Excessive venery, masturbation and continence

Front matter

CQEmiGHT DEMSm

V

EXCESSIVE VENERY

Preface

This volume contains the substance of a course of lectures delivered in the Medical Department of the University of New- York, on the Results of Excessive Venery, Masturbation and Continence. In addition to the results of my own experience obtained in hospital and private practice, I have added the peculiar methods of treatment employed by various authorities in Europe and America, thus making the volume complete as a book of reference for the student and practitioner of medicine.

Chapter I. General Considerations

Ignorance of Sexual Hygiene and its results — Should Laws Regulating Sexual Functions be taught before years of maturity are reached — Ignorance of function in the married state, and its results — Ignorance as a cause of sexual excess and Masturbation — Cases of Phthisis, from parental excess — The physician as a teacher of Sexual Hygiene— When and How to teach — Lessons to be regulated by the mental and physical peculiarities of the child— Fear as a necessary educational agent — A clergyman's idea of what should be taught of sexual physiology and Hygiene — The schoolmaster as a guardian of school morals. ^7

Chapter II. The Genital Apparatus

Anatomy and functions of portions of the male and female genital organs — Erectile Tissues — Peculiarities of erectile tissues — Blood supply of the erectile tissue of the penis — Buck's fascia — Structure of the corpora cavernosa and corpus spongiosum — Action of muscles attached to these organs — The glans Penis — Changes in the glans from Masturbation and Sexual Excess — Dorsal artery of the penis — Membranous urethra — Cowper's Gland — Character of its secretion — Prostatic Urethra — ^Veru Montanum — Prostatic Ducts — Ejaculatory Ducts — Morbid changes from Masturbation — Intimate structure of Prostate gland — Sphincter Muscle of the Neck of the Bladder 28

Chapter III. The Seminal Fluid And The Mechanism Of Erection

Physiological properties of seminal fluid — Chemical composition of semen — Gross Appearances — Characters of Spermatozoa — Peculiar movements under the microscope — Chemical composition of spermatozoa — Various quantities formed and ejaculated — Secretion of Prostate and Cowper's Glands, as forming a part of the Seminal Fluid — Natural and morbid secretions that may be mistaken for semen — Muco-Purulent secretion in Prostatitis, Urethritis and Cystitis — Mixture r>{ mucus with epithelial cells — Chylous Urine— Distinguishing characteristics of each — Mechanism of erection — Nerve centers governing erection — Function of the cerebellum — Effects of removal of the organ — Clots and tumors in the cerebellum — Emissions produced by Shampooing the occiput — Location of the genito-spinal center — Sympathetic Nervous Influence — Analogy between the act of blushing and erection — Influence of the mind — Cases of partial erection 43

Xll CONTENTS. /

Chapter IV. Diseases From Excess, Etc

What constitutes Spermatorrhoea ? — Opinions of Hippocrates, Celsus, Lallemand, Acton, Van Buren, Hamilton, Bartholow, McGraw, Gross, Post, Hutchinson, Morse, and others — ^Various causes of Spermatorrhoea and Impotence — Masturbation, Sexual excesses, Mental emotions. Continence, Diseases of nerve centers. Diseases of Testicles and Penis, Congenital and acquired Malformations — Relative indulgence in the vice of masturbation by inhabitants of savage and civilized countries — Masturbation among animals — Age at which onanism is usually begun — Nurses as teachers of immorality — Dangers of intimate companionship — Influence of certain gymnastic exercises in developing masturbation — Varieties of exercises which should be prohibited — Cases in which swinging from poles and bars gives origin to the vice — Morbid changes in the genital organs caused by self-pollution — Constitutional changes from the same cause — Why seminal emissions occur when masturbation is discontinued , 58

Chapter V. Results Of Sexual Excess And Mental Emotion

Sexual excess not so injurious as masturbation — Seminal losses not unhealthy when they occur from natural causes — Differences between local and general effects of sexual indulgence and masturbation — Excess as a cause of spermatorrhoea and impotence. Mental emotion as a cause of spermatorrhoea and impotence — Effects of emotion in hysteria. Simulation of mammitis, peritonitis, etc., by hysterical patients. Graham's bed for impotent patients — Impotence from fear, anxiety, bad odors, business troubles, bad temper, unusual surroundings, etc. — Interesting cases of Hammond's, Rouget's, and others 7^

CPIAPTER VI.

DISEASES PRODUCED BY SEXUAL EXCESS AND MASTURBATION.

Deterioration of the seminal fluid as a cause of pulmonary consumption- Changes in the healthy character of the secretions — Hereditary weakness, as a source of phthisis — Phthisis developed as a direct result of masturbation — Phthisis among young married persons — Erotic desires of consumptive Patients — Epilepsy — Connection with Onanism — Convulsive seizures during the orgasm — Changes in the nerve centers as a result of the disease — The center of sensation and voluntary motion — -Irritation of the tuber annulare — Causes of the convulsion — Termination of Epilepsy in insanity — Is insanity caused by sexual excess and masturbation — > Opinions of various authorities — Peculiar forms of insanity arising from these diseases — Nymphomania — Its causes — Characteristic cases — Mirriage as a means of cure — Amputation of the clitoris as employed by Baker Brown — Satyriasis — Curious manifestations of the disease — Treatment — Aspermatism, et : 92

CONTENTS. XIH

Chapter VII

<JISEASES OF THE GENITALS THAT ARISE FROM MASTURBATION AND SEXUAL EXCESS.

Causes of Varicocele — General changes in the spermatic veins — Effects of the congestion and dilatation of the veins in the neighboring tissues — Mental depression caused by varicocele — Emissions and impotence as a result — Ligation of veins as a means of cure — Caustic applications —Galvano cautery, etc. — Amputation of the scrotum the only safe operation — Ecchymosis of scrotum — Neuralgia of the testicle — Irritable Testicle — Various methods of treatment — Neuralgia of the neck of the bladder — Treatment — Spasm of the muscles at the neck of the bladder as a cause of impotence. Congestion and inflammation of the Prostate gland — Treatment , . . - I2i

Chapter VIII. Diseases Of The Genitals Associated With Spermatorrhcea And Impotence

Accumulation of secretions under a tight prepuce as a cause of spermatorrhoea and impotence — Illustrative cases — Reflex irritation produced by Phimosis — Loss of voice from Phimosis cured by operation — Sayre's unique case — General treatment — Congestion of the prostate and inflammation of the prostate — Cases of spermatorrhoea and impotence produced by them — Impotence following the removal of calculi from the bladder by the lateral operation — Spermatorrhoea produced by Hypospadias and Epispadias— Curvature of the penis — Large penis — Prostatic calculi as a cause of spermatorrhoea 145

Chapter IX. Diseases That Result From Sexual Excess And Masturbation

Cerebral Anaemia — Symptoms and course — Peculiarities of Cerebral Ansemia in connection with excess — Spasmodic contraction of voluntary muscles in connection with anaemia — Termination in white softening — Significance of loss of memory — Local paralysis — Effects of hemorrhage in the cerebellum — Sclerosis of Nerve Fibres of Cerebellum — Hanging — Concussion of the spinal cord — Softening of spinal cord — Impotence from bui, stroke 174

Chapter X. Continence

Fulfillment of function necessary to a healthy organization. Impairment of function as a result of disease or inaction — Results of suspending the functions of joints, muscles, eyes, etc. — Loss of s ght in animals secluded from the light — Changes in the genital organs from continence — Reasons why continence is likely to cause Spermatorrhoea and impotence — When continence produces these diseases, and marriage is not attainable, what advice should be given by the physician — Responsibility of the medical adviser — Moral aspect of the case — Views of clergymen on the subject, and their advice — Opinions of Acton and others 183

XIV CONTENTS.

CHAPTER XL

CLASSIFICATION OF CASES FOR TREATMENT.

Universal rules that are not universal — The danger of advising a single method of treatment for all cases of Spermatorrhoea and Impotence, without a special study of each case — Errors in treatment — Bromides as remedial agents. Their effects on the vascular and nervous systems — How they affect the digestive functions — The indiscriminate use of the drug productive of evil — Bromide of potassium as a cause of impotence — Cauterization of the prostatic portion of the Urethra — Its universal use in the treatment of spermatorrhoea — Why a classification of cases is necessary — Four varieties of spermatorrhoea — Peculiarities exhibited by the first class — Cases which are incurable — Second variety — Distinguishing features — Patients amenable to treatment — Peculiarities of third and fourth class of patients — Greater frequency of the milder forms of spermatorrhoea 202

Chapter XII

CONSTITUTIONAL TREATMENT OF SPERMATORRHCEA, IMPOTENCE AND AND ALLIED DISORDERS.

General Debility a leading feature in the majority of cases — A special diet necessary for each patient — How to select a suitable diet — Cases in which the number of meals should be increased — Condition of the genital organs not to be considered in selecting food — Nutritious articles not to be set aside because they have a tendency to excite the genitals— Eggs, oysters, clams, raw beef, broths, gluten, cracked wheat, cream, milk, etc. Digestible salads — Zvlethod of preparing raw beef — Quantity of food for each meal — Incompatible mixtures of food in the stomach, and their effects — Rules for the selection of compatibles — Food that should be eaten — Food that should be excluded from the bill of fare — !Meat not to be eaten with milk — Other incompatibles — No lard or pork to be used in cooking — Mild wines permitted in the treatment 215

Chapter XIII

CONSTITUTIONAL TREATMENT OF SPERMATORRHOEA, IMPOTENCE AND ALLIED DISORDERS.

Condition of the bowels in spermatorrhoea — Scanty secretion — Diminished peristaltic action — Wliy the use of cathartics is contraindicated — Effect of constipation in increasing the number of seminal emissions — Semen evacuated at stool — Cases in which small doses of calomel may be employed — Action of Belladonna and Physostigma on the bowels — Injections of oil into the rectum — Cold water injections as a remedy for const'.Dation in spermatorrhoea — Local effects of the injections — Cold water bathing — ^\''arious methods of employing cold water in the treatment of spermatorrhoea and impotence — Cold sponge bath — Sitz bath^ — Shower bath — Rubbing bath — Sea bathing — Temperature of bath for weak and nervous patients — Local and general effects of the bath — Sleep and exercise 224

Contents. xv

Chapter XIV

treatment of Spermatorrhoea, Impotence, and allied disorders — Indications for the use of tonic medicines — Cases in which they are beneficial — Reasons for their discontinuance — Effects of Strychnia on the spinal cord — Combinations of Strychnia, Iron, Quinine and Glycerine — Tonics and nerve stimulants in nervous depression — Preparations to be employed when there is obstinate constipation — Palpitation of the heart, vertigo,etc. — Employment ot arsenic, iron, nux vomica, ergot, and quinia — Aphrodisiacs — Special indications for their employment. Classes of patients benefited by their use — When they should be discontinued — Peculiar effects of phosphorus on the nervous system and genital organs — Dangers connected with its administration — Compound phosphorus pills — Cantharides as an aphrodisiac — Best mode of administration — Combination of cannabis indica, ergot, nux vomica, sanguinaria, stillingia, water pepper, damiana — Homoeopathic remedies . 239

Chapter XV. Local Treatment Of Spermatorrhcea And Impotence

Electricity the principal remedial agent in treatment of impotence — Effect of the induced and Faradic current — The continuous current — Cases illustrating the effects of electricity — Various Methods of Electrodes — Position of the patient — Urethral and rectal electrodes — Wire brush — Cauterization as a means of cure — Solid and liquid caustics — Lallemand's porte caustique — Precautionary measures to be adopted — Usual results of the operation — Caustic solutions safer — Instrument for introducing caustic solutions to the prostatic portion of the urethra — Acupuncture — Introduction of the needles — Regions in which the needles are inserted — Resulcs of Acupuncture, of astringents and anodyne applications — Medicated bougies— Spermatorrhoea rings, electrodes, rectal pessaries. 252

Chapter XVI. Treatment Of Spermatorrhcea, Impotence, And Allied Disorders

Methods of treatment used by Gross, Van Buren, Keyes, Hamilton, Post, Bartholow, Hutchinson, McGraw, Acton, Gant, Humphrey and others 269

EXCESSIVE VENERY, MASTURBATION AND CONTINENCE.

Chapter I. General Considerations

Ignorance of Sexual Hygiene and its results — Should laws regulating Sexual Functions be taught before years of maturity are reached — Ignorance ol Function in the Married State — Ignorance as a cause of Sexual Excesses and Masturbation — Instructive case — When and how to teach — Lessons to be regulated by the Mental and Physical peculiarities of the child — Fear as a Necessary Educational agent — A Clergyman's idea as to what should be taught of Sexual Physiology and Hygiene — The Schoolmastei as a guardian of Morals.

A knowledge of the sexual functions or of sexual hygiene is rarely considered to be a necessary part of our early education, and the value of such knowledge as promoting a healthy physical and mental condition is almost entirely overlooked. The age of puberty generally has passed, before the subject is introduced to the youthful mind even in the most casual way. Indeed there is scarcely a subject more completely ignored, although so much of the health and happiness of the race depends on it. The physician whose professional duties bring him a clearer insight into the private lives of his patients, beyond the point where ordinary vision reaches, is about the only one who fully realizes the great necessity for the diffusion of such knowledge, and an education that will prevent those ignorant assaults on the genital organs which in time stunt the vital forces, and whether cured or not, leave their impress on the vital forces of the patients themselves, as well as on their unfortunate offspring. Outside of the profession there are very few who ever get beneath the thin veneering to the rotten wood l8 GENERAL CONSIDERATIONS.

below, and thus see the difference between the fictitious side of life, and the real or true life of suffering occasioned by ignorance and bad habits, which might easily be avoided by a little care and wholesome advice given by parents, guardians or teachers, or perhaps best of all by the family physician, for he really is the person fitted by his position to give the necessary information in the way or manner that will carry with it its full weight of conviction, and compel a sensible enforcement of the laws which regulate sexual functions, and he can also briefly explain such points in the anatomy and physiology of the organs under consideration, as will facilitate the patient's efforts to do what is expected of him in an intelligent manner. But unfortunately, as things are, at the present day, the damage is usually done before there is a full realization of the means for preventing it. So dense, indeed, is the general ignorance on this important subject that it is not an uncommon event for men and women to enter the married state without any preliminary knowledge whatever of the sexual relation.

Married women, and men too, of much experience in other matters pertaining to the management of their physical natures, have informed me that when they entered the marriage state, they were totally unaware of the nature of the sexual relation, and that many days and nights were passed in the midst of curious sensations, doubts and fears and ridiculous performances before the marriage was consummated. Neither did they comprehend the immediate or remote results of the new relation. They knew not the difference between temperance and excess until disordered nerves and feeble bodies compelled them to seek advice from parents and friends who had passed through the same trials and with similar experiences. And in many instances this advice v/as sought too late for benefit.

GENERAL CONSIDERATIONS. I9

triends who were more versed in the matter than they were. This ignorance, of course, is more generally confined to women than to men, but there are enough instances among the latter, to make it a matter of surprise even to a physician who ought to be accustomed to surprises. As a case in point, the following instance may afford food for reflection. In the summer of '79 while sojourning in the Adirondacks, I was asked to visit a gentleman at a hotel in the neighborhood who was said to be in an advanced stage of pulmonary phthisis. He was about forty years of age, and had been an invalid for three years. Upon examining him, I found, that in addition to his phthisis, he was suffering from a perineal abscess, and a congenital phimosis. The latter had caused a chronic balinitis by preventing the secretions from being removed, and the parts from being washed. The extremity of the organ was so painful that the slightest touch gave him great distress. I opened the abscess in the perineum and it soon healed. The pain from the accumulated secretions around the glans, continued with little amelioration, except when relieved by opiates, and I finally slit the prepuce and exposed the inflamed and ulcerated glans and thus relieved him of the greater part of his suffering. He afterwards said to me, *' Dr. I know now that if that operation had been performed when I was a boy, and I had been told anything about the normal condition of my genital organs, I would now be in good health, I would not now be dying from consumption. I blame it all on my parents. When I was a mere lad, I had every night a very painful erection which kept me awake the best part of the night. Again and again I went to my father and begged him to tell me where to go for relief, but he only laughed, and said it was all right. Like appeals to Others had a similar result. Finally the irritation became

SO great that without any instruction I commenced to masturbate, and finally went frequently with loose women to such an extent that my health broke down, my lungs gave out, and now I am dying. I never knew until too late what was the cause of my frequent erections, and I was never told that any relief could be afforded by an operation."

The most singular part of this matter is, that so much ignorance can exist where natural instincts alone might be expected to prompt man, as well as the lower animals.

The education of the youthful mind in these matters need not be thoughtlessly commenced, or hastily terminated. A gradual and systematic formation of correct ideas and habits, should be fostered as the growth of the boy or girl progresses. And the various steps should be taken with due regard to the mental or physical developement of the child, and necessarily must be varied to suit this or that particular case. The education should neither be superficial, nor hurried. The teacher must feel the responsibility he is assuming, and have a thorough perception of his work on each point before he undertakes it. The perceptive faculties of children are often much keener than we generally give them credit for, and, like older folk, they have different mental and physical peculiarities, which must receive special study before the necessary knowledge is conveyed to them. If the pupil has exhibited signs of unusual sexual precocity, it would be well to point out the results of all unhealthy familiarity with the genitals before discoursing upon their uses in the accomplishment of a most beneficent plan of nature, to imbue the mind with that laudable sense of fear which should invariably accompany any infringement of the law. Fear is an essential element in controlling this class, which has many, very many members. So many indeed are in this class in all walks of life as positive indications that their parents though living in a civilized and christian community, have broken every law as thoroughly as if they had "lived and moved and had their being," where vice prevailed and moral laws were unknown. Such children are often nothing but insignias of disgrace to their ignorant, though, perhaps, wellmeaning parents.

With that other and much smaller class, who inherit healthy minds, as well as healthy bodies, with little or no disfigurement from exuberant natural passions, it is always safe to add to their general knowledge of anatomy and physiology some additional and special facts relating to the genito-urinary functions. The subject can be approached gradually, suiting the amount of information to the age of the child, and the general development of the perceptive faculties. The command to keep the hands away from the organs, if aided by the watchfulness of a faithful nurse, or mother, will generally succeed in enforcing this sanitary edict. At the same time it is well to see that all sources of temptation to examine themselves should be removed. The tight clothing with which the limbs of most children are encumbered by night, as well as by day, should be removed. Nothing tight, or irritating, or exceedingly warm, should be allowed either in the day or in the night, but especially at night, because then there is the additional weight of the bed clothing to be borne. From the warmth and superabundant moisture accumulating around the genitals irritation is engendered which naturally prompts the child to rub and finger its parts until the tendency to masturbation is fully formed, and the child is well on the road that leads to all sorts of excesses. Sometimes a warning voice reaches the innocent transgressor through the medium of a quack advertisement in a book or newspaper. Fortunately, these advertisements often send the patient to the family physician, instead of to the charlatan. Yet whatever evils may arise from such quacking, one good at least is often accomplished, namely, the immediate suspension of the pernicious habit, whatever may be its nature. I have had many cases where the patient's reformation and subsequent restoration to health originated from perusing quack advertisements.' I speak of this to show that the educated members of our profession are scarcely doing their duty to humanity by ignoring the importance, and by neglecting or making little of the subject. Fear of evil consequences is without doubt a great moral power in this world, and although it may not be the noblest propelling force, it cannot be dispensed with in the cases under consideration. We are all sadly human. Emerson, with a degree of truth, says that " there is a crack in everything that God has made," and this is undoubtedly true of poor human nature. We have not yet reached perfection and probably never will, and we must recognize the value of such a low moral force as fear in the enforcement of sanitary conditions in all matters relating to the sexual or genito-urinary organs.

The usual and conventional objection to this variety of education is, that at such an early age the understanding is not ripe enough for such knowledge, and that it might lead to the very evil that it was designed to avoid. If it were not apparent to every one that the evils and the diseases under consideration were almost universal as a result of ignorance, then that idea might be entertained, but no one can possibly object under existing circumstances to giving the child legitimate knowledge on a subject of such vital importance, where ijisufHcient teaching has produced such unfortunate results.

Acton publishes the remarks of a clergyman who seems to have been blessed with more than the ordinary amount of clerical common sense on this question. He says : "Advantage could and ought to be taken of the opportunity when a boy says his catechism to explain to him the meaning of some of the terms therein contained. When a child is taught to ' keep his body in temperance, soberness and chastity,' it would not be difficult to explain to him what chastity is, instead of leaving him to find it out as best he may. He might be given to understand that it does not merely mean that all indecency and foul language must be shunned. The child might be told that he must keep from meddling with his secret parts, except when the necessities of nature require it, and that any emotion he may experience in these members must not be encouraged, and all thoughts which originate in them must be avoided. And when he grows older every boy should be taught that chastity means continence ; that if he would be chaste he must not by any act of his own, or by the indulgence of lascivious imaginations, cause the fruit of his body to be expended. He should be taught that all such expenditure is a drain on his system, and weakens the powers which God has given him to be employed only in the married state. He may be sure that ' his sin will find him out,' and if he marries with his powers undermined by unlawful gratification it will be visited upon his children also. If he is old enough to understand the subject, the youth entering upon puberty might have explained to him some of the mysteries of life; probably it would not be incompatible with his age to explain to him that the life of the animal and vegetable kingdoms is continued and increased through the power of reproduction, with which the Creator endowed the whole produce of the earth, It is the nature of every herb that it * yieldeth seed,'

and of the fruit tree yielding fruit that its ' seed is in itself ' (Gen. i, 12). It is the nature of every living creature *to be fruitful and multiply' (Gen. i, 28). This power of reproduction or of generation constitutes the very essence of life. To enable this vital function to be fulfilled, every plant and every animal is furnished with organs of reproduction. As it has organs of respiration for breathing the air, organs of motion, organs of digestion for assimilating its food, so it has organs of reproduction for handing on the life it has received, and reproducing itself in its offspring. This is the most important function of the whole vital economy of every living form. We might further explain to him that our life is bound up with the reproductive organs of the body. Now what every young man, and boy also, ought to know about himself is this : The two appendages of the body, — of which we are too modest to speak, — but which the Holy Scriptures calls the stones, and medical men the testes or testicles, form the laboratory of the human body, where, by a process of which we are quite unconscious, the blessing given to man at the creation is being fulfilled, and out of the system a vital fluid which is the very 'essence of life,' the source of being, is being constantly produced from the time of puberty, to be employed, when he reaches maturity, not in the gratification of the lusts of the flesh but in the procreation of children. The boy might be taught the immense importance to the human constitution of this vital substance, the seed of the man which is elaborated by the organ of reproduction, and it should be made clear to him how terrible the consequences must be if the life be continually flowing away from the body. The opportunity might be taken of informing the youth that many whose lives are outwardly pure have fallen into secret sins and wasted their substance in solitary indulgence. And the consequence of such indulgence is not limited to the act itself, but the violated body becomes unable to contain its treasure, and as fast as it is elaborated the seed is poured away on the slightest provocation in sleep and in the performance of the acts of nature.

" He might further be informed that many of the sicknesses to which we are subject may be traced to this cause, and that many of those complaints set down as nervous debility, much languor and loss of spirit, much feebleness of mind, much dimness of sight, much loss of manly bearing, — to which we must add many cases of the loss of reason and an imbecile and driveling old age, — are the inevitable result of the expenditure of the vital forces in sinful gratification.

" I would further instruct a youth that this degrading practice obtains such a hold upon any one indulging in it that he seems unable to free himself from its grasp. Again and again he yields to its importunity, and life ebbs away from him, — mind and body becoming undermined. It is a sad and melancholy truth that many whose childhood has been most pure and spotless have fallen most deeply when their passions have been awakened through absence of all warning on the subject and in ignorance of the self-destruction they were committing."

Besides this instruction given by the family physician, the tutor, or the schoolmaster under whose eye the ordinary school knowledge is inculcated, should maintain a degree of watchfulness over the boy which would enable him to detect any private irregularities, and he should also add (with the advice of the physician) any further lessons as to the best methods of regulating generally the sanitary condition of the youthful pupil. Upon this point the same author says : " I maintain that a conscientious schoolmaster's task does not end with providing for cleanliness, decency, and exercise among his boys. In spite of his assumed ignorance of the practice, masturbation and other vices may spread widely through the school unless careful supervision be employed. Against these secret evils there is no better safeguard within his reach than a steady endeavor to raise the moral tone of the whole school by means of the uppei forms, so that the older boys may of their own accord join in discountenancing any ungentlemanly or disgraceful conduct, Without some such auxiliary, the efforts of the best-intentioned master to prevent the practices, with their demoralizing accompaniments and consequences, will be almost powerless. How diffused secret wickedness may become in schools appears every now and then in scandals so dreadful that the natural tendency of all concerned is to hush them up and forget them as soon as possible. Indeed, it is impossible not to sympathize with the feeling that to be obliged seriously to doubt as to the manliness and, in a rough way, of the purity of our large schools, would be a great calamity.