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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 consentaneous action between emission and erection, both being perfect at different times. The patient, I may add, ultimately recovered, and returned to his own country.
Another class of cases is met with, which is less amenable to treatment, viz., where non-emission depends upon complete obstruction of the vasa deferentia. Dissection of these appendices or canals for conducting the semen from the testes to the vesiculæ seminales, 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. (See Diagram, page 286, as explaining the possibility of this obstruction.)
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 vesiculæ seminales. These are cases that have not yet attracted much attention from the profession, but of their 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 followed by affections of the testes.
When we bear in mind the frequency of swelled testicle and enlarged inguinal glands, instead of being surprised at the occasional occurrence of these obstructions, we may rather wonder that they do not follow more frequently. Happily, nevertheless, impotence depending 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 impotence, arising from atrophy of these organs, as well as obstruction of the vasa deferentia. Such cases, I fear, must be considered beyond the reach of our art.
SECT. III.-NOCTURNAL EMISSIONS OR POLLUTIONS. WET
Instead of taking place only during connection, 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 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 believe 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 abstemiously, emissions will either not occur, or their occurrence may be looked for only very occasionally. It is when they take place repeatedly, and leave 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, conducted to the spinal cord, and thence reflected, excites the successive and co-ordinate contractions of the muscular fibres of the vasa deferentia, and vesiculæ seminales, and of the accelerator urinæ, 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.” 1
The same author further remarks,—“In this fact that the reflex movements from the cord may be perfectly performed without the intervention 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 consciousness, they-reflex movements—are performed perfectly without experience 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 perceived."2
“The emission of semen is a reflex act, that is, there is the necessary 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 1 Kirkes, 7th edition, p. 507.
2 Ibid. p. 505. 3 Ibid. p. 506.
spoken of sleep in its most complete or profound form; that is, the state of complete unconsciousness. But with the absence of consciousness 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 processes may thus be carried on during sleep with unusual vigor 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 com letely 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.
Now, 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 vesiculæ, 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, frequently have an emission, probably arising from the violent shock to the medulla oblongata.
It is an error, as I have said, to suppose that the will has no control 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 perfectly 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 endeavor to do so.
I have every reason to believe that a man recovering from spermatorrhoea, or who has been under treatment, and complains that he suffers from nocturnal emissions, often believes that he
1 Donné, 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 zoosperms.” (p. 303.)