CHAPTER VI.

MALE IMPOTENCY.

An unqualified recognition of the convenience of calling a spade a spade, and of the propriety of so doing, is one of the treats likely to be reserved for more enlightened, if not more liberal periods of sublunary existence.

I have my suspicion, however, that prudery and vice are old associates-but this is possibly a vulgar opinion, and no more of it!

So long as people (genteel people) will persist in calling a spade an agricultural implement of particular size and form; so long as periphrasis is looked upon as an indication of good breeding, is it not highly becoming that impotency in male or female should be presented to medical literature in a Greek dress? A celebrated metropolitan obstetrician has accordingly undergone the throes of a philological parturition, and has brought forth-not a mouse, but dyspareunia—an offspring on the production of which he is much more. to be congratulated. The learned inform us that Sophocles used the word in this sense, “ το δυσπάρευνον λEKтρov Evdevтоμevos." Whether Sophocles or his conλεκτρον ἐνδευτομενος. temporaries begot children after the manner of the moderns (and the word ekктроv may throw some doubt upon a question, the solution of which might obtain the fellowship of a learned society) does not

consist with my knowledge, but it is certain that what we vulgarly call impotency, the Greeks recognised, and that apparently, being the subject of it, was not at all calculated to foster, or perpetuate conjugal felicity. As the writer is not a candidate for the fellowship of a Gynæcological Society, he must dismiss the archæological view of the question, until such time as his ambition assumes a different and more exalted phase. Impotency in the male may be classified as follows: modifying the classification of Mason Good.

ENTONIC IMPOTENCY.-Of entonic impotency from super-erection, I am not cognisant of an example. Dr Mason Good cites a case in point, recorded by Dr Cockburn. The patient was a Venetian of noble family, who though married to a fine and healthy young lady, had no seminal emission in the act of sexual congress, notwithstanding that there was vigorous erection, and involuntary seminal discharge during sleep. He was greatly afflicted, as were also his family, by such a misfortune; and failing beneficial treatment at home, the Venetian ambassadors at the different courts of Europe were requested to consult the most eminent physicians in their respective quarters. Under these circumstances, Dr Cockburn was consulted, and divining the condition to be due to excessive plethora of the vessels

of the penis, and consequent coarctation of the urethra during coitus, which possibly caused a seminal refluence into the bladder, a condition he surmised not occurring during sleep, he recommended lowering treatment, purgative medicine, slender diet, &c., which were soon followed by the desired issue.

Mason Good relates a case of a somewhat similar nature, which came under his own notice. A young healthy couple were married for seven or eight years without offspring, at the end of which time, the lady became pregnant, and added every year to her family until she had six or seven children. In a professional conversation with Dr Good, the father made it appear that the temporary sterility was due to the cause under consideration. Cases of this nature are of every-day

occurrence.

That priapism, by which is to be understood persistent erection due to disease, prevents seminal emission, is known by the fact that in these painful cases, masturbation has been actually resorted to for the removal of the distressing malady, and in vain.

ANTICIPATING MESEMISSION.-This is perhaps the most frequent cause of male impotency. I am unwilling that I should lay myself open to the charge of ignoring opinions contrary to any I have adduced, or will adduce, coming from any one whose views command respect. It is but right, therefore, that I should assert that, in a vigorous literary onslaught against a Mr Dawson of London, Dr King Chambers contends that, "over-emission, when attempting connection, arises in sensitive persons from allowing the mind to dwell too much upon it." I may here remark that I yield to no one in my sympathy with the honourable motives by

which Dr Chambers was so palpably actuated throughout this controversy. Dawson's book, Acton's book, Milton's book, et hoc genus omne,* contain much, in my opinion, that is overdrawn, irrelevant, and consequently pernicious; but one is apt in the impetuosity of a righteous crusade against any form of iniquity to overlook stray facts. For myself, I must say, that I have frequently been consulted with reference to cases of this nature, and I am bound to observe, that if this is a manifestation exclusively of a purely mental state, it is a very inveterate one if allowed to work its own cure; and that I believe that I have remedied this condition by internal remedies, and I flattered myself that I discovered in certain cases, a cause for it, in prostatic hyperæsthesia. In media tutissimus ibis-so I believe there is a proportion of these cases in highly sensitive men, where mental emotion alone must be looked upon as the disturbing element, and that these cases get well without interference.

Dr Chambers, I am sure, will be charitable enough to admit, that because he may not have seen such cases, it is neither just nor permissible to throw a direct denial in the face of writers of unimpeachable respectability. I have actually never seen an ulcer of the uterus, that invaluable stronghold of the "Phalloid school." I know highly accomplished men who have been over thirty years engaged in general practice, who have never been able to diagnose a flexion, or version of the uterus, anterior, posterior, or lateral. But it does not follow that these conditions do not

There is one honourable exception, which, in justice to the author, I am bound to mention. Making allowance for legitimate differences of opinion on minor points, the little book of Mr Courtenay on this subject is unobjectionable.

exist, though much doubt must be thrown on the pathological importance assigned to them. I trust I may yet see these departures from the uterine elliptic, and be convinced of their importance. To show how susceptible we are of intellectual development, why, vaginismus has actually been discovered, of late, within a hundred miles of the classic shrine of Saint Mungo! Who would have been fool-hardy enough to have predicted this half-a-century ago?

Dr Tanner refers to the following case of misemissio anticipans. “A young man about twenty-five years of age, has never had sexual intercourse, but he confesses to having practised masturbation since he was thirteen or fourteen years of age. His penis is normal, both testicles are of a proper size, they feel healthy and they are situated in the scrotum.

"He enters into a matrimonial engagement; but unfortunately a period of eighteen months or two years must elapse before he can fulfil his contract. During this interval he sees his future wife daily, and in spite of his resolve not to encourage any feeling of excitement, yet repeatedly he suffers from seminal emissions. At the time of marriage he is nervous, weak, and has fits of mental depression, while his wedding trip is rendered perfectly miserable on finding that immediately he attempts to have connection, an emission takes place, and the erection ceases. Night after night his efforts prove unavailing; until at the end of two or three weeks he becomes thoroughly ashamed of himself, afraid of his wife's female relations, and terribly depressed."*

* Ce symptôme est très-frequent parmi les personnes qui se sont épuisées, et il contribue à entretenir l'épuisement; la plus petite tentation produit un commencement d'érection, qui est suivie d'un écoulement.-Tissot.

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