The sleep seems to be irregular and unrefreshing—restlessness during the early part of the night, and in the advanced stages of the disease, profuse sweats before morning. There is also frequent starting in the sleep, from disturbing dreams. The characteristic feature is, that your patient almost always dreams of sexual intercourse. This is one of the earliest, as well as most constant symptoms. When it occurs most frequently, it is apt to be accompanied with pain. A gleety discharge from the urethra may also be frequently discovered, especially if the patient examine when at stool or after urinating. Other common symptoms are nervous headache, giddiness, ringing in the ears, and a dull pain in the back part of the head. It is frequently the case that the patient suffers a stiffness in the neck, darting pains in the forehead, and also weak eyes are among the common symptoms.
One very frequent, and perhaps early symptom (especially in young females) is solitariness—a disposition to seclude themselves from society. Although they may be tolerably cheerful when in company, they prefer rather to be alone.
The countenance has often a gloomy and worn-down expression. The patient’s friends frequently notice a great change. Large livid spots under the eyes is a common feature. Sudden flashes of heat may be noticed passing over the patient’s face. He is liable also to palpitations. The pulse is very variable, generally too slow. Extreme emaciation, without any other assignable cause for it, may be set down as another very common symptom.
If the evil has gone on for several years, there will be a general unhealthy appearance, of a character so marked as to enable an experienced observer at once to detect the cause. In the case of onanists especially there is a peculiar rank odor emitted from the body, by which they may be readily distinguished. One striking peculiarity of all these patients is, that they cannot look a man in the face! Cowardice is constitutional with them.
1. The first condition of recovery is a prompt and permanent abandonment of the ruinous habit. Without a faithful adherence to this prohibitory law on the part of the patient all medication on the part of the physician will assuredly fail. The patient must plainly understand that future prospects, character, health, and life itself, depend on an unfaltering resistance to the morbid solicitation; with the assurance, however, that a due perseverance will eventually render, what now seems like a resistless and overwhelming propensity, not only controllable but perfectly loathsome and undesirable.
2. Keep the mind employed by interesting the patient in the various topics of the day, and social features of the community.
3. Plenty of bodily out of door exercise, hoeing in the garden, walking, or working on the farm; of course not too heavy work must be indulged in.