IMAGE EVALUATION TEST TARGET (MT-S) 1.0 I.I 1^ m 2.0 m 1.25 1.4 1.6 *« 6" ► 7]

r and more condensed foi-m in the central portion so as to constitute a septum, dividing its interior into two cavities, and separating the testi- cles, so that t! 3y can never come in contact with each other. The corrugation ot the skin of the scrotum keeps the testicles pressed upvards towards the abdominal ring, by the action of muscular fibres collectively designated by anatomists as the dartos muscle. On laying open the scrotum, the testicle of each side is found to be enveloped by its proper coverings, which extend upwards through the abdominal ring, constituting what is called the spermatic cord. The membrane immediately enveloping the body of the testicle, called the tunica vaginalis, which is a dense membraneous sac of a bluish white colour is found to have packets of muscular fibres attached to its outer surface, which can be traced upwards through the abdominal ring to the lower edge of the internal oblique muscle of the abdomen, as it descends to the pubes. These fibres from the cremaster muscle, the office of which is to assist in supporting the weight of the testicle, and sometimes, as in sexual congress, to draw it upwards. Contained within the cavity of the tunica vaf^malis, beside the testicle itself, is the appendage called the epididymis, to be afterwards described. The accu- mulation of fluid within the cavity of the tunica vagi- nalis forms the disease called hydrocele. The testicle, although not a vital organ, i. e., one necessary to the existence of life, as the heart, lungs, &c., is one absolutely necessary for the perpetuation of the species, and therefore receives its nerves from the same source as the vital organs themselves. These nerves are conveyed through the spermatic cord, as also are the spermatic veins and arteries. The vas deferens, or excretory duct of the testicle, ■which is readily distinguished from the other vessels by its cartilaginous feel, also passes through the spermatic cord. ? ^ MALE OKCIANS OF GENERATION. 9 ith cel- , which in the iividing le testi- th each I keeps lominal actively of each ^^erings, %\ ring, body of ich is a colour, ched to through internal s to the cle, the eight of )ngress, t[,,malis, [led the e accu- ca vagi- e.y one ;, lungs, etuation es from . These c cord, testicle, vessels igh the I The secreting structure of the testicle is enclosed within a firm and dense membrane called the tunica albuginea. It is possessed of some elasticity, so as to enlarge when the vessels of the testicle are full, and contract upon the evacuation of their contents ; but it is to the resistance offered by this membrane to a rapid or extensive enlargement that the intense pain conse- quent upon inflammation of the testicle is attributed. A white substance extends in a line through the testicle, from one extremity to the other, in a manner somewhat resembling the core of an orange, which has been called the corpus Mghmorlanwn, or the nucleus of the testicle. From this nucleus a number of slender white bands or divisions extend to the tunica albuginea (resem- bling the divisional membranes separating the so-called " quarters " of an orange), the spaces which they en- close being filled with a greyish or yellowish substance (corresponding with the fleshy parts of the orange), which substance, however, is found on close examina- tion to consist of packets or bundles of exceedingly minute and higlily -twisted vessels. There are from thirty to forty of these packets > and when the tubular vessels are drawn out and untwisted, their length is found to be very considerable. A celebrated anato- mist has reckoned the diameter of a single tube to be the three-hundredth part of an inch; and asserted that the length of the whole, when unravelled, in an adult testicle, proved to be 5,208 feet. These vessels have been called the tubull se?nlniferi, and they form the largest proportion — indeed, nearly the whole — of the bulk of the testicle. The semen is first formed in these tubuli. Eacli packet of tubuli surrounds a short and straight vessel, placed at its upper extremity, into the bottom and sides of which the tubuli enter and deposit the semen formed in their cavities. These common reci- piejits of the fluid from the tubuli of each packet have been called vasa recta; they aveiage about one-tenth of an inch in length, and are usually about one-third of their length in diameter. a2 10 STRUCTURE OF THE The vasa recta terminate in a set of vessels of a cylindrical shape, wliich have been named the o'ete Uitii. These are firmly attached to the tunica albu- ginea, running parallel to each other in the direction of the corpus highmorianum, or core of the testicle : they are generally about thirty in number, and form communications with each other, either by lateral openings or by very short branches, so that fluid poured in one will readily pass to the others. From the termuaations of the vessels forming the rete testis, minute tubes, to the number of thirty or forty, extend in tortuous convolutions beyond the body of the testicle to the organ next to be described, viz. : the epididymis. These tubes are termed vasa efferen- tia. The vasa efferentia, uniting one with the other in succession, ultimiitely coalesce in a single tube, which arranges itself in such multifarious convolutions that the number of the flexions has been calculated at up- wards of eleven thousand, and the length of tube, when unravelled and extended, would exceed thirty- one feet. These convolutions are arranged in a coni- cal form, resting upon the upper and back part of the testicle, and are designated in their totality — the epi- didymis. The great length of tube forming this organ proves that slowness of motion is essential to the per- fection of the semen. As the tube approaches the termination of the epi- didymis it gradually increases in capacity, its convo- lutions cease, and it then becomes the vas deferens, before referred to. The vas deferens, in company with the spermatic artery, vein and nerve, all included within the sperm- atic cord, passes almost vertically upwards to the ex- ternal abdominal ring, on entering which it shghtly alters its course, passing outwards as well as up- wards, and having gained what is called the internal abdominal ring, passes through it into the cavity of the abdomen, where its component parts separate, the blood-vessels and nerves passing on to their sources ; the vas deferens dipping into the pelvis, continuing u MALE ORGANS OF GENERATION. 11 els of a :he rete ca albu- lirection :esticle : id form lateral at fluid ling the ;hirty or he body jd, viz. : efferen- ather in 3, which ons that d at up- 3f tube, i thirty- 1 a coni- rt of the ■the epi- is organ the per- the epi- } convo- leferenSj dermatic 3 sperm- > the ex- shghtly as up- internal javity of 'ate, the sources ; ntinuing along the side of the bladder, and terminating in tlie vesiculce seminales. The vesiculae seminales resemble in structure the vasa deferentia. They are two small tubes, about two inches and a-half in length, but being convoluted, appear much shorter, and arc situated at the back part of the bladder ; the membrane lining them is thrown into folds, so as to form a number of cells. Here it is that the semen is stored up, these tubes answering the purpose of reservoirs : each vesicula terminates, posteriorly, in a rounded cul de sac, and, anteriorly, unites with the vas deferens of the same side to form a common duct. These common seminal ducts, resulting from the junction of the vas deferens and the vesicula on each side, are termed the ductus ejaculatorii. Each is about an inch in length, and its calibre is greater and more dilatable than that of the vesiculoe seminales. They are directed forwards, parallel to each other, pass through the prostate gland, and open into the urethra (the central canal of the penis), by two small oblong orifices. The prostate gland is a small body, about the size and shape of a chestnut, surrounding part of the neck of the bladder, and the commencement of the urethra, measuring about an mch from before backwards, a little more from side to side, and about half an inch in thickness. It is traversed by the urethra, and also by the ductus ejaculatorii ; the greater part of it, however, is situated below the urethra, and it there- fore rests upon the rectum. It consists of three lobes, two placed laterally — one on either side — and the third between and behind the other two. It secretes a thin white fluid, which is supposed to be for the pur- pose of lubricating the urethra : its texture is pecu- liar, and is well known to possess, in a high degree, the property of elasticity, a fact which has been turned to considerable account in the "peration of lithotomy. TJie prostate Irequently becomes enlarged in old age. Having thus described the organs concerned in tlic elaboration and conveyance to the urethra of the various secretions concerned in the office of roproduc- 12 STRUCTURE OP TIIK tioii, SO far as the male is concerned, it is now neces- sary to refer to the structure of the intromittent organ — the Penis. The penis, although it gives passage to the urine, is not a structure essentially required for that purpose, as in the female no such structure exists, except as represented by the clitoris ; its anatomical characters, therefore, have no rel'erencc to that action, but are adapted solely to the conveyance of the seminal fluid to the uterus of the female for the important purpose of impregnation. It is formed chiefly of three bodies of particular structure ; two called the corpora caver- nosa, and the other the corpus spongiosum : the whole adapting the form of the organ to the use for which it is to be employed. These bodies are covered by the common integuments, loosely attached by the cellular membrane to their surfaces, so as to allow of the ne- cessary variations in the size of the organ : no fat is discovered in the cellular membrane. The corpora cavernosa form about two-thirds of the entire volume of the penis, and determine its form ; they are of the shape of longitudinal sections of cylin- drical tubes, placed side by side, and blended together the greater part of their length, whilst at the rest they branch off" into the two muscles called the crwr^, and consequently present nearly the appearance of the letter Y, the upper part of which would be placed agahist the pubis, and the Iwver at the glans penis. The corpora cavernosa form the upper part of the penis ; their colour is generally an opaque white, and their structure a slightly elastic, dense, fibrous membrane, traversed in many places by the blood- vessels concerned in produchig that distension of the organs called erection. The corpora cavernosa do not extend quite to the end of the penis, the glans and the extremity not form- ing a part of it. The corpus spongiosum forms the loAver part of the penis, and is analogous in its struc- ture to the corpora cavernosa. The urethra is situated partly in the groove formed by the union of the tAvo corpora cavernosa, and the remaining part surrounded I i MALE ORGANS OF <^EXKRATrON". 13 V ncces- it organ e unne, purpose, "ccept as iracters, but are rial fluid purpose ) bodies % caver- e whole which it by the cellular the ne- 10 fat is s of the 3 form ; )f c jlin- ogether ?st they ra, and of the placed s penis. of the white, fibrous ! blood- i of the 3 to the )t form- •ms the s struc- 3ituatcd the two ounded by the corpus spongiosum : it extends from the neck of the bladder to the extremity of the penis, and is, in the male, from eight to ten inches in length : it serves to convey the urine from the bladder, and the seminal fluid from the ductus ejaculatorii : it is divided into— a prostatic portion, about an inch in length, into which the ductus ejaculatorii and the orifice of the mucous follicles of the prostate gland open— a mem- branous part, comprising the interval between the prostate and the bulb, also about an inch in leno-th, and being the narrowest part of the canal— and a spongy or vascular portion, extending from the bulb to the glans, and being about six or seven inches in length. At the end of this portion, viz., within the glans, there is a great dilatation of the canal, called the fossa navicularis : it is this part that is generally afiected in gonorrhoea. The (jkms penis is a conical prominence forming the extremity of the penis, and presenting at its base a circular ridge, called the coro-^ na glandis. _ Having thus described the male organs of venera- tion it becomes necessary, in order to properly un- derstand their functions, to refer briefly to those of the female. CHAPTER IL STRUCTURE OF THE FEMALE ORGANS OF GENERATION. The internal female organs of generation are the vagina i\i& passage leading from the labia or outer lips to the OS uteri or mouth of the womb, which, laid open, would enable us to notice the ruo'se of the muco r membrane by which it is lined— it is these rugoe, 0. folds of the vagina, which cause the plea- mirabe sensation when tlic intromittent organ is intro- duced m the act of coitus. The kind and quantity of these rug» vary very much in diff"erent females, and in rare cases are altogether absent. At the innermost extremity of the va'nna is the 14 STRUCTUBE OP THE the neck and the os uteri, or mouth, of the uterus or womb. The uterus, within the cavity of which the embryo becomes developed into the perfect humafi being, is a pear-shaped organ, which, in the healthy unfecundated state, is about two inches in length and one in width. In common medical parlance it has long been separated into two portions, but it was not until recently that that division has been recognized by Anatomists and Physiologists as distinct in character, function, and in the distribation of nerves. These two portions are — first, the lovver portion of the pear-shaped form, con- taining the cervix uteri, or passage from the mouth upwards ; and the upper and larger portion, con- taining the cavity of the womb. Bearing in mind the pear-shaped figure, the internal configuration of the uterus will be most easily under- stood by imagining that in the broad part of a pear, just al'ove the seed vessels of its core, there is a cavity which, if the pear were cut in two, would present an inverted triangular form ; the base of the triangle towards the broad end of the pear, the point, or apex, towards the stem ; at this point there is an opening into a canal proceeding to, and terminating at the part where the stem is inserted. This canal is the cervix uteri, small in diameter at the end next the stalk, then immediately enlarging for a short distance, and thence gradually diminishing as it approaches the entrance to the triangular cavity in the upper part of the pear, at which point it is smallest in diameter. Except per- haps at the period of menstruation, no instrument whatever can be passed through the cervix uteri into the triangular cavity of the uterus without injury to the lining membrane ; an extremely small probe would seriously puncture and lacerate the membrane, whilst one sufficiently large to avoid puncturation could only be introduced by great force. From the triangular cavity at the upper part of the womb, we find, on examination, that from the two points of the triangle, right and left, two other canals or passages proceed to the extremities of the liga- OENERATTVE OROANP. 15 ments which support tlio woml) ; these are called the fallopian tuhes^ the office of which is to convey the ova from the ovaries into the cavity of the uterus. Each of the ova is contained within an ovisac, to which sacs the name of graafian vesicles has been given. The ovaries of the female correspond in im- portance to the testicles of the male. CHAPTER HI. FUNCTIONS OF THE GENERATIVE ORGANS. liga- It becomes necessary, in the next place, to say a few words upon the functions of the organs, male and female, thus described. I will begin with the latter. From the commencement of puberty the ovaries arc the seat of a continual detachment of ova from the graafian vesicles which contain them, the emerging ovum being surrounded and seized, as it were, by%he fringed extremity of the fallopian tube, through which it gradually makes its way to the cavity of the uterus. This process takes j^lace independently of sexual con- gress, both in women and virgins, generally at the time of menstruation, but frequently at other times under conditions not yet accurately determined. Professor Bischoff, who had examined the genera- tive organs of thirteen women who had met their death suddenly during the process of menstruation, remarks of those cases that they confinn the doctrine that in woman, at every menstruation, a follicle ripens, swells and bursts ; that the ovum escapes, and that a corpus luteum (a sort of scar in the ovar;y , markino- the place whence the ovum was detached) is formed^ His eleventh case, however, seems to prove that the full consequence of menstruation is not in every in- stance fully carried out, but that a follicle may swell and the ovum ripen without the bursting of tlie one or the escape of the other; such a condition will cause sterility notwithstanding menstruation, and to such a condition, the pain sometimes experienced 16 FUNCTIONS OF THE during the menstrual period may possibly ])e attributa- ble. On the other hand, a woman may not menstruate and yet she may conceive ; for, as observed in Stenle and rfeufer's " Zeitschrift" (1853), the ripening and escape of an ovum may proceed, although the usual outward symptom of this event — the secretion of blood, &c. — may fail. At the appropriate season, the shad discharges her eggs upon the waters, trusting that they may be found and fecundated by the male. The domestic hen, at l)roper intervals, prepares a batch of eggs, which, when sufficiently matured, she " lays," whether fecun- dated or not. In like manner, "the ovaries of the human female, at her regular periods of four weeks, discharge one or more eggs, which, in a virgin, will of course perish uufecundated ; or, if sexual intercourse takes place, will be fecundated or not, as other cir- cumstances may operate. The process of menstruation is the layin<^ of a human egg, or ovum, differing little in its general characteristics, on its first appearance, from tlie ef>-"- of a dog, a cow, or a bird. The human egg corres^ ponds in almost every particular, except in size, with the egg of the hen : indeed, the egg of the fowl may be looked upon as the type of all eggs, when divested of its shell, the membrane beneath it, and the white. These, however, form no part of the egg, even in the hen ; they are added in its passage along the oviduct. The egg of the human female is very small, measuring, according to Bischoilf; from tU to 5 J-,,- of an inch; it is surrounded by a transparent membrane, which under the microscope appears as a l)right ring, and is hence termed zona pellucida, exterior to which is a heap of cells, called discus proUgmis. Within the zona pellucida is situated the yelk, composed of a number of granules and globules of various sizes, im- bedded in a fluid. In the substance of the yelk is contained the small speck, called the germinal vesicle, which is delicately transparent, contains a pellucid fluid, and has a minute opaque spot, on one part of its ing, GENEllATIVE ORGANS. 17 of a prrcT wall, to which has been given the name of the germi- nal spot. The menstrual discharge is a mixture of blood and glandular albuminous secretion. The act of men- struation is one in which the whole genital apparatus sympathizes, if not the entire constitution. During the month, the graafian vesicles enlarge, and approach the exterior of the ovary, till, having arrived at maturity, the sac bursts, as bcforo mentioned, and, borne on by a flow of blood accompanying this break- ing, the ovum is floated down the canal of the fallopian tube, the fimbriated extremity of which, concealing withui it the open mouth of the canal, has, warned by I the general uterine disturbance, been closely applied to the ovary, ready for the coming ovum. The egg then gradually makes its way into the cavity of the uterus, occupying in its transit, according to Pouchet, from two to six days. During the passage of the egg down the fallopian tube, towards the uterus, the germinal vesicle disap- pears, the yelk dividing into smaller spheroidal masses ; first two, then four, then eight, and so on. The ovum also becomes coated with an albuminous layer, corres- 1 nnding with the " white" of the hen's egg, the outer I oition of which forms a membrane called the chorion. The uterus, also forewarned of the coming of the ovum, is in a high state of turgescence, and the numerous follicular glands which stud its inner sur- face, and are continued through its neck, throw out an : abundant supply of mucous, glandular, semi-albuminous I discharge ; and sometimes blood exudes from the - turgid vessels lining its surface. When this exhala- tion is limited m character and quantity, it forms a m.embrane lining the interior of the cavity of the uterus, called the deddua, which, as the ovum enters through the :^allopian tube, recedes before it, forming I an extra but partial covering for its protection. 1 If, from any diseased action or extraordinary con^ gestion of the' parts, the flow of blood and glandular secretion be unusually profuse, the ovum may be washed aw" But if the discharge be of moderate 18 FUNCTIONS OF THE ({uantity, tlicii the ovum will bo caught in some fold or cell in the cavity of the uterus, and will remahi there until, in the course of nature, its vitality being lost by lapse of time, it be voided like all other eflfete matter of the system, or be impregnated in conse- quence of sexual congress, thenceforward becoming developed into the perfect human being. It has been known, however, from the beginning of the world, that tlio co-operation of the two sexes is necessary, in order to fulfil the purposes of the Creator. It has 1)een satisfactorily ascertahied, that the semen formed in the testes of the male of the more perfect classes of animals, must be conveyed to those bodies, which have just been described, called ova, formed in the ovaria of the females, and containing the rudiments of the fuiare animal, in order to excite the embryo to evolution, au^> to impart to it the prin- ciple of vital action. The venereal desire commences in man at puberty, and appears to depend on the secretion of the seminal fluid ; for it does not exist until the testicles begin to enlarge and secrete, and it leaves the male when they have been extirpated. It is an established fact, that when the testes have been removed in early life, the individual has no sexual desire. It is al«o of less force in advanced age, when the semen is more sparingly elaborated : and in the case of persons whose testicles are but imperfectly devel- oped, it is always languid, if not entirely absent. In the female sex it also, as already mentioned, begins at puberty, when the ovaria enlarge, and ova are formed in them; but it does not occur in the female of quadrupeds where the ovaria have been destroyed, and is much lessened in advanced life, when the ova cease to be formed, and the ovaria begin to shrink. The seminal fluid, or semen, which it is the function of the testicles to secrete, is always, when evacuated, mixed with the secretions of the vesiculae seminales and prostate gland, and mucus of the urethra : float- I omc fold 1 remain ty being cr effete 1 conse- ccoming )ginning vo sexes ) of the hat the le more to those led ova, titaining excite he prin- )ubcrty, seminal begin to en thej Lct, that life, the hen the ;he case f devel- nt. ationed, and ova in the ^e been e, when )egin to 'unction cuated, minales , : float- ii GENERATIVi3 ORGANS. 19 ing in it i^-c also to be found a greater or lesser num- ber of epithelial scales. The sccre.ions, however, which enter into the com- position of iiiG ejaculated fluid have a relative propor- tion to each other ; that of the vesiculae seminales amounting to about f(Mir-sovenths ; that of the testicles and vasa doferentia to about one-seventh ; while the remaining portion consists of the products of the pros- tate gland, mucus of the urethra, &c. To examine the semen in a pure state, it must be taken from the vasa effcrentia of an animal recently d^al, and whose death has been produced frorainten- ti(jn or accident, but not from disease. According to the analysis of Vanquilin, human semen consists of Water 90 parts. Mucus 6 „ Phosphate of lime 3 „ Phosphate of soda 1 „ 100 It is well known that the mucous secretions of the vagina and uterus occasionally present very altered chemical conditions, being either excessively alkaline or having acid properties' ; in either of these cases a deterioration of the fecundating fluid is likely to happen. It is the office of the prostate gland to secrete a mucus charged with more or less of the phosphates of lime and soda, which is evidently designed to counter- act the injurious effects likely to arise from an abnor- mal condition of the secretion of that portion of the mucous ^ membrane appropriated for the reception of the seminal fluid. It is the office of the vesicuh .Aes to elaborate a fluid, having important relatio. '.ae conservation of the fecundating properties of the spermatic secre- tion, as well as perhaps to render it more effective in the process of impregnation. The application of the microscope to semen ix<.3 discovered that very minute organic bodies float in 20 FUNCTIOXr. OF THE it, wUch move with rapidity ; au'l from tlio mauuoi; in which they disport themselvus, retrogrcsBing, avoiding o))8taclca, and changing their velocity, have beon con- sidered animalcules. Their form resembles that ot the tadpole, with a round head or body, and a narrow tail. Ludovic Ilaume is said to have been the dis- coverer of these bodies, and to have shown them to Lewenhoeck in 1677. Lewenhoeck, however, has claimed the discovery as his own. These bodies, to which the name of spormatozoa is applied, arc now generally understood not to be ani- malcules, but elementary portions of the male organ- ism. We do not, however, undersiuud the mode of production of their very curious movements ; the ol)je.H of which is evidently to propel them onwards through the uterus to the ovum, and into its substance. That the spermatozoa arc the proper fecundating elements of the semen has been placed beyond the slijihtest doubt by the observations of Prevost, Dumas, Leuchart, and ethers, on the semen after filtration, and above all by the recent researches of Newport. The last named author has also established the fact that the spermatozoa actually penetrate the substance of the ovum, as was asserted by Barry many years previously ; and on this point many other physiologists have confirmed the statement of Newport by observa- tions on the generation of various animals. Now that we are acquainted with the passage of the spermatozoa into the ovum, we can no longer regard their fecundating r -vet as being a dynamic influence, ad was formerly sn^^ o'.;ed ; on the contrary, it is now an estabUshed fa., < -.'Xh tiie material of the spermato- zoa becomes actually mingled with the yelk, and thus renders it capable of development. It is such profound physiological revelations as these, tending to illustrate how it is that the offspring resembles the parent, that must ever give to this subject the most unbounded interest. When, under the impulse of sexual excitement, the male seeks intercourse with the female, the erectile tissues of the genital organs become turgid with GENERATIVE OROANS. 21 Luuor la ivoiding ((in con- tliat of narrow the dis' thorn to er, has itozoa IS ) be ani- e organ- mode of ts ; the onwards .bstance. indating ^ond the , Dumas, tion, and )ort. [ the fact ubstance ny years siologists observa- ge of the X regard nfluence, it is now jpermato- and thus profound illustrate rent, that nbounded ment, the e erectile rgid with Mood. These erectile tissues arc chiefly coi. \ined within the corpora cavernosa in the penis of the lale, ;ind in the chtoris and tissues of the vagina in the female. The erectile tissue appears essentially to consist of a plexus of varicose veins enclosed in a fibrous envelope ; and according to Gorber, this plexus is traversed by numerous contractile muscular fibres, to the contraction of which is probably to be attributed the obstruction to the return of blood, which is the occasion of the turgescence. The discoveries of Muller, however, make the matter much clearer, lie found in the penis two sets of arteries, one destined for the nutrition of the tissues, communicating with the veins through a capillary net-work in the usual way ; the other passage into large branches, penetra- ting the cavernous substance in a spiral manner, and communicating abruptly with the venous cells ; and it appears highly probable that the contractile muscles before referred to, while impeding the return of the blood by the veins through the usual or purely nutri- tive channels, may also permit the blood to enter freely into the helicine arteries, or those specially used in producing the erection ; which blood not being able to escape with the same rapidity as it enters, the arteries necessarily become and remain filled until the emotional conditions which had given rise to the action of the muscles concerned had ceased 10 exist. Ejaculation^ or seminal emission, in the normal state, is consequent on the state of the organ pre- viously described. It is, however, in a physiological point of view, a NERVOUS phenomenon — the local excitation having, through the medium of the spinal cord, produced a reflex contraction of the muscular fibres of the vasa deferentia, and of the muscles which surround the ves- iculaB seminales and prostate gland. These receptacles discharge their contents into the urethr?= from which they are expelled with a kind of spasmodic action by its compressor muscles. The muscular contractions which produce the emissio 1i 22 THE rillLOSOPHY OF MAR..-aGE. seminis are excito-motor in tlieir nature, being inde- peXt of the ^vill,.an(l not capable of restraint by it ■when once fully excited. • ^ This emlssio seminis occurring in immediate proxi- mitv to the 08 uteri, or mouth of the womb, the sper- matozoa by the peculiar wave-like motion they possess Take Tbeir wa/ into the cavity of the -terus, .^d meeting, either there or in one or other of the iiUo- pian tubes, one or more of the ova before mentioned, impregnation ensues. CHAPTER IV. THE PHILOSOPHY OF MARBIAGE. The highest authority on earth has pronounced mar- riage to be one of the most honorable obligations which can be incurred by m^.n or woman; and the import- ance of the contract :aay be inferred from its purpose The strongest impulse of our nature is that which induces us to seek the society of the opposite sex, and it is one which the very strongest will can never hold in entu-e subordination, much less destroy. The institution of marriage is one which all nations, from an intuitive feeling of their nature, theoretically- respect, however much it may be practically violated. Few men, except the basest and most depraved, pos- sess the courage and hardihood to speak disrespect- fully of this heaven-born institution, though many act, in secret, as though its vows, its^ duties, and its obli- gations ;ere "trifles light as air." The reason ot this is a conscientious feeling that the contract is a solemn bond, which the interests of private virtue and of pubhc morality alike demand should be respected. The end and purpose of marriage is high and holy, the institution itself heaven-appointed, and its vows and (5l3lj„„tions the most sacred and binding. __ Yet, though such is marriage in the abstract-m the trie id^al of the poet and the philosopher--how different an aspect does it present when viewed m its I ,i^ momei •explai there not, THE PIlILOSOniY OF MARRIAGE. 23 f inde- t by it proxi- 3 sper- )0ssess, LS, ~nd e i lUo- tioned, ed mar- is which import- iurpose. it which sex, and ^er hold nations, retically- violated. ;red, pos- srespect- lany act, its obli- ■eason of ract is a irtue and Dspected. holy, the jTows and tract — in [ler — ^how red in its practical every-day condition. Misery and woe but too frequently follow in its footsteps ; wretchedness is often its noar companion ; and distress and grief occa- sionally cling to it as though they formed a part of its nature. The reason of this may appear difficult to divine, but to the physician — the more especially to him who, like myself, has consented to practice in what is called in medical phraseology a "specialty," and that specialty the diseases of organs having a more important relation to this contract than any others — to such a man, admitted as he is, and must be, to the arcanum of the heart — the very sanctum sanctorum, where the wide t rid is forbidden to enter, and where no intrusive prying eye would for a single moment be tolerated — to him there is no difficulty in explaining this apparent mystery. He knows that there are often circumstances, of which society dreams not, operating most powerfully upon the marriage union, and frequently blighting all the fairest hopes and joys of both husband and wife. The subject of marriage has occupied the pens of hundreds of writers, and been dilated upon in nearly all its phases and aspects ; and truly the topic is a most extensive one — a topic whose ramifications spread through nearly all branches of knowledge. The cler- gyman dilates upon it as a religious rite, and in his high calling describes some of its obligations and du- ties. The lawyer is frequently called upon to unfold and construe old enactments, in which scores of the wisest of legislators were occupied for hundreds of years in framing and bringing up to their present con- dition, relating exclusively to the conjugal bond, show- ing of how much importance the marriage union has been deemed. The historian tells us of complex old forms and ceremonies formerly employed to hedge about the marriage state, long since found unnecessary in the advances of civilization. The moral philosopher and the social reformer describe marriajjie in its bear- ing upon tiie well-being of society, show liow the con- jugal bond is implied in the social law, and how society reaps the greatest advantages from its purity and res- I 24 THE nilLOSOPHY OP MARRIAGE, pect. The psychologist, with scarcely less advantage to society, inquires into the mental difference between the sexes, and endeavors to show that one is essential to the happiness of the other. The physician looks at marriage in another aspect; and certainly the duties and obligations of that state, which are most commonly brought before his mind, are not less important than • any of the others named. Indeed, many of the latter spring from the former. The philosophy of marriage, m its widest sense, would doubtless include the social, moral, mental, physical, and religious aspects of the bond ; but as the physical is the basis of the rest—as It IS the most important, and at the same time the least understood— there is the greater necessity for teaching it; and my remarks will relate exclusively to it. It has been said, and may be said again, that sex-* ual intercourse is the lowest of the wedded duties. This, however, is not so ; and he who asserts it must either be an ascetic, living in an unnatural state of iso- lation from society, having no knowledge of the charm contained in the word "wife," or "child"— one whose mind in all probability has been debased by the gross- est^ of vices, and whose imagination, not purified by legitimate connubial love, is little better than a nest of noxious ideas ; or, on the other hand, one who, with the best of intentions, mistakes the nature of marriage for want of reflection upon its purpose. The physio- logical view of marriage is evidently more important than is generally imagined, and the mere physical pleasures, considering how they rule and regulate th« rest, are far from being the lowest. How deeply rooted the institution of marriage is in human nature, may be inferred from the fact, that it exists in some_ form or other among all races of man- kind. True, it undergoes a great variety of modifica- tions, accordhig to the influences brought to bear upon it, the advances that civilization has made in the coun- try in which it appears, and the character and temper- ament of the inhabitants; but underlying all these 'dif- ferences, there is an unanimity in the importance attached to the fact of marriage itself. It may be- THE PHILOSOPHY OF MAERIAGU. 25 1 advantage ce between is essential an looks at ' the duties b commonly ►rtant than f the latter ' marriage, the social, >cts of the le rest — as e time the cessity for ilusivelj to I, that sex-* ed duties. ts it must tate of iso- the charm one whose the gross- arified by 1 a nest of who, with ' marriage le physio- important physical ulate th« age is in it, that it 3 of man- modifica- >ear upon the coun- 1 temper- these dif- portance may be- come degraded to the lowest and basesft purposes ; ma^ be associated with all that is vile and worthless, and converted into a curse instead of a blessing; but, on the other hand, it may foster the holiest dispositions of mankind, promote love, fidehty, and truth, and become the largest factor in man and woman's happiness that earth has produced. Where the ties of Christian marriage are properly respected, and faithfully adhered to, no pleasure on earth is so great as that of living in a state of matn- mony. "Marriage," says Dr. Johnson, "has maxiy cares, but celibacy has few pleasures." No bond on earth can be more pleasurable and more divine than that in which all the members of a family are bound together by domestic ties. In all proper states of society the laws have always given encouragement to marriage. The censors ki ancient Rome paid particular attention to this object, and by subjecting the single to penalties and ridicule, made them anxious to change their condition. Caesar gave rewards to those who had many children, and prohibited women under forty-five years of age from wearing jewels, who were unmarried and had no children. The law of Augustus was even more severe; he imposed new punishments on those who remained in a celibate condition, and rewarded those who were mar- ried, more particularly if they had children. It met, however, with great obstacles, and thirty-four years after it had been passed, the Roman knights demanded its repeal. Louis XIV. gave great encouragement to early marriages, and recompensed the fathers of famihes who had a certain number of legitimate children. He exempted from taxation all those men who married on or before their twentieth year. In all ages in life the most agreeable companion that a man can have Is a kind and loving wife, one who will share his pleasures and his pains7who is always rejoiced to hear of his prosperity, but who clings to hmi all the more closely should adversity cast its sable 26 THE PHILOSOrHY OF MARRIAGE. shade over his prospects. A woman who is indeed a partner in the strict sense of the word — a true help- mate, a partaker of his joys and his sorrows—is the greatest blessing which heaven has bestowed upon poor, disconsolate, lonely man. It is, however, late in life, in the season of the sere leaves of life's autumn, that this rich and rare blessing is, and must be more highly appreciated. ^ Before quitting the subject of marriage, it is essen- tial for me to add a few hints for the guidance of those who contemplate that serious engagement, and on the conditions necessary for a thorough and healthy accom- plishment of nature's purposes. Extreme youth should be attended by the most com- plete repose of the generative functions, unbroken bv intense feeling for their employment. Should this not be the case, certain and imminent danger awaits upon dawning manhood. It is, however, but too frequently the case that this necessity for repose of the sexual organism in early hfe is ignored by those who have the care of youth. How many of my readers, who are accused of leading immoral lives, might not answer and with justice to their accusers, "you, our parents or guardians, who have all the experience of ao-e without having in the least tau-ht us the necessary selt-control over our passions and impulses, but havino- left us blindly to follow the instincts of nature, now demand of us that we should not only curb our stron^r. est passions, but expect that we can, against natur? bring them to a dead halt at the simple Avord of com- mand. You have educated us in the true and proper use of all our faculties and all our senses, save alone that which IS the strongest of all ; and now, when we have just attained to manhood, you say ' stop ' \las ' your advice comes too late. Having no other monitor but nature, we followed her impulses ; and thouo-h you now tell us the road may lead to ruin, the incline is nevertheless, too steep to enable us to apply the break at once with effect -^ It is, notwithstanding, although most difficult, absolutely necessary that he who wishes to live should do so. If we consult the biographies k. THE rHILOSOrJlY OF MARRIAGE. 2 is indeed a true hclp- vs — is the wed upon ^er, late in s autumn, b be more t is essen- ce of those md on the hy aeeom- most com- )roken bv Id this not raits upon requently ^e sexual who have !, who arc b answer, r parents ' of age, lecessarj it havinccn previously misused, the result will generally be weakly and sickly children, reared with difficulty, and possessing no stamina to enable them to reach the meridian of life. The proper age at which to marry is a somewhat vexed question, but needlessly so, because, although that age varies much, according to temperament and other circumstances, an experienced physician will have no difficulty in saying yes or no to the par- ticular individual who asks him the question, especially as the solution of it depends on the perfection of the healthy growth of the frame. The marriage state is undoubtedly the best and most natural cure for sexual suffering to many a himian being ; but to marry with the chance of happiness,* * Listen to what Purise says on Marriaire : "Amidst the abundant statistics which have been collected lately', it has been demonstrated lliat bachelors live a shorter time than the bene- dicts. This assertion is onl y tnie, provided the married couples live happily together ; otherwise bachelors must have tlie advan- tage. In a haj)py marriage, everything conduces to enjoyment, to Avell-being, health and longevity, for life is passed without shocks and agitation ; there is a kernel of felicity, around which is superimposed all the other pleasures which can arise, and which must soften the misfortunes to which human nature is inevitably doomed. In an unhajipy marriage, when each per- son is a perpetual cross for the other, every, thing is anguish, torment, trouble, and disquietude ; to-day, to-morrow, and always, at each moment the bitter cup, full to ovorflowiug, approaches and touches the lii)s. Is there a constitution sufficiently strong, or health sufficiently robust, a soul sufficiently firm to flatter itself that it can resist such cruel attacks ?" But [ fear that, after all, however advisable on medical grounds, early marriage in the upper classes of life must form the excep- tion, not the rule, being governed mainly by the imperious laws of society, and considerations of finance. 28 ME WIILOSOWli- OF JIAKIUAtu;. many thmgs are necessary. Let the youngster areen to the ™ys of the world pause, otherwise he ZfrZ from one misery mto another. The light literature rf the day urmshes ample mate.-ials showing the folly that besets the boy in love ; here it is that the sexuS passion agam, uncontrolled, may, by inducin-' him t„ marry the first pretty doll that .smile-^ on him ™™^ comes his attentions, plunge him into irretrievable r^h" But of what avail .s advice-how is it possible to coni trol some men who have nc t common sense ? I feTr they mustsink-nothmg can help them-they will not be guided so great is their belief in their ow/superior attainments. They fall out of the ranks of socierand decay-Its very rubbish-beside tlie onward piftof those whose career is happier, because eonformaWe to physical and moral laws. "nuwDie to m-,n"ri,.T™^'"f' ''"^f'^'-'^stnot with the medical man , the la vs of supply and demand will regulate tius, as seen m the following statistics — ™*'"'*'<' the first time made out, in consequence .' the census tables framed in 1851, a synopsis of wi. ■ IsS from the official report, recommending it to the atteT tive perusal of my readers. ° "" If we take only persons of the age of twenty and up- wards, the bachelors amount to 1,689,116 -the snn sters to 1,767,194.* "-,^10, tne spin- The proportions of the married among the population 57t%irfe:Ts-'^"'"^"^^'^''™«^-l««^^^^^^^^ Alwut 1 in ;! of the whole population, and nearly 4 n 6 of men, and 4 ,n 7 of the women, of the agefof twenty and upwai-ch, are living in the married sfate Ihe proportional numbers of the ages between Sfiier^' ""■■'™"' '""' '-' ■" i«« -^^"^ At the ages between forty and sixty there are 79 in 100 men ; (0 m 100 women, man-ied. sidered a qualified housewife. ^ '"'' '*''' ''*'" ^'^"- I THE PHILOSOPHY OF MAllKIAGE. 29 ?ster green le mav run teratiire of ^' the follj the sexual ing him to Q and wel- /ahh ruin. i)Ie to con- ? I fear y mil not 1 superior cietj, and d path of rniable to e medical regulate 5 noAv for le census r subjoin le atten- and up- he spin- pulation males ; learlj 4 ages of state, •etwcen es ; 55 e 79 m evalent Id have as con- # At the ages between sixty and eighty, in 100 men there are 05; in 100 women 42, married. And finally, at the ages between eighty and a hundred there are 37 in 100 men — whilst there are only 12 in 100 women, married. The mean age at which marriages are first con- tracted in England and Wales is nearly twenty-six years for males, and about twenty-four years and-a half for females. The wife is two years and-a-half younger than the husband, and tlie duration of marriage is, on an aver- age, twenty-seven years. A man or woman above twenty and below forty is called young ; so those of the age of forty and above are called old. Viewed in this light, it will be found that there are in the kingdom about 1,407,225 " young," and 359,969 "old" maids; 1,413,912 "young," and 275,204 " old " bachelers. Of 100 men of the age of twenty and upwards, 31 are bachelors in Great Britain. ^ Of 100 women of the age of twenty and upwards in Great Britain, 29 are spinsters. In London, Bath, and Cheltenham, they amount to 40 per cent. 20 in 100 famihes are childless, and 80 in 100 have children living. In 1851, the births of 015,865 living children were registered in England and Wales— 573,865 as the children of married, and 42,000 as the ofispring of un- married women ; and the census returns show that the women of the age of fifteen to fifty-five married were 2,553,894 ; the women unmarried, including widows as well as spinsters, 2,449,069. So that to 1,000 married women of that age, 224 Imng children are born annually; and to 1,000 unmarried women, 17 living children are annually born. Upon the hypothesis that as many unmarried women must, ceteris pm'ibns, be living irregularly to every child born out of wedlock, then 180,920, or 1 in 13, of the unmarried women must be living so as to con- tribute as much to the births as an equal number of married women. 30 If Till! PIIILOSOPIIV OP MARRIAfiE. f; J f »^ '""■'r~''"'""""'' '«-•'"" ''■'«•'• "P"" '-■■'i'niina- tion of the entire population, they mny l,e r,o safe guide to conclnsioiis as to the niaiTiasc statistics of tlie ughei- elasses-tell the actual state of the niarria.'c- ahle ]i(,v,pl(. „f the community at lai-'o It IS to enable man to people th? earth tliat Provi- (Icnoe has imp anted m us, in common with the l,rutc creatK.n, what ,s callcl the sexual passion, feelings which mfluencethe male to sueh an extent, that tho^l e" me the prominent ones for a portion <,f his existence ™ m'sions '^"' a'°,"™ ""^' ^'^ '"'« '■"■« "'<= ''»""«"* sen-r. "fnl " ff "^'""^""""•'' «riter forcibly ob- luiu rv h„ V' ™ ■?''"•'■' " '"" '» '^« i-oWirded iis a happiness : the ignorance of the necessity of sexual nrarpi-ios;";"''"'''""™''''' "•'■»'■ "> ■""•-• --> the^bodilvffr ^^'"''y »ff''l"-"'oS it is necessary that 1 tint Id Z t 'T '' ''"'? ?■"" "8"- =»"' «''»''1'1 '-• m tnat coiKlition tliat sexual interc.iurse should be i necessity for health, that its performance slou Tso far from leaving a weakening or exhaustive feeliu immrt to that which, when m full health, we enjoy after in dulgmg m the luxury of the bath. ^^ in n^.Ttht°it t''7'''"; ™=""'"«"y «''«"Id also bear m miiul that it is not only essential that they should taw'e •'el' A 1 7 '''""'''' '""' ■■«™''">ix.r that the vho^ tl 1 Iff^'": loth mentally and liodily, are tliosc o/be, „ * P""" "'^ ''"'•""'^ dissimilar from each hcatwns, I do not, of course, mean that the iutellee- tua should consort with the ignorant, or anyal^si Uv yti, II each party posner will rge and 3 hailed, \y cure iuse the ave not Jenner . to tlie d devo- ponentir Dhe pre- .arvejs, len who iricism, es, but would to the '. patho- ng the sexual nent, 1 are no •actice, to sav, ne and est the 1 "thousand ills that flesh is heir to," can ho depended on for advice or assistance in any hut the most simple and ordinary cases. x\or is this tlio only disadvanta-'e • It IS not merely that tliey cannot afford rehef, hut tlu'ir mabihty too often leads their patients to suppose that because Mi'// have failed, their cases are beyond the reach of art ; and consequently they give way to a state of despondency, which not only prevents their seekmg other aid, hut has such an eftbct on the .Gene- ral sys cm, as to lead many to an early grave. " Mv knowledge and experience of such lamentable results alone induces me to speak so strongly on this point; tl,. inK ' «?"*^."«^%^!ave the effect of inducing those ^^ho labor under impediments which involve the happi- ness of t,so human beings fo/ a lifetime, and of their possible offspring also, to seek really efficient aid under th.ir difficulties, my object will have been accomplished CIIAjPTER V. ABNORMAL 00*NDITr0X OF THE GENERATIVE ORGANS. I have now to draw attention to the abnormal con- dition ot the organism whose structure and functions have been previously described. It is not a difficult task in Itself; unfortunately the materials for a full description are sufficient to enable me to fill volumes upon volumes with experiences, the general knowledge ot which would be of the utmost service to the commu- nity. Eut It IS rendered a difficult task by the circum- stance that the feeling of false deHcacy,"^to which I h^ :e previously referred, and to which I shall after- wards have occasion more particularly to allude is unfortunately so prevalent, that not only is the subject Itself Ignored, but no one but myself has yet ventured to place ^popular treatise in the hands of those who have the wisdom to apply for it. The onlv work« winch profess to allude to such matters, are tliose ab struse and expensive ones intended for the perusal' of the profession alone— so crowded with technicalities m ABNORMAL CONDITION OF til at no one but an adept in anatomy and physiology can midcrstand them — or the worse than ignorant lucubrations of the charlatan, who fattens upon the fears which he creates hy his misrepresentations. Most of the functional disorders of the generative organs are due to a precocious development of sexual ideas, in a number of cases many years previously to the perfect evolution of the organs themselves. Lallem.and says : " This preponderance of the sex- ual over the material instinct announces itself, usually, at a very early age. The children we have seen taking notice of women, five, six, or even ten years before puberty commences, evince during the remain- der of their lives susceptibiUty towards everything which can provoke or recall erotic ideas. Whether the impressions spring from the sexual organs or the senses, their imagination seems to caress them, turning and returning them to every point of view. Voluptu- ous images disturb the gravest train of thought, intrude upon their meditations, and pursue them even in then* dreams. They desire every woman, and their passion for her i:=; rapturous, but the virile power does not come up to their intensity of lust. The venereal act tires and unnerves them ; they feel this, but are draAvn on in spite of themselves, and pureue tlie indulgence as far as force permits. Some there are Avho have no more power over themselves than the insane. When exhausted they make the Avisest resolutions, which, hoAvever, they break through, although, perhaps, knowing at the moment the ill conse(|uences Avhich Avill inevitably folloAv." When such a boy goes to school, his elder associates may initiate him into the pernicious habit of masturba- tion, to Avhich, in most instances, Ave may trace the great prevalence of sexual del)ility. Those Avho have Avitnessed, as I have done, the fear- ful effects of a habit destroying all the fairest prospects of earth's mo&t promising sons, Avill agree with me that nothing can be more important than to communicate correct instruction upon so vital a question. The habit to Avhich reference has just been made is knoAvn hy THE GENERATIVE ORGANS. ar various names, most of tlicm, perhaps, to some extent I objectionable. The most common, perhaps, is Onanism, . taken from the circumstance that the first instance we i ]iave on record of a perpetration of a crime of this kind is that of Onan, mentioned in Genesis. Every one, however, who reads the narrative carefully, must ? perceive that the crime of Onan was not exactly that I which is now called after his name. Another term, already named, and perhaps a more correct one, is ki» Masturbation, derived from manus, the hand, and I strcqjo, I defile. This can, however, be considered I strictly correct o??(y when applied to the procuring j emissions by titillations of the virile member with the hand ; w-h.-rcas it is used in a much more extended sense, signifying emission procured by any artificial ' means— any means, in fact, short of intercourse with the opposite sex.* Sometimes habits of this kind have been spoken of as Pollutions, but this term is object- ionable, as it confounds in many cases the cause with the effect, A pollution is merely an emission, and that may freciuently arise from weakness or disease of these organs, perhaps caused by this vice, or perhaps ■7iot, and even in the former case occurring long after the habit has been abandoned. The most expressive term is that of s^//-pollution, or self-abuse ; but as all the others are commonly used and understood, my objections to them are not sufficiently strong to prevent me from employing them. The pernicious habit of self-abuse may be commenced very early in life, and may be, as has been already intimated, the result either of teaching by associates or companions, or of accidental circumstances. Few * It is important to remark tliat excessive indulgence in inter- course will] the opposite sex, even in married life, is quite as prejudicial to health as indulgence in the habits here referred to; and that I am as frequently consulted by married mnn who are unal)le to perform their marital duties, and who tell me (until I ascertain the cutilrary by quesliuning them) that there is no evident cutise for their disability, as I am by parties unmar- ried, yvho know their own conduct has produced their impotent condition. Proper remedial treatment, however, will restore in tiie one case as in the other. 88 ABNORMAL CONDITION OF persons, except those who have had great experience in these matters, woukl for a moment guess that a habit of this kind could commence at the tender age at which children are sometimes presented to my no- tice, suiFering its dismal consequences. Indeed, it is almost impossible to say of any child that it is too young to practice it ; frequently it is commenced at three or four years of age, and sometimes even earlier. Of course there can be no emission at so early a period, but gratification is found in friction upon the glans, penis, and other adjacent parts ; and the habit is con- tinued for the sake of this pleasurable sensation till an emission takes place, which occurs under such circum- stances much earlier than otherwise.* Even infants, a few months old, will acquire the habit of handling and playing with their genital parts, if not checked by their parents uce. It was whilst in this state that in the course of his reading he came across the " Confessions of Jean Jacques Rousseau," which completely opened his eyes, and he now saw clearly the nature of the horri- ble vice he had for so many years indulged in, and the conse(j[uenccs which were now, in misery to himself, flowing from it. I had considerable difficulty with this case, on account of the extent to which the mischief had pro- ceeded ; but as he had a naturally strong constitution, and the revulsion of feeling consequent on suddenly learnino: the nature of the Vice in which he had been indulging gave him sufficient strength of resolution to conquer it, and to persevere in the treatment .1 em- ployed, the result was completely successful. This case alone should be sufficient to show the evil of keeping youth in ignorance of the nature of the generative organs, and the consequences of their abuse. Impotence declares itself with great rapidity in persons who are addicted to masturbation, especially when exposed to influences calculated to injure health. The testes, as already mentioned, rapidly become flaccid and shrivelled. The distressing sense of Aveight, so frequently described as a dragging pain, further tends to prove the organic changes going on in these organs ; the muscular fibres, which were described when speaking of the anatomy of the parts, lose their contractility, which they never do in a healthy con- dition ; hence the symptoms described. The phenomena which attend the various forms of sexual debihty create much difficulty in the attempt to represent them. An individual thus afflicted after a while presents a melancholy and dejected appearance. He is restless, ever and again desiring a change, but disinclined to physical exercise. He seeks soutade, and by allowing his thoughts to dwell on the fact of his disabiUty, fre- quently becomes hypochondriacal. In business he THE (JENERATIVfi ORGANS. 45 loses self-confidence, and is constantly in dread of seme unforeseen event about to happen to Iiini. His temper likewise becomes irritable, and he is the subject of most sudden exacer])ation of anger and passion. Muscular debility, characterized by fatigue, lassitude, and pam m the loins on the slightest exertion, prevails to a most distressing degree. The healthy color of the skm disappears, the eyes lose their brightness, and are surrounded by a dark halo, while the state of the digestive organs becomes exceedingly distressing But It IS the immediate effect of an over-excited state of the generative organs to lower the vital energy of the system ; the consequence is, that great organic and constitutional disturbance ensues. The functions of the brain are the earliest to declare the secret fact ; giddiness and headache are more or less present; memory becomes defective, and the power of commanding and controlling the ideas is lost, while a frequent disinclination to enjoy the usual amount of sleep 'orminates in general and extreme physical exhaustion. It is my firm opinion that the abuse of the sexual feelings IS tlie frequent cause of mental derangement • the primary cause of the complaint being but too often entirely ignored in ordinary treatment, and the subse- ciuent symptoms treated as if the brain had been tlie organ primarily affected.* There appears but little doubt that the morbid state of the nervous system, more particularly the spinal cord, which is produced by excessive sexual inter- course, is analogous to that which is sometimes observ- ed in the muscles after excessive exercise. And it seems a fair analogy which suggests that the loss * Since writing the above I find that Ritchie, resident Physi- cian of Bethnal House Asylum, in a paper published in the Lan- 'cf of Bebruary 16, entitled, " An Enquiry into a frequent cause ot Insanity ui loung Men," states, as regrards " the freqn«npv nf cases ol insanity arising from masturbation," that in that asylum the percentage from that cause was, in the private class, 1 in 7-98 and m the pauper class 1 in- 15-16 ; and referring to the possi- bility of its bemg thought that that proportion was exaggerated or overstated, says, " Would it were so !" 46 A15N0RMAL ruXDITlON OF .'^ of nervous power, and especially the paraple;;ia, that may follo^v l()n;j;-coutinue(l sexual excess, arc due to chau"-es very shnilar to those that are witnessed in the progressive muscular atrophy after great muscular ex- ertion ; the softening and wasting of the spinal cord being a process of dcgeneriitiou essentially similar to that traced in the muscles. It must never be forgotten tluit seminal emission is associated with what may he regarded as violent exer- cise of the spinal cord. It is, besides, the peculiar characto- of seminiferous losses, but more especially when self-provoked, to es- tablish an order of symptoms which appear to have their seat in *he region of the stomach ; the epigas- trium becomes tender to the touch ; a sensation of fiiintness referred to this spot is ctwiplained of ; also occasional pain, flatulence, a sense of distension, and other anomalous symptoms. These symptoms arc undoubtedly the result of ven- ereal excitement, implicating the central ganglia of the sympathetic nervous system, Hence avc have the strongest reason to infer, that when undue excitenent of the generative functions causes irritation of these ganglia, this undue excite- ment will be thus connnunicated to the s[)inal cord, producing depression of spirits, pain at the pit of the stomach, and general prostration. If such be the nature of these complicated nervous phenomena, it is not altogether so surprising as it would otherwise be, that in the worst cases which occur of excesses hi young men, nature has ])cen sometimes unable to recover from too rapidly repeated shocks. The irritation thus set up >ias morbidly excited the channels of nervous influence, producing in tliem some permanent injury, from which they never wholly re- cover. It is also a similar sympathetic influence thus mor- bidly developed, that reacts on the kidneys as well as the stomach, causing them to pour out a considerable quantity of thick, muddy, unhealthy urine; and an irritability of the bladder,*'inducing a frecjuent desire to micturate. THE (JENERATIVK OR(JANS. 47 Manyot tlic foregoing symptoms were apparent in case 1563, wliicli I treated successfully by correspond- once only. Tlie patient thus writes :— '^ At the age of about fifteen I acquired the fearful habit of mastur- bation, and continued an ignorant devotee and victim of it until I was twenty-one, (nine months ago). By accident I became acquainted with the terrible effects of this habit, last whiter; but though T tried hard, and prayed earnestly for strengtii to free myself from' its shackles, I Avas not enab' ?d to do so thorou<^hly till about the middle of Apnl last, when I discove'l-ed the havoc it was committhig on my frame. I then ap- peared like one for the grave. Unfortunately I ap- plied to an advertised doctor, who sent me an instru- mcntfor compressing the penis,* accompanied with certain prescriptions ; but the instrument caused such violent and painful erections that I was compelled to discontinue the use of it. I then thought I could do without medical treatment, if I lived according to a prescribed diet, and took plenty of exercise. Nature thought I would repair the loss. Still I cannot dis- guise from myself that I am gra-Iually getting thinner and weaker. I have not yet lost the power of erect- ing the penis ; and although, previously to the use of the above-mentioned instrument, I never involuntarily had an erection for days altogether — not even when my imagination was excited by wicked thoughts, it now happens almost every morning, and at times I feel strongly tempted to commence the old lial/.t again ; but then a shudder passes over me, and I conquer the inclination. Sometimes my eyes appear of a muddy cast, which causes me to feel very uneasy ; but in a day or two they get clearer again, and hope is again m the ascendant. I frequently have a dull pain in the region of the spine, but that w^ich causes me the great- est apprehension is the remarkable dreams I have at This IS not the only instance in which this clumsy and mis- I'hievoug treatment had been previously adopted by patients who have consulted me. It is about as rec:cnable as would be an attempt to stop an inclination to vomit b^ compressing the 48 ABNOUMAL CUNDiTlU.N UF night. At ouo time I am eu-^aged in ea^ur dispute with somcoTitr. inwliichtho passions of an;^or, tear, joy, &c. are uuoru.itely prcdomniant ; at another time 1 seem en'^a.j^ud in the greatest physical exertion, such asrun- niiTg,"" }i r' ting, or Ufting some tremendous weight; these all tend to ftitigiie my body, and deprive it of its due amount of rest. The daily routine of my avo- cation also fatigues me much more than it was wont ; and my memory is un(|uestionably impaired. I forgot to say'^that a pain in the region of the left kidney some- times attacks me, and on such occasions the urine ap- pears very muddy ; and although my testicles are not in such a pendulous state as they were three months since, I cmi feel that a small lump appears to be form- in" under both. I fear that my symptoms arc those of an early stage of consumption." It must be })orne in mind, also, that masturbation determines a specific and important change in the prostatic portion of the urethra— a knowledge of which is of great importance in reference to treatment. As it is impossible to trace the effects of masturba- tion of venereal excesses into anything like detail, I present to the notice of my readers the result of the researches of eminent physiologists, showing the whole material development of the human body, in reference to its average weight at different periods of life, which will afford us somo valuable general information, and also precise data, .0 enable us to judge of the ill effects which venereal excesses of any kind are likely to oc- casion at different ages : — Ih?. oz. At one year the body weighs . . 21 1 a a a u a 5 10 12 15 20 25 40 a u a a u a ii it u a (th c maximum) 35 rA 64 14 95 8 132 138 189 04 The preceding table proves approxima orxUr reaches the maximum of his weight tely that man at the age of THE OENKRATIVK 0RWAN8. 49 forty, whilst the increase from twenty-five is hardly procepti})lo. It may, therefore, be safely inferred thii the human economy reaches its full vigor at that age. When we reflect that masturbation is chiefly indulged in by persons from twelve to twenty, or even twenty- five years of age, we may readily conceive the evil it is likely to cause, as, at the age of twelve, when that vice has but too frequently become a habit of some duration, the individual would have still to gain about sixty per cent, of his weight. His growth, altl ough nearly finished at the age of twenty-five, will not be completely so, since even after thirty the weight of the body is susceptible of an al- most imperceptible increase. Now when we consider that masturbation and youthful lust are pursued with reckless indifference at a time — as we see from pre- ceding data- \yhen all the energies of the body are required for its sustentation and growth, I ask with all earnestness what room is there to doubt the ill conse- quences which must result from premature and exces- sive indulgence in venereal pleasures ? I cannot do better than close this chapter with*a self-drawn picture by a patient, at that time in one of the healthiest parts of South America, whom I had the good fortune to succeed in restoring to perfect health. After mentioning his position, &c., and that he was induced to apply to me by the accident of one of my books falling into his hands, he goeb on to say, " For the last twelve years I have p»-actised the degrading vice of self-abuse, or masturbation, without being aware of its fearful results, and which first commenced as the result of a lascivious dream without any incite- ment on my part, and the pleasure then experienced has been the cause of its continuance, and though I have several times endeavored to break it off as a filthy habit, have never succeeded. I have never co- habited with any of the other sex, though the desire was almost irresistible a few years since. But, thaiiKS to the good precepts of viriuous parents, I have never committed myself. I have been subject for the last two years to nocturnal emissions, the result c 50 THE GENERATIVE ORGANS. of lascivous dreams after being in ladies' company : the emissions are unattended with pleasure, without erection of the i)eni8, and are of a thin, watery nature ; the penis hangs down in a pendulous state, is very diminutive in size, as are all the external parts, but has not wholly lost the power of erection. I am terri- bly afraid I am suffering from spermatorrhoea, as I have noticed three or four times, while making water in the daytime, a small quantity of thin white matter escape with the last few drops, and upon passing urine into a phial, observe after a few hours, towards the bottom, a transparent fihny substance, which floats upon the least agitation, I see you request some urine for exa- mination, but I know of no available means of sending any, and trust you can judge without. My constitution IS undermined, my mental powers much impaired; I have lost all bodily strength, and have little or no ap- petite, am pale, thin and emaciated, most dreadfully nervous, subject to fits of melancholy, and rendered morose in disposition. My water is short and rather high colored during the day, which, right or wrono-, I have attributed to rheumatics, as the least exertion makes mo perspire profusely; consequently I take cold easily, and experience a dull pain in the loins, about the kidneys, which the doctors tell me is rheu- matics. I have been under their treatment for some years as a sufferer from general debility. I have been subject of late to a slight disfigurement in the fore- head, in the shape of a number of small red pimiiles, which I cannot get rid of. I suffer a good deal from dyspepsia, though I am temperate in my diet, and sel- dom drink wme or spirits .• I also suffer a good deal from constipation of the bowels. And now, Doctor, you wiU say my case is a serious one ; I know it ; and the tact ot bemg engaged to an amiable and accomplished young lady whom I had known several years, coupled •with the terrible, fearful thoughts of impotency, drive me almost wild. As a Christain, and one who I believe has the welkre of liis fellow men at heart, I beseech you to do what you can to restore some of my former Vigour ; I mu. tell you, since my eyes have boei) ■% SPERMATORRIKEA. 51 company : 'e, without ry nature ; te, is very parts, but [ am terri- i, as I have ater in the iter escape 'ine into a le bottom, upon the ie for exa- of sending onstitution ipaired; I or no ap- dreadfully rendered Hid rather or wrong, it exertion ly I take the loins, e is rheu- ' for some have been the fore- l pim}>les, deal from t, and sel- ^ood deal JCtor, you ; and the ^mplished !, coupled icy, drive I believe . beseech ly former %YQ boei] ii opened by the perusal of your work, I have given up and for ever, the vile practice that has been drainini^ aAvay my life's blood. God grant it may (throu<4 your help) not be too late." ° CHAPTER VI„ SPERM ATORRIIOSA. The term spermatorrhoea is applied in all cases where emissions of seminal fluid take place otherwise than in obedience to the impulse arising from the natural act of coition, or the will of the person in whom it occurs. It has been already remarked, that the seminal fluid IS stored up in the vesiculne seminalcs, and that small ducts open from the junction of these with the vasa deferentia into the urethra, and that, by means of these ducts, the fluid escapes. Now, in the healthy state, these ducts are continually kept closed, so that the semen cannot escape, except in obedience to the impulse arising from the natural act of coition ; but when they become weakened by excessive venery, or, what is more common, by the habit to which the last chapter was de- voted, dilatation follows, and the slightest degree of pres- sure will cause the semen— as yet imperfectly formed — to escape ; such pressure, for example, as would be pre- sent when the faeces were passing through the rectum, or when the bladder was contracting to empty itself. It will be remembered that the vesicular seminalcs are situated immediately between the bladder and the rectum, so that, when the fajces are passing down the latter, there is necessarily pressure u])on the vesicles, and consequently, it is then that the first symptoms of spermatorrhoea may be observed. The same thing occurs when the bladder is contracting to expel the urine, and for a similar reason ; a quantity of thick slimy fluid may be observed pas,sing with the last few drops, which upon examination, most frequently proves to be semen. Should the weakness, and consctpiently, thv dilatation, continue to increase, it will require no 52 SPERM ATORRHCEA. ii m pressure to force away the seminal fluid, for it will escape as it arrive 3 from the vas deferens, not remain- ing in the vesicles, but passing immediately into the urethra either making its exit thereby, or passing back- wards into the bladde", and mingling with the urine. The disease called spermatorrhoea is one of the most common results of masturbation ; indeed it is almost an invariable result, for it is next to an impossiblity for any person to practise this baneful habit for any length of time, without suffering from the involuntary escape of seminal fluid, either with the urine or otherwise. It does not follow, however, that if an individual suffers from emissions, that therfore, he must have been guilty of the vice of Onanism. Tiie disease may have had its origin in excessive venery, or weakness from other causes, and in some cases, I have no doubt it is constitutional. *' The vesicular semiuales," says Lalle- mand, '• take on the habit of contracting themselves under the influence of excitement less energetic thnn usual, and quite abnormally so. In such cases, a full bladder or rectum, a bed too warm or too soft, lying on the back, warm or exciting drinks, &c., provoke emis- tions more readily than they ought. It is in such instances that the intimate and reciprocal connection bet- Aveen the vesiculae seminalc!' and the brain produces las- civious dreams, le2)lus deaordonnes, under the slightest direct or indirect excitement of the genital organ's and inevitable pollutions, from the reproduction of all the ideas which are connected with those of generation." Among the common causes of spermatorrhoea, I might place hiiemorrhoids (piles), a long foreskin, accumula- tion of foreign matter with the secretion under the prepuce, drinking large quantities of alcoholic drinks, gonorrhoea, venereal excess, and even, though it may seem paradoxical, excessive continence ; but the most common of all is weakness of the genital urinary appa- ratus, resulting from the habit before named. Sometimes the disease makes its appearance loni^ after the habit itself has been abandoned, but -/hen ade(iuate exciting causes suddenly reveal the mischief which has been entailed upon the system. Such cases, SPERMATORRHCEA. 53 if immediatetj attended to and properly treated, are capable of speed j cure. Thus, in case 1043* the patient, a youn^ man of twenty-four yeiirs of age, informed me that he had prac- tised masturbation whilst at school, but he left it off for nearly ten years, and had recently had sexual inter- course with females, much more frequently than he thought, to use his own words, " did him good." For the preceding week he had felt a little pain in the penis, and had noticed, on going to stool, a quantity of white, glutinous matter pass away from the urethra. I requested him to furnish me with some of the matter upon a piece of glass, which he did, and on examining It by the microscope, I detected spermatozoa. I ordered a lotion to be applied to the genital organs morning and evening, and medicine to be taken inter- nally ; and in three weeks both the pain and the dis- charge had disappeared. In the healthy condition of the generative organs the seiLinal fluid is continually being formed, "and stored up in the vesiculae seminales, to be either re- absorbed or ejected from the system at regular inter- vals ; but the formation of this' fluid, like that of most other secretions, is very much under the control of the nervous system, and will consequently be much increased by the mind being continually directed towards objects calculated to excite the sexual propen- sity ; and thus, if it be frequently ejected, a much larger quantity will be produced, at a terrible expense to the other organs of the body. When, therefore, a morbid condition of those organs has been brought about, by excessive vencry, or any other evil habit,°8o as to give rise to spermatorrhoea, and the patient suffers from the continual escape of this vital fluid, the quan- tity that may be secreted and passed away is absolutely alarming to any one who understands the phvsiolo«^v of the human body. ^ ^ *^ One form., and a very common one, in wiii we *Tlie numbers mentioned in this anri other cases quoted ia tins work are merely rcfcrencess to my Case Book. 54 SPERMATORRHCEA. meet with spermatorrhoea, is the escape of semmal fluid during the night, accompanied with erection of the penis, and erotic and lascivious dreams ; the emis- sion in this case is generally supposed to arise from the^ excitement of the pictures produced by the imagi- nation ; this is, however, by no means the case. " The general belief," says Lallemand, " exists that erotic dreams produce nocturnal pollutions, and they are looked upon as very dangerous ; but lascivious pictures which occur during sleep arise from excitement of the genital organs, just as erections and spasmodic contrac- tion of the vesiculoe seminales do ; all these phenomena coincide, because they depend upon one and the same cause, but the one does not depend upon the other." In case 547, a young man of a nervous and excita- ble temperament, wrote to me that he had practised masturbation for many years, in fact, had commenced it as early as he could remember, and had continued it till within a few months of the time he wrote, at which period his age was twenty-one. For the year preceding he had suffered from emissions, but in a trifling degree — as he called it — once a week, or sometimes a little oftener. More recently, however, he had never slept a night without having his rest in- terrupted by dreams of a most lascivious character, which dreams always ended with his consummatinir his wishes, as he imagined. but which the mornmg revealed to him as copious emissions, his night-clothes and the bed being wet with the fluid which had escaped. As this was rather a serious case, a personal interview was demanded. This recpiest complied with,! found, as I had anticipated, varicocele in one testicle, and the whole of the genital organs in a state of great irrita- tion. I prescribed for him, with a good result, and by subsequent treatment had the satisfaction of efiect- ing a perfect restoration to health. This is a very common form of spermatorrhoea. Scarcely a day passes without my soeing patients whose ^/mptoms are analogous to those f have just detailed. The disease, like an assassin, attacks its victims during sleep, and when, consequently, he has SPERMATORRHEA. 55 no power to ward off the blow. Even on those nights when emissions do not occur, still the patient suffers from gloomy and terrible fancies breaking in upon his slumbers, haunting his imagination, and reviving any incidents of an unpleasant nature which have occurred during the day. Sometimes the escape of seminal fluid is experienced at regular intervals during the day, apparently without any direct cause. The patient may be walking, or sitting in one position or another, when he suddenly feels a quantity of fluid escaping from the urethra, without exciting any pleasurable sensation, and in the entire absence of erection of the penis. In case 1162, the patient stated that a few days before he had attempted intercourse with his wife, and had failed ; at first there was an erection, which, how- ever, soon subsided, without any escape of semen, and then all sexual power was gone. He had been many years in India, and had enjoyed very good health, but for the preceding three or four weeks had suffered from the escape of what he supposed to be semen, which had passed away generally whilst taking a lounge on the sofa, and smoking his pipe after dinner. This was not the result of an erection, nor did it occasion any pleasurable sensation. He had, he stated, prac- tised Onanism during his youth, but did not think it was that, or he should have felt the ill effects of it be- fore. After prescribing for him he was gradually and completely restored to health. The worst form of spermatorrhoea, because the one most likely to escape detection, is that where the semen escapes by the ducts into the urethra, not, how- ever, to be immediately ejected from the system, but to pass backwards into the bladder, and then to be brought away with the urine. In this way the disease may go on for years without even being suspected; and the person who finds himself, from this cause, fferinf' from jreueral debility and nervousness- wonders what can have given rise to the symptoms under which he labors. In case 931, the patient consulted me, to know if I 66 SPERMATORRIIfEA. could point out any probable cause why his wife had not borne children. He stated that he had been married four years, had lived rather freely previously, but did not think he suffered any ill effects from it, as he was able to have intercourse with his wife, although he admitted that the pleasure experienced during the ejection of semen was not as great as formerly. Thinking he might suffer this from of spermatorrhoea, I requested him to bring me some of his urine, which he did. Upon examination it was found to contain large numbers of spermatozao, but not perfect ones ; most of them with the tails broken off, or mutilated in some other way. I therefore informed him that the cause of his wife's baiTcnness was obvious, the seminal fluid being of such a character as could not possibly fecundate an ovum. Under the treatment I adopted, viz., great moderation in indulgence of sexual congress, cold douches against the spinal column, and the ad- ministration of certain restoratives, his seminal fluid was restored to its normal condition. ' Occasionally very peculiar cases occur, in which all the usual symptoms are absent, as illustrated by case 1432, in which the consulation took place by corres- pondence only. The patient wrote me that he was a strong mus- cular man, aged twenty-four, six feet in stature, and weighing fifleen stone. He stated that he had excel- lent appetite, the best of spirits, was not at all nervous, did not suffer from any of the symptoms indicative of seminal discharges mentioned in a previous work of mine, the persual of which had induced him to consult me, but was nevertheless impotent. He went on to gay—-" I have consulted medical men ; they laugh at me, and tell me it is imagination. But I am the last man in the world to imagine myself into a disease. From my appearance they all admit this, but offer no other explanation. Tell me, have you ever seen a casehke mine, and can you affoi*d me any relief?" I wrote to inform him that his case was by no means 80 uncommon as he appeared to suppose. He accord- ingly placed himself under my care, and, after a proper course of treatment, ro.anliood was restored. SPERMATORRHCEA. wife had 1 married isly, but it, as he lOugh he iring the brmerly. torrhoea, e, which ) contain ct ones ; dilated in that the ! seminal possibly adopted, longress, the ad- iial fluid vhich all by case corres- ng mus- ire, and d excel- lervous, ative of work of consult it on to augh at the last disease, offer no seen a f?" ) meana accord- after a red. 67 In reference to spermatorrhoea, there are two points of the greatest possible importance, on which I feel it imperative to make a few remarks ; and these are, firstly, the mode of detecting spermatorrhoea, i.e., its diagnosis ; and, secondbj, the treatment to be adopted. In refer- ence to the first point, there can be no difficulty where the semen escapes in large quantities during the day, either from excitement or otherwise ; nor is the diffi- culty great Avhen it assumes the form of nocturnal emissions, because, generally, the patient will be aware when it is passing, and if not, will observe in the morumg that his linen, or the bed clothes, will be wet or stained ; but the most common form of this disease, as I have already remarked, is that wherein the seminal fluid escapes with the urine, and here the difficulty will be very great. The patient will not be aware of any emission taking place, and the medical man can only make the discovery after the most diffi- cult investigations. Prior to the discovery of the spermatozoa in the semen, the detection of spermatorr- hoea was altogether beyond the reach of the most dis- tinguished pathologist. At that time, if a patient, who was sufFerin"* from atrophy, or wasting away, and general debility°of the whole system, presented himself to a physician, the first impression of the latter would be that the lungs or heart were affected ; on examining these organs, however, he might probably ascertain them to be sound. The glands of the mesentery might then be suspected of disease. This suspicion discovered to be groundless, the patient would then be interrogated as to whether he suffered from emissions, to which he Avould reply not to his knowledge. Other examina- tions would then be made, and Avith the same want of success. A great obscurity would thus rest over the diagnosis, and the utmost that could occur would be to suspect the escape of semen with the urine. Probably tills suspicion would not have arisen, and even if it had, would have been but a suspicion. These remarks will ajjply with equal force to other diseases resulting from spermatorrhoea, as well as general debility. The fol- o2 ft-, n 59 gPERMATORRH(EA. lowing case will serve as a good illustration. It is tli0 case (copied from the Medical and FhT/sicalJonrnal) of a patient who was treated by Sir Benjamin Brodie, in St. George's hospital. " This patient was admit^ ted into the hospital on account of a pain in the lett testicle. The organ was soft, flaccid, and about a third of the size of the opposite one. The patient had not received any injury, nor had he had gonorrhoea, but for five years had practised masturbation once a day. The testicle, before it was wasted, was the seat of very severe pain, and swelling. The patient was sad and melancholy. Various remedies were ^ tried m vain, and he left the hospital without relief." Now who that has seen anything of spermatorrhoea can doubt that the patient suffered from emissions ot semen with the urine ? I had recently under my treat- ment a case very similar to the one just described, wherein a microscopic investigation of the urine demonstrated the presence of spermatozoa. And I must here digress for a moment to say a word or two respecting that noblest instrument of natural philosophy, the microscope. In contemplating the swarms of living atoms which teem " in the leaves of every forest, in the flowers of every garden, and in the waters ef every rivulet, when placed in the field of a powerful microscope, the idea which most strongly impresses the mind, after the first sensation of surprise has subsided, is tlie infinite- simal minuteness and simple form of many of the structures in which that marvellous principle, life, is enshrined. We have been accustomed to associate the presence of vitality with bodies possessing various complicated organs for the elaboration and mainten- ance of the energies of existence ; but here we see perfect and distinct creatures, in the condition of single globules and cells, that "live and move and have their being," and increase in numbers with a rapidity so prodigious, and m mode so pecuhar, as to startle all our preconceived notions of animal organ- ization. ^^n ,' It is by a profound investigation of the motUhcations I SPERM ATOimnCEA. 69 ; is the \irnaTy 3rodie, admit- ihc left a third lad not- ea, but a day. of very sad and I vain, orrhcea 3ions of y treat- scribed, ) urine ) say » aent of 9 which wers of ivulet," 3pe, the ifter the infinite- of the , life, is Lssociate [ various caainten- we see lition of ove and •s with a ,r, as to 1 organ- ifications of structure and functions exhibited in those minute organisms, that so much light has been tlu-own u[)on what were previously some of the most obscure phenomena in human physiology. It Avas by the microscope that the existence of spermatozoa was revealed to 'us ; until then that distinction which we pointed out in dcscribhi" the various secretions of the different parts of tlie gener- ative organism was altogether unknown and unsuspec- ted. Once known, however it not cmly throw a flood of light upon physiological science, but upon pathology also ; for the same instrument Avhicli revealed to us the normal in physiology, also enabled us to examine the ahnormaL It must not be supposed, however, that the micros- cope is an instrument which it is as easy to use as a common magnifying glass— far from it— its efficient use for scientific purposes, especially pathological ones, requires unwearied patience, long practice, and acute powers of observation. As Captain Basil Ilall observes, in siieaking of a kindred instrument, " The secret often lies in knowing exactly what to look for, and thence learning how to adjust, not merely the focus of the eye, but Avhat may be termed the focus of the judgment, so as to be able to pitch the understand- ing into such a key that the information may be understood when it comes." Returning, however, to the subject matter of this chapter, it will be perceived that the discovery, by the microscope, of spermatozoa in the semen, was not only most valuable in a philosophic point of vioAv, but much more so as a matter of diagnosis. It enabled us to detect the most difficult disease that we had to deal with, and exiinsed to noon-day vicAV matters which before lay hid in the darlaioss of Egyptian night. But notwithstanding this, the spermatozoa are °not to be discovered as readily as might be imagined, even with the greatest skill, care, and experience on the part of tiie physician. The urine may probably be examined three or four times and no spermatozoa be present, but the next time, they may be discovered. 60 P*>ERMATORRH(EA. The semen, too, when it has escaped into the hladder, is generally tbuud mixed with urinary dejjosits, such as lithic acid, lithatc of ammonia, oxalate of lime, epithelium, mucus, &c., and there is great difficulty in distinguishing the spermatozoa amidst all these deposits Tand it must also be remembered that wo rarely meet with the spermatozoa in their perfect condition. In nine cases out of ten they arc in the broken, mutilated condition before referied to. Hence it requires a great amount of ca'-eful examin- ation to be able to diagnose successfully in these cases. In case 1250 the patient stated that he suffered from great debility, which, in fact, wa?, evident enough from his appearance. lie had been under the treat- ment of several physicians, and every one had declared, after a microscopic examination of the urine, that semen was not present. As he informed nie that he had, when at college, practised masturbation, I felt convinced that I should detect spermatozoa, notwith- standing what those he had previously consulted might have said to the contrary. I examhied the urine, and had great difficulty in telling what was i)rescnt, hi consecpaence of the large (piawtity of urinary deposits which obstructed the view. On the first occasion, although the examination occupied an hour, I could detect no semen. Still, however, unsatisfied, I made another examir:at on three or four days later, and after great difficulty detected spermatozoa, but ex- cessively mutilated and broken to pieces. The cause of the debility now made out, the method of treat- ment of course became evident. The tendency to the frequent occurrence of invol- untary seminal emissions is always more or less in- creased l)y an attack of gonorrhoea. A diminution of the involuntary discharges may, and \isually does, fol- low the cure of gonorrhoea ; but this must not be mis- taken for a proof of the restoration of the genital appa- ratus to a normal condition. The slightest causeof irritation is sufficient to re-establish the disease with increased severity. Sometimes this apparent^ change of symptoms indicates that the case is lapsing into one of contirmed impotency. SPERMATORRHCEA. 61 ladder, 3, such f lime, ifficulty 1 these hat we perfect in the ). Dxamin- e cases, suffered . enough e treat- eclared, le, that that he L, I felt notwith- ;d might ine, and scntj in deposits )ccasion, I could I made er, and but ex- he cause of treat- of invol- less in- nution of does, fol- t be mis- ital appa- i cause of ease with it change I into one The following case, 1534, is a vovy instructive one. It cannot be better described than in the patient's own language in his first letter. He says : — " It is with a deep sense of shame and self-condemnation that I ad- dress you, being in a fearful state of ill-heal tli, brou<^ht about as I believe, princi[)ally by that filthy practice which you so tndy denominate self-pollution. I am now about twenty years of age, and acquired the habit I have named about six years ago, when at school, and continued it for about four or five years, when expe- riencing sudden pains in the loins, and frequently observing a gummy, sticky oily fluid oozing from^ the penis, especially in the morning, sometimes only slight- ly, and just gluing together the \i\)S o^the opening, but at other times more copiously, I became alarmed, and applied to a person in London, and took his me- dicines for a considerable time, but without the slight- est benefit. I unfortunately, too, contracted gonor- hoca, which was cured with copaiba, &c. ; and for some little time afterwards, altliough I felt excessively weak, the ghiey fluid, which had increased during ' the gonorrhoea, became greatly diminished. I left England about that time, hoping that nature and my new occupations, and change of scene and air, would restore me to health ; but I soon b3cam:3 worse than ever, so much so that I was obliged to return to London. I then consulted another medical man, who told me that my gonorrhoea had been imperfectly cured, and he again gave me copaiba ; and I assure you the quantities of that remedy I have swallowed, either alone or in combination Avith other drugs, is almost incredible. Finding no relief, I have at last given it up in despair and disgust, and now write to you, in the hope that you may be able- to restore me to health and vigor. I am not now in London,^ as you see by the heading of this letter, and therefore cannot at present consult you personally ; but I will briefly describe my present symptoms. What T sufl^-r most from, and what I feel is gradually draining hfe and strength away from me, is the emissior of semen, especially after taking a few glasses of wine, or being 62 SPfiUMATORimOSA. i, I iiti l« iiii P in the company of ladioH, or any excitement otherwise occasioned. My testicles are in a very pendulous state, and are getting smaller and smaller every day,^ especially the left (^ne, which seems to be a lot of hard cords. My face and parts of the body arc covered with pimples, and the slightest degree of fatigue utterly exhausts me. I also feci at times a dull sense of pain, which I cammt describe, along the penis, extending to its furthermost partj, and the urine is very different in appearance to nliat I fancy it should l)c. I feel quite certain that unless I obtain speedy relief I shall soon be in my grave ; for besides the bodily symptoms, I find myself laboring under such despondci^cy of mind, that, conjointly, I am sure my system cannot long hold out against them. I send you, by same nicdl as thb, a small bottle containing some of my urine, and also a portion of the discharge between two pieces of clean glass." This case is remarkably illustrative of the mischief arising from a mistaken diagnosis, spermatorrhoea having been erroneously taken for gonorrhoea ; and I doubt not that oceanj of copaiba, &c., are adminis- tered prejudicially in hundreds of similar cases ; and it demonstrates, also, the impoitance of microsopic examination of urine, &c., in such cases, as I had no difficulty in at once obtaining proof that the impression I had fi^rmed upon reading his letter, viz., that he Avas suffering from a severe form of spermatorrhoea, was well founded. The treatment of spermatorrhoea is, like the diag- nosis, exceedingly difficult, and requires, also, much skill and experience. The disease arises, as has been shown, from a variety of causes, and each, as a matter of course, will require treatment peculiar to itself. Lalleraand, having observed the benefit that followed the application of nitrate of silver, or, as it is com- monly called, lunar caustic, to the eye, when its vessels were relaxed by disease, inferred that the application of the same substance to the seminal ducts, when they w -3 re relaxed, would je productive of equal benefit, lie therefore invented an instrument for tiPERMATORlUlCBA. 63 "cs thw purpoBo, called tho porU caudique ; anrl henco arose one of the most biiitiil modes of treating an aflfcction, with which the wliolc range of medical scioT?,-!e can furnish us. Even supposing this applica- tion of caustic to bo valuable, which I dispute— and admitting the possibility of the operator being (piito certain when he has reached the ducts, and, theretore, knowing when to cauterize, which I deny— still the ai)plication of so destructible an agent to such a deli- cate part as the membrane lining tlio urethra, cannot but be Di'oductivo of the worst results. How many hundreds of cases of stricture can be traced to this horrible treatment. How many persons have had to curse Uic day that English practitioners adopted this French mode of treathig spcmatorrhoea, or that on which tney were foolish enough to submit themselves to it. . .. , tf M The employment of the solid nitrate of sdver as a remedy in spermatorrhoea, is not only dangerous, but it implies u total disregard of the true pathology of that disease. . ,. , . The objections to the application of the solid caustic to the urethra, are the intense pain with which its use is attended— the risk of retention of urine following the application— the well-known liability of caustic to occasion severe attacks of rigor-thc danger of pro- fuse urethral hemorrhage, arising on the separation ot the slou^di which its application must produce ; and, lastly, the danger that the sloughing process may involve the membranes of the urinary canal to such an extent as to destroy its integrity, and thereby expose the patient to all the sufferings and dangers resulting from infiltration of urine, fistula, and the I'l. ' It is allowed by all unprejudiced persons t\>t the results of actual experience far outweigh th most specious theories, or the boldest assertions I there- fire select a few cases out of many that have conib under my notice, m whicii tnu cacuts u. .adwiiz..^.^... of the prostatic and other portions of the urethra proved most serious and distressing. 64 SPPRMAT0RRH05A. I II: In case 1742, the patient had led a most dlssohite life, and sufFered at various times from repeated attacks of gonorrhoea ; the consecpience, at last, being that he suffered from obstinate uretheral and vesicular gleet, and a shattered constitution. He applied for surgical aid, when cauterization was recommended and applied, the effects of which the patient described as terrible in the extreme — the scalding; on micturating; was for nearly three days beyond' description, the difficulty being such as almost to amount to retention. A purulent discharge ensued, tingod with blood, which continued for several days. On recovery from the local effects of the caustic, the posterior part of the urethra became the seat of a severe and fixed pain, always intensified by the escape of urine. Sexual intercourse, attempted on several occasions, created so much pain and inconvenience that it was abandoned. Nocturnal emissions were of frequent occurrence, and also discharge from the vesiculae seminales, whenever defaecation took place. In this condition he consulted me. On attempting to pass a bougie along the an- terior part of the urethra much pain was complained of ; but when it reached the posterior part it was ex- cruciating, and the spasms so violent that it had to be withdrawn. Two or three days being allowed to elapse, and, in the meantime, sedative and efficient medicine administered, another attempt was made with a smalleivsized bougie, which entered the bladder, but not without much pain and difficulty,, This clearly showed that permanent stricture was most imminent. I obviated this, however, by cathe- terising the urethra ; and at the same time success- fully counteracted other local and general symptoms by a suitable course of medicines. In another case, 1103, an inveterate gleet led the patient to seek the advice of a surgeon, who cauter- ized the urethra, particularly at its posterior part. It was accompanied by excessive pain and subse'.^uont inflammation, involving the neck of the bladder — there was, in short, the most excruciating agony on voiding urine, a throbbing in the perinoeum, and a SPERMATORRHOEA. 66 dissolute repeated 3t, being vesicular plied for idcd and iribcd as tu rating ion, the 3tention. d, which i'om the t of the ed pain, Sexual created -ndoned. nee, and henever onsulted ; the an- iiplained was ex- ad to be )wed to efficient a,de with bladder, ;ure was y cathe- success- ^mptoms led the cauter- art. It 1------ adder — gony on 1, and a profuse purulent discharge, tinged with blood. Leeches had been applied to the perinoeum, and opiates and hot baths administered, which had relieved the more active symptoms. It was three months from this period when he called to consult me. He was then suffering intense pain in the prostatic portion of the urethra, extending up to the glans penis, which was always increased in voiding urine. In this case also I had much difficulty, although the result was ultimately successful. Case 1715 came under my care many months sub- sequent to cauterization. The patient was a gentle- man evidently, of a highly nervious temperamp/it ; but since the local action of the caustic, the pain of the urethra had never niially left him, and there was also great irritation of the canal. His description of the immediate results of the action of the solid caustic was truly appalling. To be brief great mischief resulted to the patient ; so mnch so that he became the victim of a settled melancholy. Similar treat- ment was pursued in this case to combat the local disease, which resulted in considerable relief; but after a period of seven weeks, I deemed it advisable to order him on a tour, as it was evident that time and change alone would alter the state of the mental feehngs ; and this, with the accompanying remedial treatment, gradually eradicated the ill effects caused by the injurious use of the caustic. These cases will suffice to show that not only does no permanent benefit attend the local action of the solid caustic, but that by its use an array of symptoms become developed, which in some cases bid defiance to every treatment which ingenuity and skill can suggest. Nor am I alone in the opinions I have expi*essed on this matter, for a celebrated author says of Lalle- mand (after having spoken of the services which he had rendered to suffering humanity) : — " He has, how- ever, by an exaggerated representation of the effect of cauterization hi curing spermatorrhoea, not only I 66 REMARKS ON FALSE DELICACY. impaired the value of his contributions to science, but likewise injured* the patients themselves ; inasmuch as by reading his book, they have been thrown into a disconsolate state about the future, almost amounting to despair, when the vaunted infallible remedy of cauterization has not immediately produced the pro- mised effect." The daily introduction of bougies is also to be con- demned, several cases having come under^my notice in which the previous reckless use of that instrument gave rise to symptoms of a most dangerous character. This remark does not apply to an occasional use of the bougie in suitable cases ; on the contrary, I have found in many instances that an irritable urethra, with tendency to stricture, has been completely cured after a few applications. The treatment of the various phases of spermatorr- hoea, and of the diseases known under the generic term — debility, require perhaps more skill and ex- perience than any other derangements to which the physical organization is subject. These are affections in which the treatment must not be limited to the remedies employed in the practice of one country, or contained in the Pharmacopoeia of another. The cases are sometimes so desperate, and the remedies required so potent, that all lands must be ransacked for the latter. We must not confine ourselves to the vegetable kingdom ; nor seek to obtain antidotes ex- clusively from the animal or mineral ; nature in her totality must be searched for remedial agents. CHAPTER VII. REMARKS ON FALSE DELICACY. One of the most remarkable and melancholy facts, perhaps, which the history of medical science discloses, is that the most important branch of it, viz., sexual physiology, has been studiously ignored. It may re;«iarks on false delicacy. 67 Qce, but much as n into a lounting oaedy of the pro- • be con- y notice ;trument laracter. al use of , I have ira, with red after rmatorr- generic and ex- hich the iffections i to the mtry, or 3r. The remedies Misacked es to the dotes ex- •e in her 3. aly facts, discloses, z., sexual It may safely be affirmed that nearly two-thirds of the " ills that flesh is heir to," are traceable to abuses of the generative organism, and that at least one-half of those abuses are attributable to general ignorance as to the nature and functions of that organism. But not only are the suiferers themselves ignorant, but those who should have been able to instruct and relieve them are scarcely less devoid of the knowledge essential for that purpose. All branches of medical science, save that one, have been discussed, been lectured upon, been exper- imentally illustrated, and been written upon with the utmost zeal ; but sexual physiology, one of the most grave ^ and solemn subjects which can engage the attention of the philosophic physician, has been almost entirely expelled from discussion ; and the most grie- vous physical ills under which humanity can suffer, permitted to scourge the world unchecked and un- heeded. And what renders the matter even more singular is, that while all that most concerns the attainment of perfection in man^ considered as a spe- cies, is practically ignored, there is no lack whatever of attention to analogous studies with regard to the lower animals. We are content to admit in the most unconcerned manner a gradual depreciation of the " physique " of civilized man, whilst every day we are called upon to notice an equally gradual improve- n]ent in that of the animals which are of sufficient ' service to us to demand a careful study of their phy- siology and treatment. There is no reason whatever why man should not, as a rule, enjoy, in the full per- fection of health and strength, his allotted " three score years and ten," save that the very mainspring of all the evils whicli tend to shorten that span is one with the nature of which most of us are miserably ignorant. ■ True, there arc many other sources of injury to the system, than those to which it is the purpose of this book to allude ; but it must be remem- bered that injurious intiucnces which will leave the strong unscathed, will utterly destroy the weak and enfeebled ; the gust of wind which will exthiguish the I 68 KEMARKS ON FALSE DELICACY. flame of the flickering taper, will only* fan a stronger flame into abnormal fierceness. It is to a feeling oi false delicacy of the most lamen- table character, that we owe the state of things I have just been describing. Who is there that, upon mature reflection, would not fully agree with the opinion of an eminent writer in the Quarterly Review for 1858, A\ho says, *' It is time to burst through that artificial bashfulness, which has injured the growth, while it has affected the features of genuine purity. Society has suffered enough from that spurious mod- esty, which lets fearful forms of vice swell to a rank luxuriance, rather than point at their existence ; which coyly turns away its head from the wounds and putre- fying sores that are eating into our system, because it would have to blush at the exposure." This passage deserves to be written in letters of gold. There are still hundreds and thousands of persons who entertain the sentiments here so justly and powerfully con- demned. The foolish feeling is still prevalent, exer- cising what influence it possesses, to keep the human family in ignorance upon topics of the greatest impor- tance to its own well-being. Nor is this false delicacy confined to society gene- rally, it pervades, as I have already intimated, even the very schools of medicine ; and the ignorance con- sequently existing, constitutes the strongest excuse of the physicians of old for their constant failure to grap- ple effectually with the greatest foe to human happi- ness, and for their attributing its effects to other causes ; so that the sufferer from generative disarrange- ment Avas treated for a variety of affections, being only symptoms, as though they were independent diseases, and by an infinite variety of processes, according to the prejudice or professional creed of his advisers, whilst the real enemy, unsuspected and undreamed of, was undermining the citadel of health. For though, for instance, in times past, the physical composition of the seminal fluid could not be deter- mined ; and the fact of its discharge — save when in a visible and perceptible manner, by nocturnal emission REMARKS ON FALSE DELICACY. m stronger ;t lamen- bhin2!;s I at, upon rith the Review igh that growth, purity, •us mod- ) a rank ; which d putre- cause it passage lere are ntertain \\y con- it, exer- ! human t impor- J gene- id, even ice con- accuse of to grap- i happi- other irrange- I, being pendent ocesses, d of his ed and health. hysical ) deter- len in a (mission or otherwise— could not be pronounced, the profession might at least have kept its available store of know- ledge so far m readiness, that its members, after going through their scholastic and collegiate trainincr, mi-ht be competent to take advantage of, appreciate, md turn to useful purposes the scientific discoveries effect- ed from time to time by abler men. Far from this, however, students were kept in a state of ignorance the deplorable depth of which may be judged from the lact that it was considered discreditable even to dis- cuss the subject ; the whole class of diseases of the generative organs, with their manifold complications and influences, thus becoming a perfect mystery, a sealed book, to the ordinary run of practitioners. So powerful has become the prejudice, that men of some eminence-Dr Golding Bird, for example-have ac- tual y propounded the doctrine, that because the worst most wide-spread, and most ruinous of human diseases IS for the most part the result of a vice, it should not be investigated and discussed, and relieved like other diseases. Lost this statement of fact should not be believed 1 quote from his work on " Urinary Deposits," where- in, after admitting that spermatozoa are frequently found m the iirine, he says, " It certainly is not very consistent with our national character, to dilate so freely on a subject which, in the great majority of cases, can be treated of only as the effects of a most degrading vice." But supposing his conclusion as to the cause of such disorganization to be correct, does that fact place it beyond the pale of medical assistance ? If a " most degradmg vice " gives rise to a disease which prevails extensively in the land, so much is there the greater need for the medical philantliropist to endeavor to abolish both the vice itself and the consequences which It produces ; and surely that cannot be accomplished by ignoring the existence both of the one and the other. Such is nevertheless the case ; all mention of the disease already discussed, viz., spermatorrhoea, havin* 70 BEMARKS ON FALSE DELICACY. been in conaecmence of its most frequently having ita ori "; h> t^ie libit of self-abuse, ahaost entirely omit- ted' n ttie best medical works, so that the yomig prac- titio er who wishes to learn his profession thoroughly, finrthe greatest diffienlty in beeomingat all aeontaneously generated, but can always be traced back to contagion from a prc- cxisfmg virus. When brought into sufficiently close contact with the animal economy to infect it, it pro- duces certain local effects, which arc called i^rimary symptoms^ or chancres. The importance of brniging to bear all the medical skill possible to a more satisfactory treatment of syphilis than has hitherto resulted, will be most apparent by a perusal of the opinions expressed, in an article on this subject in a medical journal of the day. " What shall we do to arrest the spread of syphihs, this great social evil, and mitigate the dire results of that disease, which are visited upon generation after generation and thus sap the physical strength, as well as the moral health of the community ? " Were it possible to limit the effects of syphUis to those whose guilty indulgence creates and mamtains the disease, some might regard it as a just retribution. But, viewed even from this assumption, true charity would hardly turn her back and leave the victims of sin to suffer without hope, or without an effort to re- lieve them. " It has been the inseparable quality of sin of every kind to involve the innocent in the afflictions of the guilty. Wo may imagine a man without family, with- out dependants, without a friend, to destroy his health, and ruin his worldly interests, by addiction to drunken- ness : such a man has often been ignorantly called ' no man's enemy but his own.' " But even in such a case, where the sin and folly seem most concentrated, both in origin and conse- quences, in the sinner, would it be wise, would it be Christian-like,' to ignore the evil, and leave the wretch to wallow in his vice before the world ? If unwise here, 74 q'ECIyMi DJSKASE.'^. it is Bho.r ma'» '""f ' j^^"^^ *", vpstricted to the first, perhaps guiby sutterers , n «es a form that lingers in the frame and generates fcZonic poison, which is capable ot being trar^- mitted to an uinocent wife, and to children still """"hot much of the scrofula, consumption, idiotcy I and insanity, that create sueb havoc '--jrCnf and encumber our asylums, is ♦'"■."" "^'' ^^""1;, .vnbilis can never be accurately estn,.ated. But it is cSn thaUhc hereditary^ transmission oi the syphili- tic taint operates largely." Whilst fully endorsing these statements, 1 i" ist remark that no attemp? to eradicate this hoi h\>- scZge of he human race will be success ul, unless Sus treatment is brough' to bear, on the imm - ^dtrmanifestation of the •f-^^y^^^ which first receive the infection. 1 '\''7 W;, I^rtant. in reference to the well-being of k "~l-"\ tKof n correct diagnosis be fornieu as to tnc C^aictrrctrorthe primary forms in which this disease commences its fearful course. SPECIAL JUSEASEi-'. 75 f pyphilis ,c sufferer our "yes t the pun- lis disease ice of two [locetit. cated ? his passion mder what ii placed tment of a lis man or as wretchc^*^ ' blushes t Is of thoi^c miseries of PI be thus ifferers ; i d generates icing trans- lildron still tion, idiotcy [•population, eet effect of L But it is f the syphili- mts, T vist this hoi olc 3ssful, unless n the imme- >n the parts i also highly eing of the iied as to the in which thin Thanks to the progress of medical science, syphilis is now entirely under control ! In times past it was customary to suff.'r [jorsons th\is afflicted to die, with- out attempting their roHcf, under the iui[)ression that the complaint was contagious and incurable. I find, hy *ho results o^ my every-day experience, that it is solely by an accurate attention t«j hecharai ter of tho sore, that a ckic is obtained b'>th to its virulent nature arid the kind of treatment best calcii- lated to arrest its ].rogress. It is hence regarded under tho two form of- ' . The hiduratcd or infecting chancre ; 2. ^.riie soft or non-indurated chancre. The average period during which the sore makcf? its appearance ifter the local contact of the poison, varies between three and en days, and depends, in some measure, on tlio following ci'-cumstances: 1. The Intonsity <»f the poison ; 2. The constitutional condi- tion of the patient ; 8. '''ho presence of an abniJed surface. The local indii lOns of the first, or indurated chancre, consist of a sore, having ;i rounded or oval form, with raised indurated edges, and excavated sur- face, covered with a thick, tenacious secretion, resem- bling chamois leather. Unless arrested at once, it will probably bo attended by secondary symptoms. The local indications of the second, or non-indurated chanci , are a oore or sores devoid of i luration ; their surfaces irregul , and freely dischargi j; matter. The form of the di a- will not be attended with secondary symptoms. The practical importance of ascertaining in ai given case the peculiar characteristic? of the chancr* UvS sore, will be at once apparent when it is -tated that tn such di, (gnosis rests the indica tion which Cbtablisbes a satisfactory basi^ for treatment. I' is at the same tim.e to be obser. 'd, that these case.^ :<> not always come under treatment while tliese specific distinctions continue. It is, however, gratifying to kii'nv that there still remains, to the skilful and ohgew:! =t prac- titioner, other and acliabh "ndications *.u which unimpci he ma^' base i diagnosis with perfect certainty. 76 SPECIAL DTPEASES. >t mvo rise to 3oco..<^ary .r c ". .t U y 1^^^ „f ,„,,„„ . ;„ ,„ch cases e.in, n H ^^ „,,•„,,, a correct , t.f t c m.liscru.mmte. or even tl.e doubt «1 respect to the m t satisfactory solu- ri''''yr''\;',v,rtle exceptional class of cases •r^hich'tu" ..v:ll re,ne,lyFs i.uUcatcd becomes m ^vlln.ll ""^ ' , ;,)„,i. (loubt or nncertamty. ^^£S^isrte:«rK>^^i ''''^:Sl:f^'^^oU.t. on which the attempt to ove law the necessity of mercury in aii cases of to o\<,r""^'™,„,,„,,, tl,cv have been certainly ot an S&:ll!:ia\hfsLe time, of a limited charac- Stiul! thLc i->o lack If ignorant pretenders. h« ^^tf:cli!r^::':::^tin— ccto^epau^ r:,^^;r:::rLc.ho,tvomi.— ^^^^ scientific -earcj^ sh; ■■ I^mt o t .. lUveie outward signs ot disease ouy ^^^^ to taVe unci , -ron to lane ,u..Mulicable root in the system, Cdsubs queut disease and death, not only m patient himJelf, b.t possibly in generations yet It is i of theae (levoloj)i which I Ibssiojij' statin^ t tho " 'V \irur' Aii of tue withiii ■ indurate cial tiss are not sarily, i sion by estahUsl tho san fresh in Terti (|uenccf the sys from tl They a attack 1 to life. The sympto other h ulcerat The tales, I The erythey This denote want c patien Itn the to! come SPECIAL DISEASES. ii ivo rise to s simply a iiry in such rc( quired. a correct ipon physi- (> icstion witli fio doubtful actory solu- , [\ss of cases 3d, becomes icrtainty. ;li has been lavc yielded I by second- tlic ligbt I the attempt 1 all cases of tainly of an lited cbarac- wiioform the t day) rigidly in every case while, on the ire tenders who o the patient is taking care ither one who, nay, in curing 11^ and danger- ancc of modern as it were, the Lvc a rankling le system, and Qot only in the (rations yet t« It is impossible in a little work of this kind to treat f these diseases, in tlu'ir almost intinite variety of development with tluit minuteness or in that detail which I have used in works intended solely for i)ro- lessio)!.'' nniding ; i nnist content myself, therefore, by statin^ t'lai what are called sccondnrij ni/mpfoitis, are the " :^et depend •'legion.'" occupy a ion -vvhieh whicli arc hod, viz.. )le in this ■It' to that irst svmp- sensation hroughout L'cnt cases, ethra then lation, and s. As the n'ted into a irine ; and on account \vater soon I the blood- narrowing imation will to hhidder. )n of urine, and unless will ensue If the disease be suftered to proceed unmolested, or, occasionally, under any circumstances, the patient may be attacked by chordee, an affection of the most torturing character. On the occurrence of the invo- luntary erections, which take place in consequence of the inflammation, especially when warm in bed, the corpus spongiosum (at the under part of the penis) not permitting of so great an extension as the caver- nosa, the penis becomes curved, and produces the most excruciating agony. In some cases, from a serous infiltration into the prepuce, it becomes dis- tended to an enormous size, so as to completely obscure the glans penis, constituting the symptom called phimosu. If at the ci^mmencement of the infiltration into the prepuce, the latter has been drawn back, by accident or otherwise, beyond the glans, the swelling will then act as a gradually hicreasing ligament, tight- ening" upon the jienis behind the corona glandis, caushig frightful agony, and occasionally rendering a suro-ical operation necessary. This constriction of the foresldn is called 2)a)-aijhijmod8. Sometimes an «Milargement of the glands of the groui (bubo) may ])c produce">^ists of muco-pus, varying in character accoriii.ig H) the period of the duration of the morbid action.' During the very earliest period _ it is "-enerally of a nhite color, and consists of simple° mucus, and under the microscope exhibits epithelial scales and their debris. During the second stao-e it also contains these substances, but, in addition albumen in solution, and by the aid of the microscope o oQ SPECIAL DISEASES. ,vc also detect i,m«mera1>le r«« «°;-i;,7',^^;Te"ort catin" to it a yellow color, more or loss «"T' "J"^'", • *T tLw nirnititv III its ater and chrome stagM, ttS ™ corSefiiinisW, and tl.e epithelial scales tcrS, 3Tt remains in that tronblesome and obsU- uate form denommatod gleet. v • i .„i. =nff,.r- It is too commcly the case that mdu-uluals sufiu \J from -ronorrhoca are apt to consider it a tutlin mg tiom „on n ^^^, ^j.j.,g„g "";■ as'vm a 0™ . bi perceived .hen I mention ™e only' out of its numerous consequences, viz • , I r, Urease whi-'h in but too many eases Htnctiire. a ilisease wim .1 ■ 'n.pvc isnothn'i- rendcrs the patient a martyr for hie. ilieie isno nm nor can there be anything, in any afiection oii afterwards he was again afiectecl, and his wife f>cgan to complain of leucorrhcea. ihe author ther» goes on to say (I am (luotmg literally). * ThprP .ro. liow..r«i-, on the other hand, many (principal y charlaau who «o w> the opposite extreme, and pretend to ';^^^?' : ,,.. rli. ..e in inconceivahly short periods such aa from 24 to GU hour but although it is not impossible to stop the discharge witli.. tliat time, i he after consequences of the so called "Aboktite Trkatmknt' are o f a fearful character, and m man\' niav endure tor fetimo. D'- 82 l^PECIAL DISEASES. ! 1 a Knowin'^ all the circumstances of the case, 1 advised'soine simple astringent wash and aperient medicine ; instead of abating, the discharge in- '' creased, and was followed, in spite of alt '^advice and the best concerted measures, ly rheu- ^'matic ophthalmia, inflammation of the bladder, " and general rheumatism. The disease m a sub- '' acute fona was no sooner cured in one set of muscles " than it broke out in another. Instead of driving " the disease into the system, I was for some time "unable to master the discharge, and it tvent on, " uncontrolled by all our remedies, a stumbling bloc/c i'to the best medical and surgical opinions in <-<' London ! ^^ ,, ^ „, The author then goes on to state, that alter some years his patient, apparently undeterred by his previous martyrdom, again consulted him, having been sud- denly seized with rheumatism, " the immediate cause " of which arose, in his opinion, from having had an " instrument passed. I ought to say," proceeds the author " that he had ever since Us last attack been ^''subject to stricture, with some irritation of the a bladder * * * As soon as the rheumatic attack " commenced, the bladder, muscles, joints, and eyes ^^ became successively affected; all the medical skill '' in London was called in, with as little avail as on " the former occasion. Every sort of treatment was tried, and failed until apparently the disease wore " itself out." The autlior, however, omits to tell us whether the patient was "worn out" as well as the The incredulous reader will perhaps scarcely believe in the truth of the foregoing quotations ; I can, how- ever, furnish him with both chapter and verse m a pretentious and bulky practical treatise, pubhshed only a few months since. I could add largely to such instances, were it necessary. ,^ ^ . , I say deliberately, as the result of a long and ex- tensive experience, that when properiy treated, gonorr- hoea cannot under any circumstances be_ cured too quickly, and I am happy to find that M. Ricard, alter a careful consideration of cases, agrees with me. (( or SPECIAL DISEASES. 83 ,se, i erient ;e in- f all rheii- adder, El sub- luscles Iriving e time nt on, g block ms hi ;r some irevious . " sud- e cause had an jcds the ick been of the 3 attack nd eyes ?al ikill ill as on ent was ,se wore tell us 11 as the y believe 1 an, how- rse in a lublished y to such 5 and ex- i, gonorr- !ured too ard, after cne. The fact is, that the pathology of the diseases now under discussion has been utterly neglected. In books on this subject, one writer has copied another, from Hunter downwards, and, us has ])een well observed, " seems to have dissected hooks rather than bodies." The ordinary practitioner is, corisecpiently, not only liable to be confused in his diagnosis and treatment, by the complications which usually attended gonorrhoea, but frequently confounds it with discharges of analo- gous character, or even with those which arc (:otally dissimilar. In case 1443, the patient, a married man, consulted me in consequence of a discharge which he supposed to be gonorrhoea. He assured me he had had no im- proper connection, and was not cognizant of any cir- cumstar.ces by which he could have become infected ; and he was in a condition of the utmost terror lest his wife should suspect him of infidelity. After a close examination, I found that the discharge resulted from connexion with his wife whilst the latter was suffering from a copious discharge denominated the iiuor albus, or " whites," which in lier c... j always increased a short time previously to menstruation. The fact of this disease — the "whites"* — being under certain circunkstances communica))le to the male has been the source of almost incalculable misery ; more especially when the practitioner applied to has been either ignorant of the fact, or careless in his diag- nosis. If tlie husband be conscious that he has had no Impure connexion, the appalling supposition forces' it- self upon him that his wife has been unfaithful ; whilst, on the other hand, the wife, ignorant that her '' weak- ness," as she calls it, '^ould possibly affect him, is made !.>:.iserable by a similar contemplation. It will be seen therefore, that it is of the highest possible importance, that the conscientious physician should exercise the - A very large portion of the fcrr.ale ,sex fiuffc.r from this com- plaint ; this is more especially the case in P^nglaml, and with married women ; a circumstance, in my opinion, atributable partly to the climate and to the large quantity of tea usually drank bv them. 7; I 84 SPECIAL DISEASES. I. „ jrreatest care in his examination of tlie discliargc b6 oompetoi.t to form a correct diagnosis, and thoroughly understand the best methods of treatment. ^ Havin-r connection, too, during the menstrual periods, ^vill fre-iuently act in a similar manner, and give rise to like uneasiness and anxiety; and so also mth a variety of other circumstances to which I might allude if space permitted. , , , i _ But the most grevious mistake that can he com- mitted, as regards the patient's own health, is one to Avhich I have alluded in a previous chapter, viz., that arisin- from confounding symptoms of spermatorrhoea Avith those of gonorrhoea, and treating the patient lor the latter. 1 was consulted in such a case only a short time shice. The patient had contracted gonoiT- hoea a few years before, and consulted the family uiedical attendant, who apparently cured him. ihe discharge, however, never completely left him, and on a<^ain complaining to his adviser, he continued to pre- scribe the usual internal remedies and injections. These he took for a very considerable period, but still exi)erienced a continuation of the discharge, tmdmg almost invariably, on awaking in the morning, the lips of the urethra dued together, and, on slight pressure, a drop or two of a transparent oily character made its ar.pcarance. He gradually became more anu more debilitated, particularly within the few weeks pre- viously to his consulting me: his memory began to tail him, and a languor and general dismclmation tor occupation took possession of him. In fact, I discovered that he was suifering from a severe form of sperma- torrhoea, which had entirely escaped the notice o the "family physician," who had persevermgly, but un- wittingly, increased it by continuing, durmg the whole period'^ to treat him for gonorrhoea. I need scarcely say that, havmg ascertained the real character of the affection, I had but little difliculty in eradicating it. SELF DIAGNOSIS. 85 50, hYii ixist in re func- 'or such as until ed, the In like on may im other illy indi- it not so may be led that lomy but involun- »i/.s/e/«> 'oUowed by Acid eructations. Acrid heat at upper part of assopimgus. Alteration in secretions of liver and pancrsas. Evolution of flatus. Colic. Griping. Difficulty of breathing, and cough. Distension of stomach and intestines. Muscular flaccidity. Excessive mucous secretion.?. Irregular ^action of the heart. Apoplexy. Liquid and unnatural stools. Diarrhoea. Inflammation^of rectum. Constipation. Loss of substance. Cadaverous appearance of skin. Hollow or sunken eyes. Extreme sensibility to cold. Rheumatism. Loss of hair. Pulmonary catarrh. Indolence, or indisposition to exercise. Lassitude. Fatigue on slight exertion. Climax — Confirmed Debility. CtEnkral Symptoms — Mental. Nervous System. Restlessness. Sighing. Sensation of congestion. Want of energy. Uncertainty of tone of voice. Nervous asthma. Vertigo. Want of purpose. Dimness of sight. Weakness of hearing. Aversion to society. Blushing. Want of confidence. Avoidance of coaversatlon. Desire for solitude. Listlessness, and inability to fix the attention. Cowardice. Depresaion of spirit?. Giddiness. Loss of memory. Excitability of temper. Moroseness. Want of fixity of attention. 88 SELF DIAGNOSIS. I Disposition to ruminate. Trembling of the hands. Sudden pallar. Lachryinosity. Tremor from slight causes. I'ains in back of tlie head or the spuie. Piiin over the eyes. Disturbed and unrefreshing sleep. Strange and lascivious dreams. Hypochondriasis. Climax— Insanity. 'I'he foUowiiL!' adclitloual illustrative cases areJiy "» „cans selectecUecause they present ieaturoB o gr^v severity, Imtl.eeause they are spceunens ot tl e most ordiiiarv eases upon whieh I am consulted ; and, save Xaev^'.-y expression which could afford the sUgh test To U,Z individuality of the parties themselves has m, carefully eliminated, they are the verbat.m ^tate- ments of the patients tl.eraselves. \°^*\J^^ »;»^! imnecessary repetition, it may he mentioned tliat evei v one of the foUo>ving cases, and many thousands of s milar and far mor,r serious ones, have been uweess- S Vm,l"!.; comc°by melancholy ; my memory is beeommg defec- tive, and I have a very tiresome ht^^le cough, m*;^ sort of choking sensation when attempting to uad I SELF DIAGNOSIS. 89 ? by i>" )f great ic most d, save lightest ivcs has n state- avoid it every lands of success- ive over elf-pollu- , until I V about a r that so at I have liat time, r of your hat 1 am •ly twelve inner and appear to tired with I have no .ntly over- ling defec- rh, with a (T to read •doii t, especially uftc ni. .1 ; the left testicle hangs a little lower than the right one. nd after the urine has been allowed to stand for a time, a white, cloudy secretion a])i)ears to be floating about in it, and a sort of Lrreasy-looking scum forms on top. I iv also troubled by frecpient emissions duriug sic , .. .iiich c mt iiduce me to think I must be sutferuig from , ih«jea, and trust you will be able to do some- thing ! ' elieve me. I ap})lied to a medical man who is esteemed very clever in this neighborhood, but he said he could not see any complaint, save my getting thin, for which he advised change of air, and gave me quinine, but no good effects have followed. HMie treatment thus referred to was unsuccessful b( ise it did not touch the deep-seated cause of the synqitoms. i Case No. IIIG. I can no longer conceal from myself that I am suf- fering from supermatorrhoea, the result of that wicked habit contracted even before 1 was in my teens ; 1 even forget how, and how early it was contracted, and although I have been sometimes abandoned it for a time I have always relapsed again into it. and have only lately been able to feel that I have at length mas- tered it. My age is now 2G, and although having been three years at the sea side, every one congratu- lates me ui)on my healthy appearance. I am quite conscious of th(i unreality of those appearances. My nerves are seriously impaired. 1 have very frequent nocturnal emissions ; the spirit 1 once possessed I am afraid is for ever gone, and tlu .euse of the fatigue I experience on undertaking the smallest labor, an(l the flaccid feel of the muscles, renders me doubtful of the possibihty of their effective reparation ; I cannot fix my attention on my business, make sad blunders, and cret veiy excitable and ill-tempered- For the last few months too I have experienced a didl pain or uneasi- ness in the testicles, especially on the left side, and I •♦■ ' .;.i IMAGE EVALUATION TEST TARGET (MT-3) •v" A^ «?. 1.0 I.I ■a ViL us u I.. ■ 4 M || Z2 12.0 1.8 11.25 i.4 1.6 1^ — ^ 6" ► p> <^ /i / % /A Photographic Sciences Corporation #> V V O 23 WEST MAIN STREET WEBSTER, N.Y. 14S30 (716) 872-4503 y^ L^. 90 SELF DIAGNOSIS, have occasional darting pains of a spasmodic charac- ter in the penis, as though they suddenly received a most severe and acute electric shock. In tnis case although there were well marked local symptoms, the mischief had principally developed itself in the impairment of the nervous system. Case No. 1375. It is with great reluctance I pen the followino- let- ter : — '"' I began to indulge in masturbation or Onanism some 3'ears ago ; I do not exactly know how long since. It was brought about by accident. Since your work on Marriage fell into my hands I have resisted the temj)- tation to defile myself. At first it was very difficult and I could scarcely restrain myself for a week, I have now mauaged'to do so for about three weeks, but feel tortured with all sorts of vicious thoughts. This is my situation at i)resent, but previouslv an(i l')!- some years, scarcely a day jjassed over in which 1 .lid not practise self-poll ution. I am considerably troubled witli knots of tough inucous matter comiiig up my throat ; this alwa^^s occurred two or three hours after masturbation. As it is very considerably decreased lately, I now attribute the symptt)ms to that cause, which I did not previously suspect. My urhie is some- times very muddy, a s: 1-: ofgleot is found to stick against the side of the urinal and small white specks are some- times observable floating about in the urine. I have a tendency to be costive, but not specially so. I have not the power of erection I ought to have. I begin to feel week, and not able to work as I used to do; aTid when! rise in the morning I do not feel refreshed after my night's sleep. I have occasionally a throbbing pain at the end of the foreskhi, which is swelled, and appears somewhat inilamed, and I am veiy sul)ject to pleasure-dreams, which are very weakening. 1 have slight aching pains in the testicles, one of which is slifrhtlv wasted, and Itnvo r.iJn^s n.-voss paui: au( up the neck and back of the head, which I never had before. SELF DIAGNOSIS. dl Case No. 114G. I foel niyi^elf constramed to fiy to you at last, and reveal a sceret whicb I can no longer keep to myself. You Avill readily understand Avliat it is, and I am filled Avith shame to acknoAvledge it, but have been doing it in ignorance until the last year or two. I am one of those unhappy beings who early fell a victim to that accursed habit masturljation, or self-pollution, when at school, I will describe all the particulars. I am now twenty-five years uf age; it was when I was about fourteen I connnenced this self -abuse, and some- times I had sexual intercourse. About imv years ago I had the disease called gonorrhaia, or clap, my doctor called it. lie cured me, as I thought ; but I still kept practising that pernicious habit. About two years ago, or nearly, I felt a tremeiidous prickly itchhig underneath the testicles, so I went to my doctor again, and he told me it was gleet. I have been taking lots of stuff and injections, Imt they don t dome any good. There is scarcely any pain, but an almost contimuil discharge, which causes a stani like gum to be left on my linen. It is much aggravated by taking wine or spirits, or violent exercise ; it affects my eyes°very considerably. I only wish I had r^ad your book before, for I had made up my mind pre- viously to reading it that I sliould never be cured. My habits are pretty regular, and my occupation out-door. 1 feel a loss of memory, and a continued fcehng ot languidness, being tired with the least exel'' m, very nervous and timid ; the eyes are very weak, and sometmies very hot, ond feel sore ni then- sockets, i have pains also to the back of my head ; my sleep don't afford me nmch refreshment, for I very often feel more tired ard languid when I got up than when I rro to bed. I am troubled with dreams, and some- times fancy myself in the embrace of some beautiful woman ; and on some of these occasions I have found my ni"-lit-clothes wet with the fluid which had escaped. 'J^he last one occurred only two nights ago ; and tor the last two years I have had escape of seminal fluid 92 SELF DIAGNOSIS. Avlien ill coiiipiiuy of feiivalcs. My water is generally of a higli color, I am very low spirited, although 1 used to be full of life. Case No. 17?3'). I am suffering from the effects of self-abuse, practised until recently. 1 am now twenty-three years of age, tall and thin. When in company of females the penis is continually wet with thin semen, sometimes with erec- tion, sometimes witho.it. I have never had connection with any female, and if I did, the omission would come far too soon. My forehead and shoulders are covered with pimples, the former being very much disfigured, and they are always worse after an emission in the night, which occurs without erection. My eyes are bloodshot at times, and water in a breeze of wind, par- ticularly in the morning. The testicles hang very low, the left is varicose, and there are no wrinkles at all in the scrotum on that side. The dribbling, wlien m company of women, is very odd and unpleasant. When my urine has stood a few hours, there is gener- ally a sediment. Is there any fear of the right testicle becoming varicose, also from hann-ino-? Case No. 865. I am twenty-seven years of age, of a delicate, nerv- ous temperament , I am single, and likely to remain so, unless you can assist me ; for there is no disguising the fact, 1 am impotent through the effects of selt^ pollution, which I practised from eleven years of age until twenty-two, when I became acquainted with Ss mischief and left it off for ever. 1 then obtained medical advice, which gave me only temporary relief, and I have since applied to another medical man, who gave me tonics, but I am grieved to say without effect. My bowels are regular, as I am very careful in my vhich are very disa-recable. 1 am troubled with extreme nervous- 94 SELF DIAGxVOSIS, ness, inv^oluntaiy bliishiiigs, weakness of sight, lassi- tude, coldness of the extremities, and sometimes pains m the head and lohis. I 'ret rliemnatism hj the very sli«^htost draught, sometimes within a remature emission, and sometimes I fail altogether to have an erection, and seminal fluid will pass without any sensation. Occasionally too a dull pain follows near the root of the penis, a most uneasy sensation. There is never any certainty hi my attempts at coition. I am frequently trou1)le(l with lascivious dreams, and sometimes with others of a less agreeable kind, Ijut always causing me to rise without benefit from my rest. All these? thin '>-s were a mystery to me until I rea' your book, which com- pletely opened my eyes to the real state of the case. My appetite is very bad ; I am altogether unwell fearfully languid all day long ; I always go to bed tired, and with an aching pain in my legs, and rise hi the morning the same, never feehng better for rest. My face sometimes breaks out in spots, and I look thin and ill. In fact I feel ill ; I am afraid I have destroyed all generative power, especially as for some tmiD past I have not only been afraid to contemplate intercourse from the fear of failure, but when opportu- nity has offered, have really experienced a total want of desire. SELF DIAGNOSIS. 95 In many patients where circumstances compel the treatment to be by corres])ondence only, I find that the injury to the nervous system is such, tliat, after writing me with a full detail of their case, I shall per- haps have a letter by the next post to teli me <"luit they have overrated the symptoms, and that they feel quite well, and fancy they have been nervous almost without a cause, and a post or two after will bring a letter that they are thoroughly wretched and despon- dent. They are troul)led by miserable fancies that their letters are opened and read by unknown parties before coming to hand ; that every one who meets them sees in their countenances the effects of their habits, or is aware in some mysterious way of their ill-practices. Others tell me that the blood rushes to their face whenevei* a casual eye meets them in the street, frequently accompanied by perspiration, and that the eyes are involuntarily cast iown, as though they had been suddenly detected in some guilty act; that their conversation becomes disconnected,guilty and their observation desultory ; that they lose all their relish for pursuits which formerly interested them to the highest degree ; that they envy every one they see, fancy that there is nothing left for them in the world, either of utility or pleasure ; that they have become aimless and purposeless, and that all they can do is to drag on a miserable existence till the tomb closes over them. Although spermatorrhoea and its host of accompa- nying evils is, in the majority of cases, caused by practices of the kind spoken of in the preceding cases, it is not invariably the case that it is so. Sperma- torrhoea may be caused by constipation, hy ascarides, or worms ni the rectum, by stricture of the rectum, and many other circumstances. Some of these are easy of removal, others more difficult ; but in all such cases the removal of the cause is immediately follov, ed by the disappearance of the spermatorrhoea. I have, however, already exceeded the limits I prescribed to myself in this brochure^ and must only say, in conclusion, that I trust the various statements 96 SELF DIAGNOSIS. contained in it, which I have endeavored to divest as mucli as possible of tecJinicalitics, may be received in the spirit in wliicli they were written, and may not fail in producing thei»* legitimate effect, h^'lieving, as I do, with Dome Tooke, that " Truth needs no orna- ment, and what she borrows of the pencil is defor- mity." 85 ST. ANTulNE STREET, Montreal. Consulting hours (at Dr. Kahn's private residence as above,) from 9 till 2, and 5 till 9 evening. Sun- days till 2 only ; consultations arranged by special appointment. Instructions to Invalids. Patients who desire to be treated by correspondence should observe the following instructions : — 1. — Their letters should contain full particulars as to age — Constitution or temperament — Habits as to occupation — Mode of living — Whether mar- ried or single — Supposed cause of affection — Condition of bowels — Ordinary state of urine — Slate of particular organs affected,^ and — Whether any, and if so, what treatment has been previously adopted. 2. — The letters may, at the option of the patient, be either signed with his own name or an assumed one, or initials, as circumstances may render expedient, and must contain a remittance of Dr. Kahn's Consulation Fee of |5,