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-SEXUAL NEUROSES.
-
-CHAPTER I.
-
-_Introductory._――The term sexual presupposes the possibility of two
-distinct and perfect beings, yet one is counterpart of the other,
-distinguished by anatomical features designated male and female; with
-attributes such as passion, love and reciprocal admiration. Sexually
-the two beings become united, constituting plurality in unity.
-
-The sequel of such coalescence of the sexes, or marriage legitimately
-considered, is copulation and reproduction of the species. The
-summit, or peripheral center of venereal sensibility, is found at the
-genitalia, and in the male a concentration of nerve-force conducts,
-as it were, to and unites at the glans penis; and division of the
-terminal nerves at this point will render erection impossible. In both
-man and beast, the only mechanical irritation capable of exciting
-venereal sensibility must be at this point. When the sexual centers
-are physiologically irritated, from peripheral or centric influences,
-contentment is only possible (physiologically speaking) when male
-and female counterparts coalesce, or are in juxtaposition. The sexual
-attributes also constitute an instructive topic for study, as they
-become modified by civilization and the development of reason. The
-procreation of organic life is the sequel of the sexual connection. The
-living universe has been called into existence, and the perpetuation of
-its life-spark is only dependent upon the contact of sexes.
-
-The universe, it is said by one theorist, was evolved; by another,
-who depends upon the Holy Book for a guide, all living creatures were
-thaumaturgically or miraculously, and “in the twinkling of an eye,”
-made to exist in full form and shape. This problem will never be
-settled to the satisfaction of all men as long as theory and faith
-are at war; and small is the prospect of peace while both parties
-are redoubling in their forces annually. Then, we can but accept the
-situation of the human race, as it is, since we have no historical data
-of its origin, that are beyond controversy and that would be accepted
-as evidence in a physiological point of view. But we need no ponderous
-evidence to show the truth of the premise, that animal life is not
-perpetuated except through sexual congress. Not life _only_, but good
-and evil of every degree; vice, folly, crime; love and hate; society,
-social evil and social good: all depend, largely, upon the sexual. It
-is the bond of our existence; it is the wheel of our fortune; it is our
-guiding star; and it may be our loadstone to crime and premature death.
-Passions leading to love, true and gentle, or jealousy, hate, revenge,
-murder and suicide, all hinge on circumstances connected, directly or
-indirectly, with the sexual.
-
-Our schools are conducted upon a foundation entirely sexual; educating
-each of the sexes in the role they are to pursue, with reference to
-exclusiveness in conduct. The girl is taught to pursue only such
-vocations, practices and manners as are becoming to her sex; the boy,
-on the other hand, is instructed not to enact girlish capers, but to
-pursue masculine vocations, from the childish toys to settled, adult
-labors. This all means nothing but distinctive development of the sexes.
-
-The sexual enters our every-day lives, from childhood up; it governs
-our development; it modulates the voice, the build, the dress, the
-hair, the fashion of wearing the dress, and even the gait. In all this
-we can but observe the worship of the sexual; though obscure, yet
-every manifestation of human existence points to it. The good people
-of the earth profit by the grand and noble sexual unity in the marital
-existence, and by the pure, social relations, and chaste affections of
-the unmarried; but these are but a small part of human society. The
-masses express their worship for the sexual by debauch, dissipation,
-vice and crime. The common saying, whenever suicide or murder has been
-committed, that “_woman was at the bottom of it_,” might just as well
-read, “_man was at the bottom of it_;” as without the one, where would
-the other have been?
-
-It is the bad use of noble agencies that often constitutes vice.
-Nothing ignoble, was intended by the Great Designer, should grow out
-of the sexual privileges, and when nobly appreciated, for moral beings
-a greater happiness or pleasure has not been instituted. But by long
-prostitution of these privileges, vices have originated; beliefs have
-been established; customs have been founded; even religions have been
-constructed and modified to suit the wishes of designing “sexualists,”
-“free-thinkers,” Mormons, etc. Occasionally, dissatisfied members of
-one sex will establish an innovation, or a revolutionary commotion,
-demanding rights which they claim have been usurped from them, and
-sometimes thirsting for prerogatives belonging to the opposite sex.
-They agitate their cause until their isolated followers establish
-societies and churches, effecting discord in families, and no good to
-the world in general, and for themselves an unenviable reputation. Such
-individuals are often advocating reforms; temperance, charity, etc.;
-but when good comes out of one, evil grows out of ten. They often take
-a decided stand against the opposite sex, and when their true history
-is known, it will be often found that they have been suffering from
-unrequited love, disappointment in matrimony, deception in society,
-misplaced confidence, illegitimate pregnancy, etc.; or, they are
-phlegmatic and passionless; or, hermaphrodites; or wanting in some of
-the sexual appendages necessary to constitute a perfect man or woman.
-Then, without the complete sexual system, harmoniously balanced, all is
-imperfect.
-
-My purpose in dwelling so much upon these mixed relations and
-disappointments, has been more especially to fully expose the
-predisposing causes of neuroses and more essentially of the sexual
-variety. As I shall labor to show that neurosis is the condition
-throughout our list of sexual diseases, and that all the foregoing
-changes, excesses and defects, depending upon the sexual, are more or
-less influential in predisposing human beings to brain and spinal cord
-disease. No person, so well as the physician, will comprehend, after
-once meditating upon this theme, the necessity for thorough study and
-a more rational understanding of the sexual. Medical writers, with
-one or two exceptions, have only ventured now and then an isolated
-paragraph, and left the physician to draw his own conclusion. Among
-the aboriginal tribes, the sexual appetite is and has always been
-indulged _ad libitum_; not only in the natural manner, but in every
-conceivable way, without noticeable harm to the organs themselves,
-or to the nervous system. In a lesser degree this is true of slaves,
-sailors and peasantry, and the lower orders of civilization. Sexual
-endurance diminishes in proportion to the advancement in civilization
-and intellectual culture. A long-cultured family can not sustain,
-in sexual indulgence, what to the uncivilized would be a matter of
-indifference.
-
-Sexual intercourse, when not contra-indicated, may relieve nervous
-tension and produce sleep in a moderately feeble individual; but on
-the other hand, if carried to excess, it may produce nervous tension,
-wakefulness, headache and exhaustion. There are no definite rules to
-regulate the sexual appetite, more than the stomach for food.
-
-The evils of sexual intemperance are temporary, and if recent, quickly
-recoverable by rest only.
-
-Says Dr. Briggs, of New York, “The sexual system is notoriously the
-seat of excitement and depression from psychical and mental influences.
-It is under the control of the sympathetic nerves, and influenced by
-the solar flexus. Much of the peculiar sensibility experienced in this
-part of the body is directly referable to the mind and imagination:
-the manifestations are controlled by the sympathetic nerves, from the
-impulse given in this manner. But the mind and will, however intense,
-have little power over the sexual functions, except through this
-medium. The emotions are superior.”
-
-_Predisposition._――The innate or uncaused condition, which is so
-commonly found among the young, is quite likely congenital and
-constitutional. There is evidently structural malformation in the
-neuroglia, or nerve cells proper, which predisposes the child to sexual
-excitement. This may not be derived from the immediate parent, but
-far back. In the third or fourth generation, debauchés may be found.
-Licentious parents commonly predispose their children to morbid sexual
-desires; and what evidence have we that structural changes do not exist
-in or about the nerve centres that preside over the sexual functions,
-and that such changes are not constitutional? Then, with this
-structural change as a predisposition, the least cause will set the
-sexual centers into a blaze of excitement. They who are predisposed by
-many generations, show upon their faces the lines of coarse breeding;
-that they are the offspring of debauchés; congenital degradation; not
-but these conditions, under favorable circumstances, may be overcome,
-by rigidly cultivating opposite nerve centers; but such opportunities
-are seldom presented, and when presented seldom embraced.
-
-Circumstances are also to be considered as having a bearing upon the
-sexual “ups and downs” of our human career. With a predisposing sexual
-cause, a downfall may occur under circumstances less seductive in
-character than when no such congenital condition is present.
-
-Listen to the heart-rending stories of girls in the houses of
-prostitution. Each has her story of circumstantial events to relate.
-Circumstances of varied gravity have caused the multitudes of “fallen
-women” to occupy their degraded sphere of shame and debauch. Many of
-these have never been predisposed to a sexual livelihood by an erotic
-disposition, and they only stay by compulsion and fear of reproach that
-must follow if they return to society. The line of social demarkation
-is drawn, and there is no palliation or chance of redemption by
-reform――only secret forgiveness, secret repentance, or a nunnery. There
-are some who follow this life by choice, from the pleasure therein.
-Such are predisposed: they naturally follow this course: they learn it
-on the streets, in mere childhood: their ancestors, or some one of them
-at least, were of this type――mal-constructed――and circumstances are
-meagre that, as is said, lead them astray. They are not led astray: it
-is more natural to them than to pursue the path of rectitude and virtue.
-
-These people are predisposed to evil, and it is only, even if guarded
-from childhood up by constant watching and being kept from every
-possible circumstance, and taught only the good and pure, to adult
-life, that any reasonable assurance may be had of their safety from
-vice. This inheritance is almost indestructible and may crop out after
-the best of culture, with very slight cause, any time in adult life or
-in future generations.
-
-Not only the predisposition to sexual desire is congenital, but the
-enfeebled nervous system that can endure only a limited amount of
-sexual indulgence. They learn to indulge the sexual appetite at a very
-early period, and the males grow up effeminate, or half-sexed. The
-tendency of civilization is toward brain and mental culture. In this
-we have a cause of nervousness which is wonderful. Our ancestors, who
-knew very little of brain-work compared to the cramming of the present
-day――compared to the curriculums of our present school system――were
-not nervous; they were not excitable, but physically strong. They
-labored at a variety of toils without machinery, and they obtained
-physical endurance. Now, the boy is crammed at school and hurried
-through to professional studies, when he has but just begun life; or
-he is placed at business, to find that excitement of competition which
-is the greatest brain-stimulus and the greatest cause of nervousness
-of the present age. The multitude of collateral sciences that a young
-man is compelled to read; the books, scientific and novel, that must
-be perused by every popular student; and the short period of time in
-which he is expected to pass over this entire field: all tend to change
-the young man into a habit of nervousness which would surprise our
-ancestors of one hundred years ago.
-
-The labor that was performed by hand by our ancestors, which was the
-cause of their physical endurance, is now entirely accomplished by
-machinery; and the modern man, instead of patiently doing the labor by
-hand, expends months and years at brain-work, attempting to construct a
-machine that will run by steam, water, or horse-power, that he may save
-physical force, time, and perhaps, in the end, money.
-
-The haste in which Americans live and move, must also become an
-exciting cause of nervousness. The ancients were patient in obtaining
-information; in performing works of art, literature, or agriculture.
-The Greeks did not expect to become proficient in the varied vocations
-until middle life; but an average American is expected to finish
-college at twenty-two; to have invented some kind of a machine for the
-saving of labor, to have made a fortune, married and raised a family of
-children, wasted his father’s fortune, and be prepared to begin life
-anew by the time he is thirty years of age.
-
-Then, to answer the question, “Why are American people so nervous?”
-we have but to compare the present with the past; our country with
-others. The nervousness and mental development of our people, preclude
-anything but moderation in sexual indulgence; and whenever fast living,
-brain-working, nervous people indulge to satiety in sexual pleasure,
-they are in danger of grave consequences, such as our ancestors never
-knew of, as the results of excessive sexual indulgence. They could
-cohabit _ad libitum_, and never notice such consequences as nervous
-people are constantly suffering.
-
-
-
-
-CHAPTER II.
-
-
-_Incidents――Observation――Historical Data, and Sexual Hygiene._――Nature
-furnishes us a vast field for speculation and inquiry, when even
-confined within the domain of certainties; and there is an occult line
-beyond which everything is speculative and imaginary; but there are
-facts enough in common view to enlighten the seeker after knowledge by
-simply collecting commonplace occurrences and gleaning therefrom their
-rich lessons. Observation, by association and comparison, and correct
-judgment will teach us many things not in the least hypothetical――facts.
-
-To comprehend the obscure relations of the sexual function and the
-varieties of morbid changes, we must first systematically inquire into
-a few of nature’s designs, and ascertain thereby the true purpose of
-the sexual organs.
-
-What purpose? is the first point at issue in any observation, and must
-be answered by the physiologist and Physician in this investigation,
-as he _only_ has the results of abuse, or wrong application, to
-investigate and correct.
-
-The production of healthy offspring must be nature’s only design for
-the sexual organs. How to accomplish this end, is the great question of
-scientific observers.
-
-It seems quite axiomatic to remark, that maturity and perfect
-development _only_ can assure perfect reproduction of the species.
-Again, that pleasure should always attend the act of copulation,
-otherwise the pain of parturition and the care of rearing the young
-would always militate against the perpetuation of the race.
-
-With the normal condition of the sexual organs and functions the
-physician has comparatively little to do; but with their abuses he has
-all to do. To comprehend the abnormal, he must be familiar with the
-normal condition of structure and function. Masturbation is a small
-part of the indiscretions and evils of the sexual; and the lesions
-growing out of such evils are too numerous to mention. There is no
-doubt venereal diseases grew out of the evils of repetition of sexual
-congress, with certain unknown violations of nature’s laws, by depraved
-human beings.
-
-I am credibly informed of an occasion: “A prostitute received the
-embraces of eleven men in immediate succession: the ninth and eleventh
-took gonorrhœa, and again gave it; but the prostitute remained free
-from the disease until two months after, when she took the disease from
-one to whom she had given it, on the above-mentioned occasion, after
-which she spread it through a small town in which she lived and also in
-which she was in the habit of plying her vocation. She was free from
-disease before this occasion.”
-
-It is no more doubted that a male will contract a purulent urethritis
-from contact with a woman during her menstrual crisis, or if she be
-afflicted with an infective leucorrhœa; but such a discharge in the
-male is not generally contagious, and he may indulge freely without
-giving the disease.
-
-Uncleanliness may be considered a common cause of sexual disease in
-both sexes.
-
-_Masturbation_, after the age of maturity is no more injurious, aside
-from the degradation it leads to, than the same number of contacts
-in the natural manner; but in the youth the undeveloped organs
-suffer, as well as the nerve-centers which supply these organs with
-nervous energy. The youth is inclined to indulge the habit after once
-initiated, greatly to the detriment of the spinal cord, and through
-this to the general nervous system. He is inclined to practice the
-deplorable vice oftener than he could find opportunity to gratify his
-passion in the natural way. As a rule, to the indiscretions of youth is
-confined the permanent injury to the nervous system. It is at an early
-age, when so much injury is done, that the very common practice occurs
-at schools, when boys club together in squads and go behind embankments
-of stone-wall, or creek-banks; or a boy isolates himself, as it were,
-to “shell out a grist by hand.” With such ample opportunities, and with
-the habit fully established, the acts are repeated with such frequency
-that exhaustion of the nervous power must often attend this wonderful
-deviation from nature’s designs.
-
-With all this supposed nervous weakness, I do not incline to the
-opinion that more injury is done to the sexual organs by this practice,
-in and of itself, than is accomplished through the impressions wrought
-upon the brain from reading spermatorrhœa literature of advertising,
-“private-disease” specialists. I am satisfied that I have seen bad
-cases recover by putting their minds at ease. The carefully worded
-little books, that are sent broadcast to drive in those who have been
-indiscreet, are money-making dodges, and are of great injury to the
-confiding and simple.
-
-When the injury has become very extensive and the condition of habit
-very depraved, a young man becomes so attached to his lothly vice that
-he will refuse the natural way of gratifying the erotic desire. He is
-not in the least influenced by one of the opposite sex, and prefers his
-own company, or isolation.
-
-It is not the mule only that suffers from masturbation, but girls
-as well, though not so commonly, suffer from this peculiar sexual
-neurasthenia and hysteria growing out of sexual abuse. Our opportunities
-for discovering the extent of such practices in the unmarried female are
-very limited; consequently, we remain in ignorance to a great degree.
-
-The married woman furnishes the physician the majority of the practice
-in this class of cases, as she also suffers from a mismanagement of the
-sexual congress; and it is only to the married woman that the practical
-physician will need to devote extensive attention, and only through
-her, in this sphere, can much information be obtained.
-
-In the prostitute, sexual contacts are too promiscuous, and she is
-too unreliable, to afford any very trustworthy information, further
-than may be judged by the aspect of one who has followed the business
-for a decade. It is little to know that her life, as a rule, is short
-and her social redemption next to impossible, and her entailed ills
-irremediable. When the habit of self-pollution is once established by
-a girl, it is worse than in the male; as a female is not so likely
-to yield to any sort of a vice as a male, and she will carry it to a
-greater extreme. Modesty and fear of giving offence will always impede
-the advancement of knowledge in regard to the sexual functions in the
-so-called chaste and unmarried.
-
-The married female’s sexual life and acts are often brought to the
-knowledge of her physician. I have often been asked the question,
-why so many married women become invalids from uterine and ovarian
-diseases? Not referring to child-bearing, abortions, and many
-indirect causes of disease which are numerous, but not enough to
-furnish an etiology for the long category of nervous ailments with
-which the medical man has to contend, my answer is, sexual abuse; a
-misunderstanding of the sexual functions; a non-adaptation of two
-individuals joined in marriage. It is not so commonly excessive
-venery; or too often repeated coition; but unrequited passion. Man is
-too likely to forget his duty to his wife and look first to his own
-gratification. Any sexual embrace not attended with sexual orgasm, is
-very detrimental and causes disease. With the brutal man and phlegmatic
-woman this condition is quite likely to occur, and more especially if
-the man has been a masturbator. Where the latter condition has caused
-a partial impotency, the sexual orgasm very commonly occurs before or
-immediately after the intromission of the penis, in which condition
-beatitude is impossible, and the physician is most likely to be
-consulted by one of the parties.
-
-It will not improve our knowledge to be too modest on this question.
-As medical men we have the diseases of the sexual organs and their
-_sequelæ_ to treat, and we must discuss the causes. My suggestion,
-that a couple should be matched, sexually, seems not out of place;
-and if this condition is not present at first, it must be obtained
-by adaptation. My observation has been supplied with a number of
-instances of once faithful wives, who had forsaken their husbands for
-this seeming little discrepancy or neglect, and associated themselves
-happily with more adaptable mates.
-
-These singular facts confront us, and as teachers and scientific men
-we may, when consulted, if familiar with the causes, suggest remedies.
-I have many times corrected this discrepancy in domestic felicity by
-a little careful instruction, and thereby prevented the impending
-dissolution of the marriage relation.
-
-This might well be termed matrimonial hygiene.
-
-Such grave facts are brought to the knowledge of the family physician,
-and he has but to listen to find out all: he has only a few questions
-to put, and the case is before him. No indecency to be indulged in:
-such cases must be conducted with the strictest sense of honor and
-decorum, or the bond of confidence and trust will be immediately
-forfeited.
-
-_Continence_, while in itself not an abuse, in any manner, of the
-sexual organs, yet is a fruitful source of disease. The erotic male
-may contract troublesome disease, both local and general, by too close
-proximity with a voluptuous female; and why not as much a cause of
-disease in the female? It is the condition so commonly caused by the
-affectionate and chaste embraces of parties “engaged to be married.”
-When this condition exists the marriage ceremony had better be
-consummated as soon as possible, or injury may come to both parties.
-
-The case of a young married couple, lately under observation, is
-instructive. The wife was stricken with paralysis, from which she
-was eight months in recovering. During her illness she became much
-reduced in flesh and will. She recovered in flesh, but remained very
-neurasthenic for many months. I made use of all methods of treatment
-by drugs and electricity. I could detect no organic trouble. When
-interrogating the husband, I ascertained that they had, through fear of
-doing injury to the wife, remained continent, and, being too modest,
-had not consulted the family physician on this very delicate subject.
-I immediately advised sexual congress freely, and the neurasthenia
-gradually disappeared. She has since remained in perfect health. She
-was afflicted, as she supposed, with all manner of diseases. She was
-often too feeble to walk, and required assistance or a cane, to walk
-across the room. She was irritable and fretful, often crying, and
-no reason could be given for any trouble, as she was provided with
-everything asked for. It may seem a venturesome advice to render, yet
-I can but urge the natural use of the sexual organs when there is a
-strong erotic excitement, following a long period of continence, when
-this desire is not a morbid one; which is likely to be the case only in
-the depraved, after long abuses.
-
-Were it not for mistakes so commonly made by individuals in selecting
-such imperfect and inadaptable mates, the very poetical words of the
-old maids and bachelors, “_single blessedness_,” might better read,
-“_single cursedness_.” With the chances as they now are, it is an
-important question, whether it is more advisable for a maiden lady to
-marry or to remain continent and pine.
-
-A loathsome abuse of the sexual organs, not usually recognized by the
-fastidious, exists, in which one of the individuals, taking a part in
-this abnormal sexual act, uses the mouth as a vagina. Some of these
-benighted creatures are males, others females. Houses of prostitution
-of the present day are so accommodating to their patrons that they
-keep females who serve degraded males in this manner. I am credibly
-informed that they prefer this method; that the erotic desire has
-been transferred from the genitals to the tongue. Any person who may
-be inclined to exercise a doubt, may easily convince himself of its
-truthfulness by visiting one of the many low-down “houses of ill fame”
-in any one of our large cities.
-
-From _The Laws of Life_ we extract the language of a clergyman:
-
-    “I have officiated at forty weddings since I came here, and in
-    every case save one, I felt that the bride was running an awful
-    risk. Young men of bad habits and fast tendencies never marry
-    girls of their own sort, but demand a wife above suspicion.
-    So, pure, sweet women, kept from the touch of evil through
-    the years of their girlhood, give themselves, with all their
-    costly dower of womanhood, into the keeping of men who, in
-    base associations, have learned to undervalue all that belong
-    to them, and then find no time for repentance in the sad after
-    years. There is but one way out of this that I can see, and
-    that is for you――the young women of the country――to require,
-    in association and marriage, purity for purity, sobriety for
-    sobriety, and honor for honor. There is no reason why the young
-    men of this Christian land should not be just as virtuous as
-    its young women; and if the loss of your society and love be
-    the price they are forced to pay for vice, they will not pay
-    it. I admit, with sadness, that not all our young women are
-    capable of this high standard for themselves or others, but
-    I believe there are enough earnest, thoughtful girls in the
-    society of our country to work wonders if faithfully aroused.”
-
-_Sodomy_, or sexual contact of a human being with an animal, is an
-ancient practice and but little indulged in at the present day; as our
-laws are very rigid against such _degraded and inhuman treatment of
-animals_. There has been a civilizing influence, since human beings
-have organized societies for the “Prevention of Cruelty to Animals.”
-But it will nevertheless be remarked, that this elevating tendency
-came about entirely through the respect for animals, and not for human
-beings. Were it not for love of animal property and legal watch-care
-over our animals, and plenty of opportunity to gratify the sexual
-desire in other ways, the habits of the people would be no better
-than in ancient times, when sodomy so extensively prevailed. This
-beastiality may have been a cause of venereal disease――syphilis――which
-can be traced back to ancient times, without a doubt.
-
-In addition to such abuses, there were worships quite as degrading.
-Phallus was a figure of the virile member, which was carried about
-at the festival of _Bacchus_ as a symbol of the generative powers of
-nature. The _Athenians_, who refused to show proper respect to Phallus,
-were punished by Bacchus with a severe disease of the penis. Such may
-be concluded from the “_History of the Phallus in Greece_.” Priapus
-is now supposed to have been a venereal specialist, differing in no
-respect from such modern specialists, to whom, it is said, votive
-offerings were donated, and his great skill caused him to be worshipped
-and deified; hence the term priapismus, which is commonly applied to
-morbid erections, so frequently occurring in gonorrhœa and paralysis
-of the insane, and which is also applied to the active stage of the
-condition otherwise known as satyriasis.
-
-
-
-
-CHAPTER III.
-
-
-_Onanism._――I have adopted the term Onanism, more especially to
-illustrate a class of conjugal sins, and shall not use it, as generally
-applied, as a synonym for masturbation, but will define the term as it
-should be used. That the meaning of the word may be fully understood I
-will quote the two verses from _Genesis_ xxxviii, 8, 9:
-
-    “And Judah said unto Onan, go in unto thy brother’s wife, and
-    marry her, and raise up seed to thy brother.
-
-    “And Onan knew that the seed should not be his. And it came to
-    pass, when he went in unto his brother’s wife, that he spilled
-    _it_ on the ground, lest that he should give seed to his
-    brother.”
-
-It must not be supposed that Onan used his hand to facilitate an
-emission, but that he simply withdrew his penis and allowed the semen
-to be lost on the ground, to prevent conception. Onanism is practised
-more at the present day by married males than may at first be imagined.
-It is the commonest of all means used as a preventive of conception.
-The majority of so-called society women are wives of men who practice
-Onanism. The word has come to signify masturbation, or any intentional
-process of wasting the seminal fluid. But I have preferred its use
-here as it explains a practice which I have no other word for. The very
-common practice of withdrawing the organ before ejaculation is often
-a very hurtful one, as the orgasm is often incomplete, and there are
-more satisfactory ways of accomplishing what is intended by such a
-practice. Under the strict signification of the term, a child cannot
-be an Onanist, until after puberty, but he may be a masturbator. A
-woman cannot properly be called an Onaness, but she may masturbate
-nevertheless. To present, in a true light, this conjugal vice, I
-excerpt, from the _Ohio Med. and Surg. Reporter_, the following most
-excellent paragraph, which illustrates in the pithy and elegant style
-that speaks volumes of argument, and should be a lasting hint to
-cultured and scientific students in the learned profession of medicine:
-
-    “The sexual instinct has been given to man for the perpetuation
-    of his species; but in order to refine this gift and set
-    limits to its abuse, it has been wisely ordered that a purely
-    intellectual quality――that of love――should find its most
-    passionate expression in the gratification of this instinct.
-    Dissociate the one from the other, and man sinks below the
-    level of a brute. Destroy the reciprocity of the union, and
-    marriage is no longer an equal partnership, but a sensual
-    usurpation on the one side and a loathsome submission on the
-    other. Consider the moral effects of such shameful manœuvres:
-    wedlock lapses into licentiousness; the wife is degraded
-    into a mistress; love and affection change into aversion and
-    hate. Without suffering some penalty, man cannot disturb
-    the conditions of his well-being or trespass beyond its
-    limitations. Let him traverse her physical laws and Nature
-    exacts a forfeit: dare he violate his moral obligations, an
-    offended Deity stands ready to avenge them. That this law
-    is immutable, witness, from the history read to you, the
-    estrangement between the husband and wife; witness his ill
-    health and ill temper, and the wreck of body and mind to which
-    she has been reduced.”
-
-Again, from the _Medical Advance_ for 1876, we find the following
-language written by Dr. Arnalt:
-
-    “There is one phase of sexual depravity to which I would, in
-    passing, call your attention.
-
-    “We are fully aware of the many devices used to avoid
-    impregnation. It may be well to remember that such desires may,
-    under certain circumstances, be excusable; but let us never
-    forget the fact that generally they are conceived in iniquity.
-
-    “Of the many ways of avoiding possible conception, there is one
-    so filthy, mean and degrading, and fraught with such fearfully
-    disastrous consequences to health, that I make special mention
-    of it. I have reference to the practice of withdrawing the male
-    organ from the vagina before the completion of the embrace.
-
-    “But when man brings to the marriage-bed so foul a nature that
-    he can repeatedly and constantly perpetrate such an outrage
-    upon nature’s most precious gifts, he places himself at once
-    beyond the desert of human sympathy.
-
-    “Just imagine, if you please, man and woman in the act of
-    cohabitation; their brain reeling under the powerful stimulus
-    of that all-pervading passion; the heart’s action increased
-    to a high state of intensity; the whole system, with all the
-    energy it is capable of exciting, getting ready for that
-    great act of reproduction; and just as the act is about to be
-    completed, when the soul of the man can almost feel and grasp
-    that of the woman, the evil genius of lust, being more of a
-    fool than a knave, must dash to the ground the chalice filled
-    with ambrosia of purest bliss, if tasted with a pure lip; must
-    turn into the vilest poison the sweetest and holiest gift of
-    nature to man.
-
-    “Why, I have wondered, long and often, that man could sink so
-    low, be so foolish. Just conceive of the intensity of such a
-    shock upon the system, and then have this repeated time after
-    time, year after year. Why there are married people who never
-    once, in all their married life, completely and unreservedly
-    finished the act of cohabitation.
-
-    “No wonder that nervousness, peevishness, and all kinds of
-    distempers show themselves. No wonder we get spermatorrhœa and
-    impotence in the male, and a perfect host of troubles, insanity
-    included, in the woman. No wonder homes are broken up and human
-    lives made desolate.”
-
-
-
-
-CHAPTER IV.
-
-
-_Masturbation._――Under this caption will I proceed with the topic of
-self-abuse; as this term more properly covers the vice of both sexes,
-as well as of childhood.
-
-The small boy, only four years of age, will often titilate his genitals
-until the prepuce has become inflamed and swollen. In this undeveloped
-and delicate condition of the genitalia, more harm may be accomplished
-than could be imagined. Nurse-girls, sometimes, for the purpose of
-quieting a child, will titilate its genital organs; which is quite
-sufficient to lead the child to manipulate its own organs as it goes on
-in age and development. Often a feeble state of health in the child,
-will cause the mother to consult a physician; and the genitalia will
-show signs of irritation; and when the true nature of the difficulty
-is revealed to the mother, it will be much to her surprise, and
-often, disgust; and she will not be convinced beyond a doubt until by
-constantly watching, she has observed actions more convincing than the
-doctor’s hints.
-
-Boys at school teach each other to perform this manual pollution; and
-vile servants initiate small boys at a surprisingly early period. I
-have often gained the confidence of these little ones, and learned
-things more astounding than amusing. Not long since a boy only eight
-years of age convinced me, by his confidential description of his
-little vice, that he realized passion, erection, and as he called
-it the “goodie feeling” (orgasm); which was evidently the sensation
-without emission of semen. No small amount of injury is done to the
-nervous system by the constant titilation of the undeveloped genitalia;
-and as the habit passes on to the puberty-stage of adolescence, the
-novelty of the first ejaculation affords great and frequent amusement
-to the child, and he pursues it as often as he can obtain an obscure
-corner. This must be the time that the greatest harm is wrought upon
-the brain and spinal cord. The first five years succeeding puberty, the
-vice is carried on with great energy in a vigorous youth. Doubtless,
-the majority of boys have practiced masturbation, to some extent, some
-time during adolescence, but as they arrive at the age of discretion,
-become disgusted; or some influential person frightens them, and they
-quit the practice. Where it has only been an occasional indulgence, no
-lasting injury has occurred.
-
-Masturbation is practiced among men, not so much to the injury of their
-physical structure, but it is nevertheless a common vice. Miserly
-bachelors, hermits, and often widowers resort to self-pollution
-when financial affairs prevent their visiting houses of ill fame. I
-am credibly informed that the vice of self-pollution, by the hand,
-prevails largely among soldiers, as well as in convents, and public
-schools.
-
-_Pollution Among Females._――This is less common in childhood than in
-the male. Small girls are naturally more modest than small boys: they
-will not so readily fall into such vices, as they do not readily submit
-to having their genital organs manipulated; they therefore remain
-comparatively free until puberty, and often later; and then the habit
-is not common, but occasionally exists. With the limited opportunities
-for finding out such things, it will undoubtedly be long before an
-estimate, as to the extent that it prevails, can be made. I cannot
-better continue this subject, than by giving a case which is typical
-of many adult cases that I have observed in this peculiar and delicate
-role of physician; and it is not a “cooked” case, but one in actual
-life, which cannot be fully portrayed by type or word:
-
-Mrs. X. visited me professionally; aged 28; mother of three children;
-been married nine years; spare, dark hair and eyes, rather brilliant;
-small of stature; retiring and confiding of disposition. She was very
-neurasthenic and excitable; never hysterical; bowels constipated. I
-prescribed all kinds of treatment for her during the first six weeks,
-after which time, as I had failed to find out anything that might be a
-cause for such a peculiar nervousness, I suggested an examination _per
-vaginam_. As soon as my finger reached the orifice of the vagina, I
-was convinced that my case was a sexual one, as a nervous, passionate
-shiver ran over her; but she soon controlled herself, and I proceeded
-with my examination, with the discovery of only slight general
-irritation. She then gave me the following account of her married life
-and condition. She was married at nineteen, a robust, vigorous girl.
-Her husband was amorous and ignorant of her requirements; would soon
-satisfy his desires and go to sleep, when she had but just become
-excited; but when her erotic excitement was aroused she had no control
-of it: would remain wakeful during the entire night, with the husband
-sleeping, regardless of her condition. She finally learned to use a
-clothes-pin, by which means she could appease her burning and bring
-about an orgasm. She says that she could then sleep. She of late had
-consented to the advancements of a prominent lawyer; but she was
-conscience-stricken and desired, if possible, to be a “good woman;” but
-was satisfied that, to be a virtuous woman, she must remain away from
-her husband, so that her passion never would be beyond her control. I
-immediately, after her departure, sent for the husband, and informed
-him how to perform the marital connection, and that, if he desired that
-his wife should become a well woman, he must adhere to my instructions.
-He was glad of the information, and was successful in his efforts. She
-was soon free from her troublesome neurasthenia, and beatitude prevails
-to this day; and, I believe, she is as virtuous and worthy a woman as a
-man deserves.
-
-Women use tallow candles, clothes-pins, and other commodious means,
-such as friction over the pubes, titilations of the clitoris, etc., for
-the purpose of exciting erotic energy and sexual orgasm. The nervous
-excitement which is wrought, is not unlike shock, from general causes;
-yet, when frequently brought about, may produce an over-stimulation,
-followed by relaxation and general weakness of the nervous system, or a
-neurasthenia, advancing to hysteria and organic disease of the nervous
-system. Various devices have been resorted to to overcome the habit of
-masturbation. Such things may be of service in children, but in adults
-moral treatment alone is of any value; and as to any appliances and
-devices I have nothing new to offer. The old means of blistering, tying
-the hands, etc., may be resorted to with children, by those who have
-confidence in their efficacy. In adults, matrimony will often do good,
-when the habit is in its incipiency; but in an advanced stage it is of
-little benefit.
-
-The great variety of unnatural ways of gratifying the sexual passion
-is only an evidence of human depravity; and the entailed diseases must
-be unreservedly studied, that, as much as possible, these abominable
-conditions may be confined within a certain limit, which should be
-legally set apart and licensed, that the chaste and elevated portions
-of society may find protection.
-
-These conditions all exist: there is no remedy to abort or expunge
-them; and the numerous diseases, growing out of this great depravity
-and mismanagement of the sexual, must all be duly considered, by the
-medical man, as predisposing and exciting causes of neurine maladies.
-To prevent the spread of disease, should be the chief aim of every
-humane citizen, and more especially the physician. Much is said in
-regard to means and legislation to prohibit the spread of venereal
-disease; but the nervous diseases caused by sexual debauch and
-mismanagement are of equal importance and as devastating to the race.
-
-If we can give credence to what Dr. S. W. Gross says, in the May
-number, 1877, _Medical and Surgical Reporter_, of Philadelphia,
-masturbation has, in his cases, caused fifteen out of nineteen cases
-of urethral stricture, while four were caused by gonorrhœa. I am not
-aware of any such proportions reported by any other authority, yet I am
-thoroughly convinced that masturbation has existed in a great majority
-of cases of urethral stricture, and in many such cases has been a
-cause, primarily or secondarily. It is not far from true to say, that
-a large proportion of masturbators, of advanced age, have a general
-contraction of the entire urethral canal and a diminished dilatability.
-Purulent discharges and abscesses are not uncommon along the course of
-the urethra and prostate gland, followed by folicular disintegration
-and perforation.
-
-_The Effect of Sexual Excesses upon the Neural Axis as a Cause of
-Organic Disease._――“_Sexual excesses_ and _Onanism_ are certainly of no
-slight significance, at least in the development of a predisposition
-to tabes.” (Erb.) Again, in speaking of causes in general of spinal
-disease, the same author says: (P. 147, Ziemssen’s Cyclopœdia, vol.
-XIII.)
-
-    “Of these (causes) _sexual excesses_ and _irregularities_
-    occupy the first place. * * * * I believe we may say that
-    _any gratification of the sexual passions, whether natural or
-    unnatural, indulged in to an excess and for a long time, forms
-    for many men――not for all――a circumstance that powerfully
-    depresses the spinal cord and predisposes it to disease_.” * *
-    * *
-
-    “_Excessive natural coitus_, in many persons, certainly
-    produces symptoms which point to a weakness and a diminished
-    functional capacity on the part of the spinal cord; weakness of
-    the legs, inability to stand for a long time, trembling when
-    forcible movements are made, pains in the back, shooting pains
-    in the legs, sleeplessness, etc. This may often be noticed in
-    the newly married, or in persons who have indulged in great
-    excess for a short time. If the cause of these symptoms soon
-    disappears, the injury may in most cases be quickly repaired;
-    but if the excesses are continued, further injury, or even
-    positive disease, occurs. Any external injury, exposure to
-    cold, excessive walking, etc., may then bring on the worst
-    results.”
-
-
-
-
-CHAPTER V.
-
-
-_Copulation――Physiology and Social Attributes._――With the male, the
-condition essential to coition is erection of the penis; which is
-physiologically accomplished by fostering amative thoughts, and by
-attitudes favorable to the stimulation of the erotic desire; as in
-close proximity with one of the opposite sex. A voluptuous female
-figure may excite the erotic instinct of an amative male in vigorous
-health, even though he be chaste in his intentions and habits.
-Individuals are isolated whose amative passions are entirely under
-the will, when in perfect health, of either sex. The act of coition
-is entirely under the will, in all healthy, well-organized human
-beings; but it is not uncommon that a man or woman is observed who is
-not responsible for acts during erotic excitement. Such are either
-victims of mal-organization or a sexual delirium. Many an act has been
-committed during such delirium or excitement, on account of which an
-individual has grieved her life away, or sought the only refuge that
-could hide her life from shame; the victim’s grave, the river: yes,
-a victim to sexual delirium or uncontrollable sexual passion. This
-innate desire is the usual instigation of copulation, and has been said
-to be the index to the presence of spermatozoa within the vesiculæ
-seminales.
-
-Copulation may take place in the female before puberty or after
-the climacteric period; but in neither will the sexual congress
-be fruitful. Then, if the signification be confined to fruitful
-contact, there would seem to be a marital discrepancy between the
-male and female; as in the female we observe only thirty years of her
-existence in which it is possible for sexual congress to be followed
-by conception; while the male, from puberty to very old age, may be
-fruitful, if placed in conjunction with a female at the proper age.
-Nature, being rather wise in this respect, has not deprived the female
-of her sexual passion and pleasure at the limit of her fructification
-period.
-
-Perfect coitus is not essential to impregnation; as many authenticated
-cases are on record in which intromission had not taken place, as
-evidenced by an unruptured hymen, where only it was possible for the
-semen to come in contact with the sphincter vaginæ; and impregnation
-and conception followed. Only by contrasting natural with abnormal
-coition, is it possible for us to comprehend how much one subject
-has to do in causing nervous diseases; and not to advocate that
-normal coition――which refers to time as much as manner――produces many
-permanent morbid changes.
-
-_Copulation, practiced in moderation, is conducive to domestic felicity
-only when both parties to the marriage contract are in a state of
-health sexually._ This excludes sexual contact in too close proximity
-to the menstrual crisis, and whenever the female is not in a condition
-to appreciate the act, and that her condition and will should be
-considered and respected, and man at all times should consult her
-pleasure.
-
-For further information on the physiology of copulation, I must refer
-the reader to _Flint’s Human Physiology_, where it is treated of in an
-exhaustive manner. But there are many points of interest that are not
-alone physiological, that may well be discussed and belong especially
-to our subject.
-
-There seems to be a chosen time for fruitful coition with all
-animals. With the human race this is only partially true. The female,
-it is said, begins her period of breeding usually at fourteen and
-discontinues at forty-five; yet there are intermediate periods
-when copulation will not usually prove fruitful, viz., that period
-beginning the fourteenth day after menstruation, and ending with the
-next menstrual flow. This rule is not valid; as many times, in my own
-observation, have I known women to conceive at any and all times during
-her period of breeding. Even cases have occurred where the period
-of menstruation was not confined to the usual time of life; or the
-“second life” may appear, as in the following case which came under my
-observation some years since:
-
-A Mrs. H. ceased menstruating at 52, was free from menstrual flow
-until 71 years of age, and then menstruated regularly (a perfect
-menstrual flow), every 40 days, until she died at the age of 76. She
-possessed the erotic desire and enjoyed coition. Her husband died two
-years before she did. She became confused in religious doctrines after
-her husband’s death; was melancholy and fond of isolation; committed
-suicide by hanging herself to her bedpost. I assisted in cutting the
-scarf and learned all particulars of her past life from friends and her
-physician.
-
-Many cases are on record of females menstruating at very early periods.
-As to these discharges being indicative of the reproductive stage, much
-doubt may be expressed. It is very common for the male to retain his
-virility to a very advanced age. I am acquainted with an octogenarian,
-who married a young girl of nineteen, whose copulation was fruitful
-and the child healthy. This is doubtless not so very uncommon, in
-proportion to the circumstances offered for a test.
-
-We would naturally conclude that, on account of prostitution and
-debauch, it was necessary that marriage become a legally organized
-institution. There is no evidence that in early history marriage
-was any more than a choice, the consummation of which was simply the
-invocation of a superhuman or divine watch-care; that they were bound
-in wedlock, not by statute law, but by a superstitious belief and
-natural selection. Natural selection was more cultivated and was a
-better guidance than in modern times, when law governs the joining and
-casting asunder. Copulation is the key to morality and society. So
-certain bonds of restriction and moral government of a social character
-exist, and they are made to restrain human beings and to control
-and limit copulation to a legitimate sphere; viz., man and wife.
-Any deviation from this legitimate course has long been denominated
-prostitution, which exists in public and private.
-
-The vice of changing partners has become so open and for such trivial
-causes that laws have been enacted, of the most rigid character, and
-then divorcing and remarrying are carried on to an alarming extent.
-These are only the attributes of copulation and erotic desire.
-
-Natural copulative affinity constitutes the bond of chaste affection
-that holds together a man and wife in harmony and love. Parties, male
-and female, have existed just as happily during life, when marriage
-vows had never been solemnized and legalized by other than natural
-copulative affinity. This sexual affinity constitutes more than
-mere admiration, or transient passion or erotic anxiety: everlasting
-contentment and felicity will follow such natural adaptation. Some are
-contented in wedlock, as they possess submissive dispositions, who are
-not adapted by copulative affinity.
-
-Society is partial in her endowments and liberties bestowed upon the
-sexes. The male enjoys favors at the hands of society not permitted the
-female. For this, on account of her innate propensities, the female
-is responsible. She will expunge a female from her circle of society
-for that for which she will sustain the male. She will encourage
-insults from man, and cry for woman’s rights, and against masculine
-maltreatment. She will receive, with open arms, the young father of a
-prospective bastard, and commit the equal participant, and prospective,
-victimized mother, whose sins can only be equal to those of the father,
-to a dungeon, or permit her to accept a life of shame by refusing her
-entrance at the threshold.
-
-If these are the privileges of modern society _now_, what would women
-do with the fallen ones of their sex had they things as they so much
-desire, in “woman’s rights” circles? Every female who had made a
-mistake (that should become known) would be tortured at the rack, or
-murdered; and few would there be left to tell the tale. The moral
-beginning must be with woman. She must not offer premiums for male
-licentiousness, and must encourage her fallen sisters to “sin no
-more.” She must protect her own sex by showing forgiveness, as well
-as censuring. So far as effecting any change, moral teaching is of
-the greatest vanity. But these things are not looked upon in their
-true light. Sexualists discuss these subjects, who do not appreciate
-the first principles of sexual physiology; who do not comprehend that
-the sexual relation in itself is the very essence of deception, as of
-secrecy. The cunning devices of both male and female are exhausted by
-efforts at assignation and debauch. The greater the legal restriction
-the greater the deception. The more common, open and generous our
-society becomes, the better will be its constituents.
-
-
-
-
-CHAPTER VI.
-
-
-_Nymphomania._――The most deplorable condition of all, to which the
-female is subject, is the uncontrollable, maniacal, erotic desire,
-called nymphomania. The disease is fortunately rare, and commonly
-makes its appearance at, or soon after puberty, but has been observed
-in adult and married women. Of the six cases that have come under my
-observation, one was a married woman, the mother of children, four were
-girls at puberty and one, which will be hereafter reported, aged 19
-years.
-
-In the commencement the sufferer is a prey to perpetual contest between
-feelings of modesty and impetuous desires. At an after period she
-abandons herself to the latter, seeking no longer to restrain them. In
-the last stage the obscenity is disgusting; and the mental alienation,
-for such it is, becomes complete. The cause is often obscure, but when
-known has been undue irritation, by titilation of the genitals, or
-anything that would cause turgescence. The disease is apparently local
-in the beginning, but seems to affect the entire nervous organization,
-through reflex excitation.
-
-The clitoris, by some, is supposed to be the seat of irritation, and
-has been amputated or cauterized, but without generally effecting
-any relief. The disease is not generally confined to any particular
-locality of the genitals. If allowed, the patient will take the hand of
-the male and place it upon the _mons veneris_, and it is only by force
-that she will allow it to be taken away. She cannot locate the seat
-of pleasure, but will say that the entire surface touched contributes
-to the venereal excitement. Another peculiar feature is, that she
-obtains no satisfaction from venereal orgasm; but on the contrary it
-adds to her maniacal conduct and obscenity. She is not in any manner
-responsible for her conduct, and no punishment will cause her to
-desist. Everything is sacrificed that is feminine, for that which is
-disgusting and vulgar. The more modest she has been in health, the
-more obscene she is likely to become in her venereal frenzy. What the
-final result would be, without treatment, I have never witnessed, but
-must conclude that lunacy would soon be prominent and probably suicide.
-There is no tendency to recovery, but to continue from bad to worse,
-until publicity is no restraint to the obscenity and indecent conduct
-of the victim.
-
-_Case._――Nymphomania, with nocturnal involuntary orgasm. Miss U.――She
-was aged 19, very small in stature, only weighing 90 pounds, of very
-respectable family and herself perfectly respectable. She was refused
-by her probable “intended,” who had discovered signs entirely unnatural
-for her, in whom he had placed implicit trust. When the condition was
-first manifested in her, the intended, not thinking of anything wrong
-on her part, attempted to gratify her morbid erotic desire by coition,
-which only made her, as he said, “nearly crazy.” She had heretofore
-been modest and distant, but now she was on his lap, and all over him
-or leading him to a place of decumbiture. When she visited my office,
-and imparted to me her whole confidence, my first treatment toward
-her was so rigid and distant that my examination revealed the parts
-before orgasm had taken place; but as soon as I touched the nymphæ;
-they became lubricated with a thin viscid fluid which was profuse. At
-first the clitoris and nymphæ were red, dry and hot; but as my digit
-came in contact with the soft parts, she forgot the rough treatment
-and my cold conduct toward her, which I had assumed to prevent, if
-possible, her venereal crisis, and she became unmanageable for the
-time, until she had passed three or four orgasms, as I supposed, one
-immediately following the other, when she became more governable. To
-carefully portray in words what she said and did would be shocking to
-a fastidious doctor. With a speculum in the vagina the os uteri would
-contract and dilate in alternation, and undergo orgasms in rapid
-succession, with only a few seconds interval. She begged of me not to
-withdraw the instrument, but when I had completed my examination she
-was partially exhausted and docile. I could discover a mucoid fluid
-emitting from the os uteri which evolved a strong venereal odor.
-
-She informed me that she had voluptuous dreams nightly――as many as
-three in a night. Her figure is small and round, eyes black, hair coal
-black, countenance very sallow and chlorotic. She seemed to know that
-this condition was not right, but her modesty was entirely gone, when
-in company with a male. The presence of a woman restrained her. Her
-own mother had not determined the true nature of her difficulty, only
-noticed that something was peculiar with her daughter. The patient had
-judgment enough left to go out of the room and isolate herself when a
-man would come about. The advent of this disease she says was first
-known by a peculiar thrill at the sight of a male, which became more
-aggravated from day to day. Now, one year has she suffered from this
-intolerable mania.
-
-To pass over and not give the treatment would leave the case quite
-incomplete.
-
-_Treatment._――I directed monobromated camph., in two gr. pills, one
-every 4 hours, with formula No. 1, as directed; ice-water to the vulva
-nights, with daily applications of Faradisation by placing a wetted
-sponge upon a chair with the patient seated upon it, to which the
-negative pole is attached; used the positive in my left hand, with my
-right hand applied to the head and down the spine. Improvement took
-place from the beginning, and in forty days she was quite herself.
-She was improved in flesh, color and strength. In two months she was
-so modest that I could scarce gather courage to ask her if she was
-yet troubled with any signs of her old affliction. I could not obtain
-consent to make another physical examination, and she remains well,
-but is continuing to take the medicine, from formula No. 1. She has
-strength of will, I am informed by her “intended,” to refuse any degree
-of proximity. He says, “It seems like a dream. I am learning to court
-her over again, and succeed very slowly. She is so distant.”
-
-The two cases reported by Prof. S. H. Potter in the April number of
-_Am. Med. Journal_, 1876, do not overdraw the picture, any one will
-testify who has had a few of these perplexing patients to manage.
-
-    “Miss M. T., age 18 years, of sanguine temperament, quite
-    corpulent for her age, a wealthy farmer’s daughter,
-    distinguished for her modesty, intelligence, prudence and good
-    social qualities.
-
-    “_History._――In the hot weather of August, the writer was
-    called 15 miles to consult with Dr. A., the family physician of
-    Mr. T. About three weeks prior to this, Miss T. had suddenly
-    exhibited paroxysms of uncontrollable desire for coition.
-    When any young gentleman chanced to call upon the family, she
-    would elevate her apparel under her arms, approach and attempt
-    an embrace in the most lascivious manner, until forced to
-    desist by the interference of the overpowering strength of the
-    persons present. At first these scenes were at intervals, with
-    intervening times of great dejection, gloominess and silence.
-    The father being of rather a superstitious nature, thought her
-    ‘possessed of the devil,’ and resorted to repeated and severe
-    flagellations without effecting any perceptible reform. During
-    the last week her excitement had been almost continuous, and
-    she had been confined to and locked in her room. It may well be
-    supposed that the case had excited the entire neighborhood to
-    wonder and amazement, and in some of the more thoughtful, deep
-    sympathy, and through their advice the physician was called.
-
-    “Examination with a glass speculum showed an irritating fluid
-    oozing from the os uteri; the whole surface of the vagina,
-    the nymphæ clitoris and the vulva were suffering from active
-    congestion. Exalted general sensation was apparent, and the
-    slightest touch of the internal labia or clitoris produced the
-    most exquisite amorous excitement――an uncontrollable mania.
-
-    “_Case II._――Was called to see Mrs. F., of this city, September
-    last, age 30, a grass widow by third marriage. Found her in
-    violent hysterical spasms, with usual accompanying symptoms.
-    Her aunt, with whom she was then visiting, gave the following:
-
-    “_History of the Case._――For some time past she had exhibited
-    lasciviousness; had to be kept under surveillance; to-day
-    the aunt had ‘been out shopping;’ on coming home she found
-    her niece in a sequestered place with exposed nudity quite
-    shocking, and using persistent artifice to effect coition with
-    a canine Newfoundlander. The aunt so rashly interposed, that
-    the niece ‘went into alarming and persistent spasms.’”
-
-Dr. Potter further says that examination showed this case to be one of
-nymphomania, relying upon the turgescence of the clitoris and nymphæ
-and ichorous discharge from the os uteri as diagnostic.
-
-It may be remarked that such turgescence not uncommonly produces an
-exalted erotic desire which is analogous to turgescence of the urethra
-in the male, manifested in gonorrhœal priapism.
-
-Such irritations are not always peripheral in origin, as may be
-supposed, but more commonly a general neurasthenia, or at times a
-spinal turgescence, which qualifies the genitals for any disturbing
-titilations that come along. This may seem more evident, when it is
-once considered, that a hyperæmia of the nymphæ and clitoris may and
-has often existed and no nymphomania; and if the peculiar centric
-condition does not first exist, there will be no local venereal
-turgescence of the genitalia.
-
-Ovarian and uterine disease may produce first, a determination of
-blood to the cord, and then, by slight irritation of the vulva, the
-condition, nymphomania, may be established. Such is perhaps the most
-common cause; and the more have we reason to conclude so, from the
-fact, that the majority of these cases appear soon after puberty, when
-the first crisis of femininity has wrought its effect upon the uterus
-and ovaries. At such times is self-pollution most likely to produce a
-striking impression upon those organs, and most likely to bring about
-nervous shock by calling a superabundance of liquor-sanguinis to the
-developing genitalia and reproductive organs. This shock is sometimes
-so apparent that fainting results and alarming symptoms follow. To
-relate a case will the better illustrate what may sometimes occur.
-
-_Case._――Miss E. H., under the following peculiar circumstances, I
-was informed, needed my services, as it was known that I was the
-physician of her family. A young man, whom I well knew, came after me
-and returned with me to the house, and during our ride, he related the
-following story, to which I had reason to give entire credit:
-
-The young man and the patient were “sitting up” with a sick lady.
-During the night, when all was quiet, the young man had taken the
-liberty to place his hand upon the genitalia of Miss H., when he
-noticed that she rolled her eyes in rather a peculiar manner which he
-considered only submission, as she leaned toward him in a very passive
-manner. He took her in his arms and placed her on a couch, replaced his
-hand, introducing his finger into the vagina, when he became alarmed at
-seeing her froth at the mouth, with slight muscular twitchings of the
-eyes and mouth. He attempted to arouse her, but failed and, becoming
-still more frightened, called the family, and hastened to my office.
-
-I found the patient, Miss H., who was aged 18, fleshy (her weight was
-150 pounds), had been a very healthy girl, of an excellent family, and
-rather pleasant in disposition. She had always been very modest and
-retiring; had rosy cheeks, black hair and eyes. She was then in a very
-delirious state, with pupils contracted, face flushed, no cramping,
-feet cold; head very hot, with occasional epileptiform movements of the
-eyes and mouth; biting the tongue and frothing at the mouth; twitching
-of the facial muscles and sphincters. I informed an old lady that I
-suspected some private trouble and invited her _only_, to remain in
-the room while I made an external inspection, which only gave me the
-satisfaction of knowing that nothing was the matter with her genitals,
-and that the young man had not deceived me and effected intromission,
-as the hymen was perfect.
-
-A large dose of chloral hydrate produced quietude for the night, and I
-ordered her to be taken home as soon as she was rested by sleep.
-
-I visited her the next morning at her own home. She was conscious, with
-pulse at 120; temperature, 102; pupils contracted, and face flushed;
-skin dry; tongue dry and red; asking for water often; head drawn back;
-throbbing of the carotids, with spasms of the dorsal and posterior
-cervical muscles.
-
-She had never been sick, and she had never been of a nervous habit; and
-such a condition was entirely unexpected. There was no epidemic of such
-a character, and no accountable cause except that given. Her case was
-of an inflammatory type and lasted twenty-one days.
-
-Treated by large doses of gelseminum, veratrum viride, and quinine when
-safe. The case was a sthenic one throughout, a meningitis without a
-doubt, and no cause but venereal shock.
-
-When she recovered I asked her if she remembered what occurred during
-the night of her falling sick, and she flushed, but finally confessed
-knowing when he put his hand upon her genitalia, when she thought she
-fainted; but casually remarked, “I don’t understand it, but I had no
-power to prevent him doing so.”
-
-The young man again informed me that his hand was upon the vulva,
-perhaps a minute, when he noticed a strange expression on her
-countenance.
-
-The shock did not occur at or near her menstrual period, and she
-menstruated during convalescence, which her mother informed me was a
-period six weeks from her previous time. She never entirely recovered
-her mental vigor, and remained single till three years ago, when she
-married, and all has gone well.
-
-The shock can only be attributed to that susceptibility to nervous
-impressions so common to the female reproductive organs in the stage of
-development. There is a strong probability that had this nervous shock
-been less impressive in character and more prolonged, a nymphomania
-might have occurred.
-
-
-
-
-CHAPTER VII.
-
-
-_Satyriasis._――Not the female _only_, suffers from an ungovernable
-venereal desire, but the male also is, at times, the subject of a
-disease, analogous to nymphomania of the female. Such is the disease
-termed satyriasis. A young married man says to me, in the following
-forcible language, “My penis is stiff all night. I can’t let my wife
-rest, and she is nearly dead, and I am tired out myself; but as soon as
-I see a woman, my penis rears up like the proud standard of Wellington.
-What shall I do?” His penis became erect while I was examining it. I
-could not see anything unnatural, only it was enormously large. He
-had not been a debauché, neither had he masturbated to any degree
-of injury. There was no spermatorrhœa. He said that it required a
-more than ordinarily long time to bring about venereal orgasm, after
-which erection would remain in situ until he went to the hydrant and
-drenched his penis in cold water; but as soon as he went back to bed
-with his wife his penis would become erect immediately. He had suffered
-a month in this manner. He had not been a very amorous man before
-this, but confessed having obtained and enjoyed a usually temperate
-allowance previous to marriage. This patient had always been of a
-robust appearance, but when he consulted me was beginning to look worn
-and anxious, with sunken eyes from want of sleep and mental unrest. He
-suffered from pain in his back, head and through his lumbar spine. Deep
-pressure revealed tenderness over sacrum and last lumbar vertebra. His
-general symptoms were those of spinal hyperæmia.
-
-_Treatment._――Bromide potassium, grs. xx, 3 times a day, with general
-Faradisation and central galvanization (after the method of Beard &
-Rockwell), soon gave him relief, and after ten applications no more
-difficulty was experienced; but a number of months was required before
-his general health was restored.
-
-The symptoms of spinal hyperæmia were very prominent in this case,
-viz., pain in the cord, not affected by digital pressure, increased
-by lying down and diminished by sitting. His erections were not
-troublesome, only when he was in bed lying on his back: this point it
-will be well to remember. Many of the symptoms so commonly existing in
-spinal hyperæmia are absent.
-
-Many cases occur of a peripheral origin, from inflammation of the
-mucous membrane of the urethra or prepuce. Gonorrhœa commonly causes
-a peripheral satyriasis; but this soon passes away and is of minor
-importance compared to the disease which is intended as the premise
-of this chapter. Morbid erections appear without erotic desire, and
-peripheral causes commonly give rise to this condition. It may not
-be properly considered a disease, as it is so commonly symptomatic
-of spinal hyperæmia. And never, as yet, have I observed this morbid
-exaltation of the amative desire without spinal symptoms, with the
-usual diagnostic signs of spinal hyperæmia of the posterior columns.
-The treatment, to be followed by success, must be of such a character
-as will relieve any centric local hyperæmia, and as such treatment
-seems to give relief is additional evidence of centric turgescence.
-As a treatment for the disease, bromide of potass and ergot must be
-administered in large doses, with the addition of galvanism alternated
-with Faradisation. Cleanliness of the genitalia is indispensable, as
-well as the removal of any morbid condition or irritating influence.
-
-Satyriasis may exist as a very troublesome reflex condition in many
-painful affections of proximate regions; indurations, hæmorrhoids and
-cancer of the rectum, irritation of the bladder or prostate gland, or
-by caluli in either bladder or pelvis of the kidney.
-
-_Case._――Jno. C. consulted me on numerous occasions for troublesome
-erections. His kidneys were painful under a mild Faradic current;
-his water was high-colored and urethra contracted in calibre, with
-folicular inflammation periodically appearing, and giving great
-annoyance by the discharge produced. Dilatation of the urethra to full
-size has finally given permanent relief from the most troublesome
-morbid erections, and other reflex nervous manifestations.
-
-In such cases, no agent controls reflex irritations like bromide
-potassium; but it must be given in large doses. When causes cannot
-be removed, the satyriasis may or may not pass away by appropriate
-management, or it may be controlled temporarily and return again. I
-have more than once known this condition to appear and reappear in
-cancer of the rectum and testes, which was a troublesome feature, with
-intervals, during the existence of the patient.
-
-The local causes, if possible, must be removed.
-
-For the treatment of spinal congestion, see page 92.
-
-
-
-
-CHAPTER VIII.
-
-
-_Sexual Neurasthenia._――Another and more general aspect of the results
-of the sexual mismanagement will be studied under the above heading.
-The general weakness, nervousness, general debility, general nervous
-exhaustion, proceeding from sexual excesses, will be considered from
-another stand-point than those, subsequently, which are considered
-and named, more from the more attractive phenomena, than from an
-understanding of their pathological anatomy. A generalization of signs,
-symptoms, and conditions of sexual weakness, covers a multitude of
-manifestations found under other names, but calculated more especially
-to assist in the study of a weakness not depending upon observable
-organic disease.
-
-Sexual neurasthenia differs from neurasthenia of other origin, in that
-the former is always coupled with weakness of the genital organs, which
-is not necessarily the case in neurasthenia of mental origin. Again,
-the genital weakness is always traceable to sexual excesses or juvenile
-pollution.
-
-The most troublesome form of neurasthenia is the sexual. There are but
-few symptoms in common with neurasthenia from any cause that do not
-appear in this variety.
-
-The diagnosis, or line of demarkation between sexual neurasthenia and
-the variety of actual organic diseases, is not always well defined. It
-undoubtedly forms a stage beyond which is structural disease of sexual
-excess, or the cause is perpetuated. I cannot admit that true impotence
-and spermatorrhœa are concomitants of neurasthenia, as they are
-phenomena of structural changes; but a threatened condition may exist.
-In this, I believe, I am at variance with some modern writers high in
-authority.
-
-For the most satisfactory description of this disease, and the
-application of the term, neurasthenia, the profession is indebted
-to Geo. M. Beard, who has given the subject a most thorough review
-in periodicals and in Beard and Rockwell’s _Medical and Surgical
-Electricity_. In 1869, Beard published an article in the _Boston
-Medical and Surgical Journal_, giving illustrations of thirty
-cases treated principally by electricity; and again, with a better
-understanding of the cerebral and spinal forms, he presented a paper
-before the _New York Neurological Society_, in 1877, which was
-published in the _New York Medical Journal_. Other papers, by the
-same author, have appeared, which evince a careful study of nervous
-weakness. Erb has given also a very excellent treatise in vol. XIII of
-Ziemssen’s “Cyclopœdia.” Authors have not, thus far, given due credit
-to the sexual organs as a cause of neurasthenia. Erb treats of the
-disease in a confused manner, in portions of his treatise, compared
-to his clearness on other subjects, evincing more book theories than
-facts from clinical observation. In generalizing he is clear, but in
-classifying, he is not particular enough in pointing out the different
-signs of neurasthenia originating from the brain, from that form
-belonging to the spinal cord.
-
-The most common form of nervous manifestations is such as would lead
-one to think of exhaustion of the forces usually attributed to the
-structures of the cord: the nervous energies are very much depleted.
-They seem, at times, to be duly supplied, but the forces may as quickly
-depart and leave the system languid and depressed, without power to
-coordinate the muscles. This more especially applies to a certain class
-of cases which assimilate organic trouble in the nervous structure. No
-change observable takes place in the circulation, yet it must stand to
-reason that the replenishing power of the nerve-matter is deficient.
-This must be impaired nutrition, and a lower order of nerve-structure
-organized, not capable of evolving so perfect a function or
-force――nervous energy. This suspension of nervous energies is only
-transitory when a fair degree of activity is established. This would
-seem to be caused by depriving the nerve-tissues of elements demanded
-to supply natural waste; which is, in all probability, the true nature
-of this exhaustion.
-
-We have neither spermatorrhœa nor impotency, in the strict sense of
-these terms. They perform the sexual function well, but lack power to
-repeat the act as often as healthy people are wont to do. Sometimes
-they cannot control their ejaculation during various conditions of
-excitement, fear, or fright. It is in this condition that a lack
-of confidence in the sexual ability is had at certain times when
-copulation would be the most desired. It is in such cases that a young
-man complains of chagrin and embarrassment. Many a time have young men
-described their afflictions in the language more forcible than elegant,
-describing such opportunities with voluptuous “sylphs,” saying, “he
-went back on me.” This is a weakness of the genital organ, having lost
-its innate power to become erect, in which all the powers of mind and
-will, concentrated upon the act, are required to establish the erect
-posture. Whenever any great mental effort is required to procure an
-erection, either there is local weakness, or there has been too often
-repeated sexual contact, which has not been followed by proper rest; or
-the female has not a fascinating influence over the male.
-
-The general weakness, so much the cause of alarm in young men, and
-yet not of the least danger, is the typical case of neurasthenia. The
-young man consults a doctor, with a long discourse of his symptoms: he
-has read a book on indiscretions of youth; feels badly; has had erotic
-dreams once a month; is “nervous,” feels languid, and apprehends danger.
-
-Medical students, when listening to lectures graphically picturing
-disease of the genital organs from sexual debauch, all have each and
-every form, with the rare and peculiar sequelæ. They consult the
-professor in whom they repose the most confidence, only to receive the
-assurance that nothing is the matter, only a little weakness which will
-soon of itself subside.
-
-In treating of sexual neurasthenia I can but confine myself to that
-functional derangement caused, directly or indirectly, by the supposed
-lack of endurance of the genital organs and the coëxisting nervous
-weakness.
-
-The fact that nearly all young men have at some period polluted, gives
-them a cause to fear that any nervous debility discovered may be
-caused by their early indiscretions. In this they are deceived, and
-only putting their minds at ease will dispel, often, the cause of this
-perpetuation. I am often consulted by literary men, who only need rest
-to be free from this languor. A zealous divine consulted me, with the
-impression that he was afflicted with some organic nervous disease or
-brain disease. After examining him closely, and assuring him that he
-had only a nervous weakness of a functional character, he thought best
-to confess all by saying that he had been “wild” in his youth, and he
-was laboring under great fear that he was beginning to feel its latent
-influence upon his brain. I again assured him that it was entirety
-impossible for him to become in any manner afflicted with a brain
-disease.
-
-The transitory character of all neurasthenic symptoms is quite
-sufficient to distinguish this from organic disease. On one day the
-patient feels badly, with some signs of organic neurosis; but the next
-day he has forgotten that group of symptoms, and another is complained
-of; or he may be free and light, and in bright spirits; but whenever
-he feels weak and languid, the first thing he thinks of is his early
-indiscretion.
-
-_Neurasthenia Caused by Sexual Excess and Domestic Infelicity_――_Case._――Mrs.
-M., the mother of two children, passed through four abortions, came
-lately from Chicago to this city and, perchance, became my patient, when
-I learned her history. She had sustained a fracture of the left parietal
-bone and suffered some from compression. The specula was removed in
-Chicago. The injury was caused by a heavy glass, hurled by her husband
-in a fit of jealous rage. She is fleshy, weighing 135 pounds, and rather
-short; has some time been given to drink, to cover domestic infelicity;
-her face is florid, and on the least excitement becomes purple and
-ecchymosed in spots; she feels, sometimes, as if she would faint; often
-has vertigo, tingling in feet and hands, sickness at the stomach; she
-never cramps, but often cries, feels languid all the time, and lies in
-bed the most of the day; pulse normal, sometimes a little intermittent;
-tongue natural and bowels regular; no belt sensation; no tenderness in
-the cord; no bladder trouble.
-
-Her husband compelled her to submit to his embraces three or four
-times on Sunday and every night during the week; and this had been
-practiced, with only menstrual intervals and when too sick to submit,
-for six years. She is peevish and fretful, and suffering from general
-exhaustion.
-
-There are many manifestations of neurasthenia, when the cause has been
-from the sexual; prominent among which is irritability, exhaustion, and
-sleeplessness following sexual congress; nervous headache with black
-line under both eyes the next day; creeping sensation and itching of
-the skin, without any abnormal appearance to cause it; formication,
-numbness of the hands and feet, flushed face, tenderness and pains
-that are transitory: all without any detection of organic disease;
-not but what such symptoms exist in organic disease, but they are
-more permanent, when they do exist, and can be associated with some
-assurance. I have had my mind on the point of naming and searching for
-numerous organic and spinal and cerebral affections, when the patient
-would multiply antagonistic symptoms so rapidly that I have often
-concluded that my patient had a new and serious combination of lesions.
-
-Organic disease generally has a set of signs and phenomena entirely in
-accordance with structures involved; but neurasthenic symptoms are most
-commonly such as are antagonistic to any two forms of neurosis.
-
-A greater variety of symptoms exists in neurasthenia than any organic
-disease. Symptoms of one organic disease are common one day, and of
-another the next day; and though the two organic manifestations were
-wholly different, the patient on the third day will perceive them all
-combined and aggravated.
-
-Not all cases of neurasthenia can be attributed to the genital organs.
-In my experience cases, arising from sexual irritation and other
-causes, are very evenly divided. I have often been convinced of genital
-irritation being caused from neurasthenia; but as I have intended the
-more to discuss sexual neurasthenia, in Neurasthenia from Genital
-Irritation, I shall be compelled to leave the subject with only having
-mentioned its bearing on sexual irritation as a cause.
-
-Neurasthenia does not differ, when of a genital origin, from the same
-disease of other origin; only that the genital irritation antedates the
-neurasthenia.
-
-It has been said that neurasthenia usually confines itself to the
-nervous diathesis. If we only had a definite condition, known as the
-nervous diathesis, that could be relied on, much would be gained. Some
-of the most troublesome cases of neurasthenia have appeared in persons
-whom no one would point out as possessing a nervous diathesis. Beard
-says, “Among the chief signs of a nervous diathesis are fine, soft
-skin, fine hair, delicately cut features and tapering extremities.”
-
-These are often marked features in nervous women, but neurasthenia has
-existed in persons coarse, dark, thick-skinned, clump-fingered, and
-very uncomely in shape; often large and fleshy.
-
-In attempting to show the relation of neurasthenia to the genitals in
-both male and female, it will lend information to relate a few cases:
-
-_Case._――Jno. B. wishes to know what makes him so “fidgety and
-good-for-nothing.” He says he has visited his intended, to whom he
-is “engaged to be married,” twice a week for nearly two years. “We
-are very intimate and kiss and embrace: I think too much of her to
-do anything wrong. My penis is up all the time I am with her; and
-when I go home my testicles are sore, and I lie awake all night.”
-This is typical, as a cause from continuance; and if the female is as
-amorous as the male, she will also become nervous and irritable. The
-restlessness, following the protracted turgescence of the genitals,
-is a fruitful cause of neurasthenia. Yet all will gradually pass away
-after marriage, which should be advised speedily. With nymphomania,
-there commonly exists a neurasthenia that long remains after all signs
-of any organic disease have disappeared.
-
-Mrs. M., aged 26; the mother of one healthy child; rather adipose;
-short and firm of organization; flushed face; weight, 140 pounds;
-apparently a very vigorous woman. She cannot endure any muscular
-effort of any kind, as she becomes exhausted; dizziness, formication,
-sickness at the stomach, one day; coldness of feet and hands, with
-paresis of first one side then the other, tingling of the tongue; no
-hysterical manifestations, cramping or fainting, at any time. Uterus
-is normal; no tenderness along the spine. Sometimes a local hyperæmia
-of the brain exists, but only lasts a short time. Her heart-sounds
-are normal, and pulse regular; bowels perfectly regular at all times,
-and menses regular. Within a period of two years’ time, she produced
-four abortions upon herself. Each time at third month, and each time
-did so well that no physician was called. She informed me that she
-became more and more nervous after each abortion. I have not benefitted
-this case by any manner of treatment, as yet, and still there is no
-manifestation of any organic disease.
-
-If ever a physician is perplexed, it is when he is called on to advise
-a patient whom he calls “nervous.” This is more commonly the case with
-the general practitioner, as he is looking for something to be the
-matter, and finds nothing but phenomena which he illy comprehends.
-
-These cases are of vast interest to the neurologist, as he is in an
-expansive field for study, and he feels a pleasure with his work; not
-as to the rapidity with which he expects to see these manifestations
-pass away, but in the assurance that these most troublesome phenomena
-are harmless.
-
-_Treatment._――In the management of these peculiar nervous appearances,
-many agents may become necessary; but to obtain rest is the
-all-important consideration. To aid nutrition is the next in importance,
-and thereby build up the structure of the nervous system, improving tone
-by assimilation. All causes, of course, must be removed. The medical
-treatment will consist of agents that stimulate evolution of
-nerve-forces. Tinct. pulsatilla, bromide ammonia, dil. phos. acid, are
-agents which act excellently, given one after the other, changed in a
-manner to perpetuate their influence. With determination of blood to
-the face and head, small doses of gelseminum or bromide potassium, for
-temporary relief, and ergotine continued in grain doses.
-
-When the hands and feet are inclined to become cold, the hypophosphites
-should be given.
-
-As a tonic in these conditions, and especially when the patient is not
-often seen, formula No. 1 will act in a majority of cases very kindly.
-
-Electricity must be resorted to for the permanent relief of nearly all
-cases. General Faradisation will be the most generally useful, used
-often and by short sittings.
-
-The general bathing, resorted to in bath-houses, is often very
-injurious; as no selection of cases as to the peculiar necessities,
-and no adaptation, is made; but proper douching is a most excellent
-remedial measure, and must be conducted with special care and judgment,
-as regards the adaptation of kinds to each and every condition and
-temperament.
-
-
-
-
-CHAPTER IX.
-
-
-_Pseudo-Spermatorrhœa._――A male, enjoying the best of health may,
-under certain influences, have an involuntary discharge of seminal
-or prostatic fluid; but as the latter will be treated in full
-below, I shall first consider accidental discharges of semen as a
-pseudo-spermatorrhœa. Impressions are wrought upon the nervous system,
-sometimes of a stimulant character――other times like a shock――that are
-followed by involuntary losses of semen. It is not uncommon for semen
-to be found in the clothing of criminals hanged by the neck; or for
-soldiers to ejaculate semen at the time of entering an expected battle.
-Involuntary discharges as often occur from the bowels under similar
-influences.
-
-But mental shock is not essential to the production of such relaxation
-of sphincters. I have on numerous occasions produced an ejaculation of
-seminal fluid by the strong currents of electricity passed through the
-genitals, localized.
-
-A cold bath has not been uncommonly the cause of such losses, in
-perfectly healthy subjects. I was once riding, in company with a
-friend, through the country on horseback. My friend had suffered some
-rheumatic pains, for which I gave him opium and quinine in large doses
-which, under the influence of the friction of the saddle, caused an
-ejaculation of semen without erection or erotic thoughts. He was a
-robust fellow, and knew nothing of sexual weakness of any kind.
-
-Young men sometimes, and married men that have been continent a long
-time, and bachelors commonly, are subject to spermatic ejaculations
-involuntary, without genital debility. It has been stated by authors,
-high in authority, that seminal losses two or three times a week
-were only physiological. From this I must dissent. I do not wish to
-be understood as saying that occasional seminal losses are always
-injurious, but I do not on the other hand believe, as do some, that
-even occasional losses are really and always physiological.
-
-To think that the disease exists entirely in the act of involuntary
-emission, is as great an error; as it would seem only rational that,
-if a larger quantity of semen was manufactured than the vesiculæ
-seminales could hold, the natural result would be an evacuation. Again,
-I have known males to live continent and have involuntary losses for
-ten years, as often as weekly, and no evidence of any general or local
-debility. Yet I believe this to be an exception worthy of note. It is
-quite useless to attempt to effect a cure in some of these cases of
-pseudo-spermatorrhœa, as no real disease exists. Some of them will
-continue: others are only transitory, and need only to be assured that
-no wrong exists. Even if it is not physiological or desirable that such
-things should exist, yet it is not actually pathological.
-
-Again, so-called mental spermatorrhœa partakes partly of this
-character; especially when a young man is so pathophobic, from mere
-book-reading fright, derived from specialists and impostors, whose main
-business is to scare a young man to pay out his money and be humbugged.
-If he has not had emissions oftener than monthly, and he is of a
-confiding turn of mind, a troublesome mental disease may be founded.
-If no marked physical disturbance follows these occasional losses, I
-generally inform the young man that he has been mistaken as to the
-gravity of his troubles; thus putting his mind at ease, and the patient
-in a position for self-recovery.
-
-_Case._――Not long since, a young man was under my care who was
-pathophobic; his mind constantly dwelling upon what he had read; and
-the occurrence to his mind, that he had losses of semen as often as
-once in six weeks――although he was a vigorous blacksmith――caused him
-to imagine himself suffering with all the usual bad feelings of an
-advanced case of nightly seminal losses. He appeared in good health;
-was able to do a day’s work, and to work well; but, nevertheless, he
-was neurasthenic, and at times very feeble; or, at least, he thought
-he was. When once he could be made to forget his imagination, he would
-be as strong as ever. The simple assurance that he would recover with
-simple treatment was unavailing; but when persuaded to think much was
-being done, and that his medicine was very potent, he soon ceased to
-be troubled with his worry and was quite well, although he had taken
-only a simple bitter. He finally became afflicted with a sore upon
-his prepuce, which was of a herpetic nature _only_, and for which
-he consulted a score of doctors, as the sore would appear from time
-to time. All informed him of the harmless nature of the eruption,
-but he had faith in no one until a venereal specialist reduced his
-purse to vacuity, when he returned to me for advice. He was simply
-syphilophobic, and demanded only a deceptive treatment, with assurance
-that his trouble was of a local character and never could grow upon
-him; but shortly his herpetic trouble ceased to appear, and something
-else victimized his imagination. Such is the mental predisposition of
-the nervous, imaginative class who _only_ suffer, to any extent, with
-what to them appears to be disease.
-
-Such a case of pseudo-spermatorrhœa would not irritate, in body or
-mind, any person of good reasoning capacity; but, unfortunately, such
-persons are not as common as may be supposed; hence, the deceiving
-specialist has many willing victims.
-
-_Prostatorrhœa_, may exist as an independent, uncomplicated and local
-disease, or in conjunction with spermatorrhœa. My experience leads me
-to remark, that the latter seldom exists without the former, but that
-prostatorrhœa commonly exists as an independent disease; and when the
-flow of semen does not amount to sufficient, in frequency, to consider
-it a cause or a consequence of disease. In my judgment, this flow of
-glary, viscid fluid is most commonly observed while straining at stool
-from constipation. Young men very commonly apply to specialists and
-exhaust their funds and return to the less pretentious family doctor
-for a more satisfactory and truthful statement. Even with this little
-discharge of prostatic fluid, and when no sign of spermatorrhœa existed
-with it, the young man may experience all the phenomena of true and
-long-standing spermatorrhœa. His mind suffers, as well as his body,
-with imaginary nervous phenomena too numerous to mention. But in
-these conditions it is not uncommon to find very troublesome disease
-of the prostate gland, brought on by gonorrhœa, sexual excesses or
-masturbation, existing alone or with true spermatorrhœa.
-
-An examination will reveal enlargement and tenderness of the gland,
-commonly irritation of the neck of the bladder. If we make inquiry, the
-history of prostatic inflammation will be obtained, and gonorrhœa or
-venereal excesses. Pressure upon the prostate, through the rectum, will
-not uncommonly cause a discharge of prostatic liquid, which is followed
-by a smarting sensation. Copulation and ejaculation are sometimes
-followed by a burning pain in the prostate gland, which lasts sometimes
-a few hours――commonly a few moments. Prolonged erection is followed
-by a discharge of viscid fluid, not ejaculated, but simply flowing
-away. When the bowels are constipated, as scybala pass the gland, a
-viscid fluid is pressed out and drips from the end of the penis with
-a smarting soreness, prolonged in the gland. The fluid is not hurled
-forth, or ejaculated in jets, like semen, but a thin glary fluid. The
-disease is commonly only local, and needs very little constitutional
-treatment.
-
-The tinct. staphisagria, so highly recommended by many, will often
-act very kindly as an adjunct, but will not cure the disease. Cascara
-sagrada must be used for a long time, to regulate the bowels and
-digestion. Faradisation, localized and general, is the only agency that
-may at nearly all times be relied on for permanent relief.
-
-When the disease exists with true spermatorrhœa the above treatment is
-none the less essential, and only needs modification to meet special
-indications.
-
-The manner of using electricity for the relief of prostatic disease
-is very simple. My experience has led me into the habit of placing
-the positive pole as closely in contact as possible with the gland. I
-sometimes introduce an electrode into the urethra――other times into the
-rectum――connecting the anode, and with the cathode and large wetted
-sponge stroking the lumbar and sacral regions, especially over the
-origin of the hypogastric nerve and plexus. If there be tenderness over
-any part of the spinal cord, I change the poles and apply the anode to
-the spinal tenderness. Such tenderness is very common over the sacral
-plexus. Again, it is important in the way of ascertaining causes, to
-know which antedates the other, the prostatic tenderness or the spinal
-tenderness; and the anode should be applied to that irritation which is
-found to be the most ancient; as, commonly, upon the spinal tenderness
-the prostatic irritation depends. But this rule is not always tenable,
-yet will answer very well in a new case until an electric test, as it
-were, is obtained.
-
-Whenever unrest, pain or fulness follows the use of one pole to the
-gland, it is safe to change; as such is not the desired effect. There
-is no one thing so needful in the use of electricity as familiarity
-with the physiological effects wrought. Every electrician has marked
-out the management of a patient, and the course proper to pursue, only
-to find an entire change necessary, after the first application. Many
-cases are plain, but many more are wonderfully obscure; and only after
-repeated practical tests, do we find the proper current, intensity and
-quantity adapted to a given case.
-
-
-
-
-CHAPTER X.
-
-
-_Spermatorrhœa._――That special form of sexual neurosis, which has for
-its most common phenomenon the premature and involuntary ejaculation
-of seminal fluid, has been the great catch-all of fakirs and venders
-of popular sexual literature. Not a town of any size in any country is
-without an advertising spermatorrhœa doctor, who cries his vocation
-and writes up his fraudulent certificates of thousands of cases cured,
-and the great danger of millions more sinking into premature decay.
-Strange that laws are not made to prohibit this wholesale deception of
-a confiding and innocent class of young men. Spermatorrhœa does exist,
-but in proportion to the effects of masturbation and sexual debauch,
-grave injury is exceedingly uncommon. Not because spermatorrhœa is a
-commonly grave disease, do I insert this paragraph; but because of
-the unpopularity of the subject, the isolated cases that are really
-bad, and the still more isolated ones that fall into the hands of the
-legitimate physician.
-
-The term, spermatorrhœa, has been too loosely applied to a class of cases
-which the author has chosen to describe under _pseudo-spermatorrhœa_,
-and also to a class of cases more properly called sexual neurasthenia;
-when the weakness of a nervous character is only noticeable in a minor
-degree, or in contradistinction to centric structural changes. But the
-term is useful to describe such losses as are involuntary, and of
-frequent occurrence; or, as it were, such as occur without intentional
-friction of the glans, or without undue nervous shock from accident or
-fear of injury. To such emissions should the term be confined. Healthy
-young men sometimes have emissions before or soon after the intromission
-of the penis, and such occurrences are not uncommon; but with the
-individual such an occurrence rarely happens: such should not be called
-spermatorrhœa――only a sexual weakness――neurasthenia. Again, after
-prolonged sexual excitement, when the organs are simply weak and the
-erotic energy intense, an emission is not sufficient to declare such a
-diagnosis.
-
-When it is customary for a male to ejaculate immediately after
-intromission of the organ, he may have, and quite likely has, a
-spermatorrhœa; but this is not in itself diagnostic of anything further
-than mere weakness; and he must at other times than these lose semen,
-to constitute that real flow which is the true signification of the
-term. When a male commonly ejaculates before venereal friction of the
-glans has taken place, and in successive attempts at sexual congress
-has been baffled, he most certainly has spermatorrhœa, as well as
-partial impotence. Whenever an involuntary emission is followed by
-weakness, headache, wakefulness, heat of the skin, there is certainly
-great sexual neurasthenia; and, if such losses are continuous, the
-diagnosis of spermatorrhœa is without a doubt. It is necessary that
-these points should be duly understood, in order that our future study
-of the disease may not lead to confusion in the study of the conditions
-of the nervous system leading to such phenomena.
-
-In common cases of the disease, the losses of semen are as often as two
-or three times a week; not uncommonly, every night, for a week or two;
-and then an interval of a week, when the nightly ejaculations occur
-with a dreamy, erotic pleasure, with the patient half sleeping. The
-young man wakes up and finds his linen soiled: he remembers his dream
-and is highly disgusted, and soon visits or writes to a traveling or
-standing venerealist, who sends him a circular containing the thousands
-of cases treated and cured, with a poetical description of the ten
-years hence, and perhaps a Marriage Guide, and the price required to
-cure such a case. He feels all the many things pictured in the book,
-and if the fee is within reach he is sure to send it, and only too
-soon finds how badly he is victimized. Not every case is troublesome
-enough to visit a specialist; or the young man is wise enough to first
-call upon the family doctor, or a friendly physician, when he is sent
-home with an opposite kind of discouragement; or he is treated by the
-latter M. D. (?), who has not booked himself on such matters, and the
-poor fellow is left to himself and the “_specialists_.”
-
-It is a fact, that the common practitioner is so fastidious on this
-subject, that he has neglected to obtain the familiarity due his own
-patrons; and if he attempts to treat a case, he will be as likely to
-fail as to do good. This lack of familiarity is the great cause of such
-confusion, and in the application of the term so loosely to conditions.
-
-That the subject may be better understood, I shall arrange my treatment
-of it, that view may be had from the several points necessary to
-perfect comprehension.
-
-_Causes._――The vice of masturbation is perhaps the most common cause.
-In youth, the sexual organs being in an undeveloped state, local
-weakness is very commonly produced, and that even before puberty, by
-the titilations taught the child by accident or by a designing nurse.
-The novel sensation, followed by the profuse flow of semen, commonly
-surprises the youth, and through curiosity and a desire to reproduce
-the new pleasurable sensation, he continues this very common cause,
-masturbation. Ignorant of the consequences that may follow, he pursues
-the practice with intense vigor, until the sad effects are wrought, and
-too late to repent, he learns the evil of his vice.
-
-Boys of the effeminate type suffer first and most from this vice,
-for the reason that they practice the habit more persistently than
-phlegmatic children and, it is a fact, that they are willing victims
-and their nervous system is much more susceptible to impressions.
-Premature development predisposes a child to manipulate the genitals,
-as the curiosity is excited in finding such conditions which should
-only accompany a more advanced age. Any handling of the genitals may
-indirectly give to the child the knowledge of that sexual sensation, or
-excite precocity of the genitals.
-
-Boys of a vigorous habit of body are not inclined to play with their
-genitals; on the contrary, are often markedly disgusted at an attempt
-of a schoolboy to instruct them in the vice. They are therefore not
-easily made victims of, and commonly grow up free from, this vice;
-but they are the most willing participants in prostitutional debauch,
-in a more natural way. With the irritated and excited condition
-of the tissues of the genitals at puberty, then passing the first
-sexual crisis, what an opportunity for local and general injury must
-necessarily be present! The nutrition, so essential to growth and
-development, constantly demanded to compensate for the vicarious and
-premature waste, great neglect in the natural developments of other
-portions must necessarily be a result, which is most likely general in
-character.
-
-As the boy grows up, during the years from fourteen to twenty, the
-attention he pays to his virile member, and the frequency of his
-seminal emissions, would be astonishing to one not acquainted with the
-possibilities.
-
-In the above we have the most common cause of spermatorrhœa. I venture
-to say that the disease is rare in subjects who never practiced the
-vice till after maturity or adult age; but it is nearly as rare to find
-an adult male who has not, at some period of his adolescence, practiced
-the vice of masturbation.
-
-In addition to the vice of boyhood, the debauch of sexual congress in
-the natural way, indulged in to enormous excess, produces a state of
-weakness and loss of general health, with actual impairment of the grey
-matter of brain and spinal cord, which are reflected upon the genitals
-in the form of involuntary seminal losses.
-
-Spermatorrhœa is only a symptom of a disease, and must be studied as a
-neurosis. This diseased condition is generally wrought by frequently
-repeated erotic crises and sexual orgasms, for a long period of time,
-in conjunction with habitual spermal losses, during the period of
-development. The frequent repetition of sexual orgasm so completely
-destroys the erotic sensorii, that the long practice of masturbation
-destroys the venereal orgasm, and an emission is produced without even
-a pleasurable sensation; and even the glans penis becomes so anæsthetic
-in venereal sensibility that the mental effort _only_ produces a
-venereal excitability enough to bring about an erection. In copulation,
-such persons do not enjoy a venereal thrill, only by fresh novelties
-and different females. The subsidence of the venereal thrill, and the
-loss of erotic sensibility and intensity of enjoyment at sexual crisis,
-or during sexual orgasm, is evidence that structural changes have
-occurred and that the disease has become located.
-
-Not until structural changes are wrought in the nervous system, is it
-probable that involuntary seminal losses will continue, or should be
-corrected as a disease.
-
-Sexual congress may, under favorable circumstances, when indulged
-in to great excess, become a cause of such organic changes in the
-nerve-centers as are followed by spermal losses. A few such cases have
-come under my observation, that were of an unmistakable character. The
-report of one case, which is a typical one, will suffice.
-
-_Case._――Chas. B., a rather gentlemanly fellow, consulted me for
-spermatorrhœa, with the following history: When he was a small boy,
-some twelve years of age, a servant girl was his room-mate, with other
-small children; his parents thinking him too small to interfere with
-the servant girl, and did not change his room until a year or more
-after she taught him the significance of his erect genital organ, by
-coaxing him to an attitude favorable to her own gratification. Thus she
-cultivated her new-found pleasure, as he grew up and developed. After
-his room was changed, he found no impediment to nightly visits to the
-servant’s bed. He was soon able to comply with all demands, and nightly
-they indulged in sexual congress to satiety, and grew up together. She,
-being much older than he and knowing all the probabilities, exercised
-her vigilance and precaution, and all went well until he was twenty-two
-years of age; when he found that, upon leaving home and undergoing a
-few weeks’ deprivation from sexual contact, an involuntary discharge of
-semen occurred two or three times per week, in his sleep, accompanied
-by a lascivious dream. The constant and profuse discharge of semen and
-prostatic fluid had passed from his glans penis, for which he had often
-sought advice in vain. These cases are not very uncommon, although
-many a young man has passed through similar experiences with unimpaired
-virile powers. I opine that, if a young man passes to the age of twenty
-without much sexual excitement, he will not be likely to suffer with
-any form of sexual weakness; but if he has the predisposition spoken of
-elsewhere, he will not be likely to pass to the age of eighteen without
-being fully aware of his sexual instinct, and the pleasure that may be
-derived from sexual indulgence or masturbation.
-
-The great author, Lallemand, has given as causes a list of organic
-troubles, a great portion of which are, instead of causes, produced
-by the genital irritation and spermatorrhœa. He overlooks the general
-phenomena which point directly to neurine pathology. As causes,
-Lallemand gives, among various organic troubles, prolonged erections,
-excited by erotic ideas or lascivious publications; the use of
-diuretics, of ergot, of cantharides, etc.; the abuse of alcoholic
-drinks, coffee and tea; constipation; ascarides in the rectum;
-hemorrhoids, fissures of the anus; heating and irritation of the anal
-and perineal regions by habitual sitting, or prolonged horseback riding.
-
-Notwithstanding the eminent authority, it must appear quite impossible
-for any of the above conditions to cause spermatorrhœa as a disease.
-The few seminal emissions that may occur from such causes are in
-isolated cases, and of short duration. Even when spermal losses have
-seemed to arise from such causes, I should think grave reasons present
-for the suspicion of self-pollution or sexual excess. The simple denial
-would not be reason to attribute so permanent a disease to such trivial
-causes.
-
-It cannot be disputed with tangible evidence, that Lallemand’s causes
-may develop a morbid sexual instinct, by reflex excitation, and act
-as a predisposition by exciting sexual desire and self-pollution, and
-thereby spermatorrhœa; but the innate condition must be present also in
-every case.
-
-While it is well known that various morbid anatomical changes are
-found in the genital organs, on careful dissection, yet scarce any can
-be said to act as a cause, but rather as a result of long debauch by
-pollution and venereal diseases; and as commonly, such changes have
-been found in the genito-urinary organs, when spermatorrhœa never had
-been suspected.
-
-Roberts Bartholow, in opposition to the views of Lallemand as to
-causes, says:
-
-    “To place this question beyond controversy, I have lately made
-    a most careful dissection of the sexual apparatus of a young
-    man, dead of double pneumonia, who was known to have practiced
-    masturbation in an extreme degree for many years. Besides a
-    catarrhal condition of the mucous membrane of the seminal and
-    prostatic ducts and of the _vesiculæ seminales_, there were
-    literally no lesions of these organs. I therefore reject this
-    position of Lallemand as untenable, and as leading to improper
-    methods of treatment.”
-
-I can but conclude the cause of spermatorrhœa with one definite remark:
-That the frequently repeated sexual orgasm, continued for a long time,
-causing to be evolved so rapidly the great amount of nerve-force which
-must each time be lost forever, must be the only direct cause of that
-obscure neurosis upon which spermatorrhœa invariably depends.
-
-_Moral Effect._――There is a moral effect wrought upon the mind of every
-person suffering from an inflamed imagination. The constant dwelling
-of the mind upon the sexual organs, or the imagination of a future
-cohabitation, must stimulate the free flow of seminal fluid to the
-overflowing of the _vesiculæ seminales_. Old debauchés frequently feast
-upon the virgin countenances that pass street corners, and constantly
-stand in wait for an expected girl, to be secured by a procuress,
-that they may feast upon her ruin. The cultivation of such morbid
-imaginations is an effect, rather than a cause, of long-practiced
-sexual debauch, and grows out of a cultivated or congenital grossness
-of the sexual instinct.
-
-Elsewhere, the effects of unrequited passion have been fully
-elucidated, as cause and effect of local neurasthenia.
-
-_Symptoms._――The physiognomy of a spermatorrhœa patient is often
-very striking; especially one who has been an extensive masturbator,
-and has been led to think that any physician has but to behold his
-countenance to judge of his entire condition and its cause. He bears
-the aspect of one who has been convicted of a shameful vice. This
-is the picture of an advanced case, yet not beyond the threshold of
-reason. As he realizes his condition, he is embarrassed that he is
-compelled to converse on the subject and confess his shame. The face
-is commonly pallid: the eyes are sunken, with dark lines beneath: the
-lips are anæmic: the corners of the mouth are drawn down, and haggard
-lines are deep-cut about the face. He looks much older than he is, and
-his beard is tardy, isolated and of a dirty color. The general aspect
-of hunger is marked upon his entire figure: he is often lean and wan.
-He trembles with slight exertion, and complains of fatigue: his muscles
-feel doughy, and an unpleasant odor is emitted from his body, strong,
-like a goat or a pig, and his voice is feeble. He speaks low, as if he
-desired to be very quiet and secret, even when his subject has nothing
-in it of a secret character. In common conversation, his voice is
-reduced almost to a whisper. He often has pustules on his face――acne.
-A young man may have spermatorrhœa with very few of these symptoms
-present; but when he has advanced far in the disease――in the nervous
-lesions――the above symptoms are only the common manifestations noted
-by close observation. Yet all these symptoms may exist from other
-causes, and the patient may be free from spermatorrhœa or pollution.
-Then, only by the history and physical signs connected with the general
-aspect, can we hope to effect an exclusive and conclusive diagnosis.
-He relates his history, which is only a confession of his vice and
-the story of his spermal losses nightly, with languor, bad digestion,
-pains and aches too numerous to mention. His tongue is coated, breath
-fœtid, appetite poor, circulation feeble, and heart-sounds feeble and
-irregular. Often, a dull aching is located in his back-head, forehead
-and eyes, with asthenopia, anthropophobia, agoraphobia, astrophobia,
-monophobia, syphilophobia, nocturnal ephidrosis, palmar hyperidrosis,
-and neuralgia of different localities and of varied intensity.
-
-_Spinal Congestion._――This is one of the varieties of disease-pictures
-that call for a deviation in management, and is, perhaps, as common
-as any of the special types, and may be recognized by the following
-symptoms: pain in the back, as if from long stooping, not increased
-by pressure; also a dull, aching sensation, as after prolonged
-exercise. This pain is aggravated by the recumbent posture; hence the
-sleeplessness so common in many of these cases. Fainting sensations are
-produced by standing long upon the feet: a misstep, or a sudden jolt
-in a wagon or car, causes much suffering. Intense burning is often
-felt along the cord and base of the brain, which is not influenced
-by pressure; hyperæsthesia of the skin of one or both legs and feet,
-and the scrotum; testes and penis are often too sensitive to touch;
-at times, neuralgic pains in the genitals, with herpes præputialis,
-periodically appearing; great tenderness of the anus, with herpetic
-eruptions _ab margine ani_. Again, anæsthesia may take the place of
-exalted sensibility, with formication――or tingling, or sensation of
-“pins and needles”――of the feet and legs. Sometimes they complain of a
-sensation of fullness of tissue, as if they were swollen, with no signs
-of any puffy or œdemic condition present. I have often observed both
-anæsthesia and hyperæsthesia at the same time, in different localities,
-upon the same patient. Shooting, neuralgic, or knife-cutting pains
-often emanate from the spinal cord and pass into the limbs, testes or
-penis. Sometimes a tight belt is felt constricting the limbs, thorax
-or abdomen; again a choking sensation, as in globus hystericus, with
-a sensation of drawing in the spermatic cord and testes; pain in the
-heart, lungs, abdominal viscera and genitals, is of common occurrence.
-Irregularities in cardiac movements are not uncommon, with troublesome
-erections of the penis in the morning, even when erections were
-impossible at night. Such erections are commonly without erotic desire,
-and with the bladder empty. They are more troublesome after lying upon
-the back during the night, which seems to aggravate the engorged spinal
-cord. As these cases advance paralysis may intervene, more or less
-profound, generally in the form of paraplegia.
-
-The above, under treatment, will be referred to as the congestive
-type of spinal cord disease, where the direct adaptation of agents to
-conditions will be pointed out, founded on the only principle that
-can lead to ultimate satisfaction――“specific medicine and specific
-diagnosis.”
-
-_Spinal Anæmia._――That form of spinal anæmia caused by the sexual
-differs from spinal irritation of other causes only in the more
-usual beginning at the lower portion of the spinal cord――sacral and
-lumbar regions. In this we have a group of symptoms of spermatorrhœa
-that is not by any means rare; not always diagnostic yet, coupled
-with the necessary history, they afford a condition to which too
-little attention has been given. Spinal tenderness is always present,
-increased by pressure, relieved by the incumbent position and
-aggravated by walking. Unless these symptoms be present, no case is to
-be considered anæmia of the cord.
-
-Where spermatorrhœa and spinal anæmia are associated, and sexual
-debauch has evidently been the cause of the latter directly, it will
-be observed that sexual excesses have existed a long time before the
-latter, or before constitutional disturbance had in any way manifested
-itself. Spermatorrhœa, when associated with spinal anæmia, appears only
-secondarily, as a phenomenon of the disease thus caused.
-
-As spinal anæmia advances and other tender points appear in the cord,
-the eccentric symptoms also change and the phenomena are various
-in accordance with the location and symptoms coincident with such
-phenomena when the causes have been other than sexual.
-
-The lumbar tenderness is generally accompanied by neuralgic pains in
-the lower limbs, back, abdomen and rectum, cramps in the bladder, with
-difficulty in urinating; at other times incontinence.
-
-In one case, which was under my care two years without any benefit,
-the whole spinal cord was tender to the touch, and the patient was
-epileptic and very feeble in mind.
-
-When the dorsal region is involved and tender, as might be supposed,
-there will appear gastric troubles; acidity, pyrosis, nausea and
-vomiting, gastrodynia; again intercostal neuralgia and rheumatism,
-cough and dyspnœa, palpitation, fits of fainting and epileptiform
-convulsions.
-
-_Case._――Mrs. P., in addition to unmistakable symptoms of spinal
-anæmia, with dorsal tenderness would, at the sudden closure of a
-door, complain of great pain in her abdomen, stomach and uterus. On
-several occasions she had had involuntary evacuation of fœces and
-urine during a thunderstorm. Her skin would be covered with cold sweat
-(hyperidrosis). Medicine had very little influence in this case;
-but electricity applied daily for three months――a mild current of
-Faradisation――effected a very satisfactory improvement. This was a case
-of sexual origin and a result of fifteen years’ sexual excess in her
-early life; after which she married well to enjoy the remainder of her
-life in wedlock under the care of a physician constantly.
-
-The cervical region is not uncommonly affected and may be very tender,
-which may produce pain in the stomach and nausea, rejecting everything
-swallowed, at times. Sleep is nearly always deranged: sometimes
-sleeplessness, and again, in the same patient, profound coma of long
-duration is observed, and somnambulism is also likely to occur in
-such cases. Twitching of muscles, contraction of flexor tendons,
-hiccough, aphonia, vertigo, head-pain through the top, tinnitus aurium,
-disturbance of vision, asthenopia, and mental derangements, as the last
-stage of the disease, when the brain and entire nervous system are in a
-feeble condition: all follow, in rare occurrence, the sexual debauch,
-and are symptoms of the entailed conditions, viz., sexual neurosis, of
-which spermatorrhœa is only one of the numerous symptoms, yet perhaps
-the most attractive.
-
-As these foregoing types or conditions advance, they become complicated
-and even change in essential features; but if not remedied, the result
-must be toward paralysis, insanity, tabes dorsalis, epilepsy and
-imbecility; all of which can best be studied as special diseases in
-numerous volumes on diseases of the nervous system.
-
-_Cerebral Sexual Neurosis._――That form of neurosis, brought on by
-masturbation in adolescence and sexual excesses, does not exist
-independently of other portions of the nervous system, and only as the
-spinal cord becomes impaired by excessive sexual shocks and evolution
-of nerve-force, which is expended in orgasms during sexual excitement,
-does the brain become involved, and its tissues fail, by feeble
-perpetuative force, to evolve healthy intellect. When the formative
-forces fail to construct as perfect a brain-structure as has existed,
-renewal is required more and more often, which cannot be brought
-about by the impaired nerve-forces, and softening must, necessarily,
-follow or, at least, a mal-renewal and mal-construction of cells and
-neuroglia, too unnatural to evolve the elements of healthy mind.
-
-That there is a connecting link between the intellectual and the sexual
-there can be no doubt, and that for the sexual to be appreciated,
-without the assistance of the intellectual, would be only animal and
-should not be considered advisable for human beings, but that the
-intellectual should not only predominate, but preside over, all sexual
-conditions.
-
-Thomas would have us believe that the cerebellum is the seat of
-amative desire, and that that organ presides over the sexual function.
-Again, an opposite claim has attempted to overthrow such doctrines, by
-experiments to prove that the cerebellum presides over coôrdination of
-muscular movements.
-
-I am not prepared to accept the doctrine of either as true, but only
-can see evidence that both may be disturbed or lost for a time by
-pressure upon, or section of, a part of the cerebellum, and that this
-organ perhaps tends to effect an equilibrium of the nervous forces
-between the cerebrum and cord, and also as a generator of nerve-force.
-We do know that coôrdination of muscular movements is interfered with
-by any structural changes in this organ; but it would seem that, if the
-sexual was so much depending upon the cerebellum for force, or there
-was such an intimate relation between these organs, muscular movement
-would be oftener impaired or disturbed by reflex irritation, owing to
-the frequency of impotence and other genital diseases, through the
-close relations supposed to exist between the genitalia and cerebellum.
-The coôrdination of muscles is seldom interfered with by sexual
-diseases directly, but only as a secondary issue, by first producing
-chronic impairment of the nutritive forces, and thereby effecting the
-changes in nerve-cells.
-
-The sensitive nervous organizations are of themselves predisposed to
-morbid changes, from too often repeated shocks of pleasure or grief;
-such persons are first to suffer mentally through shame, from having
-indulged in such vices, and secondly, from actual structural changes
-that have occurred.
-
-The vice, commenced at puberty or before, interferes greatly with the
-development of the brain, and only a feeble intellect is possible as a
-product of such feeble brain-structure. The mental powers often yield,
-as it were, when the genital organs possess the power to copulate _ad
-libitum_. This is not an uncommon occurrence. Lunatics frequently
-possess such genital vigor, when their lunacy has been produced by
-masturbation and other sexual debauch.
-
-Roberts Bartholow has, in his monograph, recorded a paragraph worthy of
-mention:
-
-    “It is to be remarked that the mental phenomena of
-    spermatorrhœa are not always in proportion to seminal losses.
-    In the cerebral form, in addition to those lesions of the
-    sexual spinal system, of the digestive apparatus and of the
-    circulation, described under the genital form, there are
-    certain disorders of the mind. That spermatorrhœa will produce,
-    in one class of cases, mental disorders, and not in another,
-    indicates either that some predisposition to these disorders
-    existed, or that the habit of self-pollution was merely an
-    expression of mental alienation. The lascivious images which
-    pervade the minds of boys, possessed of the highly developed
-    nervous organization of masturbators, are those of delusional
-    insanity. In one case the spermatorrhœa is a symptom of mental
-    disorder; in the other, the spermatorrhœa is an exciting
-    cause――the predisposition already existing.”
-
-The general anæmia that so often occurs in spermatorrhœa, caused by
-impaired digestion and spermal losses, is secondarily the cause of the
-cerebral anæmia, and tertiarily of softening. The digestive powers,
-so much impaired by frequent draughts on the vegetative centers, must
-be a cause for a great disturbance in the nutritive supply of the
-brain. The vicarious expenditure of nerve-force upon the exaggerated
-secretory power of the testicles must be a source of great waste, as
-well as the actual loss of elements, necessary to the structures of a
-body losing annually by decay. The tendency of local spasm is of no
-little importance as a cause of local anæmias. Centric irritations,
-such as influence the _vaso-motor_ centers, without a doubt, cause
-local spasms of the _vasa vasorum_, capillaries and supplying arterial
-trunks of organs; and the vessels of the brain are the most likely to
-be influenced in such a manner, and the tissues of the brain the most
-likely, of all tissues, to suffer from such a condition.
-
-The brain-symptoms do not end with feeble intellection or insanity,
-but impairment of the special senses and motility is not unfrequently
-present, as a phenomenon evolved from structural changes in the
-brain. Asthenopia amblyopia, diplopia, dilatation of the pupil and
-hyperæsthesia alternated with anæsthesia of the visionary apparatus,
-aphonia, perversion of the sense of taste, with loss of smell and
-deafness, are rare yet occasional complications.
-
-The usual catalogue of symptoms bears closely to one of two forms, the
-hyperæmic or anæmic, local or general, of the cerebral substance.
-
-The profound impressions wrought upon the minds of these patients
-by popular sexual literature must greatly exaggerate the structural
-changes, but are not sufficient of themselves, as a rule, to produce
-anything but morbid emotions until after enfeeblement has first been
-organized.
-
-The records of the State Asylum, at Utica, N. Y., show five hundred and
-twenty-one cases admitted directly attributable to this vice; and Dr.
-Jno. P. Gray, the able superintendent, thinks this greatly understated.
-
-Sexual excesses, pollution, and other mismanagements of the sexual
-functions have received too little attention, and are too seldom
-mentioned in the etiology of nervous and brain lesions. Too little
-effort has been put forth to ascertain the proportion of mental
-diseases caused by the sexual and reproductive organs. A greater
-number of brain-lesions occurs, in which the sexual function has been
-a remote cause, than any author, as yet, has ventured to affirm.
-Statistics of any degree of accuracy are impossible to obtain; but
-supposition, imagination, and guess-work only can be found to assist in
-making up a statement of the most important of all causes of disease.
-
-_Clinical Illustrations――Case._――Mr. X. came from the South with his
-brother to consult a physician in St. Louis. I found the patient, who
-was aged 24 years, feeble and wan. He wore a thin, scraggy beard, about
-an inch long, over his chin and under his maxilla, but the side of his
-face contained only a little furze. When I entered the room it was not
-necessary to inquire which one of the young men had come to consult me,
-as his general aspect told me that he was a sick man. He was cadaverous
-in looks, staggering in gait, anæmic and haggard. He had been a
-masturbator, and practiced it as long as he could obtain erection,
-which had been until within a year; although I learned that for five
-years previous his erections had been only occasional and feeble. His
-semen was wasting nocturnally and his genitals flabby, cold and damp:
-his scrotum especially was relaxed and pendant. The spinal cord was
-very tender to the touch, giving great pain upon examination, over the
-lumbar, dorsal and cervical vertebræ. He complained of a sensation of
-constriction (girdle) around the body, painful digestion, constipation
-of the bowels, and talked incoherently. His mind wandered: he had no
-wishes to go home, or to stay, or to live, and became quite passive.
-He failed fast, and I soon lost sight of him, as he was placed in an
-insane asylum. All treatment failed to benefit him.
-
-I might enumerate scores of similar cases, in which it is impossible to
-see any cause but abuse of the sexual function, in which spermatorrhœa
-and impotence blend in a very obscure manner, but combined with other
-phenomena prove, beyond a doubt, the existence of a sexual neurosis,
-peculiar to itself, which needs study as to pathological anatomy; when
-it will be discovered that more than mere cause for general neurosis is
-found in the sexual abuse so lightly spoken of by authors in treatises
-on diseases of the nervous system. It will not require an accurate
-observer to discover signs of myelitis and softening in the above case;
-but his symptoms had been, long before, markedly those of anæmia, as
-related to me by his brother. Many cases selected for this section are
-in the advanced stage that I may the better show the termination of
-some of these cases. The majority of the cases that I have observed
-have been wanting in these distinctly organic features, _only_ for the
-reason that they were not so far advanced, and their indulgences had
-been limited to a more careful habit of pollution and sexual congress.
-
-The usual course of lesions appears in the following order after
-sexual excesses and pollution: Nervous weakness (neurasthenia), anæmia
-or congestion, myelitis, and softening. These may point either to
-the brain or spinal cord, or both associated, in any given case, in
-accordance with compatibility of lesions and conditions.
-
-A most striking condition of sexual neurosis is not uncommonly
-observed, that is not confined strictly to a locality, but shows a
-general breaking down of the conductors of nerve-force, both motor and
-sensory, as well as the nerve-cells, with a tendency to softening of
-both brain and spinal cord.
-
-_Case._――A marked case of impaired conductivity is now under my
-observation. The patient is a masturbator, and I have thus far failed
-to disrupt the vice.
-
-In addition to many symptoms, not of general interest, is the impaired
-condition of the sensory conductors. When he is touched, it is a
-second before he feels. He sees the finger placed upon his hand or
-foot, but does not feel it for one or two seconds: sometimes it is
-quicker than at other times. When he is spoken to, he does not receive
-the idea for ten or fifteen seconds after he has heard the sound. He
-comprehends that such is the condition. He says he does not desire to
-practice self-pollution, but simply performs the act because he can’t
-help it. He is sensible and strong-minded on some things, and very
-feeble on others. He is agoraphobic, but has no pathophobia. He is not
-anthropophobic, but even foolish after female society, and still has
-no inclination to copulate. He prefers to masturbate, rather than to
-accept of coition when accessible.
-
-The motor nerves and centers are rarely, but sometimes, involved
-directly. When paralysis does occur, it is from advanced complications
-and need not be mentioned here; but sometimes an unnatural class of
-movements is produced by this variety of neurosis, generally of a
-spasmodic character and located in the involuntary sphere. I wish only
-to record, in this place, the fact that such is a lesion of sexual
-neurosis, and take it up elsewhere with greater precision.
-
-Tabes dorsalis has not been uncommonly caused by sexual abuse, in
-proportion to the frequency of the disease. Loss of sensibility is also
-exceedingly rare, but impairment is not uncommon. The loss of venereal
-sensation is a very common consequence and will be spoken of elsewhere.
-
-Paralysis of some of the muscles of the genitals and bladder is of
-frequent occurrence, especially those connected with urination; the
-bladder is often paretic and micturition is frequent, and the quantity
-very small: often the natural warning as to time is wanting. The
-mental symptoms are often very prominent: loss of memory; conversation
-difficult; language incoherent and ideation very imperfect; insanity,
-idiocy, imbecility and epilepsy.
-
-Hitzig says, under _Etiology of Paralysis of the Insane_, “Probably
-the combination of excessive labor with excesses _in Baccho et Venere_
-is the most common cause. The influence of sexual excesses can be
-recognized in females also.”
-
-_Case._――An epileptic gentleman, æt. 24, consulted me for his fits. He
-had practiced masturbation from childhood to twenty years of age; was
-losing semen nightly; often without erection; had been epileptic four
-years. At first the fits were as frequent as every four months, but now
-they are weekly. His face was of a venous color, as if a venous stasis
-was the constant condition. His eyes and hair were black. His face was
-expressionless and covered with acne; memory very poor. He was a fine
-penman, and had been a book-keeper. He had felt no _aura_, and always
-had his fits during the day-time. All treatment failed in this case
-to produce any impression upon the fits. The bromides at first could
-not be used, as dangerous symptoms followed three successive attempts.
-Electricity, if any thing, aggravated his general condition. I cast
-lots for general treatment, in an empirical manner, but very little
-benefit followed: his general condition was downward, and the epilepsy
-continued to grow more frequent. Large doses of bromides benefited him
-and increased the interim, but finally four drachms a day failed to
-control or to modify them. Galvanization and Faradisation, both singly
-and conjointly, were tried in vain. Ergot also was tried, and many
-agents of lesser prospects, as he staid with me three years, growing
-feebler in body and mind constantly, until he is now nearly imbecile.
-Four cases so nearly alike have come under my observation, that the one
-will answer as a typical case of them all; not a single one recovering:
-two have ended up in the insane asylum: the other two I have lost sight
-of, but not until they had passed into a state of dementia.
-
-_Case._――Jno. W. My attention was called to this patient by Dr. M.,
-who was the attending physician. The patient was in bed, very much
-emaciated and feeble; form originally tall, bony and muscular; dark
-hair and eyes. The Doctor informed me that he had passed through
-the hands of a number of physicians, without relief. His pulse was
-feeble and averaging 100: his venous circulation was feeble; a livid
-appearance of the skin: the redness would disappear upon pressure and
-return very slowly. There was profuse nocturnal hyperidrosis, with
-great morning prostration and general coldness. He was exceedingly
-irritable and profane; appetite poor, and what little was eaten
-was digested with pain; bowels constipated; urine high-colored and
-of high specific gravity, containing blood and pus. The spinal cord
-was so tender, during its whole extent, that the slightest pressure
-produced intense pain. His rectum was indurated and very tender to the
-touch. The urethra was diminished in calibre to a No. 8 catheter, and
-that was passed with great pain. The prostate gland was enlarged and
-hyperæsthetic. He complained much of the girdle sensation, which placed
-the diagnosis beyond a doubt as chronic myelitis of the posterior
-columns. There were no lesions of motility, but lesions of sensibility
-were present throughout the body and lower limbs; anæsthesia of the
-skin and hyperæsthesia of the mucous membranes of the rectum, urethra
-and bladder. All treatment proved futile, and he died after a year of
-most distressed suffering.
-
-He was a debauché, given to extreme sexual indulgence and wine; was a
-victim of early indiscretions, and to a great excess: spermatorrhœa was
-present up to six months of his death; but was only impotent after he
-took his bed from general exhaustion. He was thirty-three years of age
-when he died.
-
-Gull’s case of paralysis reported must be quite exceptional, as
-paralysis generally found, which has been caused from a sexual
-neurosis, has not differed in any manner from the same paralysis
-from other causes; and I can only see the sexual neurosis as a cause
-of paralysis, and not as a special variety. The same may be said
-of an anæsthesia of the skin, or a hyperæsthesia; that the sensory
-nerve-roots are influenced by either anæmia or turgescence, and the
-phenomena are manifested at the periphera. The phenomena do not
-differ, when these conditions are caused by the sexual, from phenomena
-when conditions are wrought by other causes; and conditions causing
-identical phenomena are in themselves identical, but not as to their
-cause; hence so many forms of sexual neurosis, and so many conditions.
-
-_Local Structural Changes._――Structural changes in the genital organs,
-in a chronic case of spermatorrhœa, are not a little interesting to the
-student of pathology. The scrotum is pendant, baggy and relaxed. The
-penis is flabby, cold and pallid. The veins are dilated and tortuous,
-and the organs are in a condition of anæsthesia or hyperæsthesia;
-and as irritability often exists, causing unnatural attention of the
-patient, and he finds much difficulty in dressing to suit his genitals.
-The spermatic cord is hypertrophied, and the epididymis enlarged and
-baggy. If the examination can be obtained when there is an erection,
-tenderness will be observed, along the entire course of the urethra.
-The urethral mucous membrane is thickened, and the canal is strictured
-throughout its length. The prostate gland is changed and tender to
-touch, congested, and its ducts relaxed. (See Prostatorrhœa.) The
-anus is sore to manipulate, and at stool, when scybala pass over the
-prostate gland, a sensation of pain is felt, and fluid is forced out
-of the ducts into the canal and drips from the end of the penis. The
-veins of the spermatic cord are varicose, the erections are deficient
-in power (see Impotence), and seminal fluid is thin and watery. The
-spermatozoa are deficient in size, shape, and amœboid movements. The
-urine is of a low specific gravity and contains a superabundance
-of urates. The orgasms are feeble and often imperceptible, and the
-proportion of spermatozoa to fluid is not great.
-
-_Spermal Changes._――The only known detection of spermzoons is by the
-microscope, which only can detect the seminal from the prostatic fluid
-in this stage of disease. The reason that spermatozoa have not been
-detected oftener in the urine of spermatorrhœa patients, is simply from
-the fact that the urine was not examined more than once, perhaps twice.
-When I have watched for ten days, making daily observations, before
-discovering spermatozoa, I have then found them daily for as many days.
-The first object to be determined is, is the patient strictured, or
-has he a general narrowing of the calibre of his urethra? If so, then
-this is a good reason to suppose there may be spermatozoa in his urine,
-providing that he is losing semen; as the fluid is thin, and the walls
-of the canal are clumsy in performing those wave movements which are so
-essential in ejaculating semen or expelling the last drops of urine;
-therefore regurgitation may take place, and semen be found in the next
-discharge of urine. When nocturnal losses occur, a large portion may
-be expected in the urine at the next micturition. This is commonly the
-case in aspermatism, and may act as a cause of sterility.
-
-The married, as well as the unmarried, have involuntary discharges of
-semen when every possible opportunity is present for an emission to
-take place in the natural way. The newly married, after the novelty
-period has subsided may, from excessive indulgence, have an involuntary
-emission, which occurred during a lascivious dream, when no desire for
-cohabitation preceded his going to sleep. When the cause producing
-these involuntary emissions is not transitory, the young man must have
-indulged extensively in his boyhood. Such a discharge, if followed by
-the usual depressing effects, is invariably pathological; yet with
-proper rest, self-recovery is probable when the cause is transitory.
-
-_Sequelæ._――The common results of spermatorrhœa and sexual excesses
-become noticeable, either shortly before or soon after marriage.
-The young man well knows his defects, and he consults a physician to
-ascertain the magnitude of what may occur to him on account of his
-indiscretions. He informs us that sexual orgasm occurs very soon after
-intromission, on account of which he is grieved, and fears that his
-buxom, voluptuous bride will not be satisfied with such tantalizing as
-he may be able to afford. A few months’ tonic treatment encourages him,
-and he makes a trial of his condition before entering wedlock, that
-he may be sure not to disappoint his fresh, true and virtuous maiden.
-Again, the matrimonial rites have been consummated, and the young man
-fails to reach the expected goal of marital adaptation and aptitude:
-the wife is of course unsophisticated, and thinks there is nothing
-wrong; but the husband is well satisfied that he is not what will be
-expected, or what is necessary to promote marital felicity; and he
-consults his physician. Perhaps he was not a little disgusted, upon the
-first attempt at intromission, at ejaculating his semen either upon her
-linen, thighs, or vulva; she of course being innocent and not knowing
-the why such was not the natural procedure, he could excuse himself and
-thereby palliate his embarrassment.
-
-Others, less sensitive in organic construction, do not understand these
-shortcomings, and are not _quantum sufficit_ for a healthy female, as
-ejaculation follows a moment’s rapid copulative movement, leaving
-the female aflamed with erotic passion, and physiological turgescence
-of the sexual apparatus. These are only the _sequelæ_ of seminal
-weakness, such as pertain to the neurotic origin and character of this
-disease. The grave and less common results are, as the symptomatology
-illustrates, spinal anæmia and congestion, cerebral anæmia and
-hyperæmia, insanity, epilepsy, tabes dorsalis (progressive locomotor
-ataxia), paralysis, impotence and structural disease of the heart and
-blood-vessels.
-
-_Treatment._――The treatment of spermatorrhœa, with its associate
-phenomena, demands careful investigation of the lesions and conditions
-of every case. The results and character of lesions are so varied that
-often a diagnosis as to condition is not an easy task. To know that
-spermatorrhœa exists is but a small part of the diagnosis necessary to
-arrange a treatment that may rationally result in benefit. As has been
-shown, seminal losses may exist when opposite conditions are present;
-and only can benefit be rationally expected from equally opposite
-methods of treatment. Any physician of experience has, and always will
-have, much difficulty in treating and controlling these cases, as they
-are hard to manage when even doing well, and only an intelligent and
-positive course can succeed in managing them during any great length of
-time.
-
-A positive code of government, rigidly followed, is indispensable; as
-well as perfect confidence in the managing physician.
-
-The nasty drugs of our old-fashioned materia medica will not cure these
-cases The bringing about so-called tonicity, by tonics and nervines,
-only needs to be tested for a short period to convince any practical
-physician how useless is such a procedure, and how soon his patient
-will find another attendant. Drugs are often useful but bad ones,
-selected for a tonic principle _only_, will as often do harm. Only
-with a definite object in view, should we expect to accomplish such
-changes as can result in positive relief. The list of nasty tonics for
-indefinite purposes, or such as “have been used in such cases,” the
-author has resolved not to, in any manner, refer to, and at no time
-will he direct an agent or combination of drugs on so-called “general
-principles,” but with definite expectations only.
-
-_Spinal Congestion._――The group of manifestations pointing to spinal
-congestion will first receive attention. The remedies are bromide
-potassium, bromide ammonium, ergot and belladonna, with electricity.
-
-These are selected also with reference to conditions only; yet the
-reader can evidently see that their ultimate effects are aimed at,
-as all of this list of agents affect the calibres of capillary
-blood-vessels; therefore, the engorged spinal vessels are unloaded by
-contraction, perhaps, of capillary _parietes_.
-
-By this effect of drugs we aim at relief of the long compression of
-the cord, and liberation of nervous energies and forces supplying the
-organs of nutrition and assimilation.
-
-It is pre-supposed that all sexual excesses and vices are under
-control; otherwise, all treatment will be useless.
-
-Numerous are the contrivances to control or prevent seminal emissions.
-They have all failed, and nothing is lost; as only the effect is
-looked upon in their construction, and not the true nature of the
-disease; therefore, to prevent spermal losses is not the first object
-to accomplish, but to relieve the nerve-centers, which preside over
-the manufacture of semen, of these abnormal structural changes; and
-the loss of semen will abate. No instrument will then be required; and
-if this centric improvement cannot be effected, the patient is beyond
-help. No mechanical contrivance will relieve the centric lesions;
-therefore, such appliances are useless. The loss of semen is not a
-disease, only a manifestation or a phenomenon of centric lesions; and
-as we have said heretofore that spermatorrhœa is not even a cause of
-such lesions; but sexual shocks, often repeated for a long time, are
-the cause of the neurosis through which we have spermal losses――true
-spermatorrhœa. This reiteration is made that no mistake may be made in
-interpreting the means of relief, which are all aimed at the lesions
-instead of their phenomena.
-
-When the patient is not too much debilitated, chloral may be
-administered to produce sleep; but very commonly the ergot or ergotine
-will allay all nervous irritation and bring on perfect rest. Large
-doses are demanded, as much as two grains of Beaujon’s extract three
-times per day, or one drachm of Squibb’s fld. ext. or an ext. of equal
-strength should be used. Belladonna should be used by commencing with
-small doses and gradually increasing until asthenopia is produced, when
-small doses should again be used: by this means the extent of tolerance
-may be ascertained, and that dose should be continued which does not
-affect the eye. When the bladder is involved and urine is voided with
-a lack of expulsive energy, or the urine dribbles away, ergot and
-belladonna are the remedies. Where there is extensive hyperæsthesia the
-bromides are better agents, and also to overcome any reflex irritations.
-
-Hot applications to the spine are often followed by very excellent
-effects, as the relief of pain and other troublesome symptoms.
-
-Cold water to the hands, feet and genitals is often followed by
-surprising results, and should be used night and morning for a long
-period of time――many months. Tonics do great injury in this class of
-cases. Quinia, strychnia, phosphorus and iron should never be used in
-any form.
-
-_Electricity._――The downward, constant current, alternated with
-Faradisation, is indispensable to satisfactory results in the majority
-of the cases of the congestive type; using the galvanic one day, and
-the induced the next day, with general Faradisation, if it be followed
-by pleasant effects and relief of unpleasant nervous symptoms.
-
-Stimulating food, as well as alcoholic and malt liquors, should be
-proscribed; yet a generous diet is at all times indispensable. Opiates
-should not be administered, even for the relief of pain.
-
-_The Anæmic Form._――When this type of spermatorrhœa is satisfactorily
-diagnosed, the treatment is plain and the agents quite positive in
-their course of action, when the case is not so far gone that relief
-could not reasonably be expected. But if there be a doubt as to
-diagnosis, on account of mixed symptoms――and such is not unfrequently
-the case――if we are not well satisfied whether there is anæmia or
-congestion of the cord, the administration of 1/60 of a grain of
-sulph. strychnia will decide the matter, which will produce some of
-its physiological effects if there be congestion; but if anæmia exist,
-there will be no noticeable change, at least no unpleasant effects.
-With this point clear, we then direct a treatment which is intended to
-stimulate a free circulation of blood in the cord――_spinal stimulants_.
-Strychnia, phosphide zinc, cantharides, pulsatilla, phosphoric acid and
-collinsonia, are such agents.
-
-Cold spinal and genital douche, with hot foot and hand bathing morning
-and night, are highly important agents, with strychnia 1/60 gr., three
-times a day. The author has for many years almost entirely depended
-upon formula No. 1, not on “general principles,” but as a combination
-that applies directly to the anæmic condition of the cord and its
-consequence; and knowing its effects, as he has, so long, could not
-well do without it in the treatment of these complicated cases. If
-there be general anæmia, as well as local, chalybeates may be of
-service, but not until the patient is eating and digesting moderately
-well: then we prefer the citrate in port wine. Stimulants in moderate
-quantity are admissible, especially wine and malt liquors. Opium may be
-administered to allay pain, but chloral is better.
-
-Any agents, used for their stimulating effect upon the cord, must not
-be expected to act too rapidly. Patience is the all-important motto
-after the diagnosis is well made.
-
-Counter-irritation will always be of great service, and the cantharidal
-plaster is the most desirable form. The seaton has in a few instances
-been of service, but we prefer the emplastrum canth.
-
-Electricity is indispensable, and should be applied daily. The anode
-should be applied to the tender spots in the cord, and the cathode to
-the genitals, in the form of a large sponge placed in contact with
-the perineum, scrotum and penis. Faradisation may be alternated with
-the constant current daily. General Faradisation may be applied best
-by a large foot-plate covered with a wetted sponge, and the operator,
-holding the anode, may place his other hand on the patient’s head, back
-of his neck and along his spine: the hair of the patient will of course
-be moistened as the dry hair is a non-conductor of electricity.
-
-A highly nutritious diet should be always advised, and plenty of
-open-air exercise, even to fatigue; as the mind is thereby employed,
-and not so much time is found to brood over these physical conditions.
-The very common and exceedingly troublesome constipation may be
-overcome by rhamnus purshiana, in teaspoonful doses of the fluid
-extract, morning and night.
-
-When extreme sleeplessness prevails, grain doses of svapnia have acted
-excellently; also ten-grain doses of chloral hydrate.
-
-I do not prescribe for seminal losses under any consideration: I
-simply ignore them during the whole course of treatment. Where the
-general health improves, and with that the nerve-symptoms, the seminal
-losses become less frequent and finally cease. As the involuntary
-discharges diminish, we may conclude the central lesions are improving.
-
-_Cerebral Sexual Neurosis――Treatment._――The most prominent feature of
-the cerebral manifestation is mental asthenia, or feeble-mindedness,
-from real exhaustion of all the forces; a general lack of power.
-
-To impart vigor to the general nervous system must be the first
-indication. For this purpose dil. phos. acid may be administered. If
-the extremities are cold the hypophosphites are of positive benefit,
-and must be continued for a month or more. Tinct. nux vomica imparts
-tone to the nerve-centres. When active symptoms are present the
-bromides act very kindly, and may be combined with ergot, or the latter
-may be used separately with most excellent results. But the physician
-must be certain that he has a case of hyperæmia, before such agents are
-resorted to, and then they should be given in large doses.
-
-Electricity, in the form of general Faradisation, seems to be of the
-most service, and must be applied daily for several months. Only a
-feeble current should be used.
-
-The structural changes that have occurred in the genitals always demand
-attention.
-
-Chronic turgescence of the prostate gland will best be treated by
-the internal use of tinct. staphisagria, large doses of bromide of
-potassium, and the introduction of catheters increasing in size until
-the urethra is fully dilated.
-
-Electricity should be used as recommended under Prostatorrhœa. The
-organic stricture, which is so commonly present, should be treated by
-dilatation with suitable bougies or catheters. The bougie must be used
-as often as twice a week, until the full size and elasticity of the
-urethra are obtained.
-
-Injections are sometimes useful. A solution of nitrate of silver,
-ten grains to the ounce of water, used only once, and followed by a
-solution of brown sugar (sacch. communis), morphine and rose-water,
-will answer a most excellent purpose. After the acute inflammation has
-subsided the bougies must always be resorted to, and used persistently
-until the object for which they are used is accomplished. Any
-ulceration may be relieved by injections of permanganate of pot., not
-stronger than one-half grain to the ounce.
-
-The glans and prepuce should be closely scrutinized from time to
-time, and if the prepuce be of undue proportions, or if the patient
-is filthy, permitting accumulations to form beneath the folds and
-creating a local irritation, circumcision should be performed without
-hesitation.
-
-Reflex irritations have often prevented recovery, and even produced
-grave manifestations. Cases of epilepsy have been reported from such
-peripheral causes, and cured by relieving the cause, or circumcision.
-The division of the sensitive nerves, which occurs in the operation
-of circumcision, often prevents involuntary spermal losses, and
-even permits such patients to perform normal copulation as had even
-ejaculated previous to intromission. Such little causes must not be
-overlooked. It is often in attending to little things that great
-results are accomplished; and in this we have no exception to the rule.
-
-There is no room for a doubt in my mind that the Jewish rite was first
-established from hygienic motives _only_; and as “cleanliness is,” and
-always has been, “next to godliness,” circumcision would seem a very
-natural sacred rite for any religious sect to adopt.
-
-We have no history of anything more ancient than the operation of
-circumcision. The Egyptian priests were practicing circumcision nearly
-5,000 years ago. A translation of Herodotus informs us that such
-hygienic measures were in existence amongst the Egyptians in the most
-ancient of periods; and it is quite reasonable to suppose that the Jews
-obtained this rite from the Egyptians.
-
-_Dilatation of the Anus――Anal Plug._――A very troublesome complication
-of the genital structural changes occurring in spermatorrhœa is
-induration of the mucous membrane and sub-mucous tissues. Where such a
-condition is present, little benefit should be expected until relief is
-obtained from the local difficulty.
-
-The dilatation should be accomplished by suitable means; such as by
-bougies, or a bi-valve rectal speculum. An anal plug may be constructed
-that is self-sustaining, polypoid in shape, which will be of more
-service than compression of the anal surfaces. The troublesome
-pruritus, and hemorrhoidal tumors, and indurated anal tumors, will
-gradually subside under such management. Suppositories of iodoform are
-also of invaluable service in reducing indurated conditions of the
-anus and rectum, as well as enlargement of the prostate gland. The
-old-fashioned stretching of the sphincter ani for spermatorrhœa, so
-highly recommended by Trousseau in his clinic on this subject, from
-indiscriminate use, is neglected, when it is really a most important
-means, deviating the reflex current from the genitals as well as
-relieving actual structural change in the anus. Roberts Bartholow has
-dwelt upon this subject without pointing out definitely such cases as
-it has actually relieved, leaving the reader to guess or find out for
-himself. The failures from its use have been so numerous, and the
-cases in which benefit has followed so few, that it is no wonder that
-it is not in better repute as a remedial means.
-
-Whenever this dilating process is restricted to thickening and
-induration of the mucous membranes of the anus and rectum, much benefit
-will follow its use.
-
-Many peculiar means have been recommended and are resorted to, many of
-which only need a condemnatory mention, which seems the more necessary
-that they are in almost general use. The most prominent is _the porte
-caustique_, which was probably introduced by Ambrose Paré, and improved
-and so highly recommended by Lallemand. Other prominent supporters of
-this manner of medicating the urethra and prostate gland were Wiseman,
-Hunter, Amussat, and Everard Home. The supporters of this manner of
-cauterizing the openings of the vesiculæ seminales were under the
-impression that spermal losses constituted the essential cause of
-the disease, instead of the habit the testicles had taken on by a
-hyper-supply or vicarious evolution of nerve-force.
-
-We do not hesitate to say that this method is seldom followed by
-beneficial effects, and often by irreparable injury.
-
-Bartholow advises its use in exceptional cases; “those in which,”
-he says, “the moral effect of the application is desirable.” From
-this I must dissent; as any superabundance of attention demanded may
-be bestowed by cauterizing or vesicating the perineum, obtaining
-an excellent moral effect and even accomplishing, by way of
-counter-irritation, physical improvement.
-
-We might suppose that these harsh means of treatment, owing to the
-elevated character of their supporters, were in good repute; and that a
-work on this subject would be incomplete without a full detail of them;
-but a better success without than with them has led me to discontinue
-their use, and conscientiously speaking of the treatment, I can but
-manifest my disapprobation of all caustic applications to the urethra
-or prostatic ducts.
-
-
-
-
-CHAPTER XI.
-
-
-_Impotence._――Some misapprehension as to the signification of this
-term is prevalent, owing to the extent of weakness and the morbid
-conditions to which it has been applied. The wrong application has been
-very common; _i. e._, in using it to describe a condition of sexual
-neurasthenia and temporary suspension of the sexual powers, from moral
-shock. A young man who exercises a doubt as to his ability to copulate
-may, upon the occasion, be unable to procure an erection; and yet he
-may, after a time, secure his own confidence; or, when he the least is
-thinking of it, be in full possession of his potence. The first attempt
-at coition, after matrimony, may be unavailing for this reason, and no
-trouble occur at any time afterwards.
-
-The penis may be erect at first, and become flaccid before intromission
-can be effected. Even this does not constitute, but may be only a
-result of, nervous shock or impression produced upon the mind and
-sexual instinct, from embarrassment, that may occur to any young man
-who is not self-confident, and is no evidence of any permanent disease.
-
-Impotence, as it should be defined and considered, is the
-manifestation of a disease in which there is permanent and actual
-impairment of the nerve-centres and, as a phenomenon of such centric
-changes, inability to procure an erection of the penis, at any and all
-times, sufficient to perform the act of coition. This is a chronic
-malady, of slow advent, and when once established there is very little
-tendency to recovery. The chagrin manifested in a man who is impotent
-is at all times striking. He feels that to be impotent is to be worse
-than dead. Men pride themselves on their ability to perform coition,
-and feel the loss of sexual power more than mind. Money and time are,
-therefore, expended exorbitantly to recover this lost power, that they
-may feel themselves men once more.
-
-The flabby organ is the centre of attraction. He handles it, and dotes
-upon what has been in by-gone years, and mourns over his misspent
-fortune only for the possibility of his obtaining relief from his
-genital affliction through its influence.
-
-The disease is complicated with spermatorrhœa at nearly all times, and
-may be considered only an advanced period of the same neurosis. The
-same conditions and types of diseased manifestations are to be studied
-in impotence as in spermatorrhœa. Then, to spermatorrhœa we add the
-phenomenon, impotence, and the accompanying changes, and we quickly
-comprehend the position.
-
-The condition is a loss of excitation-power of the nerve of Eckhard,
-whereby all physiological irritation becomes impossible. This nerve
-arises from the sacral plexus, any irritation of which, in a healthy
-state, causes a flow of blood to the corpus cavernosa and spongiosa
-of the penis; but the constant stimulation of this nerve produces a
-loss of irritability and paralysis of the parietes of the arterioles
-of the erectile bodies of the penis, and no relaxation of their valves
-occurs at any time: a perfect vascular inactivity is the result. These
-arterioles anastomose with corporal venules which are very tortuous
-and sacculated and supplied with very large openings and very small
-outlets compared with the magnitude of their calibres; but the often
-turgesced condition of these venules causes a dilated condition of
-the outlets, and any blood that may be conveyed into the corpora
-through the arterioles will flow out so fast through the dilated
-venule outlets, that the turgescence necessary to produce erection is
-impossible. Again, the innate contractility of the trabecular substance
-must antagonize, to a considerable extent, the erectile tendency of
-surrounding tissue.
-
-Then there is another condition so closely connected with impotence
-that a mention of it will not be out of place. Impotence consists in
-a lack of power to effect an erection; but there is a condition, not
-always impotence, where the person has lost all desire for copulation,
-and will not make an effort to obtain an erection. He does not attempt
-to concentrate his will-power, and does not desire any relation
-whatever with the opposite sex, although he may have been a debauché in
-his early life. When such a condition has been congenital, there would
-be reason to suspect deformity or congenital defect. Such person may
-not be impotent, and if the desire returns it manifests itself in the
-genitals as soon as the mind is allowed to dwell upon erotic thoughts;
-and if erection does not occur impotence is present.
-
-The loss of semen often subsides in the aged, and atrophy of the testes
-is not an uncommon result; but some people live to be very old, and are
-never troubled with senile-impotence.
-
-The penis is at all times flaccid, if impotence be complete. Often
-partial impotence will reveal itself, deviating peculiarly in its
-character. Sometimes a man will, while entertaining erotic thoughts,
-have an erection of the penis which is perfect in all appearance, and
-when brought in contact with a female cannot sustain or even procure
-the erection, and yet the erotic desire be just as intense as if he be
-able to perform the act in a proper manner. These cases are practically
-impotent, but the disease has all to do with the mind; and as soon as
-the mind can be so corrected that self-control may be exercised as
-well as self-confidence, just so soon will the impotence disappear;
-and once the act is performed normally, the trouble will be at an end.
-But there is a condition in which all the powers of mind and body,
-exercised to control, will not impart either the power of erection or
-the erotic desire――only a longing for that once felt erotic desire
-exists. The condition often exists in which the patient cannot control
-the mental impressions, so as to effect that peculiar concentration
-of the nervous force which gives energy to the sexual organs; and yet
-there may be no disease of such nerves themselves. It is the same
-condition that will cause the mental operations to fail during any
-course of anxiety, or turbulence of the emotions. A speech-maker may
-fail in his efforts at first, even after he considered himself prepared
-for every emergency; but as soon as allowed to collect his scattered
-mental evolutions, he may compose himself.
-
-Inability to perform the sexual act while suffering from any mental
-derangement, or misunderstanding one’s own mental elaborations, is
-not impotence; but there must be impairment of the integrity of the
-nerve-substance that evolves the force that sustains the sexual organ
-in its erect attitude, and also supplies the so-called physiological
-irritation. If we attempt to name this peculiar disease from other
-stand-points, we shall become confused; as it would only demonstrate a
-function-disease, which is an impossibility and leads to confusion.
-
-I have seen cases of so-called impotence from intestinal worms: while
-impotence is not generally considered a symptom of worms, yet this is a
-case which recovered as soon as the worms were expelled. I have known
-two cases that supposed they were permanently impotent, both of which
-obtained relief after the expulsion of a tænia solium.
-
-These were cases of symptomatic impotence; which only means phenomena
-that may exist in remote structural disease, or by mechanical pressure,
-as from foreign bodies, lumbricoide, tapeworms, etc., pressing or
-directly or indirectly infringing upon the nervous track that conveys
-the force which supplies the erectile tissue of the penis. This is a
-paralysis of the vaso-motor variety, in which the impotence is only a
-symptom: the disease must be studied under nervous diseases.
-
-To comprehend and study true impotence, the student will be attracted
-to the brain and spinal cord; as there only can the pathology be
-carefully comprehended.
-
-Nearly all the descriptions of this perplexing malady have been
-confined principally to the chronic flaccid penis and the general
-nervous phenomena most likely to co-exist. I must say that our
-knowledge is very limited beyond the superficial sources of
-information; and we have to content ourselves with simply describing
-the appearance, for the real disease itself; not but what structural
-changes exist in the sexual organs, worthy of note, but such changes
-are only secondary.
-
-Depending upon organic disorganization of the nerve-substance, we have
-all grades of loss of sexual power, from the simple chronic premature
-ejaculation to advanced and perfect paralysis of the organ. Any male
-who, from exhaustion of nervous force, cannot perform the act of
-copulation in a normal manner, may be said to be in a degree impotent.
-If he be able to effect intromission and then unable to complete
-the act, from premature ejaculation――providing this is a common
-occurrence――he may be said to be impotent. The continent may undergo
-premature ejaculation and not be impotent. Neither is flaccidity likely
-to follow ejaculation from such cause.
-
-The more advanced cases of impotence are not even capable of procuring
-erections; and often semen is discharged in the flaccid condition
-without the knowledge of the patient: such may be the result of
-spermatorrhœa and impotence combined.
-
-The long-continued and frequent indulgence of masturbation must be
-a most frequent cause of impotence. I have only observed a very few
-whom I knew to have brought upon themselves this condition without the
-habit of masturbation; and even then I am not positive in knowledge.
-Yet they were rare debauchés, with money to squander and appetites so
-salacious that the almost constant contact with women was their custom.
-On the other hand, it seems that a male human being is constructed for
-endurance of his sexual organs. A notorious polygamist in practice,
-once living in the city of Elmira, New York, was known to lavish his
-smiles on his “kept women,” whom he numbered by scores, and still he
-was potent till he died in advanced life. We must have a most excellent
-example in the famous President Young whose wives, we are inclined to
-believe, must have kept him on the _qui vive_, as his children bear
-evidence, as well as the fascination and attractiveness of his young
-wives.
-
-The exciting cause of impotence must combine a constant and
-long-continued sexual debauch with the depraved chain of thought that
-must necessarily accompany such degradation; and the practice of
-self-pollution must be the most fruitful of all causes.
-
-_Treatment._――In the management of impotence, the patient’s persuasive
-influence must not in any way change the intentions of the physician,
-or the fast hold of his mind, which is so indispensable to a cure,
-will be lost. The patient is always in great haste, and constantly
-urging the physician to make rapid progress. Too great firmness cannot
-be exercised, and promises of speedy cure will invariably fail.
-Time is one of the most important of all elements in the treatment,
-as opportunity is afforded for the recuperative powers of nature or
-physical forces to become poised.
-
-Perfect confidence in the medical adviser is prerequisite to success,
-as by this alone can the patient’s mind be manipulated, and his hope
-constantly stimulated. If he has been much exercised in mind about his
-case, from reading “self-abuse” literature, moral treatment will be
-required to dispel from his mind the pictures there wrought. Not always
-can the virile organ be restored to its normal vigor, but elevating the
-general health should be first considered, and the patient’s mind kept
-constantly thinking about his improving physical condition, instead of
-watching for the first erection as he will most naturally do.
-
-When the foregoing conditions cannot be secured, no benefit will result
-to the patient. In no disease has mental influence so much to do with
-recovery, as in impotence; and I do not hesitate to say, where I can
-control my patient’s mind, that I can always effect a very satisfactory
-relief. Employment is indispensable, and must be persisted in. The
-patient should have no time to play, or brood over his disease, but
-must be engaged so constantly that he will be even fatigued after he
-has finished his day’s toil, and will sleep long and soundly from
-his exhaustion. The most nutritious diet should be selected: meat,
-eggs, oysters, milk, etc. Cold bathing at night, before retiring, is
-a very important measure; as, first, it washes the parts of a cold,
-clammy sweat, and the chill from the water after reaction, produces
-a naturally warm feeling, and his attention is not attracted to the
-parts by their otherwise doughy, unnatural feeling; and secondly, the
-tonic properties of cold are of lasting benefit. The bathing should
-extend to the back, perineum, scrotum, penis, and down the thighs. Such
-constitutional measures should be resorted to as will favor any of the
-imperfect processes in the body. The means should favor assimilation of
-food and normal excretion, and the avoidance of stimulating diet and
-alcoholic liquors.
-
-For the neurosis upon which impotence depends, I have accomplished
-very much by a single combination of medicine (see formula No. 1),
-that this preparation has been, as it were, a “stand-by” for many
-years; the patient gradually improving under its use, in nearly every
-case. I can affirm that it has been tested in hundreds of cases, in a
-great majority of which marked improvement has taken place, and many
-have been permanently cured. Many were cured before I became familiar
-with the importance of electricity in the treatment of such cases; but
-since having extensive experience with the various methods of applying
-electricity I confess I could not do well without it.
-
-As to the beneficial results following galvanism and Faradisation,
-there can be no question; but as to which of these forms should be
-applied, I am not always able to say. I have used galvanism without
-benefit, a certain length of time, and changed to Faradism with
-immediate improvement; and _vice versa_.
-
-I do not opine that either form, if used mildly, will often do harm;
-and where improvement does not follow after a reasonable length
-of time, I would advise a change. When the patient is wakeful and
-restless, a pleasant effect is produced by Faradisation, which is often
-a favorable sign, and may be continued with exalted expectations. In
-very advanced cases, the galvanic current will oftener establish an
-improvement, when a change to the Faradic current will continue the
-improvement. I consider no means of the physician demanding so much
-judgment and experience as electricity; and in the skilled operator’s
-hand much good may be realized from its use.
-
-A very natural manner of applying Faradisation in impotence, as well
-as other forms of sexual neurosis, is to seat the patient upon a large
-wet sponge, to which the negative is connected, bringing the scrotum
-and perineum well in contact with the sponge, and stroking the spinal
-column well with the positive, also using a wet sponge. The operator
-will be governed by the patient’s sensibilities, as to time of sitting
-and strength of current. The current should not be painful or very
-unpleasant; and if twenty minutes produces any uneasy sensation, the
-next application should not be continued longer than ten minutes.
-
-The galvanic current may be used in a similar manner.
-
-Beard & Rockwell’s method of general Faradisation is a most excellent
-one for alternate applications.
-
-A troublesome complication is often constipation of the bowels, which
-may be overcome by the judicious use of rhamnus purshiana. Not too much
-general bathing, but local bathing, as directed above, with stimulant
-friction, is always beneficial.
-
-Turkish baths, so often ordered, must be avoided, as great general
-debility and languor often follow their use. No undue warmth can be
-made use of, either in dressing or bathing, as the neurosis, upon which
-all these unnatural phenomena depend, is aggravated.
-
-The general treatment of neurosis, in impotency, differs very little
-from that in the neurosis of spermatorrhœa, as the conditions are
-very similar if not identical; only degrees of the same organic
-cerebro-spinal changes. The beginning is perhaps only a neurasthenia,
-but gradually increasing in intensity to spinal anæmia, or congestion,
-finally softening.
-
-Any changes of the genitals must be treated according to principles
-mentioned under treatment of structural changes of the genitals.
-
-_Clinical Illustrations._――It must not be expected that all cases
-will be confined to one definite condition, or to one combination of
-phenomena that may be grouped together and named. No one will so fully
-comprehend this as the practical physician. Cases are constantly under
-the care of the medical man, suffering with conditions too numerous
-to mention, complicated with many strange lesions. Every case must
-necessarily be studied from its own merits, in and of itself, or
-success will not follow.
-
-It is not uncommon to come in contact with spermatorrhœa and impotence,
-both together, also complicated with organic disease of testicles,
-prostate gland, and anus or rectum. At the same time the brain and
-spinal cord may be drawn upon by a variety of organic lesions. By this
-we shall see that a report of clinical cases will bear more upon the
-practical than the theoretical, as regards adapting doses to nosology.
-
-_Case._――J. S. consulted me in ’74. He was suffering from spermatorrhœa
-and partial impotence. He had tenderness over last lumbar vertebra and
-sacrum, anæsthesia of the genitals, dyspepsia, bowels constipated,
-and at times very languid; was brooding over his loss of power and
-involuntary discharges of semen, which were nocturnal, generally
-accompanied by lascivious dreams. The urethral sound revealed
-tenderness along the urethra and extreme soreness of the prostate
-gland. His semen was thin and spermatozoa scanty and imperfect. He
-was thin in flesh, and anæmic. His erections were imperfect, and he
-could not perform the act of coitus. He was a masturbator. I directed
-pills, formula No. 2, and continued until bowels became regular; also
-No. 1, which was continued one year without change, with cold local
-bathing and brisk friction over bowels, back, perineum and scrotum. His
-recovery has been very satisfactory.
-
-_Case._――J. W., when he first visited my office for examination
-and advice, was emaciated, pallid, with his eyes sunken. He was
-careworn and haggard in his expression, suffering from pain in his
-back and limbs, almost constant pain through the top of his head;
-palpitation, with accelerated pulse; formications over his back and in
-his finger-ends; bowels constipated, and urine smelled strong like a
-horse’s; tender spots along the spinal cord. The testicles and scrotum
-were doughy and constantly moist and cold. His scrotum was long and
-pendant: his penis was blue and flabby. He could only obtain partial
-erections, very occasional. He lost semen often. His urethra was very
-tender, also the prostate gland. He was restless and wakeful during the
-night. I directed local cold bathing, Faradisation, formula No. 1, for
-his general neurotic condition; pills――formula No. 2――for constipation.
-He took chloral every night, to produce sleep, for 3 months; tr.
-staphisagria, small doses, for prostatic irritation, and occasional
-opium suppository. I discharged him after sixteen months, when he
-married, and now has a healthy child.
-
-_Case._――R. confided to me his history, which was, he had been a
-debauché and masturbator. He was tall, slender, anæmic, beard thin;
-was suffering from too much medicine, which he had received from
-unprincipled specialists, as he had been three years in their hands.
-There was spinal anæmia, judging from the spinal soreness, and
-formication at times. He thought he would become paralyzed, as his
-hands and feet often became numbed. He was impotent, and often lost
-semen. His urine contained spermatozoa. As soon as his mind could
-be put at ease he began to improve, under formula No. 1, with cold
-local bathing, as directed, with Faradisation. I discharged him after
-thirteen months.
-
-_Aspermatism._――Since Roubaud’s description of this condition, and
-especially the application of the above term, much has been said in
-regard to the causation and true nature of this peculiar deficiency.
-Whenever sexual orgasm occurs in the male, after puberty, without
-ejaculation, the condition known as aspermatism may be said to exist,
-and may be considered as a symptom of disease. This may be partial or
-complete. I have known a number of individuals who failed to ejaculate
-semen at the time of sexual orgasm, and the semen would pass away in
-jets some time after the penis had become flaccid. These cases exist
-where there is no sign of organic stricture of the urethra, or any
-other organic trouble within the prostate gland or ejaculatory ducts.
-
-Dr. Van Buren is the author of a paper which appeared in the _New York
-Med. Journal_, November, 1868, in which he attempts to establish the
-cause as a spasmodic condition of the urethra, forcing the seminal
-fluid, by reflux action, into the bladder. I can not, at present, think
-that this is always the case. Only a little attention to physiology
-will familiarize any person with the calibre-contractions that follow
-a column of urine from the bladder to the meatus. This same muscular
-contraction exists in the veins, and is what constitutes the venous
-wave. The same wave exists in the ejaculation of semen; and where the
-muscles that perform accelerating movements are paralyzed, the natural
-consequence must be, that the fluid will remain in its reservoir until
-its place is supplied by new, and a portion is forced out along the
-urethra, which drips away when the penis returns to flaccidity. Then, I
-can but regard this condition, often, as one of paralysis, in which are
-affected the muscles of ejaculation and acceleration. This condition
-often exists where the genitals are not impaired as to potence. That
-such a condition is present, should not be declared until after bougies
-have proven, to entire satisfaction, the absence of organic stricture
-or spasmodic contraction.
-
-When such a lesion has come on gradually and is of long standing,
-the prognosis is very unfavorable; as relapses will most generally
-occur with the slightest indulgence. But when the condition has made
-its advent suddenly, from inflammatory causes, the prognosis is very
-favorable. A gonorrhœal orchitis will often produce this condition,
-which is only transitory, or of a few months’ duration. This is only
-symptomatic, and very much unlike the true aspermatism of a neurotic
-origin.
-
-A very extraordinary case has of late engaged my attention and
-curiosity. No case of the kind have I been able to discover, in medical
-literature or in the practice of my medical friends.
-
-_Case._――A young married man consulted me with an affliction (as it
-were), much to the discomfort of himself and to the great injury of
-his wife. He never had passed the sexual orgasm, nor ejaculated semen
-during coition. He is very erotic, and has no difficulty in performing
-the marital act, but it is followed without the slightest satisfaction.
-He continues in the act of coition until exhausted, and retires with
-the wife very much in the same condition after repeated sexual orgasms.
-He informs me that one hour is not an uncommon length of time for him
-to occupy in the act of coition, participating in the sexual beatitude
-during the entire period, until gradually becoming exhausted, when
-the pleasure dwindles away, but his penis remains erect for some time
-after. He says that he has often applied cold water to facilitate
-flaccidity.
-
-After the organ has been reduced he sometimes can detect semen, or
-prostatic fluid, on the glans and meatus, and he is very soon ready
-to perform the act again. I have often discovered spermatozoa in his
-urine. His testicles are well formed, and his penis is normal in
-appearance. He has never had a venereal disease, and has no stricture.
-Treatment has given no relief as yet. It will be observed that
-satyriasis is prominent in this case.
-
-Galvanism will often be found of great service as a paliative measure,
-with phosphide zinc and nux vomica. If a few years’ continence can be
-obtained, a better prospect for recovery may obtain. When galvanism is
-used, an insulated electrode should be passed to the orifices of the
-ejaculatory ducts, with the anode attached, and the cathode applied to
-the cord with wet sponge. I have derived some benefit from localized
-and general Faradisation, after the manner heretofore mentioned.