ments. The more powerful organs have already done so to a certain extent, and with the best effect.

But to return to the subject of this chapter. The symptoms which patients 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. They frequently partake of both characters; there is much true disease which has been aggravated by fear and ill treatment; and I believe, as stated elsewhere (p. 66), 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 in too off-hand a manner.

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 be both placed in a lunatic asylum, and that I declined prescribing without seeing the 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 get rid 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 we are now speaking of-namely, simulated diseases in highly irritable persons, who, if not treated properly, will assuredly end their days in asylums.

The most difficult thing in the treatment 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 complaints. This self-treatment is indispensable; these moral gymnastics are absolutely necessary, and they may be much assisted by regular exercise and great physical exertion, accompanied by a régime such as that described at p. 227. A return to a cheerful temper and a bright view of the case will tend likewise to the cure.

The judicious 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 fail with the imaginative and the intellectual, who must be reasoned with and convinced. before much can be done for them. Above all things, a favorable prognosis should be given, where not inconsistent with conviction. The power which a conscientious self-reliance, founded on real knowledge of disease, gives a medical practitioner, especially in these cases of half-mental disease, is remarkably great. His convictions appear to be sympathetically communicated to his patients, and the moral influence thus established, once in full play, materially accelerates his cures. This power of communicating convictions and of controlling the will of the patient, so desired by the young surgeon, is more or less innate, but can be developed by industry 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 he has learnt to respect.

But, however necessary the moral treatment I have above spoken of is, it must often be aided by physical exertion (as above alluded to), attention to diet, &c. In addition, local stimuli may be often necessary. When the impression is once awakened that the dreaded impotence may, after all, be only a delusion, these and all other stimulants should be left off, for reasons stated at page 148.

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, change of scene, travel, and society.

PERIOD IV.

THE FUNCTIONS AND DISORDERS OF THE REPRODUCTIVE ORGANS IN ADVANCED LIFE.

WE have seen that in youth the sexual powers are rather to be husbanded than taxed, and that even the adult should be chary of exhausting those desires which nature has given him for the extension of the species.

PART I.

NORMAL FUNCTIONS.

We have now to consider those conditions and desires in advanced life; and it will appear that old age resembles youth in this, that if the man in advanced life wishes to preserve his intellectual faculties, health, and vigor, and would enjoy long life, he must be con- . tent with, at most, only a very moderate indulgence of the sexual passion. His motto should be, "Deposui arma miles inermis."

Fortunately, this moderation is the usual course. The elderly man has generally learned from experience that the generative function is not wisely, or, indeed, duly exercised, before the body has attained its entire development-that it is the test of manhood, the crowning effort of maturity, and that it must diminish with a waning frame. We require a sort of vital exuberance, to transmit what is superfluous to another being; and this prerogative is given to us only during the prime of our existence.

"Love," Parise says, "at the decline of life, should take quite a moral character, freed from all its animal propensities. In the elderly man, it is paternal, conjugal, patriotic attachment, which, without being so energetic as the love experienced in youth, still warms old hearts and old age; and, believe me, these have their sweet privileges, as well as sometimes their bitter realities. These

autumn roses are not without perfume-perhaps less intoxicating than that arising from first love, but presenting none of its dangers.

"One of the most important pieces of information which a man in years can attain is, 'to learn to become old betimes,' if he wishes to attain old age. Cicero, we are told, was asked if he still indulged in the pleasures of love. Heaven forbid!' replied he; 'I have forsworn it, as I would a savage and a furious master.'

"When you see an elderly man, judicious, endowed with firm reason, whose enlightened and active mind is still capable of directing ably his affairs, and making himself useful to society, be convinced that such a man is discreet and continent, and that temperance-so justly called Sophrosyne, the Guardian of Wisdom, by the ancients has in him a fervent admirer; in fact, he has acquired his perfect moral liberty."-Traité de la Vieilesse, p. 431.

M. Flourens, in his "La Longévité Humaine," says: "It is at the turning point of the physique that the morale enters, in turn, upon its empire--strengthens, expands itself, and gives, as it were, a splendor to the second half of life.”

"Age has a much greater effect on physiological than on sentimental love, as the latter has less need of physical force or juvenile exaltation. There are men who, always young in heart and imagination, have toward this pure love a constant devotion which, ever renewing itself, seems to reanimate instead of exhausting the vital principle."

Parise says: "It is usually at the age of fifty or sixty1 that the generative functions become weakened. It is at this period that man, elevated to the sacred character of paternity, and proud of his virile power, begins to mark that power decrease, and does so almost with a feeling of indignation. The first step toward feebleness announces to him, unmistakably, that he is no longer the man he was. He He may retard the effect up to a certain point, but not entirely. This law must have its full and entire execution, 'dura lex sed lex.' The. activity of the generative organs diminishes, their functions abate, languish, and then cease entirely. The wish and the want are no longer one and the same thing; the imagina

1 The Cardinal Maury is said to have told the celebrated Portal that "a man of sense past fifty ought to give up the pleasures of love, for every time he indulged in them he threw on his head a handful of earth." (Anglice, "drove a nail into his coffin.")

tion does not exercise its olden power and fascination on these

organs.

"Blood now only flows in small quantities toward the testes. Their sensibility becomes blunted, and is reduced to what is sufficient for the nutrition of the parts. The scrotum is observed to become wrinkled and diminished in size, the testicles atrophy, and the complicated vascular tissues which form them become obliterated; the semen, that peculiar secretion of the blood, is not only less abundant, but has lost its consistence and its force. The animal culæ, or zoosperms, which constitute its nature or its essence, far from being as numerous or active as formerly, are, on the contrary, few and languid.”

Dr. Duplay, physician to the Hospital of Incurables in Paris, states that he examined the generative organs, in order to discover the existence of semen, in 51 old men, who died of various acute and chronic diseases, aged from sixty to eighty-six. In 37 he established the presence of spermatozoa, and in the other 14 he was unable to find traces of them. In 27 instances the spermatozoa were perfectly well formed, and similar in every respect to those found in the adult. In the other 10 cases neither the heads of the spermatozoa nor their tails were perfect.

The quantity varied greatly. In some old men spermatozoa were as numerous as in adults; in 14 instances they were rare, but still perfectly developed.

Spermatozoa may be found in the whole extent of the vasa deferentia, as happened in 26 instances, or at one point only of the secreting apparatus. Thus, three times only, the semen contained. in the vasa deferentia alone showed them; that in the vesiculæ evincing no traces. Once their presence was shown in the liquid of the vesiculæ seminales, and not in that of the vasa deferentia. They were found seven times in only one vesicula, four times in the right, and three times in the left, to the exclusion of that on the opposite side and of the two deferent canals.

Semen was very abundant in 3 cases, moderately so in 24, and in 10 cases there was but little to be seen.

Semen may be discovered in old men whose testes are atrophied to a considerable extent.

Everything induces the belief that in the old man the secretion of semen, although very slow, like all the other secretions, neverthe