THE DISEASE OF SELF-ABUSE is more prevalent than most people imagine. I have seen and treated a few cases successfully, employing wholesome advice, supplemented by drugs – for I do not believe that advice alone can effect a cure. The patients one is called on to treat fall into two classes.

Men in Class I: First, the type of person who has a highly sensitive nature; he is generally refined, with high thoughts and ideals, but there is a curious lack of will-power in this one direction. He often holds a good and responsible position in life, is unmarried, and being heartily ashamed of his weakness, wishes advice and treatment so that he may be able to overcome this unnatural proclivity. They never indulge themselves, unless they think of ‘les plaisirs d’amour’  in connection with some special person of the opposite sex. 

Men in Class II: Second, the type whose whole moral nature is on a very low level, who indulges in all kinds of moral depravity, whose thoughts are morbid, and whose character is bestial. Men of this type are usually small, puny, and unhealthy looking, although a few are brawny and robust. Men in Class II have little or no thought on the subject, but prostitute their natural organs with no definite idea but for the so-called pleasure of a moment.

Accentuating factors

Three factors – a long prepuce, slight urethritis, and highly sensitive nature of the part (increased by constant irritation, naturally and unnaturally) – have a great bearing on the continuance of the obnoxious practice. Another factor in many cases consists in the perusal of literature that is suggestive and sometimes even pornographic. French novels, which merely relate travesties of love and deal with the ‘sublime passion’ in gross and vulgar fashion are avidly read by these patients, just that their sensitive imaginations may be stimulated by the suggestive descriptions and hardly veiled innuendoes.

Effects of masturbation

The patient has a typical look in his eyes; he cannot look one long in the face before lowering his eyes; the latter are shifty, and the patient looks as if something were on his mind. Curiously enough, the general health is good and the various bodily organs exercise their functions satisfactorily.

One of the commonest effects, however, is a weakening in eyesight; the eyes, when looking at distant objects, get hazy and moist, and, on testing, are found to be astigmatic.

By far the most important effects are mental. In nearly every case, there is loss of memory, that is, past events are in the course of months forgotten, and only a very dim recollection remains. Forgetfulness is very common. Depression of spirits and morbidity of thought are nearly always caused. At times, the patient has exaltation of the mind, only to be followed at no very great interval by feelings of dire depression. The brain becomes less active; sedative pursuits are followed, and a disinclination for bodily action is evidenced.

The production of germ cells is far in excess of the ordinary, and when the patient marries, his chances of having children are small; or, if he has progeny, that they will almost assuredly be weak, sickly and deformed.

Treatment

One must insist on systems of healthy exercise; so many hours a day must be devoted to some kind of outdoor sport, whether walking, running, cycling, golfing or swimming.

He must eschew absolutely light or suggestive literature. A course of good reading should be prescribed for him; books which are interesting, which call for thought and invite criticism, which are restful to the mind and elevating to the spirit. Every waking hour must be occupied in some healthy pursuit.   Further, he should be encouraged to marry, because with marriage, in any case, the progress of his disease is checked, and he becomes a normal man again.

As for drugs, I have found that potassium bromide, combined with belladonna, very good.*

As for local treatment for infection, circumcision was always done. The urethra was syringed from the very beginning with increasingly strong solution of potassium permanganate, till all discharge had ceased, and no organisms were found in the urethra.

In this way several cases have been treated, so far with success.

* gr. xxv potass. bromid. And 3 minims tr. belladonnae, taken nightly for a week; then  an interval of four days without medicine, and the same drugs again for another week.  This administration of medicine  with four-day intervals is continued for six weeks. I also order salts, ¾ ounce magnes. sulph. weekly, to be taken in the four days’ interval.