliness, resulting in increased irritation underneath, from sebaceous secretions, and becoming purulent and offensive to the smell. 6* 66 SPERMATORRHEA. Elongated or Exuberant Prepuce, extend- ing beyond and at all times covering the head of the penis, and although capable of being drawn backward, and exposing the head and neck of the penis, yet through ignorance, indif- ference and neglect to cleanliness, resulting in as much evil as from contracted prepuce. To the foregoing may be added, as exciting causes of emissions, &c, inducing Spermator- rhea, strictures, costiveness, stimulating liquors, long sickness, action of certain medicines, dis- eases or malformation of the urinary and geni- tal organs, pruriginous or itching eruptions and pimples, or small pustules about the genitals, &c. The foregoing causes denominated direct, described as annoying, distressing, &c, do not generally produce serious consequences, and seldom confirmed or established Spermatorrhea They, nevertheless, produce much unpleasant- ness and disturbance of the whole system, and should be prevented or checked early as possible ; means for effecting which will suggest them- selves, or are generally known to persons of mature years ; and existing among children are generally known to parents or nurses. In cases, however, of a narrow, contracted prepuce, or elongated and exuberant, the assistance of the physician or surgeon is required, as the use of a proper instrument is necessary in the former to slit up the prepuce or foreskin, and in the latter to remove the exuberance of it ; so in cases of mal-formation and stricture is there the same SPERMATORRHEA. 67 necessity for professional aid. In fact it would be most advisable at all times to seek competent medical aid or advice, as tampering and experi- menting with various means or modes of treat- ment, in accordance with the ideas, judgments, and' views entertained by many, or the recom- mendations of others, or with boasted nostrums and specifics, much serious mischief results, be- sides loss of time, increase of suffering, cost, &c. Whilst on the subject of Seminal Emissions, I will add a few remarks (that I deem worthy of place here) of Dr. Carpenter, and an anony- mous writer, which, though somewhat peculiar, are nevertheless in accordance with my own ideas and observations. " The sexual secretions themselves are strongly influenced by the condition of the mind. When it is frequently and strongly directed toward objects of passion, these secretions are increased in amount to a degree which may cause them to be a very injurious drain on the powers of the system. On the other hand, the entire employ- ment of the mental powers on other subjects, has a tendency to render less active, or even to check altogether the processes by which they are ela- borated. This is a simple physiological fact, but of high moral application. The author would say to those of his younger readers, who urge the wants of nature as an excuse for the illicit gratification of the sexual passion — try the effects of close mental application to some of those ennobling pursuits to which your pro- 68 SPERMATORRHEA. fession introduces you, in combination with vigorous bodily exercise, before you assert that the appetite is unrestrainable and act upon that assertion. Nothing tends so much to increase the desire, as the continued direction of the mind towards the objects of its gratification. "When the appetite is naturally indulged, that is, in marriage, the necessary energy is supplied by the nervous stimulus of its natural accompaniment of love before referred to, which prevents the injury which would otherwise arise from the increased expenditure of animal power ; and in like manner also, the function being in itself grateful, this personal attachment performs the further necessary office of preventing im- moderate indulgences, by dividing the attention through the other sources of sympathy and en- joyment which it simultaneously opens to the mind. But when the appetite is irregularly indulged, that is in fornication, for want of the healthful vigor of true love, its energies become exhausted ; and from the want of the numerous other sympathetic sources of enjoyment in true love, in similar thoughts, common pursuits, and, above all, in common holy hopes, the mere gross animal gratification of lust is resorted to with unnatural frequency, and thus its powers become still further exhausted, and therefore still more unsatisfactory ; while at the same time a habit is thus created, and these jointly cause &nd increase craving ; and the still greater defi- ciency, in the satisfaction experienced in its in- SPERMATORRHEA. 69 diligence, further, continually — consequent ex- haustion — till the mind and body alike become disorganized." TREATMENT OF SPERMATORRHEA. It is impossible to detail fully the treatment necessary in each individual case of Spermator- rhea, or where suffering otherwise from the effects of Masturbation, Self-abuse, &c. ; because occur- ring and existing among both sexes at all ages, and because of the difference in constitutional powers, physical energies, and conditions of patients. Neither would it be possible in so small a work as this, as would be required in so great a variety of cases, with reference more particularly to the extent of injury or mischief resulting from such pernicious habits, the modes of indulgence, their continuance and repetition for shorter or longer periods, &c. I shall, therefore, recommend general treatment, and give such advice and instructions as will be appropriate to many, and, to a certain extent, adapted to most cases. It is of much importance that, at all times, causes of existing conditions should be ascer- tained, necessary to the proper treatment of patients. Thus, among infants, suffering from effects described in preceding pages, by causing nurses to desist from practices they resort to, 70 SPERMATORRHEA. and through watchfulness, care, and proper nourishment, many would be restored to health, when, through ignorance of causes and conse- quently misdirected treatment, they might con- tinue to suffer much and long, perhaps die before causes became manifest. Infants and small children detected in toying with their genitals, should be prevented through watchfulness, muffling their hands, or made to wear a straight waistcoat for a considerable time, when the habit will frequently be forgotten by them. When indifference to learn or study is ob- served among children, or there is apparent difficulty in making them understand while being taught, or forgetting in a very short time what was previously learned, or are less lively and active than usual, or are becoming of delicate and sickly appearance, complexion changing, &c, — the suspicion of parents, guardians, and instructors, (as well as physicians also, if ap- plied to) should be aroused, and, if possible, it should be ascertained if they indulge in perni- cious habits. If so, instead of attributing their conditions to other supposed causes and pre- scribing for such, or experimenting with quack nostrums or other vile compounds, for weeks, months, or years, adding, as it were, " fuel to fire," they should be rationally, and in a mild and feeling manner, conversed with, and made acquainted with the serious consequences result- ing from those habits, and thus intimidated SPERMATORRHEA. 71 and induced to abandon them ; as well as bring them to a feeling or sense of shame, horror and disgust, at their continuance. Opportunities should be allowed them to in- dulge in a variety of amusements, gymnastic and other exercises ; and they should not be restrained or confined too closely, but allowed full enjoyment in the open air, and furnished at all times with wholesome, nutritious food. Heavy tasks to study, if going to school, should not be imposed upon them, or be strongly urged to learn. They should be closely watched, and not permitted to congregate at hidden or by-places, thus baffling them from opportunities to practise such habits ; and their minds should be kept employed in various ways, in conversation, reading interest- ing books, innocent, rational, and instructive games, &c. , that their thoughts may be directed as much as possible from them. Early rising should be encouraged, and they should not be permitted to lie awake in their beds in the mornings, toying and playing with each other. The continuance of Masturbation and Self- abuse, among children, increases in proportion its evil effects upon the health — seriously affect- ing the intellectual functions, physical energies, and the whole system ; which is not to be re- gained always by the aid of medicines alone, though often necessary and useful, prescribed or administered by some competent person. Gene- rally they may be restored through positive abandonment of the filthy practices, and where 72 S P E R M A T QlR R H E A . not voluntary, they should be made or caused to abandon them through watchfulness, reason- ing, information, and attention to their wants, nourishment, comforts, &c, as recommended in preceding sections ; to the neglect of which thou- sands of youth are, and have been, indebted for not advancing toward, or arriving at, positions of eminence and distinction. At and after puberty, ejaculations, with semi- nal emissions taking place, more rigid recom- mendations become necessary, and medicinal agents are generally required. Persons having nocturnal emissions, once, twice, three times or more a week, should abstain from late suppers ; be regular in meals, partaking only of whole- some and nutritious food ; avoiding malt drinks, tobacco in any shape, and coffee ; vinous or spirituous liquors should be indulged in, only when required after much prostration or fatigue ; which, however, should be as much avoided as possible, as fatigue is hurtful. Lying upon spring or hair mattrasses is recommended instead of feather or soft downy beds. Douching the geni- tal organs with cold water for a few minutes, at night before retiring and in the morning after rising, will sometimes be found beneficial. Shower- baths, cold and salt-water bathing are also useful, particularly in cases not too much debilitated. Whatever tends to excite the passions should be avoided ; such as reading obscene or lascivious books ; works of fiction, particularly where the opposite sex are represented in their most en- SPERMATORRHEA. IS tiring, charming, and fascinating characters ; immoral and lascivious paintings, or pictures, should not be looked upon, or aught else in- dulged in, calculated, with the aid of thought or imagination, to cause excitement of the pas- sions, as often intro-mission will occur, followed with exhaustion of animal power, and as injurious to a certain extent as emissions produced in more unnatural ways, or through erotic dreams, &c. From their frequency, however caused, the general health suffers, and it is all important to those suffering that they should seek assistance early, that they may be restored to a more vigorous and healthy condition in approaching maturity ; as, after maturity, treatment becomes more tedious, troublesome, and requiring much longer time; besides obstacles then existing which do not in earlier life. As among different patients, different organs are affected, and some to a much greater extent than others, much discretion is required in their treatment. Among the general remedies em- ployed, but which I have found mostly ineffec- tual, are, Bearberry leaf tea with super-carbo- nate of soda ; different preparations of iron ; sulphur, ferruginous, and other mineral waters ; vegetable tonics, such as gentian, Colombo, quassia, &c. ; camphor, tar water, turpentine, and copaiba ; opiates at night, &c. &c. Besides the uncertainty of effect of many medicines, they become repugnant to patients ; and frequently, because injudiciously employed, are productive 7 74 SPERMATORRHEA. of little or no good, and ofttimes injurious. Of the numerous medicines that have been hereto- fore, and still are employed by the profession (as well as empirically in nostrums and specifics), because of their uncertainty and inefficacy, I have discarded most of them long since from use in ray practice. For many years I have em- ployed several preparations of my own, adapted to the several periods in life, and at which cer- tain conditions mostly exist, with great and un- paralleled success; and, that patients may be the more certain in obtaining such at all times as will be most appropriate and adapted to their cases, when addressing me, they should particu- larize their conditions as nearly as possible, in which they will be aided by numerous questions asked in the latter portion of this book. By thus particularizing also, there are frequently some peculiar and unusual conditions existing, though thought of little importance by many, requiring special treatment or advice, and which should not be neglected ; they will also receive my attention, and patients may feel the more assured of additional benefit and certain restora- tion to more natural and healthy conditions. The preparations referred to are composed of articles imported by me from the East Indies, and are not to be procured from Druggists or others throughout the United States. Their use does not interfere with the habits, living, or occupa- tion of any one, nor requires any restraint for fear of exposure to wet or cold. In fact they SPERMATORRHEA. 15 are of an invigorating, exhilarating, and whole- some character — possessing properties different from other preparations — by their combined effects and influences assisting and supporting nature — allaying nervousness — overcoming agi- tation and anxiety of the mind, depression of the spirits, and melancholy — giving tone to the animal functions, producing a more healthful and vigorous condition of them, and establishing, in man or woman, that confidence so necessary to their happiness and enjoyment. They can be sent by mail or otherwise, as may be directed, to all parts, accompanied with proper directions, instructions, and advice, adapted to each indi- vidual applying, according to the nature, charac- ter, and condition of his or her case. In a few instances there may be a necessity for instruments, cauterization, or other operation ; but so very seldom, that, when required, they should be under the personal attention and management of a competent physician ; and therefore it would be useless here to describe either instruments or operations, because it will be of no practical utility or benefit to patients, and will occupy space which can be devoted more benefically to the great mass of the afflicted and unfortunate. Marriage is sometimes resorted to as a reme- dy ; seldom, however, with beneficial results, unless where Masturbation had not been prac- tised to an injurious extent, and where no seri- ous consequences, as has been before described, 76 SPERMATORRHEA. had as yet resulted from Spermatorrhea. Where even a doubt, however, exists as to circumstances justifying marriage, parents or advisers should be extremely cautious in recommending it as a remedy ; and, although the most moral course that might be deemed advisable, yet, in the language of the Professor of Montpelier, (which should be particularly regarded), " What has the young girl, who is thus sacrificed to this egotistical cal- culation, done, that she should be condemned to the existence that awaits her ? Who has the right to regard her as a therapeutic agent, and thus lightly to stake her future prospects, her repose, and the happiness of the remainder of her life ?» "It is precisely because marriage is the most sacred bond for individuals, as well as the most important for society — it is because an iron law renders it indissoluble — that it is rational, as well as moral, not to contract it without having the certainty that it is proper." The force and justice of the foregoing brief extracts, laying aside all other considerations, should be sufficient to deter all parties from forming, contracting, or entering into ill-assorted matches under the circumstances referred to, when known or suspected, without some con- sultation or assurance justifying them, made doubly sure through competent and experienced advisers. SPERMATORRHEA, 17 MASTURBATION, SELF-ABUSE, &C, IN THE FEMALE. Having in the preceding pages depicted and described the deplorable consequences, more particularly to the male sex, of indulgence in masturbation, I cannot leave the subject without some brief remarks, important hints, and salu- tary advice, that may prove useful to many of the opposite sex. It must not be supposed, because little refer- ence is made to females in connection with mas- turbation, &c, that the male sex alone is guilty of indulging in such heinous, wicked, disgusting, and debasing practices. It is too true, that it is common to both sexes, but not so generally known or observed among females, because (not- withstanding all they may suffer both mentally and physically) they refrain from making their sufferings known, seldom revealing even to their own nearest and dearest friend their guilt, (in which they err, and are certainly culpable) ; preferring to suffer and linger even unto death, than to do so, or even to intimate to their medical attendants the probable cause of their suffer- ings. Equally at fault are physicians, who, through modesty or diffidence, (affected or otherwise), delicacy or fear, hesitate, or Tire deterred from making the necessary inquiries into the real or 78 SPERMATORRHEA. existing causes of the sufferings and condition of many female patients, as is their bounden pro- fessional and moral duty ; for the wife, mother, and daughter are equally entitled to their pro- fessional scrutiny, watchfulness, and care, as re- gards their health, vigor, physical and procrea- tive powers, as the opposite sex. It is not only a shame, but criminal neglect on their part, that such is the case; but the fact that physicians are thus derelict at times in their duty, the cor- respondence, and representations of many who apply to me for relief, confirm. When a girl, who, in early years, (say 12 to 16), is gay and lively, possessed of a natural and healthful complexion, full of freshness and beauty, animated in spirits, and enjoying appa- rent good health, is observed to change, becom* ing pale and sickly, dull and inanimate, spirits depressed and less lively than usual, having a dislike to society or former pleasures and enjoy- ments, and complains of weakness or languor — then, indeed, may it strongly be suspected there is a particular cause for it, and it behooves the parent, guardian, physician, or others in whose care she may be, to be watchful, and if it be ascertained that masturbation is the cause, means should be at once adopted to stay indulgence in a habit which, though in opposition to chastity and honor, still is incited by natural feelings and desires, and which', if continued, must influence the mind, overcome reason, and when least feared, plunge her into greater guilt, perhaps the loss IMPOTENCE. 79 of innocence and virtue ; or, when such is not the result, she may become miserable through life, suffering, in many respects, in the manner already described as resulting to the other sex. Females, at whatever period of life, single or married, conscious of conditions existing, the result of improper habits referred to, should cast off all fear, modesty, affectation, or delicacy, (which is inexcusable, because they, like the other sex, require professional advice and assist- ance also), and consult some competent person ; or they can consult me either at my private offices, or correspond with me (not forgetting to enclose a reasonable fee) by letter, which will at all times be sacredly confidential, when advice and proper medicine, with instructions, will be sent as required, or directed either to their own names or address, or different and assumed ones. IMPOTENCE. By impotence is understood, in a general sense, an incapacity or inability to perform or indulge in sexual intercourse, because of want of volition or otherwise ; disqualification through the workings or operations of the mind ; or the impossibility of erection of the virile organ, from whatever causes, so necessary to the performance of venereal acts and the mutual enjoyment of the sexes. 80 IMPOTENCE. Disqualification sometimes arises from malfor- mation or organic defects, which, in many in- stances, may be relieved by the surgeon or phy- sician. It exists, however, when the genital organs apparently are perfect, but owing to some cause, erections occur either imperfectly, or not at all ; happening mostly to the offspring of persons constitutionally injured through debauchery and excesses, the feeble or infirm, very aged or too young. Disqualification is also produced through the effects of certain diseases of the genital or- gans, where proper treatment has been long delayed ; or through wrong treatment, attempted by individuals themselves, or through the advice of others incompetent ; or, as is too often the case, when treated by quacks or impostors, who encourage disease or other conditions where the continued reception of fees is anticipated. Two of the principal causes of impotence, partial or complete in early manhood, are mas- turbation and the too early (frequently excessive) indulgence in sexual intercourse; the former producing effects, from the period of its com- mencement, distressing and alarming, as before described, terminating in impotence ; the latter destroying the procreative power and producing general weakness of the generative organs. The youthful reader should be warned by the preceding sections, and thus avoid such serious consequences. Those suffering with partial im- potence particularly, should at once cease their course, and seek proper advice and aid, for they IMPOTENCE. 81 can be relieved ; where it is complete, fall re~ storation is uncertain. There are also other causes of impotence not, however, always complete, but partial or tempo- rary. Want of volition has been named, which occurs under peculiar circumstances ; namely, where jealousy exists, chagrin, disappointed love, a discovery of deception practised, either of physical defects or other causes, and not known until after matrimony, unhappy matrimo- nial alliances or connexions, unwillingly formed or entered into, all which tend to create dissatis- faction, horror, and disgust between parties, opposing feelings that should otherwise exist; and where, not seeking pleasures and gratifying the passions elsewhere, (which is sometimes done), but acting under the influence of moral or conscientious views, strict continence is ob- served, impotence is sure to follow. The mind possesses the most powerful con- trolling influence of all other powers in copula- tion ; without it the act could not be per- formed ; being frequently absorbed and en- gaged in a variety of thoughts and imagina- tions ; apprehensions lest copulation be not well performed ; timidity and fear of various conse- quences ; great eagerness and anxiety under some circumstances ; disappointments and a variety of other causes, all produce nervousness and feelings which destroy powers of erection and defeat copulation ; their frequent occurrence causing impotence. 82 IMPOTENCE. Like the confirmed consumptive, so the con- firmed impotent has but faint hopes, or despairs of being restored ; nevertheless, such is the anxiety of all suffering from it, particularly where the passions, desires, and feelings common and natu- ral to the sexes exist, that all in the world pos- sessed by many, would be given to be restored ; and in the hope of it, one and another is applied to for counsel or aid, taking the chances whether for better or worse; and when not resulting favorably, persevering until nature is dragged down, sinking gradually into a state of melan- choly, imbecility, or mania. To prevent, relieve, or remove impotency, temporary, partial, or complete, and thus restore the natural procreative powers and ability of the virile organs, resulting from a variety of causes, would require equally varied treatment, to describe which would occupy more space than can be embraced in a small work like this, limited in proportion to its cost. Being desirous of introducing into it the character, description, and treatment of numerous diseases, &c, com- mon to, and afflicting a far greater number of both sexes, (thus making it more useful and im- portant to the many than the few), I shall make but a few suggestions, and give some advice to those suffering from impotence, appropriating the remaining portion of the book to diseases, &c, much more prevalent. I would particularly advise all, on the first observance of indications of impotence, from IMPOTENCE. 83 whatever cause, not to trifle, tamper, or experi- ment with the boasted, puffed, and advertised nostrums and specifics of quacks and impostors, who always urge perseverance in each one's own respective preparation or treatment, without re- gard to the different symptoms or conditions of their patients ; as though any single medicine possessed universal cure-all properties, or though one course of treatment was applicable in all cases ; thus, not only deceiving and robbing the unfortunate and afflicted, but through delay, time lost in tampering with nostrums, frequently of a powerful and dangerous nature, and through improper treatment injuring and destroying other healthy functions of the body, finally in- volving the whole system or constitution, plung- ing their too confiding, credulous, and deluded patients, or victims, into conditions or situations more desperate and hopeless, with increased sufferings, terminating frequently by earlier dis- solution than otherwise might have occurred. Apply, therefore, to some competent physician, capable of judging from the nature and history of a case fully described, as to the probable chance of restoration, who, in consideration of a reasonable fee, will give his candid opinion there- of, and, if possible, will effect it ; — if not, he will so inform his patient, and thus not only relieve him from much anxiety, if he has confidence in his judgment, but save him also from much cost, imposition of quacks, and the ignorant and un- skilful, increased suffering, &c. 84 IMPOTENCE. In many cases, where partial or temporary impotence exists, the aid of invigorating or stimu- lating medicines is not only altogether unneces- sary, but frequently injurious. I refer to those where the mind operates as described in a pre- ceding section. In such cases it is only neces- sary for individuals to cast off all fears, timidity, ideas, imaginations, &c, resolving within them- selves that they are childish, foolish, and unbe- coming, that they are possessed of the natural attributes of man, and that confidence in their ability, &c, shall supersede and overcome them. Individuals of delicate and feeble constitu- tions, whose physical powers are impaired, but whose passions and feelings strongly incline to cohabit, and in whom sufficient ability or capacity to perform is wanting, will find tonics, bathing, and douching the genitals daily, or two or three times a week, very beneficial. In the absence of inclination, or where there is indifference, but where there is ability and capacity, stimulants will be found temporarily effectual, but being artificially employed will sooner or later lose their influence, and impotency certainly follow. VENEREAL DISEASES. Under this head I shall embrace diseases, or affections, of the urinary and generative organs of both sexes, of contagious character, resulting more especially from venereal excesses, or sexual intercourse ; known generally as Blenorrhagia, Balanitis, Gonorrhoea (vulgarly called "Clap"), Syphilis (vulgarly called u Pox"), affecting dif- ferent parts, appearing in different forms, and running through several stages or periods. BLENORRHAGIA, OR BALANITIS OF THE GENERATIVE ORGANS OF MALE AND FEMALE. By some the term Blenorrhagia is used as synonymous with Gonorrhoea, or Clap — although the latter may be considered a Blenorrhagic dis- charge from the urethritic passage of either sex, or the vagina and uterus of the female ; it is, however, of an entirely distinct character from Blenorrhagia or Balanitis of the same parts, from other causes, and attended with different symp- toms, appearances, consequences, or results, as will be hereafter described. They will, therefore, be treated of in such manner as will convey as dear an understanding as possible of their differ- 8 (85) 86 VENEREAL DISEASES* ence, to avoid error and difficulty which has heretofore and may hereafter occur. Blenorrhagia, as distinct from Gonorrhoea, con- sists of a mucous or purulent discharge occur- ing in infancy, childhood, puberty, and maturity of both sexes, whether through intercourse or not. It arises often from irritation and inflam- mation of mucous membranes and surfaces, affect- ing the eyes, nose, mouth, throat, and ears of either sex mostly at an early age, and the pre- puce, glans-penis, and urethra of the male, and the uterus, vagina, labia, vulva, and urethritic passage of the female, usually in more advanced years. When affecting the genital or generative parts of the two sexes (and which only will be treated of in this small work), in the male it is often the result of uncleanliness, allowing the sebaceous or cheese-like secretions from the odoriferous glands situated around the neck at the base of the glans-penis or head, to become offensive, icherous, and irritating ; causing inflammation of the mucous surface of the same, as well as of the under side of the prepuce, followed with balanitic sores scattered over their surfaces. Men are also affected with it through inter- course with healthy females, even their wives, immediately preceding their menstrual period, as well as during, and at the time of cessation of the menstrual flow, when the condition of females is such as sometimes is capable of pro- ducing an irritation of the male organs, particu- BLENORRHAGIA, BALANITIS. 8*7 larly in cases of individuals of a peculiarly sus- ceptible temperament. Among such, also, it is conceded, similar results follow intercourse with females affected with leucorrhea (vulgarly called the "Whites"), which is common among females of all classes, including the most virtuous, single and married, arising often from unknown causes, as well as from debility, exposure, long sickness, violent exercises, excessive and improper indul- gences or habits, painful and irregular menstrua- tion, abortions, miscarriages, tedious and diffi- cult labors, etc. etc. A blenorrhagic discharge also occurs in the male, when the prepuce is much elongated, or when covering the head or glans-penis, and can- not be drawn back ; being so contracted on its edge as admitting only of the passage of the urine. The sebaceous or cheese-like secretions being confined under the prepuce, through ignor- ance and heedlessness of persons of the import- ance of its constant removal and cleanliness, are allowed to become offensive, and is converted into an irritating serous pus or fluid, discharg- ing itself sometimes profusely, and creating sores of mucous surfaces of the glans-penis — the under side — as well as edge of the prepuce, swell- ing, etc. A blenorrhagic discharge from the urethra (often mistaken for gonorrhoea, notwithstanding no previous intercourse being had for a long time previous) sometimes arises from violent exercise, venereal excesses, immoderate or exces- 88 VENEREAL DISEASES. sive use of malt or spirituous liquors ; the free use of mustard, cayenne pepper, and horse-radish with articles of food ; eating very freely or im- moderately of asparagus ; the taking of tincture of eantharides, whether prescribed for some dis- ease or employed under the deceptive and mis- taken idea or supposition of increasing animal passion or vigor. The foregoing produce influ- ences upon the kidneys and bladder, resulting in or producing such discharge, but more particu- larly among those injured or affected in earlier days through masturbation, or previously from frequent or obstinate and long-standing gonor- rhoea. Among females a similar discharge often arises, when, from necessity, they are obliged to use pessaries, and of whatever material they may be, neglecting occasionally to remove and cleanse them. Blenorrhagia, when affecting the sexual organs externally, is sometimes called external gonor- rhoea, or " bastard clap." As a forerunner and afterward co-existing with balanitis, in male or female, there is in the beginning a slight itching of the parts affected, followed with heat, unusual redness, inflammation, tenderness, soreness or pain, and more or less thickness or swelling of the prepuce — labia, vulva, etc. Afterward numerous minute and small pimples, pustules, or blisters arise, filled with a transparent watery fluid or humor, changing to an opaque and purulent matter. There being generally several of them adjacent to each other ; breaking, they BLENORRHAGIA, BALANITIS. 89 communicate and run into one patch or sore, with rough and irregular edges. Continuing to spread, they sometimes cover the whole surface of the part affected, and it becomes quite raw, appearing as though scalded or blistered ; and the purulent matter increasing, becomes profuse and offensive. At other times, instead of run- ning into patches, extensive excoriations, pene- trating, deep erosions, and sores follow, some- what resembling chancres, and with which thej are often complicated. Inflammation running on, the prepuce often becomes much swollen, even to its utmost capacity; when forward, covering the head of the penis, it is called Phy- mosis ; and back, exposing the head of the penis, called Paraphymosis. If not receiving early and proper attention, erysipelas, sloughing, gangrene, and destruction of the parts sometimes takes place. Inflammation, following the lymphatics, reaches the inguinal glands, or glands in the groins ; which, swelling, become so enlarged as to cause them to be mistaken for buboes. Care should be taken, however, not to complicate or confound them with syphilitic buboes, as differ- ent treatment is required in the two cases. Much inflammation and swelling of the exter- nal parts of the female genital organs, and glands of the groins, are also of frequent occurrence, re- sulting from the same causes, and subject to the same distressing consequences, as in the male. To avoid Menorrhagia, or balanitis, cleanli- ness is of the first importance ; as the want or 8* 90 VENEREAL DISEASES. neglect of it will originate the affection in one, and through intercourse communicate it to an- other. It may seem indelicate to charge either sex with neglect and want of proper attention to cleanliness, but both are guilty ; females, it is generally conceded, to a greater extent than males; not, however, without some palliative cause, as difference in the organic parts of the sexes renders bathing and ablutions more difficult, troublesome, and even impossible among females, without proper means or facilities at hand, and which are not always easy to be obtained by them. Often it may be attributed to ignorance of the necessity and importance of cleanliness ; but too often to indifference, neglect, or indolence. There can be but one excuse among males, that is, ignorance ; because of the great facility of bathing the parts most liable to be affected, through uncleanliness; except in instances of covered glans-penis, where the prepuce cannot be drawn back. The liability to a blenorrhagia of organic parts in the female being much greater than in the male, renders cleanliness in the former of much importance ; as the causes being more numerous, whether single or married, there is the greater chance of communicating it, if affected, to the opposite sex; if in the married state, sometimes involving domestic peace and happiness, and which is often destroyed through ignorance or BLENORRHAGIA, BALANITIS. 91 base designs of Quacks, or officious and meddle- some friends, to whom either party may happen to have communicated suspicions of infidelity. It is gratifying to me, having been appealed to in numerous instances where difficulties had arisen between man and wife through unfounded suspicions created by others, and the ignorance or villany of Quacks; that I have been instru- mental in reconciling parties after convincing them of the true nature and cause of either one's condition, and restoring them to their former happy state. "Self-styled Doctors," or Quacks, are par- ticularly guilty of such outrages ; being mostly regarded as impostors, it is not, however, aston- ishing. Regardless of reputation or results in all cases, gain being their sole object, they fear not prosecution for their acts ; as parties, how- ever innocent, dislike to appear in public print, or public tribunals, under such peculiarly deli- cate circumstances, to prosecute them when dis- covering they had been deceived and imposed upon. Sometimes, through ignorance, they will represent balanitic sores, or blenorrhagic dis- charges, as syphilis, or gonorrhoea; but, by others (particularly if the parties be wealthy), it is done designedly, that large fees may be obtained for curing (or professing to cure). Not- withstanding a party applying is satisfied of the innocence of his or her partner, and distinctly manifests it, they will still insist it is syphilis or gonorrhoea ; but suggest various modes by which 92 VENEREAL DISEASES. either may have contracted it, contrary to rea- son or common sense, to obtain the legal fee ; still leaving or creating in the mind a doubt as to the guilt or innocence of one or the other. Suspicion being aroused between man and wife, the one first applying to such impostors accuses the other of infidelity on their authority, because (as falsely represented) being afflicted with a loathsome and contagious disease. The other in turn applying for information or expla- nation, receives little satisfaction or consolation other than being told, he or she, as the case may be, is similarly afflicted. Thus, still favor- ing and encouraging the suspicion of guilt of one or the other, without explaining their real condition, or cause of affliction, designedly to secure both as patients, and charging exorbitant fees, supposing they would not, under the cir- cumstances, apply to their family or other re- spectable physician. Crimination and recrimination is thus ofttimes the consequence, leading sometimes to separa- tion ; but happily, however, through the timely intercession of friends, and application, made necessary (from various causes) to their family or other physicians, and discovering how they had been imposed upon, parties are most gene- rally reconciled. Much suffering and distress among females might be prevented if there was less false deli- cacy among physicians, in attendance upon them during certain conditions or situations incident BLENORRHAGIA, BALANITIS. 93 to their sex. If the latter were more communi- cative and explicit to females, they might be the better informed and advised, so as to prevent as much as possible the recurrence of similar conditions, as well as to enable them to communi- cate the same to their female friends. It is, also, a great mistake and a fallacy in some physicians to suppose that in being thus communicative and explicit, that they are step- ping over the bounds of modesty or propriety, and that ladies would become offended thereat. It is true, the ignorant, falsely modest, and those pretending to uncommon virtue and innocence, if not really offended, affect to be so, or be most surprisingly shocked; but the sensible, intelli- gent, truly becoming, modest and virtuous female will always be grateful to those imparting to them information, however seemingly delicate,, conducing to their healthy conditions and the prevention of great and perhaps long suffering, mischief, and evil. An urgent reason, besides, why physicians should be- more communicative to woman than man, is, because of her sex ; her natural modesty and position will not permit, nor should it be expected of her, to obtain certain information by asking questions under many circumstances ; therefore, physicians should of themselves com- municate to her, where the least indication of special disease or ailment will justify, what man would unhesitatingly and unblushingly ask to know. 94 VENEREAL DISEASES. Numerous females will, I am sure, be grate- ful and not censure me, either for my remarks or for urging upon them the necessity of cleanli- ness, not only of the external portion of the body, but parts before alluded to. The reason why it is pressed, is because three-fourths of the suffering and distress experienced among females, arising from certain conditions and diseases of those parts, originates through uncleanliness. It is truly surprising that very many, living at ease and luxuriously, with every comfort and convenience around them, are so neglectful in their ablutions. It applies, however, to all classes — the high and low — rich and poor — learned and ignorant. It is the more surprising, too, as water is abundant, and instruments adapted to their pur- poses within the reach of all, and may be ob- tained for fifty cents or upwards ; prices varying according to their material, finish, or style. Those who will pay proper attention to cleanli- ness, will, I am certain, appreciate it when they discover its importance and benefit. That there is much want and neglect of it is positive, from the fact of numerous females of respectable posi- tion and standing in society, in limited, and easy or affluent circumstances, seeking information as to their conditions or situations, making search- ing inquiry necessary, because of their suspicions of truant husbands. Wives, however, are not alone in this category; for often do husbands BLENORRHAGIA, BALANITIS. 95 apply, under similar circumstances, suspicious of truant wives. It may, perhaps, relieve many unfounded sus- picions of loathsome diseases, by further adding, that some, afflicted as represented in preceding pages, positively deny intercourse with the oppo- site sex at any time whatever, or for weeks, months, or years, (and then only with the healthy, or at home, where no suspicion of contagion ex- isted). Because, however, of the almost similar appearances, symptoms, and progress of a Men- orrhagia or balanitis (from causes before stated), to gonorrhoea or syphilis, they conceive they are afflicted with one or the other, and indulge in the improbable ideas (heard of, or suggested by some friends to whom suspicions are communi- cated, or by some designing impostor) of con- tracting them in a water-closet ; or in lying with others and coming in contact during sleep ; or from bed-clothing used by others, and who may have been so diseased. Thus do many deceive themselves, and are deceived by others, as afflicted with gonorrhoea or syphilis, when in reality balanitic sores, or a blenorrhagic dis- charge from other causes, exist. Man and wife, as well as the single or unmar- ried, should at all times, therefore, be cautious, and be not too hasty in their suspicions or con- clusions, or in applying to notorious Quacks or impostors, (whose object is to misrepresent and deceive for pecuniary gain) ; but to endeavor to trace and find out, through proper and responsi- 96 VENEREAL DISEASES. ble authority, that of one or more competent physicians, how, and with what they are afflicted. By doing so, much anxiety, mortification, and unhappiness will be avoided. TREATMENT OF BLENORRHAGIA AND BALANITIS IN THE BEGINNING OR EARLY STAGES. When there is redness, heat, and soreness of the parts, heretofore mentioned or named, and there is some thickening, or slight swelling, cold fomentations of lead or ice water, or vinegar and water, should be promptly, and, for a couple of days, continually applied. If neglected, bala- nitic pimples, or small sores, appear upon the external surfaces, discharging a muco-purulent matter, which will generally be cured by cleans- ing the parts affected, several times daily, with simple- water, lime-water, or weak alum-water — afterwards drying the surfaces, and as often covering the parts with dry and fresh pledgets of thin soft linen or muslin ; thus preventing con- tact with opposite surfaces, which otherwise would become irritated, and be similarly affected. At each time of removal of the pledgets, if stick- ing, they should be well softened with water, and not forcibly removed, which would cause bleed- ing and increased irritation. If simple treatment, as the foregoing, is in- effectual, mild astringent solutions of sulphate BLENORRHAGIA, BALANITIS. 97 or acetate of zinc, acetate of lead, tannic acid, etc., one or two grains to an ounce of water, applied to the parts, is often effectual. Aromatic wine is also highly recommended. In some in- stances these applications increase the irritation, and bran water, and solutions of borax, or ex- tract of opium, will be found more effectual in allaying irritation, soothing pain, and healing the sores. If the parts be swollen, pledgets, kept constantly wet with goulard, or lead-water, or bread and milk poultices, should be early ap- plied. Leeches, so generally applied to other local inflammations and swellings, should not here be employed, or resorted to with caution, as much mischief often results from matter entering their bites, erysipelas sometimes following, etc. If the discharge be from between the prepuce and glans-penis, the former covering the latter naturally, and cannot be drawn back, water should be first copiously injected, several times through the day, between the parts, with a syringe, cleansing and removing therefrom offensive and unhealthy matter, or secretions ; to be followed each time with injections of one or another of the solutions before recommended. When the external parts of the female, and internal vaginal surfaces are similarly affected, or discharging more or less, similar pledgets may be applied, and fomentations and injec- tions of solutions used, as recommended in the male. Glass syringes of the largest size that can be obtained, should be preferred by females, 9 98 VENEREAL DISEASES. that injections may be copious, and prove the more effectual. Where glass syringes can- not be procured, metal ones may be used ; the principal objections to them being, they cannot at all times be kept so clean as glass, and the metal is partially acted upon by some of the solutions, but not to any injurious extent. Mild aperient medicines should be occasionally taken, and particularly when costiveness exists. A healthy condition of the stomach and bowels is important ; a simple, wholesome diet, should be observed, and all malt or spirituous liquors must be avoided. Tonics will be found generally useful. In the more advanced stages of a blenorrhagia or balanitis, severe pains, violent inflammation, much swelling of different parts of the organs, or of one or both groins, large patches or deep sores, extensive excoriations and ulcerations ex- isting, profusely discharging offensive, purulent matter, and sloughing, or gangrene is threatened ; it would be improper for me to direct any course of treatment for patients to pursue, as the risk of serious consequences would be too great in their attempting it ; besides, in consequence of the varied conditions of patients, general treat- ment will not answer, and the assistance of an experienced and skilful physician is absolutely necessary in different cases. Patients applying to, or addressing me, must give a full and explicit description of their cases, the more effectually to treat them successfully ; GONORRHOEA. 99 and not forgetting to enclose a compensating fee, otherwise there will be delay in not receiv- ing prompt attention, necessary to prevent con- stitutional disturbance or injury. In the beginning of balanitic or blenorrha- gic discharges, they may seem of trifling charac- ter. Too often through neglect, delay, or in- difference, and, I may add, wrong and improper treatment, does serious consequences result — such as partial destruction of organs, long and extreme suffering, nervousness, depression of spirits, disgust and loathsomeness of one's con- dition, misery, and unhappiness. GONORRHOEA, (vulgarly called the "clap.") Gonorrhcea is a discharge distinguished from a blenorrhagic, as represented on preceding pages, of a positive contagious character ; gene- rally conceded to be conveyed through absorp- tion, by the gonorrhceal matter, or virus, coming in contact with mucous surfaces, or membranes, and as more generally and particularly affecting the urethra of the male and female, as also the uterus and vaginal parts of the latter. The genital organs, eyes, nose, etc., of newly born infants are sometimes affected with it, contracted through contagion before birth from parents. Through carelessness, or accident, adults some- 100 VENEREAL DISEASES. times convey the virus to their eyes, nose, etc., and they become similarly affected. The symptoms of gonorrhoea develop them- selves at earlier or later periods ; namely, from one to eight days after intercourse, seldom after. Instances are not wanting, however, if some statements are to be relied upon, of there being no indications or symptoms before two weeks or more after intercourse. Such statements are, generally, received by the profession with more or less doubt. There are various theories entertained by writers and practical men, as to the manner of conveying and contracting the disease ; but can- not, in so small a work as this, be introduced or commented on, because, as has been more than once observed heretofore by the author, his in- tention is not to theorize, but give such informa- tion of diseases, with desultory remarks, and advice as to their treatment, to a certain extent, as may more particularly benefit the afflicted and unfortunate. Gonorrhoea, being of inflammatory character, its virus, or matter, being received within the meatus (mouth or orifice) of the urethra, or canal, its progress is thus simply and briefly described by Ricord, who speaks of it as " Blen- orrhagia" of the urethra; a term used and pre- ferred by some writers. " Blenorrhagia of the Urethra, may be divided into phases or periods, which succeed one another, provided the inflammation is not GONORRHCEA. 101 checked. In the first period the balanic region is alone affected ; inflammation then extends itself backwards, arriving at the spongy or bulbous portion ; in a short time it gains the membranous region, and reaches the prostate portion, and sometimes the neck of the bladder." Gonorrhoea, as common to the parts named in both sexes, is oft attended and followed with a variety of effects and consequences of a dis- tressing nature. SYMPTOMS OF GONORRHOEA. In the male, the most prominent indications, in the beginning, are a slight itching along the urethra, or a redness, inflammation, and pout- ing, or thickening around the edge of its mouth ; afterward soreness is felt within the mouth, and extending along the urethra, causing a burning or scalding sensation along the passage, during and after voiding urine, which is the more or less severe, according to the degree and extent of the inflammation ; a discharge of an opaque, creamish, or yellow colored matter, sometimes tinged with green, occasionally precedes ; but most generally does not take place until inflam- mation is fully established. The scalding, or burning, is ofttimes excruciat- ing, and almost intolerable, even to cause un- willingness and dread of urinating, which is avoided until compelled ; in the course of the disease, the desire to urinate becomes more fre- 9* 102 VENEREAL DISEASES. quent, and the urine is passed in a thin, narrow, scattered, or broken stream, because of obstruc- tions created by the accumulation of matter along, the urethra, or a thickening and swelling of the walls or sides of it. Dribbling of the urine some- times happens, or it is almost entirely prevented from escaping until nature forces its passage, when it is accompanied, generally, with a mix- ture of blood, in consequence of the rupture of one or more small blood vessels. The discharges of matter increasing, and con- stantly oozing from the mouth of the penis, through ignorance, carelessness, and uncleanli- ness, the prepuce in being drawn back and for- ward over the glans-penis, ofttimes carries with it portions of matter, which, lodging upon the surface, or neck of the glans-penis, causes irrita- tion, and gives rise to sores, excoriations, warts, or excrescences. At other times, causes swell- ing or enlargement of the glans-penis, which becomes very red and shining, and so extremely tender and sensitive as not bearing contact with the garments or bed-clothing. In the female, the symptoms of gonorrhoea in the beginning, and the discharge, are similar to those described in the male. Whether the urethritic passage, or within the vagina or uterus, be affected, there is a frequent desire to micturate, sometimes attended with much difficulty and pain. Itching is felt, and unusual redness of the external parts, indicative of inflammation, fol- lowed with a sensation of burning or scalding G0N0RRHCEA. 103 during and after micturition ; more particularly when affecting the urethritic passage; occurring also, however, at times when affecting the uterus or vagina, the inflammation extending to ad- jacent parts, the bladder, etc. Swellings of the clitoris, labia, vulva, and glands of the groins, of one or both sides, are not unusual in an early stage of gonorrhoea in the female. Females should, on discovering the existence of gonorrhoea, immediately resort to remedial means ; if not at hand, or not knowing how to proceed, or what to do, they should cast off all diffidence, and apply early to a competent physi- cian ; for through neglect, or delay, their situa- tions may become distressing, troublesome, ob- stinate, and difficult of cure ; because affecting organs more extensive than the male, and often attended with constitutional disturbance. In a large majority of cases among females, the organs of generation are affected — seldom the urethritic passage. TREATMENT OP GONORRHOEA, OR " CLAP," AS VULGARLY CALLED, IN ITS INCIPIENT FORMS, OR EARLY STAGES. Before proceeding to advise or recommend any course to be pursued, I think some prefatory remarks will be productive of much good to the 104 VENEREAL DISEASES. afflicted and unfortunate, inducing reflection and precaution. Of all the various diseases incident to, or with which mankind is afflicted, there are none for which so many empirical or quackish remedies are offered, or various treatment recommended, as for venereal diseases. The reasons are obvious, and cannot be mis- taken. The scope for impostors being so great, they do not hesitate, "for pecuniary gain," to resort to lying boasts, misrepresentations, and false pretences, regardless of all moral decency, honesty, or humanity, to advertise "to cure," but in reality to u deceive and rob the unfortu- nate and afflicted." Many administer medicines from prescriptions given them whilst under treat- ment themselves, with an experienced practical physician, for some venereal disease, and affixing "Dr." to their names, employ, in their new undertakings, the same medicines in all cases, "as cure alls," in treating their misled victims, without regard to difference in character of their respective diseases, the symptoms, stages, or ex- tent to which they have arrived, etc., or knowing whether positively venereal or not. Others, having read some treatise or work on venereal diseases, set out as "Doctors," without any opportunities of obtaining a knowledge of them, or observations % during an attendance upon venereal patients in hospitals, or other institu- tutions ; or through a course of study, as to the anatomical relations or attributes of man, his GONORRHOEA. 105 liability or susceptibility to diseases, morbid conditions, or changes ; their nature, manner of treatment and cure, or even knowing the medici- nal or curative properties, character, or effects of the very medicines they recommend ; having only read of them, yet do they recklessly un- dertake, from base and sordid motives, to treat unsuspecting' patients, regardless of their future health, constitutional injury, long and protracted sufferings, even of life itself, througk their ignor- ance and wrong treatment. Thus are the afflicted and unfortunate made to suffer, and relieved of fees of various amounts fraudulently, by " self-styled Doctors and impos- tors;'' knowing their misled and unsuspecting victims, or sufferers, would not expose them- selves by prosecuting them for damages, because of mal-treatment, constitutional injury, loss of time whilst under their treatment, and obtaining money under false pretences. There are numerous preparations employed by them in the different venereal diseases, and during all stages, without judgment or discrimi- nation ; hence, the uncertainty of treatment, in- efficiency, etc., at the same time disease 'going on, daily adding to the sufferings of their too credulous patients. Thousands tamper with, and try various pre- parations or medicines, advertised " to cure all venereal diseases," costing dollar after dollar, until large amounts are expended without suc- cess ; when, for a small amount, they would be 106 VENEREAL DISEASES. cured by me, or some other competent physician, on first application to either, in the shortest possible time. Dr. N. B. Leidy has a number of specifics adapted to the various conditions or stages of gonorrhoea, syphilis, and other venereal affec- tions. Any one applying to, or addressing him, (enclosing fee,) and giving a description of his, or her symptoms, there will be sent, in full consideration of fee, by mail, express, or other- wise, as may be desired, his specifics adapted to each one's condition ; and be permanently cured to a certainty, at a reasonable expense, in a short time, and with little suffering or restraint in living and occupation. The following are some of the numerous quackish medicines referred to. There are, be- side these, numerous others, but as they would require a large volume to publish all, I will select a few that may sometimes be employed, in the earlier stages of gonorrhoea, with caution and judgment ; though even their employment at times, depending upon the condition, consti- tution, temperament, etc., of persons, are unsuc- cessful, and productive of unpleasant conse- quences ; it would, therefore, be better if they had not been taken in a large majority of cases — for, differing so much, special treatment, in other words, certain specifics at different periods, phases, or stages of disease, and adapted to cer- tain constitutions, becomes necessary. GONORRHCEA. 107 No. l. — Take of Balsam Copaiba Jounce. Powdered Cubebs J " Mucilage of Gum Arabic 6J ounces. Sweet Spirits of Nitre 2 drachms. Hydrocyanic, or Prussic Acid 8 drops. Syrup of Tolu 2 drachms. Mix — Two tablespoonsfuls to be taken twice a day, between meals. No. 2. — Take of Spirits of Turpentine, Balsam Copaiba, Oil of Amber — of each 1 ounce. Mix — 30 to 35 drops to be taken morning, noon, and evening, on sugar, in a small quantity, milk, or syrup of any kind, fifteen or twenty minutes after meals. No. 3. — Take of Venice Turpentine 1 drachm. Mucilage of Gum Arabic 2 ounces. Emulsion of bitter Almonds 4 " Syrup of Orange 1 ounce. Laudanum 1 drachm. Mix — Take two tablespoonsfuls three times a day. No. 4. — Take of Balsam Copaiba 2 ounces. Spirits of Turpentine 6 drachms. Tincture of Cantharides 2 " Tincture Muriate of Iron Jounce. Mucilage of Gum Arabic 4 ounces. Mix — A teaspoonful to be taken three times a day in water. 108 VENEREAL DISEASES. No. 5. — Take of Sweet Spirits of Nitre Tincture of Cubebs — each J ounce. Spirits of Turpentine 1 drachm. Balsam Copaiba Jounce. Mucilage of Gum Arabic Syrup of Almonds — each 3 ounces. Mix — A tablespoonful to be taken between meals twice a day. No. 6. — Take of White Turpentine Extract of Rhubarb — each 1 J drachms. Refined Camphor, powdered. 1 drachm. Mix, and make into 50 pills — take three pills morn- ing, noon, and evening. No. 7. — Take of Balsam Copaiba Spirits of Turpentine — each Jounce. Liquor of Potass 1 " Mix — 30 drops to be taken three times a day. No. 8. — Take of Powdered Cubebs Jounce. Balsam Copaiba 2 drachms. Sulphate of Iron 1 drachm. Chian Turpentine 3 drachms. Mix, and make into 60 boluses — take five three times a day, before or after meals. No. 9. — Take of White Turpentine, Powdered Cubebs, Powdered Alum — each 2 drachms. Mix, and make into 90 pills — take four three times a day, before or after meals. GONORRHOEA > 109 No. 10. —Take of Balsam Copaiba Syrup of Tolu Syrup of Poppies — each 1 ounce. Powdered Gum Arabic , 2 drachms. the latter to be previously made into mucilage, with three ounces of mint-water, and added to the foregoing. Mix — Take a teaspoonful three times a day. No. 11. — Take of Solution of Potass * 3 drachms. Oil of Cubebs Oil of Copaiba — each \ drachm, Spirit of Nutmeg Jounce. Camphor emulsion 2 ounces. Mix — Take a teaspoonful three times a day. No. 12. — Take of Powdered Cubebs 2 ounces. Cream of Tartar 1 ounce. Mix — Take a teaspoonful in water three times a day. No. 13. — Take of Balsam of Canada 1 ounce. Ginger Syrup 1J li Laudanum , 2 drachms. Mix, and add to the foregoing, the white of four eggs, previously well beat up, with a pint of water. A tablespoonful three or four times a day, to be well shaken when taken. Among the foregoing, it will be perceived, different varieties of Turpentine, Tincture of 10 110 VENEREAL DISEASES. Cantharides, Oil of Cubebs, and Balsam Copaiba, enter into the combinations of mixtures, pills, etc., as remedies for gonorrhoea or clap. Not- withstanding, one or another may perchance prove efficacious, yet, when taken under all cir- cumstances, without judgment or discrimination, us is generally done, and recommended or ad- ministered by self-styled Doctors as " cure alls," distressing and serious consequences often re- sult ; namely, retention of urine, or inability or difficulty in passing it ; inflammation of the bladder and kidney ; swelled testicles, etc. The prejudice against turpentine, as a medicine, is almost universal, but, together with mercury and copaiba, they constitute the principal basis of quackish nostrums, whether in pills, powder, mixture, or any other form, for the cure of gonorrhoea. In the employment of either of the foregoing mixtures, pills, etc., it is advisable to do so, in the absence of as little inflammation as possible. Should much inflammation exist, scalding and burning sensations, during and after urinating, profuse discharge from the urethra, or some swelling of the parts ; the bowels should at once be freely opened, and kept so for two or three days, before taking either. Warm baths will be found efficacious in reducing inflammatory conditions, and reducing swellings. Rest, com- posure, low diet, and abstinence from all malt or spirituous liquors, is recommended to expedite GONORRHOEA. Ill relief and cure. Cleanliness is all important to prevent sores and excoriations of the parts. That unpleasant, or serious consequences, such as salivation, mercurial rheumatism, swelling of the joints, diseased bones, ulcerations, etc., may not result from the employment of mercurial medicines, I deem it proper I should not give prescriptions of them, lest some might be dis- posed to try them without judgment; besides, not administering mercury myself to venereal patients, I certainly would not give any encour- agement to others to use it. Suffice it to say, that mercury is combined and disguised in most preparations of Sarsaparilla and Buchu ; in various pills, mixtures, extracts, specifics, anti- dotes, panaceas, etc., as "cure alls" in venereal diseases, "killing or curing," which is the " motto" of venereal nostrum makers, Quacks, and impostors, with whom the dollar is the " grand desideratum," regardless of the health or lives of their victims. Injections, in former days, were popular, and were much employed. At the present day, how- ever, they are seldom resorted to. There are but few cases, indeed, of gonorrhoea requiring them, particularly among males. In female cases, when affecting the uterus, or vaginal parts, they are indispensable ; but then should only be employed under the directions and advice of a physician. Among the various articles employed, depend- ing upon circumstances, are mild or strong solu- 112 VENEREAL DISEASES. tions, chiefly in rose-water (though pure water is equally efficacious), of nitrate of silver (lunar caustic) ; blue and white vitrol ; acetate or sugar of lead ; acetate of zinc ; tannic acid ; corrosive Sublimate; chloride of soda; decoctions of poppy heads ; oak barks, etc. In the employment of injections in the male, particularly if used at improper times, or injudi- ciously and unnecessary, swelled testicles, in- flammation of the urethra, prostate gland and bladder, gleet, strictures, etc., are more often pro- duced than from any other cause, not excepting the use and frequent introduction of the Bougie (a favorite instrument among Quacks), covered or besmeared with some unctuous substance com- bined with one or another of the articles named as employed for injections. Chordee. — During the continuance of gonor- rhoea, inflammation extends to the lymphatics, ligaments, or chords of the penis, etc., and when erection takes place, mostly occurring at night, the penis being in a state of tension, is curved in one direction or another, and the most intense and excruciating pain follows ; persons so afflicted are aroused from their sleep or rest, and jump- ing from their beds, are temporarily relieved by urinating, walking the floor, immersing the parts in a basin of cold water, or douching them, etc. During the existence of chordee, it is advisable to take a saline purgative in the mornings, and on retiring at night to take about thirty drops GONORRHOEA. 113 of laudanum ; or a quarter grain sulphate of morphia in camphor-water ; or a tea spoonful of lupulin ; or a pill of one grain extract of bella- donna, with four grains of camphor ; if not re- lieved by single doses of either, to be repeated at intervals, two or three times during the night. In the absence of either of the foregoing, it is recommended that a teaspoonful of spirits of camphor (which may be found in most fami- lies) be taken in warm water and sugar, which will often prove efficacious in allaying the ten- dency to erections, and in doing so much pain will be avoided. Lying at night upon a mat- tress instead of a feather-bed, and urinating be- fore retiring, is also recommended. In doing so, and the continuance of one or other of the medi- cines named, nightly, for a few nights, will most generally allay a chordee. Costiveness must particularly be avoided during its existence. Phymosis and Paraphymosis are, also, con- sequent upon a gonorrhoea. The prepuce be- coming much swollen through inflammation, even to its utmost capacity, when covering the head, or glans-penis, and cannot be drawn back, it is called " Phymosis ;" when swollen, and is back of the head or neck of the glans-penis, it is called " Paraphymosis.'' In either case the swellings should be, as early as possible reduced ; which may be done sometimes by warm fomen- tations and compression, constant application of lead-water pledgets, bread and milk or slip- 10* 114 VENEREAL DISEASES. pery elm poultices, renewed two or three times during the day. At the same time taking saline purgatives, observing low diet, rest and compo- sure. Ordinary means, as just recommended, failing to reduce the swellings, puncturing with a sharp pointed lancet, or other instrument, leeching, or dividing the prepuce along the mesial line, and circumcision, or other treatment may become necessary, which can only be conducted by a phy- sician, as much discretion, caution, and care is necessary to avoid suppuration, gangrene, or destruction of the parts. Vegetation, Warts, and Excrescences. — They appear upon the mucous membranes and surfaces of the genitals of both sexes ; around the neck of, as well as upon the glans-penis — around and within the meatus, or orifice of the urethra of the male, and upon the labia, vulva, etc., of the female organs. They are hard and soft, or spongy — of rapid and slow growth, and in proportion as they grow larger, become an- noying, troublesome, and sometimes very sore. They appear in different forms, or shapes, desig- nated by names, similar to objects they most re- semble ; thus we have the cauliflower, or rasp- berry shaped, and the mushroom, with its broad top, slender, pedicular stem. Permitted to grow, they impede the drawing of the prepuce back- ward or forward, and around their bases secrete humors extremely offensive and irritating at GONORRHOEA. 115 times, producing much soreness, excoriations, and ulcerations ; and being very vascular, bleed upon the slightest touch, not permitting even contact with the under clothing or garments. Warts and vegetations are often removed, on their early appearance, by ablutions with tepid water, or astringent washes and applications. If situated upon the surface of the glans-penis, or neck, or upon the under surface of the pre- puce, opposite to, and covering the glans-penis, dry pledgets of fine linen, or lint, should be ap- plied and frequently changed, to prevent their contact on opposite surfaces. This course con- tinued a short time, will cause them sometimes to shrivel, dry up, and disappear. When of advanced growth, wherever situated, it may be necessary to employ powerful escharo- tics, as caustic potass, Vienna paste, nitrate of silver, etc., and often the knife or surgical scis- sors ; in such cases, as well as when very sore, painful, excoriated, or ulcerated, secreting offen- sive humors, and much inflamed, it will be most advisable to seek medical aid or assistance. Swelled Testicles, otherwise known as Or- chitis, or Hernia Humor alis, as consequent upon, or co-existing with gonorrhoea, usually takes place when the inflammation through neglect or improper treatment, extends to the testicles (seldom involving both at the same time), and in its course extending along the spermatic chords and glands in the groins. Similar results 116 VENEREAL DISEASES. happen from taking powerful remedial agents to suppress quickly the gonorrhoeal discharge, or the injudicious employment of different injec- tions for the same purpose ; mostly prescribed or directed by Quacks, to attain a (false) reputa- tion for quickly curing gonorrhoea, in stopping the discharge in twenty-four to forty-eight hours ; but in reality producing consequences twenty times more distressing, serious, and difficult to cure, which they falsely attribute to other causes, to relieve themselves from censure, and with a view to secure additional fees for further services. Severe and almost intolerable pain is felt in proportion as the swelling of the testicles in- creases, as is often the case to treble, or more, their original size ; and so distending the scrotum, or bag, to its utmost capacity, as becoming ex- tremely red, shining, and painful to the touch. During this condition there is generally attend- ant much thirst, fever, nausea, etc., with more or less constitutional disturbance ; and if ener- getic means be not employed to reduce the in- flammation and swelling, much distress and suf- fering is the consequence, besides, sometimes suppuration, or sloughing, of the testicles, or they become so hardened in their enlarged state as requires a long time, and much difficulty, in being restored to their original and natural size, and, occasionally, are never restored. There is seldom a continuance of the gonor- rhoeal discharge, during the existence of orchitis, or swelled testicles, but generally recurs after GONORRHOEA. lit the abatement of the foregoing conditions and reduction, or subsidence of the swellings. A re- currence of swelled testicles is not uncommon, from various causes ; as exposure, colds, im- moderate exercise, venereal excesses, stimulating freely, etc. Some protection against swelling of the testi- cles during a gonorrhoea, will be found in wear- ing a suspensory bag, supporting them, and thereby preventing a dragging weight, or bear- ing down, through tension upon the chords ; a cause of increased irritation. If there be a par- tial swelling, the suspensory bag should be worn through the day and removed at night when retiring. Douching the testicles on retiring, and in the morning, as well as a couple of times dur- ing the day, with cold w r ater, is recommended. If not checking the swelling after tw r o or three days, but continues increasing, some active pur- gatives, as senna and manna, or compound cathartic pills, should be taken daily for three or four days ; or, if preferred, after full evacua- tion of the bowels through the first dose taken, to be followed for three or four days, every three hours, with nauseating doses of tartar emetic, or ipecac. In either case, rest and composure must be observed, and strictly low and simple diet is necessary. If, after pursuing the foregoing prescribed course, there is little or no abatement of pain, or swelling, then medical assistance should be sought without delay, as compression, bleeding, 118 VENEREAL DISEASES. leeching, or other treatment may become neces- sary, requiring medical discretion to judge of and direct. To avoid all risk and long suffer- ing, it would be most advisable, generally in case of swelled testicles, to seek medical advice or assistance. Varicocele, though often co-existing, with, more often exists in the absence of swelled testi- cles ; and though sometimes, perhaps, is caused by their swelling, is generally the result of mas- turbation, or self-abuse. It is first distinguished by a bunch of small cords or vessels, resembling a mass of worms, pendant, mostly within the lower portion of the scrotum, and occasionally become so enlarged as to force the testicles from their natural position, impairing the natural sexual vigor, becomes very annoying, and is the cause of much irritation. Upon the first discovery of varicocele existing, a suspensory bag should be worn throughout the day, and during the night also, if it can be done without too much inconvenience. Douching the scrotum, or bag, with cold water, night and morning, as well as once or twice during the day, is useful, and which, together with a liberal diet, and the use of preparations of iron and other tonics, will check its increase. Strictures. — By a stricture, it is to be under- stood, a swelling or thickening of some portion, or at some point of the lining membrane, or sur- GONORRHOEA. 119 face of the urethra, through inflammation or other causes, and may be spasmodic or temporary. Through neglect, want of timely and proper at- tention, the parts affected become callous, indu- rated, and permanent ; narrowing the canal, or urethritic passage, so as to obstruct the natural flow of urine, causing it to be voided in a single thin stream, or divided into several thread-like, twisted, and irregular streams ; or in proportion to the character and extent of the stricture (or if more than one), the urine is voided by dribbles, or drop by drop, ofttimes very painful, and some- times resulting in retention of the urine, and inability to urinate at all/ Sir B. Brodie thus briefly and intelligently describes the character and symptoms, and some- times consequences of the temporary or spasmodic stricture. "' A man who is otherwise healthy voids his urine one day in a full stream. On the following day, perhaps, he is exposed to cold and damp ; or he dines out and forgets, amidst the company of his friends, the quantity of champagne, or punch, or other liquor, contain- ing a combination of alcohol, with a vegetable acid, which he drinks. On the next morning he finds himself unable to void his urine. If you send him to bed, apply warmth, and give him Dover's powder, it is not improbable that in the course of a few hours, the urine will begin to flow. After the lapse of a few hours you give him a draught of infusion of senna, and sulphate of magnesia, and when this has acted on his 120 VENEREAL DISEASES. bowels, he makes water in a full stream." He further says : " The symptoms of retention are formidable enough, and not the less so as they generally attack the patient suddenly. He is, perhaps, sitting with his friend after dinner, and feels an inclination to make water ; in attempt- ing to do so, however, he is disappointed. A second and third attempt is made at different intervals, and are without success. Now, how- ever, the case assumes a more serious aspect. There is an indescribable uneasiness felt in the region of the bladder ; the efforts to void the urine are no longer voluntary, the patient is forced to strain, and the whole of the abdominal muscles are seen in convulsive action, instinct- ively endeavoring to unload the bladder of its contents In the great majority of cases the spasms are spontaneously or artificially relieved : but there are, nevertheless, numerous examples of the contrary, in which the retention terminates even in death. The bladder itself may be ruptured at the fundus, the urine escap- ing into the surrounding cellular membrane and into the abdomen." Gonorrhoea, and its improper treatment, is the cause of stricture of the urethra in a majority of cases. Where there is severe inflammation along the urethritic canal, during the existence of gonorrhoea, there is consequent swelling of its surface, and narrowness of its passage, causing much difficulty and pain in urinating, and the GONORRHOEA. 121 urine is often retained, notwithstanding the most painful and violent efforts to pass it. Improper and injudicious use of various in- jections, cause strictures ; also, the employment of syringes with sharp point, or bougies, catheters, or other instruments, with rough jagged surfaces, tearing, or lacerating the lining membrane of the urethra, producing inflammatory sores, which, when healed, leave elevated and thickened scars, according to their extent, contracting, and dimin- ishing the passage — the same maybe said of concealed, or indurated chancres within the meatus. The thickening, or induration, of any portion of the urethra, in case of stricture, may be longitudinal, or confined to a small space, or around its circumference, in either case obstruct- ing the passage of urine. In the early formation, or existence of strict- ure, purgatives, leeching of the perineum, gene- ral bleeding, w r arm baths, diaphoretics, and narcotics, are recommended ; in case of retention, if not yielding to their employment, a catheter should be introduced to draw off the urine. In the more advanced formation of, or per- manent stricture, bougies and catheters, from small to largest sizes, are from time to time em- ployed for dilatation ; also, cauterization, inci- sion, etc., with appropriate instruments, are sometimes resorted to. Because of much discre- tion and caution necessary to the removal and cure of stricture, I- shall not prescribe any spe- cific mode of treatment for patients of themselves 11 122 VENEREAL DISEASES. to pursue to effect it ; as it would be attended with much risk and danger in any one unskilled, incapable, or inexperienced to attempt it. Gleet. — A gleet is very often the consequence of a chronic, or long standing gonorrhoea, whether because obstinate, if neglected, or from wrong treatment. A gonorrhoea is not necessarily ob- stinate, but often becomes so, through imprud- ence, indifference, and inattention to medical counsel. Patients indulging and leading an irregular life whilst under treatment, (in many instances denying it, though fully evident from symptoms and circumstances to the physician), by their course counteract the best endeavors and intentions of the physician, and make their situations obstinate, troublesome, and difficult to treat, and despite of all remedies, though the original symptoms may be much abated, a gleet is sure to follow. By some gleet is termed a "worn-out clap,' 7 a very significant term, and the ignorant and inexperienced suppose, as suchj it is incapable of communicating disease. It is a fallacy and error, however, which has been productive of much mischief through intercourse with the opposite sex. Some medical men, I am aware, have encour- aged renewal of intercourse between man and wife, as well as expressed themselves favorable to marriage of parties, either believing in the non-contagious character of a gleet — or too soon II b i n GONORRHOEA. 123 after its disappearance, believing them cured. I have been consulted in, and treated, numerous cases where parties had been erroneously coun- selled, and innocently, on their part, involved in disagreeable, unpleasant, and sometimes serious situations. No physician is justifiable in sub- jecting any one to a risk so long as any un- natural discharge exists — whether it be opaque, serous, or milky, cream-colored, or yellow, or nmco-purulent, and thick, it is unnatural and evidence of a diseased condition, and would more often be contagious and productive of mischief, but for the existence in the female, by nature, of a lubricating secretion, covering the lining and mucous surfaces of the vaginal parts, pre- venting often contact of gleety matter with the mucous surfaces, whereby disease would be com- municated. Gleety discharges are synonymous with blen- orrhagic, and produced through various causes besides gonorrhoea, and treated differently as re- sulting from balanitis, leucorrhea, masturbation, etc., but become, in their progress, unhealthy, infectious, or contagious. A gleet resulting from gonorrhoea, or stricture, as a consequence of gonorrhoea, consists of a discharge without scalding or pain from uri- nating, slight or profuse, dependent upon cir- cumstances, from the mouth of the urethra ; sometimes of a thin muco-purulent character, sometimes thick and glutinous, drying and cover- ing the mouth of the urethra, completely closing 124 VENEREAL DISEASES. it, and preventing the escape of urine until re- moved, or forcibly passing the urine ; when re- moved a drop or more of yellow thick matter either voluntarily follows, or when pressed with the fingers. The latter conditions are mostly observed in the mornings. The discharge is not always constant, though no remedial means are employed to prevent or check it. Ofttimes, though the discharge may be colored and continue for a length of time, it will change to a watery appearance, and after a time entirely cease ; attributable, however, most generally to abstaining from intercourse, being quiet, absteminous, temperate, and irregular in living — but reappearing through intercourse, much exercise, imprudence in diet, eating aspara- gus, horse-radish, mustard, cayenne-pepper, and spices with food, indulgence in wines, malt or spirituous liquors, riding on horseback, involun- tary night erections, and emissions, use of instru- ments during existence of stricture, or other irri- tating causes. Strictures do not so often co-exist with a gleet as is suspected, or as often as represented. They are sometimes said to exist, for reasons I cannot better explain than is written by S. Durkee, M. D., a celebrated author, who says, "Patients very often apply to a surgeon to be cured of stricture when they have none. They have a gleet — the sequence of a gonorrhoea, that has been mismanaged by some knavish Quack, who has neither medical skill nor moral principle. He GONORRHOEA. 125 tells the man that his gleet is dependent on a dangerous stricture, which must be operated upon with the catheter or bougie every few days, or his urethra will close up, so that he cannot make water ; and he promises to cure the poor fellow for so much — usually an enormous sum ; whereas, upon proper examination of the part no stricture can be found." Another celebrated writer, H. J. Johnson, M. D., says, " There is a class of scoundrels, who live, not by curing strictures, but inventing them. Let an unhappy wretch fall into their hands, and if his urethra will admit a poker, they will persuade him he is strictured. The duration of his case will be in the compound ratio of the extent of his credulity, and the full- ness of his pocket." As in gonorrhoea, during its early stages or periods, there are also numerous modes of treat- ment and a variety of empirical or quackish nos- trums recommended for the cure of gleet and strictures — which however, in failing to cure through delay in tampering and experimenting with them, but add to the distress and sufferings of the afflicted, prolonging cure by others com- petent, and attended with greater loss of time and additional cost. To cure a gleet, the result of a gonorrhoea or stricture, more or less time, perseverance, and patience is generally necessary. Various medi- cines, as are recommended for gonorrhoea, may be employed, but in less doses, in conjunction with tonics (the different preparations of iron 11* 126 VENEREAL DISEASES. mostly preferred) and mild astringent injections. At the same time temperate, regular, and ab- stemious living is recommended. Stimulating drinks and high seasoned food must be avoided, as well as too much exercise and fatigue, and sexual intercourse is strictly forbidden. Occa- sionally, a person having a gleety discharge will find it suddenly to disappear, without restraint of any kind on his part, or the employment of remedial agents ; but such instances are rare, and it is extremely doubtful, when occurring, if the gleet be the result of a gonorrhoea or not ; but arising from one or another of the causes producing a blenorrhagic or gleety discharge, as before described, or cause unknown and unsus- pected at the time. Notwithstanding the general characteristic obstinacy, and, I may say peculiar freaks, ap- pearing and disappearing, of a gleet, from what- ever cause, but more particularly from a neglected or wrongly treated gonorrhoea; through a long, researching, observant, and experienced practice, I have succeeded in a plan of treatment curing the most obstinate and long-standing cases of months and years in less than, or in as many weeks. The mode of treatment is particularly and peculiarly my own ; and whilst the general modes of treatment are effectual apparently, after long and tedious treatment, yet, does the gleety discharge often from some unknown cause relapse, to the great annoyance, dismay, and discouragement of the patient ; my mode will be GONORRHOEA. 127 found permanently effectual in a short time, and numerous patients have been relieved through it, after long periods of anxiety, mental and con- stitutional disturbance, and suffering. The ordi- nary modes of treatment as recommended, or as pursued by others, in cases of gleet or blenor- rhagic discharges of a gleety character, failing, the afflicted may at all times rely upon prompt and effectual cure, either on application at my private offices, or through correspondence, with full description of existing condition, suspected or known causes, giving rise to such condition, etc. ; when both medicine and advice will be for- warded as may be directed, in consideration of a reasonable fee. GONORRHOEA IN THE FEMALE. Little has been heretofore said of gonorrhoea in the female, except naming a few prominent symptoms, and advising early treatment, at pages 102 and 103, under general head of " Symptoms of Gonorrhoea." I shall now speak more fully of it as existing in the female, its treatment, when practicable by herself, and its distinction clearly as possible, from other blenorrhagic discharges of different character; the cause sometimes of undeserved suspicion, censure, domestic discord and trouble. Itching of whatever parts of the female organs, when first affected, is more or less severe, and is 128 VENEREAL DISEASES. followed with much redness, inflammation, and swelling, becoming very sensitive and painful, even to disable females from sitting or walking. When not affecting the urethra, but the neigh- boring parts, the inflammation is increased, be- cause of irritation produced by the urine during the act of micturition (the desire to perform which becomes more frequent) being diffused over the inflamed surfaces, attended with scald- ing and burning sensations. On the appearance of gonorrhceal matter, or virus, which as before described, is at first of an opaque or dark cream color, soon changing to a dark yellow, or yellowish green, its dis- charge rapidly increases; and when profuse, through ignorance of its effects, carelessness or uncleanliness, it is permitted to spread over ad- jacent parts, reaching the anus or seat, and sometimes introduced within it, produces, around or within, vesicular eruptions and sores, causing much uneasiness of the parts, distressing annoy- ance and pain ; and, because of locality and other circumstances is troublesome and difficult to heal or cure. So, also, in permitting the gon- orrhceal discharge to run down on the inside of the thighs, producing on the surface similar effects and consequences. The importance, there- fore, of frequent ablutions and cleanliness from the first appearance of the discharge, is manifest — the neglect of it must add to increased suf- fering. Abscesses sometimes arise at some point or GONORRHCEA. 129 other of the organs ; upon the labia the most common, and if upon the inner surfaces, are very painful and annoying, either in sitting or walking, besides troublesome to heal after sup- puration. Swellings in the groins, during the existence of gonorrhoea, sometimes take place, seldom however resulting in suppuration. TREATMENT OF GONORRHCEA IN THE FEMALE. On the earliest indications, or symptoms, of gonorrhoea affecting the urethritic passage of the female, which may be strongly suspected from a tickling sensation along it, and about the mouth, and which is much reddened, or slightly swollen, and attended with unusual scalding or burning heat during and after micturition, suc- ceeded with a discharge of gonorrhceal matter or virus from it ; sulphate of magnesia (Epsom salts), or calcined magnesia alone, or the two combined, or other saline aperient medicine, should be taken at least every other day, in suffi- cient quantity to keep up free action of the bowels ; besides, daily three times, on sugar, be- fore or after meals, thirty to forty drops of Bal- sam Copaiba ; or an even teaspoonful of powdered Cubebs in water, syrup, or molasses ; or one or other of the medicinal compounds {with the ne- cessary precautions) heretofore named, from page 106 to 110 inclusive. Females, if employ- 130 VENEREAL DISEASES. ing the latter, should, however, only take one- half to two-thirds the quantities directed for males, unless of otherwise healthy condition and without constitutional derangement. Simple diet, rest, and composure, and the free use of demulcent and nutritious drinks, as slip- pery-elm or flax-seed tea ; barley, rice, gum- arabic or toast-water is recommended, particu- larly during the existence of an inflammatory condition. Baths of lukewarm water are at all times beneficial. Inflammation of the urethritic canal, unless early arrested, frequently extends to the bladder, and is generally succeeded with febrile symptoms and constitutional disturbance, requiring medi- cal counsel ; and I would, by all means, advise it. When a gonorrheal discharge is from within the vagina (except it is known to be from the uterus), the treatment is of a different and local character; various injections are chiefly em- ployed, and no special remedies or other medi- cines, require to be administered or taken inter- nally, other than such medicines as may be necessary to keep up or maintain an otherwise healthy condition of the system. If there be much redness, inflammation, or swelling of the labia, or other parts, tampons, soaked with lead water, should be constantly kept between the labia to prevent contact of their sides, or within the vaginal entrance ; as well as pledgets of lead water constantly applied to the parts externally, until the inflammation GONORRHCEA. 131 and swelling is reduced ; if not successful, appli- cations of slippery-elm or bread and milk poul- tices — or frequent ablutions of warm water will- effect it. On the appearance of a gonorrhceal discharge from within the vagina, particularly if attended with a sensation of heat or burning pain in- wardly, copious iDJections of a solution of one ounce of sugar of lead, with a quarter of an ounce of sulphate of zinc in half a gallon of water, re- peated three or four times a day for several days, or until pain, inflammation, and the discharge shall have almost or entirely disappeared, will be found very effectual, and may be followed by injections of one or other of the following (of equal merit, though one or another may be at times preferable, which cannot well be deter- mined here) ; namely, flax-seed or slippery-elm tea; decoctions of marsh mallows, poppy heads, or oak bark ; one ounce of alum dissolved in half a gallon of water ; two ounces of best pow- dered red peruvian bark, boiled ten minutes in half a gallon of water, to be used when cold ; a quarter ounce of acetate of zinc, dissolved in half a gallon of water, etc. Should the discharge become offensive, which sometimes is the case, previous to the employ- ment of any of the foregoing solutions or decoc- tions, it is advisable to employ copious and fre- quent injections of one and a half ounces solution of chloride of sodium, added to half a gallon of 132 VENEREAL DISEASES. water, to be continued until offensiveness be removed. Copious injections of cold water, in a stoop- ing position over a basin or other vessel, should always be employed for purposes of removal of diseased humors and cleanliness ; to be followed with one or another of the injections before re- commended, made in a recumbent or lying posi- tion, that the fluid injected may be retained for five minutes or more each time. The largest class, female syringe (glass pre- ferred), should be employed ; although not of sufficient capacity to contain the desired quantity of solution, etc., to be injected — the injection should be several times repeated. Half a pint or more should at all times be injected, and if a metal syringe (half pint in capacity), with long curved pipe, or pump syringe be at hand, or can be procured, it will be most desirable. The foregoing treatment recommended by me, must be understood as applicable only to the early and acute stages of gonorrhoea, by which females with ordinary intelligence and judgment, may be able to conduct their own cases. There are, however, during the existence and progress of the disease in many instances, various circum- stances intervening which renders their situations critical, and management, treatment and cure troublesome, difficult and obstinate. I allude to the existence of leucorrheal or other blenor- rhagie discharges from other causes than gonor- rhoea, simultaneously existing; or even when GONORRHOEA. 133 the disease has been almost subdued, the menses appearing when treatment cannot be persisted in, and the disease after cessation of the menses, recurring with its former violence. There are also, other circumstances or conditions, which it is unnecessary to name here, existing among females, that, except in a few cases only, where otherwise the most healthy conditions exist, would it be prudent for them to rely upon self- management of the disease ; it would, therefore, be advisable in most instances to seek medical aid. To distinguish other blenorrhagic discharges from gonorrhoea, to prevent suspicion, or domes^- tic troubles, are important. Although not so easily done by others as physicians, more familiar with the various discharges, I will endeavor to point out the differences as clearly as I can ; and if I shall succeed in preventing difficulties, whether between man and wife, or the single of either sex, I shall have gladly accomplished what I desire. It sometimes happens, because of uncleanli- ness, certain secretions, of a white, cheese-like appearance, and more or less sticky, are allowed to remain and accumulate in the folds of the labia or other parts, until producing an irrita- tion of the mucous surface ; from which escapes a watery or serous fluid, added to the secretions named, which, if not checked, increases and changes to a dark yellowish appearance. A discharge not dissimilar to that just de- 12 134 VENEEEAL DISEASES. scribed, occurs through improper habits or in- dulgences among young females, and in the ab- sence of all intercourse. A discharge often arises, also, from pruritus, or itching of the pudendum ; a complaint which will hereafter be noticed. Through carelessness and neglect of treatment the discharges become darker in color, ichorous, and sometimes offensive ; irritating surfaces when coming into contact, and creating erup- tive sores, which also take on a discharge, and, in either case, capable of transmitting similar affections through intercourse with the opposite sex, although neither may ever previously have cohabited with others, (this frequently happens, giving rise to much trouble between newly mar- ried couples and their friends.) Various symp- toms attendant upon genuine ; gonorrhoea, are mostly wanting in the discharges just referred to. Further remarks in relation to them, with advice, as to treatment, etc., will be found in preceding pages, under the heads of Spermator- rhea, Blenorrhagia, and Balanitis. Discharges also arise from various causes, per vagina, from the uterus, under circumstances re- quiring special medical attention ; it will, there- fore, be useless for me here to designate them, or add anything further in relation to them, ex- cept to say they occur among the unimpregnated and virtuous, single or married. Leucorrhcea in females, vulgarly called "the whites," are the most liable to create unfounded SYPHILIS. 135 suspicions, but mostly with the ignorant. Leu- corrheal discharges are common to the virtuous, single or married ; even existing in childhood, and, through their continuance, ofttimes chang- ing from their original color, milkish white or creamish, to a dark yellow, with greenish tinge, similar to gonorrheal matter. The leading symptoms and results of the latter are mostly wanting, however, in the former, and afford reasonable grounds for distinction. In conclusion of this subject, I will remind both sexes of what I have heretofore so strongly urged, ob- serving which, they may be candidly assured the hun- dredth part of these troubles, as well as anxiety and suf- ferings which heretofore existed, will be avoided ; I mean, " the importance of cleanliness, early and efficient coun- sel and treatment." SYPHILIS, VULGARLY CALLED " THE POX." As some writers confound the term " Syphilis" in such a manner as to make it appear synony- mous with gonorrhoea or "clap," or obscure its meaning, leaving the reader in doubt as to what is truly meant by it, I wish to be understood, that there is a positive difference between the "clap" and "pox," — "gonorrhoea" and "syphilis;" both contracted through venery (venereal indul- gences, from whence the comprehensive term "venereal diseases"); the virus, or matter, of 136 VENEREAL DISEASES. either differing, and producing, from the first of them, contagious influences, symptoms, effects, and results totally different, and requiring differ- ent treatment. Without arguing or theorizing upon technical terms or differences, for professional distinction ; to make myself intelligible and understood to the afflicted and unfortunate, particularly, I shall use the term " syphilis," as designating " the pox," and nothing else ; leaving gonorrhoea, or u clap," to be understood as I have treated of it, so that in regard to difference between the two, no one can scarcely mistake in the perusal of this small work. Syphilis, then, is to be understood as consti- tuting another of that class of diseases called " venereal;" which, with few exceptions, is con- tracted by both sexes, through sexual inter- course ; the syphilitic virus, or matter of the sores, or chancres of one, coming into contact with the mucous surfaces of the genitals of an- other, is absorbed, and is thereby transmitted or conveyed. The exceptions alluded to, are those who, without such intercourse, yet having upon their hands or persons, abrasions, eruptions, or sores of different characters, being engaged in dressing syphilitic sores, chancres, or suppurat- ing buboes of another, unobserved, or carelessly get upon their hands the matter or virus ; and unknowingly, or accidentally, brings it into con- tact with such sores, etc. , which is quickly ab- sorbed, and in a very short time manifests itself, SYPHILIS. 137 or appears in the secondary form or stage of syphilis. The same consequences result also to per- sons themselves with chancres, under similar cir- cumstances, of matter unobserved upon their fin- gers, and with one or the other picking their teeth, or nose ; rubbing their eyes or scratching them, and lodging a small quantity of the virus from the fingers upon the edges of the eyelids, or some portion of the eye ; the loss of an eye is sometimes the consequence in a very short time. That the disease can be transmitted by the virus in contact with the natural, healthy, and unbroken surface of the skin, is doubtful, and not generally admitted by the profession ; where it is supposed to have occurred, it is more than probable that there existed at the time fissures or cracks of the skin, or slight abrasions unob- served within the folds, through which the virus was conveyed. From the disposition many have, for reasons known to themselves only, to conceal the true manner of contracting the disease (particularly if through illicit intercourse), other causes are named or suggested by them, such as lying be- tween sheets, where others had previously lain ; lying with another diseased, and during sleep coming in contact ; or from virus left upon the seat of a water-closet ; or from using the same chamber-pot, etc. Such suggestions are how- ever, generally received with allowances among physicians. It is better at all times for patients, 12* 138 VENEREAL DISEASES. however situated in life, whatever their position or occupation, whether male or female, single or married, and at whatever age, they should freely and candidly acknowledge all (if they had sus- picious intercourse) to their physician ; particu- larly if he be inexperienced, that little doubt may be involved in his mind as to the true character of their disease, and he be the more certain and better governed in its treatment. The practical, observant, and experienced physician cannot be easily misled or deceived, and observes a most prudent rule in not leaving doubt, or doubtful representations to control him ; but acting upon his better judgment, treats his case as he sees, believes, or knows it to exist. The ignorant Quack and impostor (to whom many unfortunately and unsuspectingly apply), incapable of judging of, or distinguishing be- tween syphilitic or other eruptions and sores upon the genitals, or any portion of the body, and equally incapable of treating either ; blindly leads his patient (more properly " victim") on to a chance, or with positive promises of cure so long as he may be in receipt of pay or fee, how- ever inconsiderable. Thus, I may say, he crimi- nally drags his victim on to an almost irrecover- able condition, and sometimes past recovery; pre- ceded with months or years of misery, suffering, and the horrors of a disease illicitly, immorally, or otherwise contracted, fancied and pictured in his mind, added to curses against the impostor or Quack, the instrument of his loathsome, dis- SYPHILIS. 139 tressed and hopeless condition. When not end- ing in premature death, he finds his constitution so broken down, prostrated and enfeebled, as to make life itself a burthen, and death is sometimes prayed for to terminate his sufferings. This is no overdrawn picture ; I sincerely regret I should ever have seen or known of so many instances of human misery and suffering, from causes as represented. Whilst I shall give a brief history of the pro- gress of syphilis, or "pox," in as plain and in- telligible a manner as I can, from its beginning through its various stages, and its final results, I shall only advise treatment in its primary or early period ; and do so with a view of discour- aging and deterring patients, as much as possi- ble, after the 'primary stage of it, from attempt- ing, or placing too much reliance, through de- lusive hope in being able to cure themselves (not- withstanding all published treatment, which is sometimes done by impostors purposely to exag- gerate the conditions of patients in anticipation of larger fees) ; or from tampering with quack medicines, or quack Doctors, and through disap- pointment, loss of time, and wrong treatment, bring upon themselves the consequences as be- fore described. Syphilis, when running into, as well as during, and after the secondary stage, requires in treat- ment much discretion and judgment on the part of a physician ; and even he, unless he has had the benefit of considerable experience and obser- 140 VENEREAL DISEASES. vation, will often be much disappointed in his efforts, and is ofttimes baffled. PRIMARY SYPHILIS, OR CHANCRE. From one to ten days after intercourse, primary syphilis manifests itself, by the appearance upon some part of the mucous surface of the genera- tive or genital organs of either sex, of one or more pimples or pustules, containing the syphilitic virus, which being absorbed forms the nucleus, for what afterwards terminates in the syphilitic sore or chancre. Through the suppuration of the pustules, there are caused as many separate or distinct chancres, or if close and approximat- ing each other, run into one. These are usually designated as the primary sores or chancres, and as constituting the primary stage of syphilis, or "pox." It is at this period when the progress of the disease may be often arrested by persons them- selves under prescribed treatment ; but there are instances where persons of peculiar idiosyn- cracies, temperament, habits, or constitutions, susceptibilities to contagious or infectious dis- eases, etc., will resist all ordinary means, and after much trouble in their treatment, will oft- times run into the secondary stage despite of all efforts to prevent it, before a favorable impres- sion can be made. Under proper treatment, however, these cases are afterward manageable, and can be effectually cured. SYPHILIS. 141 When a chancre is once fully established and developed, the ulceration either spreading on the surface or penetrating, in the absence of much inflammation, an escharotic of some kind should be applied to the surface of it without delay. If much inflammation of the surrounding part affected exist, it is advisable, first, to reduce it by the application of slippery elm, or bread and milk poultices. The escharotics in general use, and to be preferred, are the Nitrate of Silver (lunar caustic), Yienna paste, or caustic potass. After the application of either, an eschar or scab, is produced upon the surface of the chancre, which, after a time, falls off, or is easily re- moved ; after which pledgets of fine linen or muslin, frequently moistened with one or other of the solutions or applications hereafter named, should be kept constantly applied, in such man- ner as to prevent contact of diseased parts with opposite surfaces ; the pledgets to be removed two or three times a day, and clean or fresh ones substituted, kept moistened or wet with either of the solutions recommended, and applied as before. Should the pledget be dry and stick to the sore, it should be made perfectly wet and soft with water, to prevent bleeding on its re- moval. The following are the solutions, or applica- tions, referred to : Take of Sulphate of Zinc, Sulphate of Morphia — each 3 grains. Dissolve in two ounces (half a gill) rose or fresh water. 142 VENEREAL DISEASES. Take of Acetate of Zinc 4 grains. Aqueous Extract of Opium 10 u Dissolve in two ounces of rose or fresh water. Take of Sulphate of Zinc 3 grains. Tannin 10 « Dissolve in two ounces of rose or fresh water. Take of Ammoniated Iron and Alum 10 grains. Dissolve in two ounces of rose or fresh water. In the absence of inflammation, and the sur- face of a chancre presenting a healthy appear- ance, the application of aromatic wine will prove very soothing and healing. A single application of an escharotic in the beginning may not always be sufficient, and a second or third may be necessary at intervals, after applying one or the other of the solutions recommended, for a couple of days ; and especi- ally if the chancre be indolent, that is, not dis- posed to heal, and apparently getting neither better nor worse; and after taking on renewed action, to be followed with one or the other of the solutions named. From the beginning, it is also recommended, a teaspoonful of the following be taken in any quantity of water, twice a day, at any hour be- tween meals. SYPHILIS. 143 Take Iodide of Potass 4 drachms (J oz.) Dissolve in two ounces of distilled water, and add two ounces of Tincture of Colombo, or Quassia, or Peruvian Bark, or Wine Bitters. Any of the foregoing may be procured from respectable Druggists. During treatment, as just recommended, the condition of the system requires attention. A nourishing and wholesome diet is necessary; the natural strength of the constitution must be sup- ported, and a healthy condition of the system otherwise maintained. In case of debility, or prostration from whatever cause, various tonics should be employed, and moderate indulgence in stimulating drinks. Thus far only can I prudently, and in justice to patients, without risk or danger, advise treat- ment of their own cases ; still, however, as little can be gained or saved pecuniarily by persons treating themselves, having mostly to pay very dearly for medicines, and even then run the risk of obtaining them pure or of good quality ; be- sides, the risk of their being properly prepared, making their efficacy doubtful ; I believe it would be most advisable, when practicable, at first, to seek competent medical assistance ; besides, there are conditions, or circumstances, existing with one another, requiring, in connection, other ad- ditional attention, making it impossible, in the primary stage, to succeed in curing by one pre- scribed, uniform course of treatment, in all in- stances. After the primary stage it would be 144 VENEREAL DISEASES. unsafe and injudicious for patients to attempt treatment of their own cases, and I shall not, therefore, prescribe any specific course to be pursued; because, of numerous changes occur- ring among individuals from causes not always previously known during the progress of the dis- ease, but afterward sometimes learned or dis- covered, and requiring different treatment, de- pendent upon those causes ; hence, the serious and lamentable results in so many cases, from the employment of Quackish remedies or treat- ment ; in other words, the taking of the same Quack medicine, as a "cure all," in all stages of the disease, and under all circumstances ; or, the same continued course of treatment '.? at all times/' by some Quack, without change, because knowing no other. Besides primary syphilitic chancre, as de- scribed and treated of, there are other varieties ; sometimes rapid in their progress, obstinate in character as to treatment, and often from vari- ous causes, resulting in serious constitutional dis- turbance and injury ; thus forbidding the idea or folly of persons attempting to cure themselves, or losing time in tampering, or experimenting with quackish specifics. Indurated Chancre. — This form of chancre commences by thickening and hardening of the edge, somewhat elevated at first, of a pearl color, and cartilaginous appearance, soon ex- tending over the whole or greater portion of SYPHILIS. 145 the original chancre, and hiding from view its ulcerated base, notwithstanding ulceration is still going on underneath, but slowly ; it is now elastic, and yielding to pressure with the finger upon it, and without pain ; but sooner or later, because of its hardened covering, with an ulcer- ated condition confined underneath, inflamma- tion and suppuration follows, or if not, mortifi- cation commences its work, when febrile and other symptoms arise, requiring prompt treat- ment. Phagadenic Chancre ; so-called, when in- stead of the primary chancre extending in depth through ulceration, it extends superficially over portions of the mucous, or other surfaces of the genital organs, sometimes circular, oval, or ir- regular in shape, with its edge inclining inward, presenting an hemmed appearance ; the surface is covered with a somewhat thin, yellowish, ichorous matter, penetrating through which may be seen grayish or transparent vesicles, besides elevated spots, resembling granulations, alto- gether making the base rough and uneven. There is also existing more or less inflamma- tion and irritation of the surface, making it very sensitive and painful to the touch. Serpiginous, or Creeping Chancre. — This is of similar character and appearance of the former, but in progress of ulceration of the sur- face, pursues a winding or serpentine course. 13 146 VENEREAL DISEASES. Gangrenous Chancre. — From various causes the former described chancre becomes very much inflamed and irritable, swollen and painful, giv- ing rise to a febrile condition, nervousness, head- ache, etc. The surface of the chancre instead of being covered with a thin yellowish matter, now is covered with a thick, tenacious slough, shreds of which are thrown off, and underneath exposes a somewhat dark, blackish appearance — sloughing and gangrene, or mortification fol- low, and if not early arrested there is great de- struction of the parts. There is now much prostration of the system, constitutional disturb- ance, fever, cold night-sweats, etc., and if not early relieved the worst consequences may be anticipated. Urethral, or Concealed Chancre. — This must not be understood as constituting a special variety of chancre, not heretofore treated of. Its title is simply explanatory of its' locality, be* ing within the urethra, often not within sight, and sometimes located immediately within the mouth. It is however, of much importance to refer to it ; as when concealed, through ignor- ance of persons, or carelessness when applied to by a patient, in not discriminating; mistaking the discharge from a chancre for a gonorrhoea, he is treated for the latter, and sooner or later a syphilitic bubo appears, and also secondary syphilis; or the mistake is not discovered until the point of the penis has been completely eaten SYPHILIS. 147 away in its circumference, and within the urethra from its mouth, sufficiently large to take in a large sized pea, or even larger sometimes. Frequently, patients suspecting something wrong, having had a gonorrhoea as was sup- posed (the discharge having ceased from the urethra, and thought cured by others, or them- selves) ; have applied to me with swellings in the groins, eruptions of various kinds on different portions of their bodies, and other unusual indi- cations, which, after investigation proved to be syphilitic ; and ofttimes, and to their astonish- ment were undeniably in the secondary stage of syphilis. In most of those cases I discovered upon inquiry, astringent injections had been used by them, or given and prescribed by others, for gonorrhoea; which, in case of chancre, simply has the effect of drying up or healing superfi- cially, and not capable of destroying syphilitic virus which is left in the cellular tissues under- neath the healed surface, to be introduced and conveyed through the system. The foregoing further shows the importance of applying, at all times, to a competent, as well as an experienced medical adviser. CHANCRES IN THE FEMALE. In consequence of the greater extent of sur- face of the female organs exposed to the liability of contracting syphilis than in the male, more 148 VENEREAL DISEASES. chancres are oft found to exist at one time in the former than the latter. Chancres among females sometimes exist without their knowledge for some days or weeks, because of little or no pain accompanying, and being often hidden from sight, because of their locality ; being unob- served, and originating as often within the labia and vagina as upon the external surfaces or parts. When originating internally and extending mostly superficially in their progress, reaching the ex- ternal folds or edges of the vulva or labia, or when originating upon external parts, they are soon discovered because of urine often being dif- fused over them whilst micturating, causing a smarting and burning sensation, as well as pro- ducing much irritation, inflammation, and swell- ing ; which, unless early arrested, leads to sup- puration and sloughing of the parts, attended with fever, prostration, and constitutional dis- turbance. Deep ulceration from chancres is not so com- mon in females as in males, nor are indurated chancres so frequent. Syphilis from the beginning in the female varies little, under all circumstances, in its course and consequences from the male ; treatment in the beginning or primary stage, in most in- stances, are the same in both sexes also, and to particularize further, or to recommend any par- ticular course of treatment here, would be but a repetition of what has been already said on former pages. SYPHILIS. 149 In the female the locality of chancres is most generally upon the vulva or labia, the external edges or inner sides, the internal surfaces of the vagina, or at the mouth of the uterus. BUBO. Buboes are generally considered as belonging to the primary stage of syphilis, but exist quite as often in the secondary, though originating sometimes immediately before the secondary stage has been developed. To patients, how- ever, it is of little importance whether they be- long to the first or second stage, as their greatest anxiety is to be rid and cured of them. All buboes are not necessarily venereal, but they most frequently perhaps, are the result of syphilis and gonorrhoea ; swellings in the groins of either sex often occur from a variety of other causes, which, in so small a work cannot here be detailed, and create sometimes much suspicion as to their real character. Swellings in the groins are generally called buboes, and great caution is necessary in discriminating between venereal buboes and others ; as, besides the un- founded suspicions, mortifying to, and produc- ing mischief among innocent parties, the treat- ment of the respective characters of buboes or swellings, is different. A venereal bubo originally arises from inflam- mation consequent upon chancres or urethral inflammation, and sores often arising upon some 13* 150 VENEREAL DISEASES. portion of an elongated prepuce, from a gon- orrhoea, and sometimes succeeds and co-exists with Phymosis and Paraphymosis ; the inflam- mation from either follows the course of the lymphatics and absorbents underneath the skin, until reaching the glands in the groins, which also take on inflammation and swelling ; if not early arrested or checked, the bubo sometimes increases to such size as to interfere with walk- ing ; increasing in inflammation, it also becomes very painful, and suppuration takes place, mostly accompanied with fever, prostration, night- sweats, etc., until relieved upon being opened, when, from a gill to a half pint of suppurative matter is discharged. A large cavity is thus left, and an extensive exposed opening, through the destruction from suppuration of the parts; which, in some cases, heal rapidly, while others may be more slow, troublesome and difficult to heal ; sometimes are obstinate, and months trans- pire before healing, and then only through much care and skilful management. Buboes seldom exist in both groins at the same time, and when existing, one progresses more rapidly and suppurates before the other, and through suppuration and succeeding treat- ment, one will often exhaust and dissipate the other. A bubo from observation has been mostly found to arise in the groin, corresponding with the side of the penis upon which a chancre or sore is located. If on the frenum or bridle however, or from gonorrhoea! urethritic inflam- SYPHILIS. 151 mation, there seems to be no distinction, appear- ing on either side; sometimes both, but very seldom. A bubo from gonorrhoea seldom suppurates — from syphilis more frequently, unless very early checked, though despite of all early precautions and treatment, a syphilitic bubo will sometimes run its course, suppurating, etc. Buboes are much less common among females than males ; nor are they always consequent upon chancres existing in a greater proportion than one-third, or perhaps a fourth. Upon the first indication of bubo, when there is slight pain, inflammation and enlargement, or swelling of a gland in the groin on either side or both, it is important its progress should be arrested as soon as possible. This may generally be accomplished by the constant application, for a couple of days, of pledgets steeped in cold water, or lead water ; if no lessening of the pain, or inflammation, or reduction of the swelling is effected, compression may be made by means of an oval wood pad covered with some soft mate- rials, immediately over the prominence of the swelling, and firmly retained in that position, in some manner to be devised by the patient in the absence of a regular pad and bandages made expressly for the purpose. Compression being ineffectual after several days, it is advised to blister or paint the surface of the bubo, morning and evening, for two or three days, with tincture 152 VENEREAL DISEASES. of iodine. The application of the iodine iD the beginning is generally preferred. During either of the applications, quiet, com- posure, and rest in a recumbent position, to- gether with a nourishing and wholesome diet is recommended. Ordinarily, incipient bubo, still hard and without any indication of suppuration, unless taking place very deeply, or is evinced by softness at some point on the surface, is some- times arrested in its course ; at other times de- spite all means, efforts or attempts to check it, proves unavailing ; why it is so, is dependent upon various causes and circumstances connected with patients, as has been before named, during the existence of other complaints or diseases. The bubo when increasing in size and inflam- mation, the surface becoming much reddened, shining, and very painful, soft and yielding upon pressure, and suppuration going on, it should, as quickly as possible, receive medical attention ; that by some means (opening with a lancet gene- rally made) the suppurative matter may be allowed to escape, to prevent as much as possible de- struction of the parts, and also prevent a chance of constitutional taint or disease, through absorp- tion of the matter, which is conceded to be in- fectious also. SECONDARY SYPHILIS. There is much discrepancy among medical men as to the development of the second stage SYPHILIS. 153 of syphilis ; it sometimes immediately succeeds the primary, at other times not appearing for weeks or months (and even years, according to a few writers of some practical experience and ob- servation), after the apparent cure of chancre, etc., or of the primary stage ; — thus showing the farther necessity of competent medical coun- sel, when it can be obtained, even in the begin- ning, that with the advantage of experience, and a proper discernment of the habits and peculiar conditions of patients, treatment adapted accord- ingly in each case, may be the more effectual, and the disease be permanently eradicated from the system. Simply removing the inflammation and heal- ing of a syphilitic sore 'or chancre, etc., in the primary stage, as speedily as possible, and pro- nouncing a patient cured, as is the practice of some, and Quacks especially, to obtain the (false) reputation of "effecting speedy cures," is but in reality burying for a time the syphilitic virus ; and is generally taken up by the blood and dif- fused through the system, to manifest or develop itself after a shorter or longer period, by blotches or eruptions on different portions of the body, by inflamed and ulcerated throat and tonsils, inflammation, pain and swelling of the joints, etc. As regards the development of the secondary stage, the latency between the primary and secondary, and among other contingencies, the treatment of the primary stage ; I cannot more fully, explicitly, and briefly express myself, than 154 VENEREAL DISEASES. as Dr. Silas Durkee expresses himself, who writes as follows : " There are so many differences in the con- stitution of patients, such diversities of treatment for the cure of the original accident, so many varying circumstances, in which the individuals implicated are placed, such dissimilarities in their personal habits and occupations, such gra- dations, fluctuations and extremes of climate, and such changes in the seasons of the same latitude or region, that it is impossible to deter- mine what is the natural term of latency, which the modified syphilitic virus would observe. The primitive unadulterated venereal poison, that which generates the chancre, obeys a nearly uniform law of incubation ; but the diluted ele- ment, that which has been incorporated into the blood, appears to be subject to many contingen- cies, that have a direct control over it in pro- ducing its visible effects upon the constitution. Sex has something to do with the interval be- tween the primary lesion and the consecutive manifestations. The latter developments ap- pear at an earlier day in women than in men." Symptoms op Secondary Syphilis ; — briefly described from their earliest development, to give the reader an idea of the horrors of the dis- ease and its consequences as it progresses, with- out prescribing treatment ; for reasons stated at pages 139, 143, 144, and 147. Secondary syphilis is developed upon the sur SYPHILIS. 155 face of the body, and affects the eyes, nose, mouth and throat, with more or less of a febrile condition mostly existing, and constitutional effects always accompanying. Yarious erup- tions and ulcerated sores appear upon the skin, and other parts named, differing in cha- racter, and appearing at different periods, as follows: Roseola ; — appearing in reddish and copper- colored spots, at first upon the skin ; when numerous, as in measles, approximating very closely, they sometimes run into and form patches of various sizes ; changing afterward to a pale yellow color, and eventually disappearing leave the surface of a natural color. They are most common upon the abdomen (belly), the lower extremities, back, shoulders, arms, and forehead. They are of long and short duration, disappear- ing from one locality and appearing at another, and sometimes disappearing altogether, and re- appearing at intervals of weeks and months. Eruptions almost similar to the foregoing, appear- ing from syphilis, often follow the use of Balsam Copaiba ; but may be distinguished from syphi- litic, as not running into patches, nor covering so large surfaces ; but are scattered, attended with much itching, and disappear upon ceasing the use of the balsam. Syphilitic roseola is attended with but little, seldom any itching sen- sation. 156 VENEREAL DISEASES. Yesicular Eruptions ; — appear in small and elevated pustules containing a limpid matter or fluid, generally absorbed or drying up, leaving behind copper-colored spots upon the skin ; eventually they disappear altogether, but only to add to the further progress of the syphilitic taint of the system, and to be manifested in an- other form or phase. Papular Eruptions ; — appear in small ele- vated sores upon the skin, at first hard and of a coppery color ; they appear mostly in clusters, so close as to run into one another and form one large superficial eruption; thin whitish scales form over them, which get rubbed or fall off, and are succeeded from time to time by others. They sometimes suppurate and become very sore. Their first appearance is generally upon the ab- domen, though their locality is not always con- fined to any particular portions of the surface of the body. On the soles of the feet, the palms of the hand, and inner surface of the fingers, they take on a different appearance ; increasing to the size of a half pea and become very hard, even horny and crustaceous ; they sometimes crack and fissures are created, into which fluids of any kind entering, causes much irritation, soreness, and pain. Papular eruptions also ap- pear upon the head, generally dry or scaly on the surface, and very seldom suppurate. In fact, suppuration seldom takes place in this form of eruption, except among individuals of bad or broken-down constitutions. SYPHILIS. 151 Syphilitic Pustules; — appear numerously upon different parts of the body, small, red, and elevated ; they contain a yellowish matter or serum — ulcerate and run into sores with hard and elevated edges, and extend to a large size, mostly round shaped. From the commencement of a pustule to ulcerate, the matter exuding and drying, forms a scab over its entire surface ; the secretion of matter going on underneath, de- posits and thickens upon the under surface of the scab, forcing it outward to the height of a quarter, sometimes a half inch above the sur- rounding surface ; even whilst thus increasing in height, ulceration is going on under the sur- rounding surface, beyond the circumference of the sore or scab. It is no exaggeration, when I say here, I have seen instances, and cured them too, where the outward surface of the body was covered with them, varying in size from a quar- ter to one inch or more in diameter, and spaces between not exceeding two inches, and in some localities not half an inch from each other. They often appear on the head, and are (if possible) more annoying and troublesome, because of the hair. Daring treatment they will sometimes heal entirely underneath the scab, which, falling off, discovers cicatrization, reddened on the sur- face, and the healed parts depressed and pitted. At other times when the scab falls off, or is accidentally removed, an unhealthy deep ulcer- ated sore is presented, troublesome, often obsti- nate and difficult to heal. 14 158 VENEREAL DISEASES. Syphilitic Tubercles ; — one form is desig- nated " mucous," because mostly appearing upon the mucous surfaces of the genitals, upon the lips, within the mouth, on the tonsils, the verge of the anus, etc. ; although no portion of the exterior of the body is exempt from them. The mucous tubercles are flattened and irregu- lar in shape, appear isolated or in groups and clusters ; pale red in the beginning, growing much darker, and secreting an acrid, irritating pus of an offensive odor ; and when a number of tubercles closely approximate each other, the pus being diffused, forms patches varying in size to the extent of the group ; presenting on the entire surface small, elevated, and united granulations, resembling the raspberry. The mammae (breasts), the scrotum, and parts sur- rounding the anus, are as often the seat of this form of tubercles as the mucous surfaces. Another form, more generally isolated, ap- pears without any special locality on the body ; which is at first hard, elevated, round or conical shaped, usually growing to the size of a large pea, and often much larger ; when they become much reddened, inflamed, and soft, they secrete a very offensive pus, which, sometimes drying and contracting, forms hard dark colored scabs, upon their surface ; at other times deep excava- tions are made through ulcerations, which much disfigures the parts affected, as on the forehead, on the nose, or other portions of the face. SYPHILIS. 159 Syphilitic Ulcerations within the mouth, throat, nose, and of the eyes, occur also in the secondary stage of the disease ; — upon the in- side of the cheeks, on the gums, tongue, and lips ; the ulcerations are often preceded by small white patches of film, and when extending or spreading over the mucous surface run into each other, forming large patches of irregular shape. Superficial ulceration follows, somewhat of a phagadenic character, before described ; but sometimes extends in depth, causing some de- struction to the parts affected. The tonsils and uvula often become much swollen and inflamed, followed by ulceration and sloughing ; and when taking place, as also of the pharynx and throat, serious consequences may be apprehended ; if within the nose, destruction to a greater or less extent is sure to follow ; and, if of the eye, the destruction is oft complete before it can be arrested. Ulcerations of the parts just named, as often results from mercurial treatment of syphilis in its earlier periods, as from syphilis itself; and in very many instances, follows the employment of various nostrums and preparations often con- taining mercury, referred to at page 111. If the afflicted and unfortunate would ofttimes but reflect a little, they would of themselves be con- vinced of the fallacy of any one particular pre- paration, being a specific in such a variety of diseases, as named by the proprietors or manu- facturers of them ; and by not tampering, experi- 160 VENEREAL DISEASES. menting with, or trying them, they would, be* sides, save much time, money, and additional suffering. Loss of Hair, — from secondary or constitu- tional syphilis is common. Various eruptions, as appear on other parts, also appear upon the scalp ; even at an earlier period there is ofttimes a formation of scurf, scaly eruptions and small papula upon the head, secreting a pulpy, tena- cious and yellowish matter, which as thrown out sometimes dries upon their apex or top, form- ing soft scabs, or overruns their original base, creating larger and troublesome sores; the hair coming out from the parts affected, producing partial baldness. Sometimes the entire sur- face of the scalp is divested of hair, because of numerous eruptions, etc., with inflammation sur- rounding them, causing the hair to become dry and crisp, and either breaking off at its base or falling away entirely. The loss of hair of the eye- brows, eyelashes, and of other parts besides the scalp, also occurs, but not so frequent. By means of various applications after the syphilitic taint is destroyed, the hair can most generally be restored. The finger and toe nails are also sometimes affected, becoming horny, brittle, and breaking away in particles, not admitting of cut- ting or trimming as usual. SYPHILIS. 161 TERTIARY SYPHILIS, OR THIRD STAGE . From the past brief and condensed descrip- tion of primary and secondary syphilis, it will be perceived the mucous membranes and sur- faces, the skin and soft parts of the body, are mainly affected ; whilst in the tertiary stage, be- sides affecting the muscular or soft parts, there are involved cartilages and ligaments, the heart, liver, lungs, brain, the osseous portions (bones) of the body, the periosteum (fibrous membrane or covering of the bones), etc. Tertiary syphilis is not so frequently met with as secondary, and is most generally ascribed to delay, wrong and improper treatment, or as re- sulting from the use of mercury in earlier periods of the disease ; predisposing at all times to the development of tertiary symptoms and effects, particularly among scrofulous persons, or others subjected to cold, damp, and exposure, or among persons of irregular and dissipated habits, or feeble and broken-down constitutions. Syphilis seldom attains to the third stage except from circumstances named, and is then difficult and obstinate in treatment or cure ; but where other- wise, as sometimes happens, is generally con- trollable and can be cured. Persons under mercurial treatment for syphilis at any stage, may seemingly be cured (and some- 14* 162 VENEREAL DISEASES. times may be) ; but it has been satisfactorily ascertained by myself and numerous others of the medical profession of extensive experience, observation, and practice, that whilst mercury may produce an alterative effect, and somewhat abate the symptoms, or apparently cure the dis- ease, that it is but temporary ; not specificially destroying the virus, but lurking in the system, and after weeks, months, and even years, breaks out with renewed and increased violence in a tertiary form mostly, from some exciting or pre- disposing cause as mentioned in previous sections. Tertiary symptoms as affecting the osseous portions, most' generally, first affects those bones least protected with muscle, or other integument- ary or membranous coverings ; being most liable through various causes to inflammation of the periosteum and the mucous or cellular tissues, giving rise to what are called nodes, caries, and necrosis ; resulting ofttimes in the partial or total destruction of the bones attacked. 'No bones are exempt from the effects of tertiary syphilis. Of those referred to are the cranium or skull ; the vertebral, behind the posterior portion of the pharynx ; the palate bone, forming and sup- porting the roof or arch of the mouth ; the bones of the nose, communication with which is often made from the palate bone, and through the dis- ease the greater portions are sometimes destroyed or carried away ; the maxillary or jaw-bones ; the sternum or breast bone ; the radius and ulna, or bones of the forearm ; the ribs ; the clavicles SYPHILIS. 163 or shoulder bones ; and the tibia or shin bones, all which are very liable to be affected because of the thinness of their coverings. Previous to the disease reaching the solid portions of the bones, inflammation and swelling of the periosteum and the tissues occur, followed with thickening and enlargement of the parts affected ; afterward ulceration and gangrene takes place, discharging most offensive, acrid and fetid humors or matter, embracing the me- dullary and adipose (or marrow and fatty) por- tions of the bone. Small hard tumors the size of a pea, sometimes double, are found upon the tongue during the third stage ; when inflamed they become soft and suppurate, interfering much with its natural and accustomed use in speech, deglutition, or eating and swallowing. In a previous section I have said that no bones were exempt from the effects of syphilis ; inflammation and swelling of the periosteum, etc., may arise in any bone and take on the course, as before represented, affecting the joints in similar manner with other portions ; but inflam- mation of the same parts may arise and become very painful, the pains properly termed rheuma- tic, and independent of any syphilitic taint. In such cases, however, there is little doubt, a mer- curial taint is present, and in most instances, if not all, may be termed " mercurial rheumatism," arising from the use of mercury during the ex- istence of some other disease, and when the 164 VENEREAL DISEASES. attending physician has administered or pre- scribed it ; as mercurialists are to be found, who consider the mineral their sheet anchor and hope in many diseases. To the profession, the transitions during syphi- lis, as described by me, may lack professional minutiae or technicalities. What I have said and written, however, has been done in as brief and intelligible a manner as possible, that those more particularly interested, the afflicted espe- cially, may become somewhat enlightened as to the results of syphilis, and thus be forewarned to take timely measures to avert its consequences from the beginning. The extent of this work will not, besides, admit of a more comprehensive view, description, and history of syphilis, through- out its different stages, that might be more de- sired or interesting to the profession ; still suf- ficiently so, to attain the desired end, that of benefit to the class for which this small work is more particularly written and published. Tertiary syphilis having advanced to an ex- treme condition, that is, in its latter period or phase, is sometimes termed, or known as Syphi- litic cachexia, and generally occurs among patients as before referred to of scrofulons taint or combination with syphilis ; among the dissi- pated ; persons of worn-out constitutions, etc. It is impossible for me, and I believe any other, more intelligibly to convey to the mind or under- standing of any one, what is meant or under- stood by syphilitic cachexia, than is represented SYPHILIS. 165 by M. Ricord of Paris, and shall, therefore, quote his words : " If I were to attempt a description of syphi- litic cachexia, I should fail to convey to you a clear notion of it, because its characters are not sufficiently well defined ; it might, indeed, be called an exaggeration, and an accumulation, of all the forms, which we have hitherto studied, combined with loss of flesh, paleness, flabbiness of all textures, sallow hue of the skin, weakness of the intellectual faculties, scorbutic manifesta- tions, and finally hectic or scorbutic fever, with exacerbations toward the evening. This fever very often persists, when the external cachetic symptoms have entirely disappeared ; and it is useful to know that it is sometimes symptomatic of an internal suppuration, which escapes our notice. To all these symptoms, aphonia is soon added ; diarrhoea, profuse sweats, and defective nutrition come on, and death at last relieves the wretched being from his sufferings." Whilst at a former page I have spoken of syphilis as affecting the heart, liver, lungs, etc., it would be useless for me here to say much in relation to their syphilitic condition ; still under any circumstances, however hopeless, would I be willing to render any possible assistance ; and in the language of Wm. Acton, a celebrated surgeon of Paris, on witnessing the post mortem examination by Mr. Hetley, of the case of a young girl aged seventeen, who died under pecu- liar circumstances, seduced, deserted, etc., would, 166 VENEREAL DISEASES. I repeat : " Reader, could you stand by and see a human creature brought to an untimely grave by syphilis, and not feel a pang at being unable to stay this plague, which spares the life of a common harlot, and hurries into eternity such frail vessels as these. If these be thy victims, syphilis, art thou not a punishment sent by the Almighty, as some have supposed ! . . . . Cachexia syphilitica is a very rare complaint ; it proved fatal in London only twelve times in three years ; when it does occur, however, the prognosis is very serious, still the surgeon should never despair. " SEXUAL DISEASES. Under this head I shall embrace descriptions of affections existing, and peculiar to one or both sexes ; forbidding mostly, application to family physicians, through fear, diffidence, or modesty in very many instances among youth of either sex, and the more advanced at all ages, single or married. In all such cases, Dr. N. B. Leidy can, at all times, be privately consulted at his offices (which are so arranged that one person never sees or hears another), for a small and reasonable fee ; or he can be confidentially addressed by letter, and enclosing a small fee. No first communication for information only, will receive attention, unless enclosing, at least, one dollar; — or as much more as in the judg- ment of the writer, may be thought compensa- tory, proportioned to the importance of the in- formation desired. Herpes Pr^eputialts ; — consists upon its first appearance of small groups of unnaturally red spots or pinhead-sized vesicles upon the genitals of either sex, attended with heat, and an uneasy or annoying itching sensation ; the spots disappearing sometimes at intervals, and the vesicles also sometimes dry, shrink, and form (167) 168 SEXUAL DISEASES. thin scales, which peel or fall off ; at other times filling with a transparent fluid, they break of themselves, or through accidental friction, run into and produce an extending superficial patch upon the surface, covered with an ichorous trans- parent lymph or fluid, producing much irritation, soreness, and pain, followed by ulceration and excoriation ; or drying, a thin scabious covering is formed over the extent of the patch, and inflam- ing, becomes very sensitive and painful, followed with the very singular effect of disturbing the functions of the stomach, affecting the appetite and digestion, and mostly attended with febrile symptoms. If the male prepuce be much elon- gated, and herpes appears upon its annular edge or folds, through friction from the garments, irritation is increased; and the sores or ulce- rations are made much more troublesome and difficult to treat or cure in consequence of it, and because also, of the urine being so frequently diffused over the parts during micturition, and which cannot be easily prevented, and the edge of the prepuce being so sore and contracted, it cannot be drawn back. It may seem to the reader that in the descrip- tion of herpes prceputialis, there is little differ- ence between it and chancrous sores as described under the head of Syphilis. The latter, however, is of a strictly contagious character, and forms a link in the chain which finally (unless averted) involves the whole system or body in a complete wreck ; whilst the former (herpes prceputialis) is not of a specific contagious character, and its SEXUAL DISEASES. 169 effects more local; — besides, is produced most generally through uncleanliness and other irri- tating influences, and from offensive sebaceous secretions, in the absence of intercourse, but sometimes through it, with unclean females, at improper, forbidden periods. (See Leviticus, c. xv : v. 19 to 28.) Herpes applies to, and em- braces also, local conditions or affections, as tetter, itch, ringworm, etc. ; Herpes prceputialis, denotes a peculiar diseased condition, and so called because indicative of its locality, the pre- puce as the principal ; but adjacent parts become also affected from similar causes. Pruritus, or itching of the genitals, — is distinguished from herpes of the same organs, by an excessive itching of the parts, unattended with vesicular secretions or papuloe, and not fol- lowed by ulceration or excoriations as a conse- quence ; but inflammation and sores are pro- duced sometimes by constant rubbing and scratch- ing of the parts affected, of a character that may be produced in the same manner on any other portion of the body, where itching may exist. Pruritus as applicable to the genitals, seems to be most prevalent among females, whe- ther single or married — pregnant or otherwise. In the beginning an itching and elevation of peculiar reddish appearance is felt and observed upon some visible part. The itching rapidly becomes more intense ; spreading and extending over adjacent parts, thickening and swelling be- 15 nO SEXUAL DISEASES. sides, until becoming so severe and almost in- tolerable at intervals, and suddenly or unex- pectedly too, as even induces, and I may say, obliges females to violate decency in scratching or rubbing when it cannot be avoided or resisted. Extending within the labia and vagina, the vulva, os uteri, etc., the distress is much greater, be- cause productive of unpleasant consequences, inducing voluptuous feelings and desires, some- times the forerunner of serious and disgraceful indiscretions. During pregnancy it is more common than previously ; wiien occurring, however, at any period, much relief will be found in frequent ablutions and injections of weak solutions of sugar of lead or borax (two drachms of either to a quart, rose or plain water) ; — a wineglass- ful pure cider vinegar in a quart of water ; — and even of cold water itself; — exteriorly the application of ice will give relief, and as a last resort, a tablespoonful of the solution or water of ammonias, which may be procured from any druggist, added to half a gallon of water, will temporarily relieve, where other articles named may fail. All failing, special advice should be sought, as there may be causes existing, requir- ing it ; and where females may be otherwise afflicted or diseased, I must not, however, be un- derstood as recommending those ablutions or injections. Trifling as this affection may appear, it not only is distressing in its unpleasantness and feel- ing, but often gives rise to unmerited, and SEXUAL DISEASES. .1*11 unjustifiable suspicions, resulting in domestic troubles and difficulties ; because of parties be- ing ignorant of the fact of its origin and exist- ence at all ages, independent of intercourse. It as often occurs, even among infants early after birth as later. "When occurring at a late period in the absence of intercourse among the virtuous and single, as well as after marriage, previous to, or during pregnancy, I have given views and information so far as to protect the innocent, and as far as practicable to protect themselves from the annoying and distressing effects of it. Males are not exempt from pruritus or its effects, but are not so liable for reasons explained at page 90 ; because of the facilities to cleanli- ness, being greater in the male than female ; un- cleanliness being one of the leading, and I may almost say, principal causes of pruritus, whether from bad or neglectful nursing when occurring in infancy, or ignorance, indifference, neglect, or other causes at a later period, in youth or at maturity, single or married, of either sex. Pedtcula or Crabs. — While on the subject of pruritus or itching of the genitals, it may not be out of place to refer to itching of adjacent parts, namely, of the mons-veneris and pubes, situated in the sexes immediately over the geni- tals, and mostly thickly covered with hair. The itching of the parts is sometimes equally annoy- ing, distressing, and intolerable, as of other parts named in previous sections, as almost to cause them to violate decency. It is caused by H2 SEXUAL DISEASES. small insects called crabs, a peculiar species of louse (differing from those of the head), fastening themselves so closely to the base of the hair, as scarcely to be perceived ; although not perceived at all times, their bites betray their presence or existence, causing much itching and irritation, and upon being rubbed and scratched, which is inevitable, the parts oft become much inflamed and sore. They occasionally locate themselves upon the breast, and in the arm-pits, where covered with hair, but seldom are found upon the head. Those pestiferous insects are conveyed from one to another in some manner, but from circum- stances must be left to conjecture, not being posi- tively known. Naturalists represent, they in- crease very rapidly (particularly among filthy and unclean persons), a very small number in- creasing in twenty to thirty days to many thou- sands ; — that they leave the bodies of those affected with infectious or contagious diseases, and the dead ; taking refuge in their garments or bedclothes, seemingly aware of infection or contagion; and which is besides somewhat re- markable, mercury (showing its baneful influ- ence) is fatal to them ; as mercurial ointment applied or rubbed over the parts three or four times, for as many consecutive days, com- pletely annihilates them ; afterward washing the parts with soap and water, and running a fine tooth comb over the surface, evidence of the fact will be fully manifest. Bathing the parts with decoctions of tobacco, Cayenne pepper, white SEXUAL DISEASES. 1T3 hellebore root or fish berries will sometimes also destroy them. In the event of the parts having become in- flamed, the surface sore and raw through rub- bing and scratching, such sores, etc., must be healed by other means; otherwise through ab- sorption, the employment of mercurial ointment may lead to salivation, or persons be poisoned by bathing with the decoctions. Circumstances should, therefore, govern as to seeking advice. MENSTRUATION. Menstruation, so generally and familiarly known, scarcely admits of much to be said in re- lation to it, except something perhaps may be said in addition to what is known by many, be- sides information and advisory remarks that may be beneficial to very many. By Menstruation is understood, a discharge pe- culiar to females occurring periodically, monthly ; generally calculated by the lunar month of twenty- eight days, though as often occurring three or four days before or after. The discharge taking place as stated is generally conceded to be from the uterus or womb, per vagina, differing from ordinary blood ; as to the source from whence discharged, or its nature and character, space will not admit of arguing in so small a work, — nor, is it the intention of the author as often be- fore expressed to theorise, on points of little benefit to the readers of it. 15* 114 SEXUAL DISEASES. The first appearance of the menstrual dis- charge (or flow, as it is sometimes called) takes place about the age of puberty ; the period at which youth of either sex is supposed to pass into a state or condition to propagate. This period in the female varies, sometimes occurring at ten or twelve years (and mothers at those ages) in hot climates ; and in the colder climates of the North occurring at twenty years and up- wards ; whilst in our region or country the average period is fourteen or fifteen years. Females generally cease to menstruate at about thirty years after the commencement, or first show (called the change of life). The quantity of men- strual fluid discharged also varies, being great- est in very warm climates, and less in colder ; exceptions occurring, however, among females in whatever climate, dependent upon consti- tution, mode of living, feeble and of delicate health, etc. Mothers generally know the circumstances and indications antecedent to menstruation, whether among their own daughters, or others. For information of many however, not knowing, I will state that preceding the first appearance there are generally some of the following feel- ings and symptoms manifest : namely, sluggish- ness, faintness, exhaustion from little exertion, palpitation of the heart, irritability, peevishness, nervousness, restlessness day or night, hysterical feelings, headache, feverishness, pain along the middle of the back or across the loins, etc. The appearance of the first menstrual discharge is of SEXUAL DISEASES. 1?5 a pale color at first, bat after succeeding periods changes to the resemblance of venous blood, though differing from it in character ; after which time there is generally a perceptible change, in the appearance of the female ; the mammae or breasts begin to enlarge — the chest to expand — the form and figure begin to be more fully developed— the voice often changes . — and there is also a change of demeanor or general deportment and ways, — increased vivacity in looks and expression, partaking more of the character of woman, becoming more settled, dignified and guarded, in her movements and actions, than previously. The unpleasant sen- sations and feelings preceding, and consequent upon the change at first, among the healthy, lessen and disappear entirely after three or four successive and regular periods. Notwithstanding the natural periodical chan- ges or discharges may be established for many months, or even years, there often occurs derange- ments and consequences, difficult sometimes to be accounted for, which cannot be fully described in so small a work ; but when occurring under very peculiar circnmstances, it would be most wise and prudent to apply to the family or other physician. Certain derangements or interrup- tions alluded to, I shall, however, in following sections briefly describe or account for, and ad- vise appropriate means or course to be pursued, as shall be deemed proper and prudent, at the same time be made as effectual as can be, under existing circumstances. 176 SEXUAL DISEASES. First. — Amenorrhea, the retention or tardy appear* ance of the menses. By menses is understood the men- strual discharge or flow, natural to females, and occur- ring mostly at the end of each lunar month. The discharge not appearing for the first time at an age or period, as is thought or supposed by many it should (and by some meddlesome or officious women knowing it must) ; young females are often subjected to many unpleasant recourses to force it, and drugged with teas, nauseous mixtures, vile and dangerous compounds, and all the quack menstruating nostrums or pills, etc., of the day, to an extent seriously affecting their general health, and endanger life — whilst if nature was permit- ted to have her own way, assisted by active and unre- strained exercise in the pure and open air, a wholesome diet, etc., avoiding damp and wet, or extreme cold, she (nature) would accomplish all that is necessary or re- quired at proper times or periods, and usual good health be retained. The idea that a change should or must take place at a particular or stated period, under all circumstances, among females, because occurring according to observa- tion or custom, with a majority, should not be entertained ; as there are exceptions, because of constitutional differ- ences — modes or manner of living — pursuits or occupa- tions — character of food and nourishment, wholesome or otherwise — care and attention, or negligence in some re- spects, particularly in earlier years, etc. ; all which con- tribute more or less in influencing the natural change at certain periods. Unless in cases of retention or tardy appearance of the menses, there should be undoubted unhealthy or un- natural conditions or indications existing or manifest, justifying interference, it is cruel if not criminal for physicians, mothers or others, or females of themselves to force nature at the risk of future health or life. Second. — Suppression of the Menses, or a want of their return periodically after the discharge had been regularly established. Among married females it most SEXUAL DISEASES. 1?7 generally is the result of pregnancy (and sometimes also among the single or unmarried). There are other causes, however, and when occurring, the return of the menses should be promoted early as possible to ensure future good health. Among the causes, at the time they should appear, and even occurring soon after having commenced to flow, are sudden changes from warm to cold — exposure or remaining in a damp or cold situation and getting chilled, eating ices or ice-creams, drinking freely of ice- water, taking cold baths, accidental falls or injuries, sudden alarm or fright, trouble and anxiety, excitements and outbursts of feeling and passion, etc. Among the symptoms and consequences of suppres- sion, and becoming more severe and alarming after several periods without menstruating from various causes (ex- cept pregnancy) ; are headache, dizziness or faintness, feverishness and thirst, pain of the sides, across the loins, of the back, and lower extremities, sluggish appetite, griping pains of the stomach and bowels, the eyes be- come very red, face flushed, etc. Decline of health fol- lows, also bleeding at the nose or hemorrhages of the lungs or other organs, paleness of complexion, suffocating sensations, nervousness, languor, 'palpitation of the heart, depression of spirits, emaciation, prostration, general debility, etc. It often happens, leucorrhcea (vul- garly called the " whites") supervenes, adding much to the already distressed condition of those suffering from suppression, often resisting all treatment, resulting in the continuance of long suffering, misery, and early death. Various are the means, and as various are the circum- stances and conditions or situations requiring varied treatment, to restore the discharge, making it almost imperative (certainly the most prudent) to seek profes- sional aid or advice without delay. I will however, suggest means, prescribe and give some advice, whereby very many by timely attention, may avert the consequences, and be relieved from much suffering through suppression or irregularity, in the absence of pregnancy. 118- SEXUAL DISEASES. After the menses have been, for some months, regu- larly established, females can generally calculate as to the time of their monthly return, "within one to three days. If after three days' allowance, there be no indica- tions, it is advisable something should be done, to make it certain, if possible ; as what may then be done, can be, without any bad effects whatever; to delay, day after day, dependent upon hope, is too often but time lost without realization, and but adds to trouble in effect- ing what may have been earlier accomplished. There are numerous vegetable or herb teas, known among females as beneficial ; and of those known to me as used by them, such as pennyroyal, tanzy, thyme, wormwood, catnip, hoarhound, etc. I know of none that are objectionable; I know also they are generally aware of the benefits of warm, hip or vapour baths, and the immersion of the feet above the ancles, for several nights, for ten minutes or more before retiring to bed, in salt or wood ash-water, warm as can be borne ; all which I would recommend, and that it should not be delayed after the third day of the anticipated flow. In ad- dition, however, I would recommend also the taking of one or other of the following (which may be obtained from apothecaries, or if in the country, no doubt can be procured from the family or neighbouring physician), namely : Pills of Aloes and Myrrh, No. 30. Or, Pills of Aloes and Iron, do. Take 2 at a time of either, 2 or 3 times a day. Or, Tincture of Guiacum, i ounce. Or, Elixir Propriotatus, do. Take 15 to 20 drops of either, three times a day, in warm tea, or a wineglassful milk or water. Or, Tincture of muriate of Iron, J ounce. Take 10 to 15 drops, 3 or 4 times a day, in water. Or, Hiera picra, one drachm. Mix in a half- pint best gin; shake well, and take a SEXUAL DISEASES. 1*79 tablespoonful in a wineglassful or more warm water, twice or three times a day. Either of the foregoing, all being about equally effec- tual, may be taken for one week, after the contemplated time in conjunction with the teas, soaking feet, the ancles, etc., unless effectual in a shorter time. If not then effec- tual, the course should be discontinued, and resumed near the next period, commencing one week before the anticipated time ; and if not effectual, continued a couple days after, if the general health or condition of females otherwise will admit, requiring some discretion and judgment, more particularly as relates to feeble and deli- cate, or healthy and strong constitutions. Though it might be most advisable after failure of usual means in restoring the menses at the first attempt, to seek medical advice at the second ; I would particularly urge it, in the interval between the second and third ; as neglect to do so, too often results as has been previously described. f^^** Of all the conditions, situations or ailments of the female sex, there is none where so wide a field is open for the Empyric, Quack or Impostor, and under certain circumstances taken advantage of by them, to practice fraud and deception, as upon females suffering from what- ever cause, with irregularity or suppression of the menses. Because of the great anxiety, dread and fear of suffer- ing, and misery among females, arising from irregularity and suppression, through various causes, sometimes pregnancy under peculiar circumstances not desired, in- volving exposure and disgrace. Impostors recommend and advertise pills, etc., with the ostensible purpose of relieving such, but particularly cautioning married or pregnant women not to take them. In reality, design- edly, under a delusive hope tempting or' inducing preg- nant females, who may misconstrue the meaning of such caution, to buy them; they, the Impostors knowing of their inefncacy — as if otherwise they would not dare to advertise them, because of their liability to criminal prosecution. Hence, bread or other inoffensive pills and preparations are manufactured, to avoid the possibility 180 SEXUAL DISEASES. or risk of miscarriage or clanger of prosecution, sold by them, recommended and advertised as requiring caution in their use, to delude pregnant females, single or mar- ried, into a belief of their efficacy, through which thou- sands are not only deceived in their expectations, but rob- bed also of various amounts. A little reflection will cer- tainly convince females of common sense, that any one article accomplishing so much under such a variety of circumstances, as is connected with menstruation, must be a fraud and imposition. J$@^ I would here remark that in cases of Irregulari- ties or Suppression of the menses among females, single or married, from whatever cause, or whatever their cir- cumstances or conditions ; they can privately consult me at my offices, or in addressing me (enclosing reasonable fee), describing all particular feelings, symptoms, etc. ; they will receive advice, instructions and medicines, be- sides candid views and information as their situations may require. Medicines can, at all times, be sent by mail, or will be sent as directed. Third. — Dysmenorrhea, or painful menstruation. This occurs among the single and married during men- struation, more or less severe; at times not less so than attends generally a miscarriage or difficult labor. To many, the anticipated period for menstruation is looked for with dread and horror, because of so much suffering. In some instances causes are known or conjectured, in others they are unknown to females themselves. Cold and miscarriages or abortions are among the causes, but there are others, such as internal injuries, ulcerations and diseases of the womb, obstructions, etc., which would require professional treatment particularly, and therefore would be of little use to describe here, as they could not effectually be prevented or removed by females them- selves ; there being circumstances often attendant re- quiring much discretion and judgment as to what should be done. I will recommend, however, means which may tend to allay pain and suffering, less at each time until disap- SEXUAL DISEASES. 181 pearing, in a majority of instances entirely, if perse- vered in for several successive periods ; when not, pro- fessional aid should be resorted to. Upon the least indication of the time of menstruation being at hand, a warm body bath, or if not to be had, a warm water or vapour hip bath, or steaming in a sitting posture over a jet or current of steam from some boiling water or tea of herbs heretofore named, contained in some vessel with a small spout, repeated if necessary a few times, very often gives relief. Sometimes hot gin or brandy-toddy, or a small teaspoonful spirits of cam- phor in hot water and sugar, will give instantaneous re- lief; if the discharge be very scanty, a small teaspoonful of Tincture of Guiacum, added to the foregoing, and taken two or three times a day, will facilitate as well as lessen much the painful discharge : the Tincture of Guiacum, however, is not objectionable at anytime. In case of costiveness, hot Senna and Manna tea is strongly recommended. Laudanum, Opium, Morphia, and Ergot, I am aware is often employed, but is very seldom effectual : whilst the course I have advised, if repeated several periods, is in very many cases successful in dispelling painful menstruation altogether, or until renewed from some cause. In all cases of baths, vapour steaming, or soaking the feet and ancles in hot water, it is important to have the body covered with blankets or other warm coverings, avoiding contact with cold air; and it would be most advisable, as well as after drinking hot teas, toddies, etc., immediately to get into a warm bed, to keep warmly oovered, and particularly keeping so, during perspiration, which is most certain to follow, and is besides beneficial. Fourth. — Menorrhagia, or an immoderate and exces- sive menstrual discharge, occurring at monthly periods, although sometimes varying and occurring irregularly at intervals of two and three weeks. Menorrhagia i* sometimes confounded with Haemorrhagia, or hemorrhage. excessive discharges of venous blood from within the vagina, as sometimes appears — though occurring from 16 182 SEXUAL DISEASES. various other organs also — the nose, lungs, bowels, etc. The latter may, however, be distinguished from the former, as natural venous blood coagulates, whilst men- strual bloody discharges do not. The quantity of menstrual fluid or blood varies, being much greater in some females than others. A true mssnorrhagia (unusual excessive flow) often follows mis- carriages or abortions for many months ; although it occurs also among the unimpregnated, — the plethoric, robust and feeble, — particularly if indolent, inactive, and living luxuriously ; also from having indulged much, imprudently and unnaturally. The continuance of Menorrhagia results in much de- bility, languor, disturbed stomach, paleness of the com- plexion, frequent headaches, faintness, palpitation of the heart, coldness of the extremities, dropsical effusions, etc., sooner or later, seriously affecting the general health and constitution. At each return when there is apparently an unnatural, excessive flow of the menstrual fluid, rest and composure in bed, not too warmly clad or covered, is strictly en- joined ; — spirituous and vinous liquors, and warm teas, or drinks of all kinds are prohibited, and cold lemonade or water permitted ; or if feverish, the holding of ice in the mouth, swallowing as it melts. If very costive, active drastic purgative medicines are forbidden, but cooling saline medicines, sufficient only to produce easy evacuations from the bowels, may be taken. In case of sick stomach or pains of the bowels, 30 to 40 drops Paregoric or of Hoffman's anodyne (when colored, called Golden Tincture) may be taken, according to circum- stances, in some sugar and water, every one or two hours, until abating, and not exceeding five doses. In violent cases a pill of two grains of sugar of lead with the eighth of a grain of sulphate of morphia, may be taken every two hours, until abating, and not exceeding one pill every two hours, nor more than six pills alto- gether, in twelve hours. Injections per vaginam, of one drachm of sugar of lead SEXUAL DISEASES. 183 dissolved in a quart of lukewarm water, and a table- spoonful of laudanum added ; — or of oak bark tea, alone, or one drachm of alum added, and dissolved in a quart of the tea; — or of two drachms alum alone, in a quart of water, will be useful. Injections of one giil to half a pint of either, to be made three or four times, oroftener, if necessary, a day, and retained in a lying position. In addition, the application of cloths or napkins steeped in cold water and vinegar, kept applied to the lower part of the abdomen, below the stomach, to be renewed when- ever getting warm, are also very beneficial. — During in- tervals between the periods, moderate and gentle exer- cise is recommended, also the drinking of cold bitter herb teas, and porter, or brown stout, when debilitated ; in summer, salt, sulphur or chalybeate water bathing, or whether in summer or winter, cool water injections, once a day, during the intervals between menstruations, will prove very efficacious. It must be an extreme case., indeed, where the foregoing will not prove a decided benefit eventually ; gradually overcoming in many cases, the superabundant discharge at each periodical return., until reduced to a healthful quantity. If failing, how- ever, it will be necessary to introduce tampons and otheT treatment, requiring professional assistance. Fifth. — Cessation or decline of the Menses: — gene- rally known as the critical period, or change of life in woman. In our climate this generally occurs about the forty-fifth year, occasionally a little earlier or later. For several months before taking place the menstrual discharge is sometimes irregular, appearing more often, or not so often as usual; — less scanty or more profuse in quantity, than previously, conditions and circumstan- ces influencing it. There are a variety of feelings and symptoms occur preceding, and about the time of change in females, such as hysterical and nervous ; anxiety, dread or fear of something dangerous about to take place ; the result mostly of officious, meddlesome and knowing friends. 184 SEXUAL DISEASES. who knew or heard of awful consequences, caused by change of life, when no doubt in such cases there were other conditions connected, as scirrhus, cancer or other affections of the internal organs more serious and alarm- ing, of which they were ignorant. Seldom, indeed, is there the least cause for apprehending bad consequences from the change itself, unless from ignorance, great negligence, carelessness, etc., through which many suf- fer, when not otherwise afflicted. There is, however, often an enlargement of the mammse, abdomen, and swelling of the extremities, disturbance, pain or griping of the stomach and bowels, pain across the loins, or along the back, etc., giving rise under some circum- stances to apprehensions of pregnancy ; but all disap- pearing through the change, such fears are dispelled also. Sometimes pains of the limbs occur, thought rheumatic, cutaneous eruptions oh different parts of the body, sometimes erysipelas, violent headache and febrile symptoms appear; all which disappear with the cessa- tion of the menses, or are easily controlled with little eare and proper treatment after. But little medicine is seldom required at or about the time of change. Wholesome advice is much more re- quired. Thus, a light nourishing diet and moderate exercise in the pure open -dry air, neither too warm or extreme cold is recommended; regularity of the bowels particularly necessary ; if irregular, to be gently moved with saline medicines, which are to be preferred, or castor oil. In some instances of very plethoric females, suffering severely from headache, dizziness or faintness, bleeding is sometimes necessary. Tonics are not re- quired, except among the very feeble, hysterical and nervous. Should there be any more alarming symptoms, than those named, it is almost certain other causes exist, and medical attendance may be advisable, and as appli- cable here, I would repeat a remark during a lecture of the late Professor Dewees — "As much judgment is re- quired to know, when not to give medicine, as to do so." SEXUAL DISEASES. 185 LEUCORRHCEAj OR FLUOR ALBUS. VULGARLY CALLED "THE WHITES." This is a discharge originating and emanating from within the vaginal parts, its surfaces, the vulva and os- uteri; proceeding from within the cavity of the uterus is doubtful, although not improbable. It exists among girls in childhood, mostly through uncleanliness, though sometimes from ascarides or seat- worms, or some other local irritation. Among females more advanced, there are numerous causes of leucorrhoea, which will be more particularly noticed hereafter. There is no condition, ailment or disease among females, whether before, at, or after puberty, the single and married at all ages, the virtuous, moral or unchaste, so annoying, disagreeable, loathsome and distressing as leucorrhoea; the cause of great anxiety and trouble, affecting both body and mind, and leading to consequen- ces, causing much misery, suffering, and unhappiness. So different and numerous are the causes producing it, that much care is required and necessary to prevent it; it is often unavoidable and also unaccountable, hap- pening without any positive known cause. Among young females, leucorrhoea is sometimes the result of improperpractices andindulgences combined (see page 77, and following pages), producing serious effects upon their general health: such as want of appetite, nervousness and hysteria, languor, depression of spirits, prostration and debility, palpitation of the heart, pale- ness and emaciation, restless and sleepless nights, etc. ; besides, disturbance of natural functions ending in con- stitutional injury, and impairing both mind and body. Leucorrhoea frequently precedes the first menstrual discharge, and each succeeding one; seldom however occurring at the termination : but often takes place during the intervals between menstrual periods, and con- tinuing until the appearance of the regular natural flow. 16* 186 SEXUAL DISEASES. The leucorrhoeal discharge is at first of a white milkish or starch water appearance ; after a time changing to a yellow or yellowish-green ; sometimes small in quantity, at other times profuse. Through long continuance, neglect and uncleanliness, it becomes somewhat san- guineous, escaping in clots, is offensive and causes ex- coriations of parts, attended with pain of the pubes, back and hips; the complexion changes, becoming sal- low; the digestive and other functions are weakened, causing sterility, and where such conditions arise during pregnancy, miscarriage is often the consequence. Leucorrhoea is sometimes confounded with gonorrhoea, and among the suspicious and ignorant, causes some- times trouble between parties ; more particularly, be- cause through intercourse with females who are careless and not cleanly, similarly affecting the opposite sex in case of individuals of peculiar susceptibility, temperament or idiosyncrasy. It also exists in combination with Amenorrhoea, Menorrhagia and Dysmenorrhcea as de- scribed in former pages, adding much difficulty to its cure. As before stated the causes of leucorrhoea are numer- ous ; I will name many of them as most common — namely, frequent exposures to moist, damp, wet and cold, — poor, impoverishing unwholesome and irregular living, — sedentary habits and occupations, — excessive mental and bodily exertion and fatigue from employ- ment, dancing, riding on horseback, and violent exer- cise, — debility or weakness through sickness, from mis- carriages, abortions, tedious or long labour, frequent child bearings, long suckling of infants, while prostrated, — displacements, injuries or diseases of the Womb, — irritation from ascarides (seat-worms), hardened feces in the rectum, hemorrhoids or piles, — frequent or improper use of aloetic and other drastic medicines — uncleanli- ness and irritation caused by pessaries and other sup- porters, — excessive venery or sexual intercourse, — lux- urious living, high seasoned food and too free indulgence in wines or stimulating drinks, — irritating injections ; SEXUAL DISEASES. 187 and the last that I shall name, and the most common of all causes, "uncleanliness" at all ages, from youth in the female sex, to advanced age, single and married, preg- nant or otherwise. Scrupulous cleanliness, as so often urged by me in other places being necessary at all times, under all circumstances, as a preventive of many evils, and conducive to healthy conditions. The most obstinate and aggravated forms of leucor- rhoea occur among females afflicted with scrofula, cu- taneous eruptions or diseases, gonorrhoea and syphilis, as sometimes happens. In those cases I "would par- ticularly recommend application to a competent and skil- ful physician, as serious results may otherwise follow. In the general treatment of leucorrhoea, when not complicated with other diseases, or not of very long standing, or not yet having prostrated or debilitated much the system, or affected materially the general health, I would recommend frequent ablutions, and also copious injections of lukewarm water in the manner de- scribed at page 132, for the purpose of cleanliness; to be followed two or three times a day, for a week or more, if necessary, in the interval between the menstruating periods, of one or other of the following solutions : changing, in case of no apparent benefit, as sometimes happens, from one to another ; namely, of iron alum with ammonia, or acetate of zinc, or sugar of lead, or borax, or alum, or equal quantities of alum and tannin combined ; two drachms (or quarter ounce) of either to be dissolved in half a gallon rose or pure water, used cold, and the injections copious, three or four times a day; from a gill to half a pint each time, to be beneficial. In case of pain or inflammation in connection with leucorrhoea, the addition of a tablespoonful of laudanum to the half gallon lead solution is sometimes useful; or solution of two drachms nitre, with one drachm alum in a half gallon water. Injections of port wine diluted about three-fourths, and decoctions of oak bark and green tea are sometimes beneficial. A most excellent injection, and which may be used at 188 SEXUAL DISEASES. any time also, is a decoction of four ounces red Peruvian bark braised, and well boiled in five pints of water, strain clear, and if boiled down to less than half a gallon, make it up by addition of water, and afterward add 70 to 80 drops of nitric acid, to be employed cold, three or four times daily. During menstruation, injections must not be used. At the same time of using injections, tonic and as- tringent medicines may be taken; as 10 to 15 drops of the muriate tincture of iron in water, three times a day ; one or two grain pills of quinine, three times a day ; or decoctions of Colombo, tormentilla, or gentian roots, Peruvian bark, etc. The following pills will also be useful : Take of Gum Catechu 2 drachms. " Powdered Alum 1 drachm. " Powdered Opium 8 grains. Mix and make into 60 pills ; take 2 or 3 pills, twice a day. Or, Take of Gum Kino, " Extract of Peruvian Bark, " Ammonia iron alum, each, 1 drachm. Mix and make into 60 pills ; take 2 or 3 pills, twice a day. A solution of two drachms ammonia iron alum itself in a half pint cinnamon or mint water, and a tablespoon- ful, taken 2 or 3 times a day, is very beneficial. It may be observed, I direct 2 or 3 pills or tablespoonsful ; tho lesser quantity is designed for debilitated females, or where there may be a disturbed condition of the bowels, not admitting of the larger quantities. Females of costive or plethoric habits will be much benefited by occasional purgative medicines ; but at no time during the existence of leucorrhoea should drastic purgatives as of aloes, colocynth, etc., be employed. Castor oil, rhubarb, magnesia, senna, and manna tea, or saline purgatives, are to be preferred. SEXUAL DISEASES. 189 Tepid or cold bathing, two or three times a week, with the occasional addition of a couple pounds alum, in a tub of bath water, is useful — sea-bathing or chalybeate water baths, as well as the drinking of chalybeate waters, very moderate exercise (avoiding fatigue) in the open air, either in walking or carriage riding, is recom- mended. Debilitated females should especially take a couple hours' rest during the day, in lying down. A light, nourishing and wholesome diet is necessary ; ripe fruits admissible ; luxurious living, wines and stimulat- ing drinks must be avoided. In conclusion of this s«ubject, I would say, that in few works, indeed, much more extensive than this, have the ailments among females, in connexion with menstruation, etc., been so fully treated of. I am, however, fully satisfied of its importance, and all modesty or diffidence, real or false, aside, it is particularly important, neces- sary and conducive to their general health, well being and happiness, and there is no reason why they should not be as well informed on certain subjects as Man. PECULIAR DELICATE SUBJECTS FOR THE SINGLE AND MARRIED, OF BOTH SEXES. There are many subjects not treated of in this work, being too small to do so. To many, however, they would only be of interest in gratifying a morbid curiosity. Those wanting information for their benefit, or in addition, advice and treatment, will not hesitate paying for it through interview or correspondence. — Among the subjects alluded to, are. sterility or barrenness, — nymphomania of the female, and satyriasis of the male, or amorous feelings and propensities almost irrepressible in both, — absence of feelings or desires to cohabit, — anxiety for offspring, — causes of, or impediments to conception, — how conception or pregnancy may be prevented, — symptoms, signs or indications of pregnancy, — miscarriage and abortions, — evidence of virginity or chastity, — results of late marriages or inequality in years,— loss of sexual power or ability, previously naturally possessed, — sexual excesses, — deformities or deficiency of the genital organs, — incontinence or total abstinence from sexual intercourse, its effect upon the health, mind, vigor, etc., — fitness and safety at nil ages in entering into matrimony, — diseases of the bladder, womb and kid- neys. There are, besides, other subjects not named; but Dr. N.B. Leidy can be privately consulted by interview or correspondence in all diseases or situations common or incident to both sexes, be they what they may. 190 SEXUAL DISEASES. INFORMATION DESIRED FROM PATIENTS WRIT- ING AND ENCLOSING FEE FOR TREATMENT. All persons writing should explain their diseases or situations, in their own way, avoiding language and terms they do not fully un- derstand. All have not the good fortune to be well educated. All I desire, is a plain common sense letter in such writing and language as the writer is capable of executing; and however bad the writing or language, none will see it but myself, and with whom it will be sacredly confidential; when done with it will be destroyed, or re- turned if desired. Persons not wishing to write in their own names, can assume any other, and avoid knowledge of the writer. From the appearance, symptoms, character and conditions, effects and consequences, given and described in this book, of the most preva- lent diseases or situations existing among youth before and after puberty, and from maturity to advanced ages, any one will be able to judge of the nature of his or her case, and select therefrom a de- scription of symptoms, etc., corresponding to their situations. In addition to the foregoing, general information in all cases is de- sirable ; — as to age; sex; if single, or how long married; if thin and slender in form, or robust, fleshy and plethoric ; if feeble and deli- cate, or of strong constitution: what complexion: if bilious, costive or otherwise; if appetite be good or bad; habits, mode of living and occupation. Patients suffering from self-abuse, should, in addition, state the age when having commenced, the habit, and at what age abandoned; the times and frequency of involuntary emissions; or if voluntarily escaping with or without erections ; scanty or profuse ; if thin or thick; of what color and appearance, and if smarting when urinating. Syphilitic and venereal patients, in addition to the description of their cases, are particularly requested to furnish gene- ral information as desired. Females also suffering from whatever cause, should furnish general information as desired, iu addition to the description, or of diseases, conditions or situations incident to them, so easily accomplished from information to be derived from this book ; and in any case, where with the assistance of the book, any one cannot satisfactorily to himself or herself describe their symptoms, feelings, condition or situation, let it be done in their own way and language; I will guarantee 1 can fully understand them. IMPORTANT AND USEFUL MEDICINES, PREPARED ONLY BY DR. N. B. LEIDY. Dr.Leidy's complexion purifier, removing from the face and all portions of the surface of the body, blotches, pimples, or pustules, containing small worms or humors; also sores, eruptions, and cu- taneous affections generally; (sent by mail, with printed directions, free of postage, for $2.50.) Dr.Leidy's Tonic and Stimulant, for either sex, at all ages, single and married, where naturally feeble, delicate, or deficient in organic strength; (sent ,by mail, with printed directions, free of postage, for $2.50.) SEXUAL DISEASES. 191 DR. LEIDY'S CRYSTALLINE MEDICINE, FOR SINGLE OR MARRIED FEMALES. Producing regularity monthly, where previously irregular, and re- storing the menstrual flow, when from causes unknown, after hav- ing been regularly established, it is suppressed or has ceased. This same medicine will also relieve painful menstruation, and ensure regularity monthly when established, against general causes, when taken according to directions; — for which purpose one pack- age (costing two dollars) will be sufficient for four months; or three packages (costing five dollars) sufficient for one year. Females are allowed and ofttimes obliged to suffer months and years, because of unjustifiable and unfounded suspicions, reflecting dishonorably and disgracefully upon them (an insult to the sex), par- ticularly the innocent, because of some physicians doubting their in- tegrity when seeking advice, and refusing to prescribe for their re- lief; or if prescribing at all, sometimes deceiving them by directing some inert and useless medicine, at the same time pocketing usual fees as though prescribing in good faith. If there is reason or justification in not prescribing for females, for their relief from suffering, arising from causes referred to, because forsooth, one of several thousand might injudiciously use the same prescribed or other medicine for a special purpose, leaving all others to continue in their distress or suffering; — is there not greater reason why physicians should desist from prescribing or administering opium, laudanum, morphia, aconite, belladonna, stramonium, strych- nine, arsenic, prussic acid, chloroform, corrosive sublimate, etc. ? medicines, extensively used and prescribed by physicians; but have killed their thousands, and are still employed, because of their effects being known, for suicidal and murderous purposes; besides pro- ducing fatal effects, as often happens when ignorantly, injudiciously, carelessly and mistakeably prescribed and furnished by physicians and apothecaries. — Altogether producing, in the ways mentioned, the deaths of a thousand (perhaps more, or less) of worldly, animated and living beings, in proportion to a single miscarriage (of what may or may not have been vital), through the effects of some medicine employed at an improper time — and for the imprudence of one female, thousands of others innocent must be made to suffer, and refused relief. 4^ It is not just the innocent shall be made to suffer thus for the guilty, according to the views of some ; and Dr. Leidy will remark, that on application to him, if in his power to afford re- lief for such, he will do it, without being influenced by suspicion, scrupulousness, fear, or prejudice. Dr. Leidy's Crystalline Medicine, with explicit directions, will be sent by mail, free of postage, to any part of the United States, on receipt, of two dollars for a single package, or three packages for five dollars. To those purchasing, advice or information on any special or particular matter connected with one's condition or situation, will be given without additional charge. 192 SEXUAL DISEASES. DR. LEIDY'S RESTORER AND INVIGORATOR, (For the use of both sexes, at all ages, single or married.) Restoring and invigorating those injured through masturbation or self-abuse, improper indulgences, or sexual excesses in intercourse. as well as others sexually or organically weak or impotent; — so as to be competent in complying with natural wants or desires. Of all known medicines, it is not believed there is any superior in allaying nervous irritation, disturbance or excitement, from whatever cause"; and adding to the stability and strength of the nervous system, as well as of the entire body. Delicate and feeble youths of either sex. will find in this medicine, a restorer to natural health and vigor: and of an exhilirating influence, arousing them from that despon- dency, melancholy and depressed state of mind which so long has borne them down. Extreme or bad cases may require additional advice and treatment; and it is recommended to all to describe to me fully their conditions, situations, habits, causes, etc., that I may, if necessary, direct or advise something beside, which will be done with- out extra charge* to all who procure a package; and which will be sent with printed directions, and written where necessary, by mail, free of postage, to any address, on receipt of five dollars. DR. LEIDY'S GONORRHEAL (CLAP), OR GLEET RADICAL SPECIFICS; AND DR. LEIDY'S ■ SYPHILITIC (POX) REMEDIES. 4G^=* The foregoing are medicines safe to be taken, without fear of exposure in all weathers, and with little or no restraint in living and occupation. They are medicines peculiarly Dr. Leidy's own, prepared only by him, and cannot be procured elsewhere. Dr. Leidy has em- ployed them in thousands of cases, for upwards of twenty-five years, more successfully than all other medicines heretofore in use, or that are now generally administered and prescribed by others. This book will be sent any distance by mail, free of Postage, by Dr. N. B. Leidy, for Twenty five Cents; or, six copies for One Dollar: ~^^£> > > > > 3 > > > *»> ► > r S3 > :*> -2* J >>^> > » :> --.urn* ^3» > •> 1 > >m>> >^^ -^ ~jr> > > > ^ -4 ) : .' : Z* > '~> ;■>»> -£? ^ > ' ~J*> > * .>>>>> . 13* J> >> • ^> ">» > ^^ z >> ! -^ >^-> ^*J* o "^ 3> ^> z> "~» - > ^> »z> i-v» > 3) ' ? > > > - ^ -^ > > > £>/> y - »3> to ">■ ' J> _» * J* y p » J ■ > ■ -•» j» ^ » '> >> » ~y JT > »> . ^ » > > >>. ^> > >"V 5 "> "i > .' -i> » ' ■■~» > > >-^> > s> > ;» S ^> : > » ; "1^5 >i> -*■ > > > ' ) }> > r^«> 0^^3fc» ^ > > ~~> > > ■^r»y > > LIBRARY OF CONGRESS 021 062 54