Results from treatment in these conditions are particularly gratifying
and offer a great field of activity in this day of sensational medical
advertising. This condition can well be classed under four heads,
Exhaustive, Traumatic, Psychic and Organic.
=Exhaustive Impotency= is the result of functional abuse, masturbation
in early life, excessive venery, coupled with intemperate use of
alcohol and improper diet without sufficient sleep. It can be
symptomatic in neurasthenia. There is at first irritation of the spinal
centers, which causes exaggerated sexual activity, and later this is
followed by complete or partial loss of function. The first step is
for a radical reform in habits; regulation of the bowels, as they will
likely be constipated; direction of the mind into wholesome channels,
and then skillfully directed spinal treatment. Where there has been
masturbation, look well for sources of irritation to the parts; a
long foreskin or adherent prepuce indicates surgical aid, or there
may be a lesion at the sacrals involving the nervi erigentes or, of
greater importance, the pudic nerve. The innominatum can be at fault
in this. The lower dorsal, ribs and upper lumbar are of importance.
Kraft-Ebing says: “Conditions of absolute impotency are, however, rare,
and are caused =only= by severe vertebral and nervous diseases.” Nerve
irritation undoubtedly is the cause of sexual perversion (outside of
heredity and malformation) so their relief is as necessary to bring
about reform of habits as to effect a cure. Where the general health is
affected constitutional treatment should follow. Motschutkovsky uses
suspension in treating these cases with good results. The effect is to
separate the vertebræ, freeing spinal nerve and blood channels. The
prostate will probably be found in an irritated, sensitive condition,
as well as the seminal vesicles. Treat as outlined under the prostate
gland. Ligation of the dorsal vein of the penis is recommended by some
authorities as tending to aid turgescence of the organ. Prognosis is so
dependent on how well the patient follows directions, age, environment
and general condition that it is hard to give, but as a rule is rather
favorable.
=Traumatic Impotency= is a strictly osteopathic classification, for
the reason that sexual weakness is often traced to lesions resulting
from remote injuries. These injuries may be to the spine, ribs or
sacrum. The lower spine may be impacted from a fall or the result of
long continued riding on rough streets or the railway. This inhibits
the nerve supply to the extent of often seriously impairing the sexual
functions. If the cord is injured to any extent the results are more
serious. Treatment in these cases has given uniformly good results. It
will always be due to a specific lesion, so the examination must be
thorough.
=Psychic Impotency= is the form most frequently met with and generally
the most difficult to cure, yet it should not be if the patient’s
confidence can be secured, for in many cases sexual power is but
slightly impaired, but owing to the suggestions given by the medical
advertisers the victim diagnoses his own case as hopeless. “It is not
uncommon that virility returns with the peace of mind.”[50] Observe all
the procedure given and then inspire hope where it can be honestly
given, and if the patient is progressing favorably, other things being
equal, advise early marriage under strict rules of conduct. If already
married, conjugal relations should be most carefully investigated and
the wife taken into your confidence. Her cooperation in correcting very
possible errors in sexual matters, as well as sympathetic aid in easing
the patient’s anxiety and chagrin, will be invaluable. Nothing but
the frankest understanding between all parties is permissible and the
osteopath must be in absolute control.
=Organic Impotency= is the result of a cortical injury or disease. The
latter is the most common, as it follows tabes dorsalis, paralysis
affecting the lumbar cord, some cases of diabetes, etc. Also, any
congenital malformations or absence of all or part of the organs.
Prognosis in these cases is bad, as cure is seldom possible.
In no other class of cases will honesty, tact and good judgment count
for so much or the rewards be greater.