LIBRARY OF CONGRESS. %p. ..: .. Goja|ri$i fc,. Shelf„Jt4-g UNITED STATES OF AMERICA. Section of the Male Pelvis. THE IjALE GENERATIVE ORGANS IN HEALTH AND DISEASE; FROM INFANCY TO OLD AGE; BEING A COMPLETE PRACTICAL TREATISE ON THE ANATOMY AND PHYSIOLOGY OF THE MALE SYSTEM; WITH A DESCRIPTION OP THE CAUSES, SYMPTOMS, AND TREA KENT OP ALL THE INFIRMITIES AND DISEASES TO WHICH IT IS LIABLE. ADAPTED FOB EVESY MAN'S OWN PRIVATE USE. BY FEEDEEIOK HOLLIOK, M. D. AUTHOR OP " THE MARRIAGE GUIDE," " THE DISEASES OP WOMBK, 1 "MATRON'S MANUAL," ETC, Illustrated by Numerous Engravings and Colored Plates. TWO HUNDREDTH EDITION, 1TCCH ENLARGED AND IMPROVED. 9 NEW YORK: THE AMERICAN NEWS CO., NASSAU STREET, PUBLISHERS AND AGENTS. 9 Entered according to Act of Congress in the year 1840, By FREDERICK HOLLICK. M. D„ In the Clerk's ©ffice of the District Court of the "United States foi the Southern District of New York. PREFACE. Iw the course of my practice, and more especially at the fermiaation of my Lectures to Gentlemen, I have been jrepeatedly asked whether I could not refer them to some book, that would give a plain and practical explanation of the Male System, and its various derangements, adapted for every man's own use and instruction ? In short a book was wanted that should serve the same purposes for Gentlemen that my " Diseases of Woman* did for Ladies ; explaining fully all those affections peculiar to their own systems, and none others. No such work, how- ever, was extant, and I saw that the only way to supply what seemed a general want was to write one. It is true there were works professing to treat on the Male System, for popular use, but they were all, without exception, principally devoted to Venereal diseases^ and those who made the enquiry of me were not persons at all liable to Buch affections, nor feeling any particular interest in them. My audience would frequently say, " We are not subjects of syphilis, and probably never shall be, but still we are liable to many other diseases, most of which could doubt- less be prevented if we knew their nature and causes ; but unfortunately for us, with the exception of your Lectures, there is no source of information on such matters open to us. We want a Book that will treat on these things in the same style that your Lectures do, and it will be a public service if you will write such a one." For a long time 1 IV PREFACE. was desirous of complying with this request, but my timt was so incessantly occupied that I could not do so. Th* materials I had in profusion, for I had consulted every book on these subjects that was worth reading, both in the English and other languages, and I had besides my own notes of cases, as numerous and varied as perhaps any ont ractitioner ever met with, but still all these materials required arranging and writing out I had besides to make a number of direct experiments, with animals, and of dissections of the human body, for the purpose of testing the new discoveries on Generation, announced by the European Physiologists, which were so utterly opposed to *old notions and doctrines. In addition to these causes of delay, I had also several peculiar and highly instructive cases in hand, the termination of which I was desirous to see, so that I could make use of the novel experience they gave. Had it not been for all these causes combined I should have published this book earlier. The delay, however, has been necessary in order to have it complete, and I was determined it should not be issued till it was so. It may be advisable to state also, for the information of those not acquainted with me or my previous publications, that my course of study, and long practice, has been almost exclu- sively devoted to the physiology and derangements of tht Reproductive System, in both sexes, respecting which I have had unusual opportunities for obtaining information, both in this country and in Europe. Whenever any new discovery, or mode of treatment, has been announced, I have immediately tested it thoroughly, and have furthei made every allowable experiment suggested to myself. There are certain difficulties connected with the Repro- ductive System that are very important, as affecting human health and happiness, but which are scarcely ever made the subjects of study by medical men at all, at least aot in this ccuntry The consequence is, that the trea.t- PREPACK. V flient they receive is mostly empirical, and as liable to d« harm as good. So evident is this, that many persons sc afflicted never apply for medical assistance, but prefer to suffer on and not complain. This is particularly the case with many difficulties experienced by young persons, and with many troubles incident to Marriage, such as Impotence and Sterility, aversion or indifference, and physical or moral unsuttabihty. In the old world there are men of the greatest eminence who devote their sole attention to those matters, and who are the alleviators of misery, and the dispensers of unexpected happiness to thousands. In this country I am not aware of any one, besides myself, that has embraced this peculiar line of practice, and I have found the greatest want of information prevailing, even amongst medical men, respecting the means of relief that are really at our command. In all probability many of the modes of practice, and many of the resources, pointed out in this work, will be entirely new to thousands, and will give hope to many who had previously been sunk in despair. PREFACE TO THE 200TH EDITION. On the occasion of publishing this, The Two Hun- dredth Edition of the Male Organs, it may not be out of place to call special attention to the fact. Such unprece- dented success proves that a book of this kind was really needed, and that it has met with general approbation. The demand for it is steadily increasing, and it may be now fairly considered a standard work, with which the public will no longer dispense. Every care has- been taken to make it complete and perfect, so that it may be consulted by every* man, with a full confidence that he will find in it whatever he may need to know respecting His own system. New matter and illustrations have been added, and all the information brought down to the latest moment. F. HOLLICK. CONTENTS. PAGE DESCRIPTION OF FRONTISPIECE, . ,13 PART I. REPRODUCTION, 14 CHAPTER I. The Female System, . 17 CHAPTER IL The Male System, 36 CHAPTER IE. The Semen, 39 VUl CONTENTS. P AK T II. TAGS DISEASES, MALFORMATIONS, AND DE- RANGEMENTS OF THE MALE SYS- TEM, 53 CHAPTER IV. The Diseases, Deficiencies and Malforma- tions of the Testes, their Envelops, and the parts more immediately con- nected with them, 56 Anomalies in the size and apparent number of the Testes. 60 Hydrocele, or Dropsy of the Testicles, 66 Sarcocele, or Chronic Fleshy Swelling of the Testicle, . . 80 Fungus of the Testicle, 84 Hernia Hnmoralis, Orchitis, or Inflammation of the Testicles, 86 Ossification of the Testicle, 95 Arrest of Development and Wasting of the Testes, ... 96 Tubercular Disease, or Consumption of the Testicle, . . 103 Foreign Bodies in the Scrotum along with the Testicles, . .105 Nervous Affections of the Testicles, ib. Spermatocele, or Swelling of the Testes from engorgement of Semen, 112 Scrotocele, or Rupture of the Intestines or Omentum into the Scrotum, . . 113 Varicocele and Circocele, or swelling of the veins of the Scrotum and Spermatic Cord, lib Hematocele, or Swelling of the Scrotum and Spermatic Cord from the effusion of Blood, 120 Prurigo, or Itching of the Scrotum, . . . . . .121 Elephantiasis Scroti, ... 127 Falling of the Spermatic Cord 125 Relaxation of the Scrotum, 126 Diseases of the Vasa Deferentia, ....... 127 Diseases of the Seminal Vesicles, . . . • * . .130 CONTENTS. IX PAGB CHAPTER V. The Structure, Diseases and Malforma- tions of the Penis and the parts im- mediately CONNECTED WITH IT, . . 131 Absence and Malformation of the Penis, 137 Hypospadias, 141 Epispadias, 145 Phymosis, , . . ib. Faraphymosis, 146 Want of Development, or Congenital small size of the Penis, 149 Paralysis of the Muscles of the Penis, . . . . . 164 Priapism, or Involuntary Erection, ib. Diseases of the Urethra and the parts contained therein, . 171 The Prostate Gland, 176 CHAPTER VI. Functional and Sympathetic Diseases of the Genital Organs, .... 182 Influence of the Brain on the Generative Powers, . . . 185 Influence of the Mind over the Generative Organs, . . . ' 192 Excessive Sensibility of the Genital Organs, . . . .201 CHAPTER VII. Spermatorrhea, or excessive loss of semen, 204 Causes of Spermatorrhoea, 271 Particular Effects of Spermatorrhoea, 216 Symptoms by which the Spermatorrhoea may be detected, . 249 Impotence from Involuntary Emission, 255 Treatment of Spermatorrhoea,' 276 CHAPTER VIII. The Influence op Medicines in Producing and Curing Impotence aijd Sperma- torrhea, 287 X CONTENTS. PACT CHAPTER IX. Masturbation and other Sexual Abuses, . 306 CHAPTER X. Erotomania and Satyriasis, .... 340 CHAPTER XI. General Remarks on the Preservation and Restoration op the Sexual Powers, . 348 CHAPTER XII. Remarkable Case of Elephantiasis, . 368 Facts for the Feeble, .... 373 ILLUSTRATIONS. XI ILLUSTRATIONS. +♦-♦ ; — PAOB PLATE I. SECTION OF FEMALE PELVIS, .... 16 PLATE IT. FRONT VIEW OF THE FEMALE PELVIS, . . 21 PLATE III. OVARIES AND VESICLES, 26 PLATE IV. UTERUS AND APPENDAGES LAID OPEN, . . 35 PLATE V. SEMINAL ANIMALCULES, ..... 4& PLATE YI. NON-DESCENDED TESTICLE, 47 PLATE VIL VARICOCELE, 52 PLATE Yin. SEMINAL TUBES OF THE TESTICLE, . 55 PLATE IX. HYDROCELE AND WASTED TESTICLE, ... 68 PLATE X. SECTION OF PENIS AND BLADDER, . . . 133 PLATE XL REMARKABLE CASE OF ELEPHANTIASIS, , . 367 NOTICE. Any persons wishing to communicate wrth Dr. H. of letter, can address to "Dr. F. Hollick, Box 3606, Post Office, New York City, N. Y," and they will be promptly replied to. All Letters asking an opinion, or advice, must be full and plain in their descriptions, so that a correct judgment can be formed, and they must always contain the custom- ary fee of Five Dollars, or they cannot be attended to. N. B. — Persons visiting New York, can always hear respecting Dr. H. by calling on his publisher, who will know if he is then in town or not, and will give the address of his office. In the changes constantly occur- ring in New York, removals frequently occur, which makes this precaution advisable. F. H.. DESCRIPTION OK FRONTISPIECE Section of the Male Pelvis to show the situations of th« different parts. A.. The Bladder. — B. The Rectum, or end of the large Intestine. — C. The lower part of the back bone, or Sacrum. — d. d. The small Intestines.—/. One of the Kid- neys. — g. g. The Ureter, or Tube which conveys the Urine from the Kidneys into the Bladder. — h. The Pubic or Frontal Bone of the Pelvis. 1. The left Testicle.— 2. 2. The Vas Deferens, or Tube which conveys the Semen from the Testicle. — 3. The left Seminal Vesicle, with which the Vas Deferens is con- nected. — i. The Ejaculatory Canal, into which the Semen next passes. — 5. The Prostate Gland, with which the Ejaculatory Canal connects, and through which the Semen passes into the Urethra, or Urinary passage from the Bladder, (7). — 6. Is the Veru Montanum. or small protu- berance which partly closes the neck of the Bladder. — 7 7. The Urethra, or passage by which the Urine escapes from the Bladder down the Penis. — 8. The upper part of the Penis, or Corpus Cavernosum. — 9. The lower part, or Corpus Spongiosum. — 10. The Glans, or head of the Penis. — 11. One of Cowper's Glands. The course of the Semen is from the Teste along the Va* Deferens to the Seminal Vesicle, then along the Ejacula- tory Canal and through the Prostate Gland into the Orethra, which it enters by the lower part of the Veru Montanum, at the part indicated by the two black dots. It then escapes from the body in the same way as th* Urine does PART I REPRODUCTION. The Reproductive process in the huma* being, ts in all other perfectly organized animals, requires the concurrent action of two different organizations, the male and the female, each performing a distinct part, one as necessary as the other. Neither of these organizations alone can effect the whole process of reproducing a new being, though in certain cases they may partly do so, in an imperfect manner. To understand fully the action of each, which is re- quisite before their derangements and diseases can be understood, it is requisite to give a genera description of both, and also of Reproduction it self. This description can now be given with something like accuracy, owing to the valuable dis- coveries of modern science, and a correct idea can be obtained, of the main steps at least, of this won- derful phenomenon, though hitherto it has* beeo shrouded in such imperetrable mystery. PLATE «. Section of the Female Pelvis A The Bladder. B The Womb. C. The Vagina. D The Rectum, or end of the large Intestine e. One of the Ovaries. /. The Corresponding Fallopian Tube. g. The Os Tineas, or Mouth of the Womb, which openo into the Vagina, or lower passage. h The Meatus Urinardus, or Mouth of the Bladder, fc| which the Urine escapes. t. The Small Intestines. j \ The Sacrum, or lower part of the back bone k The Pubic, or Front Bone of the Pelvis /. Tfhe Right External Lip. in The Right Internal Lip, or Nymph* n The Hymen. o. Fhe Opening through the Hymea, f The Clitoris. Fhe Perineum Plate L Section of Female Petti. »»^'i 11 r i- • CHAPTER I. THE FEMALE SYSTEM The office of the female system is twofold : it Jms to produce in the first place one of the original principles, or primary parts, from which the new being begins ; and also to effect its development into the perfect form. The female organs are therefore much more complicated than those of the male, and her part of the process is more extended. The most essential parts of the female organiza- tion are two organs termed the Ovaries ; which are located in the abdomen, one on each side, just above the groin. These organs have the power, • when their full development is attained, to produce certain little bodies called Ova, or Eggs, essen- tially the same as the eggs of birds, one of which is always required in the commencement of a new being. These organs are small in early life, and com- paratively inactive, but at a certain period, termed puberty, they become larger, and commence a •eries of curious and important physiological pro- cesses, the object of which is to develop the egg and to effect its expulsion from the body. When the ripe Ovaries are dissected they are found to contain a number of cells, or vesicles, Which may be compared to those of a honey-comb, 18 THE FEMAIE SYSTEM. and in each of those cells is contained one of th» germs or eggs, surrounded by a white fluid like the white of an egg. These cells are termed the Graafian Vesicles, after the Anatomist Graaf, who first described them ; they are about as large, when fully developed, as a small pea, but are not all of the same size at once, some being small or merely rudimentary, and others approaching per- fection. Before the age of puberty these cells and the eggs they contain, are all undeveloped and small, but at that time their gradual and successive development commences. It is found, from recent observations, that only one of them is perfected at a time, and that it requires a certain period before another can be produced. In the adult ovary therefore we find them at every stage, some being only in the rudimentary state, others just com- mencing to grow, and others having aaained a con- siderable size, there being always one more ripe than any of the others, and evidently approaching •to perfection. When the egg is fully developed it is thrown out of the Ovary, and after a time makes its escape from the body, in a very curious manner only recently discovered. There are therefore two different actions performed by the Ovaries, first the forming or developing of the eggs in successive order, and secondly, the expulsion of them from the Ovary, and ultimately from the body. This development of the eggs it must be remem- bered is entirely independent of sexual union or ex- citement, and is totally unconnected with conception, except as a preparation for it. In every female, whether virgin or not, from the age of puberty till , the turn of life in old age, this development of ths THE FEW AT, 75 SYSTEM. eggs is always going on, excepting in certain His. Bases, and during gestation and nursing, when it is usually suspended. It is also performed in ceriain definite and regular periods, which are nearly the Bame in all persons alike. This period is usually one month, or twenty-eight days, and most females observe precisely that period with singular regu- larity. During every month, therefore, after puberty, with the exceptions above named, one of the Graafian Vesicles, and its included egg, arrives at perfection, and at the end of the month the egg is expelled from the body. The egg appears to be expelled from the Ovary by a real inflammatory action, similar to what nature establishes to effect the expulsion of an in- jurious foreign substance in any other part of the body. Towards the end of the month the Vesicle begins to swell very much, and is filled with blood, instead of the white fluid seen there at othe:* cimes ; the egg, which was formerly at the bottom of the Vesicle, is now lifted up to the top, by the fluid underneath, and is at last pressed forcibly against the envelop or skin of the Vesicle. This pressure becomes eventually so great that the envelop bursts and the egg escaping through the rent reaches the outside of the Ovary. It is then taken to a particular part of the body to remain for a cer- tain number of days, during which it may be im- pregnated, or receive the male princip]e, and if this takes place, they both remain and develop into the new being, but if no impregnation is effected then, at the end of that time the egg is passed out of the body and lost. From this it is evident that impreg. nation, or conception, can take place only during ihose days after the egcr is expelled from the Ovary PLATE II. Front View of the Female Pelvis, with the External Walli removed. A. The Bladder. B The Womb. D. The Rectum, or Large Intestine. e. e. The Ovaries. /./. The Fallopian Tubes. i. i. The* Small Intestines r. r. The Round Ligaments. This shows the situation of the Organs in the front cd the bod 7, as they appear when it is first opened. Plate II. Front view of the Female Pelris. 22 THE FEMALE SYSTEM. and while it yet remains in the body, as will be ex. plained more fully further on. The inflammatory action by which the Vesicle is filled with blood, and the egg excelled from the Ovary, is not altogether confined to those parts, nor to that one process, but affects other parts, and ac- complishes othea* purposes. The whole * Ovary, and also the neighboring organs, become at that time singularly excited and congested with blood, and at last, to relieve themselves, the blood mixed with mucus is discharged, to subdue the inflamma- tion. This discharge usually lasts about four days, and is termed the Menstrual, or monthly Jlow. This flow, therefore, about which so little has pre- viously been known, is caused by the expulsion of the Ovum or Egg from the Vesicle, and indicates the period when that expulsion takes place. Con- sequently in those who have no Ovaries, or in whom they are torpid, or destroyed by disease, no menstruation takes place. And for the same rea- son it is not seen before puberty, because the eggs are not then ripened, nor after the turn of life, because then they are all expelled. This discharge is therefore an indication of ihe capability for con- ception, and it is also, in all probability, a means of removing much injurious matter from the system, so that female health is materially dependent upon it, and those in whom it does not appear, or becomes irregular, are nearly certain to become diseased. It is proper to remark, however, that it is sometimes nearly or quite colorless, and then the persons think they have no menstruation, though it may never, theless be perfectly regular. When the egg is fully expelled it leaves behind it the hollow Vesicle, filled with clotted blood, ai THE FEMALE SYSTEM. 23 trie top of which is a torn place, or rent, through which the egg escaped, in a ihort time this blood dries up and changes to a dull yellow color, while the rent forms a scar on the surface of the Ovary, and we thus have produced the yellow body called a Corpus Luteum, which was formerly thought to result from conception only, but is now known to be an old Vesicle from which an Ovum has been ex- pelled. On the surface of ihe Ovary of an adult female a number of Xhese scars are always to be seen, but as they gradually fade away and disappear, only some few, and sometimes only the last one, can be distinctly seen. The Vesicles are contained at first, in their rudimentary state, in the body of the Ovary, and appear to develop in succession, the outer ones first, each one when fully ripe projectinor Dn the surface like a small pimple or nipple till it bursts. The egg itself, when fully developed, is only about as large as the point of a pin, in fact it can only just be seen by the naked eye. This may appear singular when compared with the large egg of a bird, but it must be recollected that the bird's egg is surrounded by the nutritious matter from which the new being is to be made, because it is totally separated from all other sources of nutrition, but the Human Ovum remains in the mother's body and derives nourishment from her blood to effect its development, it has therefore no need for any supply of nourishment to be attached to it. The actual germ is probably no larger in the bird than in the human female. When the egg is fully, ripe, if it receives the male principle, it will develop, to a certain extent, into the human organization in any part of the body. But it cannot fully and perfectly develop except is 24 THE FEMALE SYSTEM. a particular organ, called the Matrix, the uterus, or Womb. The position of this organ in the Dody may be seen in the Plates. It is a small hollow organ in its natural state with very thick walls, but capable of undergoing astonishing changes, and possesses every requisite both for the perfect development of the new being, and also for its expulsion into iht world when fully grown. The Ovaries are attached to the Uterus, wie on each side, by ligaments or banc's, but have no direct connection with its cavity. The connection between the Ovaries and Womb is bv means of two organs, one attached to each side of the Womb just above the Ovaries, called the Falhxnan Tubes. A small cavity leads from the inside of the Womb down these Tubes to the end opposite the Ovaries, which is expanded like a Trumpet, a\?d surrounded by a number of fringes or Tentacular Hke the fingers of a hand. The Womb is placed at the too ox the passage or Tube called the Vagina, and opens into it by a small mouth called the Os Tincse. or mouth of the Womb. The lower part of the Vagina opens ex- ternally by the mouth called the Vulva. There is therefore a direct passage lrom the Ovaries to the outside of the body, by whiuh the Ova or Eg^s ar*» expelled. After this description, the maturation and exDi») sion of the egg, and the process of conception cs*» be readily understood by th« following explanation and by referring to the Plate*. An egg becomes ripe at tlfr end of every monthly period in one or the other of uie Ovaries, a^d when expelled in the manner abov^ described it ^ UxJceo into the Womb in the folio wi»« snsumtM ■ At the 3* 25 PLATE III. Ovaries, Graafian Vesicles, and Ova 1 One of the Ovaries just before the Crisis.— a. Is th« Graafian Vesicle that is nearly ripe, and preparing to burst, the Ovuui projecting upon it like a small pimple. 2 The same Ovary cut through, to show the Interior. - a. Is the Vesicle as seen within ; the dark centre denoting the clot of blood which throws out the Egg. — b. Is an old Vesicle, from which an Egg has been ejected at some former crisis. It is now drying up, and forms a Corpus Luteum 8 Is the Graafian Vehicle removed and magnified. — a. Is the Ovum, or Egg, just' breaking through the rent in the Vesicle. 4. Is the Egg itself magnified, showing its granular atree* ture. — a Is the G srminal Vesicle Plate m. Ovaries and Ves sides. THE FEMALE SYSTEM. precise time when the egg is fairly loose from the Vesicle, the expanded end of the Fallopian Tube grasps the Ovary over the spot where it is, and the fringes or fingers at the end of the Tube take hold «)f and ^arry it into the passage. The Tube then contracts and the egg is gradually forced down its interior till it reaches the Womb. When the egg arrives in the Womb it would of course pass immediately out, by way of the Vagina, if there were not some contrivance to prevent it, which of course there is, and of a very simple and perfect character. While the egg *is passing down the Tube there is formed in the interior of the Womb a thin membrane, or skin, which lines its walls ana closes the passage at its mouth. While the egg passes out at the Uterine end of the Tube it presses on this membrane and makes a depression or nest in which it lies. As long therefore as. this membrane remains attached the egg is retained in the Womb, and con- ception is possible, because the male principle can penetrate through it without obstruction, but at the end of a certain time the membrane looses away and parts from the body, taking the egg along with it, after which, of course, there can be no conception till another such period comes round and another egg is lodged there in the same manner. Conse- sequently theie is only apart of each month during which conception can take place, and during the rest of the month it is impossible ! The precise period during which conception can occur varies in different persons, being in some only one or two days, and in others much longer, but it probably nevei extends beyond half the month, or fourteen days. This statement I air aware will surprise manv per 28 THE FEMALE SYS'EM. sons, it being generally thought that cohesion may take place at almost any time ■ bux mere is no question that this is an error. As near as can be ascertained, the flow occurs while the expulsion is taking place- from the Ovary and tht egg does not reach the womb until the first or second day after the discharge has ceased, it is therefore from the second day after the cessation of the period that the time during which concept ion can take place is reckoned. This time, I think it necessary to staje again, is so various in different females that no general rule can be laid down, and there are so many causes which make its com- mencement and duration uncertain, that it cannot be calculated upon practically, except by ex- perienced persons. There are signs by which the period during which conception is impossible can be told in every female, with perhaps a few exceptions, but they can only be detected by those who have been long in the habit of observing them. The Membrane and Egg together are so small, and so delicate in their structure, that no female perhaps ever observed them, though passing from her body every month. I have, however, obtained them, and have pointed them out to persons, by the aid of the microscope. A knowledge of the above mentioned facts en- ables us to explain many cases of barrenness, the causes of which were previously unknown. In some females the Ovary has not power to perfect the egg y and it is constantly expelled before its development is complete, and therefore is not capable of being impregnated. In others the Womb does not form the Membrane, so that the egg instead of being re- tained vi the Womb passes immediately out, and THE FEMALE SYSTEM. 29 conception has no chance to occur. Some females can only retain the egg a few hours, or perhaps for a day, and if not impregnated during that short time they cannot be so during the rest of the month. The most probable time for conception is from the Jrst to the fifth day after the cessation of the men- strual flow. The actual process of conception is in itself very simple, and may be explained in a few words. The semen, or male principle, is deposited, during as- sociation, in the Vagina, and from thence conveyed upwards through the Os Tincae, into the cavity of the womb. If it reaches the upper part, and the egg be there, conception may occur ; but there are many causes operating both to prevent its transit and also to destroy its power. The upward passage of the semen is accomplished by a peculiar vital power in itself, which will be explained when we describe the male system. The place of union of the two principles is therefore usually in the uppe? part of the womb, or possibly also at the uterine end of the Fallopian Tube. Immediately after impregnation has been effected the egg attaches itself permanently to the walls of the womb and begins to develop into a human being, the womb expanding to allow of its doing so. When fully grown the walls of the womb begin to contract and eventually expel it from the body, by way of the vagina. During its growth the nutri- ment required is obtained, in some way not very well understood, from the mother's blood, the com- munication between the Foetus and its parent being of the most wonderful and mysterious character. Instances have been known of the egg f after its im- pregnation, being taken back again, by a reverse SO THR FEMALE SYSTEM. action of the Tube, to the outside of the womb, and partly developing there ; such cases are called extra utefine conceptions, and they are supposed to resuh from fright or other sudden and powerful emotions. The natural action of the Tube is such that it can only convey anything from the Ovaries towards the womb, but sudden and strong excitement of the nervous system. may, for a short time, reverse this natural action, and if there should then be an im- pregnated egg at the uterine end of the Tube it may be brought to the outside, and thus produce an extra uterine conception. These, however, are always imperfect, and of course can never be born. Some- times they form into tumors which may be carried for years, or even for life, but more frequently they decay after a time and pass away by an abscess, often with little injury or riek to the patient. The old notion about one Ovary producing males and the other females, is incorrect, either one pro iucing both sexes. It is also an error to suppose, a>s some persons do, that sexual feeling is requisite in the female for conception to take place. There is no question whatever that it can occur in certain cases, not only without sexual feeling, but also during sleep, or in a state of perfect unconsciousness, though it is not so likely to do so. This will be better understood, however, after the male system has been described, when it will be shown that il may be even effected artificially, without any intercourse of the sexes at all. This explanation, it will be observed, establishes a perfect correspondence between the action of the reproductive system in the human female and in all others, such as reason and analogy would lead us to expecU THE FEMALE SYSTEM. 31 The constant production of Ova, 01 Eggs, af regular periods, as a part of the proper action oj the female system, independently of sexual unioi. or excitement, is what universally occurs. In those animals that bring forth their young alive, it is true, we do not ordinarily see them, unless they are closely looked foiyowing to their small size and to their remaining within the body to develop when impregnated. But in those who produce their young externally, as birds for instance, the eggs are larger and easily seen, and it is well known that they are regularly produced without any concurrence of the male bird. These eggs so produced, however, are infecund, that is, they cannot develop, because they have not the male principle. This is what we have shown occurs in the human female ; the eggs are regularly pro- duced, but when not impregnated are thrown off and lost. The use of impregnation therefore is to vivify 01 perfect the egg, and not to produce it as the old iheories supposed. In like manner we see that in all animals a crisis is produced when the eggs are ripened and cast off, strictly analogous to the monthly crisis in the human female. The period, however, varies very much, though always constant in the same being. Thus some animals produce their Ova oniy cnce in two or three years, as the Lion and Elephant for instance, while others do so every year, usually in the spring, as the Deer and wild cattle for instance. When this occurs there is a peculiar excitement engendered in the system, called the Rut, or heat, which is accompanied by a flow, and is strictly analogous to the monthly crisis in the human being, 32 THE FEMALE SYSTEM. It is of course only at that period when the eggi are ripened that impregnation can be effected, as is well known with domestic animals, who conceive only in the season of rut, or heat, which usually occurs in the spring. They will not admit the male at any other time, ibecause there is not the requisite excitement to create the desire to do so ; but even if they were there could be no conception, simply because there is no egg to be impregnated. In the the hunran being the ovarian development i» monthly, and therefore conception can occur at almost any period of the year, though only at a particular part of each month. In some domestic , animals, as Fowls and Rabbits for instance, the ovarian development is almost incessant, so that they produce eggs, or oonceive almost without intermission. On dissecting the ovaries of any animal at the proper period, all the appearances can be noted that we have described in the human being. The vesicles may be seen at various stages of develop- ment, the Corpora Lutea may be detected where ova have formerly been expelled, and, in birds, the eggs themselves may be seen, some merely rudi- mentary, others larger, and some nearly ready to be expelled. In the human being there is usually jut one vesicle, and its egg, ripened at each period, but occasionally there are two or more, when we may have twins, and so forth. So that in those animals who have always several young at a birth, there are, of course, always as many vesicles ripened, and a Corpus Luteum is formed for each. The structure of the egg is the same in alj animals, being precisely like that of the bird The main part is a mass of yellow granules, called THE FEM4T.E SYSTEM 3$ ihe ye7H, in which is found a small greenish vesicle, called the germinal vesicle. The white por- tion seen so large in birds, is, like the shell, an accidental addition, and not strictly a part of the ovum ; it is not needed in those Ova that are developed in the body. In its passage down the Tube the egg is broken open by the germinal vesicle bursting through its outer envelop and escaping. This breaking open of the egg is, as will be shown when the male principle is described, a necessary preparation for conception, and is in itself a very curious phenomenon. I am aware that the facts I have stated, and the conclusions drawn from them, are totally at vari- aroe with many old theories and popular notions, and will seem very strange to those who hear them for the first time. It is, therefore, necessary for me to state that they are not advanced without the fullest authority. It is only very recently that a knowledge of these curious and important facts has been obtained, and they have not yet had time to find their way even into standard scientific works, in this country, though well known to practical Physiolo- gists. They are the results of actual experiment and investigation, and are placed beyond the possi- bility of doubt. These explanations have a very different foundation, therefore, from the mere theories and suppositions contained in most physiological works, which are generally supported only by questionable statements or loosely observed facts For full particulars on all these matters seo my " Marria»oe Guide," in which will be found all mat is known on such subject. PLATE IV. The Uterus and its appendages removed, to ■how th«b connections B. The WomD. 0. The Vagina e. e. The Ovaries /. /. The Fallopian Tubes. g. The Neck of the Womb. r. r. The Round Ligaments. s. The Left Broad Ligament. This view represents the Organs disconnected from all the other parts. The passage of the Ovum, from th« Ovary down the Fallopian Tube to tht Womfr eaii ht readily understood by this piste. Plate IV UWroa and appendages laid ope» wri>i> 36 CHAPTER II. THE MALE SYSTEM. The most essential organs in the male system ire two glandular bodies, called the Testes or Tes. tides, which are placed, after birth, outside of the body, in an external envelop, called the scrotum, hanging from the pubic bone. The use of these organs is to produce the male principle, o r semen, as .he ovaries produce the female ova or egg. The Testes, like the Ovaries, are not capable of per- forming their proper functions till a certain period of life, called puberty, but unlike them, they are not liable to lose their powers at any particular age, but may preserve them indefinitely. In the early stages of existence in the womb the testes are con- tained in the abdomen, and only descend to the scrotum just before birth. On dissecting one of the testicles, it is found to be chiefly composed of blood-vessels and numerous small tubes containing semen. A branch of the spermatic artery is sent from the abdomen down to each testis, in which it divides and subdivides into thousands of little branches, many of which are too small to be seen by the naked eye. It is this artery that brings to the testes the pure blood from which probably the semen is formed. The extreme ends of the minute arterial branches are appa- rently continous with the commencements of the seminal tubes, so that in examining them we grad- ually lose sight of the blood and begin to find THE MALE SYSTEM. 37 ■* the place where it originates and explain its pro- gress towards the exterior of the body. 38 THE MALE SYSTEM. The Vas Deferens from each Testis, into which all its seminal tubes have poured their contents, ascends into the Abdomen through the spermatid cord, and rises nearly as high as the top of the bladder, behind which it turns, and then begins to descend till it meets over its lower part with two small organs called the Seminal Vesicles, with which it becomes connected. From the seminal vesicles the semen passes down a small tube called the Ejaculatory Canal, which is attached to the bladder and which joins immediately under it, an organ called the Prostate Gland. Finally, by means of some curious openings through the prostate gland, the seminal fluid is passed into the Urethra, or pas- sage down the Penis, by which the urine escapes from the bladder, and is thus ejected from the body. These several parts comprise the whole male generative system, and in the act of impregnation each one has a special function to perform. The Testis secrete the semen, the Vas Deferens and ejaculatory canal convey it to the Urethra, and the penis deposits it in the Female Organs, while the seminal vesicles and prostate gland either secrete some necessary addition, or effect some modification in it. This general description will be sufficient for our present purpose. A full account of each organ, and of all their different diseases, will be given further on. After the nature and properties of the Seminal Fluid have been treated upon. (A reference to the Frontispiece and its explana. tion, will give a clear idea of the description here given, and will also make any of the subsequent articles be readily understood.) 39 CHAPTER III THE SEMEN. The vivifying principle secreted by the male testes is a yellowish white semi-fruid substance, having a peculiar odor. It is slightly viscid and of a saltish flavor, when fresh. On examination h is found to consist of two distinct parts, one nearly fluid and the other like globules of half-dissolved starch, which, however, both melt together when it is exposed some time to the air. The peculiar odor of the Semen appears to be derived from some of the parts through which it passes, for when taken from the testes it has scarcely any smell at all. Chemical analysis shows us that the semen dif- fers but little in its composition from other sub- stances found in the body. In 1000 parts there are about 900 water ; 60 animal mucilage ; 10 soda ; and 30 of phosphate of lime, with a peculiar animal principle, the composition of which is unknown. This analysis it must be recollected is that of the semen, as it leaves the body, that is the secretion of the Testes, Vesicles, Prostate Gland, and other parts, united together. How far the pure semen from the testis alone differs from this is not known By some the starchy portion only is supposed to be produced by the Testes. The Seminal Animalcule. — The most curious peculiarity of the semen, and in many respects the most important, is that there always exists in it, when perfect, a number of remarkable living 40 THE MALE SYSTEM. beings called the Zoosperme-s } or Seminal Animal culae. These beings were discovered many years ago, but have not been accurately studied and described till very recently. The representations and descriptions given of them wi old works are mostly incorrect, and sometimes very extiavagant, and calculated to mislead rather than inform* Some physiologists, who saw them imperfectly, even doubted if they were living beings. The per- fection of that magical instrument, the microscope, however, and the patient investigation of such men as Pouchet and his coadjutors have not only cor- rected these old errors, but also disclosed to us new truths, more wonderful even ihan the wild dreams of former times. As far as yet investigated these Animalcules exist universally, in the Semen of all animals whatever, but have a peculiar form and development in each. If is also ascertained that they are developed from a species of egg, or ovum, called the seminal granules, or vesicles. Under the microscope a number of these can always be detected, like little globules of mucus, and they are observed to undergo a regular series of changes similar to those of the female ovary. When first observed they are round and merely contain a number of small granules, which are the Animalcules, in a rudimen* tary state. At a further stage these granules are found to be developed into small Animacules, while the containing vesicles have expanded and become elongated, or egg-shaped. Finally the vesicle I reaks open at one end, and the Animacules escape, being at first very small and gradually growing after* wards to the size we ordinarily see them. The figures in the accompanying plate represent ?ta Aeminai Animalculas in the Human Subject. 1 One o/ tne Vesicles, containing the Animalcules ia i rudimeniary state, coiled up. 2 The Vesicle broken open, and the Animalcules escaping K and 4. Perfect Animalcules. — a. Is the stomach and in- testines. The two round white spots at the top, indicate the mouth and the sucker by which it attache? jt«e£f These are magnified many thousand times Plate V. Seminal Animalcule* THE MALE SYSTEM. 43 the form of the Zoospermes and the changes in the vesicles, as seen under the microscope, in the human being. In different beings the form both of the Vesicle and the Animaculse varies much, and occasionally the Zoospermes undergo some remarkable meta- morphoses before assuming their final form. In the human being there are about thirty Zoo* spermes in each vesicle, but in some beings there are more, and in others not so many. The number of vesicles varies very much, at different times* even in the same individual. The precise size of the Zoospermes is of course difficult to ascertain, but * Mr. Pouchet estimates their length at about the ten thousandth part of an ordinary hair, and their weight at about the hundred and forty thousand millionth part of a grain ! K spot as large as a mustard seed, he remarks, will sometimes contain fifty thousand of them, or more. Notwithstanding this extreme minuteness we are now* tolerably well acquainted with their peculiari- ties of structure, and even with many of their habits ; nor need this excite much surprise when it is recol- lected that there are beings still smaller that have been studied with even greater success. In Fig. 3 and 4 of the last plate, the form of the human Zoospermes is given correctly, and their internal organization is also partly shown by the part marked a. a. Fig. 4, which is supposed to be the stomach. In the perfect state each one has a sucker at the larger end, represented oy the white dot in Fig, 3 and 4, by which they can attach themselves to %ny object. They are observed to change then skins at certain periods, like snakes, and we some* 44 THE MALE SYSTEM. times find the loose skin hanging about them in shreds ; or cast off quite whole. In some animals they have a number of hairs, or cilia, by the motion of which they move in the flukl, and some even have perfect fins. One Physiologist assures us that he distinctly saw they were sexual, and that he could readily distinguish the male and female ! They are usually lively and active, with peculiar motions, some of which are performed in concert and others singly, with great perseverance and regu- larity , thus a number of them will sometimes form into a ring, with their heads all one way, and run rouna and round in a circle for a considerable time ; or one may be seen by itself pushing before it a large globule of mucus, or blood, many times heavier than itself, for several minutes together. One peculiarity is observable in all of them, and that is an almost i±rsri*f**« tendency to move only straight forward, and they will seldom turn to go back even though they meet with an obstruction, but often attach themselves to it by the sucker and remain till they die. Very often they are seen to enter into combats, and a number of them will fight till only one is left alive. They will live for some hours out of the body, particularly if put in warm water in which their motions may be readily seen. The Zoospermes are not found before Puberty, nor usually in extreme old age. Many diseases also destroy them, and several drugs have the same power. In all cases where they are absent or destroyed, from whatever cause it may be, the semen cannot impregnate, though in every othex respect it may be quite perfect, and the vigor of the patient seem not in the least impaired. This has been proved by filtering ihem away, ami by destroy- THE MALE SYSTEM. 45 ing them. The development of the Zoospermes it will be observed is strictly analogous to that of the ova or eggs in the lemales. Thus they are first found in the form of little granules, enclosed in a Vesicle which bursts as they become more perfect and allows them to escape. In some animals there is even a periodical development of them, similar to that of. the ova in the female, with which it usually corresponds. In such animals the Testes are small at other times, and increase in size at these periods because the Vesicles only attain their full, growth then. In tracing the semen from its source we find that the annimalcules are not developed till it reaches the Seminal Vesicles, and are sometimes not perfect till it has reached the Prostate Gland. In the Tes- ticles we never find the Zoospermes themselves, but only the Vesicles containing the granules, which gradually develop as it proceeds further on. The Testes may therefore be compared to the Ovaries, the Seminal Vesicles to the Graafian Vesicles, and the Seminal Granules to the ova. Some Physiologists consider the granules to be the ova of the animalcules themselves, but this we can- not yet decide, though it is certain the animalcules originate from them. The importance of these facts, in giving us a cor- rect knowledge of the nature and proper treatment )f many diseases of these organs, will be seen as we proceed, particularly when treating on Imphe thighs. Il is divided vertically into two parts by a small ridge, called the Kapha, and is usually covered with hairs at puberty. Underneath the Scrotum we next find a reddish cellular membrane, called the Dartos, w lich makes a separate sack for each oi Muscles of the Male Organs, and Envel* opes of the Testicles. a < ig *V l 'T ly l y ?• The muscles of ^e root of the Penia 4, 6. Muscles of the Anus, which are concerned in erection. Fig 2. The Different coats, or envelopes of the Testicles with the Vas deferens and Blood Vessels, forming the Sper- ?*£? m' Which ascends through the inguinal ring at 11. 7 The Testicle. 8. The Epididymis. 12. Shows the Var deferens ascending in the body. DISEASES OF THE TESTES, 51 the two Testicles, which are separated fiom each other by a vertical membrane placed between them, called the Septum Scroti, which acts as a partition, and thus the two organs are perfectly unconnected with each other. The nature of the Dartos has beer a subject of dispute among anatomists, some considering it to» be merely a cellular tissue, and others thinking it to be a muscle. It is undoubted- ly partly muscular, and consists mainly of long fibres, which cross and interlace each other in every direction . It is the contraction of these fibres of the Dartos that corrugates or wrinkles the Scro- tum, as is well seen when sudden cold is applied to the external parts. Next under the Dartos comes a true muscular coat, called the Cremaster Muscle, or Tunica Erythoides, the use of which is to draw the Testicle upwards. This is derived from one of the muscles of the abdomen, and comes down through the abdominal ring, forming part of the sheath of the spermatic cord. The la». coat is called the Tunica Vaginalis, which is a true serous membrane interlaced with blood-vessels, and comes next to the Tunica Albuginea. In a healthy state the muscular fibres of the Scrotum are usually contracted, so as to draw the skin into folds and brace the Testes up against the Abdomen ; but during a state of debility, or from zreat fatigue, they become relaxed, so that the testes nang low, and pull upon the cord. It is an almost eertain sign of ill health when this relaxation of the ^Scrotum occurs, at any period of life, and often its removal is the first indication of improvement In old people, and in those of a bad habit of body, his relaxed state becomes permanent. By inspecting antique statuary, it will be seen 58 DISEASES OF THE TESTES. that the ancients were practically acquainted with this physiological fact, and they have accordingly accurately represented it in their worKs of art. The figures of all their men in healtn and vigor have the Scrotum invariably drawn up to the abdo- men, while those of old men, or sufferers, hang pendant. • As a general rule the muscles of the scrotum are independent of the will, or act involuntarily, but instances have been known of men who could make them act as they pleased. Some boys exhibit this power before puberty, being able to draw the Testes up to the abdominal ring, and let them fall again, but it is seldom this command over them continues, though one instance is on record. This man drew the Testes up into the groin, so as to form apparent ruptures, in order to escape being impressed intc the service. Being detected, however, he confessed the trick, and made an exhibition of his extraordi- nary power to the examining physicians. He could pull up either one alone or both together, and could also make one go up while the other was coming down ; in short, he had the same command over them as over his arms, and could move them as quickly. In another instance* a man, who was charged with being the father of an illegitimate child, endeavored to evade the responsibility by alleging he had no Testicles, and, therefore, could not be the father, but it was discovered that he could draw them up into the groin at pleasure. In a healthy state the scrotal muscles are brought powerfully into action during coition, so as to brace the Testes tightly against the Pelvis, and one cause of partial impotence in very weak or oW people, is the \wa of &*s power, ow ing U* «:Hi.«$k tW semen it DISEASES OF THE TESTES. 59 not expelled with sufficient force. In children this relaxed or firm condition of these muscles is often f valuable indication of the state of their health. The form of the Testis is that of a somewhat Oattened oval, with one end a little larger than the other. The average weight is about one ounce. The Vas Deferens, or common Tube into which all the small ones are emptied, commences at the globus minor, or lower end of the epididymis, and then passes into the spermatic cord by which it enters the Abdomen, where its course has already been traced. It is altogether about thirty-two feet long. The sheath of the spermatic cord is com- posed of two coats, the outer one of which is veiy %m, like cartilage, so that the tube is not easily compressed ; the inner coat is a mucous membrane, similar to that inside the Urethra, This cord can be readily felt externally. This description of the Testes and their envelops, combined with that before given, will be sufficient to give a clear understanding of the various diseases and derangements to which they are liable, and also of the reasons for the line of treatment laid down. It will be seen that they are so placed, without the body, as to have no direct connection with any other organs, and they may, therefore, be removed, without any other part being interfered with. This operation, termed Castration, is sometimes necessary in certain diseases, and sometimes it is the effect of accident, or in some parts of the world of design. The removal of the Testes, however, in whatever way it may be effected, not only destroys the power 3f procreation, but also interferes in a remarkable manner with the growth and functions of various otii^T parts of the systeit*, irom which it is evidem (50 DISEASES OP THE TESTES lhat ihey are necessary for the perfection of the individual's own system, as well as for the purpose trf bringing new beings into eyistence. ANOMALIES IN THE SIZE AND APPARENT NUMBBB OF THE TESTES. The usual size of the Testes is about that of an 'nrdinary pigeon's egg, and their weight, as before stated, is about one ounce. Occasionally, however, they are seen much larger, and sometimes much smaller, and their weight may be also considera- bly greater or less than the average. I have seen them as large as a full size hen's egg, yet per- fectly healthy, and as small as marbles without being in any way deficient in power. This is im- portant to bear in mind in many cases that may come under the physician's notice. I have known men hesitate about marrying when the Testes w.ere very small, from fear that they would be deficient in power, and it was with difficulty they could be con- vinced to the contrary. In one instance of a young man aged twenty-six, they were no larger than those of a child of nine years old, yet his powers were but little, if any, inferior to those of persons gene- rally. After a great deal of hesitation, and much persuasion, he married and became the father of a large family. It is necessary to remark, however, that in these cases ail the other organs were of proper size, and that the sma! Iness of the Testes had existed from childhood, and was therefore a natural state. If they had decreased in size, after having been properly developed, it would have been very different. The falling away or wasting of the Testes, wbi«h follows na&ny diseases, and sometimei 7 DISEASES OF THE TESTES. 61 takes place without any assignable cause, is usually a serious matter, and is nearly certain to be followed by a loss of power The injudicious use of certain drugs, particularly of Iodine, will frequently cause the Testes to waste, and so will the exhalations from some metals, as lead for instance, many work- men in whijh I have known so affected. In giving an opinion in such cases therefore, their previous history must always be known, as well as the con- dition of the other parts, and the physician will then nave but little difficulty in coming to a proper deci- sion. Sometimes one only will be small, and the other of average size, or one only may waste away, without injuring the other. An unusually large size of the Testes should always excite suspicion of its being the result of disease, and a most careful examination and inquiry should therefore be made. If they have always been of that size, or nearly so, from Puberty, and especially if the other organs are large also, there may be nothing to excite apprehension. The symptoms of the different diseases hereafter de- scribed should however be carefully studied, par* ticularly those that cause enlargement, as Hydrocele and Hernia Humoralis, for instance. I have known the Testes of a youth of fourteen to be much larger than those of most men, and yet perfectly healthy ; such cases of unusual development are not necessarily accompanied by extra power. In some instances the development of all tn genital organs is very tardy, owing to the slow growth of the Testes. I have seen a youth of nine* teen that was in every respec' in the same state of these parts, as when about seven years old. He was also but very little grown in other pans of the 62 DISEASES OF THE TESTES. body, having the appearance of one about twelv* years old. In this case, there were perfect evil dences of sexual power, though slight, and all the parts were evidently healthy. It was therefore a case of torpid action, or retarded development, and I thought that in all probability nature could be aroused. I accordingly gave him directions to use stimulating lotions, with frictions and shampooing, and to have a stimulating diet, with regular warm bathing and plenty of out-door exercise. The effects of this practice was soon evident ; in less than six months an evident increase had taken place, both in the size of the parts and in the intensity of the sexual feeling. The external parts, which had previously been perfectly bare and smooth, like those of a child, became covered ; the voice assumed a more manly tone, the muscles were more solid, the mind more active, and manhood began to dawn. This improvement continued going on till he was twenty- one, when there was but little difference between him and other young men of that age. If this case had not been promptly and properly attended to, in all probability no further development would ever have taken place, and an early death would have terminated his imperfect existence. To what age an improvement of this kind is possible we cannot of course tell, though I feel sure it may be effected in older persons than is generally supposed, perhaps till nearly thirty. The younger, of course, the better. Several cases have been known of the Testes growing after twenty-six years old. Sometimes there appear to be Three Testicles* mnd possibly in some of these cases there may really be three, but more frequently one of the three bodies is either the epididymis, somewhat enlarged DISEASES OF THE TESTES. 63 and much separated from the Testis, or else it is a email, tumor. Most of those that have been observ- ed in dissection have been small harmless tumors, existing from birth. Three perfect Testicles, how- ever, are occasionally found, but they are not always accompanied by any unusual sexual power. At other times there appears but one Testicle, or perhaps none, and I have known young men in the deepest distress from this cause. In some of these instances there is really but one organ, as has been proved after birth, and yet the individual has had full average powers. It is more often the case, however, that these deficiencies are apparent rather than real. Before birth the Testes are contained in the Abdomen, and they usually descend into the Scrotum in the last month. It sometimes happens, however, that the descent of one or both does not take place, and the individual then appears so far defici- ent. In these cases the power of the Testes is not impaired by their unusual position, but perhaps is often increased, and this has led uninformed persons to think that men sometimes had procreative powers vxithout Testicles, because they could not be found. A man once died in one of the London Hospitals who had long been noted as having no Testicles, and yet having all the usual powers. On dissection two perfect ones were found in the Abdo- men that had never come down, and thus the won- der was solved. These cases, however, are but rare. Dr. Marshall examined Ten Thousand eight Hundred young recruits, among whom he fou$d Jive in whom the right Testicle had not come down, and fix in whom the left had not ; there being but one man in whom both were not descended. It is mich better for the Testes to remain totally 64 DISEASES OF THE TESTES. in the Abdomen than to descend only to the groin, as they sometimes do, because in the last position they are apt to be compressed, by the other parts crowding about them in the ring, and thus waste away. The imperfect or non-descent of the Testes must, however, always be considered an imperfection, and though it may not cause incon. venience, or loss of power, it is neverthelesi always to be feared. The Testis itself is as liable to all its different diseases while in these unusual positions as when in the Scrotum, and unfortunately cannot then be reached. The neighboring parts also become affected from it, and thus life may be lost from a simple affection which could have been completely removed, if the Testis had been in its natural position. In some instances the retained Testes desoend late in life, and if they then become fast in the ring great swelling and severe inflammation may result, with ultimate wasting away of the organs. Such cases have been mistaken for ruptures, and some men, from want of information, have thought that the Testicles really growed at that time, all at once. When there are really no Testicle from birth, there is always an imperfect development of the whole system, and a total absence of sexual power or feeling. In some animals it is natural for the Testes never to descend, but always to remain in the Ab- domen, and in others they descend only at certain seasons, that is, when they attain their periodical development, owing to the full growth of the am> malcules. It is stated on the authority of severa 1 travel) era, 1* DISEASES OF THE TESTES. 65 chat there is a tribe of Hottentots at the Cape of Good Hope that never have but one Testicle ; but many natirralists think that more likely it is a cus- tom among them to remove one in youth. It is quite possible, however, that this deficiency may be natural, and it is not in any way more singular than many peculiarities observed in the genital organs of the females of those tribes. I have known two brothers; twins, one of whom had three Testes and the other but one. In some instances the two Testes have been found grown together 9 so as apparently to form but one, owing to absence of the usual septum. The Testicles are sometimes drawn so close up against the abdomen, owing to a contraction of the cremaster muscle, that they cannot be discovered without close examination, and are then often thought to be absent, though they are quite perfect, and even outside of the body. Medical men have even testified that there were no Testicles, in such ^ases as these, which shows the necessity for a close and thorough examination of such apparent monstrosities. This state of things is not dangerous in itself, but t ad better be removed if possible, because the Testes are likely to adhere to the neighboring parts and waste away, so as to cause perfect* impotence. A surgical operation is necessary to liberate them, which is both difficult and somewhat dangerous. In some few dissections the Testes have been found completely absent, and without any trace of their having existed. Sometimes the Vas Deferens ex- ists by itself, and sometimes with the Epididymis, though at other times there are no traces of either. These cases of total ccngeni v al absence are, how 66 DISEASES OF THE TESTES. ever, very rare, and are always indicated by defi. ciencies in other parts of the system. In some rare instances the Testes haVe descend- ed into the Perineum, instead of the Scrotum, bui most probably from some imperfection in the parta bout the Perineum and Scrotum. In the course of my practice I have been con- sulted in many of these cases of Testicular anoma- lies, and have often hud the pleasure* of removing unfounded apprehensions, and of giving happiness and confidence to those who had previously been the victims of hopeless despair. HYDROCELE, OR DROPSY OF THE TESTICLES. This is sometimes called a swelled or watery Testicle. Properly speaking, this is but seldom an affection of the Testicles themselves, but of the Scrotum in which they are contained. There are three kinds of Hydrocele ; first, that in which the fluid collects in the substance or tissue of the Scro- tum ; secondly, that in which it is secreted by one* of the coats of the Scrotum ; and thirdly, that in which it collects in the spermatic cord. First Variety of Hydrocele, — This is scien- tifically called Hydrocele (Edematodes, and it ig usually connected with general dropsy, or ariset from the treatment of some of the other varieties. It is, however, but seldom met with, and rarely arises of itself. In some cases it has been brought on by wearing an improperly-constructed truss, by blows, or even by tight clothing, but much more frequently it is only a consequence of some othei PLATE IX. A case of Hydrocele laid open Fig, 1. a. The Penis much, contracted. — b. The Scrotum c. The Testicle.—*?. The Vas Deferens.— e. The cut edges of the Scrotum and the different coats.—/. The Tunica Vaginalis, which, it will be seen, is double, from being reflected over the Testicle, which is on the out- side, of it. — g. Is the water, which is between the two folds of the Tunic. — h. The Spermatic cord. Fig. 2. External appearance of the Hydrocele, showing the veins also in a case of Varicocele. 1. The dis- tended Vein. Fig. 3. Wasted Testicle. 1. Shows the left Testicle perfect. 2. Shows the right Testicle wasted away, &§ it often does from masturbation. DISEASES OF THE TESTES. 69 disease, particularly dropsy of the abdomen, which is likely to extend to the Scrotum, In this form of disease the Testicle is usually softish at first, and when pressed the mark of the ringer remains of a white color for some time after. As it progresses, however, the Scrotum becomes harder, and perfect- ly smooth, the Penis enlarges, particularly at the prepuce, and in very bad cases the skin inflames and sloughs away. The treatment of this form of Hydrocele must vary somewhat according to the conditions under which we find it. If it results from general dropsy it can be cured only by the removal of that, and will require but little local treatment. If there be my injurious pressure it must be immediately taken away, and frequently the doing so will effect an immediate improvement without anything further being done. The local treatment, after attending to the above directions, must consist of frequent bathing with cold alum water, one ounce to a pint, or of simple cold waier. A suspensory bandage must also be worn constantly, except when the patient can remain perfectly still, without standing too long. The bowels must be kept free, and but little fluid drunk. The following mixture may be taken for four days, and then omitted four days, and so on alternately till it has been taken twelve days in all, umess the swelling is obviously going down after the first four days, which it will often do, in which case it need not be continued. H. Hydriodate of Potassa, thirty-six grains, Distilled water, one ounce. Dose, ten drops, morning and night, in half a tumbler of water. 70 DISEASES OF THE TESTES Second Variety of Hydrocele. — This is usually called Hydrocele of the Tunica Vaginalis, the fluid /being secreted by the inner ooat of the Testicle, and, therefore, contained in the cavity of the Scro- tum. The swelling is observed on one side only, in most cases, like a smooth egg or pear-shaped tumor, of a natural color. It begins at the bottom of the Scrotum, and gradually progresses upwards* until it sometimes reaches the top and presses against the abdomen. It is quite soft to the touch at first, and the fluid may be distinctly felt to fluc- tuate or shift its position as the tumor is moved. As the disease progresses, however, it becomes harder, and does not fluctuate, and in form it becomes more decidedly oblong. From the above description, it will be seen that this form of Hydrocele is easily distinguished from that previously described, because in this the swell- ing is observed on one side, and commences at the bottom, while in the other it is diffused more or less over the whole Scrotum at once, and is evidently in the skin, or cellular tissue. Sometimes, it is true, both halves of the Scrotum may begin to fill up with fluid, but even then each one is sufficiently distinct from the other for both to be distinguished, and for the nature of the affection to be readilv seen. A very good way to examine a Hydrocele is to place a candle behind it and look in front, when it will usually appear semi-transparent, and some- times so perfectly so that the Testicle may be dis- tinctly seen in the middle of the water, like the yelk of an egg in the midst of the white. When the Testicle cannot be seen in this way, it is often dif- 6oult to find it, and its position can only be ascer DISEASES OF THE TESTES 71 mined by a hardish feeling in the back part of the •welling near the top. * The quantity of fluid secreted in some of these eases is very great, as much as six quarts having been removed by Mr. Cline, from Gibbon the great Historian. There may, however, be but a small portion, and it may remain for many years, or even during a person's life, without increasing, though the probability is against this, and in some cases it increases very rapidly. It is singular also that even in some very bad cases there is but little distress, and, except from the inconvenience of its weight and size, many patients suffer but little annoyance from it. Sometimes, however it causes an annoying sense ef uneasiness and pressure in the Testes and groin, and occasionally even produces numbness of the limbs. When very large the Penis is drawn into the swelling, so that it appears smaller, and ita erection becomes difficult and painful ; the sperma- tic cord is also pulled down, and becomes tender, and the motion of the limbs is much interfered with. There is not much to be feared from a Hydrocele of this kind, if the general health be good, unless it be complicated with a real swelling of the Testicle, the case then becomes very difficult, and nothing can be done till the Testicle itself is cured. I have known a man of sixty years of age who had a Hydrocele from the time he was fourteen ; it was of a considerable size, but had never much in- commoded him, nor in any way interfered with his health or functions. The difference in the symp- toms of a Hydrocele and a swelled Testicle will be pointed out in the article on Sarcocele. VI DISEASES OF THE TESTIS. The causes of this form of Hydrocele are but littb known. It is undoubtedly brought about in some cases by injuries, such as blows, pressure upon the saddle in horse-riding, and by badly made trusses Too much standing will also dispose to it, par ticularly in those with a relaxed state of the muscles" In general, however, it results f jm some constitu. tional tendency, the nature of which is unknown and which cannot be ascertained before me effect is? produced. In most instances, its beginning is altogether unknown to the patient, and it progresses so slowly and insiduously, that an advanced stage may be reached before anything wrong is suspect- ed. I have known young men suppose it was merely a natural increased growth of the parts. The Treatment. — In the early stages it is some- times sufficient to use cold lotions two or three timea a day,. as prescribed for the first variety, particular, ly that of alum. Frequent cold bathing, in addi- tion, will assist, and, if the bowels be kept free and but little fluid be drunk, the Hydrocele will occa- sionally go down considerably, or even disappear altogether. I would advise any one to continue this simple treatment even if it only arrested the disease, for though it might not positively cure, at first, still. if it keeps matters from becoming worse, nature her- self may work a cure in time. I A suspensory band- age should be worn form the very first, and as much rest should be taken as circumstances will allow* After using the simple alum-wash foi some time, if the swelling still continues, the following lotion may be applied instead, night and morning. R. Powdered Peruvian Bark, one ounce; boiling water, one pint. Boil these for ten minutes and then add, when cold, half a pint of *oirits of Camphor, DISEASES OF THE TESTES. f3 This is, perhaps, the best lotion that ever was ased for this purpose, and has done more good than all others put together. The parts should be batned with it for a6out ten minutes before the suspensory Dandage is put on in the morning, and for the same time after it is removed at night. In some cases the following wash has been found to succeed even where the other did not. ££. Sugar of Lead, one ounce ; Laudanum, & tea-spoonful ; Water, one pint. This is to be used as a lotion, the same as the other, and both must be applied cold. Very little can be done by internal medication,, except to keep the bowels free, though occasionally the following recipe may assist. R. Vinegar of Colchicum ; Vinegar of Squills-;; and Nitric Ether, of each half an ounce — to b& mixed. Of this mixture a tea-spoonful may be- taken in a drink of water, three or four times a day. Frequent bathing, and clothing the body, warmly are also beneficial. When all these means fail, however, a& they too often do, some kind of operation must be resorted to, either to give temporary relief or with a view to cure. It is customary, for the first purpose, to* puncture the sac of the Scrotum with a sharp instrument and let out the water. If nothing more be done than simply letting out the fluid, it will usually fill again, though occasionaliy it Soes not. To effect a perfect cure the Scrotum is injected' through the same wound, after the fluid has all escaped, with some astringent solution. Cold water only is used by some practitioners, but more fre- quently a mixture of two parts port wine to one of water. Solutions of Iodic a, and of Hydriodato of 74 DISEASES OF THE TESTES. i otassa have also been used, and in some eases the same fluid that was discharged, but the port win^ .and water appear to act the best of any. The manner in which this injection appears to effect the cure is this , it excites a considerable degree of inflammation in the Testicle, and also i© the coats of the Tunics, so that they grow together, and in this way the cavity in which the water occu jmulated is entirely obliterated. In most cases, if properly performed, this opera- tion is quite successful, causes but little pain, and is perfectly free from danger. In some instances, however, it is unsuccessful, owing to the fluid not being well injected, and occasionally there is much more inflammation caused by it than what is desi- rable, attended by serious constitutional irritation. The puncturing instrument, and the tube to convey the fluid, must be very carefully introduced, so as not to injure the Testicle, but they must also be carried sufficiently far to ensure all the water being discharged. The proper place to make the punc- ture is nearly at the bottom of the Tumor, behind ; the fluid may remain in about five minutes, and about as much must be injected as was drawn out. Sometimes a difficulty occurs in this way ; after the fluid has escaped the Tunica Vaginalis draws together, so that the opening into it does not corres- pond with the opening outside, and if the instrument has become displaced, before the injection is thrown in, it is difficult again to introduce it. Tn fact, it ii better, if this occurs, to leave off till another day, and operate again, for the attempt, if too often made, '.may cause serious and useless inflammation. There is also danger, if the instrument is put in again, that it may not go into the canity, but merely DISEASED OF THE TESTES. 75 into the substance of the skin, and the fluid is then thrown into the cellular tissue, and not only does no good, hut may even remain, and produce a real dropsy of the Scrotum, or Hydrocele (Edematodes, the same as described under the head of the fast variety. In fact, some Surgeons purposely perform the operation in such a way as to change the Hy- drocele into a simple dropsy of the Scrotum, by letting the fluid into the cellular tissue, by simply introducing a needle. The new disease is certainly more easily cured than the former one, and the pressure of the water on the Scrotum often prevents any more being secreted in the Tunic, but still in many cases a cure is not effected, and sometimes is made more difficult. [ would much rather advise the total discharge and injection. This operation is very simple and successful in skilful hands, but often fails from want of skill or proper care. If too much inflammation follows, poultices must be applied and other simple mean* used to subdue it, and the patient must keep still It must be borne in mind, however, that con- siderable inflammation is necessary, to effect a cure. I once knew a man who operated upon himself with a common penknife and a small catheter. He effectually discharged all the water, but knew nothing about injecting anything in return. At the end of two years there was but little accumulated iga'.R, and he thought so little of what he had done, that he said he should always repeat the operation himself, as often as might be necessary. It is sometimes necessary to do this to young children, and it must be remembered that in them the Testicle is much lower than in adulU, 8* *T6 DISEASEf OF THE TESTES. • Red greater care is, therefore, needed not to wound it. A simple dressing of mild ointment, tr even of wet cloths, is all that is needed after the injection is withdrawn. Some practio.* n rs have used Setons, and other* Galvanism, to cure Hydrocele, but though each method has been successful in some cases, yet they are not more so than the injection, which is much more simple, and causes much less pain. Either of these methods may, however, be tried, if that fells. After the water is drawn off, the Testicle should be carefully examined, as it can then be readily felt, because if there be any swelling of it, or any indications of cancer, the injection must not be thrown in till that has been benefically treated. In some persons the water will accumulate in spite of all, and it is necessary to discharge it fre- quently. In infants it will often disappear spon- taneously, without any treatment, but it rarely does so in adults, though I have known some in whom brisk exercise aloL<3 would disperse it. Sometimes this form of Hydrocele is congenital or exists from birth. In these cases the fluid descends from the Abdomen, the opening between it and the Scrotum, by which the Testicle descend- fed, not having closed. Many persons have been deceived by this affection, and have taken it for 9 rupture, but a little careful examination will sood disclose the truth. By gently compressing toe tumor the fluid will rise into the Abdomen, through the ring, and return again when the pressure is withdrawn. To a certain extent this trouule i* more general than is supposed, and is frequently ascribed to wrong causes. It is advisable to hav* DISEASES OF THE TESTES. 77 it attended to as early as possible, because there is danger, if left over the first month, of its continuing • during the whole of childhood, or perhaps even till adult age, and leading to other derangements. In the early stages, and sometimes even after it has existed long, it is possible to cure it in a very •imple manner. The water must be gently pressed oack into the abdomen, and then a truss or bandage of some kind must be worn, so constructed that the pad will press exactly on the ring, and thus prevent the fluid from returning. In a short time the pas- sage grows up, and there is then no further danger. * The period required to effect a cure varies much in different cases ; thus in some it will be complete in two or three weeks, while in others it requires as many months, or even much longer. Cold lotions must be used in these cases as with adults. In case of failure, with these means, which will sometimes happen, the only other remedy is the injection, the same as already described. The operation is precisely' the same as for an adult, but must be conducted with more care, there being more risk of serious inflammation. It must be recollected also that while the injection is being made the upper part of the Scrotum must be held firmly together, just by the ring, to prevent the injected fluid from passing up into the Abdomen, which it would otherwise do, and perhaps cause serious trouble. A truss or bandage must be worn for some time after the operation, to prevent any more fluid coming down, and also to retain the bowels in their place. Third Variety of Hydrcele. — In this form of Hy- drocele, as already explamea, the seat of the watery T8 DISEASES OF THE TESTIS. effusion is not in the Scrotum, but in the Spermatic Cord. It may occur in two ways, first in the sub- stance, or cellular tissue of the cord ; and secondly, within certain cavities in the sheath or tube itself. The first form of Spermatic Hydrocele is very rare, and is but seldom of much account. It is of similar in its nature to the first form of Hydrocele in the Scrotum, or Hydrocele (Edemaiodes ; in fact, it is the same disease only confined to the sheath of the spermatic cord. Its causes are also in all probability the same, and it requires the same treatment. When it results from general dropsy, which is usually the case, no cure can be expected until that is remedied. The palliative treatment must consist in wearing a bandage and using cold astringent lotions, and it is but seldom that anything more is required. Occasionally, however, the swelling becomes so great as to cause serious inconvenience, and the patient insists upon having relref immediately. Under such circumstances the only mode of pro- ceeding is to open the swelling, and so let the fluid escape. There is, however, some danger in this, and in most cases it is better not to perform the operation. Many persons have mistaken this affec- tion for a small hernia, or a swelled vein. The other form of Spermatic Hydrocele is usually termed Encysted Hydrocele of the Spermatic Cord, because the fluid is contained in one or more sacs. The swelling in this case is in the form of an egg, and situated between the Testicle and the groin. It is usually firm to the touch, with no fluctuation, and perfectly distinct from the Testicle, which may be felt below it. Sometimes the sac of fluid is near to the ring and can be pressed up DISEASES OF THE TESTES. 79 into tke Abdomen, so that it will disappear, but only to return immediately the pressure is with- drawn. In such cases it may easily be mistaken for a hernia or rupture, unless proper care be taken. On examination, however, it will be found that the vessels of the spermatic cord can be dis- tinctly felt even when the tumor is down, by merely pressing it on one side, which is not the case ir rupture. The functions of the bowels also are not interfered with in Hydrocele, while they are very much so in Hernia, when it is down. Occasionally the watery tumor descends much lower than usual, and may then be taken for Hydrocele of the Tunica Vaginalis. It is only requisite, however, to remember that when the fluid is contained in the Scrotum it surrounds the Testicle^ which can scarcely be felt through it, but when it is contained in a sac, in the sheath of the cord, it is always either above or on one side of the Testicle, which is quite separate from it. The treatment should consist at first in fomenta- tions, as directed for the other varieties, and in keeping the bowels perfectly free. This plan is the best one with children, who are often afflicted in this way. A mixture of two parts alcohol and one of water, is very good to use night and morning, or either of the recipes already given. With regard to internal medicines, they are perhaps less proper in this variety than in either of tke others, but if thought necessary there are none better than those before advised. Sometimes, especially in children, a small punc- ture may be made and the fluid let out, but in adults this is often of little use, as the sac fills up again. To prevent this the port wine injectior SO DISEASES OF THE TEST must be used, or the sac must be fairly cut miL Some practitioners merely lance it open the whole length, and Sir Astley Cooper was accustomed to insert a Seton, a plan which I have known to suc- ceed frequently, both in children and adults. The particular plan to be pursued must, however, de- pend upon the circumstances of the case, and I should advise every one to hesitate about submitting to any operation, if they can keep tolerably com- fortable, and get no worse without it, which they nearly always can if they will persevere with the simple directions' given, and wear a suspensory bandage. In children the following lotion, applied freely two or three times a day, will in mo.st cases cause the water to disperse without any further treatment. R. Hydrochlorate of Ammonia, one ounce ; Dis- tilled Vinegar, four ounces ; water, six ounces. The same lotion, with half the water, will also be excellent for adults. 6ARCOCELE, OR CHRONIC FLESHY SWELLING OF THE TESTICLE. This affection is the real swelled Testicle, or chronic fleshy enlargement of the substance of that organ. The causes that lead to this enlargement are various, and some of them not yet understood. Can- cer and Scrofula are perhaps the two most frequent causes, but it often arises when they do not exist, and when no other immediate agency can be detected. Sometimes a chronic swelling will take place in the Testicle, and after existing for a con- siderable time, entirely disappear wifhout any evil DISEASES OF THE TESTER. 81 consequences. More frequently, however, the re* 8ult is more serious and a malignant tumor is evr tually developed, either Cancerous, Scrofulou, Sarcomatous. Sarcomatous Tumors are of various kinds, ano are the same in the Testicle as in other parts of the body. The most frequent kind, is that called Medullary, because it resembles the substance of the brain. It is a most dangerous affection, and unless attended to at the very earliest moment is nearly sure to be fatal. The whole substance of the Tes- ticle is converted into a kind of white pulp, similar in appearance to the brain, and in a short time the disease is propagated along the absorbents till it attacks all the neighboring parts. The glands in the groin soon swell to an enormous size, and slough and bleed, and eventually the lower part of the abdomen becomes affected in the same way till the parts are all destroyed and the patient sinks. This is thought by some to be the same disease as Fungus HcB7natodes, and in many respects it closely resembles Cancer. There is, however, sufficient difference between them to enable the surgeon to distinguish with ease, but to the patient the distinc- tion is of little consequence, each being equally dangerous, and the treatment being the same for both. Sometimes the mistake may be made of con. founding Sarcoma with Hydrocele, unless a strict examination be made. In Hydrocele it must be recollected the swelling begins at the bottom, and gradually extends upwards to the abdominal ring, but no farther ; it is also semi-transparent, and fluctuating. In Sarcoma,- on the contrary, the , swelling is evidently in the whole substance of the 82 DISEASES OF THE TESTES. Testicle at once, and extends upwards into the spermatic cord ; it is also not in the least transpa- rent, and is much heavier than water. From want of attention to these points of difference the swelled Testicle has often been punctured, to let out the water. Cancer in the Testicle is precisely the same in its origin and progress as in any other part of the body. The Testicle becomes the seat of a hard tumor, through which dart deep-seated lancinating pains, which shoot up to the loins, and down the limbs. Eventually this becomes an open sloughing ulcer which destroys the substance of the organ and gradually extends to the abdomen, causing a pro- fuse offensive discharge and a rapid impairing of the general health. Scrofula of the Testicle. — This disease is scarcely ever met with except in those who plainly exhibit a scrofulous habit of body. It causes a swelling of the Testes similar to that of Cancer in its feel and appearance, but unaccompanied by any of the lancinating pains. When the tumor is cut into, it seems filled with a whitish or yellow substance like curds or soft cheese, along with a small quantity of pus. The commencement of this affection may be very slow and insidious, and for a long time, even after it has become fully established, nothing seri- ous may be indicated. There is nothing to alarm the patient much till the tumor breaks open and becomes an ulcer, its progress then is often very rapid, and all the neighboring parts speedily become diseased and destroyed. The causes of that peculiar tendency to Scrofula i and Cancer w r h.ch many persons exhibit are as yp.i unknown to us, thev are, however, in all probability DISEASES OF THE TESTES. 83 what is termed Constitutional, and not produced by any accidental agency after birth, though there may be many causes that will excite or call out these diseases, when they would otherwise have remained dormant, either for a longer time or per haps altogether. The Treatment of the various forms of Sarcocele above described may be given in a fev/ words, for unfortunately but little can be done with them. In some few cases of simple swelling, of the Medullary or fatty character, it may perhaps be dispersed, in the very earliest stages , by using Leeches and cold lotions or mercurial ointment externally, with mercury and iodine internally, but this can seldom be depended upon. Unless such means evidently decrease the swelling immediately, no further time should be lost with them or the chance may go by of doing good by other means. The removal of the Testicle, by an operation, offers the only chance of effecting a certain cure, and this is of no use either unless performed at first, for if the disease has progressed till the neighboring parts are attacked the removal of the Testicle will not check it. Unfortunately many patients delay having this necessary operation performed till it is too late, and they then conclude it is in itself of no use. It must be borne in mind that some of these cases are very rapid in their extension, and that the surrounding parts may be deeply affected without giving any sign of it. In Cancer especially it is necessary to operate as early as possible, for even when the Testicle itself shows but slight signs of the disease, it may have extended to the loins and abdomen. There have undoubtedly been many * oases of Sarcocele, of all the above kinds, that have 34 DISEASES OF THE TESTES. been entirely cured by removing the Testicle, and have never appeared again In general only one Testicle is diseased, and that only needs removing, though there is danger of both becoming affected by delay. The operation itself is comparatively simple, and not attended with so much pain or danger as many might sup» pose it to be. It is very common, as before remarked, to find Saicocele accompanied by Hydrocele, and fre- quently on evacuating the water in Hydrocele the Testis is found enlarged, though there were prev iously no signs of it. It is generally conceded that blows or other violence may produce simple induration or hardness of the Testicles, leading to medullary or fatty tumors, but not to Cancer or Scrofula, though they may excite such diseases to break out. The too frequent irritation of bougies and injections is also suspected of injuring in the same way. FUNGUS OF THE TESTICLE. This affection is different from either of those previously described, though it has some resem- blance, at certain stages, to Cancer. It is for- tunately more capable of being beneficially treated, however, and is not so likely to extend to other parts. It is supposed to be caused by bruises or other violence, or by Gonorrhoea and Gleet, particularly wher injections have been used. The first indica- tion is a simple swelling without pain, which bursts and forms an abscess discharging pus, and from the opening a Fungus begins to protrude. This Fungus may attain an immense size, if not remov DISEASES 3F THE TESTES. 85 fcd, extending to the abdomen and becoming very virulent. The discharge also may become so pro- fuse as to cause much general debility and con- stitutional irritation. In the first stages of the swelling, when it is known to arise from external violence, it may some- limes be reduced by Leeches, warm fomentations, and poultices, with purgatives used internally, and even after the abscess has opened fomentations and poultices may be sufficient to prevent any extension of the mischief. When the Fungus has appeared these simple means become useless, and resort must be had either to caustic or the knife to remove it. In my opinion the caustic is the best remedy, and seldom fails to remove the diseased growth without any injury to other parts. If the disease has not progressed too far it may often be cured without injuring the Testicle at all, though it was formerly thought necessary to castrate in every case, and some practitioners even do so now. I once knew a man who had one of these Fungous growths, arising from a bruise, who was cured by the daily use of powdered burnt alum, dusted over the Fungus, and followed by a warm Linseed poul- tice. This was done morning and night, and by these means only, combined with the use of simple purgatives, and the solution of hydriodate of potassa internally, as directed for Hydrocele, he fully recovered in about six weeks. The Testicle, how- ever, remained hard, and in all probability its power was lost. In all cases of bruising, or other violence, the timely use of rest, poultices, and warm fomenta- lions, may prevent many of these evils. There are several other kinds of tumors and S6 DSEASES OF THE TESTES. swelling? of tie Testicles occasionally met with, besides taese mentioned, but they do not differ essen tially either in their nature or treatment, and often it is scarcely possible to distinguish between them. One peculiar form of Canoer is frequently met with in England amongst chimney-sweeps, and is caused by the irritation of the soot lodged in the furrows of the Scrotum. It is met with sometimes, but rarely, on the hand, or foot. It is commonly termeo the Sweeps 9 Cancer. HERNIA HUMORALIS, ORCHITIS, OR INFLAMMATION OF THE TESTICLES. This sometimes appears to arise from some un- known constitutional cause, and comes on very slowly, but more usually it is from s>?me obvious agency, and assumes from the first an wcute form. It arises frequently from blows, falls, hard riding, and strains, but most generally from thp use of injec- tions and bougies, in Gonorrhoea, ana stricture, 01 from the performing of operations like those foj Hydrocele. I have also known it to follow intense sexual excitement, where gratification was impossible and the semen had no tendency to escape invoiun. tarily. In children it very frequently follows, 01 accompanies the Mumps. Inflammation of the Testicle usually commence*- with slight pain and soreness in the part, attendee by swelling, which is at first soft and yielding, but gradually becomes hard, and sometimes hot and very painful. The Scrotum loses all its roughness by swelling so much, becoming smooth ana red, and occasionally so tenier that it can scarcely be touched. >\s the inflammation progresses th« DISEASES OF THE TESTES. R7 swelling extends up the spermatic cord, and severe pains may be felt in the loins, and sometimes eves in the limbs, till the patient suffers the most ex- eructating agony. In many, even of the most severe cases, but little pain is experienced and the inflammation will sub- side, under proper treatment, leaving no evil effects whatever behind. There is danger, however, of its being followed by abscess, or hydrocele, if neglect- ed, even if it does not excite tumor or Fungus. A loss of sexual power is also apt to follow inflamma- tion of the Testicle, either from its deranging the structure of the organ or from its obliterating the passage in the Vas Deferens, and thus preventing ever after the passage of the Semen from the Tes- ticles to the Urethra. Orchitis arises much oftener from Gonorrhoea than any other cause, the inflammation extending from the Urethra, along the Vas Deferens, till it reaches the Epididymis, and finally the Testicle. The Epididymis is always first attacked in these cases, and very frequently the disease extends no further, when it is called an Epididymitis. If it reaches the Testicle it is then called Hernia Humoralis. When the inflammation accompanies Gonorrhoea it will generally be found to arise whenever the discharge is suddenly checked, and immediately the discharge is allowed to return the inflammation ceases; This shows the close sympathy there is ©etwee : the Urethra and the Testes, and what danger there is in irritating the Urethra in any way. I have known inflammation of the Testes arise in one hour after using a strong injection. The treatment of this severe affliction must con- sist, in the first place, in perfect rest, on the back 88 DISEASES PF TH£ TESTES. the Scrotum being supported by a suspensory ban- dage, or truss. Cold lotions must be freely and frequently used, and the bowels opened freely with salts or castor oil. No stimulating food or drink must be taken, and the mind must not be agitated. nor the feelings excited in any way. The best lotion is a mixture of half a pint of water to half a pint of alcohol, with a large spoonful of laudanum added. If the pain be very severe this lotion may be made hot, or a hot linseed or bread poultice may be applied. A hot bath is also frequently of service. A perseverence in these means will usually reduce the inflammation and pain in one or two days, unless the exciting cause continues to operate- In very severe cases, however, particularly those from bruises, it may be necessary to apply Leeches, or to open some of the veins of the Scrotum, which nearly always gives relief if the blood flows freely. If the pain be so bad that the patient cannot rest he may take twenty or thirty drops of Laudanum at bed-time, in a little flax-seed tea or barley-water, or in simple water alone, if these are not to be obtained conveniently. The following pills are the best for this purpose, however, when they do not disagree with the stomach, which unfortunately they are apt to do, but they may be tried. R. Opium, with soap, twenty grains ; Camphor, half a drachm ; to be made up into twelve pills, with as much simple mucilage as may be requisite. One of these may be taken every six hours if requisite,. The following ointment, applied externally, may also give great relief from pain when the iotion tails to do so. R. Belladonna Ointment, two ounces ; Camphor, one drachm ; Paregoric Elixir, one drachm. DISEASES OF THE TESTES. P9 This must be mixed into an Ointment, and a portion rubbed carefully over the tender parts, as often as the pain becomes severe. When the inflammation has been fully subdued there is danger of the Testicle being left perma- nently hardened, or indurated, which is nearly sure to destroy its power, if it does not originate other diseases. To prevent this, if the slightest hardness remains, it must be frequently bathed with hot water, and poulticed, or if these fail it must be rubbed with the Camphorated Mercurial Ointment. Galva- nism has been used with success when the hard, ness resisted all other means, and as it is a safe remedy, it may be readily tried. The only internal medicine likely to be of use is the solution of Hydnodate of Potassa, before directed, and even this should be but seldom taken. The regular use of the Camphorated Mercurial Ointment, followed by- hot fomentations, is the most generally successful treatment. The best remedy in some cases of acute Orchitis, particularly when arising from the sudden stoppage of a Gonorrhoeal discharge, is compression. This is effected by means of strips of sticking plaster, which are stuck firmly around the organ, and also passed underneath, the pieces being about a quarter of an inch wide, and long enough to go round and meet. These of course cross each other, and when drawn pretty tight, and made to adhere fast, they press considerably, and draw the whole organ together. The parts require to be shaved to apply them, and they must be re-applied as often as tney work loose, or as fast as the swelling shrinks. In most cases the pafei mt experiences great and im- mediate relief from this application, owing to the 00 DISEASES OF THE TESTES. support it gives ; it must always be used, however with the suspensory bandao-e. Compression is, in general, only appropriate U cases of acute Orchitis arising from Gonorrhoea, though it may be advantageously resorted to, in some few instances, when it originates from other causes. 1 have used it when the swelling arose from intense sexual excitement, and also in one or. two instances from blows, and with advantage, but generally the treatment before given will obviate the necessity for compression, if it be persevered in. Latterly the compression has been effected by means of Collodion, a substance made by dissolving gun cotton in ether, which sticks much more forci- bly, and is applied more readily. The symptoms of Epididymitis are the same, and so is the treatment, as when the whole organ is attacked, which it is nearly sure to be eventually, if the Epididymitis continues. There is always reason to fear that a severe attack of Orchitis will permanently injure the Tes. tide, more or less, by obliterating some of the Seminal Tubes, even if it does not close the Vas Deferens, or harden the Epididymis. One Tes- ticle may, however, be inflamed, and suffer, while the other remains perfectly sound. After having been once inflamed the Testicle appears more sus- ceptible of the same misfortune again, so that those who have suffered from :'t should be as careful as possible to avoid subsequent attacks, or the evil effects will probably increase each time. Impotence not unfrequently follows Orchitis. Sometimes the inflammation ends in suppuration, the matter escaping by numerous little sinuses or openings, which eventually close and heal when ail DISEASES OF THE TfiSTES 91 •is discharged. In all these eases, however, the Testicle is more or less wasted, and sometimes entirely destroyed. At other times the pus will not discharge at first, but assume the form of a firmisb curdy mass, similar to the substance of the brain and remain for a long time. The organ is then much more liable than before to inflammation, and its internal structure gradually undergoes a change by which its secreting powers are totally lost In some of these instances the Testicle becomes nearly as hard as a sione, and on being dissected appears much V.ke cartilage or bone. In some persons Acute Orchitis much resembles Rheumatism, being atfected by the changes of the weather or by exposure, and coming and going again in a short time. Indeed, some writers speak of it then as Rheumatism of the Testicle, and treat iv, the same as that affection in other parts of the body. I have known some men so extremely sensitive in this organ that an attack of Orchitis was sure to follow if they merely pressed the Testicles on crossing the limbs, and espsci'ally if they rode on horseback. In fact, many a severe case has arisen from being thrown forward upon the pommel of the saddle. Inflammation of the Testicle sometimes appeals in verv young infants, not more than a few days o)d^ and without our being able to assign any cause. I have thought sometimes that it arose from Teething, and at other times from an improper mode of carrying the child, by which these organs were bruised. I saw one instance wherein the in- flammation appeared on the day of birth, which wa^ very severe. In general, these infantile cases can be cured by simple iomentations, or cold lotions, 92 DISEASES OF THE TESTES. with a dose or two of castor oil. When very severe a Leech may be applied, and three or four grains of the Powder of Mercury and Chalk given. TV her arising from Mumps it usually subsides when the primary cause is removed, though it may remain afterwards, and must then be treated as above advised. It is somewhat disputed among medical men whether these inflammations in infants ever perma- nently injure the Testicle or not, but I am persuad- ed they often do so, and, in all probability, many a man has been made impotent for life by this affec- tion when a child. It is, therefore, of the first importance not to neglect this trouble, though it may be but slight, as the after effects may be serious. • It is proper to remark here that the Mumps arise in adults as well as in children, and that they may affect the Testicles, and cause impotence, as well at one period as at another. Such cases as these afford a singular proof of that remarkable sympa- thy which exists between distant parts of the body, but the nature of which we cannot explain. Either of the following Recipes give excellent cooling lotions, applicable to all cases. R. Lime-water, one ounce ; Alcohol, seven ounces ; mixed together. R. Hydrochlorate of Ammonia, one drachm ; CoIJ Spring-water, five ounces ; Alcohol, one ounce ; mix together. The last lotion is an excellent one to apply to the Scrotum and Perineum. In many persons, how- ever, hot fomentations succeed much better than cold lotions. It is often very beneficial, particularly when tha DISEASES OF THE TESTES. 93 pain is severe, to cause a little nausea or vomiting. For which purpose a quarter cf a grain of Tartar Emetic may be given every three or four hours, tiL the effect is produced. This frequently gives great relief, and in a short time, when all other means fail. In very obstinate cases, attended with pain, two or three grains of Calomel should be given, at bed- time, mixed with eight or ten grains of Dover's Powder. This may be given two or three times a week. It is sometimes a good plan to use the Plaster of Ammonia and Mercury to strap the Testicle with, in the manner before described, so as to gain the advantages of Compression and the effects of Mer- cury together. If the inflammation and tenderness al- subsides, but the swelling ix.id hardness continues, the follow,, ing solution may be rubbed over the Scrotum every three or four days. R. Iodine, one drachm ; Iodide of Potassium, half a drachm ; Alcohol, one ounce ; dissolve all together. In many persons, particularly those of a Scrof- ulous habit, Acute Orchitis has a tendency to assume the Chronic form, after the first severe symptoms have subsided, and this is perhaps a worse state than the other. In Chronic Orchitis a deposit of yellowish matter takes place, in different parts of the Testicle, at first soft but gradually becoming harder, till at last, the organ feels like a stone. This matter blocks up the Seminiferous Tubes and destroys their power of secretion, so that impotence ensues. It was formerly the custom lo call such cases Schirrhus, but this is improper, as it might lead to the idea that they assume a malig- 94 HSEASUS of the testes. nam form, which is not the case. Chronic Orchu tis may either follow from the acute form, or it may arise spontaneously, like Scrofulous affections of other parts ; and it also frequently follows a long course of intemperance or licentious indui. gence, and may even be produced by the long con- tinued and injudicious use of Mercury. This form of the disease may give rise to but little inconvenience for a long time, though the swelling may be of considerable size, unless a blow, or strain be experienced, when the symptoms become immediately acute, and relief is sought for. Usually in a few weeks the swelling is observed to point in some particular part of the Scrotum, and eventually it breaks, discharging some pus, together with a Fungus-looking body, which appears rough and bleeding. In a short time the opening enlarges and more or less of the Testicle itself passes through, the whole forming a granulated tumor of a yellowish white color, studded with pale red or black patches. This tumor is tightly embraced round its neck by the edges of the opening through which it passed, and which become very thick and red. A thin watery discharge flows from it, often mixed with semen, but rarely with blood. As soon as this break occurs, and the parts pass through, great relief is felt, and the disease may remain for a long time without undergoing any further change. The tumor itself is rarely tender, but may be handled,, cut, or burnt with caustic, with but little inconvenience. It is not unusual to find this singular protrusion in Scrofulous children who have had inflammation of the Testicle. It was formerly the custom always to remove the whole Testicle when afliicted with this Fungous DISEASES OF THE TESTES. iJO growth, but now the practice is seldom resorted to. The protruding part is cut off with the knife, or burnt off with caustic, and the skin of the Scrotum being then brought over it the wound is healed and no further trouble is experienced. In many cases a cure is even effected spontaneously, or by means of a simple wash of six grains of Nitiate of Silver to one ounce of water, with some internal alterative medicine. The best medicine in Chronic Orchitis is Blue nil, Jive grains of which should be given every night, with one grain of Opium, till the gums feel a little sore. In some cases a better treatment is to administer the Compound Extract of Sarsaparilla internally, and sprinkle the Fungus itself with equal parts o r powdered savin and sulphate of copper. Occasion- ally varying the medicine by giving a little of the Wine of Iron, particularly if the patient be weakly and sinking. It must be admitted, however, that Inflammation of the Testicle is, in any form and under any mode of treatment, a disease extremely dangerous to the patient's sexual powers, though it may not com. promise his life, nor interfere much with his general health OSSIFICATION OF THE TESTICLE. In some few cases the Testicle has been known ♦jo Ossify or become more or less converted into Bone. The causes of this degeneration are un- known, and unfortunately we know of no remedy. I have thought, in some few cases I have seen, that it was more likely owing to excessive con* \0 96 DISEASES OF 1HE TESTES. tinence than anything else, but it is impossible t«t decide. The Ossification generally commences in the middle, and may be felt like a hard kernel, which gradually extends till the whole organ is affected. In all cases when a hardness of this kind is felt im- mediate resort should be had to fomentations and poultices, because it may be but a simple indura- tion which they will lemove. It is propable that Ossification and induration most frequently arise from Orchitis, particularly when there has been many consecutive attacks. ARREST OF DEVELOPMENT AND WASTING OF THB TESTES. The Testes, like other parts of the body, are liable to be arrested in their development, from causes unknown to us, and this arrest may cither be permanent or the development may be comple- ted at some after period of life. I have known instances of men, at various ages, with Testes remarkably small, and passions nearly dormant, in whom a sudden development took place from the sight of some female who excited their desires to an unusual degree. In all probability these per- sons would always have remained as they were > but for this occurrence, as many others similarly circumstanced do ; and we have thus a proof of the decided influence that the awakened feelings may have on physical development. In one instance where I was consulted, in a case of this kind, the left Testis was about the size of a small hazel-nut, and the other still smaller, the per- son being abou* twenty-eight, and possessing th* DISEASES OF THE TESTES. 9*1 nsual feelings of his sex, though in a slight decree. Many circumstances induced me to think that the organs were healthy, and that in all probability their further growth would ensue, undei proper treatment, and from the new impetus given to his desires by his wish to marry. I, therefore, advised a stimulant plan of treatment, similar to that which will be directed in a subsequent article, and advised him to wait patiently. The result justified my opinion, the organs began to enlarge very soon, and in two years' time were of full average size, so that he had no misgivings whatever about marrying. It is very often the case that persons who had Scrotal Hernia in childhood have the Testei small, owing to the pressure on the cord of the instrument worn to cure it, and with some who have had Mumps their full growth is never attained. Any causes that prevent the full supply of blood from going to the Testes will prevent their growth, or cause them to waste, and it is from this cause that many such cases arise, If the spermatic arteries be small, which supply them with blood, they do not receive sufficient nutriment, and, there- fore, cannot grow nor secrete much semen. These arteries are very long, and exposed to several causes of injury as they proceed through the abdo- men, so that they frequently become more or less injured, and the Testicles suffer in consequence. Sometimes they are pressed upon by the other parts, n passing through the ring, and at other times they Jtr? affected by aneurism or their walls thicken and partly close up the passages. In old people the spermatic arteries are very apt to become more or Jess obliterated, and this is the chief cause of thai wasting of the Testes so often seen at that 98 DISEASES OF THE TESTES. period of life. To fully prove this the spermatic artery of a dog has been tied, leading to sne of the Testes, and that in a short time was completely wasted away, while the other remained perfect. It has even been proposed to perform this operation, which is comparatively simple, instead of castration, when we wish to destroy the procreative power in animals. Such facts make it evident that the power of the Testes, and consequently the amative propen- sity of any man, depends materially upon the size of the spermatic arteries, probably much more so than upon any peculiar structure of the brain. It is cer- tain that if these arteries be destroyed in early life no amativeness can ever be felt, nor any procreative power be established. A knowledge of this fact teaches us that the extent, both of the power and the propensity is very much, if not entirely, under our control, if the supply of blood admitted to the Testes can be duly regulated. This is a point never before attended to in medical practice, that 1 am aware of, but I have satisfied myself of its correct ness by repeated experiments, and I look upon it as being of 'the greatest value. There are many means by whicli the amount of blood flowing to the Testes may be regulated to a great extent, some of them increasing and others decreasing it, as I have shown in many of the cases described. It is often the case that badly fitted Trusses, by pressing on the arteries, will cause the Testes to ivaste, while, on the contrary, an ill-made suspensory bandage 01 even tight clothing, by chafing the parts, will drat* the blood to them till they are intensely excited. or even till inflammation ensues. This shows u» what principle to act upon in practice, adopting the appliances to the peculiar circumstances c* the cas*, DISEASES OF THE TESTES. 99 Hot stimulant applications will bring the blood to any part, while cold astringent ones will drive it away % and these alone, judiciously used, will often aocom- plish more than all the internal medication, or mere moral chiding ever yet tried. Besides these, how- ever, there are various other means, mechanical and medical, which will be described as we pro. ceed, and sometimes instruments may be construct- ed, for special cases, that will eiFect almost miracul- ous results. I have sometimes used a modification of the instiument called the Congester, which will be de- scribed in a subsequent article, for the purpose of drawing blood to the Testes and of enlarging per- manently the spermatic artery. In short all the means resorted to for causing an increased flow of blood to the Penis may be used, to a certain extent, and in a modified form, to the Testes. As before remarked, I have had numerous patients, of all ages, whose Testes had always been too small and inactive for the performance of their functions, and yet, by appropriate treatment, most of them have attained their proper growth and full powers. Wasting of the Testes, after they have been of a proper size, is a much more serious matter, as it usually results from some disease that is likely to permanently destroy them, though occasionally the causes of it are under our control, and the loss may be repaired. In addition to all the causes above enumerated that prevent development, we may also enumerate Hydrocele and Hsematocele, of long standing, and also Scrotal Hernia, all of which may cause the Testes to waste by the continued pressure which they exert. Spermatocele will also lead to the same result as stated in the article on that dis. 10* 100 DISEASES OF THE TESTES, ease. Too long continued and strict continence will also waste the Testes, in many persons, notwith- standing what is said to the contrary by some writers. These organs can no more preserve their powers when entirely disused then others can, noi is it in any way conducive to their health to leave them totally inactive. I am aware that it has been said that those who take vows of celibacy still pre- serve these organs, and in full development, but that has very little weight because no one can tell what may have been the actual observance of those vows, nor how far involuntary action may have taken place. I am myself fully convinced, from numerous observations, that total inaction of the Testes, in every form, is most certainly followed, in most cases, by their wasting and decay. I have known men who boasted that they were strictly continent, and had been so for years without any apparent injury of this kind, but on proper ex- amination I have satisfied them that the semen passed almost constantly, in the Urine. It is scarce- ly necessary to say that such an action was unna- tural, and decidedly injurious. The assertion, made by some theorizing physiologists, that the semen, when not discharged, is absorbed into the blood and invigorates the system, is unsupported by a single fact, or even by plausible reasoning, and, therefore, requires no refutation. Many a man who has prided himself upon his immaculate purity, and denounced those who were unable or unwilling to totally abstain, has been himself the victim of a constant pollution, both unpleasant and injurious. I have here spoken openly and fully, as a medical man ought, and no one with common sense or honest intentions, can accuse me of encouraging DISEASES OF THE TESTES* 101 anything approaching to licentiousness in what 1 have said. True virtue consists in a proper use of those powers given to us, and not in their tota" t abrogation. There are several causes of a nervous character that will also lead to wasting of the Testes, such as paralysis of the lower part of the body, or injury of the spine in the neighborhood of the Nerves leading to them, and sometimes even long-continued anxiety of mind. The most frequent causes, how- ever, are probably Inflammation and the Mumps, particularly in early life. Excessive indulgence not unfrequently ends in gradual wasting, and Mas- turbation still oftener, especially if accompanied by intemperance in strong drink. I have known in- tense excitement followed by inflammation and subsequent wasting, in a very short time, and I have known inebriates wake from their dreams of in- toxication to find themse'lves impotent, in numerous instances. There are some drugs which exert an influence this way occasionally, and to a very marked degree. Mercury will in some, if long continued, so will Opium, and Iodine still more frequently, and decidedly. It is, therefore, the duty of the physi- cian to watch well the effects of all such remedies. Tobacco, I am satisfied, is decidedly injurious to many men, and when used to excess will impair the Cone and energy of these organs to a great extent ; in several instances [ have had good reason to attribute wasting of the Testes to its influence. Injuries of the head must also be enumerated as occasional causes of wasting of the Testes, though we cannot explain why. Several instances of the kind have been noticed, particularly by Army Sur- 102 DISEASES OF THE TESTES. geons, and tne fact is established beyond doubt. Baron Larrey gives a remarkable ease, which came under his own notice. It was that of a soldier, a nealthy, robust man, with strong sexual propensities and endowments, who had a portion of the back part of his head cut off by a sabre wound. He recovered from the wound, but lost the senses of sight and hearing on the right side. Pain was also experienced down the spine, and a peculiar creep- ing feeling in the Testicles, which also began to waste, and in fifteen days were no larger than beans. He completely lost all desire for sexual enjoyment, and apparently even all remembrance of it. AC. Lallemand also mentions a case, of a French sol- diei, similarly injured in the expedition to Algiers, who speedily experienced wasting of the Testes, loss of sexual desire and all power of erection. Bruises of the Testes are nearly certain to be followed by inflammation and wasting, if severe, and few injuries cause more acute physical suffer- ing, or affect the system more generally. Sickness, vomiting, and death-like fainting generally result from bruises of the organs, and sometimes even delirum. Constant pressure, from almost any cause, even though slight, will also cause wasting, as is seen in many persons who pass much time on horse- back. It was even the custom formerly, in Tur- key, to make Eunuchs by squeezing the Testes instead of Castrating, and some persons operate upon animals in the same way now, when they wish to emasculate them, the squeezing causing them to waste away. Cutting these organs, with sharp instruments, so as not to bruise them, may not be followed by any evil effects whatever Many instances have been known of their beinu cut and DISEASES OF THE TESTES. 103 torn considerably, both by accidents and during surgical operations, but with no detriment to their powers, unless inflammation or mortification has unsued. Fanatics and insane people have injured themselves in this way frequently. All that we can do in those cases of wasting of the Testes is to find out, if possible, the immediate or exciting cause, and remove it. Very frequently, however, no cause whatever can be ascertained, and often when it can be it is not under our control. Still no such case should be left unattended to, and its treatment, if any be thought advisable, should not be neglected a single day. TUBERCULAR DISEASE, OR CONSUMMATION OF THB TESTICLE. This is essentially the same disease as Consump- tion of the Lungs, being characterized by the pro- duction of Tubercles in the substance of the organ, which eventually suppurate and break, and entirely destroy its substance. In most instances, the pa- tients are either decidedly Scrofulous or evidently disposed to consumption, and generally both Testes are attacked, either together or consecutively. The symptoms are usually a slight uneasiness, in some particular part of the Testicle, which is soon followed by violent swelling, either in the body of the organ or in the Epididymis, but with very little acute pain, if any. The swelling feels uneven, or studded with little lumps, one of which eventually projects and bursts, discharging a quan- tity of pus, and thick curdy matter of a yellowish color. It may, however, be a year or more aftej ihe swelling occurs before it breaks, though when 104 DISEASES OF THE TESTES. one opening is formed others are apt tf follow ■ The opening evidently communicates with the in* terior of the organ, and after venereal excitement it is not unusual for semen to flow from it, along with the pus. In some few cases the Tubercle will heal, and the wound close, leaving the Testicle only partially wasted, but more frequently they continue to dis- charge till it is all completely gone, or till the whole system is so affected that death ensues. Oc casionally the whole Testicle will pass through the wound, and will remain protruded till it is entirely gone. This affection occurs sometimes in children, of a scrofulous habit, and completely destroys the Testes in a short time. The treatment must depend upon many circum- stances, such as the patient's age, general health and habit of body, and mode of life. As a general rule it must be general, or calculated to act on the whole system, so as to induce a beneficial change in its action. The alterative medicines are there- fore most to be relied upon, as Mercury, Iodine, and Sarsaparilla, and in cases of tonic debility Iron must be administered. Attention to the diet, air, and climate, are also of the greatest importance. Consumptive people are always more or less liable to this affection, and I am persuaded that in many it exists sufficiently to impair the power of tns organ, and cause partial impotence when it does not proceed to the suppurative stage DISEASES OF THE TESTES. 105 FOREIGN BODIES IN THE SCROTUM ALONG WITH TH1 TESTICLES. Sometimes little round bodies like peas are found in the Tunics, composed of firm Cartilaginous mat. ter or bone. I have seen one as large as a marble, and hard as ivory. It is seldom there are mora than three of them. The origin of these bodies can only be conjectured, though they are probably only diseased secretions, like those sometimes found in the joints, which were first attached to the Tunics, and then became loose. Worms, Hydatids, and other living beings are very rarely met with, though they have been occa- sionally seen. i Tn some instances the Scrotum has contained the remains of a Fcetus, which had evidently descended from the Abdomen along with the Testicle. M. Velpeau communicated a case of this kind to the Academy of Science in the year 1840, in which he removed nearly all the parts of a Foetus from the Scrotum of a man aged twenty-seven. The patient had suffered from the enlargement from birth, but its character was not suspected till M. Velpeau performed the operation for its lemoval. (To understand how this inclusion of one Foetus tn another can take place, the reader is referred to " The Marriage Guide" if he be curious id such singular cases.) NERVOUS AFFECTIONS OF THE TESTICLES. The Testes, like other parts of the body, are sub- ject to several kinds of nervous affections, which 10 f> DISEASES OF THE TESTES. frequently cause exquisite misery, though they may not lead to any positive injury. Irritable Test's. — This is a form of nervous dis» ease in which the Testis is in a constant state of peculiar uneasiness and irritation, rather than acute pain, though sometimes it is more painful in one particular spot. It is so exceedingly sensitive that the touching of the dress, or the mere rubbing of the Scrotum against the limbs, causes such distress, ing annoyance that the sufferer dislikes even to move. Sometimes the irritation extends up the cord, so that the movements of the bowels, or the passage of urine, become exciting causes, and the patient cannot even cough without an increase of his misery taking place. In some cases this morbid sensibility affects both Testes, and in others only one, which is usually the left. It does not appear to cause any alteration in the parts nor swelling, except occasionally a little fulness, particularly of the cord, and some relaxa- tion of the Scrotum. It is seldom that an attack passes off very soon, but more usually it lasts several months, during which the sufferer loses all relish for society, and almost all capability for en- joyment in any form. All his thoughts are fixed upon his sufferings, and the idea takes possession of his mind that he will never be better, or that he will be impotent or die of Cancer, and some request their physicians to castrate them, to avoid these dreaded evils. The causes of this distressing affection are partly constitutional, it being chiefly met with in those whe are naturally weak, irritable, and disinclined t6 physical exertion, or in the hypochondrical and* DISEASES OF THE TESTES. 1 0? dyspeptic. It is however immediately produced, in most cases, by some derangement of the genital organs themselves, more especially such as are brought on by masturbation, excessive indulgence, or involuntary emissions. Young persons of a nervous habit and strong sexual feelings, are also liable to it while unmarried, and I have been con- sulted in many such cases which could not be bene- fitted by any kind of treatment till marriage took place. In a modified form it is often experienced about the period of puberty, in consequence of the great and unusual activity of the organs at tha 4 *ime, and much evil may result if a word of advice md caution be not then given. The young person will in all probability discover that a temporary relief can be obtained by the vicious practice of self-indulgence, and not knowing that this will really increase the irritation, eventually, he goes on with the practice till his health is seriously im- paired and his sufferings aggravated almost beyond endurance. The treatment of irritable Testis depends in a great measure upon the peculiar condition of the patient, and the state of his general health. In many cases it is so entirely of a nervous character that we need merely advise a change of air and scene, or cheerful company, or some interesting mental occupation, in short, any thing that wil' arouse the sufferer to activity, and turn his thought? away from his affection. If he be dyspeptic it is essential that his digestive organs should be attendee 1 -o, and if he be costive, which is often the case, th$ bowels must be brought to a more regular state before improvement can even be hoped for. In cases where there is great debility, tonics must be 11 108 DISEASES OF THE TESTES. used, such as the Steel drops, or Peruvian bark, and a generous diet must be a v l vised, with a little wine. The use of cold water externally is of the very first importance, as it gives tone to the parts, and re- moves the morbid sensibility, more perhaps than any thing else. The parts should be freely bathed with it two or three times a day if possible, or at least night and morning. In obstinate cases a plaster of Belladonna Ointment may be placed over the whole Scrotum, or laudanum may be used as a lotion. A good suspensory bandage is also very frequently of great service. In addition to any treatment, however, and still more essential, is a knowledge of the cause of the trouble. If any of the above named practices are persisted in, or if the patient's situation in life is unsuited to his temperament, no great good can possibly result from medical treatment alone. These things must therefore be spoken of, either tc* the patient himself or to his guardians. It is not necessary to perform castration for thia disease, as it is for some others, because it is not a serious one, and generally either subsides of itself in time or can be relieved by appropriate treatment. In one instance a gentleman was affected with this morbid irritability, in one of his Testes, just before the time appointed for his marriage, and was so convinced that it was but the beginning of a greater evil, that in spite of all advice to the con- trary he insisted upon having the organ removed, which was done. Directly after, however, th& other began to be as irritable as the lost one had been, but this of course he was not so desirous of parting with, and therefore bore with the trouble, DISEASES OF THE TESTES. UW He was married and had no further trouDle after- wards. The removed Testicle was perfectly healthy ani sound. Neuralgia of the Testes, — This is a nervous dis- ease of a much more serious character than the one already described, and more difficult to treat. It is characterized by acute pains, sometimes lancinating and at others dragging or pricking, which are usually accompanied by spasms of the cremaster muscles by which the Testes are drawn foroibly up to the groin. In general these pains come on periodically, as in other cases of Neuralgia, and between the paroxysm the Testes are often per- fectly free from pain, even when handled, though there is occasionally a little morbid sensibility in them, and perhaps a little soreness on the edge ®f the hip-bone. The attack may last only a few minutes or many hours, and is usually confined to only one Testis ; some patients have it come on twice a day, others once a day, and some agaia only once in several days. Some &re affected with sickness and vomiting, and others with shiverings and cold perspirations, while others again expe- rience such intense agony that they roll upon thp ground and groan, or perhaps faint away. In nearly every instance when examinations have been made of the Testes so affected, after their removal, no alteration whatever has been detected in their structure, nor any indication of disease to which the neuralgia could be ascribed. In some long-continued cases, where the pair, has been great, there has been a little swelling and inflam- mation, but this is rare. The causes of Neuralgia of the Testes are but Uxtb known, or rather, perhaps, not known at all. 110 DISEASES OP" THE TESTES. It is met with at all ages, and in almost every variety of constitution, though most frequently attacking those who are subject to derangements of the digestive organs. It very often appears to result from some disease of the Testes, particularly Orchitis, and from Varicocele, or disease of the Kidneys.- Many persons experience it from Gravel, and still more from the passage of a stone from the Kidneys to the Bladder. Gouty subjects are liable to it, and so are those affected with enlargement of the Prostate Gland. In the treatment of Neuralgia of the Testes, the first thing is to ascertain if there exists any other disease, which may possibly cause it. The Diges- tive Organs must be attended to, and the patient must be advised to avoid all causes of mental di$»- quiet, or nervous agitation. Internal medication is seldom of much use, though in some cases relief is obtained by taking Iron, in various forms, particu- larly the Pills of the Carbonate of Iron, and if the attacks be regularly periodical, Quinine may be of service, in doses of Jive grains, three or four times a day. Turpentine is occasionally very efficacious, in the following form : R. The yolk of one Egg ; oil of Turpentine, three drachms ; syrup of Orange-peel, and syrup of Tolu, of each two ounces ; Laudanum, one drachm. These are all to be well mixed together, and three table-spoonfuls to be taken daily. Warm fomentations of hops, or poppy heads, wiM sometimes benefit, but at other times ice-water will be still better. A* blister may be put upon the Scrotum, if all other means fail, and a quarter of a grain of Mfrphia placed or the r aw surface. A DISEASES OF THE TFSTES. 'Ill 8elladonna Plaster will sometimes relieve, or an Ointment composed of one grain of Aconite to one drachm of Lard, rubbed over the parts twice a day The Tincture of Aconite is sometimes still more efficacious when rubbed on the Scrotum with a sponge, and will often so numb the parts that no pain will be felt for hours. Twenty or thirty drops of Laudanum are sometimes beneficial, internally, and the following preparation still oftener. R. Extract of Hyoscyamus, five grains ; Acetate of Morphia, half a grain ; to be taken twice a day. Neither bleeding nor Mercury appear to be of any ube in this disease, but Galvanism, properly ap- plied, is frequently of great service. When the disease is too severe to be borne, or seriously affects the patient's health, if all other means fail, Castration may be performed. It should not be done prematurely, however, nor with- out due consideration, for sometimes the disease will subside spontaneously, after enduring a long time, and even when the operation has been per- formed the Neuralgia has often remained in the cord as severe as ever. I have known the disease re- main for two years, causing the most agonizing suffering nearly the whole time, and then go off and never return.- Several cases of this singular disease have lately come under my care, and in no two of them has the same treatment been beneficial. Each one has had to be studied and prescribed for separately, but in none was an operation necessary. IV U2 DISEASES Of THE TESTES. SPERMATOCELE, OR SWELLING OF THE TESTES F&O* ENGOjiGMENT OF SEMEN. It is very seldom that this affection is met with, though it sometimes ocburs from obstructions in the Vas Deferens, and Urethra. ' It may also arise in falling of the Cord, from its becoming twisted or knotted, and from swelling of the prostate Gtand, causing pressure on the ejaculatory ducts. The symptoms are swelling and heat in the Testes, with a distinct sense of fulness in them and aching pain. There is also usually considerable 'priapism, and intensity of sexual desire, but not always. The treatment consists first in removing all causes of obstruction, if any exist, and then in cola lotions and rest, with purgatives. Sometimes Sper- matocele is met with as the simple result of undue continence, but this is rare. The effects of it, if long continued, may be inflammation of the Testicle, with Hydrocele, and ultimately complete impotence. If the means above directed do not give relief Leeches may be applied to the perineum, or general bleeding may be practised from the arm. The diet should also be very spare and simple, and the drink cold water. The mind must not be allowed to be idle, nor the imagination too much excited, and the body must be inured to regular and brisk exercise in the open air. If, notwithstanding all these, the trouble still continues, and threatens to he serious, nature indicates but one more mode of relief, which is sure to succeed. In very obstinate cases of Spermatocele, the pressure of the Semen nas been known to burst the seminiferous Tubes and 1 am persuaded, fron what I have seen, that h DISEASES OF THE TESTES. 113 frequently injures the structure of the Testicle. 1 once saw the testicles of a young man dissected who died in an epileptic fit, brought on by an intense struggle to suppress all sexual desire. They pre- sented the most confirmed case of Spermatocele perhaps ever seen, being engorged with semen till much larger than the natural size, and evidently in a state of chronic inflammation. The tubes were blocked up with hardened semen, almost of the con- sistence of cheese, and many of them w«re broken and run together. In a short time the structure of the organs would have been completely destroyed. The Vas Deferens and Epididymis were also en- gorged in the same manner, and in many parts were beginning to change -their structure. SCROTOCELE OR RUPTURE OF THE INTESTINES OR OMENTUM INTO THfc SCROTUM. To understand the nature jf this affection it is necessary to refer back to waat has already been stated. During Foetal life thd Testes are contained in the Abdomen, from which they descend into the Scrotum about the ninth month, by an opening called the abdominal ring. After they have de- scended this opening usually closes, and no further direct communication then exists between the two cavities. In some cases, however, this closing up is not accomplished before birth, and then there is a liability for the Intestines, or their covering the Omentum, or both to descend after the Testes into the Scrotum, forming a Scrotal Hernia. In most cases this takes place very early, but it may be delayed some 'months, or years, and has taken place aa late as the thirtieth year. The symptoms are 114 DISEASES OF THE TESTES. much the same as those of other ruptures, excepts ing that the tumor is found in the Scrotum. If the bowel is compressed in the ring till the passage in it is obstructed, great suffering results, with inflam- mation, and nearly certain death if relief is not obtained. I have known infants suffer severely from this trouble, and in fact be almost lost from it without any idea on the part of their parents as to what they ailed. I have also known boys become subject to it suddenly from leaping, or from strain- ing of the bowels, and suffer the ' most dreadful tortures before they told how they suffered, 01 before any one found out what was wrong. If the Rupture exists from birth the Testes cannot be felt while it is down, 'because they are covered by it, but when the Rupture occurs in after-life the Testes can be felt behind, in the lower part of the Scrotum. In some cases the Hernia is small, and descends only a small distance, so that no great in- convenience is experienced, and it may exist in thi« way for years, or even for life, but there is always danger of its becoming worse. Occasionally a quantity of fluid descends from the abdomen, either with a Rupture or without, constituting a true Hy- drocele, but differing from that occuring in after- life by the fluid returning into the abdomen, when pressed upwards. Children are sometimes born with a large accumulation of fluid in this way, and in others it appears a few days after birth. In these cases the fluid also usually disappears intr the abdomen when the patient lies down, and ma) be kept there when erect by pressing the finger an the abdominal ring, but immediately the finger if taken away it re-appears. The treatment of Scmtal Hernia is much tha IHSE/iSES OF THE TESTES. 11 5 same as that of other ruptures, and when properly conducted usually produces a cure, unless there is son*e malformation of the parts that cannot be cor- rected. The protruded parts are first pushed back into the abdomen, leaving the Testes in their place, and then a properly-constructed Truss is worn that presses on the abdominal ring, to prevent their return. If this be worn regularly, and the^ parts never allowed to fall again, the passage will gene- rally close up, and the cure be thus made complete in a few weeks The older the patient is, however, the longer time it will require to effect a cure, and the greater chance there is that it may not take place at all, ir* which case a Truss must be con- stantly worn. Great care in required in applying the Truss that it does not pre^s on the Intestine, or on the Testes, for if it does so, great pain and perhaps inflamma- tion may result. It must also be carefully ascer- tained that the Testes are in the Scrotum, because if they are not the truss will be improper, as it will prevent their descent. In Congenital Hydrocele the fluid may be kept back, more or less completely, in the same way as the Intestines, and in young persons it usually absorbs m the course of time. In very bad cases of Scrotal Hernia, when the Intestine is strangula- ied, and cannot be replaced by external manipula- tion, an operation is needed, which consists in cutting the neck of the sac, or ths ring, a little larger, so as to allow of its return. This, however, must always be performed by an experienced Sur- geon, and in such hands is perfectly safe and corn- okratively et*$y. Parents cannot be too careful in" observing thei? 116 DISEASES OF THE TESTES. children to as to detect any trouble of this kind aJ the earliest moment. From want of attention this way a Scrotal Hernia may take place, and produce serious effects, before anything of the kind is sus- pected, and the proper treatment may thus be too long neglected. A severe fit of crying is very likely to bring this on, in infants who are disposed to it, and hard coughing may do the same in after years. It is very seldom cured, so as to do without a truss, after puberty. VARICOCELE AND CIRCOCELE, OR SWELLING OF THB VEINS OF THE SCROTUM AND SPERMATIC CORD. Varicocele is simply a swelling of the veins on the surface of the Scrotum, and is never of a serious nature, unless caused by other diseases. It appears to arise spontaneously in many cases, but more frequently follows severe fatigue, long standing, or debilitating diseases. All that is required is for the patient to wear a suspensory bandage, use the cold astringent lotions directed in Hydrocele, and rest. If he be of a full habit of body it may also be requisite to order a low diet for a time, and the strict use of cold water as a drink. Circocele is a swelling of the primary veins of the spermatic cord, within the Scrotum, and may become much more troublesome than Varicocele, though it is but seldom serious. The swelling is felt in the Scrotum like a firm knotty tumor, on one side of the Testicle, and becomes larger when the patient coughs or strains, but subsides when he lies down. It is on this account that Circocele has sometimes been mistaken for a rupture of the Omentum into the Scrotum. It only needs a prope/ DISEASES OF THE TESTES. ] H examination, however, to show the tiuth. When the patient lies down push the tumor up into the abdomen, and press the finger firmly on the abdo- minal ring, then let him rise, and if it be a rupture the tumor cannot descend again while the finger is held there, but if it De a Circocele it re-appears im- mediately. It is seldom that anything more is experienced than a sense of weight and uneasiness in the parts, except in severe cases, and then there may be pains in the back and loins, with weakness in the thighs, and eventually a wasting of the Testicle. The treatment must be almost precisely the same as given for other swellings. Cold astringent lotions, the suspensory bandage, purgatives, anc rest, by lying upon the back, is # all that can be generally advised, though there may be particular circumstances in each case to indicate something more. There are cases so severe as to require the removal of the Testicle, but fortunately they are rare. Many sufferers would escape this affliction if they would wear a suspensory bandage in time, when the swelling and inconvenience are first observed, and many would have no return of it if they did not leave off the supporter too soon. The veins on the right side appear to be seldom subject to swelling, nearly all the cases being o the left side, though occasionally both are afFectea. out the left always the most so. This is probably owing to the position of the Colon, or lower part of the large Intestine, which descends on the le»ft side, and by pressing on the veins prevents the blood from freely returning, and thus causes the swelling below It is on this accourtf iha persons who su£ 118 DISEASES OF THE TESTES. fer from Constipation are most liable to Varicocele, and that it is always worse when the bowels have been long unmoved and are full. It is for the same reason also that the left ovary, in females, is most apt to be affected with Varicocele. Among other general causes of this disease may be mentioned excessive indulgence, Masturbation, Inflammation of the Testicles, and Ruptures or Tumors in the Abdomen. Very fat people are sometimes affected with it, owing to the pressure of the fat in the lower part of the abdomen, and those who wear trusses are liable to it from the pressure of the instrument, unless it be well made, and carefully adjusted. Riding, hard running, leaping, and lifting will also bring on swelled veins, and sometimes even burst them, particularly if the Scrotum be much relaxed. It is most frequent at the age of puberty, though met with occasionally at other periods. The characteristics of this disease are so clearly marked that a mistake can seldom occur in regard to it, the cord is plainly observed to be swelled, the enlargement being greatest below, on the Testicle, and on pressure it feels like a roll of knotted cords, or a bunch of earth-worms. This swelling is always greatest at night, or after exertion, and from coughing or straining in any way. It may also be reduced by lying down,' and by the ap- plication of cold. Many patients discover that it ia nearly always much better after coition, and they are, therefore, apt to indulge frequently, under the idea that it does them good. This, however, is a great and fatal mistake, the temporary relief being merely owing to the contraction of the Scrotum, and to the increased speed of the circulation, which always occui immediately after coition As soon DISEASES OF THE TES 'ES. 1 1 9 as this temporary excitemerut is over the relaxation is greater than before, and the swelling of the veins increases, as all those who have tried the experiment well know. In general, if taken early the disease may be readily checked by the means already described, bu* if neglected it may become very severe and obstinate, and sometimes gives rise to Neuralgic symptoms. There is also danger of wasting of the Testes, as before remarked, owing to the circula- tion 'of the blood being impeded, and the usual supply of nutriment being thus cut off. Many instances of this kind are related in medical works, and I have seen several myself. In some cases the Testes will waste away, and almost totally disappear, in a few months after the Vari- cocele commences. This, of course, destroys all sexual power and feeling, and makes the patient an eunuch. It is therefore advisable, if all the usual means fail of arresting the swelling, and particu- larly if wasting commences, to resort to some other treatment, and several modes have been adopted by different Surgeons with various success. Sir Astley Coopei, and some others, used to cut away a piece of the Scrotum, and then draw the parts together and let them heal. This, of course, made the Scrotum less, and by drawing the Testes firmly up to the abdomen afforded a beneficial support to the parts above. In many instances this operation has effected a cure, but in others the relief from it has been but slight. The disease has also re- Appeared, with all its former severity, many years after being cured in this way. This operation is not applicable to all cases of the disease, and even ill skilful ha#ds is frequently attended by great danger. V4 i2l» DISEASES t.F THE TESTES. Besides this plan, some surgeons have cut through the veins, or tied them, and sometimes even cut part of them out. Of course either of these plan? ■ leads to the destruction of the Testes, besides being liable to cause inflammation of the veins, and othei serious results, and they are therefore very objec- tionable though often successful in curing the Vari- cocele. M. Delpech, a celebrated French surgeon, operated upon a man in this way, and cured him, but the Testes afterwards wasted away, and this being unexpected, and undesired, the man was su enraged that he assassinated the surgeon. The only treatment that can effect a cure without sacrificing the Testes is the application of pressure^ in such a way as to lessen the circulation of that blood in the veins, without stopping it entirely. This can sometimes be accomplished by a pecu- liarly formed Truss, or bandaga, and at other times by a ring; but the making and fitting of these instruments is a matter of great difficulty, and re- quires to be done for each case separately. I have often had the pleasure of affording relief in this vay, but only after immense trouble on my own part, and great perseverance and patience on the part of the patient. When nothing else can be done, castration must be performed ; and our surgical records give us many instances of this operation being resorted to. HEMATOCELE, OR SWELLING OF THE SCROTUM A lift SPERMATIC CORP FROM THE EFFUSION Of BLOOD, This affection differs from Hydrocele in being a& effusion of blood, instead of water, eith^ into th* DISkasES OF THE TESTES. 121 ftniotam or spermatic cord. It is sometimes caused in performing the operation for removing the fluid in hydrocele, by wounding one of the blood-vessels, and thus allowing the blood to run into the cellular 1 issue or Tunica Vaginalis. It may also occur, spontaneously, from the rupture of a branch of the spermatio veins, and may result from blows or sprains, the same as effusions of blood in other parts of the bud v. This accident is rare, and seldom serious. If the patient Keeps perfectly still, supports the Scro- turn with a banuage, and uses fomentations of hops boned in vinegar, or spirits of wine and water, or vinegar and waver, and keeps the bowels gently relaxed, nothing more will in general be required. Sometimes, however, the blood-vessel remains open, the blood keeps flowing, and the swelling become^ so large, and presses so much on the Testes that great distress is experienced. In these cases an inmsion must be made, the blood let out and the ressel tied, unless it can be closed by pinching it together externally, which may be done if th! place of ruptu.e is discovered. If there be any inflammation it must be combated by leeches, cold I'.ttons, and othr,r usual remedies, and if it suppu- rates a poultice must be applied. PRURIGO, OR ITCHING OF THE SCROTUM. This is one of those annoying complaints, which, enough not at all serious, are still sufficient to make any one suffering from them completely miserable and even sometimes almost desirous of death, as the only means of relief. The itching is sometimes telt without there being any unusual appearances in 122 DISEASES OF THE TESTES. the parts, but more frequently a number of roundish red pimples are seen on the Scrotum, which, by the patient scratching to relieve himself, often become much enlarged, and highly inflamed. In long con- tinued cases the skin becomes considerably thickened and very hard, and a disagreeable discharge takea place from the sebaceous glands. I have known persons so tormented with this disease as to be frequently delirious, and utterly unable to obtain the slightest alleviation of their distress. The real causes of Prurigo are entirely unknown to us, but it is undoubtedly much aggravated, it not -brought on, in many instances, by want of proper cleanliness. The plentiful and regular use of cold water would prevent more of this trouble than any kind of medication can ever cure. In many per- sons the secretions of the parts are naturally very acrid, and if not speedily removed they are sure to irritate every spot they touch. Old persons are most subject to this complaint, though it occasionally attacks others, and it is usually confined to the genitals exclusively, but will sometimes extend down the inside of the thighs and round the anus. The treatment must be chiefly external, unless there be habitual indigestion, or constipation, in which case a few simple alteratives may be of ser vice. If constipation exists a little Epsom Salts may be taken, and if the stomach be disordered Jive grains of Plummer's Pill may be given every other night, for five or six nights. The patient must be particularly cautioned not to rub the parts, and hiar dress should by no means be allowed to chafe them. nor should it be too warm and close. Even at Tiigbt th« bet -clothes must be light, and the b^d DISEASES OF THE TESTES. 123 itself hard and cool. But little exercise should be ( taken, and that very gentle, and the parts should be thoroughly washed twice a day with warm soap and tvater. A cooling lotion may also be used during the day, of Vinegar and Water, with a little Lauda- num, or what is often better, two grains of Bichloride of Mercury to two ounces of water. Equal parts of Citrine Ointment and fresh lard also forms an excel- lent application to be rubbed well over the parts at •night. Sulphur Ointment benefits in some cases, and a Sulphur Vapor Bath still more so in others. It is especially important that the diet should be eimple, light, and unstimulating, and that no alcoholic or fermented liquors should be taken. Sometimes the itching arises from the presence of certain peculiar little parasitic animals, in which case they may be readily destroyed by rubbing on a little of the white precipitate powder occasionally. In fact this may also be used with a prospect of benefit whenever the skin is not much broken. ELEPHANTIASIS SCROTI. 1 his terrible disease is fortunately extremely rare in this part of the world, and it is only neces- sary to describe it in order to complete our treatise. It appears in the form of a peculiar swelling of the Scrotum, caused by the infiltration into its integu- ments ' of a jelly-like albuminous fluid, which accumulates in some cases to a most enormous extent. The outer surface of the skin appears rough and chopped, or covered with large brown scales, so that it has somewhat the appearance of an elephant's foot. Sometimes, but not very fre- quently, a number of ulcers are formed, and th causes DISEASES OF THE TESTES. ] 21 an annoying sensation of weight and dragging, with more or less pain in the groin, and weakness in the limbs. The only treatment required is the regular use of wold astringent washes, as directed in falling of the spermatic cord, with the constant wearing of a suspensory bandage. The same precaution must also be observed as to regulating the bowels, and avoiding excesses and fatigue. — If cold water and the suspensory bandage were resorted to in time, and perseveringly, neither of these affections would scarcely ever become very bad, unless from sudden straining. — Sometimes however it is caused by un- usual weight in the testes, from swelling, tumors or hydrocele, and of course can be removed only with the cause producing it. DISEASES OF THE VASA DEFERENTIA. The Vas Deferens is only a small Tube, and is liable to several accidents that will impede the proper performance of its functions. It is not unfrequent after a recovery from Hydro- cele, or Hernia Humoralis, for the Vas Deferens to become partially obstructed, or even totally oblitera- ted, owing to its having partaken of the inflamma- tion, and its walls having in consequence grown together. When the obliteration is complete the individual is of course sterile, because there is no passage for the semen. The Testicle may be per- fect in its action, but the semen cannot leave it, and this not only produces sterility, but sometimes leads to fatal inflammation of the Testicles from their being constantly overcharge! with semen, and un- able to relieve themselves. When there is only, a 128 DISEASES OF THE TESTES. partial obstruction the patient experiences a singu tar difficulty in the evacuation of the semen, which is effected very slowly, and often with great pain, hi some of these cases the orgasm will be over and the erection gone down before the semen begins to flow and then it comes in drops for a considerable time causing great inconvenience and annoyance. Unfortunately we know of no remedy for this dif ficulty when it has long existed, but when it is onl\ a temporary result of acute inflammation it is of course only necessary to subdue that to give relief. The great point is to prevent such an accident, by checking all inflammatory action in the Testes and other parts, which lead to it, before the Vas Defe- rens becomes affected. It is mostly caused by neglecting Hydrocele and Hernia Humoralis too long, or by improperly treating them, though it may also be brought about by blows over the groin. A temporary obstruction of the Vas Deferens often arises from its being pressed upon by a swelled vein, or by tumors in the Testicle and groin, in which case it is of course relieved only when such cause is removed. It is advisable to let such causes exist as little time as possible, because the retention rf the semen may injure the Testicle. I have known an improperly-constructed truss press on the spermatic cord and close the Vas Deferens, so that the person was quite sterile while he wore it. Sometimes the Vas Deferens becomes Dilated, or Relaxed, so that its size is much increased and i* nearly or quite loses the power of retaining the semen, or become so full of it as to produce incon- venience. The causes of this trouble are unknown, though it most probably results from retaining the Bemen when it is nearly ready to flow as often a& DISEASES OF THE TESTES. 129 from any other cause. I have known men afflicted in this way who habitually tried to prevent the flow continuing, from a mistaken idea that if they could lessen the discharge they would not be so much weakened by coition. It is scarcely necessary to saj that such practices do riot lessen the discharge, but merely make it finish afterwards in an unseen and dangerous form. It is not easy to ascertain when the Vas Deferens is enlarged or relaxed, but when there is good reason to suppose it is so the treatment is simple. Cold lotions of Alum-water or Sugar of Lead, as recommended in former articles, must be constantly used, or ice may be frequently applied so as to astringe the parts, and all improper habits must be immediately abandoned. In addition to these, the Vas Deferens is liable to several other affections, as Scrofula and Tumors for instance, which are, however, very rarely seen, and as their treatment in no way differs from that of the same affection in other .parts, they do not require any special notice. In some few cases the Vas Deferens has been totally absent from birth, while the Testes and other organs were perfect. In this state the Semen is formed, erection even occurs, but there is no emission, because there is no passage from the Testes. This condition of the parts is nearly sure to lead to Orchitis, or Spermatocele, from the irritation of the retained Semen, unless the patients desires are weak, or kept much under control. If the Vas Deferens of an animal be cut out, or tied, it is found that the Testicle still secretes the Semen, though it cannot escape, showing that tb*i power of secretion is not lost by the impossi. bility of emission. ]£0 DISEASES OF THE TESTES. DISEASES OF THE SEMINAL VESU'LCS TJie precise use of these two organs is yet s matter of dispute among physiologists, some regard- ing them as real Glands, by which a peculiar liquoi is secreted to mix with the Semen, while othert look upon them as mere reservoirs in which the Semen accumulates previous to its emission. When dried and injeeted the Vesicles are seen to be two Tubes convoluted and turned upon each other so closely that their parts look like cells. The ends of these Tubes open into the Vas Deferens, just where the ejaculatory duct commences. It appears certain that the Vesicles have con siderable contractile powers, and this has favored the idea of their being intended to contain the Semen and afterwards eject it during coition. When examined after death, however, they do not contain Semen, but are filled with a yellowish fluid apparently peculiar, to themselves. Their precise use is therefore as yet unknown. They appear to be subject to obstruction and obliteration like the Vas Deferens, but we nave do means of detecting such derangements, noi can wa propose any remedy. TENTS CUT THROUGH VERTICALLY. . Vesicle. Ejaculatory Canal. Cewper's Gland. Prostate Gland. 131 CHAPTEK V. THE STRUCTURE, DISEASES AND MALFOHMA TIONS OF THE PENIS AND i'Hfi PARTS IMMEDIATELY CONNECTED WITH IT The Penis is a hollow spongy organ down which runs the passage from the bladder, called the Urethra, by which the urine escapes, which also 6erves for the exit of the semen, as before ex- plained. The Anatomical structure of this organ is not thoroughly understood by Anatomists, owing to the difficulty which necessarily exists of dissecting it in its several «tates. Sufficient, however, is known to explain it? Physiological action, which 13 all we now require to know. The bo. b. T>** Urftwrs, o? Tubes which convey the Urine from the Sidneys to the Bladder. — c. c. — The Vasa Deferentia — d. d. Tha mouths of the Ureters. — e. fhe Prostate Gland.—/. The Veru Montanum. — g. Openings of the Seminal Ducts. — h. The Ischio Cavernous .Muscles, which assist in erection. — i. i. The bulb of the Urethra. — k. k. Cow- pers Glands. — /. The wide part of the Urethra. — m. The narrow part. — n. The second wide part, called the Fos- sa Navicularis. — o. The Glans. — p. The Prepuce. — q. The Meatus Urinarius, or externa* opening of the Urethra. The Cellular, or spongy structure of the body of the Penis is shown on one side, like a honey -comb ; a»d the distiibution of its blood-vessels on the other. Fig. 2. Cross Section of the Pen:* « a. Th»3 Corp is Cavernosum. — b. The division or septum between the two parts of the Corpus Cavernosjim. — c The Corpus Spongiosum.— -d. The Urethra. — t. Ine £,seat Vein of the Penii. i. no a Plate X. Section of Penis and Bladder. 134 DISEASES OF THE PENIS. under the Perineum, by two roots called the Crura Penis. The Corpus Spongiosum surrounds the Onal of the Urethra underneath, and fills up the remainder of the groove, so as to round the whole organ. It terminates posteriorly in what is called the Bulb of the Urethra. The whole organ is surrounded by the skin, ex- cepting the end, where we find a bod^\ called the Glaus Penis, which is both different and separate from either of those described. The inner fold of the skin of the. Penis is attached to the termination of the Corpus Cavernosum, while the outer fold is . extended beyond, so that it only partly covers the Glans but is not attached to it, and may be drawn back. This loose skin is called the prepuce, or foreskin, and is the part cut off in the rite of cir- cumcision. In some persons it extends farther over the Glans than it does in others, but generally leaves more or less of it exposed. " The Glans is probably an enlargement of the peculiar erectile tissue surrounding the Urethra, and is covered by a highly sensitive and vascular skin, of an exceed, ingly delicate structure. It is in the form of a sec- tion of a cone, and terminates on the posterior or upper margin by an elevated ridge, called the Corona Glandis, behind which is a depression called the Cervia, or Neck. In this depression are several glands called the Glandula Odorifera, which produce a whitish secretion, of a peculiar odor, that some- iimes accumulates in great quantities in those who neglect proper cleanliness. On the under side of the glans the prepuce is attached nearly at the end, by a fold, or ligament, called the Frcenum, or Liga- mtntum Pr&yutii. This ligament, or cord, is son*e« 13* . DISEASES OF THE PENIS. |35 times too short, and during erection is so pulled upon as to cause great annoyance ; occasionally it even ruptures, or tears, causing severe pain, with loss of blood. These parts constitute the substance of the Penis, and are therefore most essential to the performance of its proper functions. The peculiarity of the structure of the Corpus Cavernosum and of the Corpus Spongiosum, consists in the,ir being full of curiously arranged blood ves- sels and cells, or cavities, like those of sponge, all communicating with each other, and being con- nected with the main branches of an artery and a vein. In ordinary states these vessels, excepting the larger ones, and also the cells, are nearly or quite empty, but under appropriate excitement the blood from the artery is impelled intG them and rills them up, in consequence of which the. organ en- larges, like a sponge when filled with water. This is called the Phenomenon of Erection, and it depends upon a peculiar sensibility proper to the parts, which are therefore sometimes spoken of as being composed of Erectile Tissue. There is no other part of the body that in any way resembles the Penis in structure, except the Clitoris in the female, which has a similar Tissue, and is usually capable of erection to a certain exient, in precisely the same way. When. the excitement is withdrawn the' blood or- dinarily flows back by way of the cavernosus vein, and the erection subsides, but sometimes its return is prevented, and the erection then remains, though ail excitement has gone. — The Corpus Spongiosum is so distinct from the Corpus Cavernosum that erec- tion will sometimes take place in one and not in the 136 DEBASES OF THE PENIS. other, which necessarily curves the organ, or drawi it into the form of a bow, producing what is termed a chordee. The erection, and emission of semen, is also assisted by a number of different muscles, particularly by one called the Erector Penis, or Igchic Cavernosas Muscle. Sometimes in erection the rusri of blood will be so sudden and violent that thi vessels will burst, and the erectile tissue be thus totally destroyed. In some persons the filling up of the blood-vessels always occurs in a very short time, while in others it is tire reverse ; and in like manner the erection subsides m u short time in some, while in others it will continue for a long period and subside very slowly. This depends upon some peculiarity in the vital action of the blood-vessels, not yet understood, In old age the blood generally flows in slower, and flows out much quicker than it does in youth, so that the erection is longer in taking place and goes down more rapidly. The uses of the Penis, as before remarked, are two-fold, firstly it serves as a conduit, to convey the urine from the body, and secondly as a conductor to carry the semen into the female organs. For the first use erection is not necessary, but it is for the second, and therefore its proper occurrence is both natural, and essential to the performance of one of the functions of our nature. The form of this organ varies in different ani- mals, for -the purpose of adaptation, and is some- times very singular In some it is covered with spines, so as to give great pain to the female during connexion, as in the cat, while in others its structure causes that act to be much lengthened,, as in th* dog. In birds the male organ is merely rudiment- ary, so that there is no actual union, properly speak. DISEASES OF THE PENIS. ] £J mg, but merely an emission into the female organs. In the human being there are occasional deviations from the ordinary development, and sometimes even peculiarities in structure. Thus instances have been known of the interior of the Corpus Caverno- sum being more or less ossified, so that a distinct bene always existed in the middle of the organ. This is often the case in negroeSj and in some of the lower animals it is natural. In a few rare instances !he penis has been found double, or rather divided into two parts, only one of which, of course contains a urethra, though both may be capable of erection; as I observed in one case in my own practice. Probably amputation of the imperfect part might have been safely effected, but as little incon- venience was experienced it was not thought necessary. The various peculiarities of structure and deve- lopment that interfere with the functions of thia part will be treated under appropriate heads as we proceed. ABSENCE AND MALFORMATION OF THE PENIS. Resides being liable to be lost by several acci- dents, and by necessary operations, the Penis may also be deficient from birth. I have seen instances when it was not more than a quarter of an inch in length, and sometimes only a slight swelling, like . the top of a small tumor. In such cases of course there can be no connexion, but still such men may be fathers, providing all the other parts are perfect, because, as before explaineJ. the semen .nay im- pregnate if it be only shed within the external lips, which may of course be effected in the worst of 138 DISEASES OF THE PjfclNIS. these instances. I have known instances of married couples, with famiiies 5 who never had any associa- tion, from similar causes. It is unnecessary to saj however that marriage should never take place in such cases without the nature of the infirmity being first known, though I believe the law would declare any marriage binding if impregnation was possible. In giving an opinion under such circumstances it is however difficult to decide this point. In general, in healthy females, the placing of the semen artifi- cially in the vagina will induce conception, but not always. Hunter relates an instance where he ad- vised the injection of the semen with a syringe, after its escape from the husband, and impregnation fob lowed. There are some females, however, in whom its absorption will not take place without a certain amount of excitement, dependent upon actual asso- ciation, so that there will always be more or less uncertainty, and much less probability than when no such deprivation exists. Independent of this, however, there are other considerations that should forbid the marrying of men so situated, unless with a fall knowledge of the circumstance and its conse-- quences by both. In some of these cases, especially when a portion of the organ is left, as. after opera- tions and accidents, the 'difficulty may be much remedied by an instrument, so constructed as to fit on the part remaining, and resembling that which is lost. 1 have known instances of conception fol- lowing the use of such an instrument, when the penis itself was not more than a quarter of an inch long. But then the semen was formed in great quantities, and was remarkably healthy. In some children the Penis is tied down to the Scrotum, or some oth sr of the neighboring parts, dv DISEASES OF THE PE1NS. 139 panels, which never allow it to be extended, and of course pre rent the performance of its functions. 1 saw one, child of seven years in whom it grew flat on the Abdomen, causing great trouble and annoy- ance in urinating from the direction in which the fluid had to flow. Nearly all such cases can be easily corrected by a slight operation at any age ? the adhesion being usually only by the skin, but are better attended to early in life. The one referred to was put right very readily, and in two years' time scarcely a trace of the operation could be seen. Occasionally the Penis will have a wrong direc- tion, being turned so much either on one side, under, or upwards, that association is impossible. If this depends upon contraction of the skin, or of the muscular fibres, it may be corrected by simply dividing, them, "but if it results from a tumor, o-r swelling, that must be removed before any altera- tion can be effected. Aneurisms, and swellings of the veins, will sometimes bring about such devia- tions, and so will too long continued erection, by rupturing some of the cells or vessels, and so causing accumulation of blood. I knew one in- stance of this kind in which every time erection occurred a large tumor was formed on the left side full of blood, which of course turned the end of the organ to the right side, and thus prevented con- nexion. This accident had been caused by numer. cus forcible and long-continued erections in one night, during intoxication. The tumor was as large as an egg, and when full could be distinctly felt to pulsate. It was ako very painful, and ap- peared almost ready to burst. The remedies pro posed were cold astringent lotions and wearing 8 ]40 DISEASES OF THE PENIS. thin flat plate of smooth horn over the part, boimd on so firmly as to prevent any swelling from accumulation of blood. This plan succeeded very •veil in giving relief, though it is probable there will always be more or less tendency to a recur- rence of the trouble. Besides Scrofulous and other Tumors in the Penis there will sometimes be bony swellings, and accumulations like calculi or stone in the bladder. These may either compress the Urethra, and so prevent the passage of the Urine and Semen, or they may curve the organ so as to prevent its use ; in general, however, they can be removed. Sometimes the Frsenum or cord that binds down the prepuce at the end underneath, will be so short or contracted that during evacation the point of the Glans will be pulled under. This not only prevents the Semen being thrown straight forward, but even prevents connexion in many instances, either caus- ing severe pain, or by bending the end of the organ eo much. This difficulty is easily remedied, by cutting through the cord with a pair of scissors, or a lancet. I advised a gentleman out West how to do this, in a letter, and he wrote afterwards to in- form me that he had succeeded perfectly, with his razor. It is simply necessary to take care to cut only deep enough to just sever the cord, and after- wards to keep the parts stretched asunder, so that they dG not grow together again; a simple dressing of cloths dipt in cold water is all that is required after. I have known the cord to be eaten through with caustic, but the plan is not so good as cutting, being more tedious and painful, and leaving a larger Bear. In some persons it has been broken suddenly during a violent erection, or on attempting coition^ DISEASES OF THE PENIS. 14i out such accidents are always painful, and are bet. ler avoided by a timely operation. HYPOSPADIAS. This term means a case where the end of the Urethra does not come to the end of the Penis, but opens underneath, the passage not reaching the whole length of the organ. This state of things sometimes follows severe venereal cases, and othei accidents, but its causes when congenital are of course unknown to us, and unfortunately but little success generally attends its treatment. This malformation is a cause of great trouble and annoyance in urinating, and interferes more or less with the power of impregnating, though it by no means prevents it altogether, as was formerly supposed. Sometimes the opening is close by the Fnerium, and during erection it is firmly closed, owing to the pressure, so that the Semen cannot escape from the Urethra. In such cases there cannot be impregna- tion, unless the Semen flows after the erection has somewhat subsided, but this it will not always do, because it may run backwards into the bladder, and in such cases the patient is necessarily impotent. When the Semen escapes freely, providing it be within the female organ, conception may or may not take place, according to circumstances, let the opening be where it may. At other times the opening is so near the body that the Semen, when it does escape, cannot enter the female organs. In such cases the only resort left is artificial impregnation, as before explained. The taarer the opening is to the end of the Penis 142 DISEASES 07 TiSE PENIS. generally speaking, the more chance there is of success, a*nd the nearer it is to the body the less [n some situations any kind of treatment is out oJ the question. When it is close to the body the Urine and Semen run down the Scrotum or Peru neum, unless an instrument be worn to prevent it, causing constant irritation and annoyance. Sometimes there are two openings, but they sel- dom communicate, and the fluids nearly always escape by one only. It was formerly considered, even by the most eminent surgeons, that it was impossible to operate with any prospect of success in these cases, from the nature of the parts, and from the constant flow of Urine ; they therefore advised to leave them alone, and provide the sufferer with the best remedial instruments, to lessen the inconvenience. In modern times, however, success has attended numerous attempts to correct this malformation, and under favorable circumstances it is always attempted. The mode of operation is simply to pass a small sharp-pointed instrument straight through the Penis, along where the natural opening should be, and thus make an artificial passage, which is kept open by bougies till the cut edges have healed and there is no danger of it growing up again. When this is fully accomplished a catheter is introduced, and the edges of the old opening underneath are made raw and held together, by needles or other con- trivances, till they adhere, and thus the opening is closed. In this 1 way a new passage is formed in the proper direction, and the old unnatura. one is permanently obliterated. There are, however many circumstances that may make the success oi 14 DISEASES OF THE PENIS. 743 the operation very uncertain, and some tnal may forbid it being attempted. In general the proper canal of the jrethra ex- ists, but in a small state, and is closed only at the very end, by a thick membrane. This membrane may usually be easily cut through and the canal enlarged by bougies, by which means, if the false opening can be closed, a }>erfect cure can be ob- tained. Sometimes however there is no trace of the urethra, and the passage has to be cut thiough the solid flesh the whole distance, which is apt to excite so much inflammation that no bougie can be worn, and then, all grows up again. The false opening is also so large in some cases, or the edges are so thin, that it cannot be closed, and then the new opening may be of little use, though it be formed. In some of these cases, however, a small tube can be worn internally, extending just past the opening underneath, so as to conduct the semen and urine to the proper opening at the end ; or a piece of gum elastic, or oiled silk, may be worn firmly over the opening externally, to effect the same object. By such means many a suiFerer has been enabled to urinate in comfort, in the natural way, and many an impotent man has become a father. Instances have been known where the false open- ing was between the Testicles, or even in the Peri- neum, and yet it has been perfectly closed and & new one made ihe whole length of the Penis. Such operations, -however, require great skill in the sur- geon and much endurance in the patient. In many instances, when the false opening is near the end of the Penis, it will be found that the proper passage is continued the whole length of th organ and merely closed at th^ mouth bv a skir 144 DISEASES OF THE PBNIS. I kne m A a man who was troubled in this way, th« opening being just at the base of the glans, who could close it with his fingei and send the urine along the natural passage till it made the skin at the end project. Haying heard me explain about this in some of my Lectures he determined to try and operate himself; accordingly he took the sharp end of a penknife and where the skin projected strongly he made a small puncture very readily* through which the urine escaped immediately The inflammation soon subsided and the new open, ing remained, so that by always closing the old one with his linger he could urinate as well as if nothing was wrong. I told him that the old opening c^uld be easily closed permanently, by another slight ope- ration, but he felt so well content with what was already done, and suffered so little inconvenience, that he would not consent to anything further. One of the greatest difficulties is in keeping a catheter in sufficiently long to make the urine flow down the new passage while the old opening grows together. Very often the pkice will be nearly closed, and then a rush of urine will come and break it open, destroying all that had been done, [n old cases also the edges are apt to be very thir? and ragged, and the orifice large, so that a perfect junction is next to impossible. If there is any scro- fulous tendency also the probability of its ever clos- ing is very small. In many of these cases, as in external abscess of the Prostate Gland, the wound may be perfectly healed for a time, but break. out again without any apparent reason. Many of these deformities can be corrected in infancy, or early youth, «nd they should therefore be always shown to experienced surgeons imme* DISEASES OF THE P*N!S. \4tf diately they are detected, and not concealed^ as they are by some parents. — It is difficult to say to what age success is possible in such cases, probably there is no particular limit ; some have been ope- rated upon at thirty, and others even at forty, or more, but the earlier the better. — In general the development of the Penis is more or less imperfect above the false opening, and when the full genera- tive power is desirable this must also be corrected,, by means which I will explain in another article. Sometimes it is even necessary to effect this deve* lopment before the operation can be performed. EPISPADIAS. This affection is precisely the reverse of the former, the false opening being on the top of the Penis instead of underneath. It is m.uch more rare than Hypospadias, and is somewhat more difficult to treat, owing to the opening being farther from the natural passage. The orifice will sometimes be near the end and sometimes close by the Pubic bone, occasionally being a little on one side. The mode of operation is exactly the same as in Hypospadias, but as before remarked, it is more dit- cult and the chances of success are less. PRYMOS'IS. in this malformation the skin of the prepuce comes completely over the Glans, and the opening at the •nd is so contracted that it can never be drawn back. This condition of the organ, is both unpleasant annoying, and dangerous, because it prevents proper 3ftcanlin*»8s, and thus d : sposes to various diseases. 146 DISEASES OF THE PENIS. The secretion of the Glandulae Odorifera is apt t§ accumulate under the skin, and in conjunction with the urine to create serious inflammation. Calculi will also form, like those in the Madder, and the swelling will sometimes be so great that neither semen nor urine can pass. In many cases of Phy- mosis the swelling is so great as to cause severe pain during erection, and the Glans is so compressed in consequence, that the semen cannot escape, and thus the individual is impotent. The means of giving relief are very simple. It is only necessary to introduce an instrument care- fully under the skin and cut up the Prepuce, so as to let it open. This may be done with but little trouble or pain, and with slight danger from inflam- mation if a simple dressing of cold water be applied. It is sometimes necessary to cut off the edges of the wound a little with scissors, particularly if they are anyways callous, or ragged. The whole prepuce is at times so hard and unyielding that it becomes necessary to practise complete circumcision. PARAFHYMOSIS. In this case the prepuce is drawn back, over the Corona Glandis, compressing the organ like a tightly, drawn cord. In some it is permanently in this situation, while in others the patient has drawn it over the Glans and has not been able to slip it back again, owing to the smallness of the opening and the swelling of the parts. When it results from this cause it will often be sufficient to use cold lo- tions for a time, to reduce the swelling, and lubri- cate the parts with some Belladonna Ointment, when lt»e prepuce may be drawn over without difficulty 14* DISEASES OF THE PENIS. I4T Sometimes a little bleeding may be necessary, or a few leeches on some of the neighboring parts. The only certain cure is to cut the Prepuce, in the same way as for Phyrnosis, which will of course prevent any return of th*, difficulty. Pa tients with Phyrnosis are very apt to change that trouble into Paraphymosis by their attempts to draw the Prepuce hack, and to stretch it. In young children both these states may exist without causing any great annoyance, but as they approach puberty serious trouble may be expe- rienced suddenly. It is, therefore, very necessary for parents to observe such accidents, and watch their progress, particularly near puberty, so that the Surgeon may be applied U> in time. Many a man has suffered for life, both physically and morally, from neglect of this kind while he was a child. I once knew an instance of a youth who had a permanent Paraphymosis that had never caused him any trouble till he was about twelve years old, when it began to pain him whenever he urinated, and later, when erection occurred, severely. When about fourteen years of age, in consequence of* some unusual irritation, the parts swelled very much, and the Prepuce was drawn so tightly around that the Glans was perfectly strangulated Not being in the habit of speaking about such matters to his parents he concealed it till the agony was so great he could hold out on longer. On a physician oeing sent for it was found that the parts had begun io gangrene, and the urine had been retained so long that inflammation of the bladder had also supervened. By prompt treatment the most urgent symptoms were alleviated, and after a time the Piepuce was cut through, so as to give permanent 148 DISEASES OF THE PENIS. relief. The patient, however, came very near losing the organ itself, if not his life, through want of a proper confidence and habit of communication between him and his parents. Both Phymosis and Paraphimosis may result from the inflammation attendant upon other diseases, particularly those of a venereal or syphiloid cha- racter, and then it is usually only required to remove the primary affection to give relief, though sometimes the operation is needed. It is necessary to state here that many a child has become addicted to Masturbation, and has perished in consequence, simply from having a neglected Phymosis ; the secretion accumulating under the skin, causing constant irritation and leading to mani- pulations that would not otherwise be thought of. I have known many men operate upon themselves, and successfully too, for both these affections; a penknife, or pair of scissors being thf only instru- ment used. No cutting should, howevei, be prac- tised on these parts when there is venerea) disease- becaus^- the wound may innoculctie, and thus the disease be spread. In some persons the Prepuce is absent altogether, and attempts have been made, under such circum- stances, to form a new one, by bringing forward the skin below, but no great success has attended the operation- por is it at all essential. The only reason given far desiring it is that the Glans is api to lose part of ; ts sensibility when constantly un- covered, which is undoubtedly the case, as may he seen among Jews nnd others who have been cir- curnscised ; but this a- slight inconvenience, even if it is not often an advantage, as it certainly mak** the person less liable to confr?<: 4 disease DISEASES OF THE 1ENIS. 1A9 *TANT OF DEVELOPMENT, OR CONGENITAL SMALL SIZE OF THE PENIS. It is sometimes difficult to say whether the Penis is ton short or not, because there is no precise stan- dard of limitation, and in different people the development varies very much. In some persons it never grows from the condition in which we find it in childhood, while in others it wnl attain a medium sixe, and in others again it will be nearly rudimen- tary. This may also be totally independent of any deficiency in the other organs, though most usually they correspond more or less. Thus I have seen a man of forty years of age in whom the Penis was only two inches long, and about as thick as the little finger, but whose Testes were of a full average size, and who had strong sexual feelings, with a full flow of Semen. Sometimes the orgco can scarcely be traced at all, being merely like a wart, or small tumor. When the non-development of the Penis is depen- dent upon a general torpor of the genital organs, moie especially of the Testes, their action must be aroused, and their functions fully established, in the manner pointed out in the chapter on the Testes. It this can be done the Penis may be made to grow even to an advanced period of life, as I have there *hown. In those cases in which the Penis alone is not «ufficiently developed a different treatment is re- quired, as it is simply a local effect we wish to produce. In some of these instances the organ, though small, is capable of perfect erection, and both connexion and impregnation may be effected 150 DISEASES OF THF PENIS. by its means ; it is not then a matter of such urgenl moment for any improvement to be effected, though under certain circumstances it may be desirable. More frequently, however, erection either does not take place at all, or so imperfectly that coition is impossible, and the flow Of Semen is so imperfect and irregular that impregnation can seldom be effected, even artifically. Under such circum- stances it is a matter of the greatest consequence to produce an increased development, so that both these functions may be performed, and it may be both new and pleasing, to many persons, to learn that there are means by which this desirable end may be often attained, even under the most un- promising circumstances. It is proper to remark, however, that the cases now referred to are those in which the small size is congenital, or existing from birth, and not those in which the organ has decreased, from disease or excess, after having been of average development, though even in many of them, when the constitutional stamina is not too much impaired, the same means will frequently restore what has been temporarily lost. The causes that prevent the proper development of this organ, as well as of others, are of course unknown in those cases that are congenital, because they operate before birth, but in those that become arrested during childhood or youth, we generally trace it to early masturbation, blows on the Tes. tides and other accidents, or to some severe disease which has impaired the vital energy very much. Some diseases are particularly apt to affect young persons in this way, as the Mumps for instance irhich often make the Testes swell. Scarlet Fever and Measles, when severe, I have DISEASES OF THE PENIS. ko^wn to seriously injure the virile power, but not bo frequently as rickets or scrofula. A similar deficiency is sometimes found *n females, in some the Uterus or Ovaries being ver> small, though the Vagina may be large enough to allow of coition, while in others these organs will be of usual size, but the Vagina will be too small, so that marriage is not allowable. In my work on "The Diseases of Woman," I refer to such cases, and explain what can be done to relieve them. To effect an enlargement of the Penis, in addition to every means proper to improve the general health, and impart stamina, there are certaki mechanical and manual applications, the effects of which, under right direction, are often of the most unexpected and pleasing character. To understand the nature of these, and their mode of action, it is necessary to bear in mind the anatomical structure of the or- gan, and the requisites for erection. That pheno- menon, it will be recollected from our previous de- scription, depends essentially upon the filling up of the vessels and cells of the spongy and cavernous bodies with blood, and of course if there be any fault in their make or mode of connexion, or if the blood does not flow into them, erection cannot take place. Now this is precisely the fault that is found to exist in most of the cases of non-development above referred to, and is what requires to be cor- rected. Or dissecting such cases after death we fhu that the cells and minute vessels have never been congested or filled with blood, and conse- quently the organ has never been able to grow noi become erected. In the same way after long conti- nued excess, or de nlitating disease, the artery seems to lose its power of transmuting the blood with suftv 152 DISEASES OF THE PENIS. cient vigor, and the cells, from want of being filled, decrease in size, and eventually grow up more or less, causing the organ to shrink. This is the rea- son also why absolute suppression of sexual excite- ment, if continued too long, wiil make the organ waste away, instead of increasing its power, as many uninformed people suppose. The object to be accomplished it will be seen is to open these cells, and cause the blood to flow into thera, so as gradually to increase their size and dispose them to fill spontaneously, from natural excitement In some persons, who have always shunned all thoughts of sexual matters, from a notion that they are improper, it is sometimes sufficient merely to encourage such thoughts to a proper extent, and the excitement this gives rise to in the parts will act favorably on their growth. In others the daily em- ployment of a warm local bath, with brisk rubbing, and the use of a stimulating ointment, which I shall hereafter describe, will be found still more effica- cious ; and if this treatment be regularly persisted in, under judicious direction, combined with proper internal remedies, it will succeed in a large numbei of the cases ordinarily met with. It is requisite, however, that the external and intern ai stimulants should be exactly apportioned to trie wants and ca- pabilities of the individual's system, and that a strict watch should be kept upon the action ami etfects of each, so as to know when to increase or decrease their power, and when to suspend their action alto- gether. Until over forty years of age, if the form of the organ is perfect, and its development not too small, a considerable change may be effected in thia way, though the younger the patient is the mort readily the parts are acted upon. DISEASES OF THE PKNIS. ]53 I once had a patient call upon me from Cuba, the son of a rich planter, who was troubled with this imperfection, and who was intensely desirous that ft might be remedied so as to allow of marriage. — He was about twenty-three years of age, and of a strong robust habit of body, with excellent health. On examination the Penis was found about two i?hches and a half in length, and about as thick as the fore- finger, properly formed, but with little more sensibi- lity than any other part of the body. The Testicles were fully developed, and the sexual feeling was quite strong. There had been frequent emissions of semen, under strong excitement, but no erection r and consequently no connexion could take place.— Upon enquiry I found that he had been brought up to a very rigid code of morals, and had imbibed certain notions about the necessity of not indulging sexual desires, if the mind was wished to become powerful, and as he was very ambitious of distinc- tion he made a perfect anchorite of himself. The bodily effe-et of such a course has been seen, — its effect on the mind was to make him wayward, irri- table and unhappy. A short time before he came on to see me he met with a young lady with whom he fell violently in love, and immediately the desire for marriage arose, but with it came the fear that he was totally incapacitated. The new desire, so strongly awakened, together with the fears he felt, dperated so intensely upon him that he became almost furiously insane. On assuring rtim,' how- ever, that there was a reasonable prospect of his attaining a more perfect state he became calmer, and patiently submitted himself to the prescribed *reatment. The fir^r object was to induce as much heat as 154 DISEASES OF THE PENIS. • possible in the organ, so as to promote the flow of olood to it. This was accomplished by the use of a hot stimulating lotion, two or three times a day, fol- lowed by brisk rubbing with flannel and soft brushes, In three weeks the effect of this treatment became obvious, — erections occured, partial at first, but ultimately quite forcible, and the organ evidently began to increase permanently in size. In additior to this he was directed to use some stimulant drops, and tp live generously, to impart as much vigor as possible to the Generative Organs. The flow of semen soon became much larger than before under this treatment, and the procreative instinct much more powerful. There was still one fault, however, and that was a want of power in the muscles that assist in erection and coition, more especially in the Erector Penis muscle. This was remedied by fre- quent shampooing, and pressing of their fibres till they acquired volume and firmness, the sams as any other muscle would do under similar treatment. This system was rigidly pursued for six months under my own inspection, at the end of which time the Penis was four inches long, when erect, and quite firm, so that coition was possible. At this period he was desirous to return home, and as he was evidently determined to pursue the same treatment himself, I consented to his doing so, though I would have preferred for him to have staid still longer. I heard from him eleven months after his departure, and he then informed me that the improvement had still continued till he no longer thought it necessary *o proceed. He was then intending to marry id about three months. The delight and gratitude of this young man were unbounded, rescued as he was from the very depths of despondency and despair 15 DISEASES OP THE PENIS. 155 and raked, as lie expressed it, to the highest pitch of human happiness." In the course of my practice I have had numer- ous similar cases, some of them resulting satis- factorily from the same treatment, and others requiring a different plan, which I will now explain. When the means above described fail to induce a sufficient flow of blood into the erectile Tissue an instrument is employed, called a Cone/ester. It consists of a tube, the size of which is adapted to the organ, to which is fitted an exhausting Air- Pump. The Penis being introduced into this tne air is more or less exhausted, and the blood of course flows into the contained part immediately. So great is the rush of blood, in fact, that if the ex. haustion was continued too far, or made too sud- denly, the Tissue would burst. In a short time, with care, the part begins to swell and look red, and erection, more or less complete, soon takes place. This never falls, unless the vitality of the part be totally gone, or the structure of the Tissues com- pletely disorganized. I have seen some of the most remaikable results follow from the use of this in- strument chat were perhaps ever witnessed, in a medical way. I have known patients in whom the whole organ was not half an inch long, and without the slightest tendency tther excesses, from mental anxiety and from tho effect of debilitating "disease. In a great port 7 ' en of these the result has also been favorable, though in many all vitality had left the organs before I saw them, and in others the structure was completely disorganized Many young men especially, vio DISEASES OF THE PENIS. ]C)J lirr? of Masturbation, whose organs had ceased growing, have by these means been rescued from »mpotency find imperfection, Many a man of ma- lure age also, whose powers were unimpaired, bu» who could not exercise them, owing to this particu- lar debility, has been restored to his former capa biiity in the same way. The Congester is not an instrument adapted fo/ self-treatment, and I would not advise any one to attempt its use without proper directions and super- vision. I have known it to do great mischief] with inexperienced people, and fail of accomplishing any ^ood. In one man who had it applied too forcibly and suddenly the cells were nearly all ruptured, or broken into one another, so that severe inflammation was produced, and the power of erection was for ever lost by any means. There are some means, however, that all persons may use, provided they know when they, are appro- priate to the case. The pressing and shampooing may be partially practised by the patient himself, though very imperfectly, but the general directions as to diet and exercise may be observed of course by all. Perhaps, however, there is no other functional disability so difficult to treat, or that requires sc much skill and such unremitting at- tention. In addition to the means already described there are some others occasionally useful, but which are not so generally applicable. Galvanism is some- times an excellent agent, when there is nervous in- sensibility combined with the other disabilities. A very good mode to use it is to galvanize the metallic congester, while the organ is engaged within it. The power must not be too great however, nor th>* 163 ASEASES OF THE PENIS. Application " v\iiitinued too long, or there will be*par« tial paralysis. The French have a practice of Flagellation^ which is sometimes very efficacious, and will induce erection in a short time. It is rather severe, how- ever, and few have courage or endurance suffi- cient to continue it long enough to derive full bene- fit. The Flagellator is made of six or eight small twisted thongs, about as thick as a violin string, but very flexible, and about eight inches long. To ope- rate with it to the best advantage the parts should oe made bare, and perfectly smooth, and the Fla- gellator must then be applied the whole length of the Penis, ana on the Pubes, Perineum, and inside of the thighs, till the flesh is quite red and smarts. The flogging must never be so hard, or long conti- nued, as to make any bruises, nor leave any soreness, but merely sufficient to make it red and feel hot, with slight smarting. Usually about a quarter of an hour is sufficient, every day. — After the flagella- tion the parts should be well bathed in hot water, and the patient should recline. This treatment may seem singular to those who never heard of it before, but it is undoubtedly more efficacious, in numerous cases, than any one could well believe who had not seen it practised. I have known many patients resort to it with the happiest results, who could not stay with me long enough for the usual treatment. — In some it will produce pow- erful erections the first time, and lead to an influx of blood to the parts that soon stimulates their growth. Firing is another practice that may be resorted to, if all others fail, for rousing the dormant energies of these parts in deficient growth. — It consists iv DISEASES OF THE PENIS. 1 63 burning the parts with a smooth iron button made hot by plunging it in boiling water. The parts are first made smooth and then the button is taken out of the water and pressed suddenly on, repeating it as fast as possible, till the whole length of the organ has been operated upon. No part should be touched twice, nor should the iron remain on more than an instant. The pain is very slight, and no blister is raised, the places only turning white at first, and afterwards remaining red. — The firings should be repeated only at intervals of three or four days, waiting till the effects of one are gone off before another is practised. This process is sometimes astonishingly effective, a single application producing such a powerful effect that no further treatment is required. — Care is re- quired, however, not to produce too much inflamma- tion, nor to operate too near the Teste? Sometimes the development will be much less on one side of the Penis than the other, or less in the Corpus Spon- gn<5iim than the Cavernosum, so that the organ will not be straight but cui ved ; or it may be straight in the ordinary state but not capable of erecting in all parts alike. This state of permanent chordee is perhaps better treated by the flagellation or firing than by any other means, because they can be ap. plied locally, and only to the affected part. It may perhaps be as well to remark here that a modification of the congester is sometimes of great service in certain torpid states of the female organs and that some of the other treatment is also occa* sionally applied to them, in a modified form, witfi the haopiest results. 164 DISEASES OF THE PENIS. PARALYSIS OF THE MUSCLES OF THE PENI3> I first observed this affection in the person of a patient, aged about fifty-three, having previously seen no account of it whatever. Since then I have met with other cases in persons of different ages, -hough always past thirtv. In the first case it was apparently the forerunner of general Paralysis, an attack of which was experienced some two months later, but partially recovered from. In other cases I have also regarded it as a sign that general Paralysis or Apoplexy was threatened, though i* did not always immediately follow. In this disease the secretion of the semen is not affected, nor is the flow of blood interfered with, the organ becoming as full and as firm as before, but there is no power to raise and direct it. The first case yielded in the course of a week to Galva- nism, and some others were alleviated by warm baths and stimulant lotions, but others again re- mained notwithstanding all that could be done. These were mostly old people, with an obvious pre- disposition to Paralysis. In some cases I have had reason to think that the attack was brought on by previous sexual excesses. PRIAPISM, OR INVOLUNTARY ERECTION. By this term is meant an unnatural and involun. tary erection of the Penis. In some persons it occurs only at intervals, but in others it is constant for a long time and constitutes a real state of dis. ease. Priapism is not always accompainitd by pleasurable feelings, though it usually is, but ou DISEASES OF THE PENIS. 1 ft*, the contrary it is sometimes painful. In some pe* sons it comes on suddenly, without any premonitory symptoms whatever, but in others it commences gradually, and is frequently indicated by a sense of fulness in the Testes, or of pain and heaviness in the head. The patient is utterly unnble to control the erection ir the slightest degree, nor in general can he by an means prevent it while the morbid state continues. I have known men who always suffered from this immediately they went to bed, so that their rest was much disturbed. In one young man especially the health suffered seriously. Every night when he had been in bed about an hour the Priapism would commence, and such was the effect on his nervous system that sleep was out of the question, while it continued. Very often for seve- ral nights together he did not sleep more than a single hour, and yet there was in general but little sexual feeling, and that only at first, the sensation afterwards being merely one of intense and harrow, ing excitement. The next day he suffered fron headache, pain and weakness in the back, and sore- ness in the organ itself. In no instance did he have emissions during these attacks, and this is a pecu- liarity I have frequently observed. The causes of this troublesome affection may be various, and sometimes can only be surmised. In many cases, especially among young persons in vigorous health and of perfect development, it results from an actual excess of semen, which first oauses Spermatocele, and then leads to a chronic in- flammatory condition, by whieh the erection is con stantly excited. This condition may exist in those who are not at all disposed to lascivious thoughts, End even in those who are constantly striving J6(j DISEiSES OF THE PENIS. against them, though it is of course made much worse by indulging such thoughts. Most common- ly in these persors the Priapism continues till an involuntary emiss.on takes place, and then it disap- pears for a shon time, till the semen has again accumulated in too great quantity. There are some, however, in whom th/-5e emissions never oc- cur, and in them the Priapism is frequently a constant state and becom* * eventually a real dis- ease. In the early stages marriage is of course the only certain and effectual remedy, though much mitigation may be effected by means that will here- after be pointed out ; but when the organs have become diseased or chronically inflamed, marriage would be highly improper till a healthy condition is restored. It is not always the case, however, that Priapism results from seminal accumulation, or superabun- dant energy, for ,t is sometimes experienced by those that are rainer deficient, or at least below the average. I have even observed it in those that were nearly sterile. In these cases it is induced by a diseased condition of the brain, and is usually considered a mere moral affection, though like many other moral affections it is simply an indication and consequence of physical disease. In this state! there is constant desire at fir«$t, sometimes amount- ing to furious erotomania, but eventually all feeling and desire will vanish, while the Priapism will remain, and sometimes even continue after death. Long-continued debauchery is also sometimes fol- lowed by obstinate Priapism, and eventually by absolute impotency. In the Medical Repository for April, 1824, is a case of this kind communicated by Mr. Callaway. The patient, during a fit of in- 16 DISEASES OF THE PEMS. 157 toxication associated with a female three v tir^es in succession, having emission each time, but no sub. sidence of the erection, a circumstance which I have often known to occur during intoxication. T© his great surprise the erection still continued the next morning, and it remained for sixteen days, in spite of all the means used to reduce it. The surgeon then made an incision with the lancet, just below the Scrotum, and immediately theie escaped a large quantity of thick black blood, mixed with clots. On pressing the Penis the blood all flowed out of it, by the opening, and it immediately became flaccid. The man was impotent, however, afterwards, for no erection ever took place again, owing probably to the cells of the Corpus Cavernosum and Corpus Spongiosum having grown up, from inflammation. The continued erection was probably owing, in. this case, to inflammation at the lower part of the Penis, or in the Perineal Muscles, owing to which the veins were so pressed upon that the blood could not return by them, or perhaps the veins themselves were swollen and closed up. Some men have brought on a similar condition of the parts by keeping them- selves too long excited, without allowing emission to take place, a practice which is very reprehensi- ble, and which not unfrequently causes Spermato- cele, or even Orchitis. If the erection be too powerful, or too long con- tinued, it will often cause temporary impotence by »o compressing the Urethra that the semen cannot traverse along it When" this occurs the semen either escapes afterwards, slowly, or els* 3 mixes with the Urine. Long continued priapism is always hurtful, and is very likely to destroy the power of erection alto* 168 DISEASES OF THE PENIS. gether, ultimately ; it is, therefore, desirable that we should know its various causes, and the b j sfc means of treating it. Persons who are not properly informed respecting its nature are apt to consider it as simply a result of loose thoughts, and that only a proper effort is required to overcome it. This is a great mistake, as we have a.lreadv shown, and one which leads both to the neglect of proper treatment and also to uncharitable judgments. In addition to the general causes of this affection, already enumerated, there are also several others that have a tendency more or less to originate or aggravate it. Want of proper cleanliness, hot clothing, particularly if it chafes, and the too fre- quent use of warm baths may be mentioned, and also several other diseases, such as gonorrhoea and spermatorrhoea. The Gravel and inflammation of the bladder also excite the penis very much in some persons, and the piles will do the same in others. Stimulating and highly-seasoned food, and hot or vinous drinks have the same tendency, and sleeping in a very warm soft bed is apt to assist. The use of bougies and injections will often produce pria- prism, and certain medicines still more frequently. Cantharides, Phosphorus, and Opium, perhaps act the most energetically in this way, but there are others whose effects are very decided, and they all act very differently at times and upon different per- sons. The reading of lascivious books, or listening to loose conversation, undoubtedly operates in a simi- lar manner to these physical agents, and the indul- gence of lying in bed of a morning, half awake, has the same tendency. The treatment of priapism must of course be regu- lated by the cause that produces or aggravates it. DISEASES OF THE PENIS \ fit) When it is mainly produced by a want of properly regulating the mind, or controlling the desires, the cure must depend entirely upon the individual's own self, or rather upon his strength of mind. When it arises • from a too stimulating diet and jrink, aided by a deficiency of muscular exercise, which is very often the case in yocng persons, nothing more is required than to live low, drink cold water, keep the bowers free, and. bathe the parts frequently with cold water. If there be a too great secretion of semen, with no sufficient involuntary discharge, marriage is indicated. If there be any other disease that must first be cured, and if there be heat and pain in the head, particularly in the back part, it must be frequently bathed in cold water, and kept cool, precisely the same as for in- flammation of the brain, of which in fact the pria. pism is only a symptom. During the paroxysm the parts may be bathed with warm water or a warm Enema may be given. Sitting in a warm bath is sometimes the bfist plan, or over hot steam. In ob- stinate cases Leeches may be applied to the Penis, or a vein may be opened in it, but one of the best remedies is to give sufficient Tartar Emetic to cause sickness ; this generally relieves the priapism. Two ordinary sized pills of Gum Camphor have been found efficacious in some persons, and simple fasting, till faintness ensued, in others. When the paroxysm is over strict attention must be paid to the diet, clothing and general conduct, as before indi- cated, to prevent a recurrence. I have had some patients with whom I have had to use various mechanical contrivances, to prevenS the priapism occurring at night, or while the cura >vie means were being employed. A simple band 170 DISEASES OF THE VENIS. age, drawn tightly round the organ when flaccid^ will often prevent the erection, but a better plan is to use two grooved pieces of wood, one of which must be placed above the penis and the other below so that they can be drawn together by a band, 01 screw. The organ can be compressed so tight!) by this machine, while in its ordinary state, tha erection cannot possibly take place. Several ot my patients were unable to sleep till provided witl an instrument of this kind. The longest period I ever knew an attack of pria. pism to last was six weeks, and that was in a mar- ried man. It first began during a short absence from home, and was kept up by the impossibility which he experienced, on his return, of discharging the semen, owing to the swollen and inflamed state of the parts. He suffered from spermatocele, and slightly from orchitis, and was further troubled by violent desire, which he was unable to gratify. Connexion was possible, but without emission, and consequently without gratification. I was much afraid, from the violence of the attack, and from the symptoms, that permanent impotence would follow, but by careful treatment, p^rseveringly attended to, be completely recovered. I knew one instance in which priapism followed a blow on the head, from which the person died, and it remained after his death, the parts being sj firmly congested, and so rigid, that nothing had any effect upon them. — In several instances I have known priapism follow the application of blisters to the neck and back, even in young children, a fact that should not be lost sight of, either by physicians •r parents. 16» DISEASES OF THE PENIS. 1 T 1 DISEASES OF THE URETHRA AND THE PARTS CON TUNED THEREIN. The Urethra, as before explained, is a long canal passing from the bladder down the penis, for the purpose of conveying the urine out of the body, and also for conducting the semen, it being the common passage for both fluids. The membranous walls of the Urethra are rather thick, and are elastic, and the interior is lined with a mucous coat similar to that inside the bladder. The size of the urethra is different in different parts ; ihus a little way in from the external opening, or meatus urinarius, it expands considerably, and then contracting again expands still larger at about two- thirds of its length down. The substance of which the walls of the urethra are composed appears not to be the same in its whole length, being membra- nous in some parts and in others spongy, almost like the Corpus Spongiosum. It therefore participates in the act of erection, and its concurrence is very essential to the proper emission of the semen. Where it first opens at the neck )f the bladder it is wide, but drawn together by ( ertain muscles, excepting when the urine is evacuated, when the muscles relax and allow it to open. It is not by the drawing together of the walls of the urethra alone, however, that the urine is prevented from escaping, but partly by the presence of the Veru Montanum. By refer- ring to the plate of the situation of the male organs the position of this part will be readily understood. It is a email fleshy protuberance placed on the lower wall of the urethra, just where it opens from the bladder. In snape it is like a cone, with the smai? ]72 DISEASES OF THE PENIS. end pointing towards the end of the Penis. Tha neck of the bladder closes around this little protu- berance while the urine is retained, but during eva- cuation it relaxes and opens a little and the fluid then passes on each side of the Montanum, which thus acts a similar part to the stopper of a bottle. Many cases of incontinence of urine arise from irritation of the Veru Montanum, which becomes so tender that the neck of the bladder is kept con- stantly open to prevent pressure upon it. This irritation may arise from various causes, but most usually we can only guess what they are. The mode of subduing it is simply to use general means for subduing inflammation, such as are suitable for all the neighboring parts. An irritating quality of the urine is very apt to give rise to it, particularly when very acid, and then it is readily corrected by- taking a little Carbonate of Soda every morning before breakfast, and drinking freely of gum arabic water. — I had one patient who suffered terribly from this cause, without knowing, till explained to him, what it was. Immediately the smallest portion of urine was secreted in the bladder it felt as if a piece of red hot iron was placed in the neck, and all command over it was instantly lost, the urine escaping in spite of all his efforts. The smarting, burning, and pricking sensation he described as most horribly torturing, without there being any appa- rent possibility of relief. He had been told by some practitioner that it was stone in the bladder, but I felt assured, after careful examination, that it was inflammation of the Veru Montanum, and advised him accordingly. I prescribed hot fomentations of Poppy Heads, on the pubes and perineum, wuh Leeches also on the Perineum, and inside th* DISEASES CF THE PENIS. Ifg Thighs. Internally I directed him to take the fol« loving powders with a dose of Castor Oil every evening, and to drink plentifully during tne da/ of Barley Water. H. Dried Leaves of Uva Ursi, or bear berry, one and a half drachms ; Bicarbonate of Soda, one drachm. To be mixed togetner well, and divided intc twelve powders, one of whicn to be taken three tunea a day, in the Baney-water. The eifect of this treatment was evident on ute second day, the inflammation having subsided con- siderably, and by tne third day he was quite well, with the exception of a little soreness when urinat- ing. Inflammation of the \ eru Montanum is also very apt to be produced by retaining the Urine too long, when the bladder is very lull, and particularly by trying to prevent the escape of semen, during coition, which is sometimes done by pressing; the Penis at its lower part. The effects of this practice, which is often resorted to under the idea of prevent- ing conception, are most serious ; in addition to the inflammation already referred to, it also leads to in- voluntary seminal losses, as will be explained further on. Such .destructive practices would never be attempted if men were not so thoroughly igno- rant of everything relating to their physical system, and while that ignorance remains it will always cause more disease than medical science will be Able to cure. The Veru Montanum is also ver\ apt to become diseased whenever the Prostate Gland is affected, the two parts sympathizing so intimately together. The semen enters the Urethra just at the lowei 174 DISEASES OF THE PENIS. end of the Veru Montanum, by two small openings which are very liable to be more or less cLsed when this organ, or the Prostate is inflamed, ana/ thus tne flow of semen is partially and sometimes totally prevented. Sometimes the Montanum will swell till it conv letely fills up the neck of the bladder, so that fteithei urine nor semen can possibly escape till it has been reduced. It is also liable to be the seat of Cancer or Scrofula, like the Prostate. The Urethra is liable to Congenital Malformations as well as to subsequent accidents, and some of these may be of a serious character. In some young persons it is permanently contracted, so that the escape of urine is attended with great difficulty and pain. This fault, however, usually amends with the growth, and with constant use. Children so circumstanced are a very long time in discharg- ing their urine, which flows in a small stream, and with more or less distress. In very severe cases bougies may be used to dilate the passage, but it is better, if the trouble is not too great, to wait till towards puberty, and see if nature herself will not eifect an improvement. Still more rarely there are found Congenital Strictures, or they come spon- taneously, without any apparent cause. If these are not very bad it is perhaps, better to wait till fourteen or fifteen years of age, before operating, as he changes in the system at that time are very ?;reat, and an improvement may occur naturally, f they are too severe, however, or endure beyond that time, it will be necessary to use the bougie, which is in reality trie only effective remedy in such cases. Many youths cause stricture b\ com. jessing the Penis in Masturbation, and bruising the DISEASES OF THE PENI3. 1 7o Urethra. I have known many do this to prevent ihe semen from escaping at the moment of ejacula- lion, from the notion that if this was done the prac- tice would not i?ijure them. It is of course unneces- •ary to show the fallacy of such a notion, but it may be advisable to explain what becomes of the seminal fluid in such cases, because very often not a particle is seen. At the moment of ejaculation the semen escapes by jets into the Urethra, from the ejaculatory canal, through certain small openings, called the ejaculatory ducts — which are shown in the plates — and then flows down the canal and escapes from the body. If, however, the Urethra is compressed, so as to prevent it from escaping exter- nally, it must flow in some other direction, and the only other way is into the bladder, which it enters by forcing open the neck and passing on #ach side of the Vera Mountanum. It is then expended as much as if it had left the body in the natural man- ner, as it comes away with the next flow of urine. In the mean time its presence irritates the bladder, and its passage in this reverse way is very apt to cause inflammation in the Veru Montanum and Prostate Gland, and even to produce stricture, as before explained, with a weakness of the ducts dis- posing to involuntary seminal losses. The Urethra is also unusually irritable in some persons, without any particular disease, and burns a?nd smarts when they urinate as if there were Gonorrhoea. Some men, arid even some children, have more or less of this troub e, either constantly or at times, and suffer from it considerably. It will generally be observed in such persons that the urine is high colored, and deposits a reddish or yellowish sediment,, on being allowed to stand, l16 DISEASES OF THE PENIS. indicating eifuer gravel or chronic inflammatioa of the bladder. The best treatment is that given for inflammation of the Veru Montanum, furthei back, and the best preventive is to pay strict atten- tion to the diet and drink. Nothing should be eaten or drunk that is heating or stimulating, or that ia likely to pioduce constipation, which always aggra- vates these troubles. Spirituous and fermented liquors are very bad, and coffee is usually injurious. The best drink is Soda-water, Barley-tea, Gum Arabic-water, and Mucilage of Sassafras pith, or Bene Plant. A little Carbonate of Soda taken every morning is a perfect preventive in some, and a little Magnesia in others. All excesses must be carefully avoided, and the bowels kept constantly free. A frequent warm-bath is nearly always bene- ficial. % Many of the diseases of the Prostate Gland, and many of the operations upon the Penis, are frequent causes of stricture and inflammation of the Urethra, and they therefore require, on that account, the utmost care and attention. It is not unfrequently the case, in unskilful hands, that after a perfect cure of one of these diseases, a stricture is left that is a worse evil than the original one. THE PROSTATE GLAND. The uses of this Organ, like those of the vesi cles, have not yet been satisfactorily determined. It was formerly thought to be a simple Gland, intended to secrete a peculiar Liquor which was necessary to mix with the semen. This view, however, has been lately somewhat modified, and it is now considered to be rather a collection of several glands BlSEXSiiS trf 1HK PENIS. 17*! or follicles, forming one mass or organ together. These utile follicles secrete a peculiar whitish fluid, vrhich is conveyed by a number of small ducts into the Urethia, close by the Vera Montanum where the semen enters. It is probable that this fluid is, in some way or other, essential to the perfection of the semen as it leaves the body. The Piostate Gland is liable to several forms of disease, some of which are both painful and dan- gerous, and all of which, unfortunately, are but little capable of treatment. It seems specially liable to engorgment, or swelling, and to scrofulous and cancerous indurations. Sometimes also it becomes cartilaginous, or even almost bonv, and at other times calculi or stones form in it, similar to those found in the bladder. — Inflammation and abscess of the Prostate Gland is very apt to fellow improper treatment for Gonorrhoea, particularly where bou- gies or injections have been used, and it is also s frequent consequence of cauterization for curing involuntary seminal losses. Blows on the Fen- neum may also give rise to it, or too severe and long-continued pressure, from horse-riding, or using a hard seat, or even from very light small clothes. This trouble is both an annoying and a serious one, and frequently excessively painful. When the Prostate is simply swollen it merely causes a sense of fulness and uneasiness in the Perineum, with difTiculty in urinating or discharging the semen ? arid in passing the bowels. The reason for these impediments will be evident when the situation and connections of the Organ are borne in mind. The smallest increase in the size of the Prostate makes it press on the Urethra and partly closes it, so that &e flow of urine is necessarily obstructed, and the 1 78 ftfSEASES OF THE PENIS. orifices of the Seminal Tubes being also compressed, the flow of semen through them is similarly inter- cepted. In very severe cases a total stoppage of both urine and semen occurs, which if not relieved may lead lo inflammation of the Bladder and Tes tes of the most acute and dangerous character When this stage has been reached the pain and su& fering become most intense, and if the inflammation and swelling is not speedily reduced an Abscess forms which eventually breaks and discharges its contents, when some little relief is obtained, though the disease has then assumed a much more annoy- ing form, and is more difficult to treat. If the abscess breaks internally there is a continual flow of pus or matter from the Urethra, attended by se- vere smarting and pain when the unne or semen is passed, and by. a constant irritation in all the neigh- boring parts, which acts on the nervous system in the most distressing manner. Occasionally the ab- scess breaks externally in the Perineum, which is, if possible, still more troublesome. Thti pus keeps flowing in the same manner, only not from the Ure- thra, and the same constitutional irritation is expe- rienced, but the pain in urinating is not aiwavs so great. The treatment of this trouble must depend upon the stage at which it has arrived, and the causes that produced it. While there is simply slight swelling and inflammation from bruises or blows, every means must be taken to remove it as speedily as possible. The patient must keep perfectly still, lying on his back most of the time, while fomenta- tions of hot water, with laudanum, are freely applied to the Perineum, or flannels dioped in the hot fluid may be placed between the linat» and pressed up DISEASES OF THE FENIS. ] 79 against fhe Perineum, changing them frequently, and using them as hot as they can be borne. The bowels must be freely moved with Castor Oil and the diet must be light and unstimnlating. A very good practice is for the patient to sit in not water, for half an hour at a time, or over the steam of it. — These means persevered in, when the uneasiness and diffi- culty is first felt, will often subdue the inflammation and prevent any further evil consequences. A ge- neral warm bath, during which hot Teas are taken, to promote perspiration and the flow of urine, are also of great service, and when the bruise is very bad, as shown by blackness 'of the skin, Leeches must bo? applied, either on the Perineum or inside of the thigns. If the inflammation be of a chronic form, not produced by any external violence, tne uest appli- cation is the Mercurial Ointment rubbed on the Peri- neum till it produces a decided effect on the system. Along with this may also be taken the solution of Iodide of Potassium, prescribed in Hydroce : e, the bowels being kept regularly open with Salts or Castor Oil. Cold Lotions must be frequently ap- plied of Alum or Sugar of Lead, and no spices or alcoholic liquors must be taken on any account. Sexual excesses are particularly hurtful in this complaint. Very many incipient attacks of inflammation of She Prostate might be cured in this way, and the swelling dispersed, if proper attention were paid to the diet and strict temperance practised in all things. Most frequently, however, this trouble continues, and either forms an abscess or an indolent Tumor, which every now anc then enlarges go much that 180 BISEiSES OF T1I3 PENIS. the flow of semen and urine is entirely stopped, causing intense suffering, and a palliative operation has to be performed to give relief. Many patients suffer from regular periodical attacks of this kind, and in others they come on always after any little extra bodily exertion or mental anxiety. In these cases the use of purgatives internally, with cold lotions and Belladonna or Hellebore Plasters exter- naiiy, will frequently mitigate the severity of the pain and cut short the attack. A grain of Opium may also be taken, when the suffering is most in- tense, or thirty drops of Laudanum, in some Gum Arabic- water. The" Ointment of Belladonna and Camphor, prescribed in inflammation of the Tes- ticle, will also frequently be found of great benefit, and manv experience decided relief from leeches to the Perineum and thighs. The nature of the operation to be performed, in any extreme case, de- pends upon the peculiar circumstances attending it, and must be left to the judgment of the physician. The internal application of caustic is practised by some, and others use the lancet freely, but there in both risk and difficulty in both At the very com- mencement of the difficulty it $s sometimes possible to introduce a catheter without much trouble, and this may serve to keep the Urethra opexi while the other means are employed to reduce, the inflamma- tion. The catheter, however, is not admissable when much force is needed to introduce it, nor when it increases the inflammation. One of the most reliable proofs of swelling of the Prostate Gland, when the Tumor cannot be felt externally or in the rectum, is the impossibilty of passing a catheter, owing to the enlarged Prostate having blocked up tbt Urethra. DISEASES OF THE PENIS. 1 g [ Inflammation of the I'rostate Gland may termi. lie in induration or permanent hardness, and also in mortification, as well as in abscess or dispersion. Wi.en mortification ensues it is of course exceed, ingly dangerous, if not necessarily fatal, and we nave no known remedy to cure it. The induration will sometimes exhibit a decided Scrofulous ten- dency, and pursue the same course as Scrofulous Testicle, and at other times it will become perfectly cartilaginous or bony. Wnen calculi or stones form in the Prostate it is sometimes possible to cut them out, when their pre- sence is so evident that there can be no mistake, but this is very seldom the case. Like most other dis- eases of the Prostate the indications of this are so obscure that its precise s^at and nature in most cases can only be obscurely guessed at. Sometimes the stones will be discharged, by way of the Urethra, and relief immediately follow. Warm bathing and fomentations probably tend ta facilitate this mode of escape, by releasing the parts. I have known persons who had long suffered from all the usual symptoms of enlarged Prostate be perfectly relieved after voiding a few calculi, sel- dom larger than a pea. Amoiiv* other means of obtaining relief ocea* fionally successful, in Prostatic enlargement,, I may mention injecjtions in the Rectum of cold thin starch and laudanum, frequently repeated. Galvanism I have also tried, and in some cases with marked success. Chronic enlaige^^.t of the Prostate Gland is rather common amongst old men, pa^'icularly those who have led a sedentary life or been addicted to sexual excesses. !** CHAPTER VI FUNCTIONAL AND SYMPATHETIC DISEASES Of THE GENITAL ORGANS. This is a part of our subject of the very first im- portance, and yet beset with such numerous ana peculiar difficulties that precise knowledge about it is extremely difficult to obtain. In regard to many things of the greatest moment, connected with man's virile powers, but little or nothing is known, even by medical men, who are, generally speaking, taught nothing about them in their early studies, and have but few opportunities of learning afterwards. Dr. Curling remarks, when speaking of the Testes, " Their functions are so involved in those of othei parts, are influenced by such peculiar causes, and are so dependent on nd modified by particular events and circumstances, that the investigation of them, when disordered, necessarily becomes of a complex and difficult character. The product too, of these glands, is one, the qualities of which it is almost impossible to appreciate, and which during life is never afforded in a pure and unmixed state ; and further, taking into account the repugnance felt to such inquiries, it is scarcely surprising that the subject has been but imperfectly investigated, and rarely treated of by the pathologist and practitioner^ Indeed the little information we possess respecting it is chiefly to be found under the head Impotencv. in works on medical jurisprudence, in which it is cursorily considered, principally in i elation to points 17* SYMPATHETIC DISEASES. 188 iyf medico-legal interest, and scarcely at all in re- feience 10 practice." • This is strictly true, and it will. I dare say, sur- prise many persons to learn that physicians, gene- rally speaking, know little or nothing about such matters. Such, however, is the case, as is well known to those who have occasion to apply to them, either for advice or information. I have found it absolutely necessary to set out in my investigations, on many important points, as if nothing were known, and hunt out the requisite information by the tedious but sure process of actual experiment and- extended observation. Very many of the statements made in this work will probably surprise those who see them for the first time, owing to their noveky, and to their variance with old notions. None of these statements have been made, however, without good and sufficient evidence having been obtained of their correctness, while the old notions with which they conflict are merely suppositions and assumptions utterly destitute of any foundation whatever. This is especially the case in regard to the functional and sympathetic causes of Impotence, and also its medical and moral treatment, which may be truly said to be, nearly invariably, of the most quackish character, even when practised by fhe most eminent medical men. The notions of non- professional persons, respecting such things^ are frequently as correct as those of their medical advi- aers, and their own empirical treatment is often the most successful. It is but very recently that the true action of many powerful medical agents on the Generative Organs has been ascertained, and 1 as- sert, without hesitation, that very many practitioners, some ^ven of considerable celebrity, are as truly £34 SYMPATHETIC DISEASES. ignorant in regard to it as the patients tney under- taKe to treat. in pursuing my own investigations into these im-« portant and interesting subjects, I have left no means of acquiring information untouched. Besides studying and experimenting, as far as was proper, in thousands of cases that came under my notice professionally, I have fully experimented upon hundreds of animals, to the utmost extent that humanity would allow. By these means } have ascertained many important facts, and studied the action of many powerful medical agents which could not with propriety and safety have been tried upon human beings first. Functional or sympathetic disability of the Re- productive Organs appears in two forms, hnpotence and Sterility, which are frequently, but erroneously, confounded together. Sterility means a total absence of the Reproductive principle, and mus? always be accompanied by impotence or inability to associate with the other sex, except temporarily in certain peculiar cases ; but a man may be impotent without being sterile. Absolute sterility is generally incurable, because it arises from de struction or disorganization of the Testes, and it is therefore only in the way of preventing the evil, by removing its causes, that we can do any good, but impotence can very frequently be cured, as well aa prevented. Besides impotence is the more frequem affection, and is often merely the forerunner or firs! 6tage of sterility, and it becomes therefore the mos* important subject to consider. The various kinds of deformity, deficiency, and acute disease that cause destruction of ihe genera. tive power have already been fully treaunl upon SYMPATHETIC DISEASES. ] 8f> and we have now only to explain those mysten« ous sympathetic and functional agencies, which, though they are often more powerful, are yet so dif- ferent in their operation, and hitherto so little studied, that but little is generally known respect- ing either their nature or mode of action. This* will be fully apparent in our very next article. INFLUENCE OF THE BRAIN ON THE GENERATIVE POWERS. ' In a former part of this work a number of in stances were narrated in which impotency followed injuries of the head, and we will now narrate a few others, because this is a most important fact, in many respects. About five years ago [ was consulted by a mar- ried man who had totally lost his sexual powers from striking his head against a beam. The blow had stunned him for a time, but did not lead to any serious symptoms afterwards. He found, however, in two or three days after that he was perfectly im- potent, and had so remained for eighteen months svhen 1 saw him. There was but little loss of de- sire, with no wasting of the Genital Organs, nor any other indication whatever of his deprivation. He had previously been a man of temperate habits, and at the time of the accident was as vigorous as most men. The blow, it may be as well to remark, *vas received on tne top of the head, and was not fol lowed hy any swelling or pain in the Cerebellum or ueck. When I saw him he was m perfect health, and in good spirits, in fact nothing was complained v4 but this unfortunate impotency, which he was they desirous of having removea. 186 SYMPATHETIC DISEASES. The great point was to ascertain, if possible, in what way the concussion of the brain had suspended the transmission of nervous power to the genitals, and how it could be restored. I recollected that ia several cases where injuries to the head had para, lyzed particular muscles, or limbs, their power had been restored by Galvanism, applied so as to pas? along the course of their Nerves from the spine. It seemed to me as if the blow had impaired the proper connexion between the spinal marrow and these nerves, at their roots, and that the passage of the electric current in some way or other restored that connection. It was similar in fact to starting the Electric Telegraph again by mending the wires, or making the connections perfect, after they had been destroyed by violence. I therefore applied the Galvanism, passing the current from that part of the spine where the Spermatic Nerves originate to the pubes, perineum, and neighboring parts, ap- plying also a stimulating liniment, and occasionally using the congester. The result was highly satis- factory, and speedily obtained. At the third appli- cation he experienced a decided tingling about the perineum, and along the penis, and the next time a partial erection occurred. After persevering for five weeks, using the Galvanism daily at first, and then every other day, and finally but twice a week, he was fully restored, without any apparent tendency to a relapse. In this case it will be observed that the injury was not received at the lack of the head, on what the Phrenologists call the Organ of Ama- tiveness, but at the top, nor did it in any way what- ever affect the cerebellum. In another similar instance Impotency, with com- plete loss of desire a so, followed a fracture of th« SYMPATHETIC DISEASES 187 gkull over the left Temple and no me^ns that wew used had the slightest effect in restoring it. In a few montns the Testes began to waste, and even- tually almost totally disappeared, but the general health was only slightly affected. In the American Journal of the Medical Sciences, for February, 1839, Dr. Fisher relates a curious instance of a gentleman injured in a railway car. He was looking out at the moment when a colli- sion occurred, and the shock threw the back of his head against the edge of the window with such force as to stun him ; he however recovered his senses and was taken home, but suffered great pain in the back part of the head and top of the neck. His right arm was numbed a little and some diffi- culty was experienced in passing the urine, but in two weeks he was able to walk out with no other inconvenience than a slight dimness of sight. About the fifth week he discovered that he was impotent, and had lost all sexual desire. The means used to restore his genital powers were only partially suc- cessful, nor was his memory so perfect as before, but all the other difficulties disappeared under pro- per treatment. In the Lancet for August, 1841, is an account of a medical student who received a blow on the face, in a quarrel, which knocked him down so that he fell on the back of his head. He was totally un- conscious for eight or ten hours, but gradually re- covered, and on the following day even resumed his studies which he continued unremittingly for the next six weeks. He, however, became exceedingly irritable, with a feeling of general uneasiness, and after the first week he observed the genital organs begin co waste, and desire to weaken, till he finally 188 SYMPATHETIC DISEASES. became nearly impotent, but afterwards recover**! under proper treatment. Many instances have been observed of soldiers being wounded in the head and suffering afterwards under the same disability, some of which were given in a former article. It is perhaps proper to remark, however, that this is not the only nor even the most frequent result of .such injuries, as many patients bo hurt suffer no deprivation of their genital powers but have some other function impaired. Thus some lose their sight, some their hearing, and others be- come paralytic in their limbs. The prospect of recovering the sexual powers w-hen lost from injuries of this kind is very small, especially if the parts have really begun to waste. The treatment at first must be that best calculated to subdue the irritation which is probably exist. ing in some part of the nervous system, and after- wards, if requisite, to rouse the spermatic nerves to more energetic action. Every case, however, will require something peculiar to itself, which can only be discovered by a patient and careful attention to *ll its symptoms and indications. A further corroboration of the facts above sta;^d may also be found in certain physiological induc- tions observed in those who have died from strangu- lation. It is well known that in very many men who have been hung, erections and even seminal emissions have occurred, and experiments upon animals have often led to the same result. This is attributed to the pressure of the rope on the back of the head, which in some way or other excites the spermatic nerves. I have even known pressure made on that region purposely, in a particular man- ner, in order to excite erections, and frequently vdti SYMPATHETIC DISEASES. \%$ perfect success. Some of the females in ilie Turk. ish Harem? understand this, and they habitually chafe, or shampoo, the back of the neck of their companions of the other sex, for this very purpose. I have frequently made an application of this im- portant fact in my practice, in cases wh^re there pras merely a suspension of that sympathetic influ- ence which the brain ordinarily exerts upon the jexual organs. The particular mode of doing this, though well understood to eminent medical men in the old world, is I believe totally unknown here. An explanation of the process, and the apparatus employed, would require to be extended beyond the limits of the pre- sent work, to make it practically understood, and as after all it would not be available for the patient's own use it is net necessary to enter into it. I have often astonished persons both by its singularity and its unexpected effects. A full consideration of all the facts and argu- ments bearing upon this influence of the -brain over the sexual functions, have left the subject, so far aa [ am concerned, in great obscurity. That a singu- lar influence is often exerted by the brain in this way, sometimes benefically, and at others the re- verse, is undoubted, but whether such influence emanates from a particular part of the brain, or from the whole organ is uncertain. The Phrenoio- psts affirm that only a particular part of the Encephalon is concerned in this phenomenon, name- ly, the lower part or Cerebellum, which rests upon the spkial marrow. But after a careful consideration of all the reasons brought forward in support of this affirmation I am oot yet convinced of its correctness. That many 190 SYMPATHETIC DISEASED. facts favor such a theory I am willing to admit, twt it is also certain that many others militate agains/ it, and as a searcher after truth I must consider everything that bears upon the question, even though opposed to my previous opinion. I set out with firmly believing that the Cerebellum was the organ of the sexual propensiy, and my investigations have made me doubt it. It is not true, I am convinced, that the strength of a man's sexual propensity can be estimated by the development of his Cerebellum, nor is it true in regard to animals either. If it were so we ought to find that organ largest in those who exhibit the propensity most, and in numerous cases it is not so, though in others it is. A celebra- ted German physiologist made some investigations bearing on this point of a very interesting charac- ter ; he had numerous opportunities of dissecting horses, and curiosity induced him to weigh the Cerebellums of these animals, some of whom had been castrated when young and others left entire. Now if the Cerebellum be truly the organ of Amativeness it ought of course to be largest in the entire horses, who have always exhibited that pro- pensity, and we should expect to find it almost dis appeared in the others, seeing that they could never have felt anything of the kind. The result of the experiment was, however, on taking the average of an equal number of each, that there was scarcely any difference, or if any at all the castrated ones had the largest Cerebellums. In observing idiots also, some of whom were notoriously licentious, and others directly the reverse, I have not found that the development of the Cerebellum corres- ponded to the phrenological system. Neither can it Se contended that the size of the Cerebellum* iu the *8 SYMPATHETIC DISEASES. ]C\\ cast/ated animals was only the result of disease, fci no difference could be detected in it between them and the others. All that can be said therefore is lhat certain agencies acting on the Cerebellum Mometimes cause sexual manifestations, and at other check them. The same agencies also acting on other parts of the brain will sometimes produce the game results, and sometimes when the Cerebellum is acted upon it is not the Generative Organs that are affected, but the sight, hearing, or speech, which might therefore just as properly be considered under its exclusive influence. It should also be stated, as bearing on this sub- ject, that certain influences operating on various parts of the body will often affect the Generative Or- gans in a decided manner. I have known a blister on the leg cause the most uncontrollable sexual desires in one man, and the application of caustic to the throat do the same in another. In applying blisters to the top of the neck also, though it is followed by erections in some, yet in others no such effect takee place, and occasionally it will produce a nervous twitching, like St. Vitus' Dance, in the arms. Flogging the back, it is well known, will frequently ?ause erections and emissions, even when very severe, as has often been observed in soldiers when undergoing that brutal punishment. Rousseau also tells us, in his confessions, that flogging boys at school, in the disgraceful manner formerly prac- tised, is sometimes followed by similar results, and he remarks that the pain of the punishment may be forgotten under the powerful excitement it leads to, a fact of deep moral importance. In short there seems every reason tc believe that the strength of Ihe sexual propensity is dependent upon some pecu* 192 SYMPATHETIC DISEASES. larity of the sexual organs themselves, though it may be often modified by various mysterious sym- pathies emanating from other parts. If the semen be never formed, there will never be any sexual de- sire, and if that fluid be abundant the propensity to discharge it will be proportionally gieat, indepen- dent of all other influences. In those who feel de- sire without having anv semen, as is sometimes the case in impotency, or even after castration, it is oriiy the remembrance of a lost pleasure. In treating disabilities of the Generate Organs, however, the possible influence of injuries to the head, even at former periods, and long ago, shovild always be borne in mind. INFLUENCE OF THE MIND OVER THE GENERATIVE ORGANS. It is a fact not generally known that the mind can exert an influence over the Generative Organ* of a most decided character. Not only can desire be engendered or annihilated by mental impressions, in despite of all other conditions, bui the actual growth, or development of the organs themselves can be retarded or accelerated by the same means. I have known men who never felt sexual desire, and whose organs were very imperfectly developed, until a late period of life, and then quite suddenly the long -suppressed feelings were experienced, and the parts began to grow, simply from the stimulus ol seeing some person of the opposite sex who was adapted to make the proper impression upon their minds. Such instances are, indeed, by no me&hs rare, as every person of experience must know, and ihey piove that, in many cases at least, a certain SYMPATHETIC DISEASES 193 impression must be made upon the mind oofore the mere animal feeling can be experienced, or the pnysicai development take place : or, in other words, they prove chat with some persons there are only certain individuals of the opposite sex who can call forth those fec'ings in them, and that if they never meet with these individuals it is probable that such feelings will never be experienced, or at least only to a slight extent. A knowledge of this fact will often explain to us many of those distressing cases of indifference and dislike to be met with between parties, and will also be a valuable guide in giving advice, particularly in those instances where there is only apparent impo- tence without any real deficiency.. There seems to be good reason to suppose that the sexual instinct is materially dependent upon a particular part of the brain, though we cannot tell what part it is> nor whether it is a mere develop- ment of it that is needed or some peculiarity of structure or organization. It is .not at all uncom mnn to find men perfectly organized, m every re- sf.ect, with vigorous minds, and with every other faculty in full play, but yet almost wholly destitute cf desire for sexual enjoyment. In some of these cases it is true the Generative Organs are small, or evidently inactive, but in others they are of full average development, healthy, and active. In such uaaes we can only account for the singi lar indiffe- rence exhibited by supposing that the part of the Brain which regulates the reproductive instinct has dol had sufficient power, or else that the proper object has not yet been presented to the senses, as before explained. Besides this particular influence the Generative g*)\ SYMPATHETIC D SEASE5. Organs can also be much affected by the general action of the Brain and nervous system, the same as all the other organs. Thus if a man exhaust most of his nervous energy in thinking or in mus- cular energy, the other functions, including the ge- nerative, must be proportionally weakened. I have met with many instances of this among men of bu- siness, many of whom would become quite impotent when more than usually absorbed in their pursuits, and regain their powers in a short time after their care and anxiety were lessened. The following c&be of this kind I select from my note-book as bei^g more than usually instructive. The patient, a young man of twenty-eight, had been married three years, and had o»e child ; he was very fond of his wife, and she in return reciprocated his affection. He had never been addicted to excesses or abuses of any kind, and until about six months before I saw him was in the full enjoyment of his generative powers. About that time, however, he experienced a sudden -and severe loss in his business, which had previously been very prosperous, and the care, anx- iety and incessant exertion he underwent, in endea- voring to extricate himself from his embarrassments, brought on various physical and mental troubles that he had never before experienced. Among the rest he found himself perfectly impotent, having completely lost both pov/er and will. This dis- tressed him very much, both for the loss itself ano also from apprehension that it was the beginning of general decay. In this dilemma he came to consul) me, and was exceedingly anxious to know my opi- nion as to the prospect of his ultimate recovery. After a careful examination I felt convinced that there was ao actual loss of power, but merely a 18* SYMPATHETIC DISEASES. 195 temporary absence of the requisite nervous stimu« lus. owing to the excessive mental labor and anxiety he h.ad undergone ; I therefore inquired as to his future prospects, and was gratified to learn that he was now quite relieved of his difficulties and was beginning to regain his usual health and spirits On learning this I unhesitatingly assured him tha in a short time his generative powers would return, and more especially if he could abandon all care and thought about them. I gave him a slight sti- mulus, and some general directions as to diet, exter- nal treatment and exercise, and arranged to see him twice a week. In one month afterwards he was as well as ever, though he had been for nearly seven months as impotent as if the organs had been totally destroyed. — I have also frequently had business- men remark to me that they were liable to expe- rience more or less deprivation of sexual power, and to feel much less desire, at those periods of the year when trade was most active, and their minds in consequence more absorbed. An author also told me that when writing any very particular part of a book, or when anxiously expecting the criti- cisms of the press after its issue, he was always for a time perfectly impotent. In the lives of several severe students we have further corroboration of this fact, many of them having been remarkable for their coldness and incapacity, particularly those en- gaged in absorbing abstract studies, like the Mathe- inatics. Sir Isaac Newton is said to have never known sexual ardor, though in every respect a per- fectly-formed man, and it is probable that this was in a great measure, if not entirely, owing to his in- cessant and all-absorbing studies. In short there is ao question but that intense mental occupation less* lytf SYMPATHETIC DISEASES. ens sexuai ardor in most persons, and that it may sometimes even extinguish it altogether. This is a fact of considerable importance, both medical, and moral, and one that should be more fully considered than it has lithe rto been. There is no doubt but that a great part of the licentiousness which exists, particularly in youth, is in a great measure brought about, or at least made much worse, by mental and bodily idleness. If the mind is not occupied by some proper and congenial study, that will pleas- ingly engage it at every leisure moment, a habit will soon be formed of indulging lascivious thoughts during such vacant periods, and if at the same time a due proportion of the vital energy is not absorbed in physical exertion, the sexual organs will soon become so constantly and intensely excited that such thoughts will become paramount over all others. I once pointed out the philosophy of this to a gentle- man who came to consult me both for himself and for his son, aged seventeen. The father was nearly impotent from intense occupation in business, and the son was nearly dead from constant licentious- ness and intemperance. I found on inquiry that the young man had been brought up as a gentleman^ and was not even expected to employ himself with anything useful, in consequence of which, from mere idleness, he resorted to licentiousness and drinking as a regular occupation, till he waa scarcely capable of anything else. Moral suasion was utterly useless to effect a change, and habit was too strong for the fear of consequences to break through, so that it seemed as if nothing could be done but abandon, him to his fate. His father bit- terly deplored the condition of his son, and earnestly emreate 1 me to give him any information 1 thought SYMPATHETIC DISEASES. | '/7 (ikely to be of service in preventing simi.ai misfor. tunes to his younger brother. On explaining to him how the sexual pouer and propensity is influenced by a proper exercise of ti?« rest of the system, the philosophy of his own and his son's condition was immediately apparent. " Yes," exclaimed he, " I have exhausted myself by over-exertion, and at. the same time, I have left wy son a prey to his licentious desires merely from idleness. I now see plainly enough that had pan of my Durden been laid on his shoulders it might have saved both, but from mistaken kindness, and false pride, I condemned him to a life of inactivity. and consequent depravity, and myself to a drudgery that has left me a mere ruin of what I was." Now this is a case instructive to all, and there are many others in society precisely similar. Certain feelings are also very influential over the generative functions, but only temporarily, or with particular persons. Thus some men have found themselves suddenly impotent, with certain females, merelv from disgust at something that was un- expectedly displeasing in them, and others have experienced the same difficulty from the fear of discovery or infection. Some men will experience a intal loss of power on finding their companions too coin, or too ardent, or meeting with some unusual difficulty, but perhaps the most frequent cause is Timidity, or self-distrust. I have known several men. every way competent, who were so possessed with this idea of their own incapacity that they in- variably became impotent whenever they attempted \n approach to the other sex. This timidiu is somei ;mes exhibited in the most striking manner, the patient bp'mg intensely agitated, and so nervous MM SYMPATHETIC DISEASES, that his whale frame trembles, and his bodily powers sink so much that often fainting ensues. This peculiarity appears to be constitutional, and is often seen in those who are by no means nervous, ia the ordinary acceptation of the term, and who are col ected enough in regard to other matters, The only remedy for such an infirmity is constant asso- ciation with one object, in marriage, by which means a proper familiarity is induced, and in time the in- dividual loses his distrust and becomes convinced of his perfect capability. In most of these cases there is a real excess of power, rather than a defi- ciency, and the very intensity of the feeling tends to prevent its gratification, by completely absorbing ail the vital energies. I have frequently been con- sulted by persons so circumstanced as to the pro- priety of marriage, they fearing that the failing could not be recovered from, and it has been with the greatest difficulty that I could persuade them to the contrary. In every instance,' however, I have found marriage to effect a cure, though it might not be immediate. Some have worn off their distrust very soon, others have experienced it for months, but eventually have been surprised that they ever did so at all. It is the fear of failure that causes it with these people, and when that fear is once found to be groundless the cure is complete. In some few of these cases a little medical assistance is availa- ble, but it is of a nature not necessary to point out here. I once saw a man who had been married for- three years without being able to associate with hii partner, and solely from this cause. In all proba- bility he never would have done so, had it not b^en for A he advice he received, and yet there was no real dehciency of any kind The celebrated John SYMPATHETIC DISEASES. ] ■ A Hunter gives us a similar instance, which he met witl in his practice. The patient was perfectly in- competent, solely from the fear of failure, which so operated upon him as to always •make him fail. Mr. Hunter was persuaded there was no other dif- ficulty, and that it was merek 7 necessary to break this spell, he therefore required of him, as one es- sential requisite of the treatment, that he should remain with his companion, but on no account whatever make an$ r attempt for six nights, let his desire be ever so strong. The result was that be- fore the period fixed had gone by his desires were so strong he found it difficult to obey the injunction, and feared he should have too much power instead of too little. In fact the cure was complete, with, out any further treatment. The only thing re- quired in such cases is a judicious and honest phy- sician, who will first ascertain that there is no rea deficiency, and then explain to the patient the real nature of his case and the means b}- which v may be relieved. If this be done in a proper ano sym- pathizing "manner a cure may always be effected, but by a wrong course of procedure the evil niaj be confirmed. A too great intensity of the sexual feeling itself will sometimes cause impcteney, by overpowering the patient before die act can be properly consumma- ted. I have known instances of men who always be. came so intensely excited that they fell into a kind of dreamy stupor, and had involuntary emissions while in that state. This, however can alway be' remedied by proper treatment Several instances nave eome 10 my knowledge of men being impotent, at their marriage, from then fast discovering some disagreeable fact respecting ; n SYMPATHETIC DISEASES. their partners. In one instance the lady had a small abscess on the arm, which she had hitherto concealed, and doubtless thought it a matter of little or no consequence as her health was good, and her appearance remarkable pleasing. Her partner, however, thought different, and such was the effect upon his mind that he could never afterwards expe- rience the slightest desire towards her. In some cases such simple discoveries as false hair, or false teeth, have had a similar effect. It is not so much t u at the circumstance is excessively disagreeable in itself as that it is unexpected, and its discovery de- stroys the dream of comparative perfection hitherto indulged. With uncultivated and Unimaginative peo- ple such causes might operate but slightly, or not at all, because they form no such ideal image, but with men of refinement it is different. There is no doubt but that a .good deal of the dissatisfaction, and loss of power, which many men experience after marriage is owing to this circumstance. They are ignorant of the real physical txnd moral nature of the being they take to their bosoms, ' and have formed a picture of her in the imagination very different from the /e&Iity, so that whan the truth is known their feelings undergo a complete revulsion. This ignorance sometimes extends to the mos? ordinary functional phenomena of the female sys- tem, d.r.'.d ihb nrst knowledge even' of that has, to my own knowledge, produced a very di&agreeahle and lasting effect. In short it is in this a3 m every tiling •els^, ignorance c.nd concealment produce evils that only knowledge and mutual confidence can prevent For full information see "The Marriage Guide." SYMPATHETIC DISEASES. 201 EXCESSIVE SENSIBILITY OF THE GENITAL OtJG/i.NS Sometimes the sensibility of the Genitals is so much exalted, either naturally or acci.rienr.aliy, that emission occurs upon the slightest excitement, and the individual is thus made impotent from inability to perfect the connexion. This condition is in rea- lity a diseased one, and ought so to be considered, bs much as any other we have described. The seat of this extra sensibility is sometimes in the Testes or Vas Deferens, or in the ejaeuiatory Ducts, but most frequently in the Glaus Penis. When it is very great the organs are thrown into a violent orgasm almost at a touch, and emission oc- curs at the very first attempt. I have known men married for years who never had perfect association with their partners during the whole time, and simply from this cause. They were in nc respect whatever deficient, nor even subject to nervous ex- citement, but were unfortunately affected by this excessive sensibility. Other men I have knr vvn who dare not marry at ail from this cause, feeling sure .that if they did the marriage could never be consummated. The causes- of this trouble appear to lie in the peculiar structure of the Glans, the skin of which is unusually delicate, while its nerves are ramified into mousands of minute twigs, which are distributed to every point of the surface. The exquiske sensi- bility thus produced is so great in some that the mere touch of the clothes is sufficient to excite, ano the patient is thus kept in a constant state of irrita- tion. Sometimes a similar state is induced by dis- ease, particularly by inflammation, the Penis being »jl)2 *?A«l'tTHECIC DISEASES. then as tender as the surface of an abscess just he- fore it breaks, and feeling the slightest pressurfe o fric:ion. When this excessive sensibility is produced b} any disease it will of course disappear when the disease is cured, but when it is natural the removal or modification of it becomes much more difficult, though great relief can nearly always be obtained. The first requisite ts to remove all extraneous sources of irritation, and to attend to the diet, cloth- ing, and general regimen, then the great point is to harden the skin of the Glans, so that the nerves may be more thickly covered, and their sensibility reduced. This must be effected by the constant use of a^trin^ent washes, or caustics, and in certain csases by the use of Galvanism. Every one is fa- miliar with the effect of certain substances on trib hands for instance, in making them hard and de- stroying the delicacy of their touch, and it will be readily seen that the same means will deaden the sensibility of other uarts. Lime-water is very goot in some cases, and water saturated with iron-rust in others, but the best agents are the astringents, such as alum-water, solutions of tannin or white, oak hark, or gum kino o r c^iechu. These must be used every day, as washes, and the Glans kepi covered with cotton soaked in them. They will always do good, and frequent 1 y effect a perfect cure, but when they are not sufficient caustics must be employed, and this mus f be done by a phv- . sician. — When the premature discharpe takes place from irritability of the Urethra or ejaculatory ducts, a soothing external treatment must be adopted, con- sisting of washes and baths, combined with the uss of particular medicines internally, the kind of 19 SYMPATHETIC DISEASES. 203 wnich must be determined by the peculiarity *uid seat of the irritability. — I have had some of the most distressing cases of ihis extreme sensibility brought under my notice, but I have not had one that was not relieved, except when it arose from Some incurable disease. — The connexion between this complaint and certain morwl infirmities will be obvious, and it will be readily admitted that its pro- per treatment may frequently be a matter of great consequence. — Children sometimes exhibit this trou- blesome sensibility of the parts, and it leads in them to constant manipulation, and eventually masturba- tion, if not corrected. How important that parents should know this, and how necessary that they •hould see the uselessne&s of mere moral preaching ID 92Ch GU&*, If all young men read, in time, a work like this, the sexual vices and diseases so common with them would be materially lessened. And if all young couples before marriage read the Marriage Guide , many of the causes of matrimonial unhappiness would cease to exist. CHAPTER VI!. SPERMATORRHOEA, OR EXCESSIVE LOSS OF SEMEN. This is a subject of more importance, as regaida human health and happiness, than perhaps any othe? that can be mentioned, and yet it is one about which scarcely anything is known, except by a few indi- viduals. I do not hesitate to say that more evil effects, ten times over, are produced by this almost unsuspected cause, than by all the diseases already enumerated, and perhaps even then by nearly all other diseases put together. And not only is it de- structive to the body, by preventing its proper deve- lopment in youth, making it a mass of disease in mature life, and causing its premature decay and death, but it is equally baneful to the mind. By its influence the vivacity and energy of youth is changed to a listless indifference, the vigor of man- hood is destroyed, and the calm peaceful content of mature life is turned into despondency and gloom. Many a young man, with mental powers capable of making him both eminent and happy,- and with every requisite of bodily health and strength, has terminated a short-lived miserable existence by sui- cide, or dragged out his life in a state of idiotic imbecility through this unsuspected disease. The excessive loss may either be the result of licentious indulgence or it may occur without the individual's cognizance, the elfects being much the same in either case, though apt to be ascribeJ EXCESSIVE SEMINAL LOSSES 90?) to other causes in the latter case, and also to be often underrated. The fact that the sem^n does frequently eseapt> in an involuntary manner is generally known, there being but few men who have not so suffered more © or less, and it is also well known that such involun- tary losses are very injurious to health, but the rea' extent either of the disease or its evil elfects are known to but few. The only cases known to occur, by people generally,' are those in which the escaped semen is actually seen, but for one case of this kind there are probabry ten where nothing of the kind can be observed except by means hereafter to be pointed out, and where of course it is never sus- pected. In like manner the only effects of this dis- ease that are usually taken cognizance of are those of plain and obvious character, but there are many others, much more to be dreaded, that can only be letected, and assigned to the right cause, by those practised in observing them. Many men suffer the extreme of wretchedness and disease, become in- sane, and die prematurely, from this complaint, with- out ever having dreamed of anything of the kind. In © j © general, too, their medical advisers are equally in the dark, and go on attempting to cure the mere effects while the grand cause of all is left untouched. Spermatorrhoea, as I shall show further on, when excessive, may produce symptoms similar to those if almost every disease the system is subject to, and thus lead to the belief that there is Disease of the Heart, Liver Complaint, Dyspepsia, and a hundred other affections of which there is in reality no trace whatever. It may also materially impair the pow. ers of the mind, or prevent their proper manifesta- tion, and so change the feelings and disposition thai 206 EXCESSIVE SEMINAL LOSSES. the individual can scarcely he recognised as the same person, by his conduct. The ravages of this destructive disease are no* confined to any particular class, age, or condition, nor is it always a consequence of vicious conduct, as some suppose, but on the contrary, it frequently attacks the most virtuous and exemplary. Some of the causes that lead to it may operate as well upon the healthy and strong as upon the weak and sickly, and attack the middle-aged married man, of tempe- rate habits, as well as the licentious unmarried youth. It is therefore of the utmost importance that this destructive pestilence should be unveiled, so that every one may know how to guard against it and ward off its evils. To understand why it is that Spermatorrhea leads to such manifold and diversified evils, it will be necessary to refer to the Organic and Sympathe- tic connexion between the Generative Organs and the rest of the system. The intimacy and extent of which is but little known, and consequently its importance is not appreciated. In the former part of the present work this connection is partially shown, but it is necessary here to make it still more manifest. To a considerable extent the Genital Organs are in direct connection with the Urinary, and in some [>laees the same parts are common to both. The ower part of the large Intestine, or the Rectum, i» also in close juxtoposition to them, as may be readily seen by referring to the Frontispiece, and the description of the male system. Any disease, therefore, which affects the Genital Organs is very apt to derange them likewise, and it is quite possi. ble that the secondary disease ma) be more severe 19* EXCESSIVE SEMINAL LOSSES. 207 than the primary one. Every one knows that diseases of the Bladder, Kidneys, Urethra, and Rectum, are quite common, and frequently very distressing, while the causes of them are often un- discovered. In many such cases these diseases are only symptoms, the primary trouble being sperma- torrhoea. The great cause, however, of the Genital Organs exerting such a general influence over every part is their intimate connection with the nervous system. There is no other process carried on in the body that requires so much nervous pon^r as the forma- tion and evacuation of the semeti, aud no other is therefore so exhaustive of the vital energy. Even in youth the amount of this power required is very great, to effect the full formation of the Semenifer- ous Glands; in fact Nature seems to put forth so much eifort for this purpose that every other part is stimulated at the same time, and thus the perfect- ing of the Genital Organs is the means of develop- ing che whole system. This is the reason why those who are castrated aie always imperfect, both in body and mind, and die early. If the Testes are removed there is no other part for which nature will sufficiently exert herself to stimulate the whole, and consequently the development is only partial. Those who have ever seen Eunuchs will have had sufficient proof of this, but any one may observe the same thing in mutilated animals. Compare the Ox with the Bull for instance, or the entire Horse with the castrated one, and it will be at once evident that the form of the body, and the disposition, are completely changed. Even in after-life the vital energy re- quired to secrete the semen invigorates the whole 208 EXCESSIVE SEMINAL LOSSES. system, and disposes it to a constant activity that would otherwise not be exhibited. Men deficient in this respect are never noted for their enterprize and love of adventure, but are always inclined to be calm, inactive, and retired, even when possessing genius. Nearly all men of strong energetic minda and daring dispositions are of warm temperaments, or in other words have a plentiful secretion of semen. It is therefore an essential and important agent, both for perfecting the system in early life, and also for rousing it to sufficient exertion after- awards, and beyond doubt a deficiency or superabun- dance of this fluid may exert a decided influence on the character of the individual. In all pioba- bility many are dull and inactive from deficiency in this respect, while many others are too impulsive and restless from excess, and yet the truth is sel- dom suspected. It is too much the custom with Physiologists to regard only the brain, as being con- cerned in the production of mental characteristics, and to consider it as the sole fountain of that myste- rious influence which is constantly exerted over every part of the system. A truly philosophical view of the subject will, however, I am confident, show that there are other parts whose action should by no means be overlooked, and among the most important of these are the Genital Organs. A due consideration of these facts explains the the true philosophy of sexual indulgence, and shows why licentious excess produces so many and such severe evils. In a healthy *state Nature goes on supplying the necessary nervous energy, both to the Testes and the rest of the system, till a superabuD dance of semen is formed, and then there is expe, rienced a desire for its emission, the gratification of EXCESSIVE SEMINAL LOSSES. 209 •vnich is, physiologically speaking, under such cir. cumstances, both proper and healthful. It is in fact only the expenditure of the overplus energy and does not in any way weaken or destroy. If, however, by artifical excitement, or factitious de- sire, the seminal emission occurs before this super, abundance exists it becomes exhaustive, and seri- ously impairs the vital energy. Indulgence should ' therefore be allowed only when this overplus power excites to it, and any man can easily tell when that is by studying his feelings and experience, and by not giving way to artifical excitement. When the seminal emission occurs oftener than nature properly provides for, the nervous energy expended is no longer a useless superfluity, but a portion of the common stock, and its abstraction ne- cessarily weakens the power of the whole system. For a time Nature can, by extra effort, supply the deficiency thus produced, but if the excess be too long continued this effort at last fails, and then a general prostration ensues. The career and ulti- mate end of any licentious debauchee will well illustrate this, and should act as a timely warning to shun the same evil path. The reason why the victim of excessive seminal discharge suffers from almost every ailing of boch r and mind, will now be evident. The stomach can- not digest, the heart cannot propel the blood, nor the b^ain think, unless they are each supplied with a due amount of nervous power, and if most of that be expended in the production and evacuation of tiie semen, of course they will be deficiently supplied, and will consequently perform their functions imperfectly. Here then we have the cause, in iuoh cases of Dyspepsia, Heart disease, dulnes* 210 EXCESSIVE SEMINAL LOSSES. of the intellect, insanity, and a thousand olhei evils .Besides this exhaustion of the nervous energy, however, it is also probable, from observations recently made, that the semen requires for its per- fect formation some important and subtile elements of the body, the abstraction of which, in too great quantities, is highly injurious. It has been supposed, and with considerable plausibility, that a part of the seminal fluid is identical with some portion of the brain and nervous substance, and that this common material is produced for the use of both respectively This explains why the mind is nearly always active in those who are of a warm temperament, because the brain is nourished by a part of the same mate- rial which is produced to form the semen. It also shows why the mind must suffer when the semen is expended in too great quantity, because the very substance the brain requires is that taken away, and it suffers in fact from want of its proper nutri- ment. In confirmation of this it has been stated that the brain has actually been found wasted, and softened, in many persons who have died from licentious excesses, and I have myself observed the fact, after death from Masturbation. In one case especially, the color and consistence of the brain Vas so remarkably diiferent from those of a healthy person that no one could fail to observe it ; it had in fact the very same appearance as in many states of disease, and I have no doubt but that in many of these poor victims the brain is constantly in a state of inflammation, or wasting away. This is proba- bly the true cause of that distress in the head, dim- ness of sight, and loss of hearing, that many of these patients complain of, and which sometinc* EXCESSIVE SEMI-SAL LOSSES. £.]_] zofiimues nil they become deaf, blind, and in?ane. This explanation of the wa}' in which Sperma- torrhoea produces such various evils, will make our Jetailed account of its effects easily understood, and *rill also make clear the philosophy of its proper treatment, and wnat should be done for its preven- tion. CAUSES OF SPERMATORRHOEA. There are undoubtedly manv causes of Sper-ma- torrhoea with which we are but imperfectly ac- quainted, and probably many that are not yet sus- pected. Mr. Lallemand remarks that " when it occurs spontaneously, during sleep, in a healthy and continent individual, it doubtless exerts a bene- ficial influence on the economy, by freeing it from a source of excitement, the prolonged accumulation of which might derange the animal functions. In these cases it has an effeot analogous to that pro- duced by the bleeding at the nose, during youth." If, however, the discharge becomes excessive, or continues longer than the state that first produced 11, great evil may follow, as already shown. Pro- bably the most frequent cause of Spermatorrhoea is too frequent sexual excitement, especially in the form of Masturbation. This leaves the organs in a state of irritation which stimulates them to constant activity, and makes them perfectly independent of the will. At first the emissions are alway attended fey erections and pleasurable sensations, during sleep, but in time they begin to occur without either erection or sensation, and finally take p'ace in the day-time, whenever the bowels are moved, or the urine passed, and in extreme cases there is a con. ttant running away of the semen without a"v in 21^ EXCESSIVE SEMINAL LOSSES. termission. To understand the reason of this constant and uncontrollable escape of the semen, 1 must refer to some of the Anatomical details given in the description of. the Male Organs. It was there shown that the semen passes, from the Testes, along a pipe or duct, called the Vas Deferens, which opens into the Urethra, through the Prostate Gland, by two little mouths called the Ejaculatory Ducts. These mouths are always shut in a healthy state, except under the influence of sexual excitement, and then they open to let the semen through, but after- wards firmly close. If, however, they are called upon to do this too often they become irritated or relaxed, and consequently are more disposed to open from slight causes and have less power to close again. They are especially liable, when irritated, to be acted upon by the urine, which passes over them, and as the bladder itself soon partakes of the same irritation the urine is being constantly passed and is nearly always mixed with semen. The pressure of the Rectum on the Prostate Gland, when the bowel? are moved, will also cause the ducts to open, and this is the reason why many persons always lose semen when at stool. The ordinary motions of the body even will do the same, in bad cases, and more especially riding, running, leaping, or coughing. Finally, the ducts entirely lose the power of closing, from relaxation and then the semen is constantly dribbling away. Whenever the semen can be seen there can of course be no mistake as to the nature of the trouble, but very often it flows involuntarily without being visible, as before stated, and thus the individual may suffer without its being suspected what from The manner in which this occurs will now be un EXCESSIVE SEMINAL LOSSES. 213 derstood, — the ducts become sensitive to the touch of the wine, which in a healthy state produces nc affect upon them, so that every time that fluid passes they op^n and allow the semen to escape along with St The Bladder it-self being irritable also, owing to its intimate connection with the diseased parts, the urine cannot be long retained ; the smallest quantity causes an irresistible desire to expel it, and thus the individual is constantly urinating, and con- stantly passing semen at the same time. It is only very recently that this fact has been ascertain- J, and doubtless numbers have died in this way, -is before remarked, without the slightest suspici .n being excited as to the cause of their death. T,4e means by which this mode of seminal escape is as- certained are simple and sure, in practised h-and&, as I can testify from abundant experience. They consist in examining the urine with a properly con- structed microscope, which exhibits in it the pre- sence of the seminal animalcules. These minute animals are nearly always to be found in the urine of those afflicted with Spermatorrhoea, and their pre- sence of course proves the escape of semen beyond a doubt. — It is quite common for patients to remark that the urine is thick and ropy, particularly the last drops, and it is usually thought that this arises from inflammation of the Bladder, but 'n most cases it is only from being mixed with semen. In this way I have been able to ascertain the true nature of a person's disease in numerous instances, and tn apply the proper remedy, where previously they had been treated only for some symptom of that dis- ease, and of course without any permanent benefit. Many times I have had respectable married men, of temperate habits, come to me with every symp. 51 4 EXCESSIVE SEMINAL LOSSES. torn of Spermatorrhoea, but who assured me that they had never been troubled with anything of th« kind. They judged so, simply because they never saw anything pas-s from them, and they did not know that it could occur in any hidden form. On show. ing these people the semen in their urine they were amazed, and deeply regretted the want of informa. tion that had prevented them from knowing the cause of their suffering before. I have no doubt but that this hitherto undetected form of Spermator- rhoea has been the cause of incalculable misery to thousands, and that it has condemned numbers to insanity and untimely death. — It is perhaps neces- sary to remind the reader here that when the loss occurs in this way it is from the ducts being irrita- ble, and not from being relaxed. When really re- laxed or open, the semen escapes at all times, from various causes, or perhaps without any accidental cause whatever. It was remarked above, in speaking of the causes of involuntary seminal emissions, that it probably arose most often from too frequent sexua-i excite- ments, especially in the form of masturbation. It may be as well to remark, however, to avoid mis- apprehension, that too frequent excitement in any form may act in the same way. There are un- doubtedly many married men who much exceed the bounds of true moderation, and they are apt to think that no harm will follow from such excess, because it is legitimate. This is a great and a fatal mis- take ; such men are just as liable to suffer as if their gratification was sought under any other circum- stances, and I very often have such come to me for advice. The Physiological Laws, bv which health \s maintained, are quite distinct from these morai 20 EXCESSIVE SEMINAL LOSSES. 0]5 enactments demanded by the welfare of society \ and the observance of one of these can ne^er give immunity for the infringement of the other. It is not, however, excessive indulgence onl*y thai will cause Spermatorrhoea, for the very opposite ot it may do the same. There are few men of warm temperament, if healthy, that can remain long strictly continent without having involuntary emissions dur- ing sleep. These, as before remarked, are sanitary efforts of nature to relieve herself, and when not too frequent may be beneficial rather than hurtful. Unfortunately there is always a tendency, if the continence continues, for them to become more fre- quent, so as eventually to constitute a real disease, and thus many a virtuous young man, who has never indulged in any form, is subject to the same misfor- tunes as the licentious debauchee or the victim of masturbation. This is a truth as important to be stated as any other, though its announcement may seem strange to those who hear it for the first time. — There are fortunately many means that can be used, in such cases, to lessen this tendency to an undue increase of the discharge, and therefore these persons should know of their danger, in order that they may see the necessity for adopting such means. Over-exertion or great agitation of the mind will also cause Spermatorrhoea, owing to the sympathy between the genital organs and the nervous sys- tem, and it is frequently produced in this way in merchants, students, professional men and others. I have known many men of business who always nai involuntary emissions when they were much troubled about their affairs, and several law student nave assured me that after any unusual applicatioi they surie-ea in the same way.-— Man^ r other dis 21 ti EXCESSIVE SEMINAL LOSSES. eases of the generative organs will likewise lead to Spermatorrhoea, and so will certain derangements of the neighboring parts, particularly long-continued constipation of the bowels, piles, and gravel. Cer- tain medicines also, especially Cantharides, Phos- phorus, Iron, and Opium, are very apt both to produce and aggravate it, and so will the use of Tobacco, Alcohol, and heating or highly-seasoned food. — Among occasional causes, still less likely to be suspected than any above referred to, may bo mentioned worms in the rectum, various skin diseases. and diseases or injuries of the brain. Venereal and Gonorrhoea! affections also leave a tendency to Spermatorrhoea, and often directly produce it. — I have become satisfied also that in many children there is a predisposition to it, inherited from their parents, which is likewise accompanied in many cases with a congenital weakness of the parts, which is frequently denoted by incontinence of urine. — All these causes will, however, be illustrated in the " cases" which will be given further on. — The most frequent cause, however, is sexual abuse, though it may not assume a very aggravated form till many years after ; the follies and vices of youth being thus, in many instances, the originators of disease and misery in mature life. PARTICULAR EFFECTS OF SPERMATORRHEA. The general effects already described may follow from great seminal loss occurring in any way, bat when that loss is involuntary their effects are usually more severe, and several others are also ex perienced that do not always accompany voluntary indulgence, even when excessive. In fact involun- VTCKSSIVE SEMINAL L0SS2S. 2)1 fary !ds? is generally indicative of extensive and Confirmed disease, and of course its symptoms are most severe. Some of the first effects are exhibited upon the parts more immediately connected with the Genitals, particularly the Urinary Organs. The irritation speedily extends from the Ducts and Yas Deferens to the Urethra, and finally to the Bladder, which becomes in consequence so sensitive that it cannot retain the smallest quantity of urine without in- convenience. The patient is therefore constantly desirous to urinate, though but little fluid escapes when he does so, and is thus kept in a state of con- tinual annoyance, so that he dislikes to join com- pany, or to go anywhere in public, for fear that he should not find opportunities for relieving himself. I have known men made completely wretched in this way, and in one case, very recently, the indivi- dual was compelled to give up a profitable and pleasant occupation, merely because he could not remain at his post sufficiently long at a time. Ul- timately this irritation may become so bad that all voluntary power over the bladder is lost, and the urine then escapes constantly, without the patient being able to control it. This irritation of the bladder is usually one of the first indications that a man has exceeded the bounds of moderation, though it does not always occur, even in the most con- firmed cases of involuntary emission. When the irritation h$ts existed long in the Blad- der it is apt to extend along the Ureters to the Kid. neys, and produce there ail the symptoms of inflammation of the Kidneys, and of Gravel, with ^reat weakness and pain in the back. It is difficult t ft convi-wn* majiv oatisnts that they have not these 21 g EXCBSSrVE SEMINAL LOSSES. Qiseases, and still more difficult to show them, when they are uninformed, how their troubles really arise. In fact I have known numerous cases where physicians themselves have been deceived, and where the^y have prescribed for these mere symp- toms, supposing them to be the primary disease, without ever suspecting the truth. Another part very apt to suffer from Sperma. torrhcea is the Rectum, or large intestine, which is in direct communication with the Prostate Gland and Seminal Vesicles, as may be seen by the Frontispiece. In some persons there is a constant feeling as if the bowels were about to be moved, with a bearing down sensation, and a partial pro- trusion of the Intestine. In others there is a gene- ral uneasiness around the Anus and Perineum, which causes the patient to be continually shifting about on his seat, and moving as if he were in pain. Occasionally there is considerable irritation, or itching, and very often severe Piles, from the cir- culation of the blood being impeded. In short the Rectum may be affected in many different ways, and so may the rest of the intestines, from their connection with it. Sometimes there will be a par- tial paralysis of their muscles, from the deprivation of nervous power, which, by arresting the peristal- tic motion will cause obstinate constipation. At other times the mucous coat partakes of the general irritation, and then we have Diarrhoea exhibited, and no medication whatever can check it so long as the Spermatorrhoea continues. Another symptom of Spermatorrhoea, sometimes ntet with, is a peculiar irritation of the Urethra, and Meatus Urinarius, or external opening from the Peak. This irritation is sometimes verv slight, and 20* EXCESSIVE SEMINAL LOSSES. 219 only experienced after urinating, but at other times it becomes quite severe, and pretty constant, resem- bling in fact a real Gonorrhoea, and being even accompanied by a discharge, showing the existence of nflammation. Many men have become much alarmed from this symytom, supposing it to be an infectious disease, and in several instances I have known it the cause of mutual suspicion and much domestic unhappiness. These local effects are usually the precursors of more general and severe ones, the connection of which with the true cause of all it becomes more difficult to trace. In addition to a universal lassi- tude and weakness there is experienced a remarka- ble loss of power in the lower limbs, owing to which the patient finds it impossible to walk far, or to stand long upon his feet, without being overcome with weariness, and feeling numbed in the legs and thighs. The slightest exertion makes him tremble and look pale, his heart flutters, or stops beating altogether, and he experiences a tendency to faint. This distressing debility is sometimes so exces- sive that the individual becomes almost unable to move, and yet he may not be much fallen away, nor look very sick, so that uninformed persons are apt to think it is mere idleness, or pretension. In the course of time, however, the stomach begins to suffer, and oecomes so weak that digestion is imper- fectly performed, and then emaciation follows, which sometimes becomes a complete and rapid wasting away. The loss of nervous power some, times affects f he Diaphragm more especially, and then there is great difficulty in breathing, which, with other sensations, leads to the belief that the Luugs are diseased. And when this occurs along 220 EXCESSIVE SEMINAL LOSSES. ws h palpitation of the heart, which originates much in the same way, the poor patient is in a state of constant worriment and fear, nothing being able tc convince him that he has not Consumption an could have the effect that sometimes follow fn m it. The next case, however, will convince the most skep- tical, and though it is not often that we have such e severe case, there are yet plenty that are bad enough. " M. De B consulted me in the month of May, 1834, respecting a cerebral affection, on whose nature distinguished physicians could not agree, but which all regarded as very serious. "He was of a middle heighv with a large chetf EXCESSIVE S.2PIINA* LOSSES. 235 and a well-developed muscular system ; his hair brown and curly, his beard thick, his face full and deeply colored. Notwithstanding these signs of ap- parent strength and health, I noticed that his knees were slightly bent, and that he was unable to remain long standing without shifting the weight of his body from one leg to the other ; his voice was weak and husky ; the motions of his tongue seemed em- barrassed, and he articulated his words in a con- fused manner ; his attitude was timid, and his man- ner had something of incertitude and fear; he had been married fifteen days. " His mother-in-law and his young wife, who ac- companied him, informed me that within this period he had several attacks of congestion of the brain, during which his face was highly injected. At the first of these attacks the surgeon, called in the night, had bled him to the extent of three pounds, in order to prevent apoplexy ; repeated venisection, and the frequent application of leeches, had relieved such attacks of congestion, but had not prevented their recurrence. The patient had become subject to attacks of vertigo, and was unable to look up- wards without feeling giddy ; his legs had become so weak that he had fallen several times, even when walking on level ground ; his ideas had lost their clearness, and his memory failed rapidly. " These symptoms had spread consternation through both the family of my patient and that of his wife, especially as several practitioners of repu tation were agreed as to the existence of some seri- ous disease of the brain, although they could not decide as to its nature. Most of them, however, were inclined to suspect ramollissemeni . (Softening.) " The countenance of the patient during this re- 236 EXCESSIVE SEMINAL LOSSES. eital, the coincidence of the congestion, with the [>eriod of his marriage, and the bad effects of blood- etting, made me suspect the nature of the disorder, and induced me to question the patient separately. When we were alone he told me, stammering, that an unexpected occurrence, immediately after hii marriage, had at first prevented any conjugal in- timacy, and that afterwards he had found himself completely impotent. He attributed this misfortune to the attacks of cerebral congestion, and to the bleedings he had undergone. On further inquiry, however, I discovered that he was affected by diur- nal pollutions. " The following is the history I obtained from this patient by dint of questioning : — at the age of six- teen, he possessed a very strong constitution, and an ardent and passionate character. At school he contracted the habit of masturbation, and at the eni of three months he had frequent nocturnal pollu- tions, with pain in the chest and troublesome palpi tations, which warned him of the danger of the vice, and he renounced it forever. When he became free from the restraints of school, he subdued the ardor of his temperament, by the most violent ex- ercises — especially that of the chase — and he at- tached himself to agricultural pursuits with much energy. " This new mode of life so completely re-esta- blished his health, that he was tormented by ener- getic, and continual erections, to subdue which, he employed river-baths, even in the coldest seasons. He never committed excesses of any kind, and had never suffered from any blennorrhagic or syphilitio affection. "In 1831, the erections were slightly mitigated; EXCESSIVE SLMiNAL LOSSES. 287 but he became very much constipated, which he attributed to the constant use of horse exercise. ■• in 1832, he experienced some numbness «iad creeping sensations in his feet and legs. " In 1833, frequent dazzling of sight occurred with vertigo, difficulty of vision, and flushes of heat, cowards the head and face, the patient attributed all these symptoms to the effects of his still increasing constipation. At the same time that these symptoms occurred, the patient's erections became rarer, less energetic, and altera time, incomplete; his fitness for intel- lectual labour diminished ; the cerebral congestions became more frequent, and more severe ; his face became habitually veity red ; his head burning ; an almost constant fixed pain came on in the orbits and his character became fickle and contradictory. " His family physician, attributing all these dis- orders to a state of plethora, caused blood to be drawn several times, without benefit. " In March, 1834, M. De B engaged himself to a young lady, who lived about two leagues from his estate ; and in order to visit her without neglect- ing the care of his property, he was obliged to make long and frequent journeys on horseback ; shortly before his marriage, these journeys became so frequent, that he might be said to pass the greater part of his time on horseback. His constipation now increased to such a degree, that he passed forty days without faecal evacuation ; during his efforts at stool he passed semen in large quantities, and in jets, although the penis remained flaccid. He had previously, several times, noticed the same occur- rence, but as he attributed it to his long-continued continence, he paid little attenticn to the cireun* 238 EXCESSIVE SEMINAL L0SSB5. stance. Jrf is urine was constantly muddy ; it was passed slowly, and with difficulty, and threw down a large quantity of thick and flocculent deposit. " M . De B awaited the period of his mar- riage with a vague uneasiness, of which he could not imagine the cause ; he was much attached to his betrothed, but, nevertheless, he experienced more embarrassment than pleasure in her society. " I have already stated what occurred after his marriage, I should add, that having examined his genital organs, I found them, contrary to my expec- tations, of unusual development, the Testicles were large a-nd firm, but the scrotum was slightly re- laxed. The patient experienced a strange tingling in the organs, and at times felt as if they were com- pressed by a hand of iron. These sensations in- creased when near his wife, and the penis dimi- nished in size, and became retracted towards the pubes, in proportion as he endeavored to excite erection. " The union of all these circumstances could not permit any doubt to remain on my mind as to the nature of his disease ; it became evident that all idea of cerebral affection must be abandoned, and that the diurnal pollutions, with all the symptoms of which they were the cause, must be referred to the patient's constipation. " The first indication to, be fulfilled, therefore, was to relieve the constipation ; indeed I hoped this was all that would be necessary : the youth of the patient, the development of his genital organs, and the strength of his constitution induced me to sup- pose that his cure would be prompt and easy. Things did not, however, follow so simple a course. " The next day the patient began to use ascend 22 EXCESSIVE SEMINAL LOSSES. 239 ing douches ; and was put on a vegetable diet, with iced- milk, " The first douches caused the evacuation of an immense quantity of fsecal matter in lumps, as hard as bullets, and it was not until after the sixth douche that the fseces were of normal consistence ; I then caused the temperature of the water to be lowered to 25° of Reaumur's* scale, and afterwards to 20° Reaumur. f The last few douches were given at 160 Reaumur. J After the twelfth douche had been administered, they were omitted, the bowels having acted regularly every day, without the necessity for the slightest straining. " By this time the patient's countenance had lost its purple tint, and presented a more natural appear- ance : the stunning sensations of which he had complained diminished by degrees, and at length disappeared entirely ; his legs regained their strength, and he was able to continue in a standing posture for a long time without fatigue, ahd to take long walks without inconvenience ; his voice re- sumed its natural tone, his eye regained its expres- sion, and all his motions acquired firmness. " At the expiration of a fortnight the spermatic discharges during defecation had ceased entirely ; but his urine still continued thick. His erections had already acquired sufficient energy to make him believe himself cured, but ejaculation took place almost instantaneously. The use of ice and co)d lotions did not ameliorate his condition. " Such was M. De B 's state at the end of a month ; when, in order to aef, directly on the orifices • About S8 C of Fahrenheit. f About 81° of Fahrenheit. I Abort 68° of Fahrenheit 240 EXCESSIVE SEMINAL LOSSES. of the ejaculatory ducts, I determined to uauterigt the prostatic portion of the urethra. As soon as the inflammation had subsided, his erections became more perfect and energetic ; yet ejaculation still took place too rapidly. The period for using the mineral waters having arrived, I sent M. De B to Aix, in Savoy, where I visited him shortly after. He had experienced very little benefit from the use of the waters, either externally or internally.. " I now prescribed douches, alternately very warm and very cold, on the perineum and loins, the spout being changed when the sensation, either of cold or heat, became very intense. The bath was ended after about twenty or twenty-five minutes, by the cold douche, and the patient's skin remained highly injected for some hours afterwards. " The effects of these douches were conclusive ; after the first, the patient's erections acquired a de- gree of vigor and duration which reminded him of his early torments. He continued the use of the douches for some days after his re-establishment; and when he left Aix the functions of his genital organs were perfect. Ejaculation was a good deal protracted by the use of the douches. " I have entered into a somewhat lengthy detail of this case, because the subject affects gravely the most serious interests of society, as well as the happiness and peace of families. Besides, I con- fess that I was much interested by the unhappy position of a young man whose misfortune was un- deserved, and could not have been foreseen, as well as by that of his wife — a young woman scarcely of age, who was obliged to enter into the most unplea. saat details. " It is evident that in the case of M De B ■ ■■■« -> EXCESSIVE SEMINAL LOSSES. 241 the constipation was the cause of the involuntary •eminal discharges. The patient had practised masturbation it is true, and nocturnal emissions fol lowed ; but he had continued the vice only three months, and his health, though disordered for a "short time, was soon re-established by the use of violent exercise. M. De B was even tor- mented during several years by erections, which must have been very energetic, if we may judge by the means he took to subdue them. From this time he had never committed any kind of excess, and'he had never suffered from either blennorrhagia 01 syphilis. There is then no circumstance in the history of his life, except his constipation, which vould account for the involuntary discharges. " But to what is this constipation to be referred cumstance occurred to a fifth, who, in descending a ladder missed his footing and fell. Another patient told me that if he looked down from a height, or wxiy fancied himself on the brink of a precipice, ho felt a sense of contraction in the genital organs. EXCESSIVE SEMINAL LOSSES. 249 wnieh passed rapidly to the base of the penis, and ended by causing emission. The motion of a swing produced the sam a effects in a seventh. " Almost all these excitable, persons were exposeti to erection, and e^en to pollutions whenever they rode on horseback. " Although all these involuntary discharges were caused by extraordinary circumstances, I should not have paid much attention to them if they had not been followed by nocturnal and diurnal pollu- tions, which the most trifling circumstance rendered very serious. The disease, however, did not always put on a serious aspect immediately after these sin- gular accidents ; very often, indeed, it only injured the patient's health long afterwards ; but as it« gravity could not be explained by any c^^asional cause, I feel myself compelled to admit the exis- tence of a congenital increased nervous suscepti- bility of the genito-urinary organs. Every thing indicates, in fact, that the organs of these patients were rather excitable than weak and relaxed ; and ♦his condition was congenital becausp manifested from the earliest infancy. This excessive sensi- bility of the genital organs is, however, not alwa\« preceded by a similar condition of the urinary ap paratus. " In all these cases, tonics and excitants alwaya produced bad effects ; proving that the genital organs were not suffering from atony or weakness." fYMPTOMS B7 WHICH THE SPERMATORBHCEA MAY BK DETECTED. In addition to the effects already enumerated, ihere »re several other symptoms of Spermatorrhea 250 EXCE&3IVE SEMINAL LOSSES. that &re very useful to note, for the use both of the physician and patient. Some of them are such as are observed in various diseases, but others are pe- culiar to this affection, and enable us to ascertain its existence when positive evidence is not to be ob tained. Many persons suppose that in all cases the in- voluntary discharge of semen is indicative of dis. ease, and it alarms them very much. In many cases, however, the emissions occur in those that are continent, from excess of semen, and may then be beneficial rather than hurtful. This is often the case when they are in great quantity, though this peculiarity is apt to alarm, from the idea that the injury is proportionate to the quantity lost. Mr. Lallemand remarks that : " The most abundant nocturnal pollutions are far from being always the most hurtful. When they arise from true spermatic plethora, they often re lieve erotic excitement, with its accompanying agi tation, anxiety, uneasiness, and indefinable trouble in all the functions. They are followed by a gene- ral feeling of comfort ; the head becomes clearer, the ideas more rapid, and the motions more nimble ; there is more inclination to amusement, and to every kind of occupation. I admit that nocturnal pollutions do not often produce such good effects, but then they are not often the result of spermatia plethora ; they may too, easily lose their character, so that habit alone tends to make them more and more frequent. In the greater number of cases, however, these evacuations are of very little im- portance. " But thi* state of excitement is too violent to 23 EXCESSIVE* SEHINAu LOSSES. 251 last long : by degrees the organs become fatigued. Deprived of their natural functions, and con. ftequently, being unstrengthened by regular exer. cise, they may at last fall into a state of atony, of the seminal vesicles may preserve the habit of con- tracting, under the influence of slight or indirect excitement. The evacuations now produce effects quite opposite to those experienced in the beginning. There are on waking, feelings of discontent, idle- ness, weight in the head, disorder in the ideas, &c, but this condition passes off in the course of the day, and the patient is quite well on the following morn- ing, if no further emission take place. After a time, these effects become more serious and lasting, and two or three days are required to remove them completely. There is, however, no disease as yet, Oecause the economy is not as yet permanently dis- ordered, but there is a degree of instability in the patient's health, a valetudinary condition, the pro- gress of which it is necessary to arrest." Lascivious dreams are usually considered only as causes of nocturnal emissions, but they are in fact produced, in most instances, by the excitement ex- isting primarily in the Genital Organs, and are therefore symptoms of excessive vigor, in the first stages, rather than of weakness, or disease. So long as they only present pleasant images, without any disagreeable sensations, and are not followed by lassitude and weakness in the morning, they are not indicative of anything serious. But when these dreams are filled with filthy and disgusting ideas, horrible sensations, and night-mare, during which the discharge occurs without any pleasurable feel- ing, and is followed by distress next morning, they 252 EXCESSIVE SEMINAL LOSSES. are sure signs of disease. As a general rule th« danger commences when the pleasurable accompa- niments of the dream begin to fail, and when the discharge occurs without any sensations at all, 01 with disagreeable ones, it is truly a bad symptom. Diurnal, or daily, losses of semen are in general worse symptoms than nightly ones, and they are especially bad if they occur spontaneously or from mere exercise. When they occur during the movement of the bowels, or while urinating, though they are usually indicative of a diseased state of the parts, yet they may be made much worse by constipation, gravel, and other affections of the neighboring organs, a fact that should be borne in mind when estimating their value. From not naving these circumstances explained to them many persons lose semen in this way, perhaps for years, without knowing anything about it. When their attention is directed to the occurrence, how- ever, it will generally be easy for them to detect tfc* escape, whether it occur with the urine or aftei de- fecation. When with the urine there is a sensation as if something heavier than usual is passing, which creates a slight pricking or tingling sensation, and the urine looks thick and clbudy, with globules floating in it like half-dissolved gum-arabic. If the escape occurs during the movement of the bowels a similar sensation is felt, and th* end of the penis will be found covered with a glutinous fluid, which sometimes drops, but rarely runs away. More fre. quently the flow does not take place till the move- ment of the bowels is over, and perhaps not till the patient is dressing himself; it then comes suddenly, the whole quantity being discharged at once. This is preceded bv a kind of shock, felt in the perineum EXCESSIVE SEMINAL LOSSES. 25H a»r( neck of the bladder, and sometimes wiih slight erections, accompanied by pleasure. In some cases a discharge occurs in this way of simple mucus, mixed with the fluids of the Prostate and Vesicles, and this should be suspected when losses of this kind are complained of, till a proper examination is made. These mucous discharges, however, never consist of more than a single drop, or two at most, and are quite thin and transparent, while the seminal emission is both thicker and more opaque,, and in greater quantity. If the patient empties his bladder before going to stool 'the appearance will be more obvious, and if he observes a thicK gummjr discharge, during or after the passage of the bowels,, there can be no mistake as to its being real semen. It is more difficult to ascertain tb 3 presence of the semen when it escapes in the urine, because it is so diluted, and undergoes several changes, I shall there* fore be particular to give all the indications that can* be relied upon in such cases. — In the first place it must be recollected that the semen never escapes during the first flow of the urine, but always with the last few drops, or even after the bladder is fully emptied. There is in general the peculiar sensation already described, with siigiit pleasurable feeling, and a few spasmodic jerks of the neck of the blad- der, by which the expulsion of the last drops is ef- fected. — This is quite sufficient to distinguish sper- matorrhoea from gleet, or a discharge from urethia. inflammation, as in such cases the mucus always escapes with the first flow of urine, and is not ac companied by any of the sensations above described. The appearance of the urine also, if carefully noted, will nearly always be sufficient to indicate he na tuns of the affection. The presence of the semer 254 EXCESSIVE SEMINAL LOSSES. is nearly always indicated oy the gum-like globules mentioned above, and also by numerous little irre- gularly-formed granules, somewhat like bran, which settle to the bottom of the vessel. These granules are soft, an 3 fall down to the bottom of the vessel before the urine cools, without ever adhering to the sides, which distinguishes them from gravel. In short no other discharge furnishes anything like these granules, so that their presence is a sure proof of involuntary emission. Sometimes patients have peculiar sensa-ions in other parts of the body whenever a pollution occurs thus some experience a pain in the nipple or bac* of the nec«, some a cold chill and shivering, while others feel a burning heat round the anus, and after these sensations they always observe the rlocculent deposit in the urine. As the disease progresses the bran-like granules become fewer in number, and smaller, and at last almost totally disappear, so that the existence of the spermatorrhoea has to be ascertained by other symp- toms. The urine is still clouded with the gum-like deposit, and there settles to the bottom a number of little brilliant points, something similar to what is seen in newly-boiled mush. Like the granules they are soft, and do not adhere to the vessel. — These different appearances result from the altered condition of the semen, which, as the disease pro gresses gradually loses its usual character, am* eventually becomes totally changed. I have known patients much engaged in study in whom involuntary emissions occurred in a verv sin< gular manner. They would experience, while sit ting perfectly still, a sensation in the perineum or at the root of the penis, as if the parts wc re sud 23* EXCESSIVE SEMINAL L0SSLS. 2o5 denly drawn togethei and pinched. So distinct and strong is tiiis felt sometimes that the person imme- diately starts and compresses the part in his hands. The sensation lasts but a short t'kne, however, and nothing further takes place, if he remains still, but immediately he begins to exercise, or the next time he urinates, a quantity of semen escapes. This shows that the emission really occurs when the sen- sation is felt, but there is no action of the muscles 10 expel it till the parts are in some way made to *ct for other purposes. IMPOTENCE FROM INVOLUNTARY EMISSION. Whenever impotence is not obviously owing to any of the causes enumerated in the previous part of this work, it is nearly always the result of pol- lution, and perhaps as a general rule it arises from this cause oftener than from any other. There are two modes in which it may be brought about by this cause, first by the destruction of the powers of the Genital Organs, from general weakness, and secondly from a peculiar Change which it leads to in the semen. For erection to take place there is always needed the presence of healthy semen in the seminal vesicles, and if this does not exist of course no erection can occur, and impotence ne@es- sarily follows. Any cause, therefore, which impairs the vitality and health of the semen must lead to impotence, and no cause does so more surely than iong-continued involuntary emissions. The mode in which involuntary emission, or Spermatorrhoea, from any cause, affects the semen, appears to be this. It has already been explained iow the Seminal Animalcules are produced from 256 EXCESSIVE SEMINAL LOSSES. certain little grains or vesicles, found first in tft* semen of the Testicles, which break open and allo^a the Animalcules to escape. Now these little beings are the most essentia> parts of the seminal fluid, and without them it car neither act properly on the male organs nor impreg Date the female ovum. If, therefore, their develop, ment is prevented Impotence and Sterility must re- sult, and this is what really follows from Sperma. torrhoea. It is necessary for the semen to remain a certain time in the Vas Deferens and Vesicles, after it leaves the Testicles, so that the granules may burst and the Zoospermes become perfect, and if it be expelled from the body too soon this has not time to occur. The precise time requisite for the semen to remain in the body, after being formed by the Testes, is not known, and it probably varies, both with different individuals and also under differ ent circumstances in the same person. For a time the organs can, af healthy, perfect the semen rapidly, so lhat a man can expel it very frequently, and yet have it healthy, but if this excess is continued too long the power of the parts gradually weakens and the semen is at ength discharged imperfect. This is precisely what fellows eventually, both from licentious excess and from involuntary emissions ; the semen has not been allowed to remain in the organs sufficiently long, and when it is expelled no animalcules are found in it, but only the granules fr©m which they would have been developed had it remained. These are what are seen in the urine, in cases of long-continued involuntary emission, like little shining points, and probably also the bran-lika grains, observed at an earlier period, are the gran, ules in an undeveloped state. In many cases oi EXCESSIVE SEMINAL LOSSES. 257 long .continued Spermatorrhoea, both from ext/es* and involuntary, the change is still more decided, so that the semen is merely like thin gum-water, and utterly incapable either of stimulating erection 01 of impregnating. — This is the true explanation why those who are exhausted by excesses, and those who have long suffered from involuntary emissions, De- come impotent and sterile, and it shows us what is really needed to effect a cure. If we can arrest the discharge, and restore a certain degree of tone and vigor to the organs, the semen may be again re- tained sufficiently long, and may become perfect, so that the power of erection and impregnating may be again enjoyed. The chances of this are les- sened, however, in proportion to the time the flow has continued, and at a certain stage all our efforts are fruitless. I have, however, known some remarkable instances of restoration, even under the most un- promising circumstances. In one instance a man aged forty-seven came to consult me, who had been perfectly impotent for nine years, during, which he had not experienced the slightest manifestation of sexual power, nor scarcely ever been free from a discharge, which, however, was almost like water. According to his own statement this unfortunate condition was owing to former licentiousness, his indulgence having been excessive till the wretched state of his general health, and finally his complete loss of power, compelled him to abstain. I was' obliged to say to him that the changes of restoration were so small as scarcely to be worth calculating upon, and that I should not be justified in giving him any hopes at all. He wa s so exceedingly anx- ious, however, and pressed me so earnestly to take hioi under my charge that I did so, though with 258 EXCESSIVE SEMINAL LOSSES. considerable reluctance, and with great misgiving, Fortunately he was a man of wealth, and leisure, and disposed to follow out implicitly all the direc- tions given him. — The particular plan of treatment that was followed is not necessary to be describe* here, as I shall speak upon it generally further on but the result is stated as an instance of what car be sometimes accomplished even under very unpro. raising circumstances. I had this patient under my constant care for fifteen months, at the end of which time his sexual powers were sufficiently restored to allow of his marrying, which he did and became a father. It took three months to stop the constant emission, and after that six months more elapsed before animalcules began to appear in the semen, after which his improvement was very decided, though in all probability his powers will never be equal to what they were before, nor will they endure so long as they otherwise would have done. In cases where impotence is only partial or has existed only for a short time, proper treatment can nearly always effect a decided improvement. Every moment, however, is precious in such cases, and no man should feel indifferent even to a slight falling off in his sexual vigor, if it continues, and if he de- sires to preserve his powers. A short delay may lose all chance of restoration ; and it should be re- collected also that, in most instances, the derange- ments which cause impotence have often serioui effects, and generally so impair the health as to en- danger life. I am almost daily seeing instances of weakened power from Spermat rrhcea, and though I am com- Exiled to admit that u some of them relief is hope. as, vet in many the result of the treat nent is mosl EXCESSIVE SEMINAL LOSSES. 259 aatisfactory, and highly encouraging to those simi. larly affected. There is occasionally one result of Spermatorrhoea different from any of these above described, and which is sometimes of considerable importance, both socially and as a point in medical jurisprudence. Some patients, of vigorous habits of body will continue to. secrete the semen, and retain their powers of association, e>en after the disease has existed for a considerable time. They may^ however, be sterile, though not altogether im- potent; and the fault of barrenness is ascribed to the female, because no defect exists, so far as can be seen, in the husband. These men are able to asso- ciate, as before remarked, and to emit semen, but on examining that fluid none of the animalcules are formed perfect, being either all dead or half formed. The semen in short is perfect enough to stimulate the male organs, to a certain extent, but not perfect enough to impregnate the female ovum, and I have no doubt but that many cases of supposed barren- ness in females are owing merely to a defect of this kind in their husbands. I have known men affected in this way who were remarkably active and vigor- ous, and in whom no imperfection whatever could be suspected till pointed out by the microscope. — M. Lallemand was the first author who alluded to this important subject, and his remarks are well worth reading : — " Infecundity. — Impotence is an absolute cause of tafecundity because it prevents the conditions neces. sary to fecundation from taking place ; but although tire act of coitus may be accomplished, it does not follow that the person should always be able to per- petuate his species. Stricture of the urethra may 2o0 EXCESSIVE SEMINAL LOSSES. prove an obstacle to the discharge of seminal fluid ; or the fluid may be directed towards the bladder o* the parietes of the urethra, by deviation of the ori- fices of the ejaculatory ducts. The secretion maj be altered in its nature, it may only contain imper- fect spermatozoa, &c. A man may, therefore, b© unfruitful witout being impotent. On the other hand, I have met with many patients suffering from diurnal pollutions who had children exactly resem- bling them, even during the duration of their dis- ease. Indeed, I have seen several cases in which the disposition to involuntary discharges was here- ditary, and they affected both father and son. The disease is, however, essentially irregular in its pro- gress ; it may continue long without doing serious injury to the health, long remissions may be expe- rienced, or even a perfect cessation of the complaint for a longer or shorter time ; we may easily con- ceive, therefore, that in the first degree, or during one of the periods of remission, fecundation may take place. When the disease is further advanced, however, many causes concur to render coitus un- fruitful. Ejaculation is weak and precipitate, so th»t the seminal fluid cannot be thrown into the cavity of the uterus ; it is not sufficient in order to fecundate, simply to spread the fluid over the va- gina ; it must be projected with sufficient force to pass through the orifice of the uterine neck. Be. sides, in these cases the erections, even when the) permit sexual intercourse, are incomplete and of very short duration, emission takes place without energy and very soon ; so that during such rapid acts the uterus and Fallopian tubes have not suffi. cient time to experience the excitement necessary to carry the semen to its destination, even when k EXCESSIVE SEMINAL LOSSES. %fi\ posses the neck of the uterus. The semen itself also undergoes great changes, to which perhaps the loss of the fecundating power is chiefly attributable. Microscopic researches have elu- cidated this formerly obscure subject ; I have discovered, for instance, that the spermatozoa undergo changes similar to those of the fluid which serves as their vehicle ; these changes are exceedingly important, and are owing to defective formation. Spermatozoa may be met with in a less thick and less opaque fluid than natu- ral, for they are not produced by the^same parts, or in the same manner ; but when the secretion is per- fectly thin and watery, the functions are- so seriously affected that the animalcules are altered ; they are less developed, less opaque, and less active than na- tural ; indeed, they are so transparent that peculiar precautions are necessary in order to make sure of seeing them ; their motions are weak, slow, and cease very soon ; and they rapidly undergo decomposition. All these characteristics show how much their texture is relaxed, and how imperfectly they are organized. " It is evident that the least arrest of development in the spermatozoa must prove an insurmountable obstacle to fecundation, even if the only function of the animalcules be lo carry the liquor seminis to the * ovum. When, however, their imperfect development only arises from a too rapid formation it may soon be obviated. It suffices that the involuntary dis-* charges should cease for a few days only, in conse- quence of some accidental cause, or of one of the spontaneous changes of this extraordinary disease, in order for the desires to become more lively, the erections more energetic and prolonged, and for the function to be accomplished in a natural manner. 262 EXCESSIVE SEMINA1 LOSSES. Fecundation is, therefore, possible, as I have pre riously stated, during the whole duration of one of these intermissions. "This is not the case when the spermatozoa are malformed, rudimentary, more or less deprived of tail, &c, for these changes only take place whea there is a serious alteration in the structure of the testicles. I have taken every opportunity of dis- secting the testicles altered in these cases, and I have always found the secreting structures paler, drier, and denser than natural, and the cellular tis- sue more resisting, and with difficulty allowing the secreting ducts to be separated one from another. Sometimes half or two-thirds of the testicle were transformed into a fibrous or fibro-cartilaginous tis- sue mixed in a few cases with tuberculous matter. It is the same also in the epididymis, where I have even seen traces of ossific deposit in the midst of cartilaginous indurations. These changes, caused by previous inflammation, perfectly explain why the development of the spermatozoa can no longer proceed normally. " Although in such cases the secretion of semen may be more or less diminished, pollutions may still be present if the seminal vesicles have shared the • inflammation by which the testicles have been af. fected, as happens in most cases of orchitis arising from blennoi;rhagia. I have at present a patient * who presents a remarkable example of both thes^ ffects arising from this cause : he is now forty-one years of age, and had biennorrhagia followed by inflammation of both testicles at twenty-five. Soon after his recovery, he married but has never had children, although the act has been performed regu» larly if not frequently. He became subject to ^r* 24 EXCESSIVE SEMINAL LOSSES. 203 ttimal, and sometimes flKurnal pollutions, which in- creased by degrees. His health became disordered, *>ut coitus was still possible. The semen passed, al- though it presented its characteristic odor but never showed under the microscope other than very small and brilliant globules, without any appearance of tail, but easily distinguishable from globules of mu- cus, the dimensions of which are five or six times larger. The epididymis of both sides is volumi- nous and irregular. One testicle is adherent to the skin of the scrotum, and the other appears smaller than natural. " Malformation of the spermatozoa, therefore, arises from deep-seated changes in the tissues of the testicles, changes which do not permit the animal- cules to assume their normal form, and, therefore, render infecundity permanent. " To sum up then. Involuntary seminal dis- charges may oppose fecundation previously to ac- tually producing impotence, by diminishing the energy of all the phenomena that concur to the ac- complishment of the act, and by preventing the complete development of the spermatozoa, as well as the elaboration of the fluid which acts as the vehicle for them. <: These conditions may be rapidly altered by the simple diminution of the involuntary discharges, and fecundation may again become possible. " This cannot be the case when infecundity de- pends on malformation of the spermatozoa — such malformation arising from permanent alteration in the organs that supply them." Microscopic Examination of the Sem,en, — This if a subject of great interest to every one, and of im- 264 BXnESSIVE :>EMINAL LOSSES, mense importance to the phymcan and patient. The proper mode of pursuing such examinations has been so well explained by M. Lallemand that 1 cannot do better than copy his remarks, to which T will add here that with good instruments there is nn difficulty whatever in the process. "Microscopic Examinution. — Since the discovery 3f the spermatozoa, their presence in the seminal fluid has attracted the attention of all who have sought means of distinguishing it from other fluids. Mi- croscopic examination of the spermatozoa, however, not only requires an excellent instrument, but cer- tain precautions which may be dispensed with in the investigation of coarser objects. As the spermatic animalcules can be only seen by means of trans- mitted light, it is necessary that the glass on which the fluid to be examined is placed should be of uni- form thickness, and without bubbles or striae. The fluid to be examined should be covered by another layer of extremely thin glass made on purpose, and not by portions of mica, which are seldom free from cracks, and never perfectly transparent. This thin layer of glass is indispensable in order as much as possible to diminish the thickness of the fluid, to render it perfectly uniform, to hinder evaporation and prevent the object glass from being soiled by it. A single drop of fluid suffices for a complete ob* servatiou, a larger quantity always proving incon. venient. The little glass that covers the liquid muaS be firmly pressed down so as o spread it out, arrest the currents that take place in it, and drive out the air bubbles. Although the glasses should seem to touch each other the spermatozoa move with perfect freedom in the space between them, so long as they EXCESSIVE SFMINAL LOSSKS. 265 preserve their energy and evaporation has not pro eeeded too far : should such be the case, however, a drop of tepid water favors and much prolongs their motions. However thin the layer of fluid may be, it is impossible to comprehend its whole thick- ness at once with a very high power, and it is, there- fore, necessary to alter the focus frequently in order to be sure that nothing escapes observation. And this is especially important in examining a drop of fluid obtained from diurnal pollutions, because there are frequently only two or three spermatozoa con- tained in it. It is also necessary to change the po- sition of the reflector frequently, in order to vary the direction and intensity of the light. The sper- matozoa are often exceedingly transparent in cases of disease, and a very bright perpendicular light is by no means the best for showing them. Varying the density of the fluid under examination, either by adding water or by permitting evaporation, is also often useful. The semen contains matters fur- nished by the seminal vesicles, the prostate and the urethra, and when the fluid is too thick these matters hide the animalcules. A drop of water applied to fhe edge of the covering.glasstpenetrates underneath it, and the spermatozoa are more isolated, at the same time that their contour is rendered more de- fined by the diminution in density of the fluid. On the other hand the refractive power of the sperma- tozoa differs little from that of the fluid in which they are contained, and their thinnest portions are traversed by the light without affording any distinct images to the eye. In this case there are only seen very small ovoid brilliant globules terminated by a little point. As soon as the water begins tc pene. Irate between the glasses, the rapid motion set up 266 EXCESSIVE SEMINAL LOSSES. prevents the objects from being clearly distinguished ; but as soon as rest has been re-established the tails of the animalcules appear, and their dimensions seem to have increased in consequence of the diminished density of the surrounding fluid : water suffices to produce this result. It is more sensible, however, when a small quantity of alcohol is added : but the forms of the animalcules are, after a time, altered by this agent ; and it is, therefore, advisable to use water only when it is intended to keep the prepa- ration. " Evaporation sometimes produces not less re- markable changes in the seminal fluid. I have frequently in cases of spermatorrhoea failed to perceive any thing in the fluid under examination for half an hour, an hour or more ; then suddenly an animalcule has made its appearance ; then a dozen, and then perhaps a hundred in the space of a few minutes. The following morning, when de- siccation has become complete, there are no longer any traces of these animalcules, or, at all events, I have been only able to distinguish their tails, the other parts of them being fixed in the dried up mucus. The absorption of a drop of water has restored the phenomena observed the night before. ;< These phenomena are easily explained ; when the refractive power of the spermatozoa is the same as that of the circumambient liquid, the light tra- verses the whole in the same manner, and the mas* appears homogeneous. But evaporation acts more rapidly on the liquid than on the organized bodies contained in it ; and when the difference of density alters the refractive power the forms of the sperma- tozoa are momentarily defined because they have become more transparent than the remainder of th« 24* EXCESSIVE SEMINAL LOSSES. 267 fluid. When desiccation is complete, however, the animalcules again disappear, because the refractive powers of mucus and dried animalcules are again equal. The absorption of a small quantity of water re-produces the same phenomena, which may- be repeated almost indefinitely, since the matter confined between the two layers of glass undergoes no other appreciable alteration. " In order to be enabled to discover spermatozoa quickly in cases of disease, it is necessary that they should be wed studied in healthy cases. This may be accomplisned in the following manner : — - After coitus there always remains a sufficient quantity of seminal fluid in the urethra to serve for precise and complete microscopical examination. This may be obtained by pressing the canal shortly after the act, and receiving the drop of fluid from the orifice of the glans on a plate of glass. In this drop of fluid thousands of amimalcules may be seen, agitating themselves like so many tadpoles in a pool of stagnant water, only that the tails of the spermatozoa are relatively longer and thinner, and that the head presents a brilliant point near its in- sertion. Generally the number of these amimalcu- les prevents them from being easily examined, and it becomes necessary to spread them out by intro- ducing a small quantity of water, and pressing firmly dawn the thin glass that covers them ; they are found most separated on the edges of the fluid. If the water added he of the temperature of the body their motions become free and lively, and con- tinue so until cooling and evaporation affect them. By avoiding these two causes of disturbance the motions of the spermatozoa may be kept up during oev< ral hours. 568 EXCESSIVE SEMINAL LOSSJBS. 11 However long a time may have elapsed aftei coitus there are always spermatozoa in the urethra* provided they have not been washed away by the passage of urine. Although the point of the glans may be quite dry, and pressure along the wiole length of the canal may not produce the least dampness, still on passing urine livkig animalcule* may be obtained from the first drop which escapes. This may be received on the glass, and is perhaps the easiest and most natural mode of obtaining spermatozoa for microscopic examination. " It is evident that the same experiments may be applied in the case of nocturnal pollutions as well as in all other seminal discharges in whatever man- ner they may occur. But many errors may arise from commencing with cases of disease, for it is during perfect health that the spermatozoa are most active, and their development most complete, and they live longer after coitus than after any other kind of seminal discharge. " Having thus described the means by which my microscopic observations may be verified, I proceed to show their results. " Spermatozoa. — Out of thirty-three bodies which I have examined for spermatozoa, I only twice found these animalcules in the testicles. In one of these cases the patient died from the effects of a fall on the day following it ; in the other acute gastroen- teritis was the cause of death. The seminal fluid was most abundant, and contained the greatest number of animalcules in the former case. The other patients died of chronic diseases after pro- tracted sufferings. One only among them died on the second day of acute peritonitis, but he was seventy- three years of age. In thirty-one of these EXCESSIVE SEMINAL LOSSES. 269 patients the testicies were soft, pale, and as ihougk fathered. On section they presented a grayish as- pect, and did not furnish any liquid ; the structure was almost dry, and contained a few blood-vessels ; the secreting canals were easily seperated from one another and could be spread out under the micro- scope without breaking. They presented very bril- liant granules, all of exactly the same appearance, about the size of the head of a spermatozoon, tea ♦irnes smaller than corpuscles of blood or mucus, and differing from the latter by the constancy and regularity of their form. These brilliant bodies, which occupied the place of the spermatozoa, are worthy of notice, because they offer considerable analogy to the appearances presented by the semen under certain circumstances. "'In order to observe what is present in the se- creting canals of the testicle it is necessary to spread out a portion ?£ one of them under the mi- croscope, after having examined it dry to allow a drop of water to penetrate between the two glasses, and to follow the changes which take place ; then to press down the glass so as to flatten the parietes of the canal, rupture it, and pres-s out a portion 01 its contents ; lastly, these must be examined again when desiccation is complete, for the spermarozoa found in the canals are then best seen. "In the epididymis 1 have never found sperma- tozoa, except in the two cases in which they were also found in the testicles. In all the others I met with these animalcules only in the vas deferens or seminal vesicles. There were no animalcules at aif to be found in the patient who died at the age c* seventy-three. It has always seemed to me that the animalcules were less numerous in proportion as 270 EXCESSIVE SEMINAL LOSSES. the patients had suffered long ; and in extreme case* I have generally found them only in the seminal vesicles. The fewer the spermatozoa the more dif- ficult were they of detection on account of their extreme transparency. In some cases I have only suddenly discovered them after examining for an hour or two, the liquid having previously appeared quite homogeneous. The dimensions were the same as those of the best developed animalcules, but they were pale throughput their whole extent, and more transparent than the surrounding fluid. Complete desiccation often caused them to disappear altogether ; but the same phenomena could be re- produced by the absorption of a small quantity of water. " In cases of phthisis, caries of the vertebras, white swelling, &c, I have had great difficulty in distinguishing the animalcules, probably because these diseases do not cause death for a long time. "I have almost always found in the seminal ve- sicles, especially at the bottom of any depression, a thick, grumous brilliant matter, varying in its aspect and color, but considerably resembling thick paste, and more or less transparent ; with a high power the granules of this matter appear large, irregular, more or less opaque, and without any constant shape. They are evidently the products of the in- ternal membrane of the vesicles, for they are found with similar characters in the accessory vesicles of the hedgehog, rat, &c, which never contain seminal animalcules, and do not communicate directly with the vasa deferentia, which, again, never contain any .similar substance. This matter is, therefore, analogous to that secreted by the prostatic tbDicles, Oowper's glands, &c. Its functions ar' EXCESSIVE SEMINAR LOSSES. 271 the same, and for many reasons it merits special at* tention. " The secretion of semen dii/iimshes in all seri- ous diseases, and seminal evacuations become very rare, especially towards the last. It is not, there- fore, astonishing that the products of the mucous membrane predominate in such patients over those of the testicles, and that such mucus should become more consistent during its long residence in the de- pressions of the vesicles. Hence, the difference observable between the semen obtained from the vesicles after death, and that which is passed by a healthy person. Nevertheless, after long-continued continence more or less large granules are often seen in the semen of a healthy person, and these are perfectly distinct from the fluid part. When the emissions are more frequent granules of the same kind may be observed, but much smaller, These facts are important when applied to explain several symptoms of diurnal pollutions. " I have already stated that on causing the pa- tients to make water in a bath, the semen passed may be easily recognised by means of its globules which whirl about in the middle of the cloud formed towards the close of micturition. From what we have just seen it is evident, that these globules come from the internal membrane of the seminal vesicles. They may be wanting in very uevere cases where the semen has no time to acquire consistence ; but their presence leaves no doubt as io the existence of diurnal pollutions, because they can only be furnished by the seminal vesicles. On (he other hand, I have invariably found spermatozoa in the urine of patients who observed this phenome- uon hi the bath. The same remark? hold good 272 EXClaSIVE SEMINAL LOSSES, when applied to the globules which the urine depo. . Bits in certain cases of diurnal pollutions, and whicfc have been compared by some to grains of bran, by others to millet seed, pearl barley, &c, according to their size. These globules are perceived as soon as the urine is passed, they are roundish, very soft, and do not give any sensation when squeezed be- tween the finger and thumb ; they cannot, therefore, be confounded with urinary salts which are depo- sited only when the urine has cooled, have a crys- talline form, and give the sensation of a hard body to the finger. The vesical mucus also is only depo- sited on cooling, and does not furnish brilliant granule^. As to pus, its appearance is easily de- termined. I have found animalcules whenever these globules appeared in the urine ; and. hence it is that I have pointed them out as certain signs of diurnal Pollutions. " I have also noticed that in some cases the urine, when held against the light, presents in the middle of a flocculent cloud multitudes of quite charac- teristic brilliant points. These are smaller, and consequently, lighter globules than those which in other patients fall to the bottom of the vessel. They are neither observed in the mucus of the bladder nor in the prostatic fluid, which alone present clouds analogous to those of diurnal pollutions. Such brilliant points also arise from the seminal vesicles, and their presence is, therefore, an indication that the urine contains semen. This 'I have often veri- fied with the microscope. I should, however, warn those who wish to repeat my experiments, that it is not in the midst of the flocculent cloud that the ^oosperms are to be sought, but at the bottom of the vessel, to which they soon fall on account of their EXCESSIVE SEMINAL LOSSES. 273 greater specific gravity. The results of all my ob- servations on the dead subjects, therefore, convince me of the influence of serious and long-continued diseases on the functions of the spermatic organs. But it is not only in the morbid state that these ex- perience great variations ; remarkable ditferencea may exist between healthy individuals not only in the quanity of semen secreted in a given time, but also in the number, appearance and dimensions of the spermatozoa. In this respect I have observed Hitferences amounting to a third, and, in some cases, to half. The comparison is very easily established. When the semen is kept under a thin glass as I nave before described, it is not in danger of under- going any changes, and may be always, by the ad- dition of a drop of water, compared with a recent specimen. " Notwithstanding the facility with which noc- turnal pollutions may be recognised, I have sub-" mitted the semen collected after them, by individuals in various conditions of health, to microscopic examination. At first when the evacuations are still rare and the semen preserves its ordinary characteristics, the animalcules do not present any remarkable circumstances in regard to their num. ber, dimensions, &c. ; but when the disease has reached a sufficient degree of gravity to affect the rest of the system the semen becomes more liquid, and the spermatic animalcules less developed and less lively. Their number, however, does not as yet sensibly diminish ; indeed, in some cases, it seems increased. As the disorder advances the erections diminish, the semen becomes more watery, and the animalcules are often a fourth or a third less than natural, and the tail is often distinguished 4*74 EXCESSIVE SEMINAL LOSSES. with difficulty under a power of three hundred diameters. At a still later period the animalcules become fewer, and in two individuals in the last stage of the affection the semen no longer contained animalcules, although it retained its characteristic smell. Examined with high powers and every pro- per precaution, I only found, in this semen, brilliant globules, all exactly alike, and about the same size as the head of a spermatozoon. " The microscopic examination which I have made of semen passed during efforts at stool give* analogous results. When such discharges only take place accidentally and at long intervals, the semen is thick, whitish, impregnated with a power, ful smell, and abundantly furnished with well-de. veloped animalcules. I have sometimes even found a few alive after an hour or two. But when these discharges become so frequent or habitual as to constitute disease, they become less abundant and the semen losses its normal properties. The sper- matozoa are generally smaller than in the healthy condition, and always less lively. I have some preparations in which they are only of half the ordinary size, and I have never been able to find a single living animalcule a few minutes after the fluid had been expelled. When the disease has be- come much aggravated the spermatozoa become rare, and they are. sometimes replaced by ovoid or spherical globules similar to those of which I have already spoken. In three patients in an extreme state of disease I found nothing else, although they passed as much as a dessert spoonful of semen at each stool. Such cases, however, are exceedingly rare. " In diurnal pollutions happening during the pa* 25 EXCESSIVE SEMINAL LOSSES. 275 sage of urine the following means may be employed to show the presence of spermatozoa. The urine should first be filtered ir. a conical filter, when on account of their weight, the greater number of the spermatozoa will remain on the lowest part of the paper. By taking this portion and turning it upside down in a watch-glass containing a few drops of water the animalcules become detached from the paper by degrees, and fall to the bottom of the fluid in the glass. After twenty-four hours maceration in this position, the paper may be taken away and the spermatozoa may be readily obtained by using a drop from the bottom of the fluid in the watch-glass for examination. This mode of pro- ceeding is a sure one, but it requires considerable time and trouble for its performance. I have already stated that the urine does not always contain spermatozoa in cases of diurnal pollutions ; there- fore, the urine of the same individual would perhaps require examination on many occasions before thp certainty of their presence could be established, and few medical men in active practice have time to devote to such experiments. I for one should have long since given up treating these patients had I been obliged to repeat in every case such long and tiresome examinations. Ten days or a fortnight are sometimes passed without, the appearance of sperma- tozoa in the urine, and hence all who are accus- tomed to microscopic researches will admit the indefinite amount of trouble and time required. " Fortunately, however, there is a more simple method by which such examinations may be con- ducted. It will be recollected that the semen Always escapes either with the last drops of urine, or immediately, or soon afterwards. By diieeting 276 EXCESSIVE SEMINAL LOSSES. the patient, therefore, to compress the urethra im- mediately afte.r micturating, and to receive the drop of fluid pressed out on a piece of glass, sufficient animalcules will be obtained from the walls of the urethra for microscopic observation. These being covered with a thin lamella of glass may be either at once placed under the microscope, or may be al- lowed to dry, and examined at a future time, a drop of water being previously added. This mode of examination is, therefore, easy for all practitioners who possess a good microscope, after they have ac- customed themselves to the inspection of the sperma- tozoa in their natural state. The changes which 1 have mentioned as occurring in the semen must be borne in mind, however, and the animalcules must not be expected to appear either so large, so well defined, or so numerous as in cases where there if no disease. " TREATMENT OF SPERMATORRHOEA. In treating Spermatorrhoea there are two things necessary to be ascertained, first the primary ex- citing cause, and secondly the existing cause, if such there be, that keeps up the disease. Most usually we discover that masturbation has been in- dulged or that the patient Jias been addicted to ex- cess, and it is of course necessary that such evil practices be immediately and totally abandoned, be- fore any improvement can be hoped for. Next we must see if there De any skin disease, piles, consti- Eation, worms, gravel or any other cause that may eep up the irritation, and when this has been re. moved the actual treatment of the parts themselves may begin. This treatment must consist in the EXCESSIVE SEMINAL LOSSES* 277 application of those me-ans best calculated to remove the irritability or relaxation existing in the ducts and seminal vesicles, and to give tone to the Testes,. So long as the ducts and vesicles retain their irritability "or remain open the semen must necessarily escape, and it becomes therefore absolutely requisite to re- move such disability, and restore to them that power of contraction which they possess in a healthy state. In some recent cases very simple treatment will suffice. If the patient leaves off all bad habits, avoids constipation, attends carefully to his diet, takes no simulants either in food or drink, and carefully bathes himself in cold water round the parts, night and morning, a decided improvement will often be experienced. He must, however, avoid all excite- citement of the mind or feelings, never over- fatigue himself, and not lie in bed after he is awake in the morning. — These directions are more especially applicable to those incipient cases common among young men, when the emission takes place at night, usually in consequence of a dream. It will usually be found in such cases that the loss occurs towards morning, and most frequently when the patient Is half asleep and half awake, a st%te which is very apt to produce sexual excitement. Many young men have told me that they never had an involun- tary erection except at such times, and that if they ever remained in that half dreamy condition it was nearly certain to occur. However disagreeable it may be, therefore, the patient must rise immediately he is awake, unless it be too early, and he feels con- fident he can go sound to sleep again. Many per- sons whenever they awake and feel any tendency to erection, always rise and bathe themselves and then lie down again, and by these means escape tho 278 EXCESSIVE SEMINAL LOSSES. emission. It is particularly imi >ortant also that late suppers should be avoided, and that no coffee should be drunk, and no tobacco used. This is very neces- sary, for many of my patients assure me tnat a sin- gle cigar towards bed-time will ensure an emission. in spite of all the precautions they can lake. If all young men were to observe tnese precau. tions habitually they would seldom be trowbleti with involuntary emissions at all, because the parts would be so strengthened, and all irritation so promptly subdued, that it woulu scacely ever arise, unless from excessive abuse or masturbation. The remarks which I formerly made as to the import- ance of regular occupation, botn for body and mind, are also particularly applicable here, there being no doubt but that idleness very much predisposes to all these evils. Internal medication is seldom of much benefit, but unfortunately most persons think the contrary, and this great and fatal error is often the means of perpetuating the disease. Men think, when they are afflicted with involuntary emission, that it is only necessary to take certain drugs to be made well again. They accordingly either allow the evil to go on till it becomes incurable before they do any. thing at all., or else they rely upon the medicine alone and neglect all other means. The conse- quence is that they obtain no relief from what they have taken, and find that the time has beer, uselessly lost during which a cure was possible. I do nol hesitate to say that any man, by observing the sim- ple advice already given, will be more benefitted without any medical treatment whatever, than he can be by the best he can receive if that advice be neglected. It is true that a little medication is ot> 25* EXCESSIVE SEMINAL LOSSES. 279 asionally beneficial, but it is not of a specific cha« ; acter, or adapted to all alike, but must be varied according to circumstances, and in all cases it should be regarded merely as assisting, and not as being capable of curing alone. It is more especially when there is gravel or considerable irritation of the urethra ami bladder, that good can be done by medi- cation, and even then it is of a simple character. If there is any heat and burni-ng when the urine is discharged, with a discharge of thin mucus at the beginning of the flow, the following pills will be beneficial. R. Balsam of Copaiva, two drachma ; Magnesia, seven grains. To be made into pills of -four grains each, of which two may be taken three or four times a day. If the urine is high colored, and deposits a red sediment upon the sides of the vessel, indicating gravel, the following powders will be better. R. Dried Bearberry leaves, (JJva Ursi) one drachm and a half; Bicarbonate of Soda, one drachm. Mix them and divide into twelve powders, of which one may be taken three times a day in water. These powders are also excellent when there is simply irritation of the bladder, causing a frequent desire to urinate. For this particular trouble it i& also advisable to drink but little, and never to use hot fluids of any kind, nor spices, wines, spirits, or coffee. A little gum is useful, kept in the pocket" and swallowed occasionally during the day. There are few cases in which these means will not at least give some relief, even if they do not cure, but it may not be immediate. This is a fact that should be borne in mind, so that discourage. 280 EXCESSIVE SEMINAL LOSSES. ment should not be felt because the good is not ex- perienced at once. The disease it should be remem- bered nas nearly always existed a long time, and has assumed a chronic form, so tha. it can only he successfully attacked in a gradual manner, by slowly producing a change in the action of the parts. Nevertheless, 1 have known many benefitted almost immediately, and very often I hear the re- mark, that in one week from the time of commenc- ing the treatment, the emissions decreased one half in frequency. To ascertain the extent of the im- provement, and as a guide to the physician, every one afflicted in this way should keep a diary, or date the times when the emissions occur, so that it can be seen whether they are really decreasing in fre- quency or not. One of the best means for applying cold water, both for the purpose of strengthening the genitals and also for relieving constipation, is by means of what is termed the ascending douche ; that is by a stream or jet directed upwards. This must be made to play forcibly on the Perineum, and against the Anus, by the patient sitting over the jet. The effects of this treatment, after a time, are often strikingly beneficial. I have known patrents who had previously never passed a night without emis- sions, remain for two weeks without experiencing anything of the kind ; and I have known the most obstinate constipation, in some instances of near three weeks' duration, completely cured by it in less than a month. It is in fact one of the most valuarble remedies we possess in the treatment of Spermatorrhoea, and has cured more than, perhaps, all other means put together. Those who cannot employ a p'oper apparatus may use a large ana EXCESSIVE SEMINAL LOSSES. ^i powerful syringe, bent at right angles, so that the Jet can be thrown up against the Permeum, Scro- turn, and Anus. It should be used morning ana flight, for about five minutes. The man, mentioned ui the last article, w~ho had been impotent for nine years, owed his cure to this cold douche. I have men found nothing else necessary, even in very bad zases 1 except proper attention to the diet and regi- men. In case of worms in the rectum, which often keeps up Spermatorrhoea by their irritation, there are few things • that succeed better in dislodging them, and subduing Ue irritation, than enemas of cold water. X nese seem to paralyze the worms, so that they lose their hold and are expelled with the fluid as it returns. They also cool and give tone to all the neighboring parts in a very marked man- ner, and are in short valuable remedies in the treatment of Spermatorrhoea. In some instances they will cause erections from the very first, though the person may have previously been almost impo- tent. When the loss evidently occurs more from general weakness than from irritation the plan of treatment must be somewhat varied. Warm bath- ing may then be advised, with a generous diet of meat and wines, and the occasional administration of tonics and bitters. Galvanism is also of very great service in many of these cases of debility, applied directly to the parts, or to them and the spine. It will frequently impart a feeling of warmth and vigor from the very first, and restore the natural powers sooner than almost anything else. The patient should, however, be particularly cau. tioned not to use any of the stimulating medicine, 282 EXCESS, /E SEMINAL U S8ES. cordials, and tonics, so urgently recommended foi this debility. ■ These are mostly composed of Span* ish jiies or Phosphorus, and are very hurtful, though they may appear to do good for a time. Several of the mineiai waters are highly useful in Spermatorrhoea, especially those that contain iron. And those that contain sulphur are also of service when used as baths. When there is any considerable nervous irrita. bility, with resdussness, loss of sLeep, or bad dreams, a narcotic may be of service. A few drops of laudanum may be taken at bed-time-, or some of the camphor and opium pills, directed in a formei article. If the stomach cannot bear opium it may be given as an enema, either by putting a few drops of laudanum in some starch-water, or by using a decoction of poppy-heads. Some patients even introduce an opium pill, containing one grain, into the rectum at bed-time, and leave it there till morning. This will frequently prevent emission, but it is apt to act too strongly on some persons. Occasionally setons are of service, placed inside the thighs, or acupuncture with needles, but these must always be directed and applied by the phy- sician. The position in bed is frequently of some con- sequence in very irritable persons, and should be attended to. There is no doubt but that lying on the hack is very apt to cause pollution, by the heat it produces in the loins, and sometimes it will con- tinue it notwithstanding everything else that can be done. So well aware are some persons of this that they invent peculiar contrivances to prevent them ever resting on the back, even fcr a moment. One of my patients used to wear a broad leathei deli aJ EXCESSIVE SEMINAL I OSSES. 283 night, with spikes on the inside behind, so that if ha turned on his back while asleep, these hurt hiin and waked him up. Another wore a pointed piece of wood, so adjusted that he could not turn on his back at all, and by these means he avoided the emissions that used to occur almost nightly. Sometimes it is sufficient to merely sleep upon a hard mattress, with a piece of oiled silk, or india rubber cloth under, to keep the parts cool ; or what is still better a sheet of lead may be tied over the back and loins when retiring. I have known some patients speak very highly of the effects of this metallic shield. When there is decided irritation of the genital organs, manifested by redness at the end of the penis, burning When making water, and mucus discharge from the urethra, it becomes of the first moment to prescribe a proper diet, consisting chiefly of milk. This should be used freely, both as food and drink, either thickened with rice, isinglass, or sago, or even with gum-arabic. The benefical effects of this article will soon be evident in th6 decrease of all the inflammatory symptoms. Very little meat must be used with it, but plenty of potatoes, which are not only nutritious, but have also a decidedly good effect on the urine. Some fruits are very excellent, particularly strawberries, and ripe peaches, and so are tomatoes, but any very acid ones are objectionable. If the milk disagrees with the stomach a little, which it will sometimes do, a few grains of magnesia may be added to it, or two or three spoonfuls of lime-water, which will generally correct all such tendency. The copaiva and magnesia pills may alsc be used, or the pow. ders of bearberry leaves, as formerly directed. Wines, coffee, spices, and spirits must be rigidly 284 EXCESSIVE SEMINAL LOSSES. avoided in all such cases, and in fact every hind of excitement, as far as possible. • Cauterization.— This is a process which usually is resorted to when all other modes of treatmRiV fail, though some physicians practice it from th# first. To understand how it operates the action at caustic, when applied medicinally, must be born* in mind. If we have any diseased surface, such as an open ulcer, or an inflamed mucous membrane, the caustic not only burns off that diseased surface, but by its energetic action so alters the condition of the parts that the disease is frequently removed altogether. This is why it is applied to alj virulent sores, and to inflamed sore throats, eyelids, and other parts. Now in confirmed Cases of Sperma- torrhoea there is always either a relaxed or an in. flamed condition of the Ducts, Urethra, or Vas De- ferens, and it is evident that if the caustic can be Applied to them, in a proper and efficient manner, it will in all probability affect them in the same way that it does other parts when similarly diseased. The great difficulty, however, is to find a means to apply it in the situation required. The ducts being placed at the bottom of the tirethra, completely out of sight by any means, and with great difficulty ever reached, it becomes a question as to how they are to be operated upon. This has been decided, how. ever, by M. Lallemand, who has invented an instru* rnent which enables us to apply the caustic to the ejaculatory ducts, with almost as much certainty as to any place on the exterior. This instrument consists of a silver tube, open at the end, and adapted to the size of the passage, down the inside of which passes a kind of piston, furnished at the «3i>d with a piece of lunar caustic, When the tube EXClSSSIYE SEMTNAL LOSSES. 285 is introduced into the urethra, the caaistic is con« tailed inside of it, but when the open end of the tube has reached the ducts the piston with the caus tic on it is pushed out a little way for a moment, and of course burns the surrounding parts ; it is then drawn back into the tube and the whole appa- ratus is immediately abstracted. By these means the ducts, the mouths of the prostatic vessels, and the neck of the bladder are effectually cauterized without any of the other parts being touched. The performance of this operation is certainly a little difficult, and requires great manual skill with an intimate knowledge of the structure of the parts. An unskilful person, who could not properly manage the instrument, or not judge correctly of the proper distance to introduce it, might not only fail of doing good but even do harm. Many practitioners also cause grea-t mischief by letting the caustic remain eoo long, and burning too much, or by acting only an the healthy parts and leaving the diseased ones antouched. In short, though the operation is fre- quently of the greatest benefit, when properly per- formed, and capable of effecting a complete cure in the very worst of cases, it is also exceedingly dan* gerous when improperly performed, as too many know. Not only may the irritation be made much worse, but the most severe inflammation may foL iow from it, so as to prevent the discharge of urine, and lead to abscesses and ulcers of the most incura- ble kind. Even in successful cases, and under the most favorable circumstances, great distress ia nearly always experienced, and the pain is not un- frequently very severe. Many persons are much alarmed, and even though greatly benefitted, cannul bring their .mind to submit a second time to it. 286 EXCESSIVE SEMINAL LOSSES. In general, however, one operation is sufficient, and when a repetition is required, it should selcbom be under six weeks or two months after. I have seen patients in a miserable state who had been cauterized too f lequently, and with too short inter- vals, and in all probability cauterization has, on the whole, done more evil than good. The discovery ot certain new remedies, and improved modes of treat- ment, enable us now to dispense with it altogether, except in some very iare cases. It is now very seldom resorted to. 281 CHAPTER VIII. CHE INFLUENCE OF MEDICINES IN PRODUCING AND CURING IMPOTENCE AND SPERMATOR- RHEA. There are a few medicinal substances that act in a direct manner upon the genital organs, some oeneficially and others hurtfully, but the greater number operate upon them indirectly. This is a subject about which there is great ignorance, as I before stated, and an immense deal of imposition and pretension, both among empirics and regular practitioners. It has always been a favorite notion with the public, and one that has been often encou- raged by medical men, from interested motives, that there are specific medicines capable of arous- ing the sexual ardor under almost any circum- stances. From this notion has originated ail the various cordials, stimulants, and elixirs, that are • constantly pressed upon the attention of the impo- tent and sterile. None of these things are in the slightest degree capable of accomplishing what is promised of them, as well-informed people are aware, but the public generally are deceived and much injured thereby. Very lately it has been ascertained that certain drugs can be made to have a remarkably beneficial action, in particular cases of loss of po^er, but each case requires a peculiar dose and mode of administration, which makes it impossible to prescribe for all alike. These agents, however, are probably not known, even by name 288 INFLUENCE OF MEDICINES. to the parties who compound the preparations above referred to, and it is fortunate they are not, for if they w^re, more mischief would be done than by the things^ now used. There is no doubt but that an immense deal of disease and incurable im- potence is caused by the use of these preparations, and much good will resuh from cautioning the pub- lic against them. It is not only the action of those drugs that may be beneficial -that we have to study, however, but also those that may be hurtful, and among them will be found many that few persons have suspected of having any influence on the genital organs at ail. Furgatives, for instance, are popularly thought to act only on the bowels, and not to influence sexual vigor at all, but the fact is, they often exert a very marked influence in that way. It is well known that aloes, gamboge, colocynth, and several other purgatives irritate the bowels very much, and this irritation may be extended to the neighboring parts, particularly near the rectum, and in this way they excite the flow of urine in some persons, by irritat- ing the bladder, as well as operate upon the bowels. Now the spermatic ducts, and prostate gland, lie close to the rectum, and of course are subjected to this irritation as much as the bladder, and are equally liable to become unusually sensitive. 1 have known many persons in fact who always had involuntary emissions when they took purgatives, and who were obliged to be exceedingly careful in consequence when they did so. When there is any tendency to Spermatorrhoea, therefore, the pos. sible effect of purgatives must be borne in mind, both by the physician and patient, and when they are absolutely needed those must be chosen that are INFLUENCE OF MEDICINES. 28i> least irritating, particularly to the lower part of the Dowels. Tobacco is an article that exerts a mo?t decided action, in numerous cases, upon the generative organs, though few persons suspect it of doing so. Like opium, and some other narcotics, it often stimulates at first, but afterwards greatly weakens the sexual power, so as to -bring on complete impo- tence in many cases. I am satisfied, from my own obserwitions, that it frequently leads to involuntary emissions, and keeps them up notwithstanding all that can be done for them. Many young men, patients of mine, have remarked that a cigar at bed-time would be certainly followed by emission before morning, and they found it necessary in con- sequence to abandon its use. It is true that these results are not generally seen except the tobacco is used in great quantity, but there are some persons that are affected by a very small portion, and who therefore never surmise that it has any influence upon them at all. I once saw a young man, a great smoker, who suffered from constant pollution, and who had been perfectly impotent for five years. He had submitted to every kind of treatment, even to cauterization, but only obtained temporary reli' f, and at last totally despaired of ever being benefitted. On hearing his statement, and learning what had been done for him, I was much surprised, because there were no indications of severe disease, nor were the parts themselves in an unhealthy condi- tion, though relaxed, and the Testes still secreted perfect semen in considerable quantities. During our conversation he 'accidentally alluded to his smoking habits, and said he frequently used from mo to four dozen cigars a day. I was immediately INFLUENCE OF MEDICINES. strock with the similarity of his case to that of a great opium chewer whom I had seen, and I at once concluded that the tobacco was the cause of the mischief. On explaining this to him he could scarcely be brought to think it possible, but even- tually he agreed to follow my advice and gradually leave it off. • The result even exceeded my expec- tations, for I was much' afraid that some permanent mischief had been done. He began to mend im. mediately, and though considerable lowness of spirits, weakness, and loss of sleep was experienced at first, yet all these effects ultimately passed off and he felt better, and was stronger than while using the tobacco. The most marked effect, however, was the checking of the Spermatorrhoea. When I first saw him he passed 'semen constantly in his urine, and frequently in the night. He had little or no erection, and such nervous palpitation of the heart occurred, whenever any slight sexual feeling was experienced, that he became utterly powerless, and would undoubtedly have been impotent from that cause alone. This all passed off, the involun- tary discharge ceased, and his sexual powers re« •turned as strongly as ever. Contrary to my advice he commenced using the tobacco again, thinking that it would now cease to affect him, but in three 'days all the old symptoms returned, and he became as impotent as ever. On leaving off his smoking, however, he gradually recovered again, though with more difficulty thin at first] which made me caution him not to relapse again, for fear the re-aciion might -eventually fail altogether. I have even known married men seriously injured in this way, by merely using tobacco as a domestic indulgence. In une instance a gentleman, engaged in a somewhtu 26* INFLUENCE Of MEDICINES. 291 harassing business, was induced by a friend to smoke a few cigars at night, to steady his nerves ' He found, however, that though he could readily stupify himself, yet his nerves were no steadier, particularly in the morning, and what was most sin- gular, to him, he lost all sexual power and desire, and became so weak he could scarcely stand. In this dilemma he consulted me, and gave me a full history of his proceedings and experience. On ex- amining his urine I found, as I expected I should, that the semen escaped with it, and in such quanti- ties that his impotence and weakness were no longer to be wondered at. I at once told him to leave off his tobacco, gave him a slight tonic, cauterized the ducts, and directed him to go and bathe in the, salt water for a few weeks. He did so and returned perfectly cured. I could, in fact, give numerous cases, both among single and married, showing the effects of this poisonous drug, and I do not hesitate to say that 1 think it has more to do with many of these com plaints than has been hitherto supposed. In the thirteenth Annual Report of the Massachu setts State Lunatic Assylum, are some excellent remarks on the use of tobacco, which, though they are intended to apply chiefly to its influence in pre- disposing to insanity, are nevertheless of great general interest, and I therefore quote them : " Alcohol is not the only narcotic which thus af- fects the brain and nervous system. Opium produces delirium tremens and probably insanity. Tobacco is a powerful narcotic agent, and its use is very deleterious to the nervous system, producing trem- ors, vertigo, faintness, palpitation of the heart, and 292 INFLUENCE OF MEDICINES. rther serious diseases. That tobacco certainly produces insanity, I am not able positively to ob- serve ; but that it produces a predisposition to it, I am fully confident. Its influence upon the brain and nervous system generally, is hardly less obvi- ous than that of alcohol, and if used excessively is equally injurious. The young are particularly susceptible to the influence of these narcotics. If a young man becomes intemperate before he is twenty years of age, he rarely lives to thirty. If a young man uses tobacco while the system is greatly sus- ceptible to its influence, he will not be likely to escape injurious effects that will be developed sooner or later, and both diminish the enjoyments of life and shorten its period. " The very general use of tobacco among young men at the present day, is alarming, and shows the ignorance and devotion of the devotees of this dan- gerous practice to* one of the most virulent poisons of the vegetable world. The testimony of medical men, of the most respectable character, could be quoted to any extent to sustain those views of the deleterious influence of this dangerous narcotic. "Dr. Rush says of tobacco — ' It impairs appetite, produces dyspepsia, tremors, vertigo, headache, and epilepsy. It injures the voice, destroys the teeth, and imparts to the complexion a disagreeable, dusky brown.' " Dr. Boerhaave says that * since the use oi to* bacco has been so general in Europe, the number of hypochondriacal and consumptive complaints has increased by its use.' "Dr. Cullen s*ys, '1 have known a small quan- tity snuffed up the nose to produce giddiness, stupor wid vomiting. There are many instances of itb INFLUENCE OF MEDICINES. .29$ more violent effects, even of its proving a mortal poison.' " Dr. Darwin says, ' It produces disease of the salivary glands and the pancreas, and injures the power of digestion by occasioning the person to spit off the saliva which he ought to swallow.' " Dr. Tissott once saw the smoking of it prove fatal. " Dp. Pilcher details the particulars of a case of a medical student whom he had been requested to see. * This gentleman suffered under all the symp- toms of phthisis. There was muco- purulent ex- pectoration, night sweats, &c. The mucous mem- brane of the throat, epiglottis, and the neighboring parts, was coated with a brown fur. The patient had been an immoderate snuff-taker ; he was told to discontinue the snuff; he did so, and recovered.' " Dr. Chapman says, i By a member of Congress from the West, in the meridian of life, and of a very stout frame, I was some time since consulted ; he told me that, from having been one of the most healthy and fearless of men, he had become ' sick all over, and timid as a girl.' He could not even present a petition to Congress, much less say a word concerning it, though he had long been a practising lawyer, and served much in legislative bodies. By any ordinary noise he was startled or thrown into (remulousness, and afraid to be alone at night. His appetite and digestion were gone, he had painful lensations at the pit of his stomach, and unrelenting constipated bowels. During the narrative of his suffering, his aspect approached the haggard wiid- oess of mental distemperature. On inquii v, I found that his consumption of tobacco was almost incredi- ble, by chewing, snuffing and smoking. Being sat 294 INFLUENCE OF MEDICINES. fafied that all his misery arose from tnis poisonous weed, kd use was discontinued, and in a few weeks he entirely recovered. " Distressing as was this case, I have seen others, from the same cause, even more deplorable. Two young men were in succession brought to me for advice, whom I found in a state of insanity, very much resembling delirium tremens. Each had chewed and smoked tobacco to excess, though per- fectly temperate as regarded drink. The further account given me was, ' that in early life, adopting this bad practice, it grew with their growth. Dys- pepsia soon occurred, attended by great derange- ment of the nervous system, and ultimately the mania I have mentioned. But I have also seen the same condition very speedily induced.' " Dr. Franklin says he never used it, and neve! met with a man who did use it that advised him to follow his example. " The venerable John Qnincy Adams, iu a recent letter on the subject, says that in early life he used tobacco, but for more than thirty years he had dis- continued the practice. i I have often wished, 3 says he, ' that every individual of the human rase, affected with this artificial passion, would prevail upon himself to try, but for thiee months, the expe- riment which I have made, and am sure it would turn every acre of tobacco-land into a wheat-field, and add jive years to the average of human life.' " Some cases have come under my observation which show the injurious effects of tobacco wher« no evil was suspected. " A respectable merchant, who abstained wholly from ardent spirits, applied to me for advice. He complained of great weakness, tremor of the limbs INFLUENCE OF MELICINE&. 295 and joints, with lassitude, general prostra.ion of health, and depression of spirits. Knowing that he used tobacco freely, I advised him to discontinue it entirely ; he soon became better, and after a time was wholly relieved from these disagreeable •ymptoms. "A distinguished clergyman informed me that he had been an extravagant snuff-taker ; that for years he had had a disagreeable affection of the head, and his health was not good. He did not attribute either to his use ^f snuff, but thinking it a filthy habit and a growing ev'ii, he resolved to leave it off. He was surprised to find the difficulty in his head almost immediately left him, and his general health became quite good. " A gentleman of athletic frame, and about twenty-four years of age, applied to me for advice. He complained of insufferable faintness and distress of stomach, morning-sickness, vomiting, trembling and prostration of strength. He diminished his to- bacco considerably, and was immediately better, but had not resolution to abandon the pernicious practice. u In our experience in the Hospital, tobacco in all its forms is injurious to the insane. It increases excitement of the nervous system in many cases, deranges the stomach, and produces vertigo, trem- ors, and stupor in others. It is difficult to control its use with the insane, and though considerable suf fering comes from its entire abandonment, it cannot be generally allowed with safety. " One patient, while at labor, found a quantity oi tobacco, and hi i it in his bed. He used it freely, became sick, lost his appetite, and confined himself to his bed completely intoxicated. After some (lays, 296 INFLUENCE OF MEDICINE*. diligent search was made, and a store of tobacca was found in his straw-bed ; when this W3* removed he almost immediately recovered, and in a tew days was well as before. " A person who came into the Hospital a furious maniac, soon became calm and improved favorably. He labored in the field with propriety, and exhi- bited every indication of a favorable convalescence. Suddenly, without any apparent cause, he again be- came very violent and insane. It v/as soon discov- ered that he had in some way obtained tobacco. After he ceased to use it, he again became calm and convalescent. " An aged lady was brought to us very insane* The practice of her friends for some time had been to give her ardent spirits to intoxicate her at night, and tobacco and snuff, in unlimited quantity, for the day. All these were withdrawn at once ; her suf- ferings for some days were great ; but after a time she became calm, and got better as soon as the influ- ence of this excitement was over. " I have already exceeded my intended limits in the detail of cases. "It is very natural to suppose that an article pos- sessing the active properties of this fascinating nar- cotic, should produce most deleterious effects upon health — particularly upon the brain and nevous ay stem. " The uninitiated cannot smoke a cigar, 01 use tobacco in any form, without unpleasant effects, — (tow then can it be possible that a poison so active can be used with impunity ? The stomach and brain, subjected to such influences, will become dis- eased, and show their effects as certainly as if alco- hol were used. If asked my medical opinion, which rifFLUENCE OF MEDICTNES. 297 was safkst, four glasses of wine or four quids of tobacco, daily, I should say unhesitatingly the wins* Of the two evils, this would, in my opinion, be the least. Tobacco is the strongest, most dangerous narcotic — the habit of its use is the strongest and most difficult to overcome, and the influence felt from it most baneful and destructive- to health." Opium acts similarly to tobacco, but much more fatally, the exhaustion caused by it being much less readily recovered from. In fact if a man once be- comes impotent from using opium it is a great chance if he ever recovers his powers. Dr. McDougal says that many of his friends, (nveterate smokers, have remarked to him that a decrease of their sexual desires was one of the •narked effects of their indulgence, and I have fre- quently been told the same. M. Lallemand also gives several instructive cases in which this fact is forcibly illustrated. The following is a counterpart of many that I see : — " 1 have a young man of very nervous tempera- ment at present under my care, in whom nocturnal and diurnal pollutions have brought on pain in the loins, palpitation, difficulty of breathing, &c, symp- toms which were supposed to arise from disease of the spinal cord, cardiac affection, and commencing phthisis. Among the exciting causes of these in- voluntary discharges, the effects of smoking occupy the chief place. The following is the patient's statement. " ' At twenty years of age 1 wished to accustom myself to smoking ; but a day never passed without *iy experiencing complete intoxication, attended ' with vomiting, vertigo, and trembling of the limbs. 298 INFLUENCE OF MEDICINES I continued the habit, however, and I soon oegan to perceive that my sight became Weak, and that J lost my memory ; my hands shook ; and my diges- tion became much disordered. I noticed also, great debility of the genital organs ; my erections ceased ; and at the age of twenty-two I found myself com- pletely impotent.' This patient had rarely prac- tised masturbation, and had never committed any excess when he first began to smoke ; his health had, previously, been excellent. It is, therefore,, evident that the impotence, as well as the othei symptoms, arose from the action of tobacco. Im- potence at the age of twenty-two can only be pro- duced by involuntary seminal discharges, provided there be no physical disability. In the present case, ihere was no doubt on the point, the patient himself having discovered diurnal and nocturnal pollutions, " The action of tobacco on those who smoke for the first time, is too well known to require descrip- tion ; more or less disorder of all the functions, va- rying according to the constitution of the individual, invariably arises from it ; and this disorder always presents more or less of the characteristics of poi- soning by narcotics. These effects go off by de- grees, as the patient becomes habituated to the use of tobacco, and generally after a time cease to be manifested at all. Some nervous and excitable in- dividuals are unable to accustom themselves to the habit, as in the case just mentioned ; in others again, smoking becomes an artificial habit, which in many cases is almost a necessity. " Bat this empire of custom has its limits, beyond which the narcotic influence re-appears. In such as are not easily affected, this acquired habit is ge- nerally supported with impunity ; but even then, if INFLUENCE OF MEDICINES. 299 it be indulged in to excess, it must after a time be injurious. Thus it is that the most accomplished smokers often experience vertigo, cephalalgia, ano- rexia, etc., when they have remained long in an atmospheie densely filled with smoke, which is then drawn into the lungs, and probably produces worse effects than when merely drawn into the mouth, or swallowed, as in smoking. "In a word then, if the power of habit can pre- vent the momentary effects of smoking from show ing themselves, the frequent repetition of the use of tobacco produces more lasting effects on different organs. Disorder of the digestive organs is w§ll known as occurring in inveterate smokers ; that of the genital organs has not hitherto been- noticed. [Many inveterate smokers among my professional friends, have mentioned to me the diminution of their venereal desires, as one of 'the' effects of to- bacco. I believe, however, that it is by no means rare." H. J. McD.J Cantharides, or Spanish Flies. This article is popularly supposed to have an undoubted stimulating effect upon the sexual powers, and many persona will be surprised to learn how little foundation there is for such a belief. In fact upon most persons Cantharides have but little or no effect at all in that way ; except they are given in such quantity as to be poisonous, and then they only act by causing se- vere inflammation, noi only on the genitals but also in all the neighboring parts. It is quite common for even a small dose to create great irritation of the bladder, with complete inability to discharge the urine, and this may take place without any unusual 'sexual excitement at all, though most usually th 300 INFLUENCE OF MEDICINES. generative organs are stimulated more or less . —It is a great mistake, therefore, to suppose that Can- tharides have a constant and specific aol^n on the sexual organs, for they merely create an intense irritation, which affects these organs along with others, in the same way that many other irritant poisons do. — All the popular notions on this subject are utterly unfounded, and quite opposed to the truth. It is very seldom that Cantharides are of any se* vice whatever in the treatment of Impotence 01 Spermatorrhoea, though a combination of these with other articles is useful in certain cases. They form the main ingredient in all the quack stimulants for the generative organs, and the use of them in this way unfortunately causes great mischief. Num- bers of young men are permanently ruined, from Spermatorrhoea, through taking these preparations of Cantharides, and I have known many married persons rendered hopelessly sterile from using them as stimulants. I had one distressing case of a young man, who was persuaded by a thoughtless friend to take some Spanish Flies as an experiment, ,o see if they would not increase his desires and powers. The quantity he took was only a moderate dose, but the effects were most alarming. He com- pletely lost ail power of discharging the urine, though the Bladder was full almost to bursting, and experienced such agonizing pain in the prostate and urethra that he was nearly delirious. Priapism took place, but so far from being attended by in- creased pleasure that it added to his sufferings, and yet he could not prevent it. Fortunately he had timely assistance, and the immediate danger was obviated, but immediately after he began to be trou- bled with involuntary emissions in the night, and INFLUENCE OF MEDICINES. 3qj eventually when urinating, so that he became com. pletely impotent, and so weak he could scarcely stand. I cauterized him, and used every othef means the case would allow, but in spite tf all, the trouble continued to some extent, and probably always will. He had been suffering, however over four years when I saw him. I also had a case of a young person of the other sex., who was seriously injured by Cantharides > given as a trick, and who had involuntary discharge of urine ever afterwards. Camphor. — The action of Camphor upon the gen- ital organs is sedative rather than stimulant, and when taken improperly or in excess, it may almost entirely destroy the sexual feeling, at least for a time. It is therefore given in cases of priapism, and in excessive excitement, whether from sexual or physical causes. If Cantharides or any other irri- tating poison be taken, Camphor is usually a valua- ble palliative, and it is sometimes of great service in certain forms of Spermatorrhoea. If taken in too large doses, however, or for too long a time, it will cause involuntary emission. Nitrate of Potash or Saltpetre. — It is commonly supposed that this substance acts as a direct seda- tive to the sexual organs, and that if taken in any considerable quantity, it will destroy all feeling, but this notion is a very erroneous one. Like all other diuretics Nitre stimulates the Genital Organs, and i£ taken in too large doses it will even produce in- flammation, like Cantharides. Instances have been known where a discharge from the urethra has fol. lowed its use, like that of Gonorrhoea, and after- Wards involuntary emissions have been experienced. Ergot of Rye, or Secale Cornuturn. This sub 302 INPL7ENCE OF MEDICINES. stance, as is well known, is used to expedite de livery in females, which it does by increasing th* action of the womb. Its use, however, is dangerous, except in proper hands. From recent observation* it appears to stimulate the male organs also, and the men of those parts where it grows among the rye are noted for their ardent desires, while the females* frequently miscarry. The Ergot cannot be gives alone, either with safety or advantage, but its com- bination with other articles, forms a valuable re. medy, both for impotence and for spermatorrhoea. It is one of the ingredients of a stimulating and invigorating medicine which I use extensively in my practice. Coffee and Tea. — Both these articles, but espe- cially coffee, act as direct stimulants to the genera- tive organs, and if taken in excess may produce all the effects of the most powerful drugs. I have known coffee cause priapism, lascivious dreams, and involuntary emissions, and nearly always its continued use will counteract anv treatment that can be followed for relief. Phosphorus. — This article is similar in its action to cantharides, but much more energetic, and con- sequently it is much more dangerous in wrong hands, but when properly administered it is fre- quently of great service. It is one o r the ingre- dients of the invigorating medicine which I formerly spoke of, with which I have often produced ths most unexpected restorations to power and health. Phosphorus should, however, never be experimented with by those not familiar with its action, for in some cases it will lead to the most disastrous con- sequences, and its evil effects are not easily re* ©ore red from. 27* INFLUENCE OF MEDICINES. 303 Aromatics and Spices.— These have in general a stimulating effect on the generative organs, the same as on other parts, but their power varies very much in different persons, and under different cir- cumstances. There are various spice mixtures and combinations in popular use for this purpose, but they should not be indiscriminately used. Some- times they are highly injurious, like all other stimu- lants, and even when they do cause an increase of power or feeling it is only temporary, and often fol- lowed by directly opposite effects. In short none of these articles operate specifically, in a beneficial manner, on the generative organs, though certain combinations of them may do so under particular circumstances, like the medicine I have referred to as being used in my own practice. There is one drug brought from the East Indies, • the Cannabis Indica, which is the most regular in its action, and produces the most constant beneficial effects of anything yet tried. It appears to act as a special nervous stimulant, exciting that part of the brain which influences the- sexual organs, so that they feel directly an increase of power. It also causes great mental activity, disposes to cheerful- ness, and induces a feeling of warmth and comfort over the whole system. Those who have taken it in a proper manner, are delighted with its effects, and never complain of any after-depression or re- Action in any way. If given improperly, however. or in too heavy a dose, it first causes excitement of the wildest character, with an uncontrollable dispo- sition to bodily activity, and afterwards a complete cental and physical prostration. In short it is most *>werful, either for good or for evil, according as it j&ed, and is the onl} means we possess, in iiumer 304 INFLUENCE OF MEDICINIftl. mis cases, of restoring sexual power and desire, fo the East Indies it is commonly used, like opium ig in China, for the purpose of producing pleasurable excitement, and also far removing impotence. A plant producing this drug grows in thfc United States, and with due care a similar prepara- tion may be made from it to that received from the East Indies. I have experimented with both, and when prepared by myself I have found the native product fully equal to the foreign. The Botanic physicians use this plant for various other purposes, but none of them seem to be aware of its possessing the properties I have described. Indeed the way in which they prepare and administer it prevent those properties from being exhibited. Medicines that excite the sexual organs are called Aphrodisiacs, and in various parts of the world they are in great demand, though but seldom adminis tered, so as to be of any real service. As I have already remarked some of these medicines, when properly used, have undoubted aphrodisiac powers, but they are by no means applicable in all cases. They may frequently fail of producing any good effect whatever, and sometimes may even cause ir- retrievable mischief. The successful administration of them therefore requires a perfect knowledge of their properties, and an extensive observation of their effects under all circumstances. It is for this reason I have not given any recipes for these drugs, for no one can tell when they should or should not be used unless they know something about them, and the effects of taking them improperly may be so serious that mere experiment with them is highly hazardous. In a particular class of cases ] have long been INFLUENCE OF JMEIICINEC. 30h ttsing a combination of the Cannabis, with othei articles, which I find to possess the most extraordi- nary powers, the preparat ; on of which I have been repeatedly importuned to disclose, both by parent* and medical men. At present, however, I do not feel called upon to make this disclosure, because I know the great mischief which would result froru using such a preparation improperly, and I know also how few persons there are familiar enough with its powers and properties to use it rightly. My own experience has made me acquainted with signs by which I can tell, in every case, whether it is proper to be used or not, and I will answer for its never producing evil effects when I advise it. So wonderful and unexpected have been .the effects of this preparation, in numerous instances, that if I chose to be unscrupulous and sell it indiscriminate- ly, I have no doubt but it would be used more extensively than any other medicine has ever been, for any purpose whatever. I do not think it proper to give it, however, in any case, till I know whether it be appropriate or not, and this I can always tell on receiving either a verbal or written description of the history, progress, and symptoms of the dis- ease. I do not hesitate to say that I have seen more restorations to sexual power, and more cures of Sterility, in both sexes, from the use of this pre- paration than from any other means.* Medicines that decrease the sexual powers are called An-apkrodisiacs, and I believe they have all been mentioned. * See Advertisement at the end of this Book foi the Aphrodisiac Remedy. 306 CHAPTEfi IX. MASTURBATION AND OTHER SEXUAL ABUSES* A very tew years ago only it was thought wrong even to allude to snch a subject as masturbation, much less to openly speak or write about it. For- tunately, however, people have become more ra- tional, and now begin to see that this and similar practices are of the most hurtful character, and that no successful efforts can be made for their removal till they are more fully and generally understood. Various books have been published, lectures have been delivered, and even sermons have been preached bearing upon this subject, till much general informa- tion about it is now disseminated, and a very gene- ral desire is expressed for something more complete and scientific than has yet appeared. — The greater part of the books written on the subject of Onanism or Masturbation, are very incomplete, and not ac- companied by those physiological and medical de- tails that are requisite to. give a clear view of the evil. The effects of this vice may be partly given in such works, though in an incomplete form, but the manner in which they are produced, their con- nection with other evils, and the philosophy of their treatment, cannot be understood without such a work as the present. I have, therefore, delayed speaking upon this subject till all the other topics have been introduced, so that the unnatural character of the vice, and its terrible consequences, may be clearly obvious. SEXUAL ABUSES. 30 The mere tolerance of discussion on t lis subject was a great point gained, and was soon followed by ft general conviction that such a discussion was not only desirable, but imperatively demanded by the best interests of society. It is both curious and in- structive to see how this tolerance has been gradu- ally gained, and how a perception of the manifold evils of self-abuse has extended, though slowly, from a few philosophers to the great mass of the medical profession, and from thence to non- profes- sional persons, till at last it has even been made the Bubject of legislative action. I shall now proceed to show, by extracts from an- cient medical writers, how this subject was regarded, by eminent minds, in former ages, and then to exhi- bit the more perfect knowledge, and greater interest of modern times, including the approval, by exist- ing legislators, of investigations bearing intimately upon it. Se\ era 1 of thase extracts are taken from the cele- brated ^ r orks of Tissoi and others, and being from the writings of the Fathers of Physic, many of whom lived centuries before Christ, allowance must be made, in some few cases, both for unintentional exaggeration, and also for deficiency in scientific accuracy. Generally speaking the statements are fully authorized, and the pictures by no means overdrawn ; in fact it is often the case that the whole {ruth is not told, simply because it was not known. "Hippocrates the oldest and most correct obser- ver, has already described the diseases produced by abusing the pleasures of venery, under the t^rm, dorsal consumption. ' This disease,' says he, arises from the dorsal portion of the spinal ma* g08 \ SEXUAL ABUSES. row. It principally attacks yoang marrired people, or the licen.ious. They have no fever, and although they eat well, they grow thin and waste away. They have a sensation of ants crawling from the head down along the spine. Whenever they go to stool, or evacuate their urine, a considerable quan- tity of very thin seminal fluid escapes from the urethra. They lose the power of procreation, yet often dream of venereal pleasures. They become very weak, and walking produces shortness of breath ; they have pains in the head and ringing in the ears ; and finally an acute fever (Libiria) supervenes and they die." We shall mention thia fever in another place. " Some physicians have ascribed to the same cause, a disease which he has described, in another place, and have termed it, the second dorsal con- sumption of Hippocrates, and which has some rela tion to the first. But the preservation of the strength which he mentions particularly, seems to us a con- clusive proof, and this disease does not depend on the same cause, but seems rather to be a rheumatic affection. " ' These pleasures,' says Celsus, in his excellent work on the preservation of health, ' are always injurious to weak persons, and their abuses pros- trate the strength. 5 We can find nothing more frightful, than the description, by Aretseus, of the diseases produced by a too abundant evacuation of semen. ' Young persons assume the air and the diseases of the aged ; they become pale, stupid, effeminate, i'dle, weak, and even void of understand mg ; their bodies bend forward, their leg© are weak, they have a disgust for everything, become fit fo* nothing, and many are affoeted with paralvsrs.' iu SEXUAL ABUSES. 309 diiDther place he mentions tne abuse of these plea- sures among the six causes which produce paraiyfci-n. " Galen has seen diseases of the brain and nenes from the same cause, and the powers of the body impaired ; and he also relates that a man who was convalescent from a violent attack of disease, died the same night after coition with his wife. "Pliny, the naturalist, informs us that Cornelius Gall us, the old praetor, and Titus Etherius, a Roman Knight, died in the act of copulation. " Aetius says, ' the stomach is deranged, all the body wastes, becomes pale, dry, and the eyes sunken.' These remarks of the most respectable ancient writers are confirmed by the moderns. Sanctorious who has examined, with the utmost care, all the causes which act on our bodies, has observed, that this weakens the stomach, destroys digestion, prevents insensible perspiration, the de. rangements of which produce such evil conse- quences, disposes to calculus diseases, diminishes the natural warmth, and is usually attended with a loss, or derangement of sight. " Lomnius, in his fine commentaries on the pas- sages of Celsus, whom we have just cited, supports the remarks of the author by his own observations. 1 Frequent emissions of semen relax, weaken, dry, enervate the body, and produce numerous other evils, as apoplexies, lethargies, epilepsies, loss of tight, trembling, paralysis, and all kinds of painful affections/ " One cannot read without horror the description left us by Tulpius, the celebrated burgomaster and physician of Amsterdam. ' Not only,' says he, M the spinal marrow wastes, but the whole body and mind becomes languid, and the patient perishes is 3)0 SEXUAL ABUSES. misery. Samuel Vespertius was attacked first with a humor upon the back of his neck and head ; i* ihen passed to the spine, to the loins, to the lower and lateral region of the abdomen, and to thn and a relief. 832 SEXUAL ABUSES. The effects of masturbation most frequently met with are weakness of the eyes, swelling and sore, ness of the eyelids, partial deafness, weakness of the limbs and back, headache, dizziness, fiaiuience, in- continence of urine, diarrhoea or obstinate eostive- ness, palpitation of the heart, shortness of breath, loss of memory, and confusion of judgment, with melancholy or irritable peevishness. Another effeei also met with in many cases, is a partial loss of tJte power of speech or a tendency to stammer and stutter. This effect I have often observed in persons who had previously spoken as fluently as any one, ?,nd who could not imagine themselves what the diffi- culty arose from. Most frequently it is attributed simply to that loss of self-confidence, and that feel- ing of shame, which all self-abusers experience^ and no doubt this does make it worse, but still the mam cause of the impediment is a partial paralysis of the muscles of the throat, brought on by sympathy with the irritated parts below. Not unfrequently there is more or less difficulty in swallowing at the same time, with frequent sighing and gulping, as if there was wind in the throat. In fact this class of symp- toms are very similar to those observed in the hys- teria of females, with which they are, to a grea* extent identical, both in nature and origin. Baldness is also a frequent occurrence to those who practise masturbation, and so is prematura whitening of the hair. Palsy and Epilepsy are more frequently the re- sufts of this practise than is usually thought, and Paralysis is quite commonly so. I have known many instances of young men becoming tempora- rily paralytic from excessive self-abuse, and very recently I was called to see an old man who waa SEXUAL ABUSES 333 ■tying from paralysis brought on In this way. These affections, though severe, need not be won* dered at when the powerful sympathies of the gen- erative organs are borne in mind, and when it 13 recollected what an exhaustion of the vital power is caused by their excessive action. The best way, however, to exhibit the full effects of this baneful vice is to give a few illustrative cases, which will not only portray the prominent symptoms but also indicate the course of treatment usually adopted. Some of them are contributed by M. Lallemand, and others I have selected from my own note- book. " M. D , of Philadelphia, of a very robust constitution, contracted the habit of masturbation while at school, when only eight years old. The first effect produced, was a frequent desire to pass urine, and at twelve years of age this irritability had become so great, that he was sometimes unable to retain his urine a quarter of an hour. Before entering a house he always took care to micturate several times in rapid succession ; and, notwith- standing this precaution, he soon experienced re- newed uneasiness. He felt as though his bladdoi was never entirely empty, and the smallest quantity of urine induced spasmodic contractions. The ir- ritability of the urinary organs diminished by degrees after the period of puberty, but never ceased entirely, notwithstanding the various means which were employed on different occasions. " At the age of sixteen, M. D — endeavored to break off his injurious habits by sexual inter- course, but he found himself completely impotent, and sUame induced him to return to masturbation. 334 SEXUAL ABUSES. He afterwards made further attempts to correct himself, but he experienced nocturnal pollutions, which often made him lose courage. At lengthy after many relapses, he succeeded completely, without observing any further nocturna4 emissions. Still his health, instead of improving, became more fend more impaired. His erections were less fre- quent, less prolonged, incomplete, and at length, gradually ceased, together with all venereal desire, , " At the age of twenty-eight, the state of his urine, its frequent discharge, and the wandering pains in the perineum and testicles, induced a fear of calculus ; sounding, however, only showed a morbid sensibility of the urethra, especially towards the neck of the bladder. " In the beginning of May, 1837, M. D came to Montpelier, in the following condition : — much debilitated ; unsteady in his walk ; easily chilled, and taking cold very quickly ; wandering pahis all over his body ; skin dry ; memory im- paired i digestion difficult extremities cold ; scro- tum relaxed, and testicles soft, very sensitive, and often causing a dull pain, as if they were forcibly compressed ; the semen (from the account he gave of the last nocturnal pollutions he had experienced,) clear, aqueous, and inodorous ; seminal emissions with the last drops of urine, which were clammy, and passed with difficulty, and excited a sensation of tickling in the neighborhood of the anus, which extended to the orifice of the urethra ; he often hud diarrhcea, but, at other times was very costive, and his stools were passed with difficulty and pain. Ha did not, however, often pass semen while ai stool. \* I discovered, several days following, the pre- sence of semen in M. D 's urine, and cathe. 30 SEXUtL ABUSRS. 035 lerism showed an excessive irritability of the urethra, especially in the neighborhood of the pros- tate, which, on examination, was found slightly en- larged. Nearly a table-spoonful of blood followed the withdrawal of the catheter. The circumstances did not leave the least doubt on my mind as to the state of the mucous membrane in the vicinity of the ejaculatory ducts ; and, consequently, I imme- diately performed cauterization, from the neck of the bladder, as far as the membraneous portion of the urethra. Twenty days afterwards, M. D~— left Montpellier for Italy, and when he returned, three months afterwards, he was completely cured — no involuntary seminal emissions having after- wards appeared. His urine was transparent, and could De retained seven or eight hours without in convenience ; its discharge took place without ef- fort, and was not accompanied by any remarkable sensation. Lastly, the patient's impotence, which had been present nearly twelve years, had given place to a virility previously unknown to him : I need haruly state that his physical and moral energy had shared in this regeneration. 44 1 have often had occasion to notice the connex- ion that exists between the spermatic and urinary organs ; and I have shown that there is scarcely a cause of spermatorrhoea which does not act more or less on the bladder and kidneys. The cause I am now investigating affords us numerous examples of this connexion — of which the case I have just related, is a remarkable instance — the irritation of the urinary organs having been developed very ra- pidly, having shown very marked symptoms, and having existed alone during several years. The patient was only eight years of age when he firs •536 SEXU.1L ABTTSES. became addicted to masturbation ; at this early age the urinary organs alone possessed activity, and therefore they alone were able to suffer disturbance of their functions ; on this account the symptoms were confined for a long time to the urinary organs. The character of the symptoms showed cnat they arose from a chronic state of inflammation, or from an acute irritation of the urinary organs, and thia state must have extended also towards the spermatic organs. Thus the increased secretion of the kid neys. and the extreme irritability of tne bladder, would give a very clear idea of what took place in the spermatic organs at the period of puberty, As soon as the testicles began to act, they fell under the same influence as the kidneys ; the seminal vesicles were in the same condition as the bladder ; in other words, the semen was secreted in large quantities, and was retained a very short time in its reservoirs. Being therefore imperfectly formed, the usual effect on the erectile tissues produced by its presence, did not take place, and coitus was impossible at the age of sixteen. The occurrence of impotence at so early an age is sufficient to show that diurnal pollu- tions had already commenced, although the patient did not. discover them for a long time afterwards. He was still, however, able to practise masturba- tion ; and this is a circumstance which has great effect, in preventing persons addicted to the vice, from renouncing their fatal habits. At a later period, nocturnal pollutions, which occurred after a few cays' care 5 shook the patient's resolution. This is a much less serious circumstance than the one just mentioned, but at the same time much mom common. At length the patient left off his habits, and his nocturnal pollutions disappeared ; yet th# SEXUAL ABUSES. 331 disorder of his health continued to increase. His prudence, exercised too late, did not arise from the strength )f his will, but from the weakness of his genital organs ; the disappearance of his nocturnal emissions did not arise from the remedial measures used, but from the increase of his involuntary diurnal discharges, of which he omy became aware long afterwards. These common errors are the more dangerous, because medical practitioners are apt to participate in them. " In the case of M. D — the irritability of the canal was very great, and the effect of the cauterization was correspondingly prompt and de- cided." The above case is a highly instructive one, be- cause it shows both how early the habit of mastur- bation may be commenced, and also what a general disturbance of the economy it may lead to. The following case is also a very important one, and shows how very 'readily the symptoms of Sperma- torrhoea may be thought to indicate other diseases, and what mistakes may be made in consequence : " I am indebted for the following remarkable case to the kindness of Dr. Daniel, ui Cette. * On the 26th of May. 1836, I was called to ? — -, a baker, aged twenty-two ; I found him in bed, in the following condition : — great moral prostration, car- ried even to a hatred of existence ; prostration of strength ; anaemia ; lips pale and shrivelled ; re. markable pallidity ; eyes sunken ; expression of countenance dull ; great emaciation ; skin hot and dry ; pulse small ; voice hoarse, and so low that it wafe with difficulty a few words could be heard $38 SEXUAL ABUSES. by approaching the ear ; constant cough, scarcely permitting an instant's repose ; general wandering pains, most severe in the loins, and the sides of the chest ; great irritability of the stomach — vomiting being excited after taking almost any kind of liquo* or solid food. " At first I thought that I recognised in this patient the symptoms of phthisis laryngea, complicated with chronic gastritis ; but the examination of his chest and abdomen did not support this opinion. The epigastric region was not painful on pressure ; the respiratory murmur was heard all over the chest, and percussion emitted a healthy sound, except under the left false ribs, where it was slightly dull, and the patient felt pain. " His debility did not permit me to 'practise ab- straction of blood ; and indeed, the pleuropneumonia of the left side did not seem either very extensive or very acute ; I therefore ordered a large blister to be applied over the affected spot, and prescribed a solution of tartar emetic, and a strict diet. The pain in the side disappeared, and two days after- wards, the stomach could retain milk and barley- water. Still nothing explained the patient's ema- ciation ; his almost total loss of voice, hoarseness, and constant cough. His* parents attributed these symptoms to hereditary phthisis, and mentioned that several members of the family had died of tnat dis- ease. Minute and repeated examination of F 'a chest, however, assured me that this was not the case. On the other hand, the symptoms were very severe, and I could not discover any visceral lesion sufficient to account for them. In this state of un- certainty, your views on spermatorrhoea attracted my attention. I immediately questioned the patient 30* SKXUAl ABUSES. . 33© Iwecting his past life, and learnt that at .he age of s^renteen, he practised masturbation with such fury that fie had frequently passed aqueous semen, mixed witn blood : frightened by these accidents, he had corrected himself completely. But, after about a fortnight s abstinence, he noticed that his urine con- tamed a deposit of thick, whitish, flocculent matter. He never attached any importance to this, although during four years, he observed it constantly, and noticed that it was more abundant after he had been ' much fatigued in his business. He observed also, that the last drops of urine were thick and viscid, and that a small quantity of viscid matter generally remained at the orifice of the urethra. His bad symptoms first commenced at this time ; his erec- tions and desires entirely disappeared ; and, by the time he had attained the age of twenty-one ; he was obliged to give up his employment, and shortly afterwards, his symptoms becoming aggravated he was unable to quit his bed. " I examined his urine, and found it in the condi- tion he had described ; the deposit contained m v being about an ounce in quantity. I noticed that his testicles were soft, and his scrotum flaccid. Fe agreed to my proposition of cauterizing the prosta- ' tic portion of the urethra, with eagerness, and I performed it on the following day. The effect of the cauterization was rapid : the second night after, wards, the patient slept soundly ; the third day a Change was observed in his voice ; and erections orcursed during the night. On the fourth day. the patient was able to get up and. take some light food, which was well digested ; his wandering plains had disappeared ; and, by the ninth day after the can- fcnzation, the patient's strength had returned. 340 CHAPTER Xii. EROTOMANIA ANB SATYRIASIS These two affections are usually confounded together, but there is considerable difference in • their nature, though their manifestations are similar In both of them there is^an unnatural excitation of sexual desire, so that it sometimes becomes utterly uncontrollable, and gratification is sought at any cost. In these cases there is a real furor, or mad- ness, which arises from disease, and is not a mere moral aberration, as uninformed people suppose. Satyriasis arises from a disease of the sexuai organs or of some of the adjoining parts, which keeps them in a. constant state of irritation, some- times so great that the patient cannot obtain the slightest relief, either sleeping or awake, but is kept the whole time in a state of furious excitement. The diseases that are most likely to produce Satyriasis at 3 those of the urethra and prostate gland, though sometimes gravel, or even the piles will originate it. Dr. Curling remarks that " The irritation attending the morbid condition of the mucous membrane of the prostatic portions of the urethra, tends, in a very material degree, to excite both the excessive seminal discharge and the secie. tions of the prostate, and to produce that morbid craving for indulgence and abuse, which persons who have brought themselves to this state find so difficult to repress and resist. It is well known that any irritation at the orific of an excretory duci MORAL DERANGEMENT*. 341 usually acts as a stimulus to the secieticn of the gland. Thus hurtful matter in the duodenum pro rtuces a flow of bile ; and a foreign bodv in the con- junctiva, as an inverted eyelash, a discharge of tears. So it is with the Testes, when irritation ex- ists at the Orifices of their excretory ducts. The disorder at this part, moreover, appears to react on the brain, and to become in part the cause of the patient's mind being constantly occupied with sub- jects of sexual excitement, and of his indifference and apathy to other matters. So that the local dis- ease induced by abuse powerfully aids in perpetu- ating the mischief, and, judging from the experience which I have had in these cases, is the object to which our treatment should be first directed. In many of these cases it is of no use reasoning with the patient, and telling him to control himself, unless the exciting disease be also corrected ; it would in short be of little more use than telling him he must not give way to a diarrhoea or any other morbid action. In a note in Dr. Curling's work this truth is well laid down, and applied to a class of cases for which usually no excuse is thought tc exist. The writer says, " This is a truth, I fear, not sufficiently impressed on the minds of medical men. One would be loath to offer any apology for the vicious habits and indulgences to which, it is well known, old men are occasionally addicted, — a melancholy example of the kind, in the higher ranks af life, having lately been brought under public no- dee. I cannot but think, however, that, in many- instances, these cases are not undeserving of profes- sional sympathy, and that the erotic longings which iometimes continue to distress the aged, long afte;* the period at which, in the course of nature, they 342 MORAL DERANGEMENTS. should have ceased, depend as mueft on physical in. firmity as mental depravity, the former inciting and producing the morbid desires. If these propensities were regarded and treated as symptoms of disease, (and that they frequently occur in connexion with affections of the urinary passage is well known to practical surgeons), I believe they would often sub- side, and the distressing results to which they lead would be altogether avoided." The same remarks also apply tu ©very other pe- riod of life, and especially to youth, as every physi- cian of experience in such matters must be well aware. I know that, in numerous instances, the sexual feelings of young persons are preternaturally excited by local disease, and that their genital organs are thus kept in a state of excitement by causes over which they have no control. This fact should be kept always in view when considering such cases, and we should recollect that a medical prescription may often accomplish reform, when a moral precept has failed, of which the foregoing Chapters of this work will furnish many illustrations. I was once consulted by a married man, the father of a family, whose habits had always been strictly moral and proper, but who suddenly found himself subject to occasional fits of the most intense sexual excitement, over which he had but little control. So completely was he the slave of his morbid feel- ings, in fact, that it was with the greatest difficulty he kept himself from the most disgraceful and licen- tious indulgence. He had latterly shut himself up alone when one of these fits came on, and was at other times in constant fear that he should sometime or other ruin his reputation for ever, even if he did nothing more serious. The condition of this man MORAL DERANGEMENTS. 543 *as truly pitiable, subject as he was to a state of misery for which, if it were known, he would re* ceive condemnation instead of sympathy. " Every one would tel'l me," he remarked, with tears in his eyes, " that it was disgraceful, and that I ought not to give way to it, but I cannot help it though it were to save my life, and I have sent for you because I think you must understand my true position. " — I found on examination that this gentleman was affected with a chronic inflammation of the prostate gland, and lower part of the urethra, which was liable, from various slight causes, to become temporarily worse, and to produce that excitation of the genitals above described. He distinctly remembered that before each of the fits he had either taken some se- vere exercise, or been subject to some unusual men- tal agitation or perhaps had committed some error in drink or diet, which seemed to bring it on. But of late the parts had become so extremely sensitive that the simplest excitement, of any kind, brought on afl attack, and it was scarcely possible for him to avoid one long together. I immediately informed him of -the cause of his trouble, and as it was not the result of abuse of any kind, and apparently not unusually severe, I felt justified in promising him relief, and immediately put him under proper treatment. — The diet and drink were rigidly regulated, bathing and regular exercise enjoined, and a tonic of Iron and Gentian administered. I also found it necessary to use the caustic internally, and to advise astringent lotions, with occasional injections to keep the bowels free. Under this treatment the irritation soon began to subside, and in two months he had no return of his eroiic fits — Now if this man had committed son*© 544 «ORAL DERANGEMENTS. gross immorality during one of these periods of en. citement, it would have been considered merely as the result, of moral depravity, and nothing would have been thought of but punishment, instead of me- dical treatment. — It is unfortunately true that moral depravity is often the only cause of such improper actions, and then they ought to be visited accord- ingly ; my object here is not to apologize for any. thing of that kind, but simply to show that there are often other cases, of a totally different character, which should be considered in a different light. Satyriasis is very apt to follow from the first at- tempt at masturbation and from excessive indulg- ence, particularly in those who use stimulating food or drink. — I have also known tobacco and opium to bring on an atttack, and still more frequently cer- tain medicines when improperly used, such as can- tharides and phosphorus. Erotomania differs from Satyriasis as respects the seat of the disease, which in this case is in the brain, and not in the genitals, they being affected only se- condarily. It is in fact a species of mania or insa- nity in which tjie mind is constantly occupied with sexual matters, and a constant morbid desire is ex- perienced for indulgence, sometimes even when the patient is completely impotent. Dr. Copeland draws the distinction between the two diseases very clearly, and I will, therefore, quote his words, merely re- marking that Nymphomania, to which he refers, is merely the same disease in the female as Satyriabii in the male : — " Erotomania — Monornanie errtique ot Esquirojl — is characterized by an excessive love of some object, r&zl or imaginary. — It is a mental affection in which MORAL DERANGEMENTS. £45 amorous ideas are as fixed and dominant, as reii gious iaeas are in religious monomania 01 melan- cholia. Erotomania is very different from satyria- sis and nymphomania. In the latter, the mischief is in the reproductive organs ; in the former, it is m the mind. The one is a physical, the other a moral disorder. Erotomania is the result of an exciter imagination, unrestrained by the powers of the under- standing ; satyriasis and nymphomania proceed from the local irritation of the sexual organs, reacting upon the brain, and exciting the passions beyond the restraints of reason. In the former, there is neither indecency nor the want of chastity ; in the latter, there is unrestrained expression of sexual desire and excitement. The one is commonly caused by unratified r disappointed affection excited in a virtuous mind ; the other, by inordinate irritation or indulgence of the sexual passion. " In erotomania, the eyes are bright, the manner and expressions tender and passionate, and the ac- tions free, without passing the limits of decency. Self and selfish interests are all forgotten in the devotion paid, often in secret, to the object of the mind's adoration. A state of ecstasy often occurs in the contemolation of the perfections which the imagination attaches to the subject of its admira tion. The bodily functions languish during this state of moral disorder ; the countenance becomes pale and depressed; the features shrunk; the body emaciated; the temper inquiet an 1 irritable; and the mind agitated and despairing. The ideas con- tinually revert to the loved and desired object ; and opposition or endeavors to turn them in a different direction only render them more concentrated and determined in their devotion. At last, parents and 346 MORAL DERANGEMENTS. fortune are abandoned, social ties broken asunder and the most painful difficulties are encountered in order to obtain the object of admiration. " In some cases, the attempts made by the patient to conceal and overcome this affection occasion a state of irritative fever 3 with sadness, depression, loss of appetite, emaciation, &e., which has not in. appropriately been termed by Lorry Erotic Fever> and which, after continuing an indeterminate period, may even terminate fatally. When a young per- son becomes sad, absent in mind, pale and emaciated, sighs frequently, sheds tears without any obvious reason, is incapable of mental or bodily exertion, scarcely speaks to any one, loses appetite, &c, it is sufficiently evident that the mind is inordinately possessed by some desired object. If a strong effort be not made to dispossess it of the predominant sen- timent, or if the object of desire be not obtained, the symptoms become still more distressing. The cor- poreal functions languish, the eyes sink, the pulse becomes weak and irregular, and the nights dis- turbed and sleepless. At last a form of slow hectic is produced ; and the weaker organs, especially the lungs and heart, are the seat of slowly-produced disease ; the whole frame is blighted, and the pa- tient sinks from the injurious influence of the men. tal affection on the vital organs. " This form of moral disorder may increase, and affect the intellects in a much more serious manner, until general insanity or mania is developed ; and, with the progress of time, it may at last terminate in dementia or incoherent insanity. In each of these, the primary character of the disorder, or the original moral affection, will still continue to be manifested by the frequent suggestion of the sama MORAL DERANGEMENTS. 347 srain of ideas, or recurrence to the object of devotion." The treatment of these cases requires great skill and experience on the part of the physician, and frequently a continued observation for a long time, in order to determine what the exciting cause really is. It may be wholly moral or wholly physical, or it may be partly both, and this must be ascertained before any good can be accomplished. The fact is philosophy is required as much as physiology, and the most perfect confidence must exist between the physician and the patient. The affections have often much to do with these peculiar troubles, and it should not be forgotten that there is a great differ- ence in the temperaments of different persons, and also in the sensitiveness or impressibility of their na- tures. — Those who wish to study the philosophy of this curious subject in relation to the other sex, should read the articles on Hysteria and Chlorosis in my " Diseases of Woman." Some persons always recommend marriage in these cases, to single per- sons, and there is no doubt but it is sometimes what is required, but at other times it is highly improper. In certain forms of physical derangement especially, marriage would only aggravate the evil, and the patient would in all probability ultimately become totally unfit for the married state. This advice, therefore, if followed, would not only fail of doing any good to persons so situated, but wourd make two unhappy instead of one. — Jt will be seen that lome forms of Erotomania are identical with whai is called, commonly, Love Sickness. See also the Marriage Guide. 348 CHAPTER XI. GENERAL HEM AUKS ON THE PRESERVATION AND RESTORATION OF THE SEXUAL POWERS This Chapter is intended to embrace all those items of information, and those interesting facts not directly needed in any of the previous articles, but which nevertheless it is useful to know. Some of these are moral, some medical, and some physiologi- cal, and the whole of them will be found highly suggestive, as well as directly instructive. It is pre- cisely this kind of information that is very fre- quently most needed, but hitherto there has been no source, except dear-bought experience, from which it could be obtained. The grand object of medical science should be to prevent disease, if possible, rather than attempt to cure it, and such knowledge is an important agent in prevention. It is unfortunately the case, as our previous arti- cles have shown, that the sexual power is liable to be impaired, or even totally lost, from a variety of causes, and that it is exceedingly difficult of restora- tion. There ai;e, however, many apparently simple rules which, if duly observed, would prevent much of the iniury now experienced, and there are also many others equally simple which will often mate- riaiiy assist in its restoration. The object of thie Chapter is to point out many of these, chiefly in the form of suggestions and hints ; the strictly medical treatment having been fully entered into already. It is very essential to the preservation of th« GENERAL REMARKS. 349 sexual power that the general health should bo good, and that there should be no serious derange-* rnents of any of the vital functions. When the general health is impaired and the vital energies are low, the sexual organs are sure to be weakened, and usually more in proportion than any of the others. Owing to their extensive sympathies also they are sure to be affected by the diseases of all the other organs, and not unfrequently this sympa- thetic injury becomes very serious. The stomach particularly exerts a great influence over the gene- rative organs, both beneficial and injurious. Long- continued dyspepsia is nearly always accompanied by weakened sexual power and desire, and even temporary attacks of indigestion will, for a time, produce similar effects. On the other hand a healthy stomach, with perfect digestion and nutri- tion, is highly conducive to sexual vigor. We may even go much further, and show that high feeding is nearly sure to over-excite the genital organs, 01 in other words that gluttony leads to licentiousness. This is a truth too often lost sight of in the education of children, many of whom, though predisposed to sexual ardor, are stimulated with rich food and ex- citing drinks till their passions become overpower- ingly strong. — In short the stomach exerts a mosi decided sympathetic influence over the generative organs, and we are thus enabled, by proper atten- tion to the diet and drink, to either increase or Weaken their power to a great extent. Some kinds of food stimulate the sexual organs while other kinds have the contrary effect upon them. Shell-fish, as before stated, are usually sti- mulating, owing to the phosphorus they contain, but other fish have no such power. Flesh-meat is sti« 250 GENERAL REMARKS. Ululating merely because it is nutritious, but it is » great mistake to suppose that it is of necessity more so than vegetables. There are some vegetables that are often more stimulating than flesh, especially those that are farinaceous or contain much starch, as the potato for instance, which, when of good quality, contains most of the elements the body needs. Most strong tasted or aromatic vegetables have a simulant effect, such as Celery, Parsnips, Onions, and Asparagus, especially, and so have all season- ing herbs, such as Mint, Sage. Pennyroyal, and Thyme. Spices and condiments have a still stronger action, especially the Peppers and Nutmeg. — Mush- rooms stimulate some people very much, and Truf- fles still more, and even Olives exert a marked in- fluence at times. The flesh of birds I think is not stimulating, except that which is red, such as ducks and geese. I have several times been assured that eating freely of the Canvass-back duck, when in 6eason, has been highly beneficial to those who were weakened by excess, probably partly from its own nature and partly from the wild Celery on which it feeds. Of all meats, however, Turtle has the great est reputation for exciting the generative organs, and I think with good reason. It is undoubtedly highly nutritious, and it appears also to contain some heating principle, which specially affects those parts. As a general rule all watery vegetables, such as turnips, cabbage, and squash, have no such effect as those enumerated, and are therefor proper when we wish to keep down excitement. Acid fruits also come under the same category, and indeed fruits generally, except some highly-flavored ones, such as peaches, and pine-apples which are us*. GENERAL REMARKS. 351 doubtedly aphrodisiac, except they disagiee with the stomach. Tomatoes are rather stimulating, and so are mos* kinds of beans, especially the Lima Beans, but peas are not so. Wheaten bread or wheaten flou* in any^form, is more stimulating than the flour of any other grain, while Indian meal is probably the least so. When we desire an anaphrodisiac effect therefore, Indian bread should be used, with mush, gamp or hominy, instead of wheaten bread or pota- toes. Rice is unstimulating, but sago, tapioca, and arrow-root are the reverse. In regard to drinks it may be stated that all alco- holic liquors are highly stimulating when first taken, but they soon lose their power if used too long or intemperately, and then they become injurious. Wine nas a more strengthening effect than spirits of any kind, and ale or porter is still better than wine. Those who desire to keep their passions down should not take either wine or malt liquor in any quantity. — Most of the cordials in use are highly exciting owing to the spices they contain, and so are many of the so-called bitters. — Coffee is almost as stimulating as wine, and should never be used by those who are disposed to involuntary emissions, nor by those whose desires are too strong. Tea ig different from coffee in this respect, and is therefore the better drink in such cases. Milk, though highly nutritious, is not stimulating, and it therefore forms an excellent drink for those who are disposed to emissions or exciting dreams ; such persons, how- ever, will do better to use cold water only, and they should also avoid all warm fluids, no matter how simple, because warm drinks always excite the flow of urine, and of course stimulate the sexual organ* 34* g52 GENERAL REMARKS. also. Those who cannot use (he cold water only may drink soda and mineral waters as much as they choose, or lemonade if it agrees with them, none of these being in the least degree exciting. Next to the stomach, it is important to attend to the state of the bowels, as they exercise considera- ble influence over the generative organs, and may affect them in a very injurious manner. Th^ bad effect of piles "has alread) been alluded to, and also constipation, but this last disability is of more con- sequence than it has perhaps been represented to be. No person must expect to escape seminal weakness who is habitually constipated, no matter how vigorous and healthy the genital organs them- selves may appear to be. It is, therefore, very im- portant, as a means of preserving sexual vigor, that the bowels should be always properly regulated, and frequently a little attention to this point is all that is needed to complete a recovery. — The opposite state, diarrhoea, though ot ourse weakening, is not sd decidedly hurtful as constipation, and its effects are soon recovered from. Next to tne stomach and bowels the urinary or- gans may be mentioned as exerting great influence over the sexual system. The proof of this has already been given, but I. think it necessary to call attention to the fact here as one of the very first im- portance. If the kidneys or bladder be affected in any way the genital organs are sure to be affected likewise, and if the urine have an irritating q.uality it is nearly certain to act on the urethra and ducts so as to cause sexual excitement or spermatorrhoea. This is particularly important in regard to children, many of whom are disposed to precocious virility &t to masturbation, simply from being affected wi*> 8ENBKAL REMARKS. 853 gravel or with some disease of the Kidney or blad- der. Those children most liable :o such troubles usually find it difficult to hold their urine during tire night, and it is very high colored, with a strong odor. Such children are very apt to be subject to spermatorrhoea in after-life, aijd also to be addicted to self- abuse ; it is, therefore, very important that all such affections of the urinary organs should be promptly attended to. At every after-period of life also such matters require serious attention ; for many a man is kept diseased and impotent by the same causes, which may operate so powerfully as to neu- tralize all attempts at cure while they remain. — When any of these diseases exist, at any period, it is requisite, of course, that the diet and drink should be regulated especially in reference to them, the urinary organs being readily affected by those agents. Constant and healthy exeicise of the whole mus- cular system is also of great importance to the pre- servation of sexual power. It is true that if a man takes little exertion, particularly if he lives high, he will be apt to exhibit an unusual tendency to amorous indulgence, because, as before remarked, gluttonv and idleness lead to licentiousness. This effect, bowevar, is only a temporary one and sooner or later the individual finds that he has permanently exhausted his vital energy ana [hat his health and strength is seriously impaired. The vital power that may be safely expended in sexual indulgence is only the surplus, after every part of the system has apppopriated its due amount, and if more be so expended some part must suffer. In other words we may suppose that every healthy man has a cer- tain stock of vital energy, whicl we w'll call his ft\\ GENERAL REMARKS. capital, to which he keeps adding, more or less, by the function of nutrition ; this addition may ba compared to interest which may be expended with- out any loss of capital, and of course without mak ing him any poorer. If, however, by any excess he expends more than this addition the capital is pro- portionably diminished, and permanently too, for it can seldom be again made up. Now, the idle man does not expend enough vital energy on his muscular system to keep it healthy, but at the same time gives a superabundance of it to the sexual organs, so that they are over-stimu- lated, and suffer from excess. They become habi- tuated to great indulgence, and are constantly caus- ing a drain on the vital power, that soon exhausts both principal and interest and leaves the indivi- dual completely exhausted. The philosophy of this has been frequently alluded to in the course of the present work, but it is so im- portant that I wish to present it in a strong light. I am fully persuaded that there is no case of preco- cious or excessive sexual propensity, unless caused by disease, that cannot be easily subdued by muscu- lar exercise. No matter how vigorously the semi- nal glands may act, in a state of leisure, they must become less active if the body be exhausted by ac- tive exertion, and to this rule there is scarcely any limit. One of the Reports of the Massachusetts Lunatic Asylum strongly impresses this truth, and shows conclusively that we have, in hard labor^ a certain means of subd aing this propensity to its pro- per limits under any circumstances. The applies tion of this truth to young persons is obvious, num- bers of whom are made licentious only by uodiW inactivity and over-feeding. GENIRAL REMARKS. 355 The invalid, or the man whose pcwers are inv ^**ired must of course husband his strength, because he does not require exhaustion, but only sufficient exercise to ensure health. Exercise of the mind is also equally as important as exercise of the body. The man who is mentally idle is nearly certain to experience too strongly the force of the animal propensities, and licentious thoughts are too often indulged merely from the absence of better ones. It must be recollected, however, that too much mental exertion, particular- ly if attended with care and anxiety, is most de- structive to the sexual power, and frequently leads to impotence, as many of our cases have shown. Those who wish, therefore, to preserve their virility should endeavor to maintain a happy medium, laboring with the mind sufficiently for. health and utility, and endeavoring to preserve perfect calm- ness and equanimity. This subject was explained in one of our former chapters on Impotence, and the remarks there made may be again referred to, in connection with these, with advantage. There are many indulgences which people allow themselves, some of which are apparently very simple, that exert a decided influence over the sexual organs, and in time impair their power. Some of these have been alluded to, particularly the use of tobacco and other narcotics, but there are some others also deserving of notice, though of iess consequence. Some persons are much affected by odors, which operate either as stimulants or as seda- tives to the nervous system, and sometimes produce peculiar effects. That there are odors that specially excite the sexual instinct is beyond question, some naturally and others artificaFy,' though diifereni J556 GENERAL REHARXS. people experience their effects in very different de- grees. There are also others that exert an opposite influence, though seldom in so decided a manner. Very sensitive people, particularly those in whom the sexual instinct is naturally strong, may be as much excited by a mere scent as by a medicine onveyed into the stomach, as I have frequently seen. Hysteria is often excited in this way in females, as I have shown in my work on the Dis- eases of Women, and various forms of nervous ex citement frequently supervene in the other sex from the same cause. It may be stated, as a general rule, that all power- ful odors may produce effects of this kind, and they are, therefore, better avoided, particularly the habit- ual use of them. There are some particular scents that exhibit this power more constantly, and to a greater degree than others, and several of these are articles of common use in the toilette. An enumeration of these would embrace many of the choicest perfumes used, but it is scarcely possible U* particularize among so many, nor is it necessary as the whole are better avoided. The very origin^ and natural use of some of these indicates clearly enough the purpose Nature intended them to mifil, in the animals from which they are taken, and I cannot but think that few females at least would use them if they really knew what they were. Muskj especially, is an article of this kind, the aphrodisiao effects of which I have sometimes seen exhibited in the most unequivocal mariner. The readers of classic poetry will call to mind the story of the Indian Prince, who exhibited such marvellous powers merely from smelling the flower* &i the Nympha odorato, and also several other in- GENERAL REMARKS. 357 stances in which the aphrodisiac powei of different odors is distinctly alluded to, showing that the gene- ral truth was known centuries ago. Some of these accounts are of course much exaggerated, but most of them are founded upon actual truths, as I have in some cases proved, and I believe the statement about the Nympha is one that is entitled to consideration* Perhaps, however, the most important suggestions, as regards the preservation of the procreative powe~, are those relating to its actual use. It is well known, respecting all the other vital functions, that their healthy performance and preservation, depends materially upon their being exercised at proper times, and under proper circumstances, and it is the same with the generative functions. Many persons think, because the genital organs are usually capa- ble of action at any time, and under almost any circumstances, that it is therefore of little conse- quence what time is chosen, nor under what circum- stances it may be. This, however, is a great mis- take, as any one may soon discover by studying his own experience. The time for sexual indulgence should be so chosen that the temporary excitement and after-ex- haustion resulting from it, may not interfere with any of the bodily or mentE^ functions, nor distress the sysiem by necessitating too much effort during any needful exertion. Ignorance of this important rule, and consequent neglect of it, very often leads to great inconvenience, and even serious mischief. Sexual indulgence just after eating is nearly certain to be followed by indigestion, even if it does not cause immediate vomiting, owing to the temporary loss of nervous power thereby produced, whicn trrests the action of the stomach. Just before eating 2^Q eSNLRAL REMARKS. also the same evils may follow, fiom the stomacl being made so weak that digestion cannot prone] 1 J commence, and the food consequently ferments. Many times I have heard men confirm this truth, when explained to them, though they had previously never dreamt that their troubles arose from such a cause, and when our previous explanations are borne in mind, respecting the nervous sympathies of the sexual organs, the philosophy of it will be evident. The proper time for this indulgence therefore, in reference to taking food, is at a sufficient, interval after eating for digestion to be nearly accomplished, and before another meal begins to be needed. By observing this rule the action of the stomach is not interfered with, and no indigestion or nausea are likely to follow. It is true, that most men experience stronger desire for indulgence iinmediately after a full meal, particularly when stimulating drinks have been used, but this does not prove that they choose the best time. The desire they then experience is merely a factitious one, produced by the general excitement of the whole system, and the exhaustion afterwards felt is nearly always in proportion. In the same manner a man, while under excitement from alcohol, may teel disposed to great bodily activity, and may exhibit astonishing strength, but when the stimulus is withdrawn he feels a corresponding pros- tration and lassitude. This is the reason also why sexual indulgence should not be sought during such excitement, for the disposition is nearly sure to be stronger than natural, and the cver-excitement is followed by proportionate exhaustion. In Poetry, I am aware, Venus and Bacchus are associated together, but Poetry is not always Physiology^ nor even common sense, nor should the licentious furor ftSNERAL REMARXS. 359 produced by wine be .n any way considered as the promptings of nature. Upon the same principles it is obviously injudi- cious to seek indulgence just previous to any mental effort being made, because the vital energy will be too much exhausted to allow of such , effort being made with advantage. Nor is it advisable imme- diately after any great mental effort, because it is injurious to have two causes of exhaustion in action at the same time. — The same remarks also apply to muscular exercise, which should neither immediately follow nor closely precede sexual indulgence, for the reasons above given. — In short the period chosen should be one when both body and mind can enjoy repose, at least for a short period, both before and after, and when none of the functions are likely to be disturbed. The time of day is a matter of secondary import- ance or rather no preferable time can be named, because it must so much depend upon how the indi vidual is circumstanced. That of course wil\ be the best time when the above-mentioned rules can be most fully observed. Some medical writers sug gest the evening, because the business of the day is then over and the repose of night is to follow, and this probably is the best period, generally speaking. Others again recommend the morning, because there is then the greatest vigor, and in case of con- ception the offspring may be benefitted thereby. This, however, I feel assured, is a bad suggestion, for the business of the day will be very apt to oppress a man who starts exhausted, and the various functions of his system will very likely be imperfectly performed. The notion about the offspring being influenced at the moment of conr.ep 3S 360 GENERAL REMARKS. tion, by the state of the male system. I have al- ready shown the fallacy of, because that moment may not nearly correspond with the period of association. Tne duration of tne sexual power, like any otner, materially depends *n the manner in which it is used, and this should therefore be duly considered by those wno think its preservation worth striving for. A certain amount of natural indulgence is probably essential, in most cases, to perfect health, but when that amount is exceeded of course more or less permanent injury results, as before shown. Every individual should, therefore, endeavor to as- certain, for his own guidance, the proper limits to hi$ gratification, and if he wiJJ attend to what has been previously stated on this point that limit may be readily ascertained. By doing this a real gain will always be made, for the extra duration of the power which this will ensure will more than com, pensate for any temporary denial. — With some peo- ple whose systems are in regular action, and whose health is nearly uniform, the observance of a regit* lar period is found to be advawtageous, and highly conducive to the preservation of the virile power, us it prevents both excess and gradual decline. These hints and suggestions, though apparently simple and common-place, are nevertheless of great value, and if duly observed would probably do more towards preventing untimely decay than all the medical treatment ever practised. Decay is caused, in numerous instances, by a number of small causes operating together, and if each cf those be removed, as it may generally be very readily, the decay is of course prevented. People are too apt to take notice only of the more striking agents of da* GENERAL REMARKS. S(5£ ttructiDii, passing unnoticed these apparently sim- ple ones, as being of small consequence while in reality they are the most important. There are few persons of good health, who will attend to the above suggestions, and the advice form- erly given, but what may preserve their powers to an indefinite period of their existence, particularly if they practice cold local bathing over the parts, and avoid all improper excitement. — There is no parti- cular time of life when the powers of the male sys- tem decay, but they may be preserved to extreme old age, as many cases have proved. — Old Parr for instance was condemned to do Penance when over a hundred years old, for an amorous intrigue, and he had several children after that period. There are some other circumstances, connected' with the association of the sexes, that exert an im- portant influence over the duration and manifesta- tion of the sexual power, but as they do not concern man alone it is not necessary to enter fully into a consideration of them here, but merely to point them, out as concerning both sexes. There is no doubt but that Nature has instituted^ in numerous instances at least, if not universally, & peculiar fitness, or adaptation between particular individuals of opposite sexes, that makes them more- appropriate companions to each other, in marriage,, than they can ever be to others. And on the con- trary, it is equally certain that there is as great aa unfitness in some individuals, so that their union i» in every way objectionable. This adaptation may be either mental, moral, or physical, or it may be all three, and sometimes it consists in something we cannot understand, though its existence is too obvi- ous to admit, of dispute. Nature frequently exhibit* 362 GENERAL REMARKS. wonderful sympathies and antipathies, which we cannot comprehend, but which should be attended to, as far as possible, in making our arrangements, for it is always injurious to run counter to them. There are many causes of unfitness, and consequent un- happiness, that could be discovered before marriage, and many others that could be corrected after, if the parties possessed a certain amount of physiological knowledge, but unfortunately such knowledge is seldom obtained in time, and the consequences must be experienced. It is not my purpose to discuss this matter fully here, but merely to show its bear- ing upon the subject now being discussed. There is no question but that association between persons properly adapted to each other is less exhaustive, and may be more frequently indulged, than between those who are naturally unfitted to be companions. And it is also certain that the circumstances under which the association occurs may very much deter- mine the effect it will have. It is requisite, for the act to be truly pleasurable and advantageous, that it should be fully approved both by the feelings and the judgment, otherwise it will be more or less re- gretted, and more or less injury will follow, no mat- ter what amount of mere animal gratification waa experienced. This is the reason why mere licen tious debauchery is always followed by remorse, and ill health, while legitimate association in ma* riage, with a loved and respected partner leads to no such evil results. It is a fact equally important to individuals and to society at large, that the institu- tion of marriage is conducive both to health and to happiness, and that the duration of life, in both •exes, is longer in that state than in any other. Many men fall into a great error in regard to this subject, GENERAL REMARKS. 363 and suppose tnat they can realize more pleasure in the unlicensed indulgence of the singfce state than when married. Tliis is, however, a fatal mistake, for they really enjoy less, and are after all dissatis- fied with themselves, while the duration of their powers is materially shortened. Some litfle time ago I had a very interesting conversation on this subject with a Swedenborgian, who remarked that many of the principles laid down in my lectures exactly corresponded with his spiritual views on marriage, and that his own expe- rience fully corroborated the truth of what I had stated. He told me that in his youth he was unfor- tunately led into a licentious course of life, and ex- perienced in consequence all that self-accusation and loss of real pleasure which I described, but that since his marriage, and in consequence of the im. portant truths learned from Swedenborg's writings, he had subjected his passions to the control of rea- son, and had led, as he expressed it a new life. He assured me that, with the partner of his bosom, association was never followed by exhaustion to either, but on the contrary by a feeling of increased strength and pleasure to both, and I have no doubt but he spoke the literal truth, for I have been fre- quently told the same by others. He regarded this as a spiritual effect, while J looked upon it as a simple physiological one, but be that as it may the fact is an important one, both as regards health and morals. These subjects, however, are very fully discussed in my book, called the Marriage Guide, which I have been for a long time preparing, and the Three Hundredth Edition is just out. It has been delayed in order to institute a number of ex- periments, and an extended series of observations. 35* 3fi4 GENERAL REKi.£KS. iv clear up all doubtful points and make the expla- nation complete. Another important requisite for the healthy action and extended duration of the sexual power, in both, is a near correspondence in age. Experience haa proved beyond doubt that when there is great dispa- rity of age, in marriage, the elder person is nearly sure to benefit at the expense of the younger, some, times even sufficiently to compensate for the loss resulting from great excess. This fact ^as acted upon medically in former times, and is now even in some countries, by procuring young females to sleep with old men, so that they may be strengthened thereby, which they nearly always are, though the females suffer a corresponding loss, and not unfre- quently waste and die in consequence. Such un natural practises are therefore properly discounte- nanced now, both by reason and morality, though we sometimes see a near approach to them in marriage. St is even known that when children sleep with old persons they suffer from it, and sometimes even die, without the causes of their sickness being suspected. In all probability young men who marry old females suffer in the same way, and to an equal extent, pro- viding they are as exclusive' in their companionship, but there are many causes that may make it other, arise in their case. What constitutes a great disparity of age must of course depend upon various circumstances, beside* the number of years. Some persons are younger at forty or even fifty, in respect to health and probable longevity, than others are at twenty-five or thirty and this must be taken into account. Generally speaking, however, there should not be much more than ten years difference under any circumstances. GENERAL REMARKS. 3(55 and only half that is better, the man being the elder, — Besides health this principle of similarity of age has an important bearing upon the relative number of the sexes born, as shown in my Matron's Manual, to which I. refer those who wish for more extended information on the subject. The explanation of the above-mentioned fact is probably this, — all living bodies are constantly giving off portions of their substance, in the form of insensible perspiration, and these particles thrown off are in the same state, in regard to age and health or disease, as the body from which they emanate. The same bodies are also as constantly absorbing, both by the lungs and by the skin, what- ver is presented to tnem in a proper form, which partly counterbalances the loss. Young healthy persons are, therefore, always giving off a stream of fresh wholesome material from their bodies, and old or diseased persons as constantly give off a stream of morbid and decaying matter, which ex- plains why it is that the young suffer and the old benefit when they live together. The waste of the old persons ts in part made up by absorbing the fresh exhalation from the young, and they become thereby rejuvenated, while the waste of the young persons is only made up by absorbing the decaying exhalation from the old, and they in consequence speedily decay and become old likewise. The ce- lebrated Hufeland, in his " Art of Prolonging Life" gives some curious instances of the practical ap- plication of this fact which are highly interesting, in a scientific point of view, though morally repre^ hensible. Among others he tells us of an old man who had the superintendence of a kind of alms, bouse, in which were a large number of young 366 GENERAL REMARKS. girls, in whose society he passed nearly tne whole of his time. He contrived to have a number o them always around him, so that he was constantly in an atmosphere as it were of youthful exhalation, and by these means he preserved his life to an ex- treme old age, with all his powers in full vigor. A similar practice, to a certain extent, has even been adopted in London and Paris very recently, as was discovered in the evidence on a Police Trial. It appeared, from the statements made, that a number of poor young married females were hired to attend, at certain establishments, for so many hours in the day, to associate with superannuated old men. And not only did these young females associate in com- pany with the aged patients, but they also supplied them with what ought to be kept for infantile nutri- ment alone, — in short they acted as wet nurses to them ! — -The results of the practice were said to be very satisfactory, but fortunately there is not suffi- cient degradation and poverty in this country to make it available here, though I have known it at- tempted. — With persons of equal age, and similar condition of health, the exhalations are similar, and there is an equal loss and gain on both sides. — During sexual excitement the insensible exhalation is much increased, and therefore the effects above- mentioned are more evident where there is associa- tion, and this perhaps explains, as my Swedenbor- gian friend remarked, why it is that in a proper marriage no exhaustion at all is experienced, there being merely a reciprocal interchange exactly cor- responding in both. THE END. Plate XI.— Fig. 1. 367 Plate XI.— Fig. 2. REMARKABLE CASE OF ELEPHANTIASIS, 369 REMARKABLE CASE OP ELEPHANTIASIS. Elephantiasis, though common in some parts of the world, is rare in the United States. The following case occurred at the Colored Home in this city, while it was under the care of that most painstaking and conscien- tious physician, Mr. S. Whitall. The patient's name was Isaac Newton, native of Georgia, aged 22. He was admitted to the Hospital March 20, 1866. He had previously enjoyed general good health, and was in good condition when admitted. About eight years "before, while leaping a fence, he Mi astride the rail and bruised the scrotum. Some pain and swelling followed, which, however, passed off, and about three months after it began to feel uncomfortable, and the skin commenced to thicken ; the thickening increased till it extended up the Penis, till it reached the prepuce. It then grew rapidly till at last it hung down near to his ankles. Its appearance when at the hospital is shown in Plate XI.— Fig. 1, At first it pained him very much, but latterly he was only inconvenienced by its size and weight, which hin- dered his walking. His general health being remarkably good — his weight, without the tumor, 159 pounds. The tumor weighed, when removed, 63^ pounds. His sensual desires were perfect, and he had occasional erections and emissions. 370 REMARKABLE $!ASE OF ELEPHANTIASIS, This enormous tumor was successfully removed by Dr. Thebaud, in the presence of many noted surgeons and medical men, May 30, 1866— Dr. G. F. Hollick being at that time House Physician. The patient was placed under the influence of ether, and the operation lasted nearly an hour, including the dressing. It was remark- ably successful, and on August 6th the wounds were almost entirely healed, the parts had assumed their natural appearance, and his general health was much better. He was even gaining flesh. April 2, 1867, he was discharged from the hospital and returned to Georgia. The parts then presented the appearance shown in Plate XI.— Fig. & , APPENDIX NEW FACTS AND CASES CONNECTION BETWEEN THE BRAIN AND THE SEXUAL ORGANS. The two halves of the Brain are separated, to show th*y are distinct from each other, and to show their eonnee-" need on with the Sexual Centres. (See page 4o. FACTS FOR THE FEEBLE ! OR PROFESSIONAL NOTES OF CURIOUS MEDICAL CONSULTATIONS -, RELATING TO THE VARIOUS PECULARITIES, DISABILITIES, AND FORMS OF DECAY OF THE SEXUAL SYSTEM BEING THE RECORDED EXPERIENCE OF MAUI YEARS SPECIAL PRACTICE IN SUCH CASES, AND SHOWING THE ACTUAL EFFECT OF THOSE NEW REMEDIES, A» J MODES OF TREATMENT NOT YET GENERALLY KNOWM EVEN BY MEDICAL MEN BY FREDERICK HOLLICK, M. D. ♦♦♦ NEW YORK: THE AMERICAN NEWS CO., NASSAU STREET, PUBLISHERS AXD AGENTS. I Entered according te Act of Congress \a cb« /*ar 185ft, BY F. HOLLICK, In tibft Cork's Office of the District Court of the Umted •or tfet Southern District of New York 375 CHAPTER I. THE PHYSICAL AND MORAL EFFECTS OF 00NTINSSC8. By . Continence, is meant a voluntary abandonment of sexual indulgences, in those who are capable of, aud who have a desire for them. When a person abstains simply from want of inclination for such pleasures, it is called ■Chastity, which differs from continence inasmuch as it re- quires no effort. Chastity is a natural condition for many, owing to peculi- arity of constitution, and is therefore both proper and bene- ficial. Continence on the contrary is an unnatural strug- gle, against one of the strongest animal instincts, and h always more or less injurious, as every attempt to evade the laws of our being must be. Every living thing, Vegetable as well as Animal, has, at some period or other of its existence, a desire, or tendency, towards the opposite sex, and this desire or tendency should be gratified, both for the purposes of procreation and also because it is necessary to the individual's own well being. To praise and recommend absolute continence as a Vir- tue is a great mistake, and to suppose that it can be really practised, by those who are physically perfect, is equally a mistake ! It is true we hear of it, and possibly some persons think they really are absolutely continent, but most assuredly, they deceive themselves. Some of these persons are really Impotent, and give themselves credit for Continence when in fact they are only powerless ; others who forswear natural indulgence either abandon them- selves to disgusting habits, a thousand times worse, or suffer from unnatural pollutions. 376 THE PHYSICAL 1ND MORAL There is a period of life, in all perfect organizations, when sexual indulgence becomes an actual necessity, as much so as food or drink. In some organizations this necessity is of course nrich stronger than in others, and the consequences of not ooeying it are in them proportion- ably increased. In such persons we often observe the most singular Mental eccentricities, and sometimes even moral perversity, carried to excess, and not unfrequently ending in mania, melancholy, suicide, or crime. The phy sician often sees, in cases of forced continence, the most hideous exhibitions of Nymphomania. Satyriasis, Pria pism, and Erotomania, not unfrequently terminating in Insanity or death. Besides mental and moral perversions, Continence also originates many physical derangements, such as various infirmities of the Genital and Urinary organs, softening and inflammation of the brain or spinal marrow, with wasting of the flesh, and fever. The celebrated Esquirol remarks, that most of the in- sane persons who come from Convents, exhibit morbid amative tendencies. And Mathieu gives us an instance, in his Etudes Clinique sur les Maladies des femmes, of a young girl who was attacked with Nymphomania after a fit of religious fervor, and probably from previous undue restraint. Many of the so called Perfectionists in religion, especially those who exhibit the phenomena of Trance, or Convulsions, have confessed that during their fits of excitement they experienced the liveliest sexual emotions. And I have heard similar confessions made to me, by those who have been excited in the same way at love feasts and protracted meetings. In short in all cases where the natural propensities are unduly restrained, especially from mistaken religious views, there is a constant liability to such exhibitions of Erotic furor, which are often mistaken, even by the indi- viduals themselves, for genuine devotional 'fervor. Those who are curious about details of this kind should read the writings of Hecquet, who had many opportunities of becoming acquainted with these religious enthusiasts. In my own practice I have had similar facte eommunica, EFFECTS OF CONTINENCE. 377 ted perhaps equally curious, and equally instructive, some of which will be given in another place. In all my ex- perience, and it has been extensive, I have never known a female who was subject to fits of intense religious excite- ment, such as we often see at Camp Meetings, but who either had some uterine disease, or was naturally of an ardent amative temperament. I have often seen the characters of these Devotes change in the most extraordinary manner, under a proper course of medical treatment, so that their church friends accused them of backsliding, and attributed the change to the in- fluence of Satan ! Many others I have also seen changed in a similar manner, on being married ; and in one such instance the husband was accused of leading his wife from religion. The old Ascetics, who swore to practice perfect conti- nence, have left us many records of their daily and nightly struggles against nature, and of their remarkable amative hallucinations, — for which, by the way, they often were called Saints. This is particularly seen in the records left by Ascetic Females, whose lucubrations are curious compounds, half pious half erotic, betraying either uterine disease or intense warmth of sexual feeling. Many Medical writers have testified, after long and careful observation, that uterine furor is very general among those females who resist all amative impulses from religi- ous motives. And not unfrequently, in spite of all their severe chastity, nature overpowers conviction, so that the poor victim of a so called virtue is constrained, in spite of herself, to betray her real condition. In more than one instance, during uncontrollable erotic furor, exhibitions, and advances, of the most libidinous character have been made unwittingly, by those rencv/ncd for having conquer- ed all fleshly lusts. So much so fa fact is this the case that, in France, it is a common proverb that the Convent and the Confessional are the Parents of Hysteria and Nym- phomania ! The terrible struggle which many estimable females ■naiutain in this way is most extraordinary, and not unfre o78 THE PHYSICAL AND MORAL quently terminates in Insanity or death, — though those around them have no idea that any unusual effort has been required on their part. In short sexual approach is a necessity of the organiza- tion, and those who practice undue continence will always suffer a variety of evils from which those who do not are free. It is also the foundation of Marriage, one of the fundamental Institutions of civilized society, and equally beneficial ^individuals and to the community at large. Continence is of course opposed to this institution, and should therefore be discountenanced by all well wishers of our race. Statistics prove that married persons on an average, are longer lived than single ones, and my own observation has convinced me that they are more exempt from dis- ease. So well convinced were the ancients of this that they erected a statue to Hymen, the God of marriage, with this inscription " To Hymen, who prolongs youth ! " According to statistical reports it appears that while, in a given time, among single men between 25 and 45 years of age, 28 will die out of every hundred, among married men of the same age only 18 die out of the hund- red ! It appears also that for every 78 married men who attain 48 years of age there are only 40 single ones who do so, and as we advance further in life the difference is still more striking. Thus out of every hundred married men 48 will live to be 60 years old, but . in a hundred single men only 22 will attain that period of life. And at 80 years of age we find nine married men, to only three single ones. Among females the difference is still greater in favoi of the married, notwithstanding the many dangers of maternity, and they are also less subject to disease. As a further proof of this important truth, it is found that out of every hundred suicides sixty-seven are single and only thirty-three married ! And in seventeen hund- red and twenty-six Insane, also nine hundred and eighty are single and only seven hundred and forty-six maraed. It is true that the unmarried state mav not necessarily EFFECTS OP CONTINENCE. 87^ 6e a state of Continence, but it must either be that or t Btate of illicit or unnatural indulgence, either of which is injurious Many of the diseases and infirmities arising from Con- tinence are attributed to other causes, both by people gen- erally and also by Medical men, who have not made these matters their study. This is especially the case with young females, whose natural modesty induces them to carefully conceal the truth, even if they fully perceive it themselves. A crowd of hysterical and nervous derange- ments are originated in this way, besides various uterine diseases. In describing Chlorosis, or the green sickness, which is often the result of forced Continence, a celebrated French writer gives us the following touching picture, true to the Life. — " See that young female with pale wax-like cheeks, 'anguishing sunken eyes, and tottering steps, hanging her lead like a withered flower, her heart palpitating and her breathing interrupted by heavy sighs. Her digestion is bad, her appetite capricious, and she has an unnatural tendency to eat strange unusual substances, which she often craves in the most urgent manner. If allowed to remain in this state too long she will continue to languish, and at last descend prematurely to the tomb. Let her marry however, to the being she has constantly seen in Iter dreams, and health returns like glorious day at the rising of the sun. The roses soon return to her cheeks, happiness brightens her eyes, and a pure wholesome blood rushes gaily through her veins." Such pictures are daily to be seen, though none but ex- perienced eyes detect their meaning. In the other sex also we have similar experience but not so frequently, owing to le3S innate modesty, and more facility for grati- fication. In history also, as w^ell as in modern experience, we find numerous instances of the evil effects of undue Continence, gome of which are worthy of being referred to. Hippo- crates saved the life of a young Prince, who was fading away from seme unknown cause, by advising his mar- riage with the young female he loved, and the same aer S80 THE PHYSICAL A'S n MOTUT. vice was also rendered to another ycmng Prince by Era- ffistratus. The celebrated Galen likewise, being called to treat the daughter of a noble house, who was pining away, detected at once that she was a victim of forced conti- nence, and he assured her father that nothing but marriage could save her life. Much against his will he had to Con- sent, his daughter refusing to marry any other than a young plebeian, with whom she was in love. The result proved however that, though pride was sacrificed, health was repaired and life saved. In that interesting work the Physiologie des passions, we find a curious instance of the same kind. The subject, a young lady, was intended by her parents for a Nun, but having an ardent Uterine Temperament the idea was ex tremely distasteful to her, and she became seriously sick from grief and apprehension. At first she fell into a dull stupor, from which she roused only to pass through all the stages of Hysteria, and Nymphomania, till her reason seemed almost gone. That skilful physician Alibert being called in he saw as a glance what was the cause of hei sickness, and promptly told her parents that she must marry or die ! Their love for their child was fortunately stronger than their fanaticism, and they consented to her marriage. She at once recovered and became a happy healthy wife and mother. In such cases the natural action of the Genital organs is indispensable to the health of all other parts of the system, and their forced inaction is highly prejudicial. — The Physiological reason for this, and also the rules by which indulgence should be regulated will be found in the " Marriage Guide." The evil consequences of Celibacy, whether it be ac- companied by actual Continence or not, are as great per- * haps to society as to the individual, a fact which many lawgivers have recognized. In ths sacred writings of the Persians, the Hindoos, the Chinese, the Hebrews, and the Turks, we find Celibacy expressly condemned, and in some ' of them it is even stated that the souls of those who die in a state of Celibacy will not enter heaven, but will wander eternally on earth. To avoid this it was custom- EFFECTS OF CONTINENCE. 381 uj to many the dead before they were burnt. The oU Romans, and the Greeks, had express laws against Celi- bacy, and so harrassed those who practised it that the offence was quite rare. Lvcurgus excluded those who practised Celibacy from all civil and military employments, forbade them attend- ing the public amusements and branded them as infamous. At certain solemn fetes they were also exposed to the ridicule of the populace, who promenaded them around the public places with shouts and laughter, while the wo- men tore their faces and struck them with small whips. A curious instance of the contempt which was shown for the unmarried is found in Spartan History. It is well known what extreme reverence these people had for their old men, who were invariably saluted with respect by the young whenever they met. On one occasion however, an old man was refused the customary mark of respect by a youth, of whom he accordingly complained, to the magis- trates. The youth on hearing the accusation admitted its truth, but replied, " this old man has never married, — how then can he demand marks of respect from me when he will leave no children to show them to me, when I am old ? " This reason was deemed good, and the old man was sent away with contempt. The Laws of 'Plato tolerated Celibacy in men only till the thirty-fifth year, and in females only till the twenty- fifth, — after these periods they were socially outlawed. A Roman Citizen could not testify in any case till he replied in the affirmative to this question—" on thy soul and conscience art thou married ? " Under Julius Geasar, and many of the other Emperors, laws were passed to degrade those who did not marry, and to reward those who did. EVen in the Romish Church, among the Priests, Celi- bacy is comparatively a modern Institution, and except in as far as it makes the Church itself more powerful, it has always been objected to. In fact Celibacy is an unmitigated evil to society, as Continence is to the individual. A forced abstinence from ttatural indulgence leads to disease or unnatural abuser 882 THE PHYSICAL AND AfOKAL while a neglect of marriage leads to licentiousness and prostitution. In all cases where a nation has become viti- ated by luxury and vice it has disregarded marriage, as we see in the decline of the Eoman Empire, and of the Grecian communities. In giving these remarks I presume no apology is need- ed, at least not to those who think, because thefr utility must be apparent. I will now proceed to give some cases from my note book, confirmatory of the statements above made. To the prudish, and to those who are governed by old prejudice against such discussions, I recommend the fol- lowing passage from Montaigne. " What is there then in the Genital act, necessary and natural as it is, which should cause it to be proscribed as a subject for rational conversation ? "We pronounce com- monly enough the words kill, steal, filthy, and Adulterous, but mast not name the act by which our lives begin, and by which the race is continued ! Oh false modesty ! — oh shameful hypocrisy ! " CASES FROM MY NOTE BOOK, UNDUE CONTINENCE, FROM WORLDLY PRUDENCE. The first case which I extract from my notes is a good type of a large class, — -those who are continent from pnv- iential motives, and who think to avoid complying with the requirements of nature without suffering permanent inconvenience. Case I. — The subject of this case was a Lawyer, aged thirty-one. of good constitution, and of active Tempera- ment. When he applied to me his general health was not much affected, but from various unusual symptoms lie had begun to be somewhat alarmed. 1 found on enquiry that he was naturally very amative, but at the same time very prudent, and uncommonly fond •f money He had made up his mind not to marry till ITFECTS OF CONTINENCE. 383 he had secured a fortune, and was able to support a family in would only give him greater power afterwards. Neither he nor the Phrenologist, whom he consulted, were aware that Urinary Spermatorrhoea had taken place, in consequence of his continued Continence, and that his sexual organs had nearly become powerless. Such however was the case, and to his horror he found on his marriage that he was nearly Impotent ! The state of mind of a man so circumstanced may be better imagined than described. " Here I am " — said he to me, " a poor, wealthy, imbecile wretch ! In my senseless • pursuit of riches I have lost that which all the wealth in the world cannot recompense me for. Had I known ten years ago what I have since learnt from your book, (The Male Organs,) I should now have been fifty thousand dol- lars poorer in money perhaps, but a healthy perfect man ! I might also have become a proud and happy Father, which alas I now never expect to be." This was one of the most unpromising cases I ever had to deal with, as I candidly told him, but still I undertook to do the best I could. By means of a good tonic regimen and diet, sea bath- iug, Champooing of the Genitals, and the use of the Aphrodisiac Remedy, he began in three months to have Borne slight indications of power, and in six months much stronger indications. It was not possible however to make a permanent restoration, because the Testes were con- siderably wasted/ They were not so far gone as to be EFFKorS OF CONTINENCE. 391 totally inactive, but it took them a long time to form any considerable quantity of Semen, which of course made his periods of power and inclination very rare. Even what he did gain, small though it was, was much more than he ever expected, for he fully believed he was incurable and totally impotent. Had I seen him two years before I would have answered with my life for making him comparatively perfect, for I gathered from what he told me that no wasting of the Testes had then taken place, and till that occurs no case is hopeless. In addition to these I could quote a large number of other cases, to show the evils of undue continence, and especially some very curious ones in young females, who were brought to me as being CJilorotic, and Hysterical, but these are quite sufficient for my present purpose. I have had a Priest, who declaimed against sexual indulgence as improper, and who adduced his own case as a proof that Continence was possible, came to me to be cured of a loathsome infirmity which that very continence had caused. OHAPTEK II. fHE CONSEQUENCES OF SEXUAL EXCESSES AND ABUSES. These consequences are much more frequently seen than tnose of Continence, and people are more generally aware that they are of a hurtful character, though the actual extent and nature of the injuries resulting from them are not suspected. From a variety of causes, many of which are but little known, a majority of human beings are addicted toexcesa in sexual indulgences, and to various jnnahiral modes of gratification. The reason for this is a matter deserving 8$2 SEXUAL EXCESSES AND ABUSES. of earnest investigation, though unfortunately it has hith- erto received but little attention. The Theologian is con- tent to ascribe these, in common with all other human frailties, to Original Sin, and seeks their source only in a depraved soul. But the enlightened student of human nature as it really is, recognizes various direct and indirect influences, some belonging to the individuals own Organi- zation, and others to the objects and circumstances by which he is surrounded. These influences often impel man to that course of conduct which his reason condemns, and which produces untold misery and pain. Among these influences may be mentioned Hereditary Tendency, Excessive development or morbid irritability of the Genital organs, vicious associations, stimulating food and drink, and various social institutions more or less opposed to nature's requirements. In those persons who have little or no knowledge of the consequences of sexual abuse these influences operate almost unchecked, but in those who have such knowledge the fear of those consequences operates more or less as a restraint. The influence however is frequently so power- ful as to overcome all such restraints, and the victim falls into the galph with his eyes wide open, but still impelled by a force from which he has neither the power nor the desire to escape. There is good reason to believe that sexual excesses and abuses produce, directly or indirectly, bv far the largest part of human suffering and disease, much more in fact than all other causes that can be enu- merated. People generally only observe the more palp- able and direct consequences of these vices, while the in- direct results of them are lost sight of, or attributed to Dther causes. The sympathies of the sexual Organs are "both exten- sive and complicated, in consequence of which their de- rangements often affect remote parts of the system, and in many different ways, appearing like so many different dis- eases. This is especially exemplified in Venereal diseases, and particularly in Syphylis, the different stages and liero- ditaru modifications of which, extending as they may do over several generations, are only just now being under- •EXUAL EXCESSES AND ABUSES. 39S itood oven by medical meD. (On this point I would refe* my readers tv> my Treatise on Venereal Diseases, in which all this is fully explained.) The connexion between the Sexual Organs and the Ner* votis Si/stem, especially the Brain, is another important matter, also but little studied or understood, an J vet it is (jf the most overwhelming importance. Not only may the bodily health of human beings be affected by peculi- arities in the action and development of their Sexual organs, but the tone and ability of their Minds, and also their moral tendencies are under the same influences. It is requisite, for the welfare of society, perhaps even for its very existence, thai certain actions should be called virtuous, and be held up to praise, and that others of an apposite tendency, should be called vicious, and be con- demned. Every one is interested in the maintenance of that moral order which experience has shown to be most productive of human happiness, and we must therefore, as rational beings, approve of whatever is favorable to the maintenance of that order, and disapprove of what- ever militates against it. It may be requisite, with this end in view, to condemn, or even to punish, in many cases where our consciences so far from blaming, see only cause for pity and regret. ' The regulation of society must have for its end the general good, and to secure this it is often 'the case that individuals are sacrificed to expediency. Thus, for instance, a particular crime, or immoral action, is punished the same in all who commit it. though we know that it must have been much more crrminah properly speaking, in some than in others. Thus for, instance, in sexual immorality the degree of culpability, properly measured, must be infinitely varied for the same offence, though 3.11 are punished for it alike. Some human beings are strongly impelled to seek sex- ual indulgence from the peculiarity of their organization, from disease, or from hereditary tendency, while others on the contrary are but slightly impelled, and others even avoid it, except at rare intervals. It is therefore evident that, under the same circumstances, the effort of self-denial, or resistance to temptatior is required to be much greats* 3D4 SEXUAL EXCESSES AND ABUSES. in some cases than in others, and of course the possibility of successfully resisting the temptation is proportionally less. Society however cannot consider these distinctions, be- cause it is impossible to ascertain the relative degrees of criminality, and therefore similar criminal acts must entail similar penalties on all alike. The institution of rewards and punishments has becGmf such a fundamental principle in our social order that whatever we may, in many cases, think of its abstract jus- tice, we cannot consent to its being abolished. Till bettei motives than fear, and the hope of reward can be gener- ally instilled we must, not do away with these, for if we do we shall have nothing to fall back upon. The Philosophic mind, which traces cause and effect, and which draws its conclusions from reasoning, and not from passion, must often pity the criminal as a victim, and con- scientiously exonerate him from all moral blame even when admitting the necessity for his punishment, — so true it is that our Social duties and requirements are often at vari- ance with our conscientious convictions. As Individuals, in our own hearts we must often have charity, or even commiseration, for those that social duty compels us to condemn ; and, in fact, with reflective minds this is ordin- arily the case. These remarks I have made to prevent the possibility of my being misunderstood, or misrepresented. In the course of this book I shall show numerous causes dispos- ing, or even impelling, human beings to immoral acts, and which causes many cannot escape from. I do not wish it to be understood however that I advocate, on this ac- count any radical change in our conduct towards these persons, for such acts, but merely that we think of them justly and charitably in our own minds, and that we strive to remove, or modify such unfavorable causes, and so pre- vent others being equally unfortunate. As men become more experienced the science of preventing evil will be generally studied, and then such inconsistencies as I have alluded to will gradually cease. The present little book, I trust, will do something towards attracting attention U SEXUAL EXCESSES AND ABUSES. 395 these matters, and lead those who read it to reflect and reason on human frailties as well as condemn them. Sexual abuses commence at a much earlier .period of life, in many cases, than is usually supposed, and their in- jurious effects are also much earlier experienced. A pre- cocious development of the Sexual organs, or a tendency to preternatural exaltation of the genital instinct is by no means uncommon, and from either cause the most injuri- ous habits may be practised even in Infancy. Many per- sons suppose that such manifestations never commence till the age of puberty, but this is a mistake, they are some- times observed, unmistakably, while children are yet in their Nurse's arms. It is an error to suppose that no injury can result ex cept from a loss of Semen, for long before that fluid has begun to be formed both mind and body may be irretriev- ably mined, by nervous excitement and exhaustion. This is of necessity the case with females, who form no Semen, and it is also equally the case with males, though few per- sons are aware of the fact. One of the most obvious principles of Animal Physi- ology is, that no vital action whatever can occur except through the agency of the Nervous power, — whether we think, eat, digest, walk, or speak, every muscle is movect, every secretion is produced, and every idea is eliminated by the stimulus of the mysterious Nervous fluid, the grand excitant and moving power in all Organic or Yital pro cesses. If the Nervous power be deficient in any organ, that organ will work imperfectly, to a corresponding degree, an! if it be absent altogether the organ cannot work at all, any more than a Steam Engine can work without Steam. Any cause therefore which decreases the requisite amount of nervous energy in the system causes imperfect or inefficient action, either locally or generally, and thus predisposes to' disease and premature decay. We require so much Nervous power to think, sc much to digest, so much for mascular exercise, and so much foi all the other organic processes, and in a healthy conditioi of the system there is always enough for the proper per 396 S!£UAL EXCESSES AVD ABUSES. fbrmance of them all. If however any one function be performed in an exaggerated degree, so as to exhaust mora "of the nervous power than properly should be expended opon it, the others must of necessity receive less than the} naturally should do, and must be imperfectly performed Instances of this kind are often seen among Business men, who expend so much of their nervous power in in- tense mental exertion, owing to pressure of business, that they have not enough left to effect digestion, nutrition, and all the other processes necessary to the maintenance and continuance of the system. In consequence of which they become Dyspeptic, debilitated, and Impotent, and after liv- ing miserably they at last drop off, in an orthodox business wa} , long before they naturally might be expected to do so. Such men suppose that, Pills, Bitters, and Stimulants, or a day or two of relaxation once a year or so will make all right, — but they too often find out their mistake, and become first rate patients, always on the Books, and calcu- lated upon for so many " hundreds " a year, by their phy- sicians, with as much certainty as his Bank is calculated upon by the Banker for his Dividends, In the same way other men think they can expend most of their nervous power in Sexual excesses, and yet perform sufficiently well all the ordinary organic functions at the same time, but they likewise discover their error, and frer quently too late to retrieve it. The performance of the Generative act requires more Nervous power than perhaps any other organic function, and of course it exhausts in a corresponding degree. So also does mere Sexual excitement, and therefore indulg- ence in either should be regulated on proper Physiological principles, such as are laid down in my Book called " The Marriage Guide." Excesses of this kind are the most injur rious of all, and the evils resulting from them are amongst the most irremediable. Different periods of life, as also different conditions of the system, require different amounts of Nervous power, and also to have it differently distributed. in Adults the Body is only required to Maintain Useff t 1IXUAL EXCESSES AND ABUSE3. 39Tf or to hold its own, but in Youth it must not omy do thia but also increase, or grow, to perfect itself. There is there- fore required, at this period an extra amount of nervous power, and if it is not supplied the body becomes, in con- sequence, imperfectly formed. Anything therefore which causes great nervous exhaustion is peculiarly hurtful in youth, and its evil effects are seen afterwards throughout the whole of the individual's life. This is the reason why Sexual abuses are so very injuri- ous in young persons, and why their effects are so oit^n irremediable. Numbers have their growth arrested in this way, and remain more or less dwarfed, or weakly develop- ed, while in others the internal organs are imperfectly formed, and in consequence always act imperfectly, thus causing a liability to Disease, and to premature old age, or untimely death ! Such instances come every day under the notice of the observant Physician, and are in fact every where to be met with, though there are few who understand them aright. Those however who bear in mind the Physi- ological principles above laid down, will be able to ex- plain them, and to comprehend why our efforts to cure such evils so often fail. Xo matter in what form Sexual abuses are practised during youth the same consequences, to a greater or lesser degree, may be expected to follow, and, generally speak- ing the earlier the abuses are practised the more serious are the after consequences, because of the more imperfect stage at which the system is arrested. This is the reason why Infantile Masturbation, in both sexes, is so hurtful. There is nothing similar to the loss of Semen,, of later years, but there is an equal, if not greater amount of ner- vous excitement, and exhaustion, and for want of the power thus wasted the system cannot perfect itself. In like manner Sexual abuses are extremely hurtful in the decline of life, because then there is a less amount of Nervous power eliminated, owing to the decaying energy of the system, and anything which unduly exhausts it still further hastens the period of its final extinction. Many old men have experienced this to their cost in expending 398 SEXUAL EXCESSES AND ABUSES as much vital power in one Sexual act, imperfectly per- formed, as would have sufficed for the ordinary purposes of existence for a month. In short it is only after the system has perfected its growth, and before it begins to decay, that Sexual indulg- ences can be practised with impunity, except in the most prudent and temperate manner. In the prime of life, with a perfect healthy acting body, there is more nervous power produced than the system requires merely to live with, and this surplus may be safely expended in Sexual indulgence. But even at this age, if exhausting labor have to be performed, whether bodily or mental, or if sickness makes an extra drain upon the nervous power, or lessens the quantity of it produced, Sexual indulgences must be cor- respondingly abbreviated. These are the true principles which should regulate the conduct of human beings in these important matters, and just in proportion as they understand, and act upou them, will they be able to avoid those evils which ignorance, or inattention of such things are sure to entail upon them. I shall now proceed to detail a series of Cases, in illus- tration of these matters, taking them mostly as I find them in my note book, and making such comments, and explanations, as I may think requisite. They are not ar- ranged systematically, so as to apply only to certain topics, but are taken promiscuously, to illustrate all. though I shall endeavor to make some of the first ones refer mow especially to the principles just laid down. ' The true Philosophy of Marriage, with the anat- omy of the Sexual organs, and their Physiological action m both sexes, is fully explained in the Marriage Guide. 899 MISCELLANEOUS "CASES," WITH NOTES AND EXPLANATIONS RETARDED DEVELOPMENT This was a remarkable instance of Retarded develop* ment, from Masturbation, which, fortunately was partially corrected, by the subject of it having his attention awak- ened in time. I shall first let the individual speak for himself, and make my comments, and explanations, when I think most useful. To Dr. F. Hollick, New York City, N. Y* " My dear Sir, 11 A short time ago I attended your Lectures on Parental Physiology, in Philadelphia, and from hearing them I have determined to address you. I am one of those truly pitiable creatures of whom you spoke, in the early part of your discourse, when referring to Infantile Masturba- tion, and I am perhaps as painful an instance of the awful effects of this practice as you ever saw. When you first spoke upon this subject, and pourtrayed the terrible after consequences, I was plunged in despair, and truly felt desir- ous to ■ shuffle off this mortal coil ' as soon as possible, for to live as I am i3 impossible. Your final remarks • Vol* Address will always find mo, at an/ time 400 MISCELLANEOUS CASES. however gave me some hopes that possibly it might not be too late for me to recover, at least to some extent, ao.d it is for the purpose of having your opinion on this point that I now address you. On your opinion depends much, I assure you ; — I will not however say further on this point, bat proceed to my statement, which shall be fully and truthful, in every particular, though it has cost me a severe struggle to make such a confession, and it never would have been made had I not heard you Lecture! From your excellent discourse however I felt full confi- dence, both in your skill and in your kind sympathy, and I therefore reveal to you what I have hitherto concealed from every human being, and which, had I not met wit*i you I should have carried a secret to the grave. I am the son of Parents well to do in the world, and who have always, to the best of their knowledge, striven to do what was best for me. Unfortunately however their kind intentions were but imperfectly realized, owing to their want of proper information. In early childhood I was very stout and robust, full of animal spirits, and active to an unusual degree. Every- thing seemed to promise that I should grow up a well developed man, but alas all such expectations were doom- ed to be disappointed. My parents kept a female help expressly to attend upon me, whose whole time was occupied in playing with me and taking me about. One day she took me with her to see some of her friends, who lived m a very low part of the City, (Baltimore,) and while engaged gossiping she left me to play with the children of the neighbour's, who Wdre swarming all around. They were as depraved, mis- erable, and vicious perhaps as could be found, and child as I was, being not ever four years of age, I could not help thinking their conduct and language very strange. It was new and exciting however, and that was enough to make it interesting, so that in a short time I cast off al) restraint and became fully initiated into many of their habits and savings, which I thought especially excellent, no doubt. Among the rest was one precocious ragamuf- fin, older than the rest, who undertook to explain to then MISCELLANEOUS CASES. 40l rarious mysterious points in physiology and Parentage- and the uses of certain parts of theii bodies, to which my attention had never before been directed. This was done practically, there being both girls and boys present, and none having the slightest objection to any kind of expo- sure, but rather courting it. The revelations which I then heard, given in the grossest manner, and the sights I saw, have never been effaced from my mind, but, young as I was at the time, they are as fresh and vivid now as if it occurred but yesterday. Among other things we were all of both sexes, taught the habit of Masturbation, to the pleasurable feelings from which I was peculiarly liable, owing to my tempera- ment I suppose, and from that time I began to give my- self up to the habit. I had command enough of myself to keep it secret, from my parents, because I felt instinct- ively there was something in it they would condemn, though I knew not why. My attendant knew, and rather encouraged it than otherwise, because it often relieved her of the trouble of attending me. In fact the whole group, at the time of the initiation, were surprised, in the very midst of their proceedings, by my nru-se and one of her female friends, who seemed to consider it a capital joke, and highly amusing, by the way they laughed about it when describing the scene to their companions. She however frightened me out of telling any one else about it by assuring me I should be severely punished if I did, and besides this I did not want to do so, — it was my secret, and in my way I felt quite important about it. From this time on I continued, more or less, almost constantly, to practice this habit, in various ways, till it became a perfect furor, and at six years of age I have kept awake for hours together, in the night in this way. The immediate consequences were that I became puny and weak, and irritable in my . disposition, to such an ex- tent that 1 was both wretched myself and a source of constant discomfort to those around me. To add to my misfortune my Parents placed me under the care of a Physician, who drugged me, and sent me to the sea side* tat all to no purpose, for I did not improve in the slight* |02 MISCELLANEOUS CASES. est degree. Study I could only pursue at intervals, **>4 in a very flighty manner, so that I was behind with my educatioa, and as my memory was bad I fell far behind my schoolmates. Things continued more or less in this way till I was fourteen years of age, when puberty became established, and I began to form Semen. In consequence of thi&, I suppose, my Sexual desires and feelings grew stronger, or perhaps I should say they then first became natural, and I indulged more frequently than ever. I have frequently expended the Semen four and five times a day, for several days together, till I became so weak I could scarcely walk, and quite childish in my mind. My friends all thought I was in a Consumption, and none of them ever expected me- to live. From that time till now I have never grown, and I am over twenty-one I Neither do I seem jn any way further developed. I am no heavier, — my voice has the same sound, and my Sexual Organs are quite as small as they were at fourteen years of age. In some respects, however I am better than I was, and I attribute it all to this cir- cumstance. I was one day passing down the street and looking into a Bookstore window, I saw your Book on " The Male Organs" and from curiosity went in and bought it. The perusal of that book first opened my eyes, and made me begin to think that my weakness and sickness was caused solely by Masturbation. It is true 1 had partially suspected this before, but the impression was not strong enough to make me leave off the habit. Now however I determined to do so, and by hard striving I partially succeeded. At times I had felt, for a year or two past, much bet- ter, and my mind became a little stronger, and more set- tled, so that I made up a little for my past deficiency, and began to reflect upon my situation. While in these favor- able moods I did pretty well, and conquered my fatal in- clinations, but when the mood past off I fell back again. It was in my seventeenth year when I purchased your Book, and from then till now I have been struggling in Ibis way, and on the whole perhaps I have gained* nut MISCELLANEOUS CASES 403 still very little, and latterly I have begun to fear I should never be much otherwise than I am. This fear began to haunt me continually, and I had made up my mind to come tc New York to see you when I noticed the Adver- tisement of your Lectures here, and to my great joy had an opportunity of hearing you. After I left the Lecture room I determined, in the first place, to write to you, and then, if you thought there might possibly be anything done for me, I would visit you personally. I am rich enough in this worlds goods, having inherited considerable property, and am both able and willing to recompence you to any extent you may think requisite, within a reasonable amount. Money I value no more than the dust under my feet, for unless I can be made a man I shall not need it, and if I can be, I shall be quite glad to give it to my saviour . I have thus my dear sir, made a sufficient confession, I hope, to enable you to judge of my case, and I trust you will render me your reply as promptly as possible, for you may well imagine the agony of suspense in which I am. Excuse my long and rambling Letter, which is, I fear, like my mind, very confused, — and accept the enclosed check as a retaing fee. " Yours, most truly, Upon fully considering this Letter I concluded it was possible that the subject of it could be helped, though to what extent was uncertain, and so I informed him. The result was an interview, in which I found him, as his let- ter described, half developed, puny, and weak minded, but still with indications that originally he had been possessed of a good constitution. There were also indications that nature was even now endeavoring to recover her lost ground, and some little growth, with occasional increase of mental power, gave Jtopes for the future. At his earnest request I at once commenced to advise and to treat him, his circumstances fortunately being such that he could live as I choose to direct. In the first place I prescribed sunh a regular course of diet, daily exerciaa, 404 MISCELLANEOUS GASES. bathing, and friction of the skin, as I thought most like!* to promote his general health and bodily growth. With that I also commenced to treat the Genital Organs, in the most active manner, feeling assured that their develop- ment would stimulate the whole organization, and add to the power of both body and mind. The Cougester was used daily, with shampooing, and my Aphrodisiac Remedy was also used, though very carefully. The result began to be obvious in less than three months / The Genital Organs increased in size and power. The Semen was secreted in greater quantity,— and the Sexual desire became strong and natural. The whole body also soon began to develope most obviously, so that his friend3 made remark of it, and his mind became more manly in its tone, and more steady, so that he was capable of more continued mental exertion, and soon extended his acquire- ments considerably. One difficulty however arose which I had forseen, but could not altogether prevent. His con- tinued practice of Masturbation had of course both weak- ened and irritated the Genitals, so that when fhe Semen began to be secreted in greater quantity it could not be retained, and he suffered from Spermattorrh&a. To such an extent did this evil prevail, especially in the urinate form, (as described in my book on " the Male Organs") that I feared it would counteract all I could do. By de- grees however it was overcome, by Cauterization, and then the real advance commenced in earnest. In the course of the pext two years he seemed almost to leap forward, so rapid was his growth, till I feared he would become sickly and weak from it. By good Tonic treatment however, and constant care, this danger was avoided, and he continued to advance, so that in his twenty fifth year he was fully up to the average standard of young men of that age, in size, weight and strength. His mind was also quite active, and of good ordinary capacity, though not capable of very powerful or long continued efforts. No one who had known him formerly ever sup- posed it possible for him to become what he was, and ha himself felt so elated that he entirely overlooked tht MISCELLANEOUS CASES 405 actual deficiencies which still existed, and thought himseli perfect enough. His greatest pleasure was in writing regularly to nie< and constantly noting the different stages of his advance- ment, and speculating as to the future. I never knew a patient more gratified or more grateful. In one of his Letters he remarks, " such as I now am you have made me, for without your assistance and advice I certainly should not have now been in existence ! " The Sexual powers of this young man became quite good, though irregular in their manifestation, and he was fully capable of the duties of Married Life, but not so frequently as in the generality of persons at his age. On this case I shall make but few comments, because it tells its own tale, in most respects, and the instruction it conveys must be obvious. The principal facts indicated by it are the arrest of development, caused by the loss of nervous power, from sexual abuse, and the recommence- ment of growth when the sexual power became restored If the Sexual Organs had not grown, and become active, no other development would have occurred to any useful extent, and if their weakness and irritability had not been overcome he would soon have died from Spermattorrhcea. It was also fortunate that proper attention was bestow- ed in time, before the period when growth is possible had passed. In several such instances I have been consulted too late, when that time had gone by, that is for the bodv generally, though the Sexual Organs may often be much perfected until nearly the thirtieth year, and of course the energy of the system, — especially of the mind, — along with them. The Moral Lessons which such a case conveys, particu- larly respecting the patient's childhood, must, I think, be clear to all, and do not need special remark. There are more children exposed to similar evils than is usually sup- posed. Unfortunately this individual was killed, in one of those steamboat accidents which are unfortunately so frequent out West, or he would now have been a remarkable instance of what proper Medical and Hygienic means can accom- 406 MISCELLANEOUS CASES. plish, even in the most unpromising cases, when employed on correct Physiological principles. Similar cases to the above I often have eommunicated to me, not only by Males but also by Females, many of whom are taught such practices by their domestics, or at school. In one such instance the patient was perhaps the most wretched victim of alternate excitement and depression of the Nervous System ever seen. At times she was sub- ject to fits of almost frenzied agitation, and was so rest- less, both bodily and mentally, that she could not sit down, nor sleep, nor speak on the same subject two minutes together. At other times she would be perfectly listless, and almost as if suffering from Congestion of the Brain Indifferent to all about her, powerless and torpid she seen? ed altogether too low ever to rally again. All that 'could be ascertained about the origin of he* suffering was that she had been taught the practice of Masturbation by a female domestic, when about ten years old. She had never Menstruated, though nineteen year?! of age when I saw her, and she had many peculiar imper- fections in her organization. The Pelvis, and internal Organs were unusually small, while the external Genitals- were remarkably large, and singularly irritable. Her head was also small, and her muscular system lax. The case was interpreted easily enough by these signs Her development was imperfect and irregular, from the nervous excitement and exhaustion she had undergone just previous to puberty, from the habit that h'ad beeb taught her. Every means was tried to lessen the irritation of he* Bystem, and to perfect her development, but all failed She died before her twentieth year, almost a maniac. MISCELLANEOUS CASES. 407 OASES SHOWING THE USE OP THE MICKOSCOPE, IN DETECTING THE ABSCENCE OF THE SEMINAL ANIMALCULES, Those who have read my Marriage Guide will be aware that the Semen can impregnate only when it contains liv- ing and perfect Animalcules, and that many men may be able to have connection, and even appear Vigorous, in whose Semen there are no perfect living Animalcules. Such men of course can never become Fathers, though they may be totally unaware of their imperfection, and always ascribe the fault to the female. This state of things can only be detected by microscopi- cal examination of the Semen, which in the course of my practice I am often called upon to make, frequently with very unexpected and curious results. Some years ago I was waited upon by a married couple, of high standing in society, to get my advice in regard to their being childless. They had been married nine years, both were young, and apparently perfectly healthy. The Gentleman informed me that, independent of the gratifi- 2ation to their own feelings, which were intense for off- spring, it was of the utmost importance they should have a child on other accounts. It seems a large property way so left that their child would inherit it, if they had one, or themselves as its heirs even if it died, while if they lied childless it would "go to a distant connection of the p amily, who was already enormously rich, and a very un- 3eserving personage into the bargain. Here there was both happiness and. wealth at stake, and I was requested to do or suggest everything in my power. The parties were fully communicative, and disposed to hear anything, or to discuss anything that I thought neces- Bary. The result was that I became fully convinced thg Lady was in no way whatever imperfect, but fully capable of Conception, and consequently the fault was with tha Husband ! On stating this to him he was amazed, and 408 MISCELLANEOUS CASES. quite incredulous, for, said he, how am 1 wrong ? L enjcy the same feelings, and the same powers as other men, and have even a copious Seminal Secretion. I then explained to him in what I thought the difficulty consisted, and a Microscopical examination of the Semen was at once in- stituted. My surmise proved to be correct. There were only a few, very imperfect animalcules contained in it, utterly inefficient for the purpose of impregnation. The examination was of course frequently repeated, to make sure that this was the normal condition, and always with the same results. On the true state ;t' affairs being made obvioas to him he became unusually thoughtful, and evidently brooded over the matter most intensly. At last he remarked, in a half abstracted manner, " well, it has always been my strongest desire that Maria, (his wife,) or her children, should inherit this property, and it shall be so, — if pos- sible ! So now Doctor wliat can be done ? " I told him at once that I believed the case was hope- less, for :he imperfection, in his case, was not the result of weakness, disease, or over indulgence, such as can often be recovered from, but was evidently constitutional, aLd I therefore could hold out no prospect of its removal. I T e madt me the most liberal offers if I could succeed in mak- ing him capable, but I told him at once I could not dr ceive him. Soon after this they returned to Europe, where thi property lay, and I heard no more from them for foro years, when one day the Gentleman again called upon me and after stating that they had been travelling for soim time, requested me to call and see his wife, who was some somewhat indisposed, and desirous of seeing me. On en quiring after his health I found him just about the same as usual, only much stouter, as is often the case with such constitutions on approaching forty years of age. He wat unusually cheerful however, and on leaving remarked, in a matter of course way, and with an evident effort to b* unconcerned, — " by the bye Dr. our little me is not very well either, and I shall be much obliged if you will pajf MISCELLANEOUS CASES 409 jiarticalivr attention to him, for you know how much de pends on his life ! " The announcement took me quite by surprise, and he probably saw by my look that it did so, for he at once apologized for not having- told me of their good fortune before, knowing how I should be interested in it. But, said he, it is now three years old nearly, a^d I forgot that you had not been informed of the happy event. I of course made no remark, but paid my visit, and found the mother and child only a little inconvenienced by the jour • ney. and change of air. In a short time they were quite well asraiu. A happier couple I have seldom seen than they were. The child was adored by both, and fortunately seemed likely to live to reward them for their care and affection. There was however a little awkwardness and restraint is their manner to me, and an evident avoidance of the sub- ject of our first conference. Only on one occasion, just on the eve of his departure for Canada, did he allude to it. He then remarked, " Doctor, could any one else find out what you told me four years ago ? " No. sir, said I, only by the same means, and there are perhaps not two other men in the world who would think of using them. " Oh well." said he, "I am glad of that, though its of qo consequence now, because matters have turned out right at last you see, and Maria's property will not go to those who had no right to it." To this I replied not and he went away. Six months after he died of Apoplexy, quite suddenly, to the great distress of his wife, who was sincerely attached to him. Her grief in fact made her quite sick, and for some time her life was despaired of, but finally &he recovered, apparently more from love to her child than from a desire to live on her own ac- count. In fact her whole existence seemed devoted to her son. whom she watched with unremitting care One d «y that it was indisposed, I was called to see it, and found with her an old female friend, one of those who always say whatever comes uppermost, without thinking of consequences. I had assured the mother that nothing serious was the matter with the child, as ftO MISCELLANEOUS CASES. indeed her family Physician had stated just before, when the female friend, an old Lady, remarked that the child bad a thick neck, and " what a pity it would be if it took after its Father, and was Apoplectic ! " I could not for- bear looking toward the mother, whose eyes met mine, and I saw at once that she detected my after-thought in a mo- ment, when I gravely said I thought there was no dan- ger ! Some days after she requested to see me, on the eve of her final departure for Europe. A candid admission was made to me that my first judgment had not been invalid- ated by what had occurred. Suffice it to say, the Hus- band had determined, with her concurrence, that her child at least should inherit the coveted wealth, even if one of theirs could not, — and hence what had followed. They had thought I might imagine a change had occurred iu him, and that matters were perfectly natural, which was the reason why our first consultation was never referred to. The old Lady's remark however, and my manner of replying, showed the mother that I was not deceived, and hence the confession. Of course it was no concern of mine, ami I could only assure the mother that the secret was perfectly safe. He had been, I fully believe, almost as happy as if really a parent. On another occasion I had for a patient a married Gen tleman, but Childless, who had unfortunately got entan- gled with an intriguing Mistress, who was perpetually ex- torting money from him. Being rich however, this was not of serious moment, but at last the Lady became Preg- nant, and in due time was safely delivered of a son. My Patient was now informed that he must make ample pro- vision for this new comer, and for its mother, for Life, or some very disagreeable' disclosures should be made. I was not aware of this event till the child was ten months old. The Gentleman then mentioned it to me to explain the gTeat embarrassment and trouble under which he labored, and which was acting very prejudicially upon his MISCELLANEOUS CASES. 41 ^ health. I was then treating him for Spermattorihcea, which had begun to weaken his powers and to affect hig mind. My Microscopical examination had shown me that he was naturally imperfect, like' the Gentleman in the pre- vious case, and I at once saw that he could not be the Father of the young stranger. He however had no idea of this, and was really desirous of settling upon it a hand- some annuity, but some unexpected embarrassment- had made it difficult for him then to do so. Being my Patient I considered it my duty to tell him the truth, to prevent his being imposed upon. He was both astonished and indignant on learing this unexpected fact, and would at once have had a final, and nc* very friendly interview witL (he Lady, but the fear of consequences deterred him. Now here was a terrible state of embarrassment for a man. with no apparent means of getting clear. He must eitiier be plundered and imposed upon to maintain the off- spring of another man, or he must be disgraced, and his domestic happiness destroyed, by a disclosure of his own improper doings. "What was to be done ? In his despair be was almost driven to suicide, but by degrees his mind was calmed, and I induced him to consider his predica- ment in a proper manner, with a view to his extrication. After consideration I told him I thought I saw a mean3 which might be successful, and though not called upon to do anything of the sort, as a Medical man. yet out of consideration for an old and liberal patient, I consented to try. At my suggestion the Lady was induced to visit me. as a patient, she being a little indisposed. I saw at once that she was a designing intriguante, but evidently not overburdened with information, and readily impressed by a confident manner of speaking. After attending with all due consideration to her own case, the conversation was gradually turned towards the Gentleman her friend, who I remarked was one of those peculiar beings, that Medical men like myself occasionally met with, whose bodily imperfections would never be sus- pected ! This piqued her curiosity, as I intended it to do, and led her to inquire more closely what kind of imper- fections I alluded to ? The matter being thus entered 412 MISCELLANEOUS CASES. apon T at once told her, in an off kaud manxer, thai ii was impossible for him ever to be a Father ! The aiv nounceinent seemed to come upon her like a clap of thun- der, and for some time she 'remained silent. Finally how- ever, putting on a show of offended dignity, she remarked that perhaps I was not aware of the relation in which the Gentleman and herself stood ? Excuse me madam, said I, but I am aware of your liaison perfectly well. Oh ! said she, that is not what I mean, you do not know then, it seems, that he is the Father of my son, now T ten month's old ? No madam, said I. Nor can such be the case ; — it is an utter impossibility ' This assertion brought on a perfect scene of rage and assumed grief at being suspected, but finaPy the tempest ' cooled down and she began to talk more coolly. I told her that I had no wish to give offence, *vnd was entirely ignorant that my friend was accused of being the parent till just now, and that in all probability she was deceived herself. Finally she seemed to change her tactics, doubt- less from a consciousness of being in the wrong, and at last asked me, with evident interest, if the peculiar imper- fection which I spoke of in the Gentleman could be prov- ed? I assured her it could be, and that if called upon in evidence I could readily prove it, beyond a doubt. This evidently put her completely to a nonpluss, and she went off, quite crest fallen. At my suggestion the Gentleman entirely discontinued his visits to her, and treated her in quite a cool manner, as if he no longer had any fear. This created a disposi- tion on her part to come to terms, and by the agency of a legal friend, who visited her for the purpose, and hinted something about a possible prosecution for attempted im- position, matters were finally arranged, and for a reason- able consideration she and the child went away, and my friend was relieved from his embarrassments. On another occasion I had a Patient who died of Coa- wimptioa at the age of twenty eight, leaving a widow, and MISCELLANEOUS CASES. 41$ ft son aged three years. It bad been what the French sail a marriage de convenanct, in which there was neither affection nor even respect on either side. This Gentleman made one of those unjust wills by which his widow had the enjoyment of a handsome in- come for life, providing she never married again. The disposition of considerable property also depended on the life of the child being preserved till he became of age, N ow the widow had no desire whatever for another* mar- riage — probably from her experience of the first, — and was quite satisfied with her condition. She almost idol- ized her child, and devoted every moment to his care. — lie was perfectly robust, and no apprehension whatever crossed her mind in regard to his health till in his fifth vear. She visited a part of the country where lived the connections of her late husband, with whom she had never been at all acquainted. The marriage had been altogeth- er the work of so called friends on both sides, and respect- ng the family or antecedents of her husband she knew rery little previous to their union, and cared nothing about after. Being now however quite free from all restraint, and in the neighborhood, she naturally sought some further infor- mation respecting him that was gone. To her great con- sternation she learnt that his whole family had always been noted for their tendency to Consumption. Very few of them where then left, the majority in every Branch, having died quite young, and not one having been known to live over twenty-eight years, which was the age of her nusband at his death. It was in fact generally called the doomed family, and an old Nurse thoughtlessly remarked. as a matter of course, that little Charley, strong as be looked, would never see his thirtieth year, even if he pass- ed childhood. The mother became at once almost frantic with despair. She looked upon her darling boy as doom- ed also, and thought with horror of the day when he would be taken away from her, perhaps when just burst- ing into manhood and promise. I have never seen a woman so entirely possessed by one idea as she was with this. She left the neighborhood at 414 MISCELLANEOUS GASES. ©nee where she had learnt this fatal news, a»cd began r* solving numerous plans to escape the threatened evil, bu* with no confidence in any of them. Finally she came to me, to ask my advice as to the probable success of a re moval to another part of the Globe. Our consultation was of course confidential and full in every respect, bo cause I feel it necessary to arrive at the true cause of her evident terror and apprehension. I had previously be^n her medical adviser, as well as her husband's, whom I had also known before his marriage. Now it so happened that he had consulted me immedi- ateiy after their marriage, in reference to his Sexual pow- ers, which were rapidly failing, as I discovered, from Urinary Spermattorrhoea. This was arrested and he par- tially recovered, but only imperfectly. In the course of my Microscopical examinations I discovered that he 'was then totally impotent, there being but a very few animalcules in his Semen, and all imperfect, though he had, to a cer- tain extent, the ordinary Sexual powers. This fact I had intended to make known to him in order to °xplain better his real condition, and also why he had no family. To my surprise however he announced to me one day that his wife was pregnant ! Of course I did not then feel called upon to state what I knew, more especially as the expectation of an heir seemed to give him great pleasure. His health also was evidently failing, and I expected his death from Consumption even before it occurred. This secret therefore was mine alone, and would have been buried with me, but for the present state of affairs. I knew that this man was not the father of the child whose mother was then suffering from such terrible apprehensions. I felt perfectly assured in making the as- sertion I afterwards did, and I had no doubt but that my accusation would both be admitted and pardoned, for the sake of the consolation it would bring. I therefore said at once, in the most decided and emphatic manner, that the child was in no danger whatever from his connection with the family of the late Mr. / The. way in which I said this evidently caused both surprise and inter- oted attention, and in a aomewhat confused manner sfa WSCELLANEOUS OASES. 41ft **ked me to explain what I meant ? I then remarked, without any comment, and as a matter merely of profes- sional interest, that the boy was perfectly safe from that source, because it was impossible Mr. could have been, at that time, his Father ! It is not necessary to attempt a description of the con- fusion, shame, and pretended anger which at first followed. Suffice it to say all this passed off, and in tearful humility, but with eager earnestness I was asked if this was beyond doubt. I assured her it was so, and that her child run no risk of inheriting the Consumptive fate of her late hus- band. Of course I could not say what risk he might run from his real father, because he was unknown to me. The neculiar mental condition of this woman, at this time, was one of the most curious perhaps ever known. Consternation at the discovery of what she had no doubt thought past discovery, and shame at thinking I had known it so long, was intermixed with real joy and thank- fulness at the escape of her child. I of course assured her that the secret was as safe as if it really rested with her alone, and that to me it had no other interest than professional one, and would never have been disclosed even to her but under such circumstances. Immediately afterwards she departed with her child for France, where she intended to bring him up away from all the associations of her own previous life. On the eve of her departure I received anonymously a handsome present, with these words — " I had never dared, or wished, to think it might be as you said, but now know it must have been so, and feel that I ought to make you this acknowledgment." SOFTENING OF THE BRAIN. This is a much more frequent disease than most peopte save any idea of. Medical men are only just beginning 41$ MISCELLANEOUS CASES. to appreciate its importance, and to be aware of the fear ful destruction of intellect and life, which is caused by it. Softening of the Brain is the same disease, essentially, an that called Spinal Consumption, of which the old writers tell us so much. The causes of this justly dreaded disease were till lately unknown, or but vaguely suspected, and a variety of Theories were invented to account for it. Lately how ever, its connection with Sexual derangement, in the ma- jority of cases, has been established conclusively, and to make this clear we must give a little Anatomical and Physiological explanation. The substance of the Brain, and of the Nervous Sys- tem generally, is essentially different, both in its structure and composition, from all the other parts of the body, and therefore it requires to be nutrified in a different way, and by different material, from any other part. All the Vital Organs may be perfect, and the Muscular system well de- veloped and supported, owing to their special nutrition being complete, and yet the Nervous System may be in a state of decay. It is true that decay of the Nervous System is soon followed by decay of all the other parts, but it may commence independently of any imperfection in them, and even while they are as perfect as usual. The actual material, or substance, of the Nervous Sys- tem, as elsewhere remarked, is almost identical with that of the Seminal fluid in Man, and of the Ovae in Woman, and its composition is also very similar. In all probability the same vital effort which calls forth the Generative Elements also creates, at the same time, the Nervous substance. Whenever therefore the produc- tion, or nutrition, of the one is imperfect, so is that of the other. There is therefore not only a close sympathy, but a real coincidence of origin, and mutual dependence of existence between these two most mysterious portions of our being. The Brain and the Sexual Apparatus are placed at the opposite extremities of the body, like the two poles of a Galvanic Pile, each being connected with the Spiaal marrow, which unite them. When one of these Poles is overcharged with vital power, the other is MISCELLANEOUS C4SES. 4H •mdercharged, and when one is exhausted the otbei is soos in the same condition.* This explains at once why excessive mental exertion t> often followed by Sexual importance, and why, on th« contrary, Sexual abuse so frequently destroys the intellect. Softening of the Brain is caused by an actual deficiency of some of the substances composing it, and these sub- stances are precisely those that are carried off by the ♦Seminal discharge. When a man expends too much Semen therefore he does the same thing as if he really destroyed a portion of his brain, because he takes away that which is necessary to nutrify it. Nature will not produce enough of these substances to make Brain and to allow of licen- tious indulgence at the same time. In this way arises softening, or chronic decay of the Brain, a disease which may be very slow in its progress, but every step of ^hich weakens the intellect more and more, and which eventually causes either death or idiocy. It is not wilful Licentiousness alone however which leads to softening of the Brain, but more frequently it arises from Urinary Spermattorrhoea, or loss of Semen in the urine. This is a most destructive and insidious dis- ease, but little known to Medical men, and almost totally unsuspected by the people at large, numbers of whom are its daily victims. The first, and only full account of this disease, in the English Language, was given in Dr. Hol- liek's Treatise on " The Male Generative Organs," to which the reader is referred for fuller particulars. In treating softening of the Brain, or the Sexual diffi- culties from which it arises, it will readily be seen that quite a different course is required from that which is pur- sued in other diseases. It is not only necessary to arrest the Nervous decay, and Seminal loss, but also to supply such substances as will make more new brain, or new Gen- erative elements, and this none of the ordinary Medica- ments will do. There are but few things in fact that are suitable for this purpose, and it requires an accurate know- ledge of their real properties, and of the true ChenncaJ imposition of the Nervous and Seminal matters, to know * See plate on page 372. 418 MISCELLANEOUS CASES. how to properly combine and apply them. The ordinarj Cordials, and Invigoraiors, are mere excitants, or stimu- lants a3 elsewhere explained, and only excite for a tim« the little Nervous or Generative matter that is left, but do not stop its decay, nor cause a new production of it. The effects of softening of the Brain are worse even than those which follow from Urinary loss of Semen, because they affect more generally, and quickly, the whole system It is also a more hopeless disease than Spermattorrhoea, unless taken very early. Its extent cannot always be judged of however by the apparent effects, as some pati- ents will suffer much from the first, while the Disease is but slight, and others will hold up for a considerable time against it till they give way all at once. The condition of a person suffering from Softening of the Brain is, in the main, much like that of one suffering from confirmed Spermattorrhoea, and it requires careful Microscopical examinations to tell which of the twc troubles is being experienced, or if both exist together. Usually however there is more mental imbecility in Soften ing of the Brain, with a greater change of character. Tha patient feels that his mind is passing away. He cannot think clearly, and has a sensation as if his head were really empty, and as if he would like every moment to close his eyea and go off ! There is no possibility of rousing a ma?n in this state, nor of doing him good in any way, till the waste of the Brain is arrested and the process of renova tion recommences. Many patients remark, after their recovery, that they used literally to lose themselves, and forget who and where they were. One Gentleman assured me tha* on waking in the morning he would frequently be half au hour or more before he could make out who he was, and what he should do. It would partly come in his mind and then gc out again, till he got some stimulant, and then, for a time, he would gradually come round. The fact was that his ideas were previously only half formed, and imperfect, owing to the imperfect condition of his Brain. He could no more think perfectly than a man can labcui hard who has weakened muscleu. MISCELLANEOUS CASES. NERVOUSNESS. It is scarcely necessary to remark that Nervousness ia my general, and spoken of as something which all people are supposed to be acquainted with, but still it is some- tiling which no one can describe or define. The term Nervr.ms is applied to such a variety of bodily and mental derangements, combined so differently in different people, that it is scarcely possible to find two nervous people whose experience is the same. . This however need not surprise us when we reflect upon the functions of the ner vous system, and its associations with every part of the organization. Itself the source of all organic power, upon which every part depends, and by which alone the whole is maintained in action, it cannot experience the slightest derangement without affecting all that is depend- ant upon it. If the integrity of the Brain and Spinal Marrow be impaired, we not only experience mental im- becility, or moral perversity, but derangement of the Vital organs also, though in their structure they may be apparently as perfect as we could wish. Even a slight affection of the great Nervous centres causes sympatlietic derangement of everything else, which is the reason why nervous people suffer from such a compli- cation of symptoms, without perhaps having a single organic disease they suffer the peculiar effects of almost every disease known. Once correct the vitiated condition of the Nervous System in these cases, aud all the symp- toms vanish at once, so that the patient passes in a single day almost, from the extremest misery to well being and happiness. Uninformed people either ridicule such cases, or else attribute them to mere deception or wilfulness, but those who know their nature look upon them as among the most interesting that can be met with, and eminently deserving of true sympathy. A deranged condition of the Nervous system arises either from actual decay or change, in the Nervous mat ter itself, as in Softening of the Brain, or else from sympa #20 MISCELLANEOUS CASES. thetic irritation, as in various derangements of the Sexual Organs. In fact the nervous system becomes deranged through the influence of other parts in nearly every instance, and seldom suffers from any disease originating within itself. Iu the majority of cases Sexual derange- ment precedes, or accompanies nervous derangement, and must be corrected before the Nervousness can be over- come. In Nervous females the Womb, or Ovaries are affected, and in Nervous men the Testes or Prosrtate Gland, almost invariably, and to those who are acquainted with the Physiology and connections of these different parts of our organization, this mutual action and reaction will be no mystery. Those who have not yet become acquainted with these matters are referred for a full explanation, to the Marriage Guide. The great misfortune for Nervous people is, that they are seldom treated^Tor the disease under which they really labor, but only for the secondary derangements to which it has given rise. The effects only being observed, while the cause remains unnoticed. This is owiug to the general in- attention, among medical men, of all matters relating to Sexual Physiology and sympathy. Now for instance, a female will have chronic irritation of the Womb, or Ovaries, giving rise to the most curious train of nervous derangements and symptoms, and will be treated with the utmost skill as a Nervous Patient, without the slightest benefit, but once remove the Ovarian or Uterine irritation and the Nervousness ceases at once. Numbers of men also lose their judgment, and memory, and become wretch- ed to the last degree, from Urinary loss of Semen, which must be stopped before any assistance can be rendered to them. Severe Sexual derangement will even cause actual wast- ing of the nervous substance, as before experienced, and on the other hand any serious disease, or exhaustion, of the nervous system, reacts upon the Sexual organs and deranges them. In the great majority of cases however, the Generative Organs are the first to become impaired, &ud the Nervous system follows^ in both sexes. MISCELLANEOUS OASES. 491 This intimate mutual relation of the Nervcus and Sex nal systems will be made more evident by an inspection of the Frontispiece Plate of the " Nervous and Sexual Centres." The Brain is composed of two perfectly distinct halves, either of which may act, or become diseased, without the concurrence of the other, — the same as either Testicle or Ovary may act perfectly, or become diseased, independ- ently of any action, or affection of the other. The Testicles in the Male, and the Ovaries in the Females, are precisely similar, both in their organic functions and in their sympathetic relations. In fact they are identical, in every respect, in the earlier stages of development. The Testicles are merely more fully developed Ovaries, in the same way that all the Organs of the Male Generative system are merely more perfect developments of corres- ponding parts in the female. The two Sexual Centres, and the two Nervous Centres, stand to each other in the relation of Electric Poles, being Positive and Negative reciprocally. If an undue amount of power be concentrated, or expended, in a Sexual Cen- tre, the opposing Nervous Centre must be proportionally deficient in power, and on the contrary if. the Nervous Centre be over excited the opposing Sexual Centre must become torpid. This will make the true nature of all cases of Sexual or Nervous derangemeut evident, and will also show the reason why all past treatment of them has been so useless. Dr. Hollick has found out, from his experience, that all the old ideas on these subjects were fallacious, and he has been compelled to study out the true explanation of them from actual observation and experiments. These views therefore are entirely new, and are now for the first time laid before the public. In a short time they will be more fully elucidated in a work which Dr. H. is now writing exclusively upon the Nervous system. 422 MISCELLANEOUS CASES. PERFECT RECOVERY FROM IMPOTENCE, BROUGHT ON BY EXCESSES. j*n t this case we have an example of a very large class, Persons naturally of powerful Sexual Organizations, c» pabie, in the first vigor of virile power, of the most con* tinuous and exalted enjoyment, but, from ignorance alone, becoming dispirited, debilitated, and impotent. It also shows that, in even the worst of such cases, it is generally possible, by the use of proper remedies, to recover most of what had been lost, and to rejuvenate the Sexual Organs after their functions are thought to be entirely extinct. The individual living at a distance communicated with me by the following: Letter. To 1)r. Hollick, New York City, N. Y. " My dear Sir, A fortunate charfce having thrown in my way your invaluable and unique Book on " The Male Generative Organs," I have determined to address you in regard to my case, feeling fully assured that if any mortal man can assist me it is you. Not to lose time, or to occupy you unnecessarily, I will make my statement as brief as possible. I was born in affluent circumstances, well brought up, and well educated, and at twenty-one years of age found myself the uncontrolled master of quite a respectable in- come, and in the enjoyment of a large circle of friends and acquaintances. I had never been much addicted to the usual vice of young people, Masturbation, though con- stantly in the midst of it, neither had I ever been intem- perate, and at twenty-one I was healthy, full of animal spirits, and capable of the most perfect physical enjoy- ment. About my eighteenth year my Sexual desires be« caiae very strong, but my position, and prudential consul MISCELLANEOUS CASKS. 423 i- itions, prevented me from running into excesses Be- at les this I looked forward to my majority as a time when f could indulge as I should wish, without any control, and thus repay myself for past restraint. Had it not been for my Guardian I should have married as soon as I was of age, and had I done so it would have saved me incredible suffering, and a broken down consti- tution. He however dissuaded me from it from pecuniary motives, and ignorantly sacrificed my health and happi- ness to filthy lucre. I formed several attachments of an illicit character, and being led away by my powerful Sexual propensities, T indulged to excess. How much I need not perhaps specify, but suffice it to say that till my twenty-fifth year it was almost my sole occupation, and till that period I felt no diminuation of power, but soon afterwards my appetite for these indulgences began to lessen, and by de- grees my powers also. I had neither desire nor capability so often as before, and frequently for a considerable period would be totally indifferent. This falling off in my Sex- ual powers was also followed by a lassitude and debility, both bodily and mental, which unfitted me for any active exertion whatever I became dull, listless, peevish or mo- rose, my appetite failed me, and all the symptoms of con- firmed dyspepsia set in My condition in fact became so bad that T consulted a Physician, but only about my gen- eral health, for I dared not then speak on other matters. He grave me directions as to my diet, and directed some Tonics, with cold bathing. These did me some good, for a time, but I rapidly fell off again, and became worse than before, especially Sexually. In fact I was nearly Im- potent, and in my despair I resorted to many of the Cor- dials and Antidotes which I saw advertised, in the hopes that they would restore me. Some of them did stimulate me for a time, and I began to hope I was going to recover, bul alas it was soon over, and 1 felt that I was worse than bef >re, and tnat my general health had also been much inpred by these remedies. I then gave up all hope nearly, ar i came to the melancholy conclusion that I must draq ov\ a short lived miserable existence «n the oest way J 424 MISCELLANEOUS CASES. could. This Las continued till now, my twenty-ninth year, when a gleam of hope has been awakened by perusing your book. Now Doctor I want you to deal candidly and honestly with me, and tell me plainly if a person in my situation has any prospect of recovery ? I don't wish to be deceiv ed, and would rather know the worst at once. I will tell you plainly I am as nearly Impotent as man can be, not being capable of Sexual communion more tLrm once in two or three months, and that in the most imperfect manner, with no enjoyment, and scarcely with any Seminal flow at all. My Organs are wasted, and my desires for the other sex are almost extinct — in fact I am becoming, a woman hater ! Of my state of mind I can scarcely trust myself to speak. Doctor, I am perhaps the most utterly wretched being that lives ! I sit and mopn for hours together, with the most gloomy images crowding upon me, and black despair hovering over all. Fearful apprehensions constantly haunt me of some impending evil, and I distrust every one who comes ♦ near me. This I know is wrong ; but I cannot help it ! A dark cloud seems constantly weighing upon me, and casting a gloom on all my thoughts. Reason I cannot, for my judgment and memory are nearly gone, and my mind is not under my control. Of my bodily sufferings I will not now speak, though they are severe enough I can assure you. Suffice it to say here that my system is thoroughly debilitated and run clown, and that scarcely a single function is perfectly per formed. Doctor, I am a mere wreck, and 1 fear too much broken and shattered to be ever repaired. Perhaps I am only showing my imbecility by indulging even a hope, but I could not resist the impulse to address you. Had I read you book, Doctor, when I was twenty-one, oh what might I not have been. It maddens me to think how terribly I have paid for my ignorance. But I must now stop. I have written this, Doctor, under the influence of stimu- lants, I confess it to my further shame, but I could not have made the effort without. The effect of the stimulant MISCELLANEOUS CASES. 425 rs how way, and oh the sinking which I feel com in? on is horrible to think of. — but it is done,, 1 have writ ten to you. Doctor, and earnestly pray you will speedily reply. Tell me if it be possible for me to be helped, I will uot dare to say recovered, and if you will take me under vour care. The expectation of your answer will some- what buoy me up till I hear from you, — but what that answer may do I dare not even imagine. Write soon, Doctor, and let me know my doom. Yours, despairiDgly, On receipt of this Letter I at once wrote for him to come to see me, as I considered a personal interview desir- able. On his arrival I certainly found as unpromising a case as could be well imagined, but still I did not despair, and without making any definite promise I agreed to ad- rise him. In conjunction with appropriate general treatment. J 1 commenced giving him the Aphrodisiac Remedy, and carefully watched the result. In a short time it became evident that he was recover- ing, and I gave him leave to return home, having first arranged to correspond with him regularly, and supply aim with the Medicine. In six months he was so much restored that no furthei treatment seemed called for. and I requested him to send me a full account of his condition at that time, to put on record, as a contrast to his first statement. The fol- lowing is what I received : To Dr. Hollitk, New York. u Mr dear Sir, " According to your request I send you a report of my present situation, as I feel I ought to do. if it will be father useful or interesting, for there is nothing, it seems to me, which I can do for you but what gratitude calls on me to do. I merely request that if you make use of my 426 MISCELLANEOUS CASES. Letter it will be in such a way that no ose who kaowi me can recognize them. I am now my dear sir, I verily believe, the happiest man hving ! I am quite well in health, in every way, my mind is clear, my spirits buoyant, and my strength greater than I have ever known it before ! In fact I am quite gay, and instead of moping at home, as I used to do, afraid to see any one, and thinking life a burden, I am constantly on foot, whistling, or singing, as I used to do when a boy My friends wonder what has happened, and can scarcely think it is really me. I dare not tell them the cause of my happy change however, because it would expose the secret of my former misery, and that I could not bear. The greatest change however is in my Sexual Organs, whose functions I had thought lost. I am now nearly as powerful as ever I was, and am evidently gaining still, every day. In fact I intend, if you think it proper, to marry, which at one time I never dared to look forward to ! It is now the dream of my life, and if you give me leave it seems to me there is little else I can ask for. Please be plain on this point, and tell m€ candidly if ] may, and how soon ? That Medicine of yours seems almost magical, and I wonder you do not make it generally known. The good effects of it were manifested on me the third dose, and so convinced did I feel of its good effect that I would have given all I was worth in tlie world for sufficient of it, if that had been necessary J You must, if you can, let me have some jto keep by me. The cost is no object. I have not taken any for the last two weeks, because I felt pow erful enough. How evident it now is to me, as you explained, that ali my other troubles arose from decay and derangement of my Sexual Organs. Immediately they began to improve • and gain strength, I became better in every way, just in the same proportion. How silly the practice now seema of giving tonics and stimulants for the Stomach, or Liver, to try and cure them, while the sole cause of all their dis- eases is left untouched. In conclusion my dear sir, I am a perfectly well man, MISCELLANEOUS CASES. 421 and 1 firmly believe that your advice and medicine would make any one so. May you enjoy as much happiness as I do. I cannot wish you better, — and may I be able to show myself as grateful to you as I ought and wish to be. " Yours, ever truly, Being satisfied that he might marry with propriety, 1 gave him leave to do so, and he is now the happy Father of two healthy children, and younger by Ten Years than when I first saw him ! This case I have been more particular in describing, in detail, because it is a good example of a large class that come under my care, nearly all of whom are equally bene- fitted by the same means. KESUS CITATION OF THE SEXUAL POWER IN AN OLD MAN. This individual was aged sixty-six when he called on' me. and had been for some three or four years almost en- tirely Impotent. In fact he had begun to think that his powers were really gone, from age, and he scarcely ever thought of their being in any degree restored. His health was very good, and his years had evidently affected him but little in other ways, which made him sometimes won- der why he should fall off in this respect alone, and dis- posed him to ask my opinion. I told him without any hesitation that proper treatment would act favorably upon him, but I could not judge to what extent. He accordingly commenced following my advice, and in three months afterwards sent me the fot lowing Letter. |£8 MISCELLANEOUS CASES. To Dr. Hollick, New York City, N Y> 11 My dear Sir, u I wish you to send me a fresh supply of the Aphro. disiac Remedy. I still have some, but wish to be sure of not getting short. In regard to the effect of your treatment, it has worked a real miracle ! I am almost as young, in one way at least, as I was at Forty, and I assure you that were I not prudent I might easily be led into some folly. What sur prises me most however is my not suffering in any way from my indulgences. I was somewhat afraid, when my powers were first revived, of using them, for fear it might do me an injury, but incredible as it may appear I feel no ill effects whatever afterwards. In fact I feel less lassi- tude after Sexual indulgence than I used to do, and it seems as if my organs were really stronger. To say how much my happiness has been increased, and bow much I feel indebted to you, is unnecessary. " Yours, truly, This old man I knew when he was past seventy-two^ and there was then no indication of decay in his powers. He merely required to take a little of the remedy occa- sionally, and decay seemed totally arrested. 1 have known some instances of even older persons being much benefit ted in a similar manner. BARRENNESS IN A FEMALS OP THIRTY-SIX CURED. In many instances Barrenness is caused simply by a torpid condition of the Genital Organs, which prevent* MISCELLANEOUS CASES. 429 the absorption of the Seminal fluid, as explained in my * Mari-iage Guide" The Lady referred to was an in- stance of this kind, and the result shows the power of the Aphrodisiac Remedy alone, in such cases. Her husband had obtained some of the remedy from me without saying definitely for what purpose he wished it ; the Letter will tell why. Dr. Holltck. New York " Dear Sir, " You will recollect probably that I requested you, as a personal favor, to let me have some of your Aphrodi- siac Remedy. I will now tell you what I wished it for, and what has resulted from its use. I had been married nearly Twelve years, and with no prospects of being blessed as a Father, when I read your book, " The Marriage Guide." The perusal of that work led me to think that our childless condition was owing to my Lady's extreme indifference, she having always been perfectly cold in her temperament, and I thought possibly your remedy might change this, and cause her to conceive. I according procured some from you and she agreed to take it. The effect has been as surprising as satisfactory. I need only say that she is entirely changed in her tempera- ment, and is now, our Doctor tells us, five months Preg- nant, for the first time ! If any one had told me before this that any remedy could effect such a change I should have laughed at them, but such is the fact, and I inform you of it because I know it will both interest and please you, and because I think you are justly entitled to know what your remedy has done. 1 advise all my cMldless friends to read your " Mar* riagt Guiac" « Yours truly, #30 MISCELLANEOUS CASKS. GKEAT LOSS OF SEXUAL POWEB, AND SEVERE NERVOUS DERANGEMENT, IN A MERCHAHT t CURED. This Gentleman, like a great many more of his class, aad completely exhausted his nervous power by intense application to business. He had made his fortune and lost his health. The following is a part of the incoherent Letter he first addressed me. To Dr. Hollick, New York. " My dear Sir. " Will you be so kind as to tell me at once, if you can io me any good ? I am a Merchant, age forty-one. Good constitution naturally, fully grown, and formerly of excel- lent health. About seven years ago I began my present business, which reqisred me to exert all my energies, and to apply myself unremittingly. For the first two or three years I held out well, but gradually my energy began to fail, my digestion, became disordered, and I felt miserably weak, low spirited, and dejected. In fact I became a perfect nypo, and had I not been blessed with a good and trust- worthy agent my business must have utterly failed, tew I could not, during half my time, pay proper attention to it. I found it utterly impossible to apply myself regularly; or to stick to anything, — my mind wandered away iz Bpite of me, and the smallest forcing of attention to any thing' threw me into utter confusion. For the last two years this has been much worse, and now I have many bodily ailings too. I cannot sleep well, tud wake in the morning with difficulty, and feeling as if MISCELLANEOUS CASES 431 I Lad been intoxicated the ni^ht before, which I never am. Besides al\ this I find myself Sexually Impotent My powers have l>een getting less for the past three yeare, and are now almost extinct. In fact I have a repugance to the association, and am utterly incapable either of giving or of receiving enjoyment. Doctor, I cannot say more, — this has required great effort, and 1 feel weary. Your experience will probably show you exactly how I am, in all that is not here told. Try what you can do for a wretched debilitated man, to whom money is no more than the dirt under his feet if he can but get well. Tell me at once if you can help me " Yours, &c. I made no hesitation in promising this Gentleman that he could be helped, providing he could fully relax from his business. This he did effectually, by selling out, and investing his money. He commenced at once using the Aphrodisiac Eemedy, and observing proper rules of regimen and diet which 1 gave him. In two months he was a new man, and by the fourth mouth he wrote me a Letter from the country, of which the following is an abstract. * * * " Doctor, I don't need you any longer now, nor do I think I ever shall . again, if you will only let ma always have some of that Medicine by me. Don't think this ungenerous. I mean it to be complimentary. From the very first dose I felt it would cure me. It seemed to satisfy as it were, my nervous system, like food does < fiungry stomach. All my anxiety and apprehension left me, I felt calm, cheerful, able to apply myself, and dis- posed to be active. My mind cleared up as if the sur had suddenly broke in upon it, and I began to digest s< heartily that I gained flesh rapidly. My Sexual powers also are fully restored ! I. need sa* no more on thir point, except to assure you that you 432 MISCELLANEOUS CASES. caution as to being te?nperate shall be faithfully observed, though I am free to confess it requires an effort now l How many of my brother business iBen lose their health and powers in the way I did, — but how few of thekj are so fortunate as I have been in restoration. Doc- tor, you must try to announce that remedy publicly. Why, my dear sir, it would save many a man from ruin, and not a few from insanity and suicide, to say nothing of mere suffering and imbecility. So far I have said noth- ing about it, as you requested, though I have often been sorely tempted to do so when seeing an old friend suffer- ing, and hearing him demand — ' what makes you look so well ? ? Please accept the enclosed in addition to your account I can never repay you, for I verily believe had I not met with you T should not now have been alive." Note. — I do not wish it to be supposed that a similar result would follow in all apparently similar cases, by simply following the same course. In many instances there are other matters to be attended to, and other de- -angettents to be corrected, before the remedy can act. This was a case of simple Seminal and Nervous exhau* ion, uncomplicated DR. HOLLICK'S APHRODISIAC REMEDY, THE ONLY SURE AND RELIABLE AGENT FOR THE PERMANENT CURE OF IMPOTENCE, STERILITY, AND NERVOUS AND SEXUAL DKttlLITY, IN EVERY FORM ; BEING THE CELEBRATED REMEDY USED FOR SO MAN! YEARS IN DR, HQLLICK'S EXTENSIVE PRACTICE, DEVOTED EXCLUSIVELY TO SUCH CASES, AND NOW. FOR THE FIRST TIME, OFFERED TO THE PUBLIC. GENERAL DESCRIPTION OF APHRODISIACS, AND HISTORY OF DR. HOLLICK'S APHRODISIAC REMEDIES Medical Remedies are classified and named accord- ing to the mode in which they act. Some affect one part of the system, and others affect other parts. Those which aot upon the sexual organs, so as to pre- serve or restore their powers, are called Aphrodisiacs. Remedies of this kind have always been eagerly sought, and paid for at any price : even gold itself has not been mare eagerly prized, and at this hour will be given in profusion for a good Aphrodisiac, though begrudged for anything else — for nothing does- a man more crave than sexual power, and nothing does he more fear or regret to lose. Numerous remedies, called Aphrodisiacs, have been in use in different parts of the world, for ages past, with more or less repute ; but their employment never resulted in much good and often in much positive injury. It is the same at the present; day — the greater part of such remedies now in use have no effect at all, and those which do act had better be left alone. This arises from the fact that they are administered only empirically, and withuut any knowledge of their true powers or of their variable effects under different cir- cumstances. When [ first began to use the common, remedies of this kind. I found that they were, for the most part, only traditional compounds, often dating back to the dark ages, and given merely because the physician did not know what else to give. Some of them, it is true, acted as powerful stimulants, giving temporary power APHRODISIAC REMEDIES. at the cost of future debility, but the greater part were either utterly inoperative or else acted only on other parts of the system : in short, they were not Aphro- disiacs ! I, therefore, set to' work to investigate the whole subject of man's sexual nature, and the action of all Aphrodisiac Remedies upon it, for myself. For years I experimented with them, in thousands of cases, both simply and variously combined, carefully noting their effects, and thus by degrees finding out the true value of each, and how and when to use i.t. No one else, I really believe, ever went into this subject so thorough* ly, or with such extensive opportunities for experiment and investigation. My lectures and my books made me so universally known in connection with this sub- ject, that cases of every kind came to me in abund- ance, from all parts, and 1 was thus enabled to study practically what had been before only speculated upon. The result was, after endless trials, the formation of a compound possessing true Aphrodisiac powers ! which, when judiciously employed, invariably increases and maintains sexual power, or restores it when lost. This remedy, from its constant success in all cases of impotence, sterility and natural deficiency, became very celebrated, and my practice — which comprised only such cases — rapidly extended. Every day the demand for my Aphrodisiac increased, and 1 soon found a difficulty in procuring enough for my profes- sional use, on account of the limited supply and great cost of many of the ingredients. Many of the most powerful and reliable Aphro disiacs are among the rarest of Nature's products, and are obtained only from the least known and most inae- aessible parts of the world : Musk, for instance, which is a powerful Aphrodisiac, and of which I use a large quantity, is always worth its weight in gold, and often much more. There are, however, other substances still more valuable, for which I have often given hun« dreds of dollars for a few grains. Some of these art APHROPISIAC REMEDIES. 4S6 natural ' and some artificial products, obtained by chemical means, and which can be produced only at immense cost. The great power of most of these articles fortunately makes a small portion go a long way in use, or they could scarcely be employed at all. In my Remedy, there are altogether thirty-three differ* ent ingredients, and of some of them not more than the hundredth part of a grain can be used at a dose. Each of these ingredients has some peculiar power of its own. or is necessary to the full development of the power of some other ingredient, so that the whole act together in producing that wonderful effect for which this Remedy is so celebrated. At the same time, however, that it acts so energeti- cally as an Aphrodisiac, it has no effect in any other way, and is perfectly harmless to all parts of the sys- tem. It will be readily seen that such a remedy must ne- cessarily be costly, and can never come into common use : it must, in fact, ever remain a special luxury for those who have been favored with Fortune's golden gifts, or for those who are willing to make great sacri- fices. As a natural consequence, my constantly in- creasing demand for these rare articles made them still more scarce and dear, till, finally, 1 began to fear that my supply would run short : I, therefore, sent agents to all those parts from which they are obtained, with instructions to regularly buy up and pre-engage all that could be procured. This, of course, took a long time to accomplish and entailed an enormous expense, but it was the only sure course, and was crowned with success. A supply has thus been en- sured, which enables me not only to provide all my patients with sufficient, but also leaves a surplus, so that I can now prepare the Remedy for public sale, as I have constantly been importuned to do.. but for the reasons given was unable to do previously In this way originated the Aphrodisiac Remedy, the most remarkable medicine perhaps ever compounded, and the most wonderful in its effects No advertising, *36 APHRODISIAC REMEDIES. or other means for disposing of it, are necessary, foi Its value is so well known that the difficulty will rather be in supplying all who want it. Numbers of my patients always keep as much by them as I can spare to one person, for fear of running short, and many of them would give thousands of dollars rather than run any risk of ever being without it. As regards the obtaining of this Remedy, or any similar one, I may as well remark here that no one else but myself can possibly supply it ! Not only be- cause t^e proportions of the various articles comprising it. and the manner of combining them, is a secret only known to myself but because the whole quantity pro duced, of many of the most valuable articles, is in m\ hands, or secured to me alone, by always paying large sums in advance, so that no one else can obtain a grain. This 1 was compelled to do in order to secure a sufficient supply, and to make sure that my patients would not be disappointed. Many of the artificial products are not made for public sale. and. to obtain them. I am obliged to purchase all that certain skillful chemists can produce, and at a rate. too. which offers inducement enough to them to keep up the manufac- ture for me alone : besides this, some of the articles are made by myself, by a process which I have never disclosed. It is, therefore, impossible for any one else to supply a true Aphrodisiac Remedy, containing the rarest and most effective agents, because no one else can obtain them. All other Aphrodisiacs can be formed only of the more common and inefficient remedies, such as are to be found in most apothecaries' shops, but they in no respect resemble mine. The subtle and apparently mysterious way in which this Remedy operates, surprises most people, and it is therefore necessary to give an explanation of its physiological action. Medical agents act in different ways, some as stimulants to particular parts of the body, some as alteratives, and others again as special excitants of particular organs : thua some act on the APHRODISIAC REMEDIES. 487 bowels, some on the kidneys, some on the heart, ami others on the skin. A few act on the nervous system, through the brain, like alouhol and opium. Usually, they excite in the first place, and afterwards act as sedatives, or stupify. The Indian Hemp, or Haschisch* is of this class., and usually forms one of the main ingre dients in all common Ex/iilarants and Aphrodisiacs, It is a dangerous drug when so used, and utterly valueless for any such purpose, but when properly combined with the other articles which I have described, it be- comes a valuable auxiliary. Woe to those w T ho use it and opium for the purpose of intoxication ! Alcohol is harmless compared with them ! The true Aphrodisiac, as I compound it, acts upon the brain and nervous system, not as a stimulant, but as a Tonic and Nutritive agent, thus sustaining its power and the power of the sexual organs also, which is entirely dependent upon Nervous Power. A man's sexual vigor represents merely kis excess of nervous vigor. All the functions, both of body and mind, are carried on only by nervous power, which enables each organ to perform its peculiar function. The heart, stomach, lungs and every other organ, act only from the stimulus "which the nerves bring to them from the brain and spinal marrow. Cut these nerves through and stop the supply, and they act no longer. Now, every man only possesses a certain amount of nervous power, which varies in quantity according to the health and natural vigor of his system : if, there- fore, too much of this power is employed in one of the functions, the others must run short, and, of course, be imperfectly performed. Thus, if a man thinks too much, his brain uses up so much of his nervous power that he has not enough for other purposes, and some organs must act imperfectly. Most likely his stomach will be one of these, and then he becomes Dyspeptic ; qt he may have Heart Disease, or Liver Compiaint, o* any of those numerous diseases which we commonly 438 APHRODISIAC REMEDIES. §ee— all of which spring originally from impaired nervous action. An imperfectly acting stomach again re-acts on the whole system, because it prevents proper nutrition, and thus causes general weakness or debility. No act, however, exhausts more of nervous power than the sexual act I and this is why its too frequent perform- ance is so terribly injurious, and why the votaries of Venus so frequently become debilitated, weak-minded and. impotent. (Note. — Those who wish to see this subject fully explained, should read my books, "The Marriagt Guide," and "The Male Organs," in which the whole subject is fully gone into.) Whenever the system generally, or any particular part, becomes debilitated, and performs its peculiar function imperfectly, we use some medicine to stimulate it or improve its action. Thus we employ various bitter tonics to help the stomach, in Dyspepsia, and use Aphrodisiacs in Sexual Impotence. The way in which they really act has only lately been found out, and I will, therefore, now explain it. ©0NNECTI6N BETWEEN THE NIXVOUS AND SEXUAL SYS- TEMS, WITH AN EXPLANATION OF THE MEANS WF POSSESS FOR THEIR NUTRITION AND RENOVATION. It has long been known, as a general truth, but very Vaguely, that there is an intimate connection between the Nervous and Sexual systems, but it has hitherto been thought to be merely sympathetic. Physiologist? have, however, recently discovered that the composi tion and mode of production, of the Nervous substance and the Seminal fluid are almost identical th**, in APHRODISIAC REMEDIES. 43* fact, they are essentially the same thing. It has also been ascertained that, in all cases of severe Nervous or Mental derangement, the actual substance of the Brain and Nerves either wastes away or undergoes a destruc- tive change. And in the same way, in all cases of con- firmed loss of Sexual power, the seminal substance either wastes, or becomes destructively clianged, in a similar manner. Bat. what is still more important, the destruction or injury of either one of these ele- ments of our systems brings on inevitably a similar evil to the other. Every man, therefore, who bo- comes Impotent, is in imminent danger of becoming Insane, or at least of weak Intellect, and every one whose nervous substance is seriously impaired will almost certainly lose his sexu; I powers. The two are intimately dependant, the one on the other, and are affected, for good or for evil, by the same external and internal causes. At the present time, a number of causes are in con- stant operation, on most men, exceedingly destructive both to their Nervous and their Sexual powers, causing an actual waste of Brain and Seminal substance, and entailing bodily suffering and mental deficiency to an unknown extent. This has. of course, originated plenty of remedies, as they are called, which are put forth as infallible, by those who know nothing of the nature of these evils, and who care nothing for the effect which follows after the remedy is sold. In all such cases, it is requisite, in the first instanee, to arrest further change, or waste, and then effect a Restoration, if that be possible. To effect this Renova- ,tion. we must, of course, use such means as will really create new Brain, or Seminal Substance. The same as we create new Muscle in cases of muscular weakness. That this can be done is undoubted, for each portion of the organization draws the elements of its nutrition from peculiar sources, and when we know what those elements are. and whence they can be obtained, we rt&n supply them. It is not possible to nourish and 440 APHRODISIAC REMEDIES. renovate the Nervous and Sexual systems by the \ elements alone that nourish and renovate the muscu- lar system, though these are necessary as adjuncts; there is needed in addition certain rare elements that are found only in the Nervous and Seminal substances, and which can be supplied only by the Aphrodisiat Remedy. This preparation is not a Stimulant or Excitant, noi a mere Tonic, but a real Renovator, supplying precisely that kind of material and influence, that is needed tc produce New Brain and new Seminal fluid! 1 hav« myself often been amazed at its effects, and seldom despair of any case in which it can be used ; in fact, it is almost infallible, except where there is some Organic Defect, or some primary lesion which requires correcting first. In proof of this, I need only refer to the " Cases." It is, of course, equally useful in all kinds of Nervous debility and derangement, because they depend .^ipon precisely the same causes as the sexual ones which have been described, namely, want of proper nutrition of the Brain and Nervous Substance. Especially will it be found effective in that terrible, and too frequent disease Softening of the Brain ) hith- erto deemed incurable! The reader will now understated the Nature of this Remedy, and will see the footing on which 1 place it. It is not advertised in the manner of the Quack Cordials and Invigorators of the day, nor will it to so, but can always be obtained by those who require it. In short, it will be found, I venture to assert, aa nearly infallible, and self-sufficient, as any medical remedy, in the nature of things, can be ! If it fails, the patient should at once seek Dr. H.*s advice, for he may rest fully assured there is some Organic or func- tional derangement which imperatively and urgently requires Surgical or Mechanical aid. For convenience, I have it so put up, in a dry form, air and water tight, that it can be kept uninjured, foi APHRODISIAC REMEDIES. 441 any length of time, in any climate, and under any oir Cumstauoes It can also be taken without the incon- venience of measuring, using Liquids, or any other troublesome requirement, thus ensuring secrecy and facility of use, let a man be situated however he may. A gentleman can keep it in his vest pocket without any fcar of detection from smell or appearance. It will go anywhere by Post, with perfect safety, and in •uch a form that no one through whose hands it passes would ever suspect its nature, or that it was anything peculiar ! The price for a package is Five Dollars! and if ordered by Post it will be sent free, to any part, with full directions. There are no Agents for it anywhere, at present, nor will there be except they are specially mentioned in my Books, so that it can only be obtained" by addressing through the Post to "Dr. F/Hollick, Box 3606, New York City." I do this to avoid trouble, and also to prevent Counterfeiting, which would be sure to be practiced if it were generally sold through Agents. One package is usually sufficient in all ordinary case3 of simple debility, from excesses or imprudence ; but, in severe cases, it will, of course, require to be used longer, according to the severity of the derangement. Old per- ' sons, and those who are much broken down, should use it r gularly, at intervals: but, in every case, one single package will prove its power. It is scarcely necessary for me to repeat that there is nothing whatever in this preparation that can be in any way hurtful, under any circumstances. It is applicable to eases of Female Sterility and torpor, as well as derangements of the male System or Nerves, as will be seen by some of the " Cases" in my Books #42 APHRODISIAC REMEDIES. Persons sending for Dr. Hollick's AphrodiSUO Remedy, should be careful to send the address plaifd§ and in full! naming the Post Office, County and State, and be sure to address — For the Five Dollars, it will be sent free anywnere I EXTRACTS FROM LETTERS FROM MY AGENTS IN VARI- OUS PLACES. Aden, Arabia, at the mouth of the Red Sea, ) October 3, 1861. J To Dr. Hollick, New York, U. S. A. :— Box, 3606. Dear Sir — [n accordance with your directions. I proceeded from Egypt to this place, and have now been here three weeks. I find, as you supposed, that this is the best place at w r hich to secure many of the. articles you have commissioned me to purchase : but it is much more difficult and expensive to obtain some of them than 1 had supposed. The , though brought to this place, really comes from the interior of Africa, and reaches here by way of Abyssinia. The Somali, a most wild and blood- thirsty tribe, possess the country where it is pro- duced, and they will take the trouble to procure it only in exchange for arms and certain kinds of cloths. 1 shall therefore be compelled to keep here a stock of these articles constantly on hand, sufficient to ex- change for all they may bring. 1 do not suppose there will be more than you will need, but if there is. it must still be bought, both to secure the monoply, and to give them encouragement not to neglect gathering it APHRODISIAC REMEDIES. 448 The comes to this place from the interior of Arabia — where, I have not yet learnt. The caravans that bring it arrive only twice in the year. 1 have Been the only merchants who deal with it. and have arranged with them for the purchase of the whole supply in future, so that no one else can procure any. The or her articles I shall also ensure in the same way, and stay here till I have done so. Respectfully yours, Arnold Hufer. Assam, in the interior of Hindostan, ) March 3, 1861. J To Dr. Hollick, New York, U. S. A. : Dear Sir — I have now been at this point five weeks, snd have been very successful in the objects for which I came. In regard to Musk, I find that it can be obtained pu.^er and in larger quantities, at the southern borders of Mindostan, than anywhere else. It is not produced here, but on the' other side of the mountains, in Thibet, South-east China, and some parts of Tartary; there is, however, an active trade carried on across the mountains to those regions, from these parts, and th.^ is the way it corner. Tt is far purer than what comes from China, but is much dearer, owing to the long and dangerous journey which the traders have to take, f am told it occupies seven months to go and return, and through a most lawless, inhospitable region. I have already arranged with the prin- cipal merchants to whom it is always consigned, to take all that comes, at each trip, so that it is useless for any one else to come here after Musk. It is ne- eessary, however, to make large advances and run considerable risk of loss, but that is unavoidable. The , I find, comes only from Northern B«r- and is never openly sold. The despotic rulert 444 APHRODISIAC REMEDIES. of the districts from which it comes, prize it so highly. that they utterly forbid its exportation, under penalty of Death ! Like everything else here, however, it can be obtained if you go the right way to work, and give plenty of money in the right quarter. It will cost some lakhs of rupees to obtain the quantity you name, besides heavy fees to the officials, but you may depend upon it. and may also rest assured that, no one eke, will kave any out of this country. Merchandise can- not be brought here, so that all has to be paid for fa silver, and you must, therefore, be careful always to keep a sufficient supply at your agents in Calcutta. This region is quite healthy, and I shall stay here till the necessary arrangements are made perma* nently Yours, etc., Jamjcj Hoxton. Cuzco, in tlie Andes. South America, ) May 15, 1862. ( To Dr. Hollick, New York City. U. S. A. ; Dear Sir — Now I am here, I find no difficulty in procuring all the articles you need. They can be ob- tained only from the Indians who gather them, and who never take them to the cities. My own experi- ence has shown me the astonishing virtue of the Coco- leaves most conclusively, and I now know that the statements of Tschudi, Stevens and others, are not at all exaggerated. An Indian, at least 50 years old, carried me on hie back up the mountains, in a kind of chair, at the rate of twenty miles a day, without a particle of food for a whole day at a time, and yet showed no signs of ex- haustion. At starting, he placed his ball of Coco- leaves in his mouth, with a little lime, as a taster, and this sustained him thoroughly ; in fact, he seemed ai fresh at the end of the journey as when he began. I» the same time, 1 required three good meals, and ye 4 APHRODISIAC REMEDIES. 44* wu tired enough, though walking with another man's legs. They both chow it and make tea of it, and I am beginning to use it regularly myself. It is certainly harmless, a? all experience proves, and its power of preventing bodily and mental fatigue is amazing J have been busily occupied for a whole day. and yet at night, by using the Co^o — could sit up all night, if necessary, writing, with scarcely a symptom of fatigue It seems to suspend the waste ot nervous power almost entirely. You will receive a regular supply, both of ti: Toco and other articles, from Lima City. Yours, etc., Arthur Le Roy. (Translation.] Leipzig, Germany, October 9, 1861. Doctor Hollick:-P. 0. Box, 3606, N. York, U. $. Dear Sir — I can arrange with Mr. , the well- known chemist, to prepare you the articles you name ; but he will require to build a special apparatus for the purpose, and will require you to give security for all the expense, and also to take all the produce at the price agreed upon. He is the only man who will undertake the manufacture. Yours, etc., Herman Blum. These few extracts will show what an expense and labor it has been to procure a certain and sufficient supply of these rare articles, and also why it is that no one else can possibly provide an article like the Aphrodisiac Remedu! F. Holliok. 446 MICROSCOPICAL EXAMINATION OW TFTE TIRING. No. 1. Represents the appearance of tfee bemen f**^* perfectly healthy, as seen under the microscope. It w A « a portion lost in consequence of straining at stool, fro •* constipation, as is very often the case. The Seminal Animalcules, those minute living beings, al >vays found in that fluid, and without which it is imper feet, will be seen perfect in their form, and active in thei* motions. While this state of the vital fluid exists, a insrt will retain his powers, but if it continues to be lost to ad undue extent — and especially if it passes in the urine, a change occurs — the animalcules becomes less abundant imperfect in form, and with very feeble powers of motion This is shown in No. 2. ADDENDA. 447 No. 2. This was a portion of feemen contained tn tha wine of a person who had debilitated himself by mastur- bation, in early life. There are a few animalcules, but they are imperfect and very feeble. Tins individual had but faint amative desires, and but little power. It is possible that a man so circumstanced may be capable of association, to a limited extent, and may even become a parent, but his children, if he have any, are sure to be either deformed, still born, or constitutionally weak ! Most usually, however, there is no impregnation, or if there be, miscarriage takes place. The reason for this is obvious enough, to those who know the part which the Animalcule performs in originating the new being, and it is fully explained in " The Marriage Guide." No. 3. This was also taken from the urine ot a man who had long suffered from Urinary Seminal loss, and who had become nearly impotent, with great decay of his men- tal powers, gloomy feelings, general debility, and all those distressing symptoms of constitutional decay, which invari- ably follow this disease if it is not checked. In this case the Animalcules are all dead, and the parts of the body detached from each other. Impregnation from this semen could never take place, though the person might still at. times, retain slight powers of association. Many men are circumstanced in this way — especially those long addicted to excesses of any kind, and also business men, exhausted by too much anxiety and mental labor. No. 4. This view was taken from a man wholly d,nd hopelessly impotent, and in the last stages of decay, bodily and mental. Of course, at this stage, there is neither power nor desire. The Semen is utterly destitute of ani- malcules, and almost substance. It passes almost constantly in the urine, and is merely like gum water. During the tecond and third stages, a man may recover, with piopo* assistance, but in the last stage there is no hope. There are many married people without children, owing to these imperfections in the male, though it is generally thought Ihat it must be from the female. Some men are even nam* tliy imperfect n this way, and never can be parents, tho'igfe, 443 ADDENDA. apparentk/ y like other men. The true reason for we&fclj and deformed children, and also for frequent miscarriage, is also often in the male, though not suspected. Dr. H, is*daily making microscopical examinatioris of thk kind, both for those who call upon him, and for others. Persons at a distance, who cannot possibly pay a per- sonal visit to Dr. H. need not give up all hopes o f receiv- ing proper treatment iu any of the above affections. Dr. H. can suggest a means by which the necessary examin- ations can be made perfectly, without their coming, so that' he can advise by regular correspondence, as he does con- stantly with hundreds. All the peculiar medicines which he uses are so prepared as to go by post , without fear of injury or detection. In short, Dr. H. attends to all those derangements which are connected in any way with the parental system, in both sexes, and those peculiar nervous affections which arise from them. His practice is, therefore, different from that of any other medical man of the day, and he does not in- terfere, except incidentally, with those diseases that ordin- arily engage professional attention. The success that has attended his efforts, and the public confidence and patronage that has been so extensively awarded him for many years past, and which is daily in- creasing, make it utterly unnecessary for him to adopt any means for extending his practice ; nor is this statement published for any such purpose. It has merely been issued at the request of many former patients, to let those per- sons know, who are suffering from these peculiar causes, that there is now one upon whom they can rely, who de- votes special attention to such derangements, aDd thus res- cue them from the despairing and hopeless condition into which they are too apt, naturally enough, to- fall. It is scarcely necessary to add that the strictest confi dence and secresy, is observed in all communications, per- gonal or otherwise, and that the most careful attention a bestowed upon every case. Dr. H. has numerous testimo- aials from those who were formerly impotent, debilitated or childless, but who were fully restored to health, happi bob, and parental enjoyment. 449 DR, HOLLICK'S BOOKS THE OR NATURAL HISTORY OF GENERATION. PRICE.— ONE DOLLAR. A private instructor for Married People, and those about to marry, both male and female, in everything relating to the Anatomy and Physiology of the Generative system, in both sexes, and the process of Reproduction. Including a full description of everything that is now known respect- ing the prevention and production of offspring, the causa of the difference in sex, — Parental influence, — Natural ad- aptation, — Philosophy of Marriage, pub Kc audiences of ladies. J&f iVb Female should be without it, especially if Married, THE MATRON'S MANUAL OP MIDWIFERY DISEASES OF WOMEN DURING PREGNANCT AND CHILD-BIRTH. A complete practical treatise upon the Art of Delivery, aD'l upon all the accidents and diseases that may occur during these peiiods. This work is especially intended for the instruction of /emales themselves, and any one of ordinary intelligence, upon reading it carefully through, will be able to render the requisite assistance in cases of emergency. — The description of all the various Positions and Presentations is on an entirely new plan, and is made both simple and intelligible. — The management of new born infants is also given in full, and the use of Ether and Chloroform during delivery is discussed. This work contains over sixty Engravings, besides colored Plates showing the various periods, and how to ascertain them. — The ditie* •at positions. — The progress of delivery, &c. PRICE.— ONE DOLLAR EACH. DR.HOLLICK'S PUBLICATIONS. w We have just read a new work called M The Marriage Guide? by Dr. F. Kollick, the well known ^Author of the Origin of Lite, and we are constrained to admit that it is the most extraordinary Book that ever came under our notice. Thoroughly scientific enough tor deeply read scholars, or for practical experimenters, it is yet plain and popular enough for the most ordinary understanding. Nowhere else in the English Language, can there be found such a complete and practically useful compendium of Physiological information, strictly adapted for the use of married people, or of those intending to marry. All the new discoveries of Pouched Bisekoff, and others, are fuliy given, as well as many others by the author himself, never before made known. The engravings are also excellent, as well as curious, fn fact, taking it altogether, it is beyond all question the Book upon Uiese maiters, and will probably become as popular in future, and as uni versally referred to as Aristotle has formerly been. One feature which peculiarly distinguishes this book from all others or the kind, is the peculiar toue of morality and delicacy which pervades it all )h rough, and which makes it both proper and useful to be read by all persons, of both sexes, who have attained the age of puberty. A very eminent clergyman, authorises us to say that he deems it a duty to in- troduce it privately among his flock, as the best means he knows of preventing and overcoming those haieful vices, unfortunately so de- structive to soul and body, which are at the present time so fearfully prevalent." — [Med. <£• Surg. Review. «»-*-« w Ths Male Generative Organs."— This book, by Dr. Hol- lick, the eminent popular Lecturer, and successful practitioner, should be in the hands of every man who values his health, and the preservation or restoration of his powers. It is complete in every particular, and is the only work in the English Language where that fell destroyer of thousands, urinary seminal loss^ is fully explained, and its cure and prevention pointed out. How many thousands jrearly die. or become imbecile from this cause, who have never heard it mentioned. — [Med. Journal. "his List embraces the whole of the Works, which may either be obtained singly or in the set. PRICE, ONE DOLLAR EACH, &&- ALL WITH COLORED PLATES. -*» On forwarding the money and address to "Dk. HOLLICK, Box 36)6," they will also be sent, by post to any place free. N.B. — The attention of P6$t.jtna$ters and Agents is respectfully directed to these Works. Their sale is rapid and sure, and the discount is most liberal. 458 APPENDIX ftotitts of §r. f tfliitk's Stetani D*. Hollick and Physiology. — The second of a series of Lectures, by ^bis gentleman, on human physiology, ( and the all important ti-uth* corrected with our physical constitution, was attended by a ful} house, in National Hall, last evening. The time was well ipent, and so appeared to think the audience. On the delivery of the first of thes« • Lectures on Tuesday evening, the speaker in a comprehensive and weiL-digested exordium, placed himself and the subject right with the public. His manner, language and style, did the first ; his sound logic, bis argument, his candor and research, accomplished the second. Apart from the interesting and apposite details of the wonders of reproduction, the illustrations of the immutable wisdom of nature, which teem in the animal and vegetable worlds — which " Glows in each stem, and blossoms in each tree ; Lives through all life, extends through all extent, Spreads undivided, operates unspent." Apart from all this, Dr. Hollick's Lecture was excellent as a defence of truth, a vindication of the right of free and unshackled inquiry, and as a convincing refutation of that silly, but far too prevalent opinion that there are truths of which it is better to remain in a state of igno- rance. Had nothing else been imparted in the forcible and well defined exordium of Dr. Hollick, than this judicious demolition of that fallacious, silly, but injurious twaddle which would forbid research to pass in advance of the old landmarks prescribed by custom, igno- rance or a spurious morality — even that would well deserve the public patronage. Truths, well set forth, will make an impression, whether their investigation be fashionable or not. There is an affinity between the capacity to learn, and the truths to be learned, which always results, when a fitting opportunity is presented, in a free inquiry, and the g3ntleman who is bringing, in a judicious and elevated manner, a knowledge of those fundamental principles of our corporeal existence which are abused because unknown, will accomplish more good than half a dozen teacher? of higher pretentions, and lower ability. It waa gratifying to observe the decorum — the sense of respect for both speaker and subject, that was observed throughout the evening, which evidently shows that those who go there are actuated by higher motives than mere curiosity ; by desires more ennobling than a passing gratification ; in a word, it was clear that those who com- posed T)r. H's hearers, were men who know and dare to think, and who will profit by these most useful discourses. — iVW York Htraid .ft*—* 7, 1844. At a Meeting of the Class attendant upon Dr. Rollick's Select Lea tares on the Physiology and Philosophy of the " Origin of Life " in Plants and Animals, hekL at the Lecture Room of the Museum, Wed- nesday evening, December 1, 1844, George G. West, Esq., was called to the Chair, and Samuel W. Black appointed Secretary. Resolved, That we have listened with unfeigned pleasure and interest to the Course of Lectures delivered by Dr. Hollick, and now brought to a close, and that we deem it an act of justice to him and the community, to express our entire confidence in his character, ability, and the manner of illustrating his subject, which, to use the words of a dairy journal. " is couched in such delicate as well as per- spicuous language, that the most fastidious could find no fault, nor the idlest curiosity go away unimproved." Resolved, That a committee of three be appointed to tender to Dr. H. the thanks of the Class for his courtesy to the members in affording them every facility for obtaining information upon the subject of hii Lectures, and that he be requested to repeat the Course at the earliest period consistent with his other engagements. Published in all the Philadelphia daily papers of December, 14, 1844, «nd signed by one hundi td and forty of the most respectable and influ- ential inhabitants. (See similar Resolutions, with over two hundred names attached, in the Philadelphia daily papers of March 9, 1844 ; also of March 16/ and on several other occasions.) From the Philadelphia Daily Papers, Feb. 21, 1845. At a meeting of the Ladies composing Dr. Hollick's Class, held ta Wednesday afternoon, February 19th, in the Lecture Room of tlus Museum, the following resolutions were unanimously adopted, and ordered to be published in one or more of the city papers : Resolved, That we have listened with great pleasure and interest tw Dr. Hollick's Lectures, and we are happy to add our testimony to the many already recorded in behalf of such Lectures : and regarding Dr. Hollick as a benefactor of his race, and especially of our sex, we cor- dially wish for him abundant success, and ample reward in the con- sciousness of doing good. Resolved, That we will exert ourselves to induce our female friends and acquaintances to avail themselves of the great and rare privilege of obtaining the valuable instruction imparted in these Lectures in s« ikaste and dignified a manner Signed on behalf of the meeting by Susan Wood> President. Sarah Webb, Secretary. $fgT With over 50 names attached thereto. (See also similar Resolutions, with numerous names, on Feb. 87. 1846, March 20, 1840, and on April 10, 1846, with over three himind r attached.) *PPEN1>IX. 45* A Gold Medal to Doctob Hollick. — "ne Ladies of Dr. Hollick M IMS have presented him wih. a beautiii?l Gold Medal, enclosed in a Handsome morocco case. Th« front of tho Medal bea>*fi the following inscription : | ** Presented to Frederick Ho.^ick, M. D., by the Ladies who attended his Lectures on Physiological Science, delivered at Philadelphia, March, 1846, as an expression of their ipprobation of the knowledge therein eonveyed, and as a testimonial u£ pergonal regard." On the reverse is the Sun, and reflected by the rays of the luminary a scroll containing the words ** To give light to them that sit in darkness.* PhiUi. Spirit of the Timti^ Starch 28, 1846 "LETTERS FROM NEW YORK, NO. 11. « • * * * There have been several courses of Lecture* en Anatomy, this winter, adapted to popular comprehension. I rejoice at this ; for 'it has long been a cherished wish with me that a genera] knowledge of the structure of our bodies, and the laws which govern It, should extend from the scientific few into the common education of the people. I know of nothing so well calculated to diminish vice and vulgarity as universal and rational information on these subjects. But the impure state of society has so preverted nature, and blinded eommon sense, that intelligent women, though eagerly studying the structure of the Earth, the attraction of the Planets, and the repro duction of Plants, seem ashamed to know anything of the structure of the human Body, and of those Physiological facts most intimately con- nected with their deepest and purest emotions, and the holiest experi- ence of their lives. I am often tempted to say, as Sir C. Grandisoa did to the Prude — ' Wbttest thou not how much »n-delicacy there is in thy delicacy ? ' ** The only Lectures I happened to attend were those of Dr. Hollick, which interested and edified me much. They were plain, familiar conversations, uttered and listened to with great modesty of language, and propriety of demeanor. The Manikin, or Artificial Anatomy, by which he illustrated his subject, is a most wonderful machine invented by a French Physician. It is made of pcpier mache, and represents ihe human boay with admirable perfection, in the shape, coloring, and arrangement even to the minutest fibres. By the removal of wires it tan be dissected completely, *** as to show the locality and functions cf the various Organs, the intwtor of the Heart, Lungs, &c. *' Until I examined this curious piece of mechanism, I bad very faint end Imperfect ideas of the miraculous machinery of the house we live la. I found it highly suggestive of many things to my mind." * * • L. M- C. ( Extract from a Letter in the '*' Boston Courier * of lionfaj, Jus* H 1M4, by Mrs. L. M. Child.] 456 APPENDJK. Dm. Rollick's course of lectures at Washingtonlan Hall on the Origin of Life, cemmenced on Monday, and were listened to with breathless attention till the close, when the audience, in a body assembled ajound the speaker's stand, and congratulated him apon the excellence, novelty and utility of his disdourse, and the vigor and felicity of his explanations. The manikin used by the Dr. to illustrate his remarks, is as large as life, and contains a fac simile of all the im- portant machinery of the human body, and it is a treat to behold them and listen to the accompanying observations regarding their uses and abuses. The advance of modern science is aptly illustrated by the declaration of Dr. H., that within the last two years there have been discovered greater facilities for teaching medical doctrines to the multitude than the two foregoing centuries furnished for the instruc- tion of medical men. If then, modern days afford so much additional light, it is even culpable on the part of the community if they do not avail themselves of knowledge so indispensible to health and happi- ness. Dr. Hollick's remarks are unexceptionable, easily understood, and have all the force of philosophy without the learned jargon of the pedant.— Bost on Post, March 23, 1848. j$J- Dr. Hollick's new series of Lectures which commence to-day for ladies in the afternoon, and for gentlemen in the evening, will no doubt prove a source of high gratification, and useful instruction, to all who can attend them. We understand each lecture will be quit€ eomplete by itself, and will embrace every topic of interest and every fact of value, that have the slightest bearing upon the subject dis* eussed. The Dr. has a most admirable 'power of condensation, ana never loses time with mere words, so that he puts more valuable matter in one of his discourses than is ordinarily scattered over four. The ladies* lectures are all to be of a strictly useful character, em- bracing the causes of their various complaints, and how to avoid them, Jtc. It was remarked by many, who were there last week, that guoh knowledge would prevent more disease than any medical skill could cure, and that they scarcely knew which to admire most, the value of the information itself, or the singularly pleasing, plain, and delicate manner in which it was communicated. The attendance will no doubt be large, and those who go late will probably be again dis- appointed, as hundreds were last week. — Boston Bee, March 7, 1-848. Bit. Rollick's New Series of Lectures.— At the request of many vf our citizens Dr. H. has arranged to commence on Monday next, a teurse for ladies and gentlemen together, on Physiology and Health, and also one in the afternoon for ladies alone, illustrated by his cele- brated models ; paintings, &c. The great interest and importance of this subject, and the reputation of the lecturer himself, will no doubt cause a very large attendance, but the Doctor has properly made his arrangements so that no more will be admitted than can be comfortably seated. These lectures will be quite a prominent fea ture in next week's entertainments, and we should not be surprised if the Doctor is even better patronized than he was last winter, whea hundreds could not obtain admission to hear him. — Boston Titnu B*vtmbtr % 1848 APPENDIX. 457 Dr. ITs. style of lecturing is exceedingly plain, lucid and intelligi- ble, lie relies on no trick or art of oratory — no effort to surprise or Itartle— to obtain or keep up the interest of his lectures. But they are deeply interesting. They are listened to in silence and with enchained attention— an attention that would feel annoyed at any fictitious arts of the speaker. The reason of thi6 is obvious. The entirely novel character of the lectures, the deep and pervading in- torest of the subjects discussed — subjects embracing all that is mys« t.erious and of momentous importance in the matter of man's repro- luction and existence in this world— give to the lectures a solid and inestimable value as well as enchaining freshness and interest. We believe Dr. Hollick is the only man in the country who has de- voted years of study to this important but too much neglected branch of human knowledge, or rather of human ignorance: and who is now trying to extend the lights of wholesome understanding on the sub- jects embraced, among the people. la this matter, we recognize in Dr. H. a public benefactor, and we owe it to the welfare of our fellows to commend him as such in this <3ec'ded manner. We give utterance to no formal or paid-for puffin this matter. Our readers kuow us to be incapable of such a prostitu- tion of our columns. The large numbers of ladies and gentlemen who have attended Dr. H.'s lectures know that we do but speak of this subject as it merits. — St. Louis Intelligencer. Feb. 8, 1850. We were most agreeably surprised and delighted. Highly as Dr. H. came recommended, and thoroughly as were his lectures approved by men of intelligence abroad, we had no idea before hearing him, of the vast utility of his labors. The subjects he discusses are of the highest importance to the well-being of the human race, and an ignorance of them is daily pro- ducing a decree of disease and death, the extent of which nothing but the astounding disclosures of eternity will reveal.— Si. Loui% Era, fsb. 1. 1860. He is certainly an admirable lecturer, being clear in voice, distinct in expression, and having a very felicitcus mannes of imparting in- struction. We are persuaded his lectures must be productive of great good. — Organ, St. Louis , Mo. Dr. Hollick — This distinguished lecturer had a crowded house at the Apollo last evening and his delighted audience expressed their approbation at the close of his discourse by loud applause. Dr. H. is indeed a most entertaining and instructive lecturer. We heard a medical gentlemen say last even ; ng. after listening 'o him, that be would not fail to hear the whole series even if he snodd have fco sell his coat to raise the means. The information, imparted by Dr. H., must be truly invaluable to every one who possesses it.— Louisville Journal, Jan. 8, I960. Undoubtedly he is the most eloquent, instructive and impressive lecturer in the United States upon physiology and health. Trie peQ- ple of Cincinnati were so delighted with him that the 7 pievailed on tim to deliver four courses of lectures, and, when he was at length •bliged to leave them, they obtained from hioi a promise to r*tura.— Louitvillt Journal, Jon. 5, 1864). 158 AFPENDHC. Another Course. — Dr. Hollick, in consequence of + he &?*at sacee* with which he has met, has concluded to repeat hif %jurse of lecture* as will be seen by reference to another column, h..* lectures imparl information of such value and are so highly interes mg, that & per Bon who hears him once. Trill not fail *-> attend the series. — Timet Cindrm , December. 1849 Dr. Rollick's Lecture have excited great attention and pi< ducen much benefit throughout the country. These lectures are strict!) moral an 1 highly instructive. There is nothing connected with then calculated to oifend the most sensitive delicacy. — Delta, New O'iesn Feb. 24, 1350. In November, 1849, Dr. Hollick lectured in Pittsburgh, Pa., to crowd ed audiences, and at the termination of his last course was publiclj thanked and requested to return. In December, 1849, he gave four courses in Cincinnati, Ohio., an$ then bad to give a promise to return at an early period. In January, 1850, after two crowded courses, the ladies of Louisville, Ky , tendered him publicly a most nattering vote of thanks and re- quested him to visit them again as early as his engagements woula allow. In St. Louis, Mo., February, 1850, he had crowded houses, both of ladies and gentlemen, for three weeks > and public resolutions, com mending his lectures in the highest terms, were passed on severaJ 'Vcasions. On going down the Mississippi River, February, 1850, he was unan Imously requested by the officers and passengers of the splendid steam- er Atlantic, to unpack his Models and lecture to them on the boat, which he did on three several days. At the conclusion, the audience resolved itself into a meeting, Dr. Gibson of Mississippi, being called to the chair, and Dr. Clark of St. Louis, elected Secretary. A series of resolutions were then passed unanimously, returning thanks for the lectures and commending them in the highest terms. Theae reso lutions, headed, " Novel and interesting scene on board a Mississippi steamer" were published in the Picayune, New Orleans, the inhabitants oi which place were strongly urged to nttend when the lectures wen given in their city, and which they did not fail to do Dur.ng his stay in the West and South, Dr. H. was everywhere re- vived in the most flattering manner, and his efforts to impart import- ant physiological knowledge in a popular manner, were fully appreci- ated. In every place the largest room that could be obtained wai •rowded at each .ecture, and the number of applicants for consulta tions was so great that on several occasions Dr. H. was obliged *» jpostpoae the lectures in order to attend to thwu. APPENDIX. 469 ADDITIONAL NOTICES. la the early part of this year Dr. H. lectwed for frur tces/ci, wit* the most unbounded success, in Philadelphia, and for four mere il ^Baltimore, v^ere his reception was enthusiastic, the ladies filling tba room, and p:r-sing on the last day a series of highly flattering and eommendator- Resolutions, which were published in the dany papers The following L-e a few of the PditorUls given at that time : — [COintOTCATED.] Messrs. Editors — The most scientific and useful lectures of th« present day, which should claim the attention of every one. are now being delivered at Masonic Hall, by Dr. Hollick, on the subject of Pa- ternal Physiology and Health. The writer of this heard his first course, delivered during the last week, and having been educate! to the medical profession, is, perhaps, capable of judging c€ their use- fulness. There is no doubt that the general feeling of the medics* faculty, and of an enlightened community, towards itinerant lectur- ; been one of disapprobation and apprehension of quackery, but in the present instance there is certainly an exception. Dr. Dunbar, (formerly Professor at the Washington College.) who Srttended Dr. H.^s last lecture, on Friday evening, was so pleased with the manner and matter of the lecture that he came out openly at the close of the lecture and stated, before the audience had dispersed, tha/ he had come there at the request of a patient, prejudiced against tfc% lecturer, but on hearing him he thought it his duty to say t^at the lecture was perfectly fair, scientific, calculated to do a vast amount »f good, and that evej-y man, young or old;, should hear, and would be benefited thereby. Jrs illustrations are complete and beautiful, and his explanations couched in such delicate language that the most fas- tidious can find no fault. Those of your numerous readers who may devote an hour to his remaining lectures will thank you for giving this publicity. — Baltimore •American, March 2. 1S52. Dr. Holijck's Lectures. — The distinction which Dr. Hollick has ac quired as a most intelligent, judicious and salutary lecturer on the mter^ting and important subjects of human physiology and health, renders any commendation from us quite unnecessary ; yet, in view of the fact that the course which he has lately delivered in this city, is, at the solicitation of many, to be repeated on this and the next two days at Masonic Hail, we would take occasion to assure all of their great value to every individual member of the human family. Many of the most prominent o* the medical faculty in this city bear testi- mony to the excellence of these lectures, as calculated to be highly useful, in imparting, in the most unexceptionable manner, that know- ledge of hfunan physical structure and the laws oi health, the want tf which r^w cw%£l*£,s so much disaster and suffering — £altim*9t Sim, Mar U 1 . ltoa 460 APPErTIHX. tfRITIJIO DISK AND GOLD PEN PRESENTED TO DR. H. IT OIW OF HIS LADY CLASSES. Dr. Hollick — Dear Sir : The members o/ . your class, desiring the gratification of offering you some, testimonial of their personal regard, and grateful appreciation of the benefits which you are conferring upon them and their se.i generally, respectfully request your acceptance of the accompanying writing desk. Were it necessary, we might repeat our as- surances that your services to humanity will be, by us, long and gratefully remembered. The women of this generation have reason to rejoice that, by your efforts, a new and extensive field of information has been opened to them, whence they may derive treasures of knowledge, of im- mense importance to themselves and their pos- terity, hitherto concealed within professional enclosures. Wishing you health and happiness, we b€g leave to subscribe ourselves, Truly your Friends, Signed on behalf of the class by, M. G. ^ O. W. B. Pkila. March 20, 1845. 461 DR. HOLLICK'S APHRODISIAC REMEDY. This is the celebrated Remedy so long used in Dr. Sollick's extensive practice, for the cure of IMPO- fBNOB, STERILITY, and all forms of Sexual and Nervous Debility ! For many years Dr. Hollick has been importuned to offer this remedy for public sale, but till now, has not been able to do so, on account of the scarcity and dearness, of many of its ingredients, and the large quantity required in his practice. Having at length succeeded after immense cost and labor, in procuring a larger supply, Dr. Hollick now for the first time offers it to the community at large, in compliance with the numerous and urgent requests that have been tendered to him ever since its first intro- duction ! This Remedy is the only one of the kind which can possibly be obtained, because Dr. Hollick alone possesses the secret of its composition, and has secured the entire monopoly of the rarest and most powerful of its ingredi- ents. It is composed of thirty-three different sub- stances ; some so powerful that not more tb/;n the hund- reth part of' a grain can be used at a dose, and so dear that a single grain will often cost from two to four Dol- lars ! It is however perfectly harmless, and may be Bafely used by ali persons, and in any circumstances. To the Childless, the Impotent, the Nervous, the Feeble, both in Body and Mind, the Hypochondriac, and those who find themselves becoming old too soon of Both Sexes ; the Aphrodisiac will be found a sure and Permanently effective Remedy 1 UR. HOLLlC&g 461 It is not a mere stimulant, or Injurious Excitant, acting only for the moment, but a true Nervine and Sex* cai. Tonic and Renovator, producing new Nervous and Sexual material, wheD these have been wasted by excess abuse, or disease! Several of the articles which compose the Aphrodisiac Remedy, have been used from time immemorial, in a crude form, and separately, but no scientific combination of the whole was ever possible till now. The celebrated Dream Drug of the East, the Indian Hemp, is often used as an Aphrodisiac, and will sometimes cause erotic dreams. This however is only accasional, and such an effect is always followed by unusual debility, terminating at last, if its use is continued, in complete sexual impotence. In the Harems of Turkey,, a compound is used called, in Arabic, " Loves Assistant ! " It is composed of various stimulating spices, with opium and musk, and has some power, when first used, but at last it eventually causes general weakness and decay, both of body and mind. The late Sultan of Turkey used this compound till he was nearly an idiot ; and at last died from sheer pxhaustion. In China they have a Pill somewhat similar to this, and which causes almost identically the same results Sometime ago this Chinese Remedy was brought to France, and sold in Paris under the name of Honneur de la Fa- mille ! (Honour of the Family !) this being its Chinese name, — the evil results from its use however, soon caused it to be but little called for. In some parts of Arabia and Africa, an Aphrodisiac has* also been long employed, as we can see from allusions in old Chronicles, and in various Poems. Even in the Hebrew Scriptures the Mandrake is spoken of as being bo used. The Hindoos have always been great lovers of A phrodisiacs. and they possess some powerful ones, which however they use without knowledge, and consequently derive but little good from them, and much harm. All these articles, after much trouble, time; and expen- 464: APHRODISIAC REMEDY. pes, Dr. Hollick obtained and analyzed, so as to kno* exactly what they were. The Aphrodisiac Remedy contains what is really good and effective in all of them, without any of their hurtful qualities. The Common Aphrodisiacs are merely compounds of Spanish flies t Opium, Strychnine, Arsenic, Phosphorus and imilar drugs ; Most of them are rank poisons! Among other names used for Aphrodisiacs, by tha Turks, Arabians, and Hindoos, we find the following. Parent of Pleasure ! — Delight of Paradise ! — Fam- ily Multiplier! — Youth Prolonger ! — Hope of the Aged ! — Brain Strengthener ! — Fountain of Power 1 --Strength Giver! — And numerous others, all indicaU ing the same powers. All of these various articles there* fore, imperfect though they are, have still gained a repu- tation, and are eagerly sought. How much more valuable therefore must be a compound which combines the excel- lences of all, without any hurtful qualities whatever! Although never advertised, and only known through the reports of those who had been restored by its use, the Aphrodisiac of Dr. Hollick has become known, and sought for in all the principal cities of Europe! Many persons of eminence have regularly obtained it, privately, and in more than one instance the wishes and hopes of married people of high rank, have been fulfilled through its means. Its fame has even reached Turkey, and in Constantino- ple itself, the Aphrodisiac is rapidly supplanting the hurt- ful and inefficient drugs formerly in use. No public announcement is needed therefore to sell the Aphrodtttac, but only to let those persons know they can now have it who have so long been wishing for it in vain. In most ordinary cases of Sexual Debility, One package of the Aphrodisiac usually restores the virile power com* pletely, and in all cases enough to show that entire resto- ration is only a question of lime. When the system is much run down however, and the decay has existed for a bug period, the remedy must be persisted in for a longei time, and several packages may be needed. Old person^ DR. rollick's 4W or those worn down by excesses, should take it regularly, to prevent further decay, — and so should those who ovei mdidge, to ward off the consequences of their indiscretion. If no sufficient restoration follows a fair trial of the Aphrodisiac Remedy, it may safely be inferred, that there H either a natural imperfection, or some Organic Disease, most probably there is loss of semen in the urine ! In all such cases the person should at once consult Dr. Holliok, for the purpose of having a thorough examination, and a full treatment tiU the difficulty is removed. Females who are Childless, cold in temperament, Ner- vous, and sexually feeble, are as much benefited by the Re- medy as males, and ma»y a solitary hearth has been bless- ed with children through its use. For those who cannot possibly visit Dr. Hollick, he wiii explain a simple mode of examining the urine by which the facts of the case can be fully ascertained, so that patients at a distance can be treated by correspon- dence with perfect success. All Dr. Hollick's Medi- cines are put up in the form of concentrated dry powders, to go by post, without any risk of detection. Hundreds of patients are constantly being prescribed for in this way, with perfect success. gg&* All letters are destroyed as soon as notes are taken of the case. (See the Pamphlet accompanying each package — and also Dr. Hollick's Books on Marriage, and on the Male Sexual system.) The Aphrodisiac Remedy is put up in flat Gold Boxes in such a manner that it will go anywhere by Post like a letter, without any risk of Inspection or detection. It will also keep unhurt for any length of time, in any climate and in any circumstances ! It may be carried unobserved in the vest pocket, and requires no liquids, nor any meas- uring, or apparatus of any kind when taken ; being in a solid form, divided into graduated doses, and vtithmA naell or taste. 466 APHRODISIAC REMEDY. PRICE FIVE DOLLARS Per Paekage, for which it will be sent free by Post^ to any Address. 5gf~ To Prevent Counterfeiting, and to make sure that no one can be imposed upon by pretenders, Dr. Hollick does not sell his Remedy through Agents (unless specially mentioned in his publications). Address to "Dr. F. Hollick, Box 3606, New York City."