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wtOLOCT LIBRARY

BIOLOGY LIBRARY

*»n

THE

FUNCTIONS AND DISORDERS

REPRODUCTIVE ORGANS

WORKS BY THE SAME AUTHOR.

A Practical Treatise on Diseases of the Urinary aud

Generative Organs (in both Sexes). — Part I. Non-Specific Diseases. Part II.
Syphilis. Entirely Rewritten, with Copious Additions. Illustrated by Wood-
cuts and Coloured Plates. 3rd Edition. Octavo, £1 11*. 6d.

Prostitution, considered in its Moral, Social, and Sanitary

Aspects, in London and other Large Cities ; with Proposals for the Mitigation
and Prevention of its Attendant Evils. 2nd Edition. Octavo, 12*.

THE

FUNCTIONS AND DISORDERS

OF THE

REPRODUCTIVE ORGANS

CPtvok, fttty, $tatt gge, an* gJtantri fife

CONSIDERED IN THEIR PHYSIOLOGICAL, SOCIAL, AND
MORAL RELATIONS

BY WILLIAM ACTON, M.R>C>S>

LATB SURGEON 10 THE ISMSQTOS DISPKNSART, AKD FORMBRLT BXTBRNE TO THB VBSEREAL HOSPITALS,
PARIS, FELLOW OF THB BOIAL MED. AND CHIB. BOCIETT, ETC. E1C-

SIXTH EDITION

LONDON
J. & A. CHURCHILL, NEW BURLINGTON STREET

1875

^W3^^i

WOLOGY LIBRARY

42-

Bio/c

<\y

PREFACE

THE SIXTH EDITION

In preparing the present edition I hope I may again consci-
entiously state that no time or labour has been spared in the
endeavour to make the work more worthy of the continued favour
the profession has shown it.

I have sought to investigate the subjects treated of in the calm
and philosophic spirit in which all scientific inquiries should be
approached, and have striven to keep the text free from any
sentiment or expression incompatible with the dignity and the
high calling of a medical man.

I would further add that I have not relied on my own
observations only, but have quoted largely from the works of
Carpenter, Lallemand, and Parise; preferring that they should
share the responsibility of many statements which I could have
established on my own experience. Hence I would fain hope
that the professional reader, who takes up this work in a serious,
thoughtful, and what I would term a loyal spirit, will not rise
from its perusal without having derived considerable information.
( The continent student will find reasons for continuing to live
according to the dictates of virtue. The dissolute will be taught,
on positive and irrefragable grounds, the value of self-control?^
The bachelor, who is often placed in a trying social position,
will glean consolation from observing that not only are his sexual
sufferings recognised, but that rules are given him for their

£f9§W*

APR 3 1972 nn3^ i Ko 1 3l

VI fcREtfACE

mitigation. The married man will find advice and guidance,
in order to avoid excesses. The surgeon will learn how to
manage those difficult classes the hypochondriacal and the
libertine. Lastly, the advocate who practises in the divorce or
criminal courts will here find the basis for many valuable argu-
ments, — nay more, he may learn how, in many cases of guilt, fair
cause may be shown for a culprit's committal to a lunatic asylum
instead of to a prison.

In conclusion, I would fain indulge the hope that the book
may continue to exert, as I trust it has already exerted, some
good practical influence upon public health and public morals.

17, Haeley Steeet, Cavendish Squaee
October ', 1875.

TABLE OF CONTENTS

FIRST PERIOD-CHILDHOOD

THE FUNCTIONS AND DISORDERS IN CHILDHOOD

PART I

PAGE

NORMAL SEXUAL CONDITIONS IN CHILDHOOD . 1

PART II

ABNORMAL SEXUAL CONDITION IN CHILDHOOD

Sexual Pbecocity ........ 3

SECOND PERIOD-YOUTH

THE FUNCTIONS AND DISORDERS IN YOUTH

PART I

NORMAL SEXUAL CONDITION IN YOUTH .

. 9

i 12

Vlll CONTENTS

PAET n

ABNORMAL CONDITION IN YOUTH

Cha.pt. I. — Incontinence ......

„ II.— Masturbation ......

Sect. I. — Masturbation in Eablt Childhood
„ II. — Masturbation in the Youth and Adult
„ III.— Insanity arising from Masturbation .
„ IV. — Phthisis arising from Masturbation .
„ V.— Affections of the Heart arising from Mas
turbation ....

PAGE

33
38
39
54
62

THIRD PERIOD

THE FUNCTIONS AND DISORDERS OP THE REPRO-
DUCTIVE ORGANS IN THE ADULT

dfi'rstf Wbi&Um

GENERAL CONSIDERATIONS ON THE SEXUAL CONDITION OF

THE ADULT . . . .71

CHAPTER I— VIRILITY . .74

*econb fflttnsuon

THE SEXUAL ACT, ITS PHYSIOLOGY AND DISORDERS . 74

CHAPTER I— ERECTION . . 75

PART I
NORMAL ERECTION, OR CONDITIONS ESSENTIAL TO IT . . 76

CONTENTS

PAET n

ABNORMAL ERECTION AND DISORDERS AFFECTING ERECTION

Sbct. I.— Slow Erection

II. — Erection not lasting long enough
III. — Impeefect Erection .
IV. — Irregular Erection .
V.— Non-Erection ....
VI.— Priapism, or Permanent Erection
„ VII.— Satyriasis ....

PAGE

82
83
83
86
86
87

CHAPTER II— EMISSION

PART I
NORMAL EMISSION; CONDITIONS ESSENTIAL TO IT

PART II

DISORDERS AFFECTING EMISSION

Sect. I. — Premature Ejaculation
„ II.— Non-Emission .....
„ III.— Nocturnal Emissions ....
,, IV.— Diurnal Pollutions or Emissions .

100
102
105
116

CHAPTER III— THE EMITTED FLUID SEMEN

PART I
NORMAL CONDITION OF THE SEMEN

PART II

DISORDERS AFFECTING THE SEMEN
Sect. I. — Inpecund Semen
„ II.— Ungratified Sexual Excitement
„ III. — Sexual suffering in the Married
„ IV. — Disappointment in Love
„ V. — Passing Bloody Sembn
„ VI. — Spermatorrhea ' .
False Spermatorrhea

CHAPTER IV— SEXUAL INTERCOURSE

12.2

122

131
131
138
141
143
144
145
171

178

CHAPTER V— MARITAL EXCESSES

191

CONTENTS

PAGE

CHAPTER VI— CELIBACY . . .195

CHAPTER VII
EARLY BETROTHALS-LONG ENGAGEMENTS . 198

Cfnrti Sibfetim

IMPOTENCE . . . .200

Sect. I. — Sexual Indiffebence, oe Tempobaey Absence of Desiee 203

„ II. — Tetje Pebmanent Impotence, oe Absence of Vibility . 222

N III. — Steeility . . . . . . 230

„ IV. — Impotence considbeed as a Gbound foe a Deceee of

Nullity of Mabeiage ..... 234

FOURTH PERIOD-ADVANCED LIFE

THE FUNCTIONS AND DISORDERS OF THE REPRO-
DUCTIVE ORGANS IN ADVANCED LIFE . 249

PART I
NORMAL FUNCTIONS IN ADVANCED LIFE . . 249

PART H

DISORDERS IN ADVANCED LIFE . . 254

Chapt. I.— Functional Disoedees in Pbesons who do not know the
Consequences of Repeated Acts of Sexual Inteecoubse,
and commit excesse8 feom ignoeance . . . 255

„ II. — Functional Disoedees in Peesons who know the Conse-
quences of Sexual Excesses, but cannot contbol theib
Passions ....... 260

„ III.— Functional Disoedees in Debauches who, hoping to

SUPPLY THE LOSS OF I'OWEB CONSEQUENT ON THEIB PBE-

vious Excesses, fbefeb to stimulate the Repeoductive
Oegans fob the pubpose of gbatifying theib Animal
Passions . . . . . . .261

APPENDIX.— Pbescbiptions . . . .265

INTRODUCTION

I have in the following pages treated of the Functions and
DisorderSj as distinguished from the Anatomy and Pathology, of
the reproductive organs. On the latter topics there are many
excellent and exhaustive works, but the former still need much
elucidation. Until lately, indeed, many standard surgical writers
on the generative l system have practically ignored the functional
aspect of their subject ; dealing with the whole of the wonderful
and complex machinery of which they treat, as if the offices it
fulfils, the thousand feelings it affects, the countless social, moral,
and scientific interests with which it is so intimately connected,
were of little or no moment.

A different, and I trust, healthier feeling has arisen since the
first edition of this book was published ; and I think I need not
here repeat the apology or defence with which the earlier editions
were prefaced.

I have laid under contribution the domains of Natural History
and Comparative Anatomy, with the illustrative treasures of the
College of Surgeons' Museum, the Veterinary College, and the
Zoological Gardens, and have, moreover, availed myself of the
experience of practical breeders of stock.

I have again followed in this edition the natural division of the
subject, and have considered it under the four main periods of —
Childhood — Youth — Adult Age — and Advanced Life. Taking

1 In the following pages the words " generative," " sexual," u reproductive," will
be used synonymously ; there are some instances in which distinctions may be made
between them, but these are so slight I need not further allude to them,

Xll INTRODUCTION

each period separately, I have first discussed the normal Functions
or Conditions of the reproductive organs incidental to it. Having
fully explained these by the help of the most recent physiological
investigations, I have examined the Disorders to which each
period is most subject. I venture to hope that scarcely a single
ailment to which the generative functions are liable has escaped
notice. To each it will be found that I have at least indicated
the appropriate treatment.

FIRST PERIOD— CHILDHOOD

THE FUNCTIONS AND DISORDERS IN
CHILDHOOD

PART I
NORMAL SEXUAL CONDITION IN CHILDHOOD

Any preliminary detailed analysis of the anatomy of the reproduc*
tive organs would be foreign to the purposes of the present treatise ;
a few words as to their relative size and appearance at different
periods of life at the outset of our inquiry will suffice. In childhood
the penis is naturally small, with the foreskin pointed, and not only
completely covering the glans, but even extending beyond it. The
attempt to uncover the glans is attended with difficulty in conse-
quence of the existence of a natural phymosis, and similarly the
process of recovering the glans owing to a natural paraphymosis,
cannot be accomplished without resort to a certain degree of violence.

The mucous membrane is soft and flaccid, and (in a healthy con-
stitution) free from the secretion called smegma by which it is covered
in after life.

With sensitive children the withdrawal of the prepuce appears to
promote erection, and to induce a gradual increase in the size of the
penis, and such withdrawal is in all cases so far as possible to be
avoided. In childhood the testes are small and flaccid, often pendent,
and not sensitive to the touch. Such briefly described are the
external appearance and general characteristics of the reproductive
organs during childhood. We may now turn our attention to their
functions. (^Previously to the attainment of puberty the normal condi-
tion of a healthy child is one of entire freedo m from sexual impres-
sions)

All its v ital energ y is employed in constructing the growing frainj ?,
in storing up external impressions, and in educating the brain to

2 NORMAL SEXUAL CONDITION IN CHILDHOOD

receive them. ^During a well-regulated childhood, and in the case of
ordinary temperaments, there is no temptation to infringe this
primary law of nature^ The sexes, it is true, in most English homes,
are allowed unrestricted companionship, and experience shows that
this intimacy is in the main unattended with evil results. In the
immense majority of instances, indeed, it is of great benefit. How-
ever this may be, at a very early age the pastimes of the girl and boy
diverge. The boy takes to more boisterous amusements, and affects
the society of boys older than himself, simply because they make
rougher, or, in his opinion, manlier playfellows. The quieter games of
girls are despised, and their society is to a considerable extent
deserted. This apparent rudeness, often grieved over by anxious
parents, may almost be regarded as a provision of nature against
possible danger.

Education, of course, still further separates children as they grow
into boys and girls ; and the instinctive, and powerful check of natural
modesty is an additional safeguard. ^Thus it happens that with most
healthy and well brought up children no sensual idea or feeling has
ever entered their heads, even in the way of speculation} I believe
that such children's curiosity is seldom excited on these subjects
except as the result of suggestion by persons older than themselves.
At any rate in healthy subjects and especially in "children brought
up in the pure air and amid the simple amusements of the country,
perfect freedom from, and indeed total ignorance of any sexual attrac-
tion is the rule. The first and only feeling exhibited between the
sexes in the young should be that pure fraternal and sisterly affection
which it is the glory and blessing of our simple English home habits to
create and foster with all their softening influences on the after life.

This state of purity and ignorant innocence in children is not in any
way unnatural. It is true that a different rule prevails among many
of the lower animals. For instance, no one can have seen young
lambs gambolling together without noticing at what an early age the
young rams evince the most definite sexual propensities. Precocity in
them is evidently intuitive, as it cannot depend on the force of
example. This contrast between children and young animals may be
explained by the fact that the animal's life is much shorter than
that of man, its growth is more rapid, its office in the world is lower
and more material, its maturity is sooner reached, and sexual propen-
sities are therefore naturally exhibited at a much earlier age. In still
lower forms of life sexual feeling commences yet earlier. In many
Bpecies of moths no sooner is the perfect insect produced than it
proceeds at once to the exercise of the function of procreation, which
completed, its own existence ceases.

Very different should be the case with the human being, who needs

ABNORMAL SEXUAL CONDITION IN CHILDHOOD 3

all the strength and all the nutrition he can command for the gradual
development and consolidation of his more slowly maturing body and
mind. ^The full development of the physical frame should precede
reproduction. This applies to both sexes alike^)

PART II
ABNORMAL SEXUAL CONDITION IN CHILDHOOD

SEXUAL PRECOCITY

It were well if the child's reproductive organs always remained in a
quiescent state till puberty. This is unfortunately not the case.

Amongst the earliest disorders that we notice is sexual precocity.

In many instances, eitner from hereditary predisposition, bad com-
panionship, or other evil influences, sexual feelings become developed
at a very early age, and this abnormal excitement is always attended
with injurious, often with the most deplorable consequences. Slight
signs are sufficient to indicate when a boy otherwise apparently
healthy, and fond of playing with other boys, has this unfortunate
tendency. He shows undoubted preferences. He will single out
some one particular girl, and evidently derive a more than boyish
pleasure from her society. His penchant does not take the ordinary
form of a boy's good nature, but little attentions that are generally
reserved for a later period prove that his feelings are different from
the ordinary standard and sadly premature. His play with the girl is
different from his play with his brothers. His kindness to her is too
ardent. He follows her he knows not why. He fondles her with
tenderness painfully suggestive of a vague dawning of passion. No
one can find fault with him. He does nothing wrong. Parents and
friends are delighted at his gentleness and politeness, and not a little
amused at the traces of early flirtation. If they were wise they would
rather feel profound anxiety ; and he would be an unfaithful or incom-
petent medical adviser who did not, if an opportunity occurred, warn
them that such a boy ought to be carefully watched, and removed
from eveiy influence calculated to foster his abnormal propensities.

The premature development of the sexual inclination is not merely
repugnant to all we associate with the term childhood, but is also
fraught with danger to dawning manhood. On the judicious treat-
ment of a case such as has been sketched, it probably depends whether
the dangerous propensity shall be so kept in check as to preserve the
boy's health and innocence, or whether one more shattered constitution

4 ABNORMAL SEXUAL CONDITION IN CHILDHOOD

and wounded conscience shall be added to the victims of sexual
precocity and careless training. It ought not to be forgotten that in
such cases a quasi-sexual power often accompanies these premature
sexual inclinations. Few, perhaps, except medical men, know how
early in life a mere infant may experience erections. Frequently it
may be noticed that a little child, on being taken out of bed in the
morning, cannot make water at once. It would be as well if it were
recognised by parents and nurses that this often depends upon a more
or less complete erection.

Predisposing Causes. — What the cause of this early sexual predis-
position in a young child may be, it is difficult to lay down with
certainty in any given case. My own belief is, that there are sexual
predisposing causes. I should specify hereditary predisposition as by
no means the least common. It cannot be denied that as children
soon after birth inherit a peculiar conformation of features or frame
from the parent, so they frequently evince, even in the earlier years of
childhood, mental characteristics and peculiarities that nothing but
hereditary predisposition can account for. \I believe that, as in body
and mind, so also in the passions, the predispositions of the father
are frequently inherited by the children. No man or woman
can inordinately indulge their own sexual passions without at least
running the risk of finding a disposition to gratify their sensual
passions at an early age inherited by their offsprings In this
way only can . we explain the existence in generation after gene-
ration of an early and apparently almost irresistible propensity
to similar tastes and feelings. No doubt vicious tendencies are
frequently, perhaps most frequently acquired. But I firmly believe
that moral as well as physical tendencies and irregularities can be
transmitted to the progeny.

Exciting Causes. — There are, however, not a few directly exciting
causes which can, and do frequently, not only foster this early proclivity
to sexual feeling when there is hereditary predisposition, but even of
themselves alone beget it.

| (We see in some children at a very early age an almost ungovernable
disposition to touch or excite the sexual organs. This most dangerous
habit is not unfrequently, I believe, produced by irritation in the
rectum arising from worms. In other instances it arises from excessive
irritability of the bladder. In addition to the manipulation another
symptom often supervenes, viz., the constant wetting of the bed
at nightN

There is, besides, in many young persons, as will be mentioned here-
after (p. 32), a morbid sensibility of the external organs that is exces-
sively troublesome and often painful. This symptom may, I believe,
appear very curly in life, and, if not removed, lead to consequences

SEXUAL PRECOCITY. 5

that will be aggravated by youthful ignorance and want of self-control.
It is to be wished that all medical men attached to large institutions
where young boys are collected would bear this in mind, and when
they have reason to suspect its existence remedy it at once. How-
ever natural the delicacy they feel in investigating such ailments,
yet in this, perhaps above all other evils, prevention is .better than
cure.

Irritation of the glans penis arising from an unusually long
prepuce or the collection of secretion under it is another exciting cause
which should not be neglected. Since my attention was first called to
this subject I have had abundant evidence that the influence of a long
prepuce in producing sexual precocity has not been sufficiently noted.
In the child the prepuce usually, as stated at p. 1, entirely covers the
glans penis, and when, as generally happens in early life, smegma is not
secreted, no ill consequences arise, but in some cases the urine lodges
behind the prepuce and (especially if it becomes acrid) produces irri-
tation which accordingly requires local treatment. A judicious mother
or nurse should on observing any redness, swelling, or peculiar appear-
ance call the attention of the surgeon to the case, as when taken in
time the treatment is very simple and efficacious.
£l do not recommend that the child under normal conditions should
be advised, like the adult, to draw back the prepuce and employ
ablution daily, but in all cases where the smegma is secreted early,
daily ablutions are indispensable. As the boy grows older careful
ablution of the glans and prepuce every morning will be beneficial,
and if it is neglected, annoyance will be experienced, especially
by those who have a long prepuce, from the collection of the
secretion round the glans penis ; but it should be remembered that this
white secretion is natural, and not a symptom of disease?) Quacks have
frequently so wrought upon the fears of ignorant patients, especially
those whose consciences were not clear, as to induce them to think
they were labouring under some peculiar affection, whereas a little soap
and water would have acted as a sufficient remedy.

A long and narrow prepuce is, in my opinion, a much more common
cause of the subsequent contraction of evil habits than parents or
medical men have any idea of. The collection of smegma between the
glans and the prepuce is almost certain to produce irritation.

Preventive Treatment. — The first point to be observed will
already have suggested itself — cleanliness. Yet I have never heard of
any steps being taken by those having the care of youth to induce boys
to adopt precautionary methods. Children are educated to remove
secretions from every other part of their bodies (where they are of less
importance in their consequences than these are here), but probably a
nurse, parent, schoolmaster, or even doctor, would be somewhat

6 ABNORMAL SEXUAL CONDITION IN CHILDHOOD

astonished at its being proposed that a boy of twelve should be told
(for if not told he will never do it) to draw back the prepuce and
thoroughly cleanse the glans penis every day in his bath. In my own
experience of the treatment of children I have found this practice so
beneficial, that I never hesitate to recommend it in any case where
there is the least symptom of local irritation^

VThe only objection which can be suggested to recommending
thorough cleanliness in early childhood is the supposed risk of teaching
the boy to practise manipulations which may tend to excite sexual
desires^)

This vague alarm that we must not allude to these sexual matters
because some ill consequences may arise has no longer any influence on
me. I am fully convinced from the acknowledgments of patients that
the course I suggest will not be accompanied by the risk above
referred to. Even if the dreaded evil should arise, and the carrying
out of advice was followed by any morbid sensations, the boy who had
received such recommendation would go to his adviser and state the
consequences, in the full assurance that he would receive sympathy and
any further advice that might be necessary, fl am convinced of the
fact that when any irritation or derangement exists, if the proper steps
(of which cleanliness is the most effectual) are not taken to check it,
the child will in ignorance handle or rub the organs, and the dangers
arising in this way are much greater than any to be apprehended as
indirectly arising from mere ablution, especially in cold water/)

\The shock .joi cold water falling on the organs in susceptiblepeople is
most beneficiajj In subsequent pages, see p. 53, we shall see that this
treatment will often by itself suffice to cure the irritability that
occasionally is noticed in the reproductive organs, and which produces,
if unremoved, much mental and sexual suffering.

Nothing of course can be more important than carefully to guard
against unnecessary irritation from whatever cause. \Children
should be early cautioned against playing with the external organs.
Without giving any reason, they may be desired to keep their hands
away, which will in most cases be sufficient, if there is no physical
exciting cause. The slightest symptom, however, of the existence of
any such cause should never be neglected. If, for instance, a child
wets his bed, — which is generally almost the first indication the parents
have of the presence of irritation, — the organ should be examined, and
the boy's other habits watched. The irritation of the bladder is only
too likely to determine blood to the part, and the unpleasant symptoms,
moreover, show a nervous susceptible temperament, which always
requires careful watching^

A few practical hints may here be added for the benefit of those
who have not had much experience in the tra&ment of children. If

SEXUAL TRECOCITY 7

the prepuce comes back readily all well and good, but if (especially in
boyhood) it is retracted with difficulty, the introduction of dry lint
between the glans and prepuco will suffice to stretch the latter and the
lint may be gradually increased in thickness. If there is paraphy-
mosis, division of the few threads which cause contraction of the
prepuce, and keeping it drawn back for a few days by covering it with dry-
lint, will usually suffice. I have by using these precautions in many
instances been able to dispense with circumcision, which would have
been otherwise necessary — an operation that I always avoid, if possible,
especially in young children.

It has been, indeed, suggested by some persons that the universal
performance of circumcision would be of no small benefit. This,
however, can be only a speculation. Circumcision is never likely to
be introduced amongst us, and there is no doubt that the above-
mentioned precautions will suffice in most cases to remove all ill effects
arising from the existence of a long and narrow prepuce or from the
retention of the prepuce. 1

If in the young human being the existence of the foreskin may
produce the above evil consequences, later in life we shall see that its
presence or absence may lead to most important consequences,
particularly when speaking of impotence (see that chapter) .

Several confessions that have been made to me induce the suggestion
for the consideration of parents and schoolmasters, whether the practice
of climbing in gymnasia is not open in some degree to objections. The
muscles chiefly called into action in climbing, are those, the excessive
exertion of which tends to excite sexual feelings. Boys have, as I
know, sometimes discovered this, for more than one adult has
told me that, when at school, he had found that he derived pleasure
from the exercise, and had repeated it quite in ignorance of the
consequences.

Those who will refer to p, 30 will not suspect me of undervaluing
athletic exercises, but if this particular one has the effect I have
described, I should certainly advise its discontinuance.

Persons having the care of children cannot too constantly bear in
mind that the tendency of all irritation or excitement of the genera-
tive system, either mental or physical, is to induce even the youngest

1 In a state of nature the foreskin serves as a complete protection to the glans
penis ; nevertheless, to the sensitive, excitable, civilised individual, the prepuce often
becomes a source of serious mischief. In warm climates, the collection of the secretions
between it and the glans is likely to cause irritation and its consequences; and this
danger was probably the origin of circumcision. The existence of the foreskin pre-
disposes to exaggerate the effects of syphilis, and I am fully convinced that- the excessive
ibility induced by a narrow foreskin, and the difficulty of drawing back the
•ice, is often the cause of emissions, masturbation, or undue excitement of the
sexual desires.

8 ABNORMAL SEXUAL CONDITION IN CHILDHOOD

child to stimulate the awakened appetite, and attempt to gratify the
immature sexual desires which would otherwise have remained dormant
for years to come. In a state so artificial as that of our modern civilisa-
tion the children of the upper classes are sadly open to this temptation.
An enervated sickly refinement tells directly on the children that are
at once its offspring and its victims, begetting precocious desires, too
often gratified, and giving rise to the meanest and most debasing of all
vices. The melancholy and repulsive habit of masturbation, so
degrading and debilitating to the child, and so injurious in its effect
on the after life, will be fully discussed in a later chapter (p. 38).

SECOND PERIOD-YOUTH
THE FUNCTIONS AND DISORDERS IN YOUTH

PAET I
NORMAL SEXUAL CONDITION IN YOUTH

Youth (by which we mean that portion of a man's earthly existence
during which he is growing — that is, in which he has not yet attained
his maximum of mental and physical stature and strength) is, as regards
the reproductive functions, to be divided into two periods. The line of
demarcation is the occurrence of that series of phenomena which con-
stitute what we call puberty. During the first of these two periods,
or childhood, strictly so termed, the fitting condition is, as we have
seen in the last chapter, absolute sexual quiescence.

In the second period, or that of youth, which we now purpose to con-
sider quiescence wakes into all the excitement of the most animated
life — a spring season, so to speak, like that so brilliantly sketched by
our great poet :

" In the spring a fuller crimson comes upon the robin's breast,
In the spring the wanton lapwing gets himself another crest,
In the spring a livelier iris changes in the burnished dove,
In the spring a young man's fancy lightly turns to thoughts of love."

Of the real nature of this new condition, of its temptations, of the
incalculable advantages of resisting them, and of the means of doing
so, it is now my purpose to speak, as plainly and concisely as possible.

Dr. Carpenter thus describes the change from childhood to youth :
" The period of youth is distinguished by that advance in the evolu-
tion of the generative apparatus in both sexes, and by that acquire-
ment of its power of functional activity, which constitutes the state of
puberty. At this epoch a considerable change takes place in the
bodily constitution: the sexual organs undergo a much increased

10 NORMAL SEXUAL CONDITION IN YOUTH

development ; various parts of the surface, es]>ecially the chin and the
pubes, become covered with hair ; the larynx enlarges, and the voice
becomes lower in pitch, as well as rougher and more powerful ; and
new feelings and desires are awakened in the mind."

" To the use of the sexual organs for the continuance of his race
Man is prompted by a powerful instinctive desire, which he shares
with the lower animals. This instinct, like the other propensities, is
excited by sensations ; and these may either originate in the sexual
organs themselves or may be excited through the organs of special sense.
Thus in man it is most powerfully aroused by impressions conveyed
through the sight or touch, but in many other animals the auditory and
olfactory organs communicate impressions which have an equal power,
and it is not improbable that in certain morbidly excited states of feeling
the same may be the case with ourselves." — Carpenter's Physiology,
7th edition, p. 825.

With this bodily and mental change or development special functions,
hitherto quiescent, begin their operations. Of these the most impor-
tant in the male is the secretion of the impregnating fluid, the semen.

" From the moment," says Lallemand, " that the evolution of the
generative organs commences (the testicles act), if the texture is not
accidentally destroyed, they will continue to secrete up to a very
advanced age. It is true that the secretion may be diminished by the
absence of all excitement, direct or ^indirect, by the momentary feeble-
ness of the economy, or by the action of special medicines, but it never
entirely ceases from puberty up to old age." (' Les Pertes Seminales,'
p. 240, vol. ii.)

And now begins the trial which every healthy youth has to encounter,
and from which MTniust conie 'out victorious if he is to be all that he
can and ought to be. The_child should know nothing of this trialjjind
ought never to be disturbed with one sexual feeling or thought. But
with puberty a* ver y different state of thiiogs^anses^ A new power
demands to be exercised, a new want to be satisfied, ylt is, I take it, of
vital importance that boys and young men should know, not only the
guilt of an illicit indulgence of their dawning passions, but also the
gan ger of sjra ini n^an immature powe r, and the solemn truth that the
want will be an irresistible tyrant only to those who have lent it strength
by yielding ; that the only true safety lies in keeping even the thoughts
pure. Nothing, I feel convinced, but a frank statement of the truth
will persuade those entering upon pubei^v that these new feelings,
powers, and delights must not be indulged^

^It is very well known to medical men that the healthy secretion of
semen has a direct effect upon the whole physical and mental confor-
mation of the man. A series of phenomena attend the natural action
of the testicles influencing the whole system; helping, in fact, in no

TOXTINENCE 11

small degree, to form the character itself. A function so important,
which, in truth, to a great extent determines, according as it is
dealt with, the happiness or misery of a life, is surely one of the last,
if not the very last, that should be abused (see chapter on Semen)!)

But what, too often, are the facts ? The youth, finding himself in
possession of these sexual feelings and powers, utterly ignorant of their
importance or even of their nature, except from the ribald conversation
of the worst of his companions, and knowing absolutely nothing of the
consequences of giving way to them, fancies — as he, with many com-
punctions, begins a career of depravity — t hat>ir> i s obeying nature's
digtates^ Every fresh indulgence helps_tpiorge the chains of habit ;
and it too often happens in consequence of the morbid depression
to which these errors have reduced him, that he fancies that he is more
or less ruined for this world, that he can never be what he might have
been, and that it is only by a struggle as for life or death that he can
hope for any recovery. In too many instances there is no strength left
for any such struggle, and, hopelessly and helplessly, the victim drifts
into irremediable ruin, tied and bound injjie chai n of a sin with the
commencement of which, ignorance had as much to do as vice.

Not that this natural instinct is to be regarded with a Manichaean
philosophy as in itself bad. Far from it. That it is natural forbids
such a theory. It has its own beneficent purpose ; but that purpose
is not early and sensual indulgence, but mature and lawful love. Let
us hear what Carpenter eloquently says on this point :

" The instinct of reproduction, when once aroused, even though very
obscurely felt, acts in man upon his mental faculties and moral feelings,
and thus becomes the source, though almost unconsciously so to the
individual, of the tendency to form that kind of attachment towards
one of the opposite sex which is known as love. This tendency, except
in men who have degraded themselves to the level of brutes, is not
merely an appetite or emotion, since it is the result of the combined
operations of the reason, the imagination, the moral feelings, and the
physical desire. It is just in this connection of the psychical attach-
ment with the more corporeal instinct that the difference between the
sexual relations of man and those of the lower animals lies. In pro-
portion as the human being makes the temporary gratification of the
mere sexual appetite his chief object, and overlooks the happiness
arising from mental and spiritual communion, which is not only purer
but more permanent, and of which a renewal may be anticipated in
another world, does he degrade himself to a level with the brutes that
perish." — Carpenter's Physiology, 7th edition, p. 826.

Shakespeare makes even Iago say —

" If the balance of our lives had not one scale of reason to poise another of sen-

12 NORMAL SEXUAL CONDITION IN YOUTH

guality, the blood and baseness of our natures would conduct us to most preposterous
conclusions ; but we have reason to cool our raging motions, our carnal stings, our
unbitted lusts."— Othello.

" Nuptial love," says Lord Bacon, " maketh mankind, friendly love
perfecteth it, but wanton love corrupteth and enibaseth it."

Here, then, is our problem. A natural instinct, a great longing,
Las arisen in a boy's heart, together with the advent of the powers
requisite to procure its gratification. Everything — the habits of the
world, the keen appetite of youth for all that is new — the example of
companions — the pride of health and strength — opportunity — all com-
bine to urge him to give the rein to what seems a natural propensity.
Such indulgence is, indeed, not natural, for man is not a_Jiierilanimal,
and the nobler parts of his nature cry out against the vio latio n of their
sane6tyTT^ay~m^re, such induIgence^/atoZ. It may be repented of.
Some of its consequences may be, more or less", recovered from. But,
from Solomon's time to ours, it is true that it leads to a " house of
death."

The boy, however, does not know all this. ^le nas *° l earn that to
his immature frame every sexual indulgence is unmitigated evil. It
does not occur to his inexperienced mind and heart that every illicit
pleasure is a degradation, to be bitterly regretted hereafter — a link
in a chain that does not need many more to be too strong to break>

" Amare et sapere vix Deo conceditur," said the ancients. It is my
object, nevertheless, to point out how the two can be combined — how,
in spite of all temptations, the boy can be at once loving and wise, and
grow into what indeed, I think, is one of the noblest objects in the
world in these our days, — a continent man.

CONTINENCE

f In the following pages the word " continence " will be used in the
( sense of voluntary and entire forbearance from sexual excitement or
indulgences in any form.

The abstinence must be voluntary, 'for continence must not be con-
founded with impotence. An impotent man is continent in a sense,
but his continence, not depending on any effort of the will, is not what
we are now speaking of.

Nor is the continence — which I advise, and would encourage by every
means in my power — mere absence of desire arising from ignorance.
That, as I shall hereafter show, p. 20, 1 consider a dangerous condition.
(True continence is complete control over the passions, exercised by one
who has felt their power, and who, were it not for his steady will, not
only could, but would indulge thenA

CONTINENCE 13

Again, continence must be entire. The fact of the indulgence being ^>
lawful or unlawful does not affect the question of continence. In this
respect our definition differs from those in most dictionaries. 1

This definition, of course, excludes the masturbator from the
^ory of continent men, even though he may never have had con-
nexion with a female. It can be only iu a loose and inaccurate s^nse
that an Onanist can be called continent. He is not really so. vCon-
tinence consists not only in abstaining from sexual congress, but in
controlling all sexual excitement. If a young man gives way to mas-
turbation it is easy enough, as will be presently shown, for him to
abstain from fornication. In fact, the one indulgence is generally
incompatible with the otherj)

O'Ve may confidently assert that no man is entitled to the character
of being continent or chaste who by any unnatural means causes
expulsion of semen. On the other hand, the occasional occurrence of
nocturnal emissions or wet dreams is quite compatible with, and,
indeed, is to be expected as a consequence of continence, whether
temporary or permanent. It is in this way that nature provides
relieO

Professor Newman in his pamphlet on the relation of physiology to
sexual morals has some excellent observations on this subject, which I
generally coincide in, and which I prefer to quote rather than attempt
to epitomise.

"Moralists have at all times regarded strict temperance in food, and
abstinence from strong drinks, to be of cardinal value in the mainte-
nance of young men's purity. But whatever our care to be temperate,
whatever our activity of body, it is not possible always to keep the
exact balance between supply and bodily need. Every_Qrgaii_iaJiable
occasionally to be ove rcharged, and, in every youthful or vigorous
naTu^y-hsiS power to relieve itself. Considering that in man the sexual
appeme~isliot, as in wild animals, something which comes for only a
short season, and then imperatively demands gratification, but on the
contrary is perennial, constant, and yet is not necessarily to be
exercised at all, his nature cannot be harmonious and happy, unless it
can right itself under smaller derangements of balance. But this is
precisely what it does ; and I cannot but think it of extreme import-
ance not to allow a bugbear to be made out of that, which on the face
of the matter is God's provision that the unmarried man shall not be

1 The following are one or two of the definitions of the word " continence " in
standard works :

"Abstinence from, or moderation in, the pleasures of physical love.'' — B. Dun-
c/Uson, M.D.

" The abstaining from unlawful pleasures." — Bailey.

" Forbearance of lawful pleasure."— Ash,

14 NORMAL SEXUAL CONDITION IN YOUTH

harmed by perfect chastity. That it is ever other than natural,
normal, and beneficial, I never heard or dreamed until I was well past
the age of fifty. The Eoman poet Lucretius, in a medico-philoso-
phical discussion, speaks of this matter quite plainly, and treats it as
universal to mankind : iv, 1024 — 1045. He imputes it to strength and
youthful maturity, not to weakness ; and while his description is
tinged with epic extravagance, the thought of its doing any one harm
evidently does not cross his mind, much less that it is an evil effect and
disgraceful stain from previous vice. Now that I learn so many
medical men to be unacquainted with it except as something immo-
derate, and, thereby, depressing and dangerous, — morbid and alarm-
ing ; I have thought it a duty to make inquiries, where I could
properly do so, from persons of whose true purity from early life I am
thoroughly persuaded ; and all that I elicit, direct or indirect, confirms
me in what I have all my life believed. A clergyman reminds me
that the ceremonial regulations in the books of Moses count upon it,
and so does Jeremy Taylor; — dates, countries and races (says he)
distant enough : he adds his belief that it is perfectly healthful, and
tends to be nearly periodical. A traveller to Jerusalem tells me that
he found one of the superior monks * unclean ' for the day on account
of it ; and an inferior monk alluded to it as an ordinary matter. On
gathering up what I know, what I have read, and what I believe on
testimony, I distinctly assert, first, that this occurrence is strictly
1 spontaneous,' — that it comes upon youths who not only have never
practised, but have never heard of such a thing as secret vice : that it
comes on, without having been induced by any voluntary act of the
person, and without any previous mental inflammation : next, that it
occasionally comes upon married men, when circumstances put them
for long together in the position of the unmarried; moreover, even
when they become elderly, it does not wholly forsake them under such
circumstances. My belief is that it is a sign of vigour. At any rate
I assert most positively that it is an utter mistake to "Suppose that it
necessarily weakens or depresses, or entails any disagreeable after-
results whatever. I have never so much as once in my life had reason
to think so. I have even believed that it adjJs JL jtcJbhfi_-spri»g-©f the
WL^, and to the pride of manhood in youths. Of course there is an
amount of starvation (at least I assume there is) which would super-
sede it ; but to overdo the starvation even a little, may be an error on
the wrong side. — Again, there is probably an amount of athletic
practice which will take up all the supplies of full nutriment in the
intensifying of muscle or of vital force,' and leave no sexual superfluity.
But labour so severe is stupefying to the brain and very unfavorable
to high mental action. Plato is not alone in regarding athletes as
unintellectual. Aristotle deprecates their system of ' overfeeding and

CONTINEV I. 15

overworking.' And after all, } r ou will not succeed in exactly keeping
the balance, whether you try by starvation or by toil ; and the over
careful effort will but produce either a valetudinarian, or else a
religious ascetic, who is in terrible alarm lest Nature inflict upon him
a momentary animal pleasure. A state of anxiety and tremor is not
mentally wholesome. We must take things as they come, observing
broad rules of moderation as wisely as we can, but without nervous
alarm about details. The advantages of vegetarian food I have
learned only late in life. I now know that I might have been wiser in
my diet. With better knowledge I should have done far better as to
the quality of food ; but I do not easily believe that a more scrupulous
dread of satisfying my appetite lest it cause some small sexual super-
fluity would have conduced either to mental or to bodily health, at
any time of my life, unmarried or married." — Loc. cit., p. 26.

Voluntary imitation or excitement of this natural relief is, in every
sense of the word, incontinence. I would exclude from the category
of continent men those (and they are more numerous than may be
generally supposed) who actually forbear from sexual intercourse,
but put no restraint upon impure thoughts or the indulgence of
sexual excitement, provided intercourse does not follow. This is
only physical continence : it is incomplete without mental continence
also.

Such men as these, supposing the sexual excitement is followed by
nocturnal emissions, as it often is, and this with great detriment
to the nervous system, must not be ranked with the continents ; to all
intents and purposes they are Onanists. The subject will be further
discussed in the section " On ungratified sexual excitement." v

The advantages of Continence. — If a healthy, well-disposed boy \
has been properly educated, by the time he arrives at the age of four-
teen or sixteen he possesses a frame approaching its full vigour. His
conscience is unburdened, his .intellect clear, his address frank and
candid, his memory good, his spirits are buoyant, his complexion is
bright. Every function of the body is well performed, and no fatigue
is felt after moderate exertion. The youth evinces that elasticity of
body and that happy control of himself and his feelings which are
indicative of the robust health and absence of care which should accom-
pany youth. His whole time is given up to his studies and amuse*
ments, and as he feels his stature increase and his intellect enlarge, he
gladly prepares for his coming struggle with the world.

(If, then, the above are the advantages of continence, let us now
glance at the reverse of the picture hereafter more fully considered,
and notice the symptoms when a boy has been incontinent, especially
in that most vicious of all ways, masturbation. In extreme cases the
outward signs of debasement are only too obvious* The frame is

10 NORMAL SEXUAL CONDITION IN YOUTll

L ^^stunted and weak, the muscles undeveloped, the eye is sunken and
heavy, the complexion is sallow, pasty, or covered with spots of acne,
the hands are damp and cold, and the skin moist. The boy shuns the
society of others, creeps about alone, joins with repugnance in the
amusements of his schoolfellows. He cannot look any one in the face,
and becomes careless in dress and uncleanly in person. His intellect
becomes sluggish and enfeebled, and if his evil habits are per-
sisted in, he may end in becoming a drivelling idiot or a peevish
valetudinarian. Such boys are to be seen in all the^stagesjif-de^ene-
ration, but what we have described is but the result towards which
f/i^aTTare tending^

\The cause of the difference between these cases is very simple. The
■ continent bov has not_expendcd t h at jvital fluid, &emeiv_Qr exhausted
his nervous energy, on the contrary, his vigour has been em ployed for its
legitimate purpose, namely, in building up his growing frame. On
the other hand, the wear and tear of the nervous system arising from
the incessant excitement of sexual thoughts, the constant strain on the
nervous system, and the large expenditure of semen, has exhausted the
vital force of the incontinent, and has reduced the immature frame to
a pitiable wreckj)

Difficulty of Maintaining. — An almost infinite variety of
opinion exists on this subject, between the extreme proposition on the
one hand, that a young man has, or need have no sexual desire, at
least to any troublesome degree, and consequently need neither take
precautions, nor be warned against the danger of exciting his sexual
feelings, and the equally extreme doctrine on the other hand, that the
sufferings of chastity are such as to justify, or at least excuse, inconti-
nence. ("My own opinion is, that where, as in the case with a very
large number, a young man's education has been properly watched, and
1 his mind has not been debased by vile practices, it is usually a com-
' paratively easy task to be continent, and requires no great or extra-
ordinary effort ; and every year of voluntary chastity renders the task
easier by the mere force of habitT)

Yet it can hardly be denied that a very considerable number, even
of the more or less pure, do suffer, at least temporarily, no little
distress.

Lallemand has given a vivid sketch of this sexual uneasiness, which
/ the early recollections of many of my readers may verify. " There is
ajxmstant st ate oL orga sm. and erotic preoccupation, accompanied with
agitation, disquiet, and malaise, an indefinable derangement of all the
functions. This state of distress is seen particularly in young men
who have arrived at puberty, and whose innocence has been preserved
from any unfortunate initiation. Their disposition becomes soured,
impatient, and sad. They fall into a state of melancholy or niisan*

CONTINENCE 17

tliropy, sometimes become disgusted with life, and are disposed to
shed tears without any cause. They seek solitude in order to dream
about the great mystery which absorbs them ; about those great un-
known passions which cause their blood to boil. They are at the
same time restless and apathetic, agitated, and drowsy. Their head
is in a state of fermentation, and nevertheless weighed down by a sort
of habitual headache. A spontaneous emission or escape, which
causes this state of plethora to cease, is a true and salutary crisis which
for the moment re-establishes the equilibrium of the economy.''
(Vol. II, p. 324.)

I have quoted this passage, as containing a brilliant, though, per-
haps, rather exaggerated sketch of a state of mind and body that is
very common, and is the chief difficulty in the way of a youth's
remaining chaste. I am, however, far from endorsing Lallemand's
remark, that this distress affects those particularly " whose innocence
has been preserved from any unfortunate initiations." On the
contrary, it is my experience that these are just the persons who
are, generally speaking, too happy and healthy to be troubled with
these importunate weaknesses. The semi-continent, the men who
indeed see the better course, and approve of it, but follow the worse—
the men who, without any of the recklessness of the hardened sen-
sualist, or any of the strength of the conscientiously pure man, endure
at once the sufferings of self-denial and the remorse of self-indul-
gence — these are the men of whom Lallemand's words are a living
description.

The facts which show the truth of this are innumerable, and apply
to the youth, of whom I am now more particularly speaking, as much
as to the adult, tit is a matter of every-day experience to hear patients
complaining that a state of continence after a certain time produces a
most irritable condition of the nervous system, so that the individual
is unable to settle his mind to anything : — study becomes impossible ;
the student cannot sit still ; sedentary occupations are unbearable, and
sexual ideas intrude perpetually on the patient's thoughts. When I
listen to this complaint, I have little doubt o f ihe c onfession that is to
follow — a confession that at once explains_jthe__s^[mptoms^_» Of course
in such cases 1 am prepared to learn that the self- prescribed remedy
has been most effective, that sexual intercourse has enabled the student
at once to recommence his labours, the poet his verses, and the faded
imagination of the painter to resume its fervour and its brilliancy ;
while the writer who for days has not been able to construct two
phrases that he considered readable, has found himself, after relief of
niinal vessels, in a condition to dictate his best performances.
In individuals constituted as these are, continence is sure to induce this
state of irritability. Still , no such symptoms, however feelingly de-

18 NORMAL SEXUAL CONDITION IN TOUTS

scribed, should ever induce a medical man even to seem to sanction his
patient's continuing the fatal remedy, which is only perpetuating the

?sease^
In all solemn earnestness I protest against a medical man counte-
nancing such a remedy. It is better for a youth to live a continent
life. The strictly continent suffer little or__n one of this irrit ability j^
but the incontinent, as soon as seminal plethora occurs, are sure to be
troubled in one or other of the modes above spoken of ; while the remedy
of indulgence, if effective, requires repetition as often as the incon-
venience returns. If instead of gratifying his inclinations the young
patient should consult a conscientious medical man, he would probably
be told, and the result would soon prove the correctness of the advice
given, that low diet, partial abstinence from meat and stimulants, ape-
rient medicine (if necessary), gymnastic exercise, and self-control, will
most effectually relieve the symptoms^ The patient might further be
advised to adopt the precautions mentioned in the chapter on
Nocturnal Emissions, which will tend to prevent a repetition of the
plethora.

The truth is, that most people, and especially the young, are often
only too glad to find an excuse for indulging their animal propensities,
instead of endeavouring to regulate or control them. I have not a
doubt that this sexual suffering is often much exaggerated, if not
invented, for this purpose. Even where it really exists (and I am free
to confess that in certain individuals continence of the sexual feelings
is very difficult), one of the last remedies the patient would entertain
the idea of, would be, that first recommended by a conscientious
professional man, viz., attention to diet — exercise — and, in fact,
regimen. That there should be more available and willing testimony
in favour of the remedy considered agreeable than of that involving
constraint or inconvenience, is easily explicable on the supposition that

tp witnesses have not had experience of both systems.
If a young man wished to undergo the acutest sexual suffering, he
could adopt no more certain method than to propose to be incontinent,
with the avowed intention of becoming continent again, when he had
" sown his wild oats." The agony of breaking off a habit which so
rapidlyje ntwinea^ itself with every fibre of the human frame is such
that it would not be too much to say to any youtE^commencing a
career of vice — " You are going a road on which you will never turn
back. However much you may wish it, the struggle will be too much
for you. You had better stop now. It is your last chance.^

There is a terrible significance in the Wise Man's words, " None
that go to her return again, neither take they hold on the paths of
life."

How much more severe, occasional incontinence makes the necessary

CONTINENCE 19

struggle to remain continent at all, appears from the sexual distress
which widowers, or those married men to whom access to their wives
is forbidden, suffer.

To show that this is not the result of my experience alone, I may

quote the statement of my friend Dr. , who is constantly attending

for serious diseases of the womb the wives of clergymen, as well as of
dissenting ministers, in whose cases, for months together, marital
intercourse is necessarily forbidden. He tells me that he has often been
surprised at the amount of sexual suffering — the result of their com-
pulsory celibacy — endured by the husbands of some of his patients —
men in every other relation of life most determined and energetic.
Indeed, it is not wonderful that it should be so, if we consider the
position of such men, who for years may have indulged, with modera-
tion, the sex-passion as we have described it, untrained to mortification
in the shape of food or exercise, or marital intercourse, the secretion of
perfect semen going on in obedience to the healthy course of a married
man's existence. Conceive them reined up suddenly, as it were, and
bidden to do battle with their instincts. Religion and morality
prevent them, more than others, from having sexual intercourse with
strange wonien ; intense ignorance on the subject of the sex-passion
in general, as well as misapprehension of the effects of disease of
the generative organs, only aggravate their suffering : conceive all
this, and it is not difficult to believe that affections of the brain may
supervene.

These remarks are in no way intended as any excuse or palliation for
incontinence, but as warnings to the young. These, it must be
remembered, are the complaints of incontinent men, and I mention
them here to show^ow much easier it is even in adult life to abstain
altogether than it is to control the feelings, when they have been once
excited and indulgecp The real remedy for this form of sexual distress
is resolute continence and the use of all the hygienic aids in our power
— not the empiric receipt of present indulgence with the futile intention
of curing the incontinence afterwards.

The admitted fact that continence, even at the very beginning of
manhood, is frequently productive of distress, is often a struggle
hard to be borne, — still harder to be completely victorious in, — is not
to be at all regarded as an argument that it is an evil. A thoughtful
writer has on this subject some admirable remarks : — " Providence has
seen it necessary to make very ample provision for the preservation and
utmost possible extension of all species. The aim seems to diffuse
existence as widely as possible, to fill up every vacant piece of space
with some sentient being, to be a vehicle of enjoyment. Hence this
passion is conferred in great force. But the relation between the
number of beings and the means of supporting them is only on the

20 NOEMAL SEXUAL CONDITION IN YOTJTfi

footing of a general law. There may be occasional discrepancy between
the laws operating for the multiplication of individuals and tbe laws
operating to supply them with the means of subsistence, and evils will
be endured in consequence, even in our own highly favoured species ;
but against all these evils and against those numberless vexations
which have arisen in all ages from the attachment of the sexes, place
the vast amount of happiness which is derived from this source — the
centre of the whole circle of the domestic affections, the sweetening
principle of life, the prompter of all our most generous feelings and
even of our most virtuous resolves and exertions — and every ill that
can be traced to it is but as dust in the balance. And here also we
must be on our guard against judging from what we see in the world
at a particular era. As reason and the higher sentiments of man's
nature increase in force, this passion is put under better regulation, so
as to lessen many of the evils connected with it. The civilised man is
more able to give it due control ; his attachments are less the result of
impulse ; he studies more the weal of his partner and offspring. There
are even some of the resentful feelings connected in early society with
love, such as hatred of successful rivalry, and jealousy, which almost
disappear in an advanced state of civilisation. The evil springing, in
our own species at least, from this passion may, therefore, be an excep-
tion mainly peculiar to a particular term of the world's progress, and
which may be expected to decrease greatly in amount." 1

In addition to the foregoing considerations, I would venture to
suggest one that should not be forgotten. {Granted that continence is
a trial, a sore trial, a bitter trial, if you will — what, I would ask, is the
use or object of a trial but to try, to test, to elicit, strengthen and
brace^whatever of sterling, whatever of valuable, there is in the thing
tried M To yield at once — is this the right way to meet a trial ? To
lay down one's arms at the first threatening of conflict — is this a cre-
ditable escape from trial, to say no more ? Nay, is it safe, when the
trial is imposed by the highest possible authority ?

" The first use," says the late Eev. F. Robertson, " a man makes of
every power or talent given to him is a bad use. The first time a man
ever uses a flail it is to the injury of his own head and of those who
stand around him. The first time a child has a sharp-edged tool in
his hand he cuts his finger. But this is no reason why he should not
be ever taught to use a knife. The first use a man makes of his affec-
tions is to sensualise his spirit. Yet he cannot be ennobled except
through those very affections. The first time a kingdom is put in
possession of liberty the result is anarchy. The first time a man is
put in possession of intellectual knowledge he is conscious of the

1 ' Vestiges of Creation,' tenth edition, p. 310.

CONTINENCE 21

approaches of sceptical feeling. But that is no j>roof that liberty is
bad or that instruction should not be given. It is a law of our
humanity that man must know both good and evil; he must know
good through evil. There never was a principle but what triumphed
through much evil ; do man ever progressed to greatness and goodness
but through great mistakes." 1

The argument in favour of the great mental, moral, and physical
advantage of early continence does not want for high secular authority
and countenance, as the recollection of the least learned reader will
suggest in a moment. Let us be content here with the wise Greek, 2
who, to the question when men should love, answered, " A young man,
not yet ; an old man, not at all ;" and with the still wiser Englishman, 3
who thus writes :— \" You may observe that amongst all the great and
worthy persons (whereof the memory remaineth, either ancient or
recent) there is not one that hath been transported to the mad degree
of love — which shows that great spirits and great business do keep out

this weak passion By how much the more ought men to

beware of this passion, which loseth not only other things, but itself.
As for the other losses, the poet's relation doth well figure them : —
' Tliat he that preferred Helena quitted the gifts of Juno and Pallas :'
for whosoever esteemeth too much of amorous affection, quitteth both
riches and wisdom. . . . They do best who, if they cannot but admit
love, yet make it keep quarter. '^)

Aids to Continence. — Every wise man must feel that no help is to
be despised in any part of the life-battle all have to fight. And in that
struggle for purity, which is, at least for the young, the hardest part of
it, what help to seek, and where and how to seek it, are no unimportant
questions, and in a practical treatise well deserve a few words.

Religion. -\F2ly above all other assistance must, of course, be placed
the influence of religionA-not the superstition of which the bitter poet

speaks :

" Humana . . . cum vita jaceret
In terris oppressa gravi sub religione,"

but that whose chief est beatitude is promised to the " pure in heart."

Of the direct personal influence of religion upon the individual in
this respect, it is not my purpose to speak here — the very nature of
that influence is, in these days, the ground of too much and too fervid
controversy. It is not, however, without interest to observe the diffe-
rent way in which the two great western divisions of the Christian
Church treat the subject of continence.

Among modern Protestants, I cannot help feeling that there is, both
in the spoken and written teaching of their authorised ministers, a

1 Robertson's ' Discourses/ pages 87, 88.

3 Thales, 3 Lord Bacon,

22 NOEMAL SEXUAL CONDITION IN YOUTH

certain timorousness in dealing with the matter, which, however natural,
almost gives the idea of a lack of sympathy with the arduous nature of
the effort requisite to obey the commands that so urgently demand
perfect purity from the consistent Christian.

It is much the same among the fathers of our Church. In those
writings which are, from their antiquity — the wide assent they have
commanded — the character and station of their authors — or from other
causes, usually regarded as of authority among us, there is often a defi-
ciency in frank and kindly discussion of the subject.

It was far from my intention, when I commenced this work, to put
myself forward as a religious adviser, but I so frequently receive painful
letters from young men, seeking advice how to curb the lusts of the
flesh, that I was induced to inquire as to the views entertained upon
the subject by the modern executive of the Church of England. I
found, on application to competent persons, that it is not deemed expe-
dient to be very diffuse upon the observance of the seventh command-
ment. I was referred, indeed, by one worthy divine to the head of
"Fasts and Vigils" in our Offices; but, after careful perusal, I was
unable to discover much that could be of assistance to the earnest lay-
man desirous of arming himself against the promptings of nature and
imagination.

The contrast, we may remark, between the common sense and wisdom
of the more ancient writers and some modern ecclesiastical views on
these subjects is rather painful. All the help that one excellent
clergyman can give to tempted brethren is this : (" Another man is
tormented by evil thoughts at night. Let him be directed to cross
his arms upon his breast, and extend himself as if he were lying in his
coffin. Let him endeavour to think of himself as he will be one day
stretched in death. If such solemn thoughts do not drive away evil
imaginings, let him rise from his bed and lie on the floor.'

As will be seen by reference to pp. 26 to 30,^there is just so much
truth in this advice as to cause a regret that the adviser had not the
courage or the knowledge sufficient to go farther, and make it practical
and useful^

I believe that in the writings of the more eminent divines among
the various bodies of Dissenters in England, and the Protestant com-
munities throughout Europe, there are to be found very few discus-
sions of the subject of sexual temptations which can be appealed to as
real aids to continence. Reference to the list of authorities I have con-
sulted will show that some have, however, mentioned the subject.

The Church of Rome, with that practical wisdom which so often
characterises her, and which no Protestant prejudices should lead us
to deny, has, in many of her arrangements, and in much of her
authorised teaching, fully and sympathisingly recognised the great

CONTINENCE 23

facts of the existence and intensity of sexual misery and temptation,
and of the absolute necessity of perfect purity, for those who would
reap the blessings of continence. 1

1 "1. Of this commandment we can say but little. St Francis de Sales says that
chastity b snlliedja^h ^ J)are ment jonjof _ it. Hence let each person, in his doubts
on this subject, take advice from his confessor, and regulate his conduct according to
the direction which he receives. I will only observe here in general that it is neces-
sary to confess, not only all acts, but also miproper touche s, all unchaste lookg. all
jahac^nejvords, and whether they are spoken with oomplacency and danger of scandal
to others. It is, moreover, necessary to confess oUJmjjiP rlgcf +i»migV»f<s, Some unin-
structed persons imagine that they are bound only to confess impure actions ; they
must also confess all the bad thoughts to which they have consented. Humanjaws
forbid only external acts, because men see only what is manifested external l y ; hnfc.
Go<V who_sees the h e art, condemns every evil though t t ' Man sees those things that
appear; but the Lord beholdeth the heart.' (1 Kings xvi, 7.) This holds for every
species of bad thoughts to which the will consents. In a word, before God it is a
sin to desire whatever is criminal in act.

"2. I have said thoughts to which the toill consents. Hence, it is necessary to
know how to determine when a bad thought is a mortal sin, when it is venial, and
when it is not sinful at all. In every sin of thought there are there things ; the

^suggestion, the delectation, and the consent. Th e^ugf/estion is the first thought of
doing an evil action which is presented to the mind. This is no sin ; on the contrary,
when the will rejects it, we merit a reward. ■ As often,' says St Antoine, ' as you
resist, so often are you crowned.' Even the, sainis^haxg , peen tormented by bad
thoughts. To conquer a temptation against chastity, f jt Benedict threw himself

Imio ugs TTliorns , St Peter of Alcantara cast himself into a frozen poo l. Even St
Paul writes that he was tempted against purity. ' There was given me a sting of
my flesh, an angel of Satan to buffet me ' (2 Cor. xii, 7.) He several times implored
the Lord to deliver him from the temptation. ' For which thing thrice I besought
the Lord that it might depart from me.' The Lord refused to free him from the
temptation, but said to him : ' My grace is sufficient for thee.' And why did God
refuse to remove the temptation ? That, by resisting it, the saint might gain greater
merit. * For power is made perfect in infirmity.' ....

" 3. After the suggestion comes the delectation. When a person is not careful to
banish the temptation immediatel y, but stops to reason . wJLtki k the thought instantly

"pegtu^ tu delight, U'nd thus^o ntinues to gain th e consent of the will. As long as the

*vill withholds the consent, the sin i3"6hly venial, and not mortal. But, if the
soul does not turn to God, and make an effort to resist the delectation, the consent
will be easily obtained. ' Unless,* says St Anselm, ' a ppr a ft n rp p p l tp p d electation^it

jaasses into consent, and kills the soul.' ....

"4. The soul loses the grace of God^andJs condemned to hell, the instant a person _
consents to the desire of committing sin, or delights in thinking of the im,rpoflest_ i
action, as if he were then CQJPjttffiUlg it. This is called morose delectation, w hich is

different from the sin of desire He who contracts the habit of

consenting to bad thoughts, exposes himself to great danger of dying in sin— -first
because it is very easy to commit sins of thought. Jn a quarter of an hour a
person may entertain a thousand bad_thoughts ; and every thought to which he
consents deserves a hell for itself.
*"' "5.~My brother, do not say, as many do, that the sins against chastity are light
sins, and that God has compassion on such sins. What ! Do you say that it is a

24 NORMAL SEXUAL CONDITION IN YOUTH

Training of the will. — And now, leaving the religious aids to con-
tinence to those authorised to speak on the subject from that point of

light sin ? But it is a mortal sin : evenasi n of thought against chastity is a mort al
sin, and is sufficient to send ynn tnT\ell. T No fornicator . . . hath inheritance
in the kingdom of Jesus Christ and of God ' (Eph. v, 5). Is it a light sin ? Even
the pagans held impurity to he the worst of vices, on account of the bad effects
which it produces. Seneca says : ' Impurity is the foremost of the world's wicked-
ness f and Cicero writes : ' There is no more heinous pest than the indulgence of
uncleanness.' — St Isidore has written: 'Whatsoever sin you name, you shall find
nothing equal to this crime.'

" 12. For those who are unable to abstain from impurity, or who are in great
danger of falling into it, God has, as St Paul says, instituted matrimony as_a remedy.
'But if they do not contain themselves, let them marry; for ib is better to marry,
than to be burnt ' (1 Cor. vii, 9). But, some may say, father, marriage is a great
lurden. Who denies it ? But have you heard the words of the apostle ? It is
better to marry, and to bear this great burden, than to burn for ever in hell. But
do not imagine that, for those who are unwilling or unable to marry, there is no
other means but marriage by which they may preserve chastity. By the grace of
God, and by recommending themselves to Him, they can conquer all the temptations
of hell. What are the remedies ? Behold them.

"13. The first remedy is to humb le ourse lves constantly before God. The Lord
chastises the pride of some by permitting them to fall into a sin against chastity. It
is necessary, then, to be humble, and to distrust altogether our own strength. David
confessed that he had fallen into sin in consequence of not having been humble, and
of having, perhaps, trusted too much in himself. ' Before I was humbled I offended '
(Ps. cxviii, 67). We must,"then, be always afraid of ourselves, and must trust in
God that he will preserve us from sin.

"14. The second remedy is instantly J;q_ have recourse to God for help, without
stopping to reason with the temptation. When an impure image is presented to the
mind, we must immediately endeavour to turn our thoughts to God or to something
which is indifferent.

" 15. The third remedy is j;o fre/m^nt th e jjncramonts of p enance and eucharist.
It is very useful to disclose unchaste temptations to your confessor. St Philip NerT
says that a temptation disclosed is half conquered. And should a person have the
misfortune to fall into a sin against purity, let him go to confession immediately.

lij) Neri
lfrivinq
strength to conquer temptations against chastity. The Most Holy Sacrament is
called ' wine springing forth virgins ' (Zach. ix, 17). The wine is converted into the
blood of Jesus Christ by the words of consecration. Earthly wine is injurious to
f ha^it.y j hut the celestial wine p reserves it. . . .

"17. The fifth remedy, whlcli is tlie most necessary for avoiding sins against
chastity, is to ilv from dangerous occasions. Generally speaking, the first of all the
means of preserving yourself always chaste, is to avoid the occasions of sin. The
means are, to frequent the sacraments, to have recourse to God in temptation, to be
devoted to the Blessed Virgin; but the first of all is to avoid the occasion of sin.
1 And your strength,' says Isaias, ' shall be as the ashes of tow .... and there
shall be none to quench it' (Isa. i, 31). Our strength is like the strength of tow
thrown into the fire — it is instantly burned and consumed. Would it not be a
miracle if tow past intp the fire did not burn? It would also be a miracle if wn

By ordering him, whenever he fell into sin, to confess it immediately, St Phili^Xeri
freed a young man from this sin. The holy communion has great efficacy

against chastity. The Most Holy Saci

CONTINENCE 25

view, let us consider whether there is not much practical counsel to be
given to the boy or youth who, having been made aware (as I suggest
he should be), p. 44, of the ruinous effects of early impurity — is desirous
of living a life of continence.

His object is — our object for him ought to be — to preserve a pure
and healthy mind in a pure and healthy body. Judiciously directed
training and exercise of both towards this definite object would, I am
sure, in most cases reduce the difficulty of living a chaste life to the
minimum, and, indeed, render the conflict rather a proud and thankful
sense of self-command than an arduous struggle.

The first requisite is, that power of the mind over outer circumstances
which we call "a strong will." Without this resolute grasp of the
intellect and moral nature, to direct, control, and thoroughly master
all the animal instincts, a man's life is but an aimless, rudderless
drifting, at the mercy of every gust of passion or breeze of inclination
towards tolerably certain shipwreck.

exposed ourselves to the occasion, and did not fall. According to St Bernardine, of
Sienna, it is a greater miracle not to fall in the occasion of sin than to raise a dead
man to life. 'It is a greater miracle not to fall when one is in the occasion of sin
than to resuscitate the dead.' St Philip Neri used to say in the warfare of the flesh,
cowards — that is, they who fly from occasions — are always victorious. You say,
I hope that God will assist me. But God says : ' He that loveth danger shall perish
in it ' (Eccl. iii, 27). God does not assist those who, without necessity, expose
themselves voluntarily to the occasion of sin. It is necessary to know that he
who pu ts himself in the p roxi mate occasion of sin is in the state of sin, though lie

j sLould have no intention of committing the principal sin to which he exposes
himself. . . .

" 22. But let us return to the necessity of avoiding the occasions of sin. It is
necessary als o to abstain from looking at immodest pictures. St Charles Borromeo
forbids all fathers of families to keep such pictures in their houses. It is necessary
nko in abstain frprq rpnriino r bad books^ and not only from those that are positively
obscene, but also from those that treat of profane love, such as certain poems,
Ariosto, Pastor Fido, and all such works. fathers ! be careful not to allow your
children to read romances. These sometimes do more harm than even obscene books :
they infuse into young persons certain malignant affections, which destroy devotion,
and afterwards impel them to give themselves up to sin. 'Yam reading.* savs St

_Bonaventure, ' begets vain thoughts, and extinguishes devotion/ Make your children
read spiritual books, ecclesiastical histories, and the lives of the saints. And here I
repeat : do. not allow your daughters to be taught letters by a man, though he be a
.St Paul, or a St Francis o f Assisinm. „ Thp saints nre in heaven." — • Instructions on
the Commandments and Sacraments,' translated from the Italian of Saint Alphonsus
M. Liguori, Bishop of Agatha, by a Catholic Clergyman, pp. 154 — 173.

Divest this advice of the peculiar colouring derived from the Church of the writer,
and, for the priestly confessor, substitute reverently the ear of our loving Father who
is in heaven, and of Him who took our human nature upon Him in its completeness,
that we might have no doubt as to His capability of sympathising with us iu all our
troubles and infirmities — Protestantize its phraseology in short — and it would he
difficult to find any more worthy of adoption, — W. 4»

26 NORMAL SEXUAL CONDITION IN YOUTH

It is a solemn truth that the sovereignty of the will, or, in other
words, the command of the man over himself and his outward circum-
stances, is a matter of habit. Every victory strengthens the victor.
With one, long years of courageous self-rule have made it apparently
impossible for him ever to yield. The whole force of his character,
braced and multiplied by the exercise of a lifetime, drives him with
unwavering energy along his chosen course of purity. The very word
we have used — continence — admirably expresses the firm and watchful
hold with which his trained and disciplined will grasps and guides all
the circumstances and influences of his lifeA

Contrast with this man the feeble-willed ; for him the first little
concession, the first lost battle between the will and a temptation, is
but the commencement of a long series of failures. Every succeeding
conflict is harder because the last has been lost. Every defeat lessens
the last trembling remnants of self-reliance. And at last, with the
bitterest pain of all — self-contempt — gnawing at his heart, with no
strength to say, " I will not " — under the tyrannous dominion of foul
passions, which all the good that is left in him abhors, the man slinks
and stumbles towards his grave.

But, more than this, the steady discipline of the will has a direct
physical effect on the body. The young man who can command even
his thoughts, will have an easier task in keeping himself continent
than he who cannot. He who, when physical temptations assail him,
can determinately apply his mind to other subjects, and employ the
whole force of his will in turning away, as it were, from the danger,
has a power over the body itself which will make his victory tenfold
easier than his who, unable to check bodily excitement, though deter-
mined not to yield, must endure in the conflict great sexual misery.

Dr Carter, in his 'Treatise on Hysteria,' makes some striking
remarks on the effect of continual direction of the mind in producing
emotional congestion of organs, which illustrate this view of the sub-
ject. He says (p. 13) : " The glands liable to emotional congestion are
those which, by forming their products in larger quantity, subserve to
the gratification of the excited feeling. Thus, blood is directed to the
mammae by the maternal emotions, to the testes by the sexual, and to
the salivary glands by the influence of appetizing odours ; while in
either case the sudden demand may produce an exsanguine condition
of other organs, and may check some function which was being
actively performed, as, for instauce, the digestive."

In accordance with the same law, a steady avoidance of all impure
thoughts — a turning away, so to speak, of the will from sexual
subjects — will spare the young man much of the distress and tempta-
tion arising from the abnormal excitement of the reproductive system
induced by the mind's dwelling much on such topics.

CONTINENCE 27

iFlie essence of all this training of the will, however, lies in begin-
ning early. If a boy is once fnlly impressed that all such indulgences
are dirty and mean, and, with the whole force of his unimpaired
energy , determines he will not disgrace himself by yielding, a very
bright and happy future is before hinf^

yA striking example of what resolution can do was related to me
lately by a distinguished patient. " You may be somewhat surprised,
Mr Acton," said he, " by the statement I am about to make to you,
that before my marriage I lived a perfectly continent life. During
my university career my passions were veiy strong, sometimes almost
uncontrollable, but I have the satisfaction of thinking that I mastered
them ; it was, however, by great efforts. I obliged myself to take
violent physical exertion ; I was the best oar of my year, and when I
felt particularly strong sexual desire, I sallied out to take more
exercise. I was victorious always ; and I never committed fornica-
tion ; you see in what robust health I am, it was exercise that alone
saved me." I may mention that this gentleman took a most excellent
degree, and has reached the highest point of his profession. Here
then is an instance of what energy of character, indomitable persever-
ance, and unimpaired health will effecy

The advice given by Carpenter in the fifth edition of his work,
p. 779, is as follows : — " The author would say to those of his younger
readers who urge the wants of nature as an excuse for the illicit grati-
fication of the sexual passion, ' Try the effects of close mental applica-
tion to some of those ennobling pursuits to which your profession
introduces you, in combination with vigorous bodily exercise, before
you assert that the appetite is unrestrainable, and act upon that asser-
tion.' Nothing tends so much to increase the desire as the continual
direction of the mind towards the objects of its gratification, espe-
cially under the favouring influence of sedentary habits ; whilst
nothing so effectually represses it as the determinate exercise of the
mental faculties upon other objects and the expenditure of nervous
energy in other channels."

With reference to the vital importance of a strong, well-trained will,
we may also quote the valuable testimony of Dr Eeid : —

" Let us, as psychological physicians, impress upon the minds of
those predisposed to attacks of mental aberration, and other forms of
nervous disease, the important truth that they have it in their power
to crush, by determined, persevering, and continuous acts of volition,
the floating atoms, the minute embryos, the early scintillations of
insanity. Many of the diseases of the mind, in their premonitory
stage, admit, under certain favorable conditions, of an easy cure, if the
mind has in early life been accustomed to habits of self-control, and
the patient is happily gifted with strong volitionary power, and brings

28 NORMAL SEXUAL CONDITION IN YOUTH

it to bear upon the scarcely formed filaments of mental disease. We
should have fewer disorders of the mind if we could acquire more
power of volition, and endeavour by our energy to disperse the clouds
which occasionally arise within our own horizon — if we resolutely tore
the first threads of the net which gloom and ill-humour may cast
around us, and made an effort to drive away the melancholy images of
the imagination by incessant occupation."

It should not be forgotten that this training of the will is not with-
out its immediate and sensible rewards. Without it, or at least with-
out some measure of it, those faculties of the mind on the regular
exercise of which our success in any pursuit, and in fact our general
intellectual advancement, depend, cannot be rightly cultivated. How
absolutely essential it is for the attainment of real happiness, which
depends so largely upon self -approbation, has been already noticed.

Exercise and Diet. — It is not, however, sufficient to train and
strengthen the mind and will ; the body must be subjected to a regular
and determined discipline, before the proper command can be obtained
over its rebellious instincts. And this discipline, when properly car-
ried out, will not consist in any violation of the natural rules of health,
but in a strict conformity to the hygienic regulations which science has
proved must be obeyed before real health and vigour can be ensured.

For instance, religious and mental discipline may be vastly assisted
by partial or total abstinence from fermented drinks and exciting
animal food. (J^xperience teaches us that by merely judiciously stint-
ing the food of man in quantity and quality, while, at the same time,
the brain is kept in exercise a*id the body fatigued, the animal instincts
may be well-nigh subjugated^ I cannot, therefore, but believe, that a
well-directed combination of spiritual, mental, and physical training
would secure, as nearly as man may hope for, a perfect result. I lay
stress upon the words "judiciously" and "well-directed," because it is
necessary I should guard myself against being supposed to counsel a
rash or unscientific self -treatment. Much of the danger which has
always attended attempts at ill- directed self -maceration, 1 by fasting
and purgatives, undertaken sometimes with a view of correcting corpu-
lency and sometimes for mortification's sake, by religious enthusiasts,
will as surely wait upon unscientific training to continence. During

1 1 am inclined to believe that many of the penances which ascetics in former times
get themselves — such as starvation, scourging, and exposure — were the most potent
means then known of restraining the animal passions, and teaching the sufferers from
them to control their feelings j with the same object we may believe that many a
hermit shut himself out of the world in order to escape the effect of female society.
In the present day I am acquainted with individuals who in former times would have
become some misdirected enthusiasts; — for human nature is little changed, although
the fashion of self-chastisement has gone out. There are self-made martyrs in this
nineteenth century, as there were in the sixteenth,

CONTINENCE 29

the initiatory period, at all events, some medical superintendence is
desirable to decide when the process should be commenced and how it
should be graduated, what amount of pressure may be put upon each
constitution, when to increase and when to relax it, what should be the
nature and extent of exercise, and the quantity and quality of nutri-
ment required to keep the system in true form and balance.

I am convinced, all other considerations apart, that were there one
or two days weekly set aside by all of us for extreme moderation in
diet, public health and morals would be much benefited. The writer
who would rationally consider and popularise such discipline, would
be entitled to our thanks as a public benefactor. At present, all
healthy persons in anything like easy circumstances eat and drink too
much. £Our over-eating is often attended visibly by the pendulous
abdomen and lethargic frame, and less obviously by depreciated mental
energy, and what I may term an artificial desire for and imaginary
increase of sexual powefj The dining, drinking, and sexual indulgence
which are practised with unvarying regularity by too many of our
young men among the middle classes who take little or no exercise, are
acting as surely, though perhaps slowly, against the mens sana in
corpore sano of the generation, as the opposite system I recommend of
bodily labour and organised abstemiousness 1 would tend to its main-
tenance. So we come after all to the good old adage on the way to
live well — " On a shilling a day, and earn it."

Healthy and Intellectual Employment and Amusement. — The passive
means, namely, abstinence from exciting causes, are not, however, the
only ones that must be employed in order to maintain that condition
of self -restraining health which we desire to see in young men ; —
active hygiene is most essential. Exercise, gymnastics, regular
employment, and all agencies that direct the energies of the growing

1 The influence of food in modifying the process of development is seen in a very
marked form in the hive-bee. If we can put confidence in the observations of
apiarians we must believe that the neuters which constitute the majority of every
bee-community, are really females with the sexual organs undeveloped, the capacity
for generation being restricted to the queen. If the queen should be destroyed, or
removed, the bees choose two or three among the neuter eggs that have been
deposited in their appropriate cells, and change those cells (by breaking down others
around them) into royal cells, differing considerably from the rest in form, and of
much larger dimensions ; and the larvae when they come forth are supplied with
" royal jelly," a pungent, stimulating aliment of a very different nature from the
"bee-bread" which is stored up for the nourishment of the neuters. After going
through its transformation, the grub thus treated comes forth a perfect queen,
differing from the " neuter " into which it would otherwise have changed, not only in
the development of the generative apparatus, but also in the form of the body, in the
proportionate length of the wings, in the shape of the tongue, jaws, and sting ; in the
absence of the hollow on the thighs, in which pollen is carried, and in the absence of
the power of secreting wax.

30 NORMAL SEXUAL CONDITION IN YOUTH

frame to its increase and consolidation, and away from the indul-
gence of the reproductive organs, should be regularly used. I am con-
vinced that much of the incontinence of the present day could be
avoided by finding amusement, instruction, and recreation, for the
young men of large towns. Every association or institution which
encourages young men who desire to live virtuously to consort with
one another on the principles of purity and self-denial seems to be
worthy of all support and encouragement. Such bodies of young men
are of the greatest use even to those who do not belong to them. They
insensibly modify the tone of young men's society. They all help to
render vice, at least open vice, unfashionable. This I believe has been
one of the many good results arising from the praiseworthy efforts
which have now for some years been made by the various Young Men's
Christian Associations, to raise the tone of thought and feeling among
the middle-class youth of England. Most perceptibly beneficial
results, too, have been produced by the institution of reading-rooms,
instruction classes, gymnasiums and places for healthy recreation,
where young men may pass their leisure hours in a cheerful, agreeable
way, and be not only to a great extent withdrawn from temptation, but
directly brought under those influences which above all others lessen
the force of that temptation. Every measure that provides healthy and
rational occupation for young people — such, for instance, as the Govern-
ment classes for improvement in art, and the throwing open the
Kensington Museum for evening instruction — is a step in the right
direction, and must tend to realise the one great object of improving
the morals of the people.

Much has been written during the last few years on the national
advantages of the Volunteer movement. Not the least, in my opinion,
of these advantages is the direct influence it has had in promoting con-
tinence among our young men, not only by the excellent effect which
drilling has had on their physique and health, but by the vigorous and
interesting occupation it has afforded them for mind and body. It
affords a notable instance of the effect which a well-directed movement,
judiciously carried out, can have on the rising generation. Much of
the dissipation and libertinage of our youth in past years has depended
upon their having had literally nothing to do when their day's work
was over. A pursuit which draws a man away from low society, and
encourages him to spend his leisure in healthy and ennobling recrea-
tions among his equals, is most profitable to himself and his country.
If the Volunteer movement had done nothing more than this, the
parents of England would have had ample cause for supporting it. 1

1 The physical advantages of the Volunteer movement have, of course, struck others
besides myself. In a leading article in the ' Telegraph ' for November, 1861, I read
the following observations, which are evidently based on sound reason: — "The

CONTINENCE 31

\Seeing as mucli as I do of the private life of young men in England, I
can safely say that a healthier tone has sprung up among them of late,
dependent, I believe, in great measure, on the love for athletic sports.
In the course of years, I trust, it will be found to have exerted a most
beneficial influence on the morals of the count ry?)

I have now, I think, discussed the chief aids to continence. They
will, I am finnly convinced, if honestly used, in most cases enable a
young man to conquer in the noble endeavour to obtain and keep the
masteiy over his passions during the most trying periods of his life.
Nevertheless, I should belie my experience as a medical man if I were
to represent this struggle as an easy one. It needs the whole energy
of any man to succeed completely. No legitimate inducement, there-
fore, to the effort should be withheld. The greatest of all such induce-
ments undoubtedly is the prospect of early marriage ; and this I would
urgently press on the young, that the continent man is generally the
energetic man, and that to the energetic man his trial is likely to be
but temporary. He may fairly look forward to the time when he may
think of marriage as the happy end to very much of the temptation
which in early life requires so much anxious watchfulness, and even
painful effort to subdue.

Surgical aids. — In the early editions of this book I treated only of
the religious, educational, and hygienic plans for enabling a young
man to continue or return to a continent mode of life which were most
efficacious, leaving the medical treatment to a subsequent part of the
book. Now, however, I propose before going further to show what
surgical means there are of assisting the youth in his struggles against
the temptations of the flesh.

Experience has taught me that the several remedies already con-
sidered, however beneficial in the slighter cases and in those instances
where the sufferers have strong wills, are by themselves perfectly
futile in a large proportion of the cases of young men who have little
or no determination and perseverance. It is to this class of young
men that the medical practitioner can render most important service,
more especially when gymnastic remedies alone have been relied on
and failed. The examination of a very large number of youths teaches
me that sufferers through continence labour under a peculiar sensi-

physical advantages of the rifle-training are also great. fX man of loose life or care*
less habits cannot become a good shot ; dissipation over-night does not give either
the cool brain or the steady hand absolutely required^ In fact, the ■ training ' and
1 keeping in good condition ' required for success in our public matches are, though
less harsh, as absolutely needful as those required from oarsmen in the Oxford or
Cambridge crews. With such a new national game, loved by young Englishmen, we
need not despair of keeping up fully to the old mark the physical and moral manli-
ness of our race."

32 NOKMAL SEXUAL CONDITION IN YOUTH

bility of the reproductive organs. No one who has not closely investi-
gated this subject can have any idea of the morbid sensibility which
we meet with, both externally and internally. If, therefore, we would
assist the youth in maintaining continence, we must first of all palliate
or remove this nervous hysterical-like sensibility which almost invari-
ably attends such cases.

There are patients who can hardly allow the air to blow upon, or
the clothes to touch their sexual organs. Such sensitive persons are
afraid of using cold water, they dread the most cursory examination,
and declare it would make them faint. The proposal to pass an
instrument almost produces a state of catalepsy. In all these cases it
is not pain, but the dread of being hurt, apparently, which produces
the suffering. Once an examination is submitted to and the confi-
dence of the patient gained, the cure progresses most rapidly. In
many instances this morbid irritability is confined to the skin, others
only complain when the urethra is touched, or when an instrument
passes over some particular portion of the canal, yet a second introduc-
tion of the instrument produces no inconvenience. When a surgeon
has to treat such abnormally nervous patients as these, he will not be
surprised that previous hygienic precautions or the inculcation of
moral restraints have not succeeded in preventing emissions. As soon
as local remedies have dulled the morbid sensibility of the sexual
organs, the greatest advantage is at once derived from the moral and
hygienic remedies.

In commencing the treatment of such cases the surgeon must evince
some firmness of purpose, or the patient will not submit. The medical
man in his first interview must be satisfied with moderate progress.
In a day or two the patient will often ask him to proceed faster than
he is disposed to do, so satisfied has the sufferer become of the benefit
derived from the remedy. Simple local treatment will often suffice to
cure the patient, but in more serious cases it may be necessary to
employ instruments and use injections. These, however, will be more
particularly alluded to in the chapter on Spermatorrhoea, to which I
must refer my readers.

I shall have occasion to mention in the chapter on Marriage that its
consideration as the legitimate hope of the young man who desires to
remain continent suggests several questions, on each of which there is
some difference of opinion, and neither of which should be omitted
from consideration here. I refer to celibacy, early marriages, and

EARLY ENGAGEMENTS.

PART II
ABNORMAL CONDITION IN YOUTH

CHAP. I.— INCONTINENCE

In the previous chapter I spoke of the advantages of continence in
youth. My remarks would not be complete were I to omit to say a
few words on the evils of incontinence. I feel this to be all the more
needful, as I am well aware that young men often wish to persuade
themselves that incontinence is medically beneficial, or even necessary.

Notwithstanding the evils which, in the previous chapter, I acknow-
ledge sometimes attend a state of continence (see p. 16), it is
impossible for me to recommend illicit sexual intercourse. Setting
aside moral considerations, I feel fully convinced that no physiological
or other reasons can justify a medical man in suggesting or palliating
any promiscuous or systematic commerce with women.

The occasional indulgence of the sexual feelings is not, in the first
place, medically desirable, as it stimulates, without satisfying, the
appetite, and each casual intercourse, again, is attended with this
danger : — that it may but initiate a more permanent liaison, often
fraught with painful consequences. If it once assume regularity, a
man may form ties most difficult to break. The class of women who
will accept a youth's attentions on these terms without marriage is
beneath him in station and education. He finds himself presently in
a false position. If the female is true to him alone, there is often
great inducement to make her what in common parlance is called " an
honest woman." Should a marriage ensue, the ill-fated youth — con-
signed to social ostracism — finds that he has learnt too late a bitter
lesson for the rest of his life.

When, on the contrary, the sensual young man is fortunate or
shrewd enough to avoid the " permanent liaison," and wise, no doubt,
in his own conceit, indulges his passions by promiscuous illicit inter-
course, the day is not far off when he will contract disease — particu-
larly in England, where the complaints of prostitutes are too little
cared for. 1

1 Those who wish to pursue this suhject further, should refer to the second edition
of the author's work ' On Prostitution,' page 249, et seq., in which the dangers
attending promiscuous intercourse are fully treated of.

34 ABNOEMAL CONDITION IN YOUTH

The late Father Mathew knew human nature well when he en-
joined, not moderate indulgence, but total abstinence from spirituous
liquors. So it is with the sexual passion. It is easier to abstain alto-
gether than to be occasionally incontinent and then continent for a
period ; and the youth is a dreamer, who will open the floodgates of an
ocean, and then attempt to prescribe at will a limit to the inundation.

The medical, or so-called scientific adviser, who should recommend
the commencement of a habit so dangerous, incurs the gravest respon-
sibility. It should be rather the medical man's object to impress
upon his patient's inexperienced mind the simple truth, that instead
of being a mere sexual indulgence, the consorting with prostitutes is
one of the very worst sins, both in nature and result, which man can
commit. His tone should rather be that adopted in the following
extract from a celebrated article in the ' Quarterly Eeview :'

" Our morality will be considered by the divines as strangely lax and inconsistent,
and by the men of the world, the ordinary thinker, and the mass who follow current
ideas without thinking at all, as savage and absurd; nevertheless we conceive it to
harmonise with the ethics of nature and the dictates of unsophisticated sense. We
look upon fornication, then (by which we always mean promiscuous intercourse with
women who prostitute themselves for pay), as the worst and lowest form of sexual
irregularity, the most revolting to the unpolluted feelings, the most indicative of a
loio nature, the most degrading and sapping to the loftier life, —

' The sin, of all, most sure to blight —

The sin, of all, that the soul's light

Is soonest lost, extinguish'd in/

Sexual indulgence, however guilty in its circumstances, however tragic in its results,
is, when accompanied by love, a sin according to nature ; its peculiarity and heinous-
ness consist in its divorcing from all feelings of love that which was meant by nature
as the last and intensest expression of passionate love ; in its putting asunder that
which God has joined; in its reducing the deepest gratification of unreserved affec-
tion to a mere momentary and brutal indulgence ; in its making that only one of our
appetites which is redeemed from mere animality by the hallowing influence of the
better and tenderer feelings with which nature has connected it, as animal as the
rest. It is a voluntary exchange of the passionate love of a spiritual and intellectual
being for the hunger and thirst of the beast. It is a profanation of that which the
higher organisation of man enables him to elevate and refine. It is the introduction
of filth into the pure sanctuary of the affections. We have said that fornication
reduces the most fervent expression of deep and devoted human love to a mere animal
gratification. But it docs more than this ; it not only brings man down to a level
with the brutes, but it has one feature which places him far, far below them.
Sexual indulgence with them is the simple indulgence of a natural desire mutually
felt; in the case of human prostitution, it is in many, probably in most, instances a
brutal desire on the one side only, and a reluctant and loathing submission, purchased
by money, on the other. Among cattle the sexes meet by common instinct, and a
common will ; it is reserved for the human animal to treat the female as a mere
victim to his lust."—' Quarterly Rev.,' July, 1850.

INCONTINENCE 35

To this eloquent writer's indignant remonstrance may we not add a
still more disinterested witness — even the old heathen Ovid.

" Sumite in exemplum pecudes ratione carentes

Turpe erit ingenium mitius esse feris.
Non equa munus equum, non taurum vacca poposcit

Non aries plaeitam munere captat ovem.
Sola viro mulier spoliis exultat ademptis

Sola locat noctes ; sola locanda venit.
Et vendit, quod utrumque juvat, quod uterque petebat

Et pretium, quanto gaudeat ipsa, facit."

If, then, the benefits of continence be so great and the results of in-
continence so deplorable, and if, as has been suggested, mere ignorance
is so dangerously likely to lead youths astray, what reprobation can be
too strong for those advisers, medical or not, who deliberately en-
courage the early indulgence of the passions, on the false and wicked
ground that self-restraint is incompatible with health ? What abhor-
rence can be too deep for a doctrine so destructive, or for the teachers
who thus, before the eyes of those whose youthful ignorance, whose sore
natural temptation, rather call for the wisest and tenderest guidance
and encouragement, put light for darkness, evil for good, and bitter
for sweet ?

Unfortunately, it is not only among the dregs of either the medical
or literary professions that these false teachers are to be found. The
following opinions, enunciated by a writer of no mean standing or
ability, may serve as an example of the kind of principles (if they can
be so called) which I am deprecating.

" To have offspring is not to be regarded as a luxury, but as a great
primary necessary of health and happiness, of which every man and
woman should have a fair share.

" The ignorance of the necessity of sexual intercourse to the health
and virtue of both man and woman, is the most fundamental error in
medical and moral philosophy.

" The hopes of man lie in a nutshell ; they are all comprehended in
this question of questions — Is it possible to have both food and love ?
Is it possible that each individual among us can have a due share of
food, love, and leisure ?

"Rather than resign love, rather than practise increased sexual
abstinence, and so check population, they (mankind) have been
willing to submit to the smallest proportion of food and leisure which
the human frame could for a season endure. The want of love is so
miserable a state of constraint, and, moreover, so destructive to the
health of body and mind, that people who have a choice in the matter
will rather put up with any evils than endure it.

36 ABNORMAL CONDITION IN YOUTH

" It may be mentioned as curious, that a young man entering on
puberty is to indulge the exercise of all his organs, all his feelings,
except that of the most violent — namely, love."

Few will be surprised, after reading the above, to find that this
writer l feels himself obliged, for consistency's sake, to admit, that
what he calls unmarried intimacy should be sanctioned, precautions
being taken to prevent the females having children ; and to propose
that the frail sisterhood should be received into society, because both
they and their paramours but follow Nature's laws, and indulge
sexual desires which Nature has given them for their own gratifi-
cation.

I mention these opinions, not with the intention of wasting time in
refuting them, but as showing the consequences such an argument
must lead to, if carried out. I leave it to the reader's imagination to
depict the state of society which would ensue.

Fortunately, such sophistry as that I have quoted is rare among
English authors of reputation or ability. Similar sentiments, never-
theless, no doubt often float vaguely in the minds of many, especially
in early life. The answer to them is very clear in the case we are now
considering, viz. that of boys who have only just reached the age of
puberty. For them it is sufficient to state the simple physiological
fact, that, merely considering a boy of sixteen years old as an animal,
any indulgence of his sexual passion is a direct and unmitigated
mischief.

To himself, as we shall see further on, marriage would be attended
with the worst possible consequences. And as regards any progeny
he might beget, the results would be no less deplorable. His children
would almost certainly be weak, sickly, difficult to rear, and wretched
burdens to themselves and others if they were reared.

Even among the lower animals the provisions of nature and the
experience of breeders indorse the rule which Tacitus tells us obtained
among the ancient Germans —

" Sera juvenum Venus, ideo que inexhausta pubertas."

Nature does not permit animals to gratify their passions at the
earliest moment that indulgence becomes possible. We find that the

1 The anonymous author when he wrote this dangerous volume was, as he represents
himself, but a medical student. Let us hope that ere this he has seen reason to alter
his views, although, I regret to say, the latest edition of the work still contains these
untrue and unphysiological statements.

I presume it is from such evidence as is gleaned from this writer that Professor
Newman, an Emeritus Professor of University College, has in a recent pamphlet
taken the medical profession to task for recommending fornication — a charge which
I wish most energetically to repel.

INCONTINENCE 37

young bucks are driven away from the hinds by the older and stronger
ones. In a farm-yard the cock must show his prowess, and win his
sjKirs, before he is allowed by the more powerful birds to tread the
hens. Breeders of cattle have long since ceased to raise their stock
from either young males or females. The frame of the sire or dam
must be perfected before their owners can call on them to discharge
their procreative functions. I have been told that the demand for
horses some years ago induced Yorkshire dealers to breed from mares
at two years old. This injudicious practice was soon given up, as it
was fomid that the system of the mother became impaired, and that
the produce was good for nothing.

Parise has said, very truly, " to diffuse the species, the species ought
to be perfect and in perfection." Puberty must not be just dawning ;
it must be in full vigour.

On this point, indeed, the testimony of all scientific and practical
authorities is singularly unanimous. Carpenter says —

" This development of the generative organs at puberty is attended
with manifestations of the sexual passion, but it can only be rightly
regarded as preparatory to the exercise of these organs, and not as
showing that the aptitude for their exercise has already been fully
attained. It is only when the growth and development of the indi-
vidual are completed that the procreative power can be properly
exerted for the continuance of the race ; and all experience shows that
by prematurely and unrestrainedly yielding to the sexual instincts, not
merely the generative power is early exhausted, but the vital powers
of the organism generally are reduced and permanently enfeebled, so
that any latent predisposition to disease is extremely liable to manifest
itself, or the bodily vigour, if for a time retained with little deteriora-
tion, early undergoes a marked diminution."

One argument in favour of incontinence deserves special notice, as it
purports to be founded on physiology. I have been consulted by per-
sons who feared, or professed to fear, that if the organs were not regu-
larly exercised, they would become atrophied, or that in some way
impotence might be the result of chastity. This is the assigned reason
for committing fornication. There exists no greater error than this, or
one more opposed to physiological truth. In the first place, I may
state that I have, after many years' experience, never seen a single
instance of atrophy of the generative organs from this cause. I have,
it is true, met with the complaint — but in what class of cases does it
occur ? It arises in all instances from the exactly opposite cause —
early abuse : the organs become worn out, and hence arises atrophy.
Physiologically considered, it is not a fact that the power of secreting
semen is annihilated in well-formed adults leading a healthy life and
\ . t remaining continent. I have daily evidence that the function goes

38 ABNORMAL CONDITION IN YOUTH

on in the organ always, from puberty to old age. Semen is secreted
sometimes slowly, sometimes quickly, but very frequently only under
the influence of the will. I have already referred to the fact — which I
shall hereafter treat of in more detail — that when the seminal vessels are
full, emission at night is not unfrequent. This natural relief will
suffice to show that the testes are fully equal to their work when called
upon. No continent man need be deterred by this apocryphal fear of
atrophy of the testes from living a chaste life. It is a device of the
unchaste — a lame excuse for their own incontinence, not founded on
any physiological law. The testes will take care that their action is
not interfered with.

That continence is not followed by impotence is shown most forcibly
in animals, tylr Varnell, late a professor at the Veterinary College,
told me of an entire horse, kept by a friend of his for hunting. This
animal early in life was not allowed to mount mares, yet was quiet in
their presence and hunted regularly. When twenty years old he was
put to the stud and became a sure foal-getter.

It is, I repeat, my deliberate and earnest advice to all boys as well
as young men to live a perfectly continent life, in thought, word, and
deed. It is quite possible ; and the means I have pointed out in the
foregoing part of this work, pages 21 to 32, viz. regular training of
the will — and careful attention to exercise and general hygienic treat-
ment of the body — are, even apart from the greatest preservative of all
— true religious feeling — amply sufficient to attain this end, unless in
a few exceptional cases.

CHAP. II.— MASTUKBATION

From the general view of continence and incontinence presented in
the previous chapter, I pass on to the consideration of that particular
form of incontinence to which children and youths are more especially
liable.

SECT. I.— MASTURBATION IN EARLY CHILDHOOD

Masturbation may be best described as an habitual incontinence
eminently productive of disease ; its effects are worse than those of
most diseases.

The term, like the word Chiromania, can properly be applied, in the
case of males, only to emission or ejaculation induced by titillation
and friction of the virile member with the hand ; and in the course of
the next few pages such will be the meaning of the term. Use has,
however, given it a larger signification. It is now employed to express
ejaculation or emission attained by almost any other means than that

MASTURBATION 39

of the natural excitement arising from sexual intercourse. In children *
too young to emit semen, friction of the organ is liable to produce that
nervous spasm which is, in the adult, accompanied by ejaculation.

This degrading practice in a young child may arise in a variety of
ways. The most common is of course the bad example of other
children. In other cases, vicious or foolish female servants suggest
the idea. 1 In such sexually disposed children as have been described
above, the least hint is sufficient, or indeed they may, even without
any suggestion from others, invent the habit for themselves. This
latter origin, however, is rare in very early life.

The symptoms which mark the commencement of the practice are
too clear for an experienced eye to be deceived. As Lallemand remarks :
" However young the children may be, they become thin, pale, and
irritable, and their features assume a haggard appearance. We notice
the sunken eye, the long, cadaverous -looking countenance, the down-
cast look which seems to arise from a consciousness in the boy that his
habits are suspected, and, at a later period, from the ascertained fact
that his virility is lost. I wish by no means to assert that every boy
unable to look another in the face, is or has been a masturbator, but I
believe this vice is a very frequent cause of timidity. Habitual mas-
turbators have a dank, moist, cold hand, very characteristic of great )
vital exhaustion ; their sleep is short, and most complete marasmus
conies on ; they may gradually waste away if the evil passion is not
got the better of ; nervous symptoms set in, such as spasmodic con-
traction, or partial or entire convulsive movements, together with epi-
lepsy, eclampsy, and a species of paralysis accompanied with contrac-
tions of the limbs." (Vol. i, p. 462.)

Besides the physical symptoms, there are many signs which should
warn a parent at once to use all possible precautionary measures.
Lallemand truly remarks — " When a child, who has once shown signs
of a good memory and of considerable intelligence, is found to evince a
greater difficulty in retaining or comprehending what he is taught, we
may be sure that it does not depend upon indisposition, as he states,
or idleness, as is generally supposed. Morever, the progressive
derangement in his health, and falling off in his activity, and in his

1 I have heard of a vile hahit which some foreign nurses have (I hope it is confined
to the Continent) of quieting children when they cry by tickling the sexual organs. I
need hardly point out how very dangerous this is. There seems hardly any limit to
the age at which a young child can be initiated into these abominations, or to the
depth of degradation to which it may fall under such hideous teaching. Books
treating of this subject are unfortunately too full of accounts of the habits of such
children. Parent Duchatelet mentions a child which, from the age of four years, had
been in the habit of abusing its powers with boys of ten or twelve, though it had been
brought up by a respectable and religious woman. ('Annales d'Hygiene Publique/
tome vii, 1832, p. 173.)

40 PROGNOSIS IN EARLY CHILDHOOD

application, depend upon the same cause, only the intellectual func-
tions become enfeebled in the most marked manner." (Vol. iii, p.
165.)

Provided the vicious habit is left off, or has not been long practised,
the recuperative power of Nature in the boy soon repairs the mischief,
which appears to act principally on the nervous system, 1 for in very
young boys no semen is lost. If, however, masturbation is continued
for any length of time Nature replies to the call of the excitement, and
semen, or something analogous is secreted. Occasionally, the ejacula-
tion gives pleasure, and there is then great danger of the habit
becoming confirmed. In proportion as the habit is indulged in, the
boy's health fails, he is troubled with indigestion, his intellectual
powers are dimmed, he becomes pale, emaciated, and depressed in
spirits ; exercise he has no longer any taste for, and he seeks solitude.
At a later period the youth cannot so easily minister to his solitary
pleasures, and he excites his organs the more as they flag under the
accustomed stimulus. There is a case, related by Chopart, of a
shepherd boy who was in the habit of passing a piece of twig down
the urethra, in order to produce ejaculation, when all other means had
failed.

Prognosis in Early Childhood. — Evil as the effects are, even in
early childhood, the prognosis of the ailment, looking on it as an ail-
ment, is not, in children, unfavorable. Lallemand observes : — " In
respect to the evil habit in children, it is easy to re-establish the
health, if we can prevent the little patient masturbating himself, for
at this period the resources of nature are great ;" the French professor
does not, however, think that " it is so easy to repair the injury
inflicted on nutrition during the development of the body ; neverthe-
less he has seen the consequences disappear readily, and all the func-
tions become re-established. (Vol. i, p. 468.)

Preventive Treatment. — I cannot but think that many of the
evil consequences following this practice could be prevented, by wisely
watching children in early life ; and, where a sexual temperament, a
suspicion of the practice having been only recently indulged in, or
other circumstances, render it desirable, by pointing out the dreadful
evils that result from the practice, and kindly but solemnly warning

1 Lallemand admits that in children it is not the loss of the semen that can produce
the usual effects of spermatorrhoea, but that the symptoms must depend upon the
influence exercised on the nervous system, or what he terms the ebranlement nerveux
tpileptiforme, the impairment or exhaustion of nervous power which follows over-
excitement, tickling, or spasmodic affections in young and susceptible children, and
which may produce such a perturbation of the nervous system as to occasion even
death. He gives an instance of this, which he attributed to the effect produced on
the brain by repeated convulsive shocks similar to those which susceptible subjects
receive when the soles of tho feet aro tickled. (See Lallemand, pp. 467-8.)

MASTURBATION 41

them against it. I have noticed that all patients who have confessed
to me that they have practised this vice, have lamented that they were
not, when children, made aware of its consequences, and I have been
entreated over and over again to urge on parents, guardians, school-
masters, and others interested in the education of youth, the necessity
of giving their charges some warning, or some intimation of their
danger. Almost all sufferers coincide in the opinion that at the early
age at which these practices are learnt, it is generally mere curiosity
which prompts to them. And it is often only when too late, that the
adult finds out that the idle trick of the child, practised in ignorance
of consequences, has resulted in seriously impaired health, if not in
calamities that embitter his whole after life. It is not to be denied,
however, that there are great difficulties in the way of carrying out
these preventive measures. I find, for instance, that the parents of
boys about to be sent to school are — not unnaturally — most unwilling to
speak of these matters to their sons. In addition to the instinctive
shrinking which every right-minded person must feel from the risk
of putting ideas of impurity into a child's innocent mind, a parent's
pride leads him to hope that his boy would not indulge in any such
mean and disgusting practices, while he trusts that he may safely leave
these matters to the master whose interest, as well as duty it is to
check such evils.

The schoolmaster, on the other hand, is just as disinclined to inter-
fere. Till it is positively forced upon his notice, he will, most natu-
rally, affirm that the practice never has existed, and never could be
countenanced in his school. Many masters feel, and say, that such
precautions are no business of theirs. They hint at the delicacy of the
subject and ask how they can even allude to matters of this kind,
which do not properly come under their supervision. They assert that
it is the parent's duty, and that if proper care be taken to see that
boys are well brought up, they will not fall into dirty habits of any
kind, much less into so filthy a one as masturbation. And, indeed, it
is a good deal to ask of a schoolmaster. He naturally feels that, when
he has done all he can in the way of supervision and management to
prevent his boys from indulging in evil propensities, the responsibility
of warning them against habits which he hopes they have never heard
of, and which might be put into their heads if he were to broach the
subject at all, is greater than he ought to be called upon to bear. If
he were, he says, to discover any boys practising or inciting others to
practise the evil habit, they would of course be severely punished or
even expelled ; but never having discovered such offenders, he does
not believe the habit is indulged in at all, and declines to interfere.
At schools I fear it is impossible to doubt that these practices are
(though perhaps less frequently than formerly) indulged in, and as

42 PREVENTIVE TREATMENT OF

I have said, it is my deliberate opinion that in many cases it would be
true wisdom and true kindness for a parent openly and in plain
language to lay before a boy the full extent of his danger, and impress
upon him as urgently as possible, the fact that it is a danger, and that
the consequences of yielding on his part will be most lamentable. In
many cases an elder brother may be asked to speak to a youth, and
warn him of the ill results which playing with the organ will induce.
I have myself no hesitation as to the advice I should give to parents
in such matters. In all cases, I would tell them, the best preventive
step to be taken i s_to watch t heir children, if not actually to warn
them against what it is to be hoped they are ignorant of, and to
develop all their muscular powers by strong gymnastic exercises.

A vigorous healthy boy is not likely to have any tendency to
debase himself, and it is a question with many parents if it is wise (on
his going to school) to caution Him against the vile habit of mastur-
bation and its consequences. My own impression once was, that it
would be a pity to poison the mind of a high-spirited lad with any
cautions about such debasing practices ; but that opinion has been
altered by the confessions of many who, in ignorance of the results,
have, by the example of others, been led to practise masturbation. I
believe that in many cases a parent should at least hint to his son that
he may very possibly have to witness unclean practices, and warn him
at once manfully to resist and oppose them, pointing out at the same
time the consequences to which they tend. There may be the risk of
tainting an ingenuous mind by broaching such a subject, and unfold-
ing before it this distressing page in the book of knowledge of good
and evil ; but, when it is needful, a father should in my opinion accept
the grave responsibility and ought not to fall into the greater un-
known ill of dismissing his child to the probability of contamination,
without an attempt to save him. I esteem it false delicacy and a
wrong, that a parent should hesitate to warn his boy, when, at the
most, he can only anticipate by a few days or weeks the offices of a
youthful schoolmaster in vice, as ignorant of consequences as the pupil,
and unable to administer the antidote with the poison.

Whatever may be considered the best course for ordinary children,
on one point my mind is fully made up. If I saw a young boy paying
attention to female children only, and toying with them I should
watch over his career most anxiously. On the occurrence of any
symptoms of debility, paleness, or ill-health, my vigilance would be
still greater, particularly if I observed any development of the idees
genesiques, as Lallemand calls them. In such a case I should have no
hesitation in directing the precocious child's attention to the pitfall
yawning before him, fully convinced that not only could advice do no
harm, but that I should merely be teaching such a boy what he ought

MASTURBATION IN EARLY CHILDHOOD 43

to know by calling his attention to sexual subjects. I am of opinion
tbat I sbould but anticipate the natural curiosity of such peculiarly
organised children, who early acquire, from the habit of watching
animals, and reading novels left about by their seniors, a smattering
knowledge which excites their feelings, but which teaches them
nothing of the ill consequences of the only sexual indulgence they can
practise at this early age. To suppose that a parent can keep such a
sexually disposed child from knowing much that he had better
not be acquainted with, shows a grievous ignorance of the infantile
mind. But this mind may be regulated, and the dangerous conse-
quences of the practices may be pointed out. 1

Although I would not give too much weight to the opinions of suf-
ferers, yet I cannot refrain from introducing the following unsolicited
letter from a patient on this duty of parents to their children.

" I fear you may think me somewhat presuming if I say how enitrely I agree with
you as to the desirableness, not to say absolute duty, of parents and others duly to
caution youths as to their conduct in early life relating to sexual matters. Had my
father taken such a course with me, I am fully justified in saying I should not have
fallen into an error which I now most deeply deplore. This was all that was wanted,
for the strictly moral way in which I have been brought up has prevented me
running into any of the excesses of the day. But, of course, I went to a large public
school, and there, 0/ course, became acquainted with the practice of masturbation, and,
almost equally as a matter of course, indulged in the habit, and, without a thought
of its baneful consequences, have practised it for years. In fact, I fear you must some-
what doubt this statement, but I assure you it is the literal fact, I pursued the practice
from an idea of its necessity, and was fortified in my supposition (so ignorant was I)
by the idea that, if omitted, nocturnal emissions supplied the omission Of the practice.
Besides, I considered it a natural means for allaying the sexual desire, the act relieving
me from such desire for some time.

" I see now and regret deeply the great folly of which I have been guilty, but am
I wrong in feeling some indignation at not having been put better on my guard by
those I considered my instructors ? Recently, however (I am now near twenty-two),
I happened to discover the disastrous results likely to ensue, and also that nocturnal
emissions are symptoms of disease. I, of course, immediately relinquished the habit,
never to resume it. I must say, however, that it never had the effect upon me I
should have expected from reading your book, inasmuch as I have always appeared
and felt strong, healthy, vigorous at school, very fond of play, subsequently well able
to perform my daily duties either as regards business or intellectual engagements,
and have never been averse to society."

1 As I was preparing a former edition for the press, a stranger called on me to ask
my opinion as to what he should do in the case of a boy of twelve years whom he
suspected of evil practices. The boy had fallen away in his studies, had dark patches
under his eyes, and was depressed in spirits. In such a case I told him I should have
no hesitation in quietly talking to the boy, without taxing him with any evil practices
(which the lad would probably deny). I should tell him that it was well recognised
that secret vices are sometimes carried on at schools. I should tell him that such
practices cannot be continued with impunity, and warn him against them. Steps
must, of course, be taken at the same time to improve his general health.

44 PREVENTIVE TREATMENT OF

We have already seen that as a rule in the case of young children
the practice has only to be left off, and the system will speedily rally.
One great advantage in early warning a boy, therefore, is that, as he
probably derives little or no pleasure from the act, if he is once put in
possession of the probable consequences, he will very likely abandon
the practice. His example and advice may, moreover, deter others,
who are not so well informed. So strongly do I fell the propriety of
such a course of proceeding in the case of sexually disposed children,
that I would urge parents, if they feel themselves unequal to the
responsibility, to transfer the duty to their medical adviser.

I have been so often urged by parents and schoolmasters to draw up
a plan which might be of service in teaching them how properly to
address children, as well as boys arriving at the age of puberty, that I
had determined, to trace out a few notes which might aid parents
desirous of following my advice. In place of any words of my own,
however, I will here give, by the kind permission of the author, the
following advice taken from a pamphlet printed by a clergyman,
but never published : — " Advantage could, and ought to be taken
of the opportunity when a boy says his catechism to explain to him
the meaning of some of the terms therein mentioned. When a
child is taught 'to keep his body iu temperance, ^soberness, and
chastity,' it would not be difficult to explain to him what chastity is,
instead of leaving him to find it out, as best he may. He might be
given to understand that it does not merely mean that all indecency and
k foul language must be shunned. The child might be told that he must
keep his hands from meddling with his secret parts, except when the
necessities of nature require it ; and that any emotions he may expe-
L/ rience in those members must not be encouraged, and all thoughts
which originate them must be avoided. And when he grows older
' every boy should be taught that chastity means continence ; that if he
would be chaste he must not by any act of his own, or by the indul-
gence of lascivious imaginations, cause the fruit of his body to be
expended. He should be taught that all such expenditure is a drain
upon his whole system, and weakens the powers which God has given
him to be employed only in the married state. He may be sure that
1 his sin will find him out,' and if he marries with his powers under-
minded by unlawful gratification, it will be visited upon his children
also.

" If he is old enough to understand the subject, the youth entering
upon puberty might have explained to him some of the mysteries of
life, probably it would not be incompatible with his age to explain to
him that the life of the animal and vegetable kingdoms is continued
and increased through the power of reproduction, with which the
Creator endowed the whole produce of the earth, It is the nature

MASTURBATION IN EARLY CHILDHOOD 45

of every herb, that it ' yieldeth seed, 1 and of the f rait tree yielding frnit,
that its 'seed is in itself (Gen. i, 12). It is the nature of every
living creature ' to be fruitful and multiply ' (Gen. i, 28) . This power
of reproduction or of generation constitutes the very essence of life.
To enable this vital function to be fulfilled, every plant, and every
animal is furnished with organs of reproduction. As it has organs of
respiration for breathing the air, organs of motion, organs of digestion
for assimilating its food, so it has organs of reproduction, for handing
on the life it has received, and reproducing itself in its offspring. This
is the most important function of the whole vital economy of every
living form.

" We might further explain to him that our life is bound up with the
reproductive organs of the body. Now what every young man, and
boy also, ought to know about himself is this. The two appendages of
the body, of which we are too modest to speak, but which Holy Scrip-
ture calls ' the stones,' and medical men the ' testes ' or ' testicles,'
form the laboratory of the human body, where by a process of which
we are quite unconscious, the blessing given to man at the Creation is
being fulfilled, and out of the system a vital fluid, which is the very
1 Essence of Life,' the source of Being (a life and being, remember,
derived from God) is being constantly produced from the time of
puberty, to be employed, when he reaches maturity, not in the gratifi-
cation of the lusts of the flesh, but in the procreation of children.

" The boy might be taught the immense importance to the human
constitution of this vital substance, the seed of man which is elaborated
by the organ of reproduction, and it should be made clear to him how
terrible the consequences must be if the life be continually flowing
away from his body. 1

" The opportunity might be taken of informing the youth that many
whose lives are outwardly pure have fallen into ' secret sins ' (Ps. xix,

1 Parise, on speaking on this subject, very eloquently observes, " One grand
purpose pervades the creation — to live and to impart life. This last function ought
to be considered the most important. If men will conform to the laws of nature —
laws which, moreover, are immutable and eternal — they must submit themselves to
conditions of existence and of organization, and learn how to limit their desires within
the spheres of their real wants. If they will do so, wisdom and health will bloom of
themselves and abide without effort ; but all this is too often forgotten when the
functions of generation are in question. This sublime gift of transmitting life — fatal
prerogative, which man continually forfeits — at once the mainstay of morality, by
means of family ties, and the powerful cause of depravity — the energetic spring of
life and health — the ceaseless source of disease and infirmity — this faculty involves
almost all that man can attain of earthly happiness or misfortune, of earthly pleasure
or of pain; and the tree of knowledge of good and evil is the symbol of it, as true as
it is expressive. Thus even love by its excesses hastens and abets the inevitable
doom for which, in the first instance, by the aid of passion, it had provided the
victims."

46 PREVENTIVE TREATMENT OF

12), and wasted their substance in solitary indulgence. And the con-
sequence of such indulgence is not confined to the act itself ; but the
violated body becomes unable to contain its treasure, and as fast as it
is elaborated the seed is poured away on the slightest provocation in
sleep, and in the performance of the acts of nature.

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

" I would further instruct a youth that this degrading practice obtains
such a hold upon any one indulging in it, that he seems unable to
free himself from its grasp. Again and again he yields to its im-
portunity, and life ebbs away from him, mind and body becoming
undermined. #

" It is a sad and melancholy truth, that many whose childhood
has been most pure and spotless, have fallen most deeply, when
their passions have been awakened, through absence of all warning on
the subject, and in ignorance of the self-destruction they were
committing." l

V I maintain that a conscientious schoolmaster's task does not end
with providing for cleanliness, decency, and exercise among his boys.
In spite of his assumed ignorance of the existence of the practice,
masturbation and other vices may spread widely through the school
unless careful supervision be employed. Against these secret evils
there is no better safeguard within his reach than a steady endeavour
to raise the moral tone of the whole school by means of the upper
forms, so that the elder boys may of their own accord join in discoun-
tenancing any ungentlemanly or disgraceful conduct. Without some
such auxiliary, the efforts of the best-intentioned master to prevent the
practices with their demoralising accompaniments and consequences
will be almost powerless^)

How diffused secret "wickedness may become in schools appears
every now and then in scandals so dreadful, that the natural tendency
of all concerned is to hush them up and forget them as speedily as
may be. Indeed it is impossible not to sympathise with the feeling,
that to be obliged seriously to doubt as to the manliness, and, in a

1 Some such advice as this will, I am sure be gratefully acknowledged by many
parents, and I have introduced it here in the language of the author; at the same
time I have taken the liberty of altering its phraseology a little, to adapt it to my
book; but in the views which it inculcates I quite coincide, and am pleased to
acknowledge in the author one of my most able coadjutors.

MASTURBATION IN EARLY CHILDHOOD 47

rough way, of the purity of our large schools, would be a great

calamity. And in the main this confidence has been no doubt hitherto

justified. Still, there are points on which I think all concerned may

be a little too confident, not to say remiss. One in particular I wish

to mention (I can hardly do more). It seems to be included clearly J

within the scope of these remarks. s ■

I think a schoolmaster should be alive to the excessive danger of the W\\«fi
platonic attachments that sometimes become fashionable in a school #^lv
especially between boys of very different ages. I am not speaking of » '
ordinary boyish friendship, than which there can hardly be a greater
blessing, either during boyhood or in after life. I would encourage
such friendship in every way I could. Growing as it does with the
growth of the boys, strengthening with their strength, and cemented
by scrapes, fights, sports, sorrows, all increasing their mutual respect
and interest, such a manly happy connection strikes its roots so deep
as generally to survive most other ties. I am speaking of what school-
masters cannot be ignorant of — the sentimental fancy taken by an
elder boy to a younger, between whom there can be, in the regular
course of the school, little natural companionship, and having about it
a most unpleasant and dangerous resemblance to abnormal passion.
I know that such attachments have led to most melancholy results. I
have been made aware that some public-school men have declined
masterships in their own school because they knew the custom pre-
vailed — which they were alike unable to sanction, and afraid to attack.
I have been informed that it has been preached at, not obscurely, from
school pulpits. And I could point to living men, with a wretched
burden of recollection from it on their consciences which they would
give the world to erase. •

I am not suggesting that such modern imitations of ancient platonic
attachments are universal, general, or even common in English schools.
I only say that they do sometimes exist, and that to the remotest
approach to the manners or the morals of the Phsedrus the school-
master should be sensitively alive.

No doubt it has often struck others as it has myself, how advisable
it would be in schools, and, indeed, in all institutions where bodies of
boys or young men are collected, to establish, if possible, a kind of
public opinion as a rallying point for virtue. There is never any lack
of fellowship and countenance for vice ; the majority too often favour
or support it more or less openly. To make virtue, propriety, self-
restraint, fashionable (so to speak) should be, it appears to me, one of
the chief objects at which masters and tutors should aim. With ad-
mirable common sense and shrewdness the Eev. Sydney Smith recom-
mends the enlistment of the dread of ridicule, even, on the same side :
— " Put a hundred boys," he says, " together, and the fear of being

48 PREVENTIVE TREATMENT OF

laughed at will always be a strong influencing motive with every indi-
vidual among them. If a master can turn this principle to his own
use, and get boys to laugh at vice, instead of the old plan of laughing
at virtue, is he not doing a very new, a very difficult, and a very laud-
able thing ?" Surely by means of frank sympathy, thorough
earnestness, and spotless rectitude in the instructor, it can be
done. The help which such a tone of feeling would be to a
wavering boy is incalcuable. Supported by such a " public opinion,"
a well-disposed boy would have no need to blush when tempted
or jeered at by the licentious. Innocence, or even ignorance of
vice will no longer be a dishonour or a jest. The better disposed
will reprove any immorality, and utterly discountenance all conduct
inconsistent with the character of a Christian and a gentleman.
No one can have read the life of the late Dr Arnold without
seeing that it was one of the chief objects of his life to establish
some such feeling as this among his boys. That he was to a
great extent successful those who have had the good fortune to become
acquainted with any number of his pupils will be the first to acknow-
ledge.

This manful meeting of temptation is not only, in my opinion, a far
more courageous, but a far more successful way of disciplining the
young to virtue than that sickly, hotbed training, that keeps them
more often ignorant than innocent. Herbert Spencer, in speaking of
moral education, has well remarked : — " Eemember that the aim of your
discipline should be to produce ei^getf-governing being, not to produce a
being to be governed by others. As your "children are by and by to be
free men, with no one to control their daily conduct, you cannot too
much accustom them to self-control while they are still under your
eye. Aim, therefore, to diminish the parental government as fast as
you can substitute for it in your child's mind that self-government
arising from a foresight of results. All transitions are dangerous, and
the most dangerous is the transition from the restraint of the family
circle to the non-restraint of the world. Hence the policy of cultivat-
ing a boy's faculty of self-restraint by continually increasing the
degree in which he is left to his self-constraint, and by so bringing
him step by step to a state of unaided self-restraint, obliterates the
ordinary sudden and hazardous change from externally governed
youth to internally governed maturity." — Moral Education (p. 140.)

In the same direction we find the weighty testimony of the Rev.
Sydney Smith : — " Very few young men," he says, " have the power of
negation in any great degree at first. Every young man must be ex-
posed to temptation ; he cannot learn the ways of men without being
witness to their vices. If you attempt to preserve him from danger
by keeping him out of the way of it, you render him quite unfit for

MASTURBATION IN EARLY CHILDHOOD 49

any style of life in which he may be placed. The great point is not to
turn him out too soon, and to give him a pilot."

There are many parents who, when reports of police courts or
divorce cases appear in the newspapers, at once burn the papers lest
their sons should read the details. There are others who regret that
the usual channels of public information should publish such cases ;
they dread (as they express it) that the morals of their sons should be
corrupted.

My answer to these anxious parents is that in spite of all remon-
strances these details will continue to be published ; but I believe, —
as I stated July 16th, 1870, in a letter in the 'British Medical
Journal,' — that " as a set-off to this publicity and inquiry which so
many of my friends are now deploring, we have the compensation of
noticing that, if the youth of the nineteenth century becomes now
necessarily familiarised early with the details of vice, the knowledge is
accompanied with the practical lesson that illicit pleasure is invariably
attended with much physical pain. The veriest trifler who reads his
penny paper cannot become acquainted with the offensive details there
to be found, without listening to the attendant moral ; and thus the
antidote follows the poison. It is in this way that men of my mode of
thinking view the distinction between the modern newspaper details
and the prurient literature which has been generally known as Holy-
well Street. In this last-named literary garbage, illicit pleasure was
depicted in all its most attractive and meretricious forms ; but the
anonymous author, like the translators of the Greek and Latin loves
of the heathen gods and goddesses, omitted to allude to the frightful
consequences that illicit love or bestial proclivities produce on aU
those who directly or indirectly indulge their animal instincts.

My ideas on the subject are strongly corroborated by some remarks
published by the late Rev. Mr. Robertson, of Brighton, and as they
have a practical bearing on the question, I reproduce them here :
— " I would far rather that there was much less of censorship of
opinion. I know that millions of books, infidel and bad books, swarm
out of the press, and yet I would not wish to see them stopped by
force, except, of course, such as are shocking to public decency. Great
as are the evils of unchecked license in publishing and reading, the
evil of permitting any persons to restrict either authoritatively would
be immeasurably greater. It is a part of our moral discipline. I
would not have that exotic virtue which is kept from the chill blast,
hidden from evil, without any permission to be exposed to temptation.
That alone is virtue which has good placed before it and evil, and
seeing the evil, chooses the good " (p. 73, ' Addresses ').

The following letters with which I have been favoured on the subject
_iv corroborate the views here expressed, and, giving as they

50 PREVENTIVE TREATMENT OF

do the personal experience of the writers, are worthy of careful
perusal.

Rectory, Feb., 18—.

Bear Mr. Acton, — It is indeed a difficult subject to treat wisely and usefully, but
I fully believe you are right in saying that it ought to be faced ; and though it is
very questionable how far any publication should be placed in the hands of youth,
yet good service is done if you supply parents and instructors with such informa-
tion as shall enable them to speak to individual boys according to their discretion
with a confident knowledge of those physical facts on which their admonitions
are based.

You are not far wrong, I am afraid, in your facts, if I may judge from my experience
of three great public schools and several private ones. And if I hesitate to adopt
your opinion, it is on the a priori grounds that it is hardly conceivable that the wise
and merciful Creator should annex so fearful a penalty to indulgences which the
multitude are sure to fall into — indulgences which (unlike the luxuries introduced by
art) are supplied — if that is not using too strong a word, for I will not believe they
are suggested — by nature itself. A priori grounds, however, in such a question, are
very uncertain ones. I do not know whether the case is the same with the labouring
population or with savage nations. If not, we may believe that artificial stimulus
brings the upper classes, and civilised societies, under a probation which sifts them
justly, and provides for the deterioration and downfall of those who do not stand
the test.

I think those judge erroneously who select the public schools as the chief seat of
this evil. My own experience is the other way. I used to see it practised shamelessly
at a large private school I was at ; and, alas ! it was known and taught even at a little

one, of boys all below ten years old, where I was before that. At , on the other

hand — which I consider far the purest of the three public schools I have been con-
nected with — an open or avowed practice of the vice was sternly repressed by the
force of public opinion ; and this is more or less the case, I believe, at all of them.
The superiority of ■ I attribute principally to the influence of the monitorial

system, which modern sentimentalism is trying to undermine, and which was far more
firmly and effectively at work there than at another school which has been more
especially selected by the assailants as their point of attack. No system, however,
can prevent the secret indulgence of the vice, nor the communication of this habit
from one boy to another. Parents and tutors may well be assured that, wherever a
few boys are gathered together, the evil will become known, however it be regarded
by individuals or by the majority ; and it follows that such advice as you recommend
ought not to be withheld from those who are in danger. Still I dare not urge that
the instinctive feeling of the heart should be outraged, or in any way overborne. A
hint, a word, addressed to a young boy may often suffice to strengthen the resolutions
of purity — a fervent exhortation to chastity and modesty, with a warning that he will
be tempted by his fellows to evils which perhaps he is ignorant of; and an affectionate
invitation on the parents' part to confidence and confessions, which may in many
cases make it necessary, or very advisable, to go much more deeply into the matter.

At any rate, it is very important, as I said at first, that parents and tutors should
be fortified with a knowledge far greater than they generally possess on these subjects.
I should have found it myself far easier to deal with cases of this sort among my
pupils had I felt more secure of my point on physiological as well as religious grounds.
And in each individual case, I believe, in that desperate struggle which every one has

MASTURBATION 51

to maintain in early life who tries to rule bis passions by the law of God — every one,
that is, who has once let go the reins, and has to gather them up again — in would be
the greatest encouragement to know that physical science confirms the dictates of
revelation, and to know why and how to look for the aid of nature in resisting
an almost resistless propensity.

Believe me, yours very truly,

The second is from a member of one of the universities, who had
been previously at a large public school :

Dear Sir, — In these few lines I will endeavour to state, as clearly as possible, my
opinions on the suppressal of the vice which formed the subject of our conversation
vday evening.

The suppressal of this vice at a school cannot, I think, be effected by the authority
of a master, nor can the efforts of the older boys, though they may forcibly put a stop
to any open public practice of the same, compel the others to desist from it. Good,
sound, scientific information is what, in my opinion, is required at schools, both
public and private.

My first reason for saying this is, that by learning the consequences of this practice,
I think a great many will be persuaded, through fear, to discontinue it.

It may be said, however, by some, that the ill effects of it are known at schools,
but I can affirm that during the five years which I passed at school (both public and
private), from the age of nine to fourteen, I never heard that any consequence
followed this practice, except the vague one of " weakening ."

My second reasoning is this. Curiosity, I am certain, from my own experience,
and what I have seen at schools, is a great supporter of masturbation. Boys are
naturally, from what they hear, curious to obtain some idea of sexual congress. With
this intent they resort to the vice, and, with the hope of obtaining more information,
they search out all the amorous stories in the writings of classical authors, and in
' Lempriere's Dictionary.'

This curiosity, of course, causes the mind to dwell constantly on sexual subjects. I
think, then, that good information w r ill, by satisfying this curiosity, free the mind to
a great extent from sexual thoughts. I will now venture to suggest in what way the
necessary information may be communicated to the boys.

It is obvious that if some of the older boys were made acquainted with the subject,
and not the masters, when the former left the school there w r ould be no one
remaining to impart the information to others.

I should suggest, then, that all the masters be provided with such information as
is necessary. They might, I think, very well speak to some of the senior boys on the
subject, and request them to warn the others of the practice, and exhort them
to discontinue it.

The doctor of the place might be considered, perhaps, a fit person to speak to the
boy 8. I think, however, that if he alone were to give his advice, the boys would not
perceive that a general interest was taken in the matter, but that it was a subject in
which he, as a medical man, was alone concerned; and so probably even his advice
would not have the influence which it otherwise might. He, of course, 1 y acting in
concert with the masters, might do a great deal.

52 PREVENTIVE TREATMENT OF

It might, perhaps, be advisable for the masters to lend a medical work such as
your own to the senior boys, in order that they might see that the ill effects of the
practice were not fancies of the masters, but that they were well known by surgeons
and other medical men.

Hoping that these suggestions may prove useful both to yourself and the public,

I remain, yours truly,

Preventive Tteatment. — If the practice of masturbation be ascer-
tained to exist, steps must be taken to check it. In young infants
the habit may be corrected by the ordinary mode of muffling^the
hands, or applying a sort of_strait-waistcoat. But in attempting to
prevent an older chilcTpolluting "himself the most careful watching
will often fail : especially is this so when emissions have produced
those changes in the urethra and its appendages, which keep up the
complaint and react on the brain, or which, having at first excited the
boy's imagination, react again through the brain on the genito -urinary
system.

In the growing boy it is of the most vital importance that the mind
be directed into a different channel, and that every means be taken to
check the secretion of semen. Experience has proved that to effect
this, there is nothing so good as gymnastic exercises regularly employed
and carried to an extent just short of fatigue. A taste should be
encouraged for cricket, rowing, walking, swimming, and other athletic
amusements. Under such training, if unfortunately self -abuse has
been indulged in, the tendency to it will diminish even though involun-
tary nocturnal emissions may not cease at once. No doubt can exist
that when the blood is diverted to the muscles as it is by taking violent
exercise, semen is secreted slowly, if at all. 1

If irritation or inflammation of the vesiculse seminales exist, the
appropriate remedies, to be hereafter spoken of, must be combined with
gymnastic exercises. If the surgeon has reason to suspect any of the
other local causes of irritation, such as worms, stricture, haemorrhoids,
or fissure of the anus, these complaints must at once be attended to.
1 An account of the proper treatment of these diseases, however, would
be out of place here.

Where the fatal habit is discovered to be actually in existence, there
can be no doubt that the consequences to which such indulgences lead

1 Lallemand says — " The urgent necessity of recruiting each day the great waste
occasioned by varied and progressive gymnastic exercise diminishes in an equal pro-
portion the secretion of the semen ; for the economy only occupies itself with the
reproduction of the species when it has provided for the conservation of the indi-
vidual, as I stated when speaking of the influence of nutrition on generation"
(Vol. iii, p. 406).

MASTURBATION 53

should be plainly pointed out ; and the youth should be taught to look
upon masturbation as a cowardly, selfish, debasing habit, and one which
makes those who practise it unfit to associate with boys of proper
spirit. If this feeling can be so far established as to overcome the
tendency, the surgeon can soon remedy the mischief that has been done
by previous excesses. It is, I am convinced, from a want of attention —
in parents, and those who direct the studies of youth — to the com-
mencement of this evil habit, and of a little seasonable advice and
judgment, that many a career begun under the most favorable auspices,
has been thwarted, and many a boy's mental and bodily powers and
growth checked.

Among what may be called the prophylactic remedies for self -abuse,
the sponge-bath stands pre-eminent. Its constant use cannot be taught
too early, for it not only conduces more than anything to the general
health of children, but is within the reach of almost every one. In the
nursery, indeed, and at home, it is now very generally employed. I see
no sufficient reason why it should be left off when a boy goes to school.
Its benefit is quite as great there as at college or during after life,
when, with modern habits, it is pretty certain to be resumed. In all
public schools, then, its use should, I submit, be enjoined, and I believe
might be carried out with little trouble.

A few words on the method of taking a sponging-bath, so as to
secure the greatest benefit, may be useful. The apparatus I recom-
mend is a shallow painted zinc bath, such as can be purchased for
about eleven shillings. A larger size would be proper for adults. It
should be round, and not of the high-backed description termed the
"hip-bath." With this, a water-can of a gallon and a half or two
gallons capacity, and a honeycomb sponge (which holds water best)
as large as the two fists, the outfit is complete.

Patients who have not been accustomed to sponge-bathing should
use lukewarm water at first, and lower its temperature by degrees.
The bather should sit down in the centre of the bath, with his feet
on the floor, and then, having drawn back the foreskin, for one or two
minutes briskly squeeze the water over his back, chest, abdomen, and
thighs, taking care to lead as much as possible towards the genitals.
He may then stand up in the bath, rapidly sponge the feet and legs,
and on leaving the bath rub himself thoroughly dry, using roughish
towels.

Cold shower-baths should never, I think, be used by an invalid or
weakly person. They are a luxury for the strong only, and I am
disposed to think the tepid sponge-bath, as a general rule, • far
preferable.

Sea or river bathing is a good thing, no doubt, but is never likely to
be of the same value as the sponge-bath, as, from circumstances of

54 PREVENTIVE TREATMENT OF

climate, weather, wind, rain, or trouble, danger of catching cold, &c, it
is but few times comparatively that a boy bathes in a season. Still, as
all influences of this kind are likely to be useful, every boy ought to
learn to swim, though a dip in the sea or river should not be permitted
to take the place of the sponge-bath. It must not, however, be
forgotten that the habit of remaining too long in the water may be a
source of evil. Boys should not be left to themselves in this indul-
gence. Indeed, their time for remaining in the water should be care-
fully regulated, as after the first shock and swim the system derives
no benefit from being in the water, but, on the contrary, the exercise is
succeeded by debility. In the public baths at Paris I have known boys
from southern climates pass the whole of the morning in and out of the
water, even taking their meals and smoking their cigars there, and
looking as debilitated afterwards as possible, instead of presenting
that ruddy glow of health which the rapid application of cold water to
the surface ought to produce.

Among other preventive measures I should recommend the precau-
tion which is, I believe, now almost universal in schools, that every
boy should have a separate bed. This is, as regards the subject we are
now treating of, most important, and should be made a sine qua non
in all schools. Evil practices are, I believe, most frequently commenced
and practised in bed.

An additional advantage would perhaps be obtained if each boy in
a school had not only a separate bed, but a separate compartment in
which he might enjoy some sort of privacy.

SECT. II.— MASTURBATION IN THE YOUTH AND ADULT

I now proceed to point out what the results of masturbation are,
when the vicious habit is practised after the age at which semen begins
to be secreted.

The symptoms. — It is often difficult to obtain much certain informa-
tion on the subject during the early practice of the vice. Its unfortu-
nate victims, so long as they can practise it with impunity, or are
ignorant of its consequences, can hardly be induced to make the
confession. And few authors who could avoid the task, have ventured
even to speculate on the frequency of a vice at once so wide-spread and
so deplorable.

One author indeed, there is, whose extraordinary confessions, dis-
playing as they do at once the terrible ease with which the vile habit
can make a human being its slave, and the kind of judicial blindness
which comes over its besotted victim are of no small value.

MASTURBATION IN THE YOUTH AND ADULT 55

In the ' Confessions of Jean Jacques Eousseau,' we find a philosopher
not only acknowledging the habitual practice of masturbation, but
describing in the most forcible language the causes which tended, in his
own case, to excite his sexual feelings, and calmly painting in words the
way in which his excited youthful imagination exaggerated the
pleasures the vice gave. He seems, however, to have been utterly
unaware that the miserable mental and bodily condition, which he goes
on to describe and to deplore, was in any way the natural consequence
of the habit. This, perhaps, is not to be wondered at, since the very
medical men he consulted did not attribute his maladies to the real
cause.

Modern experience, however, and the confessions of recent patients
who have sinned and suffered — as Eousseau did — give only too clear
an explanation of his ailments.

The book itself is not one that I could recommend any young man
to read, containing as it does much that is most objectionable and
painful. But as it gives the description, by a sufferer, of that peculiar
condition to which masturbation reduces a man, a few extracts may not
be out of place here.

The cause to which he himself attributes the commencement of the
habit has been already mentioned at p. 7 of this volume.

With a strange self -complacency, he claims for himself purity and
chastity in the same breath in which he confesses the practice of the
odious vice.

" Though my blood boiled with sensuality almost from my birth, I
kept myself free from every stain up to the age when the coldest and
most backward temperaments begin to develop."

What strikes us now as being equally remarkable is, that while
confessing the habit as a vice, he seems still to hanker after the old
excitement, and to be labouring under a moral obliquity that prevents
him from seeing either its wickedness or its danger.

" Soon taking courage, I learned that dangerous substitute which
deceives nature, and saves young people of such a disposition as mine
from many disorders, at the expense of their health, of their strength,
and sometimes of their life. This vice, which shame and timidity find
so convenient, has, in addition, a strong attraction for lively imagina-
tions. They have at their disposal, so to speak, the whole female sex,
and employ for their pleasure the beauty which tempts them, without
the necessity of any avowal." — Edition Charpentier, p. 146.

The ultimate results, however, are the most terrible warning. With
an astonishing mixture of blindness and sharp-sightedness, the misan-
thropic philo8ophe pries into his mental and moral character with a
despicably morbid minuteness, apparently utterly unconscious that he
has furnished a sufficient cause for the very tendency he thereby dis-

56 THE SYMPTOMS OF

plays, as well as for the weakness and follies he laments over, and for
the unmanliness, the pettish feminine temper and conceit, which would
make a hearty English lad shudder with disgust, and which are only
indications, after all, of lower and lower depths of mental and moral
debasement.

He proceeds thus to describe himself, and presents us with what may
be taken, after due allowance for self-deception and falsehood, for a
tolerably accurate portrait of a masturbator half-way on the road to
his ruin. The description is one of the most vivid and lifelike that I
have ever read.

" It might be said of me that my heart and my mind do not belong
to the same person. My feelings, quicker than lightning, fill my soul ;
but instead of illuminating, they burn and dazzle me. I feel every-
thing, I see nothing. I am excited, but stupid ; I cannot think except
in cool blood. The wonderful thing is that I have sound enough tact,
penetration, even finesse, if people will wait for me. I make excellent
impromptus at leisure ; but at the moment I have nothing ready to
say or do. I should converse brilliantly by post, as they say the
Spaniards play at chess. When I read of a Duke of Savoy who turned
back after starting on his journey to say, ' In your teeth ! you Paris
shopkeeper !' I said, ' That is like me !'

" I find the same sluggishness of thinking, joined with the same vivid-
ness of feeling, not only in conversation, but even while I work. My
ideas arrange themselves in my brain with incredible difficulty; they
circulate there dully, fermenting so as to excite me, heat me, give me
palpitations ; while in the midst of all this emotion I see nothing
clearly, I could not write a single word — I must wait. Insensibly this
great turmoil calms down — the chaos disentangles itself — each idea puts
itself in its own place, but slowly and after long confused agitation.
Have you ever seen the opera in Italy ? while the scenes are being
changed, there is a disagreeable and prolonged disorder in these great
theatres ; all the decorations are mixed up ; you see pulling and hauling
everywhere, which is postively annoying ; everything seems on the
point of tumbling down ; however, little by little, all gets arranged ;
nothing is wanting, and the spectator is astonished at seeing an exqui-
site scene succeed the long tumult. Almost the same kind of proceed-
ing goes on in my brain when I want to write. Could I have waited,
and rendered in all their beauty the images thus painted there, few
authors would have surpassed me.

" Hence arises the extreme difficulty I find in writing. My MSS.,
scratched, blotted, mixed up, undecipherable, attest the labour they
have cost me. There is not one of them I have not had to transcribe
four or five times before sending it to press. I have never been able to
do anything pen in hand, with a table and my paper before me. It is

MASTURBATION IN THE YOUTH AND ADULT 57

out walking among the rocks and woods, at night in bed, while lying
awake, that I write in my brain ; it may be imagined with what slow-
ness, especially for a man absolutely without verbal memory, and who
has never in all his life been able to learn six lines by heart. There are .
some of my sentences that I have turned and re-turned during five or
six nights in my bed before they were in a state to be put on paper.
Hence I succeed better in works that require labour than in those which
must be written with a certain degree of readiness, like letters — a kind
of composition of which I have never been able to catch the proper
tone, and the effort at which is misery to me. I never write a letter on
the smallest subject which does not cost me hours of fatigue, or if I
want to write at once what occurs to me, I can neither begin nor end ;
my letter is a long and confused verbiage, hardly to be understood
when read.

"But not only is it a labour to me to express, but also to receive
ideas. I have studied men, and I think I am a tolerably good observer ;
yet I can see nothing of what I do see. I can hardly say that I see
anything except what I recall ; I have no power of mind but in my
recollection. Of all that is said, of all that is done, of all that passes
in my presence, I feel nothing, I appreciate nothing. The external
sign is all that strikes me. But after a while it all comes back to me.
I remember the place, the time, the tone, the look, the gesture, the
circumstance — nothing escapes me. Then, from what has been done
or said, I discover what was thought, and I am rarely deceived.

" If I am so little master of my mind while alone, it may be conceived
what I must be in conversation, where to speak a apropos, one must
think at the same time and at a moment's notice of a thousand things.
The mere idea of so many proprieties, of which I am sure to forget at
least one, is enough to intimidate me. I do not even understand how
a person can dare to speak in company — for at each word one ought to
pass in review every one that is present ; to be acquainted with all their
characters and know their histories, in order to be sure to say nothing
that may offend any. Certainly those who live in the world have a
great advantage here ; knowing better what not to say, they are surer
of what they do say ; yet even from them slips many an unfortunate
speech. Imagine the condition of a man who falls into it all from the
clouds ; he can hardly talk with impunity for a minute. In a tete-a-tete
there is another disagreeable, which I find worse. I mean the necessity
of talking constantly ; if you are spoken to you must answer, and if
nothing is said, you must take up the conversation. This unendurable
constraint alone would have disgusted me with society. I find no
burden more intolerable than the obligation to speak at once and con-
stantly. I do not know if this arises from my mortal aversion from all

58 THE SYMPTOMS OF

subjection ; but it is quite enough to be obliged to speak to mate me
infallibly say something foolish.

" What is more fatal is that, instead of knowing how to hold my
tongue when I have nothing to say, it is just then that, to pay my
debt as quickly as possible, I have a mania for talking. I try in a
hurry to stammer, promptly, words without ideas, only too haj^py if
they mean nothing at all. In trying to conquer or hide my inapti-
tude, I seldom fail to display it.

" I believe that this is the real explanation of why, though I am not
a fool, I have often passed for one, even with persons capable of judg-
ing ; all the more unhappy because my physiognomy and my eyes
promise something better, and my failure makes my stupidity all the
more shocking to others. This detail, which a particular instance has
suggested, will not be useless to any one who follows it. It contains
the key of many extraordinary performances of mine, which have been
attributed to an untamed humour which I do not possess. I should
relish society as well as any one, if I were not sure to exhibit myself, I
do not say only to disadvantage, but as something quite different from
what I am. The system I have adopted of retirement and writing
precisely suits me. No one would ever have known, from my presence,
what I was worth ; no one would ever have suspected it." — Loc. cit.,
pp. 151—155.

I think this description has been seldom surpassed in hideous frank-
ness : similar cases are almost daily brought before me, but few could
or would describe their condition so fully as Jean Jaques Eosseau has
done. The slowness of thought and comprehension, the timidity in
conversation, the morbid quickness of feeling, the wretched dwelling
on self, and diseased love of solitude, of mind as well as body, are most
characteristic.

It would be well for humanity if masturbation did no more than
produce even such humiliating mental effects as these. Daily experi-
ence teaches us that the evil habit is attended with the worst physical
consequences also. These may as well be disposed of before we come
J to the last, worst, and most constant result, when the practice has be-
come a confirmed habit.

At first we remark but little local irritation of the canal of the
urethra. Pain may occur in making water, as well as a frequent
desire to empty the bladder ; the orifice of the meatus is frequently
found red, and ejaculation, which before could only be excited by
much friction, now takes place immediately ; the secretion is watery,
and even slightly sanguinolent, and emission is attended with spasm.
A sense of weight is felt in the prostate, perinseum, or rectum, and
anomalous pains are often complained of in the testes. Nocturnal
emissions become very frequent, and are easily excited by slight erotic

MASTURBATION IN THE YOUTH AND ADULT 59

dreams. Those at first arc attended with pleasurable sensations, but
later the patient is only aware of ejaculation from having his attention
the next morning attracted to it by the condition of his linen. In
other instances the semen does not pass away in jets, but flows off
imperceptibly. In some cases it makes its way back into the bladder,
to pass out with the urine. Other patients will tell you that emis-
sions have ceased to occur, but on going to stool, or on the last drops
of urine passing from the bladder, a quantity of viscous fluid, varying
from a drop to a teaspoonful, dribbles from the end of the penis
which, if collected, or allowed to fall on a piece of glass, and exposed
to the microscope, may furnish spermatozoa in greater or less numbers.

The vicious habit having impaired the growth, health, and intellect
of the patient, ceases often to be voluntarily indulged in, because
pleasure is no longer derived from it. The drain on the system
during defaecation or micturition, however, as I have stated above con-
tinues, and what depended at first on an artificial excitement, is kept
up by the irritation or inflammation of the urethra, vesicuke seminales,
and spermatic ducts. The too frequent irritation of the testes causes
badly eliminated semen to be secreted, which is at once emitted. The
mucous membrane is more sensitive than usual (see p. 32), and acquires
an irritability like that often seen in the bladder, which irritability
appears to be more or less general. I may mention here that pleasurable
sensations seldom attend the expulsion of ill-conditioned semen, this
is probably caused by over-abuse of the sensations, which become
subsequently blunted. The patient is now frequently reduced to a
state of complete bodily and mental impotence.

We need not pursue the progress of the physical disease further
here, as the subsequent symptoms will be more fully described in the
chapter on Spermatorrhoea.

Peognosis. — My opinion is that, unassisted and without medical
sympathy and aid, it is not an easy matter to give up the practice.
When once the vile habit has become confirmed the young libertine
runs the risk of finding himself, a few years later, but a debauched old
man. I have known lads and men of strong energy of will who have
by their own confession failed, until they were aided by the other
remedies which I shall hereafter describe. Want of resolution is, of
course, one cause of failure, and where there is hereditary predispo-
sition to strong sexual excitement, the task is often too great without
good counsels and sound medical advice; and I should advise all
sufferers not to rely on themselves for a cure, but at once to resort to
their usual surgeon, who will give them sympathy and counsel. Let
them, above all things, avoid advertising quacks.

If the struggle is severe for a youth to extricate himself from these
vicious propensities, experience teaches me that it is very doubtful if,

60 THE PROGNOSE OF

wlien the practice lias been much indulged in, the physical frame will
ever be wholly built up again ; the haggard expression, 1 the sunken
eye, the long, cadaverous-looking countenance, the downcast expres-
sion, which seems to arise from the dread of looking a fellow-creature
in the face, may be carried to the grave. Undoubtedly care and at-
tention may do much in remedying the intellectual wreck which we
notice in such youths.

It will be remembered that I am describing the results of only the
worst and longest continued cases. The probability is that in many
who read these pages and who have at some time or other practised
this vice, but have early abandoned it, the symptoms will be of the
slightest kind, and a speedy cure may be promised.

Quacks are eager, of course, to represent every case as of the worst
description ; and I therefore wish clearly to guard myself against being
supposed to mean that in my opinion all, or even most persons who have
for a short time fallen into this wretched habit are doomed to all the
results above described. These results are, it is true, the end towards
j which sufferers are tending, if they do not conquer the propensity, but
if they do so before the last stage is reached, there is good hope for
them yet. Nevertheless, the other extreme must be avoided, of think-
ing lightly of the habit, or denying that it is the cause of disease. A
great change on the prognosis of these diseases has come over the pro-
fession in this respect of late, and many eminent surgeons now admit
that various unrecognisable ailments are caused by these practices ;
and the ' Lancet,' in a series of remarkable leading articles, has (1870)
suggested that all surgical authorities should discuss these ailments in
the different manuals and dictionaries, instead of neglecting to treat
of them as hitherto.

It is not very long ago that an able physiologist told me he believed

1 Since writing the above a very favorable case of recovery has come under my
notice. About six years ago a youth consulted me, suffering from some of the worst
effects of masturbation. He has lately come to ask my opinion on the advisability of
marriage. I find that, intellectually and physically, my patient has to a great extent
recovered, but he still retains the peculiar physiognomy which, to me, is very
characteristic. There is the hollow, sunken eye still left, although nature has filled
up all other interstices. The expression has nearly become natural, but still the
practised eye sees that there remains an unsettled look, very different from the calm,
steady gaze of other men. In this case I was able to give my sanction to an early
marriage, strict continence having always been maintained, only occasional emissions
occurring, and I have little doubt that a few years of married life will still further
improve the expression of the face.

This opinion was borne out by the results. I have lately (1874) met my former
patient, an altered man, much improved in appearance, and we had much earnest
conversation as to how he should protect his growing-up boys from falling into a
condition similar to that of their father.

MASTURBATION IN THE YOUTH AND ADULT 61

that one half the boy population masturbated themselves more or less,
and yet that the resultant consequences were very slight. He saw
much of conscience-stricken young men who consulted him ; but, in his
opinion, they exaggerated their sufferings, and writers on the subject
had magnified the ill-effects of self-abuse. This gentleman and those
professional men who agree in this view have probably only met with
slight cases, for there can be no doubt that there are others, whose
wretched condition, mental and bodily, can hardly be exaggerated.

There are many false cases, no doubt, which are often misunderstood
and have misled even able professional men, but it is not less certain
that there are true cases. I could speak, from my own experience, of
the many wrecks of high intellectual attainments, and the foul blot
which has been made on the virgin page of youth — of shocks from
which the youth's nervous system will never, in my opinion, be able to
rally — of maladies engendered which no after course of treatment can
altogether cure, although surgery may do much to alleviate symptoms
as they arise.

One of the chief causes which impede recovery, and interfere with
the action of any remedies, is the mental anguish arising from the
horror and remorse which the patient experiences. This has been well
put by Tissot, who wrote a book on ' Onanism ' a century ago. His
observations are as true now as then. He says :

" When the veil is removed, the picture of their conduct is brought
before them in all its hideousness ; they find themselves guilty of a
crime, of which Divine justice wishes not to supersede the penalty, and
which it punishes by death — of a crime reputed as a great crime, even
by heathens :

* Hoc nihil esse putas ? Scelus est, nrihi crede sed ingens
Quartum vis animo concipis ipse tuo.' Maet.

"This distress cannot be alleviated by the sympathy of others.
Shame obliges the patient to hide his crime from every one, till some
unbearable torment force a revelation. Many, indeed, die because
they have not been able to muster courage to reveal the cause of their
misery. I often receive letters saying, I would rather die than appear
before you after such an avowal.

" Feeling that he must be held in detestation by society if his dis-
grace were known, the idea pursues him incessantly. ' It appears to
me/ says one of my correspondents, ' that every one reads in my face the
infamous cause of my disease, and this idea renders society unbearable ;'
and what is most frightful, I have no pretext of justification or motive
for consolation."

I need hardly say that, instead of fostering in the least this morbid
feeling, it is the duty of the surgeon to assure his patient of sympathy

62 TREATMENT OF MASTURBATION

and cordial help, and to do all in his power to remove these delusions,
for happily in many cases these ideas are but delusions.

Treatment — In the earlier stages of this mental and bodily debility

Ithe services of the surgeon may be of great benefit. If a bougie be
introduced into the urethra, and the treatment alluded to at p. 32 be
employed, the patient will find it much easier to exercise self-control
(which is what is wanted). If he will aid the surgical treatment, by
taking gymnastic exercise, and following the other rules laid down
above, pp. 24, 32, a favorable result may be expected. It is in the
earlier stages that advice should be sought, instead of waiting until
dementia has occurred, or the brain become disorganised. Those who
treat mental diseases are not consulted sufficiently early to admit of
recourse being had to the treatment here recommended ; they see the
effects when too often the mischief is irremediable : and it may be from
the impression thus produced that sufficient attention has not been as
yet given to surgical treatment in the incipient forms of insanity,
brought on by this malady.

If, however, a patient will not attempt self-control, mental as well as
physical, and if, — instead of consulting a qualified medical man, —
hearing from him a statement of the consequences of the practice, —
strictly following out the treatment recommended, — and giving up the
vile habit, — he should abandon himself to humiliation and despair,
the downward course may be very rapid and fatal. When this frame
of mind has completely got possession of a man, the step to insanity
in its worst and most hopeless forms is alarmingly short.

SECT. III.— INSANITY ARISING FROM MASTURBATION

I That insanity is a consequence of this habit is now beyond a
t'doubt. 1 The subject has recently been thoroughly investigated by
Dr Eitchie, from whose able treatise, entitled ' An inquiry into a fre-
quent cause of insanity in young men/ I have condensed the following
particulars :

The Cause. — Dr Eitchie thus quotes from a work by Esquirol, en-
titled ' Des Maladies Mentales :' — " La masturbation, ce fleau do
l'espece humaine, est, plus souvent qu'on ne pense, cause de folic,
surtout chez les riches." And again — " La masturbation, dont nous
avons parlc sous un autre rapport, est signalee dans tous les pays,
comme une des causes frcquentes de folie ; quelque fois c'est le prelude

1 The connection between insanity and extravagant sensuaj desire is alarmingly
close, as appears from many modern investigations, especially with regard to t he-
central portion of the cerebellum.

Deslandes has remarked that, " in proportion as the intellect becomes enfeebled, the
generative sensibility is augmented."

INSANITY ARISING FROM MASTURBATION 63

de la nianie, de la demence, et meme de la demence senile ; elle jette
dans la melancholie, conduit au suicide. Elle est plus funeste aux
hommes qu'aux feinnies," &c.

Class of Persons Affected. — " It might be expected," says Dr
Eitchie, " that these cases would chiefly occur in members of families
of strict religious education. Experience indorses this expectation;
and facts also show that those who from this cause become insane
have generally, to all appearance, been of strictly moral life, and re-
cognised as persons who paid much attention to the forms of religion.
As will be afterwards more fully stated, it is frequently observed, es-
pecially in the acute attack resulting from this cause, that religion
forms a noted subject of conversation or delusion."

Premonitory Symptoms. — "The parent, after her son (the only
child it may be) is taken to an asylum will tell you that his insanity
cannot be accounted for. He has been so well conducted, so quiet and
studious, not seeking the company of the gay, the idle, and the
thoughtless, but remaining quietly at home rather than joining the
social amusements of those of his own age. Further inquiry may
elicit that he has been of good abilities, and it may be, clever in his
occupation ; that he had few friends, and rather shunned the society of
those of the other sex. Had he been other than he was, some cause
might have been found in the irregularities of life to cause insanity in
one scarcely beyond boyhood's years ; but in such a quiet lad, and so
carefully brought up, she is unable to suppose a cause. Then she
may tell you that for some time past a gradual alteration has been
going on ; he has changed not only in manner but in appearance ; he
has become so peevish and irritable, so reserved in his conversation,
so apathetic in manner, so slovenly in dress, so contradictory and so
uncertain in his actions, so hesitating, first determining on one thing,
and before he could execute the course determined on changing to
some other, and has shown such a want of self-reliance. That quite
recently he has grown more and more apathetic, more slovenly in
dress, paying less attention to cleanliness, and become slower in his
actions ; that he is now not only irritable in his temper, but is at times
violent ; that he does things by ' fits and starts,' is impulsive, delibera-
ting long, and then suddenly hastens apparently to carry out his
intention ; and has become so stupid-looking and lost, and incapable of
taking care either of himself or his business ; and all this has occurred
without any apparent cause, except it may be his ' studious habits.'
At last he can be borne with no longer ; he is unmanageable in a
private house, and is obliged to be removed from his home."

General Symptoms. — " On entering an asylum for the insane,
especially if it be one receiving patients from the middle as well as
from the lower class of society, there is one group of inmates which

64 INSANITY ARISING FROM MASTURBATION

may arrest the attention of the visitor from the contrast presented to
the excited persons around him, on the one hand, and to those who are
convalescent on the other. Engaged in no social diversion, the
patients of this group live alone in the midst of many. In their ex-
ercise they choose the quietest and most unfrequented parts of the
airing grounds. They join in no social conversation, nor enter with
others into any amusement. They walk alone, or they sit alone. If
engaged in reading, they talk not to others of what they may have
read ; their desire apparently is, in the midst of numbers, to be in
solitude. They seek no social joys, nor is any wish for fellowship
evinced.

" The pale complexion, the emaciated form, the slouching gait, the
clammy palm, the glassy or leaden eye, and the averted gaze, indicate
the lunatic victim to this vice.

"Apathy, loss of memory, abeyance of concentrative power and
manifestation of mind generally, combined with loss of self-reliance,
and indisposition for or impulsiveness of action, irritability of temper,
and incoherence of language, are the most characteristic mental phe-
nomena of chronic dementia resulting from masturbation in young
men.

" As in diseases of an exhaustive nature we find that the cutaneous
secretion is poured forth abundantly, so in the cases occupying our
attention the perspiration breaks forth on the slightest exertion.
This relaxed condition of the perspiratory system is especially marked
in the palms, and the exception is to find these dry in a masturbator ;
for generally a damp, or cold, clammy perspiration is constantly pre-
sent, and makes it particularly disagreeable to take the hand of one of
these persons. The sub-integumentary layer is but sparingly supplied
with fat, which is remarkable, considering the little exercise these
patients, if left to their own guidance, would take.

" To conclude this description, it is only necessary to add that the
gait is slovenly or slouching, that the gaze is downcast or averted, and
when addressed, the masturbator does not look the speaker openly in
the face while he replies, but looks to the ground or beyond the ques-
tioner."

Diagnosis. — " The physical system is, as a rule, but indifferently
developed. The muscles are small, soft, and flabby ; the body is gene-
rally emaciated, the adipose tissue being but feebly stored up ; the
complexion is variable, but, though occasionally flushed, is, as a rule,
pale ; the gaze is not constantly averted, but in all the cornea will be
found dull and the expression inanimate.

" Excitement, with delusion of a melancholic cast, and frequently, if
not in most cases, of a religious tendency, combined with a suicidal or
a self -mutilating inclination, occurring in a thin or emaciated man,

INSANITY AlUStNG FROM MASTURBATION 65

under the age of twenty-five (who does not present evidence of organic
cerebral disease), of generally pale complexion and averted gaze, but
always with the dull cornea and expressionless countenance, would lead
to the diagnosis of the cause."

Prognosis. — " This condition does not continue many days. The
cause being discontinued, the stupor becomes less intense, the inclina-
tion for repose more marked, and the sleep more natural and refresh-
ing ; the sensations of hunger and thirst are once more experienced ;
the secretions are more active ; the cleanliness of habit is attended to ;
the dress is looked after ; the obstinacy decreases, and gradually an incli-
nation and the ability to converse return, and at last, though slowly, the
health of mind and body is restored. Such, in favorable cases, is the
result, but it too often happens that convalescence is arrested, and that
the condition of ordinary or chronic dementia becomes established, and
with it the prospect of recovery diminishes."

Relapses. — " Remonstrate with these victims after they are received
into an asylum, whilst reason is still not quite destroyed, and they
will agree with your remarks. They will express their thankfulness
that they have yet been spared some portion of reason; they will
express their deep abhorrence of their conduct ; they will shed tears
of apparent penitence ; and yet the old habit will be relapsed into ; and
when they think themselves removed beyond control, they will once
again iudulge in their self -destroying practice. The determination to
conduct themselves in the pure course is wanting, and in this there is
evidence of the pernicious energy -sapping cause.

" Few incidents are more capable of occasioning annoyance and dis-
appointment to the physician, and none more calculated to excite his
pity and regret, than to find the recovery he regarded as certain, marred
and prevented, or delayed, by the preventible act of the patient him-
self. This cause of relapse is but little believed in, except by those
who are intimately acquainted with the habits of the insane ; but
regarding it as possible, many an unexpected and unaccountable relapse
can be readily explained. When any tendency to indulgence has been
observed in the early stages of mania, the prognosis ought to be stated
in well-weighed words. The fact of a patient, neither epileptic nor
the subject of paralysis (although in young men the former is more
probable), who, when put to bed was progressing favorably, being in
a lost or much confused state when he got up on the succeeding morn-
ing would be significant of some cause acting during the night. In
the absence of excitement or a fit, the probability of this cause ought
not to be forgotten."

Termination of Cases. — " In acute or recent dementia, the con-
dition of the patient is most pitiable. His existence is, for a time,
merely vegetative, and in well-marked cases the obstinacy of disposi-

66 ABNORMAL CONDITION IN YOUTtf

tion is almost the only indication of a mental action, and the mental
origin of this may even be doubted. The sufferer becomes quite
silent, and is lost and unable to take care of himself. He becomes
statuesque, and extremely obstinate. He resists passively, and occa-
sionally actively. If he be in bed, he will not rise to be washed
or dressed. If up, he will not retire at proper time to bed, or allow
himself to be undressed. Everything requires to be done for
him. Cleanliness is neglected, and his dress unattended to. He
makes no effort to speak, and when addressed, although con-
scious, does not appear to comprehend what is said. He will not feed
himself.

" How earnestly do those who know what the future will bring to
such a one repeat these feeling words of Ellis— 'Would that I could
take its melancholy victims with me in my daily rounds (at Hanwell
Asylum), and could point out to them the awful consequences which
they do but little suspect to be the result of its indulgence. I could
show them those gifted by nature with high talents, and fitted to be
an ornament and a benefit to society, sunk into such a state of physical
and moral degradation as wrings the heart to witness, and still per-
severing, with the last remnant of mind gradually sinking into fatuity,
the consciousness that their hopeless wretchedness is the just reward
of their own misconduct.' "

Tendency to Commit Suicide. — On this point Dr Eitchie says :
"As regards suicide, the greater frequency of this occurs in those
whose cases assume a melancholic character with the excitement.

" Although it will be found that various supposed causes may be
alleged, still I believe that in the greater proportion of such cases the
immediate exciting cause is the feeling of disgust at, combined with
alarm for, the consequences of, the patient's criminal conduct. Hence
it is that feelings of their own unworthiness arise in such patients, and,
under the impression that they have committed the unpardonable sin —
have sinned against the Holy Ghost — and that a future world presents
no hope of joy or happiness for them, as they are excluded from it by
their past conduct, they frequently make attempts to terminate their
own existence. Such an act is occasionally incited by hallucination of
the aural organ ; but I have not found that suicide is so frequently to
be traced to this, as in other cases of mental aberration depending on
other causes."

Self-mutilation. — " Another peculiarity of these cases is the ten-
dency frequently exhibited to self -mutilation, and, as reports show,
the attempts are not unfrequently successful. Thus is indicated an
unsound reasoning power, the visiting on the supposed offending organs
the faults of the ill-regulated mind." 1

1 I was recently called upon to sign a certificate, for a gentleman of high standing

Insanity aeising from masturbation 67

As Dr Ritchie states, the delusions in many instances assume a
religious character, and hence it is that it is repeatedly found that the
cause of the sufferer's condition is supposed to be religion. The delu-
sions of this class generally are of the melancholic character stated
above : fears that eternal happiness is lost — that they have no hope
beyond the grave — that they have committed an unpardonable sin —
or that they are unworthy to live.

From the true, cause of the mental condition of these cases not being
understood, the meaning of these reproaches for past conduct cannot
be comprehended ; and it is easily explained why a young man of
apparently blameless life making these self -accusations, is regarded by
his friends as suffering from acute religious feelings, whereas remorse
or fear has generally more to do with his condition than true religious
impressions or conviction.

It is probable that some of those young men whose insanity has be-
come developed through revival meetings, of which there have been
many instances, would, on close inquiry, be found to belong to the
class now occupying our attention.

In some patients, rash and even criminal acts are the result of the
idea that an atonement may thereby be made for the sin committed.
The attempt to injure the genitals and similar extravagances often, I
believe, arises from such insane fancy. While, on the other hand,
extravagant masturbation or the tendency to commit rapes or unnatural
crimes may be in some cases traced to the not less insane desire the
sufferer feels to test, and prove to himself, or others, that he is not
impotent.

Treatment. — The long extracts I have given from Dr Ritchie's
pamphlet may testify to the high value which I set on this acute
observer's remarks on the disease ; I differ from him, however, some-
what as to the prognosis and treatment, and am far more sanguine
than he is of the success which may be anticipated from appropriate
management.

in his profession, who was himself willing to enter an asylum. His case was a very
sad one, and exemplifies the ideas a patient, in this state, forms of his own ailments.
His history, which, however, I gleaned from him with some difficulty, was as fol-
lows : — Early in life he contracted the habit of masturbation, nevertheless he married,
and lived tolerably happily with his wife; and his marital duties were performed, he
assured me, in a satisfactory manner. He became, however, depressed, his conscience
told him that he had done wrong in abusing himself early in life, and he deter-
mined as a punishment, that he would cut away the testes. This he effected, — the
parts healed, and the patient entered an asylum, which he subsequently left. At the
period I saw him, he was in what, I suppose, I may call a lucid interval. He still
regretted most bitterly his early sins, and was satisfied that he had not been justified
in mutilating himself. He was conscious that he was again losing his self-will, and
felt that he ought to be watched, lest he should further injure himself (I was told he
had attempted his life). — W. A.

68 ABNORMAL CONDITION IN YOUTH

Still, when dementia has set in, I quite agree with Dr Eitchie, that
the case assumes a very serious form, and then passes from the surgeon's
care into the hands of those who attend to such cases. Kind care and
domestic attentions are all that can be suggested to soothe the latter
days of these victims of ignorance or vice.

In a former edition of this book diffidence on my part prevented my
giving any positive opinion on this subject, and I preferred quoting
the opinions of Dr Ritchie, who had then recently published his
pamphlet.

Further experience enables me (while allowing the present chapter
to remain) to give my personal opinion on this most important ques-
tion, and I confidently assert that, at least in the earlier stages of
dementia caused by self -abuse, the greatest service can be done to the
patient. Even in the more confirmed cases of insanity arising from
this cause, I should not be disposed to give up the hope of effecting a
cure, instead of consigning them to confinement in a lunatic asylum, and
I trust my personal experience may induce those who specially devote
their attention to mental diseases to give my plan of treatment, recom-
mended at page 31, a fair trial. One thing I can confidently promise,
that if my advice does not cure the confirmed case, it cannot do any
harm. If it Enables but one poor sufferer to be rescued from the mad-
house, it deserves a trial, and I think my professional brethren will
often find it succeed in cases previously considered hopeless.

SECT. IV.— PHTHISIS ARISING FROM MASTURBATION

The attention of physicians has been of late years directed to this
subject. In the year 1862, Dr E. Smith read a paper before the
Med. Chir. Society entitled " A Statistical Inquiry into the prevalence
of numerous conditions affecting the constitution in one thousand
phthisical persons when in health." In this paper, he stated that
11*6 per cent, of the males had committed sexual excesses ; 18'2 per
cent, had been addicted to masturbation, and 22 per cent, had suffered
from involuntary emissions. I can, from my own observations, fully
corroborate his statements, though whether the phthisical cachexia is
to be regarded as a cause or an effect of sexual excess I am not sure.
Delicate constitutions, with a consumptive tendency, are often very
susceptible of sexual excitement. They are consequently peculiarly
liable to nocturnal emissions, and to the temptation to commit excesses.
Coupled with this special tendency, there is often in such persons a
high spirit, and a carelessness of consequences, which will not yield to
any slight indisposition. It may, perhaps, often be, in such instances*
as much the constitution which predisposes to excesses, as the sexual

AFFECTIONS OF THE HEART ARISING FROM MASTURBATION 69

excesses which induce the delicacy of constitution. There can be,
however, no doubt that these excesses are doubly fatal to such idiosyn-
crasies. It is well when the surgeon or physician is able, early in life,
to impress on a patient with marked family predisposition to phthisis
the imminent risk he incurs in allowing the sexual feelings to run
riot. I am convinced that it is from such preventible causes as these
that the hopeful career of many of our most promising youths and
hard-working students comes to a sad and early end. It should be
here noticed, and the fact will be more fully considered in the latter
portions of this volume, that a lavish expenditure of the vital fluid semen
is most detrimental to a young man's constitution. Whether this
arises from masturbation, sexual excesses, or very frequent nocturnal
emissions, the effects will be very similar. If we here treat of mastur-
bation, it is because this vice is one more readily and easily practised
and repeated by young men, and to it, therefore, more frequently than
to the other causes, it is that the evil consequences which we are now
considering are due.

The Prognosis is favorable if the patient is seen early, and the
treatment conformable to the causes of the complaint adopted. I have
seen many young men in consultation with some of the leading autho-
rities of London, and have rescued them from what has been con-
sidered a very dangerous condition. The ordinary remedies for
phthisis are of no avail unless we at once check the cause of the com-
plaint, namely, sexual excesses. When this has been done, everything
that can improve the health, or enable the system to rally, will, of
course, be beneficial, and the observations I have already made, page
67, on the treatment of insanity apply with equal force to phthisis.
I shall, therefore, not repeat them, but merely express my conviction
that we can, in a large number of cases, afford relief and rescue the
sufferers from imminent danger.

SECT. V.— AFFECTIONS OF THE HEART ARISING FROM
MASTURBATION

I have seldom met an instance of sexual excess in which complaints
of the heart's action have not been made. Patients assert that they
can make no exertion without suffering under palpitation. In order
to satisfy myself that these affections of the heart were not organic, I
have met in consultation most of the ablest men in London, and we
have come to the conclusion that these patients are suffering from
functional diseases of the heart, and consequently the prognosis
becomes much Jess serious, provided, as I stated in the preceding

70 AFFECTIONS OF THE HEART ARISING FROM MASTURBATION

chapter, the patients will forego these excesses, and treatment is pre-
scribed calculated to enable them to gain mastery of their will
and to exert self-control. As soon as this power of exercising self-
restraint is gained, the usual tonics, stimulants, and sedatives will
exert the beneficial influence proper to them, though they may have
been taken previously without any benefit. It is in this that the
advantages of the modern treatment for functional diseases of the
heart among young men consist, and the results achieved fully bear
out my favorable prognosis of such cases.

THIRD PERIOD-ADULT AGE

THE FUNCTIONS AND DISORDERS OF THE
REPRODUCTIVE ORGANS IN THE ADULT

The following pages will, for the purpose of greater clearness and
conciseness, be divided into two parts. In the first I propose to enter
on general considerations relating to the sexual condition of the adult,
and in the second, to refer, with rather more minuteness, to the special
constitutent parts and necessary requisites of . the sexual act, viz.,
erection, ejaculation, and emitted semen.

FIRST DIVISION

GENERAL CONSIDERATIONS ON THE SEXUAL
CONDITION OF THE ADULT

VIRILITY

The commencement of adult life is a period in human existence less
marked, perhaps, but not less real, and hardly less critical, than that of
puberty. The general growth of the body is complete. The immature
limbs of youth are converted into the firm and elastic frame of the
man. The mental powers should be at their highest. The will and
judgment should command, and yet be enlivened by the remains of
youthful energy and enthusiasm. And, what is more to our present
purpose, the virile powers, whose active development commenced at
puberty, — now at last matured, — should be fit and ready to be
exercised in obedience to the Creator's command to " be fruitful and
multiply."

At a period differing in every man's life — but occurring generally

72 SEXUAL CONDITION IN THE ADULT

somewhere between twenty and thirty — the individual is conscious, if
he has lived on the whole a tolerably chaste life, of a great change in
those sexual tendencies of which he has been frequently conscious
before. They are no longer the fitful fancies of a boy, but are capable,
he feels, of ripening at once into the steady rational passion, or
rather purpose, of the full-grown man. The natural longing is
there still, but it is no longer towards mere sensual indulgence
(it will be remembered that I am speaking of the continent man)
but is deeply tinctured with the craving for wife — and home — and
children.

Still, it is not to be denied, that — however purified and fortified by
these additional elements — the sex-passion in a healthy continent adult
is very powerful ; very different from the sickly cravings of the volup-
tuary, or the mad half -poetical desires of a boy, but requiring even the
adult's utmost efforts to control, and his best wisdom to guide, when he
is able at last lawfully to indulge it.

My object, at present, will be to consider these sexual desires in
the adult with a view to furnish, if I can, some hints and suggestions
which may be not without their use, in enabling the individual to
judge wisely, and decide rightly in some of the most important crises of
his life.

First let us recall the real physical character of the sexual desires-
" They are," says Carpenter, " in man, prompted by instinct, which he
shares with the lower animals. This instinct, like the other propensities
is excited by sensations, and these may either originate in the sexual
organs themselves, or may be excited through the organs of special
sense. Thus, in man it is most powerfully aroused by impressions con-
veyed through the sight or touch ; but in many other animals, the
auditory and olfactory organs communicate impressions which have an
equal power ; and it is not improbable that in certain morbidly excited
states of feeling, the same may be the case in ourselves. Localized sen-
sations have also a powerful effect in exciting sexual desires, as must
have been within the experience of almost every one ; the fact is most
remarkable, however, in cases of satyriasis, which disease is generally
found to be connected with some obvious cause of irritation of the
general system, such as pruritus, active congestion, &c. The seat of this
sexual sensation is no longer supposed to be in the cerebellum 1 generally,

1 M. Flourens removed the cerebellum from cocks, yet they exhibited sexual desire
—but were incapable of gratifying it. Among animals, there is no proportion to be
observed between the size of the cerebellum and the development of the sexual
passion. On the contrary, many instances may be mentioned in which a larger
sexual appetite co-exists with a smaller cerebellum; e.g. rays and eels, which are
among the fish that copulate, have no lamina) on their almost rudimental cerebella ;
and codfish, which do not copulate, but deposit their generative fluids in the water,

SEXUAL CONDITION IN THE ADULT 73

but probably in its central portion, or some part of the medulla ob-
longata.

Roubaud considers that as venereal desires are instinctive in animals
at the rutting season, so also are they in young human males, at
puberty, after long periods of continence, or after intervals of
healthy rural repose. Later in life these desires, he thinks, answer
to no appeals but those of sensation or imagination. It is the sense
of smell which principally affects the lower animals, the odour of
the sexual organs of the female possessing an extraordinary attrac-
tion for the males of the breed ; but all the senses have power to
influence the desires of man. " There is no doubt," adds this author^
" that mere volition, without the aid of the senses, is adequate to
engender venereal desires. Such is the force of imagination, that
without reference to instinct and sensation, it is competent by itself
to produce not only venereal erethism, but even the very act of
ejaculation."

It is to be expected that, at the time when the man is physically
in the fittest state to procreate his species, nature should provide
him with a natural and earnest desire, a stimulus, as it were, to the
commission of the act which he is now fully competent to perform,
not only without injury, but often with positive advantage to himself.
This physical condition is thus described in the ' Encyclopaedia of
Anatomy :'

"During the period of excitement, spermatozoa are becoming
rapidly adult, the testicles and the ducts are full of semen, the indi-
vidual is in the condition of a fish with a full milt, or a bird or stag
with enlarged testes. He now instinctively seeks the society of women.
Intercourse with females increases his excitement, and all is ready
for the copulative act." (' Encyclopaedia of Anatomy? Art " Vesiculw
Seminales.")

These, then, are the physiological conditions of the adult male. He

have comparatively well- developed cerebella. Among Amphibia, the sexual passion
is apparently very strong in frogs and toads ; yet the cerebellum is only a narrow-
bar of nervous substance. Among birds there is no enlargement of the cerebellum
in the males that are polygamous ; the domestic cock's cerebellum is not larger than
the hen's, though his sexual passion must be estimated at many times greater than
hers. Among Mammalia the same rule holds ; and in this class the experiments of
M. Sassaigne have plainly shown that the abolition of the sexual passion by removal
of the testes in early life is not followed by any diminution of the cerebellum ; for
in mares and stallions the average absolute weight of the cerebellum is 61 grains,
and in geldings 70 grains, and its proportionate weight compared with that of the
cerebrum is on an average as 1 : 659 in mares, as 1 : 5*97 in geldings, and only as
1 : 7*07 in stallions. On the whole, therefore, it appears advisable to wait for more
evidence before concluding that there is any peculiar and direct connection between
the cerebellum and the sexual instinct or sexual pasoion, — Kirke's Handbook of
Physiology, 7th. edition, by M. Baker, p. 530 f

74 SEXUAL CONDITION IN THE ADULT

feels that manhood Las been attained, he experiences all those mys-
terious sensations which make up what we call virility.

CHAP. I.— VIEILITY

Lallemand thus describes the normal condition of the healthy adult :
— " Virility, derived from the Latin word vir, a man, is the distinctive
^characteristic of the male ; it is the condition upon which essentially
depends the preservation of the species. Is this deep and moral senti-
ment the artificial result of education, of social convenance, of institu-
tions, &c. ? Certainly not ! for it is identical in all men, among all
people, it is even more energetic, or at least more potent among the
least educated, and the least civilised. It depends then evidently on
the instinct of propagation, the most powerful feeling of all, after that
of self-preservation." (Vol. iii, p. 124.)

This feeling of virility is much more developed in man than is that
of maternity in woman. Its existence, indeed, seems necessary to give
a man that consciousness of his dignity, of his character as Jiead and
roiler^ and of his importance, which is absolutely essential to the well-
being of the family, and through it, of society itself. It is a power, a
privilege, of which the man is, and should be, proud — so proud that he
should husband it, and not squander or debase it. Too many a man,
with a recklessness that can only be attributed to ignorance of its value,
exhausts or defiles this noble prerogative of his manhood, a possession
as precious in its own way as that of chastity — " The fayrest vertue,
far above the rest,"

SECOND DIVISION
THE SEXUAL ACT, ITS PHYSIOLOGY AND DISORDERS

We come now to the second of the main divisions of this part of the
work. And first of all I propose to consider the several conditions
and acts which constitute sexual intercourse. 1st, I shall describe
them as they occur in health or normally ; and 2ndly, I shall point out
in what way they may occur abnormally, preventing or interfering with
the complete performance of the copulative act.

To the physiologist, but more especially to the medical man engaged
in practice, a knowledge of the more intimate causes of potence or
impotence is most important, and hardly less so to the thousands who
suffer in one way or another, from some of the many causes that may

SEXUAL CONDITION IN THE ADULT 75

interfere with, or entirely prevent, the exercise of the reproductive
functions.

To the due performance of copulation three things are indispensable
— namely, 1st, erection of the penis ; 2nd, the power of emission or ejacu-
lation ; and 3rd, a clue amount of well-formed semen ; all which it will he
necessary to treat of in the three following chapters.

CHAP. L— EKECTION

In pursuance of the plan which we have hitherto followed, we shall
divide the chapter into two parts, in the first describing the normal
act and its essential conditions, and in the second the disorders to
which erection may be subject.

Size op Penis. — But before dealing with the subject of erection,
I may say a few words on the size of the intromittent organ. In the
negro it is proverbially large, but, as is the case also where the same
peculiarity exists in a white man, the penis does not proportionately
increase in size on erection taking place.

Size, I may repeat, is no sign of vigour. One of the first character-
istics of the perfect athlete of classic times was unusually small though
well-shaped genital organs. Indeed, as I have before said, a large,
flaccid penis is not unfrequently a result and an indication of mastur-
bation having been indulged in to a dangerous extent. Veterinary
surgeons, it is true, condemn a horse with an abnormally small sheath,
as likely to be delicate in constitution. The rule, however, does not
apply to human beings, though, undoubtedly, a shrivelled, atrophied
condition of the organ may in addition to other signs become a pretty
sure sign of the existence of partial or entire impotence.

There are few questions more frequently put by patients than " Do I
not suffer under a diminished or diminishing size of penis ?" In nine
cases out of ten there is no cause for alarm whatever. A nervous
patient in bathing has seen another man with a larger organ, or from
some other cause fancies that his powers must necessarily be deficient,
because he thinks the organ does not possess what he considers the
usual dimensions. The size of the penis varies greatly, and it has been
a great source of consolation to many patients to be told that its
efficiency bears no relation whatever to its size. A small penis, in-
deed, is often a more efficient organ than a large and massive one.
A small penis, it should also be remembered, when in a state of
erection often exceeds in size one which is larger while in a quiescent
state. An abnormal smallness of the penis can sometimes be success-
fully treated, as in the instance mentioned in a subsequent page. There
as the pressure of the truss was taken off the penis regained its normal

76 SEXUAL CONDITION IN THE ADULT

size. Marriage also will frequently increase the size of the organ.
Circumcision in cases where the prepuce is very narrow will tend to the
same end. In most cases, however, no treatment whatever is required,
and the patient may be assured that the due performance of marital
duties are fully compatible with a moderate-sized organ.

PAET I

NORMAL ERECTION, OR CONDITIONS ESSENTIAL

TO IT

This external sign of virility, as Buffon calls Erection, depends
chiefly on the existence in the organ of certain tissues known as erectile
tissues. Let us see what the most recent anatomical investigations
have taught us regarding these important structures. The following
remarks are extracted from the seventh edition of Kirke's \ Physiology,'
by M. Baker.

" Erectile Tissues. — The instances of greatest variation in the
quantity of blood contained at different times in the same organs are
found in certain structures which, under ordinary circumstances, are
soft and flaccid, but at certain times receive an unusually large quan-
tity of blood, become distended and swollen by it, and pass into the
state which has been termed erection. Such structures are the corpora
cavernosa (see diagram page 104) and corpus spongiosum of the penis
in the male, and the clitoris in the female, and, in a less degree, the
nipple of the mammary gland in both sexes. The corpus caver-
nosum penis, which isjthe best example of an erectile tissue, has an
external fibrous membrane or sheath, from the inner surface of which
numerous fine lamellae pass into the interior of the body, dividing its
cavity into small compartments, which look like cells when they are
inflated.

" Within these is situated the plexus of veins upon which the pecu-
liar erectile property of the organ mainly depends. It consists of short
veins, which very closely interlace and anastomose with each other in
all directions, and admit of great variation of size, collapsing in the
passive state of the organ, but, for erection, capable of an amount of
dilatation, which exceeds beyond comparison that of the arteries and
veins which convey the blood to and from them. The strong fibrous
tissue lying in the intervals of the venous plexuses, and the external
fibrous membrane or sheath with which it is connected, limit the dis-
tension of the vessels, and during the state of erection give to the penis
jts condition of tension and firmness, The same general condition o%

ERECTION — CONDITIONS ESSENTIAL TO IT 71

vessels exists in the corpus spongiosum urethree, but around the urethra
the fibrous tissue is much weaker than around the body of the penis,
and around the glans there is none. The venous blood is returned
from the plexuses by comparatively small veins ; those from the glans
and the fore part of the urethra empty themselves into the dorsal vein
of the penis, those from the corpus cavernosum pass into the deeper
veins which issue from the corpora cavernosa at the crura penis, and
those from the rest of the urethra and bulb pass more directly into the
plexus of the veins about the prostate. For all these veins one con-
dition is the same, namely, that they are liable to the pressure of
muscles, when they leave the penis. The vena dorsalis penis may be
compressed by the uniting tendons of the ischio-cavernosi ; the crura
penis and the veins issuing from them are under the same muscles,
and the veins of the bulb are subject to the compression of the bulbo-
cavernosi. (See Krause, lxxx, 1837 ; Kobelt, cxxvii and xxv, 1843,
p. 58.)

" Erection results from the distension of the venous plexuses with
blood. The principal exciting cause in the erection of the penis is
nervous irritation originating in the part itself, 1 or derived from the
brain or spinal cord. The nervous influence is communicated to the
penis by the pubic nerves, which ramify in its vascular tissue, and
Giinther (xcvi, 1828, p. 364) has observed that, after their division in
the horse the penis is no longer capable of erection. It affords a good
example of the subjection of the circulation in an individual organ to
the influence of the nerves, but the mode in which they excite a greater
influx of blood is not with certainty known.

"The most probable explanation is that offered by Professor
Kolliker, 2 who ascribes the distension of the venous plexuses to the
influence of organic muscular fibres, which he finds in abundance in
the corpora cavernosa of the penis, from the bulb to the glans, also in
the clitoris and other parts capable of erection. While erectile organs
are flaccid and at rest, these contractile fibres exercise an amount of

1 " The glans penis," says Kobelt, " is the principal point of reunion of the sensi-
tive nerves of the virile organ, no other part which it regulates can be compared
with it in this respect. In respect to richness in nerves, the glans penis yields to no
other part of the economy, not even the organs of sense." (Kobelt, loc. cit., p. 10.)

* Kolliker says, " Erection is caused, as I have shown (' Wurzb. Verh./ 13d. ii), by
a relaxation of the muscular elements in the trabecules of the cavernous and spongy
bodies, and of the tunica media of the arteries of those parts, in consequence of which
the tissue, like a sponge which has been compressed, expands, and becomes filled with
blood. The rigidity ensues so soon as the muscles are completely relaxed and the
sinuses filled to the utmost, without there being any necessity that the return of
the blood should be impeded and the circulation stopped. It ceases when the
muscles again contract, the venous spaces become narrowed, and the blood is ex-
pressed from them."

78 ERECTION — CONDITIONS ESSENTIAL TO IT

pressure on the plexuses of vessels distributed amongst them sufficient
to prevent their distension with blood. But when, through the
influence of their nerves, these parts are stimulated to erection, the
action of these fibres is suspended, and the plexuses thus liberated
from pressure yield to the distended force of the blood, which,
probably, at the same time, arrives in greater quantity, owing to a
simultaneous dilatation of the parts; and thus the plexuses become
filled, and remain so until the stimulus to erection subsides, when
the organic muscular fibres again contract, and so gradually expel
the excess of blood from the previously distended vessels." — Kirhes,
p. 142.

In speaking of the nerves, Miiller says : " The corpora cavernosa of
the penis and urethra are provided in greater part with nerves of
organic life, whereas the glans penis, very sensitive as it is, receives
nerves exclusively sensitive." — Miiller, * TJeber die Organischen Nerven
der erectilen Mannlichen Geschlechts-organe,' &c, p. 44.

" The arteries of erectile organs present a special disposition, which
strikes one at once. At first (as Miiller has shown) the arterial trunks
in the bulb and at the roots of the corpora cavernosa do not divide in
the usual way into dichotomic branches, but are surrounded on all
sides by bunches of vessels which arise, from three to ten in number,
from a short common trunk. These vessels are not mere short diver-
ticula, but traverse for some disance the large sinuses of the central
portion of the corpora cavernosa and of the bulb, and penetrate, after
numerous subdivisions and anastomoses, especially about the periphery,
the muscular trabeculse. After traversing these fibres, the arteries
pass to the surface through slit-like openings ; but from their origin
to their termination in the muscular fibres, the vessels from the
arterial branches are twisted on themselves in abrupt and closely com-
pressed spiral folds, interlacing, entwining, and anastomosing, so as to
form a sort of vascular tangle, and this, unlike any simple flexions
which a slight distension suffices to obliterate, persists during even
complete erection, and closely resembles a beautiful network." —
Mouget, Professeur agrege a la Faculte de Medecine de Paris, * Journ. de
Physiologie,' torn, i, p. 331.

Kobelt describes erection as follows : — " Thus, on the one hand, the
glans penis, endowed as it is with sensibility, and, on the other hand,
the irritable muscular apparatus of the bulb, act and react upon one
another as reciprocal exciting causes. The glans penis, when excited,
reacts on the bulb, which sends more and more blood — the exciting
material — towards it. Each new rush of blood to the glans exalts its
sensibility ; the bulbo-cavernosus muscle, irritated in its turn, progres-
sively accelerates its contractions, in order to satisfy the require*
ments of the glans, which also increases more and more, till at last,

ERECTION— CONDITIONS ESSENTIAL TO IT 79

by alternate actions, the entire apparatus reaches its highest point
of excitement. At this moment a new series of secondary reflex
phenomena is suddenly produced between the glans penis and the
muscles which produce evacuation of the vesiculse seminales, these
muscles become excited, a spermatic ejaculation is produced, and
at this point the currents of exchange cease, the special function is
accomplished, and the organ, as soon as nature has gained her end,
returns to its ordinary state of repose and vegetative life." — Kobelt,
loc. cit., p. 39.

Eouget has lately given up his views as to the way in which erection
takes place. Contraction commences in front of the bulb and the root
of the cavernous body, or at least at their margin. He supposes that
" the distension of the vesiculae seminales is the first cause of natural
erection. The latter commences by a species of spasm, which, develop-
ing itself in the muscular apparatus of the generative system, is trans-
mitted de proche en proche to the bundles of the root of the cavernous
body and the bulb, and tends to propagate itself to the whole extent
of the penis. The obstacle to the course of blood in the veins of the
plexus of Santorini, imposed by the first muscular contractions, has
for its immediate effect the dilatation of the areola of the cavernous
bodies by the blood ; and the tension of the liquid struggles ener-
getically against the muscular tonicity up to the moment when, ejacu-
lation being accomplished, spasm ceases little by little in the same
situations where it began ; the circulation then becoming free, muscular
contraction gets the better of the tension of the blood, and partially
drives on this liquid. The organ itself then gradually resumes its
natural dimensions."

These researches seem to demonstrate that the muscular contrac-
tions, the effect of which is to hamper the venous circulation, play
a considerable part in the phenomenon of erection ; nevertheless, they
do not play the principal part, and should not be considered other-
wise than as auxiliaries to the act. The first phenomenon observed —
that by which erection commences, and without which it could not
manifest itself — is the dilatation of the little arteries and veins under
the influence of the vaso-motor nerves. These are the erector nerves
(nervi erigentes) ; they arise from the sciatic plexus, and are distributed
with the vessels on the side of the bladder and prostate, as far as the
membranous and bulbous portion of the urethra, where we cease to
follow them.

At this point of their course we observe a certain number of gan-
glionic cells on the continuite of the nervous filaments.

The course of erection, I may add, is from the base of the organ
towards the glans, and the progressive return to the normal condition
seems to be in the opposite direction. After seminal emission the

80 ERECTION — CONDITIONS ESSENTIAL TO M

erection soon diminishes, and the return of the organ to its normal
bulk occupies less time than its previous erection. The sluices of the
venous blood are now suddenly opened. The elastic reaction of the
immoderately distended partitions and membranes presses upon the
blood in contact with them. The non-striated muscular fibres pro-
bably add to this propulsive force. The excess of blood is, therefore,
returned with increased velocity from the spongy texture towards the
pelvic cavity.

" When the nervous discharge which generally accompanies seminal
emission does not occur, the erection disappears much more slowly,
and nervous influences can subsequently produce a second erection
with greater ease and rapidity." — Valentin, translated by Brinton,
p. 630.

Hunter says — "When the erection is not strong, it shall go off
without the emission, but I doubt much if erection will take place
without the power of emitting semen, unless under unnatural excite-
ment, or except in cases of lesion of the spinal cord."

Bcecke thus describes the complicated act of erection in the human
being : — " A sensation produced either by an impression on the eye or
the touch, a dream or a simple recollection produces a first-reflex action
causing dilatation of the arteries of the erectile tissues. The blood
suddenly diverted (deverse) into these parts is arrested in the
cavernous bodies by the self-closure (autocloue) of these veins ; it
distends the membrana albuginea till it can contain no more blood ;
the contraction of the trabecular muscles further supports the mem-
brane, and increases the general stiffness of the organ. At the same
time blood is poured abundantly into the glans penis, but as it can
escape without meeting with any obstacle, it produces but simple
turgescence and a vague desire of pleasure. Soon, however, the
repeated friction of the glans produces contraction of the ischio- and
bulbo -cavernous muscles in consequence of a fresh reflex action. The
efferent veins supplying "these parts are compressed at the same
moment as the blood is pushed back from behind (d'arriere en avant).
The erection of the glans is complete, the venereal orgasm (a son
apogee) at its height, and a third reflex action acting on the vesiculm
seminales produces ejaculation. Lastly, the arteries retract or
tighten (se resserrent) and the blood accumulated in the erectile
tissues is impelled by the normal canals." Diet, de Medecine et de
Chirurgie Pratique, torn, xiii, p. 279.

In man the act of erection lasts only a short time, but the case is
different with many animals. For instance, in the dog, when the
penis is introduced into the vagina of the bitch, its body beconit a
suddenly enlarged, and the animal is thus unable to withdraw from
connection for a long time. This, according to Eicherand, depends

CONDITIONS ESSENTIAL TO ERECTION 8i

upon the absence of vesiculoe seminales in the dog ; and as the semen
passes only drop by drop, impregnation would not occur had not
nature ordained such prolonged copulation. This appears very
probable.

In some animals, as in the monkeys, the bats, the carnivora, the
rodentia, and the balsenidse among cetaceans, erection is further
assisted by a bone which is imbedded in the substance of the male
organ, of which it forms a considerable part. Where this bone exists
the corpora cavernosa are proportionately small, and the fibrous walls
of the peDis are confounded with its periosteal covering.

That the erect penis should fill the vagina and distend it seems
necessary to the full excitement of the female sexual feelings. It
appears from the following account given by Byiner Jones, in his
' General Outline of the Animal Kingdom,' that nature has given to
certain classes of animals an apparatus which deserves the attention of
the surgeon ; he says —

" In the guinea-pig no one will be disposed to deny that the penis is
an instrument of excitement. It is strengthened by a flat bone that
reaches forward as far as the extremity of the glans, beneath which is
the termination of the urethra ; but behind and below the orifice of
this canal is the opening of the pouch, wherein are lodged two long,
horny spikes. When the member is erect the pouch alluded to
becomes everted, and the spikes are protruded externally to a con-
siderable length. Both the everted pouch and the entire surface of
the glans are, moreover, covered densely with sharp spines or
hooklets ; and as though even all this were not sufficient to produce
the needful irritation, still further back there are, in some species, two
short and strong horny saws appended to the sides of the organ.
From this terrible armature of the male cavys it would be only
natural to expect some corresponding peculiarity in the female parts ;
but, however inexplicable it may appear, the female vagina offers no
uncommon structure." (P. 835.)

82 ABNORMAL ERECTION

PAET n

ABNORMAL ERECTION AND DISORDERS AFFECTING

ERECTION

Having described normal erection and its essential conditions, it
remains for us to consider a few of the more frequent perversions or
morbid states affecting this function, and for the convenience of
description I have treated of them under the separate sections of —

I. Slow Erection.
II. Erection not lasting long enough.
m. Imperfect Erection.
TV. Irregular Erection.

V. Non-erection.
VI. Priapism, or Permanent Erection.
VII. Satyriasis.

SECT. I.— SLOW ERECTION

This peculiarity occurs in animals as well as men. I observed it in
horses when, in 1862, I had the opportunity of visiting the well-
organised horse-breeding establishment of Mr Blenkiron in company
with Professor Spooner. A chestnut stallion in particular, aged and
somewhat fat, was remarkable in this respect. He required to be
walked about and around the mare before any erection took place, and
in mounting the act lasted rather longer than is usual with other
stallions.

This sluggishness, which is often rather a congenital peculiarity
than a disorder, sometimes causes alarm when it exists in man. I
have often been consulted by persons telling me that erection is very
tardy, and requesting some stimulus for the purpose of expediting the
act. Of course the invariable reply to such a request is that it would
be very dangerous to interfere. The best means of allaying the
anxiety of such patients is to explain to them the real cause of the
symptom. If it arises from temperament, there is nothing to be
alarmed at. Lethargic heavy men experience this symptom just as
the too susceptible suffer from the contrary one of too rapid erection
and emission. A little seasonable advice and sympathy may often in
such cases prevent much unhappiness and misunderstanding. Fitting

ERECTION NOT LASTING LOttG ENOUGfl 83

medical treatment, moreover, can often insure some amendment,
although of course nothing can alter the character and temperament
of the man.

SECT. II.— ERECTION NOT LASTING LONG ENOUGH

This is one of tlie varieties of disordered erection which is not
unfrequent, and gives rise to a great deal of annoyance. A married
man considers himself potent ; he wakes with erections of a morning,
and finds that they occur also under excitement, but to his chagrin
discovers that when he attempts sexual intercourse the erection ceases,
and the act is imperfectly performed, because the organ all at once
suddenly collapses.

In the opinion of the patient this is a very serious matter, but for-
tunately the medical man is able to give a very reassuring opinion.
On investigating the causes of such failures, it will be found that this
state of things depends upon causes that can be in many cases easily
removed. I have known this form of disorder arise in some instances
from the patient waiting too long. Erection will last but a certain
time, this of course varying in different persons, and in some it can be
maintained only a short time. Persons so circumstanced should not
dally, otherwise failure is likely to occur. The treatment in these
cases is of the simplest kind ; I advise the patient not to attempt to ,
repeat the act for twelve or twenty -four hours, or until strong desire
recurs ; then let him take care not to delay the act, and he will find
that the erection will suffice. The occurrence, however, particularly if
it happen in married men, should prove to them that age is advanc-
ing, and that the sexual power thus gives evidence of failure. To the
prudent man, under these circumstances, it is a warning that he must
economise his resources, and not give way to his passions, particularly
if in youth he has committed excesses.

SECT. III.— IMPERFECT ERECTION

This affection is much more common than is generally supposed.
It depends, according to Koubaud, upon perversion of energy, and may
be caused " by the nervous system having been excited beyond its
proper limits ; in some eases the excitement produced has not been
able to attain a sufficient energy ; it consequently follows that the
nervous influence soon ceases to animate the penis, in consequence of
the lassitude which the efforts made to produce turgescence of the
organ occasion ; and the blood, no longer retained in the cavernous
bodies, re-enters the general circulation."

Roubaud's view, however, is in my opinion too contracted, and if

84 ABNORMAL EHEOTION

the reader will refer to page 80, where the rationale of erection is de*
scribed, he will, I think, agree with me in preferring to attribute imperfect
erection either to abnormal reflex action of the sympathetic nerve, or to
a want of that co-ordinate action between the veins, muscles, and
arteries which is required to produce perfect erection. Instead of the
occurrence of cases of imperfect erection occasioning surprise, the wonder
really is that erection is so often perfect when the abuses to which the
functions causing it are exposed and the variety of ways in which it is
liable to be excited, thwarted, arrested, abused, interfered with, repeated,
or exhausted, are taken into consideration. When we, moreover, remem-
ber that erection is more or less an involuntary act, assisted by voluntary
muscles which are too often put upon the stretch, sometimes under less,
sometimes under more than ordinary stimulants, when we see boys
in their ignorance making all sorts of experiments in exciting, thwart-
ing, or impeding naturally associated functions which should act
synchronously, we can hardly be surprised if it taxes all the powers
of the educated medical man who has studied the anatomy and phy-
siology of the reproductive organs, to detect the precise point at which
the mechanism has been put out of gear, and this most minute, intricate,
and highly-organised nervous system been abnormally affected.

It is clearly not the nervous system only that may be thus deranged,
any impediment to the arrest of the blood in the veins at the right
moment will, if the anatomical explanation of erection be correct, inter-
fere with its due occurrence. I may further mention non-develoj)-
ment of the muscles, the too great irritability and over-excitement of
the fibres, as influential causes of disturbance ; so also any abnormal
deposit from accident, wound, inflammation or thromboid condition of
the blood in the trabecular tissue will detrimentally affect erection.
It is difficult to lay down general rules for the repair of machinery
so complicated ; the treatment of each particular case must in great
measure depend upon the conclusion at which the pathologist arrives
as to the most probable cause of the special derangement in question,
and to the formation of a sound judgment on such a point practical
experience is absolutely essential. The following observations may,
however, assist the surgeon who has not had large opportunities of
treating this variety of disease.

When a patient consults me I generally am at some pains to ascer-
tain if the sufferer at any time of the night or morning has a perfect
erection. An answer in the affirmative shows the case to be promising,
and proves that nervousness, diffidence, or some general cause must
intervene. When, however, the complainant admits he never has the
erection perfect, the prognosis is less favorable, and we must look for
some local cause interfering with the proper performance of the act.
Some light may be thrown on the best means of cure, by ascertaining

IMPERFECT ERECTION 85

the circumstances under which the imperfect erection occurs, and
whether it may not have depended upon temporary causes, such as we
have described in preceding sections. It is, however, as I have said,
impossible to lay down any general rules as to what should be done ;
the treatment in each case must be guided by special circumstances,
hereafter to be noticed.

We may occasionally discover a local cause for this imperfect
erection, as in the following case : — W — came to me, complaining that
erection was not perfect ; to effect penetration, he was obliged to grasp
the penis firmly with the hand, otherwise erection would not last, the
penis falling into a flaccid state ; I prescribed a number of remedies
and cauterized the urethra, but he subsequently told me that the opera-
tion was not attended with much benefit. In this instance W — had a
slight curvature in the back, and he mentioned that in early life he had
suffered from disease of the spine, with loss of motion in the lower
extremities ; from this he recovered by lying in the prone position.
He likewise confessed that he had been a great masturbator. I did not,
however, ascertain if the affection of the spine preceded or followed the
indulgence of this habit.

Writers on anatomy and physiology have furnished very little infor-
mation which will assist the surgeon in the treatment of these cases ;
however, Kobelt thinks that indolent erections (that is to say, those
which we notice in drunken people, in children, in old men and
persons of debilitated constitution) never extend beyond the corpora
cavernosa of the penis, and they never affect the passive organ, that is
to say, the glans penis and corpus spongiosum urethrse. The glans
particularly, in such cases, never attains its full size, except when the
other subordinate parts have been previously in a state of complete
turgescence; it will be hence understood why in certain conditions
(notwithstanding the complete rigidity of the body of the penis),
neither orgasm nor seminal ejaculation can be produced. — Kubelt,
loc. cit., p. 60.

In many of these cases, where the imperfect erection has appeared to
depend upon want of support to the vessels, I have found great benefit
from binding up the penis with strips of plaster, on the same
principle that we treat varicose veins in the lower extremities. The
occasional passing of a bougie, and even cauterization, has been like-
wise attended with remarkably successful results, while in other
instances galvanism, and even local stimulants, with the precaution
mentioned under the head of Impotence, have proved highly beneficial.

No doubt can exist that a want of a sufficiently powerful erection
depends upon a feebleness of the general muscular power. That is
proved by the result of treatment. In former pages I have advocated
gymnastic exercise, and I have found that as the general muscular

86 ABNORMAL ERECTION

force improves so do the muscles which minister to ejaculation and
erection. Let this be borne in mind, and often such seasonable advice
as tends to improve the general state of health will bring about local
muscular energy, and cure the want of erectile power.

SECT. IV.— IRREGULAR ERECTION

The erection may be abnormal in nature and most painfully distort
the penis while it lasts.

In March, 18 — , a middle-aged gentleman called on me, and stated
that he was a married man, with several children. He complained that
of late the penis, in erection, had been curved upwards, presenting
a scimitar shape, without any assignable cause. Connection gave him
pain, and he wisely indulged very little, fearing lest he should injure
himself.

In another patient the penis was of the natural size, or, if anything,
rather larger than usual, but it had a very marked irregular curve.
In the flaccid state, the whole organ curved forward, and at the same
time to the left. The patient mentioned that in erection the penis
had two curves, but he experienced no particular inconvenience from
its unusual shape. The only explanation which I can offer of these
strange anomalies, is that in consequence of violence, or from some
other causes, inflammation of the spongy portion of the urethra has
taken place, and plastic lymph been deposited, and that portions
of the tissues being thus no longer distensible, but always firm and
unyielding, these curvings necessarily arise on every erection. I
have successfully recommended friction with iodine as a remedy.
I have found equable compression, as described at page 85, with adhe-
sive plaster very beneficial, leading, as it does, to very considerable
absorption of any plastic lymph that may have been deposited.

SECT. V.— NON-ERECTION

Cases like the following not unfrequently come before a medical man,
and medical students are peculiarly the subjects of the complaint.

The patient states that the erection, formerly natural, has gradually
ceased to appear of a morning, although he is otherwise healthy,
and does not suffer from spermatorrhoea, and examination of the urine
detects no spermatozoa. Such cases can be readily explained. A man
studies hard, his health fails and semen is not secreted. As a natural
consequence the tendency to erections diminishes. Frequently no excess
Jias been committed— unless the inordinate exercise of the brain, often

PRIAPISM OR PERMANENT ERECTION 87

shown by the deposition of phosphates in the urine, can be so con-
sidered. My reply to such a man is, " Be thankful that your studies
are not interfered with by sensual thoughts." I advise him to continue
to work hard, but not to omit regular and daily gymnastic exercise.
Long observation of many such cases teaches me that after this long
rest of the organs, the seminal fluid will probably again be secreted
in great abundance as soon as the brain shall have ceased its inordinate
demands upon the blood.

The antagonism of the nervous and generative system has no!: escaped
the notice of writers on population. Herbert Spencer says, " Thus,
the fact that intense mental application, involving great waste of the
nervous tissues, and a corresponding consumption of nervous matter
for their repair, is accompanied by a cessation in the production of
sperm-cells, gives strong support to the hypothesis that the sperm-
cells consist essentially of neurine. And this becomes yet clearer on
finding that the converse fact is true, that undue production of sperm-
cells involves cerebral inactivity. Throughout the vertebrate tribes
the degree of fertility varies inversely to the development of the
nervous system."

SECT. VI.- PRIAPISM, OR PERMANENT ERECTION

Erection, again, instead of being absent or imperfect, may be only
too frequently and readily excited and too persistent. This is what is
called priapism. Fortunately for human nature, this terrible and
humiliating condition, in its full extent, is by no means common,
Every now and then, nevertheless, we meet with cases where, instead
of the erection only lasting a few minutes, — the male organ again
resuming its usual relaxed condition, — the penis will, if the statements
of patients can be believed, remain erect either permanently or during
long periods.

It is to the condition of the spinal cord and brain that we must look
for the source of this phenomenon. These, after all, are the primary
sources of sexual excitement, and on them depend the phenomena
of erection and ejaculation. Lallemand relates a case in which a
patient could produce ejaculation by striking his head with his
knuckles. Dupuytren has long since shown that lesions of the spinal
cord produce priapism. I have witnessed several such cases, but
ejaculation did not necessarily follow. It is a curious fact that this
state of priapism co-exists with loss of motion and sensation in the
lower extremities ; and as the power in the limbs is regained the
priapism ceases. It is, however, an anomaly, and Lallemand thinks it
shows that priapism does not depend on irritation of the lower part ctf

„

88 ABNORMAL ERECTION

the spinal cord ; though, as he justly observes, injuries to this part of
the spinal cord generally produce diminution, if not annihilation, of
the virile power and of the generative functions.

The Montpelier professor mentions a curious case (vol. ii, p. 55) of a
soldier who came under his care, having fallen on his sacrum ; there
was loss of power in the lower extremities and loss of sensation in the
glans, prepuce, skin of penis, and scrotum : catheterism produced no
pain, but there was catarrh of the bladder. The penis was frequently
in a complete state of erection, but ejaculation never was induced,
although the patient had attempted, by masturbation, to rid himself of
the erection. On one occasion sexual intercourse was indulged in for
several hours, but ejaculation did not occur ; nocturnal emissions,
notwithstanding, occasionally took place. ■ This, Lallemand thinks,
proves the special influence of the spinal and ganglionic nerves in
inducing ejaculation and involuntary emissions, as the cerebro- spinal
influence was completely annihilated; and this state, he thinks, is
somewhat analogous to the condition of a man under the influence of
wine or opium.

Such extreme cases as these are not, of course, common in practice,
but still very distressing instances are not unfrequently met with.

Only a short time ago a young, highly sensitive, educated clergy-
man consulted me for such a condition. Walking, riding, even the
friction of the trousers, would produce erection. He strove his utmost
to prevent this, but in vain. On examining him I found the prepuce
long, and he had been deterred from adopting the customary measures
of cleanliness, for fear of directing his attention or thoughts towards
subjects he found so dangerous. The treatment I enjoined in this
case was not so much moral discipline or self-restraint — which there
was little need to inculcate, — but simply physical cleanliness, to accus-
tom the part to the contact of water. I told him, if ablution produced
sexual feelings at first, not to mind, but to persevere, as these would
cease immediately the morbid irritability had been got rid of. As
soon as the external sensitiveness had been overcome, I gradually
passed an instrument, and discovered the greatest morbid irritability
of the urethra I ever met with. This, however, gradually declined,
and the tendency to priapism disappeared.

The medical man, however, must not expect always to produce so
speedy a cure as this. Indeed, as regards the treatment of this
troublesome ailment, I must admit I have been much disappointed
with most remedies, though I have tried nearly all those that have
from time to time been recommended. Some years ago Sir Charles
Locock made known, at a meeting of the Royal Medical and Chirur-
gical Society, what he considered a very important fact with regard to
the treatment of some forms of epilepsy. He stated that in cases of

SATYRIASIS

hysterical epilepsy in young women connected with sexual excitement,
and recurring at the periods of menstruation, he had found the
bromide of potassium, in doses of from five to ten grains, remarkably
efficacious. Of fifteen cases in which he had tried it, it had failed in
only one. Sir Charles attributed the good effects of the bromide to its
power of diminishing sexual excitement. In consequence of this
recommendation I experimented with this salt pretty largely and in
very various doses. In some instances I thought I noticed beneficial
effects, but in other cases no amendment followed ; and I now depend
upon local remedies and those applications which, acting as counter-
irritants, more especially influence the spinal cord, irritation of which
seems particularly to promote priapism.

SECT. VII.— SATYRIASIS

Erection again may be not only morbidly frequent and persistent,
but connected with a maniacal sensuality that is one of the most awful
visitations to which humanity can be subject. Continual erections,
immoderate desire for connection, and erotic delirium, have been given
as the definition of Satyriasis.

I see, from time to time, patients who do vividly realise in their
own persons the ancient fables concerning satyrs. One man, who
exhibited the most distressing symptoms of this condition in unusual
force, made a deep impression on me. He was young and in good
circumstances, but was habitually untidy about his head and hair.
His face was flushed, the cheeks and nose especially. His eyes were
hollow, and had a haggard expression. The lips were thick and
sensuous, the mouth wide. He was short and thickset, and of a full
habit of body. I never saw a case in which the animal was so
markedly prominent, although his intellect had not been altogether
neglected. I learned that early in life he had masturbated himself,
but had left off the practice only to commit excesses with women, of a
nature and extent that were shocking to hear of. It may be worth
while to notice that this man — like others afflicted in the same way —
showed no particular tendency to indulge in obscene talk, nor did his
tastes lie in the direction of libidinous works or pictures. I believe
the latter penchants are rather cultivated by nearly impotent or used-
up debauchees. Refinement of vice is not sought after by the victims
of satyriasis : it is quantity rather than quality that they require.

The probable explanation of such aberration is, that the brain or
medulla oblongata has received some injury from excessive indulgence
that has never been attempted to be controlled. A low animal organi-
zation, with a strong hereditary disposition to lust, has been over-
taxed by the enormous licence the victim has permitted himself, or

90 ABNORMAL ERECTION — SATYRIASIS

some undetectable lesion Las taken place which puts the man at once
beyond his own control, almost out of the category of rational or moral
agents, and leaves him in a condition in which there seems, indeed,
little hope of any restoration.

Admitting that the condition of satyriasis depends for its com-
mencement upon uncontrolled lust, sometimes aided by local irritation
existing in or about the generative organs, yet its ultimate and
frightful extravagances seem always to depend on positive lesion of
the nervous system. In many cases, recognisable irritation of the
cerebellum exists to a degree quite sufficient to account for the most
painful and deplorable symptoms.

Mr Dunn, in 1849, brought before the Medical and Chirurgical
Society an interesting case of death from apoplexy, attended with a
softened, pulpy state of the right hemisphere of the cerebellum, in the
midst of which was an apoplectic clot of the size of a pullet's egg.
The patient's wife had observed that he had been subject to a constant
desire for sexual intercourse. In the discussion which followed, Dr
Carpenter referred to a case mentioned to him some years previously by
Mr Turley, of Worcester, in which a man advanced in life became the
subject of satyriasis to such a degree that he would even practise
masturbation in the presence of females, and after death a tumour of
the size of a split pea was found on the pons variolii. (See ' Lancet,'
vol. i, 1849, p. 320.)

A physician in the west of London was recently called in to attend
a powerful man, of between fifty and sixty, who exhibited every indi-
cation of approaching homicidal mania. He found, on inquiry,
that the present fit had been preceded by an extravagant indulgence
in connection with his wife. The proper remedies were used, the
patient became somewhat calmed, and the wife was solemnly warned
on no account to permit any renewal of intercourse. She was a weak
woman, and from time to time yielded, each indulgence being followed
by a fresh outbreak on the part of the patient. At last, after a series
of excesses, the homicidal fury broke out in full force, when, with
considerable danger, the patient was secured and conveyed to a lunatic
asylum.

EMISSION 91

CHAP. II.— EMISSION

Emission is the second of the requisites specified at page 75 to
ensure successful intercourse.

PART I

NORMAL EMISSION— CONDITIONS ESSENTIAL

TO IT

It is thus described by Kirkes : — " The emission of semen is a
reflex act, and as such is governed by the spinal cord. The irrita-
tion of the glans penis conducted to the spinal cord, and thence
reflected, excites the successive and co-ordinate contracting of the
muscular fibres of the vasa deferentia and vesiculse seminales, of the
accelerator urinse and other muscles of the urethra ; and a forcible
expulsion of semen takes place over which the mind has little or no
control, and which in cases of paraplegia may be unfelt." — 7th Edition,
p. 506.

Valentin adds : — " This effect may be artificially produced in recently
killed animals. The semen reaches the inferior and glandular part
of the vas deferens. It then traverses the urethra to the orifice of the
glans, when it is ejaculated with a force which in vigorous men can
expel it to a distance of many feet." — Valentin translated by Brinton,
p. 625.

The semen, however, as emitted, is not the semen as it is secreted in
the testes. It may be said, while in the testes, to be in little more
than a rudimentary state. When ejaculated, it is a highly elaborated
secretion. None, in fact, amongst the various secretions of the body
seem to require so much time to mature. Not only have cells to be
formed and thrown off, as in the case of other secretions, but, after
they are liberated in the tubercles of the testis, nuclei have to divide, y
nucleoli to multiply, and each division of the nucleoli to become,
through a gradual adolescence, an adult spermatozoon. -When thus
prepared, it is passed down the spermatic cords to the vesiculsB
seminales. The vesiculae, Pittard says, " are never found empty, except
when they are diminished after the periodic rut in certain animals.
They do, indeed, seem equally full at all times, but there is little doubt

92 NORMAL EMISSION

that this appearance is deceitful. They have the power of contracting
and expanding, according to the volume of their contents, so that they
are never flaccid, and always appear to be full. I have observed them
exceedingly full and large in animals just killed, and have watched
them contracting under the stimulus of exposure to cold air, and
when nearly the whole of their contents have been expelled by the
contraction they have still appeared to be quite full. I should have
considered them to be so if I had not actually seen them expel their
contents." It is certain, nevertheless, that the whole contents of the
vesiculse are not emitted in one copulation. The possibility of the act
of copulation, however, does not depend on the existence of matured
semen in the vesiculse.

Some authors, indeed, assert that emissions depend wholly on
the presence of well-formed semen in the vesiculse seminales. This,
however, is incorrect, for Sir A. Cooper states that a patient of
his, from whom "he had removed both testes, was able, some time
after ablation of the organs, to have connection, accompanied with
the feeling of ejaculation ; and even, at a later period, erection
of the penis took place, but without the sensation of emission. In
the East the value of a eunuch is much enhanced by ablation of
the penis, as removal of the testes alone does not suffice to prevent
erection.

The matured semen lies in the vesiculse until the ejaculatory act is
excited. This action is performed principally by the involuntary
muscles of those organs. Kolliker says : "In ejaculation the vasa
deferentia, provided, as they are, with a colossal muscular apparatus,
are chiefly operative; these organs, as Virchow and I found in an
executed criminal, shorten and contract with remarkable energy when
excited by galvanism, as also do the vesiculse seminales, the highly
muscular prostate, and of course, the transversely muscular tissue of
the urethra and penis." (P. 243.)

The fascia that invests the vesiculse seminales in man contains a great
proportion of involuntary muscular fibre, and there is also a large
admixture of involuntary fibre in the proper parietes of the tube. In
the elephant the vesiculse seminales present, on the outer and anterior
aspect, a peculiar muscle rising from the neck and middle part of the
sac, and spreading out over the upper part, which can contract the
cavity and expel the contents.

In animals that have a rutting season the vesiculse seminales, as well
as the testicles and scrotum, are exceedingly small during the period
of rest, and enlarge enormously and rapidly previously to the season
of rut.

The semen, before it is ejaculated, is not only matured, as has been
described, but is mixed with the secretion of the vesiculse seminales

NORMAL EMISSION 93

;ukI with tliat of the prostate. The object of this dilution seems to
be to render it more fluid, and thus more capable of passing easily
along its course. As soon as the thick mucus of the vesiculse semi-
nal es meets and amalgamates with the semen, the mixture becomes
much more fluid than either of its component parts. Indeed, if the
mucus is exposed to the air before the semen is added, it becomes
almost solid.

It is owing to the abundance of these other secretions that ejacula-
tion takes place after the removal of the testicles. A striking instance
of this came under my notice a few years ago. On the 4th of January,
1859, Mr. Holthouse removed both testes from a man in consequence
of his suffering from epilepsy. The case created a good deal of discus-
sion at the time ; and as the patient entered another hospital for a
different complaint, a medical friend, thinking I should like to know
the result, sent him to me, and on the 26th of March, 1859, — that is,
nearly three months after the castration, — I ascertained the following
particulars :

Within the week following the removal of the testes this man had
two emissions. Subsequently three more emissions occurred, the last
on the 2nd of March ; that is, two months after the operation. At the
time I saw him he appeared in no way distressed in mind, and I could
note no symptoms betokening him a monomaniac. He complained of
a frequent desire to make water. I tested the urine, but found it
natural.

Sir Astley Cooper, in his observations on ' Diseases of the Testes/
p. 54, mentions having removed both testes from a man. Four
days afterwards the patient had an emission, which appeared upon his
linen.

" For nearly the first twelve months he stated that he had emissions
in coitu, or that he had the sensations of emission. That then he had
erections and coitus at distant intervals, but without the sensation of
emission. After two years he had erections very rarely and very
imperfectly, and they generally ceased immediately upon the attempt
at coitus. Ten years after the operation, he said he had during the
past year been only once connected.

" Twenty-eight years after the operation, he stated that for years he
had seldom any erection, and then that it was imperfect ; that he had
no emissions from the first year of the operation ; that he had for many
years only a few times attempted coitus, but unsuccessfully ; that he
had once or twice dreams of desire, and a sensation of emission, but
without the slightest appearance of it. The penis was shrivelled and
I. He was in the habit of shaving once a week, and sometimes
twice. His voice, naturally rather feeble, remained as at the time of
the operation."

94 NORMAL EMISSION

Of the persistence of sexual desires, and to a certain extent sexual
power, we read in Juvenal :

" Sunt quas eunuchi iuibelles ac inollia semper
Oscula delectent ac desperatio barbae
Et quod abortive- non est opus."

Kobelt imagines that excision of the glans penis would destroy all
desire, as it is the rendezvous of the sensitive nerves which excite
venereal desires.

That this statement is not borne out by facts, is clearly proved by
the case in my own practice, related subsequently, where the glans penis
had been destroyed, and yet the patient fully performed all his marital
duties. We have also the experience of practical shepherds, who find
that the removal of the " worm," as they call the point of the penis in
the ram, does not prevent the ram from attempting connection. Division
of the pubic nerves, however, seems infallibly to annihilate all sexual
feeling, and to destroy at once the power and the desire of connection.
Gunther observes :

" After division of the nerves of the penis (nervi dorsalis penis) the
most powerful and erotic stallion appears almost at once to be more
completely deprived of every sexual feeling than he could possibly
be after castration." — Giinther, ' Untersuchungen und Erfahrungenim
Gebiete der Anatomie, JPhysiologie, und Thierarzenei-Kunde,' Hanover,
1837, § 153.

Effect of Emission in the Male. — Emission in healthy males is
attended with spasmodic excitement, followed by temporary nervous
prostration. Lallemand calls this excitement ebranlement nerveux
epileptiforme. This is seen in a very exaggerated form in the
buck rabbit, who, after every copulation, may be noticed to fall
on his side in a sort of epileptic fit; the whites of his eyes are
turned up ; he gives several spasmodic twitches with his hind legs,
and lies panting for some moments, until the nervous system recovers
itself.

There are some men in whom this sort of epileptiform orgasm takes
place every time connection is indulged in. Napoleon I is said to
have been subject to epilepsy when, resting from his great labours, he
indulged in sexual intercourse. No doubt can exist that deaths which
have occurred in houses of ill-fame, as well as on the marriage couch,
have arisen from this cause acting upon highly susceptible organisa-
tions. Entomological works abound with cases in which the male
dies after the act of copulation. The following, which reads almost
like romance, may be explained, perhaps, by this epileptiform attack
killing the frail insect. It is a brief history of the establishment and
growth of a colony of termite ants, as related by Burineister.

NORMAL EMISSION 05

"At the termination of the hot season, the young males and
females quit the nest, and appear upon the surface of the earth, where
they swarm in innumerable hosts, and pair. The busied workers then
convey a chosen male and female back into the dwelling, and
imprison them in the central royal cell, the entrances to which they
decrease, and guard. Through these apertures the imprisoned pair
receive the nutriment they require. The male now, as amongst all
other insects, speedily dies after the impregnation of the female has
been effected : but the female from this period begins to swell enor-
mously, from the development of her countless eggs, and by the time
she is ready to commence laying, her abdomen is about 1500 or 2000
times larger than all the rest of her body."

Of course any such epileptic attack in man is only the rare excep-
tion. In a young healthy, fully-developed adult, the shock which the
nervous system receives is recovered from immediately. Ejaculation
is in him a healthy function, from which he rallies directly ; and the
act may be, and is, repeated with impunity by some men, at very short
intervals.

In other instances, however, particularly in those who suffer from
any of the severer functional affections spoken of in this volume, the
act is followed by intense depression, and a day or two may pass
before the system rallies. In such instances, I believe, it will
generally be found that the frame has previously been enfeebled by
great excesses, and then each act of insemination produces serious
depressing effects, far different from the natural ones.

I have been consulted by some few persons, on the other hand, who
never appear to suffer from the act, although excesses may be
committed to a great extent. This tolerance of the orgasm — which is
remarkable in individual cases, and which permits the frequent recur-
rence of the shock without any ill effect either at the time or later —
must depend upon some constitutional difference of nervous system of
which we are ignorant.

We may, however, for the present, neglect both of these extremes —
the persons who die or seriously suffer from one act of coition, and
those who can commit almost satyrine excesses with apparent, though
temporary, impunity. The question we have to consider is, what
effect the act has upon ordinary men. It is, I conceive, most impor-
tant to have correct notions upon this subject, to be neither alarmed
by vague fears nor led astray by rash ignorance.

It is, of course, the nervous system which is primarily affected.
The ancients had some curious, and I need not say erroneous, notions
on these matters. They believed that emission was the actual passage
of brain down the spinal cord ; and we find them speaking of connec-
tion being followed by the stillicidium cerebri.

9$ Formal emission

Hippocrates says : " The humours enter into a sort of fermentation,
which separates what is most precious and most balsamic, and this
part thus separated from the rest is carried by the spinal marrow to
the generative organs." — De Genitura, Foesius, p. 231.

This popular notion is not yet extinct. It is not long since I heard
one man about town coolly asserting to another his entire belief that
Lord — , a noted old libertine, was killing himself by inches ; that he
had long since ceased to emit semen ; and under unnatural excitement
the substance of the brain was now passing away in the venereal
orgasm, as was proved by the great nervous depression which was
known to follow each sexual effort. . The narrator, moreover, asserted
most confidently that his lordship was aware of the fact ; but that, in
spite of all remonstrance, no sooner did the old debauchee recover
from the effects of one loss than he incurred another.

Tabes dorsalis (apparently the ancient term for the disease called by
the moderns spermatorrhoea) is described by old writers as wasting of
the spinal cord. So late as the time of Eicherand, we find him, in his
1 Physiology/ seriously asking his readers " if the nervous depression
which follows connection depends upon the fatigue of the organs, or,
as some metaphysicians have believed, is it caused by the confused
and indistinct notion that the soul takes of its own destruction ?"-

M. Parise also, in his valuable book on the diseases of old age, uses
figurative, but no less erroneous expressions to the same effect, which
he has gleamed from the old writers.

" Semen is life itself under a fluid form — the vital principle con-
densed and perceptible. Camus said it was composed of microscopical
brains directly emanating from the great brain. The ancients con-
sidered this liquid as a discharge from the spinal marrow and brain,
and called it cerebri stillicidiuni."

"Its importance is demonstrated by the fact that the smallest
quantity contains life in activity, and can communicate it ; that its
presence and its secretion impress the organisation with an extra
quantity of force and energy, whereas repeated loss of it enervates
and rapidly wears out the body. Nothing costs the economy so much
as the production of semen, and its forced ejaculation. It has been
calculated that an ounce of semen was equivalent to forty ounces of
blood. According to Bichat, the secretion of sperm is in an inverse
proportion to the secretion of fat ; and we at once see the reason,
semen is the essence of the whole individual. Hence Fernel has said
' totus homo semen est.' It is the balm of life — one of its best and
most powerful stimulants. That which gives life is intended for its
preservation. (Reveillc-Parise, ' De la Vieilesse,' p. 415.)

Of course these alarming statements are not such as modern science
can at all indorse. Nevertheless it should be remembered that the

DISORDERS AFFECTING EMISSION 97

semen, as I shall have occasion presently to show, is a highly
organised fluid, requiring the expenditure of much vital force in its
elaboration and in its expulsion. Even in the strongest adult, and
much more in the youth or the weakly man, the whole of the functions
connected with it are most vital and important — the last that should
be abused.

PAET n

DISORDERS AFFECTING EMISSION

We have now to consider the disorders that may complicate or
interfere with the ejaculatory part of the sexual act. It has been
generally supposed that the loss of semen was the sole cause of sexual
debility in the male. That such is not the case is proved by the
nervous depression coming on in young children from sexual excite-
ment before they can be said to secrete semen. Similar exhausting
nervous effects are noticed in women, who do not secrete any such
fluid, but merely mucus, 1 and yet may experience the nervous orgasm
or spasm which acts as harmfully on them, when much indulged in,
as on males. The immediate cause of this nervous depression has,
within the last few years, excited a good deal of attention ; and I, in
common with many modern writers, have come to the conclusion that

1 No woman, any more than any other female animal, secretes or loses semen, or
anything analogous to it, during the sexual orgasm. The spent secretion contains no
spermatozoa. What passes, if examined under the microscope, consists of mucus or the
debris of epithelium. Nevertheless, as an effect of long-continued, and often repeated
sexual shocks, women may exceptionally — feeble as their sexual tendencies are compared
with men's — become subject to epileptiform attacks, and various nervous affections, as
well as local affections of the uterus, direct consequences of sexual excesses. The
womb— as has been well observed — is the centre round which women's sentient feelings
radiate. No one who has treated a large number of women labouring under uterine
affections, but must have been struck with the haggard feverish pinched cast of
countenance which too often characteristically denotes the existence of long-standing
uterine affections. In every way it resembles the look of the young libertine who
has given way to a long-continued course of sexual excesses; aud the long lank hair
of the enfeebled delicate girl-like boy tends often to make the delusion more perfect.
I had the painful duty lately of inspecting some photographs of boys who had for
some time ministered to the depravity of the vilest men, and the lens had but too
truly depicted, and perhaps exaggerated, the hang-dog look which these youthful
miscreants exhibited; but I must admit that in that collection there were other
portraits of youths who presented all the external symptoms of perfect blooming
health, and whose features could not be distinguished from ordinary well-conditioned
young men.

93 DISORDEKS AFFECTING EMISSION

there is a good deal of evidence now existing which shows that shocks
constantly received and frequently repeated on the great ganglionic
centres may produce irritation in them, and thus cause many of the
obscure forms of disease to which we have hitherto failed in discover-
ing a key. If there is any cause which is likely more than another
to produce undue excitement of the ganglionic system, it is the too
frequent repetition of acts involving this nervous orgasm.

It has been clearly proved by Brachet that if the solar plexus and
semilunar ganglion in an animal be irritated, it will, as soon as the
parts become imflamed, express feelings of suffering. "When the com-
munication is cut off between these ganglia and the spinal cord, all
symptoms of pain or irritation of the ganglia cease.

Hence we should infer, I think, that undue excitement of the gene-
rative functions may set up irritation of these ganglia, and that this
undue excitement will be communicated to the spinal cord, producing
depression of spirits, pain at the pit of the stomach, and general pro-
stration. I may, moreover, remark, that if this is the modus operandi
of such lesions, it is not surprising that in many cases where we notice
the effects of excesses in young men, nature should be with difficulty
able to recover from such rapidly repeated shocks. We have reason,
also, to believe that the irritation set up has in such cases so morbidly
excited the channels of nervous influence, that they have received some
permanent damage which they very slowly recover from. Miiller
considers the ganglia as the source of the energies of the sympathetic
nerves, and the fountain from which the ganglionic system draws the
constant, gradual, galvanoid action which is kept up in the capillaries
throughout the frame.

Many of my readers will probably agree with me in considering that
this view of the subject is the one most in accordance with our know-
ledge of physiological phenomena of the nervous system ; of course it
does not admit of positive proof, but it has the most recent indications
of experiment on its side, and is in strict accordance with our observa-
tions on the living. If these views are correct, we should the more
insist upon the necessity, in susceptible individuals, of avoiding too
great excitement of the nervous system by repeated sexual shocks, and
upon the baneful effects of any such excitement on the youthful frame
before it has arrived at maturity.

Sir James Paget has kindly favoured me with his opinion as to the
probable morbid state of the nervous system induced by excesses.

" I believe that the morbid state of the nervous system — more par-
ticularly of the spinal cord — which is produced by excessive sexual
intercourse, is analogous to that which is v sometimes observed in
muscles after excessive exercise. The history of some of the cases of
* progressive muscular atrophy ' makes it evident that, in some

DISORDERS AFFECTING EMISSION D9

persons, the excessive employment of single muscles, or groups of
muscles, may lead to their complete atrophy ; and that this atrophy
nuiv be manifested sometimes by simple wasting of the muscular tissue,
sometimes by fatty degeneration, sometimes by these forms of atrophy
combined in various proportions. And it seems not improbable that
these states are to be ascribed to the impairments of texture, which
a iv naturally produced in the exercise of muscles, being in these
instances unrepaired. It is certain that in the natural exercise of a
muscle its composition and texture are, in however small a measure,
changed ; many of the results of the change have been traced by
chemical analysis ; fatigue is the sensation we have of the changed
state of the muscles or its nerves ; and the state is one of impairment,
for the muscle has lost power. In health, and the natural course of
events, the repair of the thus impaired muscle is accomplished
during the repose which follows exercise. But, if due repose be not
allowed, the impairments may accumulate, and the muscles may
become gradually weaker, so as to need greater stimulus for the fulfil-
ment of their ordinary work ; and aj; length, in some instances, they
may even lose the power of repairing themselves during repose. In
these instances they are the subjects of the * progressive muscular
atrophy.'

" Now, although the very nature and products of the changes that
ensue in nervous organs during [their exercise are less well known
than are those that ensue in muscles, yet the occurrence of such
changes is certain ; some of them are traced by analysis ; they are
similarly felt by fatigue ; similarly repaired in repose. And it seems
a fair analogy which suggests that the loss of nervous power, and
especially the paraplegia, that may follow long -continued sexual
excess, are due to changes parallel with those that are witnessed in
the progressive muscular atrophy after excessive muscular exercises
— the softening and wasting of the paraplegic cord being a process
of fatty and wasting degeneration essentially similar to that traced in
muscles.

" In the progressive muscular atrophy, the wasting or other degene-
ration of the muscles generally proceeds, in course of time, to muscles
more and more distant from those first affected after over-work ; by
similar progress, the degeneration of the spinal cord may extend far
from the part first affected in consequence of its over-exercise in the
sexual acts.

" It is taken for granted here that the act of copulation and emission
is associated with what may be regarded as violent exercise of the spinal
cord ; and this cannot reasonably be doubted. But I have also no doubt
that cases of paraplegia may be sometimes seen in which the excessive
exercise of the cord has been in its participation in violent and long-

100 DISORDERS AFFECTING EMISSION

continued voluntary muscular actions, especially in excessive walking,
running, and other such acts.

" In what is said above, I have had in view only the cases of gradual
loss of nervous power due to excessive sexual acts. Where the loss is
rapid, it may -be due to inflammation (associated as that process is with
rapid degeneration) of the nervous organs. But here also the parallel
with muscles will hold ; for an excessively exercised muscle not un-
frequently becomes inflamed, and its inflammation may very quickly
lead to its wasting or other degeneration, and its corresponding loss of
power.

" I cannot guess why excessive sexual acts should be followed, in
some persons, by loss of nervous power, while in other persons they
seem harmless ; but the same differences are seen, and are equally
inexplicable, in the case of the muscles. In some persons the same
exercise which in others leads to muscular atrophy is followed by the
attainment of greater power, and by the growth of the exercised
muscles.

" I do not know what lesions ensue in the nerves-fibres when the cord
degenerates in the instances referred to above ; but the analogy of the
muscular atrophy, in which the nerves degenerate with their muscles
(though probably only secondarily), makes it probable that the spinal
nerves partake of the degeneracy with the cord."

SECT. I.— PREMATURE EJACULATION

Of all the disorders of the sexual organs this is the one that a sur-
geon most frequently is consulted about.

Patients complain that semen is emitted so readily, that if they even
converse with women, or if they ride on horseback, or walk fast, semen
will come away. The friction of the trousers, in some instances, appears
sufficient to produce an escape of seminal fluid ; others affirm that
ejaculation is attended with scarcely any spasm. 1

In other instances, erection is hardly complete before emission fol-
lows, and then, as the erection immediately ceases, the intended inter-
course fails. It is fortunate, considering the disappointment and
distress which such a state of things causes, that this disordered func-
tion is very amenable to treatment.

Such patients should be made aware that hardly any man ever
attempted connection for the first time without emission taking place

1 This rapidity of emission has been likewise noticed, under similar circumstances,
in animals. Breeders know so well that the first leap which an entire horse takes
after being put by for some time will be attended with too rapid ejaculation, that at
the end of a few days the marc is again put to the horse.

PREMATURE EJACULATION 101

prematurely, sometimes from nervousness, but more frequently, perhaps,
from natural impetuosity. This is, as I have said, often the case with
animals. In most instances the repetition of the act will soon correct
this over-rapidity of ejaculation. Whatever the cause, the symptom,
if it occurs, should not be neglected or treated lightly ; above all, the
patient should not be thoughtlessly recommended to repeat his
attempts. I have seen some very lamentable cases of complete impo-
tence resulting from such a course. In addition, however, to the more
ordinary causes arising from ignorance, alarm, a bad conscience, or
want of power over the will, I would particularly mention another
which is not generally appreciated, namely, an excessive irritability of
the organs.

A gentleman was sent to me from a midland county suffering from
debility of the most marked kind. He was subject to frequent
emissions, and the least mental or physical impression produced ejacu-
lation. I desired my patient to uncover the glans; this he was
unable to do ; he feared either to touch the organ himself, or allow
me to examine it, so great was its sensibility. After several efforts
I succeeded in uncovering the glans, and found it coated with
hardened, wrinkled, and dry smegma, which was very tenacious.
With great care this was washed off, and my patient fainted before
I succeeded in removing the secretion. In subsequently passing
an instrument, I could not discover any unusual morbid irritability
of the urethra in this case. Nothing but the sensibility of the glans
and prepuce had caused the morbid symptoms, and as soon as
these were relieved, the previous tendency to premature ejaculation
ceased.

A tight foreskin is very often the cause of many a functional disorder,
as the following instance will show :

A middle-aged clergyman called on me, stating that he was
partially engaged, but feared he was unable, or rather unequal, to
marry, and wished my opinion on the subject. External examination
detected a very long foreskin, which I induced him, after some diffi-
culty, to allow me to withdraw, as the parts, he stated, were too
sensitive even to be touched. I effected my purpose after many
attempts, but I was unable to return it without giving my patient
more pain than I was disposed to do, in consequence of the glans penis
being of that mushroom shape that I shall subsequently speak of. I
therefore at once divided the little fibres which caused the paraphy-
mosis, and at once the foreskin could be easily reduced. The grati-
tude this gentleman the next day expressed was beyond measure for
the benefit conferred ; he at once felt that the cause of a miserable
existence had been removed ; he had been wretched for years, he knew
not why, till now. Fond of the society of women, he had shunned

102 DISORDERS AFFECTING EMISSION

them, and he might have been married years before had not his sexual
sufferings been so great.

The treatment must depend upon the causes ; but the first and most
important step is to refrain from attempting connection when frequent
efforts have already been made without success, until the patient
has consulted a medical man. In the slighter forms of the affection,
indeed, and in incipient cases, the patient may be told to repeat
connection as speedily as possible after failure, and as soon as erection
returns. In the more severe cases, however, this will not be prudent.
Indeed, erection will probably not again recur ; the disappointment
and depression are so great that a second attempt will not and cannot
be made.

In such instances some irritability of the glans or urethra probably
exists, and the surgeon's aid must be called in. It is surprising how
easily these cases are cured if the irritability is first of all removed,
as in the instance I have mentioned above. Merely accustoming the
glans to the application of air, water, or lint, will often suffice. Some-
times the passage of a bougie along the urethra will be necessary, or
cauterization may be required.

SECT. II.-NON-EMISSION

The next affection which calls for notice is non-emission. An other-
wise healthy patient will tell you that he is able to have connection,
the erection is perfect, but no emission follows, and no pleasurable
sensations are felt. I am indisposed to believe that a patient's sensa-
tions can always be depended upon when the organs have been much
abused, for emission may sometimes take place without his knowledge.
There are, however, numberless instances in which emission fails to
attend connection.

Among the causes of this disorder the most frequent, perhaps, is
stricture, often of old standing. In such a case the mechanical obstruc-
tion prevents the passage of the semen, and it is only when erection
has passed away that the fluid oozes out. In very severe cases of
stricture I believe the semen, if emitted from the testes, passes back
into the bladder instead of forward along the urethra, and may be
noticed in the urine in the form of a thick, viscous substance. But I
would here warn the reader against mistaking for semen all deposits, 1

1 Patients often require to be warned against considering as semen the various
deposits to be seen, the next morning, at the bottom of the vessel into which they may
have made water. If semen is present, it maybe noticed falling to the lower stratum
of the urine immediately after micturition. As a general rule it may be laid down

NON-EMISSION 103

observed in the urine. These are of the most miscellaneous and
varying composition, such as mucus from the bladder, the lithates, or
the phosphates, produced by a variety of causes which this is not the
place to inquire into, and which only a medical man can diagnose.
True semen is very rarely found in any perceptible quantity deposited
in the urine.

I need hardly point out that non -emission under sexual excitement
requires surgical treatment. When the stricture is cured, and the
canal of the urethra properly dilated, the emission will, if no other
ailment exist, occur at the proper time.

The most serious and puzzling instances of non-emission are those
where there is no appreciable mechanical cause to account for it.

I met with a most singular case of this kind some time ago. The
patient was an American. Erection was perfect, but emission did not
follow. When erection ceased there was occasionally a slight oozing
from the urethra. Strange to say, this patient had emissions at night
once or twice a week. The testicles were small. A short time before,
he had been operated on for varicocele without any good effect. He
had also been cauterized. Slight stricture existed, as was ascertained
by the bulbed instrument, but a conical bougie easily passed. In this
instance there was apparently nothing but a want of co-ordinate
action between emission and erection, both being perfect at different
times. The patient under proper treatment ultimately recovered.

Another class of cases is met with, which is less amenable to treat-
ment, viz., where non-emission depends upon complete obstruction of the
vasa deferentia (h) . (See Diagram on succeeding page.)

Dissection of the appendices or canals for conducting the semen
from the testes (/) to the vesiculae seminales (I) shows that after
inflammation or injury the passage through them may be completely
blocked up ; the secretion of the testes then going on as usual, remains
pent up in those glands without any direct means of exit.

In such cases as these, sexual intercourse will either be unattended
with any kind of emission, or, if fluid is ejaculated, it cannot contain
spermatozoa and be fertile, but must consist only of prostatic fluid, or
the secretions from the vesiculse seminales (7). These are cases that
have not yet attracted much attention from the profession, but of their

that all deposits falling down when the urine is cold are not composed of semen.
The knowledge of this fact will give great satisfaction to patients and prevent much
misapprehension.

I may even further state that all deposits following immediately after making
water are not necessarily semen. Thus, within the last few days I saw a patient, on
a cold day, make water into an empty tube in my consulting- room ; the tube was
placed in cold urine, and immediately the urine of the patient coagulated, as it were,
and a white flocculent deposit was found in the bottom of the tube, dependent upon
the urine being phosphatic.

104

DISORDERS AFFECTING EMISSION

DIAGRAM SHOWING A SIDE VIEW OF THE MALE REPRODUCTIVE

ORGANS

Explanation of Figures

a Bladder.

b Prostatic portion of the urethra laid
open, showing the position of the
veru-montanum or caput gallina-
genis, and how the different canals
conveying fluid from the Vesiculse
Seminales (J) and Prostate (t) meet
and mix their secretions with that of
the semen (proper) coming from the
testicles (/).

c Membranous portion of the urethra.

d Spongy portion of the urethra.

e Right ureter as it enters the bladder.

/ Testicle (right).

g Epididymis globus major.
h Epididymis globus minor.
h Vas deferens (right).
I Vesicula seminalis (right).
m Ejaculatory duct.
n Cowper's gland.
o Corpus cavernosum of the penis.
p Bulb of the urethra.
r Corpus spongiosum of the urethra.
s Corpus spongiosum of the glans penis.
t Prostate (bisected).
v Anus.

uu Anterior wall of abdomen, and outline
of sacrum.

The reader will see in the above Diagram the relative positions of the reproductive
organs most admirably portrayed. I have much pleasure in acknowledging the
advantage I have derived from the kind assistance of Mr, Callender, who has cor-
rected the anatomical relations,

NON-EMISSION 105

existence there can be no doubt. Obstruction, in its early stages, may
be suspected when we find the testicles enlarged, painful, and tense,
and yet no emissions following sexual intercourse ; and also in cases
where gonorrhoea has been succeeded by inflammation of the testes.

When we bear in mind the frequency of swelled testicle and inflam-
mation of the chord, instead of being surprised at the occasional
occurrence of these obstructions, we may rather wonder that they
do not follow more frequently. Happily, however, impotence de-
pending upon non-emission from such causes is rare. Where one
testicle or one epididymis or one chord only is affected, the other will
carry on all the proper functions. When both chords are blocked up
the testes will probably diminish in size until we have hopeless
sterility with or without atrophy of these organs, as well as obstruc-
tion of the vasa deferentia (k). Such cases, I fear, must be considered
beyond the reach of our art. (See chapter on Sterility.)

SECT. III.— NOCTURNAL EMISSIONS OR POLLUTIONS. WET DREAMS

Instead of taking place only during sexual congress, emission may
occur at night. The surgeon is usually consulted for cases presenting
as nearly as possible the following symptoms : — Patients will tell him
that, though leading a continent life, they suffer from emissions at
night, and that these generally occur during a dream, and that on
waking they find the penis is at the time in a state of erection.

Great alarm is often expressed by patients who suffer in this way ;
but I am enabled to give them much relief when I mention that
such emissions, occurring once in every ten or fourteen days, are
in the nature of a safety valve, and are even conducive to health in
persons who do not take enough exercise, and live generously. It
would, however, be better for the adult to be free even from these ;
and I feel convinced that in one who has not allowed himself to dwell
on sexual thoughts, but takes strong bodily exercise, and lives abste-
miously, emissions will either not occur, or their occurrence may be
looked for only very rarely. It is when the losses or escapes take
place repeatedly, attended by symptoms of prostration, with other
ill consequences, that the patient should seek medical advice.

It will be well to bear in mind, while we are considering these
phenomena, the nature of emission with relation to the will, and also
what is known on the very obscure subject of dreams.

" The emission of semen," says Kirkes, " is a reflex act governed by
the spinal cord ; the irritation of the glans penis (s), conducted to the
spinal cord, and thence reflected, excites the successive and co-ordinate

106 DISORDERS AFFECTING EMISSION

contractions of the muscular fibres of the vasa deferentia (&), and
vesiculae seminales (I), and of the accelerator urinse, and other muscles
of the urethra ; and a forcible expulsion of semen takes place, over
which the mind has little or no control, and which in cases of para-
plegia may be unfelt." l

The same author further remarks, — " In this fact that the reflex
movements from the cord may be perfectly performed without the in-
tervention of consciousness or will, yet are amenable to the control of
the will, we may see their admirable adaptation to the well-being of
the body. Thus, for example, the respiratory movements may be
performed while the mind is in other things fully occupied, or in sleep
powerless ; yet, in an emergency, the mind can direct and strengthen
them ; and it can adapt them to the several acts of speech, effort, &c.
Being for ordinary purposes independent of the will and conscious-
ness, they — reflex movements — are performed perfectly without ex-
perience or education of the mind; yet they may be employed for
other and extraordinary uses when the mind wills, and so far as it
acquires power over them. Being commonly independent of the
brain, their constant continuance does not produce weariness ; for
it is only in the brain that it or any other sensation can be per-
ceived." 2

" The emission of semen is a reflex act, that is, there is the neces-
sary precedence of a stimulus, the independence of the will, and,
sometimes, of consciousness, the combination of many muscles, the
perfection of the act, without the help of education or experience,
and its failure or imperfection in disease of the lower part of the
cord." 3

On the subject of dreams, Carpenter says, " We have hitherto
spoken of sleep in its most complete or profound form ; that is, the
state of complete unconsciousness. But with the absence of con-
sciousness of external things there may be a state of mental activity of
which we are more or less distinctly cognizant at the time, and of
which our subsequent remembrance in the waking state varies greatly
in completeness. The chief peculiarity of this state of dreaming*
appears to be that there is an entire suspension of volitional control
over the current of thought, which flows on automatically, sometimes
in a uniform coherent order, but more commonly in a strangely
incongruous sequence. The former is most likely to occur when the
mind simply takes up the train of thought on which it had been
engaged during the waking hours not long previously, and it may
even happen that in consequence of the freedom from distraction
resulting from the suspension of external influences the reasoning

1 Kirke's, 7th edition, p. 507. 2 Ibid., p. 505. » Ibid., p. 506.

NOCTURNAL EMISSIONS — WET DEEAMS 107

processes may thus be carried on during sleep with unusual vigour
and success, and the imagination may develop new and harmonious
forms of beauty. The more general fact is, however, that there is an
entire want of any ostensible coherence between the ideas which
successively present themselves to the consciousness ; and yet we are
completely unaware of the incongruousness of the combinations which

are thus formed It has been argued by some, that all our

dreams really take place in the momentary passage between the states
of sleeping and waking ; but such an idea is not consistent with the
fact that the course of a dream may often be traced, by observing the
successive changes of expression in the countenance of the dreamer.
It seems, however, that those dreams are most distinctly remembered
in the waking state, which have passed through the mind during the
transitional phase just alluded to ; whilst those which occur in a state
more allied to somnambulism are more completely isolated from the
ordinary consciousness. There is a phase of the dreaming state
which is worthy of notice as marking another gradation between this
and the vigilant state ; that, namely, in which the dreamer has a
consciousness that he is dreaming, being aware of the unreality of the
images which present themselves before his mind. He may even
make a voluntary and successful effort to prolong them if agreeable,
or to dissipate them if unpleasing ; thus evincing the possession of a
certain degree of that directing power the entire want of which is the
characteristic of the true state of dreams." — Human Physiology, p.
642.

The idea may originate in impressions derived from any part of the
bodily frame ; thus we find that indigestion is a very common cause of
nightmare, and that an irritable state of the genital apparatus produces
lascivious dreams. — Carpenter, in Todd's Cyclop., p. 689.

I would wish to relate some additional recent experience on the effect
irritating substances have in producing most unpleasant dreams.

Just before going to bed I ate some oysters. In the course of the
night I dreamed that I was choking and unable to breathe. Then
1 came the ineffectual efforts to clear my throat, and I felt that death
was imminent. I recollected afterwards, however, that this might
only be a dream, and I remembered attempting to wake myself ; this
I succeeded in doing, and then found to my delight that I could
dislodge from the throat some very tenacious mucus — which occasion-
ally collects there, as I am subject to bronchitis in winter — and at
other times a collection of birdlime-like mucus. The undigested food
taken the night before had, no doubt, augmented the tenacity of the
mucus and caused the dream. Now, as any irritating substance in
the throat may cause one person to dream of suffocation, with all its
attendant horrors, so any irritation of the rectum or acidity of the

108 DISORDERS AFFECTING EMISSION

urine acting on the bladder — which organs sympathise freely with the
vesiculae seminales — may by reflex action act on the muscles which
produce emission,and a wet dream will follow under the influences of
these causes. Here, as in the former case, the will may or may not
come into operation, and the emission may or may not be avoided.

From these data, then, I venture to argue that we may experience
in a dream all the sensations of emission, and that it is only on
awaking that we can ascertain whether such an event has really hap-
pened or not.

The modified power of control by the will does, I believe, almost
invariably exist in lascivious dreams, not that, after the orgasm itself
has commenced, the will has much power to check the continuation of
the muscular spasms and the ejaculatory efforts of the vesiculse,
though even over these it has, when honestly exerted, no little control,
being able to shorten as well as prolong the ejaculatory act.

But to put an entire stop to it, when once commenced, is apparently
impossible. That the mere convulsive act itself is neither dependent
on nor subject to the control of the will, appears from the singular
fact that criminals who have been hanged 1 frequently have an
emission, probably arising from the violent shock to the medulla
oblongata.

It is an error, then, as I have said, to suppose that the will has no con-
trol in these cases. It entirely depends upon when the will is exerted.
In waking moments, every man who has not debased and enervated his
will is more or less able to keep his thoughts entirely pure. It is of
his own free will that he sins. Hardly less, as I shall go on to show,
is his power of keeping his dreaming thoughts pure, if he goes the
right way to work. Not at all less is it his duty and his true profit to
endeavour to do so.

I have every reason to believe that a man recovering from sperma-
torrhoea, or who has been under treatment, and complains that he
suffers from nocturnal emissions, often believes that he still suffers
from nocturnal emissions because he dreams he has had them.

A case now under treatment will illustrate this. A rather dreamy- '
looking individual came to me, after having been under the care of
most of the leading physicians and surgeons in London, complaining
that he suffered severely from nocturnal emissions. He was cauterized
and recovered his health : he admitted he had never felt better, and,
but for the emissions, would consider himself quite well. I could

1 Donne*, on the authority of Orfila, says, " Individuals that have been hung by
the neck have been known even after death to have an ejaculation, and a semi-
erection ; I have examined the semen emitted in this way, and I have found it filled
with animalcules, and containing living zoospcrins." (p. 303.)

NOCTURNAL EMISSIONS — WET DREAMS 109

find nothing the matter with him ; he had gained flesh, his former
bright look had returned, but he maintained that he had had emis-
sions sixteen times within the previous month. All that I could say
was that his looks did not correspond with his statements. To con-
vince me, he brought some of the emitted fluid, but I failed to detect
in it any of the characteristics of semen. I am of course perfectly
satisfied that this patient had no wish to deceive me, but I am equally
convinced that he merely dreamed that emissions occurred, and that
what he brought me was prostatic fluid.

Such cases deserve great commiseration, for they frequently arise
from hypochondriasis, that strange psychological phenomenon which
has often deceived me as well as other surgeons. Where it is present it
often retards convalescence, as the invalid cannot bring himself to
believe that he is recovering his health and vigour so long as he thinks
himself subject to nightly wet dreams.

There is a popular belief existing that it is dangerous to attempt by
the will to check emissions. This is as true and as false at the same
time as many popular notions are. It is undoubtedly dangerous
mechanically to prevent ejaculations, by attempting to compress the
perinseum, or by the pressure of a cord tied round the penis, for in
these cases the semen is merely forced back into the bladder, but not
prevented passing from the vesiculse seminales.

It is dangerous for a man to excite himself, or to allow his sexual
feelings to be excited frequently, and by his will habitually to attempt
to check emission ; but it is not dangerous, nor is it attended with any
ill consequences, so to train the will that emissions shall not occur, or —
if in spite of our will they do commence involuntarily — to shorten the
duration of the emission, which in a manner all can more or less do.
The only exception that I know of is in the case subsequently reported,
where temporary impotence occurred in a distinguished artist, who
had much studied the nude figure, and by a strong will curbed his
animal propensities ; but even here I cannot say but that other causes
may have produced the partial impotence.

Patients will tell you that they cannot control their dreams. This is
only partially true. Those who have studied the connection between
thoughts during waking hours and dreams during sleep know that the
two are closely connected. The character is the same sleeping or waking.
It is not surprising that, if a man has allowed his thoughts during the
day to rest upon libidinous subjects, he should find his sleep at night
traversed by lascivious dreams — the one is a consequence of the other,
and the nocturnal pollution is a natural consequence, particularly
when diurnal indulgence has produced an irritability of the generative
organs. A will which in our waking hours we have not exercised in
repressing sexual desires will not, when we fall asleep, preserve us

110 DISORDERS AFFECTING EMISSION

from carrying the sleeping echo of our waking thought farther than
we dared to do in the daytime.

Tissot, who wrote more than seventy years ago, says : — " Occupied
with ideas relating to the pleasures of love, given up to lascivious
dreams, the objects which the brain paints for itself produce on the
organs of generation the same movements which would have been
produced during our waking moments, and hence the ejaculatory act
is physically produced instead of being so only in imagination." —
' L'Onanisme,' p. 222.

The prognosis of an ordinary case is very favorable, provided the
patient will honestly aid the surgeon in effecting a cure. Even when
nocturnal emissions are alarmingly frequent, occurring night after
night, and sometimes more than once in a night, and perfectly pro-
strating the patient, still these discharges are quite under the surgeon's
control. But at a later stage, when the emission has become a con-
firmed habit, a cure is not so rapid.

The disposition in the system to repeat an act and establish a habit

once contracted is very curious. We notice it in children who wet their

beds. Another instance is that of going to stool at a particular hour.

• Once establish the time of the bowels acting, and they usually act with

/ regularity. The same rule is more or less true of emissions ; if they

occur one night they are likely to occur the next, and the next. The

h secret of success is to break the habit. The sooner this can be effected

the better, and it should be attempted before the habit becomes

imprinted on the system.

It is a fact so generally recognised that the reader need scarcely be
more than reminded of it, that one nocturnal emission in a reduced con-
stitution often weakens the subject of it much more than does connection
repeated several times the same night by a healthy person. It is, more-
over, a well-ascertained fact that erotic dreams attended with pleasure
leave less weakness than when emissions occur without the cognizance
of the dreamer. Explain this as we may, the fact is undoubted ; but it
is no more to be wondered at than that persons will undergo great
exertions and perform extraordinary feats when inspired by hope, and
confident of success. We may say such results depend upon nervous
energy — others call it pluck. It is said that persons so circumstanced
have a good tone to their system ; that reaction takes place readily.
Doubtless the brain or spinal cord plays an important part in the
results we are describing, as well as in supporting the loss of semen,
which some constitutions have the power of renewing much more
readily than others.

Before concluding my remarks on this important subject I should
wish to say a few words on the occurrence of dreams of a disgusting
nature — a sort of satyriasis in dreaming. One instance must suffice.

NOCTURNAL EMISSIONS — WET DREAMS 111

A married man, of continent habits and no vicious propensities, Buffered
from a severe attack of diarrhoea, which he was recovering from and
was consequently very careful about his diet, having the previous
night taken little to drink or eat. Connection had not taken place for
a fortnight. On awaking in the morning he found that an abundant
emission had occurred, and the following is his account of the cause of
the emission, taken down in pencil immediately after awaking :

He dreamt that while lying on the grass, a child, with hands covered
with some sort of india-rubber elastic apparatus, was lying near him,
who little by little approached closer until the sleeper felt his generative
organs touched, and then manipulated by these india-rubber appliances.
No sooner was the emission over than some men who had placed and
trained the child started out of ambush and demanded money to com-
promise the matter. The sleeper felt most grievously his folly as well
as the truth of the charge ; then followed an indistinct recollection of
the trial. At this stage the sufferer from the emission awoke to find
the satisfaction that the whole had been a dream.

What can be more dreadful than the occurrence of such dreams ?
yet some patients suffer greatly in this way, and I have been con-
sulted by persons who dreaded going to bed from a fear of such
horrors.

Preventive Treatment. — In strong, robust young men the surgeon
need not take much notice of emissions coming on once a week, but
recommend the patient to avoid suppers, to abstain from tea, coffee,
and tobacco, and to lie on hair or spring mattresses, instead of feather
beds, and sleep with only a moderate quantity of clothing.

I recommend my patients to drink no fluid after dinner, supposing
that meal to be taken at 6 or 7 o'clock. This, and regular evacuation
of the bladder at bedtime, together with the advice to get up and make
water as often as the patient wakes in the night, will singularly assist
the treatment. A very little fluid will be sufficient to relieve any
great thirst that may occur in the evening, but the rule should be,
avoid drinking after 8 o'clock.

The sufferer should be told that emission usually takes place in heavy
sleepers, and the best way of preventing this intense drowsiness in the
morning is not to load the stomach over night with all sorts of indiges-
tible and miscellaneous food. Care should be taken in regard to quan-
tity as well as quality, and I should rather say to such persons, make
your principal meal in the middle of the day, and let your evening
meal be light. I do not advise a man to go hungry to bed, but I am
convinced if a patient will judiciously attend to his diet, and in this
respect exercise self-control, he may, without much assistance from his
medical adviser, ward off frequent emissions. If, however, a young
man will persist in gorging himself with what to his delicate stomach

112 DISORDERS AFFECTING EMISSION

is an indigestible meal, he must not expect that any means a surgeon
has at his disposal will avail to prevent these losses.

Let me further remark, that if a man is disposed to emissions he
should not allow himself to fall into a second sleep, but should rise
early ; in following out this plan there is no difficulty if the patient
goes to bed at a reasonable hour. No doubt can exist that emissions
most frequently take place in this second sleep ; and it is equally
certain that although a man awakes thoroughly refreshed from his
first sleep, he may arise after having taken a second doze thoroughly
prostrated. An early call, or an alarum clock, may cure many a
patient better than all the preparations in the pharmacopoeia. At
first these early hours may disagree with him, but they soon become as
natural as late ones were, and the patient feels a disinclination to
lie in bed, equal to his old disinclination to get up early. Of course
large numbers of patients will tell you that they feel so fatigued in the
morning that they cannot get up. If more sleep is required — should
be the answer — let it be taken in the daytime.

It would be a curious and important question for physiologists to
investigate why the second sleep refreshes us so slightly when compared
with the first? On awaking the first thing in the morning, most
persons, and especially convalescents, feel refreshed by their night's
rest ; but if they go to sleep again, and rise say at ten, they remain
languid all day. Perhaps it may depend in a great measure upon the
first sleep being sounder and quieter, and not being disturbed by the
dreams to which those who indulge in the second are liable.

The recommendation may be difficult, then, for young men to follow,
but I have often thought of advising some of my confirmed cases to
take a voyage on board ship, and keep the watches with the sailors,
which allow of taking only four hour's sleep at a time, in the belief
that this interruption of rest would break through the almost inveterate
habit ; but it is difficult in these, the worst forms, to induce the patient
to use any self-restraint to cure himself ; he wishes to rely on medi-
cine, and will not give himself the trouble to exert self-will.

Another very valuable suggestion is to desire the patient to practise
the habit of waking early in the morning, turning out of bed, and
emptying the bladder. It is in the early morning, when the bladder is
full, that emissions and erections take place. In such cases, if a
patient rises at 5 or 6, and goes to bed early, he may altogether avoid
emissions.
^ I believe this precaution of keeping the bladder empty at night to be

more important than almost anything else in the simpler cases, and
that it will be usually successful. I have known an enema of halt'-a-
pint of cold water, used at bedtime, to work well where other means
have not produced satisfactory results. It has been said that sleeping

NOCTURNAL EMISSIONS 113

between the "blankets will prevent emissions, but I cannot say that I
have any experience as to this remedy. Tying a towel round the
waist, so as to bring a hard knot opposite the spine, will, by preventing
the patient from lying on his back, often prevent emission at night. It
is doubtless quite true that the close observer of his own symptoms
finds himself generally lying on his back when the emission takes
place, but it is equally certain that emission may occur when the
patient lies on his side, as in the following case. One of my most
intelligent patients notices that, on suddenly waking on the occurrence
of an emission, he finds himself lying on his left side, his legs and
knees firmly drawn up against the abdomen, and the erect penis
prevented from gaining its natural position by the thighs. Trousseau,
in the ' Gazette des Hopitaux,' Mai 15, 1856, recommends an instru-
ment to pass up the rectum to press on the vesiculae, and mechanically
prevent the emissions. I have tried the plan on one or two patients,
but was obliged to leave it off, as I found that it produced considerable
irritation ; and even if such clumsy contrivances answered, it would
only be by causing the semen to pass back into the bladder, and make
its exit when the patient micturated. I should doubt if the instru-
ment would prevent emission.

In the more obstinate cases mentioned under the head of Prognosis,
p. 110, the greatest watchfulness over the thoughts and actions during
the day is absolutely essential. I find that there are patients (and
very intelligent ones) who have had the greatest difficulty in surmount-
ing the disposition the brain has to summon up and apparently revel
in lascivious images. Such persons are not generally strong minded
in anything ; they express a wish, but have not the courage to employ
the energy which the medical man tells them they must use to carry
out their purpose. And, most unfortunately for such persons, these
frequent emissions react on the system, and render them less and
less capable of exerting proper self-control.

In the present improved way of treating such affections this is the
only class of sufferers who do not readily recover, and I cannot but
repeat what I often tell the suffering — that if a patient will not and
cannot practise self-control, he must not expect that his medical
adviser will continue to take any further interest in his case, for let
me assure him (as I am obliged to do some of my most rebellious
patients) that when the surgeon sees no efforts made towards self-cure,
he loses his own self-reliance and is apt to prescribe haphazard.

Too many patients are under the impression that all their ailments
may be removed by a dose of physic, and disrelish the notion that it
behoves them to exert themselves or to do anything except take the
draught. For such persons medical skill can do nothing, and the
patient can expect to gain no relief. Cauterization may indeed remove

114 DISORDERS AFFECTING EMISSION

morbid irritability from the urethra, and in cases where the emissions
arise from this local cause, there is reason to hope that the reflex action
on the chord or on the brain may cease. If the patient will co-operate
with the surgeon, much benefit will result from the united action,
but the operation alone is not sufficient. Constant supervision will
be required, and if this is omitted, relapses are sure to follow.

In the more intractable cases of seminal emissions I should be
disposed, at least with people of any strength of mind, to attempt the
following plan, which Tissot recommended as far back as 1790. This
author says, that since to break the habit is the first object, it is as well
to go to the root of it at once, and accordingly recommends the follow-
ing plan. I have met with one instance in which its manful adoption
was attended with perfect success. " An Italian gentleman, of very
high station and character, consulted me for quite a different affection ;
but in order to put me in possession of all the facts in reference to his
state of health, he related his history. He had been inconvenienced
five years before with frequent emissions, which totally unnerved him.
He determined resolutely, that the very instant the image of a woman
or any libidinous idea presented itself to his imagination, he would ivake ;
and to insure his doing so, dwelt in his thoughts on his resolution for a
long time before going to sleep. The remedy, applied by a vigorous
will, had the most happy results. The idea, the remembrance of its
being a danger, and the determination to wake, closely united the
evening before, were never dissociated even in sleep, and he awoke in
time; and this reiterated precaution repeated during some evenings
absolutely cured the complaint." 1

This plan is founded on such true physiological grounds, that I feel
convinced it must succeed in a great variety of cases. To carry it out,
however, requires great firmness and resolution, and it will succeed
only with those who have habitually exercised self-control. 2

1 ' L'Onanisrae,' p. 241.

8 A letter I received on this subject some time ago from a very distinguished
provincial physician is interesting, and corroborates the above statement as to the
possibility of schooling the will so as to awake in time to prevent emission.

" I had no such success," he says, " as to satisfy myself (in overcoming the ten-
dency to emission during sleep), until I adopted the plan of being lightly clad in
bed (on a mattress). When not in London studying, I never lay with more than a
single sheet on the bed in summer, and a sheet and coverlet in winter, and one blanket
extra during keen frosts. Even with this the abomination used to come on about
once a month. Indulgence in wine or ale always made the erection more trouble-
some; but brandy invariably was followed by emission during sleep, without a dream.

From what a medical friend told mo that he had accomplished, I have

learned so to school my mind during sleep, that I awake in time to prevent a cata-
strophe. The transition from the apparent reality of the dream to the consciousness
that the scene is a dream which I must awake from, is very curious. The only
occasions when I now suffer are after great fatigue, which involves a profound dream-

HOCTUJRNAL EMISSIONS 115

Curative Treatment. — When a patient consults ine, suffering
from the scwivr forms of the complaint, I almost invariably discover,
on pawring a bougie, an excessive degree of sensibility along the canal.
This local cause reacts easily during sleep on the brain, which by
reflex action brings on spasm, and hence the frequent emission, which
is, as stated at p. 113, more or less under the influence of the will. In
many instances the passage of an instrument once or twice a week will
■office to remove the morbid irritability, particularly if the treatment
i-ompanied with some slight astringent injection. It is singular
to note the success of this treatment in cases that have resisted
all other means previously adopted, such as tonics, &c, and when
the surgeon has omitted to accompany his tonics with any local
examination.

When, however, this produces no effect, I generally have recourse to
cauterization (see treatment of spermatorrhoea, p. 162), and I find that
few oases fail to yield to the operation, which is attended with
little or no pain when performed by a competent surgeon. Cauteriza-
tion gives the permanent relief that, in the great majority of cases,
nothing else will, and I have never yet had cause to regret having
recourse to it. Those who decry the above method of treatment cannot,
I venture to think, have employed it properly, for both theory and
actual practice point it out, in my opinion, as the best means of
checking the tendency. As soon as the excessive morbid sensibility
of the canal of the urethra has disappeared, the will can assert its force,
and then, if the after treatment recommended at p. 32 be followed, I
am convinced that the health will rally, and it is often surprising to
see how the whole physical condition of the patient will improve.

Successful as I have generally found this treatment, I must admit
that even cauterization will not, in every instance, effect a cure.
Every now and then I meet with exceptional cases where the irritation
is not confined in the urethra ; but either from neglect or from some
strong hereditary tendency the habit has already — before any medical
aid has been sought — had too serious an influence on the brain or
spinal chord to be thus overcome. Instances like the above are the
rare exceptions, and belong rather to the class of mental diseases, for
the discussion of which this is not the place.

In the more severe cases of nocturnal emissions, by prescribing

less sleep I do not know whether such things are common, hut my father

told me that he was very much troubled with wet dreams after he was sixty years of
age ; sexual desire and connection had ceased and did not return, yet the amount of
the discharge was large and weakened him considerably.

I am,

Yours very sincerely,
W. Acton, Esq. _ ,

116 DIURNAL POLLUTIONS OR EMISSIONS

opiate enemata in the proportion of sixty or eighty drops of Liq. Opii
sedativ. to an ounce and a half of fluid before going to bed, and
following the plan recommended at p. 115, a cure may generally be
effected. In addition to the medical treatment, the patient should be
advised to seek cheerful society, but at first to shun association with
females. I need hardly add the obvious advice that he should, above
all things, break off any acquaintance he may have formed with
immodest women. His reading should be of a nature calculated not
to tax the strength, and strict injunctiens should be given to abstain
from the perusal of any book containing allusion to the subject of his
complaint, or any work which would be likely to produce erotic ideas.

SECT. IV.— DIURNAL POLLUTIONS OR EMISSIONS

These terms properly include any emission of semen, voluntary or
involuntary, during the waking hours. The emission is not neces-
sarily preceded by erection, or attended with pleasure.

A strictly continent man in good health, who follows the rules
of healthy and chaste living, will notice little or no secretion from the
urethra during the daytime.

We must, therefore, consider as abnormal all escapes of glutinous
moisture or discharges which the patient notices during the day. If,
however, the young man has been under sexual excitement, if he has
been reading works of imagination, or looking at pictures that pro-
duce erotic thoughts, he must not be surprised if he notices escapes
of glutinous secretions from the urethra during the daytime. It
would indeed be a bad sign if such influences did not excite the
susceptible, and it would bode ill for his generative organs when he
married if these escapes did not occur. The sufferer who has read in
quack books of the exaggerated consequences of these affections,
particularly if, as often occurs, he happens to be of a hypochondriacal
disposition, will endure great anxiety as to the results. I propose,
therefore, making a few remarks upon these discharges.

I have already stated that, unpreceded by sexual excitement, escapes
of semen occurring during the day are abnormal, and betoken
an impaired state of health ; but, at the same time, an occasional loss
of even a teaspoonful of secretion will not alone bespeak disorder of
the function. It is the repeated escape or leakage, so to speak, that
betokens a relaxed condition of the generative apparatus. I admit
that great exaggeration has been indulged in upon the subject, but
those are equally blameable who assert that the symptoms of debility,
exhaustion, and impotence, cannot ever depend upon this drain of

DIAGNOSIS OF DIURNAL POLLUTIONS 117

semen. In practice, we find that this escape of semen, when occurring
once or twice a day, or every time a patient makes water, — goes to
the water-closet, — or golfers from sexual excitement, — is attended with
1 train of symptoms which have a very prejudicial effect on the con-
stitution of a large number of susceptible adults.

It is very easy for cynics to ridicule the idea that the mere escapo
of a little fluid should be attended with such serious nervous depres-
sion. We must recollect that we are speaking of the loss of semen 1 in
an already exhausted individual. No one who has seen much practice
can deny the statements of such patients, that one nocturnal emission
will debilitate such sufferers for a week ; then why, I would ask, dis-
believe that one diurnal emission does not produce a similar effect on
the already exhausted sufferer ? And often such patients will tell you
that these losses occur several times a day.

I am ready to admit, however, that the hypochondriacal may exag-
gerate the influence of these losses, and that possibly what they suffer
from may depend upon what they imagine they suffer. 2 But whilst
taking into consideration all these circumstances, the statements are
repeated too often not to satisfy me that a series of well-marked
symptoms, namely, those of exhausting nervous power, attend and
follow those diurnal losses. Indeed, they require very accurate dia-
gnosis and appropriate treatment.

If, then, we come to the conclusion that in the daytime emissions
may occur which may give rise to a train of very distressing
symptoms, the first question we have to discuss is as to what they
consist of. I would lay it down as a rule that these discharges are
not necessarily composed of semen. I am rather disposed to believe
that in the majority of cases the exuding fluid is principally
composed of those other secretions which are intended to mix with the
semen previous to its ejaculation, such as the fluid coming from the
vesiculae seminales and the prostate gland. I am, however, equally
certain that in a large number of other cases semen does form a part
of the emitted discharge, and when this is the fact it must be con-
sidered in determining the line of treatment.

1 See what semen is composed of, at pp. 118 and 122.

2 There is a circumstance that must not be lost sight of by the judicious practitioner
in the treatment of these cases, namely, an invalid may pass a secretion which he
considers or fancies to be semen, but which is only mucus mixed with semen or fluid
secreted by the prostate or vesiculae seminales. In such highly nervous and sus-
ceptible individuals, ignorant, moreover, of its true nature, the leakage of this fluid
will have a highly detrimental effect on their health and condition. When we notice
how some men will concentrate all their thoughts on these sexual subjects, who have
never read a quack book or been frightened by alarming details, the practitioner will
not be so much surprised at the importance to be attached to an otherwise compara-
tively harmless circumstance.

118 DIURNAL POLLUTIONS

When any such secretion is observed to proceed from the meatus of
the urethra, the immediately exciting cause is generally one of the
following three — sexual excitement, defecation, or micturition.

Discharges arising from Sexual Excitement. — In one sense
all discharges of this kind take their rise from sexual excitement, for
neither by common observation nor the microscope can we detect fluid
of any kind habitually coming from the urethra at any moment, unless
the patient has been lately and previously subject to more or less
sexual excitement. In__a state of healthjthere can be no leakage (so
to speak) of semen from the system. -Under the influence, however,
of sexual desire, a tenacious, transparent fluid frequently oozes from
the meatus. Nervous patients pay great attention to this, and will
tell their medical adviser a variety of circumstances that they have
noticed attending it, and describe the qualities of the discharge with
painful minuteness.

Instead of viewing this as an abnormal symptom, I have often to
tell my patients that it would be very surprising if, under excite-
ment, some such discharge did not occur. If it betokens anything, it
is a sign that the patient is potent, as the non-emission of a small
quantity of fluid under excitement usually betokens a want of power.

If, however, under very slight excitement — friction of the trousers,
&c. — a large quantity of fluid comes away, say a teaspoonful, and if
this, instead of being an occasional occurrence, is frequently repeated
during the day, or if it occurs without having been preceded by any
erection, then the semen, prostatic fluid, or secretion from the vesiculoe
seminales (for, on microscopical examination, it may be found to be or
contain either or all of these), may be said to flow away in an abnormal
manner, and the case requires medical supervision.

There are cases in which the slightest sexual allusion or thought —
or the least exercise that tends to increase the susceptibility of the
genital organs — such as riding on horseback, sitting in a carriage or
a railway train, will occasion an escape. In such a state of things
medical assistance should always be sought, more especially if the
general health suffers, or the patient acquires that careworn haggard
look which a skilled eye detects at once as dependent upon sexual
derangement. Proper surgical care will arrest the discharge if
taken in time. But amenable as this special symptom is to cure, it
must not be forgotten that, if the general health has been seriously
impaired, the renovation of the constitution may be a far slower and
more difficult matter.

Discharges during Defecation. — If the bowels are not habitually
confined, they will usually be relieved without any secretion being
forced from the urethra ; but in many persons a hard stool will cause
a small quantity of liquid to pass from the meatus each time the

DISCHARGES DURING MICTURITION 119

bowels are evacuated, or at least whenever any straining takes place.
This must not be considered as an abnormal symptom ; it depends
upon the hardened faeces mechanically pressing on the prostate (t) or
vesiculae seminales (I, see diag., p. 104) and driving forward their con-
tents, which thus exude from the meatus. As soon as the bowels cease to
be confined this oozing ought at once to cease. When, however, each
act of defecation is attended with the discharge of a considerable
quantity of fluid from the urethra the case is one requiring medical
interference. As in the last case, excess in the escape is a local sign
of an unnatural condition of the canal of the urethra.

The best remedy for this is to relieve the habitual constipation.
Mild remedies will often suffice. A little fruit or a draught of cold
water (half a pint to a pint) taken immediately on rising in the morn-
ing, or brown bread instead of white with meals, will frequently give
great relief. Another very good plan is to commence breakfast with a
saucerful of oatmeal porridge. 1

The administration of a wineglassful of Frederichshall water, in a
tumbler of lukewarm water, on rising in the morning, before dressing,
will often regulate sluggish bowels. When this fails Pullna water
may be tried, or in other instances Carlsbad salts, a tablespoonful dis-
solved in hot water, and cold afterwards being added, will effect the
same purpose.

Taking an additional pint of cold water with the meals will often
suffice. In other cases I have treated constipation by desiring my
patient to take a tablespoonful of oil daily with his meals. It is by
ringing the changes on these plans, and enjoining daily exercise, that
a cure must be effected.

Discharge during Micturition. — In a perfectly healthy indi-
vidual, who has not been recently subject to sexual excitement, the
urine ought to be passed clear to the end, the last drops being as
transparent as the first. If, however, sexual excitement has been
indulged in, the first as well as the last drops of urine may be some-
what thick, and, if collected and examined under the microscope,
traces of spermatozoa may be discovered in them. Such an occasional
slight discharge is quite different from the waste known as a diurnal
pollution. In cases, however, where the least amount of straining to

1 As a cook may not understand how to make the Scotch dish, I append the
following directions from Tegetmeier : — " Strew oatmeal with one hand into a vessel of
boiling water (to which salt has been previously added), so gradually that it does not
become lumpy, stirring the mixture the whole time with the other. After the requisite
quantity has been stirred in— namely, about two large handfuls of coarse oatmeal
to a quart of boiling water — the whole should be allowed to stand by the side of
the fire, so as to simmer gently for twenty-five or thirty minutes. During this time
it thickens considerably. As thus prepared it is usually eaten with the addition of
milk.

120 DIURNAL POLLUTIONS

make water, or indeed very slight effort, invariably causes a certain
quantity of gelatinous fluid to exude after the last drops of urine
have been expelled, while at the same time the microscope shows that
this fluid contains spermatozoa, and the general health is noticed to
suffer from its abundant expenditure, the medical man should at onco
be applied to.

I am daily becoming more and more convinced that a very con-
siderable proportion of people who are constantly ailing rather than ill,
whose health is impaired, whose spirits are low, and who derive no
benefit from tonics, change of air or doctors — suffer, in fact, from loss
of semen, brought about by marital or other sexual excesses, or in one
or more of the ways just specified. I have more than once alluded to
the fact that loss of semen (in whatever way caused) induces a
peculiar train of symptoms that are very marked and common to all
such cases. The usual treatment for affections of the stomach, or the
liver, or the heart or the lungs, is futile, so long as the system is being
thus exhausted. Physicians frequently do not suspect that this
seminal drain on the system is the cause of the patient's suffering ; or
if they do, hesitate even to allude to such a source.

I cannot help thinking that the professional ignorance evinced of
what is at least a possible cause of such symptoms, is one of the reasons
for the success of the quacks who fatten on the fears of hypochon-
driacal or conscience-smitten patients. If the true cause of these
ailments is forgotten, or put out of sight, the patient is not likely to
get well, or the medical man obtain much credit for cures.

Diagnosis. — Grave errors have been committed in diagnosing these
secretions. A discharge consisting only of mucus from the bladder, or
composed of phosphatic deposits, which in nervous subjects pass away
like so much cream or milk, and in surprising abundance, is often
taken for true seminal fluid, to the great alarm and serious detriment of
the patient. These phosphatic deposits, which occur at certain times
of the day, generally after breakfast, and most abundantly in damp
weather, have been often mistaken for semen. Cases are often sent to
me from the country, even by medical men, and I am told the
sufferers labour under diurnal emissions, but, on examination, I find
that it is only the phosphates, and not semen, which cause the
peculiar appearance in their urine. However, it is no wonder that
these white secretions should alarm the patient ; the hypochondriac
fully believes that it is semen that is passing away ; and curiously
enough, the general depression which attends the profuse discharge of
these deposits bears a close resemblance to that following loss of
semen. Simple microscopic and chemical tests will, however, speedily
clear up the difficulty. The addition of a little nitric acid to the sus-
pected fluid containing the phosphates will at once, in clearing tho

DIAGNOSIS AND PROGNOSIS OF DIURNAL POLLUTIONS 121

urine where its turbidity depends upon the phosphates, render the
diagnosis certain, and convince both the medical man and the patient
that semen is not present.

Donne, who has made the microscopic examination of semen his
especial study, says — "At the moment that semen" is ejaculated, the
zoosperms move abdut so rapidly that the eye can with difficulty
follow each separate animalcule. They move in all directions in the
fluid, just as so many eels would do, by means of their tails, over-
coming obstacles in the current, avoiding obstructions, and in fact
possessing and exhibiting the power of locomotion to the fullest
extent. Little by little, however, their movements diminish in
rapidity and energy. This depends on two causes — 1st, by the actual
diminution of the vitality of the spermatozoa themselves ; and 2nd, by
the condensation of the liquid in which they exist, and which evapo-
rates. Their progression becomes more difficult, soon they only
oscillate, and it seems as if they were held in consequence of their
tails becoming fixed in the viscous fluid. They cease to move, and, in
fact, die. I have, however, seen the movements of these zoosperms
last for hours, even days, provided care be taken to protect the fluid
in which they are, from evaporation and from cold." — Cours de
Microscopie.

Such appearances as the above are quite sufficient to distinguish
semen from all other fluids under the microscope. But I need scarcely
say that this way of attempting to distinguish semen avails little
when it is passed in the urine. As soon as the spermatozoa become
mixed with that fluid, they die and are not to be looked for in the
fluid, but are only to be met with at the bottom of the vessel. Their
discovery under these circumstances is not so easy as Donne's account
would lead us to suppose.

To the naked eye I know of no means by which one secretion coming
from the urethra can be distinguished from another. Even when
diffused in the urine, semen presents no particular appearances ; and
we cannot distinguish it from the mucus that is often suspended in
the urine in the form of a cloud, entangling sometimes epithelial
scales, and at other times semen.

Prognosis. — Lallemand has greatly exaggerated the unfavorable
prognosis of semen passed in the day when he says — " Diurnal
pollutions are (other things being equal) much more difficult to cure
than nocturnal emissions ; and seminal emissions which attend the
simple passage of the urine are more serious and more obstinate than
those which take place during the effort of straining in defecation.
In a word, experience proves that the severity of spermatorrhoea is
proportioned to the ease with which it takes place, and common sense
would predict such a result." (Vol. i, p. 627.)

122 THE EMITTED FLUID SEMEN

" In cases where the generative organs are still uninjured, and the
constitution is healthy, seminal emissions will be only voluntary, and
if the digestive powers are good we may promise a speedy reparation.
But if irritation has already attacked the spermatic organs and an
abundant supply of semen escapes daily, or several times a day,
without the patient's knowledge, the digestion will become deranged,
and the power of erection, as well as pleasurable sensation, will
diminish." (p. 472.)

I have met with instances where pleasure was diminished, and the
power of erection was certainly less. But I do not consider that even
these I symptoms are proof that the case is pro tanto incurable. On
the contrary, in by far the greater number of patients all local distress
or weakness, when appropriately treated, may, with little difficulty, be
permanently removed.

Treatment. — The same or similar treatment to that already pointed
out as the best for nocturnal emissions should be followed where the
disease is still in the condition of diurnal emission merely. It is then,
to a very great extent, amenable to the will and to medical treatment.
When it assumes the form of spermatorrhoea, the treatment detailed
hereafter under that head should be adopted.

CHAP. III.— THE EMITTED FLUID SEMEN

We now come to describe the third of the subjects specified at p. 75
as indispensable for the due performance of copulation, namely, a due
amount of well-formed semen,

PART I

NORMAL CONDITION OF THE SEMEN

Composition of Semen. — " Pure semen," says Carpenter, " is a
milky fluid of a mucous consistence, and neutral, or slightly alkaline
reaction. The imperfectly developed spermatozoa are composed of an
albuminous substance, the quantity of which diminishes with their
progress towards maturation ; so that the perfectly developed semen
contains no albuminous compound. On the other hand, the principal
component substance of the mature spermatozoa is the same with that
which is the chief constituent of the epithelia, and of the horny tissues
generally ; namely, the ■ binoxide of protein ' of Miiller. Besides this,
the spermatozoa contain about four per cent, of a butter-like fat, with
some phosphorus in an unoxidized state (probably combined with the

COMPOSITION OF SEMEN 123

fat, as in the phosphoiized fats of the blood- corpuscles and of nervous
matter), and about five per cent, of phosphate of lime. The fluid
portion of the secretion is a thin solution of mucus, which, in addition
t«> the animal matter, contains chloride of sodium, and small quantities
of alkaline sulphates and phosphates. The peculiar odour which the
■amen possesses does not appear to belong to the proper spermatic:
fluid, but is probably derived from one or other of the secretions with
which it is mingled.

" The mode op evolution of the spermatoza is such as to indicate
that these bodies are true products of the formative action of the organs
in which they are found, and cannot be ranked in the same category
with animalcules. They are developed in the interior of cells, or
vesicles of evolution, such as are visible in the semial fluid in various
stages of production (figs, f, g, h, i), and have been known under the
head of seminal granules.

" These appear to have been themselves formed within parent cells,
which are probably to be regarded as the epithelial cells of the tubuli
seminiferi, constituting, like the analogous cells of other glands, the
essential elements of the spermatic apparatus. These parent cells are
sometimes observed to contain but a single vesicle of evolution, as
shown at d ; but more commonly from three to seven are seen within
them, as in e.

A, B C. Single vesicles of evolution, of different sizes, from the seminal fluid of the doe.
D. Single vesicle, within its parent cell. E. Parent cell, enclosing seven vesicles of evolution,
r, t*. Vesicles containing spermatozoa in process of formation. H, I. Spermatozoa escaping from
the vesicles. (Copied from Wagner and Leuckardt.)

" When the vesicle is completely matured it bursts, and gives exit to
the contained spermatozoa. The spermatozoa are not normally found
free in the tubuli seminiferi, although they may be there so far advanced
in development that the addition of water liberates them by occasioning
the rupture of their envelopes. In the rete testis and vasa efferentia

124 THE EMITTED FLUID SEMEN

the spermatoza are very commonly found lying in bundles within the
parent cells, the vesicles of evolution having disappeared ; and they are
usually set free completely by the time that they reach the epididymis,
though still frequently associated in bundles. The earlier phases are
occasionally met with, however, even in the vas deferens." 1

That the essential elements of the spermatic fluid are the sperma-
tozoa, may be reasonably inferred from several considerations. There
are some cases in which the liquor seminis is altogether absent, so that
they constitute the sole element of the semen; but they are never
wanting in the semen of animals capable of procreation, though they are
absent, or imperfectly developed, in that of hybrids which are nearly or
entirely sterile. Moreover, it may be considered as certain that the
absolute contact of the spermatozoa with the ovum is requisite for its
fecundation. This appears from the fact that, if the spermatozoa be
carefully removed from the liquor seminis by filtration, the latter is
entirely destitute of fertilising power. Hence the presence of the
liquor seminis must be considered as merely incidental, and as
answering some secondary purpose either in the development or in the
conveyance of the spermatozoa.

Miiller says — " Not only are spermatozoa absent from the semen of
many animals, and particularly of birds — except at the pairing time —
but the development is imperfect in hybrid animals, which are generally
incapable of reproducing their kind, or at most pair with individuals
of one of the unmixed species, and produce forms which then return
to the original fixed type. Hebenstreet, Bonnet, and Gleichen, all
failed to detect spermatozoa in the semen of the male mule." (Yol.
ii, p. 1478.)

Secretion op Semen. — Carpenter says, in his ' Comparative Physio-
ology,' p. 533-

" The development of the spermatozoa is, in most cases, periodical,
man and most of the domesticated races being the only animals in which
there is a constant aptitude for procreation. The spermatic organs,
which remain for long periods in a state of atrophy, at particular times
take on an increased development, and their product is then formed in
great abundance."

(The secretion of semen takes place slowly in the continent man — so
slowly that, in fact, in many instances, I think little or none is formed
in healthy adults whose attention is not directed to sexual subjects, and
who take a great deal of strong exercise^ The same may be said of
animals that are not allowed sexual congress.

Quality op the Semen. — Semen, as we shall show (p. 126), when
first secreted, is not the same elaborated fluid which we find in the

1 ' Human Physiology/ p. 791, fifth edition,

THE EMITTED FLUID SEMEN 125

totioulas seminales. "The complete development of the spermatozoa
in their full proportion of number is not achieved till the semen has
reached, or has for some time lain in, the vesicul® seminales. Earlier
after its first secretion, the semen contains none of these bodies, but
granules and round corpuscles (seminal corpuscles), like large nuclei
enclosed within parent cells. Within each of these corpuscles or nuclei
a seminal filament is developed by a similar process in nearly all
animals. Each corpuscle or nucleus is filled with granular matter ;
this is gradually converted into a spermatozoid, which is at first coiled
up, and in contact with the inner surface of the wall of the corpuscle."
— Kirkes, 7th edition, p. 735.

With respect to these vivifying agents, the spermatozoa, the micro-
scope shows that specimens of semen differ much ; that in some
persons it is, so to speak, permanently immature, and that in other
instances it may be so temporarily.

Whether the semen is secreted as required, or stored up, is some-
what doubtful. On the whole, it seems to me, after considerable
investigation, pretty clear that the semen is stored up and elaborated
in the vesiculse seminales. It is tolerably certain that the testicles do
not necessarily go on continually secreting, but cease when there is no
further occasion for their action. What makes this very probable is
the fact that the vas deferens (see diagram, h, p. 104) is generally
found empty in men who have been long removed from the society
of women. As the semen is secreted in the testes (/) it is, I believe,
pushed forwards into the vasa deferentia (k), and thence is deposited
in the vesiculse seminales (e), and, while there, mixed with the secre-
tion of these organs, and is then ready for use at an instant's notice.
It is owing, I believe, to its previous secretion, elaboration, and storing
up, that emission occurs under slight mental or physical causes. If
semen were not thus ready at a moment's call, much more preliminary
excitement than that usually required to produce nocturnal emission
would be necessary to cause ejaculation. In some animals, however,
this storing up does not and cannot occur, as they have no vesiculai
seminales.. But in most of these cases there are means for attaining
the same end — the elaboration of the semen — as, for instance, the
dilatation of the vasa deferentia. Thus, " In the horse this portion of
the duct is extremely thickened by the occurrence of numerous glan-
dular cellules in its walls. Much the same condition is met with
in the bull. In the elephant each vas deferens, when it arrives at this
point, enlarges into a cavity of considerable size, which it is evident
may readily, and no doubt does really, fulfil the function indicated by
the words vesiculae seminales." — Pittard, * Cyclop, of Anat. and Physiol., 1
vol. iv, p. 1431.

A very important difference, however, between most animals and

126 THE EMITTED FLUID SEMEN

man is, that man has no rutting season. Man may require his semen
at any moment ; and the vesiculae seminales supply his need. Most
animals, on the contrary, requiring semen only for a short time, pro-
duce enormous quantities with great rapidity, and probably expend
most of it as it is secreted. The periodic enlargement of the testes,
and the other changes noticed at the rutting season, supply this
requirement. The animal system answers wonderfully to these sudden
demands. We observe a similar process when nature is called upon
for sudden and extraordinary supplies of horn and bone. Bone, we
know, grows very slowly under ordinary circumstances ; it is often
deposited round fractures in less quantities than we wish it ; yet such
is the lavishness of nature when called upon, that a stag's antlers will
be replaced fully in eleven weeks.

The injected preparation made by John Hunter of the testes of
animals that have a rutting season shows how a healthy male
may secrete an almost unlimited quantity of semen for a short time.
It should, moreover, be borne in mind that the animal has two
testes, only one of which probably is drained at a time, and a large
quantity of semen is probably hoarded up in the testes and vasa
deferentia.

The quantity of Semen actually emitted in each Sexual Act
in Man amounts, generally, to two teaspoonfuls or one, according as
the male has been continent or not. Of course, the whole of this
emission does not consist only of pure semen. The secretion, as it
leaves the meatus, is a heterogeneous compound. Pittard thus describes
it : — " Some dilution, some addition to the volume, seems necessary
in order to obtain an efficient injection of the life-giving fluid. And
the quantity actually emitted by a man amounts, by all accounts, to
two or three drachms. There has, therefore, been an addition some-
where. The prostate has doubtless contributed its share ; the tiny
glands of Cowper theirs ; the urethra has given its mite of mucus,
more mucus is waiting in the vagina ; and I believe that the vesiculaB
are not behind in adding a portion of their ready-formed contribution
to the general stock. The spermatozoa, huddled" and crowded in
countless millions in the vas deferens, are now able to disport them-
selves at ease in the congenial medium, and the number contained in a
few drops of pure semen would be sufficient to people abundantly
several drachms of fluid." — Pittard, in 'Cyclop, of Anat. and Phys.,'
article " Vesiculce Seminales." r

Influence of Secreted Semen on the System at LAROE.-Vt is
a generally received impression that semen, after having been secreted,
can be reabsorbed into the circulation, giving buoyancy to the feelings,
and the manly vigour which characterises the male. This opinion
has, it appears, given rise to the celibacy of the priesthood^

INFLUENCE OF SEMEN ON THE SYSTEM 127

In the article on eunuchs 1 in the ' Dictionnaire des Sciences Medi-
cal. «,' p. US, it is stated that no eunuch can now be received into the
priesthood of the Catholic Church; "for although," adds the writer,
" priests are required to observe a moral eunuchism, inasmuch as they
must be bachelors, still they must have the merit of resistance to the
thorns of the flesh, to obtain la palme de la recompense. There are,
moreover, other considerations. Not only has it been desired to dis-
embarrass the priest from the cares of a family, as the shepherd of
souls, in order that he should charge himself with the great flock, but
it has been intended to give to him a great moral energy, the result of
chastity and celibacy, in order the better to direct other men. (in fact,
who is ignorant that the semen, reabsorbed into the animal economy,
when it is not emitted, augments in an astonishing degree the cor-
poreal and mental forces ? This powerful vital stimulant animates,
warms the whole economy, places it in a state of exaltation and
orgasm ; renders it in some sort more capable of thinking and acting
with ascendancy — with a superiority, as we equally observe amongst
animals in the rutting season^

^" This state contributes so much to courage and vigour that the
athletae and gladiators were forbidden sexual intercourse from this
cause, and the same was recommended to warriors : Moses directed the
Israelites in war time not to approach their wives .^3
Clu former editions of this work I was not prepared to entirely
acquiesce in these opinions of the reabsorption of semen, but I am now
disposed to think that semen, after it has been secreted by the testes,
must be taken up again and carried into the general circulation, there
to produce effects on the system that are only noticed in men and

1 The following account of the mode of rendering a man a eunuch, employed in
the present day, is given by Dr. Morache in his recent account of China.

The patient, be be adult or child, is, previously to the operation, well fed for some
time. He is then put into a hot bath. Pressure is exercised on the penis and testes,
in order to dull the sensibility. The two organs are compressed into one packet, the
whole encircled with a silk baud, regularly applied from the extremity to the base,
till the parts have the appearance of a long sausage. The operator now takes a
sharp knife, and with one cut removes the organs from the pubis; an assist-
ant immediately applies to the wound a handful of styptic powder, composed of
odoriferous resins, alum, and dried pufi'-ball powder (boletus powder). The assistant
continues the compression till haemorrhage ceases, adding fresh supplies of the
astringent powder, a bandage is added, and the patient left to himself. Subsequent
hecniorrhage rarely occurs, but obliteration of the canal of the urethra is to be
dreaded. If at the end of the third or fourth day the patient does not make water,
his life is despaired of. In children the operation succeeds in two out of three cases ;
in adults, in one half less. Poverty is the cause which induces adults to allow them-
selves to be thus mutilated. It is said to be difficult to distinguish these last from
ordinary Chinese men. Adult-made eunuchs are much sought after, as they present
all the attributes of virility without any of its inconveniences. — Die, Ency. des Sciences
Medicates ; article China, p. 205.

128 INFLUENCE OF SEMEN ON THE SYSTEM '

animals who enjoy virility^ It is not certain elements remaining in
the blood, and not eliminated from it, which produce manly vigour
or virility; if so, castration would produce it, instead of preventing
its development. For true manly vigour to be apparent, it would
seem as if the animal should be in good health, with sound organs
generally ; the testes should be normal and equal to the secretion of
laudable semen, and to the retention of it so long as may be required
in the natural reservoirs adapted to the purpose.

There are, moreover, many facts which it is quite impossible, as it
seems to me, to explain without believing that semen is really absorbed.

The effect of castration on the system is, as I stated above, almost suf-
ficient, alone, to lead to the inference that semen is reabsorbed. That
semen has an influence on the system is obvious, from the marked dif-
ferences between castrated and non-castrated animals . These differences
cannot depend upon anything retained in the blood, and not excreted.
The vigour of the uncastrated animal must depend upon the testes
secreting semen — that is, taking its elements from the blood. C5?his
semen is slowly secreted by the testes (/), and passes slowly along the
vasa deferentia (&) towards their terminations, which are dilated, and
some passes into the vesiculse seminales (I), there and along the course
of the vasa deferentia absorption most probably takes placed (See
diagram, p. 104.) ^Admitting, then, as I now do, the reabsorption
of semen, I am disposed somewhat to agree with Haller, that
"the greater part of the semen — that which is the most valuable
and the strongest smelling, that which has most force — is pumped
back again into the blood, and there produces, as soon as it reaches
the circulation, changes the most marvellous — the beard, the
hair, the horn ; it alters the voice and the manners ; for age does
not produce these changes in animals, it is the seminal fluid alone
which can effect this, as we never remark these changes in eunuchs."
— Primce linece Physiol., § 790.)

Accurate observation and physiology render it probable that semen,
or at least a portion, with its spermatozoa, is absorbed through the
ordinary channels ; the other portion of secreted semen may, like other
secretions that have not a free outlet, undergo fatty degeneration
in the tubuli, and be carried away like other effete matter by the
absorbents. 1 ^Should my readers require further proof on this point, I
may again cite the fact that losses of semen arising from masturbation,
nocturnal pollutions, or sexual excesses, enervate the sufferer and reduce
him to a condition exactly opposite to that resulting from continence.
I therefore come to the conclusion that semen plays a most important
part in the human economy, and can be ill spared in the healthy,
vigorous adul£)

1 As competent authorities may differ on this subject, I subjoin the opinion of

DOES SEMEN BECOME ABSORBED? 129

If I were asked bow does the system rid itself of the superabundant
somen, I should answer first in the words of Kolliker :

" In Man the capability of producing semen, assuredly, always exists ;
although it does not appear to me to follow from this that semen is
being continually formed, and that what is not emitted undergoes
absorption ; and consequently it seems justifiable to suppose that the
seminal tubes secrete semen only when the secretion has been partially
evacuated externally — either in consequence of sexual congress or
of seminal emissions — and an excitement of the nervous system has
caused an increased flow of blood to the testis." — Manual of Histology y
vol. ii, p. 241.

If this be the case, then we have not to account for much secretion
in continent men. In others, I believe, nocturnal emissions will carry
off a good deal ; the effects of defecation and micturition will also dis-
pose of some. But, admitting all this, I think we must infer that even
in the testis itself absorption must take place, as we notice that the
semen is secreted and disappears even when the vasa deferentia are
tied, or when inflammation has blocked up those canals, so as to prevent
the egress of the spermatic fluid.

I was in the year 1864 consulted by an eminent physician who had
very accurately observed his own symptoms. There was a turgid
condition of the testes, attended with pain. This gentleman told me
that formerly, while leading a continent life, nocturnal emissions had
occurred ; but that latterly, when his wife was away from home, no emis-
sions took place, and the testicles had become enlarged and painful. He
considered this condition arose from the testes being, as it were, choked
with semen, and had experienced, he said, great relief from occasionally
taking Ejisom salts and magnesia, and he attempted to solve the
problem as to what became of the secretion by supposing that these
aperients promoted the absorption of the semen, causing the vessels to
take it up, but he failed to explain what set of vessels were the agents

Kulliker. He says — " Tbere are no certain facts in favour of an absorption of the
semen when formed, which could only take place iu the vasa deferentia and vesicular
seminales ; for what is observed in animals after the rutting season is over, has no
reference to this point ; and the very circumstance that in the situations above men-
tioned, no traces of a disintegration of the semen are ever found, appears to' be very
much opposed to such a supposition. At the same time, however, it is, perhaps,
unquestionable that, without seminal evacuations, a formation of semen may be
possible; for it is sufficiently established that a rich heating diet, and an unsatisfied
sexual excitement, often produce a turgescence of these organs, attended with pain,
ful sensations, and most probably with a formation of semen. The subsequent re-
moval of this fulness does not, however, appear to me incontestably to prove any ab-
sorption; because a difference in the quantity of blood in the testes, and the passing
of the semen into the vasa deferentia, are sufficient to account for the restoration of
the usual condition." — (« Manual of Histologv/ p. 241.)

130 INFLUENCE OF SEMEN ON THE SYSTEM

in this absorption. This, however, is the material point, for, according to
him, the absorption under the influence of the aperients was rapid. My
own opinion, however, was, as I told him, that his symptoms probably
arose simply from ungratified sexual excitement.

It may be interesting if I add here a few facts with regards to animals
which may seem to throw a light on^Jris at present obscure subject^
Sir Philip Egerton says —

" Fawns, when cut prior to the formation of any horn — that is,
within a week or so after birth — both testes being wholly removed,
with a portion of the cord (vas deferens) also, will never bear horns,
however long they may live ; but if the bodies of the testes only be
taken away, the ' knob ' (epididymis) being left attached to the cord,
the animal will have horns, and renew them annually, the shedding
being always rather later in the season, and the velvet covering
remaining for a somewhat longer period on their surface than with the
entire buck ; and, further, they will be more slender in the beam, and
more porous in their internal structure. These semi-castrated — if I
may so style them — animals will go into rut, but not to the degree
which produces emaciation ; nor does the great thickening of the neck
occur which is so characteristic in the perfect animal during that peculiar
season ; nor are they capable of procreation. When the adult buck is
castrated, the horns are shed shortly afterwards, and renewed ; but the
persistent periosteum, or * velvet/ never separates from their surface,
and the horns do not again fall, but remain attached during any period
the animal may survive. These permanent antlers are often more
developed than those produced by entire bucks of equivalent age, which
I think may be well accounted for from the fattened state, and the
longer influence, from the continued adherence of the vascular integu-
ment by which the horns are formed. I may here observe, that
circulation continues in the bone or horn after the periosteum has
separated, and that, diminishing by degrees, first from the points, the
vessels become obliterated, and vitality therefore ceasing, it is cast off."
— Gascoine, " On Castration of the Cervidai;" ' Proceedings of the Zoolog.
Soc? June, 1856, p. 156.

I have attempted to settle the question of the influence of semen on
the system, by inquiries amongst those who have the largest opportu-
nities of studying the subject amongst entire as well as gelded animals,
with relation to the enduring qualities in males and females, and this is
the information I have arrived at.

There can be no doubt that entire horses are capable of undergoing
more work than geldings. It is a saying in Norfolk, that a stallion
is equal in draught to one gelding and a half. One such horse is often
kept on a farm, and works a certain number of months in the year when
not required for breeding purposes. The farmer then puts him by,

INFLUENCE OF SEMEN ON THE SYSTEM 131

and receives thirty or forty pounds for his mounting services. Such
entire horses are not, however, always tractable, which is the reason they
arc not employed more frequently in England. And the correct-
ness of this opinion has been corroborated by one of the best and
I rideri in England, who tells me that he has seen and ridden entire
horses with the hounds, but that they soon shut up in the hunting field ;
they grow sulky, and refuse to go. He says on this score they are
« -I j. » t ionable ; and he gives a stallion a wide berth, as they bite occasion-
ally, and are very vicious. Besides, their tempers are generally uncertain.
Although their endurance might be good, it would be rather in draught,
he should think, that they might be used. Experience has taught him
that they are not adapted for hunting, although they may do for hacks ;
and here often the same bad temper interferes. He has ridden good
geldings as well as good mares, and cannot say which he prefers.

At Tattersall's a gelding is always worth, cceteris paribus, <£5 more
than a mare ; this is probably because a mare is liable to kick at the
time of horsing. I myself object to drive mares on this score, as no
one can be sure of their tempers when in this condition.

I was talking the other day to the manager of a large cab company,
and remarking on the number of mares the company possessed. " Yes,"
said he, " geldings, we find, are not equal to do the thirty miles a day
we expect out of our Hansom cab mares, and we purchase only this
description of animal, as suited to our work."

Any one who has travelled much in France must be aware of the
fact that stallions are used by preference for all draught purposes ;
and by means of hard work and driving in teams together they are
made very gentle, even though well fed and in excellent condition.

PART II
DISORDERS AFFECTING THE SEMEN

We have now to consider the abnormal or unhealthy conditions
which, by influencing the semen, may interfere with the due perform-
ance of the sexual act.

SECT. L— INFECUND SEMEN

Though the terms are often used loosely as synonymous — " want of
power to produce its like " (Barclay) — unfruitfulness (infecundite) is
not impotence. A man may be unable to beget children, and yet not

13.2 DISORDERS AFFECTING THfi SEMEN

be impotent, though an impotent man is, of course, unable to beget
children.

This state may last a short time, or it may be permanent. Rest may
give the semen time to become perfect, or ripen, and the spermatozoa
may reappear and become mature. Stricture, again, as we shall presently
see, may make a man practically sterile, and so may other affections of
the testes or generative organs. Not that infecundity — meaning by
that term the lack of children — necessarily rests with the man alone,
the cause of non-impregnation may depend wholly or partially on the
female.

Infecundity in the Male. — Science is very deficient in any accu-
rate examination of the state of the seminal secretions. It is a field
still open to the examination of strict observers, and would amply
repay the trouble.

Dr Davy, Assistant-Inspector of Army Hospitals, at the General
Military Hospital at Fort Pitt, published in 1858, in the ' Edinburgh
Medical and Surgical Journal ' for July, vol. xl, p. 1, a very interesting
examination of twenty post-mortem appearances of men who, dying
of various diseases, were examined by him.

From this paper I have condensed the following table. The details
are reported at great length, as well as the causes of death ; the post-
mortem appearances, not only of the organs generally, but a minute
examination of the secretions found in the vesiculae seminales, as well
as the microscopical character of their contents, are given.

The object-glass used was one of one-eighth inch focal distance,
constructed by Moss.

It would appear from the above examinations that there is but little
difference in the microscopic character of the fluid found in the vasa
deferentia (ft) and in the vesiculae seminales (T) . (See Diagram,. p. 104.)

In the vasa the quantity is smaller, and appears to be in transition
from the testes, where it was secreted, into the vesiculae, where it is
retained and mixed with other secretions.

The fluid found in the vasa deferentia is generally creamy or puru-
lent looking, and is liquid and small in quantity. That found in the
vesiculae is more abundant, of a brownish colour — the brown tint
increasing after death — and is occasionally tinged with blood. The
colour, however, may depend upon post-mortem appearances. The two
vesiculae may differ in the quantity of fluid they contain. One may be
empty, the other more or less distended.

In consistence the fluid in the vesiculae varies, being sometimes thin
like starch, but more frequently thick, viscid, and gelatinous. After
standing a few hours it separates into two parts ; the one which sub-
sides being opaque, while the other is transparent ; the latter is
copiously precipitable by alcohol, and becomes almost gelatinous.

INFECUND SEMEN

133

iii Mono-
graph.

Age.

4
10
11

20
20
27

29
30

Condition of Vesiculse Seniinalcs.

Slightly viscid ; brown tint
Starchy, aud gelatinous
Partly thick aud partly thiu

secretion
Few spermatozoa, but glo-
bules
Gelatinous; well- formed ani-
malcules
Gelatinous, thick, globules
Similar to that in vasa def.

Fluid thick at fundus, in the

interior fluid
Fluid opaque, purulent

Mucilaginous ; animalcules
numerous

Purulent ; animalcules abun-
dant

Small in quantity, brown,
opaque

Small in quantity ; no ani-
malcules

Globules; no animalcules

Showed no animalcules; no
globules

Gelatinous; no animalcules
or globules

Mucilaginous ; many ani-
malcules

Slightly opaque; abundant
animalcules

Animalcules abundant, dead
in seventeen hours

Abundant vestiges of ani-
malcules; few distinct

Condition of Vasa Deferentia.

Examined

hours after

death.

Starchy

Few animalcules ; not brown

Healthy, with few spermatic
animalcules

No distinct animalcules, glo-
bules

No fluid in

Numerous animalcules in
active motion

Globules and fragments

Cream or purulent appear-
ance
Cream-like globules

Few animalcules

Dilute, purulent — animal-
cules few

Small particles; large glo-
bules

Minute globules; no ani-
malcules

Purely purulent, with glo-
bules ; no animalcules

Of a cream or purulent co-
lour ; no animalcules

Particles, but no animalcules

A few animalcules

Abundant animalcules, lively
ten hours

Purulent ; animalcules abun-
dant, dead

4
10

6 and 48

6 and 36

38 and 58

10 and 17

From the above table it appears that the spermatozoa, or spermatic
animalcules were found equally in the vesiculse seminales and in the
It is curious to remark that, in all the cases in which sperma-
tozoa were found in the vasa deferentia, similar animalcules were
noticed in the vesicuke seminales. In cases in which the body was
examined a few hours after death the spermatozoa were found alive,
and moving actively, while in a few hours later they were motionless
and dead, and warmth had no effect in reanimating them. In some
cases the animalcules were not perfect, portions only of imperfect
spermatozoa being found. In other cases no animalcules could be
discovered either in the vasa deferentia or vesiculse ; they were
replaced by large or minute globules, small particles, or fragments.

134 DISORDERS AFFECTING THE SEMEN

The age of the individual appeared to have little to do with this
condition of the spermatozoa, or indeed with their presence, numbers,
or total absence. It is curious further to remark that, although
spermatozoa were found frequently in the vesiculae and vasa defe-
rentia, they were only found twice in the testes. The fluid expressed
from the testes was transparent, generally contained globules nearly
equal in diameter to the blood-corpuscles, and invariably contained
dense particles, apparently spherical, from ten to fifteen times smaller.

" Dr Davy thinks, first, that chronic wasting diseases terminating in
death arrest the secretion of the testes, or the production of those
animalcules on which there is much reason to believe the active powers
of the semen depend. Secondly, that the contents of the vesiculce and
vasa deferentia, under the influence of disease, retain their character-
istic qualities longer than the contents of the tubuli; and, thirdly,
that there is least fluid in the vesiculae and in the vasa deferentia, and
that it is most altered in instances of chronic diseases of the abdo-
minal viscera, and especially of the intestines." — Edinburgh Med. and
Burg. Jour., vol. 1, p. 14.

Dr Davy considers that, admitting that the vesiculse are, like the
gall-bladder and bladder of urine, recipients, the fact may be viewed as
a fortunate circumstance in our economy, and admirably adapted to
the condition of man. Like the bile or the urine, the spermatic fluid
in the healthy adult appears to be in constant process of secretion, and
to pass as it is formed into its appropriate reservoir, from which,
without disturbance of the system, in a state of continence, it is either
passed out and voided during the act of alvine evacuation, or is in part
absorbed.

" Mr Hunter, in accordance with the opinion which he had formed
of the use of the vesiculse, did not admit this. He believed that the
fluid rather accumulated in the testes, and gave rise there to annoy-
ance, requiring its evacuation by a disturbing act — a dangerous
doctrine, and one for which there is, in modern science, no sufficient
evidence. In opposition to the doctrine of Hunter, I may further
state, that I have frequently examined microscopically the fluid from
the urethra, following the alvine evacuations, and I have always found
it, in a healthy person, abounding in animalcules, the majority of
which have always been dead ; and thus, perhaps, seeming to indicate
that the vesiculso are cloacw as well as reservoirs, and are essentially
designed for man to enable him to control and to exercise that moral
check on the passions by which he should be distinguished from brute
animals, and without which no considerable advance can be made in
civilisation or in elevation of individual condition and character." —
Edin. Med. and Surg. Jour., vol. 1, p. 14.

The most obvious deduction from the foregoing inquiries is that in

INFECUND SEMEN 135

the human adult the seminal fluid varies much in different subjects, at
different times, and at different ages. Thus it may be more or less
matured ;uul elaborated, and it may be secreted in larger or smaller
quantities. I do not think sufficient attention has been paid to these
circumstances. The quality of the semen, and the consequent exhaus-
tion of the system which secretes it, must have a great influence on the
progeny. May not the fact observed in all ages, that the children of
self-made men are not usually equal to their sires, depend, among other
causes, upon deterioration of the impregnating fluid in the parent from
the great mental demand to which he was subject at the time
impregnation took place ?

Observation teaches us many facts that it may be of importance to
mention here. It is an old aphorism that " like begets like," and we
find that not only are the features of the father reproduced in the son,
but also that those of the grandfather and remoter ancestors reappear
in their descendants. Often we see peculiarities and deformities, such
as supplemental fingers, handed down. In these cases it is evident
that it is not by association, education, imitation, or copying habits,
good or bad, that the progeny are influenced. The cause is wholly
external to them and beyond their control, and the simple fact is that
at the time of impregnation the SEMEN influenced the mother's
system so as to reproduce its like even to the most minute part, say a
webbed finger. This, then, is what the semen does. Let us next
consider what semen does not do. Mental qualities may be inherited,
but they are not necessarily ; on the contrary, it would appear that a
clever man, who has risen by his own abilities, seldom begets a clever
son. If we take the judges, the bench of bishops, the medical profession,
it is curious to remark how few self-made men beget sons who distin-
guish themselves either in their fathers' or in other professions. The
great fact is there ; the explanation may be various. Many whom
I have conversed with admit the data, that with the exception of some
judges' sons, there are few able men now alive or holding high in-
tellectual positions who are the sons of distinguished fathers risen
from the ranks.

This admitted degeneration has been attributed, by the majority of
persons with whom I have talked on the subject, to the belief that
easy circumstances and the competency made by the father release the
son from the obligation to work hard and gain his own livelihood ; the
son of such a father is satisfied with his condition, and does not
exert himself to the extent that an ambitious youth does who has
no such paternal antecedents. This explanation may be, and is, more
or less true.

I have, however, had many opportunities of examining early
in life the sons of eminent men who have risen by their own unaided

136 DISORDERS AFFECTING THE SEMEN

exertions, and my belief rather is that, the obligation to work hard
early in life, incessant intellectual labour, and late marriage, have
exhausted all the mental energy in the father's frame, so that
there is none left to impart. If energy, without which no great
success can be obtained, is the deficient element in the sons of
successful men — who have spared no expense in the education of their
sons — have had opportunities of pushing the youths on in every pos-
sible way — we explain why the sons are not pouasable (to use a terse
French expression) . In spite of all other advantages, they are almost
invariably pushed off their stools by youths beneath them, whose fathers
if they have not had money, position, and social considerations, have
had this important element, energy, to hand down to them.

It has been often said that it is to the mother that the a,ble man owes
his success ; popular opinion leans to this opinion, and numerous cases
may be cited in corroboration of this view ; but I leave it for others to
consider my view, that, given an able mother, the constant nervous
expenditure of an active and energetic father's life will often fail in
enabling him to pass on to his offspring his own vital energy — this
must come from some unused and abundant source.

May not many of the weedy horses met with be the result of an
exhausted and overworked sexual system in the travelling stallions,
their sires P 1 We may assume generally that to obtain perfect and
fertile semen some rest must follow each sexual effort.

To effect impregnation certainly, and for the semen to be not only
fertile but capable of producing healthy and perfect offspring, it is
indispensable that it should remain and be matured in the vesiculee
seminales ; in favour of which use of these organs we may quote the
authority of Kolliker, who says — " In common with many other ob-
servers, I have so frequently seen spermatic filaments in the vesiculce

1 I have attempted to procure evidence on this subject, particularly with regard
to the breeding of horses. The difficulties are naturally great. Owners of stallions
are loth to believe that weeds can depend upon this cause. When a celebrated horse
can fill his list of forty-five mares, at thirty-five guineas a mare, I fear the pecuniary
consideration will make the owner blind to the supposition that his horse's powers
may become exhausted. If, however, the owners of the stallion cannot see the question
in this point of view, it is time for those breeders who own' valuable mares to be
pnt in possession of the information that their disappointment probably depends upon
the sires they choose being over-taxed. It is the object of all owners of race-horses to
get their mares served as early in the season as possible, so that the mare may drop her
foal as soon after January as possible. A two-year-old born in January is better able
to compete with his compeers than one foaled in March; at this age, a couple of
months tell. As a consequence, the stallion, if a celebrated sire, is called upon to
serve in a short time a large number of mare3. Now supposing forty- five mares,
each to be mounted once, at least, and several every nine d:»ys until stinted, it is
hardly conceivable but that the quality of semen emitted by the horse should deteriorate
after so enormous an expenditure of the vital fluid.

INFECUND SEMEN 137

st )»inales, that I should describe their occurrence there as normal, and
assign a double function to the seminal vesicles ; viz., its principal one,
of affording a special secretion, and also that of acting as seminal
reservoirs." (Loc. cit., p. 232.)

Infecundity, however, does not depend wholly on the male. In
many instances no doubt can exist that the fault is with the female.
The most common female cause of sterility is, as we might almost
have expected, obstruction of some portion of the generative canal,
arising from various causes.

Perfect occlusion of the os uteri may occur as a consequence of
disease. Again, we meet with it only partially blocked up, from the
canal being so devious that, though the menstrual secretion may be
able to pass out, the semen cannot find admittance — at least in time to
impregnate. Or, again, the os may be temporarily closed by a
tenaceous glairy mucus, and until this is removed and prevented from
again accumulating, impregnation cannot take place. (See Plate II,
fig. 2, in my work on the diseases of the generative organs.)

It is not my intention here to speak of all the causes of sterility in
the female. Those desirous of learning more on this subject must
consult my larger work on the urinary and generative organs. It
must not, however, be supposed that mere mechanical obstruction is
the only cause of sterility in the female. Many others, effectual
beyond a doubt, but very mysterious in their origin, undoubtedly
exist. 1

In considering the subject of sterility, it should not be forgotten
that idiosyncrasies exist in all animals. A male and female may be
perfectly potent and fertile, and yet be unable to breed together. In
fact, the semen of one male, from some hidden cause, will not impreg-
nate a particular female, though it will others. A similar phenomenon
occurs also in the vegetable world.

In Mr Darwin's book on the ' Origin of Species,' there are some
curious experiments mentioned bearing on this question. " Thus one
tree will not take (be grafted) on another, apparently from differences
in their rate of growth — in the hardness of the wood — in the period of
the flow — or nature of their sap. On the contrary, great diversity in
these very particulars, and even in more important ones, are not
infallible tests. One may be woody and the other herbaceous — one

1 Donne has shown that the mucus coming from the os uteri is alkaline, so alka-
line sometimes, that in one of his experiments the contact of apparently healthy
uterine secretion, in a few seconds, killed several hundred spermatozoa. Blood, it
seems, does not kill the spermatozoa, but urine does, although not very rapidly.
(See ' Cours de Microscopie par Donne,' pp. 295, 298.) Leucorrhcea, or " whites/'
will at once destroy the spermatozoa, and as large numbers of women suffer under
these disorders, we cannot be surprised at finding such women barren.

138 DISORDERS AFFECTING THE SEMEN

evergreen and the other deciduous — one the native of a hot climate,
the other of a cold one — and the grafts from one on the other may
succeed. The pear can be grafted far more readily on the quince,
which is ranked as a distinct genus, than on the apple, which is a
member of the same genus. Even different varieties of the pear take
with different degrees of facility on the quince ; so do different
varieties of the apricot and peach on certain varieties of the plum."
(Loc. cit., p. 264.)

" Sterility may be produced by the attempt to cross between very
different races. An embryo may be developed to a considerable
extent, but the mother's system never recovers the disturbance caused
by the attempt to unite two organizations so widely unlike. This
often happens, according to Mr Hewitt, in attempts to cross among
gallinaceous birds." (P. 264.)

That one horse will fail to impregnate a mare, while she will prove
in foal by another, is well known to breeders. During the season of
1864, I sent a mare several times to be served by a particular horse,
but without success, while, on being put to another, she was imme-
diately impregnated. I observed the same in the case of a very cele-
brated high-bred short-horned bull, in my own neighbourhood, which,
although he mounted cows, did not impregnate them. These and
other anomalies deserve the consideration and close observation of all
breeders of valuable stock.

Fecundity Lessened. — Greg, p. 84, hints at the existence of
certain physiological and occult causes which affect the fertility of
animals, especially when in what we may term for them a state
of civilisation. One such influence may be specified with considerable
confidence, namely, " The Tendency of Cerebral Development to
Lessen Fecundity." (See notes on p. 87, from H. Spencer, in
1 Enigmas of Life.')

SECT. II.— UNGItATIFIED SEXUAL EXCITEMENT

Just in proportion to the degree of uneasiness caused by the pre-
sence of an excess of semen in the organs, is the relief experienced
after its natural, or, so to speak, legitimate emission. As will be
shortly stated, regular and moderate sexual intercourse, at the adult
age, is undoubtedly of advantage to the system at large. But the
mere excitement of the sexual feelings when not followed by the result
which it should produce, is, as has also already been stated (p. 19), an
unmitigated evil. I am becoming every day more and more con-
vinced that much suffering and many ailments arise in great measure

UNGRATIFIED SEXUAL EXCITEMENT

139

from the repeated and long-continued excitement of the sexual
feelings unattended by subsequent sexual relations. I could mention
many instances where I have traced serious affections and very great
■offering to this cause.

The cases may occur at any period of life. We meet with them fre-
quently among such as are usually called or think themselves conti-
nent young men. There are large classes of persons who seem to
consider that they may, without moral guilt, excite their own feelings
or those of others by loose or libidinous conversation in society, pro-
vided such impure thoughts or acts are not followed by masturbation
or fornication. I have almost daily to tell such persons that physi-
cally and in a sanitary point of view they are ruining their constitu-
tions. There are young men who almost pass their lives in making
casual acquaintances in the streets, but just stop short of seduction ;
there are others who haunt the lower class of places of public amuse-
ment for the purpose of sexual excitement and live, in fact, a
thoroughly immoral life in all respects except absolutely going home
with prostitutes. When these men come to me labouring under the
various forms of sexual debility, they are surprised at my suggesting
to them the possibility of the impairment of their powers being depen-
dent upon these vicious habits.

Parents and guardians should warn young men against idling away
their spare time in such detrimental amusements. There would often
be less inducement for them thus to demean themselves were greater
pains taken to render their homes agreeable, and especially by provid-
ing that they shall learn in the domestic circle to appreciate the society
of modest women.

Similar evil consequences, only in a modified way, follow long
engagements, and are witnessed also in the many instances where vain
worldly women trifle with serious men's affections to jilt them in the
long run.

This opposition to nature's laws is not confined to single life. I
almost daily witness such ill consequences as the following very painful
case, in which the patient's wife — to whom he is passionately attached
— is the real cause of serious illness in her husband, by obdurately
refusing to allow marital intercourse, for fear of having any. more
children (she has perhaps had several), although she otherwise keeps
up the semblance of familiarity and affection, and thus adds very
greatly to his suffering.

Few medical men venture to suggest such a cause for the general ill
health and sexual debility they meet with, but I am sure such cases
are not unfrequent ; and where the excitement is allowed to continue,
all the remedies of the Pharmacopoeia will avail nothing, and in the
more severe cases, I fear that even subsequent abstinence from all

140 DISORDERS AFFECTING THE SEMEN

causes of excitement will not ensure a cure. I have every reason to
believe that if the co-ordinate performance of what constitutes the
sexual act be repeatedly disturbed, the best medical treatment is not
always efficacious in restoring sexual power.

These ailments, I repeat, are not confined to the young. There are
old men who marry young wives, and who pay the penalty by
becoming martyrs to paralysis, softening of the brain, and drivelling
idiocy. Such unions as these, although not always recognised, are
certain sooner or later to do mischief. I am daily made cognisant
that many cases of the most intractable forms of impotence and
abeyance of virility I have to treat arise from similar causes. In the
first place, these indulgences — which are thought so harmless — pro-
duce local mischief in the reproductive organs. Among the principal
and primary evils they cause, is the weakening of that co-ordinate
action which should connect the excitement of the organs and the
complete performance of the sexual act. In the next stage, the
excited nervous system, if it does not receive and reciprocate that
shock which we have seen ought to attend ejaculation, suffers a
longer and more severe strain, lasting often days or nights, and this
new explosion of the Ley den jar is repeated over and over again. In
fact, the non-occurrence of emission after sexual excitement [permits
for a time the repetition of the excitement ; but ultimately a collapse
takes place from which it is very difficult to rally a patient. The
consequences are, that when after the preliminary excitement has
occurred, and the control of the will shall have been able to prevent
emission, the patient will very probably find that when he wishes it,
emission will not follow erection. These practices, unnatural in the
highest degree, cannot be carried on with impunity. Nature is sure,
sooner or later, to inflict a severe retaliation.

Under the head of impotence I have described several other
instances of this detrimental action on the reproductive powers. I
have more especially alluded to the case of an artist who had so
schooled his will that he could look at the nude figure without excite-
ment, yet when the time came for his marriage he felt himself unequal
to the task.

I cannot bring to a close this important chapter without directing
the attention of the profession to the dangers that married couples
incur in defrauding nature by practices that have been called conjugal
onanism, and a M. Bergeret has in a French work entitled ' Des
Fraudes dans l'accomplissement des fonctions generatrices,' given a
very succinct account of how it is that French parents determine (and
carry out) that they shall only have one, or at most two children. M.
Bergeret mentions that this method of limiting the family is not con-
fined to the poor; the system also holds good among the upper

SEXUAL SUFFERING IN THE MARRIED

141

s in France. In a discussion which took place a few years ago
in the French Academy of Medicine, it was publicly admitted that the
arrest in the progressive augmentation of the population in France did
virtually depend upon the means the nation took to check its increase
by fraudes gcncsiques.

I am far from attributing, with the author of this treatise, so many
of the local ill consequences which he traces in the female to the
means pursued. On the contrary, I am fully convinced that the many
ailments, such as simple affections of the uterus, which M. Bergeret
considers to follow the practices adopted in France, attend — although,
perhaps, in a less degree — married life in England, where, I am
convinced, the practices are hardly known, and still less frequently
resorted to. Still I raise a warning voice against either married or
unmarried persons giving themselves up to ungratified sexual excite-
ment.

SECT. III.— SEXUAL SUFFERING IN THE MARRIED

In speaking of continence (page 17), I admitted the difficulties
some young men experience in maintaining it, and I furnished some
important evidence proving that a strong will, plenty of exercise, and
surgical supervision, should enable a man to control his sexual appetites.
In the present section I propose devoting a few pages to sexual suffer-
ing in the married — a subject which has not met with that considera-
tion from medical men which it deserves.

It often occurs that married men come to me with sad complaints
of the intense suffering they have to undergo. I saw one such
patient who was a man of strong sexual disposition, married, and the
father of several children. In consequence of the rapidity with which
his wife (a delicate woman) had brought him a family, she had been
suffering severely from uterine disease, for which she was then under
treatment, and the medical attendant had recommended separate beds
and abstinence from all sexual relations. This patient assures me
that no one could imagine what torments he has undergone ; warmly
attached as he, is to a loving, educated, and beautiful wife, yet debarred
from all the most cherished advantages of a married man. " What
could I recommend?" was his inquiry.

Let me cite another instance. Such a man as the above came to me
with a budget of grievances. Married to a woman of strong animal
instincts, she had proved unfaithful to him, and an action for divorce
was about being brought by my patient against the lady. En attendant
my married patient was the subject of most acute sexual suffering,
without any immediate chance of becoming legally separated from a

142 DISORDERS AFFECTING THE SEMEN

woman who, although his wife, had ceased to be a wife to him ; yet
society had decreed that he must bear his hard lot, without any
chance of being speedily released from the most acute sexual suffering.
Moving in the best and most fashionable society, much admired
by ladies of his acquaintance, he assured me that no one could form
any idea of the sufferings or temptations he had hourly to undergo ;
yet he was chained to this torment, and his every action watched by
the most vigilant detective police that the friends of the wife could call
to their aid.

I regret to say that in such cases as these, I can do little more than
offer my sympathy ; still, to persons who are thus situated my remarks
on continence are of value ; and as a surgeon, I have no hesitation in
saying that a man of strong sexual disposition must make many
sacrifices. He must eschew much agreeable female society, he should
abstain from the indulgences of the table, and he must take more
exercise than the indolent are disposed to adopt. The profession can
offer him little assistance and but little benefit, unless he be
endowed with a strong will — an aid to treatment, often found wanting
in strongly-developed animal natures. Is it surprising, then, that so
many who, under more favorable auspices, would have continued to
make the best of husbands, fall victims to a vicious mode of living,
and seek in fornication some alleviation of their sexual sufferings ?

These are some of the arcana of social life that are revealed only to
medical men, in the hope (often a vain hope) that they may be in a
position to suggest some mode of relief.

During the last few years, and since the rights of women have been
so much insisted upon, and practically carried out by the " strongest-
minded of the sex," numerous husbands have complained to me of the
hardships under which they suffer by being married to women who
regard themselves as martyrs when called upon to fulfil the duties of
wives. This spirit of insubordination has become more intolerable —
as the husbands assert — since it has been backed by the opinions of
John Stuart Mill, who in his work on the ' Subjection of Women,'
would induce the sex to believe that they are " but personal body-
servants of a despot." Mr Mill complains that the wife has not even
the privilege of the female slave, who he states " has (in Christian
countries) an admitted right and is considered under a moral obli-
gation to refuse to her master the last familiarity. Not so the wife,
however brutal a tyrant she may be chained to — though she may know
that he hates her — though it may be his daily pleasure to torture her,
and though she may feel it impossible not to loathe him — he can claim
from her and enforce the lowest degradation of a human being, that
of being made the instrument of an animal function contrary to her
inclinations."

DISAPPOINTMENT IN LOVE 143

As opposed to these doctrines, I would rather urge the sex to follow
the example of those bright, cheerful, and happily constituted women,
who, instead of exaggeruting their supposed grievances, instinctively, as I
it were, become the soothers of man's woes, their greatest gratification
apparently being to minister to his pleasures, seeing that woman WM
created for the purpose of being a help-meet to her husband. Doubt-
less many a medical man can, like myself, recal the self-condemnation
of more than one married womau who, in her repentant moments, has
Acknowledged that want of sympathy and affection on her part has led
first to estrangement and subsequently to a permanent separation from
a husband whose merits she has learnt too late to appreciate.

>< SECT. IV.— DISAPPOINTMENT IN LOVE

Disappointment in love or misplaced affections are frequently attended
with most painful sexual consequences, even among men who are not
usually thought very susceptible. In October, 1861, 1 attended a patient
who came to me complaining that his health was breaking down,
owing (as his medical attendant had told him) to loss of semen. It
appeared that, originally of a good constitution, and having by
strenuous exertion attained a position of some eminence, he had thought
of marrying. Owing to circumstances of the exact nature of which
I did not care to be informed, but for which he assured me he
was not to blame, two or three serious engagements were successively
formed and broken off. The last had come to an end on account of
some difficulty on the important point of settlements. The young
people, however, had been thrown frequently in one another's way ; and
notwithstanding I urged my patient not to expose himself to any sexual
excitement, he assured me there were professional reasons which
rendered it impossible that he could absent himself from the com-
panionship of the lady. His condition when I saw him was very sad.
He seemed to have had originally a healthy frame ; but he was
beginning to find his memory failing. On rising in the morning there
was great languor, and a growing indisposition to transact his business.
This symptom made him all the more anxious, as there was an heredi-
tary disposition to mental affections in his family which in several
instances had resulted in idiocy. I could detect no morbid nocturnal
or diurnal emissions ; my patient told me that, with very few excep-
tions, he had led a strictly continent life, and that in these isolated
instances the sexual act had been well performed.

All I could do was to point out to him the dangerous position in

which he was placing himself, and the necessity for him to be more

il than others, if he would preserve his health and mental faculties,

144 DISORDERS AFFECTING THE SEMEN

In this particular instance I did not feel justified in applying any local
treatment, in the belief that nothing but a thorough change of habits
was likely to relieve him. I recommended daily gymnastic exercise,
with less mental labour, and entire abstinence from all sexual excite-
ment, if marriage with the lady was impossible. As long as such
excitement lasted, I told him I had no hope that physic would do him
any good.

In the present day in addition to the advice given above, I should
try the various preparations of potassium, remedies which are asserted
to have direct effect in allying irritation of the nervous system origi-
nating in these causes. I have witnessed some instances in which
benefit has been derived from these preparations. Under their use I
have observed the anomalous symptoms gradually disappear and a
patient restored to health, if he has the will strong enough to abstain
from exposing himself to similar trials.

I believe cases similar to the one just related are much more common
than is supposed, and I have selected it as a type of the ignorance
shown by young men and the carelessness with which they injure their
health by conduct which a very little reflection ought to convince
them is dangerous in the last degree. Of course this state of ill -health
may arise from other causes ; but the numerous instances in which
debility does undoubtedly follow from this cause serve to show that a
man cannot with impunity disobey natural laws. Sexual excitement
is intended to be followed by sexual gratification, and where this is
not the case the pent-up feelings will pretty certainly, as I have already
said, avenge themselves on both mind and body in a way equally
unexpected and destructive.

X SECT. V.— PASSING BLOODY SEMEN

Occasionally patients not only complain of emission taking place at
unusual times, but state that the semen is coloured red. I have very
recently had such a case under my care. It occurred in a married
man about fifty, who, so far as I could learn, had committed no
excesses : he was surprised one night by an emission — to which he had
not been previously subject — and, to his further astonishment, observed
that his night shirt was stained with blood. As soon as he could dress
he came to consult me ; I could find nothing unusual in his* urine, nor
could I discover any lesion in the canal. Although this patient w&l
under my care for some days subsequently, no recurrence either of the
bloody discharge or the emission took place. In other instances that have
come under my notice, I am inclined to think that some mechanical
injury must have happened to the penis during sleep, so as slightly to

DISORDERS AFFECTING THE SEMEN 145

rupture the lining membrane. At any rate I doubted in this particular
instance whether the blood was in any way mixed with the semen,
except at the very moment of ejaculation.

Since my attention has been called to the subject, I have not been
consulted by any one immediately after semen tinged with blood
has been passed, but every now and then patients say that they have
passed bloody semen when connection has been often repeated. In
books, allusion is made to the subject, and the occurrence of bloody
semen is said to follow frequent masturbation : it may be so, but I
have 'had no opportunity as yet of minutely examining the symptoms of
any such case.

The case of an elderly gentleman is subsequently mentioned, who
passed bloody semen in consequence of ungratified sexual excitement.
In this as in all the other cases that have come under my notice, how-
ever, the patient did well, and no ill consequences ultimately resulted.

The treatment I have followed has always been the administration of
opiates and alkalies, with rest and abstinence from stimulating fluids.
I need not say that indulgence in thought or deed as regards sexual
excitement should be strictly prohibited for at least a week after
noticing this (to the patient) alarming symptom.

SECT. VI.— SPERMATORRHOEA

It often happens in medicine, as in other sciences, that premature
generalisations draw in their train their own destruction. When, for
instance, a name has been coined as designating a specific form of
disease, on the authority derived merely from a few ill-observed
instances of some morbid affection, in which an individual symptom
has been exaggerated, no very long period of time elapses before the
profession, failing to discover in its experience sufficient confirmations
of the assumption, not only rejects the name but denies the indivi-
duality of the disease which it signifies, and even the facts narrated.
Such a reaction is natural and scientifically remedial. It is to the
interested exaggeration by quack writers (professional as well as extra-
professional) of the symptoms of spermatorrhoea that we must, I
imagine, attribute the fact of medical men of eminence having denied
that such a disease exists at all. Great exaggeration has doubtless
been indulged in by many of those who have described the complaint,
and this from obvious and infamous motives ; but I am convinced, as
I have already stated, that many of the most obstinate as well as
obscure complaints which the medical man meets with arise from the
»ss of semen, and I am no less certain tn*at sucfrcrnrrpkiints as

146 DISORDERS AFFECTING THE SEMEN

hypochondriasis, the various forms of indigestion, debility, and nervous
depression, with loss of sleep, are often only the effects of spermator-
rhoea. In such cases the best, and indeed the only treatment, is that
which removes the cause, and is not confined to combating the sym-
ptoms. The best evidence of this cause and effect is, that such radical
treatment alone relieves the symptoms when all other remedies have
failed.

The condition or ailment which we here characterise as Spermator-
rhoea, then, as we shall use the word, J£_a_state of enervationjproducecl,
at least primarily, Jby the loss^ofc-semen. The term, I admit, has
manj^objections, but its present general acceptance would render the
alteration or employment of any substitute inconvenient. The disease,
however, has received many other titles. No doubt can exist that the
series of symptoms — to be hereafter spoken of — were well known to
the ancients. Hippocrates, for example, describes it thus : " Tabes
dorsalis proceeds from the spinal cord, it is frequently met with among
newly married people and libertines. There is no fever, the appetite
is preserved, but the body falls away. If you interrogate the patients,
they will tell you that they feel as if ants were crawling down along
the spine. In making water or going to stool, they pass much semen.
If they have connection the congress is fruitless ; they lose semen in
bed, whether they are troubled with lascivious dreams or not — they
lose it on horseback or in walking. To epitomise, they find their
breathing become difficult, they fall into a state of feebleness, and
suffer from weight in the head and a singing in the ears. If in this
condition they become attacked with a strong fever, they die with cold
extremities."

In a great number of individuals, both young and adult, an enervated
state of body exists, which the profession, as well as patients when
attacked with marked loss of semen, characterise by the somewhat
vague term Spermatorrhoea, a complaint which, as I shall now attempt to
show, is as peculiar and as certainly to be distinguished by its own
symptoms as fever, or any other general disease. Many a man has
believed himself to be labouring under this affection when, in fact,
entirely free from it. This is the case with various other diseases.
There is, however, as regards this particular ailment, an additional
reason for the existence of much hypochondriacal fancy about it. From
the painful stigma which its existence is imagined to cast on the past
life of the patient, and the secrecy consequently desired, as well as
from the ease with which indications absolutely harmless may be con-
founded — by the inexperienced — with symptoms of this disorder, it has
always been freely employed by unprincipled quacks as a means of
imposition. Every disease or fancied ailment which their unfortunate
victim can be persuaded into believing to be Spermatorrhoea, is called

CAUSES OF SPERMATORRHEA 147

Spermatorrhoea forthwith ; and in his agony of terror and humiliation,
i1h> wretched and often innocent patient becomes a ready subject for
the wickedest cruelty, and, I need hardly add, the most exorbitant
extortion. With some faint hope of partially counteracting this great
evil, 1 have appended to this section a chapter on False Sperma-
torrkcea (p. 171).

Pel haps a knowledge of the truth may save some reader from the
perils to which his ignorance, judiciously played on by an unscrupulous
quack, would leave him exposed. I earnestly recommend persons suf-
fering in this way to seek the advice of their usual medical attendant,
from whom they are certain to obtain sympathy, and who, if dealt with
frankly, is competent to afford them the advice they need.

Causes op Spermatorrhea. — Hard study I have already men-
tioned more than once as predisposing to this condition. The fol-
lowing is a sample of the cases to be met with in which over-exertion
of the brain has had this effect. A patient called on me in June,
1860, complaining that he was labouring under spermatorrhoea. He
stated that he had recently been studying hard at the University, and
admitted also having had connection about four times in a month,
without feeling any great desire, and without experiencing any great
pleasure ; erection and emission had, however, taken place. I found
he was engaged, but from pecuniary circumstances the marriage was
postponed. He complained of nearly all the symptoms which con-
stitute spermatorrhoea, and was naturally alarmed at his state ; this I
could and did assure him was temporary. After contrasting the con-
ditions of the continent and incontinent man, I think I succeeded in
convincing him that the only danger he had to dread arose from con-
tinuing venereal excess ; that, if he remained continent, the temporary
result of vigorous mental exertion would pass away, leaving him none
the worse ; but that the double strain on both the brain and the gene-
rative system — against which nature herself appeared to take this means
of appealing — would most certainly deteriorate if not ruin both.

I have become more and more convinced of the large proportion of
students in all professions who suffer in a similar manner. My usual
advice to them, in addition to maintaining strict continence, is to con-
tinue their studies, but by no means to neglect regular bodily exercise.
Benefit also is derived by abstaining from the use of coffee, tea, and
tobacco, and the too frequent use of meat, or heavy meals, or late
suppers.

In the more nervous cases the occasional passage of a bougie will
dull the acute sensibility too often present in these sufferers, and give
the patient that control of the will that is most desirable in such
afflicting cases.

Masturbation and Venereal Excesses. — That these are the chief causes

148 DISORDERS AFFECTING THE SEMEN

of spermatorrhoea appears sufficiently from the former part of this
work, to which I refer the reader for the description of both, and their
effects, as well as to the chapter on Marital Excesses. (P. 191.)

Nevertheless, a large proportion of cases of spermatorrhoea depend
upon other causes ; and I desire particularly to dwell upon this fact,
and to obtain its recognition, inasmuch as the complaint is not always
a self-inflicted one, and when this is the case the stigma attaching to
it may be undeserved.

Nervous affections are often the cause of spermatorrhoea ; still I am
not prepared to say that these nervous affections themselves may not
be consequences of previous masturbation or venereal excesses. It is
very difficult in some instances, and especially in the later stages, to
determine what relation they bear to the spermatorrhoea, as in the
following instance.

In September, 1859, a tall, cadaverous, worn-looking man, called on
me complaining of pain in the head, disordered digestion, impaired
intellect, loss of memory, uncertain gait, difficulty of progression,
and uncertainty in putting his foot forward. His history was that of
many others related in these pages ; early excesses, mental distress in
consequence — feeble resolves, followed by miserable failures and bitter
repentance. Whether his present condition really arose altogether
from these causes or from what is vaguely called a nervous affection —
chiefly because no cause can be assigned to it — I could not for some
time determine. One or two indications which pointed to local irrita-
tion of the generative organs still existing, decided me to try the
treatment appropriate to a case of undoubted spermatorrhoea. The
result proved that my surmise was right, and the nervous affections
disappeared with the treatment of the local symptoms.

Other cases, however, exist which are clearly traceable to nervous
affections of hereditary origin. I have for years attended a young
man who has suffered, off and on, from some of the most severe sym-
ptoms of this malady. He tells me his mother has been a martyr to
nervous affections, and his family all more or less labour under
various hysterical and nervous disorders. In the male these functional
disturbances often assume the form of spermatorrhoea in cases where I
am persuaded no vicious habits have been practised. I am not so sure,
however, that in married life sexual excesses have not aggravated the
symptoms, as reference to the chapter on Marital Excesses (p. 191)
will conclusively show.

Nocturnal emissions, as they induce loss of semen, act as a very fre-
quent exciting cause of spermatorrhoea. (P. 110.)
•f Marital excesses act exactly in the same way. I need not here dwell
upon a subject to which I recur hereafter further than to point out that
*/ excessive loss of semen from whatever cause will produce the very effects

SYMPTOMS OP SPERMATORRHEA 149

which are usually classed under the general term of spermatorrhaea
and its consequences.

SYMPTOMS. — True spermatorrhoea, as has been stated, consists not
in any one particular symptom, but rather in a train of symptoms
which make up the affection. One or two of these, however, are so
prominent, and yet are such fertile sources of error, that it may be as
well to mention them separately. And first,

Loss of semen. — A patient will come to his medical adviser, stating
that he is constantly losing semen, either by day or night, or both.
This may be true, and, if true, is a serious thing, but alone it does not
constitute spermatorrhoea. In nine cases out of ten, however, the
statement is much exaggerated, or only very partially true. The first
duty of the surgeon, therefore, is to ascertain the nature of the fluid
passed. If the patient make water in a test-tube, and the water is
allowed to stand and cool, various deposits may be thrown down, any
of which are sufficient to account for his alarm, but none of which need
necessarily arise from the presence of semen in the water, thus : —

The urine when first passed may be milky or slightly turbid. This,
as I shall presently show, depends upon a deposit of phosphates, which
although a symptom to be attended to and requiring medical interfer-
ence, depends in no way on semen in the urine, as the addition of nitric
acid will at once clear the urine.

In other instances, small floating atoms or flocculi may be seen sus-
pended in the liquid passed, and which the patient will point to as, in
his opinion, presenting undoubted proofs of the affection. These the
medical man will be enabled to tell him are nothing but epithelial scales
thrown off by the mucous membrane, and are a sign of gleet, which, of
course, should be treated ; but, happily, spermatorrhoea is not the
affection the patient suffers from.

The suspension of mucus in the urine as it cools will often be
pointed out as semen. This — depending upon some slight irritation
of the bladder — may be easily distinguished by the medical man from
semen.

Again, after the urine has stood some little time, a white flocculent
matter may be observed deposited at the bottom of the test-tube or
suspended in the lower half of the fluid. Instead of becoming white
this deposit may be of a brick-red colour. The patient may be
assured that these deposits are the urates or lithates depending upon
indigestion, and present one of the means by which the system gets
rid of superfluous nourishment.

Long streamers or cottony -looking flocculi are now recognised as
coming from the prostate or the vesiculee seminales ; the masses of
mucus, of all kinds of secretions and the vermicelli-like threads are
only broken-down epithelium, or may depend upon a neglected stric-

150 DISORDERS AFFECTING THE SEMEN

ture or old gleet, and are all quite independent of the testes and their
secretions.

These appearances will be most evident in the morning, particularly
when the night has been restless, or after breakfast, when nervous ex-
citement has come on, or the digestion has been impaired. The test-
tubes used for the purpose of examining these deposits, I may mention,
should be much larger than the ordinary ones, large enough to enable
the patient to make water directly into them ; the urine, when cold,
can be thus accurately examined.

The microscope will dissipate the fear which most of the above
appearances raise.

Lastly, and most rarely, the microscope detects the presence in the
urine of spermatozoa, dead or alive, but most frequently the former, as
urine is fatal to them ; and they are to be looked for at the bottom of
the tube, where they may be seen mixed with the other secretions
above alluded to.

Although this comparatively rare symptom of the constant involun-
tary loss of semen is one of the symptoms of true spermatorrhoea, it
does not by any means follow that, whenever spermatozoa are found in
the urine, the patient is suffering from spermatorrhoea ; for as we have
shown above, semen occasionally passes away habitually under certain
conditions.

Non-erection or imperfect erection, in the opinion of some nervous pa-
tients, is sufficient to prove that they have spermatorrhoea, and coupled
with other symptoms no doubt can exist that the symptoms require
careful investigation ; but I must refer my readers to pages 83 and
86 for their fuller consideration.

Lallemand thus describes other local symptoms : " If excesses are
carried far enough, or last long enough, the excitement augments, and
the first symptoms of irritation manifest themselves. Heat in the canal
commences, particularly during the act of making water, the urine
is more abundant than usual, and the desire to pass it more frequent,
accompanied with a tickling which is sometimes agreeable ; the
meatus is more injected than usual, and the intensity of pleasure is
diminished."

In another place he says — " One of the earliest symptoms of sperma-
torrhoea consists in a diminution of pleasure during the act, even before
the general health has become deranged." He continues —

" At the same time that the sensation becomes weakened, erections
are less complete and prolonged ; ejaculation is more rapid ; it becomes,
in fact, so precipitate, that intromission cannot take place. The act, in
regard to its duration, is almost reduced to nothing, and the same may
be said of the other phenomena j it consists of a simple excretion of
semen ; we should moreover add that the seminal liquor is little abtto-

SYMPTOMS OF SPERMATORRHEA 151

dant, watery, transparent, without smell, and incapable of fecunda-
tion." (Vol. i, p. 623.)

One of the worst features is when, in the words of this author, —

" Little by little, the phenomena of excitement which precede the
orgasm diminish, and at last completely disappear ; the emission then
occurs without dreams, without erection, without pleasure, and even
without any particular sensation ; in fact, the patients are not aware
that emission has taken place except by the stains which they observe
on the linen when they awake. At the same time the seminal fluid
loses by degrees its consistence, its colour, its smell, and resembles
most closely mucus or prostatic fluid." (Vol. ii, p. 329.)

The same author remarks, and I quite coincide in his opinion, —

" Every exaggerated evacuation of semen is susceptible of producing
similar effects on the economy, in whatever way it may have been
produced." Thus masturbation, marital excesses, or licentious habits
will produce one and the same effect. Morality has nothing to do with
this escape, the unfavorable symptoms occur in both unmarried and
married life.

Where we find the general health suffering, the disposition to intel-
lectual employment almost lost or impaired, exercise becoming a toil,
society spurned, and the company of females particularly avoided, there
is strong reason to suspect something wrong with the generative organs
which may possibly depend upon the excessive and habitual loss of
semen. This debility and enervation, which are so frequently connected
with the loss of semen, may complicate almost every affection to which
the human frame is subject.

Another affection which must be noted as a consequence and compli-
cation of spermatorrhoea is

Loss of Memory. — It is an undeniable fact that in many individuals
any excess in sexual indulgence, or even a nocturnal emission, will be
followed the next day by a temporary loss of memory. In a few days
the memory will again improve, and many facts or duties which have
been altogether lost, can be recalled with the usual rapidity. In other
instances the loss of memory is gradual. Patients tell you that at one
period of their life their recollection was excellent. As excesses were
committed or frequent emissions occurred, they remarked that their
memory gradually got worse until it was quite lost. This has been so
often repeated to me on the most conclusive evidence that there can be
no doubt as to the relation of loss of memory and sexual excesses.

The reader will remember (p. 56) that among other symptoms loss of
memory was a prominent one in the case of Jean Jacques Rousseau.

I have every reason to think another affection not usually attributed
to loss of semen depends upon spermatorrhoea in many instances ; I
allude to what is usually but vaguely called —

152 DISORDERS AFFECTING THE SEMEN

Clergyman's Throat. — The voice, as every one must have noticed,
changes in most young men about the time of puberty. This change
is evidently connected in some way with the development of the gene-
rative functions, as castration to a great extent prevents its occurring,
and produces that kind of voice known as falsetto. Not only non-
development, but repeated loss of semen and abuse of the sexual
organs, have a perceptible effect in some cases upon the timbre of the
voice.

It has not, however, until quite lately, been noticed how closely
those affections of the throat, so commonly met with in young and
continent men, and known generally under the term clergyman's
throat, are connected with disorders or disturbances of the sexual
organs.

That sexual intercourse has the singular effect of producing dryness
^ of the throat has long been known. Masturbation often repeated, or
profuse nocturnal emissions, have the same effect ; and in process of
time this symptom, which at first is only temporary, may become
permanent. Of course the throat affection may arise from many other
causes, but I have seen it so frequently associated with excesses which
have debilitated the reproductive organs, that little doubt exists in my
own mind that in the majority it is the consequence more or less direct
of those excesses, and not merely a casually contemporaneous affection.
That this must be so is proved, moreover, by finding the throat- symptom
often cured by the treatment adopted to relieve the generative ailments,
though they have resisted all other remedies. When the fons et origo
inali has been reached, the hoarseness disappears under appropriate
treatment with great rapidity.

The following are notes taken down and sent to me by a young
clergyman who was a sufferer from the complaint, and had derived no
benefit from any treatment of the specific affection till the sexual
local symptoms had been overcome :

" When I began the practice of masturbation, at the age of 16, I was in the habit
of exercising my voice regularly. The first part in which I felt the bad effects of
that habit was in the organs of articulation. After the act, the voice wanted tone,
and there was a disagreeable feeling about the throat which made speaking a source

f of no pleasure to me as it had been. By-and bye, it became painful to speak after the
act. This arose from a feeling as if. a morbid matter wag being secreted in the -throat,
so ^tcrid that it sent te^rs to the eyes-Adien speaking, and would have taken away

I the breath if not swallowed. This, however, passed away in a day or two afu t the
act. In the course of years, when involuntary emissions began to impair the consti-
tution, this symptom became permanent. The throat always feels very delicate, and there
is often such irritability in it, along with this feeling of the secretion of morbid matter,
as to make it impossible to speak without swallowing at every second or third word.
This is felt even in conversation, and there is a great disinclination to attempt to
speak at all, In many instances, in which the thrqat has been supposed to give way

clergyman's throat 153

from other causes, I have known this to be the real one. May it not be that the
general irritation always produced by the habit referred to, shows itself also in this
organ, and more fully in those who are required habitually to exercise it?"

Another case, of a different kind, may be interesting. A boy, fifteen
vcars of age, was sent to me by a medical man in the country for an
opinion as to his general state of health. He was small in stature,
pale in face, with large ears, and prominent, thick lips. I noticed that
he spoke thickly, and was very dull of comprehension. His health, I
was told, had been failing for some time, and had not benefited under
the ordinary treatment. The throat was painful, the tonsils swollen,
the articulation thick, and the words uttered with evident difficulty.
The expression of his features irresistibly suggested vice and early
sensuality.

On inquiry I found that this youth had been taken from school, as
he made no progress and had been petted at home. In reply to some
searching questions, I learnt from the boy that he had masturbated
himself at school three or four times a week for a long time ; that the
affection of the throat then became a prominent symptom, and that the
condition of the throat was but one of a series of symptoms, all of
which I had no difficulty in referring at once to the excesses of which
he had been guilty. I may add that, under proper treatment, this
unpromising case recovered, and the youth became able to pursue his
studies with advantage, and used in his holidays to ride well across
country.

Irritation of the Genital Organs and Scrotum. — A not less serious and
distressing consequence of masturbation is the local irritation caused
by it. A case which came under my notice in 1862, may serve as an
example. Similar ones are by no means uncommon.

Dr wished me to see a case of his, a tutor in a family, who

had been for eighteen months suffering severely, and whose symptoms
had resisted all remedies. On examination, I found the testes large
and somewhat pendulous. There were no external symptoms of mis-
chief to be observed, yet the patient complained of all sorts of uneasy
sensations, weight, pain, and such severe irritation of all the genital
organs as to keep him awake during the greater part of the night, and
to render his life a burden to him. I examined his urine, which was
normal ; I passed an instrument (bulbed bougie) and could detect no
particular local irritation of the urethra. The patient, however,
acknowledged that he thought his ailments might depend upon
masturbation, which he had practised formerly, and even now he had
not entirely abandoned, the desire being occasionally so strong as to
amount almost to a sort of satyriasis. He had never had connection
or even attempted it. He was a freshly coloured man with somewhat

154 DISORDERS AFFECTING THE SEMEN

sunken eyes. One of his most distressing symptoms was frequent and
painful erection, and I advised cauterization as the best treatment
under the circumstances.

The Prognosis of Spermatorrhea. — We may usually give a very
favorable opinion, in case of spermatorrhoea, as to the prospect of a cure
if the surgeon be consulted in the early stages of the complaint.
Unfortunately ignorance on his part regarding the nature of the
affection, general stimulants prescribed by some medical man, and his
own false delicacy, often cause much delay and anxiety to the patient.

But, however confident we may be in giving a favorable prognosis
relative to the disappearance of specialand local symptoms in the slighter
cases of spermatorrhoea, we must be somewhat cautious, when the
nervous system has been once impaired, in promising perfect and speedy
restoration of the natural sensations or feelings, or more than a very
partial return to the buoyant state of health the patient previously
enjoyed. We can guarantee, even in severe cases, a comfortable state
of existence, but the patient must not expect his countenance will at
once lose its haggard expression, or that his broken health will be
immediately restored. His nervous system has received a shock from
which it takes time to recover. Travel, amusing and intellectual
employment, with cheerful society and the comforts of life which easy
pecuniary circumstances give, do certainly sometimes effect greater
cures than I at first had even dared to prognosticate.

Diagnosis. — The diagnosis of these affections is easy enough when
all the symptoms are present, and daily or nightly discharges of semen
take place. It is not of such cases I am about to speak.

Most practical surgeons now acknowledge the complaint Sperma-
torrhoea to consist in the constitutional results of disorders of the
reproductive system. Many a surgeon who a few years ago would have
denied the relation of the two affections, now admits that diseases of
the reproductive organs do produce constitutional affections. Their
complication, however, with many nervous symptoms, causes functional
diseases of the sexual organs to be confounded with the various affec-
tions of the brain by which they are not uncommonly attended. It is
impossible in this place to enter into a disquisition on the various shades
of difference ; my own belief is, that many cases of imbecility, insanity,
and epileptic affections may be traced to previous abuses of the gene-
rative functions ; still I am equally persuaded that affections of the
brain and spinal cord can hardly run through their course without im-
plicating the sexual apparatus, so intimately are the two related;
Abuse of the sexual feeling has often been the cause which has first
produced the head symptoms, and it unfortunately too often happens
that the primary cause of the complaint is ignored, while the subse-
quent symptoms are treated as if the brain had been primarily affected.

DIAGNOSIS OF SPERMATORRHEA 155

in psychologists are, however, ni^re closely examining this sub-

iiul many of the most enlightened physicians of onr existing

lunatic asylums recognise the dependence of insanity on derangements

in the sexual functions, and direct their treatment accordingly. (See

p. 67.)

If, then, the diagnosis between these affections of the sexual organs
and the general diseases now admitted to depend upon the nervous
system, may be difficult and ill understood, even in the present day,
from a disinclination on the part of some persons to attribute the
a fleet ion to the right cause, the same difficulty cannot impede the
diagnosis of the purely local sexual lesions.

I have already pointed out (p. 149) the great error it would be for a
medical man to set down as seminal discharge all secretions that are
to be found in the urine at the time it is passed, or which may be dis-
covered after allowing it to stand. In these cases of difficult diagnosis
the microscope and chemistry generally enable us to decide on the
nature of the secretion. Three rules, however, should never be for-
gotten, rules which are of equal value to the nervous patient and the
medical man.

1st. Spermatozoa or traces of them may always be found in a
seminal discharge. To discover the presence of spermatozoa we
should desire the patient, as I have already said, to micturate into a
long and narrow tube capable of containing an ounce of fluid, and
place it for a few minutes in a test-rack. The spermatozoa, in conse-
quence of their greater specific gravity, will, if present, sink to the
bottom of the fluid. If there is much saline matter, it may be dis-
solved by adding plenty of water and letting the mixture stand, when
the spermatozoa will sink as before. Donne asserts that the fluid may
even be boiled without destroying them. The same author states that
he has discovered spermatozoa in urine several days after it has been
passed (loc. cit., p. 315.)

2nd. The presence of spermatozoa in urine does not conclusively
prove the existence of spermatorrhoea, or even of constant seminal dis-
charge. The effort of difficult micturition, or defecation, the fact of
the patient having lately had connection, or even of his having under-
gone sexual excitement, is enough to account for the first subsequent
emission of urine containing spermatozoa. A small quantity of semen
may have been left in the urethra and pass away with the first stream.
It is not then the occasional presence of spermatozoa in the urine, but
tli> habitual escape of semen coupled with general symptoms of
debility, that constitutes the condition — Spermatorrhoea.

3rd. Spermatorrhoea may really exist, though it may be impossible
at first to discover spermatozoa in the urine.

I cannot allow another edition to appear without urging my profes-

156 DISOEDEES AFFECTING EMISSION

sional brethren to depend' leis upon the discovery of spermatozoa
than on the consideration of the symptoms existing at the time when
these patients consult him. Thus, if a patient has that peculiar worn
or haggard expression with which the surgeon is so familar, if he
complains of lassitude, indisposition to work, and loss of memory,
and if on cross-examination he admits evil practices in his youth,
followed by mental excesses or inability to consummate marriage for
want of erection, what does it matter to the surgeon whether he can
or cannot detect the presence of semen in the urine? Scientific
curiosity may prompt an effort to discover semen, but the chief care
of the surgeon must clearly be to treat the symptoms patent to his
sight. Experience tells us that this can best be done by directing
the attention to restore the sexual powers, preventing any loss, and
prescribing phosphorus, that being the ingredient most deficient in
such a man's system.

Donne gives some interesting particulars of cases of suspected dis-
charge of semen which he has watched for days together without
finding any traces of spermatozoa. After several days, perhaps, the
discharges all at once were found to contain large quantities of sper-
matozoa. In one case, during eighteen days the urine was most
carefully examined several times a day, and yet on three occasions
only could the spermatozoa be detected, and each time the patient was
aware that a nocturnal emission had occurred. In other instances all
the urine passed during the night may contain spermatozoa, while
that passed in the daytime is found to be perfectly free from them.
(Loc. cit., pp. 329—332.)

It frequently happens also that at the time of consulting the
surgeon, a patient no longer passes semen, this stage of the complaint
having passed by. Consequently, the closest examination fails to
detect any spermatozoa in the urine, though the patient is suffering
all the consequences of loss of semen, and presents all the other
symptoms of Spermatorrhoea. What we have to decide is, whether
the general and local symptoms (and not one symptom only) are
such as indicate what we have here called Spermatorrhoea.

These simple rules and remarks should be impressed on patients,
who are only too ready to fall into error on this subject, or, still worse,
into the hands of quacks, and to suppose, or be persuaded, that all
discharges that follow or attend micturition consist wholly or partially
of semen. A very nervous patient, who had lately married, and
whose wife was in the family way, came to me complaining of
impaired health and of frequent emissions in passing urine, although
he occasionally indulged in sexual intercourse. I desired him to
make water in my presence, and he did so about two hours after
breakfast. As the last glassful of urine came away, the patient called

PATHOLOGY OF SPERMATORRHEA 157

my attention to the so-called semen, and I could scarcely be surprised
at his terrors, especially as I knew he had heard and read a great deal
of Spermatorrhoea. A thickish fluid, in colour and consistence resem-
bling oreun, dropped into the glass, and in a few seconds fell to the
bottom, the supernatant fluid being more or less transparent. The
pat i. -lit stated that this discharge took place only occasionally, and
most frequently after breakfast, and as the subsequent effects were
invariably debilitating, he felt no doubt that the secretion was really
semen. I was able easily to reassure my patient, and to convince him
that this creamy discharge was nothing but a deposit of phosphates,
as a little acid poured into the test-tube caused the instantaneous dis-
appearance of the so-called semen.

Pathology. — Little is known as to the local condition which gives
rise to spermatorrhoea. I believe that in the earlier phases but a
slight if any local change takes place, the affection being functional
only.

When the practised hand of the surgeon passes an instrument, he
may find an exceptional amount of sensibility. .When this is present
it is not surprising that emotional influence on the brain will react on
the generative system, and under such influences semen be lost.
Hence the treatment is to dull the sensibility of the urethra, and a
cure is effected, as we shall presently see. In other instances an
instrument may be passed, and the urethra will be found to have lost
all its sensibility ; there is an apathy of the parts to all stimulants that
is very marked.

In the more advanced cases, however, we find an enormously in-
creased sensibility. The mucous membrane is susceptible to both
local and general influences in a surprising degree. This irritability
leaves no traces after death, and I am not aware that any post-
mortem examination has ever been made which throws any light on
the subject.

In some instances there is, during life, an increased redness and ten-
derness of the meatus, glans, or urethra, but these symptoms do not
necessarily occur.

Of the Urethra. — In the advanced stages, when irritation or inflam-
mation has existed for some time in the genito -urinary systems, or
nocturnal or diumal pollutions have been established, and pain,
dysuria, or a frequent desire of passing urine occur, the surgeon will
notice — when he introduces an olivary bougie, about the size of No. 8
— that for the first three or four inches it passes readily enough ; at
this point of the instrument's progress some patients will complain of
pain, and as it advances towards the bladder the more susceptible will
sometimes accuse you of cutting them as if with a knife, so acute is the
suffering, even when the bougie is passed by one who has a delicate

158 DISORDEES AFFECTING THE SEMEN

hand. When the instrument reaches the bladder, and is allowed to
remain at rest for a few minutes, the pain ceases, and on withdrawing
it the suffering is slight, and no blood follows ; a drop or two, how-
ever, may sometimes ooze out. In these cases, then, we may naturally
suppose (for I have never had an opportunity of verifying my opinion
on the dead subject) that we have to deal either with simply a morbid
sensibility of the mucous membrane about the veru-montanum
(6, vide diagram, p. 104), or else with a granular condition, similar to that
observed sometimes on the inner surface of the eyelids, and occasion-
ally in other mucous membranes, as a consequence of chronic inflam-
mation.

Again, [there may be stricture of the urethra near the veru-mon-
tanum, causing the semen to pass back into the bladder instead of
forward along the urethra.

Of the Vesiculce Seminales. — " The vesiculse seminales," says Lalle-
mand, " may be dilated and thickened ; they may lose their character-
istic irregular, uneven surface, and become firmly adherent to the
surrounding structures. Their lining membrane may be covered
with lymph, or granular fungoid vegetations. They may be filled with
pus or tuberculous matter.

" I have almost always found in the vesiculse seminales, particularly
at the bottom of the depressions, a thick, granular, shining liquid,
variable in its aspect, colour, and consistence, but resembling pretty
thick glue, and more or less transparent. Under a power strong
enough to observe the spermatozoa, the particles 1 (grumeaux) of this
secretion appear somewhat irregular in size, more or less opaque, and
of a uniform shape. These are evidently the products of the internal
membrane of the vesiculee seminales ; for they are found with analo-
gous characters in the accessory vesiculae of the rat, &c, which never
contain animalcules, and do not directly communicate with the vas
deferens. These canals never contain similar bodies in any species.
This secretion, then, is analogous to that produced by the prostatic
follicles, Cowper's glands, &c. Its use is the same, and it deserves for
many reasons our special attention." (Vol. ii, p. 398.)

In the earlier editions of this work I depended upon Lallemand for
the description of these affections. Subsequent experience induces me
now to believe that many of the most obstinate affections we meet with
in practice depend upon previous inflammation spreading from the

1 They have been compared to grains of sago. I am inclined to think the Pro-
fessor has rather exaggerated this state of things. Modern investigation has led to
a different view being taken of these bodies, and comparative anatomy teaches
us that the secretion of the vesiculce seminales is very variable in consistence : in the
guinea-pig it is nearly solid, and becomes softened as soon as it comes in contact
with the secretions of the vagina. W. A.

AS SHOWN IN THE VESICULiE SEM1NALES i59

urethra downwards to the vesiculse seminales, and permanently and
persistently causing those interminably obstinate discharges that
patients suffer from. In most of the cases complained of — when
patients, on the least exertion, pass what they call semen — especially
in those instances when a thick, ropy, tenacious slime exudes in defe-
cation or micturition, or even during sleep, probably in consequence of
spasmodic action of the complex muscular contraction alluded to at
92, the discharge comes, as I now believe, from the increased and
pent-up secretion resulting from a previous inflammation of the vesi-
cula> seminales. When we examine the structures and extent of these
organs, when we notice their relation to the surrounding parts, and
the probability of their becoming inflamed when the inflammation
caused by acute gonorrhoea is communicated along the canal to these
large mucous sacs, the surprise is, not that patients should suffer, but
rather how it is that the profession has not attributed hitherto most of
these chronic and obstinate cases of discharge from the urethra to ill-
understood and badly treated gleet and gonorrhoea followed by inflam-
mation of the vesicuhe seminales.

When we notice the depth at which these sacs are placed, and the
difficulty in reaching them so as to apply local treatment, we must not
be surprised that, in many instances, the usual methods of cure tend
only to the aggravation of the complaint. This is so much the case in
my opinion that, in more instances than one, where injections and
specifics, such as the internal administration of copaiba, capsules, and
turpentines, have been employed for months without avail, I have
succeeded by leaving them all off and employing external counter-irri-
tants on the perinseum, with other local and general means of improv-
ing the general health, in gradually re-establishing a healthy condition
of the organs, and in curing a long standing malady.

In this way we obtain a key to the popular cure of interminable
gleets, when a patient tells us that, having for months carefully followed
his doctor's prescriptions, he at length got well by getting drunk and
abstaining from every sort of local and general treatment. The cure
must have been effected in such instances by leaving nature, aided by
a good constitution, gradually to allay all irritation. Of the fact that
gleet or the passing a considerable quantity of a thick mucilaginous
fluid, more or less tinged yellow or green, will subside of itself, there
can be no doubt. Whether the surgeon will accept my explanation of
the case admits, perhaps, of some doubt, but I have for some years
been in the habit of attributing the cause to inflammation of these
sacs, and daily experience increases my confidence in the correctness of
this opinion.

Spermatic Cords. — In speaking of the morbid appearances of the
spermatic cords, Lallemand states — " The terminal extremities in the

160 DISORDERS AFFECTING THE SEMEN

urethra of one or both the spermatic cords may be affected. Instead
of being circular, and forming little nipple-like projections, their orifices
may present a stretched chink, large enough to admit a goose-quill,
and there may be erosion of a sort of sphincter which surrounds them.
Ulceration may attack the mucous membrane. The lining membrane
may present a villous alveolar inflamed appearance, or it may become
of a yellow colour. Instead of being the elastic free bodies they are,
they may become cartilaginous or ossified, and they may have a tor-
tuous crooked direction." (Vol. i, pp. 11, 23.)

Of late years I have had few opportunities of personally examining
the spermatic cords after death. The cases I have been consulted about
have fortunately not had a fatal termination, and I have had no means
of corroborating Lallemand's views. Judging from the symptoms I
have witnessed, I should say that the most frequent morbid conditions
of these parts depend upon inflammation attacking the vasa defe-
rentia, consequent upon affections of the testis, and terminating in a
closure, temporary or permanent, of one or both canals. In such
cases the passage of the spermatic fluid is obstructed, and when the
affection is permanent, sterility may be considered as beyond the con-
trol of surgery. In these cases, however, impotence, according to
our definition given subsequently, does not necessarily follow. I believe
that erection without subsequent emission is quite compatible with
this state of occlusion of the vasa deferentia. When only one vas
deferens is obstructed, of course neither sterility nor impotence exists ;
for, as I have elsewhere stated, one perfect testis will be sufficient to
carry on effectively the reproductive function, and it seldom happens
that both testes become affected. Still, I believe that not unf requentjy
the vas deferens of one side is obstructed, and this gives rise to much
local mischief, and in too many instances atrophy of the testis is the
consequence, as there is no exit for the secreted semen except through
the absorbent system.

Treatment. — The first consideration in dealing with any case of
spermatorrhoea is to ascertain from which of its many causes the affec-
tion may have more especially arisen. Each patient may complain of
some particular or well-marked symptom to the exclusion of all the
others, though the affection itself may consist of a lesion of more than
one function. It is, therefore, of great importance that this distinction
should be clearly understood. According as one or other of the func-
tions (e.g. erection, emission, or the character of the emitted semen) is
in fault, so must the treatment vary ; what may be good in one case,
may not be applicable in another. Having heard what particular
symptom the patient complains of, he should be desired to make water
into a glass, which should be deposited at once in a stand, to be exa-
mined at leisure. It is well at the same time to pass an olivary bougie,

PREVENTIVE TREATMENT OF SPERMATORRHEA 161

in order to ascertain the susceptibility of the urethra — an excellent
means of arriving at an accurate diagnosis of the local state of the
mucous membrane. In order to cure the affection, it is of more con-
sequence to ascertain the immediately inducing local cause than the
try cause which may have impaired the functions or originated
the lesion.

Before attempting the curative treatment, the preventive one should
be commenced. It should be ascertained if masturbation is still ever
practised, or if the patient finds himself in his half- sleeping,
half -waking moments with his hands playing with the penis. The
patient should be at once told that unless a strict watch be set on
these practices, a cure is not to be expected. At the same time he
may be informed that the treatment about to be recommended will at
once give him that power of resisting these tendencies, which he,
unaided, has been so long in want of. Occasional failures will, no
doubt, occur, owing to the fact that some men have no power of
self-will ; they have lost all control over themselves ; this is seen more
especially in those whose brain is affected. It should, however, not be
concealed from the sufferer that the means about to be employed will
speedily impart such power to the will that, by his own volition, if he
can exert himself at all, he will be capable of correcting habits which
were previously beyond his control. Moderation in sexual indulgence,
if not abstinence, should be enjoined on the married, and a promise to f
that effect obtained. It should be next ascertained whether constipa-
tion exists, or whether ascarides be irritating the rectum, or the patient
suffering from varicocele. If this last complication be present, a
suspensory bandage must be worn, or, what is still better, a varicocele-
ring, which the surgeon should teach the patient how to put on. The
ring should be attached by a little piece of thread to the button of the
drawers, otherwise it may readily slip off and be lost, and thus the
testes be left without support during exercise.

The surgeon has next to determine whether the vesiculse seminales
are affected by any of the forms of irritation or inflammation spoken
of at page 159, and, if so, whether the evil may not be kept up by some
of the numerous causes which, as we have seen, produce or aggravate
them. The patient must do his utmost to prevent emissions taking
place, and, to effect this, should have recourse to all the means spoken
of at pages 111 and 115.

In the slighter cases of spermatorrhoea these remedies may alone

suffice ; and, as stated above, the occasional passage of an olivary

bougie, or the glass tube of the instrument, hereafter to be described,

age 216, will suffice to cure the patient. If, however, these plans

do not succeed, and if the emissions recur, I have no hesitation in at

162

TREATMENT OF SPERMATORRHEA

once employing cauterization — a plan of treatment I will now pro-
ceed to describe.

Cauterization. — In passing such an instrument, one of two con-
ditions usually exists : either the instrument passes down to the
veru-montanum without pain, when all at once excessive sensibility
is felt in one or more spots ; or the urethra is found large, patulous,
and insensible, hardly seeming to feel the presence of the instrument ;
the former condition is, however, the one most frequently met with,
and I usually counteract this by passing an instrument a few times
before proceeding to operate.

Care should be taken not to administer an aperient the night before
the operation, but precaution should be taken against the bowels being
confined, otherwise the patient may wish to go to stool soon after the
injection and thus complicate the case.

I usually prefer operating at my own house, having all my appliances
at hand, and I have never found any objection to the patient return-
ing home in a cab if the distance is not
great. On the morning of the operation
the patient may be allowed to eat a simple
breakfast of bread, butter, or meat, but he
must be strictly enjoined to abstain from
fluid of any kind.

Before proceeding to perform the opera-
tion I desire the patient to completely empty
the bladder. I employ a syringe similar to
the one here represented, which may be
procured at Ferguson's, instrument -maker,
Gilt spur Street, Smithfield. It is made
entirely of stout glass, to obviate breakage,
and to avoid all decomposition of the solu-
tion of nitrate of silver. The lower part (a.)
can be taken off and ou (at b), so as to fit
into a case, thus making the instrument very
portable. When put together and charged
with fluid (containing a solution of ten
grains of nitrate of silver to the ounce of
distilled water), the instrument is passed
down the urethra, the patient standing
against a wall. No oil should be used, as
it will interfere with the action of the caustic.
The surgeon should take the precaution of
folding a towel between the legs in order to
protect the trousers of the patient from
being stained. The piston of the instru-

Al'THOR'S INSTRUMENT FOE
CALTKBIZIWG THK URETHKA.

TREATMENT OF SPERMATORRHOEA 163

ment is then to be forced down, at the same time that the finger and
thumb of the operator's left hand compress the lips of the meatus
firmly against the instrument, so as to prevent the fluid escaping from
the urethra until the syringe is withdrawn, which is done as soon as the
injection has been forced out of the instrument.

Before allowing the fluid to escape I with the index finger of the
right hand press the fluid back along the urethra as far as I can, so as
to bring it in contact with the posterior part of the canal ; I then, on
releasing the pressure, let the caustic solution pass out, and the whole
escapes into the vessel used for the purpose. It may be well to see
that the piston of your syringe acts truly, otherwise, in the case of
patients who instinctively or involuntarily employ great muscular
contraction, the fluid may be forced back behind the piston, and the
operation thus fail of its effects.

The patient may now sit down in an arm-chair, and remain there a
quarter of an hour. The first result of the operation is to produce a
warm pricking sensation at the end of the penis, which soon, however,
subsides, and usually in ten minutes disappears gradually. In some
cases an urgent desire to make water may come on, but as the bladder
has been previously emptied, this is a fictitious want, and rapidly
passes off, the patient being told to restrain the desire as much as
possible. As to the pain felt after the operation, I have been over
and over again assured that the suffering consequent on the appli-
cation of the caustic has been much less than the patient anticipated,
and in some instances it has been so slight that the patient has
doubted if any caustic can have reached the affected parts.

Other patients say they have experienced none of that shock to the
nervous system which interested individuals had led them to believe
was sure to follow the injection of a solution of nitrate of silver,
and which they had read that medical men had understated, in order
to induce patients to submit to the operation. The first effect of
the operation is to produce an oozing from the urethra, caused by the
of a drop or two of caustic mixed with mucus, and hence a
piece of lint or a handkerchief should be placed around the meatus to
absorb the moisture and protect the shirt from becoming stained.
The patient within half an hour may be allowed to return home, but
must not walk at all that day, and should swallow a copaiba capsule,
repeating it every eight hours or after each meal. Too strict injunc-
tions cannot be given to abstain from drinking fluid of any kind until
after making water, and not to pass urine until absolutely obliged.
Some men can easily remain twelve hours without passing water; a
space of time which allows the caustic solution to produce its proper
action on the mucous membrane. When the patient is no longer
able to resist the desire of making water, say, twelve hours after the

164 TREATMENT OF SPERMATORRHEA

operation, he may drink as much weak tea, soda-water, or diluents as
he pleases. Immediately after the operation he may take his usual
meals, abstaining, as before said, from fluid, and confining himself to
an easy chair or sofa. During the few following hours some slight
whitish discharge, like mucus, will flow from the urethra, but there
will be little or no pain. When the patient first makes water there is
some scalding, but the urine passes without difficulty. In some few
cases, where I have reason to suppose there is an extra amount of
irritability of the bladder, I have prescribed opium after the opera-
tion, but this is very rarely necessary. When the patient has made
water once, he may continue to do so as often as occasion requires, and
he will each time experience a diminution of the scalding sensation,
until at last it wholly disappears. Until the scalding has wholly
ceased the patient should take a tumbler of some diluent, such as soda-
water, milk, cocoa, or toast and water, every two hours during the day,
abstaining from it late at night, so as to prevent erections which would
be painful.

On the day following the operation, a tinge of blood is sometimes no-
ticed attending the last drops of urine, but this disappears in a day or
two, the urine becoming again clear. On the second or third day the
copaiba capsules may be dispensed with, and the patient may commence
a course of tonics with gymna,stic exercises, sponging, &c, as spoken of
at p. 169. Violent exercise should not be indulged in for the first few
days after the operation, but a moderate walk need not be inter-
dicted. In from four to ten days the patient may take a little claret,
and subsequently resume his usual mode of life, observing, however,
abstinence from tobacco or strong coffee.

Lastly, I would again remark that patients who have undergone the
operation all speak of the slight pain or inconvenience they have
suffered from it, and they urge me to impress on others the trifling
nature of what they had been assured was a formidable operation. It
frequently happens that, when performed on the Saturday afternoon,
the patient is able to resume his duties, if light, on the Monday, it
having been only necessary to remain quiet on the Sunday.

Beneficial effects of the operation. — The advantages of injecting a
solution of nitrate of silver are so manifold, that I now never employ
any other plan, and yet I have occasionally to treat some of the most
obstinate forms other surgeons have failed in curing. The operation
as here described has never been attended with any unpleasant results,
and I have never been called up, or been subsequently sent for, in
consequence of the alarm of the patient. If the surgeon takes the
precautions I have above spoken of, I have no reason to think that
any untoward symptom can arise.

I am told that, in some of the books on spermatorrhoea so largely

TREATMENT OF SPERMATORRHOEA 165

advertised in the papers, the operation is inveighed against in no
measured terms. The only reply I wish to make is, that in my hands
I find it most efficient and effectual, and my patients often regret that
it had not bees proposed to them earlier. As a result of cauteriza-
tion, the patient succeeds in obtaining a control over the will which he
never had before — the morbid irritability of the canal disappears —
the emissions cease, and the health improves. The caustic appears
to modify the local condition of the veru-montanum, and the effect is
permanent if supported by other treatment. In this mode of operating
the liquid comes in contact with every part of the canal, and does not
leave untouched those depressions which probably are unaffected by the
solid caustic, when Lallemand's instrument is employed. We also have
every reason to believe that by this plan the fluid enters the follicles,
which are so frequently the seat of the disease, and thus tends to the
cure of the complaint.

There is one further observation I should like to make before
closing these observations. The patient may be told not to be sur-
prised if on the night after the operation, or on subsequent nights, an
emission should occur ; this may depend upon the irritation the caustic
will produce in special cases. My experience tells me, however, that
it rarely occurs, and as soon as the irritation passes off emissions
cease to recur and a cure is effected.

Relapses. — The result of my experience proves that relapses of the
local affection after cauterization do not often take place, nor is a
second operation required ; still every now and then cases like the

following occur : — In 1853 I cauterized Mr for spermatorrhoea ;

in August, 1854, he returned, telling me that after the last operation
emissions had almost ceased, and his health improved, when within
six weeks he paid attention to, and was the accepted lover of, a young
lady. The marriage was to be delayed till Christmas. Lately the
emissions had recurred with redoubled frequency, and he was relapsing
into his former condition. Hearing that he would not see his intended
for four months, I told him the emissions would probably cease, and
if not, to take the ordinary precautions — baths, exercise (gymnastic),
attention to diet and drink — and come to me a fortnight before his
marriage, when I would repeat the operation.

The exceptional cases followed by relapses are those in which men
are engaged, but owing to pecuniary or other circumstances cannot
marry ; we meet with relapses likewise among some who will not or
cannot take regular gymnastic exercise.

The success which has attended this mode of operating has induced
me to lay aside Lallemand's instrument, which, when I commenced
practice more than five and thirty years ago, I used to employ. I
have altered and improved the instrument I recommended on page

TREATMENT OP SPERMATORRHEA

162 so much that I now consider it perfect, alike on the score of
simplicity, usefulness, and impossibility of getting out of order.

As, however, in a work like this my readers may
be desirous of comparing the one instrument with
the other, I subjoin a woodcut of the catheter psed
by the Montpellier Professor ; and I propose giving
a precis of the mode of employing it, taken from his
latest published edition.

Lallemand's plan. — A catheter should be passed
in order to empty the bladder, and to judge of the
length of the urethra. This, according to the Pro-
fessor's recommendation, should be done by stretching
the urethra, and, as the catheter is withdrawn, watch-
ing the moment when the water ceases to pass. On
thus discovering the length of the canal, the finger
should be placed on the instrument at the point just
beyond the glans penis, in order that the exact depth
to which the porte caustique should be subsequently
introduced may be accurately ascertained. On the
instrument which goes under Lallemand's name, there
are means for measuring this distance, which can be
fixed by the slide seen in the woodcut.

When I was in the habit of employing Lallemand's
porte caustique, I did not find it necessary to pass a
catheter, as I usually enjoined a patient not to drink
on the day I proposed applying the instrument, and
requested him to empty the bladder immediately
before its introduction. It is a good precaution,
moreover, to previously relieve the bowels by castor
oil, or by means of an enema. The porte caustique
must be prepared in the following manner : — " Fuse
some broken pieces of nitrate of silver in a watch-
glass held over a spirit-lamp by means of a pair of
forceps, taking care to apply the heat at first at some
distance, otherwise an explosion may take place ;
when fused, the caustic should be poured into the
little cup (see woodcut), allowed to cool, and the
projecting portions removed by a file; the canula
must then be returned into the closed instrument,
which, after being oiled, may be passed down into the
bladder, the patient being in bed or lying on a sofa —
a surgeon at all in the habit of passing instruments
. . is able to distinguish when the instrument enters

LALLKMAN D S POHTE , D .

caustiqui. the viscus. The diseased part is at once known (so

TREATMENT OF SPERMATOKKHflEA 107

Lallenuund states) by the instrument causing some pain to the patient
on reaching it. This once ascertained, the surgeon will withdraw the
outer canula to the extent of half an inch, and at the same time give
a rotatory motion to the inner canula containing the caustic. By this
means the diseased surface is slightly cauterized, eschars are not
in-<vssarily formed, nor are any passed in the urine, and the internal
canula, being drawn within the external one, cauterization is confined
to the morbid structures only. Kest in the horizontal position must
be enjoined, and the patient desired not to make water for some hours.
If pain comes on, a good dose of laudanum, or an enema with opium,
may be prescribed. For the few following days there is some pain in
making water. The discharge increases, and is mixed with a little
blood ; but by attention to diet and rest, together with moderate doses
of copaiba or cubeb capsules, these symptoms abate, and with them
the emissions, although in some cases the cauterization may induce one
or two escapes of semen during the following nights. Sexual inter-
course must be strictly prohibited, and any cause which may originally
have produced spermatorrhoea must be studiously avoided. In some
cases it may be necessary to have recourse to a second or third applica-
tion of the caustic ; but at least ten days should elapse between each
cauterization, and any accidents which may arise must be treated on
general principles.

In the annexed woodcut the instrument is nearly straight, but
experience taught me that such catheters cannot readily reach the
bladder, and I formerly employed instruments with a considerable
curve, which facilitated their passage. The cup is usually made too
deep ; this causes the surgeon to use not only a large proportion of
caustic, but requires great care in removing the salt when it hasJbeen
used. After performing the operation, I immediately withdrew the
canula, and soaked both it and the part holding the caustic in water,
or with a pointed instrument removed the nitrate of silver.

Lallemand does not assert that his plan of cauterization will be
always successful. " It has succeeded," he says, " in cases where
atony and debility were the prominent symptoms ; less rarely when
accompanied with nervous symptoms, and a strong hereditary ten-
dency." (Vol iii, p. 392.) Again he says, " Two thirds of the cases
of spermatorrhoea would be beyond the resources of our art, were
it not for the assistance we derive from this powerful medication."
(Vol. iii, p. 406.)

In twenty years, during which he was daily in the habit of using
the instrument, he asserts (p. 401) that he never saw any ill conse-
quence arise from the treatment, and I can fully bear out this state-
ment, as far as my own experience is concerned.

>t after Cauterization. — As soon as the effects of cauteriza-

168 TREATMENT OF SPERMATORRHEA

tion have subsided, the surgeon should take steps to improve the
general health. All the remedial measures (which others may have
tried in vain before the cauterization) to build up the health of the
patient may now be employed with the greatest advantage. Among
the foremost of tonic agents stands the sponging-bath, of which we
have already spoken (p. 53), and I usually recommend my patient to
employ it in the evening on going to bed as well as in the morning, or
at least to sponge the generative organs over every night before getting
into bed. I find this plan much preferable to bathing in the sea or in
river water, as under the latter circumstances an occasional bath is
only indulged in, as rain, wind, or chilly weather, may occasion its
omission, whereas we can always depend upon a sponging bath whatever
the weather, and I repeat it is much better that the water be used
with the chill off even in summer, for such patients are usually exces-
sively susceptible of cold, and bear chilled water very indifferently,
reaction taking place with difficulty.

I prescribe early rising ; the patient in summer should not be in bed
later than 7 o'clock. On awaking he may drink a tumbler of cold water,
particularly if there is a tendency to constipation. Some may take
walking exercise before breakfast. If, however, this induces faintness,
I suggest eating a piece of bread or biscuit before starting, to be followed
by breakfast soon after the patient's return home. As a rule, it is
injudicious to take exercise either on an empty or a full stomach.
Rest and reading should follow light meals.

In addition to the employment of the sponge-bath, a patient should
take regular exercise short of fatigue — as boating, fencing, rackets,
quoits, riding, boxing, and gymnastics generally. To ensure regularity
in London, I usually recommend a convalescent to place himself under
the tuition of one of those persons who superintend gymnasia, and who
are usually very attentive. If my patients cannot stay in London, I
devise some scheme for exercise which they may be able to carry out
at their own homes. Thus —

One may be able to cleave wood, another to grind corn in a mill,
another may prefer skittles or bowls. Quoits afford excellent athletic
exercise ; a cart-rope attached to a bough of a tree, or beam in a barn
or shed, will serve as an extempore gymnasium. If no other means of
obtaining muscular exertion be possible, I recommend dumb bells or the
Indian clubs. In one or other of these ways muscular exertion must be
regular employed. Excessive walking I find objectionable, as if carried
to any extent it may produce determination of blood to the sexual
organs and subsequent emissions ; the same objection may be urged
against riding on horseback. The effect of exercise in diverting the
activity of the circulation from the genital organs into other channels
was known to the ancients, who, with their very numerous gymnasia,

TREATMENT OF SPERMATORRHOEA 169

could not fail to remark the continence of the athletes. It is likewise a
well-known fact that those who are obliged to undergo great physical
exertion are remarkable for their abstinence from sexual intercourse.
The moderns who are training are well aware that such indulgence
wholly unfits them for great feats of strength, and the captain of a boat
strictly prohibits his crew from anything of the sort previously to a race.
Some trainers have gone as far as to assure me that they can discover
by a man's style of pulling, whether he has committed such a breach of
discipline over-night, and have not scrupled to attribute the occasional
loss of matches to this cause.

The diet of convalescents taking gymnastic exercise should be
Attended to pretty carefully. Thus, for breakfast, I prescribe cocoa and
milk, and I recommend the cocoa nibs stewed down for several hours
as preferable to the cocoa sold ready prepared in the shops.

Tea, coffee, and tobacco I look on as so many poisons for persons
suffering under nervous depression such as we are here speaking of.
It is in vain to recommend weak tea, so I prohibit tea or coffee for
breakfast, and substitute in summer aerated- water, soda-water, or lime-
water with cream or milk, provided the urine does not become alkaline
or deposit the phosphates. In these latter cases I at once have recourse
to claret and water, which is an excellent substitute for tea or coffee ;
and in winter I recommend the patient to employ lukewarm water to
mix with his claret.

The taking warm fluids for breakfast is a habit that may be soon got
over. I am convinced that deluging the stomach of invalids with hot
strong fluid is injudicious, but at first it is somewhat difficult to
induce patients to become singular and take cold fluids for breakfast.
Stale bread and a moderate quantity of lean meat are advisable if the
patient has a fair digestion, and if he does not feel oppressed after
eating. I order luncheon for those who dine late, which may consist
of a small portion of meat and stale bread, with a glass of sherry or
a little bitter beer. This mid-day meal is absolutely necessary, for I
find if a man in exercise does not take nourishment in the middle of
the day, he eats voraciously at dinner, and his digestion becomes
impaired. I forbid late dinners, and counsel plain but whole-
some diet. I forbid fried fish, cheese, pastry, or suet-puddings, and
advise only moderate quantities of meat, vegetables, and bread, with a
pint of bitter beer or three moderate -sized glasses of wine (claret or
sherry). Both (beer and wine) should not be taken at the same meal.
The rules of diet that are followed in training may be interesting,
though I would not recommend an invalid to attend to them strictly,
except under medical advice.

One of the most successful pedestrians of the day thus described his
mode of living to me. He rose early, walked one mile and a half out

170 TRAINING — OBSERVATIONS ON DIET

and back, then had a sponge-bath and took his breakfast, consisting
of a cup of weak tea, or of eggs beaten up instead of milk, and a small
quantity of meat. Then his exercise again, change of flannels, a rub
down ; as regards flannels he told me he preferred wearing a tight
flannel waistcoat, not merino or flannel shirts, as they felt cold if not
changed. At half-past 12 o'clock he took a moderate dinner of meat,
with vegetables, rice, sago, or light pudding, and a small quantity of
bottled stout. In the afternoon he took his exercise again, tea at five,
no meat but a little lettuce or watercress, and at eight or nine a little
arrowroot or light supper, and then to bed in blankets. I may add
that this man was, although in very vigorous health, most moderate in
sexual indulgence.

To this account I may add a description of the training that boating
men go through :

" The training of University oarsmen consists of early hours, running,
rowing, and a temperate use of the most nourishing food and drink.
The same treatment cannot be prescribed for all constitutions ; but the
following seems to be about an average specimen of the way in which
the month preceding the match is spent. All meet at 7 a.m., and run
a couple of miles — at first gently, afterwards at a sharp burst ; this is
essential, as it is the only improver of the wind. After a tub and rub,
they breakfast together in turn at one another's rooms, and have
broiled steaks and chops, bread and butter, watercresses, and tea in
moderation. A little reading fills up the morning capitally, and keeps
the mind quietly occupied; indeed, high classical attainments and
good rowing often go hand in hand. At 12.30 a biscuit and a glass of
wine, and at 2 p.m. down to the river to row the course. This over,
they have a comfortable wash, and then dine together upon beef or
mutton sufficiently roasted, broiled, or boiled, wholesome vegetables,
plain jelly, watercresses, lettuces, and a pint of sound home-brewed
ale. Pork, veal, salted meat, made dishes, pastry, cheese, condiments,
and smoking 1 are forbidden. Those who are used to wine are allowed
a glass or two after dinner. All ought to be in bed shortly after 10
o'clock ; and, for those with whom it agrees, the best thing to take as
supper is a basin of carefully -made plain oatmeal water-gruel. But
training is very ticklish work with many men ; they are apt to get
feverish, and nearly the same round of food day after day often palls.
Again, about ten days after the system of training has been begun, a
period of depression sometimes occurs ; this, however, is a turning-
point, and once passed, the patient feels brighter and harder. The
mentor and the coxswain strive to keep the crew cheerful and good-
tempered one with another, free from all sensations of staleness and over-

1 This rule has been a little relaxed of late years, and a very moderate indulgence
in tobacco has been allowed, and indeed considered beneficial,

TKAINING, THE BEST PLAN OF 171

training. If the cast of character includes a good low-comedy man, so
much the better." — Once a Week.

Of late years the theory and practice of training has received a good
deal of attention, and I find on referring to a book published by
Archibald Maclaren, at Oxford, that the present system of training men
for the University boat races is very much the same as I have
described. The modern plan seems to be not to stint a man of water ;
he should, however, be advised not to drink more than a pint of beer
at his meals. I therefore should suggest that a thirsty man had better
at first quench his thirst with water, and take his beer subsequently.

Butter seems to be taken only in moderate quantities, and men in
training are allowed marmalade. In regard to the use of this article
of diet I have some misgivings, as it often produces a sick headache
in certain constitutions, and I am sure it could not be taken by persons
passing the phosphates without increasing the alkalinity of the urine,
and consequently doing in these instances much harm.

In other respects I am glad to find that science and practice go
hand in hand in training, and that the young men of the day are
instructed in the very best plan of improving their muscular powers
with the least strain on their constitutions.

Another recommendation, in which I fully concur, is that a man in
training should be in bed before 11 o'clock, and early rising cannot
be too strongly inculcated.

A statement is made which I was unprepared for, that under training
and exercise a man's chest may become developed from thirty-two
inches to thirty -four, and that some men measure as much as thirty -
eight inches around the chest.

FALSE SPERMATORRHEA.— DISEASES SIMULATING SPERMATOR-
RHEA.— QUACKS

In the first edition of a work I published on ' Diseases of the Urinary
and G-enerative Organs,' I wrote a chapter entitled Syphiliphobia, in
which I collected together a variety of complaints that presented many
of the characteristics of true disease. Since then a wider knowledge
of these subjects has sprung up. Hypochondriacs and a large class of
patients who have leisure to dwell on their morbid thoughts and
feelings have, by reading the books formerly so freely advertised in
the quacks' corner of the newspapers, come to the conclusion that they
are suffering under spermatorrhoea — a word with which they are now
familiar. In this corner formerly five or six such advertisements
directed public attention to the so-called disease ; the headings of
il Manly Vigour" and "Secret Diseases " have disappeared, and are

172 FALSE SPERMATORRHEA — QUACKS

replaced by the term " Spermatorrhoea," 1 the form of sexual disease
now in fashion ; and as, in such hypochondriaco-misanthropic persons,
the sexual feelings are generally more or less affected, the conclusion is
arrived at that every one who, with a bad conscience, feels himself out
of sorts, is suffering from some of the forms of spermatorrhoea. There
is a fashion in diseases, just as there is in amusements or occupations.
Patients come to us, half persuaded that they suffer in the way described,
but still in some doubt whether what they complain of is fancy or the
real disease. In such cases we have too often to deal with ignorance,
irritability of temper, and sometimes with true symptoms, though
magnified by great exaggeration, and no inconsiderable alarm about
the consequences. Conscience tells many that their previous lives have
been far from faultless, and the above pseudo -medical books exaggerate
the consequences of indiscretion, and predict the most awful conse-
quences, describing trains of symptoms enough to frighten the most
courageous. It cannot be difficult for my readers to surmise what must
be the effect on the ignorant, the weak-minded, and those already
depressed by their fears, with no friend at hand to confide in or to
calm their excited feelings. Too many threw themselves into the
meshes of these harpies, and the consequence was that they were
fleeced to an amount that is almost inconceivable, except to those
familiar with the swindling transactions of the class. As I may not
have another opportunity, I would just mention a few circumstances
out of many that have come under my personal knowledge. A
student at Cambridge sought my advice suffering from one of these
sexual complaints, half real, half ideal. When cured, he mentioned
that, before coming to me, he had consulted one of the advertising firms,
and after paying some <£40 in fees, was told that he could be cured
only after giving his note-of -hand for =£300. Worn down by his alarms,
fearful that he should never get well without compliance, and being of a
very delicate and susceptible disposition, he signed the agreement, and
the purport of his visit was to show me a letter in which the c£300
was demanded in a very peremptory manner. I advised him to put
the case into a competent lawyer's hands, and, after some hesita-
tion on his part, this was done. The interviews between the opposing
solicitors were very characteristic, but to describe them would occupy
too much space here ; suffice it to say, my patient's letters were only
given up after a compromise had been effected by the payment of a
sum of money.

In another case, a nobleman was asked for and gave .£1000 to one of
these advertising firms ; they had the impudence to ask another .£1000

1 Since the earlier editions of this book were published, its title has been pirated
by more than two persons in such advertisements. On inquiry I found that it was
impossible to prevent any one copying my title.

fAlSE SPERMATORRHEA — QUACKS 173

some time after, under the plea that his case was a particularly difficult
one. This somewhat surprised his lordship, and the family solicitor
was consulted. All attempts, however, to induce the quack to refund
the .£1000 failed, probably in consequence of the threats of exposure
used by the firm.

Those who may be curious to know the former practices of quacks
may consult the Appendix B, p. 249, of the fifth edition of this
book.

In the more recent cases in which appropriate legal proceedings
have been threatened, a moiety of the money has been returned,
without recourse to an open trial ; but it too often happens that the
dupe prefers losing his money to the chance of having his weakness
exposed.

This alternative, which is always threatened but never carried into
effect, however, is no longer found necessary. I once thought that the
exposure of such nefarious practices would do good, but I now feel
convinced all that can be done with advantage is to secure a return of
the money. The frequent recurrence of prosecutions for almost any
disgracefully nefarious crime shows that the trial of one case does
little, if anything, to prevent others from occurring attended with
exactly the same features of rascality and credulity ; and I am afraid
that no medical bill will cure the evil under consideration, though it
may possibly change the modus operandi. The only efficient remedy
for this system of plunder is that the profession should no longer
allow it to be supposed that medical men shun the treatment of this
class of diseases. It should be clearly understood by sufferers, that
surgeons of repute willingly undertake the treatment of these as well
as all the other ailments to which flesh is heir, and that it is by no
means necessary to resort to quacks or advertising firms. If, how-
ever, medical men desire to obtain the confidence of this class of
patients, they must be prepared to listen patiently to their statements,
and not pooh-pooh what at first may seem fanciful, a practice that has
been too frequently followed, if the statements of patients can be
believed.

Sufferers from false spermatorrhoea are as fully convinced that they
suffer from the real ailment, the symptoms of which they complain of,
as do actual invalids, and I have too much reason to think that my
profession does not always appreciate these ideal sufferings. Eather
with Dr Eeid in his treatise on hypochondriasis we would say :
" Nothing surely can surpass the inhumanity, as well as the folly, with
which patients of this class (sufferers from nervous diseases) are too
frequently treated. We often act upon the ill-founded idea that such
complaints are altogether dependent upon the power of the will; a
notion which, in paradoxical extravagance, scarcely yields to the

174 FALSE SPEttMA^OfefcHCEA^QUACKS

doctrine of a modern, though already obsolete, writer on l The Phiio*
sophy of Morals,' who asserted that no one need die, if with a suffi-
cient energy he determined to live. To command or to advise a person
labouring under nervous depression to be cheerful and alert, is no less
idle and absurd than it would be to command or advise a person, under
the direct and most intense influence of the sun's rays, to shiver with
cold, or one who is ' wallowing in December's snows ' to perspire from
a sensation of excessive heat. The practice of laughing at or scolding
a patient of this class is equally cruel and ineffectual. No one was
ever laughed or scolded out of hypochondriasis. Lt is scarcely likely
that we should elevate a person's spirits by insulting his under-
standing. The malady of the nerves is in general of too obstinate a
nature to yield to a sarcasm or a sneer. Lt would scarcely be more
preposterous to think of dissipating a dropsy of the chest than a
distemper of the mind, by the force of ridicule or rebuke. The hypo-
chondriac may feel, indeed, the edge of satire as keenly as he would
that of a sword ; but, although its point should penetrate his bosom,
it would not be likely to let out from it any portion of that noxious
matter by which it is so painfully oppressed. The external expression
of his disorder may be checked by the coercive influence of shame or
fear ; but, in doing this, a similar kind of risk is incurred to what
arises from the repelling of a cutaneous eruption, which, although it
conceals the outward appearance, seldom fails still more firmly to
establish the internal strength, to increase the danger, and to protract
the continuance of the disease." (Loc. cit., p. 7.)

The immediate consequence of a surgeon not attending sufficiently to
these cases is, that the patients, who are often very sensitive, finding the
profession unwilling to sympathise with them, at once resort to the
quack fraternity, who humour their delusions at the same time that they
fleece them, and have even been known to administer to their dupes
depressing medicines so as to retain them still more surely in their
power. The only other way in which this infamous trade can be
checked is for the newspaper press to refuse to insert the quack adver-
tisements. The more powerful organs have already done so to a
certain extent, and with the best effect ; and if this refusal were made
general the system could be at once put a stop to. The Post Office
authorities might assist also by refusing to circulate the pamphlets and
even books which these advertising firms now despatch wholesale to the
country, and by this means bring their plans for fleecing their dupes to
the notice of every family in the kingdom. Lt is an abuse of the
Post Office which we should think need only be brought officially
under the notice of the Postmaster General for an effectual remedy to
be applied. 1

1 I liave lately (1874) seen that the London police magistrates have taken cogni-

tfAtSE SPERMATORRHEA — QUACltS 1.73

The symptoms which patients who suffer from false spermatorrhoea
complain of are frequently of the most exaggerated description ; they
have been mentioned in the previous pages, and it is for the medical
man to decide whether they are real or assumed. Frequently they
partake of both characters ; there is a certain proportion of true dis-
which has been aggravated by fear and ill-treatment; and I
believe, as stated elsewhere (p. 26), that determination of the thoughts
to a particular organ may superinduce, in a greater or less degree, its
functional aberration. Admitting this, great sympathy must be shown
to a class of sufferers whom I fear the profession often treat with too
little regard to their susceptible feelings.

In 1854 a medical student wrote to me from the country, saying that
he had been twice cauterized ; and he added, " supposing all further
measures you may suggest for trial fail, what do you think of the ope-
ration of castration as a remedial means ?" I wrote in answer, that
the operator and the operated upon should be both placed in a lunatic
asylum, and that I declined prescribing without seeing the patient,
experience having taught me the inutility of doing so. This man re-
presents a large class who will undergo any amount of present physical
suffering to rid themselves of the ailment under which they believe
they labour ; and the probability always is, that these exaggerated
accounts of disorders will turn out to be cases such as we are now
speaking of — namely, real complaints enormously magnified by a highly
irritable temperament. If not judiciously treated, such sufferers will
assuredly end their days in asylums. I every now and then see patients
who avow that they owe their lives to me, since, had it not been for the
assistance and sympathy held out to them, they had determined to
destroy themselves — so firmly convinced had they become that they
were labouring under an incurable malady, the nature of which they
believed was apparent to all beholders. It is these victories of
sympathy and science that make up for the disappointments medical
men sometimes meet with in this sad department of the profession.

From what I occasionally witness, I am convinced that many of the
suicides occurring among young men have been caused by the ineffec-
tual treatment of supposed spermatorrhoea, and the fixed idea that no
relief can possibly be obtained. If any additional reason can be urged
why the profession should take these cases under its more immediate
care it is this — the saving from utter destruction the future of a class
of men, many of whom have, through the instrumentality of surgical

zance of and punished the distribution of fly-sheets of this description too often
thrust into the hands of persons passing along the streets by the poor threadbare men
employed for the purpose, who, in the pay of quacks, distribute what has (by magis-
terial authority) been called obscene literature. This has proved an efficient way
of putting down one form of quackery.

176 FALSE SPERMATORRHEA, TREATMENT OE

means, been rescued from this unhappy state of mind, and to my certain
knowledge have become useful members of society, and are now dis-
charging most important duties in the higher ranks of their several
professions.

Treatment — The most difficult thing in the management of these
cases is to bring the patients to exercise self-control. They have never
been taught it early in life, and they have never practised it since they
have arrived at adult age ; yet without its exercise all our endeavours
to obtain convalescence will fail. This self-denial must be mental as
well as physical ; the sufferers must be impressed with a full determi-
nation not to allow themselves to dwell on or think of their complaint.
Such self -treatment is indispensable ; these moral gymnastics are abso-
lutely necessary, and they may be much assisted by regular bodily
exercise and physical exertion, accompanied by a regime such as that
described at page 168.

Another of the difficulties which the medical man has to meet, is
that of being unable to persuade the misanthrope to seek cheerful
society, and to give up his solitary habits and moping ways.

The judicious treatment of a spoilt child must be the type for the
surgeon to follow. He must display tact and knowledge of men, for
what will succeed with the illiterate will fail with the imaginative and
the intellectual, who must be reasoned with and convinced before much
can be done with them. Above all things, a favorable prognosis, if not
inconsistent with conviction, should be given. The power which con-
scientious self-reliance, founded on a real knowledge of disease, gives a
medical practitioner, especially in these cases of incipient mental dis-
ease, is remarkably great. The physician's convictions appear to be
sympathetically communicated to his patients, and the moral influence
thus established, once in full play, materially accelerates the cure.
This power of imparting convictions and of controlling the will of the
patient, so desired by the young surgeon, is more or less innate, but I
believe can be developed by attention and extensive practice ; it is fre-
quently favoured by the inferior mental acquirements of the patient,
who feels comfort in reposing on one whose knowledge and truthful-
ness the invalid has learnt to respect.

Necessary, however, as the moral treatment I have above spoken of
may be, it must often be aided by physical exertion, attention to
diet, &c. In addition, local stimuli may be often necessary. When
the hope can again be indulged that the dreaded impotence may,
after all, be only a delusion, these and all other stimulants should be
left off.

It may be advisable to interdict all sedentary and intellectual
employments for the time being, and to recommend the substitution
of light literature, open-air exercise, and change of scene ; and I

FALSE SPERMATORRHEA \77

know of nothing that tends so much to the benefit of a patient as does
a walking tour with a knapsack, particularly if he can secure the
society of a pleasant companion. It is surprising what even a short
trip of this kind will do, when a visit to Switzerland cannot be under-
taken.

I advise patients to avail themselves of the advertised trips of
Messrs. Cook, of Ludgate Circus. By the payment of a stipulated
sum the firm personally conduct their clients round the world, or through
Inland, England, and Scotland, without trouble or anxiety to the in-
valid. This is just what many of my patients require, who, without
Messrs Cook's assistance would, I am sure, never have undertaken
the journey, long or short, or have enjoyed the society of their fellow-
travellers, and again re-entered the world or sought recreation and
health in travel. It is by such means that I have been able to effect
many a cure for patients whose cases had been considered hopeless.

Before closing these remarks on false spermatorrhoea, I am glad to
have the opportunity of inserting a letter from the late Sir B. Brodie
sent in reply to one from a patient of this class, who has asked me to
print it for the benefit of sufferers.

Broome Pake, Betchwobth, Sueret,
October 14, 1854.

Sib, — Your letter reached me this morning at my country house, where I am
staying for my annual vacation. I am sorry that my ahsence from London has
caused some delay in my answering' it. The practice that you mention is certainly
a very bad one, and, if carried to excess, is often productive of very ill consequences.
At the same time it must he owned that those who have been guilty of it are of ten
led to think that they suffer from it more than they really do, by the obscene and
wicked representations of quacks, whose object is to frighten young men and extort
money from them. I have little doubt that you are one of the numerous class of
persons who are unnecessarily alarmed. Most of the symptoms which you mention
are nothing to the purpose. Many persons besides yourself have pimples on the skin
which are of no consequence, and can have nothing to do with the bad habits to
which you refer, though one testicle always hangs lower down than the other. (It
would be very inconvenient if it were otherwise.) You cannot have been made im-
potent. If you were, you could not have nocturnal emissions ; to which, by the
way, all young men who are not having regular sexual intercourse are more or less
liable. You cannot really be very weak, as you walk seven or eight miles daily, and
could, if it were necessary (as you say), walk fourteen or sixteen miles. I can per-
ceive, however, that you are very nervous, and I dare say that you have a weak
digestion. I advise you first to take the mixture of which I enclose the prescription
twice daily ; to live on a plain and simple diet, avoiding malt liquors, raw fruit and
vegetables ; and drinking merely a small quantity of sherry or weak brandy and
water. Probably a visit to the sea-side will do you good. It is important that you
should keep your mind well occupied. You must not expect to be relieved from the
nocturnal emissions until you are married. — I am, Sir,

Your obedient servant,

B. C. Bbodie.

t*«& The medicine should be taken for three weeks; perhaps longer.

178 SEXUAL INTERCOURSE

CHAP. IV.— SEXUAL INTEKCOTTKSE

The Act op Copulation. — In order to deal intelligently with
cases in which sexual congress is not properly performed, it is
necessary clearly to understand in what the act of copulation consists.
It is thus described by Carpenter : — '• When, impelled by sexual
excitement, the male seeks intercourse with the female, the erectile
tissue of the genital organs becomes turgid with blood, 1 and the
surface acquires a much increased sensibility. This is especially acute
in the glans penis. By the friction of the glans against the rugous
walls of the vagina the excitement is increased, and the impression
which is thus produced at last becomes so strong that it calls forth,
through the medium of the spinal cord, a reflex contraction of the
muscular fibres of the vasa deferentia, and of the muscles which sur-
round the vesiculae seminales and prostate gland. These receptacles
discharge their contents into the urethra, from which they are expelled
with some degree of force, and with a kind of convulsive action, by its
compressor muscles. Now, although the sensations concerned in this
act are ordinarily most acutely pleasurable, there appears sufficient
evidence that they are by no means essential to its performance, and
that the impression which is conveyed to the spinal cord need not give
rise to a sensation in order to produce the reflex contraction of the
ejaculator muscles." (' Principles of Human Physiology,' 7th edition,
p. 826.) The muscular contractions which produce the emissio
seminis are excito-motor in their nature, being independent of the will
and not capable of restraint by it when once fully excited, and being
(like those of deglutition) excitable in no other way than by a particu-
lar local irritation.

As stated in the above paragraph, the sexual act is ordinarily
attended with great pleasure. In fact, from the risks which animals
will run to enjoy the gratification, and the recklessness with which
even the wildest male will approach the tame female when in heat, it
would seem that no pleasure is equal to this. 2 There is every reason

1 See page 180 for explanation of this.

2 I am speaking here, it will be observed, of the pleasure experienced by the male.
In the females of many animals, and especially of those low down in the scale of
existence, we can scarcely believe that any gratification at all attends the act.

In fishes copulation, properly speaking, does not take place. According to Mr
"Walsh, a close observer who wrote an account in the ' Field ' newspaper for March 7th,
1863, the mode of impregnation is as follows :— " The female fish does not first
deposit her spawn, and then leave it to be impregnated by the male ; the male cares
nothing for the spawn, except to eat it; his desire is for the female, for the possession
of whom he will fight as long he is able. The spawning process is carried on in this

THE ACT OF COPULATION 179

to believe that it is the mere and simple act of emission which gives
the pleasurable sensations in animals which (like many birds) have
no intromittent organ. This pleasurable sensation, however, is of
momentary duration ; like a battery, it exhausts itself in a shock. The
Derroufl excitement is very intense while it lasts, and, were it less
momentary than it is, more mischief would probably result from
repeated acts than ordinarily happens.

Parise has remarked, perhaps with some exaggeration, that " if the
pleasurable moments, as well as the torments, which attend love lasted,
there would be no human strength capable of supporting them, unless
our actual condition were changed."

A kind of natural safeguard is provided against the nervous exhaus-
tion consequent on the excitement of coitus, by the rapid diminution of
thf sensation during successive acts. Indeed, in persons who repeat
coitus frequently during the same night, the pleasurable sensation
will diminish so rapidly that the act at last will not be attended with
any.

This pleasure, in fact, seems in its own way to be subject to the same
laws which apply to our other gratifications. As Carpenter says —
" Feelings of pleasure or pain are connected with particular sensations,
which cannot (for the most part, at least) be explained upon any other
principle than that of the necessary association of those feelings by an
original law of our nature with the sensation in question. As a gene-
ral rule, it may be stated that the violent excitement of any sensation is
disagreeable, even when the same sensation in a moderate degree may
be a source of extreme pleasure."

By this merciful provision nature herself dictates that excesses
must not be committed. The frequent complaint heard from persons

manner: — The female works away at the ridd, and after she has made a kind of
trough she lies in it quite still ; the male — who, during the time she is working, is
carrying on a constant war — comes up, enters the trough, and lies side hy side with
the female ; they then fall over on their sides, and with a tremulous motion the spawn
and milt are exuded at the same instant. The male then drops astern. After a short
time the female again throws herself on her side, and fans up the gravel, advancing
the trough a little, and covering up the deposited spawn. The operation is repeated
till both fish are exhausted. A great quantity of spawn is of course wasted, being
eaten by trout and other fish, which are always waiting about for the purpose. The
exhaustion of the males is greater than that of the females; they die in numbers;
the females do not die. You may pick up a great many exhausted and dead males,
but never a female."

In some animals the act must, we would think, be an unmitigated distress and
annoyance to the female. The female frog, for instance, is not only encumbered
with an abdomen distended with ova, but is obliged to carry about her husband
on her back as long as he may see fit, as he is provided by nature at this period with
an enlarged thumb, which enables him to keep his hold, so that the female is unable
to shake him off.

180 SfcXUAii INTERCOURSE

who have committed excesses, that they experience no more pleasure
in the act, is the best evidence we can have that nature's laws have
been infringed.

The physiological explanation of the pleasure attendant on the sexual
act is, perhaps, as follows : — " Accumulation of blood," says Kobelt,
" causes, whenever it occurs in the body, a gradual augmentation of
sensibility ; but in this case the glans penis, in passing from a non-erect
state to the condition of complete turgescence, becomes the seat of a
completely new and specific sensibility, up to this moment dormant.
All the attendant phenomena react on the nervous centres. From this
it appears that, in addition to the nerves of general sensibility, which
fulfil their functions in a state' of repose and also during erection,
although in a different manner, there must be in the glans penis special
nerves of pleasure, the particular action of which does not take place
except under the indispensable condition of a state of orgasm of the
glans. Moreover, the orgasm once over, the nerves return to their
former state of inaction, and remain unaffected under all ulterior
excitement.

" They are, then, in the same condition as the rest of the generative
apparatus ; their irritability ceases with the consummation of the act,
and, together with this irritability, the venereal appetite ceases also to
be repeated, and to bring about the same series of phenomena at each
new excitement." — Kobelt, 'Die miinnlichen und weiblichen Wollust-
Organe des Menschen und einiger Siiugethiere,' p. 35.

Many foreign writers maintain, and the above observations would
seem to corroborate the assertion, that the chief source of sexual
pleasure resides in the glans penis. That it has a considerable share
in the sensations experienced is very true, but from certain cases that
have come under my notice, I cannot help thinking that it has less to
do with them than is generally supposed. Some time ago I attended an
officer on his return from India who had lost the whole of the glans
penis. This patient completely recovered his health, the parts healed,
leaving but a stump of the penis two inches in length. I found, to my
surprise, that the sexual act was not only possible, but that the same
amount of pleasure as formerly was still experienced. He assured me,
indeed, that the sexual act differed in no respect (as far as he could
detect) from what it had been before the mutilation.

Duration of the Act. — It is, indeed, a wise provision that in the
human being the act should last but a short time — some few
minutes.

In animals the greatest differences in this particular take place.

Thus I read in the ' Description of the Preparations of the College
of Surgeons,' that " the coitus in the kangaroo, and probably in other
marsupials, is of long duration, and the scrotum during that act dis-

THE ACT OF COPULATION 181

appears, and seems to be partially inverted during the forcible retraction
of the testes against the marsupial bones." — No. 2477, Physiological
Catalogue, by Owen.

The act of copulation, as I can testify, in the moth of the silk-
worm is very prolonged. The male is the smaller and darker of the
two, and as soon as he leaves the grub state he is ready for the act.
He then vibrates his wings with a very singular humming noise, and
goes round and round the female. The tails are then approximated,
copulation takes place, and lasts for days. As soon as the sexes sepa-
rate, the same process is repeated, and sexual congress again occurs.
It would almost appear as if the short life of these insects was passed
in copulation. The female moths died first in all the cases I witnessed,
but the males, although surviving the females, were dull and could
hardly move, being apparently thoroughly exhausted by their repro-
ductive labours.

•In the chapter on erection (p. 80) we have noticed the prolonged
copulation of the dog. In some other classes of animals it takes place
with wonderful celerity. Among deer for instance, it was at one time
stated that coitus had never been observed even by the oldest keepers.
Professor Owen mentioned that it may be witnessed in Richmond
Park, somewhat in the following way : — The buck will be seen to
scrape hollows two or three feet deep in certain portions of the park ;
to these places he leads the does. One by one, they place themselves
in these hollows ; the buck drives away all other bucks from the neigh-
bourhood, then, with a rush, mounts the doe ; in an instant the act is
accomplished, and the female retires to be replaced by another. Pro-
fessor Owen says he cannot explain why these hollows should be made
in the ground, as there is nothing in the conformation of the doe to
require that she should be placed on a level lower than that which the
buck leaps from. However, though the act itself is instantaneous, the
premonitory excitement is of long duration. It is possible, therefore,
that erection lasts but for an instant, and hence the convenience of this
preparation and position.

Mr Thompson, the late superintendent at the Zoological Gardens,
told me that he has seen copulation take place in the stags both in
the wild state and in confinement. He thinks that a peculiar place
is not necessary for the act. He agrees that it is effected in a few
moments, and that in the case of the giraffe, also, no peculiar position
is necessary.

The Effect of the Act. — The immediate effect of the act on the male
deserves some few remarks. Even in the healthiest and strongest
person a feeling of fatigue immediately follows.

This nervous orgasm is very powerfully exhibited in some animals.
The buck rabbit, for instance, after each sexual act, falls on his side*

182 SEXUAL INTERCOURSE

the whites of his eyes turn up, and his hind legs are spasmodically
agitated. The cause of this, and the corresponding phenomena in
other animals, is the nervous shock which particularly affects the
spinal cord.

The way in which this shock affects a healthy man is, generally, to
make him languid and drowsy for a time.

This temporary depression has not escaped the observation of the
ancients, who have remarked —

" Lseta venire Venus tristis abire solet ;"
and again —

" Post coitum omne animal triste, nisi gallus qui cantat."

So serious, indeed, is the paroxysm of the nervous system produced
by the sexual spasm, that its immediate effect is not always unattended
with danger, and men with weak hearts have died in the act. Every
now and then we learn that men are found dead on the night of their
wedding, and it is not very uncommon to hear of inquests being held
on men discovered in houses of ill-fame, without any marks of ill-usage
or poison. The cause has been, doubtless, the sudden nervous shock
overpowering a feeble or diseased frame.

However exceptional these cases are, they are warnings, and should
serve to show that an act which may destroy the weak should not be
tampered with even by the strong.

Lallemand well describes the test which every married man should
apply in his own case : — " When connection is followed by a joyous
feeling, a bien etre general, as well as fresh vigour ; when the head feels
lighter, the body more elastic and ready for work ; when a greater
disposition to exercise or intellectual labour arises, and the genital
organs evince an increase of vigour and activity, we may infer that an
imperious want has been satisfied within the limits necessary for health.
The happy influence which all the organs experience is similar to that
which follows the accomplishment of every function necessary to the
economy."

How serious — how vital an act, so to speak, that of copulation is,
appears from the marked changes which accompany its performance in
some animals. It is a well -accredited fact that in the rutting season
buck venison is strong, lean, and ill-flavoured. At this time, we are
told, the flesh becomes soft and flabby, the hair looks " unkind ;" and
in birds, the feathers, after the season of breeding, are in a ruffled state,
and droop. The horns of stags (see Effects of Castration, p. 130) fall
off, and the blood is occupied in supplying the consequent demand for
new osseous matter.

It is before the spawning season has passed that we prefer the
herring, and it is only wh^le it is filled with roe that we care to eat the

THE ACT OP COPULATION 183

mackerel. A spent salmon is not fit food for man ; and, at this period,
as all fishermen are aware, the vivid colours of the trout disappear ;
and the fish retires exhausted and impoverished, until the vital forces
are regained. *

Repetition of the Act. — Whilst one individual will suffer for days after
a single attempt, or even from an involuntary emission, another will not
evince the least sign of depression, although the act be repeated several
times in succession or on several consecutive nights. Still, as a general
rule, the act is and ought to be repeated but rarely. In newly married
people, of course, sexual intercourse takes place more frequently, and
hence it happens that conception often fails during the first few months
of wedlock, depending probably upon the fact that the semen of the
male contains but few perfect spermatozoa : in such cases it is only
when the ardour of first love has abated, and the spermatozoa have
been allowed the time requisite for their full development, that the
female becomes impregnated.

This part of my subject will, however, occupy further attention when
I come to speak (page 191) of marital excesses. I may, however, here
state that the monthly periods, of course, put a temporary stop to
intercourse, while nature provides a further check upon its too frequent
repetition, in the effect which pregnancy produces on the female, and
through her upon the male.

If the married female conceives every second year, we usually notice
that during the nine months following conception she experiences no
great sexual excitement. The consequence is that sexual desire in the
male is somewhat diminished, and the act of coition takes place but
rarely. Again, while women are suckling there is usually such a demand
made on the vital force by the organs secreting milk that sexual desire
is almost annihilated. 1 Now, as experience teaches us that a recipro-
city of desire is, to a great extent, necessary to excite the male, we must
not be surprised if we learn that excesses in fertile married life are com-

1 We are apt to believe that in the human female it is almost impossible for gesta-
tion and lactation to go on simultaneously. In the mare, however, this occurs. In
large breeding establishments the mare is usually put to the stallion, and will " show
to the horse " nine days after a foal is dropped. The object of this of course is that
in eleven months she shall again give birth to another foal. This is the surest way
to obtain foals, although the produce of a mare after being a year barren is generally
stronger and presumably better than on her becoming with foal while suckling. In
fact, if left a twelvemonth barren, mares, I am informed by competent men, are
stinted with great difficulty.

The late Mr Blenkiron, a well-known breeder of race-horses at Middle Park,
kindly looked over this note, and he told me that, although this happens, mares often
require some little management " to show to a horse, although in season," and it is
necessary to put the twich on the nose to distract their attention, otherwise their
affection for the foal induces them " not to show to the horse, although in season."

184

SEXUAL INTERCOURSE

paratively rare, and that sensual feelings in the man become gradually
sobered down.

It is a curious fact that man and a few domesticated animals are alone
liable to suffer from the effects of sexual excesses. In a state of nature
wild female animals will not allow the approach of the male except
when in a state of rut, and this occurs at long intervals and only at
certain seasons of the year. The human female probably would not
differ much in this respect from the wild animal, had she not been civi-
lised, for as I shall have occasion again and again to remark, she would
not for her own gratification allow sexual congress except at certain
periods. The courtezan who makes a livelihood by her person may be
toujours pres, but not so the pregnant wife or nursing mother. Love
for her husband and a wish to gratify his passion, and in some
women the knowledge that they would be deserted for courtezans if
they did not waive their own inclinations may induce the indifferent,
the passionless, to admit the embraces of their husbands. These are
truths about which much ignorance and consequently much false
reasoning prevails. No portion of my book has more surprised un-
married men than such statements as these. Married men, however,
generally confirm my opinion, and not a few have acknowledged that
had wives been but judicious and consulted more the feelings of their
husbands, the Divorce Court would not have been so often appealed to,
nor would women have had cause to complain of there being so many
unfaithful husbands.

Besides this kind of natural protection against excesses, arising from
the periodical unwillingness of the human female to permit congress,
we find that there is not in men, particularly in the intellectual and
civilised man, any need for or natural impulse towards that excessive
periodical indulgence which we notice in the brute creation. The human
male is naturally prepared to copulate at all times of the year ; he is
not, therefore, instinctively required to repeat the act so many times
within a short period, as some domesticated animals are, for the purpose
of propagating the species. The ram has been supposed to repeat the
act from fifty to eighty times 1 in the course of one night. The stal-
lion 2 is, or rather ought to be, always limited to a certain number of

1 This statement has been doubted. It is founded on the hypothesis, perhaps
somewhat loose, that the chest and abdomen of a ram having been covered with
u ruddle " over night, and the haunches of fifty ewes found smeared with the same
composition in the morning, the animal had to such a numerical extent exercised
his generative functions. This may or may not be a sequitur ; but no manner of
doubt exists that the sexual power of the animal is, in fact, as well as proverbially,
very considerable; but let it be recollected that it is exercised only for a very short
time during the twelve months.

3 The late Mr Grey, who had the management of a large breeding establishment
at Theobalds, told me that the celebrated stallion " Teddington," who was then

THE ACT OF COrULATION 185

mares, but as he takes his mounts during a limited time (two or three
months), the act is necessarily repeated very often, and at very short
intervals.

Of course, these enormous copulative powers are not only not examples,
but positive contrasts to what should obtain in the human being. As
man has no real rutting season (which in animals appears to be a kind
of periodic puberty), there is no occasion, and therefore no provision, for
the sudden or excessive employment of his reproductive organs, and
consequently any such excesses will be fraught with much danger.
The brute, moreover, is deficient in the intellectual qualities of man :
propagation of his species appears to be about the most important of
the objects of his existence. Man is formed for higher purposes than
this. To devote the whole energy of his nature to sensual indulgence
is literally to degrade himself to the level of a brute, and to impair or
totally destroy those intellectual and moral capacities which distinguish
him from the inferior creation. Even in the lower animals a limit is
placed to sexual indulgence, and we find in some cases very curious
physical provisions for attaining this end.

Among the preparations in the College of Surgeons' Museum may
be seen the penis of the young tom-cat. It is described by Owen
in the catalogue as " penis of a cat, showing the retroverted callous
papillae of the glans," and it is covered with spinous-looking eleva-
tions, which, in connection, must give the female much pain. They
disappear in the old torn. The same conformation, and to a much
greater extent, exists in the guinea-pig. It is supposed that this
rugous .state of the male organ excites, if not anger, the greatest pain
in the female.

Mr. Thompson, late Superintendent at the Zoological Gardens,
corroborates the statement that in the feline race it is the female
that makes the noise. He notices it as occurring constantly in
leopards, tigers, lions, &c, and as presaging the conclusion of the
sexual act. He agrees with me that the female requires to lend

serving mares at his farm, was limited by his owner to forty-five mares during the
season, which lasts from February to July, but as it is desirable that mares should
foal early in the year, the repeated acts of connection were included in a compara-
tively short period. In addition to this, the same mare is repeatedly (about every
nine days) put to the horse, to secure impregnation. It appears, nevertheless, that
these stallions do not suffer, and Mr Grey was of opinion that this number, forty-five,
is not too much. In reply to my inquiries, he said that nothing but oats and hay
are given to these horses; beans are considered to heat them. He seemed not to
think that a horse can cover too much, but admits that he may too rapidly. He did
not allow any horse in his establishment to mount more than twice a day. Two trials
are generally advisable, as the first leap is often a failure. Country-travelling
stallions are said to have stimulants given them, and to have as many as two hundred
mounts in the season,

186 SEXUAL INTEKCOURSE

herself to the act, which is prolonged in this class of animals more
than in some others in consequence of the position of her sexual
organ.

To some such cause as this, I suppose, must be attributed the singular
facts observed by Owen with regard to the copulation of spiders. He
says — "The young and inexperienced male — always the smaller and
weaker of the sexes — has been known to fall a victim, and pay the
forfeit of his life for his too rash proposals. The more practised suitor
advances with many precautions, carefully feels about with his long legs,
his outstretched palpi much agitated. The female indicates acquiescence
by raising her fore feet from the web, when the male rapidly advances ;
his palpi are extended to their utmost, and a drop of clear liquid is
ejected from the tip of each clavate end, where it remains attached,
the tips themselves immediately coming in contact with a transverse
fleshy kind of teat or tubercle, protruded by the female from the base
of the under side of the abdomen. After consummation the male is
sometimes obliged to save himself by a precipitate retreat. The ordinary
savage instincts of the female — etiam in amoribus sceva — are apt to
return, and she has been known to sacrifice and devour her too-long
tarrying or dallying spouse."

It should be remembered that different rules apply to different
races. While the ram and the goat can copulate so frequently as to
excite our astonishment, one copulative act seems among other crea-
tures to satisfy all the requirements of nature for a very long period.
Thus, for instance, in certain birds coitus is only requisite once in the
season. In many parts of the country, where old women keep but one
turkey hen, she is sent to the distant cock only once in the season, yet
all the eggs laid during the year are fertile ones. In such cases all
the eggs must be impregnated at once, or the spermatozoa be hoarded
up in the cloaca till they are required.

Birds, I may here state, have no spermatheca, such as is found in
the bee.

The bee is the example which at once suggests itself of one impreg-
nation exhibiting the utmost limit of efficiency.

In the recent work of Siebold, translated by Dallas, entitled 'On
the True Parthenogenesis in Moths and Bees,' a very interesting
account is given of the act in the latter insects :

" It would appear that, whilst in the higher animals the male is the perfect and
ruling creature — the bull keeps together, and, as it were, governs the herd of cattle,
and the cock does the same by the hens — the reverse of this takes place in imootii
In the wasps, hornets, humble bees, ants, and especially in the bees, the perfect
female forms the central point, and holds the swarm together." (p. 40.) " Copula-
tion never takes place in the hive. When the queen takes her wedding flight in line
warm weather, she makes her selection of a male bee (drone), and the act takes place

SEXUAL ATTRACTION 187

in the air. It is very quickly completed, whereas other insects may remain for days
united in copulation. When the queen returns to the hive after this single copu-
lative act, the external orifice of the sexual apparatus, which was kept closed before
the wedding flight, stands open, and the torn male copulative organs remain sticking
in the vagina, and partly protrude from it. This eunuchism, Siebold says, not un-
frequently occurs in other insects, as in the beetles. In the particular case examined
by Siebold, the seminal receptacle (spermatheca), which is empty in all virgin female
insects, was in this queen filled to overflowing with spermatozoids.

" In the copulation of the queen the ovary is not impregnated, but this vesicle, or
seminal receptacle, is penetrated or filled by the male semen. By this, much — nay,
all — of what was enigmatical is solved, especially how the queen can lay fertile eggs
in the early spring, when there are no males in the hive. The supply of semen
received during copulation is sufficient for her whole life. The copulation takes place
once for all. The queen then never flies out again, except when the whole colony
removes. When she has begun to lay, we may without scruple cut off her wings, she
will still remain fertile until her death. But in her youth every queen must have
flown out at least once, because the fertilisation only takes place in the air; there-
fore no queen which has been lame in her wings from birth can ever be perfectly
fertile. I say perfectly fertile, or capable of producing both sexes ; for to lay drones'
eggs, according to my experience, requires no fecundation at all." (p. 41.)

"After this single fecundation a queen bee can for a long time (four or five years)
lay male or female eggs at will ; for by filling her seminal receptacle with male
semen she has acquired the power of producing female eggs ; whilst before copu-
lation, and with an empty seminal capsule, and therefore in the virgin state, she can
only lay male eggs." (p. 53.)

The possibility of the semen thus lying in the spermatheca is a fact
of great significance and importance, and illustrates the fact that
seminal animalcules will live and thrive in the upper portion of the
vagina long after they have been emitted from the testes.

Nature has, however, not only given the adult animal these instincts,
but provides in a most wonderful way for their gratification.

Sexual Attraction. — The devices, so to speak, which nature
employs to bring the sexes together, are among the most interesting
facts of zoology. No one can fail to notice the wonderful design
evinced in bringing the sexes together by means of a phosphorescent
light, as in the case with luminous insects. " The glowworm (Lam-
pyris noctiluca) is an animal resembling a caterpillar ; its light pro-
ceeds from a pale-coloured patch, that terminates the under side of
the abdomen. It is, indeed, the perfect female of a winged beetle,
from which it is altogether so different that nothing but actual
observation could have inferred the fact of their being the different
sexes of the same insect. The object of the light appears to be to
attract the male, since it is most brilliant in the female, and in some
species, if not all, is present only in the season when the sexes are
destined to meet, and strikingly more vivid at the very moment when
the meeting takes place. The torch which the wingless female,

188 t SEXUAL INTERCOURSE

doomed to crawl upon the grass, lights up at the approach of night,
is a beacon which unerringly guides the vagrant male to her 'lone
illumined form,' however obscure the place of her abode." 1 The
cause of this light is doubtless phosphorus, and we have reason to
suppose that this is expended to a great extent in the act of copula-
tion.

Marital Duties. — As I have advised continence, absolute and
entire, for the young and the unmarried, so not the less urgently
would I impress on the married the duty, for their own sakes, of
moderation in sexual indulgence.

None, perhaps, but medical men can know at all (and they can know
but a fraction of) the misery and suffering caused by ill-regulated
desires and extravagant indulgences among married people. (See
Marital Excesses, at page 191.)

Antiquity was sensible of the expediency of regulating to some
extent these indulgences. Many ordinances existed among ancient
nations for the purpose, of which I will give a few examples.

The following is a freely translated extract from the ' Uxor Hebraica '
of John Selden, lib. iii, cap. 6 (in his works, ed. 1646, vol. ii, pp. 717-
720):

"They would have the conjugal debt paid regularly by the husband in proportion
to the energy unused in his avocation. According to the Misna, a man was allowed
one or two weeks' leave of absence on the score of a religious vow of abstinence. Law
students were exempt. A weekly debt was forced upon artificers, but a daily one
upon vigorous young husbands having no occupation. Donkey-drivers (employed in
transport of merchandise, &c.) were liable once a week; camel-drivers (a calling
entailing much labour and travelling) once in thirty days ; sailors once (at any time)
in six months. This is according to the Rabbi Eliezer."

Solon required three payments a month, without reference to the
husband's avocations.

Mottray states in his ' Travels/ vol. i, p. 250, that the Turkish law
obliges husbands to cohabit with their wives once a week, and that
if they neglect to do so, the wife can lodge a complaint before a
magistrate.

My own opinion is that, talcing hard-worked intellectual married men
residing in London as the type, sexual congress had better not take
place more frequently than once in seven or ten days ; and when my
opinion is asked by patients whose natural desires are strong, I advise
those wishing to control their passions to indulge in intercourse twice
on the same night. I have noticed that in many persons a single
intercourse does not effectually empty the vasa differentia, and that
within the next twenty-four hours strong sexual feelings again arise ;
1 Kirby and Spence, vol. ii, p. 420.

MABITAL DUTIES 189

whereas, if sexual intercourse is repeated on the same night, the
patient is able to so restrain his feelings that ten days or a fortnight
may elapse without the recurrence of desire. The advantage of a
second emission may be further considered with reference to state-
ments on page 91, where I notice the probability that one vas
deferens is only emptied at each emission. I believe the non-obser-
vance of some such rule as this is a very frequent cause of sterility in
the female, as the spermatozoa are not fully formed.

The reader will remark that I specially desire to confine my remarks
to hard-worked, intellectual married men residing in London, and
every year's experience teaches me that I have done well in thus
limiting my remarks to the denizens of large cities. No one, perhaps,
more than myself is aware that strong muscular countrymen, who
have no occupation or mental drain on their systems, may and do
follow out a very different course, without any apparent detriment to
the system. On the other hand, I could point to the case of many a
married man suffering from derangement of health solely, or at all
events mainly, attributable to unsuspected sexual excesses, the best
proof of which is that the health becomes restored as soon as the
excesses are left off.

No one can deny that an enormous expenditure of semen can take
place in men as well as in animals, but I believe medical men them-
m h . a have only recently become aware of the amount of ill-health
and debility which follows the lavish waste of the seminal fluid in
those who, so to speak, cannot afford it. In my own experience I
have met with many persons who, as they look back to their past
career, regret that ignorance of nature's laws induced them to overstep
the bounds of prudence, and now attribute many of their ailments to
sexual excesses continued for a long period in ignorance that they
were excesses at all." 1

It should not be forgotten that excess, even among married people,
should be guarded against from higher motives than mere prudence.
On this view of the subject I will quote from Bishop Jeremy Taylor's
1 Kule and Exercises of Holy Living ;' in the chapter entitled " Eules
for Married Persons, or Matrimonial Chastity," he says :

"In their permissions and license, they must he sure to observe the order of
nature and the ends of God. He is an ill husband that uses his wife as a man treats
a harlot, having no other end but pleasure. Concerning which our best rule is, that
although in this, as in eating and drinking, there is an appetite to be satisfied, which
cannot be done without pleasing that desire, yet since that desire and satisfaction
was intended by nature for other ends, they should never be separate from those ends,

See further observations in chapter on Marital Excesses at page 191,

]90 SEXUAL INTERCOURSE

but always be joined with all or one of these ends, with a desire of children, or to avoid
fornication, or to lighten and ease the cares and sadnesses of household affairs, or to
endear each other; but never with a purpose, either in act or desire, to separate the
sensuality from these ends which hallow it.

"Married persons must keep such modesty and decency of treating each other
that they never force themselves into high and violent lusts with arts and misbe-
coming devices ; always remembering that those mixtures are most innocent which
are most simple and most natural, most orderly and most safe. It is the duty of
matrimonial chastity to be restrained and temperate in the use of their lawful plea-
sures ; concerning which, although no universal rule can antecedently be given to all
persons, any more than to all bodies one proportion of meat and drink, yet married
persons are to estimate the degree of their license according to the following pro-
portions. — 1. That it be moderate, so as to consist with health. 2. That it be so
ordered as not to be too expensive of time, that precious opportunity of working out
our salvation. 3. That, when duty is demanded, it be always paid (so far as in our
powers and election) according to the foregoing measures. 4. That it be with a
temperate affection, without violent transporting desires or too sensual applications.
Concerning which a man is to make judgment by proportion to other actions and
the severities of his religion, and the sentences of sober and wise persons, always re-
membering that marriage is a provision for supply of the natural necessities of the
body, not for the artificial and procured appetites of the mind. And it is a sad
truth that many married persons, thinking that the floodgates of liberty are set
wide open, without measures or restraints (so they sail in the channel), have felt the
final rewards of intemperance and lust by their unlawful using of lawful permissions.
Only let each of them be temperate, and both of them be modest. Socrates was wont
to say that those women to whom nature hath not been indulgent in good features
and colours should make it up themselves with excellent manners, and those who
were beautiful and comely should be careful that so fair a body be not polluted with
unhandsome usages. To which Plutarch adds, that a wife, if she be unhandsome,
should consider how extremely ugly she should be if she wanted modesty ; but if she
be handsome, let her think how gracious that beauty would be if she superadds
chastity/' (P. 70, Bell and Daldy edition, 1857.)

Let me add the advice of a still older writer, who, on these subjects,
amid much quaintness has many most sound and excellent remarks —
Chaucer.

"And for that many a man," he says," " weeneth he may not sinne for no lecherous-
ness that he doth with his wife, certes that opinion is false ; God wot a man may
slay himself with his own knife, and make himself drunk with his own tun. Man
should love his wife by discretion — patiently and temperately

" Then shall man understand that for three things a man and his wife may fleshly
assemble (come together). The first is in intent of engendure of children to the
service of God — for certes that is the cause final of matrimony. The second cause is
to yield every of them his debt unto other of his body, for neither of them has power
of his own body. The third is to eschew lechery and villany. The fourth forsooth

is deadly sin Understand that if they assemble only for amorous love, and

for none of the foresaid causes, but for to accomplish that burning delight, they reek
never how oft, soothly, it is deadly sin; and yet, with sorrow, some folk will more
pain them for to do, than to their appetite sufficeth.'' (' Chaucer's Canterbury Tales, 1
" The Parson's Tale.")

MARITAL EXCESSES 191

CHAP. V.— MAKITAL EXCESSES

It is a common notion among the public, and even among profes-
sional men, that the word excess chiefly applies to illicit sexual connec-
tion. Of course, whether extravagant in degree or not, all such
connection is, from one point of view, an excess. But any warning
against sexual dangers would be very incomplete if it did not extend
to the excesses too often committed by married persons in ignorance
of their ill-effects. Too frequent emission of the life-giving fluid, and
too frequent sexual excitement of the nervous system, are, as we have
seen, in themselves most destructive. The result is the same within
the marriage bond as without it. The married man who thinks that,
because he is a married man, he can commit no excess, however often
the act of sexual congress is repeated, will suffer as certainly and as
seriously as the unmarried debauchee who acts on the same principle
in his indulgences — perhaps more certainly, from his very ignorance,
and from his not taking those precautions and following those rules
which a career of vice is apt to teach the sensualist. Many a man
has, until his marriage, lived a most continent life ; — so has his wife.
As soon as they are wedded, intercourse is indulged in night after
night ; neither party having any idea that these repeated sexual acts
are excesses, which the system of neither can with impunity bear, and
which to the delicate man, at least, is occasionally absolute ruin. The
practice is continued till health is impaired, sometimes permanently ;
and when a patient is at last obliged to seek medical advice, his usual
surgeon may have no idea or suspicion of the excess, and treat the
symptom without recommending the removal of the cause, namely
the sexual excess ; hence it is that the patient experiences no relief
for the indigestion, lowness of spirits, or general debility from
which he may be suffering. If, however, the patient comes under
the care of a medical man in the habit of treating such cases, the
invalid is thunderstruck at learning that his sufferings arise from
excesses unwittingly committed. Married people often appear to
think that connection may be repeated just as regularly and almost as
often as their meals. Till they are told of the danger, the idea never
enters their heads that they have been guilty of great and almost
criminal excess ; nor is this to be wondered at, since the possibility of
such a cause of disease is seldom hinted at.

Some years ago a young man called on me, complaining that he was
unequal to sexual congress, and was suffering from spermatorrhoea,
the result, he said, of self -abuse. He was cauterised, and I lost sight
of him for some time, and when he returned he came complaining that

192 MARITAL EXCESSES

he was scarcely able to move alone. His mind had become enfeebled,
there was great pain in the back, and he wished me to repeat the
operation.

On cross-examining the patient, I found that after the previous cau-
terization he had recovered his powers, and, having subsequently
married, had been in the habit of indulging in connection (ever since I
had seen him, two years previously) three times a week, without any
idea that he was committing an excess, or that his present weakness
could depend upon this cause. The above is far from being an
isolated instance of men who, having been reduced by former excesses,
still imagine themselves equal to any excitement, and when their
powers are recruited, to any expenditure of vital force. Some go so
far as to believe that indulgence may increase these powers, just as
gymnastic exercises augment the force of the muscles. This is a
popular error, and requires correction. Such patients should be told
that the shock on the system, each time connection is indulged in, is
very powerful, and that the expenditure of seminal fluid must be par-
ticularly injurious to organs previously debilitated. It is by this and
similar excesses that premature old age and debility of the generative
organs is brought on.

A few months later I again saw this young man, and all his symp-
toms had improved under moderated indulgence, care, and tonics.

In 1856, a gentleman, twenty -three years of age, who had been
married two years, came to me in great alarm, complaining that he
was nervous, and unable to manage his affairs. There was pain in his
back, the least exertion caused him to perspire, and he had a most
careworn countenance. I may further mention that he had been
highly scrofulous as a boy. I learnt that he had married a young
wife, and fearing that he might be considered a Joseph, as he had
never known woman beforehand (although he acknowledged to having
been guilty of evil practices at school), he unconsciously fell into
excess, and attempted connection nightly ; latterly, erection had been
deficient, emission was attended with difficulty, and he felt himself
daily less able to discharge what he thought were his family duties.
Having read my book, he came to me for relief, and was extremely
surprised at finding that I considered he had committed excesses, believ-
ing that after marriage frequent intercourse could not be so termed.
This history was given with such a naif air, that I was obliged to
yield implicit credence to it. I desired him to put a check on his
sexual feelings, and as a remedial measure ordered him phosphorus.

In December, 1861, a stout, florid man, about forty-five years of
age, was sent to me by a distinguished provincial practitioner, in con-
sequence of his sexual powers failing him, and one of his testes being
smaller than the other. On cross-examination I found that he had

MARITAL EXCESM - 1D3

been married some years, and had a family. Connection had been
indulged in very freely, when, about four years ago, a feeling of
nervousness insensibly came over him, and about the same time his
sexual powers gradually became impaired. The real object, he
avowed, which he had in coming to me was to obtain some stimulus to
increase his sexual powers, rather than to gain relief for the nervous-
- and debility under which he was labouring. Indeed, at his own
request, the efforts of the country practitioner had been made in the
former direction. Instead of giving remedies to excite, I told him
that his convalescence must depend upon moderate indulgence, and
allowing the system time to rally, and treated him accordingly.

The lengths to which some married people carry excesses is per-
fectly astonishing. I lately saw a married medical man who told me
that for the previous fourteen years, he believed, he had never allowed
a night to pass without having had connection, and it was only lately,
on reading my book, that he had attributed his present ailments to
marital excesses. The contrast between such a case as this, where an
individual for fourteen years has resisted this drain on the system,
and that of a man who is, as many are, prostrated for twenty-four
hours by one nocturnal emission, is most striking. This great dis-
parity is further discussed at p. 110. All experience however, shows
that, whatever may be the condition of the nervous system, as regards
sexual indulgences, excesess will sooner or later tell upon any frame,
and can never be indulged in with impunity. I believe general
debility and impaired health dependent upon too frequent sexual rela-
tions to be much more common than is generally supposed, and that
they are hardly yet sufficiently appreciated by the profession as very
fruitful causes of ill-health.

I will give one more instance. A medical man called on me, saying
he found himself suffering from spermatorrhoea. There were general
debility, inaptitude to work, and disinclination for sexual intercourse ;
in fact, he thought he was losing his senses and the sight of one
eye was affected. The only way in which he lost semen was, as he
thought, by slight occasional oozing from the penis. I asked him at
once if he had ever committed excesses. As a boy, he acknowledged
having abused himself, but he married seven years previously to his
visit to me, being then a hearty, healthy man, and it was only lately
that he had been complaining. In answer to my further inquiry, he
stated that since his marriage he had had connection two or three
times a week, and often more than once a night. This one fact, I was
obliged to tell him, sufficiently accounted for all his troubles. The
symptoms he complained of were similar to those we find in boys who
abuse themselves. It is true that it may take years to impair the
health of some exceptionally strong men, just as it may be a long time

194 MARtTAL EXCESSES

before some boys are prejudicially influenced, but the ill effects of
excesses are sooner or later sure to follow.

Since my attention has been particularly called to this class of ail-
ments, I feel confident that many of the forms of indigestion, general
ill-health, hypochondriasis, &c, so often met with in adults, depend
upon sexual excesses. The directors of hydropathic establishments
must probably hold some such opinions, or they would not have
thought it expedient to separate married patients when they are
undergoing the water treatment. That this cause of illness is not
more widely acknowledged and acted on, arises from the natural
delicacy which medical men must feel in putting such questions to
their patients as are necessary to elicit the facts.

I have often been surprised at the immediate and manifest benefit
produced in these cases by enjoining moderate indulgence or complete
abstinence, together with the local treatment previously detailed under
the head of Spermatorrhoea (p. 161), when other remedies in the hands
QJLoflier practitioners had entirely failed.

It may very naturally be asked, what is meant by an excess in sexual
indulgence ? The simple reply is, the same as in any other indulgence.
An excess is what injures health. I have at page 188 stated that,
according to my experience, few hard-working intellectual married men
should indulge in connection oftener than once in seven or perhaps ten
days. This, however, is only a guide for strong, healthy men. Gene-
rally, I should say that an individual may consider he has committed
a,n excess when coitus is succeeded by languor, depression of spirits,
and malaise. This is the safest definition ! Such results should not
happen if the male be in good health and indulge his sexual desires
moderately.

No invariable law can be laid down in a case where so much must
depend upon temperament, age, climate, and other circumstances, as
well as the health and strength of both parties. I maintain that
in highly civilised communities the continuance of a high degree of
bodily and mental vigour is inconsistent with more than a very
moderate indulgence in sexual intercourse. The still higher prin-
ciple also holds good that man was not created only to indulge his
sexual appetites, and that he should subordinate them to his other
duties.

It is not the body alone which suffers from excesses committed in
married life. Experience every day convinces me that much of the
languor of mind, confusion of ideas, and inability to control the
thoughts of which some married men complain, arises from this cause.
These ill effects are noticed not unfrequently in patients who have
married late in life, and still more often in persons who have married
a second time after having been widowers for some years.

CELIBACY 195

The ill ( t;il excesses ore not cc>nfined to the offending

parties. No doubt can exist that many of the obscure cases of sickly-
children born of apparently healthy parents arise from this cause, and
this is borne out by investigations amongst animals.

M. Goddard has related some interesting experiments made at the
Haras of Poitou on the liquid ejaculated by stallions in their different
jumps on the same day. He has established that the semen, which
was tolerably thick and very opaline, of an amber colour, in the first
jump, became more and more clear, and less and less thick, so that
after the fourth jump the liquid was absolutely like water, and
scarcely contained any animalcules. It was thus easy by the eye alone
to distinguish the semen ejaculated by the same animal at different
times of the day. According to the same observer, the semen of the
first jump of a morning would possess alone certain fecundating pro-
perties, and in a covering establishment it would be advantageous to
allow the same animal only one jump a day ; one jump every second
day would be even preferable. By acting in this way the owner
would obtain a better result than by obliging stallions to jump four or
five times in the twenty-four hours. — ' Traite de Physiologie Longet,'
p. 779.

I have no similar experiments to quote in regard to the human male,
but I have little doubt that similar results would be observed were
the semen examined in persons accustomed to marital excesses. Those,
therefore, who are desirous of procreating healthy offspring will do
well to bear this advice of mine in mind, and the result will show that
the advantages of self-restraint are much more marked than are gene-
rally supposed.

CHAP. VI.— CELIBACY

The term " celibacy " should mean continence enforced on one who
is of a fit age to marry. Continence in mere boys and very young
men is not what we are now speaking of. After what has preceded I
shall take it for granted that every rational person must be an advocate
for celibacy, or rather, the strictest continence (p. 15), in the very young,
and ready to admit that with a view to the full development of their
being (thej should not only physically abstain, but so exercise their
wills as not to allow their thoughts to dwell on sensual matters^

I believe I have already mentioned the fact that in children,

precocious and strong sexual desires are often accompanied by and

produce a dull intellect, and in the adult it is similarly found that

(tne inordinate exercise of the sexual organs frequently annihilates the

intellectual faculties?) It is an undoubted fact that we meet with a

196 CELIBACY

large proportion of unmarried men among the intellectual, and some
of the ablest works have been written by bachelors. Newton and
Pitt were single, Kant disliked women. " They do best," says Bacon,
" who, if they cannot but admit love, yet make it keep quarter, and sever
it wholly from their serious affairs and actions of life ; for if it check
once with business, it troubleth men's fortunes and maketh men that
they can no ways be true to their own ends."

It was doubtless from such considerations as these that our ances-
tors ordained that college fellows at the universities should remain
single. Similar reasons probably had their influence in inducing the
church of Eome to prescribe that their priests should take vows of
celibacy.

Whether or not the Roman Catholic priest continues celibate may
not much interest the English public j 1 but whether college fellows at
the universities should be allowed to marry, has occupied a good deal
of attention during the last few years.

As to that chaste form of continence, celibacy, which is practised by
a certain number of both sexes under the dominion of ideas which are
of the highest order, it is undisputed that this voluntary paralysis of
the reproductive organs protects the individual from the greater part of
the affections that I have described as mainly occasioned by inordinate
and too early exercise of the generative organs.

In former editions of this work I asserted that in the adult the
intellectual qualities are usually in an inverse ratio to the sexual
appetite.

It has been pointed out to me that there are so many exceptions to
this rule, that I have thought it necessary to modify the language in
which I have expressed my views. ^1 maintain that debauchery
weakens the intellect and debases the mental powers, and I reassert
my opinion that if a man observes strict continence in thought as well
as deed, and is gifted with ordinary intelligence, he is more likely to
distinguish himself in liberal pursuits than one who lives inconti-
nently, whether in the way of fornication or by committing marital
excessesX The strictest continence, therefore, in the unmarried, and
very moderate sexual indulgence in the married state, best befit any
one engaged in serious studies. In making this statement, however, I
am bound to admit thaiyn practice we meet with a large number of
young men of more than average abilities, but of a delicate consti-
tution, who cannot remain continent without becoming subject to

1 Bergeret says, " As physician during many years to religious societies I have never
seen serious affections of the organs of generation in these communities."

" Continent celihacy, however, produces on the health other conseqnences not less
severe, particularly in women; here the annihilation of the grand functions of
maternity causes its victim to become phthisical."

CELIBACY 197

frequent nocturnal emissions. When this is the case, the sufferer may
be intellectually in a worse plight than if he were married, and so
occasionally indulged in sexual intercourse^ In these exceptional
instances it is not true that celibacy is the state best adapted to intel-
lect ual excellence. Of this I have had satisfactory evidence year by
year. Numbers of men studying at the universities come to me com-
plaining that, although living a continent life, they have become so
troubled by emissions that they are unable to pursue for any length of
time hard or continuous intellectual work ; their memories fail them,
and their health becomes impaired. Under appropriate treatment the
constitution rallies, and the intellectual powers are restored. From
these and other cases that come under the care of the medical practi-
tioner, it appears that celibacy in the adult is not unattended with
danger to exceptional temperaments. These dangers, however, it
should never be forgotten, very seldom attend perfect continence. It
will be generally found that they are merely the penalty of past indul-
gences. Robust, energetic men are seldom troubled in this way — at
least without some fault of their own. In all such cases incontinence
is not the remedy that should be recommended, but gymnastic exer-
cise, appropriate diet, and such measures as improve the health. It
is, as we have seen (p. 28), the almost universal rule that all men,
old and young, who have led a continent life, so long as they continue
to give themselves up to study, and take proper exercise, will not be
troubled with strong sexual desires. Nevertheless, when any period
of temporary idleness suspends the celibate's regular work, the sexual
feeling will often reappear with redoubled force, and then real distress
and often illness may ensue. Self-control is followed by nocturnal
emissions, which may so increase in frequency as seriously to impair
the health, while the evil results — due as I maintain to the inordinate
loss of the vital fluid, semen — are attributed to previous hard work.
The patient is supposed to labour under indigestion, heart disease, or
general debility, and is ineffectually treated for them, whereas the
medical man, instead of treating symptoms, should at once proceed
resolutely to check the emissions — the cause of the ailment.

It has been my duty to investigate the causes of several instances of
clerical scandal, and I have reason for believing that the seeds of a
vicious life may have been sown in days when a man, prevented from
marriage either by lack of means or by holding a celibate fellowship
or by any similiar cause, and being in a state of idleness with no
incentive to exertion, has been led away by his passions to indulge in a
course of illicit intercourse, which he might have excaped if, like
others, he could have married. 1

1 Bergeret thus speaks of celibacy : — " Is celibacy a sure refuge from all chances
of disease? No! celibacy leading to illegitimate unions, to debauchery, anil the

198 EARLY BETROTHALS. — LONG ENGAGEMENTS

Admitting, then, as I do that celibacy is attended with many draw-
backs and temptations, and much sexual and mental suffering, I still
consider that it is the necessary condition of the young, while in the
adult, although it is in many instances attended with some inconveni-
ences, that these may be obviated, or at all events sensibly relieved, by
due medical supervision. Unmarried men who intend to lead a celibate
life must not believe that they can do so if they indiscriminately indulge
in the pleasures of the table ; for them abstemious diet, and regular
and almost exhausting exercise under proper medical supervision, are
absolutely essential, and so assisted, they may with impunity to them-
selves, and with advantage to society, continue to lead a celibate life.

CHAP. VII.— EAELY BETEOTHALS.— LONG ENGAGEMENTS

In a work entitled ' A Fraternal Address to Young Men,' issued by
the Young Men's Christian Association, early engagement is recom-
mended. The author says, p. 52 : — " Let the affections be engaged,
and the prospect of marriage occupy the mind. If such betrothal be
truthful and preserved in fidelity many advantages beyond those
already hinted at would be enjoyed."

This opinion has been entertained by many excellent men ; but if we
examine it from a medical point of view, it is very doubtful, to say no
more, whether it is desirable for any youth, who has his way to make
in the world, to attach himself to a girl early in life, however purely
and faithfully. If an adult is in a position to marry, by all means let
him do so. If his sexual desires are strong, the power of the will
deficient, and his intellectual faculties not great, early marriage will
keep him out of much mischief and temptation. All medical expe-
rience, however, proves that for any one, especially a young and sus-
ceptible man, to enter into a long engagement without any immediate
hope of fulfilling it, is physically an almost unmitigated evil. It is
bad for any one to be tormented with sexual ideas and ungratified
desires year after year. The frequent correspondence and interviews
cause a morbid dwelling upon thoughts which it would be well to
banish altogether from the mind ; and I have reason to know that this
condition of almost constant excitement has often caused not only
dangerously frequent and long-continued nocturnal emissions, but
most painful affections of the testes. These results sometimes follow
the progress of ordinary courtships to an alarming extent. The

Hbertinage of bachelors, presents more inconveniences than that which exiltl UBOftg
married people." (See ' Aunalcs d'Hygiene/ torn, xx, iv, p. 34.)

EARLY BETROTHALS. — LONG ENGAGEMENTS 199

danger and distress may be much more serious when the marriage is
postponed for years.

I am aware that to the more romantic of my readers these warnings
may be very distasteful. Their idea of love is that it is a feeling too
pure and spiritual to be denied with any earthly alloy. I confess that
I doubt whether any but the inexperienced really entertain this notion.
During the first passionate delight of an attachment, no doubt, the
lower and more mundane feelings are ignored. But they are present,
nevertheless; and according to my professional experience, are
tolerably certain to be aroused in every case, sooner or later. Of
course, where the affection felt is true and loyal, they may be corrected
and kept within the strictest bounds of the most respectful tender-
ness ; to do this, however, in the case of a protracted engagement is
a far harder task than the ardent and poetical lover allows himself at
first to think.

The suffering caused by the repression of continually excited feelings
that cannot be gratified, is often very great.

I am very far from wishing to degrade love to the level of mere animal
passion ; on the contrary, it should be a true and deep anion of the whole
nature, every part taking in this, as in all other matters, its own place.
To ignore the bodily and secular aspect of it, however, would be as
false and unwise, though not so degrading, as to forget the mental and
spiritual.

It is, indeed, more than false and unwise, it is dangerous. Experi-
ence too often proves that what has commenced as a pure and most
refined attachment may end very differently, if not most carefully
guided. And this guidance, as I have said, may involve much trouble-
some and almost dangerous distress.

Continence from all sexual excitement in thought and deed is my
advice to all young men ; and even the adult, who is not in a position
to marry, had better divert his thoughts from sexual matters as much
as possible. It is wiser for him to devote himself altogether to his
profession, instead of having to divide his attentions between a fiancee
and his success in life. When the latter is attained, it will be time to
think of the former. He will then be in a better position to select his
partner for life.

Socially speaking, too, these long or early engagements often
turn out badly. Hope deferred not only makes the heart sick, but
the temper sour. Differences that the closer bond of marriage would
have healed at once, or never allowed to arise, become permanent
sources of disagreement, and very often the parties have to regret
a youth that has been rendered less useful and less happy by an
engagement which has at last to be broken off, after much suffering,
to the mutual relief of both.

200 EABLY BETEOTHALS. — LONG ENGAGEMENTS

George Herbert says, in his ' Church Porch :'

" Wholly abstain, or wed — tby bounteous Lord
Allows the cboice of paths — take no by-ways,

But gladly welcome what He doth afford,
Not grudging that thy lust hath bounds and stays j

Continence has its charms — weigh both, and so

If rottenness have more, let heaven go.'*

In the case of young men, however, the rules above laid down apply
with nearly equal force to early marriages. Lycurgus forbad any man
to marry under the age of thirty — a state of celibacy probably well
adapted to the times. As to early marriages I can only say that
marriage, even for a young man, is better than fornication. But the true
remedy, it cannot be too often repeated, for sexual distress in youth is
a training to continence, not indulgence, even lawful. Those are in
error who think that early marriages are advisable on the theory that
there is no alternative.

After a pretty wide experience I should lay it down as a rule that
marriage for the very young is not only not in any sense necessary,
but is an evil, both from a medical and a social point of view.

No medical man, I hold, should ever recommend the hardly-worked
metropolitan population to marry early. Marriage is not the panacea
of all earthly woes, or the sole correction of all earthly vices. It often
interferes with work and success in life, and its only result is, that the
poor man (poor in a pecuniary point of view) never reaches the bodily
health or social happiness he might otherwise have reasonably expected.
Under the age of twenty-five, I have no scruple in enjoining perfect
continence. The sighing lackadaisical boy should be bidden to work,
righteously and purely, and win his wife before he can hope to taste
any of the happiness or benefits of married life.

THIRD DIVISION
IMPOTENCE

Impotence is the term commonly applied to a state of inability to con-
summate marriage, and to all those morbid conditions in man opposed
to the physiological union of the two sexes, that is, coition. Such
inability is most commonly due to some derangement or deficiency of
either the erectile or the emitting forces.

I have not been altogether free from doubt whether the subject of
impotence should not have been treated as a part of my second division,
under the head of disorders of erection; but partly on account of its great

IMPOTENCE, ITS CAUSES 201

importance, and partly that it has a sort of bifold nature, being from
one aspect a result of disease, and from another an abnormal physical
condition, I have determined to place it in a separate division by
itself.

" True impotence," says Lallemand, " consists in want of power in
connection, not once, but habitually; not only with courtesans, but
with those whom we most love ; not under unfavorable circumstances,
but during long periods of time, say, five, fifteen, or twenty years, when
married to lovely and handsome women, whose devotion to their
husbands has never been questioned." (Vol. ii, p. 242.)

That this lamentable state of things truly exists there can be no
doubt, and in London those whose attention is devoted to diseases of
the reproductive organs occasionally meet with cases in which there
appears to be complete annihilation of all the sexual feelings and
actions, and in which the man is reduced to what Eoubaud describes
as generative syncope. Such instances, however, are rare. Usually it
happens, at least in England, that the functional diseases requiring
treatment consist in the absence of only one or more of the conditions
necessary for coition. In the East, I am told, the Levantines are often
utterly impotent before they arrive at the age of thirty. If report
speaks correctly, Hien Fung, a recent Emperor of China, was in this
condition.

The forms that impotence assumes are various, though the result is
the same in all cases, viz. inability to perform the sexual act. Thus,
a man may be utterly impotent whether he has or has not erection
attendant on desire — again, there may be only a partial erection,
lasting an insufficient length of time for penetration — or the erection
may be so weak — or the emission so quick, as practically to render the
man impotent — or a man may be impotent from emission not taking
place at all — or emission may not occur until some time after connec-
tion has been attempted.

Causes. — I fear we must come to the conclusion that when there is
desire, and merely a want of power, this state of things arises from
abuse of the generative organs, aggravated in most instances by alarm,
a guilty conscience, diffidence, habits of intemperance, or too free use
of tobacco, from timidity, or from too frequent excitement without
gratification.

The exact way in which these causes produce the effects of impotence
is not certainly known, but it is most probably by occasioning lesions
of the nervous system, which is under the influence of the sympathetic
nerve or excito-motoiw system.

It is abundantly clear that this state is susceptible of many different
degrees, and is induced by various and conflicting causes. I propose
in the following chapter to inquire with more precision than has hereto-

202 IMPOTENCE, ITS CAUSES

fore been attempted into the nature and character of impotence, and to
indicate as accurately as possible the lines of demarcation between the
curable and incurable forms.

Aptness for and desire of coition is the invariable condition of every
young and healthy adult. Impotence is the term applied to the absence,
whether temporary or permanent, of this condition. Considering
the important issues dependent upon the presence or absence of virile
power, it might be expected that the term indicating its absence would
be the subject of very careful scientific analysis and exact definition.
Strange to say, this is so far from being the case that I believe I may
safely say that there is no term in the whole medical repertory more
loosely used. In this term impotence as ordinarily used there are
included disorders of the most opposite character. It is applied alike
to cases of physical malformation, which preclude all possibility of
intercourse, and to the various morbid conditions in man or woman
which are opposed, without any apparent malformation, to the physio-
logical union of the two sexes ; in other words, general inability to
consummate marriage, no matter from what cause, is loosely termed
impotence. The careless application of this term to various states
differing widely from each other, both in their origin and general
characteristics, has given rise to great confusion of ideas. If the old
nomenclature be adhered to, impotence will perhaps be best described
under the two divisions : — 1. Temporary or false impotence ; 2. True
impotence. It would, however, be more convenient to abstain from
making identical in name things absolutely different in kind.

With the view, therefore, of marking off more accurately conditions
which are susceptible of treatment from the one that is incurable, I
shall adopt a different nomenclature to that hitherto in vogue.
Aptness for and desire of coition, whether in esse or in posse I shall
term virility, while as distinguished from impotence, or the absence of
virility, I shall collect under the term of abeyance of virility, the
various morbid conditions opposed to the physiological union of the two
sexes. Under this latter general heading I may class sexual indifference
or temporary absence of desire, absence or deficiency of power, and
inability to consummate marriage.

IMPOTENCE 203

SECT. L— SEXUAL INDIFFERENCE, OR TEMPORARY ABSENCE OF

DESIRE,

May again bo subdivided into two heads : 1st. Where desire has never
been felt ; '2nd. Where desire once experienced has been lost. It may
occur either among married men or unmarried, but is naturally more
frequently met with among the latter, and to it I may, therefore, first
call attention.

Sexual Indifference among Single Men. — This condition may
arise from a variety of causes. We find, for instance, that some men
reach adult age without having experienced any sexual desire at all.
That complete sexual quiescence which we have noticed as being the
proper condition of childhood continues in such cases during the
period of youth, extending even into adult age.

In some it is only at an abnormally late period that the natural
sexual desire commences ; this delay in the development of the repro-
ductive powers gives rise to a variety of surmises, but curiously enough
the subject of the deficiency may be the last person surprised at the
delay in the appearance of sexual feeling, and it is often only acci-
dentally that a medical man is consulted about it at all.

I shall be told, and no doubt with some truth, that this continued
sexual quiescence is a perfectly abnormal state of things ; it is never-
theless one with which I am very familiar, and is far more frequently
met with than is generally supposed. It occurs principally where the
intellectual powers have been very highly cultivated or where the
body has been subjected to strong and constant physical exertion. I
have met with it alike in the very delicate and the very robust. Fat
youths and stout young men often exhibit this peculiarity. A large
class of men commonly supposed to be nervous, bashful, or timid, are
in fact sufferers from this absence of sexual feeling, which may, perhaps,
be due to their having been brought up in retired country places without
any female companions. They can hardly be said to have lost that of
which they had never had experience, or to have failed to exercise
powers of whose very existence they are unconscious. Failure implies
in the very term unsuccessful effort, and how can this be predicated of
persons who have made no attempt at all ? It would be obviously
erroneous to conclude without further evidence that any individual
of this class is in fact impotent, when all that can be said of him is
that his life has been perfectly chaste, and undisturbed by the usual
virile phenomenon.

It will be found that this class is again subdivided into — 1st. Persons
who have no wish to marry ; 2nd. Persons who are afraid to marry.
It is hardly too much to say that cases of absence of virility or true

201 TEMPORARY ABSENCE OF DESIRE

impotence are furnished almost exclusively by the former subdivision.
The desire to marry indicates the presence or, at all events, possibility
of potency. I have frequently been consulted in the course of my
practice by sufferers from the latter subdivision.

The following is a not unfrequent phase of this affection. A young
man has been continent all his life. When his studies are completed,
and his university career is drawing to a close, he forms an attachment
which in every way is desirable, but he thinks he has reason to believe
himself impotent. If occasionally subject to nocturnal emissions, or if
on going to the water-closet or even after passing water some slightly
tenacious fluid escapes, the youth imagines that these are signs of
impotence, that his happiness is marred — that he is incapable of
marriage. If, unfortunately, he has been guilty as a boy of self-abuse
the conviction comes home to him that he deserves the personal
chastisement inflicted on him ; and with all the self-sacrifice of youth
he deems himself unworthy to have a wife, and in a fit of despair pro-
poses breaking off the engagement, declaring that whatever his own
sufferings may be he never will sacrifice the happines of the woman
whom he has selected to be his partner. It is well if such a man, in this
despondent mood, consults a competent and judicious medical man.
In too many instances pride, or his stricken conscience, or ignorance,
or the fear of entrusting his secret to any human ear, brings about a
state of mental and bodily prostration that must be seen to be appre-
ciated. No one but those who have witnessed the condition of the
sufferer can form any idea of the hell upon earth which these conscience -
stricken penitents carve out for themselves. I can testify to the
enormous numbers that annually consult us, and well it is for them
if they do not resort to the quacks. It is such sufferers as these that
furnish funds for the advertising firms who fill the pages of some
of our country and London journals with their trashy advertisements.
These harpies fatten on the ignorance and prejudices of their patients,
humour their fears, increasing and exaggerating the supposed
symptoms, and only turning them adrift when they have emptied their
pockets. If, however, a sympathetic and competent medical man be
consulted, he can conscientiously inform such sufferers that a youth
on first falling in love is often beset by these alarms, which I have
classed under the symptoms of false impotence, and that a little
sympathy on the part of the surgeon, with some confidence on
the part of the patient, and the treatment recommended at page 32,
will suffice to effect a cure, and to justify his being advised to marry.
It is important and most satisfactory to the medical man to be able
to say to such a patient, "Wait, and you will witness your sexual
feeling recur with redoubled power, and care must be taken lest
escapes follow the restoration."

POBAJtt ABSENCE OF DESIRE 205

It is difficult for persons riot engaged in actual practice, or who are
not in the habit of seeing supposed impotent men, to credit how
numerous is the class of those who, without adequate cause, believe
themselves to be impotent. I now mention the following case which
is similar to many others I see weekly. It was that of an officer in the
army who after serving with great distinction came to me asking my
opinion as to his fitness to marry. After subjecting him to treatment
1 -auctioned his marriage, but the day previous to the one fixed for
t he wedding, he returned to me in great alarm under the belief that he
was utterly incompetent to perform his marital duties. He founded
this opinion on a fancied want of sexual power indicated by absence
of morning erections, occasional passing away of semen, and a dread of
the consequences of failure. After hearing his statement I assured him
of the needlessness of his alarm, and his subsequent experience coin-
1 with the opinion I expressed.
I was lately attending another patient, an Indian of some rank, who
consulted me for sexual debility. I treated and soon cured him ; with
my sanction he married, though not without certain misgivings on his
part ; he returned to me within a week after his marriage, stating that
in his opinion, although partially successful, he had failed in consum-
mating the marriage. I sent him back to his wife, and not having
seen him since feel confident that he has proved himself an efficient
husband. If this gentleman had married without first obtaining the
benefit of medical advice, I have not the slightest doubt that his wife
might have sought for and obtained a divorce on the ground of his
impotence.

A distinguished artist once called on me to obtain my opinion as to
whether he might marry. Over-work had apparently weakened his
frame, and in the course of conversation he also told me that he had
drawn much from the nude figure. He had acquired through constant
practice such complete self-control that he suffered little from sexual
itement. He had become, a short time previously to his visit to me,
attached to a very charming and intellectual lady, but hesitated to
propose to her without my sanction, fearful lest he should be incom-
petent to fulfil his marital duties. I told him I had some doubt about
the amount of assistance I could give him, as I was fully aware of the
influence imagination exerts on the sexual organs. I did all I could
firstly to improve his general health, enjoining him to exercise his
brain less and his muscles more than he had previously been in the
habit of doing. I forbade him to see the lady often, I cauterized the
urethra, and finding that he rallied I gave my sanction to his marriage,
and have every redlon to believe that it was happily consummated.

Here, again, is an instance of partial impotence which must have
become permanent had the patient neglected to consult a medical man.

208 TEMPORARY ABSENCE OF DESIRE

This want of self-confidence once established is very difficult to
remove, and unless suitable measures are taken to remedy early this
supposed inability, temporary impotence may assume a permanent form.
I am convinced, however, that most of these forms of impotence are
remediable if only early and proper treatment be pursued.

Long experience has completely satisfied me of the soundness of the
principle here laid down, and I trust to see it more widely adopted
than it has hitherto been by the medical profession generally. As
will be seen hereafter, the confusion prevailing among those who should
be better informed has extended to the courts of law, and I fear that
in many cases decrees of nullity of marriage on the ground of impotence
have been pronounced, when all that was wanting to supply the defi-
ciency of power in the husband was proper advice and careful treatment.
A long series of decisions have all tended towards settling the law
on an erroneous footing, and it can only be placed on a satisfactory
basis by the action of enlightened and concordant medical opinion.
So convinced am I of the truth of the principle above enunciated
that whenever I am consulted as to the advisability of contracting
marriage, if I am unable to detect any signs of imperfect physical
formation, and have no reason for suspecting that the powers have
been unnaturally abused, I invariably urge the patient to marry,
assuring him of his perfect competence to enter into the married state,
and it is seldom that I do not find myself justified by the result. I
could mention numerous instances of persons such as I have above
described, marrying and becoming the fathers of large families. But
of course such advice can only be given after the most careful analysis
of the patient's condition.

Marriage has been classed among the remedies for the slighter affec-
tions of the sexual organs ; and if I may credit the statements of
patients, medical men, on being consulted, in the most off-hand manner^
without inquiring into the particular symptoms or probable cause of
the supposed impotency, at once say, " Oh ! you are only nervous ; go
and get married — a wife will cure you ! "

In the milder cases, and in instances where the patient only
slightly suffers from too frequent nocturnal emissions, — but in other
respects is in good health, — no advice can be better, and I am only
too glad to corroborate it.

Amidst all the important questions, however, that come before a
medical man, I know of none which require more tact and knowledge
than this : — " Am I in a condition to marry ? " On the one hand, you
have, perhaps, the very timid, nervous individual, previously depict ed
in these pages, who may or may not have exaggerated his weaknea
until neither he nor his medical adviser can exactly say what is his
condition. Often, even in the slighter cases, it requires all the knowlc I

TEMPORARY ABSENCE OF DESIRE 207

acquired by long practice to arrive at a just conclusion as to what is
real, what fanciful, in a patient's narrative. It is, in short, most diffi-
cult to say, off-hand, in such cases, whether a man may or may not
marry. From what I have already said, it will be seen that I am
always disposed to take the sanguine view of the probabilities, not
merely because it is a calamitous thing for an otherwise healthy adult
to be told by a scientific man, unless on clear and sufficient grounds,
that he is so far impotent that he should not marry, but because
experience teaches me that the majority of adults are able to perform
the sexual act. 1

Although a professional man may almost invariably give this favor-
able opinion, he should recollect that the very fact of its being thought
worth while to consult him affords prima facie evidence that the patient
feels that something is amiss ; and experience teaches me that the
healthy adult does not ask the opinion of a medical man without
having pretty good reason to suspect a deficiency of virile power. So
convinced am I of this, that when a patient consults me on the advisa-
bility of marriage I enter fully into details, and inquire into his
antecedents. I generally find that he is not only suffering from too
frequent emissions, but also that his fears depend upon facts which he
is not all at once ready to disclose. The result of these inquiries too
often proves that the patient, although a continent man, goaded by his
fears, has made one or two unsuccessful attempts at sexual intercourse.

The pleasure with which these patients receive the announcement
that they may marry must be seen to be appreciated, yet they can
hardly believe that the opinion is unbiassed. As I have said elsewhere,
diffidence is a marked characteristic of these men, and they again and
again ask, " Are you not taking too favorable a view of my case ? "
They display the most unselfish feelings, and assert that they could
bear their own miserable state of existence, but entreat the surgeon not
to sacrifice the woman. As I have said above, these are not for the most
part cases of true impotence, and it would indeed be a grievous error on
the part of a medical man to condemn such patients to a state of celibacy;
and if the appropriate treatment described at page 32 be followed, in a

1 It not unfrequently happens that a young man, in consulting his doctor, appeals
to his feelings, and says, " Tell me the worst ; I am ready to hear the statement that
I may not marry, but do not let me marry and repent of it, and make two people
wretched — at present I have only myself to care for, and I could bear the worst
opinion you can give of me." I may say that, after thirty years' experience, I have
hardly ever found myself compelled to pronounce a young man, otherwise healthy, to
be impotent who held such language as this. I can most conscientiously state that
in nine cases out of ten such complainants are only diffident men, who belong to the
susceptible class so often depicted in these pages. I may lay it down as a general rule
that although, as I state in the text, there is generally some reason for the medical
man being consulted, those who are anxious to marry may do so, at all events after
proper treatment, without any dread of finding themselves impotent.

208 TEMPORARY ABSENCE OF DESIRE •

very short time a marked recovery may be observed, which surely
progresses, until at length the patient becomes satisfied of his healthy
condition. I am in the habit of assuring such sufferers that no one
is more convinced than myself of the danger of recommending a man
to marry who is physically unfit to do so. I fully agree in the truth of
what the professor of Montpelier has nobly observed, " What has the
young girl, who is thus sacrificed to an egotistical calculation, done,
that she should be condemned to the existence that awaits her ? Who
has the right to regard her as a therapeutic agent, and to risk thus
lightly her future prospects, her repose, and the happiness of the
remainder of her life ?

"Until a man has contracted these indissoluble bonds, impotence
the most complete can compromise the future of no one.

" It is precisely because marriage is the most sacred bond for indi-
viduals, as well as the most important for society, and because an iron
law renders it indissoluble, that it is rational as well as moral not to
contract it without the certainty that it will be perfect and complete."
(Vol. iii, p. 470.)

I can, however, affirm that in practice I have never known an in-
stance of this sort of martyrdom where my sanction to a marriage has
previously been asked and granted.

It often happens that when a medical man thinks it desirable for a
patient to marry, his advice is frustrated by other considerations. In
many cases, the patient is too young ; in other instances, where sexual
abuse has been indulged in, or nocturnal emission has been frequent,
the dislike to marriage is such that every woman is alike distasteful to
the sufferer, and we must first improve the patient's state of health.

Those nervous, hypochondriacal people who, from a bad conscience, a
weak frame, the effects of depressed health, or some extravagant ideas of
the possible requirements of the young lady, 1 on a subject of which all
well-brought-up English maidens are ignorant, fancy that they are
unfit to undertake the rational duties of husbands and fathers, should
be encouraged to marry and be happy.

I may further add my firm conviction that when the surgeon has
improved the health of these self -accusing nervous men, nothing is
so likely to establish a permanent cure, and therefore conduce to the
happiness of individuals, as marriage. But it will be well for the
medical man who thus advises marriage to impress on the patient the
necessity of indulging in no form of excess. Organs that have been
temporarily weakened require to be exercised with great moderation.

There are, however, other cases which do not admit of such ready
solution, as the following instance shows : — A middle-aged man, with
deep marks under each eye, came to ask me if he might marry. He
1 See page 212 in corroboration of this statement.

SEXUAL INDIFFERENCE 209

was engaged to a person of about his own age, and they were mutually
attached. He had abused himself early in life, but had never com-
mit i I'd fornication, and, having read my book, was anxious to have
medical sanction to his nuptials, as he doubted whether he ought to
many. Emissions, not very abundant, I found, took place once a week,
and there were occasional erections in the morning. The testes were
small and flaccid, although he had worn a varicocele ring ; the penis was
mall, being, as my patient stated, not large even when erection
took place, so that all I could conscientiously do was to tell him that
I had serious doubts as to the propriety of his marrying, but could
Hoi say positively that he ought not to marry. Unsatisfactory as
such a dictum must always be, anything is better than the unjusti-
fiable advice, putting aside its immorality, which some medical men
are said to give to their patients, viz. to commit fornication in order to
ascertain if they are competent to marry. I would earnestly insist
that such a test is not only fallacious, but often most dangerous. 1

1 Since the last edition of this book was published a most unjustifiable attack has
been made on the profession by Professor Newman, in the accusation that physicians
of eminence recommend harlotry to their patients. The Emeritus Professor of
University College, London, proceeds thus — " I am further informed by a younger
friend, who in his boyhood (through erroneous judgment in his father) was forbidden
ordinary boyish exercise, but was a very diligent student, — that, when quite a youth,
he suffered from an excess of this depletion to which I have referred, and went to an
eminent London physician for advice. The reply was shortly this: ■ The only cure is
intercourse with women. You are too young to marry. I cannot advise you to take
the risk of the streets ; but you ought to keep a mistress.' My friend, though then so
young, was strongly religious, and revolted with horror from the thought. — After
such information, I was unable to suppose this theory confined to the disreputable
members of the profession. Besides I have in recent months received or seen letters
from several ladies, bitterly complaining of the awful counsel given by doctors to
young men, and deploring that so many women are overpowered by the doctors'
authority, and settle down into the doleful, depressing belief that men must be
immoral for their health's sake. As others put it, women under the doctors' teach-
ing are coming to a universal disbelief in male chastity. Some mothers have had
vehement contest against doctors, in the effort to save their sons from immoral
courses. Further, an intimate friend of mine, whose age must be near fifty, now
tells me, that in his youth he consulted an eminent London physician, who, though
the ailment had no relation whatever to the sexual system, volunteered to say that it
was bad for him to remain chaste ; and, in reply to some exclamation of surprise,
explained that ' he must judge for himself how to act : the question of morality
did not belong to the physician ; but, that a man must not expect to be in health, if
he neglected to exercise a natural function.' " Mr. Newman goes on to say — " Dif-
ferent in basis, but equally formidable to morals, is the notion, that it is useless to
struggle for the entire purity of young men ; and that their temporary unchastity
(of course at the expense of women) is to be counted on. On all sides, a despair of
moral influences is deplorably prevalent. It must be disowned, and a strict moral
practice demanded ; else, more and more, we shall see fatal acquiescence in a most
destructive vice. The European Continent gives us most awful warning. On the

210 IMPOTENCE

What, for instance, is more probable than that a nervous man, who,
for the first time, meets a loose woman, goes to a strange house, and is
frightened by the disgrace which may attend any exposure of his
folly, should find himself unable to perform the act? The only
greater misfortune that can befall him is to be deluded subsequently
and consequently into consulting the advertising quacks. If he does
not end his days in a lunatic asylum he will be singularly fortunate.

The secoND form of sexual indifference — temporary absence of
desire, above referred to — namely, when desire, once experienced,
has been lost, may now be noticed. It is a kind of temporary impo-
tence proceeding from an easily assigned cause, which nevertheless
often creates much anxiety. The student, who has previously ex-
perienced all the sexual desires common to his age, all at once,
during some strenuous and long-continued mental exertion while
he is absorbed in his studies, finds all sexual feeling annihilated.
Men who are [or have recently been reading hard at the universities
frequently come to me complaining of absence of desire, which I
am happy enough to prove to them is only temporary, and to be easily
accounted for. It is undoubtedly true that such persons are tempo-
rarily impotent. Nature has wisely ordained that the secretion of the
testes may be temporarily arrested. Whenever the brain is overtaxed,
or any prolonged muscular exertion is taken, sexual desire may for
the time cease ; but it is quite certain that if the reproductive organs
are healthy and have not been abused, sexual feelings and increased
power will return as soon as the overtaxed brain or muscles are allowed
to regain their normal condition.

Sexual Indifference among Married Men, as a temporary
affection, is another cause of anxiety, which in some persons produces
the greatest alarm ; and well it may, because if instead of being
properly treated, it be allowed to continue, it may, as will be seen
further on at p. 240, lead to domestic differences, and even induce the
wife to appeal to the Divorce Court for an order to annul the
marriage.

whole, I find it impossible to resist the conviction, that in all ranks of the medical
faculty there is at least a fraction (highly dangerous, if only a fraction), which
actively preaches deadly immorality." — The Relation of Physiology to Sexual Morals,
p. 23.

1 As these pages were passing through the press a very lamentable case MM
under my notice. An officer returned from India, and, attracted by the advertise-
ment of a notorious quack, consulted him. After a great number of visits, inu r-
course with a woman of the town was recommended,, and the first attempt \\ ;is
followed by chancre, and this by secondary symptoms. Before his victim escaped*
the quack had obtained from him JE1500. Fortunately for himself the patient sought
other advice in time, and is now, I am happy to say, in a condition to perform his
military duties efficiently.

TEMPORARY ABSENCE OF DESIRE 211

Causes. — Men who gain their bread by tho sweat of their brows or
the txliiiust injjr labour of their brains, cannot be always ready to
perform the sexual act. During certain periods, when occupied with
oihor matters, a man's thoughts may dwell but little on sexual subjects,
and no disposition exist to indulge anything but the favourite or
absorbing pursuit, mental or physical, as the case may be. After a
UpM of time, different in various individuals, sexual thoughts recur,
and the man who yesterday was so indifferent to sexual feelings, as
practically to be temporarily impotent, now becomes ardent and
sexually 'disposed, remaining so until the necessary and, in fact, healthy
lethargy of the organs, consequent on the performance of the act, has
supervened.

This quiescent condition is much more persistent in some married
men than in others. There are persons (married as well as single)
who only at very infrequent intervals feel any disposition for sexual
intercourse, just as there are others who never feel any such desire at
all. Again, there are lethargic men who, unless roused, will hardly do
any tiling. It requires an effort in some men to eat. There is in some
of these cases undoubtedly great sexual debility. Again the habitual
drinker cares little for sexual enjoyments. I am quite certain that
some excessive smokers, if very young, never acquire, and if older,
rapidly lose, any keen desire for coDnection. The pleasures of the
table so monopolise many a man's thoughts that he is indifferent to all
other indulgences. In all the above cases the sexual feelings occupy a
secondary position, and offer a strong contrast to that tyrannous
mastery from which the thorough voluptuary suffers. In the more
advanced stages of this quiescent condition, it is often difficult to say
whether the sexual organisation was originally weak, whether the other
tastes have overpowered the sexual appetite, or whether the individual
has not early in life abused his generative faculty.

Among the married we sometimes find men taking a dislike or even
a disgust to their wives, and, as a consequence, there is an entire want
of desire. A first failure will sometimes so annihilate men's sexual
appetite that they are never able or anxious to attempt connection a
second time. In many cases this arises from wounded amour propre,
as they have succeeded with other women. Early excesses in married
life, will, in a certain number of cases, occasionally produce a temporary
iinp<»t< nry later in life. Want of sympathy or want of sexual feeling,
on the woman's part, again, is not an unfrequent cause of apathy,
indifference, or frigidity on the part of the husband. Lastly, there
are cases of amiable men who carry their consideration for the women
they love to such an extent as to render themselves practically
impotent for very dread of inflicting pain.

WamX of Sexual Feeling in the Female a Cause of Absence of Virility.

212 IMPOTENCE

— We have already mentioned lack of sexual feeling in the female as
not an uncommon cause of apparent or temporary impotence in the
male. There is so much ignorance on the subject, and so many false
ideas are current as to women's sexual condition, and are so productive
of mischief, that I need offer no apology for giving here a plain state-
ment that most medical men will corroborate.

I have taken pains to obtain and compare abundant evidence on this
f subject, and the result of my inquiries I may briefly epitomise as
j follows :-W should say that the majority of women (happily for
) society) are not very much troubled with sexual feeling of any kind.
What men are habitually, women are only exceptionally It is too
true, I admit, as the Divorce Court shows, that there are'some few
women who have sexual desires so strong that they surpass those of
men, and shock public feeling by their consequences. I admit, of
course, the existence of sexual excitement terminating even in nympho-
mania, 1 a form of insanity that those accustomed to visit lunatic
asylums must be fully conversant with ; but, with these sad exceptions,
there can be no doubt that sexual feeling in the female is in the
majority of cases in abeyance, and that it requires positive and con-
siderable excitement to be roused to all ; and even if roused (which
in many instances it never can be) it is very moderate compared with
that of the male. Many persons, and particularly young men, form
their ideas of women's sensuous feeling from what they notice early in
life among loose or, at least, low and immoral women. There is always
a certain number of females who, though not ostensibly in the ranks
of prostitutes, make a kind of a trade of a pretty face. They are fond
of admiration, they like to attract the attention of those immediately
above them. Any susceptible boy is easily led to believe, whether he
is altogether overcome by the syren or not, that she, and therefore all
women, must have at least as strong passions as himself. Such
women, however, give a very false idea of the condition of female
sexual feeling in general. Association with the loose women of
the London streets in casinos and other immoral haunts (who, if they
have not sexual feeling, counterfeit it so well that the novice does not
suspect but that it is genuine), seems to corroborate such an impres-

1 I shall probably have no other opportunity of noticing that, as excision of the
clitoris has been recommended for the cure of this complaint, Kobelt thinks that it
would not be necessary to remove the whole of the clitoris in nymphomania, the same
results (that is destruction of venereal desire) would follow if the glans clitoridis had
been alone removed, as it is now considered that it is the glans alone in which the
sensitive nerves expand. This view I do not agree with, as I have already stated with
regard to the analogous structure of the penis, p. 180. I am fully convinced that in
many women there is no special sexual sensation in the clitoris, and I am as positive
that the special sensibility dependent on the erectile tissue exists in several portions
of the vaginal canal.

TEMPORARY ABSENCE OF DESIRE 213

sion, and as I have stated above, it is from these erroneous notions
that so many unmarried men imagine that the marital duties they will
have to undertake are beyond their exhausted strength, and from this
reason dread and avoid marriage.

Married men — medical men — or married women themselves, would,
if appealed to, tell a very different tale, and vindicate female nature
from the vile aspersions cast on it by the abandoned conduct and
ungoverned lusts of a few of its worst examples.
(l am ready to maintain that there are many females who never f eel\
any sexual excitement whatever. Others, again, immediately after
e*oh period, do become, to a limited degree, capable of experiencing it ;
but this capacity is often temporary, and may entirely cease till the
ii. xt menst rual period. Many of the best mothers, wives, and managers
of households, know little of or are careless about sexual indulgences.
Love of home, of children, and of domestic duties are the only passions J
they feel.f) /

vA.s a general rule, a modest woman seldom desires any sexual. grati-"V
fication for herself. She submits to her husband's embraces, but \
principally to gratify him ; and, were it not for the desire of
maternity, would far rather be relieved from his attentions. No /
nervous or feeble young man need, therefore, be deterred from marriage \
by any exaggerated notion of the ardous duties required from him. Let /
him be well assured, on my authority backed by the opinion of many, /
that the married woman has no wish to be placed on the footing of a
mistress!j /

One instance may better illustrate the real state of the case than
much description.

In — , 185-, a barrister, about thirty years of age, came to me on
account of sexual debility. On cross-examination I found he had been
married a twelvemonth, that an attempt at connection had taken place
but once since the commencement of the year, and that even then
there was some doubt as to the completion of the act. He brought his
wife with him, as she was, he said, desirous of having some conversa-
tion with me.

I found the lady a refined but highly sensitive person. Speaking

1 The physiologist will not be surprised that the human female should in these
respects differ but little from the female among animals. We well know it as a fact
that the female animal will not allow the dog or stallion to approach her except at
particular seasons. In many a human female, indeed, I believe, it is rather from the
wish of pleasing or gratifying the husband than from any strong sexual feeling, that
cohabitation is so habitually allowed. Certainly, during the months of gestation this
holds good. I have known instances where the female has during gestation evinced
positive loathing for any marital familiarity whatever. In some exceptional cases,
indeed, feeling has been sacrificed to duty, and the wife has endured, with all the self -
martyrdom of womanhood, what was almost worse than death.

214 IMPOTENCE

with a freedom equally removed from assurance, or mauvaise honte, she
told me she thought it her duty to consult me. She neither blushed
nor faltered in telling her story, and I regret that my words must fail
to convey the delicacy with which her avowal was made.

Her husband and herself, she said, had been acquainted from child-
hood, had grown up together, become mutually attached, and married.
She had reason to consider him debilitated, but— as she was fully
convinced — from no indiscrete acts on his part. She believed it was
his natural condition. She was dotingly attached to him, and would
not have determined to consult me, but that she wished, for his sake,
to have a family, as it would, she hoped, conduce to their mutual
happiness. She assured me that she felt no sexual passions whatever ;
that if she was capable of them, they were dormant. Her passion for
her husband was of a Platonic kind, and far from wishing to stimulate
his frigid feelings, she doubted whether it would be right or not. She
loved him as he was, and would not desire him to be otherwise except
for the hope of having a family.

I believe this lady is a perfect ideal of an English wife and mother,
kind, considerate, self-sacrificing, and sensible, so pure-hearted as to be
utterly ignorant of and averse to any sensual indulgence, but so un-
selfishly attached to the man she loves as to be willing to give up her
own wishes and feelings for his sake.

In strong contrast to the unselfish sacrifices such married women
make of their feelings in allowing cohabitation, stand out others, who,
either from ignorance or utter want of sympathy, although they are
model wives in every other respect, not only evince no sexual feeling,
but, on the contrary, scruple not to declare their aversion to the least
manifestation of it. Doubtless this may, and often does, depend upon
disease, and if so, the sooner the suffering female is treated the better.
Much more frequently, however, it depends upon apathy, selfish in-
difference to please, or unwillingness to overcome a natural repugnance
for cohabitation.

Other mental conditions may influence the female. Thus, the High
Church enthusiast may consider it her strictly religious duty to be
separated from her husband during the forty days of Lent ; and at
page 39 I have given an instance of a wife refusing to cohabit with
her husband because she would not again become a mother. I was
lately in conversation with a lady who maintains women's rights to
such an extent that she denied the husband any voice in the matter,
whether or not cohabitation should take place. She maintained, most
strenuously, that as the woman bears the consequences— has all the
discomfort of being nine months in the family-way, and thus is obliged
to give up her amusements and many of her social relations — considering
too that she suffers all the pains and risks of childbirth — a married

TEMPORARY ABSENCE OF DESIRE 215

woman has a perfect right to refuse to cohabit with her husband. I
ventured to point out to this strong-minded female that such conduct
on her part might be, in a medical point of view, highly detrimental
to the health of the husband, particularly if he happened to be strongly
-. \ually disposed. She, however, refused to admit the validity of my
Argument, and replied that such a man, unable to control his feelings,
ought to have married a street-walker, not an intellectually disposed
person, who could not and ought not to be obliged to devote her time
to duties only compatible with the position of a female drudge or wet-
nurse.

I am not prepared to say what weight Sir James Hannen would attach
to such evidence in the case of a man seeking a divorce, and I am not
•\ware that counsel has as yet urged such conduct on the part of the
female in extenuation of immorality on t\\e part of the husband.
Of one thing I am quite certain, that many times in the course of the
year I am consulted by conscientious married men, who complain, and
I think with reason, that they are debarred from the privileges of
marriage, and that their sexual sufferings are almost greater than
they can bear in consequence of their being mated to women who think
and act as in the above-cited instances. I regret to add that medical
skill can be of little avail here. The more conscientious the husband
and the stronger his sexual feelings, the more distressing are the
sufferings he is doomed to undergo, ultimately too often ending in
impotence.

Perversion of Sexual Feeling. — Where, in addition to the indisposi-
tion to cohabitation which many modest women feel, we find a per-
sistent aversion to it, so strong as to be invincible by entreaty or
by any amount of kindness on the husband's part, a very painful
suspicion may sometimes arise as to the origin of so unconquerable a
frigidity.

The following is a case in which these suspicions seemed to be
justified by the facts : — A gentleman came to ask my opinion on the
cause of want of sexual feeling in his wife. He told me he had been
married four years. His wife was about his own age (twenty-seven),
and had had four children, but she evinced no sexual feeling, although
a lively, healthy lady, living in the country. I suggested several
causes, when he at last asked me if it was possible that a woman might
lose sexual feeling from the same causes as men. " I have read your
former edition, Mr. Acton," said he, " and though you only allude
to the subject incidentally, yet from what I have learned since my
marriage, I am led to think that my wife's want of sexual feeling may
Mj If you can affirm to me that such a thing is possible, from self-
abuse. She has confessed to me that at a boarding-school, in perfect
ignorance of any injurious effects, she early acquired the habit. This

216 IMPOTENCE

practice still gives her gratification ; not so connection, which she views
with positive aversion, although it gives her no pain. I told him that
medical men, who are consulted about female complaints, have not un-
f requently observed cases like that of his wife. It appears that at last
nothing but the morbid excitement produced by the baneful practice
can give any sexual gratification, and that the natural stimulus fails to
cause any pleasure whatever, i^imilar phenomenon occurs in men,
and this state is seldom got the better of-M-long as self -abuse is prac-
tised. I feared, therefore, that his surmises were correct, and that the
lady practised self-abuse more frequently than she was wiil^g to admit.
So ruinous is the practice of solitary vice, both in the one 3P& other
sex, so difficult is it to give it up, that I fear it may be carried ori-£ ven
in married life, where no excuse can be devised, and may actuairj^ .
come to be preferred to the natural excitement. Venereal excesses
engender satiety just as certainly as any other indulgences, and
satiety is followed by indifference and disgust. If the unnatural
excesses of masturbation take place early in life, before the subjects
who commit them have arrived at maturity, it is not surprising that
we meet with women whose sexual feelings, if they ever existed, become
prematurely worn out. Doubtless sexual feeling differs largely in
different women, and although it is not my object to treat otherwise
than incidentally of the sexual economy in women, yet I may here say
that the causes which in early life induce abnormal sexual excitement
in boys operate in a similar manner on girls. This tendency may be
checked in girls, as in boys, by carefuly moral education in early life.
But no doubt can exist that hereditary predisposition has much to do
with this, independently of education and early associations. It is
publicly maintained by some credible persons that there are well-known
families, for instance, in which chastity is not a characteristic feature
among the females. "We offer, I hope, no apology for light conduct
when we admit that there are some few women who, like men, in con-
sequence of hereditary predisposition or ill- directed moral education,
find it difficult to restrain their passions, while their more fortunate
sisters have never been tempted, and have, therefore, never fallen.
This, however, does not alter the fact which I would venture again to
impress on the reader, that, in general, women do not feel any great
sexual tendencies. The unfortunately large numbers whose lives
would seem to prove the contrary are to be otherwise accounted for.
Vanity, giddiness, greediness, love of dress, distress, or hunger, mafa
women prostitutes, but do not induce female profligacy so largely as
has been supposed. 1

Malformation in the female is sometimes a cause of non-con sum -

1 See Author's work on 'Prostitution,' 2nd edition, p. 167.

TRUSSES A CAUSE OF IMPOTENCE 217

mation, wrongly attributed to want of power in the man. A singu-
larly agreeable and gentlemanly, but very mild-looking man, once
called on me, saying that lie had been lately married, and had not
succeeded in performing his marital duties. I treated him in the
usual way and he got stronger, but still the act was not satisfactorily
performed, and my patient said enough to induce me to believe that
the failure was not to be attributed to him alone. After some little
hesitation the lady consulted me. I found ber a pretty, pleasing, but
excessively nervous and excitable person. At first the mere appli-
cation of cold water to the generative organs could not be borne, but
after some time, and after a good deal of careful management, an
astringent lotion was used. When the morbid excitability was some-
what reduced, the hymen was found not only entire, but very tough,
presenting the appearance of the finger of a kid glove on the
stretchers. Division of the hymen and dilatation of the vagina at
length accustomed the parts to bear contact, and a permanent cure
was effected. I have reason to believe that cases of supposed impo-
tence arising from this cause are not uncommon ; cohabitation is,
under these circumstances, not likely to be followed by impregnation
when the husband has been previously continent, and his natural dis-
position renders him particularly unwilling to distress or hurt his wife
while she is in this state of unnatural and morbid sensitiveness. It is
not improbable that divorces have taken place before now from such
causes as these, particularly when interfering friends have exagge-
rated and envenomed the painful difference between the young
couple.

Hernia and Trusses. — Since former editions of this book were
published, I have paid considerable attention to this subject, and I
think I may now state confidently that trusses may and often do most
seriously interfere with the reproductive powers, and in a way that
truss makers might readily obviate by adopting some improved con-
struction. The object of mechanicians being solely to keep the
hernia in place, the penis or testes are often so carelessly thrust
aside or pressed upon, that their functions are seriously interfered
with.

When a case of the kind comes under my care, and the patient com-
plains of want of sexual power, I always examine how the truss
presses. If I see any reason to suppose that it can by any possibility
be the cause of the symptoms, I attempt in the first place, by diet and
abstinence from certain articles, to cause absorption of fat in the
mesentery and omentum ; this being done I attempt, but with great
caution, to reduce the size of the truss. It is singular how often this
can be effected with safety ; I find that not only are the sexual powers
often recovered when the pressure is thus relieved, but that the penis,

218 IMPOTENCE

when it is no longer thrust aside, regains its natural size where that
had diminished.

I strongly object to springs crossing the abdomen, inasmuch as I
think the procreative powers may very probably be interfered with
when a double truss is worn ; and in cases such as I speak of, where
the impotence is the most marked feature, it becomes a serious ques-
tion whether the use of the instrument should be continued, particu-
larly when, as in some instances, it has merely been sanctioned as a
precautionary measure. I need not say, however, that if a truss on
one side can be altogether dispensed with, the partial recovery of the
reproductive powers will be more likely to be effected. I believe,
moreover, that in many cases great relief can be obtained by judicious
alterations in the shape, size, and point of pressure, and in the method
of attachment of the truss.

Varicocele, or enlargement of the veins of the chord, is another
affection which, in its severer forms, if it does not produce impotence,
at least aggravates it. Whenever a patient comes to me with this
affection, I at once order a suspensory bandage, or what I prefer, a
varicocele ring, an instrument formed of soft pliable metal, covered
with wash-leather. These are made of different sizes, and can be
procured at Furgusson's, surgical instrument maker, Giltspur Street,
City ; or of Bell's or Corbyn's, Oxford Street. These rings, in the
majority of cases, answer the purpose admirably, but when the
scrotum is very thin or deficient in cellular tissue, they are liable to
slip off. This may be obviated by tying a piece of thin twine to the
ring, the other end of it being attached to the button of the drawers.
The ring should be taken off at night, and only put on after the
sponging bath — it should be worn for some months.

It should be recollected that there are other causes producing indif-
ference to the opposite sex and deficiency in manly vigour. The most
common of such causes is the wretched habit of masturbation, of
which we have already treated. A youth who masturbates himself
and continues the practice as he grows up to manhood, may evince,
even after he has arrived at the marriageable age, no disposition
towards the other sex. The patient now finds that only his own
solitary pleasure can give him any gratification ; as far as women are
concerned, he is virtually impotent. Lallemand gives the following
perhaps rather too * graphic account of such a person's state of feeling

1 I think I am bound to state that, although we are very much indebted to
this distinguished Professor for having written a most valuable treatise on seminal
losses, yet the reader must not be led away with the idea that every youni; man who
has been a victim to the vice would suffer as described in this paragraph, or that I
would say, "ex uno disce omnes." We must consider these as symptoms in sufferers
who have carried the vice to its utmost limits ; and the illustrations arc not given

TEMPORARY A I :s IIVOE OF DESIRE 210

inwards ili.> opposite NX: " Thoir solitary vice has a tendency to
•eparate thott practising it from women. At first, of course, it is on
x tlial their thoughts dwell, and they embellish an ideal being
with all the charms of imaginary perfection ; the habit, however, which
enslaves them little by little, changes and depraves the nature of their
ideas, and at last leaves nothing but indifference for the very reality
»»t which the image has been so constantly evoked to aid their
criminal indulgence. At a later period, when erection is only tem-
porary and is too incomplete for them to think of sexual intercourse,
tli.v abandon themselves with fury to their fatal habit, notwithstand-
ing the almost complete flaccidity in which the erectile tissues are left.
At this period the handsomest woman only inspires these patients
with repugnance and disgust; and they ultimately acquire an instinc-
tive aversion — a real hatred for the sex. They dare not always let
their feelings on this subject escape them, from fear of their shameful
vice being suspected or the humiliating condition to which they are
reduced being discovered ; but they lose no opportunity of, as it were,
rer©nghlg themselves for the repugnance which they believe they pro-
duce in women, and which in truth they do inspire in consequence of
the instinctive reciprocity of such feelings that is inevitable." (Vol.
iii, p. 114.)

This perversion of the natural excitement causing temporary impo-
tence is among one of the saddest pictures which suffering humanity
can show. A striking instance of the kind has lately come under my
care, as the following letter will prove :

London.

Mr peak Sir, — A few minutes after this reaches you I shall follow with the old
story. Wine, an attempt at sexual intercourse, and failure, drove me again to the
ahominnhle hahit. I am determined from henceforth to abstain entirely from stimu-
lants, and also from women, when I do not douht being ahle to abstain also from the
other. I feel, however, so thoroughly unable to recover without the aid of the local
operation ; that I must beg of you once more to perform it. I come to you to-day
entirely for that purpose. Should you refuse to do it, candour compels me to tell
you that you would only drive me to some other practitioner, who would adopt the
local treatment in some form or other. In regard to my own feelings, I will only
say that my punishment is almost greater than I can bear. I shall bring this note
myself, shall therefore probably be in your waiting-room when you receive it. I
have adopted this as the easiest and least embarrassing mode of telling an otherwise
long and painful story.

I remain, my dear Sir, yours, &c.

W. Acton, Esq.

as ordinary typical cases, but as the most strongly marked. I have cited Lallemand
for this reason, but I may add that during long experience I have seldom met with
su li ( : , and when I have done so it has usually been in persons who, from

having had no one to consult or sympathise with them, have exaggerated their
v morbidly dwelling upon them.

220 IMPOTENCE

The writer was a tall, gentlemanly young man. He assure J me that
he masturbated himself in sleep in spite of all his efforts, and that it
particularly occurred after taking wine. He did not find the desire
irresistible during his waking moments, except after he had failed in
attempting intercourse with women, when in a kind of despair he
generally yielded to the old temptation. To avoid the practice during
sleep, he had sometimes been compelled to tie his wrists together by a
cord that passed round his neck, so as to prevent himself from touch-
ing the penis. I have known several such cases, where patients who
wished to cure themselves of the habit of masturbation have, against
their feelings, sought the society of women, have attempted connection
in vain, and then have come to me, ashamed of their failure, disgusted
with themselves for the vice, and apparently almost ready to commit
suicide from despair and misery. Others have confessed to me that,
though sexual intercourse has been attended with difficulty, still the
act was accomplished, but that it was attended with no pleasure. As
their own self -pollution could still afford them gratification, they
acknowledged that they fell back to their old vice, of which they were
all the time thoroughly ashamed.

This strange phenomenon of self- abuse affording greater gratifica-
tion than intercourse with the other sex, the idea of whom, after all,
creates the excitement, is more common than is generally supposed,
and more in accordance with what we should expect than at first sight
appears. The confirmed masturbator (as Eousseau has described) has
to picture in his imagination all the female charms that can exist, so as
to be able to rouse his flagging sexual desires. But when he attempts
for the first time, or at long intervals, to accomplish sexual intercourse
he finds much difficulty and very little pleasure. He is probably
naturally timid, he dreads the exposure of his infirmities, he fears con-
tamination, and is, on the whole, thoroughly ill at ease. His ignorance,
his conscience, the very novelty of his position, and the dread of conse-
quences, tend, for the time, to paralyse his sexual desires.

Another explanation, also to some extent true, is that the nervous
system, and particularly the sympathetic system, has been so often and
repeatedly excited that it will only respond to the particular kind of
stimulus to which it has become accustomed, and is proof against all
others.

It would appear, then, that a large class of men suffer from absence
of desire for the other sex, either from having never experienced it or
from being so entirely engaged in their studies and other occupations
that they have ceased to be disturbed by amatory feelings previously ex-
perienced, while another class having an imaginary cause for self -accu-
sation are haunted with a belief that they are impotent ; they imagine
that the consequences of malpractices are written on their counter

TExMPORARY ABSENCE Of DESIRE 221

nancee, and become misanthropes of the most painful type. This class,
although susceptible, when submitted to proper medical treatment, of
speedy cure, is, if neglected, in danger of ultimately terminating in
suicidal mania. It is, in fact, impossible to over-estimate the dangerous
condition of this class of patients, forming, as they do, the border-land
beta wen false and true impotence. There is too much reason to fear
that many of this class are regarded, not by themselves merely, but
by doctors, as permanently impotent, yet who might recover under
proper medical advice. In the infancy of lunatic medical science
persons were shut up for life in various asylums as hopelessly insane,
to whom nothing more than eccentricity, strangeness of conduct, or
weakness of mind, could have been properly imputed. I confidently
believe that it is not too much to affirm that, thanks to equal igno-
rance, many temporarily impotent persons are permanently debarred
from marriage or separated from their wives. Just as more accurate
knowledge has saved the former class, the latter may, I trust, be
saved in like manner from their bitter fate. These self-accusing
persons will, of course, continue to condemn themselves ; is it too much
to hope that they will cease to be condemned by lawyers and doctors ?
From the foregoing observations it appears that the temporarily
impotent are divided into three distinct classes, — those whose powers
have never been called into action ; those whose powers, after coming
into existence, have become dormant, owing to some counteracting
influence ; and those whose powers have been affected by secret abuse.
Sometimes, as we have seen, the attempt to enjoy sexual congress is
followed by failure. Such cases are familiar to me, though they are
probably far from common. Even in them it would be an extremely rash
judgment to conclude at once that the failure is due to real or perma-
nent impotence. A timid man distrustful of his powers may marry, and
obtaining no sympathy from his wife, fail in the attempt to consum-
mate the marriage ; if he neglects to obtain medical advice he is, no
doubt, in great danger of becoming permanently and incurably impo-
tent ; but, in the great majority of such cases, proper medical treat-
ment is all that is required to call into action the latent power. It
sometimes happens that after marriage has been duly consummated,
temporary impotence supervenes. This, again, is usually occasioned by
an attempt to perform the act being, from some accidental cause,
followed by failure, and owing to mauvaise honte, or timidity, which
results in the man's becoming really impotent towards that particular
woman. In such cases proper medical treatment is all that is required
to restore the patient to potency. We find, then, that so-called
impotence is divided into two distinct classes, one of which I may call
true impotence, or absence of virility ; and the other, false impotence,
or virility in abeyance.

222 TRUE IMPOTENCE

SECT. II.— TRUE PERMANENT IMPOTENCE, OR ABSENCE OP
VIRILITY

Permanent Absence of Desire. — So unnatural a phenomenon as an
entire absence of sexual desire, alluded to at page 201, must always be
rather an alarming and a suspicious circumstance. Unfortunately in
the majority of such cases the medical man is seldom consulted at an
early period, as neither the patient nor his friends are aware that
there is anything unusual in his condition until it is accidentally
discovered.

I shall hardly be putting the case too strongly if I say that the
distinction between false and true impotence, between abeyance of
virility and absence of virility (I am speaking, of course, of those cases
where there is no physical malformation to which to attribute the want
of power), is one not so much of kind as of degree. The deficiency,
that treated in time would have proved temporary and amenable
to remedies has by neglect become chronic, and passed into the
permanent and irremediable stage of true impotence, or absence of
virility.

It is impossible to lay down any rules by which the medical man can
satisfy himself on the first visit of the patient whether the border line
has in fact been passed which separates the two stages of the disorder,
the temporary from the permanent, the false from the true. The
symptoms will in both cases be much the same, the treatment,
speaking in general terms, and making all due allowances, identical.

The only test that the medical man can apply is that of experience.
If he finds the symptoms after a time beginning to yield to treatment
he will be justified in adopting a favorable view of the case, and in
holding out hopes of ultimate recovery. But if, after a reasonable
time has elapsed, he finds his efforts unattended by any result, he will be
compelled, however reluctantly, to adopt the opinion that his remedies
have been applied too late, and that the case has in fact passed beyond
the reach of the physician's skill.

I may, however, point out a few of the leading symptoms which
usually indicate that the later stages have been reached, and that the
disorder is present in its more serious form. In such cases the surgeon
appealed to will usually find that the individual is fat, without hair on
his face, or even down on the pubes ; the testes and penis are small,
almost rudimentary, like those of a young child, 1 there is no sexual

1 Dr Davy has given the following post-mortem appearances in a patient who
showed (according to the account given by his comrades) an aversion to the sex,
" There was little hair on pubes or chin, the partes naturalea were all small, the

MlSENCE OF VIRILITY 223

desire, and the voice is often weak and almost falsetto in quality ; in
fact, the condition is much the same as that of the castrated individual
or eunuch. 2

In such a case it is clear that an imperfect development of the testes
has resulted in a state of eunuchism, accompanied by many of the
peculiarities which, both in animals and in human beings, follow on
castration.

This partially undeveloped state of the reproductive system usually
indicates itself, among other signs, by a marked indifference to manly
sports and exercises, and a visible deficiency in virile attributes
generally.

If, on examination, it should appear that the testes, instead of
being merely small, are little more than rudimentary organs ; if
they are apparently mere ,nodules ; if this change of structure has
followed an early attack of mumps or some inflammatory affection of
the testes, or an accident which has injured them early in life, the
case must, I fear, be considered as a hopeless one, and the patient
should be treated as permanently impotent. Terrible as this doom
may seem, it is singular to notice how indifferent such persons
appear to their deficiency. They do not know the value of what they
never possessed and never will possess, and they pass through life con-
tented men, evincing neither aversion to nor liking for the opposite sex.

It may be some satisfaction for nervous patients who may read these
pages to be reminded that the really impotent men are, as a rule, thus
indifferent to their symptoms ; and I may lay it down as a general
rule that a man who is very timid about the existence of impotence is
not likely to be impotent at all, but only fears he may become so.

Abnormal condition of the Erectile Tissue. — Where, however, manifest
impotence exists, which cannot be accounted for by the accidental
causes, so to speak, of early excess, or the predominance of the nutritive

larynx was small, the skin delicate. A very minute portion of fluid only could be
procured from the vasa deferentia, which under the microscope exhibited numerous
small particles and a few larger globules, but no spermatic animalcules. The fluid of
the vesiculce was also small in quantity and destitute of animalcules ; it was of a light-
brownish hue, slightly opaque, containing some globules, and did not change the
colour of turmeric or of litmus paper. The fluid from their fundus was most gelatinous
and appeared to consist chiefly of mucus. The vesiculce seminales in this instance and
their contents resembled those of such castrated animals as I have hitherto examined.
(' Edinburgh Medical and Surgical Journal,' vol. L, p. 7.)

3 Pope Clement XIV, in the eighteenth century, abolished castration of youths,
which was then practised in Italy for the purpose of retaining the soprano voice. It
is well known that the castrated preserve the shrill voice (voix aigue) of infancy, at
the same time that the chest becomes fully developed, thus giving volume to the
voice. Women were not allowed to sing in the cathedral or church services j hence
this horrid mutilation, as it qualified the victims to sing soprano parts.

224 TRUE IMPOTENCE

over the other functions of the frame, it is necessary to closely investi-
gate the structure of the parts. It will generally be found that this
kind of impotence depends on some lesion of the nervous condition
or trabecular structure of the penis, or imperfect development of
the erectile tissue. The penis may be, for instance, of an unusual
length, but thin, particularly at its base. It may be terminated by a
large, fungiform glans, extending beyond the corpora cavernosa, and
being almost always uncovered, or at least imperfectly covered by the
prepuce. These massive penes, which seem to thin as they approach
the point of their insertion, are almost invariably deficient in erectile
power. In fact, the erections are rarely complete, particularly towards
the base. "Where, therefore, this peculiarity of formation is very
marked, permanent and hopeless impotence may, and probably will,
be found to exist. On this subject Lallemand remarks : — " The
firmness of the erectile tissues differs greatly in individuals of the
same age, independently of their volume and form. When I have
noticed the penis completely hanging on the scrotum, the corpora
cavernosa empty, flabby, without any resistence or elasticity under
the finger, I have always remarked that the function was, to say
the least, not energetic, and a cure, if possible, difficult." (Yol. ii,
p. 187.)

A very small and shrivelled condition of the organs may equally pro-
duce permanent impotence. This is described by Lallemand thus : —
" There is unnatural development of the prepuce, depending probably
on the unusually small size of the penis. The rudimentary state of
the erectile tissue, as well as of the testicles, necessarily allows of but
little energy in the functions of these fundamental parts of the genera-
tive apparatus." (Vol. ii, p. 185.)

Again, we find, on the other hand, that in some cases the penis is
hard and inelastic, the coverings are firm and indurated, and not con-
tractile. The cause of this state has been, I believe, frequently attri-
buted to abuse, or excesses, or to blood having been accidentally
effused into the trabecular tissue of the organs. In other instances
inflammation has caused the deposition of lymph, which has not been
reabsorbed, but remains in the shape of small, indurated masses. The
deposition of this lymph in the coverings of the penis causes them to
lose their elasticity, the organ becomes non-erectile, and the man
becomes incurably impotent.

Tubercular Affection of the Testes. — Impotence is occasionally found
arising from syphilitic deposits in the testes. It is partial or entire,
according as one or both organs are more or less deeply implicated
and in proportion as the deposits have existed for a longer or shorter
time. Orchitis may more or less interfere with the functions of the
testes, but the impotence arising from the inflammation set up in the

TRUE OR PERMANENT IMPOTENCE 225

parenchymatous structure may rapidly subside, and the organ recover
its full function. When, however, hard nodules remain in the epidi-
dymis, and in spite of treatment are persistent in both testicles, a grave
suspicion may arise whether the patient will ever regain his virile
powers ; if, however, only one organ is affected, complete recovery may,
i rule, be expected. Each case must be judged by itself, and the
gnosis will depend upon a variety of circumstances that cannot be
noted in these pages.

Prognosis. — "When we remember the variety of complex and co-
ordinate actions which perfect sexual congress requires, it seems
really astonishing that impotence should not be more common than
it is.

To make coition complete, there must be — 1. Excitement of the
glans penis. 2. Suffusion of blood through the organ. 3. Contraction
of the bulbo-cavernosi and ischio-cavernosi muscles. 4. Welling back
of the blood of the bulb in the corpus spongiosum urethrse. 5. Com-
pression of the dorsal vein of the penis by the anterior portion of the
bulbo-cavernosi muscles. Now, if any one of these phenomena is
checked or prevented, virtually impotence is the necessary result.
Thus, if the venous plexuses which make up the spongy portion of
the urethra present varicose tumours, or if the muscle is enfeebled
or paralysed, the blood not arriving in sufficient quantity at the
glans, the necessary excitement will not arise, and the erethism will
not occur, and, as the sensibility of the glans ceases, the erection will
subside.

Considering, then, the nature of the causes of impotence, we
can hardly be surprised that, in the face of any serious nervous or
organic lesions, the prognosis must be generally unfavorable, especially
in the more severe cases, or in those instances in which the affection
has been of long standing. Experience teaches us that, in many
instances where the loss of power is due to early abuse, or to too
great demands having been made upon the nervous system at a time
when it was unequal to its duties, this condition can often be remedied
by strengthening the constitution generally, and allowing it to
repose and rally — in fact, by pursuing the course exactly opposite to
that which has brought about the complaint. In cases where
there is no physical lesion or other condition rendering them
hopeless, it is certainly not by a few doses of physic, or the
administration of any stimulant or quack remedy, that we can expect
restitution of power ; and undoubtedly there is often great difficulty
in applying even the proper treatment to these melancholy cases.
The hardest part of the medical man's task frequently is to rouse
the patient from the depression which impotence induces, and to con-
vince him of the inutility of dwelling on the dreadful self -accusation,

$26 TRUE OR PERMANENT IMPOTENCE

which only tends to further unnerve him and to complete the prostration
of his system.

Lallemand remarks in his terse though rather overdrawn description
of such cases 1 — " In losing before the usual age the generative function,
man loses the consciousness of the dignity of his essential character,
because he feels himself fallen in importance in relation to his species.
In consequence, the loss of virile power produces an effect more over-
powering than that of honours, fortune, friends, or relatives ; even
the loss of liberty is as nothing compared to this internal and con-
tinual torture. Those who suffer from injustice or misfortune can
accuse their enemies, society, chance, &c, and invent or retain the
consciousness of not having deserved their lot ; they have, moreover,
the consolation of being able to complain, and the certainty of
sympathy. But the impotent man 2 asserts that he can make a con-
fidant of no one, that he can expect sympathy from no one. His
misery is of a sort which cannot even inspire pity, and his greatest
anxiety is lest any should penetrate his dismal secret." (Yol. iii,
p. 119.)

Diagnosis. — Before marriage, it has been supposed that it is very
difficult for a medical man to decide whether an individual is truly im-
potent or not. Lallemand greatly exaggerates and indeed misrepre-
sents the case, when he says that the power of easily maintaining
perfect continence and entire quiescence of the sexual organs and de-
sires " are fair grounds for presuming that there is little, if any, energy
in the generative system, for if the semen was retained in the vesiculaa
seminales it would produce from time to time energetic, or at least per-
ceptible, effects." (Vol. ii, p. 245.)

So vague a test as this can be hardly ever applied with safety. For
instance, if a healthy man has his organs well developed, suffers only
occasionally from emissions, has never abused his sexual powers, and is
subject occasionally, in the early morning, to erections ; then I should

1 I have called tliis description rather overdrawn. Any symptoms so entirely
hopeless are comparatively rare, and I must here again warn my readers against
hastily applying to themselves any descriptions or cases which are after all exceptional.
This caution is the more necessary, as I have often met with patients who seem to
have read this as well as Lallemand's book apparently with the sole purpose of dis-
covering such passages as the foregoing, and imagining that the most extreme cases
really represent their own condition. It must be remembered that this volume is
written for the profession, and in the course of its pages I have to describe severe
typical cases as distinguishing different phases of the complaints here treated of.

2 The belief, or rather assertion, of the patient, that he can make a confidant of
no one is most untrue, as my profetiion are admitted to be ever ready to i
their sympathy to the afflicted; and there are, I believe, few clergymen who would
not sympathise fully with their distresses if the sufferers would but make a confidant
of them.

TRUE OR PERMANENT IMPOTENCE 227

have no hesitation in saying that, although he may have been always
continent, and may have found it easy to be so, there is, nevertheless,
little doubt of his capacity for performing the sexual act.

If, however, real impotence is thought to exist, we must push our
diagnosis further, and inquire whether it extends to the entire act of
copulation, or only to some part of it, that is, whether the weakness
depends upon something amiss in the acts of Erection or Emission, or
in the condition of the Ejaculated Semen, subjects which have been
fully treated of in preceding pages, as it is most important that the
surgeon, in investigating the local symptoms, should discover which of
these functions is imperfectly performed, otherwise he stands but a
poor chance of relieving his patient's special complaint.

Treatment. — If, then, the preceding remarks are borne in mind,
the proper treatment is no longer a problem of extreme difficulty
Where impotence is curable at all, the general rules as to the requisite
treatment can be comprised in a very few words. To give the system
rest — to improve the general health, so that the nervous centres shall
have time, opportunity, and encouragement to rally, if that be possible
— to invigorate the muscular powers so that both voluntary and invo-
luntary muscles may regain their tone — these are among the most
important maxims to be borne in mind. At the same time it is neces-
sary to avoid as much as possible any local or other stimulants which
merely excite without strengthening. In the curable cases it is prob-
ftfale that the nervous system has merely been over-excited beyond the
natural limits which the constitution imposes. The one object the
medical man should have in view is to restore the nervous power, or
rather to allow it to restore itself — not to excite or exhaust it still
further. The diet should, I need hardly add, be of the most whole-
some and nutritious kind, for we should not forget the true old
proverb — "Sine Cerere et Baccho friget Venus."

Hitherto I have spoken of the general treatment of impotence ; in
other words, of the best means of improving the health. By doing
this, the sexual organs will, probably, in all the milder cases, become,
in common with other functions, equal to their duties. Some, how-
ever, not content with these simple means, have devised remedies for
the purpose of stimulating the flagging powers. No doubt can exist
that in certain persons, when the affection arises from some temporary
cause — more especially in the timid and hypochondriacal, or those
suffering from mental disquietude, the temporary employment of
stimulants may be very proper. But though this treatment is occa-
sionally justifiable and advantageous, it is most unscientific and
dangerous in the majority of cases— particularly in those of general
prostration — where the immediate effect of stimulating the organs can
be no other than to produce emission. Here stimulants can have no

228 TRUE OR PERMANENT IMPOTENCE

other effect than to aggravate the mischief ; whereas, had the general
health been first improved, the local disorder next relieved, and sub-
sequently a stimulant given, we could understand the formula. Such
is the true method of effecting a cure ; and I shall attempt, in
the following pages, to indicate the principles which should guide its
application. Had these principles been more generally followed, many
of the invalids we meet with would have been rescued from much
physical and mental suffering.

Cantharides have been employed against impotence. They form the
basis of the pastilles de Serail, as well as of the numerous pills, pastes,
and opiates which constitute in the East the principal commerce of
all those who sell drugs. The Spanish fly enters largely into the
diavolini and other aphrodisiac preparations still too much employed
in Italy.

Lallemand protests strongly against the use of this dangerous
stimulant.

" The effect," he says, " produced by cantharides on a healthy man,
has induced persons to believe that they could restore virility lost
from excesses. Thus, charlatans, and even many legitimate practi-
tioners, have at all times prescribed cantharides as a traditional
resource. For my own part, I have seldom met with an impotent
person who has not had cause to regret using this drug. The greater
proportion have not even experienced the momentary benefit which
they had expected ; and in many cases the erectile tissues have become
smaller than in the habitual state of repose. Some few have expe-
rienced erections more or less energetic, which have lasted a longer or
shorter period ; but the loss of semen has exasperated the symptoms
instantaneously, or very shortly afterwards." — Lallemand, vol. iii,
p. 333.

No doubt jsan exist that the habitual employment of cantharides is
prejudicial ; but in the present day, when this substance is no longer
given so indiscriminately as it was formerly, the surgeon may occa-
sionally prescribe it with advantage. Thus, where the erection is
feeble, when the fears of the patient exert much influence over his
mind, or when there is doubt of his power to perform the copulative
act, a few doses are very advisable. But after success, the remedy
must be left off, for we do not want to excite the organs frequently,
experience teaching us that the repeated shocks on the nervous system
will often only further depress the vital powers (for formula) see
Appendix A).

'Phosphorus is, in my opinion, one of those pharmaceutical prepara-
tions which the modern surgeon may most frequently employ in the
treatment of impotence. The object is to supply that particular
pabulum which the too frequent exercise of nervous force appears to

TRUE OR PERMANENT IMPOTENCE 229

exhaust. We may theoretically infer that in these complaints there has
been great expenditure of phosphorus in its various combinations, and
that there may be a deficiency of this substance in the system, just as
in some other diseases, particularly chlorosis, we are well aware that
there is a deficiency of iron. In either case we should supply the
system freely with the element it seems to need, and in such a form as
may be easily taken up and retained in the circulation. Practice, as
well as theory, seems to sanction this treatment, and daily experience
teaches me that phosphoric acid in combination with syrup of orange-
peel, and syrup of ginger, is a most valuable adjunct, in all those cases
where there is reason to suppose that semen is not secreted in sufli-
cient abundance, where too rapid ejaculation attends the sexual act, or
where connection is attended with serious nervous depression. (See
Appendix A.)

Strychnine has been frequently recommended in the treatment of
impotence, and I have found it a very valuable tonic in cases attended
with great nervous depression, whether resulting from sexual excesses
or any other cause. I have noticed it to be equally beneficial in those
forms of impotence which depend upon weak or imperfect erection. I
find that it is capable of increasing the general muscular energy, and in
such cases I usually prescribe it, either alone or in combination with
quinine, or in the form of pills combined with other remedies. (See
Appendix A.)

Electricity must be classed among the modem remedies for impotence.
I have had considerable experience of its powers, and I have every reason
to be satisfied with the results. I find that it has answered best in those
lethargic constitutions that require rousing, and simply demand a local
stimulant capable of determining blood and nervous power towards the
generative system.

If, however, I admit the value of this remedy in such cases, I must
raise my voice against the indiscriminate and general employment of
belts and other apparatus, so largely advertised. Hardly does a day
pass but I find cases coming under my notice of patients wearing these
appliances, who say they have derived no benefit, although they have
worn them for months. Such a result is not surprising. If these bat-
teries are efficient, they are always acting, and consequently are con-
tinually stimulating the sexual nerves. This, as I have above mentioned,
has a most injurious effect.

It is one thing to rouse a lethargic constitution at periods when the
stimulus is required, but quite another to keep the sexual organs in a
constant state of nervous excitability. The consequence naturally
follows that, at different and at long intervals, when the excitement is
required, this valuable remedy ceases to exert any influence, and the
most heart-rending effects are produced on the mind of the patient.

230 STERILITY

who, believing that a cure is impossible, relapses into a condition of
desperation that no one can conceive, except those who have witnessed
it. It is, moreover, difficult to rouse the nervous system a second
time. The further objection to these batteries is that, as the patient
can apply them himself, he does so at most inopportune moments, dis-
pensing with the medical superintendence of the remedy which is
necessary to secure a good result. I raise my voice most energetically
against the public using either electricity or cantharides, without first
taking the opinion of a medical man, as to whether such stimulants are
applicable to the case, and also as to the dose, and the frequency and
time of application,

SECT. III.— STERILITY

I have hitherto endeavoured to show how some disorders which, to a
certain extent, have the appearance of true impotence, or absence of
virility, are to be distinguished from the incurable condition. Before
entirely quitting the subject, I may mention another state which is
sometimes confounded with it. Sterility is the term applied to all
those morbid states which, either in the one or the other sex, prevent
the reproduction of the species when sexual intercourse has taken place.
When, however, the term sterility is mentioned, it more especially
applies to the female, and is synonymous with barrenness.

Non- descent of the Testes is a cause of impotence in some men, and it
appears almost invariably to be attended by sterility. I do not pre-
tend to say that every man who has an undescended testicle must
necessarily be altogether impotent ; a few cases are recorded of men
whose testes have never descended into the scrotum having had
families ; but I have met with several instances, one of which I shall
presently describe, where, I believe, sterility arose entirely from this
cause. It is true that in the elephant, and some other animals, in the
cetacea, in birds and reptiles, the testes are constantly found in the
abdomen, side by side with the kidneys, lungs, &c. These facts point
to the possibility that if the adult's testes are truly in the abdomen,
they may secrete x semen as readily as when in the scrotum. When,

1 I say may, for I believe that in the greater number of instances the testes, even
if free within the abdomen, will not secrete spermatozoa or living animalcules. This
subject has been repeatedly examined in France, and among others M. Goubax, pro-
fessor of the veterinary school at Alfort, says, " When the testicles remain within the
abdomen of the animal they augment very little in size. The substance of the gland,
although healthy, remains soft, as it is in the foetus. The semen which is contained
in the vcsiculoo seminales of the side corresponding to that on which the testis is in
the abdomen, is found on microscopic examination to contain no spermatic animalcules,

STERILITY 231

ST, tin 's h&Y6 been compressed into the inguinal canal, or in the
groin, such pressure may have been, and probably has been, exercised
on the glands as to impair their secreting powers.

i ders look with great distrust on animals with undescended
testes. The phenomenon of undescended testes has lately been inves-
tigated in France. M. Godard has written a very interesting account
of this condition, which he has called Cryptorcliidie. This author goes
on to say, that in the case of a dog-wolf he examined, in which both
the testes were undescended, their structure was neither fibrous nor
had they uudergone fatty degeneration ; the parenchyma was gray and
dryer than usual, although of a natural consistence ; in size the gland
was a third smaller than usual. The semen contained no traces of
seminal animalcules, but simply epithelial cells. M. Godard further
observes that, in the case of a man with undescended testicles, whom
he examined after death, the section of the testes presented no pecu-
liarity. The glandular parenchyma was of the ordinary colour ; the
canals were healthy and pervious ; the liquid which was pressed from
them contained epithelial cells, blood, and fatty globules. The vasa
deferentia contained a liquid composed of fatty globules of variable
diameters. No animalcules, but epithelial cells were present. He
personally examined the seminal secretion of many living men who had
both testes in the abdomen, and his conclusion was that in the Cryp-
torchis no seminal animalcules are ever found in the secretion, although
the ejaculated fluid has been frequently examined. He concludes that
" men both of whose testicles are arrested in their evolution are sterile,
but not impotent ; that those who have for their generative apparatus
only vasa deferentia are sterile, and nearly incapable of sexual inter-
course." — Comptes rendus des seances de la Societe de Biohgie, tome iii,
scrie 2, 1856, p. 315.

My own experience in practice certainly is, that men with unde-
scended testes have no family. I was consulted by a gentleman in
1861, in consequence of his wife's having no children. My patient
told me he had been married some years, and the lady whom I likewise
saw, presented all the external attributes of a person likely to nave a
large family, and I was aware that she had consulted a celebrated
physician, at whose suggestion the husband had come to me. There
was no suspicion on my part at the time that the testes were absent,
or even imperfectly developed. However, on examination, it was

and observation and experience prove that the animals in whom double Cryptorchis
is found are unfruitful or barren. In corroboration of these views, Mr Simonds,
the Professor of Medicine at the London Veterinary College, kindly writes to me to
say that— " Up to the present my examination of the fluid obtained from the seminal
ducts of the testes of the several domesticated animals, has shown an entire absence
of spermatozoa. I believe that sterility, not unfrequently, is due to a cause of this
kind."

232 STERILITY

impossible to detect any testicles in the scrotum, and pressure in the
groin did not give the patient any peculiar pain. There was, never-
theless, abundant evidence that the testes existed, although they had
not descended. In no other respect did the patient differ from other
men, and he assured me that the sexual feeling was natural, and that
he had connection once or twice a week, the emission being as abundant
as he supposed it would be in other men. I must, notwithstanding,
say that, as far as my personal observations go, I look with great
suspicion on the procreative powers of any person with undescended
testes.

I should, however, guard myself against saying that the respondent
was impotent ; on the contrary, such patients perform their marital
duties satisfactorily.

Before leaving this branch of our subject, I should remind the reader
that all the practical results of sterility can be, and constantly are,
produced by the mechanical effect of a —

Stricture of the urethra, by preventing the emission of semen. The
description of this form of disease of the reproductive organs is not
within the scope of the present treatise. For further information upon
it, I may refer to my larger work on the ' Urinary and Generative
Organs,' page 81.

Impregnation is, of course, rendered almost impossible by a serious
stricture, as the semen, instead of being at once ejaculated, can only
dribble away afterwards when all erection has disappeared. The act
of connection, moreover, is often painful, the pain being generally felt
during the ejaculatory act. This form of sterility is amenable to
treatment, such as dilatation and other appropriate measures for
removing the stricture.

Impotence arising from a similar cause is observed in sheep. The
high-fed and high-bred rams, from which the best breeds are obtained,
become subject to a kind of stricture arising from the deposit of calca-
reous matter in the urethra. The peculiar conformation of the organ
in sheep conduces to this result. 1

1 The glans penis of the ram consists of an oval and wrinkled swelling, divided
horizontally at the end, looking like the head of a snake. From this glans projects
a long, thin appendix, of a consistent character. This appendix, which shepherds
call " the worm," tapers to a point, and the canal passing through it is very small.
A ram is sometimes observed to be very uneasy, and apparently to be less and less
able to micturate. On examination,* the vermiform appendage is found distended
and stiffened from an accumulation of calcareous matter within the urethral canal.
This in some instances can be removed by slightly pressing and rolling the appendix
between the fingers, which will at once relieve the strangury, and save the animal,
but .frequently eit 1 cr the ram has to be killed or part of "the worm " be removed.
If sufficient is left, the ram may still be able to breed. And even if complete con-
nection is impossible, breeders still use these mutilated animals, called " teazers," to

STERILITY 233

Another cause of sterility is the inflammation of, and subsequent
obstruction of the chords ; this is further alluded to at page 225.

Carpenter, in his * Comparative Physiology,' particularises —

Obesity or Corpulence as a cause of sterility ; he says " it must be
observed that there is a certain degree of antagonism between the
nutritive and the generative functions, the one set being exercised at
the expense of the other. The generative apparatus derives the
materials of its operations through the nutritive system, and is
entirely dependent upon it for the continuance of its activity. If,
therefore, the generative activity be excessive, it will necessarily draw
off some portion of the aliment destined for the maintenance of the
fabric at large. It may be universally observed that where the nutri-
tive functions are particularly active in supporting the individual, the
reproductive system is in a corresponding degree undeveloped, and
vice versa." That excessive corpulence tends to generative debility
or sterility, is brought almost daily under my notice. It is like-
wise becoming very well known amongst breeders of the finest stock.
At the Veterinary College I have had various opportunities of seeing
this exemplified. It is noticed that sterility in bulls rarely occurs
in the commoner sorts. Those that have been seen sent to the
college, in consequence of not getting stock, are found to be the
highly-bred animals ; a class of prize stock that are not prolific ;
the owners caring only to breed animals that produce fat readily.
If we had the statistics of these high-bred cattle, we should find that
the large prices obtained for them are fully warranted, as the sire and
dams are anything but prolific ; and the vulgar saying, " a lean dog for
a bitch," is a terse but significant mode of enunciating the same
proposition.

There is every reason to suppose that in many of the highly bred
stock first alluded to, the testis has itself undergone fatty degeneration.

Sterility arising from corpulency is by no means a hopeless case,
provided exercise and attention to diet can be, and are, observed.

That sterility then frequently depends upon the undue increase of
fat in the male may be considered an established fact. There is every
.reason to believe that the same cause occasionally induces sterility
in females.

I was lately in conversation with a gentleman, a large farmer in
Suffolk. He told me that he is often disappointed when he wishes to
breed from cart-mares. This year, out of his own working stock of
twenty-eight horses, eleven mares did not stand, greatly to his disap-

excite the ewes, and so spare the valuable tups some fatigue. The subject is so
curious that it fully deserves the careful attention which Mr. Simonds, professor at the
il Veterinary College in London, has bestowed on it, to whom I am indebted for
much information on this and similar subjects.

234 IMPOTENCE AS A GEOUND OF NULLITY OF MARRIAGE

pointment and loss, as a yearling colt is worth twenty pounds, and the
mare ceases work only during one month before and during one month
after parturition. This sterility he attributes to the high condition his
cattle are kept in by the carters, who, proud of their teams, do not care
to see them in foal. To obviate it, fresh stallions have been purchased,
and with as little success, sterility still prevailing. Among these eleven
mares there were young as well as old ones, but none of them proved
in foal.

The treatment of cases of Corpulence has within the last few years
excited considerable attention, no doubt through the pamphlet of Mr.
Banting, who, however, is indebted to Mr. Harvey, a member of our
profession, for the plan he recommends. I have from the first strongly
recommended the chief features of the system as beneficial for the
general health, especially in the case of persons of a corpulent
tendency. No doubt can exist that abstinence from, or extreme
moderation in the use of fat, butter, milk, cream, bread, potatoes, sugar,
and beer, will in one week considerably diminish the weight, and in fat
persons remove many uncomfortable sensations. When a patient is
over stout the weight may be fairly and safely reduced one or two
pounds weekly. I have often found such treatment assist the recovery
of sexual power in persons in whom it has been failing. Abstinence has
been proved to work equally well with animals, and I have heard of
several instances of over-fat bulls that had become sterile, recovering
their procreative powers after being sent to work on the farm upon less
food.

Tubercular Affection of the Testes. — Sterility may also arise in
delicate constitutions from tubercles deposited in the testis itself or in
the epididymis.

SECT. IV.— IMPOTENCE CONSIDERED AS A GROUND FOR A DECREE
OF NULLITY OF MARRIAGE

On the subject of this section, medical authorities are almost
silent, and it is to be regretted that more attention has not been
paid to the question. The natural consequence of the absence of
scientific inquiry is the existence of a very considerable amount of
physical infirmity capable of mitigation or removal. The purely
medical aspect, however, is not the only or even the most important.
In these days when divorce has ceased to be the luxury of the rich,
and been placed within the reach of all, questions bearing upon the
right to a release from the marriage tie have acquired proportionately
increased importance. Impotence is, as my readers are probably
aware, a good and sufficient ground for obtaining a decree of nullity

IMPOTENCE AS A GROUND OP NULLITY OF MARRIAGE 235

of marriage, and it is upon the medical testimony adduced that the
application must stand or fall. This being so, any treatise upon the
subject of impotence would be incomplete which was simply confined
to the purely medical side. I propose in the following pages to sup-
plement my inquiries into the nature and character of impotence, with
a short investigation of the principles on which the Court acts in
dealing with applications for nullity of marriage on this ground. I
shall briefly describe the practice of the Court, and the mode of
procedure, and offer a few suggestions, founded upon my own experi-
ence, in the hope, that the effect of drawing the attention of my
reader to the subject may be the means of producing an alteration of
the law.

The legal definition of impotence is inability to consummate
marriage. This impotence must be incurable, and must have existed
from the time of the marriage, and the woman, to entitle her to a
decree of nullity of marriage, must prove herself to be " virgo intact a
sed apta viro." For legal purposes, impotence may be divided into two
heads. 1st. It may be capable of direct proof. 2nd. It may be
incapable of direct proof, but the subject of necessary inference.

1st. The non-consummation of the marriage may be attributable to
some apparent and incurable defect, such as malformation — absence of
testes— non-development — arrest within the abdomen — non-descent of
the testicles.

2nd. In the absence of any apparent physical defect the marriage
may remain unconsummated.

In the first class of cases the Court, on being satisfied of the
existence of the defect, of its permanent character, and of the
consequent non- consummation of the marriage, will at once grant
a decree of nullity of marriage. In the second class of cases the
procedure is more cautious. Here the only facts capable of direct
proof are, that the marriage has not been consummated, and that the
woman is apt for coition, and the Court will not at once infer either
that the state of circumstances is due to any defect in the
man, or that the defect, if existing, is other than temporary and
removable. The Court will, however, after the lapse of a sufficient
period of cohabitation — if the marriage still remains unconsummated —
infer that the man is impotent, and grant a decree of nullity of
marriage. The cohabitation must, in order to raise this inference,
have been carried on for the space of three years, and must have been
continuous, by which is intended, not that the parties should have
lived together de die in diem, but a general cohabiting only as is
usual among married persons. The rule as to triennial cohabitation
only applies when the inference is left to be presumed from continual
non-consummation, and not where it is plainly proved aliunde.

236 IMPOTENCE AS A GROUND OP NULLITY OF MAREIAGE

Cases where the alleged impotence is attributed to the apparent
physical causes above enumerated may or may not, according to degree,
be diagnosed with certainty, and may or may not be legitimate causes of
nullity of marriage. The rule which I adopt in practice in reference
to such cases is to advise any patient so circumstanced not to resist the
decree. And it appears to me that in accepting these physical
indications as conclusive of impotence, the Courts have adopted a test
which, though it cannot be regarded as producing absolute scientific
certainty, is nevertheless of sufficiently universal operation as to secure
substantial justice. As will be presently seen (p. 244), I am unable to
regard with equal satisfaction either the three-year rule above referred
to, or the adoption — as the test of the presence or absence of potency —
of ability or inability for erection.

The principle on which the Court acts in granting a decree of
nullity of marriage on the ground of impotence, appears to be, that in
order to constitute the marriage bond, there must be the possibility,
present or to come, of sexual intercourse ; without this possibility the
two principal ends of matrimony cannot be obtained. Incapacity to
consummate a marriage, however, is no ground for a decree of nullity,
unless the incapacity be permanent ; if there is a possibility that its cause
may be removed, the Court will not pronounce a sentence of nullity,
although such cure may be highly improbable. On this ground it has
been held that impotence not congenital, but temporarily occasioned
by excessive self-abuse, and therefore such as may possibly, though not
probably, be cured, is not a ground for a decree of nullity of marriage.
Thus in S. f. c. E. v. E., 3 S & T 240, it was decided that even
assuming the wife to be a virgin intact, a point on which some doubt
was thrown by the evidence, the decree prayed for could not be made,
as the medical men negatived malformation, and negatived impotence
from disease or natural infirmity, but ascribed the non-consummation
of the marriage to temporary incapacity, occasioned by the indulgence
of a disgusting and degrading habit, and believed' that such incapa-
city would continue until that habit was corrected, but no longer.

It moreover appears that in order to found a sentence of nullity of
marriage by reason of impotence, present impotence must be made
out, and improbability of recovery. When there is probability of
recovery the Court will not annul the marriage. Impotence, it must
bo observed, does not render a marriage void, but only voidable, or in
other words it is in the option of the injured party to hold to the
contract or annul it. " It is obvious enough," says Sir J. Wilde, " that
this matter of impotence is one which ought to be raised only by the
party who suffers an injury from it, and who elects to make it a
ground for asking that the contract of marriage should be annulled.
For although it has been said that the procreation of children is one

IMPOTENCE AS A GROUND OE NULLITY OF MARRIAGE 237

main object of marriage, yet it canuot be doubted that marriages
between persons so advanced in years as effectually and certainly to
defeat that object are perfectly legal and binding. The truth is,
* Consensus non concubitus facit matrimonium.' In all cases in which
the incapacity to marriage is one in which society has an interest, and
which rests on grounds of public policy, it would be wrong and illogical
that validity or invalidity should depend upon the option of the parties,
and in all such cases the marriage is absolutely void, and not voidable
only. But impotency has always hitherto been considered in the
Ecclesiastical Courts (and since their abolition in the Divorce and
Matrimonial Court) as a matter of personal complaint only. I do not
find the principle of the Court's interference to annul such a marriage
anywhere distinctly set forth. But I conceive that it has a sound
basis of justice in the consideration that the party complaining was,
though perhaps unintentionally, deceived in the contract and ought not
to be bound by it. On whatever ground it is rested, this much at
least is clear, that it has been, and is always dealt with as a matter of
personal complaint and grievance, and that it has been so dealt with
is apparent from the fact that the Courts have been in the habit of
requiring many conditions to be fulfilled before they would grant
relief, all of which are inconsistent with the notion that the marriage
is absolutely void. Thus the party complaining must be sincere in the
ground on which he is asking relief, there must be no unreasonable
delay, and the defect must be incurable." (A. v. B. and another, L. R.,
1R&D. 559.)

Eelief in suits of this nature is never accorded by the Court unless the
petitioner be prompt in seeking it, and sincere in the motive for doing
so. (M. f . c. C. v. C, L. E., 2P.&D. 414.) Thus, when the petitioner
in a suit for nullity on the ground of his wife's malformation had not
instituted the suit until upwards of eleven years after the marriage,
the Court, before making a decree in his favour, required an explanation
of the delay. When a man has submitted to such a grievance and has
forborne to seek relief for a considerable length of time, the Court will
presume that when he does come before it, he comes not to be relieved
from a real grievance, but for some other reason. (E. v. F. f. c. E.,
33 L. J. P. & M. 37.)

In another case where a period of ten years had elapsed between the
solemnisation of the marriage and the commencement of the suit, and
it appeared that the petitioner was actuated by an indirect motive in
taking proceedings, the Court refused to make a decree of nullity of
marriage on the ground of the husband's impotence. (M. f. c. B. v.
B., 33 L. J. P. & M. 203.)

So also in a suit by a woman for nullity on the ground of the man's
impotence, the petitioner's evidence that the marriage had never been

238 IMPOTENCE AS A GROUND OF NULLITY OF MARRIAGE

consummated was neither corroborated nor contradicted, the medical
evidence being consistent both with consummation and non- consumma-
tion. It appeared that cohabitation had continued for eight years
without complaint on the part of the petitioner, and that the separation
was caused by the respondent's ill-treatment of her ; the Court dismissed
the petition. (T. f. c. D. v. D., L. E., 1P.&D. 127.)

In another case the physical appearances of the wife were, according
to the medical witnesses, such that no opinion could be formed whether
for two years she had had ordinary and regular connection with her
husband or not. It appeared further that the wife saw her mother
about every fortnight during the two years of her cohabitation, but
she made no complaint, although she complained much of other matters,
and was by no means satisfied with her husband's treatment. At the
end of two years and a few months she left him. But the cause of her
doing so was his alleged violence, for which she summoned him before
the magistrates. At this period she had taken refuge with her mother,
and plainly desired and intended not to return to cohabitation, but
even then she did not mention her alleged ground of complaint ; the
Court held that it was impossible not to entertain the suspicion that
the desire to be set free from her husband proceeded from the same
causes as had rendered her married life unhappy, and that the grievance
she ultimately asserted might have been simulated as the sole means
of reaching her end, and dismissed her petition. (U. f . c. J. v. J.,
L. E., 1P.&D, 460.)

Similarly when a marriage took place in 1863, and the wife became
aware of her husband's impotence in 1868, but continued to live with
him till 1870, when serious disputes having arisen between them, a
deed of separation was executed, and ultimately in 1871 the wife
discovered that she had her remedy in the Divorce Court, and instituted
her suit ; the Court held that her delay and insensibility to the alleged
wrong were sufficient of themselves to constitute a bar to relief.
(M, f. c. C. v. C, L. E., 2 P. & D. 414.)

In order, then, to obtain a decree of nullity of marriage on the
ground of impotence, it is necessary that complaint should be made
by the person injured, and that the injury complained of should be the
real motive for coming to the Court. It must further appear that the
cause of the non-consummation is practically irremovable. It is,
however, necessary to show that the impotence is absolutely incurable.
A decree will be granted if the Court is satisfied either that the impo-
tence is incurable, or that it is curable only by means which the
impotent person will not adopt. Thus, in a case where the parties
had cohabited for two years and ten months, and the man's capacity
and desire to consummate were not questioned, the Court being
satisfied of the bona fides of the suit, and of the practical impossibility

Impotence as a ground of nullity of marriage 239

of consummation in consequence of the condition of the woman, pro-
nounced a decree of nullity, although there was no structural defect in
the woman. Here, although there was no structural defect in the woman,
she was suffering from an excessive sensibility, and, according to the
medical evidence, sexual intercourse was practically impossible, owing
to this circumstance, unless she adopted the remedies prescribed for
her, which she declined to do. The Court held that the absence of a
physical structural defect cannot be sufficient to render a marriage
valid if it be shown that connection is practically impossible, or even
if it be shown that it is only practicable after a remedy has been
applied which the husband cannot enforce, and which the wife, whether
wilfully or acting under the influence of hysteria, is determined not to
submit to, and granted a decree of nullity of marriage accordingly.
(G. v. a., L. R.2P.& D., 287.)

Similarly in a case where from the medical evidence it appeared
that the malformation might possibly, but at a great risk to life, and
with doubtful success as to the end desired, be removed, it was held
that the petitioner need not call upon the respondent to submit to an
operation, and that such a state of things was equivalent to a
permanent and irremovable malformation (W. v. H. f. c. W., 2 S. & T.
240).

The impossibility of effecting consummation being the ground of the
interference of the Court, it becomes necessary to ascertain the legal
significance attaching to consummation. The old libel used to charge
an absolute incapacity — " Cceundi propter inhabilitatem penem eri-
gendi" — and I do not know that apter words can be found to
describe the legal view of impotence. If sufficient erection can be
obtained to admit of penetration being achieved, the man is legally
held to be potent without any reference to the question whether the
erection has or not been accompanied with emission, although it is
evident that without emission the procreation of children is impossible,
and the husband little better than an eunuch, in whose case, as we have
seen at pages 92 and 93, erection is not ^infrequently to be met with.
Upon this point I shall presently say a few words, but I will firstly
shortly describe the practice of the Court, and then call attention to a
recent case in which the respondent was, in my opinion, hardly treated*

Suits for nullity of marriage on the ground of impotence are heard
in camera, that is, in the judge's private room without a jury, no one
being present except the judge and the parties with their counsel,
attorneys, and witnesses, and a short-hand writer.

Previously to the hearing, the parties are inspected by two medical
•men, appointed by the Court, to ascertain the appearance and condition
of their parts of generation. The result of each examination is embodied
in a certificate, both certificates being signed by each of the medical

240 IMPOTENCE AS A GROUND OF NULLITY OF MARRIAGE

men. At the hearing the certificates are produced in evidence, and
the medical men examined and cross-examined. 1

The following case, in which I was a witness, seems to illustrate very
clearly the points in which I conceive that the law, as at present
administered, works injustice, and for that purpose I will ask the
attention of my readers to it.

Proceedings had been instituted by a wife against her husband for
a decree of nullity of marriage on the ground of his impotence. I was
appointed by the Court to conduct the examinations on behalf of the
respondent. This gentleman had been previously under my care as a
patient, but did not consult me until after his wife had become
estranged from him, and withdrawn herself from cohabitation. At
that time his general aspect and local condition were as follows :

General aspect. — Stout, but with an unhealthy complexion, consider-
able hesitation in his speech, betokening some threatened affection of
the brain, very nervous, great depression of spirits, digestion bad,
fully under the impression that he could not recover, and utterly
unable to get through the great press of business which had
worried him, and to which he felt quite unequal.

Local condition. — Flaccidity of the organs, no morning erections,
oozing of fluid on going to the water-closet, and after micturition
unattended with erections. On his consulting me I gave him the
following general directions as to the course of life he should follow. ' I
advised him to absent himself from business two or three times a
week, to take plenty of exercise in the open air, to be very careful as
to his diet, and to be as much as possible in ladies' society.

The local treatment consisted in strengthening the organs by pass-
ing bougies with a view to bringing the parts back into a healthy
state, and rousing the organs which had fallen into a state of lethargy
for want of use. As soon as the parts had by these means become
restored to their normal condition, I cauterized the urethra in accord-
ance with the modified practice first introduced by that distinguished
surgeon, M. Lallemand, and which is fully described at p. 162, et sea.
The eminent Frenchman to whom the profession is indebted for the
introduction of this method has always been accustomed to find it most
efficacious in restoring power to the sexually weak, and my experience
entirely coincides with his ; nor did the case now under consideration
form in my opinion any exception to the general rule.

1 In examining the petitioner on behalf of the respondent too great precaution
cannot be taken. It is better that the petitioner's surgeon should be invited to
make the first examination, and to state whether the petitioner is or is not, in his
Opinion, virga intacta sed apta viro. This would prevent the possibility of any
alleged rupture of the hymen being attributed to the surgeon appointed on behalf of
the respondent.

IMPOTENCE AS A GROUND OF NULLITY OF MARRIAGE 24l

The respondent's appearance and condition at the time of the trial
•were as follows : — Spirits good, able to attend to his business, feeling
equal to any amount of work arid enjoying society. He passed
through his examination and cross-examination without hesitation ;
while as regards his local condition, the organs had. regained their
vigour. Morning erections were experienced, and the escape of semen
except under sexual excitement had entirely ceased.

In fact, his progress had been thus far so satisfactory that had it
been possible for him to appeal to the congressus — a mode of proof
formerly allowed in a neighbouring country — I feel no manner of
doubt that he would have passed triumphantly through his ordeal.
But no such appeal being possible, and his wife refusing the oppor-
tunity which he sought of putting his newly acquired powers to the
test, by declining to resume cohabitation, the change in his condition
could not for judicial purposes be placed higher than matter of opinion.

Under the circumstances I was necessarily compelled to abstain (in
giving my evidence) from asserting that the respondent was absolutely
cured, he not having demonstrated his powers by successful con-
nection.

I also felt constrained to admit that, if the wife was unwilling or
indifferent, I could not vouch that their intercourse would result in
consummation, and further that should any coldness be shown, or no
encouragement be given, my patient might still continue impotent. He
was to the best of my belief perfectly competent to consummate marriage
with a willing wife. In fact, so convinced was I of the restored
powers of my patient, that at a consultation attended by all medical
men on both sides previously to the hearing, I proposed that cohabita-
tion should be resumed between the parties, and that if consum-
mation did not follow, the respondent should allow the decree to pass
without any further opposition on his part. This offer was, however,
declined.

The certificates signed by the surgeons representing each party,
after examining the petitioner and respondent respectively, were as
follows :

The Petitionee's Ceetificate.

1st. That we have examined the parts and organs of generation of M — , otherwise
B — , the petitioner in this cause, and that we find the said Octavia M — , otherwise
B — , has no hymen or vestiges of one, otherwise she is normally formed in those
parts.

We are of opinion that there is no physical impediment on her part to prevent the
consummation of marriage.

The Respondent's Ceetificate.
We have examined the parts and organs of generation of C— B— , the respondent

242 IMPOTENCE AS A GROUND OF NULLITY OF MARRIAGE

in this case, and that we find no apparent impediment to the consummation of
marriage.

The said B — states he has been for some months under medical treatment, and
that he believes he has now the power of consummating marriage.

I append a transcript of the judgment delivered by Sir James
Hannen in this case, which will, I apprehend, unless the law can be
altered, rule all subsequent cases.

" I am of opinion that I ought to pronounce a decree of nullity of
marriage in this case. Where a healthy man and woman sleep
together for some considerable time, the presumption is that con-
nection will take place, and if it does not take place, the presumption
is that it arises from some inability on the part of the one or the
other, if the circumstances are such as to exclude the idea of the absence
of connection from the result of wilfulness on the one side or the
other. The evidence satisfies me in this case that neither on the one
side nor on the other was there any unwillingness to consummate
marriage ; on the contrary, there was the natural desire on the gentle-
man's part, as well as on the part of the lady, that the marriage
should have its usual results. Now, my view of the effect of the three
years' cohabitation rule is this : it does not do in cases of this kind
lightly to assume that because the connection has not taken place as
speedily as it usually does take place after the marriage, therefore
there is physical inability. There is no doubt on the part of the woman
frequently, coyness, and exaggerated delicacy, and nervousness, which
may interpose obstacles on her side to the consummation ; on the
other hand there is no doubt, that the very solemnity, I may almost
say sanctity, of the relations that have been created between the man
and the woman has an effect upon the man's mind, which operates
upon his body and prevents for a time, until he recovers the due
balance of his mind, the consummation of the marriage. It is right,
therefore, that time, and ample time, should be given in order to
ascertain whether absence of connection results from one of the tem-
porary causes, or results from a lasting inability on the one side or the
other. Now, the three years' rule has been adopted as a time which
for all ordinary purposes must put it beyond the doubt of the
tribunal having to determine such a matter, that the inability is not
of a temporary but of a lasting character. Now that, it is admitted,
has been always so considered in the courts having to deal with
these matters. That is evidenced clearly by the authorities, and it
matters not whether a three years' rule be taken as a hard and fast
line in the sense that the three years must elapse, or whether some
time something like three years, as in the case before Dr Lushing-
ton. It matters not, I say, how that is to be treated, nevertheless, a

IMPOTENCE AS A GKOUND OF NULLITY OF MAREIAGE 243

period something like three years has hitherto been considered
sufficient, but, says Dr Deane, we cannot put any arbitrary limit
upon the advance of science, we cannot say so far and no further will
it go. I believe that is so, but I must not make a particular suitor
who comes before me the object of experiment upon such a subject.
Whenever, if ever, it shall be established that, though a man has been
incapable of sexual intercourse for three years, he has recovered the
power, then and then only will the question arise whether or not I
should alter the rule which at present prevails ; but it is clear that at
present it cannot be taken as established that after such a period of
time a man who has not had the power during that time will recover
it. Sir William Fergusson very properly limited his evidence to a
statement that there was a chance of recovery. But I repeat, this
lady must not be made to speculate upon chance. With regard to Mr

Acton, no doubt he has pronounced a more confident opinion

I suppose, from the nature of the inquiry, he was unable to state
with more positiveness that he ever had known a case in which, where
there was want of sexual power to have connection during three
years, it ever had been restored. Now, hoping very much indeed that
he may be right in his view of what may hereafter be discovered, I am
not satisfied upon this evidence that there is any reasonable hope
that this gentleman will ever recover that power which it is admitted
during the three years that he had the opportunity of sexual inter-
course with his wife he was not possessed of. I therefore pronounce
a decree of nullity of marriage."

I fully admit that both the decree and the reasoning upon which it
was based are according to the present state of the law perfectly
sound and xmimpeachable. My quarrel is not with the decree, though
I have no doubt that its effect was to inflict considerable hardship and
injustice upon my patient. My complaint is with the faulty state of
the law, which compelled a judge so eminent to pronounce a decree,
from a medical point of view, so erroneous. The three years' rule is
the creation not of medical men but of lawyers, and proceeds upon a
misapprehension of the true nature and character of impotence, for
which the medical profession is undoubtedly responsible. Inability to
consummate marriage, in other words want of erectile power, are
treated as synonyms for impotence, whereas these are in truth merely
indicia from which, when taken in connection with other circumstances,
impotence may be inferred. This confusion of thought unfortunately
extends also, as we have seen, to the word impotence itself, under which
term various types of disease absolutely different are lumped together
and treated as one and the same form of complaint, and that form an
incurable one. Impotence is assumed to be an incurable condition,
and its existence to be demonstrated by the fact of non-consummatioa

244 IMPOTENCE AS A GEOUND OF frULLITY OF MAEEIAGE

during the period of three years. This is the position on which the
three years' rule rests ; I confess that it is apparently justified by the
prevailing notions both among scientific and unscientific persons ; but
I venture to think that in proportion as the nature of impotence
becomes the subject of further scientific inquiry, the unsoundness of
the rule will become apparent. The period is too long, if all that is
required is time for the husband to recover his balance of mind, or
the wife to abandon her coyness. It is more than sufficiently long,
if the man is really impotent, to secure for the wife, perhaps for
both, a very wretched existence ; it may be too short — if removable
cause of mischief exists, and the respondent has not taken steps to
obtain competent medical advice. The principle is admitted that if
non-consummation — as in the case of the masturbator, p. 236 — is
attributable not to innate want of power, but to a removable cause,
however remote the probability of removal may be, no relief can be
given to the complaining party, and this is the true principle by
which all the cases should be governed. The true point to be ascer-
tained is not so much whether the marriage is in fact unconsummated,
and has remained so during a period of three years, as what the
actual condition of the person is, to whose want of capacity the non-
consummation is attributed, and whether the evidence adduced as to
his condition holds out any reasonable prospect of his ultimate reco-
very, if submitted to proper medical treatment. A man capable of
consummating marriage is a man possessed of virility ; a man incapable
is either, one from whom virility is absent, or one in whom virility is in
abeyance. Absence of virility is the only condition on which a decree
of nullity of marriage should be founded, for to supply this deficiency
creation is necessary, and creation is beyond the power of science.
Virility in abeyance, on the other hand, may be due to masturbation,
want of confidence, feeble erection, and many other causes all more or
less susceptible of being remedied by art and skill, and it is unreason-
able that the indulgence extended to the masturbator should be with-
held from other persons whose cases — while assuredly not less deserving
of sympathy — are perhaps more susceptible of cure.

As the law at present stands a man practically impotent may be
pronounced efficient, while another capable of becoming efficient may
be pronounced incurably impotent. So long as the question of
potence or impotence is made to depend solely upon the question — has
penetration been effected or not — so long will this unsatisfactory con-
dition of things continue. If it can only be proved, that there is
sufficient erectile power in the penis to penetrate and rupture the
hymen, no judge would decide such a husband to be impotent, although
no emission followed the erection ; but, as we have already seen, an
eunuch may have erections (p. 92), and this husband may for all

IMPOTENCE AS A GROUND OF NULLITY OF MARRIAGE 245

procreative purposes be no better than an eunuch. On the other hand,
a man who has morning erections and nocturnal emissions, but is
unable to effect complete penetration, may become capable, under
proper medical advice, of procreating children (which in the last
preceding case must be impossible), and yet, merely because he has
not within three years consummated marriage, he is stigmatised as an
impotent man unless his failure can be clearly attributed to mastur-
bation.

The present state of the law may be shortly summarised as follows :
A man who has well-formed testes and penis and an occasional
erection sufficiently strong for penetration — although he has obstruction
of both spermatic chords so that ejaculation of semen and consequently
impregnation of his wife is impossible, and who consequently, from an
anatomical or physiological point of view, is little, if at all, better than an
eunuch — is nevertheless legally potent, and his wife can obtain no
judicial release from his sterile embraces. A man who has occasional
morning erections and nocturnal emissions, and who, medically speak-
ing, is potent or able to become so under treatment, is — if he does not
happen within a period of three years from the day of marriage to have
effected penetration, unless he should be a masturbator — legally im-
potent.

\A man who masturbates himself, and thus debars himself from
ability for sexual intercourse, is legally potent ; he may degrade himself
and his wife by practising by her side his disgusting habit, and his
wife can obtain no judicial separation from her filthy companion.
Surely this state of the law is opposed alike to medical science, to
common sense, and to common decency, and requires amendment.
When we remember that though, in a certain sense, the law is made
by lawyers, they can, when dealing with scientific subjects, use in
the manufacture such materials only as science supplies, we shall
recognise that it is incumbent on the medical profession to diagnose
more accurately than has ever yet been done the causes of sexual
weakness, and thus enable the lawyers to relieve from the charge of
inconsistency and hardship the administration of the law on a point
that so materially affects the happiness and welfare of mankind)

In the meantime the lawyers may do something themselves towards
placing the law on a more satisfactory footing. Let the principle
enunciated in S.,/. c. E., v. F., which I have cited above, be a little
more generally applied, and much will have been effected. In conjunc-
tion with the wider application of this principle it will be necessary also
to extend the medical test of impotence. The inspection of the persons
both of the man and the woman must be retained, in order to place in
the possession of the medical witnesses the information obtainable
from physical indications, but the inquiries of the surgeon should

246 IMPOTENCE AS A GROUND OP NULLITY OF MARRIAGE

not cease with the inspection. He should apply himself to discover
so far as possible the actual condition of the man, paying especial
regard to whether or not he then has, or at any time previously, has
had morning erections and nocturnal emissions. If as the result of
the inquiry, it shall appear that in addition to failure to consummate
marriage, he then is, and always has been free from these symptoms,
His condition may safely be attributed to absence of virility, and a
decree of nullity of marriage on the ground of his impotence will be
properly pronounced. If as a result of the inquiry — notwithstanding
the non- con summation of marriage — the indications to which I have
above referred shall be discovered, equal weight should in my opinion
be given to them as to the fact of the failure being attributable [to
masturbation. In both cases there is possibility of recovering potency,
both alike come under my heading of virility in abeyance — in the one
case a filthy habit, in the other functional derangement, are the assignable
causes of failure ; the former is within the power of the will, the latter
amenable to medical care and skill ; in neither, unless in both, ought a
decree of nullity of marriage to be pronounced. I would further sug-
gest that in doubtful cases no decree ought to be pronounced unless
it appears that the person charged with impotence has been under
competent medical treatment, even although three years may have
elapsed without consummation, as in cases where a cure is possible a
few weeks are ordinarily sufficient to effect it. The rule I suggest
would inflict no appreciable hardship on the petitioner.

The following question has often been put to me by counsel: —
" Surely, you do not pretend that a man can be otherwise than impotent
who for months or years has cohabited with his wife and slept in
the same bed without having had sexual relations with her ?" Strange
as it may appear, I am satisfied that such a state of things is not
only possible, but that it often exists. The fact is, as I have already
pointed out (p. 212), that in many women sexual feelings are either
very slight or entirely dormant, at all events, until aggressively
aroused. If a cold or nervous man should be married to a woman of
similar disposition, I know it is quite possible that they may cohabit
together and sleep in the same bed for months and years without any
sexual intercourse taking place, and it is obvious that every day that
passes after the marriage without consummation being attempted, de-
creases the probability of and even the ability (unless medical treat-
ment is had recouse to) for sexual congress. It often happens that
time passes on without the marriage having ever been consummated,
and the parties live happily together untroubled by sexual thoughts.
At length estrangement arises, mutual disappointment, incompatibility
of temper, or poverty, or some other cause intervenes, or perhaps the
lady forms an attachment for some other man, and so separation comes

IMPOTENCE AS A GROUND OF NULLITY OF MARRIAGE 247

to be desired, a lawyer to be consulted, and a petition for nullity of
marriage on the ground of the husband's impotence to be presented.
In such a case the non-consummation of the marriage has clearly in-
flicted no hardship on the wife, and is attributable as much to her own
fault as her husband's, and the wife as little deserves to be released from
her contract as the husband does to be burdened with an odious stigma
as the price of her freedom.

In concluding this part of the subject, I can only express the hope
that greater attention, than it has received in the past, may be vouch-
safed to it in the future by the medical profession. Assured as I am
that just as in former days men were consigned to helpless confine-
ment, as idiots and lunatics, whom proper treatment would have
restored to society and usefulness, so now many are condemned to bear
the stigma and privations of impotence who are in fact merely the
victims of ailments removable by medical care and skill.

Upon these cases, which I consider have hitherto been neg-
lected and misunderstood, I have attempted to throw new light, and
I have eveiy reason to hope that in future distinctions will be made
between many of these cases of impotence which are now mixed up
together, owing to the assumed inability to distinguish between the
true and false complaint.

I consider these charges of alleged impotence some of the gravest
that can be brought against a man. They, like some other accusations,
are easily made, but not so easily disproved.

In my opinion these suits for nullity of marriage are becoming
much too common, 1 and I hope the law will cease to countenance some
wives in dishonouring instead of honouring the husbands they have
sworn to cherish, and this the more especially as a worldly experience
teaches me that a woman seldom brings these charges till she has formed
another attachment.

1 I have been told that the instances of women seeking divorce on account of
impotence have largely increased of late, the increase reaching the formidable pro-
portion of about 12 to 1 in the course of the last twelve months.

FOURTH PERIOD-ADVANCED LIFE

THE FUNCTIONS AND DISORDERS OF THE REPRO-
DUCTIVE ORGANS IN ADVANCED LIFE

PART I
NORMAL FUNCTIONS IN ADVANCED LIFE

My readers will by this time have become aware that in child-
hood the generative functions should be absolutely quiescent, that
even in youth the sexual powers are rather to be husbanded than
taxed, and that the adult himself should be chary of exhausting
those capacities which nature has given him for the continuance of his
species.

We have now to consider these functions, powers, and desires in
advanced life ; and it will appear that old age resembles youth in this,
that, if the elderly man wishes to preserve his intellectual faculties,
health, and vigour, and would enjoy a long life, he must be content
with, at most, only a very moderate indulgence of the sexual passion.
His motto should be, " Deposui arma miles inermis."

Fortunately for the individual, moderation is usually practised. The
elderly man has generally learned from experience that the generative
function could not have been wisely, or, indeed, duly exercised, before
the body had attained its entire development — that it is the test of
manhood, the crowning effort of maturity, and that it must diminish
with a waning frame. Experience ought to have taught men that we
require a sort of vital exuberance, to transmit what may become another
being ; and this prerogative is given to us only during the prime of our
existence."

"Love," Parise, 1 that elegant writer, says, "at the decline of life,

1 It has been very much the fashion to decry the French school. That many
prurient ideas have been given currency to in La Belle France no one pretends to
doubt, but every reader acquainted with French literature must be aware that among
its writers exist men who have given most valuable assistance in recommending
moral conduct. In this category no one stands more prominently forward than

NORMAL FUNCTIONS IN ADVANCED LIFE 249

should take quite a moral character, freed from all its animal propen-
sities. In the elderly man, it is paternal, conjugal, patriotic attach-
ment, which, without being so energetic as the love experienced in
youth, still warms old hearts and old age ; — and, believe me, these
have their sweet privileges, as well as sometimes their bitter realities.
These autumn roses are not without perfume — perhaps less in-
toxicating than that arising from first love, but presenting none of its
dangers."

" One of the most important pieces of information which a man in
years can attain is, ? to learn to become old betimes,' if he wishes to
attain old age. Cicero, we are told, was asked if he still indulged in
the pleasures of love. ' Heaven forbid ! ' replied he, ' I have foresworn
it as I would a savage and a furious master.' 1

" When you see an elderly man, judicious, endowed with firm reason,
whose enlightened and active mind is still capable of directing his
affairs ably, and making himself useful to society, be convinced that
such a man is discreet and continent, and that temperance — so justly
called Sophrosyne, the Guardian of Wisdom, by the ancients — has in
him a fervent admirer; in fact, he has acquired his perfect moral
liberty." — Traite de la Vieillesse, p. 431.

M.' Flourens, in his ' La Longevite Humaine,' says — " It is at the
turning point of the physique that the morale enters, in turn, upon its
empire — strengthens, expands itself, and gives, as it were, a splendour
to the second half of life."

"Age has a much greater effect on physiological than on senti-
mental love, as the latter has less need of physical force or juvenile
exaltation. There are men who, always young in heart and imagina-
tion, have towards this pure love a constant devotion which, ever

M. Parise, for many years Secretary to the Royal Academy. I am proud to acknow-
ledge the great advantage I have derived from the perusal of his work on old age.
It breathes that spirit of contentment, and is written in such pure and elegant
French, that I fear I shall be unable, in many instances, to give the true rendering of
the text ; but I regret this the less if I shall induce my readers to refer to the
original. I am fully convinced they will not be disappointed, but agree with me
that, among modern French literature, valuable moral instruction is to be found
draped in the most eloquent language.

1 This saying is attributed to more than one great man of antiquity ; to Sophocles,
for instance. At the beginning of Plato's Republic, the merry old Cephalus says :

" I was once in company with Sophocles, the poet, when he was asked by some
one, ' How do you feel, Sophocles, as to the pleasures of love ? Are you still able to
enjoy them ? ' ' Softly, friend/ replied he, ' most gladly indeed have I escaped from
these pleasures, as from some furious and savage master.' "

And again of Cato —

"Quam in eo quidam jam affecto oetate quaereret, utereturne rebus venereis
Dii meliora" inquit, "s. lubenter vero istinc tanquam domino agresti et furioso
profugi."— Cato Maj., c. 47.

250 NORMAL FUNCTIONS IN ADVANCED LIFE

renewing itself, seems to reanimate instead of exhausting the vital
principle."

Parise says — " It is usually at the age of fifty or sixty 1 that the gene-
rative function becomes weakened. It is at this period that man,
elevated to the sacred character of paternity, and proud of his virile
power, begins to remark that power decrease, and does so almost with
a feeling of indignation. The first step towards feebleness announces
to him, unmistakably, that he is no longer the man he was. He may
retard the effect up to a certain point, but not entirely. This law must
have its full and entire execution, " dura lex sed lex." The activity of
the generative organs diminishes, their functions abate, languish, and
then cease entirely. The wish and the want are no longer one and the
same thing; the imagination does not exercise its olden power and
fascination on these organs.

" Blood now only flows in small quantities towards the testes. Their
sensibility becomes blunted, and is reduced to what is sufficient for the
nutrition of the parts. The scrotum is observed to become wrinkled
and diminished in size, the testicles atrophy, and the complicated vas-
cular tissues which form them become obliterated ; the semen, that
peculiar secretion of the blood, is not only less abundant, but has lost
its consistence and its force. The animalculse, or zoosperms, which
constitute its nature or its essence, far from being as numerous or active
as formerly, are, on the contrary, few and languid."

Dr Duplay, physician to the Hospital for Incurables in Paris, states that
he examined the generative organs, in order to discover the existence or
absence of semen, in 51 old men who died of various acute and chronic
diseases, aged from sixty to eighty-six. In 37 he established the pre-
sence of spermatozoa, and in the other 14 he was unable to find traces
of them. In 27 instances the spermatozoa were perfectly well formed,
and similar in every respect to those found in the adult. In the other
10 cases neither the heads of the spermatozoa nor their tails were per-
fect. The quantity varied greatly. In some old men spermatozoa were
as numerous as in adults ; in 14 instances they were rare, but still
perfectly developed.

Spermatozoa may be found in the whole extent of the vasa def erentia,
as happened in 26 instances, or at one point only of the secreting
apparatus. Thus, three times only, the semen contained in the vasa
def erentia alone showed them ; that in the vesicul® evincing no traces.
Once their presence was shown in the liquid of the vesiculse seminales,
and not in that of the vasa deferentia. They were found seven times

• The Cardinal Maury is said to have told the celebrated Portal that " a man of
sense past fifty ought to give up the pleasures of love, for every time he indulged
in them he threw on his head a handful of earth." (Anglice, " drove a nail into his
coffin/')

NORMAL FUNCTIONS IN ADVANCED LIFE 251

in only one vesicula, four times in the right, and three times in the left
to the exclusion of that on the opposite side and of the two deferent
canals.

Semen was very abundant in 3 cases, moderately so in 24, and in 10
cases there was but little to be seen.

Semen, then, may be discovered in old men whose testes are atro-
phied to a considerable extent, and it clearly appears from the above
investigations that the secretion of semen takes place in the old man,
although slowly, just like that of the saliva, bile, or pancreatic fluid.
What proves it is that semen is found in the whole course of the
spermatic canal ; it is met with not only in the vesiculee seminales, but
in the deferent canals, in the epididymis, and in the testis itself (see
Diagram, p. 104, in explanation of this) ; and the spermatozoa are
found likewise in all these situations. It is, therefore, probable that
if, among the spermatozoa which the microscope enables us to dis-
cover, some date from long antecedent periods, there are others that
have been recently formed. The oldest of these twenty-seven persons
in whom spermatozoa were found was eighty -two years of age ; and the
rest were from sixty to eighty -two.

Dr Duplay concludes by saying, — " If old men are not so apt to
beget children as adults, their inaptitude depends less on the compo-
sition of the semen than it does on a want of the other conditions
essential to the reproductive acts." 1

I would supplement these observations by the statement made to
me by several most observant and intelligent elderly persons, who
assure me that as they have advanced in life the emission of semen
has been attended with absolute pain — a sort of scalding or burning
as the fluid passes. This is so great that they dread the occurrence,
as it takes away from the pleasure of the act. Does this arise from
the muscles aiding in the act very feebly ? Can it depend upon the
canal being less pervious, or upon a diminution of the accessory fluids
which make up the bulk of the semen ? I cannot decide, but of the
fact I have no doubt.

Should any after this exclaim in reply to my cautions against
excesses, as some of my senior patients have, "Why may I not
exercise my sexual organs, as your science shows that nature still
provides fertile semen ?" My answer is, " do not attempt to spend a
great deal out of your small capital.' ' Old age cannot support the
drain and the subsequent nervous depression arising from ejacula-
tion. Science merely shows that secretion is not absolutely stopped
by bountiful nature ; it only proves that semen is formed slowly, and
with effort, and may remain for a long time pent up in the canals

1 'ArchivesGenerales de Medecine/ quatrteme s£rie, torn. lxxx, Dec, 1852, p. 393.

252 NORMAL FUNCTIONS IN ADVANCED LIFE

which have secreted it. I have often occasion to reiterate that pro-
fessed breeders of animals refuse to rear the produce of old sires or
dams, and have learnt to recognise this class of young stock by
several marks, as for instance the deeper hollows over the eyes, and
by the sunken eye itself. So well are these facts known to horse-
dealers, that they refuse to purchase young horses presenting these
appearances, being convinced that they will not stand work, or turn
out well. As far as my experience goes, no doubt can exist that old
men may and do retain the power of connection under the influence of
certain stimuli. Even intercourse may be, in some healthy old men,
frequently repeated. Such men may have children, but experience
teaches us that these infants are difficult to rear, they are not the best
specimens of the English race. Too many are of a nervous irritable
frame, their intellectual qualities are not equal to those of the father,
and they suffer as they progress in life from affections of the brain
and nervous system. It is an undoubted fact, and is now become
generally admitted, that from the moment of conception of the indi-
vidual the duration of existence is, to a certain extent, pre-determined,
in accordance with the organization which he has received. I think
all will agree, then, that a human being born with a rich stock of
force and vitality will take a greater number of years to arrive at the
culmination and the term of his existence, than another born under
opposite conditions (even though more favorable as far as worldly
externals are concerned). We are, therefore, forced to the conclusion
that the children of old men have an inferior chance of life ; and facts
daily observed confirm our deductions. Look but at the progeny of
men who marry late in life, what is its value ? As far as I have seen,
it is of the worst kind — spoilt childhood, feeble and precocious youth,
extravagant manhood, early and premature death.

In speaking thus, however, I must not be supposed to set my face
against even elderly men marrying if they will, but let them select a
suitable companion. What I object to is December allying itself with
May. Daily do I give my sanction to a man advanced in life (but left
on the strand, without relations or friends) marrying if he has the wish,
and his health is good, and he can select a lady of suitable age. My
opinion is, that if such a man avoids marital excesses, the best thing
he can do with a view to prolonging life is to marry. Certainly I
can say that the results I have witnessed have borne out the correct-
ness of the advice I have given ; marriage even late in life has conduced,
in numerous instances' that have come under my observation, to the
happiness and longevity of many elderly people. It is only against
injudicious and ill-assorted marriages and consequent injurious
excesses that I set my face.

253

PAET II
DISORDERS IN ADVANCED LIFE

From the above remarks we gather that the functions of the gene-
rative organs should be husbanded, not abused, in advanced life.
Extreme moderation should be inculcated, and the greater the age
the greater the moderation. Entire continence — the rule of youth —
is hardly less the rule of age. The transgression of this rule, indeed,
in age is more fatal than in youth. There is no superabundant stock
of vitality to repair its destructive waste of error or extravagance. 1

The greater part of mankind, however, show excessive feebleness in
withstanding the abuse of the generative functions ; and what
surprises us most is, that those advanced in life are not always the
least exposed to this reproach. It is certain that in old age, at a time
when the passions should have given way to reason, there are still
many individuals who allow themselves to stray imprudently on the
very precipitous edge of these dangerous enjoyments. They applaud
themselves for postponing moderation till it is rather forced 2 than
voluntary; till they stop from sheer want of vigour. What heroic
wisdom ! Nature, pitiless as she is, will most certainly cause them
to pay dearly for the transgression of her laws ; and the steady accu-
mulation of diseases soon gives demonstrative proof of it. This result
is the more certain and prompt, inasmuch as in these cases excesses
are almost always of very old standing. The libertine in advanced
years has usually been dissolute in youth and manhood, so that we may
trace the progress and calculate the extent of his organic deterioration.

" If we possess ever so little reflective or physiological knowledge of
mankind, how can we fail to inculcate rigorously the precepts of con-
tinence, more especially as we find them calculated to maintain both
the duration and happiness of our life ? It is well established that,
of all the powers of the economy, no one is lavished upon us by
Nature with greater profusion or, at the same time, within more
clearly defined limits than this one of generation."

For the purposes of description, I shall, in the following pages,
divide the functional diseases in elderly persons in the following
manner, premising that it is principally from excesses that those
advanced in life suffer. All I have to say may be, I think, included
under the following heads which will enable me to arrange some

1 See observations bearing on this question, at p. 45.

2 Some writer has said, " We do not forsake our vices, our vices forsake us."

2&4 DISORDERS IN ADVANCED LIFE"

curious facts which have not hitherto met with that consideration
from the profession which their importance deserves :

1. Functional disorders in persons who do not "know the consequences of

repeated acts of sexual intercourse, and commit excesses from
ignorance.

2. In persons who know the consequences of sexual excesses, but cannot

control their passions.

3. In debauches who, hoping to supply the loss of power consequent on

their previous excesses, deliberately choose to stimulate the repro-
ductive organs for the purpose of gratifying their animal passions.

CHAPTEE I

FUNCTIONAL DISORDERS IN PERSONS WHO DO NOT KNOW THE
CONSEQUENCES OF REPEATED ACTS OF SEXUAL INTERCOURSE,
AND COMMIT EXCESSES FROM IGNORANCE

It is somewhat curious to notice the naivete exhibited by elderly
gentlemen. Patients from sixty to eighty come to me, complaining
that they are not sexually so energetic as they were ; that the sexual
act is no longer attended with the same degree of pleasure as formerly,
They grumble because desire does not come on so frequently, or
because, when they attempt the act, they no longer experience perfect
erection.

These are among the most difficult patients we have to deal with, and
their treatment requires considerable tact and discrimination. I, how-
ever, attempt to meet them on their own ground ; I inquire at what
age they began to indulge the sexual instinct — whether in some
official capacity they have not resided in warm or trying climates —
and, with proper respect for proprieties, inform myself as to their
antecedents. Thus armed, I ask them if they have considered the
consequences which they wish me to bring about. I appeal to their
common sense, and gently remind them that their symptoms may be
slight warnings of the approach of the enemy ; that, as old soldiers,
thej should begin to exercise a little caution. I even dare to recall to
their recollection that man has other duties which require his attention
besides those of reproduction. I ask them if they have no pleasure
in the luxuries of the table, or if they wish so to derange their health
that their appetites shall fail. I remind them of the saying of Bichslt,
" that the organ of taste is the last thread on which hangs the pleasure
of living." I repeat a few of the hints I have already detailed ; and
beg them to look around, and consider if their old friends who marry
young wives have improved in health, or if they cannot call to mind

DISORDERS IN ADVANCED LIFE 255

some very notable instances of the reverse. It occurs to them, and
they do not deny, that this may be even so ; and as life, and, above all,
life with good health, is fully appreciated by this class of men, they
become better satisfied with their position, and often appreciate my
motive in thus warning them. When I further remind them that, if
nature has interdicted great sexual indulgence, it still has reserved for
them many compensating pleasures ; and when I hint a little later that
there are other and higher enjoyments and duties which their position
in society warrants and demands, we usually part pretty good friends.
I trust I have in this way been the means of rescuing many a man
who has been on the point of damaging his health in ignorance, from
the dangers which beset his path, and have preserved his powers for a
more prolonged discharge of his higher duties than could, under other
circumstances, have been hoped for. Lord Bacon's dictum, " Age doth
profit rather in the powers of understanding than in the virtues of the
affections," is not only the observation of a fact, but the inculcation of
a pregnant moral.

It cannot be concealed that there are persons moving in good society
(although fortunately they are few) who come to the surgeon osten-
sibly for other reasons, but virtually under the belief that he will pre-
scribe something that will excite their flagging powers. I have already
alluded at length to these cases, and fully described the language
which the profession does and should hold towards them.

In all such cases the man advanced in life should be at once told
that, although his powers are somewhat enfeebled, no immediate mis-
chief has occurred (if the surgeon can conscientiously say so) — nature
only wants rest, and all will be well. It is of great importance that
the sexual fears of the elderly person should be quieted. We have
seen, in previous pages, the influence of the imagination on the sexual
ideas. As age advances, this effect grows still stronger — it is of primary
importance that the morale of a man should be strengthened ; and I at
once tell these patients most positively, that I can relieve their present
sufferings ; but if I attempt to renovate their sexual powers, I must
exact a promise that after recovery they shall use them with extreme
moderation. On no other terms will I undertake the case ; for I tell
them it is a better guarantee for their life and happiness to remain
invalids as they are than to have their organs strengthened and then
to kill themselves by inches through fresh fits of excitement. I need
hardly say that every upright practitioner refuses to be an accomplice
in any way whatever to mere excitement. Libertinage, men should be
told, is bad enough at any age ; in the elderly man it is a crime, and one
that no conscientious surgeon will lend himself to abet. This language
held to elderly men is good in more ways than one. It proves to them
that their weakened condition depends upon themselves and not upon a

256 EXCESSES IN ADVANCED LIFE

dreamy life alone ; it " pulls them up " at a moment when they may
be disposed to go astray. The assurance that their case is amenable
to treatment, if they will only observe the ordinary rules of moderation
encourages them to leave the vicious course they may have drifted
into, and regain that peace of mind the loss of which preys greatly on
the bodily health of such men. No " man of the world " can pretend
to be shocked by advice of this kind; many take it in good part,
common sense telling them that it is reasonable, and that they must
follow it, if they would preserve their health.

Experience has taught me how vastly different is the situation of the
class of moderate men, who, having married early, have regularly in-
dulged their passions, at longer and longer intervals, as age has crept
upon them, from that of widowers of some years' standing, or of men
who have, through the demands of their public or other duties, been
separated from their wives for prolonged periods. The former class
rarely come under the medical man's care : excesses with them are
exceptional, and they are equal to the sexual shock. On the other hand,
when the latter class, after leading lives of chastity, suddenly resume
sexual intercourse, they are apt to suffer greatly from generative dis-
orders. -The impression made by sexual excesses on the nervous
system, after years of rest, is calculated to impart a shock to any consti-
tution, and this result follows with the greater certainty in those whose
nervous powers are already depressed, as for instance, by prolonged
residence in the East. These cases require great care, and their suc-
cessful treatment must mainly depend on the conduct of the patient,
who, by irregularities of his own, — which would appear no more than
moderate in persons thoroughly sound, — may altogether frustrate every
attempt to relieve him.

I was lately consulted by a gentleman of nearly seventy years of age,
who, after remaining a widower many years, was captivated by the
charms of a young girl. The courtship prospered, the patient was
affianced, and all appeared in satisfactory train, when he became
alarmed by observing the very frequent recurrence of seminal emissions
(to which he had been for years subject occasionally) ; and worse —
which, in fact, brought him to me — these emissions stained his linen
with blood, a symptom which gave him great anxiety. I pointed out
to him the dangers attending this state of sexual excitement, and
assured him that the treatment I should propose would avail little, so
long as the excitement under which he was then labouring continued,
and that I dreaded the consequences. Circumstances, however, so fell
out that the marriage was broken off. My patient soon recovered his
health, and he has now occasional nocturnal emissions as before, but
unattended with any haemorrhage.

MARRIAGE IN ADVANCED LIFE 257

The medical man may be occasionally consulted by men in years
upon the subject of marriage, and he may be asked if they may marry.

In the earlier editions of this book I spoke strongly against such
men marrying, and I wrote thus : " I have but one answer to all such
questions. Do it on your own responsibility ; I cannot give my sanc-
tion. If you value life, if you consider your health, if you look for
happiness, I advise you to remain as you are. Much as I approve and
recommend marriage to the young adult, as strongly would I forbid it
to the old man."

Subsequent and more extensive experience, however, has assured me
that, in the present state of civilisation, there are many cases in which
a man may marry late in life with great advantage. I now submit a
patient who desires to marry late in life to a close examination. If I
find him a hale person with a sound constitution, I see no objection to
his settling, provided always he selects a suitable person as regards
age, position, &c. That which alone I object to, in consideration of
his future health and happiness, is his uniting himself with a young,
gay or volatile girl. I am quite certain that marriage, even late in life,
contributes to a man's longevity, if the woman he chooses is suitable
as regards age, disposition, and temper. The observations already
made in this chapter particularly apply here. If the newly -married
man will but be moderate and commit no excesses of any kind, I am an
advocate for his marriage, rather than that he should remain single.
The reader should recollect that in these cases the surgeon does not
advise all elderly people to marry, but he sees no valid reason why an
attachment already formed should be broken off merely because
a hale and hearty bridegroom is advanced in life. I am cog-
nizant of many instances of persons who are now living very com-
fortably and happily who have married late in life. In these instances
no ill consequences have happened. If, however, an elderly man is
disposed to marry beneath him, or to contract marriage with a young
and worldly woman, I think his medical adviser should do all in his
power to dissuade and warn him of the danger he is about to incur.
Nevertheless, experience teaches us that the advice is but little heeded.
I am well aware that many cases can be cited in which men have
married late in life, and had families. Undoubted instances of virility
at the age of nearly one hundred years are on record ; but in these
cases the general bodily vigour has been preserved in a very remarkable
degree. The ordinary rule seems to be, that sexual power is not
retained by the male to any considerable extent after the age of sixty
or sixty -five.

The impunity with which some elderly men continue the practice of
sexual intercourse is certainly surprising; still, abuse or excess, which-
ever we may term it, must sooner or later tell its tale. In some, its

258 EXCESSES IN ADVANCED LIFE

effects assume the form of hypochondriasis, followed by all the protean
miseries of indigestion ; in others, of fatuity ; in the more advanced
stages, paralysis or paraplegia come on, accompanied by softening of
the brain, and its attendant consequences. What in early life was
attended by temporary languor, is in age not unusually followed by
the train of symptoms alluded to above ; and, when we are called in,
it is too late to do aught but palliate them.

I am every day becoming more convinced that many of the affections
of the brain, under which elderly persons suffer, and to which a certain
proportion annually succumb, are caused by excesses committed at a
time when the enfeebled powers are unequal to supporting them, and
I think it the duty of the medical profession to put such sufferers in
possession of these facts. Kind advice and sympathy would thus, I
am sure, save the valuable life of many a man who errs from ignorance.
Let us listen to the warning voice of one who, as I have before said,
has wrtiten the best work on the diseases of old age. Parise is
inveighing against ill-assorted marriages of elderly persons. " There
are great risks run ; for in the extreme disparity of age, and often-
times of condition — as when the man is rich and the girl is young —
Nature avenges herself by spreading scandals — doubts about paternity,
and domestic troubles; everything is at variance, age, disposition,
character, tastes, and amusements. * What shall I do with him, and
what will he do with me ?' said a clever young girl of eighteen, whose
parents wished her to marry an old gentleman. With regard to health
and vital force, it is easy to foresee what will become of them in these
unequal marriages, where a young and fresh girl is * flesh of the flesh !
of a man used up from age, and mayhap from excesses. Evidently
she commits a suicidal act more or less certain or rapid. On the other
hand, experience shows that the elderly man who thus risks his repose
and his existence, speedily finds his health grievously affected ; and
with what justice may not the lines of the poet Hardy be applied to
his case —

" * On ne se servira que d'un m6me flambeau,
Pour te conduire au lit, et du lit au tombeau.'

" Would you," continues Parise, " know the difference between love
in youth and in old men ? It is this, * of a truth great folly appertaineth
to the first love, but great feebleness to the last. 1 Hereby hangs a tale,
for sudden danger lies in the path, and the siren sings upon the very
verge. Blessed should the old man deem himself who can put up with
calmness, happiness, and reason, instead of craving after those senile
accessions of delirium too often the parents of regret and remorse
without end. The chastisement of those who love the sex too much is
to love too long. Is Nature silent ? 'Tis that she would not speak !

DISORDERS IN MEN UNABLE TO CONTROL THEIR PASSIONS 259

Would you provoke or excite her ? It is a crime against her — a crime
for which she will some day claim a deep revenge. Why, then, not
listen to the voice of Wisdom — for those who sit at her feet, and listen
to her awful counsels, shall be delivered from strong passion, and many
sore straits, and much folly ?"

Let the elderly man, then, pause and reflect, that a human sacrifice,
either male or female, is generally bound to the horns of the altar that
sanctifies such marriages. In the present state of society, with our
manners, passions, miseries, man does not always die — he sometimes
destroys himself. And the sort of union I have touched upon is one
of the most ingenious devices of men to expedite that natural " wear
and tear " by which our vital forces are expended in the course of
threescore years and ten.

It was thus I wrote in composing the last edition of this book, and I
cannot even now characterise in stronger terms the danger an old man
incurs in contracting an unequal marriage than what I have said at
page 258.

I see no objection to an elderly man marrying a woman in a rank
compatible with his own, and whose age renders it probable that she
will not have a large family.

In these cases, excesses are not likely to occur, and I feel convinced
that an old bachelor by remaining an old roue may run greater risk
than by marrying. In either case I should say avoid excess ; but I
no longer set my face against marrying late, only against the excesses
to which it may lead. Not a few such marriages about which I have
been consulted have turned out well, and have led to much mutual
domestic happiness.

CHAPTER n

FUNCTIONAL DISORDERS IN PERSONS WHO KNOW THE CONSE-
QUENCES OF SEXUAL EXCESSES, BUT CANNOT CONTROL THEIR
PASSIONS.

This is a class of persons, the consulting surgeon occasionally meets
with, and are deserving of great sympathy. Their passions depend
too frequently on a state of excitement over which they themselves
have no control, although its origin may be traced to their own
excesses. These patients come to ask our assistance, not with any
object of obtaining power, but because they suffer from urgent desire,
which a careful examination of the case often convinces us is fictitious,
and dependent upon some irritation going on in one part or other of
the canal. In some persons, a full bladder will occasion it ; in others,

260 FUNCTIONAL DISORDERS IN D^BAUCH^S

irritation about the rectum, proceeding from worms or haemorrhoids ;
in others, again, acidity of the urine will induce a morbid craving
that is often most distressing to the sufferer. Frequently the affection
depends upon neuralgia of the bladder, or stone in that viscus. In
other instances, I have seen reason to attribute it to some affection
of the skin covering the generative organs, causing local excitement.
It is all very well to desire such patients to resist these morbid
desires, but until appropriate local treatment is prescribed, there can
be little hope of amendment. Some few think that this unnatural
excitement is healthy. They pride themselves upon it, appear asto-
nished at the surgeon wishing to remove the cause, and cannot
comprehend that their constitutions have been much reduced by the
fatigue which the organs have undergone. Ultimately, for the most
part, common sense triumphs, and they feel intensely grateful for the
relief they obtain.

The surgeon must acknowledge, however, that these affections are
frequently very rebellious. The duration of disease, prolonged resi-
dence in warm or unhealthy climates, or the fact of the sexual passions
having been allowed unrestrained liberty, have often brought the
constitution of the elderly man into a very irritable state : still, great
amelioration may be surely promised. The means of cure cannot here
be dwelt upon. They must depend not only on the particular affection
present, but the case must be treated on the ordinary principles of
surgery.

CHAPTEE m

FUNCTIONAL DISORDERS IN DtfBAUCHtfS WHO, HOPING TO SUPPLY
THE LOSS OF POWER CONSEQUENT ON THEIR PREVIOUS EX-
CESSES, PREFER TO STIMULATE THE REPRODUCTIVE ORGANS
FOR THE PURPOSE OF GRATIFYING THEIR ANIMAL PASSIONS.

Again to quote Parise : " Unfortunately there are those who, either
more infatuated, more helplessly drifting on the tide of passion, or
more depraved, use all their endeavours to realise desires which it is
no longer possible to satisfy, unless by a forced compliance of the
organs. Not only has the energy — the superfluous vitality of early
day 8 — disappeared, but the organic power of reproduction is nearly
obliterated. Is all over then ? Credat Judceus, non ego. It is now
that Venus Impudica lavishes on her used-up votaries her appetising
stimulants to vice and debauchery. The imagination, polluted with
impurities, seeks pleasure which reason and good sense repudiate.
There are instances of debauched and shameless old age which,

FUNCTIONAL DISOKDEKS IN DEBAUCH £s 261

deficient in vital resources, strives to supply their place by fictitious
excitement; a kind of brutish lasciviousness, that is ever the more
cruelly punished by nature, from the fact that the immediately ensuing
debility is in direct proportion to the forced stimulation which has
preceded it.

"Seduced to the pleasures of recollection, at once passionate and
impotent, their sensuality may kill, but cannot satiate. There are
such old libertines who are constantly seeking after the means of
revivifying their withered, used-up organism, as if that were possible
without imminent danger. The law of nature is without appeal. To
submit to it is the result of great good judgment, and the reward is
speedy. But submission is no invariable rule, and persons of pru-
dence and chastity have but faint conception of the devices to evade
it, of the folly, caprice, luxury, immodesty, the monstrous lewdness
and indescribable saturnalia of the senses which are the result. The
surgeon alone knows from the confession of his patients, or surmises
from his experience, to what a depth corruption will descend, and the
evils which will follow, particularly in large capitals. One of the most
common means of excitement employed by these senile Lovelaces is
change — variety in the persons they pursue. What is more fatal to
the organism? Extreme youth is sacrificed to these shameless old
men. The full-blown charms of fine women no longer suffice — they
address themselves to mere children, to the great scandal of our
manners, and of all that these victims of debauchery hold dear and
sacred. Nevertheless, let it be remarked, it is seldom — very seldom —
that punishment comes pede claudo ; old age, which disease changes
every day into decrepitude — often sudden death, and death that lingers
for years, a consequence of cruel infirmities — prove the justice of
Nature." (Parise, p. 423.)

It would be well if the above picture, sketched, of course, from
Parisian society by a distinguished French physician, were inconsistent
with experiences gathered elsewhere.

Regret it as we may, medical men of large experience must acknow-
ledge that human nature presents much the same features under all
climates, and that it is in London as elsewhere. Virtue and sin,
refinement and vice, appear to me to herd together and to grow intense,
pari passu with civilisation.

When a young man, without any redeeming qualities, has run
through a career of debauchery, when his adult age is but a new lease
of similar associations, the necessity for additional excitement appears
to goad him on. Fictitious desires increase, until it is impossible to
say where shall be his acme of debauchery, or what devices may be
invented by those in his pay " to minister to a mind diseased." This
is particularly the case when such a pampered, ill-directed, unre-

262 FUNCTIONAL DISORDERS IN DEBAUCHES

strained will is accompanied by unlimited wealth. For such an one,
youth, innocence and beauty soon cease to have attraction. Well has
it been said of him, that " the beast has destroyed the man." Variety
may for a time satisfy or stimulate his failing powers, but not for
very long. Local stimulants are tried, and, after a short repetition,
these also fail. As a last resource unnatural excitement is had recourse
to, and now public decency is forgotten, and we probably find that
the first check to the lust of the opulent satyr is his finding himself
the hero of some filthy police case — then, maybe, a convict, or a
voluntary exile.

As schoolboys we may have been accustomed to wonder at the fables
of the grotesque sylvan monsters of antiquity, ignorant of what
hideous truths of human nature their half -animal forms were the
symbols. Even after sad experience has enlarged our knowledge of
the possibilities of vice, few of us, happily, have any idea of how com-
pletely these bestial forms of ancient art represent the condition of
the satyrs who so notoriously affect the seclusion and the shade of
the parks and gardens in modern cities. I question if a prison is
not the proper place for such debased individuals. As far as I have
noticed their organization, I should say an uncontrolled giving way to
the sexual passion has over-excited a brain never very strong. A con-
stant drain on the nervous power has produced an effect which renders its
subject indifferent to consequences, provided his all-absorbing pursuit
(namely, ministering to the excitement of his sexual passion) can be
indulged in. Doubtless, in many instances, the brain has become
affected, particularly when there exists a strong hereditary tendency to
disease. This, together with deficiency of occupation, has caused
many of these victims to their own feelings to make the pandering
to their vile desires, and gratification of every sensuality the imagi-
nation can devise, the chief occupation of life. The medical man
would hardly feel justified in certifying their fitness for a lunatic
asylum, as in all other respects their conduct appears to be sane.
Observing, as these persons do, all the other usual convenances of
society, there is a something about them which marks them as thralls
of a debasing pursuit. It is an error, however, to suppose that they
often suffer from venereal disease. Your old debauches know too well
the parties they have to deal with, and every precaution is taken to
avoid the consequences. They are living and suffering spectres whom,
as some clever writer has observed, " Death seems to forget to strike,
because he believes them already in the tomb."

I very much question if, with their disordered brains, the fear of
punishment will deter such men from crime. These satyrs are reduced
to so morbid a condition, that the very chance of exposure seems to add
a last stimulus to their debased inclinations. No other reason can, it

FUNCTIONAL DISORDERS IN d£bAUCH£s 263

seems, be given to explain why these rich old debauches should choose
places of public resort for their vile practices, when all that is there
performed could, by the aid of money and existing agencies, be done in
secret. It would seem as though stolen sweets and covert joys had
lost their charm ; and the chance of evading the law had become the
fascinating novelty. Hence the risk, the subsequent detection, and
the public scandal attendant on practices of those whose penchants have
long been known to the police. It is a form of a aberration of intellect
to which libertinage is subject ; and seems to show into what a morass
of defilement unrestrained sexual excitement may finally lead its
victim.

It may, perhaps, be thought singular to suggest a moral based
upon such vile practices as the above, but allusion to them may not be
without benefit to those beginning life ; and I would say, let those
persons take warning who with an active imagination once enter upon a
career of vice, and dream that at a certain spot they can arrest their
progress. It is an old tale, and often told, that, although the slope
of criminality be easy and gradual, it is still " le premier pas qui
coute ;" — and he who launches himself on such a course, will acquire,
as he goes, velocity and force, until at last he cannot be stayed.

The eloquent words of one of the best writers of modern times,
although alluding to another vice, are equally applicable to this :

" Persons not accustomed to examine the motives of their actions, to reckon up the
countless nails that rivet the chains of habit, or perhaps being bound by none so
obdurate as those I have confessed to, may recoil from this as from an overcharged
picture. But what short of such a bondage is it ? . . . .

" I have seen a print after Corregio in which three female figures are ministering
to a man who sits fast bound at the root of a tree. Sensuality is soothing him, evil
habit is nailing him to a branch, and repugnance at the same instant of time is
applying a snake to his side. In his face is feeble delight, the recollection of the
past, rather than the perception of present pleasures, languid enjoyment of evil with
utter imbecility to good, a Sybaritic effeminacy, a submission to bondage, the springs
of the will gone down like a broken clock, the sin and the suffering co-instantaneous
or the latter forerunning the former, remorse preceding action — all this represented
in one point of time. When I saw this I admired the wonderful skill of the painter,
But when I went away, I wept, because I thought of my own condition.

" Of that there is no hope that it should ever change. The waters have gone over
me. But out of the black depths, could I be heard, I would cry to all those who
have but set a foot in the perilous flood. Could the youth look into my deso-
lation, and be made to understand what a dreary thing it is when a man shall feel
himself going down a precipice with open eyes and passive will — to see his destruction
and have no power to stop it, and yet to feel it all the way emanating from himself ;
to perceive all goodness emptied out of him, and yet not be able to forget a time
when it was otherwise j to bear about with him the spectacle of his own self -ruin ;
could he feel the body of death out of which I cry hourly with feebler and feebler
outcry to be delivered "

There is a terrible truthfulness in this description of the depths of

264 FUNCTIONAL DISORDERS IN d£bAUCh£s

long-indulged evil habit. There is, perhaps, only one lower depth ;
that in which no remorse, no longing after past self-restraint or purity
is felt any more.

Not the least active among the motives that have urged me to write
these pages describing the cod sequences of human depravity, is that of
offering frank and kindly warning and advice, which may serve to
assist some to conquer in a conflict wherein the consequences of defeat
may be so irremediable.

The medical man is, I think, the only person who can foresee, as he
probably is the only friend who will dare to point out, the consequences
to which a course of vice, such as I have above alluded to, inevitably
tends. The companions of the victim are not likely to do so. Once
in the vicious circle, he must, sooner or later, find a confidant in our
profession ; it is then that the judicious surgeon may step in, and by
firm but feeling language he often can, and, if he can, I need not say
he ought to tiy and put a stop to this career of iniquity. There are
moments of regret, there are periods of suffering, when a word of
advice can be given; and if the true consequences of unrestrained
licentiousness be urged, the easy descent from comparative happiness
and respectability may be arrested, and the ignominious end averted.
I admit the difficulty. I am well aware that such interference may be
thought impertinent ; but no one can so well interfere or has such
opportunities of expostulation as the medical man. If he do not, few
else can, and no one else will. His duty to his country as a citizen, to
his patient as a friend, calls upon him loudly, I think, to act the part
of a kind and sympathetic adviser.

With his store of argument based upon experience, and his ample
choice of opportunities, it is hard to say how often the well-intentioned
professional man may not be the means of saving a fellow-creature
from the prison, the poor-house, or the lunatic asylum ; and of rescuing
from base perversion the noble faculties lent by the Almighty for the
fulfilment of His first command to Man.

APPENDIX

Supra, p. 228 et 229.
PRESCRIPTIONS.

I have thought it better, for many reasons, to collect a few of the
more usual prescriptions I employ in an Appendix than to encumber
the text with them.

R; Ferri et Quinia? Citratis, 9ij ;
Liq. Strychnia? (B. P.), mxl;
Syrupi, 5iv ;

Aq. Chlorofornii ad ^iv. M. fiat nristura.
A tablespoonf ul to be taken in a wineglass of water three times a day.

R> Tinct. Valerianae Amnion., 3j >
Etheris Chlorici, 33 ;
Tinct. Aurantii, ^ss ;
Aqua? ad ^viij. M. fiat mistnra.
An eighth part to be taken two or three times a day.

R, Tinet. Lnpuli, 5viij ;
Syrnpi Aurantii, 5iv ;
Aqua? ad Sviij. M. fiat mistura.
An eighth part to be taken three times a day.

R. Ext. Ergota? liquidi,

Tinct. Hyoscyami, aa 3ss. M. fiat mistura.
Thirty drops to be taken in water three times a day.

R, Ext. Ergota> liquidi,

Tinct. Lupuli, aa ^ss. M. fiat mistura.
Thirty drops to be taken in water three times a day.

P> Soda? Hypophosph., 3vj j
Tinct. Aurant., ^j ;
Aqua? ad Jvj. M.
A dessert-spoonful to be taken three times a day.

R. Ext. Cannabis Indica?, gr. j ;

Pulv. Glycyrrhiza?, q. suf. M. fiat pilula.
One pill to be taken at bedtime.

266 APPENDIX A

P> 01. Phosphorat., £j j 1
01. Morrhuae, ^vij. M.
A teaspoonful, gradually increased, for a dose.

JJ, Pil. Phosphori, gr. ^. Mitte xxiv,
One pill three times a day.

P> Acid. Phosph. dilut.,
Syrup. Zingiberis,

Syrup. Aurant., aa ^ss. M. fiat mistura.
A teaspoonful to be taken three times a day in a wineglass of water.

P> Syrup. Ferri Phosph., 3j ;
Acid. Phosph. dilut., 5i ss *
Mist. Acacia), ^iij ;
Tinct. Aurant., £ss ;
Aqua) Anethi ad |viij. M.
Two table-spoonfuls to be taken twice a day, at eleven and four, with a
table-spoonful of Cod-liver Oil.

p, Ext. Belladonna?, gr. \ ;

Pulv. Glycyrrhizae q. s. ft. pilula. Mitte xij.
One pill to be taken at night.

Jfc> Tinct. Cantharidis, 5iss ;
Sp. Lavandulae co., 5j >
^Etheris Chlorici, 5j ;
Aqua) ad ^viij. M. fiat mistura.
Two table-spoonfuls to be taken three times a day ; at eleven, four, and at
bedtime.

P= Chloralis Hydratis, 5j ;
Syrupi Aurantii, £j ;
Tinct. Aurantii, 5'iv;
Aqua) ad ^iij- M.
A dessert- spoonful for a dose.

In cases where a local stimulant is necessary, I have found the
following answer well :

J£> Linim. Sinapis comp., 5 SS J

Eau de Cologne, Sj. M. fiat embrocatio.

1 p. Phosphori, gr. vj ;

01. Amygdala), 5j. M.

J'russ. Ph.

CRITICISMS OF THE MEDICAL PRESS

Off

FORMER EDITIONS OF THIS WORK

' The British and Foreign Medico-Chirurgical Quarterly Review,' July, 1857

" We think Mr. Acton 1ms done good service to society by grappling manfully with sexual vice, and wo
trust that others, whose position as men of science and teachers enable them to speak with authority,
will assist in combating and arresting the evils which it entails, and thus enable man to devote more
enduring energies and more lofty aims to the advancement of his race, and to the service of his
God ,

" We are of opinion that the spirit which pervades it is one that does credit equally to the head and to
the heart of the author."

' The Lancet,' May 30th, 1857

"The only way by which some of the most important functional ailments and aberrant physiologic states
affecting humanity can be rescued from the grasp of the most disgusting and villainous quackery, and
treated with benefit to the patient, is by the scientific and conscientious practitioner openly taking them
under his own charge

" Now, however, that legitimate and able practitioners permit themselves to be known as willing to
bestow as much consideration on the aberrations of the generative function as on those of any other, we
trust that some stoppage will be put to the basest system of plunder ever conducted under the mask of
' medical advice.'

" In the work now before us, nil essential detail upon its subject matter is clearly and scientifically
given. We recommend it accordingly, as meeting a necessary requisition of the day, refusing to join in
that opinion which regards the consideration of the topics in question as beyond the duties of the medical
practitioner."

1 The Medical Times,' May 16th, 1857

" Mr. Acton has devoted himself for many years with unwearyiug assiduity to the study of the diseases
of the reproductive organs, and after an intimate acquaintance with syphilitic diseases gained in the Clinique
of II. Ricord, lie has pursued in this country the same series of researches as those which he commenced
under that distinguished specialist. Indeed, with Mr. Acton, the investigation of every circumstance
connected with the generative function has been a labour of love; and we accordingly find that whether
as regards the structure, the functions, or the diseases of the organs in question, every circumstance has
received the minutest attention

" On the subjects of Impotence and Spermatorrhoea, those bugbears of so many weak and foolish persons,
and sources of inexhaustible wealth to the quack fraternity, Mr. Acton discourses with good sense, and
indignantly exposes the nefarious tricks of the scoundrels who, on the pretence of curing a disease which
often exists onlv in imagination, extract enormous sums from their unwary victims. He seems to regard
the spermatorrhoea-phobia, as we may term it, to be a species of monomania, in which light we ourselves
are inclined to regard it ; but he judiciously advises that to a patient labouring under this form of mental
malady, the tone adopted should be one of sympathy and attention, not of ridicule or disbelief; and that
by the employment of appropriate moral and therapeutical means, the morbid terrors of the imagination
may be dispelled, and a healthy and hopeful tone of mind be restored."

1 La Gazette Medicale de Paris,' July, 1863, in Reviewing the French Translation of
Mr. Acton's book, says :

" Trois 6ditions ont consacr<5 en Angleterre le succes de cet excellent ouvrage. Le public francais n'en
verra pas la traduction avec indifference. La raison, qui purifie tout ce qu'clle peut atteindre, quand elle
est vivifiee par un rayon d'amour, la raison a inspire Pauteur admirablement, lui donnant a la fois et
rintclligence vraie de la matiere et le ton convcnable pour la traiter. Partout un langage simple, clair,
decent sans prudcrie, exprimant toutcs choses en termes appropri6s et sans reticences. 11 u'y a, en verite,
qu'un anglais qui puisse cntrer dans P6tude de ces questions epineuses et formidables, sans ceder jamais
& la tentation u'etaler quelque bonne piece d'eloquence.

"Les praticiens spdcialistes nc sauraient suivre un'meillcur guide que le doctcur Acton pour le traitc-
ment des lesions des organes genito-urinaires, et en Pimitant dans sa pratique, ils feraient sagement de lui
emprunter quelques-unes de cesvues generates, qui elargissent le champ de Pobservation, fecondent les
resultats de Pexperiencc, et font qu'une specialite n'est jamais etroite."

London, New Burlington Street,
September, 1876.

SELECTION

MESSRS J. & A. CHURCHILL'S

(General (ffaialape

COMPRISING

ALL REGENT WORKS PUBLISHED BX THEM

ART AND SCIENCE

MEDICINE

INDEX

PAGE

Acton on the Reproductive Organs . 8

Adams (W.) on Clubfoot . . .6

— (R.) on Rheumatic Gout . 18
Allen on Aural Catarrh . . .6
Allingham on Diseases of Rectum . 8
Anatomical Remembrancer . . 11
Anderson (McC) on Eczema . . 19

— (McC.) on Parasitic Affec-

tions . . . .19

— (A. F.) Photographs of Le-

prosy . . . .20

Arnott on Cancer . . . .18

Aveling's English Midwives . . 14

Balfour's Diseases of the Heart . 15

Barclay's Medical Diagnosis . . 11

Barker's Puerperal Diseases . . 13

Barnes' Obstetric Operations . .13

— Diseases of Women . . 13
Basham on Renal Diseases . . 8

— on Diseases of the Kidneys . 8
Beale on Kidney Diseases . . .8

— on Disease Germs . . .23
Bellamy's Guide to Surgical Anatomy 11
Bennet's Winter and Spring on the

Mediterranean . . .16

— Pulmonary Consumption . 16
Bennett (J. H.) Antagonism of

Medicines . . . .11

Bennett (J. R.) on Cancerous and other

Intrathoracic Growths . . 18
Elack on the Urinary Organs . . 8

— on Bright's Disease . . 8
Brodhurst's Orthopaedic Surgery . 6
Bryant's Practice of Surgery . . 4
Buchanan's Circulation of the Blood 10
Bucknill and Tuke's Psychological

Medicine 21

Buzzard on Syphilitic Nervous Affec-
tions 9

Carpenter's Human Physiology . . 9
Carter on the Structure of Calculi . 8

— on Mycetoma . . .19
Cauty on Diseases of the Skin . . 20
Chapman on Neuralgia . . .18
Clark's Outlines of Surgery . . 4

— Surgical Diaguosis . . 6
Clarke's Autobiographical Recollec-
tions 22

Clay's Obstetric Surgery . . .12
Cobbold on Worms . . . .20
Coles' Dental Mechanics . . .23
Cooper's Surgical Dictionary . . 5
Coulson on Syphilis .... 9

— on Stone in the Bladder . 9
Oullingworth's Nurse's Companion . 14
Curling's Diseases of the Rectum . 7
Dalby on the Ear .... 6
Dalton's Human Physiology . . 10
Day on Children's Diseases . . 13

PAGE

De Morgan on the Origin of Cancer 18
De Valcourt on Cannes . . .16
Dobell's Lectures on Winter Cough . 14

— First Stage of Consumption 14
Domville's Manual for Hospital Nurses ] 4
Druitt's Surgeon's Vade-Mecum . 4
Dunglison's Dictionary of Medical

Science 22

Elam on Cerebria . . . .21
Ellis's Manual of Diseases of Children 12
Fayrer's Observations in India . . 4
Fergusson's Practical Surgery . . 4
Fenwick's Guide to Medical Diagnosis 11

— on the Stomach, &c. . . 17
Flint on Phthisis . . . .15
Flower's Nerves of the Human Body 11
Foster's Clinical Medicine . . 12
Fox (T.) Atlas of Skin Diseases . 19
Fox and Farquhar's Skin Diseases

of India 19

Frey's Histology and Histo-Chem-

istry of Man .... 9
Gamgee on Fractures of the Limbs 6
Gant on the Science and Practice of

Surgery ... .4

— on Diseases of the Bladder . 8
Gaskoiu en Psoriasis or Lepra . . 19
Glenn on the Laws affecting Medical

Men 20

Gordon on Fractures . . .5

Habershon on Diseases of the Liver . 17

— on Diseases of the Stomach 17
Hamilton on Syphilitic Osteitis and

Periostitis ... .9

Hancock's Surgery of Foot and Ankle 6
Harley on the Urine ... .8
Harris on Lithotomy . . .7
Hayden on the Heart . . .15
Heath's Minor Surgery and Bandaging 5

— Diseases and Injuries of the

Jaws . . . .5

— Operative Surgery . . 5

— Practical Anatomy . .11
Holden's Landmarks . . .10
Holt on Stricture of the Urethra . 7
Holthouse on Hernial and other

Tumours 7

Hood on Gout, Rheumatism, &c. . 18
Hooper's Physician's Vade-Mecum . 12
Horton's Diseases of Tropical Cli-
mates 16

Hutchinson's Clinical Surgery . . 5
Huth's Marriage of Near Kin . . 10
Jones (C. H.) and Sieveking's Patho-
logical Anatomy . . .10

— (C. H.) on Functional Nervous

Disorders . . . .17

— (Wharton) Ophthalmic Medi-
cine and Surgery . . 23

INDEX

PAGE

Jofdaa'l Treatment of Surgical In-
flammations .... 6

— Plgl ctl I mini: . . 6

Reunion's Springs of Harrogate . 16
Leo (H.) Practical Pathology . . 9

— on Syphilis . . .9
Leared on Imperfect Digestion . . 17
Liebreieh's Atlas of Ophthalmoscopy 22
Lining on Ifegrim, &c. . . .17
Macdonald'i Examination of Water . 21
Mackenzie on Growths in the Larynx 15
Macnainara on Diseases of the Eye . 22
Madden*! Health Resorts . . .16
Marsden on certain Forms of Cancer 18
Maunder' s Operative Surgery . . 4

Surgery of Arteries . . 4
Mayne's Medical Vocabulary . . 22
Meryon's System of Nerves . . 18
Moore's Family Medicine for India . 16
Paton on Action and Sounds of Heart 15
Parkes' Manual of Practical Hygiene 21

— Issue of a Spirit Ration . 17
Parkin's Epidemiology . . .23
Pavy on Food and Dietetics . . 17
Phillips' Materia Medica and Thera-
peutics . . . . .12

Pirrie's Principles and Practice of

Surgery . . . .4

Ramsbotham's Obstetric Medicine

and Surgery . . . .13
Reynolds' Uses of Electricity . . 22
Richardson's Practical Physic . . 11
Roberts' Practice of Midwifery . 13

Ross's Graft Theory of Disease . . 23
Roy's Burdwan Fever . . .16
Royle and Harley's Materia Medica . 12
Rutherford's Practical Histology . 10
Sabben and Browne's Handbook of

Law aud Lunacy . . .21
Sanderson's Physiological Handbook . 10
Sansora's Diseases of the Heart . 15

Savage on the Female Pelvic Organs 5
Savory's Domestic Medicine . . 14
Sayre's Orthopaedic Surgery . . 6
Schroeder's Manual of Midwifery . 13
Semple on the Heart . . .15

Sewill's Dental Anatomy . . .23
Shapter's Diseases of the Heart . 15
Shaw's Medical Remembrancer . 11

Sheppard on Madness . . .21
Sibson's Medical Anatomy . . . 11

Sieveking's Medical Adviser in Life

Assurance 20

Smith (H.) on the Surgery of the

turn 8

Smith (E.) on Wasting Diseases of

Children 12

— Clinical Studies . . 12

PACK

Smith (W. R.) on Nursing . . 14
Smith's Dental Anatomy . . .23
Squire's Temperature Observations . 18
Steiner's Diseases of Children . . 13
Stowe's Toxicological Chart . . 20
Swain's Surgical Emergencies . . 5
Swayne's Obstetric Aphorisms . . 13
Taylor's Principles of Medical Juris-
prudence . . . .20

— Manual of Medical Juris-

prudence . . . .20

— Poisons in relation to Medical

Jurisprudence . . .20
Thompson on Stricture of Urethra . 7

— on Practical Lithotomy

and Lithotrity . . 7

— on Diseases of the Urinary

Organs . . .7

— on Diseases of the Prostate 7

— on Calculous Disease . 7
Thornton on Tracheotomy . . 15
Thorowgood on Asthma . . .15

— on Materia Medica . 12
Tibbits' Medical Electricity . . 21
Tilt's Uterine Therapeutics . . 13

— Change of Life . . .13

— Health in India . . .16
Tomes' Dental Surgery . . .23
Tufnell's Internal Aneurism . . 7
Tuke on the Influence of the Mind

upon the Body . . . .21
Van Buren on Diseases of the Genito-
urinary Organs . . .9
Veitch's Handbook for Nurses . . 14
Wagstaffe's Human Osteology . 10

Walker on Egypt . . . .16
Walton's Diseases of the Eye . . 23
Ward on Affections of the Liver . 17
Waring's Practical Therapeutics . 12

— Bazaar Medicines of India . 17
Waters on Diseases of the Chest . 14
Wells (Soelberg) on Diseases of the

Eye . . . • . . .22

— Long, Short, and Weak Sight . 22

— (Spencer) on Diseases of the

Ovaries . . . .14

Wife's Domain . . . .14

Wilks' Pathological Anatomy . . 10

Wilson (E.) Anatomist's Vade-

Mecutn 11

— on Diseases of the Skin . 19

— Lectures on Ekzema . . 19

— Lectures on Dermatology . 19

— (G.) Handbook of Hygiene . 21
Winslow's Obscure Diseases of the

Brain and Mind . . .20

Wolff on Zymotic Diseases . . 23

CATALOGUE OF EEOENT WOEKS

THE PRACTICE OF SURGERY:

a Manual by Thomas Bryant, F.R.C.S., Surgeon to Guy's Hospital.
Second Edition, 2 vols., crown 8vo, with 559 Engravings, 25s. [1876]

THE PRINCIPLES AND PRACTICE OF SURGERY

by William Pirrie, F.R.S.E., Professor of Surgery in tlie University
of Aberdeen. Third Edition, 8vo, with 490 Engravings, 28s. C1873]

A SYSTEM OF PRACTICAL SURGERY

by Sir William Fergusson, Bart., F.R.C.S., F.R.S., Serjeant-
Surgeon to the Queen. Fifth Edition, 8vo, with 463 Engravings, 21s.

[1870]

OPERATIVE SURGERY

by 0. F. Maunder, F.R.C.S., Surgeon to the London Hospital, for-
merly Demonstrator of Anatomy at Guy's Hospital. Second Edition,
post 8vo, with 164 Engravings, 6s. [18721

BY THE SAME AUTHOR.

SURGERY OF THE ARTERIES:

Lettsomian Lectures for 1875, on Aneurisms, Wounds, Haemorrhages,
&c. Post 8vo, with 18 Engravings, 5s. £1875]

THE SURGEON'S VADE-MECUM

by Robert Druitt. Tenth Edition, fcap. 8vo, with numerous En-
gravings, 12s. 6d. £1870]

THE SCIENCE AND PRACTICE OF SURGERY:

a complete System and Textbook by F. J. Gant, F.R.C.S., Surgeon to
the Royal Free Hospital. 8vo, with 470 Engravings, 24s. P8711

OUTLINES OF SURGERY AND SURGICAL PATHOLOGY

including the Diagnosis and Treatment of Obscure and Urgent
Cases, and ihe Surgical Anatomy of some Important Structures and
Regions, by F. Le Gros Clark, F.R.S., Consulting Surgeon to St.
Thomas's Hospital. Second Edition, Revised and Expanded by the
Author, assisted by W. W. Wagstaffe, F.R.C.S., Assistant-Surgeon
to, and Joint -Lecturer on Anatomy at, St. Thomas's Hospital. 8vo,
10s. 6cL [1872]

CLINICAL AND PATHOLOGICAL OBSERVATIONS IN INDIA

by Sir J. Fayrer, K.S.I., M.D., F.R.C.P. Lond., F.R.S.E., Honorary
Physician to the Queen. 8vo, with Engravings, 20s. [l 873 J

PUBLISHED BY J. AND A. CHURCHILL

SURGICAL EMERGENCIES

together with the Emergencies attendant on Parturition and the
Treatment of Poisoning : a Manual for the use of General Practi-
tioners, by William P. Swain, F.R.C.S., Surgeon to the Royal Albert
Hospital, Devonport. Second Edition, post 8vo, with 104 Engravings,
6s. 6d. [1876]

ILLUSTRATIONS OF CLINICAL SURGERY,

consisting of Plates, Photographs, Woodcuts, Diagrams, &c, illus-
trating Surgical Diseases, Symptoms and Accidents; also Operations
and other methods of Treatment. By Jonathan Hutchinson,
F.R.C.S., Senior Surgeon to the London Hospital. In Quarterly
Fasciculi. Fasc. I to IV already issued. 6s. 6d. each. C1876J

FRACTURES OF THE LOWER END OF THE RADIUS,

Fractures of the Clavicle, and on the Reduction of the Recent Inward
Dislocations of the Shoulder Joint. By Alexander Gordon, M.D.,
Professor of Surgery in Queen's College, Belfast. With Engravings,

8V0, OS. C1875]

MINOR SURGERY AND BANDAGING

a Manual for the Use of House-Surgeons, Dressers, and Junior
Practitioners, by Christopher Heath, F.R.C.S., Surgeon to Uni-
versity College Hospital. Fifth Edition, fcap 8vo, with 86 Engrav-
ings, 5s. 6d. [1875]

BY THE SAME ATTTHOB,

INJURIES AND DISEASES OF THE JAWS:

Jacksonian Prize Essay. Second Edition, 8vo, with 164 Engrav-
ings, 12s. [1872]

BY THE SAME AUTHOB.

A COURSE OF OPERATIVE SURGERY:

with Plates drawn from Nature by M. Leveille, and coloured by
hand under his direction. In Five Parts, each to contain 4 Plates.
Large 8vo. 7s. 6d. each Part. [1876]

DICTIONARY OF PRACTICAL SURGERY

and Encyclopaedia of Surgical Science, by Samuel Cooper. New
Edition, brought down to the present Time by Samuel A. Lane,
Consulting Surgeon to St. Mary's and to the Lock Hospitals ; assisted
by various Eminent Surgeons. 2 vols. 8vo, 50s. [1861 and 1872]

THE FEMALE PELVIC ORGANS

their Surgery, Surgical Pathology, and Surgical Anatomy, in a
Series of Coloured Plates taken from Nature: with Commentaries,
Notes, and Cases, by Henry Savage, M.D. Lond., F.R.C.S., Consulting
Officer of the Samaritan Free Hospital Third Edition, 4to, £1 15s.

[1875]

CATALOGUE OF RECENT WORKS

FRACTURES OF THE LIMBS

(Treatment of) by J. Sampson Gamgee, Surgeon to the Queen's
Hospital, Birmingham. 8vo, with Plates, 10s. 6d. £ 1871 3

DISEASES AND INJURIES OF THE EAR

by W. B. Dalby, F.R.C.S., M.B., Aural Surgeon and Lecturer on
Aural Surgery at St. George's Hospital. Crown 8vo, with 21 Engrav-
ings, 6s. 6d. [WS]

AURAL CATARRH;

or, the Commonest Forms of Deafness, and their Cure, by Peter
Allen, M.D., F.R.C.S.E., late Aural Surgeon to St. Mary's Hospital.
Second Edition, crown 8vo, with Engravings, 8s. 6d. t 18 ? 4 }

PRINCIPLES OF SURGICAL DIAGNOSIS

especially in Relation to Shock and Visceral Lesions, Lectures
delivered at the Royal College of Surgeons by F. Le Gros Clark,
F.R.C.S., Consulting Surgeon to St. Thomas's Hospital. 8vo,
10s. 6d. C18703

CLUBFOOT:

its Causes, Pathology, and Treatment; being the Jacksonian Prize
Essay by Wm. Adams, F.R.C.S., Surgeon to the Great Northern Hos-
pital. Second Edition, 8vo, with 106 Engravings and 6 Lithographic
Plates, 15s. WW

ORTHOPiEDIC SURGERY

Lectures delivered at St. George's Hospital, by Bernard E. Brod-
htjrst, F.R.C.S., Surgeon to the Royal Orthopaedic Hospital. Second
Edition, 8vo, with Engravings, 12s. 6d. C 18 ? 6 ]

OPERATIVE SURGERY OF THE FOOT AND ANKLE

by Henry Hancock, F.R.C.S., Consulting Surgeon to Charing Cross
Hospital. 8vo, with Engravings, 15s. £ 187S J

ORTHOPEDIC SURGERY:

and Diseases of the Joints. Lectures by Lewis A. Sayre, M.D.,
Professor of Orthopaedic Surgery, Fractures and Dislocations, and
Clinical Surgery, in Bellevue Hospital Medical College, New York.
With 274 Wood Engravings, 8vo, 20s. t 18 ?*]

THE TREATMENT OF SURGICAL INFLAMMATIONS

by a New Method, which greatly shortens their Duration, by Furneaux
Jordan, F.R.C.S., Professor of Surgery in Queen's College, Birming-
ham. 8vo, with Plates, 7s. 6d. t 18 ™]

BY THE SAME AUTHOE,

SURGICAL INQUIRIES

With numerous Lithographic Plates. 8vo, 5s. t 1873 l

PUBLfSHED BY J. AND A. CHURCHILL

INTERNAL ANEURISM:

Successful Treatment of, by Consolidation of the Contents of the Sac.
By T. Jolifpe Tufnell, F.R.C.S.I., President of the Royal College
of Surgeons in Ireland. With Coloured Plates. Second Edition,
royal 8vo, 5s. [1875]

HERNIAL AND OTHER TUMOURS

of the Groin and its Neighbourhood, with some Practical Remarks on
the Radical Cure of Ruptures, by C. Holthouse, F.R.C.S., Surgeon to
the Westminster Hospital. 8vo, 6s. 6d. C1870]

DISEASES OF THE RECTUM

by T. B. Curling, F.R.S., Consulting Surgeon to the London
Hospital. Fourth Edition, Revised, 8vo, 7s. 6d. [1876]

STRICTURE OF THE URETHRA

and Urinary Fistula ; their Pathology and Treatment : Jacksonian
Prize Essay by Sir Henry Thompson, F.R.C.S., Emeritus Professor
of Surgery to University College. Third Edition, Svo, with Plates,

10s. [1869]

BY TIIE SAME AUTHOR,

PRACTICAL LITHOTOMY AND LITHOTRITY;

or, An Inquiry into the best Modes of removing Stone from the
Bladder. Second Edition, Svo, with numerous Engravings. 10s. [1871]

ALSO,

DISEASES OF THE URINARY ORGANS

(Clinical Lectures). Fourth Edition, 8vo, with 2 Plates and 59
Engravings, 12s. . [1876]

ALSO,

DISEASES OF THE PROSTATE:

their Pathology and Treatment. Fourth Edition, Svo, with numerous
Plates, 10s. [Wl

ALSO,

THE PREVENTIVE TREATMENT OF CALCULOUS DISEASE

and the Use of Solvent Remedies. Second Edition, fcap. 8vo, 2s. 6d.

[1876]

STRICTURE OF THE URETHRA

(the Immediate Treatment of), by Barnard Holt, F.R.C.S^
Consulting Surgeon to the Westminster Hospital. Third Edition,
8vo, 6s. [1868]

LITHOTOMY AND EXTRACTION OF STONE

from the Bladder, Urethra, and Prostate of the Male, and from the
Bladder of the Female, by W. Poulett Harris, M.D., Surgeon-Major
H.M. Bengal Medical Service. With Engravings, 8vo, 10s. 6d. [1876]

CATALOGUE OF RECENT WOEKS

THE SURGERY OF THE RECTUM:

Lettsomian Lectures by Henry Smith, F.R.C.S., Surgeon to King's
College Hospital. Fourth Edition, fcap. 8vo, 5s. [1876]

FISTULA, HEMORRHOIDS, PAINFUL ULCER,

Stricture, Prolapsus, and other Diseases of the Rectum : their Diag aosis
and Treatment, by Wm. Allingham, F.R.C.S., Surgeon to St. Mark's
Hospital for Fistula, &c, late Surgeon to the Great Northern Hospital.
Second Edition, 8vo, 7s. [1872]

THE URINE AND ITS DERANGEMENTS

with the Application of Physiological Chemistry to the Diagnosis and
Treatment of Constitutional as well as Local Diseases. Lectures
by George Harley, M.D., F.R.S., F.R.C.P., formerly Professor in
University College. Post 8vo, 9s. [1872]

XIDNEY DISEASES, URINARY DEPOSITS

and Calculous Disorders by Lionel S. Beale, M.B., F.R.S., F.R.C.P.,
Physician to King's College Hospital. Third Edition, 8vo, with
70 Plates, 25s. [1868]

DISEASES OF THE BLADDER,

Prostate Gland and Urethra, including a practical view of Urinary
Diseases, Deposits and Calculi, by F. J. Gant, F.R.C.S., Surgeon to
the Royal Free Hospital. Fourth Edition, crown 8vo, with Engravings,
10s. 6d. [1876]

RENAL DISEASES:

a Clinical Guide to their] Diagnosis and Treatment by W. R. Basham,
M.D., F.R.C.P., Senior Physician to the Westminster Hospital. Post
8vo, 7s. [1870]

BY THE SAME AUTHOB,

THE DIAGNOSIS OF DISEASES OF THE KIDNEYS

(Aids to). 8vo, with 10 Plates, 5s. t 18 ^

MICROSCOPIC STRUCTURE OF URINARY CALCULI

by H. V. Carter, M.D., Surgeon- Major, H.M.'s Bombay Army. 8vo,
with 4 Plates, 5s. [1873]

THE REPRODUCTIVE ORGANS

in Childhood, Youth} Adult Age, and Advanced Life (Functions and
Disorders of), considered in their Physiological, Social, and Moral
Relations, by William Acton, M.R.C.S. Sixth Edition, 8vo, 12s.

[1875]

- URINARY AND REPRODUCTIVE ORGANS

(Functional Diseases of) by D. Campbell Black, M.D., L.R.C.S.
Edin. Second Edition. 8vo, 10s. 6d. [1875]

BY TIIE SAMK AUTHOE.

LECTURES ON BRIGHTS DISEASE

delivered at the Royal Infirmary of Glasgow. 8vo, with 20 Engrav-
ings, '6s. 6d. [1875]

PUBLISHED BY J. AND A. CHURCHILL 9

GENITO-URINARY ORGANS, INCLUDING SYPHILIS

A Practical Treatise on their Surgical Diseases, designed as a Manual
for Students and Practitioners, by W. H. Van Buren, M.D., Pro-
fessor of the Principles of Surgery in Bellevue Hospital Medical Col-
lege, New York, and E. L. Keyes, M.D., Professor of Dermatology in
Bellevue Hospital Medical College, New York. Royal 8vo, with 140
Engravings, 21s. t 18 7*3

SYPHILIS

A Treatise by "Walter J. Coulson, F.R.C.S., Surgeon to the Lock
Hospital. 8vo, 10s. CW69]

BY THE SAME AUTHOE,

STONE IN THE BLADDER:

Its Prevention, Early Symptoms, and Treatment by Lithotrity. 8vo,
6s. [18683

PRACTICAL PATHOLOGY:

containing Lectures on Suppurative Fever, Diseases of the Veins,
Hemorrhoidal Tumours, Diseases of the Rectum, Syphilis, Gonor-
rheal Ophthalmia, &c, by Henry Lee, F.R.C.S., Surgeon to St. George's
Hospital. Third Edition, in 2 vols. 8vo, 10s. each. B«70]

BY THE SAME AUTHOE,

- LECTURES ON SYPHILIS,

and on some forms of Local Disease, affecting principally the Organs
of Generation. With Engravings, 8vo, 10s. t 18 ^]

SYPHILITIC NERVOUS AFFECTIONS

(Clinical Aspects of) by Thomas Buzzard, M.D., F.R.C.P. Lond.,
Physician to the National Hospital for Paralysis and Epilepsy. Post
8vo, 5s. . [1874]

SYPHILITIC OSTEITIS AND PERIOSTITIS

Lectures by John Hamilton, F.R.C.S.I., Surgeon to the Richmond
Hospital and to Swift's Hospital for Lunatics, Dublin. 8vo, with
Plates, 6s. 6d. [1874]

PRINCIPLES OF HUMAN PHYSIOLOGY

by W. B. Carpenter, M.D., F.R.S. Eighth Edition by Henry
Power, M.B., F.R.C.S., Examiner in Natural Science, University of
Oxford, and in Natural Science and Medicine, University of Cambridge.
8vo, with 3 Steel Plates and 371 Engravings, 31s. 6d. [1876]

HISTOLOGY AND HISTOCHEMISTRY OF MAN

A Treatise on the Elements of Composition and Structure of the
Human Body, by Heinrich Frey, Professor of Medicine in Zurich.
Translated from the Fourth German Edition by Arthur E. J.
Barker, Assistant- Surgeon to University College Hospital. And
Revised by the Author. 8vo, with 608 Engravings, 21s. U87*]

10 CATALOGUE OF RECENT WORKS

HITMAN PHYSIOLOGY:

A Treatise designed for the Use of Students and Practitioners of
Medicine, by John C. Dalton, M.D., Professor of Physiology and
Hygiene in the College of Physicians and Surgeons, New York. Sixth
Edition, royal 8vo, with 316 Engravings, 20s. [1875]

HANDBOOK FOR THE PHYSIOLOGICAL LABORATORY

by E. Klein, M.D., F.R.S., Assistant Professor in the PathologicalLabo-
ratory of the Brown Institution, London ; J. Burdon-Sanderson,
M.D., F.R.S., Professor of Practical Physiology in University College,
London ; Michael Fostee, M.D., F.R.S., Prselector of Physiology
in Trinity College, Cambridge; and T. Lauder Brunton, M.D.,
D.Sc, Lecturer on Materia Medica at St. Bartholomew's Hospital;
edited by J. Burdon-Sanderson. 8vo, with 123 Plates, 24s. [1873]

PRACTICAL HISTOLOGY

(Outlines of) by William Rutherford, M.D., Professor of the
Institutes of Medicine in the University Of Edinburgh. With En-
gravings. Crown 8vo, interleaved, 3s. [18751

THE MARRIAGE OF NEAR KIN

Considered with respect to the Laws of Nations, Results of Experience,
and the Teachings of Biology, by Alfred H. Huth. 8vo, 14s. [iS75]

STUDENTS' GUIDE TO HUMAN OSTEOLOGY

By William Warwick Wagstaffe, F.R.C.S., Assistant-Surgeon
and Lecturer on Anatomy, St. Thomas's Hospital. With 23 Plates
and 66 Engravings. Fcap. 8vo, 10s. 6d. D»763

LANDMARKS, MEDICAL AND SURGICAL.

By Luther Holden, F.R.C.S., Surgeon to St. Bartholomew's Hospital.
8vo, 3s. 6d. [1876]

THE CIRCULATION OF THE BLOOD

(Forces which carry on) by Andrew Buchanan, M.D., Professor
of Physiology in the University of Glasgow. Second Edition, 8vo,
with Engravings, 5s. [1874]

PATHOLOGICAL ANATOMY

Lectures by Samuel Wilks, M.D., F.R.S., Physician to, and Lec-
turer on Medicine at, Guy's Hospital ; and Walter Moxon, M.D.,
F.R.C.P., Physician to, and Lecturer on Materia Medica at, Guy's
Hospital. Second Edition, 8vo, with Plates, 18s. [1875]

PATHOLOGICAL ANATOMY

A Manual by C. Handfield Jones, M.B., F.R.S., Physician to St.
Mary's Hospital, and Edward H. Sieveking, M.D., F.R.C.P.,
Physician to St. Mary's Hospital. Edited by J. F. Payne, M.D.,
F.R.C.P., Assistant Physician and late Demonstrator of Morbid
Anatomy at St. Thomas's Hospital. Second Edition, crown 8vo, with
195 Engravings, 16s. [1875]

PUBLISHED BY J. AND A. CHURCHILL 11

THE ANATOMISTS VADE-MECUM:

a System of Human Anatomy by Erasmus Wilson, F.R.C.S., F.R.S.
Ninth Edition, by G. Buchanan, M.A., M.D., Professor of Clinical
Surgery in the University of Glasgow. Crown 8vo, with 371 Engrav-
ings, 14s. [1873]

PRACTICAL ANATOMY:

a Manual of Dissections by Christopher Heath, F.R.C.S., Surgeon
to University College Hospital, Third Edition, fcap 8vo, with 226
Engravings, 12s. 6d. [1874]

MEDICAL ANATOMY

by Francis Sibson, M.D., F.R.C.P., F.R.S., Consulting Physician t©
St. Mary's Hospital. Imp. folio, with 21 coloured Plates, cloth, 42s. ;

half -morOCCO, 50s. [Completed in 1869j

STUDENTS GUIDE TO SURGICAL ANATOMY:

a Text-book for the Pass Examination, by E. Bellamy, F.R.C.S.,
Senior Assistant-Surgeon and Lecturer on Anatomy at Charing
Cross Hospital. Fcap Svo, with 50 Engravings, 6s. 6d. [1873]

DIAGRAMS OF THE NERVES OF THE HUMAN BODY

Exhibiting their Origin, Divisions, and Connexions, with their Distri-
bution, by William Henry Flower, F.R.S., Conservator of the
Museum of the Royal College of Surgeons. Second Edition, roy. 4to,
12s. C18723

THE STUDENT'S GUIDE TO MEDICAL DIAGNOSIS

by Samuel Fenwick, M.D., F.R.C.P., Physician to the London
Hospital. Fourth Edition, fcap 8vo, with 106 Engravings, 6s. 6d.

[18763

A MANUAL OF MEDICAL DIAGNOSIS

by A. W. Barclay, M.D., F.R.C.P., Physician to, and Lecturer on
Medicine at, St. George's Hospital. Third Edition, fcap 8vo, 10s. 6<L

[18763

THE MEDICAL REMEMBRANCER;

or, Book of Emergencies. By E. Shaw, M.R.C.S. Fifth Edition by
Jonathan Hutchinson, F.R.C.S., Senior Surgeon to the London
Hospital. 32mo, 2s. 6d. [1867]

THE ANATOMICAL REMEMBRANCER;

or, Complete Pocket Anatomist. Seventh Edition, 32mo, 3s. 6d. ri872]

ANTAGONISM OF MEDICINES

(Researches into the) being the Report of the Edinburgh Committee
of the British Medical Association. By J. Hughes Bennett, M.D.
Post 8vo, 3s. 6d. [18753

DISCOURSES ON PRACTICAL PHYSIC

by I ;. W. Richardson, M.D., F.R.C.P., F.R.S. 8vo, 5s. CWi?

12 . CATALOGUE OF RECENT WOEKS

HOOPER'S PHYSICIANS VADE-MECUM;

or, Manual of the Principles and Practice of Physic, Ninth Edition
by W. A. Guy, M.B., F.R.S., and John Harley, M.D.J F.R.C.P.
Fcap 8vo, with Engravings, 12s. 6d. [W^l

CLINICAL MEDICINE

Lectures and Essays by Balthazar Foster, M.D., F.R.C.P. Lond.,
Professor of Medicine in Queen's College, Birmingham. 8vo, 10s. 6d.

[1874]

BOYLE'S MANUAL OF MATERIA MEDICA AND THERAPEUTICS.

Sixth Edition by John Harley, M.D., Assistant Physician to, and
Joint Lecturer on Physiology at, St. Thomas's Hospital. Crown 8vo,
with 139 Engravings, 15 s. ri87G]

MATERIA MEDICA AND THERAPEUTICS:

(Yegetable Kingdom), by Charles D. F. Phillips, M.D., F.R.C.S.E.
8vo, 15s. TI874]

PRACTICAL THERAPEUTICS

A Manual by E. J. Waring, M.D., F.R.C.P. Lond. Third Edition,
fcap 8vo, 12s. 6d. [1871]

THE STUDENT'S GUIDE TO MATERIA MEDICA

by John C. Thorowgood, M.D. Lond., Physician to the City of
London Hospital for Diseases of the Chest. Fcap 8vo, with Engrav-
ings, 6s. 6d. CWfl

—THE DISEASES OF CHILDREN

A Practical Manual, with a Formulary, by Edward Ellis, M.D.,
Physician to the Yictoria Hospital for Children. Second Edition,
crown 8vo, 7s. [1873]

— THE WASTING DISEASES OF CHILDREN

by Eustace Smith, M.D. Lond., Physician to the King of the Belgians,
Physician to the East London Hospital for Children. Second Edition,
post 8vo, 7s. 6d. ^870]

BY THE SAME AUTHOB,

^CLINICAL STUDIES OF DISEASE IN CHILDREN.

Diseases of the Lungs ; Acute Tuberculosis. Post 8vo, 7s. 6d. C187G]

OBSTETRIC SURGERY

A Complete Handbook, giving Short Rules of Practice in every Emer-
gency, from the Simplest to the most Formidable Operations connected
with the Science of Obstetricy, by Charles Clay, Ext.L.R.C.P. Lond.,
L.R.C.S.E., late Senior Surgeon and Lecturer on Midwifery, St.
Mary's Hospital, Manchester. Fcap 8vo, with 91 Engravings, Gs. 6d.

[1874]

PUBLISHED BY J. AND A. CHURCHILL 13

—THE DISEASES OF CHILDREN

Essays by William Henry Day, M.D., Physician, to the Samaritan
Hospital for Diseases of Women and Children. Fca.p 8vo, 5s. [1873]

—COMPENDIUM OF CHILDREN'S DISEASES

A Handbook for Practitioners and Students, by Johann Steiner,
M.D., Professor of the Diseases of Children in the University of
Prague. Translated from the Second German Edition by Lawson
Tait, F.R.C.S., Surgeon to the Birmingham Hospital for Women.
8vo, 12s. 6d. [1874]

THE STUDENT'S GUIDE TO THE PRACTICE OF MIDWIFERY
by D. Lloyd Roberts, M.D., Physician to St. Mary's Hospital, Man-
chester. Fcap. 8vo, with 95 Engravings, 6s. 6d. [1875]

PUERPERAL DISEASES

Clinical Lectures by Fordyce Barker, M.D., Obstetric Physician
to Bellevue Hospital, New York. 8vo, 15s. [1874]

OBSTETRIC OPERATIONS,

including the Treatment of Hemorrhage, and forming a Guide to the
Management of Difficult Labour ; Lectures by Robert Barnes, M.D.,
F.R.C.P., Obstetric Physician and Lecturer on Obstetrics and the Dis-
eases of Women and Children to St. George's Hospital. Third Edition,
8vo, with 124 Engravings, 18s. [I875]

BY THE SAME AUTHOR,

—MEDICAL AND SURGICAL DISEASES OF WOMEN

(a Clinical History). 8vo, with 169 Engravings, 28s. [1873]

OBSTETRIC MEDICINE AND SURGERY

(Principles and Practice of) by F. H. Ramsbotham, M.D., F.R.C.P.
Fifth Edition, 8vo, with 120 Plates, 22s. [1887]

OBSTETRIC APHORISMS

for the Use of Students commencing Midwifery Practice by J. G.
Swayne, M.D., Consulting Physician-Accoucheur to the Bristol
General Hospital, and Lecturer on Obstetric Medicine at the Bristol
Medical School. Sixth Edition, fcap 8vo, with Engravings, 3s. 6d. [1876]

SCHROEDER'S MANUAL OF MIDWIFERY,

including the Pathology of Pregnancy and the Puerperal State.
Translated by Charles H. Carter, B.A., M.D. 8vo, with Engrav-
ings, 12s. 6d. [1873]

c^A HANDBOOK OF UTERINE THERAPEUTICS

and of Diseases of Women by E. J. Tilt, M.D., M.R.C.P. Third
Edition, post 8vo, 10s. [1868]

by the same atjthoe,
THE CHANGE OF LIFE

in Health and Disease : a Practical Treatise on the Nervous and other
Affections incidental to Women at the Decline of Life. Third Edition,
8vo, 10s. 6d. [1870]

14 CATALOGUE OF EECENT WOEKS

DISEASES OF THE OVARIES :

their Diagnosis and Treatment, by T. Spencer Wells, F.R.C.S.,
Surgeon to the Queen's Household and to the Samaritan Hospital.
8vo, with about 150 Engravings, 21s. [1872]

HANDBOOK FOR NURSES FOR THE SICK

by Zepherina P. Yeitch. Second Edition, crown 8vo, 3s. 6d. [1876]

A MANUAL FOR HOSPITAL NURSES

and others engaged in Attending on the Sick by Edward J. Dom-
ville, L.R.C.P., M.R.C.S. Second Edition, crown 8vo, 2s. 6d. [1875]

THE NURSE'S COMPANION:

A Manual of General and Monthly Nursing, by Charles J. Culling-
worth, Surgeon to St. Mary's Hospital, Manchester. Fcap. 8vo,
2s. 6d. [1976]

LECTURES ON NURSING

by William Robert Smith, L.R.C.S.E, Resident Surgeon, Royal
Hants County Hosxrital, Winchester. With 26 Engravings. Post
8vo, 6s. [1875]

ENGLISH MIDWIVES:

their History and Prospects, by J. H. Aveling, M.D., Physician to
the Chelsea Hospital for Women, Examiner of Midwives for the
Obstetrical Society of London. Crown 8vo, 5s. [1872]

A COMPENDIUM OF DOMESTIC MEDICINE

and Companion to the Medicine Chest ; intended as a Source of Easy
Reference for Clergymen, and for Families residing at a Distance
from Professional Assistance, by John Savory, M.S.A. Eighth
Edition, 12mo, 5s. [1871]

THE WIFE'S DOMAIN

The Young Couple — The Mother — The Nurse— The Nursling, by Phi-
lothalos. Second Edition, post 8vo, 3s. 6d. [187*3

WINTER COUGH

(Catarrh, Bronchitis, Emphysema, Asthma), Lectures by Horace
Dobell,M.D., Consulting Physician to the Royal Hospital for Diseases
of the Chest. Third Edition, with Coloured Plates, 8vo, 10s. 6d. [1875]

BY THE SAME ATJTHOE,

THE TRUE FIRST STAGE OF CONSUMPTION

(Lectures). Crown 8vo, 3s. 6d. [1867]

DISEASES OF THE CHEST:

Contributions to their Clinical History, Pathology, and Treatment, by
A. T. H. Waters, M.D., F.R.C.P., Physician to the Liverpool Royal
Infirmary. Second Edition, 8vo, with Plates, 15s. [1873]

PUBLISHED BY J. AND A. CHURCHILL 15

DISEASES OF THE HEART

Their Pathology, Diagnosis, Prognosis, and Treatment (a Manual),
by Robert H. Semple, M.D., F.R.C.P., Physician to the Hospital for
Diseases of I&6 Throat. 8vo, 8s. 6d. [1876]

DISEASES OF THE HEART AND AORTA

By Thomas Hayden, F.K.Q.C.P. Irel., Physician to the Mater
Misericordia) Hospital, Dublin. With 80 Engravings. 8vo, 25s. [1875]

PHTHISIS

In a series of Clinical Studies, by Austin Flint, M.D., Professor of
the Principles and Practice of Medicine and of Clinical Medicine in
the Bellevue Hospital Medical College. 8vo, 16s. [1875]

DISEASES OF THE HEART

and of the Lungs in Connexion therewith— Notes and Observations
by Thomas Shapter, M.D., F.R.C.P. Lond., Senior Physician to the
Devon and Exeter Hospital. 8vo, 7s. 6d. [1874]

DISEASES OF THE HEART AND AORTA

Clinical Lectures by George W. Balfour, M.D., F.R.C.P., Physician
to, and Lecturer on Clinical Medicine in, the Royal Infirmary, Edin-
burgh. 8vo, with Engravings, 12s. 6d. [1876]

THE ACTION AND SOUNDS OF THE HEART

Researches by George Paton, M.D., author of numerous papers
published in the British and American Medical Journals. Re-
issue, with Appendix, 8vo, 3s. 6d. [1874]

PHYSICAL DIAGNOSIS OF DISEASES OF THE HEART.

Lectures by Arthur E. Sansom, M.D., Assistant Physician to the
London Hospital; Physician to the North. Eastern Hospital for
Children. With Engravings, fcap. 8vo, 3s. 6d. [1876]

NOTES ON ASTHMA;

its Forms and Treatment, by John C. Thorowgood, M.D. Lond.,
F.R.C.P., Physician to the Hospital for Diseases of the Chest, Victoria
Park. Second Edition, crown 8vo, 4s. 6d. [1873]

GROWTHS IN THE LARYNX,

with Reports and an Analysis of 100 consecutive Cases treated since
the Invention of the Laryngoscope by Morell Mackenzie, M.D.
Lond., M.R.C.P., Physician to the Hospital for Diseases of the
Throat. 8vo, with Coloured Plates, 12s. 6d. [1871]

TRACHEOTOMY,

especially in Relation to Diseases of the Larynx and Trachea, by
Pugin Thornton, Surgeon to the Hospital for Diseases of the
Throat. With Photographic Plates and Woodcuts, 8vo, 5s. 6d. [1876]

16 CATALOGUE OF RECENT WORKS

WINTER AND SPRING

on the Shores of the Mediterranean ; or, the Genoese Rivieras, Italy,
Spain, Greece, the Archipelago, Constantinople, Corsica, Sardinia,
Sicily, Corfu, Malta, Tunis, Algeria, Smyrna, Asia Minor, with
Biarritz and Arcachon, as Winter Climates. By Henry Bennet,
M.D. Fifth Edition, post 8vo, with numerous Plates, Maps, and
Engravings, 12s. 6d. WW

BY THE SAME ATTTHOE,

TREATMENT OF PULMONARY CONSUMPTION

by Hygiene, Climate, and Medicine. Second Edition, 8vo, 5s. [1871]

PRINCIPAL HEALTH RESORTS

of Europe and Africa, and their Use in the Treatment of Chronic
Diseases. A Handbook by Thomas More Madden, M.D., M.R.I.A.,
Yice-President of the Dublin Obstetrical Society. 8vo, 10s. [ 18 >6]

MINERAL SPRINGS OF HARROGATE

By Dr. Kennion. Revised and enlarged by Adam Bealey, M.A.,
M.D. Cantab., F.R.C.P. Lond. Seventh Thousand. Crown 8vo, Is.

[1875]

SKETCH OF CANNES AND ITS CLIMATE

by Th. De Yalcourt, M.D. Paris, Physician at Cannes. Second

Edition, with Photographic Yiew and 6 Meteorological Charts.

Crown 8vo, 2s. 6d. WW

EGYPT AS A HEALTH RESORT;

with Medical and other Hints for Travellers in Syria, by A. Dunbar
Walker M.D. Fcap 8vo, 3s. 6d. CWS]

FAMILY MEDICINE FOR INDIA

A Manual, by William J. Moore, M.D., Surgeon-Major H.M. Indian
Medical Service. Published under the Authority of the Government
of India. Post 8vo, with 57 Engravings, 8s. 6d. CW4]

DISEASES OF TROPICAL CLIMATES

and their Treatment : with Hints for the Preservation of Health in the
Tropics, by James A. Horton, M.D., Surgeon- Major, Army Medical
Department. Post 8vo, 12s. 6d. [1874]

HEALTH IN INDIA FOR BRITISH WOMEN

and on the Prevention of Disease in Tropical Climates by Edward J.
Tilt, M.D., Consulting Physician- Accoucheur to the Farringdon
General Dispensary. Fourth Edition, crown 8vo, 5s. ci87oi

BURDWAN FEVER,

or the Epidemic Fever of Lower Bengal (Causes, Symptoms, and
Treatment), by Gopaul Chunder Roy, M.D., Surgeon Bengal
Establishment. New Edition, 8vo, 5s. £ 18 7°J

PUBLISHED BY J. AND A. CHURCHILL 17

BAZAAR MEDICINES OF INDIA

and Common Medical Plants : Remarks on their Uses, with Full Index
of Diseases, indicating their Treatment by these and other Agents pro-
curable throughout India, &c, by Edward J. Waring, M.D., F.R.C.P.
Lond., Retired Surgeon H.M. Indian Army. Third Edition. Fcap
8vo, 5s. [1875]

SOME AFFECTIONS OF THE LIVER

and Intestinal Canal ; with Remarks on Ague and its Sequela?, Scurvy,
Purpura, &c, by Stephen H. Ward, M.D. Lond., F.R.C.P., Physician
to the Seamen's Hospital, Greenwich. Svo, 7s. C1872]

DISEASES OF THE LIVER:

Lettsomian Lectures for 1872 by S. O. Habershon, M.D., F.R.C.P.,
Senior Physician to Guy's Hospital. Post 8vo, 3s. 6d. t 18 723

BY TIIE SAME AT7TIIOK.

DISEASES OF THE STOMACH: DYSPEPSIA

Second Edition, crown Svo, 5s.

THE STOMACH AND DUODENUM

Their Morbid States and their Relations to the Diseases of other
Organs, by Samuel Fenwick, M.D., F.R.C.P., Assistant-Physician
to the London Hospital. Svo, with 10 Plates, 12s. t 1868 l

FOOD AND DIETETICS

Physiologically and Therapeutically Considered. By Frederick W.
Pavst, M.D., F.R.S., Physician to Guy's Hospital. Second Edition,
8vo, 15s. P8753

IMPERFECT DIGESTION:

its Causes and Treatment by Arthur Leared, M.D., F.R.C.P.,
Senior Physician to the Great Northern Hospital. Sixth Edition,
fcap 8vo, 4s. 6d. C 18 75]

THE ISSUE OF A SPIRIT RATION

during the Ashanti Campaign of 1874 ; with two Appendices contain-
ing Experiments to show the Relative Effects of Rum, Meat Extract
and Coffee during Marching, and the Use of Oatmeal Drink during
Labour, by Edmund A. Parkes, M.D., F.R.S., Professor of Hygiene
to the Army. Medical School, Netley. Svo, 2s. 6d. C18753

MEGRIM, SICK-HEADACHE,

and some Allied Disorders : a Contribution to the Pathology of Nerve-
Storms, by Edward Liveing, M.D. Cantab., Hon. Fellow of King's
College, London. 8vo, with Coloured Plate, 15s. t 1873 ^

FUNCTIONAL NERVOUS DISORDERS

Studies by C. Handfield Jones, M.B., F.R.C.P., F.R.S., Physician
to St. Mary's Hospital. Second Edition, 8vo, 18s. t 187 ^

18 CATALOGUE OF RECENT WORKS

NEURALGIA AND KINDRED DISEASES

of the Nervous System : their Nature, Causes, and Treatment, with a
series of Cases, by John Chapman, M.D., M.R.C.P. 8vo, 14s. [WS]

THE SYMPATHETIC SYSTEM OF NERVES

and their Functions as a Physiological Basis for a Rational System of
Therapeutics by Edward Meryon, M.D., F.R.C.P., Physician to the
Hospital for Diseases of the Nervous System. 8vo, 3s. 6d. d 8 ? 2 ]

GOUT, RHEUMATISM

and the Allied Affections ; a Treatise by P. Hood, M.D. Crown 8vo,
10s. 6d. C1871]

RHEUMATIC GOUT,

or Chronic Rheumatic Arthritis of all the Joints ; a Treatise by
Robert Adams, M.D., M.R.I.A., Surgeon to H.M. the Queen in
Ireland, Regius Professor of Surgery in the University of Dublin.
Second Edition, 8vo, with Atlas of Plates, 21s. £1872]

TEMPERATURE OBSERVATIONS

containing (1) Temperature Variations in the Diseases of Children,
(2) Puerperal Temperatures, (3) Infantile Temperatures in Health and
Disease, by Wm. Squire, M.R.C.P. Lond. 8vo, 5s. Ci87i]

THE ORIGIN OF CANCER

considered with Reference to the Treatment of the Disease by Camp-
bell de Morgan, F.R.S., F.R.C.S., Surgeon to the Middlesex Hos-
pital. Crown 8vo, 3s. 6d. CI8723

CANCER:

its varieties, their Histology and Diagnosis, by Henry Arnott,
F.R.C.S., Assistant-Surgeon to, and Lecturer on Morbid Anatomy at,
St. Thomas's Hospital. 8vo, with 5 Plates and 22 Engravings, 5s. 6d.

[1872]

CANCEROUS AND OTHER INTRA-THORACIC GROWTHS:

their Natural History and Diagnosis, by J. Risdon Bennett, M.D.,
F.R.C.P., Member of the General Medical Council. Post 8vo, with
Plates, 8s. [1872]

CERTAIN FORMS OF CANCER

with a New and successful Mode of Treating it, to which is prefixed a
Practical and Systematic Description of all the varieties of this Disease,
by Alex. Marsden, M.D., F.R.C.S.E., Consulting Surgeon to the
Royal Free Hospital, and Senior Surgeon to the Cancer Hospital.
Second Edition, with Coloured Plates, 8vo, 8s. 6d. C1873J

PUBLISHED BY J. AND A. CHURCHILL 19

ATLAS OF SKIN DISEASES:

a series of Illustrations, with Descriptive Text and Notes upon Treat-
ment. By Tilbury Fox, M.D., F.R.C.P., Physician to the Department
for Skin Diseases in University College Hospital. In monthly parts,
roy. 4to, each containing Four Coloured Plates. Parts I to V issued
since October. 6s. 6d. each. t 1875 3

CERTAIN ENDEMIC SKIN AND OTHER DISEASES

of India and Hot Climates generally, by Tilbury Fox, M.D., and
T. Farquhar, M.D., Surgeon Major H.M. Bengal Medical Service
(retired). Including Notes on Pellagra, Clou de Biskra, Caneotica,
and Aleppo Evil (with 5 Plates), by H. Vandyke Carter, M.D.,
Surgeon Major H.M. Indian Medical Service. (Published under the
sanction of the Secretary of State for India in Council). 8vo, 10s. 6d.

[1876]

DISEASES OF THE SKIN:

a System of Cutaneous Medicine by Erasmus Wilson, F.R.C.S.,
F.R.S. Sixth Edition, Svo, 18s., with Coloured Plates, 36s. C1867

BY the same attthoe,
LECTURES ON EKZEMA

and Ekzematous Affections : with an Introduction on the General
Pathology of the Skin, and an Appendix of Essays and Cases. 8vo,
10s. 6d. " C1870J

ALSO,

LECTURES ON DERMATOLOGY

delivered at the Royal College of Surgeons, 1870, 6s. ; 1871-3, 10s. 6d,.
1874.5, 10s. 6d.

ECZEMA

by McCall Anderson, M.D., Professor of Clinical Medicine in the
University of Glasgow. Third Edition, 8vo, with Engravings, 7s. 6d.

[1874]
BY THE SAME AUTHOE,

PARASITIC AFFECTIONS OF THE SKIN

Second Edition, 8vo, with Engravings, 7s. 6d. [1868]

PSORIASIS OR LEPRA

by George Gaskoin, M.R.C.S., Surgeon to the British Hospital for
Diseases of the Skin. 8vo, 5s. [1875]

MYCETOMA ;

or, the Fungus Disease of India, by H. Vandyke Carter, M.D., Sur-
geon-Major H.M. Indian Army. 4to, with 11 Coloured Plates, 42s.

[1874]

20 CATALOGUE OF RECENT WORKS

FOURTEEN COLOURED PHOTOGRAPHS OF LEPROSY

as met with in the Straits Settlements, with Explanatory Notes by
A. F. Anderson, M.D., Acting Colonial Surgeon, Singapore. 4to,
31s. 6d. [1872]

DISEASES OF THE SKIN

in Twenty-four Letters on the Principles and Practice of Cutaneous
Medicine, by Henry Evans Cauty, Surgeon to the Liverpool Dis-
pensary for Diseases of the Skin, 8vo, 12s. 6d. lW4]

WORMS:

a Series of Lectures delivered at the Middlesex Hospital on Practical
Helminthology by T. Spencer Cobbold, M.D., F.R.S. Post 8vo,
5s. d 8 72]

THE MEDICAL ADVISER IN LIFE ASSURANCE

by Edward Henry Sieveking, M.D., F.R.C.P., Physician to St.
Mary's aud the Lock Hospitals; Physician-Extraordinary to the
Queen; Physician-in- Ordinary to the Prince of "Wales, &c. Crown
8vo, 6s. [1874]

THE LAWS AFFECTING MEDICAL MEN

a Manual by Robert G. Glenn, LL.B., Barrister-at-Law ; with a
Chapter on Medical Etiquette by Dr. A. Carpenter. Svo, 14s.

[1871]

MEDICAL JURISPRUDENCE

(Principles and Practice of) by Alfred S. Taylor, M.D., F.R.C.P.,
F.R.S. Second Edition, 2 vols., 8vo, with 189 Engravings, £1 lis. 6d.

[1873]
BY THE SAME AUTHOR,

A MANUAL OF MEDICAL JURISPRUDENCE

Ninth Edition. Crown 8vo, with Engravings. 14s. C 18 74]

ALSO,

POISONS

in Relation to Medical Jurisprudence and Medicine. Third Edition,
crown Svo, with 104 Engravings, 16s. [1875]

A T0XIC0L0GICAL CHART,

exhibiting at one View the Symptoms, Treatment, and mode of
Detecting the various Poisons— Mineral, Vegetable, and Animal :
with Concise Directions for the Treatment of Suspended Animation,
by William Stowe, M.R.C.S.E. Thirteenth Edition, 2s.; on
roller, 5s. [1872]

OBSCURE DISEASES OF THE BRAIN AND MIND

by Forbes Winslow, M.D., D.C.L. Oxon. Fourth Edition, post
8vo, 10s. 6d. [18C8]

PUBLISHED BY J. AND A. CHURCHILL 21

PSYCHOLOGICAL MEDICINE:

a Manual, containing the Lunacy Laws, the Nosology, ^Etiology,
Statistics, Description, Diagnosis, Pathology (including Morbid His-
tology), and Treatment of Insanity, by J. C. Bucknill, M.D.,
F.RS., and D. H. Tuke, M.D., F.R.C.P. Third Edition, 8vo, with
10 Plates and 34 Engravings, 25s. [1873]

--BADNESS

in its Medical, Legal, and Social Aspects, Lectures by Edgar
Sheppard, M.D., M.R.C.P., Professor of Psychological Medicine in
King's College; one of the Medical Superintendents of the Colney
Hatch Lunatic Asylum. 8vo, 6s. 6d. C1873J

— HANDBOOK OF LAW AND LUNACY;

or, the Medical Practitioner's Complete Guide in all Matters relating
to Lunacy Practice, by J. T. Sabben, M.D., and J. H. Balfour
Browne, Barrister- at -Law. 8vo, 5s. [1872]

^DEREBBIA

and other Diseases of the Brain by Charles Elam, M.D., F.R.C.P.,
Assistant-Physician to the National Hospital for Paralysis and
Epilepsy. 8vo, 6s. [1872]

---INFLUENCE OF THE MIND UPON THE BODY

in Health and Disease, Illustrations designed to elucidate the Action
of the Imagination, by Daniel Hack Tuke, M.D., F.R.C.P.
8vo, 14s. [1872]

A MANUAL OF PRACTICAL HYGIENE

by E. A. Parkes, M.D., F.R.C.P., F.R.S., Professor of Hygiene in
the Army Medical School. Fourth Edition, 8vo, with Plates and
Engravings, 16s. [1873]

A HANDBOOK OF HYGIENE

for the Use of Sanitary Authorities and Health Officers by George
Wilson, M.D. Edin., Medical Officer of Health for the Warwick
Union of Sanitary Authorities. Second Edition, crown 8vo, with
Engravings, 8s. 6d. [1873]

MICROSCOPICAL EXAMINATION OF DRINKING WATER

A Guide, by John D. Macdonald, M.D., F.R.S., Assistant Pro-
fessor of Naval Hygiene, Army Medical School. 8vo, with 24 Plates,
7s. 6d. [1875]

HANDBOOK OF MEDICAL ELECTRICITY

by Herbert Tibbits, M.D., M.R.C.P.E., Medical Superintendent of
the National Hospital for the Paralysed and Epileptic. 8vo, with 64
Engravings, 6s. [1873]

22 CATALOGUE OP EECENT WORKS

CLINICAL USES OF ELECTRICITY

Lectures delivered at University College Hospital by J. Russell
Reynolds, M.D. Lond., F.R.C.P., F.R.S., Professor of Medicine
in University College. Second Edition, post 8vo, 3s. 6d.

[1373]

AUTOBIOGRAPHICAL RECOLLECTIONS

of the Medical Profession, being personal reminiscences of many
distinguished Medical Men during the last forty years, by J. Fer-
nandez Clarke, M.R.C.S., for many years on the Editorial Staff of
the ' Lancet,' Post 8vo, 10s. 6d. [1874]

A DICTIONARY OF MEDICAL SCIENCE

containing a concise explanation of the various subjects and terms of
Anatomy, Physiology, Pathology, Hygiene, Therapeutics, Medical
Chemistry, Pharmacology, Pharmacy, Surgery, Obstetrics, Medical
Jurisprudence and Dentistry ; Notices of Climate and Mineral Waters ;
formulae for Officinal, Empirical, and Dietetic Preparations ; with the
Accentuation and Etymology of the terms and the French and other
Synonyms, by Robley Dunglison, M.D., LL.D. New Edition,
by Richard J. Dunglison, M.D. Royal 8vo, 28s. [1874

A MEDICAL VOCABULARY;

being an Explanation of all Terms and Phrases used in the various
Departments of Medical Science and Practice, giving their derivation,
meaning, application, and pronunciation, by Robert G. Mayne, M.D.,
LL.D. Fourth Edition, fcap 8vo, 10s. [1875]

ATLAS OF OPHTHALMOSCOPY:

representing the Normal and Pathological Conditions of the Fundus
Oculi as seen with the Ophthalmoscope : composed of 12 Chromo-
lithographic Plates (containing 59 Figures), accompanied by an
Explanatory Text by R. Liebreich, Ophthalmic Surgeon to St.
Thomas's Hospital. Translated into English by H. Rosborough
Swanzy, M.B. Dub. Second Edition, 4to, £1 10s. [WO]

DISEASES OF THE EYE

a Manual by C. Macnamara, Surgeon to Westminster Hospital. Third
Edition, fcap, 8vo, with Coloured Plates and Engravings, 12s. 6d. [1876]

DISEASES OF THE EYE

A Treatise by J. Soelberg Wells, F.R.C.S., Ophthalmic Surgeon to
King's College Hospital and Surgeon to the Royal London Ophthalmic
Hospital. Third Edition, 8vo, with Coloured Plates and Engravings,
25s. C187S]

BY THE SAME ATTTHOB,

LONG, SHORT, AND WEAK SIGHT,

and their Treatment by the Scientific use of Spectacles. Fourth
Edition, 8vo, 6s. [1873]

PUBLISHED BY J. AND A. CHUKOIIILL 23

DISEASES OF THE EYE

A Practical Treatise by Haynes "Walton, F.R.C.S., Surgeon to St.
Mary's Hospital and in charge of its Ophthalmological Department.
Third Edition, 8vo, with 3 Plates and nearly 300 Engravings, 25s.

[1875]

OPHTHALMIC MEDICINE AND SURGERY

a Manual by T. Wharton Jones, F.R.S., Professor of Ophthalmic
Medicine and Surgery in University College. Third Edition, fcap
8vo, with 9 Coloured Plates and 173 Engravings, 12s. 6d. CW86]

A SYSTEM OF DENTAL SURGERY

by John Tomes, F.R.S., and Charles S. Tomes, M.A., Lecturer on
Dental Anatomy and Physiology, and Assistant Dental Surgeon to
the Dental Hospital of London. Second Edition, fcap 8vo, with 268
Engravings, 14s. [1873]

A MANUAL OF DENTAL MECHANICS

with an Account of the Materials and Appliances used in Mechanical
Dentistry, by Oakley Coles, L.D.S., R.C.S., Surgeon-Dentist to
the Hospital for Diseases of the Throat. Crown 8vo, with 140
Engravings, 7s. 6d. [1873]

HANDBOOK OF DENTAL ANATOMY

and Surgery for the use of Students and Practitioners by John
Smith, M^D., F.R.S. Edin., Surgeon-Dentist to the Queen in Scotland.
Second Edition, fcap 8vo, 4s. Gd. [1871]

STUDENT'S GUIDE TO DENTAL ANATOMY AND SURGERY
by Henry Sewill, M.R.C.S., L.D.S., Dentist to the West London
Hospital. With 77 Engravings, fcap. 8vo, 5s. fid. [1876]

EPIDEMIOLOGY;

or, the Remote Cause of Epidemic Diseases in the Animal and in the
Vegetable Creation, by John Parkin, M.D., F.R.C.S. Part I,
8vo, 5s. [1S73]

DISEASE GERMS;

and on the Treatment of the Feverish State, by Lionel S. Beale,
M.B., F.R.C.P., F.R.S., Physician to King's College Hospital. Second
Edition, crown 8vo, with 28 Plates, 12s. 6d. [1872]

THE GRAFT THEORY OF DISEASE

being an Application of Mr. Darwin's Hypothesis of Pangenesis
to the Explanation of the Phenomena of the Zymotic Diseases, by
James Ross, M.D. 8vo, 10s. [1872]

ZYMOTIC DISEASES:

their Correlation and Causation by A. Wolff, F.R.C.S. Post
8vo, 5s. [1872]

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(510)642-6753
. Vyear loans may be recharged by bringing

books to NRLF
. Renewals and recharges may be made

4 days prior to due date

DUE AS STAMPEDJ3ELOW

NOV *0 2003

DD20 15M 4-02