Case.—J. W., when he first visited my office for examination and advice, was emaciated, pallid, with his eyes sunken. He was careworn and haggard in his expression, suffering from pain in his back and limbs, almost constant pain through the top of his head; palpitation, with accelerated pulse; formications over his back and in his finger-ends; bowels constipated, and urine smelled strong like a horse’s; tender spots along the spinal cord. The testicles and scrotum were doughy and constantly moist and cold. His scrotum was long and pendant: his penis was blue and flabby. He could only obtain partial erections, very occasional. He lost semen often. His urethra was very tender, also the prostate gland. He was restless and wakeful during the night. I directed local cold bathing, Faradisation, formula No. 1, for his general neurotic condition; pills—formula No. 2—for constipation. He took chloral every night, to produce sleep, for 3 months; tr. staphisagria, small doses, for prostatic irritation, and occasional opium suppository. I discharged him after sixteen months, when he married, and now has a healthy child.
Case.—R. confided to me his history, which was, he had been a debauché and masturbator. He was tall, slender, anæmic, beard thin; was suffering from too much medicine, which he had received from unprincipled specialists, as he had been three years in their hands. There was spinal anæmia, judging from the spinal soreness, and formication at times. He thought he would become paralyzed, as his hands and feet often became numbed. He was impotent, and often lost semen. His urine contained spermatozoa. As soon as his mind could be put at ease he began to improve, under formula No. 1, with cold local bathing, as directed, with Faradisation. I discharged him after thirteen months.
[Aspermatism.]—Since Roubaud’s description of this condition, and especially the application of the above term, much has been said in regard to the causation and true nature of this peculiar deficiency. Whenever sexual orgasm occurs in the male, after puberty, without ejaculation, the condition known as aspermatism may be said to exist, and may be considered as a symptom of disease. This may be partial or complete. I have known a number of individuals who failed to ejaculate semen at the time of sexual orgasm, and the semen would pass away in jets some time after the penis had become flaccid. These cases exist where there is no sign of organic stricture of the urethra, or any other organic trouble within the prostate gland or ejaculatory ducts.
Dr. Van Buren is the author of a paper which appeared in the New York Med. Journal, November, 1868, in which he attempts to establish the cause as a spasmodic condition of the urethra, forcing the seminal fluid, by reflux action, into the bladder. I can not, at present, think that this is always the case. Only a little attention to physiology will familiarize any person with the calibre-contractions that follow a column of urine from the bladder to the meatus. This same muscular contraction exists in the veins, and is what constitutes the venous wave. The same wave exists in the ejaculation of semen; and where the muscles that perform accelerating movements are paralyzed, the natural consequence must be, that the fluid will remain in its reservoir until its place is supplied by new, and a portion is forced out along the urethra, which drips away when the penis returns to flaccidity. Then, I can but regard this condition, often, as one of paralysis, in which are affected the muscles of ejaculation and acceleration. This condition often exists where the genitals are not impaired as to potence. That such a condition is present, should not be declared until after bougies have proven, to entire satisfaction, the absence of organic stricture or spasmodic contraction.
When such a lesion has come on gradually and is of long standing, the prognosis is very unfavorable; as relapses will most generally occur with the slightest indulgence. But when the condition has made its advent suddenly, from inflammatory causes, the prognosis is very favorable. A gonorrhœal orchitis will often produce this condition, which is only transitory, or of a few months’ duration. This is only symptomatic, and very much unlike the true aspermatism of a neurotic origin.
A very extraordinary case has of late engaged my attention and curiosity. No case of the kind have I been able to discover, in medical literature or in the practice of my medical friends.
Case.—A young married man consulted me with an affliction (as it were), much to the discomfort of himself and to the great injury of his wife. He never had passed the sexual orgasm, nor ejaculated semen during coition. He is very erotic, and has no difficulty in performing the marital act, but it is followed without the slightest satisfaction. He continues in the act of coition until exhausted, and retires with the wife very much in the same condition after repeated sexual orgasms. He informs me that one hour is not an uncommon length of time for him to occupy in the act of coition, participating in the sexual beatitude during the entire period, until gradually becoming exhausted, when the pleasure dwindles away, but his penis remains erect for some time after. He says that he has often applied cold water to facilitate flaccidity.
After the organ has been reduced he sometimes can detect semen, or prostatic fluid, on the glans and meatus, and he is very soon ready to perform the act again. I have often discovered spermatozoa in his urine. His testicles are well formed, and his penis is normal in appearance. He has never had a venereal disease, and has no stricture. Treatment has given no relief as yet. It will be observed that satyriasis is prominent in this case.
Galvanism will often be found of great service as a paliative measure, with phosphide zinc and nux vomica. If a few years’ continence can be obtained, a better prospect for recovery may obtain. When galvanism is used, an insulated electrode should be passed to the orifices of the ejaculatory ducts, with the anode attached, and the cathode applied to the cord with wet sponge. I have derived some benefit from localized and general Faradisation, after the manner heretofore mentioned.