Michael Crossland
London, United Kingdom

Jay is a large man in his twenties with a plume of unruly red hair, giving him the air of an oversized rooster. He is a great storyteller with a contagious laugh, and I always smile when I see his name on the clinic list. Jay attends the hospital because he has retinitis pigmentosa—a serious retinal disease which is gradually but irrevocably leading him to total blindness. Jay’s approach to losing his sight—perhaps his approach to life in general—is to joke about it and tell anecdotes.

In the low vision clinic a couple of years ago, I was laughing at one of Jay’s stories—this one about mistakenly getting into a waiter’s car rather than his partner’s—when his face fell. He looked towards his shoes and said, in a quiet voice, “Do you think it’s because I masturbated a lot as a teenager?” The heat from his blushing face radiated across the consultation room.

I moved my chair slightly closer to his, mirrored his concerned expression and tried to hide my surprise at the sudden turn in the conversation.

“What makes you say that?” I asked. “You know we think this is inherited.” Modern genetic testing means the exact mutation causing Jay’s condition had been pinpointed. He also had a grandfather with the same condition, now completely blind.

Jay stuttered a little. “I know. It’s just . . . I can’t help thinking . . . when I was fourteen my eyes started going bad and . . .” His voice trailed off.

Serious eye disease often develops in people’s teens and our brains are hard-wired to create associations: if a disease develops at the same time as a new habit then it is natural to assume the two events are linked. This is especially true if we are told the habit is harmful. Jay was brought up in a large Catholic family and probably knew the catechism, which says masturbation is an “intrinsically and gravely disordered action.”

“You’re not the first person to ask me this,” I told Jay, “but do you know where that belief comes from?” This gave me an excuse to turn the tables and tell Jay one of my own favorite stories. In the early eighteenth century, a book was published with the fabulous title Onania, or, the heinous sin of self-pollution, and all its frightful consequences (in both sexes) consider’d; with spiritual and physical advice to those who have already injur’d themselves by this abominable practice.¹ Believed to have been written by quack physician John Marten, the book was so popular that by 1730 it was in its fifteenth printing.²

“Dimness of sight” is the most enduring myth from Onania, but Marten described dozens of other associated conditions, including growth retardation, epilepsy, gonorrhoea, depression, and memory loss. More pornographer than physician, Marten’s book includes dozens of raunchy testimonials written by people describing their experiences of masturbation-induced illness. Titillating passages describe the behavior of “lascivious widows” and misbehaving schoolgirls. Readers are told that redemption comes from abstinence, prayer, and frequent doses of “strengthening tincture,” conveniently sold by John Marten.

Marten was not the only doctor in town profiting from masturbation. William Farrer also sold remedies for those afflicted by the consequences of this habit. In his 1767 book A short treatise on Onanism, he describes some ophthalmological features of a frequent self-abuser:

“when he was about to read any thing, he seemed to be drunk, and flushed with wine; the pupils of his eyes were extremely dilated, and his eyes themselves racked with darting pains, accompanied with some degree of tension; . . . both corners of his eyes . . . were also clogged and stuffed with a whitish kind of matter.”³

Although Marten and his peers were charlatans, more respected doctors shared the belief that masturbation could lead to poor sight. In an early example of a literature review, celebrated physician Samuel-Auguste Tissot described several cases of poor sight associated with what he called “secret and excessive venery,” ranging from gutta serena (blindness of unknown cause) to “a langour in the eyes” and the vision being “bleared.”⁴

There were other reasons why people associated poor vision with poor behavior. Before antibiotics, sailors frequently went blind due to syphilis. Pubic lice infestation caused people’s eyelashes to fall out. So many soldiers returned from the 1801 Egyptian campaign with chlamydial eye disease that specialist eye hospitals were opened to deal with them, including the hospital where I met Jay. It is no surprise that blindness has long been equated with immorality.

Jay sticks in my memory, but I have met people who associate all sorts of innocent activities with poor vision. Blindness caused by overuse of the eyes is a particularly long standing belief: 350 years ago John Milton wrote “from the twelfth year of my age I scarcely ever went from my lessons to bed before midnight; which indeed was the first cause of injury to my eyes.”⁵ Nearly every week I will hear someone say, “If only I hadn’t read so much as a child,” or “I wish I hadn’t watched TV with the lights off.”

The fear of blindness is so strong that it can be used as a parenting tool. I am frequently asked to tell children to spend less time on their iPad as it is “bad for their eyes” (it is not, or at least no worse than reading a book). Older colleagues tell me they were asked the same thing about videos, and before that color television was seen as somehow more harmful than black-and-white. Until the 1920s, official advice from the Chief Medical Officer of the London Education Board was that short-sighted schoolchildren should not be allowed to read or write, and were told that reading for pleasure “is a vice until fully grown.”⁶ I am waiting for the first time I meet someone who blames their blindness on too much time spent in virtual reality.

Jay knew that his eye disease was genetic, so why blame himself for his blindness? Health beliefs are complex: people often take Western and Chinese medicines simultaneously, or continue with prescribed medication when making a pilgrimage to Lourdes. It is completely plausible to believe in genetics and the sins of self-pollution. Losing sight is a form of bereavement, and guilt is a common stage of the grieving process. It is this sense of guilt which John Marten and his peers exploited to financial gain.

I have met Jay a few more times since this consultation. He continues to tell tales of life with visual impairment and keeps promising to start a blog. He appears to have adapted well to his sight loss, but Jay’s story shows John Marten’s get-rich-quick scheme still causes anxiety in twenty-first century London.

Note: Jay’s name, description, and clinical details have been changed to preserve his anonymity.

References

1. Onania: or, the heinous sin of self-pollution, and all its frightful consequences, (in both sexes,) consider’d; with spiritual and physical advice to those who have already injur’d themselves by this abominable Practice. and now Printed together, in this One Volume. And as the several Passages, in the Former Impressions, that have been charg’d with being Obscure and Ambiguous, are, in These, clear’d up, and explain’d, there will be no more Alterations or Additions made to them, 15th ed. London: printed for, and now sold only by J. Isted, at the Golden-Ball, between St. Dunstan’s Church, and Chancery-Lane End in Fleet-Street, Bookseller, 1730. Eighteenth Century Collections Online (accessed April 4, 2019).
2.  Thomas W. Laqueur. Solitary Sex: A Cultural History of Masturbation.  New York: Zone Books, 2003
3. Farrer, W. (William). A short treatise on onanism; or, the detestable vice of self-pollution. Describing the variety of nervous and other disorders, that are occasioned by that shameful practice, or too early and excessive venery, and directing the best method for their cure. By a physician in the country. The second edition. London, 1767. Eighteenth Century Collections Online (accessed 2 April 2019).
4. Tissot, S. A. D. (Samuel Auguste David). Onanism: or, a treatise upon the disorders produced by masturbation: or, the dangerous effects of secret and excessive venery. By M. Tissot, M.D. Fellow of the Royal Society of London. Member of the Medico-Physical Society of Basle, and of the Oeconomical Society of Berne. Translated from the last Paris edition by A. Hume, M.D. London, 1766. Eighteenth Century Collections Online (accessed 2 April 2019).
5. Sorsby, A. On the nature of Milton’s blindness. Br J Ophthalmol. 1930;14:339–354, cited in Bartley, G.B., The Blindness of John Milton, Mayo Clinic Proceedings 1993, 68(4):395 – 399
6. Kerr, J. School vision and the myopic scholar. London: George Allen and Unwin Ltd; 1925.