especially if it is one of lessened or irregular activity, which may be due to some unusual experience, when long protracted, or an undesired excitement of the organs, may prove quite sufficient to arouse this anxiety and render the individual miserable for the time being. Hence almost every practitioner of medicine has had numerous visits from young persons who nearly all come with a similar story, which runs somewhat as follows: that when young boys they had learned from older ones the wretched habit of self-abuse; that they occasionally practiced it for years, or until they learned in some manner that it was wrong, or became convinced of it by its effects upon themselves; that since such discovery they have abandoned the habit, but have been subject to seminal discharges; that these experiences, which have occurred as often as every two or three weeks or oftener, they feel confident, are producing a very bad effect upon their general health, are, in fact, sapping its very foundation.

When asked for the reason on which they base such conclusions, they can only reply, in a general way, that they feel languid and fatigued after wakening in the morning; that they frequently do not sleep so soundly as in former times; that they are subject to occasional headaches and unpleasant dreams, and constantly harassed with fears as to their future health and manhood.

When questioned more definitely as to any actual change which has already taken place, whether they are disabled from labor, or have lost flesh or strength, or have any actual pain or debility which disqualifies them from performing their usual duties, they are forced to admit that no such results have already occurred. They, however, are constantly haunted with the expectation that they will soon come, and hence they beg you to prescribe such remedial

and preventive measures and medicines as will be sure to save them from such experiences.

Another class, less numerous than that already referred to, come with a similar story, except that they did not learn of the evil effects of the habit until after long years and an excessive indulgence in it.

Many of them have attained this knowledge at last only by the debility which has occurred in the sexual organs, or from some stray quack advertisement of a newspaper, the full meaning of which they have hardly comprehended. When finally they have determined to abandon the habit, they find themselves greatly annoyed and weakened by frequent seminal discharges. These have continued so long that the subjects experience a debility of both mind and body; they lose flesh, have occasional night-sweats, and wretched dreams; have lost interest in their usual avocations and the society of friends, and think they are unable to become interested in either study or labor, however much they may endeavor to do so. They have become timorous, emotional, easily excited, and often restless, and have frequent foreboding as to their future, and, in short, are in a state of mind to believe almost anything, however bad and hopeless it may be, in reference to the probabilities of their case. Indeed, generally the more unfavorable the prognosis of any physician may be in reference to their future, the more serious and alarming the statements he makes in reference to the necessity for immediate and skillful treatment, the more ready are they to place confidence in his statements, and regard that physician as the one who fully understands their case.

These are the unfortunate ones who are preyed upon by medical sharks who prowl about through almost all large

towns and cities and parade their vile advertisements and nostrums on the pages of our daily papers.

The following is a very good illustration of this class of

cases :

A young man about twenty-four years of age came to me with the statement that he had recently become engaged to be married; that now he was in great distress of mind and was hardly able to sleep because he found he should not be able to consummate the marriage relation; that when a boy he had learned to masturbate and practiced it for several years, but had for a long time given it up, since which time he had been subject to seminal discharges at times, and there existed little or no sensation about the genitals; they were lax and flabby, and he had no doubt that his semen was running away from him every time he had an evacuation of the bowels. He was fast losing flesh and vigor, and something must be done at once. Now, it is of very little use to tell such a person that his condition is far less grave than he supposes, and that he need not be alarmed, that he is sure to come out all right if he goes on the even tenor of his way-that he does not require much from the physician in the way of treatment. Such a statement, instead of assuring and comforting him, as you design to have it, will only lead him to think that you do not understand his condition, and in nine cases out of ten he will leave your office and hunt up that of some physician, or more likely that of some quack, who will tell him that his condition is indeed a very grave one, but that he can, in two weeks' time, set him all right, and put him into a condition to be married, which he proceeds to do at a charge of fifty or one hundred dollars.

Persons comprising the above-mentioned classes are

generally of a neurotic or sanguine temperament; they are highly sensitive to objective and subjective experiences, and will require special moral, and occasionally medical, treatment, but they rarely become insane.

What I desire to call special attention to in connection with this mention of them now is the marked effect which has been produced by the habit of masturbation upon those centres of the nervous system upon which the emotional activities depend; sooner or later these may become greatly influenced or deranged by such practices in persons of a highly sensitive and nervous organization; and more often long before marked physical changes occur.

There is yet another class which does not often come under the attention or care of the general practitioner. These persons differ from those already alluded to in that they generally have an inheritance of insanity, or some other neurosis; one or the other of the parents has either been insane or consumptive, or addicted to the excessive use of alcohol, or other vices.

When the system is burdened with such an inheritance, and the inhibitory centres are undeveloped or anæmic, or an unstable condition of the brain exists from any other cause, the practice of self-abuse is more likely to become excessive, and appears to produce a more profound influence upon the intellectual faculties; the brain is more susceptible to its effects, and manifests this by a derangement of its activities and a failure in its energy in such forms as are hereafter to be referred to. It may therefore be assumed that the effects of the habit of masturbation upon individuals will differ very much and will depend primarily upon the age, constitution, temperament, and inheritance.

The very young and sensitive and illy-balanced individual will become more nervous and sensitive, and therefore

apprehensive of effects which he is all the time magnifying and regarding as sure to become greater in the future, while another, who has a lymphatic temperament and a larger measure of inhibition, tends toward reserve and hesitation and is disposed to shun society, especially that of females. It should, however, be remarked that by far the larger proportion of young persons who are insane and addicted to this habit while in this state, are not insane as a consequence of its former practice. The habit is a consequence and not a cause of their disease.

A super-sensitive or excited condition of certain portions of the brain, which has resulted from other causes, not unfrequently extends to those portions which preside over the sexual organs, and these in consequence are aroused into a morbid activity, which leads the patient into the practice. This is especially the case with females who become affected with what is termed nymphomania, and are occasionally found in all asylums. I very well remember such a case in the person of an old woman more than seventy years of age who must have been dead to all normal sexual feelings for years, whose conduct was so indecent as to require her seclusion for considerable periods. It is not unfrequently the case with highly excited and maniacal patients, and especially with those who are partially demented; and so long as the nerve centres are exhausted by the continual practice of this habit there exists little probability of improvement in the mental condition.

Symptoms. As has already been intimated, there are cases in which the habit becomes the chief factor in causing mental derangement. The records of many such are found in the journals of all asylums. It almost always arises during the period of adolescence, though it may also appear at the grand climacteric, and even in old age; and