Depending upon organic disorganization of the nerve-substance, we have all grades of loss of sexual power, from the simple chronic premature ejaculation to advanced and perfect paralysis of the organ. Any male who, from exhaustion of nervous force, cannot perform the act of copulation in a normal manner, may be said to be in a degree impotent. If he be able to effect intromission and then unable to complete the act, from premature ejaculation—providing this is a common occurrence—he may be said to be impotent. The continent may undergo premature ejaculation and not be impotent. Neither is flaccidity likely to follow ejaculation from such cause.
The more advanced cases of impotence are not even capable of procuring erections; and often semen is discharged in the flaccid condition without the knowledge of the patient: such may be the result of spermatorrhœa and impotence combined.
The long-continued and frequent indulgence of masturbation must be a most frequent cause of impotence. I have only observed a very few whom I knew to have brought upon themselves this condition without the habit of masturbation; and even then I am not positive in knowledge. Yet they were rare debauchés, with money to squander and appetites so salacious that the almost constant contact with women was their custom. On the other hand, it seems that a male human being is constructed for endurance of his sexual organs. A notorious polygamist in practice, once living in the city of Elmira, New York, was known to lavish his smiles on his “kept women,” whom he numbered by scores, and still he was potent till he died in advanced life. We must have a most excellent example in the famous President Young whose wives, we are inclined to believe, must have kept him on the qui vive, as his children bear evidence, as well as the fascination and attractiveness of his young wives.
The exciting cause of impotence must combine a constant and long-continued sexual debauch with the depraved chain of thought that must necessarily accompany such degradation; and the practice of self-pollution must be the most fruitful of all causes.
[Treatment.]—In the management of impotence, the patient’s persuasive influence must not in any way change the intentions of the physician, or the fast hold of his mind, which is so indispensable to a cure, will be lost. The patient is always in great haste, and constantly urging the physician to make rapid progress. Too great firmness cannot be exercised, and promises of speedy cure will invariably fail. Time is one of the most important of all elements in the treatment, as opportunity is afforded for the recuperative powers of nature or physical forces to become poised.
Perfect confidence in the medical adviser is prerequisite to success, as by this alone can the patient’s mind be manipulated, and his hope constantly stimulated. If he has been much exercised in mind about his case, from reading “self-abuse” literature, moral treatment will be required to dispel from his mind the pictures there wrought. Not always can the virile organ be restored to its normal vigor, but elevating the general health should be first considered, and the patient’s mind kept constantly thinking about his improving physical condition, instead of watching for the first erection as he will most naturally do.
When the foregoing conditions cannot be secured, no benefit will result to the patient. In no disease has mental influence so much to do with recovery, as in impotence; and I do not hesitate to say, where I can control my patient’s mind, that I can always effect a very satisfactory relief. Employment is indispensable, and must be persisted in. The patient should have no time to play, or brood over his disease, but must be engaged so constantly that he will be even fatigued after he has finished his day’s toil, and will sleep long and soundly from his exhaustion. The most nutritious diet should be selected: meat, eggs, oysters, milk, etc. Cold bathing at night, before retiring, is a very important measure; as, first, it washes the parts of a cold, clammy sweat, and the chill from the water after reaction, produces a naturally warm feeling, and his attention is not attracted to the parts by their otherwise doughy, unnatural feeling; and secondly, the tonic properties of cold are of lasting benefit. The bathing should extend to the back, perineum, scrotum, penis, and down the thighs. Such constitutional measures should be resorted to as will favor any of the imperfect processes in the body. The means should favor assimilation of food and normal excretion, and the avoidance of stimulating diet and alcoholic liquors.
For the neurosis upon which impotence depends, I have accomplished very much by a single combination of medicine ([see formula No. 1]), that this preparation has been, as it were, a “stand-by” for many years; the patient gradually improving under its use, in nearly every case. I can affirm that it has been tested in hundreds of cases, in a great majority of which marked improvement has taken place, and many have been permanently cured. Many were cured before I became familiar with the importance of electricity in the treatment of such cases; but since having extensive experience with the various methods of applying electricity I confess I could not do well without it.
As to the beneficial results following galvanism and Faradisation, there can be no question; but as to which of these forms should be applied, I am not always able to say. I have used galvanism without benefit, a certain length of time, and changed to Faradism with immediate improvement; and vice versa.
I do not opine that either form, if used mildly, will often do harm; and where improvement does not follow after a reasonable length of time, I would advise a change. When the patient is wakeful and restless, a pleasant effect is produced by Faradisation, which is often a favorable sign, and may be continued with exalted expectations. In very advanced cases, the galvanic current will oftener establish an improvement, when a change to the Faradic current will continue the improvement. I consider no means of the physician demanding so much judgment and experience as electricity; and in the skilled operator’s hand much good may be realized from its use.