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standing, or of men who have, through the demands of their public or other duties, been separated from their wives for prolonged periods. The former class rarely come under the medical man's care: excesses with them are exceptional, and they are equal to the sexual shock. On the other hand, when the latter class, after leading lives of chastity, suddenly resume sexual intercourse, they are apt to suffer greatiy from generative disorders. The impression made on the nervous system, after years of rest, is calculated to impart a shock to any constitution, and this result follows with the greater certainty in those whose nervous powers are already depressed, as, for instance, by prolonged residence in the East. These cases require great care, and their successful treatment must mainly depend on the conduct of the patient, who, by irregularities of his own,—which would appear no more than moderate in persons thoroughly sound,-may altogether frustrate every attempt to relieve him.

I was lately consulted by a gentleman of nearly seventy years of age, who, after remaining a widower many years, was captivated by the charms of a young girl. The courtship prospered, the patient was affianced, and all appeared in satisfactory train, when he became alarmed by observing the very frequent recurrence of seminal emissions (to which he had for years been subject occasionally); and worse—which, in fact brought him to me -these emissions stained his linen with blood, a symptom which gave him great anxiety. I pointed out to him the dangers attending this state of sexual excitement, and assured him that the treatment I should propose would avail little, so long the excitement under which he was then laboring continued, and that I dreaded the consequences. Circumstances, however, so fell out that the marriage was broken off. My patient soon recovered his health, and he has now occasional nocturnal emissions as before, but unattended with any hemorrhage.

The medical man may be occasionally consulted by men in years upon the subject of marriage, and he may be asked if his patient may marry.

In the former editions of this book I spoke strongly against such men marrying, and I wrote thus: “I have but one answer to


all such questions. Do it on your own responsibility; I cannot give my sanction. If you value life, if you consider health, if you look for happiness, I advise you to remain as you are. Much

I approve and recommend marriage to the young adult, as strongly would I forbid it to the old man.”

Subsequent and more extensive experience, however, has assured me that, in the present state of civilization, there are many cases in which a man may marry late in life with great advantage. I now subrnit a patient who desires to marry late in life, to a close examination. If I find him a hale person with a sound constitution, I see no objection to his settling, provided always he selects a suitable person as regards age, position, &c. That which alone I object to, in consideration of his future health and happiness, is the uniting himself with a young, gay or volatile girl. I am quite certain that marriage, even late in life, contributes to a man's longevity, if the woman he chooses is suitable in age, disposition, and temper. The observations already made in this chapter particularly apply here. If the newly-married man will but be moderate and commit no excesses of any kind, I am an advocate for his marriage, rather than that he should remain single. The reader should recollect that in these cases the surgeon does not advise elderly people to marry, but he sees no valid reason why an attachment already formed should be broken off because the bridegroom is advanced in life. I am cognizant of many instances of persons who are now living very comfortably and happily who have married late in life. In these instances no ill consequences have happened. If, however, an elderly man is disposed to marry beneath him, or to contract marriage with a young and worldly woman, I think his medical adviser should do all in his power to dissuade him and to warn him of the danger he is about to incur. Nevertheless, experience teaches us that the advice is but little heeded. I am well aware that many cases can be cited in which men have married late in life, and had families. Undoubted instances of virility at the age of nearly one hundred years are on record; but in these cases the general bodily vigor has been preserved in a very remarkable degree. The ordinary rule seems to be, that sexual power is not retained

by the male to any considerable amount after the age of sixty or sixty-five.

The impunity with which some elderly men continue the practice of sexual intercourse is certainly surprising ; still, abuse or excess, whichever we may term it, must sooner or later tell its tale. In some, its effects assume the form of hypochondriasis, followed by all the protean miseries of indigestion ; in others, of fatuity ; in the more advanced stages, paralysis or paraplegia come on, accompanied by softening of the brain, and its attendant consequences. What in early life was followed by temporary languor, is in age not unusually followed by the train of symptoms alluded to above; and, when we are called in, it is too late to do aught but palliate them.

I am becoming every day more convinced that many of the affections of the brain, under which elderly persons suffer, and from which a certain proportion annually perish, are caused by excesses committed at a time when the enfeebled powers are unequal to supporting them, and I think it the duty of the medical profession to put such sufferers in possession of these facts. Kind advice and sympathy would thus, I am sure, save the valuable life of many a man who errs from ignorance. Let us listen to the warning voice of one who, as I have before said, has written the best work on the diseases of old age. Parise is inveighing against ill-assorted marriages of elderly persons. 6. There are great risks run; for in the extreme disparity of age, and oftentimes of condition—as when the man is rich and the girl is young-Nature avenges herself by spreading scandals, doubts about paternity, and domestic troubles ; everything is at variance, age, disposition, character, tastes, and amusements. What shall I do with him, and what will he do with me?' said a clever young girl of eighteen, whose parents wished her to marry an old gentleman. With regard to health and vital force, it is easy to foresee what will become of them in these unequal marriages, where a young and fresh girl is 'flesh of the flesh' of a man used up from age, and mayhap from excesses. Evidently she commits a suicidal act more or less certain or rapid. On the other hand, experience shows that the elderly man who thus risks his repose and his existence, speedily finds his health grievously affected; and with what justice may not the lines of the poet Hardy be applied to his case

«On ne se servira que d’um même flambeau,

Pour te conduire au lit, et du lit au tombeau.'' “Would you,” continued Parise, “know the difference between love in youth and in old men? It is this, “of a truth great folly appertaineth to the first love, but great feebleness to the last.' Hereby hangs a tale, for sudden danger lies in the path, and the siren sings upon the very verge. Blessed should the old man deem himself who can put up with calmness, happiness, and reason, instead of craving after those senile accessions of delirium too often the parents of regret and remorse without end. The chastisement of those who love the sex too much is to love too long. Is Nature silent ? 'Tis that she would not speak! Would you provoke or excite her? It is a crime against her-a crime for which she will some day claim a deep revenge. Why, then, not listen to the voice of Wisdom—for those who sit at her feet, and listen to her awful counsels, shall be delivered from strong passion, and many sore straits and much folly ?

Let the elderly man, then, pause and reflect, that a human sacrifice, either male or female, is generally bound to the horns of the altar that sanctifies such marriages. In the present state of society, with our manners, passions, miseries, man does not always diehe sometimes destroys himself. And the sort of union I have touched upon is one of the most ingenious devices of men to expedite that natural friction by which our vital forces are expended in the course of threescore years and ten. .

It was thus I wrote in composing the last edition of this book, and I cannot even now characterize in stronger terms the danger an old man incurs in contracting unequal marriages ; but I would here repeat what I said at page 320.

I see no objection to an elderly man marrying a woman in a rank compatible with his own, and whose age is in proportion to the average we have laid down at

127. In these cases, excesses are not likely to occur, and I feel convinced that an old bachelor by remaining an old roué may run greater risk than by marrying. In either case I should say avoid excess; but I no longer set my face against marrying late, only against the excesses to which it may lead. Not a few such marriages about which I have been consulted have turned out well, and have led to much mutual domestic happiness.





This is a class of persons the consulting surgeon occasionally meets with who are deserving of great sympathy. Their passions depend too frequently on a state of excitement over which they themselves have no control, although its origin may be traced to their own excesses. These patients come to ask our assistance, not with any object of obtaining power, but because they suffer from urgent desire, which a careful examination of the case often convinces us is fictitious, and dependent upon some irritation going on in one part or other of the canal. In some persons, a full bladder will occasion it; in others, irritation about the rectum, proceeding from worms or hæmorrhoids ; in others, again, acidity of the urine will induce a morbid craving that is often most distressing to the sufferer. Often the affection depends upon neuralgia of the bladder, or stone in that viscus. In other instances, I have seen reason to attribute it to some affection of the skin covering the generative organs, causing local excitement. It is all very well to desire such patients to resist these morbid desires, but until appropriate local treatment is prescribed, there can be little hope of amendment. Some few think that this unnatural excitement is healthy. They pride themselves upon it, appear astonished at the surgeon wishing to remove the cause, and cannot comprehend that their constitutions have been much reduced by the fatigue which the organs have

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