Sterility depends either on imperfect organization, or imperfect action
of the organs of generation. In the former cases, which are rare, the
menses do not generally appear, the breasts are not developed, and the
sexual desire is inconsiderable. There is no remedy in these cases.
The action may be imperfect in several respects. The menses may be
obstructed or sparing, or they may be too profuse or frequent. It
is extremely rare for a woman to conceive who does not menstruate
regularly. Hence where this is the case the first step is to regulate
this periodical discharge. For this purpose the advice of a physician
will generally be required, for these irregularities depend upon such
various causes and require such a variety of treatment that it would
be inconsistent with the plan of this work to give instructions for
remedying them. A state of exhaustion or weakness of the uterine
system, occasioned by too frequent intercourse, is a frequent cause of
sterility. The sterility of prostitutes is attributed to this cause, but
I doubt it being the only one. With females who are apparently healthy,
the most frequent cause is a torpor, rather than weakness of the genital
organs.
For the removal of sterility from this cause, I shall give some
instructions, and this I do the more readily because the requisite means
are such as will regulate the menses in many cases, where they do not
appear so early in life, so freely or so frequently as they ought.
In the first place, it will generally be necessary to do something
toward invigorating the system by exercise in the open air, by
nourishing food of easy digestion, by sufficient dress, particularly
flannel, and especially by strict temperance in all things. With this
view, also, some scales which fall from the blacksmith's anvil, or some
steel filings may be put into old cider or wine (cider the best), and
after standing a week or so, as much may be taken two or three times a
day as can be borne without disturbing the stomach.
All the while the bowels are to be kept rather open by taking from one
to three of _Pill rufi_ every night on going to bed. These pills consist
of four parts of aloes, two parts of myrrh, and one of saffron, by
weight.
These measures having been regularly pursued until the system be brought
into a vigorous state, medicines which are more particularly calculated
to arouse the genital organs from a state of torpor may be commenced,
and continued for months if necessary. The cheapest, most simple (and
I am not prepared to say it is not the most effectual in many cases) is
cayenne. All the virtues of this article are not generally known even
to physicians. I know it does not have the effect upon the coats of the
stomach that many have conjectured. It may be taken in the quantity of
from one to two rising teaspoonsful, or even more, everyday up on food
or on any liquid vehicle. Another medicine of much efficacy is Dewees'
Volatile Tincture of Guaiac. It is generally kept by apothecaries, and
is prepared as follows:
Take of Gum Guaicum, in powder, eight ounces; carbonate of Potash, or
of Soda, or (what will answer) Saleratus, three drachms; Allspice, in
powder, two ounces; any common spirits of good strength, two pounds,
or what is about the same two pints and a gill. Put all into a bottle,
which may be shaken now and then, and use of it may be commenced in
a few days. To every gill of this, at least a large teaspoon-ful of
Spirits of Ammonia is to be added. A teaspoonful is to be taken for
a dose, three times a day, in a glass of milk, cider or wine. It is
usually given before eating; but if it should chance to offend the
stomach when taken before breakfast, it may in this case be taken an
hour after.
Dr. Dewees found this tincture, taken perhaps for months, the most
effectual remedy for painful menstruation, which is an obstinate
complaint. If there be frequent strong pulse, heat, thirst, florid
countenance, etc., it is not to be taken until these symptoms be removed
by low diet, a few doses of salts, and bleeding, if required.
A third medicine for arousing the genital organs, is tincture of Spanish
Flies. But I doubt its being equal, in sterility, to the above mentioned
medicines, though it may exceed them in some cases, and may be tried if
these fail. A drachm of them may be put to two gills of spirits. Dose,
25 drops, in water, three times a day, increasing each one by two or
three drops, until some degree of stranguary occurs, then omit until
this pass off, as it will in a day or two. Should the stranguary be
severe, drink freely of milk and water, slippery elm, or flaxseed tea.
In many cases of sterility, where the general health is considerably
in fault, and especially when the digestive organs are torpid, I should
have much faith in a Thomsonian course. It is calculated to arouse the
capillary vessels throughout the whole system, and thus to open the
secretions, to remove obstructions, and free the blood of those effete
and phlegmy materials which nature requires to be thrown off. The views
of the Thomsonian as to heat and cold appear to me unphilosophical. But
this has nothing to do with the efficiency of their measures.
In relation to sterility, I would here bring to mind, what has before
been stated, that a woman is most likely to conceive immediately after
a menstrual turn. And now, also, let me suggest the idea that Nature's
delicate beginnings may be frustrated by the same means that put her a
going. This idea is certainly important when the woman is known to have
miscarried a number of times. Sterility is sometimes to be attributed
to the male, though he apparently be in perfect health. It would be an
interesting fact to ascertain if there be no seminal animalculae in these
cases; and whether medicines of any kind are available.
It has been ascertained that a male and female may be sterile in
relation to each other, though neither of them be so with others.
The foregoing measures for sterility are also suitable in cases of
impotency. This term, I believe, is generally con-lined to, and defined
as a want of desire or ability, or both on the part of the male; but I
see no good reason why it should not comprehend the case in which there
is neither desire nor pleasure with the female. Such females, it is
true, may be fruitful; but so, on the other hand, the semen may not have
lost its fecundating property. Impotency, at a young or middle age,
and in some situations in life especially, is certainly a serious
misfortune, to say the least of it. The whole evil by no means consists,
in every case, in the loss of a source of pleasure. All young people
ought to be apprised of the causes of it--causes which, in many
instances, greatly lessen one's ability of giving and receiving that
pleasure which is the root of domestic happiness. I shall allude to
one cause, that of premature, and especially solitary gratification, in
another place. Intemperance in the use of spirits is another powerful
cause. Even a moderate use of spirits, and also of tobacco, in any form,
have some effect It is a law of animal economy, that no one part of the
system can be stimulated or excited, without an expense of vitality, as
it is termed. The part which is stimulated draws the energy from other
parts. And hence it is, that close and deep study, as well as all
the mental passions when excessive, impair the venereal appetite.
All excesses, all diseases and modes of life which impair the general
health, impair this appetite, but some things more directly and
powerfully than others.
As to the remedies for impotency, they are much the same as for
sterility. It is of the first importance that the mind be relieved
from all care and anxiety. The general health is to be improved by
temperance, proper exercise in the open air, cheerful company, change
of scenery, or some occupation to divert the mind without requiring much
exercise of it; nourishing food of easy digestion; flannel worn next to
the skin. The cold bath may be tried, and if it be followed by agreeable
feelings, it will do good. The bowels may be gently stimulated by
the pills before mentioned; and the preparation of iron also, already
mentioned, should be taken.
To stimulate the genital organs more directly, cayenne, Dewees' tincture
of guaiac, or tincture of flies, may be taken. I have given directions
for making and taking the tincture of flies, chiefly because it is
esteemed one of the best remedies for impotency caused by or connected
with nocturnal emissions, to which I have before alluded.
It is in cases where little or no pleasure, nor erection, attend these
emissions--cases brought on by debauchery, or in elderly persons--that
I would recommend tincture of flies, and the other measures above
mentioned. In some bad cases, enormous doses of this tincture are
required, say two or three hundred drops. Yet the best rule for taking
it is that already given, namely, begin with small doses, and gradually
increase until some stranguary be felt, or some benefit be received. In
this affection, as well as in all cases of impaired virility, the means
I have mentioned are to be pursued for a long time, unless relief be
obtained. These have cured after having been taken for a year or more
without the result. In all cases of impotency not evidently depending
upon disease of some part besides the genital organs, I should have much
confidence in blisters applied to the lower part of the spine.
Occasional nocturnal emissions, accompanied with erection and pleasure,
are by no means to be considered a disease, though they have given
many a one such uneasiness. Even if they be frequent, and the system
considerably debilitated, if not caused by debauch, and the person be
young, marriage is the proper measure.
There have been several means proposed and practiced for checking
conception. I shall briefly notice them, though a knowledge of the best
is what most concerns us. That of withdrawal immediately before emission
is certainly effectual, if practiced with sufficient care. But if (as
I believe) Dr. Dewees' theory of conception be correct, and as
Spallanzani's experiments show that only a trifle of semen, even largely
diluted with water, may impregnate by being injected into the vagina, it
is clear that nothing short of entire withdrawal is to be depended
upon. But the old notion that the semen must enter the uterus to
cause conception, has led many to believe that a partial withdrawal
is sufficient, and it is on this account that this error has proved
mischievous, as all important errors generally do. It is said by those
who speak from experience that the practice of withdrawal has an effect
upon the health similar to intemperance in eating. As the subsequent
exhaustion is probably mainly owing to the shock the nervous system
sustains in the act of coition, this opinion may be correct. It is
further said that this practice serves to keep alive those fine feelings
with which married people first come together. Still, I leave it for
every one to decide for himself whether this check be so far from
satisfactory as not to render some other very desirable.
As to the baudruche, which consists in a covering used by the male, made
of very delicate skin, it is by no means calculated to come into general
use. It has been used to secure immunity from syphilitic affections.
Another check which the old idea of conception has led some to recommend
with considerable confidence, consists in introducing into the vagina,
previous to connection, a very delicate piece of sponge, moistened with
water, to be immediately afterward withdrawn by means of a very narrow
ribbon attached to it, But, as our views would lead us to expect, this
check has not proved a sure preventive. As there are many little ridges
or folds in the vagina, we cannot suppose the withdrawal of the sponge
would dislodge all the semen in every instance. If, however, it were
well moistened with some liquid which acted chemically upon the semen,
it would be pretty likely to destroy the fecundating property of what
might remain. But if this check were ever so sure, it would, in my
opinion, fall short of being equal, all things considered, to the one
I am about to mention--one which not only dislodges the semen pretty
effectually, but at the same time destroys the fecundating property of
the whole of it.
It consists in syringing the vagina immediately after connection with a
solution of sulphate of zinc, of alum, pearl-ash, or any salt that acts
chemically on the semen, and at the same time produces no unfavorable
effect on the female.
In all probability a vegetable astringent would answer--as an infusion
of white oak bark, of red rose leaves, of nut-galls, and the like. A
lump of either of the above-mentioned salts, of the size of a chestnut,
may be dissolved in a pint of water, making the solution weaker or
stronger, as it may be borne without any irritation of the parts to
which it is applied. These solutions will not lose their virtues by age.
A female syringe, which will be required in the use of the check, may be
had at the shop of an apothecary for a shilling or less. If preferred,
the semen may be dislodged as far as it can be, by syringing with simple
water, after which some of the solution is to be injected, to destroy
the fecundating property of what may remain lodged between the ridges of
the vagina, etc.
I know the use of this check requires the woman to leave her bed for
a few moments, but this is its only objection; and it would be
unreasonable to suppose that any check can ever be devised entirely free
of objections. In its favor it may be said, it costs nearly nothing; it
is sure; it requires no sacrifice of pleasure; it is in the hand of
the female; it is to be used after, instead of before the connection,
a weighty consideration in its favor, as a moment's reflection
will convince any one; and last, but not least, it is conducive to
cleanliness, and preserves the parts from relaxation and disease. The
vagina may be very much contracted by a persevering use of astringent
injections, and they are constantly used for this purpose in cases of
_procidentia uteri_, or a sinking down of the womb; subject as women are
to _fluor albus_, and other diseases of the genital organs, it is rather
a matter of wonder that they are not more so, considering the prevailing
practices. Those who have used this check (and some have used it, to my
certain knowledge with entire success for nine or ten years, and under
such circumstances as leave no room to doubt its efficacy) affirm that
they would be at the trouble of using injections merely for the purposes
of health and cleanliness.
By actual experiment it has been rendered highly probable that pregnancy
may, in many instances, be prevented by injections of simple water,
applied with a tolerable degree of care. But simple water has failed,
and its occasional failure is what we should expect, considering the
anatomy of the parts, and the results of Spallanzani's experiments
heretofore alluded to.
This much did I say respecting this check in the first edition of this
work. That is what I call the chemical check. The idea of destroying the
fecundating property of the semen was original, if it did not originate
with me. My attention was drawn to the subject by the perusal of "Moral
Physiology." Such was my confidence in the chemical idea that I sat down
and wrote this work in July, 1831. But the reflection that I did not
know that this check would never fail, and that if it should, I might
do someone an injury in recommending it, caused the manuscript to lie on
hand until the following December. Some time in November I fell in with
an old acquaintance, who agreeably surprised me by stating that to his
personal knowledge this last check had been used as above stated. I have
since conversed with a gentleman with whom I was acquainted, who stated
that, being in Baltimore some few years ago, he was there informed of
this check by those who have no doubt of its efficacy. From what has
as yet fell under my observation, I am not warranted in drawing any
conclusion. I can only say that I have never known it to fail. Such are
my views on the whole subject, that it would require many instances of
its reputed failure to satisfy me that such failures were not owing to
an insufficient use of it. I even believe that quite cold water alone,
if thoroughly used, would be sufficient. In Spallanzani's experiments
warm water was unquestionably used. As the seminal animalcule are
essential to impregnation, all we have to do is to change the condition
of, or, if you will, to kill them; and as they are so exceedingly small
and delicate, this is doubtless easily done, and hence cold water may be
sufficient.
What has now been advanced in this work will enable the reader to judge
for himself or herself of the efficacy of the chemical or syringe check,
and time will probably determine whether I am correct in this matter. I
do know that those married females who have much desire to escape will
not stand for the little trouble of using this check, especially when
they consider that on the score of cleanliness and health alone it is
worth the trouble.
A great part of the time no check is necessary, and women of experience
and observation, with the information conveyed by this work, will be
able to judge pretty correctly when it is and when it is not. They may
rest assured that none of the salts mentioned will have any deleterious
effect. The sulphate of zinc is commonly known by the name of white
vitriol. This, as well as alum, have been extensively used for
leucorrhae. Acetate of lead would doubtless be effectual--indeed, it
has proven to be so; but I do not recommend it, because I conceive it
possible that a long continued use of it might impair the instinct.
I hope that no failures will be charged of efficacy of this check which
ought to be attributed to negligence or insufficient use of it. I will
therefore recommend at least two applications of the syringe, the sooner
the surer, yet it is my opinion that five minutes' delay would not prove
mischievous--perhaps not ten.