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 carefully studied by 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 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 color and consistence resembling cream, dropped into the glass, and in a few seconds fell to the bottom, the supernatant fluid being more or less transparent. The patient 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 disappearance of the so-called semen.

PATHOLOGY.-Little is known as to the local condition which gives rise to this complaint. I believe that in the earlier phases little or no local change takes place, the affection being functional only.

In the more advanced cases, however, we find an enormously increased sensibility. The mucous membrane is susceptible to both local and general influences to 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 tenderness of the meatus, glans, or urethra, but these symptoms do not necessarily occur.

Of the Urethra.-In the advanced stages, when irritation or inflammation has existed for some time in the genito-urinary systems, or nocturnal or diurnal 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 with a knife, so acute is the suffering, even when the bougie is passed by one who has a delicate 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, however, 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 (see Diagram, p. 286), or else with a granular condition, similar to that observed sometimes. on the inner surface of the eyelids, and occasionally in other mucous membranes, as a consequence of chronic inflammation.

DIAGRAM SHOWING A SIDE VIEW OF THE MALE REPRODUCTIVE ORGANS.

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 corrected the anatomical relations.

Again, there may be stricture of the urethra near the veramontanum, causing the semen to pass back into the bladder instead of forward along the urethra.

Of the Vesicula Seminales.-"The vesiculæ seminales," says Lallemand, "may be dilated and thickened; they may lose their characteristic 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 vesiculæ seminales, particularly at the bottom of the depressions, a thick, granular, shining liquid, variable in its aspect, color, and consistence, but resembling pretty thick glue, and more or less transparent. Under a power strong enough to observe the spermatozoa, the particles1 (grumeaux) of this secretion appear somewhat irregular in size, more or less opaque, and of a constant shape. These are evidently the products of the internal membrane of the vesiculæ seminales; for they are found with analogous characters in the accessory vesiculæ 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 former 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 inflammations spreading from the urethra downwards to the vesiculæ 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,

1 They have been compared to grains of sago. I am inclined to think the Professor 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 vesiculæ 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.

pass what they call semen-in many of the instances, when a thick, ropy, tenacious slime exudes in defacation or micturation, or even during sleep, probably in consequence of spasmodic action of the complex muscular contraction alluded to at page 211, the discharge comes from the increased and pent-up secretion resulting from a previous inflammation of the vesiculæ 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.

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-irritants on the perinæum, with other local and general means of improving 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 no doubt can exist, although all may not admit my explanation.

Spermatic Cords.-In speaking of the morbid appearances of the spermatic cords, the same authority states-"The terminal