entire surface of the glans are moreover covered densely with sharp spines or hooklets; and as though even all this were not sufficient to produce the needful irritation, still further back there are, in some species, two short and strong horny saws appended to the sides of the organ. From this terrible armature of the male cavys it would be only natural to expect some corresponding peculiarity in the female parts; but, however inexplicable it may appear, the female vagina offers no uncommon structure." (P. 835.)

Before quitting the subject of erection, I must remark on the size of the intromittent organ. In the negro it is proverbially large, but, as in the case in whites also who have the same peculiarity, does not proportionately increase in size on erection taking place.

Size, I may here again remark, is no sign of vigor. One of the first characteristics of the perfect athlete of classic times was unusually small though well-shaped genital organs. Indeed, as I have before said, a large, flaccid penis is not unfrequently a result and an indication of masturbation having been indulged in to a dangerous extent. Veterinary surgeons, it is true, condemn a horse with an abnormally small sheath, as likely to be delicate in constitution. The rule, however, does not apply to human beings, though, undoubtedly, a shriveled, atrophied condition of the organs is a pretty sure sign of the existence of partial or entire impo

tence.

PART II.

DISORDERS AFFECTING ERECTION.

Having thus described the normal functions or conditions with regard to erection, it remains for us to consider one or two of the more frequent perversions or morbid states affecting this function. The first that suggests itself is one that we have already partially dealt with, viz., non-erection.

SECT. I.-NON-ERECTION.

Cases like the following not unfrequently come before a medical man, and medical students are peculiarly the subjects of the complaint.

The patient states that erection has ceased to occur. Examination of the urine detects no spermatozoa. Such cases can be readily explained. A man studies hard, is out of health, and semen is not secreted. Consequently erections are not likely to occur. Frequently no excess is committed, unless the inordinate exercise of the brain, which is often shown by the deposition of phosphates in the urine, can be so considered. My reply to such a man is, be thankful that your health is good; finish your studies, and I guarantee that semen, and more than you want, will be secreted. Observation teaches me that, after this long rest of the organs, the vital fluid will be formed in great abundance, as soon as the brain shall have ceased its inordinate calls on the blood.

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The antagonism of the nervous and generative system has not escaped the notice of writers on population. Spencer says: "Thus, the fact that intense mental application, involving great waste of the nervous tissues, and a corresponding consumption of nervous matter for their repair, is accompanied by a cessation in the production of sperm-cells, gives strong support to the hypothesis that the sperm-cells consist essentially of neurine. And this becomes yet clearer on finding that the converse fact is true, that undue production of the sperm-cells involves cerebral inactivity. Throughout the vertebrate tribes the degree of fertility varies inversely as the development of the nervous system."

SECT. II.-IMPERFECT ERECTION.

Again, erection may occur, but never attain its proper extent. For instance, patients come to us complaining that sexual intercourse is imperfect, because erection does not take place, or lasts so short a time that intromission of the male organ is impossible.

This form of impotence depends upon perversion of energy, according to Roubaud, and may be caused "by the nervous system having been excited beyond its proper limits; in some cases the excitement produced has not been able to attain a sufficient energy, it consequently happens that the nervous influence soon ceases to animate the penis, in consequence of the lassitude which the efforts made to produce turgescence of the organ occasion; and the blood, no longer retained in the cavernous bodies, re-enters the general circulation."

We may occasionally discover a local cause for this imperfect

erection, as in the following case: W

came to me, complain

ing that erection was not perfect; to effect penetration, he was obliged to grasp the penis firmly with the hand, otherwise erection would not last, the penis falling into a flaccid state; I cauterized the urethra, but he subsequently told me that the operation was not attended with much benefit. In this instance Wwas slightly curved in the back, and he mentioned that in early life he had suffered from disease of the spine, with loss of motion in the lower extremities; from this he recovered by extension. He likewise confessed that he had been a great masturbator. I did not, however, ascertain if the affection of the spine preceded or followed the indulgence of this habit.

Kobelt thinks that indolent erections (that is to say, those which we notice in drunken people, in children, in old men and persons of debilitated constitutions) never extend beyond the corpora cavernosa of the penis, and they never affect the passive organ; that is to say, the glans penis and corpus spongiosum urethra. The glans particularly, in such cases, never attains its full size, except when the other subordinate parts have been previously in a state of complete turgescence; it will be hence understood why, in certain conditions (notwithstanding the complete rigidity of the body of the penis), neither orgasm nor seminal ejaculation can be produced.-Kobelt, loc. cit., p. 60.

SECT. III.-IRREGULAR ERECTIONS.

Again, the erection may be abnormal in nature and most painfully distort the penis while it lasts.

In March, 18-, a middle-aged gentleman called on me, and stated that he was a married man, with several children. He complained that of late the penis, in erection, had been curved upward, presenting a scimitar shape, without any assignable cause. Connection gave him pain, but he indulged very little, wisely fearing lest he should injure himself.

In another patient the penis was of the natural size, or, if anything, rather larger than usual, but it had a very marked, irregular curve. In the flaccid state, the whole organ curved forward, and at the same time to the left. The patient mentioned that in erection the penis had two curves, but he experienced no particular in

convenience from its unusual shape. The only explanation which I can offer of these strange appearances is that, in consequence of violence, or from some other causes, inflammation of the spongy portion of the urethra has taken place, plastic lymph has been deposited, and that portion of the tissues being thus no longer distensible, but always firm and unyielding, these curvings necessarily arise on every erection. I have successfully recommended friction with iodine as a remedy.

SECT. IV.-PRIAPISM, OR PERMANENT ERECTION.

Again, erection, instead of being absent or imperfect, may be only too perfect and too persistent. This is what is called priapism. Fortunately for human nature, this terrible and humiliating condition, in its full extent, is by no means common. Every now and then, nevertheless, we meet with cases when, instead of the erection only lasting a few minutes, and the male organ again resuming its usual relaxed condition, the penis will, if the statements of patients can be believed, either remain permanently erect, or during half the night.

It is to the condition of the spinal cord and brain that we must look for the source of so alarming a phenomenon as this. They, after all, are the ultimate source of sensual excitement, and on them depend the entire processes of erection and ejaculation. Lallemand relates a case in which a patient could produce ejaculation by striking his head with his knuckles. Dupuytren has long since shown that lesions of the spinal cord produce priapism, and I have witnessed several such cases although ejaculation did not follow. It is a curious fact that this state of priapism coexists with loss of motion and sensation in the lower extremities, and as the power in the limbs is regained the priapism ceases. It is, however, an anomaly, and Lallemand thinks it shows that priapism does not depend on irritation of the lower part of the spinal cord, though, as he justly observes, injuries to this part of the spinal cord generally produce diminution, if not annihilation, of the virile power and of the generative functions. (See Appendix D.)

This author mentions a curious case (Vol. ii, p. 55), of a soldier who came under his care, having fallen on his sacrum; there was loss of power in the lower extremities and loss of sensation in the

glans, prepuce, skin of penis, and scrotum; catheterism produced no pain, but there was catarrh of the bladder. The penis was frequently in a complete state of erection, but ejaculation never was induced, although the patient had attempted, by masturbation, to rid himself of the erection. On one occasion sexual intercourse was indulged in for several hours, but ejaculation did not occur; nocturnal emissions, notwithstanding, occasionally took place. This, Lallemand thinks, proves the special influence of the spinal and ganglionic nerves in inducing ejaculation and involuntary emission, as the cerebro-spinal influence was completely annihilated; and this state, he thinks, is somewhat analogous to the condition of a man under the influence of wine or opium.

Such extreme cases as these are not, of course, common in practice, but still very distressing instances are not unfrequent, especially among the younger clergy, who lead the most continent lives, and have never given themselves up to self-abuse.

Only a short time ago, a young, highly sensitive, educated clergyman consulted me for such a condition. Walking, riding, even the friction of the trousers, would produce erection. He strove his utmost to prevent this, but in vain. On examining him I found the prepuce long, and he had not ventured to adopt customary measures of cleanliness, for fear of directing his attention or thoughts toward subjects he found so dangerous. The treatment I enjoined in this case was not so much moral discipline or self-restraint,--which there was little need to inculcate, but simply physical cleanliness, to accustom the part to feel water. I told him that if this produced sexual feelings at first, not to mind, but to persevere, as these would cease immediately after the morbid irritability had been got rid of. As soon as the external sensitiveness had been overcome, I gradually passed an instrument, and discovered the greatest morbid irritability in the urethra I ever met with. This, however, gradually declined, and he got completely rid of his old troubles.

SECT. V.-SATYRIASIS.

Lastly, erection may be not only morbidly frequent and persistent, but connected with a maniacal sensuality that is one of the most awful visitations to which humanity can be subject. Continual