Before entering into detailed consideration of the pathology, i. e., diseases of the sexual organs, it should be stated that while the bulk of these diseases is of venereal character—that is, acquired thru some abuse of the sexual function or thru unclean intercourse—there is a large number of diseases that may develop on and affect the sexual organs without any fault or indiscretion on the part of the patient. First, the sexual organs, like any other part of the body, can be the seat of different inflammations, tumors, accidental injuries, etc., and in the case of any grave general sickness the sexual system is naturally involved and suffers to a greater or smaller degree. Second, the sexual organs present very often congenital (inborn) defects of development, varying to an enormous degree in individual cases. There are also several non-venereal acquired diseases. Most of these conditions are practically unknown to the public, and quite often the afflicted victims are terror-stricken and driven to despair thru ignorance of the true nature of their case, laboring under the idea that their condition is due to a venereal infection or some indiscretion on their part. For this reason, we shall briefly consider these conditions.
Among congenital non-venereal abnormal conditions possibly the most common is the long and tight prepuce, which in a good many cases gives rise to many nervous complaints and minor disorders. It is relieved usually by operation or circumcision, which has been adopted by the Jews and Mohammedans as a religious procedure. As to the sanitary advantages of circumcision, discussed so often, it must be admitted that while it is not necessary in all cases, in general it is undoubtedly a useful procedure. It does not lessen any chances of venereal infection, which can be seen from the fact that the Jews proportionately contract Gonorrhea as often as the Gentiles; but it does undoubtedly lessen the chances of infection with Chancre, soft or hard, and in cases where Chancre is contracted, the treatment in a circumcised case is a good deal easier than in the non-circumcised.
Another congenital abnormality of practical interest is an “undescended testicle.” It is not known commonly that the testicles are not formed in the scrotum, that they descend there before the birth of the child from the abdominal cavity. But in some cases the testicle does not descend until later years of childhood, or does not descend at all. In these cases the retention of the testicle takes place either in the abdominal cavity or in the groin (inguinal canal). In this location particularly it is likely to cause pain and distress, and it can even atrophy and dry up from pressure of the tissues, if not relieved by operation.
There are a number of non-venereal acquired diseases that may occur on sexual organs. Among these should be mentioned, first, Varicocele.
Varicocele is a very common condition in young men, and is manifested by dilation and enlargement of the veins that go thru the earlier described spermatic cord to the testicle. It occurs mostly on the left side, and is felt like a snake-like cord twisted on itself, producing an unpleasant, dragging-down, heavy sensation, and occasionally real neuralgic pains in the testicles.
Varicocele is usually a harmless condition, passes away by itself as a man grows older, and, if annoying, can be relieved by a snugly-fitting suspensory bandage.
Another very common condition which occurs in the sexual organs is Herpes. Herpes occurs as grouped in a circle, small superficial vesicles or blisters on any part of the sexual organs. It is perfectly harmless and dries by itself in a few days, but it has a peculiar tendency to recur again and again, particularly after an intercourse, even a clean one. The cause of its appearance is to be sought in a certain nervous debility, local or general, but different local conditions, like a long and tight prepuce, predispose a man toward its outbreak.
Herpes very often affects men who have had some venereal disease in the past, particularly Gonorrhea, and naturally those men become very uneasy and worried by breaking out of Herpes, fearing this may be a relapse or some after development of the old disease. It is true, tho, that a man afflicted with herpes is very much predisposed to Chancroidal infection, and as herpes often resembles the beginning of Chancroid, the opinion of a competent physician should be secured to make proper diagnosis.
It is also of practical interest to know that a number of various skin diseases can start from and be limited to the sexual organs, appearing as red spots, patches, warts, etc. These cases, by being mistaken for venereal infection, often give rise to unnecessary worry and wrong treatment.
Before entering into a consideration of the venereal diseases proper, we shall consider a sexual disorder which is extremely important on account of its widespread character, but the origin of which is just the opposite to venereal diseases, as it is due not to sexual intemperance, but to sexual continence. This disorder is masturbation or self-abuse, and it is rather a sexual vice or bad habit than a disease. Self-abuse is so widespread that some medical writers claim that every man has been masturbating at some time or other in his life. The chief danger of the masturbation habit lies in the fact that its victims are not only adults, but children as well; in fact, children constitute the main bulk of its victims. The habit of masturbation takes its roots ordinarily very early in childhood, even babyhood. It is a well-known fact that babies and small children, in their search for amusement and through innocent curiosity as to different parts of their own body, like to handle their sexual organs. They easily detect a very vague and pleasant sensation resulting from it. This gives them the impulse and stimulation to repeat this action, and thus is formed the first link of the chain of the habit that may prove later to be a curse of the child’s life. This is the reason why mothers should watch any tendency to bad habits in children from a very early age, at the time when the formation of the habit can be checked more easily. Should the child escape the danger of masturbation habit early in life, the second equally dangerous period of temptation is the school time. It is a peculiar and most dangerous feature of the masturbation habit that its victim feels a strong impulse and gloats in a beastly satisfaction if he succeeds in initiating a younger and innocent boy into his habit. This is why one or two vicious boys in a class can demoralize and mislead in their vice the whole class of younger boys. The school age up to adolescence and puberty is the time when the masturbation vice rages in its greatest fury, and then it gradually begins to abate. Getting older, the boys learn in some way, mostly from quack literature, how destructive and dangerous is this habit, and most of them gradually drop it, never to resume. But some of them become so enslaved to the habit that they cannot resist its lure, and this is the class to which mostly belong the adult masturbators. Masturbation has been extensively exploited by the quack medical literature, which claims that the habit inevitably leads to most terrible and destructive diseases, such as paralysis, insanity, tuberculosis, loss of sexual power, etc. These statements are far too sweeping and exaggerated. Discussing the dangers and evil consequences of the masturbation habit, we have to consider separately the effects of it on children on one hand, and on adolescents or adults on the other.
The physical dangers and evils naturally cannot be as serious with the adults as with the children. First, because the adults know its evil effects and use self-control to limit their self-indulgence to the minimum; second, the physical loss of seminal fluid with each ejaculation can be easier and with less danger spared by a grown-up body, as the vitalizing fluid of the sexual glands is not needed so urgently any more for the growth and development of the body, so the damage to an adult from the habit of masturbation is mostly limited to his nervous system and to his mental and moral forces.
This fact easily explains why the masturbation habit is so destructive and dangerous to younger children. They are unconscious of the evil character of their habit, and helplessly yield to the lure of impulse; neither can they exert any self-control. On the other hand, every drop of sexual fluid they lose means that much of vitality and life energy taken away from their growing body; it means that much loss of the natural source of their physical health and development. It is natural, therefore, that excessive and persistent masturbation in younger children may lead to physical exhaustion, may blunt their bodily growth and dwarf their mentality, may lead to development of epilepsy, idiocy, and other mental diseases; in a word, it may blight the child’s life forever and render him a physical and mental invalid. The older the victim of masturbation the smaller is the physical damage resulting from this habit, and the more this damage is transferred to his nervous system, mentality, and moral character.
The changes that take place in the personality of a habitual masturbator are a natural result of slowly-accumulating influences, exerted by the habit on its victim.
There are two cardinal features in the psychology of every masturbator which give us a keynote toward understanding his character, and serve as a starting point for all subsequent changes in his personality. The first is that every masturbator of age knows that he is doing something wrong; that he is committing a shameful act against his manhood and against Nature. As a result, he reproaches and pledges himself to shake off this degrading habit. But his will power is weak and temptation is strong, and he again and again fails in his efforts and falls back in the clutches of his master. This internal conflict gradually unnerves him and puts an indelible stamp of shiftlessness and weakness on his whole being. A feeling of guilt and shame makes him morose, seclusive, depressed, and unsociable. Particularly characteristic it is for an inveterate masturbator to avoid the company of all girls, and those pleasures and games that are so attractive to normal and healthy boys. A masturbator gets bodily weak, flabby, and unfit for any muscular exertion or physical work. The changes in his nervous system and mentality are still more striking. He becomes shiftless and restless, and at the same time shows signs of nervous weakness and irritability. He sleeps bad and feels in the morning more tired and broken up than before going to bed; he is subject to headaches; he gets easily tired, and is unable to concentrate his attention for any sustained mental effort. His personality also changes markedly; he becomes deceitful, self-retired, cowardly, and grouchy. His physical appearance reflects well the internal conflict and the slow sapping of his physical and mental strength; his look is haggard and dejected; the eyes are dull and deeply encircled with blue rings underneath; his hands are cold and clammy; his gait is slow, feeble, and uncertain. In a word, strong, happy, and full of life a boy can in a few years or even months be transformed under a loathsome mastery of the masturbation habit into a wreck and a mere shadow of his former self. There is no more sad and pathetic picture than that of an inveterate masturbator, who wants and cannot break his slavery to the habit. Such cases can be redeemed back to health by a long and tedious treatment. Much easier, and, in fact, the only proper way to fight the scourge of masturbation is by spreading knowledge of its dangers among the boys.
The prevention of the formation of the habit can best be affected thru the same physical training of the boys that has been above recommended to check unnecessary and premature sexual excitement. Give to a boy whom you suspect or know to be in danger of forming the habit of masturbation a friendly help; take him out into the fresh air for games and physical sports; distract his attention by physical and mental pleasures; regulate his diet and mode of life; even bring him into companionship with clean and refined girls, and you may save him from a slow waste and destruction of his physical and mental health and save his manhood for a healthy and happy family life.