Sexual Neuroses

by J. T. Kent

The condition is a loss of excitation-power of the nerve of Eckhard, whereby all physiological irritation becomes impossible. This nerve arises from the sacral plexus, any irritation of which, in a healthy state, causes a flow of blood to the corpus cavernosa and spongiosa of the penis; but the constant stimulation of this nerve produces a loss of irritability and paralysis of the parietes of the arterioles of the erectile bodies of the penis, and no relaxation of their valves occurs at any time: a perfect vascular inactivity is the result. These arterioles anastomose with corporal venules which are very tortuous and sacculated and supplied with very large openings and very small outlets compared with the magnitude of their calibres; but the often turgesced condition of these venules causes a dilated condition of the outlets, and any blood that may be conveyed into the corpora through the arterioles will flow out so fast through the dilated venule outlets, that the turgescence necessary to produce erection is impossible. Again, the innate contractility of the trabecular substance must antagonize, to a considerable extent, the erectile tendency of surrounding tissue.

Then there is another condition so closely connected with impotence that a mention of it will not be out of place. Impotence consists in a lack of power to effect an erection; but there is a condition, not always impotence, where the person has lost all desire for copulation, and will not make an effort to obtain an erection. He does not attempt to concentrate his will-power, and does not desire any relation whatever with the opposite sex, although he may have been a debauché in his early life. When such a condition has been congenital, there would be reason to suspect deformity or congenital defect. Such person may not be impotent, and if the desire returns it manifests itself in the genitals as soon as the mind is allowed to dwell upon erotic thoughts; and if erection does not occur impotence is present.

The loss of semen often subsides in the aged, and atrophy of the testes is not an uncommon result; but some people live to be very old, and are never troubled with senile-impotence.

The penis is at all times flaccid, if impotence be complete. Often partial impotence will reveal itself, deviating peculiarly in its character. Sometimes a man will, while entertaining erotic thoughts, have an erection of the penis which is perfect in all appearance, and when brought in contact with a female cannot sustain or even procure the erection, and yet the erotic desire be just as intense as if he be able to perform the act in a proper manner. These cases are practically impotent, but the disease has all to do with the mind; and as soon as the mind can be so corrected that self-control may be exercised as well as self-confidence, just so soon will the impotence disappear; and once the act is performed normally, the trouble will be at an end. But there is a condition in which all the powers of mind and body, exercised to control, will not impart either the power of erection or the erotic desire—only a longing for that once felt erotic desire exists. The condition often exists in which the patient cannot control the mental impressions, so as to effect that peculiar concentration of the nervous force which gives energy to the sexual organs; and yet there may be no disease of such nerves themselves. It is the same condition that will cause the mental operations to fail during any course of anxiety, or turbulence of the emotions. A speech-maker may fail in his efforts at first, even after he considered himself prepared for every emergency; but as soon as allowed to collect his scattered mental evolutions, he may compose himself.

Inability to perform the sexual act while suffering from any mental derangement, or misunderstanding one’s own mental elaborations, is not impotence; but there must be impairment of the integrity of the nerve-substance that evolves the force that sustains the sexual organ in its erect attitude, and also supplies the so-called physiological irritation. If we attempt to name this peculiar disease from other stand-points, we shall become confused; as it would only demonstrate a function-disease, which is an impossibility and leads to confusion.

I have seen cases of so-called impotence from intestinal worms: while impotence is not generally considered a symptom of worms, yet this is a case which recovered as soon as the worms were expelled. I have known two cases that supposed they were permanently impotent, both of which obtained relief after the expulsion of a tænia solium.

These were cases of symptomatic impotence; which only means phenomena that may exist in remote structural disease, or by mechanical pressure, as from foreign bodies, lumbricoide, tapeworms, etc., pressing or directly or indirectly infringing upon the nervous track that conveys the force which supplies the erectile tissue of the penis. This is a paralysis of the vaso-motor variety, in which the impotence is only a symptom: the disease must be studied under nervous diseases.

To comprehend and study true impotence, the student will be attracted to the brain and spinal cord; as there only can the pathology be carefully comprehended.

Nearly all the descriptions of this perplexing malady have been confined principally to the chronic flaccid penis and the general nervous phenomena most likely to co-exist. I must say that our knowledge is very limited beyond the superficial sources of information; and we have to content ourselves with simply describing the appearance, for the real disease itself; not but what structural changes exist in the sexual organs, worthy of note, but such changes are only secondary.