A positive code of government, rigidly followed, is indispensable; as well as perfect confidence in the managing physician.
The nasty drugs of our old-fashioned materia medica will not cure these cases The bringing about so-called tonicity, by tonics and nervines, only needs to be tested for a short period to convince any practical physician how useless is such a procedure, and how soon his patient will find another attendant. Drugs are often useful but bad ones, selected for a tonic principle only, will as often do harm. Only with a definite object in view, should we expect to accomplish such changes as can result in positive relief. The list of nasty tonics for indefinite purposes, or such as “have been used in such cases,” the author has resolved not to, in any manner, refer to, and at no time will he direct an agent or combination of drugs on so-called “general principles,” but with definite expectations only.
[Spinal Congestion.]—The group of manifestations pointing to spinal congestion will first receive attention. The remedies are bromide potassium, bromide ammonium, ergot and belladonna, with electricity.
These are selected also with reference to conditions only; yet the reader can evidently see that their ultimate effects are aimed at, as all of this list of agents affect the calibres of capillary blood-vessels; therefore, the engorged spinal vessels are unloaded by contraction, perhaps, of capillary parietes.
By this effect of drugs we aim at relief of the long compression of the cord, and liberation of nervous energies and forces supplying the organs of nutrition and assimilation.
It is pre-supposed that all sexual excesses and vices are under control; otherwise, all treatment will be useless.
Numerous are the contrivances to control or prevent seminal emissions. They have all failed, and nothing is lost; as only the effect is looked upon in their construction, and not the true nature of the disease; therefore, to prevent spermal losses is not the first object to accomplish, but to relieve the nerve-centers, which preside over the manufacture of semen, of these abnormal structural changes; and the loss of semen will abate. No instrument will then be required; and if this centric improvement cannot be effected, the patient is beyond help. No mechanical contrivance will relieve the centric lesions; therefore, such appliances are useless. The loss of semen is not a disease, only a manifestation or a phenomenon of centric lesions; and as we have said heretofore that spermatorrhœa is not even a cause of such lesions; but sexual shocks, often repeated for a long time, are the cause of the neurosis through which we have spermal losses—true spermatorrhœa. This reiteration is made that no mistake may be made in interpreting the means of relief, which are all aimed at the lesions instead of their phenomena.
When the patient is not too much debilitated, chloral may be administered to produce sleep; but very commonly the ergot or ergotine will allay all nervous irritation and bring on perfect rest. Large doses are demanded, as much as two grains of Beaujon’s extract three times per day, or one drachm of Squibb’s fld. ext. or an ext. of equal strength should be used. Belladonna should be used by commencing with small doses and gradually increasing until asthenopia is produced, when small doses should again be used: by this means the extent of tolerance may be ascertained, and that dose should be continued which does not affect the eye. When the bladder is involved and urine is voided with a lack of expulsive energy, or the urine dribbles away, ergot and belladonna are the remedies. Where there is extensive hyperæsthesia the bromides are better agents, and also to overcome any reflex irritations.
Hot applications to the spine are often followed by very excellent effects, as the relief of pain and other troublesome symptoms.