SECTION I.
IMPOTENCE AND STERILITY OF THE MALE.
Where the hindrance to cohabitation arises from organic defect, congenital malformation, or diseases of some of the organs of generation, the disqualification may generally be considered absolute or irremediable. It is remarkable, however, to what extent mutilation or disease may occur, without total annihilation of the procreative powers; the smallest remnant of the penis, for instance, capable of entering the vagina, provided the testes be sound, being sufficient for impregnation.
A learned lecturer on medical jurisprudence gives it as his opinion, that the smallest quantity of seminal discharge, deposited in the lower part of the female generative apparatus, provided the female be apt to conceive, is sufficient for impregnation: and it is astonishing how minute a quantity of this plastic agent is necessary for that purpose in some species of creatures. Spallanzani took three grains by weight of the male fluid of the frog, and mixing it with seventeen ounces of water, found that impregnation of the eggs was produced by as much of this exceedingly weak mixture as would adhere to the point of a fine needle.
Although, in human formation, it is not essentially necessary that the male material should be deposited in the upper part of the vagina of the female, yet there is little doubt that the deeper entrance of this substance conduces to impregnation.[13]
Malformation of the genital organs has already been stated as a cause of impotence. Such cases furnish much uneasiness at first, but are easily relievable. I have met with many instances, where consummation has been prolonged from months to years, which a slight knowledge of the functions of the parturient organs might have relieved in a few days; and with respect to the latter, it may be pardonable to mention that, as the husband should be the first to instruct his companion in what is to be expected, but little disappointment will be experienced, except with the vicious and unworthy.
There is room for much ingenuity in these matters; and as marriages are made for better or worse, there exist powerful inducements to resort to the contrivances of the ingenious and humane.
The following case of malformation fell under my own observation; the adjoining delineation is a true picture of the circumstance.
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The penis, b, at its under surface, was adherent, from birth, to the scrotum c, consequently, when erection ensued, it presented the form of a half circle; the urine escaped near the root of the penis, a. The penis itself was impervious, but sensible to the amative passion. The gentleman submitted to a division of the fold which united the penis with the scrotum, which former, on being thus released, assumed its proper position; sexual congress was thereby attainable, and during erection the orifice of the urethra was drawn sufficiently up to allow of the ejection of the semen into the vagina. Of the ultimate result I have yet to hear.
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It may appear almost incredible, that the sketch here presented can be a true one of the penis and testicles of a young man upward of 19 years of age. No less was it a source of wonderment to myself than it may afford a doubt to others. I carefully examined the individual, and saw him urinate; the stream was certainly small, but surprisingly large for so minute an organization. He was quite unconscious of amative feeling; the testicles were distinctly perceptible by the finger, but they certainly were not larger than cherry kernels. The young man, in other respects, preserved the male attributes; he had a slight beard, and his voice, though not powerful, was by no means effeminate. I had several interviews with him, and then lost sight of him.
I have elsewhere portrayed a relaxed state of the testicle, called varicocele: the accompanying draught exhibits the same in an aggravated form. The patient possessed but little amative power, and had also a thickened condition of the prepuce, which produced a perfect phymosis. The case, however, under treatment became considerably relieved. The phymosis required a division of the prepuce, an operation productive but of little and momentary pain, or rather twinge, and healed in a few days. Children are sometimes not procreated for want of sufficient erectile and consequently penetrative power of the male organ. Much and often needless misery results from this infirmity.
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The loss of erectile power is occasioned through more causes than one. Erection ensues independently of the will or imagination, as instanced on awaking in the morning—the cause is most probably a distended bladder; the phenomena may be a sympathetic irritability of the muscles of the perinœum, especially the erectores; there is a general pelvic disturbance, the nervous excitement is increased, and the rush of blood (obedient to that excitement) is sent to the penis: such, I believe, is the sympathy between all these structures. The will exercises the same, and the results of the imagination do not materially differ; consequently, where the mind fails in producing these effects, local excitants may be found to supply its office hence the usefulness of art in combating the eccentricities of nature. The mere handling of the testicles kindles desire, and in like manner, stimulatives applied over the scrotum generate amative heat.
A curve of the penis is sometimes an obstruction to connubial intercourse; this arises from adhesion or obliteration of the cells of the Corpora Cavernosa on one side only, preventing the uniform flow of blood into those structures, and consequently the equal distention of the penis. The curve is of course laterally, and occasions in the act of coition pain to both parties, or the power of penetration is insufficient. Occasionally this malformation is only temporary, and consequently remediable.
Franck gives an instance in which so considerable a portion of the penis had been carried away by a musket-shot, that when the wound healed, the organ remained curved, and yet proved adequate to the performance of its functions.
An opinion formerly prevailed, that the existence of the testes was unnecessary for effective copulation; but that is no longer a point of dispute: their absence, whether natural or artificial, invariably rendering the invalid unfruitful. It is not, however, to be inferred, that a person is impotent in whom no testicles are discovered in the scrotum, instances occurring where they do not descend from the abdomen (their embryotic abode) through the whole period of life. One testicle, provided it be sound, is sufficient for procreation. Complete extirpation of the testes, although destructive of procreative powers, does not extinguish venereal desire. Where the genital organs exist, but are malformed, or pathologically altered, their virility may be nullified.
The most frequent malformation is in the urethra, which sometimes opens in the perinœum—the part marked a in the annexed cut; at others, on the dorsum of the penis, and not unfrequently under its surface: so long, however, as the orifice opens in that portion of the penis which enters the vagina, so that the emissio seminis may be therein deposited, impregnation may and will take place; and even in cases where artificial means have been employed to convey the fluid.
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A contracted state of the prepuce, its adherence to the glans, or that condition of it termed phymosis, form impediments to the emission of the semen which can only be removed by an operation; and if that be neglected, the evil continues through life.
Among the diseases which occasion sterility in the male, those affecting the penis and those incident to the testicles may be enumerated. With regard to the former, there often exists an excess or deficiency of muscular or nervous energy, inducing priapism or permanent erection in some instances, or paralysis or permanent flaccidity in others. In priapism, the erection is so vigorous, and all the parts so distended, that the semen can not pass into the urethra; while in paralysis, from some inaptitude of nervous or muscular powers of the genital organs, the corpora cavernosa receive but a limited supply of blood, insufficient to create erection, or provoke a seminal discharge.
Strictures of the urethra are among the barriers to sexual intercourse; but happily, only in extreme cases, where the urethra is all but closed, so as to oppose the passing of the finest bougie.
The testicle is subject to a variety of diseases, wherein such a relaxation or obliteration of its structure ensues, that the seminal fluid is no longer formed: and where both testicles are alike affected, sexual desire is most usually wholly extinguished—the smallest portion, however, of either gland remaining uninjured, may still be capable of secreting semen sufficient for impregnation.
Impotence may follow accidents to the testicles, such as produced by a bruise; or even a testicle, which shall have become inflamed from clap, shall become so chronically hardened as to be useless. Bruising the testicles was the mode adopted by the oriental courts for destroying masculine efficiency in the attendants of the harem.
There are certain conditions of health in which, although the genital organs may be perfect, yet, owing to some constitutional frigidity, there is an incapability of erection. The offspring of too young, or very aged, infirm persons, or of those worn down by debauchery, are but too common instances.
The appearance of persons of this temperament is thus described by a French writer: “The hair is white, fair, and thin; no beard, and countenance pale; flesh soft and without hair; voice clear, sharp, and piercing; the eyes sorrowful and dull; the form round, shoulders narrow; perspiration acid; testicle small, withered, pendulous, and soft; the spermatic chords small; the scrotum flaccid; the gland of the testicle insensible; no capillary growth on the pubis; a moral apathy; pusillanimity and fear on the least occasion.”
The most frequent cause of impotence, at that period of existence when man should be in the zenith of his procreative power, is in a general weakness of the generative organs, induced by too early an indulgence in coition, the pernicious and demoralizing crime of masturbation, or the abuse of venereal pleasures. In these cases, erection will not take place, or but feebly, although the mind be highly excited by lascivious ideas. The erector muscles are paralysed from over-use, and the semen, if any is secreted, from the lax and withered state of the testes, is clear, serous, without consistence, and consequently deficient of prolific virtue. Sometimes there is a want of consent between the immediate and secondary organs of generation; thus, the penis acts without the testicles, and becomes erected when there is no semen to be evacuated; while the testicles secrete too quickly, and an evacuation takes place without any erection of the penis; the latter disappointment is of extensive prevalence.
Impotence is sometimes occasioned by particular diseases during their continuance, such as nervous and malignant fevers; while, strange to relate, an opposite effect is sometimes produced by other diseases, such as gout and rheumatism, hæmorrhoids, &c.; and instances are on record, that others produce such a change in the constitution, that an impotent man may find himself cured of his impotency on their cessation.
Of all the functions of the animal economy, none are so subservient to nervous influence as those of generation, which, when the organs are perfect, and respond not to the natural application of them, the cause may be classed among those impediments termed moral.
As the parts of generation are not necessary for the existence or support of the individual, but have a reference to something else in which the mind has a principal concern; so a complete action in those parts can not take place without a perfect harmony of body and mind, that is, there must be both a power of body and disposition of mind; for the mind is subject to a thousand caprices which affect the action of these parts.
As these cases do not arise from real inability, they are to be carefully distinguished from such as do; and, perhaps, the only way to distinguish them, is to examine into the state of mind respecting this act. So trifling often is the circumstance which shall produce this inability depending on the mind, that the very desire to please shall have that effect, as in making the woman the sole object to be gratified.