blem of such extreme difficulty. Where impotence is curable at all, the general rules as to the requisite treatment can be comprised in a very few words. To give the system rest-to improve the general health, so that the nervous centers shall have time, opportunity, and encouragement to rally, if it be possible;-to invigorate the muscular powers, so that both voluntary and involuntary muscles may regain their tone-are among the most important maxims to be borne in mind; at the same time it is necessary to avoid as much as possible any local or other stimuli which merely excite without strengthening. In any curable case it is probable that the nervous system has been over-excited beyond the natural limits which a phlegmatic constitution imposes. The one object is to restore the nervous power, or rather to allow it to restore itself— not to excite or exhaust it still further. The diet should, I need hardly add, be of the most wholesome and nutritious kind; but we should not forget the old proverb-" Sine Cerere et Baccho friget Venus."

Hitherto I have spoken of the general treatment of impotence; in other words, of the best means of improving the health. By doing this, the sexual organs will, probably, in all simple cases become, in common with other functions, equal to their duties. Some, however, not content with these simple means, have devised remedies for the purpose of stimulating the flagging powers. No doubt can exist that in certain persons, when the affection arises from some temporary cause-more especially in the timid, hypochondriacal, and those suffering from mental disquietude-the employment of stimulants may be very proper. But though this treatment is sometimes justifiable and advantageous, it is most unscientific and dangerous in other cases-particularly in those of general prostration-so to stimulate the organs as to produce emission. Here it can only aggravate the mischief; whereas, had the general health been first improved, the local disorder next relieved, and subsequently a stimulant given, we could understand the formula. Such should be the true method of effecting a cure; and I shall attempt to show here the principles which should guide its application. Had these principles been more generally known, many of the invalids we meet with would have been rescued from much physical and mental suffering.

Cantharides have been employed against impotence. They form the basis of the pastilles de Serail, as well as of the numerous pills,

pastes, and opiates which constitute in the East the principal commerce of all those who sell drugs. The Spanish fly enters largely into the diavolini and other aphrodisiac preparations still too much employed in Italy.

Lallemand protests strongly against the use of this drug.

"The effect," he says, "produced by cantharides on a healthy man has induced persons to believe that they could restore virility lost from excesses. Thus, charlatans, and even many legitimate practitioners, have at all times prescribed cantharides as a traditional resource. For my own part, I have seldom met with an impotent person who has not had cause to regret the use of this drug. The greater proportion have not even experienced the momentary benefit which they expected; and in many cases the erectile tissues have become smaller than in the habitual state of repose. Some few have experienced erections more or less energetic, which have lasted a longer or shorter period; but the loss of semen has exasperated symptoms instantaneously, or very shortly afterward."-Lallemand, vol. iii, p. 333.

No doubt can exist that the habitual employment of cantharides is prejudicial; but in the present day, when this substance is no longer given as indiscriminately as it was formerly, the surgeon may often advantageously prescribe it. Thus, where erection is feeble, when the fears of the patient greatly influence his mind, or when there is doubt of success in the copulative act, a few doses are very advisable. But, after success, the remedy must be left off, for we do not want to excite the organs frequently, as the repeated shocks on the nervous system will often only further depress the vital powers.

Phosphorus is another of the pharmaceutical preparations which the modern surgeon frequently employs in the treatment of impotence. The object is to supply that particular pabulum which the exertion of nervous influence appears to exhaust. We may theoretically infer that in these complaints there is a great expenditure of phosphorus in its various combinations, and that there may be a deficiency of this substance in the system, just as in other diseases, particularly chlorosis, there is a deficiency of iron. In either case we should supply the system freely with the element it seems. to need, in such a way as that it may be easily taken up and retained in the circulation. Practice, as well as theory, seems to

sanction this treatment, and I must admit that phosphoric acid, in combination with syrup of orange-peel and syrup of ginger, is a favorite formula with me, particularly in those cases where there is reason to suppose the semen is not secreted in sufficient abundance, or where too rapid ejaculation attends the sexual act, or when connection is attended with serious nervous depression.

Strychnine has been frequently recommended in the treatment of impotence, and I believe it is a very valuable tonic in cases attended with great nervous depression, whether resulting from sexual excesses or any other cause. I have found it equally beneficial in those forms of impotence depending upon weak or imperfect erection. I find that it is capable of increasing the general muscular energy, and in such cases I usually prescribe it, either alone or in combination with quinine. (See Appendix C.)

Electricity must be classed among the modern remedies for impotence. Since the last edition of this book was published I have had considerable experience of this agent, and I have every reason to be satisfied with the results. I find that it has answered best in those lethargic constitutions that require rousing, and simply demand a local stimulant capable of determining blood and nervous power toward the generative system. When, on the contrary, there is debility dependent on previous over-excitement, this, as well as every other local stimulant, acts injuriously on the system. The patient can by means of the batteries which may now be obtained anywhere, at no great cost, apply the remedy himself. I need hardly warn my readers that this should never be ventured on except under medical advice.

Marriage has been classed among the remedies for the slighter affections of the sexual organs. It is very well to speak of it as advisable, and no doubt can exist that, in the slighter cases of nocturnal emission, the cure of the complaint will be speedily effected by marriage; that is to say, sexual intercourse will cause the disappearance of the nocturnal symptom.

In practice, however, the question comes before the surgeon in a different way. A patient will complain of a variety of local sexual ailments, which perhaps he has suffered from during long periods, and when he is asked why he wishes now to be treated, the reply often is, that, as he is desirous to marry, he is anxious to be informed if he may do so, or if he is competent to perform his

marital duties. He will sometimes resort to us under the full conviction that he is physically unable to consummate the nuptials, and he is nervous at the idea of exposing himself to the chance of being found impotent. In such cases as these it is useless to advise marriage, for the patient will sometimes tell you that he has attempted connection, failed in his endeavors, and intends remaining a bachelor for life.

Lallemand thinks that, in the slighter cases of functional disease, no doubt can exist that marriage may completely cure the patient, before continued excess or evil habit has produced those ill consequences which have been described, for "the regular exercise of organs will alone give all the energy of which they are susceptible, and those of generation are far from forming an exception to this general law. To complete the cure, it is necessary that sexual relations should be established."

In the confirmed cases, where irritation or inflammation is set up in the vesiculæ seminales, or when diurnal or nocturnal emissions take place involuntarily, the man who is injudiciously persuaded to "commit" matrimony will only aggravate the complaint. He will probably find all his previous symptoms exaggerated, and eréction, even under excitement, will probably not take place. And even if it does, ejaculation may precede the intromission of the virile organ, or in many cases will not occur at all.

Let his parents or advisers consider the position of this inefficient bridegroom; let them picture to themselves his disappointment, chagrin, and shame. Is it wonderful that, under such circumstances, more than one has committed suicide? But, as the professor of Montpellier has nobly observed, "What has the young girl, who is thus sacrificed to an egotistical calculation, done, that she should be condemned to the existence that awaits her? Who has the right to regard her as a therapeutic agent, and to risk thus lightly her future prospects, her repose, and the happiness of the remainder of her life?

"Until a man has contracted these indissoluble bonds, impotence the most complete can compromise the future of no one.

"It is precisely because marriage is the most sacred bond for individuals, as well as the most important for society, and because an iron law renders it indissoluble, that it is rational as well as moral not to contract it without the certainty that it will be perfect and complete." (Vol. iii, p. 470.)

In practice, however, we find that the plans of parents and the advice of the surgeon are alike frustrated by other considerations. In many cases, the patient is too young to marry; in other instances of spermatorrhoea the dislike to marriage is such that every woman is distasteful to the sufferer, as if nature really intended to spare the victim those mental sufferings we have noted as attendant on these ill-starred matches.

Indeed, my experience is that, as a general rule, there is little need to dissuade those who ought not to marry, from doing so. Our task is rather in the other direction-to encourage those nervous, hypochondriacal people to marry and be happy, who, from a bad conscience, a weak frame, the effects of depressed health, or some wild ideas of the possible requirements of the young lady, on a subject of which all well-brought-up English maidens are ignorant, fancy that they are unfit to undertake the rational duties of husbands and fathers.

SECOND DIVISION.

THE SEXUAL ACT, ITS CONSTITUENT PARTS, PHYSIOLOGY, AND DISORDERS.

WE now come to the second of the main divisions of this part of the work. I propose to consider the several acts and states which go to make up the healthy act of coition. the healthy act of coition. And in this consideration I shall discuss, with regard to each of these acts and states, 1st, the healthy or normal performance of it; and 2d, the disorders that prevent or interfere with it.

To the medical man, a knowledge of the more intimate conditions and causes of potence or impotence is most important, and hardly less to the thousands who suffer, in one way or another, from some of the many causes that may hamper, or entirely prohibit, the exercise of the reproductive functions.

To the due performance of copulation three things are indispensable-namely, 1st, erection of the penis; 2d, the power of emission or ejaculation; and 3d, a due amount of well-formed semen; all which it will be necessary to treat of in the three following chapters.