IMPOTENCY.
The frequent obstinacy of this distressing condition under every variety of non-electrical treatment, is the cause of the frequency with which cases present themselves to the specialist. Unfortunately however but few of the referred cases are of recent origin. In almost all instances they have gone through a vast amount of medication and other treatment, and finally, either through their attending physicians or of their own accord, they come as a dernier ressort to seek relief from electrical treatment. I have already ([p. 47]) spoken of the comparative merits in this disease of local and general electrization. A few years ago I was ignorant of the good effects of the baths in male impotency. I came to test and employ them here from two causes. In the first place, patients were sent me specially for electro-balneological treatment, ordered by their physicians; and, second, I began, when I became familiarized with the effects of the baths, to have recourse to them in cases where with local electrical and other treatment I had been unable to accomplish anything. My average results, without becoming uniformly successful, became so very much better, that after a brief but abundant experience with this treatment, I have come to consider it the most important we possess in this affection; one that will frequently succeed when everything else, including local electrization, has failed, and which, in cases where no incurable organic changes underlie the affection, will, if properly persisted in, either cure or improve to a great extent a large majority of the cases. I have even seen instances where, the sexual power having receded as the legitimate result of advancing age, it returned almost or quite perfectly and with seeming permanency under the influence of the baths. In the class of cases—and they are quite numerous—in which impotency (loss of the power of erection) occurs as a purely nervous symptom in comparatively young men; where its cause is sometimes purely imaginative, at others the result of early excesses, the baths are attended with the most gratifying average results. Where the cause is purely psychical, a very few baths are sometimes sufficient to dispel the morbid phenomena. Where masturbation or excessive venery are at the bottom of the trouble, there is always a probability of more or less organic change in the lower portion of the spinal cord, and frequently also a secondary enfeeblement of the digestive functions, which render requisite a long and steadily continued use of the baths. Patients whose sexual power was intact, who took the baths for other purposes, have time and again called my attention to their aphrodisiac effects.
While here the general electric influence is the main remedial agency, there is no reason why the possible—or, I should say, probable—good to be obtained from its local influence should not be realized—the less so that it is so facile to obtain this in the bath, by means of the surface board. While individual cases will undoubtedly call for modifications, I have found the following plan to answer best in certainly more than half the cases that have come under my observation: The first five minutes of the bath may be occupied by a general galvanic current of medium intensity, descending where the patient is of an irritable, ascending where of a phlegmatic temperament. The pole connected with the foot electrode should now be detached, and the surface board substituted. The second five or ten minutes may be consumed by running a galvanic current between the head electrode and the surface board, the latter applied alternately to the penis, scrotum, perineum and, where thought best, also to the lumbo-sacral region. Where, as is usual, the impotency is accompanied by a certain degree of cutaneous anæsthesia of the penis, but especially where the seminal secretion is scanty, the board should be positive (ascending current); where however nocturnal spermatorrhœa, premature discharges (before coition is possible) or other irritable phenomena characterize a case, the surface board should be negative (descending current). The head of the patient should rest on a sponge thoroughly saturated with water, and communicating with the water of the bath, so as to include the cerebellum in the direct circuit. The last five or ten minutes of the bath should be devoted to passing the faradic current between the head electrode and the surface board, this last applied about the genitals, but chiefly about the perineum, the current to be of sufficient intensity to contract the perineal muscles. With anæmic patients iron should be added to the baths. These should be taken at first daily, later on every other day, then three times a week, and so on until it becomes apparent that all the good that can be obtained from them has been obtained—whether this be a perfect cure or only a certain degree of improvement. Where it is thought requisite, internal medication and various hygienic measures may be advantageously resorted to as adjuvants. While these will do no good when employed alone, they may serve to enhance the effects of the baths.
In the following cases, I will include some where the impotency was not perfect, where the conditions were merely those of sexual debility. As there is here merely a difference in degree, it would be superfluous to separate the two conditions under distinct heads.
Case XXV.* Perfect impotency.—Mr. F., from the practice of Dr. Caro, a robust gentleman, aet. thirty-six, full of muscular vigor. Had had syphilis, the symptoms of which had disappeared under Dr. C.’s treatment. For two years the power of erection as well as sexual appetite had become extinct—if we except an occasional imperfect spontaneous erection on waking up in the morning, and even this was of rare occurrence. Ordinary medication proving inadequate, Dr. C. sent patient to take electric baths. From March 7th to July 16th, Mr. F. used the baths, averaging about two weekly. He was then, and still remains, perfectly restored.
Case XXVI. Perfect impotency. A. E. K., aet. 23, commercial traveler, applied to me for treatment in the spring of 1873. His general health was very good. He had masturbated but little. Had been in full possession of his sexual power until almost twenty-two years of age, when he found that, without assignable cause, he had lost the power of erection. His general condition being, as far as discoverable, perfect in every respect, I instituted a local electrical treatment. This was continued for some time without avail. Strychnia was then administered with no better result, and after some months’ treatment I told him that I could do nothing for him. He remained without any treatment whatever until the spring of 1874, when I advised him to try electric baths. He took in all about half a dozen baths, which resulted in his complete and thus far permanent restoration.
Case XXVII. Sexual debility. Mr. W., aet. 32, married, manufacturer, consulted me in February 1875. Had gradually for about a year past lost sexual power. Was able to perform the marital act at rare intervals only, and when he did, felt exhausted the whole of the succeeding day. I ordered him electric baths. He took the first on February 22d, 1875. Between this date and March 22d, he took six baths. The sexual power had then fully returned. I must not omit to state that during the time he was under treatment he took, by my direction, gr. 1⁄25 phosphorus twice daily, which may have somewhat accelerated the result.