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 irritation 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 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 symptoms of this malady. He tells me his mother has been a martyr to nervous affections, and his family all more or less labor 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 Chapter on Marital Excesses, page 148 will show.

Nocturnal emissions, as they induce loss of semen, act as a very frequent exciting cause of spermatorrhoea. (p. 230.)

Marital excesses act exactly in the same way. I need not here repeat what I have said at page 148 further than again to point out that excessive loss of semen from whatever cause will produce the very effects which are usually classed under the general term of spermatorrhoea. (p. 277.)

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 accouut 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 interference, depends in no way on semen in the urine.

In other instances, small floating atoms or flocculi may be seen floating 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 cells 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 color. The patient may be assured that these deposits are the urates or

lithates depending upon indigestion, and a means by which the system throws off superfluous nourishment.

Long streamers or cottony-looking flocculi are now recognized as coming from the prostate or the vesiculæ seminales; the masses of mucus, of all kinds of secretions and the vermicellilike threads are only broken-down epithelium, or may depend upon a neglected stricture 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 excitement 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 involuntary 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 (see page 236), semen occasionally passes away naturally under certain conditions.

Non-erection or imperfect erection, in the opinion of some nervous patients, is sufficient to prove that they have spermatorrhoea, and coupled with other symptoms no doubt can exist that these symptoms require careful investigation; but I must refer my readers to pages to 200 and 202 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 spermatorrhoea 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; it consists of a simple excretion of semen; we should moreover add that the seminal liquor is little abundant, watery, transparent, without smell, and incapable of fecundation." (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 he seminal fluid loses by degrees its consistence, its color, 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. Moral

ity has nothing to do with this, the unfavorable symptoms occur both in unmarried and married life.

Where we find the general health suffering, the disposition to intellectual 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 destructive 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 complication 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 the 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 (page 101) that among other symptoms this was a prominent one in the case of Jean Jaques 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―

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 generative functions, as castration to a great extent prevents its occurring, and produces that kind of voice