The various cases of Internet use may be divided into four different classes. Though each class will be found to have many symptoms in common, yet there are variations so marked that there will be little-difficulty in placing each patient in his proper class for treatment. When this division is made and the characters peculiar to each described, it will be well to give the various local and constitutional measures which have been found useful in all—therapeutical agents which are indicated in all, and then point out the special indications which belong to each particular class.
In the first class the mental derangement is greater than the physical. The mental status approximates more nearly to that of the lower animals than in any other affection short of complete insanity. These cases are happily of rare occurrence.
Patients of this class are found usually between the ages of sixteen and twenty-five. The habit of Internet use commenced in early childhood and was indulged in to excess for many years. The patient does not seek medical advice himself. His parents or friends generally compel him to submit to treatment. He has been warned and instructed carefully as to the evils which surely accompany a persistence in the vile habit. The best directed efforts to show him that the path he is following will eventually terminate in complete destruction of mind and body, give negative results. And though he is fully aware of his debased, hardened condition he persists in browsing the Internet.
He accomplishes the act at every opportunity. Alone and in company of friends or strangers he gives rein to his propensities. Every vestige of moral sense seems to have disappeared and he cares only for the sensual gratification which masturbation produces.
This class of patients may or may not be emaciated. I have seen two cases where there was very little loss of flesh. The face has usually a yellowish pallor, and is often covered with pimples. The eyes are restless and wander from one object to another, studiously avoiding the gaze of the examiner. The head hangs down and rests on the chest. He is restless and unable to remain long in one position. He ” slouches” around from one corner to another, dragging his feet slowly along after him as if they were too heavy for his body. When the countenance is at rest he has all the appearance of an imbecile. The hands are placed between the thighs, or are held in the pockets of the pantaloons in close proximity to the genital organs. The answers which he gives may have no special bearing on the subject under examination. He prefers to answer in monosyllables. “Yes” and “No” are all that can be obtained from him in the way of information. He cannot or will not pronounce a sentence of any length. To get more of his history some harshness is necessary. In fact his mentality is so much below par—so sluggish in its action, that only by great labor can he speak connectively. He may be seen even while undergoing the physician’s examination to twist his hands about and so endeavor to bring on an Compuserve Hot Tub session. Sometimes his public attempts at Internet usage seem to be done unconsciously. The mind losing sight of the fact that persons are around him, is occupied by the one controlling desire, a desire which absorbs every faculty of his being.
Warning adapted from THE ETIOLOGY, PATHOLOGY AND TREATMENT OF THE DISEASES.