expression, by a characteristic mannerism, and by a peculiar mental state.
THE FACE.--_The +facial expression+ consists of a +pale+ and +sallow tint+ of the skin, unusual +development+ of +acne+,--red pimples,-- especially on the +forehead+; a +dark circle+ around the +orbits+; +dilated+ and +sluggish pupils+; +lustreless eyes+, and an +oblique line extending+ from the +inner angle+ of the +lids transversely+ across the +cheek+ to the +lower margin+ of the +malar+ (cheek) +bone+. The +face+ has a +haggard, troubled, furtive expression+._
THE MANNER.--_The +manner+ of the +masturbator+ is peculiar. He is +listless, shy, retiring+, and +easily confused+; he +avoids society+, preferring +solitude+; there is a want of +steadiness+ and +decision+ in his +locomotion+; his inferior +extremities+ seem +deficient+ in +power+, and all his movements betray +a mind ill at ease+._
THE MIND.--_His +mental operations+ are +confused+; his +speech is embarrassed, awkward+, and +without directness+; his +memory+ is +defective+, and he is +absent-minded+ and +given+ to +reverie+. If the habit has long existed, and been excessively frequent in repetition, +epilepsy+ may be produced; or +serious mental disorder+, as +delusional insanity+, +dementia+, etc., may occur._
THE SEXUAL ORGANS.--The state of the +genital organs+ varies with the length of time the habit has been indulged. In some young subjects, there will be observed an +extraordinary development+ of the +organ+, owing to premature excitement; but the disproportion is not maintained. Prof. Barthalow says: "With the progress of the habit the organ becomes _+small+ and +relaxed+, the +erections feeble+, the +corpora cavernosa+ either +waste away+ or their +vessels+ lose their +tonicity+, whereby an apparent +shrinkage takes place+; the +corpus spongiosum+ and the +glands+ also +shrink+, so that the +prepuce+ (fore-skin) appears +unnaturally elongated+. The +testes+ may +increase+ in +size+, become +tender+ and +irritable+_, or they may waste away to nothing but little strings; the latter is the more usual result.
"_+Pains+ in the small of the +back+, a sense of +weight+ and +aching+ in the +loins+, around the +anus+, and in the +testes+_ is experienced. _The +appetite is capricious+, the +digestion feeble, and the bowels+ are +constipated+_, or constipation alternates with diarrhoea.
"_The+ mind+ is +deficient+ in +power+ of +attention+, the +imagination is constantly pervaded with vague erotic dreams+, the +moral sense+ is +blunted+, and the +perceptions+ are +dull+ and +confused+. +Pains+ in the +head+, in the +occipital+ and +frontal regions+ (front and back of head), and a sense of fullness, and in serious cases alarming +Vertigo+ (dizziness and falling); +pains+ in the course of the +principal nerves+, and an extreme +nervous susceptibility+, are experienced. The +organic nervous system+_ manifests a functional disturbance in harmony with the disorder of the nervous system of animal life. +Gastralgia+ and +abdominal pain+ (pain in stomach and bowels) and +uneasiness+ are in some cases very distressing symptoms.
"The distinctiveness of the foregoing symptoms will be determined by the extent and duration of the habit, and by the constitutional peculiarities of the patient. +The more highly developed the nervous system, and the more it preponderates in activity over the muscular and digestive systems, the more serious the effects.+
EFFECTS OF MASTURBATION ON THE MIND
"The most serious +mental effects+ are produced by +masturbation+. This vice, commenced at or before the period of puberty, interferes seriously with the development of the brain and the evolution of the mental faculties.
"That +spermatorrhoea+ will produce in one class of cases +mental disorders+, and not in another, indicates either that some predisposition to these disorders existed, or that the habit of +self-pollution+ was merely an expression of +mental alienation+ (insanity). The +images+ which pervade the minds of boys possessed of the highly-developed nervous organization of masturbators are those of +delusional insanity+.
"There is, however, a +cerebral+ (brain) +phase+ of spermatorrhoea which may be separated from the two preceding classes. It is characterized by _+indistinctness of vision+, +dilatation+ of the +pupil+, +amblyopia+ (near-sightedness), +diplopia+ (double sight); +diminution+ in the +sensitiveness+ of the +auditory apparatus+ (deafness); +feebleness+ of +voice+; +mental preoccupation+, +hebetude+ of +mind+, +confusion+ of +ideas+, and a +profound melancholy+._
"The termination of such cases is in _+suicidal monomania+, +delusional insanity+, etc._ In that variety of the cerebral form in which a decided predisposition must be admitted to exist, to disorder of the intellectual faculties, there are found various forms of mental alienation. The +chronic form+ is the most common, which corresponds to the _+melancholia+ of +Pinel+, or the +lypemania+ of +Esquirol+, terminating in +dementia+._ Several of the most characteristic cases which have happened under my observation correspond to the _+delusional insanity+ of +Bucknill and Tuke+_."--[Manual of Psychological Medicine, Phila. ed., p. 103.]
INSANITY FROM SPERMATORRHOEA.
Many writers are disposed to underrate the importance of this tendency in spermatorrhoea. The statistics of any of our large insane asylums will illustrate the influence of masturbation in the production of insanity. Mr. Holmes Coote, in a discussion which followed Dr. Drysdale's paper on the "Medical Aspects of Prostitution," read before the Harveian Society
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