IN the last chapter we refuted a very common error of the past, when people always used to enquire the purpose of Nature, and were then often led to form the most outrageous hypotheses. Now we shall cast a glance at the old medical ideas of the past, of those days when our colleagues still wore peruques and birettas.
First and foremost there were the learned, speculative philosophers, who, according to the particular school to which they belonged, endeavoured by one method or another to remove the “morbid matter,” or if they could not manage this, to divert it to other portions of the body, preferably the surface of the arm or leg, where it could not do so much damage.
This they effected by the employment of counter-irritants or derivants, for the diversion of the humours, relics of which may still be seen in the popular use of setons, moxas, and blisters. And when all this failed, they flew to blood-letting, a method by which they thought they could actually see the morbid matter flowing into the basin, which a member of the family usually had the honour of holding.
Was this all useless? Many of these methods certainly brought relief or cure. If you doubt it, ask your grandparents or great-aunts! When I was a young man I knew old people who heaved many a sigh as they remembered the good old times: “Ah, yes,” said they, “folks don’t do these things nowadays, but they always used to do such a lot of good!” But times change; our patients expect quite other derivants for their relief from us: watering place after watering place, operation after operation. These do good too, only they are rather more troublesome and expensive. In reality it was not a removal of “morbid matter,” but an inflammatory process that was concerned.
In regard to the four cardinal symptoms of inflammation: rubor, calor, dolor, tumors (redness, heat, pain and swelling), these symptoms of congestion would be favourably influenced by this method, and if in such cases it was possible to excite symptoms of congestion in some other part of the body, then the redness, heat, pain and swelling in the morbid part were relieved.
We can now understand the success in their own day of our historic predecessors, as well as the fact that nearly all of these methods have fallen into disuse. We know now that the congestive conditions are not so much dependent on the quantity of blood as on the innervation of the vessels. At present we possess much more effective methods of controlling these vessels, and increasing or regulating the blood pressure, and of relieving freely moving part the edges, and from the less mobile part the middle portion, will be then known, we have all the modern methods of electro- mechano- and balneo-therapy, as well as many antipyretic and sedative drugs for internal administration which were not then dreamt of.
Above all, we are now much better acquainted with etiology, the causes of disease, and consequently with the principles of antisepsis. And therefore modern medicine lays more stress on prevention than on cure.
We strive first of all to prevent disease (prophylaxis), and then if disease occurs, to lead to a cure by the use of hygienic methods.
We do not want first to fall sick and then to allow ourselves to be tortured. On hygienic grounds we are led to regard the rush of blood to the sexual organs and their erection every time as a physiological derivant against all other congestive influences, while, finally, nocturnal emissions, and above all normal copulation, act as soothing as blood-letting. The latter is also accompanied by a feeling of faintness, which was formerly interpreted as a sign that enough blood had been removed. It is just this soothing relief of tension which does us so much good, in contrast to the irritating effect of masturbation.
Medical science is often shamed by Nature, which so frequently does things more simply and better than we can by artificial methods. But unfortunately not less devoid of danger, for one can also give way too passionately to sexual pleasures, just as some people in former times had become so used to bleeding that it no longer had the slightest effect on them.
We may remark in passing that we find an analogous relief of tension to that formerly obtained by bleeding, not only as a result of exercise of the sexual functions, but of the other two secretory functions.
For instance we may feel greatly relieved after a thorough urinary or intestinal evacuation, and if congestion or inflammation has been present, the increased blood pressure of the affected part will more or less disappear as a result of the evacuation. In the seminal secretion the evacuation takes a secondary place; the innervation of the vessels is more strongly influenced.
On the other hand we can now better realise why asceticism and denial of the sexual life are commonly compared to a stagnant pool; while normally functioning sexual life stimulates us ever afresh, like a running brook always fresh and clear, because through it the blood pressure varies healthily each time, and so the blood is constantly refreshed.
While not every girl unhappy in love dies of wasting disease, it cannot be denied that a starved sexual life may lead to all sorts of illness, dyscrasias and scrofula, or at least may act as a predisposing cause of these.
We physicians see this only too often. On one occasion at least I had experimental proof given me. I remember the case of a young fellow of good pious family, whose medical attendant I was. He was terribly scrofulous and was persuaded by some of his friends to try sexual intercourse as a remedy. He did so, and the experiment was so strikingly successful that his parents, who knew nothing of the matter, were agreeably surprised at his appearance, as they told me themselves. Unfortunately he had sought the remedy in the most dangerous way in prostitution, with the consequence that he got acute gonorrhea. He came to me for treatment, and he told me the whole story in self-extenuation. He recognised too late that in this case the remedy was worse than the disease, as vivisection is more useful to science than to the animal experimented on.
1 We may here remark for the benefit of the layman that in a great many diseases there is no question of “morbid matter”. Many ailments are only functional derangements of the activity of the organ, e.g., a hypertrophy, i.e., excessive, or atrophy, i.e., defective, development of one or more organs.