_Nymphomania._――The most deplorable condition of all, to which the
female is subject, is the uncontrollable, maniacal, erotic desire,
called nymphomania. The disease is fortunately rare, and commonly
makes its appearance at, or soon after puberty, but has been observed
in adult and married women. Of the six cases that have come under my
observation, one was a married woman, the mother of children, four were
girls at puberty and one, which will be hereafter reported, aged 19
years.
In the commencement the sufferer is a prey to perpetual contest between
feelings of modesty and impetuous desires. At an after period she
abandons herself to the latter, seeking no longer to restrain them. In
the last stage the obscenity is disgusting; and the mental alienation,
for such it is, becomes complete. The cause is often obscure, but when
known has been undue irritation, by titilation of the genitals, or
anything that would cause turgescence. The disease is apparently local
in the beginning, but seems to affect the entire nervous organization,
through reflex excitation.
The clitoris, by some, is supposed to be the seat of irritation, and
has been amputated or cauterized, but without generally effecting
any relief. The disease is not generally confined to any particular
locality of the genitals. If allowed, the patient will take the hand of
the male and place it upon the _mons veneris_, and it is only by force
that she will allow it to be taken away. She cannot locate the seat
of pleasure, but will say that the entire surface touched contributes
to the venereal excitement. Another peculiar feature is, that she
obtains no satisfaction from venereal orgasm; but on the contrary it
adds to her maniacal conduct and obscenity. She is not in any manner
responsible for her conduct, and no punishment will cause her to
desist. Everything is sacrificed that is feminine, for that which is
disgusting and vulgar. The more modest she has been in health, the
more obscene she is likely to become in her venereal frenzy. What the
final result would be, without treatment, I have never witnessed, but
must conclude that lunacy would soon be prominent and probably suicide.
There is no tendency to recovery, but to continue from bad to worse,
until publicity is no restraint to the obscenity and indecent conduct
of the victim.
_Case._――Nymphomania, with nocturnal involuntary orgasm. Miss U.――She
was aged 19, very small in stature, only weighing 90 pounds, of very
respectable family and herself perfectly respectable. She was refused
by her probable “intended,” who had discovered signs entirely unnatural
for her, in whom he had placed implicit trust. When the condition was
first manifested in her, the intended, not thinking of anything wrong
on her part, attempted to gratify her morbid erotic desire by coition,
which only made her, as he said, “nearly crazy.” She had heretofore
been modest and distant, but now she was on his lap, and all over him
or leading him to a place of decumbiture. When she visited my office,
and imparted to me her whole confidence, my first treatment toward
her was so rigid and distant that my examination revealed the parts
before orgasm had taken place; but as soon as I touched the nymphæ;
they became lubricated with a thin viscid fluid which was profuse. At
first the clitoris and nymphæ were red, dry and hot; but as my digit
came in contact with the soft parts, she forgot the rough treatment
and my cold conduct toward her, which I had assumed to prevent, if
possible, her venereal crisis, and she became unmanageable for the
time, until she had passed three or four orgasms, as I supposed, one
immediately following the other, when she became more governable. To
carefully portray in words what she said and did would be shocking to
a fastidious doctor. With a speculum in the vagina the os uteri would
contract and dilate in alternation, and undergo orgasms in rapid
succession, with only a few seconds interval. She begged of me not to
withdraw the instrument, but when I had completed my examination she
was partially exhausted and docile. I could discover a mucoid fluid
emitting from the os uteri which evolved a strong venereal odor.
She informed me that she had voluptuous dreams nightly――as many as
three in a night. Her figure is small and round, eyes black, hair coal
black, countenance very sallow and chlorotic. She seemed to know that
this condition was not right, but her modesty was entirely gone, when
in company with a male. The presence of a woman restrained her. Her
own mother had not determined the true nature of her difficulty, only
noticed that something was peculiar with her daughter. The patient had
judgment enough left to go out of the room and isolate herself when a
man would come about. The advent of this disease she says was first
known by a peculiar thrill at the sight of a male, which became more
aggravated from day to day. Now, one year has she suffered from this
intolerable mania.
To pass over and not give the treatment would leave the case quite
incomplete.
_Treatment._――I directed monobromated camph., in two gr. pills, one
every 4 hours, with formula No. 1, as directed; ice-water to the vulva
nights, with daily applications of Faradisation by placing a wetted
sponge upon a chair with the patient seated upon it, to which the
negative pole is attached; used the positive in my left hand, with my
right hand applied to the head and down the spine. Improvement took
place from the beginning, and in forty days she was quite herself.
She was improved in flesh, color and strength. In two months she was
so modest that I could scarce gather courage to ask her if she was
yet troubled with any signs of her old affliction. I could not obtain
consent to make another physical examination, and she remains well,
but is continuing to take the medicine, from formula No. 1. She has
strength of will, I am informed by her “intended,” to refuse any degree
of proximity. He says, “It seems like a dream. I am learning to court
her over again, and succeed very slowly. She is so distant.”
The two cases reported by Prof. S. H. Potter in the April number of
_Am. Med. Journal_, 1876, do not overdraw the picture, any one will
testify who has had a few of these perplexing patients to manage.
“Miss M. T., age 18 years, of sanguine temperament, quite
corpulent for her age, a wealthy farmer’s daughter,
distinguished for her modesty, intelligence, prudence and good
social qualities.
“_History._――In the hot weather of August, the writer was
called 15 miles to consult with Dr. A., the family physician of
Mr. T. About three weeks prior to this, Miss T. had suddenly
exhibited paroxysms of uncontrollable desire for coition.
When any young gentleman chanced to call upon the family, she
would elevate her apparel under her arms, approach and attempt
an embrace in the most lascivious manner, until forced to
desist by the interference of the overpowering strength of the
persons present. At first these scenes were at intervals, with
intervening times of great dejection, gloominess and silence.
The father being of rather a superstitious nature, thought her
‘possessed of the devil,’ and resorted to repeated and severe
flagellations without effecting any perceptible reform. During
the last week her excitement had been almost continuous, and
she had been confined to and locked in her room. It may well be
supposed that the case had excited the entire neighborhood to
wonder and amazement, and in some of the more thoughtful, deep
sympathy, and through their advice the physician was called.
“Examination with a glass speculum showed an irritating fluid
oozing from the os uteri; the whole surface of the vagina,
the nymphæ clitoris and the vulva were suffering from active
congestion. Exalted general sensation was apparent, and the
slightest touch of the internal labia or clitoris produced the
most exquisite amorous excitement――an uncontrollable mania.
“_Case II._――Was called to see Mrs. F., of this city, September
last, age 30, a grass widow by third marriage. Found her in
violent hysterical spasms, with usual accompanying symptoms.
Her aunt, with whom she was then visiting, gave the following:
“_History of the Case._――For some time past she had exhibited
lasciviousness; had to be kept under surveillance; to-day
the aunt had ‘been out shopping;’ on coming home she found
her niece in a sequestered place with exposed nudity quite
shocking, and using persistent artifice to effect coition with
a canine Newfoundlander. The aunt so rashly interposed, that
the niece ‘went into alarming and persistent spasms.’”
Dr. Potter further says that examination showed this case to be one of
nymphomania, relying upon the turgescence of the clitoris and nymphæ
and ichorous discharge from the os uteri as diagnostic.
It may be remarked that such turgescence not uncommonly produces an
exalted erotic desire which is analogous to turgescence of the urethra
in the male, manifested in gonorrhœal priapism.
Such irritations are not always peripheral in origin, as may be
supposed, but more commonly a general neurasthenia, or at times a
spinal turgescence, which qualifies the genitals for any disturbing
titilations that come along. This may seem more evident, when it is
once considered, that a hyperæmia of the nymphæ and clitoris may and
has often existed and no nymphomania; and if the peculiar centric
condition does not first exist, there will be no local venereal
turgescence of the genitalia.
Ovarian and uterine disease may produce first, a determination of
blood to the cord, and then, by slight irritation of the vulva, the
condition, nymphomania, may be established. Such is perhaps the most
common cause; and the more have we reason to conclude so, from the
fact, that the majority of these cases appear soon after puberty, when
the first crisis of femininity has wrought its effect upon the uterus
and ovaries. At such times is self-pollution most likely to produce a
striking impression upon those organs, and most likely to bring about
nervous shock by calling a superabundance of liquor-sanguinis to the
developing genitalia and reproductive organs. This shock is sometimes
so apparent that fainting results and alarming symptoms follow. To
relate a case will the better illustrate what may sometimes occur.
_Case._――Miss E. H., under the following peculiar circumstances, I
was informed, needed my services, as it was known that I was the
physician of her family. A young man, whom I well knew, came after me
and returned with me to the house, and during our ride, he related the
following story, to which I had reason to give entire credit:
The young man and the patient were “sitting up” with a sick lady.
During the night, when all was quiet, the young man had taken the
liberty to place his hand upon the genitalia of Miss H., when he
noticed that she rolled her eyes in rather a peculiar manner which he
considered only submission, as she leaned toward him in a very passive
manner. He took her in his arms and placed her on a couch, replaced his
hand, introducing his finger into the vagina, when he became alarmed at
seeing her froth at the mouth, with slight muscular twitchings of the
eyes and mouth. He attempted to arouse her, but failed and, becoming
still more frightened, called the family, and hastened to my office.
I found the patient, Miss H., who was aged 18, fleshy (her weight was
150 pounds), had been a very healthy girl, of an excellent family, and
rather pleasant in disposition. She had always been very modest and
retiring; had rosy cheeks, black hair and eyes. She was then in a very
delirious state, with pupils contracted, face flushed, no cramping,
feet cold; head very hot, with occasional epileptiform movements of the
eyes and mouth; biting the tongue and frothing at the mouth; twitching
of the facial muscles and sphincters. I informed an old lady that I
suspected some private trouble and invited her _only_, to remain in
the room while I made an external inspection, which only gave me the
satisfaction of knowing that nothing was the matter with her genitals,
and that the young man had not deceived me and effected intromission,
as the hymen was perfect.
A large dose of chloral hydrate produced quietude for the night, and I
ordered her to be taken home as soon as she was rested by sleep.
I visited her the next morning at her own home. She was conscious, with
pulse at 120; temperature, 102; pupils contracted, and face flushed;
skin dry; tongue dry and red; asking for water often; head drawn back;
throbbing of the carotids, with spasms of the dorsal and posterior
cervical muscles.
She had never been sick, and she had never been of a nervous habit; and
such a condition was entirely unexpected. There was no epidemic of such
a character, and no accountable cause except that given. Her case was
of an inflammatory type and lasted twenty-one days.
Treated by large doses of gelseminum, veratrum viride, and quinine when
safe. The case was a sthenic one throughout, a meningitis without a
doubt, and no cause but venereal shock.
When she recovered I asked her if she remembered what occurred during
the night of her falling sick, and she flushed, but finally confessed
knowing when he put his hand upon her genitalia, when she thought she
fainted; but casually remarked, “I don’t understand it, but I had no
power to prevent him doing so.”
The young man again informed me that his hand was upon the vulva,
perhaps a minute, when he noticed a strange expression on her
countenance.
The shock did not occur at or near her menstrual period, and she
menstruated during convalescence, which her mother informed me was a
period six weeks from her previous time. She never entirely recovered
her mental vigor, and remained single till three years ago, when she
married, and all has gone well.
The shock can only be attributed to that susceptibility to nervous
impressions so common to the female reproductive organs in the stage of
development. There is a strong probability that had this nervous shock
been less impressive in character and more prolonged, a nymphomania
might have occurred.