I do not prescribe for seminal losses under any consideration: I simply ignore them during the whole course of treatment. Where the general health improves, and with that the nerve-symptoms, the seminal losses become less frequent and finally cease. As the involuntary discharges diminish, we may conclude the central lesions are improving.
[Cerebral Sexual Neurosis—Treatment.]—The most prominent feature of the cerebral manifestation is mental asthenia, or feeble-mindedness, from real exhaustion of all the forces; a general lack of power.
To impart vigor to the general nervous system must be the first indication. For this purpose dil. phos. acid may be administered. If the extremities are cold the hypophosphites are of positive benefit, and must be continued for a month or more. Tinct. nux vomica imparts tone to the nerve-centres. When active symptoms are present the bromides act very kindly, and may be combined with ergot, or the latter may be used separately with most excellent results. But the physician must be certain that he has a case of hyperæmia, before such agents are resorted to, and then they should be given in large doses.
Electricity, in the form of general Faradisation, seems to be of the most service, and must be applied daily for several months. Only a feeble current should be used.
The structural changes that have occurred in the genitals always demand attention.
Chronic turgescence of the prostate gland will best be treated by the internal use of tinct. staphisagria, large doses of bromide of potassium, and the introduction of catheters increasing in size until the urethra is fully dilated.
Electricity should be used as recommended under [Prostatorrhœa]. The organic stricture, which is so commonly present, should be treated by dilatation with suitable bougies or catheters. The bougie must be used as often as twice a week, until the full size and elasticity of the urethra are obtained.
Injections are sometimes useful. A solution of nitrate of silver, ten grains to the ounce of water, used only once, and followed by a solution of brown sugar (sacch. communis), morphine and rose-water, will answer a most excellent purpose. After the acute inflammation has subsided the bougies must always be resorted to, and used persistently until the object for which they are used is accomplished. Any ulceration may be relieved by injections of permanganate of pot., not stronger than one-half grain to the ounce.
The glans and prepuce should be closely scrutinized from time to time, and if the prepuce be of undue proportions, or if the patient is filthy, permitting accumulations to form beneath the folds and creating a local irritation, circumcision should be performed without hesitation.