DISORDERS OF THE EXTERNAL GENITALS



Nymphomania is to be distinguished from erotomania. The former is a purely sensual passion, alike physical in its origin, in its local influence, in its development and in its much-desired forms of gratification. The latter, although still to be considered sensual in a strictly moral point of view; from a physical point of view would seem rather spiritual,-as neither requiring sensual means of gratification nor dependent upon physical ability. Erotomania is a psychical state, which may find its highest if not its only gratification in the reveries and dreams of amorous imagination and fancy, by day or by night. Nymphomania is a physical disease whose progress may be traced through a period of internal incubation, of external, reluctant and partially restrained development, to a final condition of open, unrestrained manifestation; characterized by a most intense, all-controlling sexual desire, and by an equal unconsciousness of shame and of decency.

Without directly mentioning nymphomania, Hahnemann seems to have had it in his mind, when he says: “It is not until the whole of the organism is infected that psora discloses its huge internal chronic miasm, by a cutaneous eruption (sometimes consisting only in a few pimples) that is wholly peculiar to it, accompanied by insupportable tickling, voluptuous itching and a specific odor.

This disease has repeatedly appeared in strongly marked cases where there was one constant characteristic of the temperament or constitution; and that was an unusual susceptibility of the skin to tettery affections. In these cases the disorder is so profoundly connected with the entire system, that it induces paroxysms of convulsions, which indicate that the entire cerebro-spinal nervous centre is involved. The actual monomania, with entire obliteration of all feeling of modesty or sense of shame, and unconsciousness of all the duties and proprieties arising from the domestic relation, indicates also an equally complete subjection of the purely cerebral functions and moral feeling to the same morbid influence. While the spasmodic closure of the oesophagus, and impossibility of deglutition and consequent destruction of organic life, show also that the same disease has possessed itself of the organic nervous centre and so completely invested the whole of the organism. The insupportable tickling and voluptuous itching” can be no more violently manifested than in the pruritus so frequently seen in cases of nymphomania; and the same may be said also of the specific odor, which, like that of goats, often emanates from the genitals or from the entire person in such cases.

True nymphomania may be considered, therefore, as a most remarkable illustration of the psoric diathesis, as a most astonishing proof of the truth of the psoric principle. For if we observe this malady to arise from the more immediate influences of ascarides or onanism, these latter are but intermediate steps in the chain of causation, being themselves the results of the same psoric influence in the system. The same may be said of the enlarged, hypertrophic condition of the clitoris so often seen in connection with this disease. The nymphomania is more apt to make its appearance at either one of the other of those two epochs of the female life, in which the constitution is stirred up as i were in its profoundest depths,-that is, at the accession of puberty, or on the cessation of the menses, -but more particularly at the former of these two periods. And in addition to the influences already mentioned as constitutional or provoking causes,- and which will thus exert an important influence in determining the choice of the remedy,-we may mention: suppression or great disturbance of the menstrual function, and organic diseases of the uterus.

But in both of these, as in the other causative influences, the psoric diathesis is still predominant. For it is from the presence of such deep-seated, morbid influence, hereditarily implanted in the organic or vegetative life, that the menses fail to make their appearance in due proportion and at the proper time. So the outset of any organic disease must be attributed to the same ultimate cause.

But in prescribing for this truly distressing complaint, the various attendant symptoms, as well as the peculiar constitutional indications must be carefully considered; it will not be necessary to enumerate here all the varied symptoms, and morbid moral, mental and physical conditions which may accompany a case of nymphomania. As in hysteria, and in fact what is this disease itself but a most violently aggravated hysterical affection, or morbid excitement of the entire sexual system of the female, so in nymphomania, an endless succession and variety of symptoms may present. There may be leucorrhoea of more or less peculiar kind, pruritus of the external organs; intense lasciviousness, both spiritual and physical; inflammation and excitation of the sexual parts; fever, with fetid breath; nocturnal restlessness; sleep, with dreams which renew the sexual excitement; paroxysms, with spasmodic closure of the oesophagus; general and exhaustive convulsions; diarrhoea, etc. And these attacks and symptoms of the disease may appear in consequence of onanism, or be attended with irresistible disposition to it; they may accompany menstruation; or appear in its absence; and finally, may be relieved or brought on by pregnancy. We have devoted considerable space to this not very frequent form of disease, because the homoeopathic remedies, as in the somewhat analogous case of delirium tremens, have been found capable of producing the most salutary results and thus of saving from destruction and of restoring to society some of its most valuable and important members. And the indications given for the remedies may be useful also, in the milder and more common forms of amorousness and erotomania, for the relief of which the physician is often consulted.

Agaricus. Itching and irritation of the genital organs, with strong desire for an embrace. Great selfishness.

Arsen. a. Sexual desire, with an involuntary discharge of mucus as a particular symptom. Restlessness. Thirst for cold water, a very little satisfies her. Unhappy, fatiguing dreams; nothing comes our right in her dreams.

Calcarea carb. Pale, leucophlegmatic. Much headache. Vertigo on running up stairs. Swelling over the pit of the stomach, like a saucer turned bottom up. Menses too often and too profuse.

Cannabis. s. Great excitation of the sexual instinct, the female being sterile.

Cantharis. Pruritus of the vagina, with strong sexual desire. She must urinate very frequently, with cutting burning pain.

Carbo veget. She is troubled much with varicose veins in the vulva. Itching at the same time of both the vulva and the anus. Much belching of wind, which affords relief for a short time only.

China. Sensation as if the abdomen were too full after eating with desire to eructate, which however affords no relief. Trouble some itching and spasmodic contraction in the inner parts. Nymphomania of lying in women.

Cocculus. Particularly in chlorotic females. Shivering over the mammae. Lower extremities very weak.

Coffea. Voluptuous itching in the genital organs. She is in a state of ecstasy. Sleeplessness.

Conium. Shriveling of the mammae, with increasing sexual desire. She is much troubled with vertigo, particularly when lying down and when turning over in bed. The urine flows and stops and flows again, at each emission.

Digitalis. Lascivious state of the fancy day and night. Remarkably slow pulse. Stools of a very light color.

Dulcamara. Heat and itching in the genitals, with desire for an embrace. All her symptoms are aggravated by a cool change in the weather. Her sexual desires are also increased by this change.

Graphites. Inclination to obesity. Enlarged ovaries, which become more tender and more enlarged time she takes cold or gets her feet damp. Menses delay. Itching blotches here and there over the surface of the body, from which oozes out a colorless, glutinous fluid.

Gratiola. Gnawing about the umbilicus, as if of worms. Tingling in the hypogastrium and around the umbilicus. Gnawing at the pit of the stomach after eating, as if of hunger. Irresistible drowsiness and involuntary closing of the eyes as the other symptoms abate.

Hyoscyamus. Excited sexual desire without excitement of the fancy. Lascivious furore without modesty. She inclines to uncover and expose herself. Convulsive trembling. Immoderate loud laughter.

Ignatia. Strongly inclined to solitude; and to be very secretive; and to be passive. Sadness and sighing, with an empty feeling in the pit of the stomach.

Jodium. Dwindling and falling away of the mammae; they hang down heavily and lose their fatness. Heaviness of the mammae, as if they would fall off. All her symptoms are relieved by eating.

Lachesis. Tickling and jerking, extending from the thighs to the genital organs, with sexual excitement. Her symptoms are usually worse after sleeping. She feels extremely sad, unhappy and distressed in mind on waking in the morning.

H.N. Guernsey
Henry Newell Guernsey (1817-1885) was born in Rochester, Vermont in 1817. He earned his medical degree from New York University in 1842, and in 1856 moved to Philadelphia and subsequently became professor of Obstetrics at the Homeopathic Medical College of Pennsylvania (which merged with the Hahnemann Medical College in 1869). His writings include The Application of the Principles and Practice of Homoeopathy to Obstetrics, and Keynotes to the Materia Medica.