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 advertisements. 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. It 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.'

The symptoms which patients who suffer from false spermatorrhea 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 disease, 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 operation of castration as a remedial means?" I wrote in answer, that the operator and the operated upon should both be placed in a lunatic asylum, and that I declined prescribing without seeing my patient, experience having taught me the inutility of doing so. This man represents a large class who will undergo any amount of present physical suffering to rid themselves of the ailment under which they believe they labor; 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 temperaIf not judiciously treated, such sufferers will assuredly end their days in asylums. I every now and then see patients who avow that

ment.

1I have lately (1874) seen that the London police magistrates have taken cognizance 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 magisterial authority) been called obscene literature. This has proved an efficient way of putting down one form of quackery.

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 laboring 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 ineffectual 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 means, been rescued from this unhappy state of mind, and to my certain knowledge have become useful members of society, and are now discharging 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 practiced it since they have arrived at adult age; yet without its exercise all our endeavors to obtain convalescence will fail. This self-denial must be mental as well as physical; the sufferers must be impressed with a full determination not to allow themselves to dwell on or think of their complaint. Such self-treatment is indispensable; these moral gymnastics are absolutely necessary, and they may be much assisted by regular bodily exercise and physical exertion, accompanied by a régime such as that described at page 167.

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 judicous 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 fall 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 conscientious self-reliance, founded on a real knowledge of disease, gives a medical practitioner, especially in these cases of incipent mental disease, 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 frequently favored by the inferior mental acquirements of the patient, who feels comfort in reposing on one whose knowledge and truthfulness 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 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 undertaken.

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 Ireland, England, and Scotland, without trouble or anxiety to the invalid. 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-travelers, 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 opprtunity 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.

ces.

BROOME PARK, BETCHWORTH, SURREY,
October 14, 1854.

SIR,-Your letter reached me this morning at my country house, where I am staying for my annual vacation. I am sorry that my absence 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 consequenAt the same time it must be owned that those who have been guilty of it are often 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 impotent. 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 perceive, 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. BRODIE.

P. S. The medicine should be taken for three weeks; perhaps longer.

CHAP. IV.-SEXUAL INTERCOURSE

THE ACT OF 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,' 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 surround the vesiculæ 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 particular local irritation.

1 See page 177 for explanation of this.

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.1 There is every reason 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 nervous 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 exhaustion consequent on the excitement of coitus, by the rapid diminution of the sensation during successive acts. Indeed, in persons who repeat

1I 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 as he able. The spawning process is carried on in this 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 by 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.