pwm£mm^ «MMMuM ■*\MJV'*' \jv7\pys} VVU: iltw ■ ■ W V- . ^ w t 1 p ^ ; y J0& yv* > mi fM < v^w^^B4Jyy^S wmm MMMM^Lf u^ys^V^^wii J'v^V^ «M^rarae«v w 5 y?Vi»:W|«M MMM LIBRA CONGRKSS. VWWU mat IliS UNITED "WHS* MMM mm yuvvum V&yV-y fJJVWWgWW wwwwWWS 1 'N/Sipn' in JSfltSPW^P vVV v Vv v yyvw f*n mmmmmm ^ywwv *&flffiW «Vf f to*»fc* H|PP9?WJ U " !My,u v ^ t ! W)MMU \teM>jmZ)&zwm* glfifi^uS^ .jyuawud* &w VwW wvy yv: OJ\J"V with in young persons. Medical men differ re- specting the cause ; experience, however, teaches me, and eminent authorities support me in my opinion, that the predisposing and exciting causes are chiefly such as produce derangement of the digestive organs and debilitate the general system, — as the abuse of spirituous liquors, cold applied to the body, immoderate evacuations, unwholesome diet, and the extensive use of mercury ; whilst not unfrequently it follows long-continued self-abuse, adding another to the many punishments which attend this detestable practice. The disease itself is accompanied with a considerable discharge of urine, for the most part excessive in quantity, of a violet smell, sweet taste, attended with great thirst and general symptoms of debility. It often makes its first advances insidiously, the patient being affected for weeks without his being aware of its presence. Patients affected have usually voracious appetites, insatiable thirst, a dry, harsh skin, a clammy tongue, a sense of weight about the loins, and frequently their bodies emit a hay- like odor. The kidneys discharge a limpid fluid, tinged with green, like a mixture of honey and water, and possessing a sweet taste, more or less 53 observable ; the pulse beats quicker, the flesh wastes rapidly, and in an advanced stage of the illness, the feet and legs swell, and the skin be- comes cold and damp ; a troublesome costiveness "frequently attends, and sometimes an affection of the lungs. The quantity of urine voided is im- mense, and I have seen cases where as much as twelve quarts of urine have been evacuated in twenty-four hours. The immediate cause of diabetes may, in short, be set down to the morbid action of the stomach and the other digestive organs. Its distinguishing feature is the presence of sugar in the urine. The disease itself arises from a deficiency of animal salts in the urine. If, therefore, we wish to cope successfully with the disease and effect .a cure, we must stop the original cause, if it still continues, and then proceed to give back to the patient those human ingredients which he lacks. This may be effected, in whole or in part, by dieting the patient on light, easily digested animal food, to the almost total exclusion of every kind of vegetable matter, together with the use of tonic, astringent, and nar- cotic medicines. Where the patient has been a man of dissolute habits, especially where he has indulged in venery, or, worse still, self-abuse, the disease is always apt to be worse, not only in itself, but it is apt to be complicated with other diseases of a painful nature, which very mucb 54 diminish the chances of cure. As we have several other urinary diseases to take notice of, we cannot afford time sufficient to expatiate more fully upon the diabetic disease. The next evil we come to, in connection with our subject, is the loss of blood during the making of water. This may be occasioned by external violence, as blows or bruises, or the consequence of very violent exercise, or the result of irritation of the bladder, and it may and constantly does arise from excessive self-abuse. Sometimes the flow of blood is so great as to cause an alarming debility. If we find the disease arises from sud- den violence, notwithstanding the serious nature of the blow, we yet find much more facility in ob- taining cure, than where the patient has gradually fallen into it from excessive self-indulgence. In the treatment of the disease we are of course to guide ourselves by the cause. When occasioned by external injury or violence, the inflammation must be decreased by mild purgatives and diluent liquors. When the result of abuse, the cause must be at once ended, and those parts which have fallen into debility and decay must be again, if possible, built up and renovated. As this malady diminishes, the patient is apt to fall into another affection, which is called incontinence of urine. This disease may arise from various causes. In very old people, whose organs have become relaxed 55 from excessive old age, we naturally find it in a greater or lesser degree ; and, of course, arising from the natural weakness of senility, is not easily prevented or cured. Where, however, it arises from abuse of acidulous mineral waters, hysterical and epileptic paroxysms, or injuries of the head or com- atose diseases, the case is far different. When in- duced by palsy, the disease cannot be removed, though some relief may be given the patient. And here, again, where the disease arises from sensuality, we find trouble in arresting it, for it then takes the nature of senile weakness. The old man yields to it through weakness of his organs, or weakness produced by length of years. The j r oung Onanist is affected by it from the same weakness of the parts, but a weakness and decay brought on prematurely by excessive indulgence and abuse. Jfc sometimes arises from stone in the bladder. Where such is the case, the stone must be removed. In scirrhus of the gland, the cure is very difficult, — some medical writers affirm to be impossible ; but in my own experience, where the originating cause has received its proper attention from the physi- cian, and where the patient himself has sought advice early and followed it closely, cure has cer- tainly been effected from incontinence of urine. We will now turn to the opposite disease, which is opposite to it in name and nature ; this is called retention of urine. There are two dif- 56 ferent states of the disease, in which the urine is not passed properly, — that wherein the kidneys do not secrete it, or where, after secretion and conveying into the bladder, it is not discharged from that cavity. It is this last affection which is denominated retention of urine. The distinguish- ing symptom is a swelling at the lower part of the belly, occasioned by the distended bladder, and this accompanied with pain or pressure and lack of urine either partial or total. By examina- tion of the abdomen and the introduction of the catheter, the true state of things may easily be ascertained. It is of considerable importance that every one should pass water whenever he feels a desire to do so. As some persons fall into the habit of retaining it longer than nature intended, the result of their careless inattention to the requirements of nature often ends in what is called palsy of the bladder, and they then, when too late, find out the folly of their habitual disre- gard of the laws which govern the system. Re- tention sometimes originates in the more virulent forms of typhus fever. Again, it sometimes comes on from extreme debility, which hinders the pa- tient from completely emptying the bladder, so that he still feels a desire to do so ; this inconven- ience increases until at length the patient becomes entirely incapable of discharging it at all ; the bladder then becomes distended and rises above 57 the pubes. This form of the disease is most com- mon amongst those who have abused themselves by masturbation. The terrible strain upon the organs has so weakened them that they cease to be able to fulfil their proper functions ; and when we take into consideration the extreme delicacy of these parts, and the strain upon them in the wear and tear of natural life, it becomes a matter of wonder, not that they break down under the double pressure and work which they have to undergo, but that they are able to continue to discharge their proper functions as long as they do. When the organs are in a sound state, that is, uninjured by gross indulgence, the introduction of the catheter and the relief of the bladder will frequently be all that is required to cure the disease ; but, in the other case, nothing but great experience and a long course of medical attention will enable the patient co recover what he has sacrificed to the grossest passions. Could men generally see the results of sensuality as the professional man sees them, and could they, with his knowledge, understand the nature, cause, and effect of the ills that flesh is heir to, and fully appreciate the delicate organization and regular functions of each vital agent, how they would start back from the commission of such acts of folly as may inflict upon themselves years of suffering and uneasiness ! And yet it is this very knowledge which must be given to them ; not that professional 58 knowledge which years of careful study and expe rience alone give the doctor ; but that general and easily acquired knowledge which may teach man the wonders of his own existence, and that code of laws which governs the wonderful mechanism, and which, like that of Draco, may be said to be writ- ten in blood. To return to our subject. We next find stem- gury to be one of those evils which are too common among men. Strangury, then, is a constant desire to make water ; which, when made, is attended with great difficulty and intense pain. Like all other complaints, its causes are various. It may arise from inflammation of the urethra, of the bladder, or of other neighboring parts, from inter- nal use of cantharides, excess in drinking spirituous liquors, or from gravel in the passage. It is also sometimes a symptom of gout ; but it is most gener- ally of all caused by the weakening of the genital functions from that terrible self-abuse, the results and effects of which obtrude upon us at every pathological step we take. The application of a blister, in connection with cantharides, will some- times bring it about, in which case the patient is soon recovered by drinking plentifully of diluent liquors. Here, as in every other class of disease, its continuance and gravity will mainly depend upon the originating cause, and with this the phy- sician must acquaint himself. Thus, if the stran- 59 gury arise from inflammation, cooling purgatives and fomentations will often bring things to a proper status ; if, however, from spasm, opiates must be resorted to ; but where it arises from self-pol- lution, the case becomes graver. The disease in this case has not originated in an inflammation or spasm, which at once may be allayed or rectified ; but it has arisen from the feebleness of those vital functions which are necessar} 7 to carry on the works of nature. Here, then, we have to build them up, to bring them back to their proper vigor. We have to work on agents which are weak and debilitated, and we have first to raise them up to a certain vitality before we can b^in our work of cure. Such cases must needs be more protracted than others. In practice we meet with them so constantly that one would think their frequency would act as a check and restraint, in fact a warn- ing, to others to beware of the results of bad hab- its. Unfortunately, however, youth, under the present system of restricting physiological knowl- edge, is not aware of the miseries which they are inflicting on themselves ; and therefore it becomes the duty of those who, by profession and experience, are enabled to appreciate the extent of the injuries so arising, to warn the un- professional public, and by warning and advice lessen the terrible evils which are increasing in our midst. 60 The next affection I would call attention to is Dysuria. This is a pain, or difficulty in making water, and, like all others, arises from various causes, which require different modes of treatment. Sometimes it arises in inflammation of the urethra, or neck of the bladder ; sometimes from spasm, in which case we must use anti-spasmodic treatment. If from stone in the bladder, it cannot be cured until the stone be removed. And again, it often arises from the debilitating nature of self-pollution ; in which case, as in the former one, and for the same reasons, cure will be retarded until the sys- tem is in part restored to a proper state of vitality. In some cases the pain is more severe than others, being sometimes so intense as to cause the patient even to shriek with agony. As many of the urinary complaints owe their origin to inflammation of the kidneys or bladder, we will now turn our attention to these serious complications. Inflammation of the kidneys is marked by uneasiness, a dull pain about the loins, and sometimes stupor; the urine becomes of a reddish color, often bloody, and is voided frequently in small quantities ; the disease is attended with vomiting, costiveness, difficulty of breathing, and coldness in the extremities. The markworthy point in the result of this disease is that, if it attack se- verely a person of broken-down constitution, it most commonly gives rise to dropsy, either «ster 61 nally or of f he abdomen, and, in such case of fee- ble vitality, it often terminates fatally in apoplexy. This disease may be induced by cold, by the use of powerful diuretics, by excessive drink, by con- tusions and sprains and gravel ; but one thing must not be lost sight of, and that is, that in most cases the kidneys are in a diseased state from some other cause, and it is that which makes them liable to inflammation. In its treatment, the disease requires prompt and early attention ; for, if neg- lected or mismanaged, an irremediable disorgan- ization of the kidneys ensues, which finally ter- minates in death ; while, again, much will de- pend upon the patient's constitution, and the med- ical man must guide himself by this, as the reme- dies to be employed in the case of strong, robust, and weak, debilitated systems are very different. And here again do we find remarkably exemplified my remarks about the necessity for obedience to nature's laws. If the patient has been a man who has respected his health and strength, and has never given way to abuses of any kind, but has carefully preserved and cherished those qualities of body and mind which Providence blessed him with, now, in the hour of sickness, when disease has thrown him down, when his energies have be- come torpid from the exhaustion of the malady, and when death seems ready to seize upon its prey, — then it is that unabused nature arises in 62 its majesty to grapp.e with the stern king of ter- rors ; then it is that he reaps the full benefit of his temperance and self-control, and the. physician has the satisfaction of seeing his own efforts warmly seconded and supported by that greatest of all recuperators, Nature. How different is his case who has run the round of guilty pleasures, sap- ping his health and wasting his energies ! Now he falls upon the bed of sickness, and looks with imploring eye upon that medical science whose warnings and exhortations he has so often de- spised ; but, alas ! it is now too late. In vain the physician tries to rally the exhausted frame. Na- ture, too long abused, lies torpid, unable to make even one vigorous effort at restoration, and so fol- lows dropsy or apoplexy and death. The world sets down another victim to disease, but truth re- cords another victim to sensuality and self-abuse. From inflammation of the kidneys we will now turn to inflammation of the bladder : this is indicated by a sense of tension and pain in the situation of that organ ; there is a frequent desire, and consid* erable difficulty in discharging the urine, often a suppression entire, with frequent ineffectual efforts to evacuate the bowels, occasioned by the irritation extending to the rectum. These symptoms are attended with fever, sickness, and vomiting ; great anxiety and restlessness, sometimes delirium, and clammy perspirations ensue. The lining mem 63 brane of the bladder is likewise occasionally af- fected with a chronic inflammation. In such a • csrse, there is a dull, uneasy sensation, frequent desire to pass urine, which is generally thick from being loaded with mucus sometimes bloody ; or, if ulceration has set in, it is mixed with matter ; the coats of the bladder often, when affected with chronic inflammation, thickened, indurated, and otherwise disorganized, giving to the patient great uneasiness referable to these parts, and causing a constant inclination to urinate, or a total suppres- sion of it. Here, again, the medical adviser must carefully consult the patient's constitution ; he must be careful to work with nature at every step and stage of the disease. The causes which lead to this illness are of course varied. Unlimited sexual indulgence, whether natural or artificial, but more especially the latter, will often bring on this train of symptoms. The disease is itself generally amenable to medical art. If, however, not care- fully treated, it may be apt to return, in which case danger is incurred, as the constant repetition of inflammation of the bladder is likely to superin- duce a long train of evils which may be incurable. Having, in the course of my remarks, touched several times upon stone and gravel, it may be as well, whilst on this subject, to give them some share of attention. Urine, then, is in a state of health one of the most compound fluids which there 64 is ; it consists of various acids, alkalies, calcareous earth, and other materials. It is natural, there- fore, that when exposed, as man constantly is, to deteriorating influence, a change should often oc- cur in the urine, and the natural affinity between these various elements which compose it be sub- verted and give rise to a deposition of one or other of them. When this occurs it produces the complaint called gravel. The markworthy feature in gravel is that there are two kinds, one red and the other white, and, as they proceed from different causes, they require a different mode of treatment. Red gravel disease is highly inflammatory. In the white gravel the symptoms are more distress ing and give rise to great irritability of the system and derangement of the digestive organs generally ; the face becomes sallow and haggard, and, as the disease spreads, symptoms analogous to those of diabetes begin to appear, such as languor and de- pression of spirits. The predisposing causes of gravel are hereditary tendency, general indolence, or a sedentary life, excessive indulgence in fer- mented liquors. The chief cause, however, is in a want of constitutional vigor. A cold and variable climate often becomes a cause of this complaint. Stone, or calculi in the bladder, is a much more serious complaint. They differ much in form, size, and color. The symptoms attendant are a sort of itching along the urethra, particularly at the end 65 of the glands, frequent propensities to make water, pain in voiding the mine. Bat as all these symp- toms are to be met with in other diseases, the careful surgeon will not decide there is a stone in the bladder until with a sound — a polished steel rod — introduced through the urethra he has actualty felt it. This disease, though a serious one, yields to skilful treatment. When, however, it obsti- nately refuses to be cured, but one measure remains, and that is by extraction. The operation is, how- ever, a dangerous one. The size of the stone is sometimes very large. Time will not allow of our protracting our sub- ject any further. Enough has been shown to con- vince the most careless observer that we in a great measure hold our life and health and strength in our own hands, if we obey the dictates of rea- son, — that reason which was given to enable man to shun things hurtful and improper. If we obey the great laws of nature, and neither abuse our strength by actual abuse or neglect, then shall we enjoy a state of comfort and happiness that will make our life here below pleasant and com- fortable ; and then, when dark clouds of disease and sickness throw themselves upon the frail bark of life, the guiding hand of nature, aided by medi- cal science will pilot the bark over the wild, tu- multuous waves to a harbor of recovery and health. 51 Hancock Street, Boston, Mass. 5 LECTURE ON INSANITY. Gentlemen : I have the honor to inform you that Dr. Jourdain's lecture on madness will be read this evening. As delivered by him in England and Paris, of course there are many technicalities and long scientific observations which will not be in- telligible to the unprofessional public ; therefore Dr. Jourdain has simplified and abbreviated much which otherwise might have seemed unintelligible to the present audience. Gentlemen, our subject is madness. Now, what is this frightful calamity which assails the hu- man frame, and whence comes it? If we look back into past history, we find that the disease, as a whole, is by no means modern. Thus, the great- est of ancient times, and many others, suffered under its partial or concentrated influence ; but if we turn from the past to the present, — that present with which every medical m&n is, or ought to be, more interested than the past, — then we find (even allowing for multiplicity of inhabitants) the disease frightfully increased ; and what is the reason of this increase? Some have 66 67 declared that, us civilization advanced, the strain upon the brain increased, and also the weakening effect upon it from over-indulgence ; others, that as families married and intermarried, the blood became degenerated, whence proceeded madness. But, alas ! however satisfactory to some superficial medical ob- servers this diagnosis or theory might appear, we ourselves require far more tangible reasons, and, in looking for them, in practice have found suffi- cient to confirm the assertions of some medical writers, and to refute the works of others. The brain of man is that portion of him which, oy its delicate organization, its superior powers, and its extra nervous force, iorcls it over the rest of the body, and exalts the creature to a nearer resemblance to its Divine Creator. The brain itself is an agglomeration of delicate cells in intimate connection with minute tubes or fila ments, which communicate impressions made upon the cells at one end to those which lie on the other. The mass may be generally called the nerve apparatus. But it may be asked for what purpose is this apparatus ? Its purpose is the perception of sensations of all kinds, the power of comparing these sensations, the power of combining them so as to form fresh imaginations, and the power of feeling emotions and propensities. The activity of the vesicular nervine is the occasion of all these capabilities. These little cells of the brain are 68 what is called the mind, the agents of our sense tions, and thoughts, and desires. The gray sub- stance of the human brain contains millions of vesicles lying in a semi-fluid, granulated substance, and bound together by a minute network of blood- vessels, and fine areola tissue. Now, the mark- worthy points in the relative position of the brain- cell are, first, its proximity to the nerve-tube from which and to which it conveys impressions, the taking of which causes its exhaustion. Second, its proximity to the blood capillary, which exudes a plasma in which the cell is bathed and renovated, and from which new cells are formed to replace those which are finally exhausted ; so long as the brain is acted upon by the rest of the body regularly and properly, so long will the brain-cells be renovated by a natural arrangement ; but when excessively stim- ulated, the renovating power is not sufficient to keep pace with the exhaustion, and so diseases of the brain are engendered. In speaking of the brain, so far we have merely touched upon the brain proper, or convolutions of the cerebrum. The cerebellum and central masses of gray matter are subservient to motion alone, or by impressions upon the nerves of sensation ; whilst the medullary substance of the brain is merely a conducting medium. From this we find that disease may exist in these without necessarily 69 destroying the mind. Sensation may be affected, but judgment may be left intact. Having shown the delicate construction of the mind, and its close connection with every vital part, it must evidently be apt to be injured and impaired ; and yet its renovating powers are such, that in reality it is, unless very much abused, al- most more powerful than any other part. When from any cause it does become injured, then mad- ness, of course, occurs, and it becomes the medical man's duty to discover the cause, remove it if pos- sible, and then assist nature in renovating the parts injured. The most difficult, or rather that which the greater part of the medical faculty think the most difficult, is in the discovery of the cause and its removal. Those, however, who have, like my- self, made a specialty of the diseases arising from solitary or sexual abuse, and have a large experi- ence in such matters, seldom find much difficulty in finding and pointing out one of the greatest causes ; and I am happy to say that the fact is now becoming generally recognized. However, we find the talented and learned medical keeper of the Asylum of Devonshire, and editor of the " Journal of Medical Science," in his otherwise excellent work on madness, gives the following table of causes of madness. He divides them under two heads, namely, physical and moral ; a division which must be open to objection, as they are so inti* 70 mately connected as often hardly to allow of defi- nition and separation. Mr. Parcleappe has also, I see, done the same thing, Dr. Tuke says, from his experience, the physical causes of madness bear this proportion to each other : — Physical Causes. Moral Causes. Epilepsy, 68 Disappointed affections, 53 Intemperance, " 164 Domestic troubles, 241 Vice, % 40 Grief, 88 Injuries to head, 4 Religious excitement, 56 Disease of the brain, 14 Political excitement, 34 Other diseases, 18 Wounded feelings, 84 Uterine, 45 Fright, 48 Old age, 8 Over study, 8 Mercury, 3 364 612 Now here, at once, without any explanation, we see at a glance that the table, as to the cause, is a very imperfect one. The actual* leading cause is given, but the original and primary one is lost sight of. I will, therefore, give you the result of my own experience and inquiries ; and I can point to eminent authorities who have not only agreed with me fully, but have even quoted from my own published report. At the Asylum of St. Gore, the cases ran similar to that of the Devon- shire above quoted. Although the numbers were larger, the causes bore the same relative proportions to each other. But on close inquiry I found that in addition to 71 the large number who were lunatic from actual self-abuse, upwards of one-third of the epileptic cases had originated in masturbation. Nearly one-half the intemperate, the same ; disappointed affection, two-fifths ; religious excitement, very nearly three-fourths ; wounded feelings, two-thirds ; and of over-study I found every individual of these had weakened his brain by vicious indulgence. How absurd is it to argue for an instant that that godlike brain which is naturally so active, so power, ful, so indefatigable, should be broken down by the griefs, trials, and cares, which are of e very-day oc- currence ! If we acknowledge these to be actual causes, why do not thousands more of our fellow- creatures break down and retire to the asylum when grief, trouble, love, excitement, or wounded feelings overtake them ? No, gentlemen ; the brain has suf- fered either from hereditary taint, injury, disease, or, most prolific cause of all, masturbation ; then, when overtaken with the usual trials of life, it has no power to meet them. To return to my report on St. Gore : by care- fully following up my inquiries, I found that whereas only about one-tenth of the patients were the actual victims of self-abuse, upwards of one- half of the whole number owed their insanity, originally, to this fearful practice. On the au- thority of the Thirteenth Report (Victoria, Aus- tralia), we find one hundred and forty-five cases 72 are set down as the direct result of masturba- tion. It goes on to say, this secret vice produces the very worst form of insanity ; because after insanity has supervened the crime is continued, and hence the energies are more prostrated. Again, we find that out of two hundred and seventy-one males and twenty-nine female patients from this detestable practice, upwards of one hundred and ninety-seven males are hopelessly incurable. In all the re- ports on lunacy that have come under my no- tice, and in all my large experience, I have never heard or seen where a medical man has lost his reason from this cause ; thus proving that a physi- ological knowledge will always act as a check and a restraint. We will now turn from the causes of insanity to an examination of its different forms. Be- fore doing so, however, I think it cannot but be interesting to cite a case in point, showing where madness had been set clown to the wrong cause, and the impossibility of cure while such is the case. The case was one in Dr. Burnet's pri- vate asylum. The patient, a man of about twen- ty-six, had been of a studious mind, and, after being at Oxford, was sent home, study being inju- rious to his health. His faculties soon became impaired, and he was placed in Dr. B.'s hands. So far from becoming better, he seemed fast sink- ing into a hopeless state, when his parents, who 73 were wealthy, determined to get other advice ; and several eminent medical men consulted on the case, apparently without coming to any definite result. At this period, the father happened to come upon one of my published lectures upon emotional insanity, and I was forthwith invited to join in consultation. I found that all my confreres accepted as an established fact that the disease was the result of an overtaxed brain. I, however, would only accept it as an effect?, and, after a careful examination, proved not only to my sat- isfaction, but, what was better still, to the satis- faction of my colleagues, that this was the result of Onanism. The patient was forthwith placed under my charge, and by changing the treatment and exercising a strict surveillance over him, he was restored to sanity, and as far as I know, has never relapsed. The various forms of insanity have been dif- ferently classified by different authors. Amongst these, Dr. Arnold has given an elaborate table of distinctions. But my own experience shows that he has rather specified the different results arising from forms of insanity than the actual symptoms themselves. Dr. Tuke's classification comes nearest to my own views upon the subject; but he again after- wards fails in classifying the original causes. Ilia table runs thus : Class 1. The intellect, — forms of 74 insanity, idiocy, imbecility, dementia, and mono* mania. As the disease increases, delusions, illu- sions, and hallucinations. Class 2. Arise from xaoral sentiments, — moral idiocy, moral imbecil- ity, moral insanity, melancholia ; further develop- ments, religious, hypochondriacal, nostalgic. Class 3. Affect the sentiments, and come under the head of mania, which may be subdivided again in- to six different kinds, such as homicidal, suicidal, dyspnomania (or excessive love of drink), etc. As my hearers may not be able to distinguish between these different forms, I will briefly define them. Idiocy proper is that form of madness where every appearance of thought and under- standing is entirely blotted out; imbecility im- plies a childishness ; dementia is marked by the abolition, more or less marked, of all the senses, intellect, and will ; moral imbecility is that im- becility arising from moral causes, chiefly mastur- bation, or intemperance ; moral insanity is a more active and ardent form of the former ; whilst melancholia is a state of utter hopelessness and constant tear, chiefly arising from self-abuse, or else the result of incipient madness ; mania is the most ardent state, and takes the form of murder, violence, and outrage. Time and space will not allow us to go into minute details. I must there- fore confine n^self more particularly to the prin- cipal cause and causes of insanity, — that first link 75 in the chain which has not sufficiently been inquired into by the general faculty. Thus we find the great Dr. Connally, in describing cases of melancholia, says their chief propensities are indolence and in- difference ; they exclaim, " Once I was industri- ous, now I am worthless ; the world is changed ; it does not seem as it used to ; all good has gone out of me." Young men and women thus affected cease to be interested in anything ; they are averse to going into society, they shun everybody ; one propensity alone remains, that is, self-destruction. Long afterwards, the same writer acknowledged that these symptoms were inseparable from long- continued self-abuse. At that time he ignored it. We have before said that whilst there are forms of madness the actual result of self-abuse, there are others which have arisen from other causes, them- selves originating in masturbation. Thus Esqui- val classes some of these, though unwittingly, un- der the head of reasoning monomania. He says we distinguish three periods in it. In the first, the disposition and habits are changed ; memory fails. In the second, the affections are perverted. Third, a weakening of the faculties leads the monomaniac to dementia. Of the numbers of cases of rea- soning (so called) dementia, which have come under my own practice, I have met with but three who had not been reduced to their state by self- pollution. 76 A very interesting case occurred, where the symptoms baffled several highly esteemed physi- cians, entirely owing to their having preferred the old beaten path of practice on insanity, instead of stud3 T ing moral causes and physical for them- selves. A gentleman holding a high position in England, possessed of wealth, and married to an excellent wife, had gradually fallen into a state of absorbing melancholy ; which, although causing pain and uneasiness to his family, was not sup- posed to be serious, and was thought to arise from care. After a while, however, he evidentty grew worse, spent restless nights, frequently talked to himself, shed tears, and evinced a perfect indiffer- ence to his wife and children. Medical advice was called in, and, after some consultations, it was de- cided that his was a simple case of melancholia. Under the treatment he received, a slight altera- tion for the better took place. He then relapsed into a state of delusory insanity, — imagined him- self dead, his wife married to somebody else, and he, in spirit, compelled to witness her connubial enjoyments. The case becoming more serious, other advice was callec. in, the affectionate wife refusing to allow him tc be taken to the asylum. Notwithstanding every effort, the patient was evi- dently becoming worse, — in fact, lapsing into a stage of mania which might be dangerous to life. At this stage of the disease I was admitted to 77 consultation, and immediately recognized the pri- mary incentive. Still not one of my confreres seemed able to decide. In fact, they had busied them- selves more about the symptoms than the cause ; thus rather lopping off the branches than striking at the root of the disease. The three causes, how- ever, which seemed to find most favor with my colleague, were over-mental exertion, intemperance, or the effects of severe illness. I immediately sought an interview with the patient, and, although careful to avoid all appearance of medical inter- ference, I could see, by his shrewdness and suspi- cion, that his faculties were rather unduly excited than impaired ; and I soon found that the whole of his derangement lay in some exciting and de- pressing object upon his brain, resulting in some physical cause. With some difficulty I got him to place himself under my care, and soon discov- ered, by examination, that the patient was impo- tent, his testicles being fearfully reduced. By the judicious use of baths and medicines, I succeeded in arresting the terrible mental excitement, and as this became sufficiently allayed to allow of kind and soothing conversations upon his state of health, I succeeded in calming the fearful despair which had assailed him : hope once more took the place of terrible gloom ; his spirits began to rise ; and the most affectionate letters began to pass between him and his wife. He seemed, as he 78 himself afterwards described it, to have suddenly awoke from a fearful nightmare to the bright and brilliant light of broad day. Acting upon my ad- vice he remained with me a few weeks longer, and then went back home physically and mentally well. Now, this case was not the result of any won- derful improvement or discovery either in medi- cine or medical art. It was simply the result of experience in detecting and removing the true cause of disease ; and this, gentlemen, is the Alpha and Omega of every curative system. In this case, had not the terrible results of self-abuse been a specialty of mine, I, too, would have failed, as the others did, in my diagnosis, and this unfor- tunate gentleman would now be in an asylum or his grave. How necessary is it> then, for us, to instruct our medical students in a more comprehensive course of study than at present exists ! How imperatively necessary is it for us, as exponents of me'clical science, to inquire into and discover and discriminate between cause and ef- fect ! Within the last few years a general exami- nation into insane statistics shows a fearful in- crease of nearly twenty-five per cent., while the moral causes of insanity are more than double the physical. Some writers have set down much of this increase of moral insanity to the use of sensational writings, religious revivals, and the 79 wear and tear of speculation ; but if we accept these as results, why has not the number of insane increased fifty per cent. ? Why do so many read books, attend revivals, and push on a furious trade without injury to themselves ? The reason is be- cause their minds and brains are strong, unim- paired by that enervating influence which is sap- ping the mental faculties of so many. And what is the cause which is thus eating into our na- tional intellect? That is the subject for medical attention, and until it receives the amount due its importance, the statistics will mount up, in spite of all the restoratives and alteratives of the most copious materia medica. It is with considerable satisfaction that I read to you the following extract from a letter, written by the talented medical superintendent of the Insane Asylum at Havre : — " Dear Sir, — A case of a painful nature came under my treatment some time since. The patient, a young man aged twenty-nine, was placed under my care, he- having become insane through reading the French translation of the works of Doctor Cummings. Up to that period, though of a mel- ancholy and absent frame of mind, he had never evinced any mental alienation. After this, how-' ever, he was seized with the most vigorous form of religious mania, fancying himself the subject 80 of sacred prophecies, and the object of Satanic possession. My endeavors to soothe and relieve him were, however, useless, when having fortu- nately met with your lecture, entitled, " Causes of Religious Insanity " (which at the time of my first reading I did not entirely agree with), I deter- mined to adopt your own course of inquiry into the cause, and found that this was another of those melancholy cases which medical science has too often overlooked. The result was that, — thanks to your valuable advice, — I was enabled to restore his mind to its proper balance, and his body to that state of health which his own sensuality had nearly deprived him of." I read this letter, especially as the author of it had, at the first appearance of my lectures on this subject, been not only very dubious of, but even very much opposed to, the reformation I sought to introduce. There is another important fact, and one which in itself carries conviction as to the chief cause of insanity, and that is that the unmarried kisane are infinitely more numerous than the married. By statistics taken from the census of the population of England of 1857, the number of married persons is double the single ; and yet of patients admit- ted to the asylum we find the unmarried in the ma- jority. What, then, is the cause of this? Mar- 81 riage certainly increases the cares and trials of life, and one would therefore be led to suppose that it would rather tend towards insanity than otherwise. . The cause evidently is, then, the frequency of solitary vice and masturbation among the unmarried. Again, we find the number of suicides far greater among single persons, — an- other distressing proof of the cause which leads to it. We will now examine the painful physical results of masturbation ; and the very appearance and number of them will be sufficient to convince every professional or unprofessional person that they can- not be suffered long without producing insanity in one form or another. The results, then, every Onanist must sooner or later experience, arc loss of memory, nervousness, restlessness, lack of energy, want of judgment, want of purpose, confusion of ideas, aversion to society, depression of spirits, excitability of tem- per, moroseness, cowardice, listlessness, pains in the head, pains over the eyes, frequent sigh- ings, secret dread, broken rest, want of confi- dence, dimness of sight, confused noises in the head, and constant suspicion. Such are the symptoms, gentlemen, which follow masturbation, and so also are they the symptoms which pre- cede madness. Who, then, can for a moment wonder what is the origin and reason of the in- 82 crease in lunacy? The reason is, gentlemen, — » and let the words be engraved on every human heart, — that our young are giving way to the horri- ble crime of self-abuse ; and if we wish to check this terrible torrent, which is sweeping away thou- sands of our best and brightest youths, emaciating their frames, and breaking up their godlike in- tellect, we must labor in the cause of physiological reform. Every father of a family must acquaint himself with physiology, and must impart its greatest lesson to his children. And now, gentlemen, in conclusion I would add, that having, by a long experience gained by an extensive practice on this very subject, learned the fearful extent of this evil and the multifa- rious disasters which befall the human race therefrom, — disasters which are of such a magni- tude as to affect even the natural existence of the present race, — I determined to devote myself to the great task of ameliorating the existing evil. For this very purpose, then, I have opened this institution, the mere examination of which must impart valuable knowledge to all. And I have also prepared lectures on all those different sub- jects which are intimately connected with our health, happiness, and welfare. Sincerely hoping, therefore, that my objects may be attained, and that hereafter numbers will look back to this insti- tution and these lectures as the hand-board which 83 directed them to the road of health, honor, and happiness, and warned them from that path which must end in ruin and destruction, I now conclude this lecture. 51 Hancock Street, Boston, Mass. LECTURE ON THE VOICE. Gentlemen : I rise to address you on subjects which it is the duty of every person who has tho use of his faculties to study and to learn, — yes, I might even say his sacred duty. Years and years have men suffered, and languished, entirely owing to the ignorance which generally exists on those subjects which intimately concern the human body. Science has with prodigious strides advanced some subjects and has left other and even more important ones unrecognized. The mighty mind of man has concentrated upon these subjects, ignoring others ; nay, not only ignoring, but even sometimes laugh- ing to scorn the efforts of those few good and philanthropic men who have endeavored to bring the matter into general recognition. Such has too often been the fate of those who, by books, dia- grams, and lectures, have striven to teach the human mind about the corporeal care which en- velops it. And does it not seem strange that that which is the most intimately connected with our health, happiness, and welfare should invaria- bly be the subject on which few bestow the slight- 84 85 est attention? And what, gentlemen, is the result of this apathy and carelessness? The result is that thousands and thousands of persons either suffer in body or mind. Not only are they apt to destroy themselves by vicious habits and abom- inable abuses, but they are also apt to injure themselves seriously by inattention to the laws which govern the system. Therefore, gentlemen, a physiological knowledge is essentially requisite to all. It will tend to keep youth from that abomi- nable soul and body destroying habit, masturba- tion. It will cause him to abandon it if he has already fallen into the dark and loathsome pit. It will cause him to shun the loathsome evils of sensuality and immorality. It will cause him to respect that wonderful machine which God made in his own image, and compared to w r hich the greatest work of man is but as dust in the bal- ance. Is this, then, a subject unworthy of science and public attention? Is it to be kept hidden and secret, and locked up when thousands of fellow-creatures are imploring for it, — ah! im- ploring for it, not with hands uplifted and voice upraised, but with the much more touching though mute voice which pallid cheeks, and sunken eyes, and forms tottering to an early grave, sadly, solemnly express? No, gentlemen, the onward march of progress, that great unseen power which sweeps away abuses from the earth and opens out 86 to man fresh fields for human intellect to wander in, will break down the walls which ignorance and false delicacy have built to hedge it in ; nay> more, will even eventually compel every man to attain the required knowledge. For the very purpose of giving to as many as I possibly could this invaluable knowledge, I have opened this institution, prepared lectures on vari- ous subjects of peculiar interest and extraordinary importance. These lectures will be read nightly, and will in their course embrace all that extensive range of subjects with which it is every one's duty to become familiar. Having premised this much, I will at once enter upon my subject. The first branch, then, of the lecture is upon that power of man which enables him to converse, — the voice. Now, here at once we come upon one of those subjects which so few take notice of. Nine- ty-nine men out of one hundred have this ability of speech, and yet not one of a thousand has ever troubled himself to think how the sounds were produced. First of all, then, the voice of man and animals depends on the form and structure of the larynx or upper part of the windpipe, and on the opening to it called the glottis. Man's articulation, therefore, is produced by the muscles of respiration, the tongue, the teeth, the palate, and the lips. The glottis has been proved to possess the properties both of a 87 wind and a stringed instrument, as its opening or chink can be enlarged or contracted, and the liga- ments attached to it can be more or less stretched ; but the voice can be so varied and complicated in its tones that it would be a difficult matter to explain all the peculiarities. According to Halles, the eminent authority on such matters, the organ of speech is nothing more nor less than a musical instrument. He says that the sound entirely depends upon the tension of the strings, and not in the enlargement or diminu- tion of the aperture. Now, in wind instruments We can gain an octave with the same aperture by shortening the tube. So also is the sound changed in the larynx ; the muscles produce tone by tight- ening the strings. If we attend to the construc- tion of musical instruments, we find that the strings are not the cause of the tone ; tone arises from the vibration of the wood by which the strings are surrounded. Thus we find it in the harpsichord and in the fiddle. Now do the strings give the sound? No, certainly not. The wood gives the vibration ; this communicates with the air, the material, and the result is sound. So is it, gen- tlemen, in the tone of voice ; the strings do not give the sound, but split it up ; then the current of air is split up into different channels, and so also the current of sound is subdivided. This subdivision, then, and splitting up of sound, are 88 necessary for articulation of words. From in- quiry into, and study of, this wonderful construc- tion, resulted the effect of teaching deaf men how to speak. All vowels, which are notes of the voice, are rn^de in the larynx'; labial consonants are produced by closing the lips, while the lingual are made by the back part of the mouth. Again, the dentals are caused by the hissing through the teeth, like S and T. So delicate and compli- cated a construction as the machine which enables us to speak must necessarily be easily affected or hurt. Thus, cold attacks the larynx, and at once makes us hoarse ; fevers loosen the strings, and of course weaken its powers ; fear and sur- prise will even take it away. Such being the case, how careful, gentlemen, ought every one worthy of the name of a man to be of that power which at once places him above the rest of the animal creation, and enables him, as an orator, a musician, or even as a good and honorable mortal, to influence, inspire, teach, and comfort his fellow- ' creatures ! And yet, gentlemen, how many a bright and brilliant youth, — one who might have led the counsels of the nations and held multitudes enchanted by his eloquence, — how many, I say, have thoughtlessly, foolishly, and wickedly de- stroyed or impaired these great talents by the commission of vicious acts ! Syphilis, that scourge whose origin none kno\x> but whose direful effects 89 most men are aware of, — ah ! and some to their sorrow, — at once if it proceeds any distance in its secondary course, impairs or destroys this precious boon by eating and corroding the roof of that temple which contains one of the greatest gifts of a merciful Creator. Look, gentlemen, at No. . . . and you will see how that scourge of sin has destroyed the able work of the Divine Architect. No*T, gentlemen, I will not go the length of say- ing that a knowledge "of that divine mechanism by which we move, and have our being, will always, or even generally, deter men from the commission of sensual sin ; but I do hold, and that decidedly, that the more we study this great science, and the more intimate man's knowledge of himself be- comes, the more careful will he be in his actions, and the better.care will he be apt to take of a ma- chine which is so intricate, and so delicately con- structed, as is the corporeal frame. If we, as phys- iological leaders, neglect to raise our voices in warning and exhortation, then there is but one other great teacher on this subject, and he will thunder forth a direful eloquence to countless multitudes, — multitudes who will shudder at that teacher's experience. But, alas ! gentlemen, he comes to us, not as a gentle and patient instructor, but too often as a fierce and terrible judge, armed w T ith the frightful lash of bitter reminiscences and terror- inspiring recollections. Shall, then, the philan- 90 thropic and enlightened nineteenth century fold its hands where so great a field for labor and refor- mation is lying desolate? — a waste filled with prowling fiends lying in wait for innocent youth or incautious middle age. No, gentlemen ; though prejudice and false delicacy may, nay, will raise its puny voice against our efforts, yet a conscious- ness of right and the onward march of reformed science shall support us in the effort ; and if but one innocent victim is snatched from the jaws of soul-consuming despair and unutterable remorse, then even will I consider myself repaid for my endeavors. Do I say but one? I trust and I know, that, as the magnitude of the horrors, which must sooner or later overtake the sensualist in his crime, is placed before the young in the bright and powerful light of truth, so many parents will not weep over the early and wretched graves of those who might have been as angels, but who have sunk to the lowest depths of despair. So many unfortunate, broken-hearted wives will not sob and lament over those who might have sur- rounded their hearths and homes with the sunshine of love, peace, and domestic contentment, but who have gone, leaving behind them poverty, disease, wretchedness, and dishonor. Let, then, the loud, ringing voice of science, Of medical knowledge, clash through the land, until the voice of undisguised truth has exhorted, has warned, 91 has saved the lives of men ; and what better footprint can we leave behind than that which has been trodden in the paths of progress and philan- thropy, — trodden whilst conveying comfort and hope to the lost and wretched sensualist, whilst sounding the tocsin of warning to ignorant and unprotected youth? Then, gentlemen, let us one and all do what in our power lies to promote this good work. Hith- erto I have touched lightly upon this evening's subject, for my aim is to save rather than con- demn ; to lead the profligate back to the paths of rectitude, virtue, peace, and happiness, rather than, by harshness and severity to hurry him on his downward course ; but on that part of my subject which I am about to enter, it is my duty to speak emphatically, solemnly, and truthfully. The subject is one of vital importance to the young, — of such importance, indeed, that words cannot suffice to express it ; and yet it is one so filthy in its practice, so abominable in its deed, and so soul and body destroying in its effects, that it is a pain- ful task even to touch upon it ; but, alas ! daily experience — ah, how sad an experience ! — teaches us that we must shake off the thin veil which an ultra and false delicacy has thrown around, and expose the deed in all its frightful aspects. The subject, gentlemen, is that fearful, abominable crime which is filling our hospitals with patients, 92 our asylums with idiots, our streets with pitiable wrecks of manhood, and our cemeteries with the graves of those we loved ; that crime which called forth the Almighty wrath to destroy Onan ; in fine, gentlemen, that crime of crimes called masturba- tion or Onanism. The subject itself, without painting its deplor- able and filthy details, is abhorrent to all well-con- stituted minds. But, gentlemen, we have a duty to perform. That duty is to find out, and, by ex- hortation and warning, to recall such poor unfortu nate beings as have been lured by this most horn- hie of demons to the brink of everlasting ruin, both in body and mind. Such a duty I have to perform, . and I will do so without mincing the truth. First, the word masturbation is derived from two Latin words, manus, the hand, and strapo, which means fornication ; the word then means the act of forni- cation as committed by the hand. It is that filthy habit which young persons of both sexes are liable to fall into through ignorance and temptation. It is that soul and brain destroying habit which, alas ! is too much practised all over the world. At an early age, perhaps of eight, ten, or twelve, by bad asso- ciates, the youth is first initiated into the horrid mystery. At that age, under the present system of keeping back from youth all pltysiological knowledge, the chi] i probably looks upon it as a pleasant, I might almost say, an innocent recrea- 93 tion. As he grows older, what was done merely for experiment, or, perhaps, to be in fashion with his vile and older associate, becomes by repeti- tion a regular habit. Lassitude, weakness, dizzi- ness, loss of recollection, and timidity, cause him to think that something must be wrong. A doctor is called in ; he is questioned, of course ; the lad carefully conceals his practices ; though not ashamed to commit the offensive deed, he is j^et too modest to talk about it. The doctor shakes his head ; the symptoms are not sufficiently marked as yet to allow of his deciding on the true cause. The verdict is given, — stomach out of order, or cold, or too much hard study. Under the influence of medicine, he temporarily feels, or fancies himself, better. Then the disease again as- sails him. He shrinks from company, he almost trembles at the idea of a rough-and-tumble game with his tougher comrades ; and, at the prospect of a fight, his cheek blanches, his lips quiver, and his heart almost chokes him with its throbs. Then he begins to feel melancholy. Strange ideas of early death come over him, and he wanders about in a state of semi-unconsciousness. The habit grows deeper upon him. Still, if he have an idea it is his fatal habit which is injuring him, yet it is but a faint, glimmering idea. And so it continues ; his mind, conjuring up filthy and unholy thoughts, feeds the fire which is steadily and surely wasting 94 his strength and energy. He looks back upon the time when, even as a child, his heart beat with boyish, yet great and lofty aspirations. Now all seems dark and gloomy; he feels as though he were different from others. He, in his wretched soul, arraigns the Almighty for refusing him those qual- ities of courage and strength he sees around him. Such, then, are a few of the sufferings which must attend the victim of this unhallowed crime. Great as they are, and sad as we as human men must feel in seeing them, yet they are nothing but the just deserts of the sufferers. What better can any man expect who with his own hand defaces and destroys that beautiful form made in God's image ; blots out and obliterates those great men- tal faculties, which, under other circumstances, might have raised the happy possessor to the highest pinnacle of fame ; destroys that creative power which might have given to posterity great and talented beings, — beings who would have been a boon to the age they lived in, — and blackens and damns a soul born to wander in realms of happiness? Alas! gentlemen, experi- ence teaches us that this is a world of sorrow and suffering ; but how true it is that two-thirds of these are of our own contrivance ! Those who give way to this abominable vice at once deprive themselves of those calm and peaceful domestic joys which are the best and highest gratifications 95 a mortal can enjoy. Of all the boons a merciful Providence has given to man, a loving and faithful wife is perhaps the greatest. How miserable, then, must be the fate of those who by their crimes render themselves unworthy of a woman's re- gard ! He now begins at length to find out what is the cause of all his terrible sufferings ; but still shrinking from publicity, and not fully appre- ciating his frightful condition, he attempts to battle with the enemy alone ; but, alas ! that strong will which once would have held him to the path of rectitude and virtue is so weakened by vicious indulgence that the task is a hopeless one, and he sinks back into his abominable practices, till at length he ends his days a drivelling idiot, or shrinks away from the bold and stern fight of life into a miserable grave. He sleeps the sleep of eternity ; but, alas, not that state of repose where 44 the wicked cease from troubling and the weary are at rest." No, no ; other and more fearful punishments await him. But on this subject we must not expatiate. Our task is a practical and physiological one ; our duty to save only phy- sically and mentally ; our lessons are confined to this world. We have shown you the general ap- parent results of this crime, — results which, alas have largely come under my own experience. I will now show you the actual physical and local results arising from this detestable practice. 96 As my object is to instruct and exhort, I en- deavor to avoid as many of those long-sounding and, to the bulk of the people, unintelligible words which most medical men make use of in their lec- tures and writings. I strive to make myself in- telligible to the meanest capacity, and therefore trust that the course of lectures delivered here, together with the exhibition of these models, may be a blessing to many. We have seen, gen- tlemen, the effects of this horrible, destroying agent ; let us now consider why these results are brought about. Now the reason is this, — that whereas the organs of generation are made to per- form the wonderful functions of procreation, their structure is of the most delicate mechanism ; they are, as it were, a physical centre, hence and whence all the functions and essences, so to speak, of the body congregate and emanate ; therefore they have, by means of veins, arteries, and nerves, connection with every vital part, such as the heart, • the brain, the lungs, and the intestines ; in fact, these organs of generation are, as it were, the very main-spring of the corporeal frame. In a haalthy state, they are kept supplied with seminal fluid, and this seminal fluid is the very quint- essence of humanity. What we eat, drink, and absorb becomes, after a certain manufacture is carried on within us, blood, water, and other ma- terials which are necessary to our existence ; but 97 a further manufacturing takes place until the very essence itself is obtained. Now, if we use this gift only in legitimate and lawful ways, the supply will always meet the demand, and we shall enjoy a perfect state of health. Our brains will be clear, our minds strong and ready, our hearts exultant, and our nerves as iron ; but the moment the de- mand is greater than the supply, then the scene changes, and everything becomes deranged in a greater or less degree. Then, if the vice of Onan- ism be indulged in, the supply is soon drained off; then the manufacturing process, goes on ; the sys- tem is forced ; the brain, the heart, every part of the body is robbed of its just share of its vital supplies in order to allow the* wretched Onanist to gratify his hideous desires. So it continues until at length exhausted nature, worked under this double and treble high-pressure system, cries out too much, breaks down, and leaves the sufferer a wreck in mind, body, and morals. But it is not only in the waste of the human essence that the wretched victim injures and defaces his manly form ; the parts themselves through overwork and constant use soon become weak, debilitated, and at length useless. Ignorance on this branch of physiology has been the stumbling-block of men for ages, and the medical faculty have been, as a rule, very backward in recognizing the extent of this fearful evil and in providing for its cure, 7 98 Fortunately science has at length turned its atten- tion this way, and^ the consequences are being made manifest in the restoration to health and happiness of hundreds who otherwise would have been lost. So that although the crime is so dis- gusting that the mind revolts from its contempla- tion, and although the wretched Onanist deserves in retribution all the horrors which attend upon the committal of this crime, yet it is our duty, not only as a medical man but also as a Christian, to offer him the means to return to the paths of duty and virtue. Too often men who have given them- selves up to this destroying power are driven into madness or suicide by the idea that their case is hopeless. Now, all cases are not hopeless. Hope- less they will be if the victim continues in his crime, and fruitless will be the doctor's efforts to save him ; but happily the body, especially in the young, has strong recuperative powers. These, when aided by medical science, will, in most cases, if the patient keep himself in proper bounds, after a time, restore the patient. Some wretched quacks advertise cure by specific medicines or the use of instruments. Against such the loud voice of science exclaims with almost as much energy as against the crime of Onanism itself. Let the unfortunate victim, then, make up his mind to abstain from his lust ; then let him go to some physician of experience in such matters, 99 state his case, and place himself under his treat- ment, and he will, in all probability, be cured. As my object is to incite men to regard their physical structure with the reverence due its wonderful mechanism, and to hold them back from vice, or by encouraging hope, inspiring confidence, gently lead back to health and happiness, I cannot do better than cite a case in point where cure has been effected, and that at a period and stage of the disease which, in my — alas ! that I have to say it — large experience in such cases, seemed utterly hopeless. Without specifying either the date or locality, — strict secrecy in such matters being the duty of the physician, — I will briefly say that a gentleman called upon me, requesting me to see his son, who, from being a bright and clever boy, had grown into a foolish and half-idiotic man. Upon visiting my patient I felt certain by his looks that self-abuse had either wrought the wreck I saw be- fore me, or had helped to bring it about. I called the father one side, and although he denied all knowledge of his son's having acted in this man- ner, he supplied me with data sufficient to con- vince me that my first diagnosis was a correct one. Upon examining the generative organs I found that, though in a critical state, they were yet capa- ble of cure. It would be unnecessary for me to go through all the details of my professional at- tendance ; sufficient to state that after a constraint 100 of three or four months, and a course of medicine for about the same time, I restored the patient to perfect sanity, and to a physical state of health which, unless again abused, would in time restore him to all those advantages which he had forfeited. The other case was a more peculiar one, and I cite it as a warning to all young men who have ever committed the crime of Onanism, never mind how long they may have left it off, not to go into the state of matrimony without first getting medi- cal advice. Many men, seeing the error of their way, have honorably abandoned the habit, and have fancied that time would bring everything right; but too often their organs have been in- jured, and while they think they are gaining strength, the seed is flowing from them in every wa- ter they pass, — this is called spermatorrhoea, — or by nocturnal emissions. In either case it is essen- tially necessary that a radical and complete cure be effected before marriage, else shame and misery will assuredly follow. The case I am about to mention was a man of thirty-five years of age. He had fallen in love and married a wife who in amia- bility and good looks could not well be surpassed. After six or seven months of connubial happiness he found, to his amazement, his powers leaving him ; soon he found himself totally impotent. He very wisely resolved at once to get medical advice, and chanced to come to me. He was very 101 much affected and eagerly sought for cure. I com- forted and cheered him up with hopes, if he would only give me every information so that I might understand his case, I probably would set him to rights. Thus exliorted, he told me that when at school he had yielded himself to the dreadful practice, but upon reaching his twentieth year he had abandoned it, and not only lived a virtuous life but even a religious one, — he having become a prominent member of an association. Upon ex- amination I found that he had all through this in- terval been suffering from spermatorrhoea, which had very much impaired his sexual organs, and al- though the excitement and love of the period of marriage had temporarily restored his magnetic power, yet it had also hurried its prostration. Although the disease may be said to have be- come chronic, yet with skilful treatment he was restored to those domestic pleasures which he had almost forfeited by the errors of youth, and lived to raise up quite a family. In conclusion I would merely observe that, not only is it for our own interest to find out our state of health before entering upon matrimony, but it is even a sacred duty, for, if we believe the Bible, we there find it written, " The sins of the father shall be visited upon the children." And so it is in this abominable crime ; visiting the child with feebleness and deformity, and, even though a man 102 may feel that he is physically capable to perform all the duties of man, even then, if he has ever been a victim to this vice, he should be careful, be- fore entering matrimony, to make sure that his personal health is in that state which will ensure to his offspring a proper and robust constitution. SELF-EXAMINATION. How shall we know whether we are fit to enter into the married state ? The question most frequently put to me is, How shall I know if I am suffering from Masturbation or Spermatorrhoea? What are indications of the diseases ? There are symptoms which the medical man only can perceive; but on the other hand there are indications which are so self-evident, that, if the reader of this suffer from them, he cannot fail to recognize the disease under which he is laboring. The symptoms are not always the same, but vary with the constitution of the patient. To render them patent to everybody, I have classified the most remarkable of them. Symptoms which affect the generative organs only, or LOCAL SYMPTOMS. Defective erectile power. Eruptions on shoulders and forehead. Emissions in voiding urine. Emissions at stool. 103 104 Undue excitement and emissions in the presence of the sex. Atrophy or wasting away of the testicles. Spermatic Urine. Premature emissions during intercourse. Erections without sufficient exciting cause. Bloody emissions. Dull pains in the generative organs. Decrease of sensual desire. I must here observe that many symptoms occur which are indicative of ordinary disease ; but if they are the result of Onanism, or s}^philis, or ex- cess of venery, then the ordinary means of cure will not avail until the original cause be first re- moved. The seminal fluid is vitality itself, and any seminal loss affects, in a more or less degree, the various functions of respiration, digestion, and circulation. BODILY SYMPTOMS. Flatulence. Alteration of the functions of the liven Craving for food. Heat of epigastrium. Disgust of ordinary food. Nausea after meals. Involuntary blushing. Irregular pulse. 105 Difficulty of respiration and coughs. Want of firmness of the muscles. Swelling of stomach and intestines. Excessive mucous secretions. Palpitation of the heart. Diarrhoea. Inflammation of the rectum. Costiveness. Loss of flesh. Unnatural appearance of skin. Indolence. Indisposition to exercise. Fatigue on the slightest exertion. Undue sensibility to heat or cold. Discoloration under the eyes. Symptoms which affect the mental organs, and which if not tended skilfully end in madness. Desire of solitude. Inability to concentrate the mind. Cowardice. Loss of memory. Moroseness. Impaired hearing. Impaired sight. Black spots in the vision. Deterioration of the voice. Sighing. Unnatural dreams. Unrefreshing sleep. 106 Depression of spirits. Sensation as of cold water down the back, tj Giddiness. Sudden access of emotion while reading. NOTICE TO PATIENTS. Dr. Jourdain, having spent thirty years in the study and treatment of diseases affecting the mental and generative organs, nervous and dyspeptic debility, either constitutional or acquired, decline of physical vigor, loss of mental energy, and the numerous concomitants to sexual disorganization, begs to inform those so afflicted that he may be consulted, personally, at his residence, 51 Hancock Street, opposite the Reservoir, Boston, Mass. Office hours from 10 A. M. till 2 P. M., and from 5 P. M. till 8 P. M. Sundays till 2 P. M. only. Consultation fee, $5.00. COUNTRY PATIENTS. Dr. Jourdain begs to inform his country patients that by sending their communications by post, or otherwise, they can be supplied with the remedies adapted to their cases, forwarded to any address. The packages will be carefully secured from obser- 107 vation, and may be safely taken without confine- ment, prevention of daily business, or loss of time. Patients will please to rigorously describe their case, according to the form appended. The communi- cation must, in all cases, be accompanied by the usual fee of five dollars, without which all letters of consultation will remain unnoticed, and' in all cases inviolable secrecy may be relied on. Sex. Age. Married or single. Supposed cause. How long ill. Trade or occupation- Symptoms. What treatment adopted. Name and address. Forward, also, if possible, a small phial of urine. It must be that which is voided on rising in the morning, and before the patient has partaken of food. The quick and successful treatment of the case depends, in a great measure, upon its careful microscopic examination. R. J. JOURDAIN, M.D., M.R.C.S.E. 61 Hancock St., back of tlic State llouse, and opposite the Reservoir, Boston, Mass. 060 C <»» NOW IN THE PRESS AND WILL BE SHOBTLYPTJBLISHED, *)6 «$ A Gonoealed Causes which shortens the duration of Life, BY R J. JOURDALN, M. D., Principal of the Gallery of Anatomy, BOSTON. .A. IT HOUB IN DR. JOURDAIN'S FAMISIAN GALLERY OF NOW OPEN AT THE ARLINGTON HOUSE, Corner of Washington and Esses Streets, Boston, Mass. 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