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ally disappear under the careful administration of these salts 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 one as a type of the ignorance and carelessness with which young men will injure their health by conduct which a very little knowledge would convince them is dangerous to the last degree. Of course this state of 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 the pent up feelings, both physical and mental will pretty certainly, as I have already said, avenge themselves on both mind and body in a way equally unexpected and destructive.

SECT. V.-PASSING BLOODY SEMEN.

Occasionally patients not only complain of emission taking place at unusual times, but state that the semen is colored red. I have very recently had such a case under my care. It occurred in a married man about fifty, who, as 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 the 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 of the canal. Although this patient was 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 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 bloody semen 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. At page 319, the case of an elderly gentleman is mentioned, who passed bloody semen in consequence of ungratified sexual excitement. In this and in all the other cases that have come under my notice, however, the patients did well, and no ill consequences 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 symptoms.

SECT. VI.-SPERMATORRHEA.

It often happens in medicine, as in other sciences, that premature generalizations 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 individuality 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 denying 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 repeated loss of semen, and I am no less certain that hypochondriasis, the various forms of indigestion, debility, and nervous affection, with loss of sleep, are often only the effects of spermatorrhoea. In such cases the best, and indeed the only treatment, is that which removes the cause, and is not confined to combating the symptoms. 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 characterize as Spermatorrhoea, then, as we shall use the word, is a state of enervation produced, at least primarily, by the loss of semen. The term, I admit, has many objections, but its general acceptance would render it inconvenient to alter it or employ any other. The disease, however, has received many other titles. No doubt can exist that the series of symptoms—here 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. have connection the congress is fruitless; they lose semen in bed, whether they are troubled with lascivious dreams or notthey lose it on horseback or in walking. To epitomize, 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

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, characterized by the somewhat vague term Spermatorrhæa, a complaint (I

If they

ears.

shall now attempt to show) which is as peculiar and as certainly to be distinguished by its own symptoms as fever, or any

other general disease. Of course, many a man has believed himself laboring under this affection when he was not. 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 he would naturally desire, as well as from the somewhat doubtful nature of the symptoms to an inexperienced eye, it has been and is used by unprincipled quacks as a means of imposition to a very great extent. Every disease or fancied ailment which their unfortunate victim can be persuaded into believing to be Spermatorrhoea, is called Spermatorrhea forthwith; and in his agony of terror and humiliation, the wretched and often innocent patient becomes a ready subject for the wickedest cruelty, and, I need hardly add, the most exhorbitant extortion. With some faint hope of partially counteracting this great evil, I have appended to this section a few remarks on False Spermatorrhoea (p. 300).

Perhaps 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 suffering 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 OF SPERMATORRHEA.Hard study I have already mentioned more than once as predisposing to this condition. The following is a sample of the cases to be met with in which overexertion of the brain has had this effect. A patient called on me in June, 1860, complaining that he was laboring 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 constitute spermatorrhæa, and was naturally alarmed at his state; this I could and did assure him was temporary. After contrasting the conditions of the continent and incontinent man, I think I succeeded in convincing him that the only danger he had to dread, arose from continuing 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 generative 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 continue 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. 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 of spermatorrhoea appears sufficiently from the former part of this work, to which I refer the reader for a description of both, and their effects, as well as (p. 152) for a definition of what constitutes excess.

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

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