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What do you do when your patient refuses to listen?

That’s the question posed by a young surgery student named Martin. The letter begins as follows: “Dear Sir, Even though I do not have the honour of knowing you, I am taking the liberty to communicate to you the frightening portrait of a victim of onanism.” Martin goes on to the case of a 30 year old man who began masturbating at 14 or 15, suffered from the ravages of excessive masturbation but refused to see the light.  Instead, he consulted numerous “doctors, surgeons, charlatans and magicians” about his sufferings, without actually revealing their cause. He knew the source of his infirmities, but he didn’t stop: on the contrary, he continued.

The letters concerning masturbation fall into three categories (generally speaking). In the first category are the epistles penned by (mostly) young men desperate to stave off (or reverse) the inevitable corporeal decrepitude resulting from their immoderate engagement with the pleasures of the flesh. Pain, guilt, shame, and horror mark these letters as the correspondents attempt to detail their masturbatory history and inclinations. Some, like a young philosophy student named Gauteron, write numerous letters, each a mirror of the others.

In the second category, masturbation is just glossed over as patients attempt to position themselves as morally sound individuals. Thus, we read of individuals who appear to suffer from ailments that might be caused by excessive masturbation (nervous disorders, for example), but who take great pains to assure the doctor that they have not engaged in this practice (or in any other related practice, like excessive ‘usage des femmes’). For such correspondents, proof is offered in the form of family health, and their arguments go something like this:

I appear to be suffering from some form of nervous disorder, but it’s not due to masturbation/ sexual pleasure outside of marriage/excessive ‘pollutions’/ STD, because … if my wife has no symptoms of gonorrhoea (or any other sexually transmitted disease) and my children are healthy, then how could my own suffering be due to immoderate sexual pleasure? Their health, indeed, is proof that my actions have been morally sound. My illness must, therefore, have another cause.

Methinks that some of these men do protest too much. (As an aside, however, it is clear that many correspondent positioned their moral health carefully vis-à-vis the good doctor and that the performance of morality was a key component in their presentation of self.)

The letter that begins this post falls into Category #3. In these letters the individuals are fully aware that they are engaging in activities that Tissot (and others) have deemed harmful to their physical and moral health, but they apparently don’t care. Some refuse to listen to doctors. Others just gloss over it and deal with other issues that concerning them. The masturbating man in this particular letter offers one of the strongest challenges to Tissot’s anti-masturbation campaign (and campaign it must be seen to be, given the geographic and linguistic reach of his work). This man, Claude Joseph Démeunier de Chaunneuve, now apparently close to death, is quite clearly suffering from what Tissot himself has diagnosed as the ills resulting from onanism, but until now he has refused a. to accept this and b. to stop.

What’s a young apprentice surgeon and friend to do?

 

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Interestingly, in the preface to the fourth edition of his treatise on onanism, Tissot makes a clear distinction between moral and medical approaches to masturbation and positions himself quite firmly within the medical camp. As he writes:

“Je me suis proposé d’écrire des maladies produites par la masturbation, & non point du crime de la masturbation; n’est-ce pas d’ailleurs assez en prouver le crime, que de démontrer qu’elle est un acte de suicide?”

“My design was to write upon the disorders occasioned by Masturbation, or self-pollution: besides, is not the crime sufficiently proved, when it is demonstrated to be an act of suicide?”

(L’onanisme. Dissertation sur les maladies produites par la masturbation, 4th edn. Lausanne: Marc Chapuis, 1770, p. iv; Onanism: or, a treatise upon the disorders produced by masturbation: or, the dangerous effects of secret and excessive venery. Trans. A. Hume. London, 1781. Eighteenth Century Collections Online. Gale. Memorial University of Newfoundland. 18 Feb. 2011, p. iii)

One might quibble, however, with his choice of wording: ‘crime’ and ‘suicide’ are not necessarily the most ‘value neutral’ descriptors available! Nor, I imagine, would his discussion of the irksome difficulties of writing about such an indecent topic be comforting for those seeking to assuage their feelings of guilt and shame.

However, despite Tissot’s conscious self-positioning as a medical doctor interested in the physical, rather than moral, manifestations of masturbation, it is obvious that some of his patients addressed precisely because of what they perceived as the beneficent union of medicine and morality. In the words of one anonymous onanist:

“… [je suis] Persuadé, Monsieur, que vous connoisses aussi bien les maux mauraux que les maux physiques ; [et] persuadé en meme tems que vous juges des uns et des autres comme Philosophe …” (Fonds Tissot, Bibliothèque cantonale et universitaire de Lausanne  IS3784/II/144.05.03.08)

Tissot is seen here as a benefactor of humanity (another of the common titles bestowed by his patients) because of his ability to move beyond medicine – to treat both psyche and soma as a philosopher, not merely as a medical doctor. It is in the medical philosopher that they put their trust, and the philosopher to whom they turn in situations of profound moral disorder. Nevertheless, it is only the doctor, with his concern for the physical, who can cure them of the distressing fallout from their onanytic afflictions. Tissot, in this sense is both confessor and healer.

I’m in the middle of Kathleen Winter’s acclaimed novel Annabel, the story of Wayne, born in Labrador with ambiguous genitalia and ‘made’ male through a combination of surgery and hormone pills. Wayne learns of the Annabel that is also a part of him and struggles to integrate her into himself – and into a social world defined by the male/female binary, a world that has no room for ambiguity. By no means is Annabel an autobiography; nor is it a medical consultation. But in it I found some beautiful meditations on the relationships between body, self and society.

“What was beauty? Not frailness, not smallness. … Years of hormones had made him angular, and it occurred to him that he wished he could stop taking them. He wanted to stop swallowing them every day and having them alter his body from what it wanted to be into what the world desired from it …. He wanted to throw the pills away and see what would happen to his body. How much of his body image was accurate and how much was a construct he had come to believe? …. If he stopped taking the pills might his breasts bud, as they had at puberty? He was afraid of having breasts. But were breasts beautiful? Could anyone tell him? At night when he danced alone, his body wanted to be water, but it was not water. It was a man’s body, and a man’s body was frozen. Wayne was frozen, and the girl-self trapped inside him was cold. He did not know what he could do to melt the frozen man.” (Kathleen Winter, Annabel, Toronto: House of Anansi Press, 2010, p. 343).

Just a few pages later, Wayne considers the immense chasm that separates male and female in his social world, reflecting on what it might mean to claim the space between: “Could the two halves bear to see Wayne walk the fissure and not name him a beast?” (Kathleen Winter, Annabel, Toronto: House of Anansi Press, 2010, p. 350). In Wayne/Annabel’s mourning, I hear echoes of Susan Stryker’s rage, so evocatively captured in her1994 GLQ article: “My Words to Victor Frankenstein above the Village of Chamounix: Performing Transgender Rage.”

Which bodies matter? And how do they come to matter? Perhaps we all need to find ourselves in Frankenstein’s monster.

A brief interlude with Siri Hustvedt, whose The Shaking Woman or A History of My Nerves ties in with the letters to Tissot about nervous disorders and neurological complaints. At the very end of her book, she discusses the the autobiographical ‘I’ – a fleeting and ambiguous subject always created in face of ‘You’:

“Clearly, a self is much larger than the internal narrator. Around and beneath the island of that self-conscious storyteller is a vast sea of unconsciousness, of what we don’t know, will never now, or have forgotten. There is much in us we don’t control or will but that doesn’t mean that making a narrative for ourselves is unimportant. In language we represent the passage of time as we sense it – the was, the is, the  will be. We abstract and we think and we tell. We order our memories and link them together, and those disparate fragments gain an owner: the ‘I’ of autobiography, who is no one without a ‘you’. For whom do we narrate, after all? Even when alone in our heads, there is a presumed other, the second person of our speech. Can a story ever be true?” (S. Hustvedt, The Shaking Woman or A History of My Nerves, New York: Henry Holt, 2009, p. 198)

I’ve been re-reading Mary Prince’s The History of Mary Prince for the first time in about six years. I’d forgotten just what an impact this short book makes, and somehow, I’m not quite sure how, forgotten how present the body is in this life story.

For Mary Prince the body is weapon, testament and witness, all in one. The fists that pummel her flesh, the hands that wield the whip whose lashes make her bleed, that tie her up, that force salt into bleeding wounds reveal the capacity of humans to do violence, to use their own bodies as weapons.

But Mary’s body is, itself, also a weapon: as testament to the relentless violence of slavery, it serves as a weapon against barbarism, against the horrors of slavery. Mary’s words reveal the extent of the physical suffering she endured: salt boils that, in some cases, ate away to the bone, raw pulpy flesh that later must have been crisscrossed with scars, and a prematurely worn out body whose aches and pains bear witness to the endless hours of toil.

And through her tears and her sorrow, her body bears witness to all the other slave bodies that surround her. This is, indeed, not only the autobiography of Mary Prince, but a collective autobiography of slavery, in which the salty tears of the slave mingle with the harsh water of Grand Turk’s salt ponds, and the maggot infested wounds of an abused slave.

“I have been a slave myself–I know what slaves feel–I can tell by myself what other slaves feel, and by what they have told me” (p. 23)

Fanny Burney, inveterate scribbler and archivist, thought a lot about the afterlife of her words. While she couldn’t stop herself from writing and collecting, she was nonetheless deeply concerned that someone, at a later date, might misread her words and in so doing, mistake her intentions. Simone de Beauvoir was apparently similarly concerned with her intellectual inheritance, so much so that she adopted an adult daughter – Sylvie Le Bon de Beauvoir – a student who possessed the integrity and strength of character necessary to act as the executor of her adoptive mother’s intellectual wishes.

Some of Tissot’s patients demonstrate similar desires to control their bodily narratives. In one haunting letter, a young man suffering from onanism entreats the good doctor to destroy his letter, that nobody else would be privy to the horrors of his immoral behaviour. This precaution, even though the letter is unsigned. And yet. Two hundred years later, the letter still exists…

Scholars like Jacqueline Hellegouarc’h have pointed to The Birth of Intimacy during the eighteenth century, a growing preoccupation with private life and with the necessity of shielding the private self from the public eyes of the courtly sphere. The shift from courtly life in Versailles to city life in Paris, the careful designation of individual rooms in grand hotels, the birth of the novel with its emphasis on the life of the domestic sphere, and the emergence of literary novels, built on the trope of the author as editor of a collection of mysterious correspondence all attest to a growing interest in the intimate life.  For some of Tissot’s patients, the workings of their bodies, too, were private, meant only for careful revelation to the most respected of doctors.

As researchers, we carry a huge responsibility. We must tread most carefully indeed.