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“Masturbation is a wonderful art. It’s clean, it’s efficient, and you get to mix with an altogether better class of citizen.” So said Oscar Wilde, supposedly, a citizen continually ahead of his time. Sadly, not everyone has agreed with Oscar’s enlightened view of the solitary sexual act. One who decidedly did not was John Harvey Kellogg (1852–1943), inventor of the corn flake. A pioneering light of the health-food movement and a prominent Seventh-day Adventist, Kellogg was concerned not just about the nation’s dietary fiber, but also about its moral fiber. “The most loathsome reptile, rolling in the slush and slime of its stagnant pool, would not demean itself” by masturbating, Kellogg wrote. With few exceptions the medical establishment of the 19th century agreed with him, and almost no deterrent was deemed too extreme in the effort to “cure” this loathsome “disease.” Sedatives were commonly prescribed, from the run-of-the-mill potassium bromide to opium. Homeopathic cures included Spanish fly, hot pepper, mercury and marijuana, while nonhomeopathic physicians resorted to more muscular remedies: digitalis, belladonna, strychnine, nitric acid and hydrochloric acid.

If drugs and poisons failed, there was always direct physical intervention. Some 19th-century doctors applied leeches to the inner thighs, others blistered and scalded the penis, and still others inserted electrodes into the rectum and urethra to pass electrical currents through the offending parts. In his marvelous book The Wages of Sin, Peter Lewis Allen tells us that the erstwhile Dr. Kellogg “recommended using an electrical urethral probe in 15-minute doses, two or three times a week.” No less gruesome was the common use of the “bougie,” a long, flexible tube made of rubber or metal that was inserted into the male urethra, often delivering a caustic dose of burnt alum, silver nitrate or some other noxious substance.

Female self-abusers fared little better: These “monsters in human shape” (as one doctor called them) were often restrained for months at a time. Powerful drugs were injected into the vagina, and circumcision could be pretty effective. Allen tells the horrific tale of two small girls, 6 and 10 (probably slightly retarded, in today’s terms), whose chronic masturbation brought down the wrath of the medical establishment; their labia and clitorises were cauterized with a burning iron.

From the start of the 18th century, Allen tells us, Europeans became increasingly neurotic about the “disease” of self-abuse or “self-pollution.” Dire symptoms were sure to result if the condition went untreated, physicians ever more loudly claimed — everything from burning urine, stupidity, paralysis, spontaneous gangrene, apoplexy, even death. Masturbation may have had physical consequences, but it was also, of course, a moral “disease.” No lesser Enlightenment authorities than Denis Diderot and Jean d’Alembert, editors of the famous Encyclopédie, warned that masturbation was a crime against Nature. For others, it was not so much Nature as God who was offended.

The intertwining of Western views about sex, sin and disease is the pattern Allen wants to alert us to, and it is a deeply depressing fact that over and over again the same pattern repeats: Illnesses associated with sex — rightly (as in the case of syphilis and AIDS), wrongly (in the case of bubonic plague and leprosy) or purely imagined (in those associated with masturbation) — invoke not sympathy but moral outrage and social disgrace. Instead of care and compassion, sufferers have faced incarceration, treatments that are indistinguishable from torture, and social ostracization.


The catalyst for Allen’s book was a personal one — the death of a gay lover from AIDS. Attempting to make sense of his beloved’s untimely passing and the tidal wave of AIDS deaths sweeping through the gay community, Allen set out on a historical quest. Seven years later, the result is a beautifully wrought and mercifully slim volume. “Mercifully,” I say, because packed into these 160 pages are enough gruesome tales to last a lifetime.

Take the case of syphilis. In this instance, the link with sex was real enough, and as that association sunk in, curative measures became more and more fierce. To quote Allen: “Treatments for the pox were often more excruciating than the disease’s symptoms . . . It was hard to say which was worse — to languish untreated, as syphilis ate its way through one’s organs, or to be tortured by poisonous and savage remedies administered by physicians and surgeons who often believed that their job was to punish their patients for their sins.”

The first “remedies” were relatively mild, but they soon became positively barbaric. Racking syphilitic headaches were countered with trepanation, the ancient practice of boring holes in the skull. Oozing ulcers were cauterized with white-hot irons. Then there was the practice of the “stew,” in which patients were spread from head to foot with mercury-based ointment, swathed in blankets, and left to sweat it out in a small, heated steam room for 20 or 30 days at a time. The theory was that the atoms of quicksilver would dispel the miasmic vapors causing the disease, but in truth few patients lived through the cure, whose toxic vapors caused sores to fill the throat and cheeks, and disgusting secretions to issue from the mouth and nose. Some strangled when their throats swelled from mercury poisoning; others died of kidney failure.

But, hey, this was a battle against evil itself. “God has raised up new diseases against debauchery,” John Calvin announced at the peak of the 16th-century syphilis epidemic. Across Europe syphilitics were denounced from pulpits, and medical authorities all too often concurred that the pox was “a notable testimony of the just wrath of God,” to quote William Clowes, a physician who counted Queen Elizabeth I among his patients. Driven by fear and loathing, whole towns panicked and barred their gates against syphilitics, as did many hospitals. Leper houses were reopened to incarcerate this new class of untouchable.


Those who don’t know history are doomed to repeat it. And so, perhaps, are those who do. Of how far we haven’t come, Allen reminds us in his final chapter on AIDS. Once again, those suffering from a sexually transmitted disease have been blamed for their own affliction and told that they are witnessing the just wrath of God. As the Rev. Jerry Falwell compassionately proclaimed to a national television audience in 1987, “A God who hates sin has stopped [homosexuality] dead in its tracks by saying, ‘Do it and die.’” Once again, the association of sex and disease has served as a justification for condemning — and, more seriously, for abandoning — groups of people deemed morally reprehensible: homosexuals, IV drug users and prostitutes, in particular. America’s refusal to face up squarely to AIDS has resulted in countless unnecessary deaths, Allen writes: 400,000 Americans have died so far of this largely preventable disease. In the end, Allen rightly notes, AIDS too will pass, like all other sexually transmitted epidemics — though it may well kill huge numbers before it subsides, especially in Africa.

But what will come after it, and how will we deal with the next round of “venereal disease”? I spent 1988 working on a documentary about AIDS, and during my research an epidemiologist assured me that one thing of which we can be certain is that there will be more such diseases. The creative genius of Darwinian evolution must never be underestimated; as long as there are people to infect, bacteria and viruses will continue to evolve. If we can learn anything from history, Allen suggests, it is that hiding behind moral opprobrium can never be the solution.


Margaret Wertheim is the author of The Pearly Gates of Cyberspace: A History of Space From Dante to the Internet and Pythagoras’ Trousers: God, Physics and the Gender Wars.

THE WAGES OF SIN: Sex and Disease, Past and Present | By PETER LEWIS ALLEN | University of Chicago Press | 202 pages | $25 hardcover

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