Reflex irritations have often prevented recovery, and even produced grave manifestations. Cases of epilepsy have been reported from such peripheral causes, and cured by relieving the cause, or circumcision. The division of the sensitive nerves, which occurs in the operation of circumcision, often prevents involuntary spermal losses, and even permits such patients to perform normal copulation as had even ejaculated previous to intromission. Such little causes must not be overlooked. It is often in attending to little things that great results are accomplished; and in this we have no exception to the rule.
There is no room for a doubt in my mind that the Jewish rite was first established from hygienic motives only; and as “cleanliness is,” and always has been, “next to godliness,” circumcision would seem a very natural sacred rite for any religious sect to adopt.
We have no history of anything more ancient than the operation of circumcision. The Egyptian priests were practicing circumcision nearly 5,000 years ago. A translation of Herodotus informs us that such hygienic measures were in existence amongst the Egyptians in the most ancient of periods; and it is quite reasonable to suppose that the Jews obtained this rite from the Egyptians.
[Dilatation of the Anus]—[Anal Plug.]—A very troublesome complication of the genital structural changes occurring in spermatorrhœa is induration of the mucous membrane and sub-mucous tissues. Where such a condition is present, little benefit should be expected until relief is obtained from the local difficulty.
The dilatation should be accomplished by suitable means; such as by bougies, or a bi-valve rectal speculum. An anal plug may be constructed that is self-sustaining, polypoid in shape, which will be of more service than compression of the anal surfaces. The troublesome pruritus, and hemorrhoidal tumors, and indurated anal tumors, will gradually subside under such management. Suppositories of iodoform are also of invaluable service in reducing indurated conditions of the anus and rectum, as well as enlargement of the prostate gland. The old-fashioned stretching of the sphincter ani for spermatorrhœa, so highly recommended by Trousseau in his clinic on this subject, from indiscriminate use, is neglected, when it is really a most important means, deviating the reflex current from the genitals as well as relieving actual structural change in the anus. Roberts Bartholow has dwelt upon this subject without pointing out definitely such cases as it has actually relieved, leaving the reader to guess or find out for himself. The failures from its use have been so numerous, and the cases in which benefit has followed so few, that it is no wonder that it is not in better repute as a remedial means.
Whenever this dilating process is restricted to thickening and induration of the mucous membranes of the anus and rectum, much benefit will follow its use.
Many peculiar means have been recommended and are resorted to, many of which only need a condemnatory mention, which seems the more necessary that they are in almost general use. The most prominent is the porte caustique, which was probably introduced by Ambrose Paré, and improved and so highly recommended by Lallemand. Other prominent supporters of this manner of medicating the urethra and prostate gland were Wiseman, Hunter, Amussat, and Everard Home. The supporters of this manner of cauterizing the openings of the vesiculæ seminales were under the impression that spermal losses constituted the essential cause of the disease, instead of the habit the testicles had taken on by a hyper-supply or vicarious evolution of nerve-force.
We do not hesitate to say that this method is seldom followed by beneficial effects, and often by irreparable injury.
Bartholow advises its use in exceptional cases; “those in which,” he says, “the moral effect of the application is desirable.” From this I must dissent; as any superabundance of attention demanded may be bestowed by cauterizing or vesicating the perineum, obtaining an excellent moral effect and even accomplishing, by way of counter-irritation, physical improvement.