AN 
INAUGURAL DISSERTATION 
k 
ON 
SPERMATORRHOEA: 
* 
PATHOLOGICALLY AND THERAPEUTICALLY CONSIDERED. 
BY 
WILLIAM EDWIN JOHNSTON. 
PRESENTED TO THE MEDICAL FACULTY OF THE UNIVERSITY OF NEW YORK, 
foe the degree of doctor in medicine, 
AT TIIE SESSION OF 1M6 T. 
NEW-YORK: * 
GEORGE F. NESBITT, STATIONER AND PRINTER, 
CORNER WALL AND WATER STREETS. 
1847. Gentlemen of the Medical Faculty : 
In offering- for your consideration the following 
Essay upon Involuntary Seminal Discharges, it seems proper that 
the writer should indicate, briefly, the reasons which have prompt- 
ed him to the selection of this subject. 
Several cases of more than ordinary interest have recently 
come under the writer’s immediate observation, and the deplora- 
ble situation of these patients has made a most vivid and lasting 
impression upon his mind—an impression which has been main- 
ly instrumental in giving birth to this effort of his pen. The 
devastations which this disease is carrying, unsuspected, through 
every vein of society; its insidiousness ; the multiform and 
anomalous character of the symptoms which indicate it, and the 
comparatively little attention which has been given to the subject 
by the profession, are additional incentives to the execution of 
his design. 
The writer asks for his Thesis a charitable reception at the 
hands of those whom he is proud to call his teachers, and from 
the profession at large he claims more attention to the subject of 
which he treats. 
7 Yandewater-street, New-York: 
December, 1846. INVOLUNTARY SEMINAL DISCHARGES. 
In all ages of tlie world, the passions have governed mankind. Pas- 
sion holds in abeyance the will; and misery and degradation follow in its 
train. The instincts of animal life are imperative in their demands— 
they own no control when once they have gained the ascendancy over 
the individual; he fortifies himself but to yield;—and it is of the modify- 
ing, and in some instances, disastrous effects which these influences exert 
upon the health and endurance of the human organization, that I intend 
to speak in these pages. 
A condition of disease so insidious and calamitous in its character to 
the mind and the physique, as the one which now occupies our attention, 
demands from the physician, not only the most profound professional 
research, but the warmest sympathies of his heart. It is the physician 
who comes in contact with real human suffering—suffering of which the 
world can have no knowledge. It is to him that the fountains of human 
misery are opened up, and at his feet are cast the hopes of the miserable 
invalid. To alleviate human suffering, and to bring back to life and 
energy the victim of a relentless and cruel disease, is a boon which the 
physician alone enjoys. Should not thesovconsiderations arouse him to a 
deep feeling of the responsibility which rests upon him, and to an appre- 
ciation of the position which he occupies ? 
I am about to speak of a disease which, more than all others, poisons 
the individual’s whole existence; a disease which robs life of its enjoy- 
ment ; which carries devastation into the very citadel of life; saps the 
energy; enfeebles the mind; which pales the cheek, blanches the lip, 
sinks the eye, exhausts the sti-ength, and consigns ultimately to the tomb 
its miserable victim. 
It is a condition of the system calculated to produce the most poignant 
suffering of which a human being can be susceptible; and it is so, be- 
cause the seat of intellect is a principal sufferer; and because the brain 6 
SPEBMA.TORRHCEA, OR 
is painfully conscious of its own condition. Moreover, I have observed 
that men of sedentary habits and intellectual pursuits are more prone to 
this disease than those of a different class ; and it is in these patients that 
the disease manifests itself in its more cruel forms. This class of pa- 
tients have finer susceptibilities; they feel more keenly their deplorable 
situation; and this in-turning of the mind upon itself, only enhances the 
difficulty under which the individual is laboring. 
Every infringement of the organic law's Avhich regulate the functions 
of the body, is attended W'ith a punishment corresponding to the magni- 
tude of the offence committed; and it will be easy to see how an indi- 
vidual may become accessory to his own destruction by a wTant of proper 
attention in preserving the harmonious equilibrium of interior life ;—thus 
the gastronome prepares the vray for disease of the stomach by the con- 
stant irritation which he establishes in that organ from overloading it, or 
using indigestible food; the brain of every literary person is enfeebled 
by intense study, and thus rendered obnoxious to the attacks of those 
diseases which are known to be peculiar to that class of persons—apo- 
plexy, cerebral congestions, etc.; aphonia will result from an undue exer- 
cise of the organs of the throat in public speaking; the liver gives away 
from the stimulation of the drunkard; the heart and the stomach too, are 
more particularly under the influence of strong emotion and exhausting 
melancholy,—and so on, with regard to all the functions of interior life. 
And it will be remembered, that begin where you may, such is the or- 
der of dependence of one organ upon another, that the absence or undue 
performance of function of any one, introduces that disorder, which, un- 
less timely arrested, involves in its fatal influence every other—destroys 
the cohesiveness of life*—produces morbid sympathy—and then ultimately 
the organ dies, and involves its dependent organs and the whole economy 
in one common ruin. 
It is barely possible that in seme of these instances the brain may be- 
come disordered from constant mental excitement, independent of any 
direct morbid nervous influence; but it is under those circumstances 
where a morbidly abundant, powerful and constant irritability of the 
nervous system is directed upon the brain, that wre witness those destruct- 
ive changes which steadily and certainly unhinge the great powers of 
life, and terminate in the death of the individual. 
I design keeping in view throughout these investigations some of those 
curious symptoms of disordered nervous action wdiich is found so univer- 
sally attendant upon these cases. The nervous system is a medium of 
communication every wrhere distributed with the minutest care, and in the 
richest profusion; possessing its grand centre in the head. Not the mi- 
nutest sensation occurs at the extremity of the system, without its being INVOLUNTARY SEMINAL DISCHARGES. 
7 
instantaneously propagated to its centre ; not a desire is excited in the 
mind, but a corresponding action is set up in the organ destined for its 
gratification ; and the endless variety of communication with its several 
regions, by means of plexuses, ganglia, interlacing and decussation of 
fibres, separate twigs of intercourse, and the one agency of the great 
sympathetic nerve, show us what powerful influences may be brought to 
bear upon the brain by exalted morbid action. As we progress in our 
inquiries these morbid agencies will become strikingly apparent. 
The disease designated by the term Spermatorrhoea, or Spermor- 
rhoea, has received but little attention from the profession at large. The 
credit of having first brought this subject fully before the attention of 
physicians is due to the distinguished Professor of Surgery in the Uni- 
versity of Montpelier, in France—M. Lallemand. The little work of 
Wickmann, with the commentaries of Sainte-Marie, its translator,* are 
all that we had upon this subject previous to the appearance of Lalle- 
mand’s brief, but valuable book.f This book of the Montpelier Profes- 
sor is made up almost exclusively of the details of cases which have 
come under his own observation ; and in this consists mainly its value ; 
for until he disclosed the true symptoms and pathological condition of this 
disease by autopsical demonstrations, but little was known concerning it. 
These investigations have developed many useful truths ; and although 
our knowledge of the disease cannot be considered at all perfect, facts 
enough have been developed to assist us materially in tracing out its pa- 
thology and in directing our therapeutic means. 
Spermatorrhoea is a term employed to specify a morbid or wasteful 
discharge of the fluids peculiar to the spermatic organs—taking place 
involuntarily. These seminal losses may arise from a blennorrhagic affec- 
tion ; from venereal excesses, either in coition or masturbation; from 
hoemorrlioids ; from ascarides in the rectum; from metastases of cutane- 
ous affections, and from mechanical obstructions in the rectum, which by 
producing pressure upon the prostrate gland and vesiculse seminales during 
defecation, causes the expulsion of their fluids. 
I shall speak of these discharges under two distinct forms: diurnal 
and nocturnal pollutions. And although these forms are sometimes 
blended, and run, imperceptibly, the one into the other, yet the distinc- 
tion is a correct one, and must be observed for a proper comprehension 
of the subject. I shall proceed to define what is here meant by these two 
varieties of discharge. 
* Dissertation upon Involuntary Diurnal Pollution, by Wickmann, translation of Sainte-Marie. 
Lyons, 1817. 
t It is to be regretted that the English translation of this work has not received a more extensive 
circulation in this country. The book is hardly known to exist. SPERMATORRIKEA, OR 
By nocturnal pollutions I mean those seminal discharges which take 
place spontaneously during sleep, either with or without erection or las- 
civious dreams. They arise from an undue excitation of the genital or- 
gans, either in masturbation or coition; most generally from the former. 
In a robust and continent individual, these discharges may not only be 
useful, but absolutely essential to the integrity of the nervous • system; 
and it proves essential, by carrying off a stimulant which, if re-absorbed, 
would inevitably disturb the exercise of the nervous functions. That it 
does so; will be proven farther on in these pages. We see in these dis- 
charges a complete analogue to the epistaxis so common and useful in the 
young. As these nasal hemorrhages are nature’s favorite method of 
blood-letting in plethoric youth, so in the other instance, are the nocturnal 
seminal discharges indicative of the same conservative principle of nature. 
This is further seen in hemorrhoidal fluxes, vicarious menstruation, and 
the conservative changes which take place in women after the “ turn of 
life.” How anxious does nature seem to preserve the individual from 
the attacks of disease, and how beautifully will she maintain herself when 
not controverted! 
But these discharges may become excessive, and outlive the wants of 
the system. It is then that they become morbid and threaten to compro- 
mise the health of the individual. The irritation which has arisen from 
the presence of a super-abundance of the spermatic fluid, still persisting 
and increasing, the organs themselves begin to feel the pernicious effects 
of the over-excitement, and the erections now become incomplete, the 
ejaculations hurried, owing to the relaxed condition of the ejaculatory 
orifices, and the act is almost entirely devoid of pleasure. Soon the pow- 
er of erection is entirely lost, the nocturnal discharges are diminished, 
and in some instances entirely suppressed, and the transition from the 
nocturnal to the diurnal form of the disease is accomplished. The inflam- 
mation has extended throughout the entire series of organs—they are 
relaxed—the ejaculatory ducts have lost tone—the spermatic fluids are se- 
creted in a ratio proportioned to the increasing demand, and now every 
act of defecation and micturition is attended with a sensible loss of these 
fluids. 
We have then the nocturnal merged into the diurnal form of dischar- 
ges, bringing with them a prostrated condition of the individual’s general 
health. And what are the symptoms now to be observed upon the pa- 
tient indicative of this condition ? He becomes lean, Wan and dejected; 
wandering pains are felt throughout the whole body, but particularly in 
the head and region of the kidneys ; a want of power will be felt to move 
with alacrity the lower extremities; digestion will be laboriously and 
painfully performed; the most obstinate constipation will be present; INVOLUNTARY SEMINAL DISCHARGES. 
9 
flatuosities of the intestinal canal will continually torment and harrass the 
patient, driving him out of society; the lassitude and general debility 
which result from these conditions will induce a state of moroseness in 
the patient which renders him discontented with himself and others; he 
avoids society because of the restraints thrown around him; he becomes 
averse to every thing which reminds him of the pleasures in which he 
can no longer take a part; he falls into profound melancholy, becomes 
irascible, misanthropic, completely hypochondriac; occupied with one 
sole object, he manifests the greatest indifference for every thing that 
does not pertain to his own condition. 
But it is to the cerebro-spinal axis we are to look for the gravest lesions, 
and here the destructive influence of the disease is more easily appreci- 
ated, although the pathological condition which establishes this change is 
unappreciable and shrouded in darkness. That the disease in question 
does make a profound morbid impression upon the nervous system through 
the medium of the cerebro-spinal axis, we know ; but autopsical investi- 
gations aid us nothing in ascertaining that fact. So far as I am acquainted 
with it, the habits of the nervous system make against our discovering 
any organic changes in that system, as the result of disease : for, first, its 
changes are always produced in an exceedingly slow manner; and next, 
we are quite sure, that in other violent disorders of that system, it is of- 
ten difficult, often impossible to discover the in fluence of change. It is, 
for instance, doubtful whether tetanus or hydrophobia produce any cog- 
nizable permanent change of structure: no definite lesion, such as we 
might expect to find, has ever been discovered. In apoplexy, sometimes 
a trace of disease is hardly to be found ; and catalepsy shall have existed 
during a long life, and yet nothing be discoverable after death to indicate 
its existence. A patient shall have been subject to violent attacks of 
hysteria for twenty, thirty or forty years, and not the slightest visible in- 
fluence be perceived in any part of the nervous system. Yet no one 
doubts the existence of these diseases, or of their being diseases of that 
system, because their effects are not discernible. 
Returning to the symptoms which are presented by the brain and ner- 
vous system, we observe, first, that the elasticity and tension of the intel- 
lect are impaired—the power of application is diminished—the love of 
pursuit is decreased—the perception becomes slow, confused and errone- 
ous—the wide range of imagination is curtailed and concentrated upon 
the one all-absorbing subject—the mind becomes old, if I may so speak, so 
that the memory of the immediate past is obliterated; while that of scenes 
and events long since passed, of by-gone days of happiness and mental 
hilarity, remains to harrass and torment the mind that would escape from 
its torturing and terrible thoughts ; the judgment becomes infirm and va- 10 
SPERMATORRHOEA, OR 
dilating; a horrible inclination to commit suicide is felt by the patient at 
the sight of instruments of death—a feeling rendered still more horrible 
by the ineffectual attempts which are made to flee from it; the grim 
monster Death stares him in the face at every slight turn of his disease, 
in all the hideous forms which a powei*fully moi’bid and depraved imagi- 
nation can invent; in fine, he has become a poor, miserable, debilitated 
hypochondriac, obnoxious to himself and a drag to his friends—without 
the courage to take his own life, or the power to contend with his disease. 
Here, then, we have a picture of human suffering which calls for, as I 
have said before, not only the profoundest professional interest, but the 
warmest sympathies of our hearts. 
It may be well to inquire under what aspect this disease generally pre- 
sents itself to the physician for remedial treatment. An individual will 
experience after the subsidence of a protracted gonorrhoea, an unusual 
weakness of. the genital organs, and a general prostration of bodily 
strength, for which he is unable to give any account. An anomalous 
train of symptoms will spring up, which give rise to endless and fruitless 
speculations concerning their true origin, and the patient will think him- 
self menaced with apoplexy, cerebral congestions, (both of which do in 
some cases occur,) and an interminable train of diseases for the cure of 
which the entire materia medica is put under requisition; and without 
any avail. Neither physician or patient suspects, all this time, that there 
may be a lesion of the spermatic organs of sufficient magnitude to give 
rise to these nervous and other manifestations of the presence of disease. 
After a term of years of intense and unaccountable suffering, this patient 
dies, and the cadaver, if properly examined, discloses a chronic inflam- 
mation of the spermatic and urinary organs, which has extended gradu- 
ally from the mucous membrane of the urethra to the vesiculie seminales, 
the prostrate gland, the testes, the bladder, the ureters, and finally to the 
kidneys, producing the disorganization of all these parts, and the death 
of the individual. Now the great and prominent symptoms indicative of 
this condition, and those which should have been observed by the physi- 
cian, would have been the constant discharge of badly elaborated semen 
from the urethral canal during defecation and the evacuation of the blad- 
der, the state of the urine, which would have been found to contain con- 
siderable quantities of semen, the want of tone in the genital organs, 
and the presence, perhaps, of nocturnal pollutions also, although this lat- 
ter symptom is rarely present in the advanced stages of the disease. 
From this extensive lesion of the genito-urinary organs flow those multi- 
tudinous and perplexing symptoms of which I have already spoken, and 
which are so admirably calculated to deceive the physician. 
By far the greater number of cases which come under the observation INVOLUNTARY SEMINAL DISCHARGES. 
11 
of the physician, result from an inflammation of the spermatic organs— 
occurring under the form of diurnal pollutions; yet he will meet with a 
goodly proportion of cases resulting from venereal excesses, abnormal 
conditions of the rectum, etc. And the reason why cases of this charac- 
ter are most frequently presented to us, is obviously, because the symp- 
toms are mistaken for every thing else than those of the real disease. 
Cerebral congestions, threatened apoplexy, chronic gastritis, gastro-ente- 
ritis, palpitation and enlargement of the heart, vertigo, lumbago, gravel, 
venereal pains, ay, and phthisis pulmonalis—these are the diseases about 
which patients will seek medical advice, and for these, unfortunately, they 
are most frequently treated, without any knowledge or even suspicion of 
the real source of difficulty. On the other hand, patients afflicted with 
nocturnal pollution, arising, as they generally do, from masturbation or ex- 
cesses in coition, are aware of the true cause of their disease, and hesitate 
to disclose it—preferring rather to rely upon their own resources than to 
publish their own shame. That these remarks are true, will at once strike 
every physician who is at all familiar with the subject. The members of 
the profession are constantly meeting with these unfortunate hypochon- 
driacs, whose troubles about their imaginary diseases, are treated care- 
lessly, empirically, and I will add, cruelly; because physicians ought to 
sympathize with, and especially cure them. The miserable dyspeptic, 
with his wan countenance and morbid susceptibilities—the hepatieally 
demented, with his imaginary hypochondric and sub-scapular pains—the 
gormandizing victim of the lithic acid diathesis—the phthisicky worship- 
per of hoarhound candy—the “heart-smothered”—the mind-diseased be- 
liever in his own insanity—all these go to form a brilliant panoply to 
cover up our ignorance, and present a fine array of victims at whom to 
fire our batteries of bran bread, blue pill, potash, wood naptha, digitalis, 
and—the fundamental application of leeches ! 
The causes which provoke seminal discharges are very various; and 
these are, unquestionably, the most important topics for our consideration. 
We seldom find a cause isolated; more frequently we have two or more 
causes combined, operating simultaneously or successively, and in which 
we cannot tell, from their combined mode of action, which was primary 
and which secondary. Blennorrhagia is, out of all proportfon, the most 
frequent cause of these losses; and yet it is rarely found acting unaided 
by some antecedent or simultaneous subsidiary cause. This will be made 
apparent in the cases which follow. I may also remark that this latter 
is the most direct and energetic in its mode of action of all these causes. 
It is therefore more easily understood. 
It is my design to introduce through the course of this essay, a few 
cases illustrative of the various prominent causes which go to establish 12 
SPERMATORRHOEA, OR 
this peculiar condition of the system; and in doing so I will necessarily 
be obliged to rely upon other sources for a portion of these cases. A 
few instances have, indeed, as I before observed, fallen under my own 
observation ; but in order to illustrate fully the views which I wish to 
establish, I must incorporate into my pathology, as I advance, cases which 
I find reported elsewhere. These will be taken principally from Lalle- 
mand, as his is the most accurate work with which I am acquainted, and 
the only one on which I can rely confidently. 
Blennorriiagia, as being the most frequent, is the first cause of in- 
voluntary seminal discharges to which I shall direct attention. M. Lal- 
lemand’s first case will illustrate admirably, many of the prominent 
symptoms which arise from these discharges. 
Elennorrhagia—diurnalpollutions—symptoms of hypochondriasis, of chronic affections of the brain’ 
or its meninges—congestions of the head—death. Right kidney in a state of suppuration—pros- 
tratalmost destroyed—ejaculatory ducts isolated, frayed—vesiculae seminales diseased. Nothing 
remarkable in the other organs. 
In the month of January 1824, I was called to M. de S. for symptoms of cerebral con- 
gestion, to which he had been frequently exposed for a long time. The following is 
what I learned from the numerous opinions of physicians that were sent me, and the de- 
tailed information that was addedto them. 
Born at Payerne, (Suisse,) issue of healthy parents, one of whom died suddenly with 
symptoms of cerebral affection. M. de S. of a robust constitution and an ardent imagina- 
tion, received a careful education, and applied himself early to the solution of the most 
delicate questions of philosophy and metaphysics; at a later period, he became ardently 
occupied with ethics and policy. 
After having passed some years at Paris, in the midst of his favorite pursuits, M. de S. 
was obliged to put himself at the head of a manufactory, and to become occupied with 
details that offended his pride. He became gradually pettish and capricious; passing, 
without any known cause, from trifling gaiety to profound melancholy ; easily affected 
by the slightest difficulties, without rejoicing in prosperous events; giving himself up 
with pleasure to ill-timed censure: in fine, he appeared disgusted and wearied with cor- 
respondence and calculations. 
At this epoch he married. Dr. Butini, of Ge»eva, his physician and friend, wrote as 
follows upon this subject in a consultation : 
“This marriage, with a woman of his choice, appeared to form a happier epoch in his 
life: but, very soon, the germs of the disease, which so many causes had assisted in pro- 
ducing, developed themselves rapidly. It was perceived that M. de S. wrote with slow- 
ness and oifficulty; his style bore the impress of the decline of his faculties : he stuttered 
and expressed imperfectly his ideas; he suffered from vertigo, at times sufficiently vio- 
lent to make him fall; without, however,fainting or convulsions everbeing superadded.” 
One day, as he wus writing a veiv simple letter, he was seized by one of these etour- 
ditseriens, and could not finish it. This accident strongly alarmed the patient, and left 
a dt> impression upon his family. It was attributed by the physician to a cerebral con- 
gestion which had produced a weakness of the right side of the body. Twenty leeches 
were applied to the anus, and the danger appeared to be removed. 
However, analogous phenomena having been repeated at Geneva and at Montpelier, 
they consulted, anew, Dr. Butini, the professors, Baumes, Fages, and other distinguished 
practitioners: some, struck with the misanthropic irascibility of the patient, with his 
passion for solitude, &c., regarded the affection as purely hypochondriac or nervous; 
others, dwelling upon the Derangement of the digestive organs, thought of a chronic af- 
fection of the liver: but the greatest number believed it to be an organic disease of the 
brain or of its membranes; a chronic encephalitis or meningitis, owing to an hereditary 
predisposition. 
In these different cons'dtations they were agreed upon the necessity of withdrawing 
the patient fr. m all serious occupation ; upon the utility of travelling, diversion, and 
regimen ; upon the importance of keeping the bowels open by enemata and purgatives: 
tiie greater part advised frequent application of leeches to the anus, with milk diet, &c.: 
some proposed assafeetida, baths and pills of camphor. These means produced no evi- 
dent amendment: the leeches weakened him ; milk diet deranged the stomach; consti- 
pation became obstinate. Cold baths by immersion, cold affusions upon the head, calmed 
the insuppoitable spasms that the patient experienced in the legs, thighs and face: the 
waters of Aix in Savoy and the douches Ecossaises appeared also to produce some ame- 
lioration. 
However, the patient became gradually more irascible, and at the same time more in- 
sensible: his moments of passion more frequent and violent, and he showed more indif- 
ference for things and persons whom he had most loved. The weakness cf the limbs INVOLUNTARY SEMINAL DISCHARGES. 
13 
increased, to the point of producing frequent falls upon the most level ground. His nights 
became agitated ; sleep lighter, often interrupted by nervous tremblings or acute pains, 
accompanied with cramps and with throwing of the head backwards. 
The cerebral congestions increased: fear of an imminent apoplexy made him recur to 
new applications of leeches to the anus, to bleedings from the foot, to frictions with anti- 
monial ointment, to blisters, to sinapised pediluvia, and to the application of ice upon die 
head. 
Notwithstanding the employment of these energetic and multiplied means, there came 
on a new and violent congestion; it was then that I was called. Here is what I re- 
marked : 
The patient was restless, agitated, incapable of remaining two minutes in the same 
place; his countenance was red, his eyes prominent, injected, fixed and wild ; his phy- 
siognomy bore the impress of profound fright; his gait was unsteady; his limbs bent 
under the weight of the body; his skin was cold, his pulse small and slow. 
These last circumstances struck me less than those upon which my attention had been 
directed by all that I had just learned, and I also advised leeches to the anus. Immedi- 
ately M. de S. became violently angry, and assured me that leeches had always weakened 
without ever helping him. I was too much pre-occupied with the danger of an apoplexy, 
to be arrested by this profound conviction, manifested with so much energy, and I had 
six leeches applied to the neck. 
The following day, I found the patient very pale,and so much weakened that he could 
not go out, which threw him into a state of despair, for he could not remain in any one 
place. There came on an oedematous swelling of the right parotid and of the cheek, 
which was replaced on the following day by a similar state of the foot and left leg. 
Repose had become indispensable; the patient was deeply affected by it, and told me 
with tears in his eyes, that he was going to lose his appetite, and would no more be able 
to go to stool. I learned then, that, notwithstanding repeated falls, he was tormented 
with a desire to walk and to change his position ; that his abdomen was habitually dis- 
tended and meteorised ; that he took many enemata and purgatives to combat an obsti- 
nate constipation; in fine, that his promenades and his stools had become the only objects 
of his thoughts and conversation. 
Having observed analogous phenomena in almost all the individuals affected with 
diurnal pollution, I made new inquiries with regard to that attack, in which they thought 
that the right side had been affected, and I assured myself very soon that it was the ideas 
that had failed, and not the movements of the hand that held the pen : the two halves of 
the body had in reality preserved an equal energy. 
Struck with the remark of Dr. Butini, concerning the progress of the disease after 
marriage, I addressed myself to Madame de S., and I learned that in fact the character 
of her husband had become peevish, irascible, and meddlesome; which had made his 
relations suppose that he was unhappy in his family. I began then to believe that we 
had been deceived as to the true cause of all the symptoms observed during seven or 
eight years, and I recommended them to preserve the urine of the patient, in order to 
show it to me the next day. 
Its aspect alone proved to me that I had divined justly: it was troubled, thick, of a fe- 
tid and nauseousodour? similar to water in which anatomical preparations have remained 
a long time in maceration. In decanting it slowly, I saw flow out a fleecy cloud like a 
very thick decoction of barley; a glairy, ropy and greenish matter remained strongly 
adherent to the bottom of the vessel; in fine, some thick globules, yellowish-white and 
not adherent, were mingled with this sediment like drops of pus. I remained convinced 
from that time, that there existed, not only a seminal loss, but also a chronic inflamma- 
tion of the prostrate, and a suppuration of the kidneys. 
I imparted my opinion to Madame de S., which surprised her much: I obtained from 
her the following particulars: she had always thought that her husband was naturally 
very cold ; as well as she could judge, he had never committed any excess with her, and 
nothing inclined her to suspect his conjugal fidelity; coition had always been so rapid, 
and she had taken so little part in it, that she could not conceive how she could have be- 
come a mother; gradually all intercourse had become of very rare occurrence; it had 
even entirely ceased for the last three years. These hints confirmed me more and more 
in my opinion ; but they were still incomplete. 
Notwithstanding the state of the intellectual functions of M. de S., I was able, at a fa- 
vorable moment, to obtain from him some information that had never been demanded of 
him. Having lost his way in a botanical excursion, in the environs of Geneva, he found 
himself alone, with a shepherdess, who had left her flock to show him his way* He was 
Id years of age, and was just leaving college. Some dafs after, there came on a blen- 
norrhagic discharge; he concealed it carefully, and succeeded in curing it by the simple 
use of cooling drinks. The following year the discharge re-appeared and was arrested 
by astringents. Two years after, having drunk a great quantity of beer in the heat of 
summer, ne saw it make its appearance anew: in fine it returned again during along 
journey that he made on horseback. Since then, M. de S. had felt but little inclination 
for women, and deprived himself of their society without difficulty. 
Fully convinced, after thp relation of all these circumstances, I explained to M. de S. 
the nature of his disease. He would not believe it; but he promised to watch himself. 
The next day, he took me aside and told me that in fact the last drops of urine were vis- 
cous, and that in going to stool, he had collected the hollow of his hand full of similar 
matter. (Iced milk, §-c.) 
Eight days after, there came on a new cerebral congestion, in consequence of which 
the respiration became stertorous, the skin of an icy coldness, the pulse imperceptible j 
the patient fell into a kind of syncope, which was followed by speedy death. 14 
SPERMATORRHOEA, OR 
I abridge the post-mortem details: 
In the brain were found some bubbles of air and several spoonfuls of limpid serosity; 
the substance of the brain softened throughout, and more or less injected. In the thorax 
the pulmonary pleura was found every where adherent to the costal pleura ; lungs crepi- 
tant and pale ; heart healthy. Abdomen green, meteorized, emitting a strong odor; tne 
intestinal mucous membrane thin, supple, of a slate gray color, and distended with gases. 
Left kidney healthy; the right a third larger, adherent to the surrounding parts by a 
dense, fibrous, and very strong cellular tissue, containing in its parenchyma about forty 
smail abscesses, varying from the size of a pea to that of a walnut; the tissue of the kid- 
ney reduced in four-fifths of its extent, into a dense, coriaceous membrane filled with 
thick septa, fibrous, and somewhat of a violet color; internal membrane of the pelvis 
red, villous; ureter thin, distended, brownish, very much injected on its internal surface. 
Bladder contained a quart of transparent urine; its walls thin and degenerated. Left 
vesicula seminahs small, brown ; the right separated from the corresponding vas deferens, 
folded upon the posterior border of the prostrate, and, as it were, wasted ; surrounded by 
a dense fibrous tissue, and difficult to dissect. Prostrate projecting three or four lines 
behind the neck of the bladder, to the extent of an inch and a half in surface ; twice its 
ordinary volume, pressing upon the rectum ; hard upon the lateral p irts of the neck of the 
bladder, soft in its middle part; a stroke of the scalpel having divided its fibrous enve- 
lope, there flows from it a purulent matter, thick, opaque, stringy, and elastic, similar to 
pus in color, and to the nasal mucus in consistency. The canal of the uretha being split, 
an infinity of filaments which are inserted into as many little holes, are seen coming out 
from the openings of the mucous follicles of the prostrute. The orifices of the ejaculatory 
ducts, instead of being circular and mammary, form an elongated, ragged slit, especially 
on the side towards the bladder; two stilets introduced by the vasa aeferentia, although 
quite large, pass out easily by these openings; the ducts are small and thin, and, as it 
were, dissected; the posterior border of the prostrate is not yet destroyed, but it is pale, 
flaccid, easy to tear, as well as the parts in the neighborhood of the principal disease; an 
unctuous and puriform mattermav be pressed out as through long tubes. Testicles small, 
flaccid and pale. Urethral canal intact. 
It will at once be admitted that the lesions of the genito-urinary organs 
disclosed by the autopsy, were abundantly adequate to the production of 
all the symptoms observed in this patient during life ; and that these le- 
sions were capable of producing death by their own influence, and that 
exerted by them through morbid changes on more important organs. 
The regularity which the inflammation observed in its march tln'ough 
the various organs, and the corresponding symptoms which were devel- 
oped, are worthy of remark. Gonorrhoea laid the foundation, in limine, 
for all the succeeding trouble. This was the starting point—the match 
which fired tl;e tram; and the catenation of destructive attacks which 
were subsequently made, terminated in death. The prostrate gland, the 
ejaculatory ducts, the vesiculoe seminales, were successively involved in 
the inflammation. Serious general disturbance of the patient’s health, 
aberrations in the cerebral functions, and certain pathognomonic symp- 
toms indicative of spermorrhoeal discharges, now declared themselves. 
The patient marries, and all the symptoms are aggravated. There is a 
sad deterioration of the virile powers ; the ejaculations are hurried ; the 
erections are incomplete, because the semen is expelled as fast as it is se- 
creted—guttatim, I may say, and the manly stimulus is therefore want- 
ing ; further, the loss is great in amount, because the testicles, owing to 
their irritable condition, secrete more than their ordinary quantum of fluid. 
The urinary organs eventually became involved in the difficulty: by re- 
ferring back, it will be seen that there not only existed an inflammation of 
the spermatic organs, determining a seminal loss, but also a chronic inflam- 15 
INVOLUNTARY SEMINAL DISCHARGES. 
mat.ion of the prostrate, and a suppuration of the kidneys ; and hence the 
peculiar character of the urine. This is a point of more than ordinary 
interest to the profession, since it is this peculiar character of the urine 
which has given to empirics so wide a field for lucrative employment.* 
The right kidney was found extensively diseased; but I cannot concede 
what M. Lallemand asserts, that the kidney was the last organ involved ; 
and I infer so because pain in this region is one of the first symptoms 
present in spermorrhoea, and because abundant analogy proves that an 
irritation at one point, may, by nervous sympathy, establish disease at 
another. What do we observe in the various phenomena presented by 
spinal irritation ? A slight point of irritation established in a motor 
nerve of the stomach, will be at once referred to its origin in the spinal 
axis; disease of the ipedullary substance follows, and the corresponding 
sensitive branch feels, and conveys to its extremity this diseased condi- 
tion ; and through the influence of this reflex action a profoundly disor- 
dered condition of the functions of the stomach may be established. Every 
set of organs in the human body destined for a combined or a subsidiary 
action—an action having in view a common end—no matter how remote 
they may be from each other, are known to be intimately connected by 
nervous sympathy ;—as, for instance, the mammary glands and the ute- 
rus ; certain secretory organs—the testes and the parotids, etc. More- 
over, the kidney would not he likely to be so extensively diseased, if it 
was the last organ attacked ; for taking as data the length of time it re- 
quired for the other organs to take on this condition, the plausibility of 
this proposition will be obvious. I infer, therefore, that the pain and 
weakness which is felt in the lumbar region early in the disease, arises 
from the irritation in the lower part of the urinary organs, and that this 
irritation may, as in other instances, exert a morbid influence upon the 
kidney which shall not only pre-dispose that organ to inflammation, but 
actually establish disease there, before the inflammation can have reached 
it by the long and slow route through the ureters. 
I would gladly enter farther into an examination of the pathological 
facts developed by the case of M. de S., for they are all exceedingly in- 
teresting, and of the most essential value to the physician ; but my limits 
* A young frii'nd of mine in this city, of fine constitution, discovered in his urine one day, a floccu- 
lent, opaque sediment, which had settled to the bottom of the vessel in which he had made his water; 
and he had felt for some time, considerable pain in the region of the kidneys, together with more or 
less of general constitutional disturbance. He was at once alarmed ; and believing that these were 
phosphatic deposites, he hastened to lay his case before a gentleman of this city renowned as a “gravel- 
curerthe diagnosis was, of course, in accordance with the young man’s apprehensions. He sub- 
jected himself to a course of treatment during a period of eighteen months, which could be compared 
to nothing short of the pagan’s penitential sacrifices, and without any amelioration in his condition. I 
prevailed upon him finally to discard the empiric and his medicines ; he married, was circumspect in 
his connubial enjoyments, and being of a good constitution, and by using some tonic medicines, he is 
now, two years after marriage, a healthy man. There was not the least doubt in my mind that this 
person wai suffering from seminal losses. His previous habits pre-disposed him to an inflammation 
of the spermatic organs, and an examination of the urinary precipitation, proved to me the true char- 
acter of the disease. How many hundreds are there, like him, victims to the empiricism of tho age 16 
SPERMATORRHOEA, OR 
do not permit. Suffice it, that the final analysis leads us back to the blen- 
norrhagia contracted twenty years before death, as the primary and effi- 
cient cause of the whole difficulty which succeeded. 
In conclusion, this case teaches us a valuable lesson in diagnosis. 
The following interesting case came under my own observation. Many 
of the symptoms were new and striking, and I became therefore zealous- 
ly enlisted in ascertaining the true pathological condition of the patient. 
There are some points of particular interest in this case, which present, 
to my mind, powerful inducements for extending our investigations far- 
ther into the pathology of the disease. 
Masturbation—Excesses in coition—Abundant nocturnal emissions—Then diurnal 
emissions—Great prostration—Epilepsy—Profound hypochondriacism—Disposition to 
commit suicide—Cauterization—Strict hygienic course—Cure. 
C. C., te. 22, of a sanguino-nervous temperament, good constitution and 
robust health, contracted, at the age of 13, while at college, the habit of 
masturbation, which he continued until about seventeen. At this time he 
went to reside in the city, to enter into commercial pursuits, and having 
discovered that the pernicious habit of which he was guilty was likely to 
prove prejudicial to his health, he discontinued it entirely. But soon, 
however, his continence produced such an exaltation of the venereal de- 
sires, (owing to the retained semen, which, seeking its natural channel, 
was secreted in excess,) that nature was obliged to relieve herself, and in 
consequence his nocturnal emissions became more frequent and annoy- 
ing ; and he found it quite convenient, at the same time, to supply himself 
with a niistress. 
For two years he indulged wildly in these excesses, and gradually and 
steadily his health and strength failed. Habit, and cultivated and ungov- 
ernable desires urged him on ; the power of resistance was diminished ; 
but then he no longer found pleasure in the embrace of his mistress. The 
periods of intercourse became lengthened, less and less attended with 
pleasure, and finally really burthensome. He became disgusted, and cast 
her off. 
Diurnal pollutions now manifested themselves, attended also with an 
occasional nocturnal emission. Great prostration of his physical powers 
gradually supervened ; he went on from bad to worse, when one day, after 
a longer than usual suspension of seminal discharges, he fell into an epi- 
leptic fit, which lasted but for a few moments. He was justly alarmed at 
his condition, and became more cautious about his health. The multitu- 
dinous and varied pains which constantly annoyed him, the seriously 
altered state of his health, and the fear of epilepsy, had the effect of 
throwing him into a profound state of hypochondriasis. The shock which 
the nervous system had felt from these diversified influences was more 
than it could bear with impunity. INVOLUNTARY SEMINAL DISCHARGES. 
17 
He had used various remedies for the usual diseases under which these 
persons are thought to be laboring, and he now came to me, to tell me 
what he had not disclosed before,—the whole history of his life, in order 
to obtain my advice. I became deeply interested in his case, and zeal- 
ously set about a thorough examination of his condition. I found most 
of the symptoms present corresponding so closely to those laid down by 
M. Lallemand, that I was at once convinced that seminal losses Avas the 
primary and efficient cause of all his trouble. Constipation, which Avas 
only relieved by cathartic medicine; itchings of the anus, unattended 
Avith dartrous eruptions or parasites ; pain in the head ; vertigo ; ringing 
in the ears; lassitude ; palpitation of the heart; he Avas incessantly an- 
noyed Avith flatulence ; face and head flushed with blood ; digestion des- 
troyed in a great measure; appetite uncontrollable; an intermittent, 
burning pain in the stomach ; loAver limbs Aveak, and scarcely capable of 
supporting his body ; the intellect was disturbed, the poAver of fixing the 
attention destroyed; he was keenly acute in all things concerning his 
disease, but obtuse on other subjects; he Avas timid, and his countenance 
betrayed much agitation when spoken to ; Avas easily chilled by cold, or 
on the contrary suffused Avith perspiration—the transition being l'apid 
and from the most trivial alternations of temperature or exercise; there 
was a constant exudation of glairy mucous from the orifice of the urethra 
when venereally excited; he urinated often, the few last drops being lost 
in his pantaloons, indicating deficient action in the sphincter; the last 
portionso f the urine Avere Avhite, and he lost a similar substance also du- 
ring, or after defecation.—Most of these symptoms are always present in 
seminal losses. 
But the symptoms to which I AA'ould direct especial attention, are 
these : After a few days’ indulgence in coition, or more than a usual num- 
ber of nocturnal pollutions, and then a feAV days of total abstinence; or 
when from some cause the discharges had been suppressed for a few days, 
and, of course, there Avas a great accumulation of semen, there Avas an 
augmentation of the lumbar pain, a greater disposition to nervousness, a 
greater depression of spirits, a stronger impulse to commit suicide ;—and 
it was on an occasion like this that epilepsy seized him. What is the con- 
clusion ? Obviously this, that the absorption into the system of the abun- 
dantly secreted and badly elaborated fluid is capable of producing an irri- 
table and morbid state of the nervous system,—such a state as Ave have 
seen manifested in this young man. I recollect hearing Professor Mott, 
in endeavoring to ascertain the cause of a case of epilepsy Avhich came 
before him, propound the following questions. The patient was a man, 
ae. 24, and the convulsions had attacked him four years previously. Have 
you ever been in the habit of masturbating?—No. Wasn’t you subject 18 
SPERMATOEKIKEA, OR 
to nocturnal emissions, supervening upon lascivious dreams ?—No. Were 
you not in the habit of enjoying venereal pleasures to excess ?—No. Did 
you not have a great deal of intercourse with females, at parties, in pri- 
vate, &c.?—Yes. And were not your amorous desires easily excited by 
such intercourse, and did you not feel an almost uncontrollable desire to 
enjoy their persons ?—Yes. And did not this excitement, after your re- 
turn to your bed, produce an involuntary erection, and an emission of se- 
men ?—No. Here, then, is an instance (rare, it i3 true) where the super- 
abundant secretion was absorbed, rather than excreted by the ordinary 
way. Now I conceive there is as much harm done to the nervous sys- 
tem by this absorption, as by the voluntary abuse of the veneral organs. 
The secretory process is stimulated into powerful action by the constant 
amorous excitement that is maintained, semen is deposited in large quan- 
tities in answer to this call of the mind, and being retained instead of dis- 
charged, it is absorbed and again carried into the circulation, producing, 
if long continued, (in connection with the diseased condition of the sper- 
matic organs,) highly disastrous consequences to the nervous system; and 
by the mysterious and unaccountable sympathies which are known to ex- 
ist in this system, developes itself in the brain, and in the medulla spina- 
lis, in the form of chorea, epilepsy, ramollissement, tabes dorsalis, and so 
on. There are but few men who do not have occasional emissions ; and 
I believe, as I have before stated, that robust, plethoric men, who are 
mixing much in female society, especially, should have these emissions to 
carry off the super-abundant fluid. They are nature’s tappings, and so 
long as they are not too abundant, are salutary. 
Physiologists say that the absorption of the semen in the youth who 
has attained the period of puberty, is the developing stimulus of the man : 
giving growth to the hair* strength to the voice, firmness to the limbs, 
and boldness to the countenance. There is languor post coitum—the bull 
is brave—the eunich is effeminate; and this absorbing process may be 
the cause, though I cannot concede that it is necessarily so. There is no 
analagous process to it in the system,—where a fluid is secreted (for some 
other specific purpose) to be absorbed again. But where the spermatic 
organs are functionally deranged by disease, the fluid super-abundant, 
and, of course, badly elaborated, unhealthy, we can easily see how a se- 
rious shock may be impressed upon the nervous system. It is therefore 
evident that seminal losses make their great impression upon the nervous 
system. A change is brought about in the condition of the nerves of the 
venereal organs—a point of irritation is established in the nervous circle 
—to use a figure, there is an obstruction in the course of the orbit which 
disturbs the equanimity of the planetary motions; its equilibrium is de- 
stroyed—the harmony of its action is broken in upon; and disease will INVOLUNTARY SEMINAL DISCHARGES. 
19 
result precisely upon the same principle as does tetanus from a punctur- 
ed wound of the foot, or neuralgia from the cicatrix of phlebotomy ;— 
the difference being only this—that in one instance there is disordered 
function, perhaps partial disorganization of the nerves of the part, and in 
the other complete strangulation. There is a habit established by the 
constant access of fluid to the spermatic organs, by which the suscepti- 
bility of the nerves is heightened and goes on increasing pari passu with 
the access of the secretion, until finally the slightest source of irritation 
applied to any part of the system is rapidly diffused by the agency of 
these, now willing cords, to all parts of the frame. Irr fine, I repeat that 
seminal losses exert their influence essentially upon the nervous system 
—it is a nervous disease, and it is no stretch of the imagination to con- 
ceive how epilepsy, chorea sancti viti, ramollissement, apoplexy, insanity, 
idiocy and other affections of the cerebro-spinal system may arise from it.* 
To return from this digression: C. C. had a horror of suicide, and yet 
an evil genius seemed always urging him to it; the sight of pointed 
bodies, of cutting instruments and fire arms, made him tremble, and 
caused in him a desire to kill, which he could only get rid of by subject- 
ing himself to some acute pain ; by pinching, for example, strongly some 
part of his body. The feeling manner in which he depicted his sufferings 
from this cause was calculated to awaken the deepest sympathies. Bu- 
ried in his melancholy thoughts, and stepping aside from a communion 
with his fellow-men, lie brooded in silence over the fear of suicide on the 
one hand, and death from some of his other ailments on the other. Can 
any condition of the human mind be more pitiable, more desolate than 
this ? There is a mysterious and unaccountable propensity for imitation 
—an unconquerable inclination to commit some dreadful crime, which we 
see manifested in certain individuals, mostly those of a nervous or sensi- 
tive temperament, that is to me peculiarly interesting. It is a fact too 
well established for denial, that murders and suicides are sometimes per- 
petrated under the influence of this curious hallucination; and a question 
of law might very properly arise as to how far a man is amenable to the 
law for the commission of a criminal offence while in this condition. We 
are informed that the trial of Henriette Cornier, in France, for infanticide 
—it becoming, from its peculiar, and deeply exciting circumstances, a 
subject of very general attention and conversation—occasioned in many 
respectable females a strong propensity to the same unnatural deed. 
The repeated attempts on the lives of Louis Phillippe and Queen Victo- 
* A case in point recurs to memory, which I saw in the City Hospital two years ago. A boy, aged 
19, who had been laboring under chorea sancti viti for two months, attended with dry cough and great 
nervous excitability, presented himself for treatment. He was put upon the use of the different 
remedies employed for that condition, successively, without any improvement for three months; when 
it was discovered that he was in the daily habit of masturbating—the cause which had, no doubt, 
produced the disease, and which now evidently maintained it in opposition to the remedies employed. 
His penis was olistered, to prevent farther manipulations, and he got well. 20 
SrERMATORRHCGA, OR 
ria, must be in part dependent upon this inclination to imitation; and we 
find on record an abundance of instances further illustrative of this pro- 
pensity. We read of mothers and nurses who have had such an ungo- 
vernable desire to destroy the child which they were nursing, that they 
have voluntarily begged that they might be tied or imprisoned to prevent 
their doing harm. This feeling of imitation is unquestionably engendered 
in many instances by reading public notices of suicides, infanticides, rapes, 
and so on; and this conviction has induced me on former occasions to 
oppose, in the public prints, the avidity which is manifested by those hav- 
ing in charge the press to seize upon every instance within reach, and to 
dwell with nice prolixity upon all the horrid details of the case. Such 
publications not only do harm by creating perversions of the natural 
channels of thought and action, but they serve to pamper a morbid, de- 
praved taste which exists in every community, for all that is horrible and 
indicative of man’s depravity. 
In pursuing the history of C. C. I shall only refer to one or two more 
symptoms which were present. lie noticed by my directions that he had 
involuntary spasmodic contractions of the vesiculae seminales, and that 
the first time following these contractions that he made water, there was 
a greater turbidness of the urine than at other evacuations. I infer that 
the afflux of the spermatic fluid was too rapid for the chances of escape 
which ofiered, and hence this phenomenon. 
The rectum I found swollen, turgescent and hot. I imagine that this 
condition has much to do with the constipation, not only in this patient, 
but in all those afflicteO with seminal losses. Would not the injection of 
a solution of nitrate of silver be indicated for this condition, taken per se ? 
I informed the patient of the treatment now generally adopted in these 
cases—that recommended and practised by M. Lallemand. He eagerly 
embraced it as being the only resource left him, for he had already ex- 
hausted the materia medica, and death was staring him in the face. Af- 
ter subduing the excessive irritability of the urethra which exists in all 
these patients, by a week’s use of the bougie, I introduced the instrument 
for cauterising and swept the porte caustique once slowly over the whole 
(as near as I could judge) of the prostatic and membranous portions of the 
canal. I then put him at once upon a strict hygienic course as regarded 
diet, intercourse with females, and indulgence in erotic thoughts. There 
was an augmentation of all the symptoms for two or three days following 
the operation, with a discharge of blood and much pain during micturi- 
tion, but soon the sky began to clear; the change established by the cau- 
terisation became manifest; constipation disappeared—digestion improved 
—palpitation ceased—the head cleared—bodily pains vanished—the urine 
was retained—the virile powers returned—the erections even became 21 
INVOLUNTARY SEMINAL DISCHARGES. 
annoying; and in two months’ time this young man stood forth regenera- 
ted, rejuvenated: to use his own triumphant language—“ Richard was 
himself again!” 
A distinguished medical gentleman of this city has kindly permitted 
me to transcribe from his private memoranda, the following history of 
one of the most extraordinary cases of which I have any knowledge. 
The case was that of a young lady of high respectability; and as an ex- 
ample of highly exalted nervous susceptibility, perhaps has no parallel. 
I abridge the details somewhat, to accommodate them to the prescribed 
limits of this essay. 
Deranged catamenia—Spasmodic muscular contractions—Spinal irritation—Loss of 
muscular power—Remarkable exaltation of nervous sensibility—Discovery of the 
cause. 
The patient was aged 23, (1842,) of medium size, healthy parentage, 
finely developed form, system active and rather plethoric, mental facul- 
ties healthy and active, and she has experienced deranged health for six 
years. Suppressed catamenia was the first manifestation of a diseased 
condition; this continued about three months and terminated in menor- 
rhagia, which was continued, with more or less violence, for about eighteen 
months. During this time the nervous system began to exhibit symp- 
toms of derangement, and before the menorrhagia ceased, she was seized 
with spasms in the muscles of the trunk and extremities, accompanied 
with slight delirium, which left her in a very enervated state; but from 
which she gradually recovered. These spasmodic attacks usually lasted 
from ten to twelve hours, occurred at irregular intervals, and seemed de- 
pendent upon too much mental or physical exertion. She had much pain 
during these attacks, chiefly along the spine and in the occipital region of 
the head. 
About eighteen months since she began to complain of increased sensi- 
bility of the left side, extending from the occipital region to the upper 
half of the extremities. This increased sensibility was accompanied by 
a loss of muscular power in the parts thus affected, which continued to 
increase for eight months, since which time it has remained stationary, 
and at this time presents the following very singular phenomenon: the 
slightest touch of the hand or of any substance whatever, upon any part 
of the left side affected as before mentioned, caused the most acute pain, 
with violent tremors. The light contact of a silk handkerchief even, 
caused her to beg for its removal. But what was most astonishing of all, 
the sensibility finally increased to such a degree, that the passage of 
the hand over her back, shoulder and arm, either from the spine forward, 
or the reverse, and not in contact with the skin,—indeed, an inch from 
it—produced almost as much disturbance in the muscular and nervous 22 
SPERMATORRHOEA, OR 
systems, as if the hand had actually been in contact! To test this matter 
further, she was blind-folded, so as totally to prevent her from perceiving 
the approach of the hand, yet the same result followed, and under these 
manipulations the system became so much excited that we were compelled 
to desist. She described the pain as being sharp and lancinating, follow- 
ing the course of the hand, and continuing only whilst the hand was in 
proximity to the body. The passage of a conductor or non-conductor of 
electricity produced equally the same effect. 
It was observed that the passage of her own hand over the affected 
parts produced no effect whatever, being borne without pain. The same 
was the case with her own clothing after being in contact with her a short 
time. 
More recently the patient had suffered many severe attacks of the spas- 
modic pain, lasting for several hours, and occasioned principally by men- 
tal anxiety concerning the loss, by an apoplectic seizure, of her father. 
These paroxysms manifested no regularity, either in time or the parts 
attacked, seizing the hip, the stomach, the uterus, the head, the diaphragm, 
&c., and seldom more than one at a time. Large doses of morphia and 
camphor, (three grains of the former to six or eight of the latter,) seemed 
to diminish the uterine pain, but had little effect upon any other. She 
has been (at the time of her father’s sickness) ninety-six hours without 
nourishment. Yet during this time she has been not only calm, but 
cheerful and resigned, and all the time rational. She has now been con- 
fined to her bed two years. The attacks of pain seem to wear themselves 
out, and to cease from a loss of excitability in the sensitive nerves. 
This lady had been faithfully attended by an intelligent and sympa- 
thising physician, who had treated her, in counsel with several other pro- 
fessional men, for a long time without benefit. The whole catalogue of 
counter-irritants, alone and in conjunction with constitutional treatment, 
had availed nothing. Anti-spasmodics, narcotics, purgatives, etc. etc,, 
had shared a like result. The cause and the treatment remained alike a 
mystery : the symptoms were startlingly palpable. 
Subsequent developments disclosed the fact that all this trouble arose 
from a factitious excitation of the venereal organs, which the patient had 
long indulged in. The issue of the case remains doubtful. 
Now here was a case to intimidate a man. A physician who wa3 not 
au fait in the master passion’s romantic indulgences, would legitimately 
stare, and wonder, and be astounded at such a formidable array of mys- 
terious and unconquerable symptoms. The difficulty of obtaining any 
disclosures that might betray the secret, in a patient of this kind, en- 
hanced infinitely the obscurity which surrounded the diagnosis. 
How are we to explain the very singular phenomenon presented in the INVOLUNTARY SEMINAL DISCHARGES. 
23 
nervous system of this patient ? Laying aside animal magnetism, witfc 
which I acknowledge no fellowship, it can he explained on no other 
ground than that of the radiation of caloric—the slightest degrees of which 
the supernaturally sensitive nerves were enabled to perceive. The 
brain, being apprised of this approach of a foreign substance, and associa- 
ting this idea w'ith the manipulations that had given pain, it was easy, 
under these circumstances, for this morbidly educated organ and the ner- 
vous system to not only imagine, but actually feel pain. The nervous 
system might, in this instance, and indeed in all those cases where there 
is such an exalted state of nervous susceptibility, be compared to a net- 
work of wires floating in a thin jelly : not the slightest touch, not a breath 
of air even, can be communicated to any point of it, but it will be syn- 
chronously, and in full force, felt at every extremity of the arrangement; 
or, perhaps a better illustration will be found in the ear, in the cochlear 
arrangement of nervous fibrilla?, where the slightest vibratory motions in 
the atmosphere are so quickly perceived and conveyed to the brain. The 
' degree of intelligence, if I may so speak, of the nervous system of this 
woman, was certainly astonishing. 
As in the other instances, disease was induced in this girl, by the es- 
tablishment, in the venereal organs, of a point of irritation in the round 
of the nervous circles. There was no seminal waste, as in the male; 
therefore the morbid condition of the nervous and muscular systems must 
have been brought about by the operation of vital sympathies. From 
the close union which is established between the venereal organs and the 
medulla spinalis through the medium of the sacral plexus of nerves, it 
will be easily understood how the irritation is so readily referred from the 
former organs to the medulla ; and how again, through the medium of the 
excito-motory and sensorial branches which radiate from every point of 
the column, all those anomalous and most perplexingly obscure symp- 
toms arise throughout the various parts of the body. This law is, I ap- 
prehend, universal in all cases of seminal disease; for the convenient 
arrangement which here exists for the propagation of nervous sympathies, 
must unavoidably direct our attention to the medulla spinalis for the first 
foreign impression. 
The symptoms which characterized this case were so anomalous, so dis- 
tressing, and so mysterious, as to render them well calculated to awaken 
not only sympathy, but the most profound scientific curiosity. It will be 
seen that the diagnosis was; in this instance, every thing. 
Cutaneous affections are now known to give rise, by their metas- 
tases, to morbid spermatic discharges, attended with the same disastrous 24 
SPERMATOURHtEA, OH 
results to the economy as in the preceding instances. I am again indebt- 
ed to Lallemand for an illustration of this subject. 
Cutaneous affections—Repeated gonorrhoeas, &c.—One cauterisation—Cure. 
M. N., of a spare habit and irritable constitution, subject to frequent and varied cuta- 
neous affections, had in his youth some temporary gleets that always disappeared very 
soon. Afterwards he married and remained faithful to his wife. 
Yet these discharges reappeared several times, varying in intensity and duration ; al- 
ternating witli dartrous eruptions more or less acute, sometimes with numerous boils ; 
succeeding, at another time, to an eruption of pimples upon the head, that had lasted a 
long time and left cicatrices similar to those of small pox. At other periods, obstinate 
ophthalmias or violent rheumatic pains came on, during the absence of these cutaneous 
affections. 
Several times some slight excoriations became irritated to a troublesome degree, and 
a simple wound of the leg confined him several months to the bed. 
In 1820, in consequence of enormous and numerous boils, there came on an inflamma- 
tion of the urethra more intense and more painful than usual: I found M. N. in a state o 
extreme prostration, accompanied with great anxiety, excited by tormenting suspicions 
as to the nature of that abundant and greenish discharge, in every way similar to that of 
intense blennorrhagia. 
Knowing the constitution of the patient, I thought that this inflammation depended 
upon the general cause that had given rise to so many others. In fact, it yielded prompt- 
ly to an antiphlogistic and derivative treatment. 
I prescribed afterwards ptisans of burdock, of bitter-sweet, &c.: at a later period, the 
use of the hydro-sulphurous thermal waters. M. N. went successively to Cauterets, Lu- 
chon, and Arles, (near Perpignan.) 
At the end of three years his general health was improved, but the inflammations of 
the urethra still appeared from time to time, particularly in winter, when there was no 
irritation of the skin or other organ. Then he became dejected, restless, changeable, 
melancholy, and little capable of serious occupation. 
He was strongly desirous to rid himself of these periodical discharges that empoisoned 
his existence. 1 had already employed, with success, cauterisation in some cases of in- 
veterate blennorrhagia: I proposed the trial of it to him, with the hope of essentially 
modifying the mucous membrane of the urethra; he submitted to it with eagerness, and 
the result exceeded my hopes. 
For twelve years M. N. has not perceived the least trace of these discouraging gleets, 
although he has travelled much and has not subjected himself to any particular diet or 
privations. But he very soon perceived changes much more important. 
His venereal desires became more intense, mere imperious ; the erections assumed a 
new energy; the ejaculation no longer took place precipitately, as before. He is, at 
fifty-five, more vigorous than he was at twenty, and capable of doing habitually what lie 
would have regarded then as an excess: this new regimen, far from diminishing his 
powers, appears to augment them. It is also since that epoch that he has had children. 
This single cauterisation, then, produced a real revolution in the genital organs, of 
which the effects still continue at the end of twelve years. 
In order to have a complete idea of the important change that must have taken place 
in the cauterised membrane, it is well to remark that M. N. has remained exposed to 
the same cutaneous eruptions, and that they alternate, as formerly, with ophthalmias, 
attacks of gout, wandering pains in the chest, abdomen, &c.; but that, since then, the 
urethra has not been a single time the seat of these wandering inflammations, which 
continue to attack all the other organs. 
Thus, although the first cause acts continually upon the rest of the economy, the organ 
cauterised is found, for twelve years, uninfluenced by it. 
What do we observe in this case worthy of particular attention ? This 
man had been the subject of several gleets, as well as frequent and varied 
cutaneous affections while young. He married, and although continent 
in his new situation, these glecty discharges recurred at regular intervals, 
alternating with the cutaneous eruptions, until finally, after the subsidence 
of a more than ordinary severe attack of the phlegmonous eruptions, a 
violent inflammation of the urethra was established, attended with an 
abundant greenish discharge, resembling that' of gonorrhoea. But there 
has been no opportunity for a blennorrhagic infection, and there was no 
other cause discoverable which might be thought instrumental in produc- 
ing this inflammation and discharge; lienee we infer that a transfer of 
the cutaneous affection was the cause of it. INVOLUNTARY SEMINAL DISCHARGES. 
25 
In this case there had been an enervated condition of the mucous mem- 
brane of the urethra established by the repeated gonorrhoeas; a predis- 
position to inflammation existed; and we can easily see, keeping in view 
the peculiar sympathy which is known to exist here, how, by the opera- 
tion of cold, slight errors of diet, or other cause, these eruptions of the 
skin may be transferred, though manifested in a different form, to the 
genito-urinary membranes. 
We see, too, in these metastases, analagous phenomena to those which 
are exhibited in the determinations of a severe common catarrh. If an 
individual suffering from catarrh, have debilitated bronchial mucous 
membranes, a kind of nervous affinity will seem to attract the disease to 
that part, and a bronchite will supervene; or if he have a weak knee 
joint, the disease will be invited to spend its force upon that part, and 
acute rheumatism results. To carry our analogies farther, we see how, 
by the operation of cold on the external surface of the body, colitis may 
be established: nature, in endeavoring to throw off by the intestinal ca- 
nal the suppressed perspiration, first establishes irritation; inflammation 
follows, and complete dysentery is the result. And we think we see 
also how certain self-limited, constitutional diseases—measles, scarlatina, 
small-pox—exercise their agency in the development of latent pre-dis- 
positions to phthisis pulmonalis, strumor, obstinate cutaneous affections, 
etc. And how malaria impinges first upon the weakest organs of the 
body—producing in one individual ague, in a second remittent fever, in a 
third typhus fever, and so on. 
The history of this case furnishes us with a striking example of the 
close and peculiar sympathy which exists between the skin and mucous 
membranes, more particularly that which exists between the skin of the 
scrotum and perineum and the urethral membrane; it advertises us of 
the proneness which cutaneous affections exhibit to change their locality 
to mucous surfaces, and it admonishes us of the necessity of guarding 
against these metastases in the treatment of disease. 
Diurnal pollutions were provoked by the repeated inflammations which 
'this patient had experienced ; and these, being unnoticed and unsuspected 
■by the patient, were the principal causes which operated in the gradual 
overthrow of his health. 
Tinea, herpes, dartres, scabies, may disappear simultaneously with a 
copulation: there may have been a metastasis of one of these cutaneous 
affections to the urethral membrane, and an inflammation and a subse- 
quent discharge be the result. Now we have here a practical lesson which 
it would be well to remember. The patient will think that the coition 
has been an impure one, let the woman be as free from suspicion as it is 
possible to be, ay, even if she be a young wife, so strongly are the symp- SPERMATORRHOEA, OR 
toms indicative of a viritic infection; and his physician may confirm his 
unjust suspicions. The fact that there happened simultaneously with 
this supposed infection a spontaneous disappearance of an herpetic, or 
other cutaneous affection, has been entirely overlooked by the physician, 
and he is at once dosed with those very medicines which are calculated 
to exasperate his disease—copaiba, and the like. 
A gentleman who had been a long time annoyed by a prurigo that he 
thought the itch, had recourse, in order to rid himself of it, to an empi- 
ric, who anointed the whole body. Scarcely was he cured, when he 
brought to a termination an affair of gallantry about which he had been 
for a long time engaged. Some days afterwards, he had an abundant and 
greenish discharge, accompanied with pains, and all the symptoms of a 
violent blennorrliagia. His suspicions were not hastily adopted; he was 
advised to cover himself with flannel from head to foot: at the end of a 
few days the vesicles re-appeared, and the discharge subsided of itself. 
This case affords us a striking exemplification of the readiness with 
which these diseases transfer themselves from the slightest cause. It 
admonishes us in the strongest language, of the circumspection which 
should be used in establishing a diagnosis in these cases. We must 
always take into account the circumstances under which these discharges 
developed themselves, with what facility they have been re-produced, and 
how they have behaved under the different modes of treatment which 
have been adopted. 
A youth had, at 14, pityriasis of the head: it disappeared at 19, and 
was replaced by a chronic inflammation of the pulmonary mucous 
membrane. After the cure of this catarrh, there appeared, without any 
known cause, a pain at the neck of the bladder, accompanied with itcli- 
ings, darting pains like to thrusts of a lancet, and weight in the rectum : 
then succeeded a gleet; the spermatic cords became swelled and painful, 
as well as the testicles, and diurnal pollutions ensued, with all the difficul- 
ties consequent thereto. 
Here we have a case still more insidious and obscure in its character: 
no preceding blennorrliagia had been here to indicate a debility of the 
urethral mucous membrane ; no antecedent venereal excesses pointed out 
our path; there was nothing to enlighten us but the symptoms which we 
know to characterize diurnal pollutions. 
It will be observed then, that we have precisely the same symptoms 
manifested in these subjects of transferred diseases, as among those 
whose pollutions originated in contagious urethritis. So that we have 
the same ultimate effects from one as from the other cause. The irrita- 
tion must have extended itself in the same manner along the spermatic 
ducts. INVOLUNTARY SEMINAL DISCHARGES. 
27 
In the treatment of inflammations of the spermatic organs arising from 
the metastasis of cutaneous affections, the same indications are to be ful- 
filled as in the previous instances. Cauterisation and the sulphurous 
waters have been found most efficient. The sovereignty of these reme- 
dies are beautifully exemplified in the case of M. N., where it will be 
seen, that, notwithstanding this patient was still subject to the same cuta- 
neous affections, the same alternations of these with opthalmias, attacks 
of gout, wandering pains in the chest, abdomen, &c., the urethra remained 
permanently invulnerable to the attacks to which it was formerly so 
obnoxious. 
In conclusion, I feel that I cannot enforce too strongly the convictions 
regarding mal-practice, which the investigation of this subject has devel- 
oped. After the presentation of these few facts concerning the transla- 
tion of these diseases, (and many more might have been added,) I say 
that we cannot be too cautious in pronouncing upon the nature of an ure- 
thral discharge attacking an individual hitherto affected with cutaneous 
disease ; more especially if there be already present a debility of these 
parts from antecedent attacks of blennorrhagia, or from venereal impro- 
prieties. 
The Rectum maybe instrumental in the production of seminal fluxes. 
The causes which operate through this medium are various: the modes 
in which they operate are diversified. Thus, any cause which will pro- 
duce pressure upon the prostrate gland or vesiculm seminales, will cause 
to flow out at certain times, the fluids peculiar to those organs ;—these 
causes are principally two: first, habitual constipation, and next, abnor- 
mal formations in the rectum, such as tumors, strictures, fistulas, and so on. 
Again, an inflammation precisely analagous to that which has been 
seen to result from blennorrhagia, masturbation, and the metastasis of 
cutaneous affections, may be propagated to the spermatic organs by con- 
tinuous and contiguous sympathy from the rectum—the primary or re- 
mote cause being located in the rectum. These primary agents are asca- 
rides, hocmorrhoids, dartres, etc. 
Now although none of those causes designated as mechanical are likely 
to operate isolated—independent of any supporting cause, (since we are 
so apt to believe that irritation and inflammation must always be depend- 
ent upon mechanical obstructions,) yet it is possible. 
I shall speak first of those causes which are purely mechanical in their 
nature. All those causes which oppose mechanically the escape of fecal 
matters, and which favor constipation, will be embraced under this head. 
I will relate a case for illustration, which came under my own care. 28 
SPERMATORRIKEA, OR 
Stricture of the Rectum-Seminal losses resulting therefrom—Great physical and men- 
tal prostration—Disposition to commit suicide—Profound hypochondriasis—Division 
of the stricture—Prompt and complete cure.* 
A man came to my father’s office one day to obtain medical advice, 
whose appearance was strongly indicative of an advanced stage of phthisis 
pulmonalis. Upon interrogating him as to the cause of his prostrated 
condition, I obtained the following details of his case. 
This man had been the subject, about ten years previously, of an acci- 
dent by which the rectum had been injured to such an extent that a vio- 
lent inflammation of the part was the consequence. It was treated 
anti-phlogistically and readily yielded to the remedies applied. Soon 
afterwards, however, he experienced difficulty in performing the act of 
defecation; the most laborious efforts were required to perform this act, 
and the difficulty gradually increased; the feces discharged were small in 
diameter, somewhat flattened, riband-like; he constantly felt a sense of 
weight and tension in the sacral region that were peculiarly annoying; 
constipation proper became profound, and the feces were discharged at 
longer intervals; the discharge was accomplished with great suffering to 
the patient, and the globules of feces were observed to be smeared with 
blood. He was treated at various times with drastic purgatives, but the 
relief obtained from these was transitory. 
From the time that this patient first observed the obstacle to the act of 
defecation, his health had become progressively more and more deranged ; 
his appetite was diminished; his digestion laborious, protracted, and 
painfully performed; constant, and at times violent pains in the head; 
vertigo; when he sat down for awhile and then arose suddenly he would 
stagger as if drunk; determinations of blood to the head, at times 
amounting to actual congestion; countenance habitually high-colored and 
the head hot; he slept but little, for his imagination constantly agitated 
him with hideous visions of death ; he had palpitations of the heart; his 
desire to urinate was frequent, and the discharge small; by degrees hi3 
sexual desires were diminished, and the power of erection lost; the ejac- 
ulation was slowly instigated, and the emission protracted; he became 
restless, peevish and morose—highly nervous and morbidly sensitive to 
his own complaints; he constantly felt an inclination to commit suicide, 
which he feared he should carry into execution, and this thought harrass- 
ed him more than any other; he shunned society, became averse even to 
his own friends, sought solitude, and in fine, I found him a profound 
hypochondriac. 
He had been catharticised for his constipation, phlebotomised for his 
cerebral congestions, and narcotised for his sleeplessness! And he now 
* A case much similar to this is related by Lallemand. INVOLUNTARY SEMINAL DISCHARGES. 
29 
declared to me that he had come to seek medical advice for the last time. 
I confess that I was somewhat intimidated at the formidable physiognomy 
which this disease presented; but I was at once interested in the case, 
and determined to establish, if possible, a true diagnosis before proceed- 
ing farther : for upon this was based every thing. I was stimulated in 
my endeavors by the very magnitude of the disease, and by the fact that 
its true pathology had evaded the acumen of previous observers and re- 
mained to be established. , 
Recollecting the symptoms usually manifested by diurnal pollutions, 
and comparing them with the symptoms present in this man, there cer- 
tainly appeared to be an analogy; and connecting this with the constipa- 
tion, I thought I had sufficient ground-work for interrogating the patient 
upon this point. But nothing satisfactory was elicited; he had never ob- 
served that he passed semen with his urine or during defecation. Still 
holding to this idea, however, we conjointly made observations for three or 
four days, and I found that what I had suspected was the fact. I had 
now ascertained the principal cause of the derangement of his health, 
and the next thing was to determine the primary cause of the whole dif- 
ficulty—that which produced the constipation. 
All the known remedies for constipation had been used without benefit, 
not excepting the syringe—a remedy eminently successful under other 
circumstances. It was theretore useless for me to look to the common 
causes of constipation for a solution of the difficulty. He told me of his 
antecedent accident. I was prompted to an examination of the rectum; 
and introducing my finger, it was interrupted at about half its length by 
a fibrous band, nearly circular, which projected into the gut. I scarcely 
need say that I was delighted with the discovery. Examining with care, 
I found that this stricture had a perforation in the centre into which I 
could push, with some difficulty, the point of my index finger, and above 
there was an accumulation of hardened feces, evidently contained in a 
large cul-de-sac formed by the distension of the rectum, which must have 
occupied the greater portion of the pelvic cavity. 
I at once introduced a probe-pointed bistoury, using my index finger 
for a director, and made a crucial incision into the constricted part; then 
throwing in a large injection, the constipation was speedily removed, and 
there remained nothing to do, but to introduce repeatedly some round 
object into the rectum to prevent adhesion of the edges of the four flaps 
of the stricture. 
The seminal losses ceased; gradually the powers of life began to 
resume their wonted energies; the countenance brightened; the cheeks 
assumed a healthful glow; the brows were no longer contracted and 
lowering; the limbs regained their vigor; buoyant health took the place 30 
SPERMATORRHCKA, OR 
of universal disease ; and in a few weeks my grateful patient left me with 
brightened hopes and a light heart. 
To elucidate more clearly the pathology of this case, and the charac- 
teristics by which it may be known, let us analyse, briefly, some of the 
more prominent symptoms which were present, and compare them with 
the lesions known to exist. 
There was a stricture of the rectum, and constipation resulted as a con- 
sequence ; developing the gastric derangement, the vertigo, the determi- 
nations of blood to the head, the flushed countenance;—the mechanical 
pressure exerted by the accumulated feces upon the prostrate gland and 
vesiculze seminales, and the violent efforts required to expel the dejec- 
tions, produced an undue loss of the fluids of those organs, and hence 
result the disturbances observed in the nervous system, the mental 
inquietude, and the loss of virile powers;—the collected feces in the 
rectum pressed also upon the bladder, and hence we find the patient 
frequently urinating, and in small quantities;—they pressed upon the 
spermatic organs, and the emission of semen was retarded during coition. 
Now we know that some of these symptoms are not always indicative 
of the lesions which existed here; but they are sufficiently so to awaken 
the attention of the observant physician in his inquiries concerning a 
proper diagnosis. We know also that these different effects cannot be 
said to stand in an isolated relation to the causes which I have designated 
as their origin, because the cause and effects of each go hand in hand, 
observe a regular, simultaneous catenation, and each must sympathise 
more or less with the other. 
In a preponderance of instances where seminal losses follow mechanical 
obstructions in the rectum, the causes which directly instigate this loss 
may be regarded as two—the pressure exerted mechanically upon the 
spermatic organs, and the inflammation of those organs from the irritation 
which the obstacle induces by continuous and contiguous sympathy from 
the rectum. In a majority of instances, I say, this fact holds, but in the 
foregoing case it does not. The symptoms did not indicate, specifically, 
an inflammation of the spermatic organs; they were nothing more than 
might occur from simple waste of semen from mechanical pressure, and 
were, at the same time, adequate to produce all the effects observed. 
This case proves, therefore, what I have insisted upon a few pages back: 
that simple mechanical obstruction, unattended with irritative inflamma- 
tion, is adequate to produce seminal losses that may compromise the 
health and the life of the individual. 
An interesting fact now presents itself for consideration: the recipro- 
cal influence which the genito-urinary organs exert upon the rectum when 
these organs have become inflamed. We will see how an inflammation INVOLUNTARY SEMINAL DISCHARGES. 
31 
of the spermatic organs, when once established, may, in turn, induce a 
condition of the rectum which is equally pernicious to the health of the 
patient; showing, in a striking manner, the close sympathy which binds 
together these several organs. 
A soldier of light infantry, passionately fond of w'ine, had good health 
with the exception of a few gonorrhoeas, until he was thirty years of age, 
when, one day, being under the influence of wine, and covered with 
sweat, he entered the water up to his middle, and then left his clothes to 
dry upon him. Some time afterwards he experienced an acute pain in 
the lumbar region, a sense of weight in the liypogastrium, a more fre- 
quent desire to urinate, and some difficulty in voiding the urine. All this 
produced much general debility, especially a weakness of the legs, which 
induced him to become a tailor. He had worked at his trade but a short 
time, when he perceived he passed semen without erection or pleasure. 
These pollutions became more and more common, and were accompanied 
with a frequent and irresistible desire to go to stool: it was with great 
difficulty that the urine was passed, and that only after very fatiguing 
efforts. Ilis general health went on deteriorating for the next three 
years, and we now find him with a still more frequent desire to go to 
stool; the presence of the fecal matters in the rectum produces a pain- 
ful impression, that causes their involuntary expulsion. The urine passes 
off every ten or fifteen minutes, without the patient being conscious of it; 
it contains an abundant sediment of a greenish white appearance, floccu- 
lent at the surface, and is very readily decomposed. No venereal desires ; 
not the least appearance of erections. The inferior extremities are so 
feeble, that they cannot support the weight of the body. The legs are 
the seat of osteocopic pains, and the feet are constantly cold. The pa- 
tient appears indifferent to every thing. (Lallemand.) 
I have cited this case to show the reciprocal influence which the geni- 
to-urinary organs may exert on the rectum, and it is a beautiful illustra- 
tion of that fact. It gives us an illustration of the influence which cold 
may exert in the production of seminal discharges.* This man went into 
the water under circumstances calculated to do him injury, and a chronic 
cystitis lias been seen to have been the result; this inflammation subse- 
quently extended itself first to the vesiculas seminales and then to the 
rectum. The patient w;is intemperate, and while under the influence of 
stimulating drinks, had been in the habit of exposing himself much to 
cold ; and it is easy to see why, in this case, the cold should have acted 
on the bladder, since his intemperate habits must have pre-disposed this 
organ to it. Cold, indeed, is capable of producing seminal discharges 
* I had intended to introduce this subject—the influence of cold—in a more prominent form into this 
essay, but this brief reference to it must sufliec. 32 
SPERMATORRIKEA, OR 
under other and dissimilar circumstances, but I cannot go into details 
here. I merely mention it, en passant, because the physician should be 
on his guard against a cause of disease so deceptive. 
There are a few points of interest in the preceding case which I can- 
not pass over without a more extended notice. The high degree of sus- 
ceptibility which the rectum attained in the march of this inflammation, 
is a point worthy of remark. It could not bear for a moment the pres- 
ence of the fecal matters, but as soon as they arrived on a level with the 
bladder, convulsive contractions of the muscular coat was instigated, and 
they were immediately expelled, even contrary to the patient’s will. The 
stools were not retained long enough in the rectum to become liquid— 
they -were hastily discharged, mixed with the mucosities of the intestinal 
canal above, as in diarrhceal discharges. So likewise of the urine and 
semen: these were also discharged, as has been seen, as soon as a small 
quantity was collected in their respective receptacles; the stimulant in- 
fluence which they exerted upon the tender, inflamed surfaces, deter- 
mining their expulsion in a badly elaborated condition. 
This case teaches us the dependency which exists between all these 
organs, and of the necessity of contrasting the different phenomena which 
each manifests in disease, if we wish to get a clear understanding of them. 
This influence of the genito-urinary organs upon the rectum is constant: 
it is present in health, it is present in disease; and he deceives himself 
who thinks it of rare occurrence. 
Equestrian exercise is capable of producing seminal losses, by the 
obstinate constipation of which it is well known often to be the'cause. 
An example will illustrate this point. Lallemand mentions in detail, the 
following case: A young man who had been placed at college at the age 
of 16, soon learned to practice digital manipulations, but discovering its 
injurious effects, discontinued it before any serious general disturbance of 
his health took place. After he had grown up, he was in the habit of 
riding much on horseback, superintending his estates, and for other pur- 
poses. Constipation troubled him much, which he attributed to his 
equestrian exercise; and for two or three years he experienced a gradual 
decline in his general health. lie felt a numbness and formication in 
his feet and legs; his erections became more and more rare, less ener- 
getic, and finally incomplete; his intellect was obscure, diminished; he 
had frequent and severe cerebral congestions; the countenance became 
habitually high-colored and the head hot; an almost constant pain became 
seated about the orbits; his character became restless and peevish. 
About this time, without a proper regard for his physical imbecility, a 
marriage was projected between himself and a charming young lady who 
resided in the country a considerable distance from the city where the INVOLUNTARY SEMINAL DISCHARGES. 
33 
young man lived. In order to visit her frequently and superintend his 
estates at the same time, he was necessarily obliged to occupy much of his 
time on horseback; indeed, as his nuptials approached he passed most of his 
time in this way, and his costiveness now became profound: he even went 
forty days without a stool! Ilis urine was slowly emitted, and with it he 
passed large quantities of semen. His prostration of health, his cerebral 
congestions, had now become dangerous and alarming, but yet the mar- 
riage ceremony was celebrated at the appointed time. Things stood in 
rather an awkward position between the happy pair. All intercourse 
was impossible, owing to the physical prostration of the patient; his mor- 
tification and alarm augmented all his troubles; the cerebral and other 
symptoms began to wear a more serious aspect: the two families were 
very properly alarmed at his condition, and deemed it advisable to seek 
other medical advice than that which he had previously relied on. With 
this view, ten days after marriage, he sought, in charge of his wife and 
her mother, the advice of M. Lallemand, to whom they applied for a cure 
of the cerebral congestions: this they thought to be the whole difficulty, 
and for this had he been treated by his former medical advisers. (As- 
cending douches, vegetable regimen, iced milk; after a month, cauterisa- 
tion, water dashes, cure.) 
What are the great features of this case ? Evidently these, that con- 
stipation is capable of determining seminal losses; and that equestrian 
exercise is adequate to the production of constipation. From other mi- 
nor facts detailed in this case, which I have omitted, there was nothing 
in his history which would, by any possibility, point to any other cause 
for the production of these seminal losses than the constipation, and I 
might add a slight pre-disposition to take on inflammation which may 
have existed in the mucous membrane of the urethra from the antecedent 
habit of masturbating; a circumstance, however, which could not have 
had much influence, for the habit was discontinued before any serious 
lesion of that organ could have taken place. Do not the facts presented 
by this case, establish an interesting and important principle in pathology ? 
This case proves, moreover, a fact which I have often observed, and 
which must have been noticed by almost all country practitioners: that 
constant riding on horseback will establish the most profound constipation. 
I have observed it in my own person, and in others in so palpable a man- 
ner, that there could be no doubt about it. The mode in which this in- 
fluence is exerted, is, I think, of easy explanation. The nates are brought 
into close juxtaposition by the manner in which the individual is seated 
upon the saddle, and the constant pressure which is thus exerted upon the 
sphincter ani and the rectum, produces a mechanical constriction of the 
parts, and constipation results. The cause is, therefore, primarily and 34 
SPERMATORRHCEA, OR 
Essentially, mechanical: its ultimate results, as has been seen, sympathetic, 
vital. 
The great father of medicine, Hippocrates, was not slow to notice the 
influence which constantly riding on horseback exerted upon an individ- 
ual. It will be remembered that it was to this cause that he attributed 
the well-known impotence of the Scythians; a fact which was so notori- 
ous as to make it a peculiar characteristic of that people. The opinion 
of Hippocrates could not, of course, have been based upon our present 
knowledge of pathology: the remote cause and its ultimate effects were 
palpable to him—the modus operandi obscure. 
Fissures of the anus may be mentioned as one of the rectal causes 
which operate in the production of seminal discharges. A medical stu- 
dent who had been for some time troubled with an obstinate constipation, 
lacerated, one day, in his violent efforts at defecation, the mucous mem- 
brane lining the sphincters. The pain which now accompanied each at- 
tempt at defecation was so distressing that he delayed this act as long as 
possible, and then the retained and hardened feces only tended to increase 
the fissures. He had had gonorrhoea with swelled testicle ; and now di- 
urnal pollutions supervened, as a result of the combined influence of the 
constipation and the inflammatory action of the fissures. (Cathartics for 
two weeks, cicatrisation of the ruptures, cessation of the spermorrhoea, 
cure.) 
Hemorrhoids and anal dartres are causes capable of producing diurnal 
pollutions. I have met with several cases on record where these causes, 
more particularly the former, have proved to be the primary exciting 
causes. After what has been already said concerning the intimate sym- 
pathy which exists between the pelvic organs, the readiness with which 
disease is propagated from one to the other, and the almost absolute de- 
pendency of each upon the other for the preservation of its individual 
integrity, the manner in which hemorrhoids exert their influence will be 
at once obvious. Irritation, inflammation, in the rectum; then a travel- 
ling to the spermatic organs, where an attack is first made upon the 
mucous tissues of those parts; soon the whole are involved in the inflam- 
mation, a lesion of function follows, and thus we have spermorrhoea es- 
tablished, with all its deplorable train of evils. The symptoms which 
characterize this condition are quite analagous to those which flow from 
the sequel® of blennorrhagia, masturbation, etc. And moreover, hemor- 
rhoids are apt to be attended with tumors of greater or lesser magnitude, 
prolapsed anus, and so on; and these concomitants, it is apparent, will go 
far to swell the danger of a transmigration to contiguous parts, by means 
of their mechanical irritation. 
I am under the impression that seminal losses are not as rare an atten- INVOLUNTARY SEMINAL DISCHARGES. 
35 
dant upon hemorrhoids as is supposed. I can recollect more than one 
case which has come under my own notice, where, from the appearances 
and symptoms indicated, I should now certainly be prompted to carry my 
investigations farther than the simple hemorrhoidal affection; and with a 
certain assurance of discovering something beyond which would account, 
more properly, for the peculiar symptoms which are sometimes exhibited 
by these patients. 
Ascarides in the rectum are known to be a prolific cause of seminal 
losses; prolific, speaking comparatively. This may, at first sight, appear 
to be a strange cause, but it is, nevertheless, one of considerable impor- 
tance. It is well known that there is scarcely an organ or tissue of our 
bodies that is not occasionally desecrated by the intrusion of some one of 
the numerous parasitic tribes that make their homes either within or 
without our persons. Each tribe has its favorite hiding-place; thus one 
species of strongle chooses the heart for its domicile, another the arteries, 
a third the kidneys. The guinea-worm and the chigoe bore through the 
skin and nestle in the subjacent cellular tissue. The tissue which connects 
the fibres of the voluntary muscles contains myriads of them. Hydatids 
are found principally in the liver and brain. Even the gall-bladder, and 
the eye, have their living inhabitants. In the intestinal canal they are 
found most troublesome, because they are the largest, and are more capa- 
ble of doing injury. Independently of the minute scientific divisions 
into genera and species, there are other grand distinctions, in which some 
are designated as external, some internal, and some I shall call amphibi- 
ous. Of this latter class—the ascaris vermicularis—I intend to speak. 
The favorite habitat of these animals is the rectum, and I call them am- 
phibious, because they are not unfrequently found without the verge of 
the anus and vulva; and because, moreover, they sometimes migrate— 
performing journeys by land, to find their way into the vagina and even 
the urethra of the male. 
It can be easily understood how these animals tend to the production 
of seminal discharges. They act as a constant excitant to the genital 
organs, producing in the young, in whom they are the most frequently 
found, precocious desires which are uncontrollable, and which exercise 
the worst tendency. Thus you will see quite young boys tormented with 
erections that can be attributed to no other cause. Girls of the most 
tender age are not exempt, and these little parasites will be found not 
only in the rectum, but within the vulva, producing a degree of titillation 
there that is exceedingly pernicious, not only in a physical, but in a 
moral light. In a male youth, masturbation is almost certain to follow 
the presence of these little worms; in the female, the same result, with 
copious leucorrhoea, irresistible itchings of the genital organs, redness and 36 
SPERMATORRHOEA, OR 
excoriation of tlie nymph®, clitoris, etc. This is a familiar subject, 
however, to practitioners, and I need not therefore pursue it further. 
I would gladly introduce here some cases of thrilling interest, in illus- 
tration of this condition, but am positively restricted by the want of room. 
Cases are on record where individuals have been harrassed with these 
worms for years, in whom the final result was precisely similar to that of 
the former cases—seminal losses were determined : in this case they are 
determined either by masturbation or irritation from contiguous sympa- 
thy. Sufficient has already been said concerning the sympathies which 
exist between the pelvic organs, and the manner in which those sympa- 
thies are propagated, to render any further illustration superfluous. The 
insignificance of the cause and the magnitude of the effect, must strike 
the ordinary reader with wonder, and the professional man with shame, 
that a cause so trifling should be overlooked. The therapeutic indica- 
tions are obvious. 
With these remarks I take leave of the causes and symptoms which 
characterize seminal losses. 
Treatment.—I shall not dwell long upon the treatment of seminal 
losses. My object has been rather to define the pathology of the disease, 
than to indulge in speculations regarding curative means; for I cannot 
be supposed to possess that intimate knowledge of the properties of 
remedies which my seniors do. 
Ample experience has, I think, established the process of M. Lalle- 
mand as being the most efficient, and indeed, the only reliable remedy 
in use. Before his time, tonics, balsamics, baths, strict hygiene, etc., 
were the remedies employed, and the treatment was attended with very 
indifferent success. The Porte Caustiquc of Lallemand, with the modern 
modifications, has obtained universal favor in this country, and I believe 
in Europe also. The mode of using this instrument is no longer a nov- 
elty to physicians, and I shall add nothing on this point. 
It is perfectly astonishing to me that one application of the Caustic, 
lightly swept over the parts, should produce such instantaneous and as- 
tounding remedial effects. Its metliodus medendi, is, I apprehend, not 
readily appreciable. Some change is obviously brought about in the 
vital endowments of the part—a change which at once restores its heal- 
thy functions. We can judge somewhat of its effects, perhaps, by analo- 
gy. Thus, when nitrate of silver is applied to fungous injected and 
engorged tissues, especially of a scrofulous character, (the results of in- 
flammation,) or to those chronic inflammations of the vagina and neck of 
the uterus that induce so many leucorrhceas, or to chronic catarrhs of the 
bladder and bronchial mucous membrane, it promptly and permanently INVOLUNTARY SEMINAL DISCHARGES. 
37 
modifies the condition of these several parts. It seldom excites either 
pain or inflammation. “ When applied to mucous membranes, a similar 
white compound of the nitrate with the animal matter of the secreted 
mucous is formed, and this defends the living tissue from the action of 
the caustic, so that the effects are not so violent as might be expected.” 
{Pereira, Mat. Med., vol. i., p. 582.) Soon after the application of the 
caustic, the tissue becomes disengorged, contracts upon itself, becomes 
pale, and a new energy is infused, whose action, I infer, is entirely vitalr 
and independent of any merely contractile or chemical agency; and 
hence this mode of cure, not only in spermatitis, but in the other inflam- 
mations spoken of, proves so permanently remedial, and so little liable to 
relapses. We may therefore conclude that nitrate of silver operates 
upon these inflamed and iri*itable tissues by essentially modifying their 
organization and sensibility ; thus establishing a change in their vital en- 
dowments, by which a source of irritation to the whole nervous system is 
removed, and the entire economy is enabled to take on a condition of 
health. 
Physicians have been much in the habit, owing to the cachectic and 
atonic appearances, of administering the ferruginous and other tonics, cold 
baths, balsamics, sulphurous baths, ice, etc., because these remedies most 
certainly appear to be indicated, and they are astonished at their want of 
success. Like mercury prescribed for syphilitic persons who are ner- 
vously irritable, or antimony preceding venesection in acute thoracic 
inflammations, or balsam copaiba in the acute stage of urethritis, no bene- 
fit is received, and indeed harm may result. An irritable state of the 
system, or of a part, accompanying disease, contra-indicates, I believe, as 
a general rule, the employment of those very remedies which are gener- 
ally serviceable after the irritability shall have been removed. Thus after 
the cauterisation of the irritable urethra for seminal discharges, we find 
nothing so salutary as those very tonics, baths, and so on, referred to 
above, in restoring the tone of the organs, and in building up the broken 
down constitution of the patient. And yet we know that they serve but 
to enhance the irritability of the system, if they are employed before that 
irritability shall have been allayed by cauterisation. 
There is in all these patients an astonishing degree of susceptibility in 
the membranous, prostatic, and sphincter portions of the canal. The 
most cautious catheterism will cause acute pains and spasmodic contrac- 
tions, violent enough in some instances, to resemble the resistance of 
strictures. It appears to the patient as if the bougie was passing over 
parts that are denuded; it is a cutting, burning sensation, and is felt much 
more intensely as the point of the instrument penetrates the sphincter. 
It is a curious fact, and one wrorth remembering, that at this moment 38 
SPERMAT0RRH05A, OR 
many persons fall into a state of syncope. It will be apparent therefore 
to the practitioner, that the bougie should be used for some days preceding 
the operation, in order to inure the urethra to the presence of a foreign 
body, and thus not only prevent the spasmodic seizure of the bulb of the 
porte causlique by the sphincter, but guard against other inconveniences 
which might arise. 
Not unfrequently the urine will still remain more or less muddy after 
the operation, although the greater proportion of the losses may have 
been commanded. Under these circumstances, sulphurous baths, ice, or 
hot and oold dashes to the perineum, will be found adequate to complete 
the cure. These remedies would have been found worse than useless 
before the irritation had been allayed by the cauterisation ; but now they 
are eminently curative. I think the cold dash applied to the perineum 
two or three times daily would prove most efficient. 
Objections have been urged, not alone by patients, but even physicians 
have shared their apprehensions, that the direct application of caustic to 
the orifices of the ejaculatory ducts, must of necessity produce impo- 
tence, by the occlusion or complete obliteration of these orifices. I have 
only to say that these fears have never been entertained by those who 
have had experience in the use of the remedy. Cauterisation, when pro- 
perly performed, is emphatically a curative process—not a destructive one. 
In conclusion, let me ask, what are the great difficulties which phy- 
sicians experience in the way of diagnosing spermorrhoea ? And what 
are the duties of the profession regarding this disease ? 
The question quid negotii est ? must be the starting point in the inves- 
tigation of all diseases; and it has therefore been my endeavor, as I 
stated before, rather to point out the symptoms and causes of the disease, 
as it is presented to us in its multiplicity of forms, than to indulge in 
speculations regarding the therapeia. 
The obstacles which physicians have to contend with in ascertaining 
the true nature of the disease, arise from various causes. In the first 
place, the symptoms approximate very closely to those which characte- 
rize a variety of nervous affections; secondly, in many instances the true 
character of the disease is not suspected by the patient himself, thus lead- 
ing him to suppose that the abnormal condition, whatever it may be, of 
the genital organs, is the sequence, not the cause of the other symptoms; 
thirdly, the patient not unfrequently deceives the physician designedly, 
through shame, hoping at the same time that the remedies prescribed, 
may, perchance, be of service to him. INVOLUNTART SEMINAR DISCHARGES. 
39 
Thus it will be seen that M. de S. and his friends were convinced that 
he was laboring under cerebral disease; his physicians shared the same 
opinion, and I must admit that there was every apparent indication for 
blood-letting and a general anti-plilogistic treatment. But when light 
was thrown on the subject, the fallacy, nay, positive perniciousness of this 
course, was rendered palpable. C. C., during a period of three years, 
before he came under my notice, had been treated for not less than 
seven diseases, and by as many physicians—each one drawing afresh 
upon our bountiful nosology. The case of the young lady was still more 
shrouded in obscurity and perplexity, for we have no reason to believe 
that she even suspected the cause of her difficulty herself; and it was 
certainly a case well calculated to baffle the best directed efforts of the 
medical men who saw her. In fine, all the cases which have been intro- 
duced into this paper, and indeed, all the cases of which I have ever read, 
were more or less obscure and calculated to deceive. 
The brain is always involved to a greater or lesser extent—in some 
instances, as has been seen, amounting to congestions of a serious charac- 
ter, epilepsia, melancholia bordering on insanity, etc. The chylopoietic 
viscera, and the -whole tract of the intestinal canal, are invariably impli- 
cated, and to no small extent, in this difficulty; and hence so many of 
these persons are supposed to be primarily affected with dyspepsia. I am 
inclined to think from what I have observed of the effects of sudden 
transitions from excessive venereal indulgences to strict continence, and 
vice versa, upon the condition of the alimentary canal, that there is a 
more intimate sympathetic connection between the venereal organs and 
this canal, than is generally conceded. The alimentary canal is known 
to wield a powerful sympathetic influence over the rest of the economy 
by means of its extensive nervous communications; and this fact has led 
to some magnificent errors in pathology ; for what but a knowledge of this 
powerful influence could have induced the giant mind of Broussais to be- 
lieve that all fevers originated in this canal? To continue, the liver 
alone sometimes gives out indications that induces the practitioner to refer 
the difficulty to that organ. Professional dignity is often provoked into a 
smile to witness the accommodating manner in which the poor liver is 
made the scape-goat of half the organs in the body ; being placed in the 
front rank to shield its more fortunate fellow-organs behind from the blue- 
pill cannonading which is innocently discharged at it. Again, there is 
universally present a lumbar pain, and not unfrequently pain along the 
whole tract of the spinal column, and so the pix burgundica is called into 
requisition—“ Sherman’s poor man’s plasters ” are vigorously plied, ad 
infinitum. I think I have observed also in these patients a peculiar prone- 
ness of the mucous surfaces of the larynx, trachea, and larger bronchii, 40 
SPERMATORRHOEA, OR 
to sympathize with the disease of the mucous surfaces of the genito- 
urinary organs. There is certainly an improvement in the tone of voice, 
and a decreased liability to pulmonary catarrhal affections, after cauteri- 
sation for spermorrhoea; and this change is so prompt that I am inclined 
to attribute it rather to sympathetic action than to the general altered 
condition of the system. There are other prominent appearances present 
in this disease calculated to throw the medical man into a wrong train of 
inquiry, but my limits will not permit me to enter into farther detail. 
There is, however, in all these patients, in the very manner in which 
they enter the physician’s presence, in the eyes, in the voice, attitude, and 
countenance, something timid and bashful, that no language can exactly 
describe, but which the observant physician will soon learn to distinguish. 
Address is required to get at the secret. The confidence of the patient 
must first be secured, and in order to do this, he must be impressed with 
the belief that the physician feels a lively interest in his welfare,—beyond 
mere dollars and cents ; once convinced that the physician is his friend, 
there is an easy access to hig secret. 
Post-mortem examinations of those individuals who die of spermor- 
rhoea, generally exhibit lesions of sufficient magnitude in other organs to 
be thought adequate to the death of the individual, and no notice is 
fore taken of the spermatic organs. For this reason the pathological 
anatomy of this particular disease, has, no doubt, been retarded ; and the 
barrenness of our pathology, and the obscurity which surrounds the sub- 
ject, may be attributed to this fact. But few autopsies have ever been 
made with a view of detecting primary disease in the spermatic organs; 
but in every instance where examinations have been made upon those 
individuals who have died with unequivocal symptoms of spermatic dis- 
ease, the most extensive disorganization of these organs has been found. 
The simple lesion of the spermatic organs, par se, is not certainly capa- 
ble of compromising life, for persons of both sexes may lose the essential 
organs of generation with perfect impunity, as far as regards hazard to 
the integrity of the constitution ; it is the destructive influence which is 
propagated from these organs to remote and more vital parts through the 
medium of the nervous system, that does the work of death. But when 
we come to examine the nerves themselves, we are compelled involunta- 
rily to ask ourselves—how is it that these tender, delicate cords are capa- 
ble of transmitting so much disease—of being the couriers of death 
from one organ to another—of being encompassed about by diseased 
tissues of every character, at their origins, terminations, and along 
their course, and yet remain, so far as the eye can detect, invincible 
to this extensive morbid influence ? Who shall say how this influence 
is diffused abroad through the nerves from this one isolated spot, so as to 41 
INVOLUNTARY SEMINAL DISCHARGES. 
produce such extensive functional and structural lesion of the brain, the 
medulla spinalis, the heart, the stomach, and so on ? And this serves well 
as a type of the whole catalogue of nervous diseases. What are the 
writings of the illustrious Marshall Hall and the whole host of writers 
upon nervous pathology worth to us so long as they do not explain to us 
how this influence is exerted ? The marvellous and often fatal effects 
of mind over body, in the acquisition, continuance or cure of abnormal 
conditions of the system, is one of the unexplained, and, I fear, inexpli- 
cable phenomena which is daily occurring in the nervous system to 
astound and overwhelm us with surprise. How are we to account for the 
frolicsome vagaries of an intermittent fever, yielding to medicines the 
very antipodes of each other, to the charm of the wizard and to fright ? 
An illustrative fact or two may be mentioned : A man afflicted with ague 
for a long time, and who was in the habit of watching the clock regular- 
ly to anticipate the recurrence of his paroxysm, was cured by a friend 
having set the clock back until the time was passed by; he was soon af- 
terwards informed of it, but the paroxysm did not occur for that time; 
and the morbid catenation being once broken, the disease was cured. A 
distinguished gentleman of this city who had suffered intensely from tic 
douloureux for a number of years, and had tried various remedies with- 
out any benefit, was induced one day by a student to attend the lectures 
of Professor Mott, in the University of New York, on that subject. He 
sat comparatively unconcerned while Dr. M. passed in review the various 
modes of medicinal treatment: for with these he was acquainted. But 
when the lecturer came to the surgical treatment, and gave an exhibition 
upon the dead subject of the various steps of the operation, the gentle- 
man evidently became very uneasy, and presently losing all power of 
sustaining himself, he swooned away; when he recovered his senses, 
he found himself at the door of the University, in the street, sup- 
ported by his friend. From that time to this, now four or five years, 
he has had no recurrence of the neuralgic affection! A violent cere- 
bral excitement wrought a change in the condition of the affected 
nerves at that point where the irritation originated, perhaps; but our 
limited knowledge of the habits of the nervous system throws no light 
upon the subject, upon which we can rely. Can any one say why, when 
a woman first conceives, and the womb takes on itself a new function, 
neuralgia about the lower jaw, cheek and neck, sometimes supervenes, as 
the result of this change in the system ? or why the testicle swells in 
parotitis ? or ascarides in the rectum produces itching of the nose ? or the 
pain of morbus coxarius is felt in the sound knee ? or a punctured wound 
of the bottom of the foot produces trismus? or why chancrous ul- 
ceration of the penis is attended with enlargement of the contiguous 42 
SPERMATORRHOEA, OR 
glands—constituting bubo; or why, in like manner, ulceration of the 
glands of Peyer are attended with enlargement of the pancreatic gland ? 
These are but a few of the manifestations of this mysterious and unac- 
countable operation of nervous sympathies, and how limited must our 
knowledge be when we cannot even essay an opinion, predicated upon 
correct data, as to their mode of manifestation ! 
The brain, as the centre of the nervous system, sits enthroned upon her 
proud pinnacle, enshrouded in her secret panoply—the conservator and 
guardian of the actions of the economy—herself mysterious and unknown. 
When we look at the various organs of the body, we cannot but admire 
their nice adaptation to the functions which they severally perform; and 
we cannot be mistaken about the mode in which that function is performed. 
Thus, any tyro in anatomy must know by their conformation and location 
that the lungs are the organs of respiration, the stomach of digestion, the 
liver of the elaboration of bile, the kidneys of the secretion of urine, the 
heart the organ of the circulation ; but who will say that there is an anal- 
ogy between the conformation of the brain and its radiating appendages, 
and the functions which they perform ? There is none ; and we can only 
know some of the laws which govern them by cause and effect—by direct 
experiment. 
We are unquestionably upon the threshold of a mighty and astonishing 
advancement in our knowledge of the pathology of the nervons system. 
There are, however, certain boundaries beyond which inquirers cannot 
go in their investigations of nature’s peculiarities; but we should not 
lay down a certain limit because there appears something beyond which 
looks impenetrable, and not within the cognizance of human eye; for 
these nervous diseases form so large a proportion of the maladies which 
affect the human frame, and are of such universal interest to the profes- 
sional man, that not only duty, but inclination should urge him on to an 
elucidation of all that is possible concerning them.'} 
Returning to the subject properly under consideration, let me ask, what 
are the duties of the profession regarding this disease ? 
Philanthropy, a desire to relieve human suffering, and a zealous 
interest in the advancement of science, should enlist the medical man in 
the condition of these unfortunate victims. The world is full of suffering; 
civilized mankind is an embodiment, physically speaking, of miserable 
infirmity; morally speaking, nothing less. Natural depravity, inherent 
pre-dispositions, favored by unhappy adventitious circumstances, developes 
unconsciously a behemothean, health-destroying, mind-destroying, de- 
moralizing disease, which, like a foul ulcer, spreads out its long, tortuous, 
insidious, insinuating ramifications into every pore of the body politic,— 
there committing its ravages incognito, deceiving all by its protein quali- Pages 43-44 missing