_Pseudo-Spermatorrhœa._――A male, enjoying the best of health may,
under certain influences, have an involuntary discharge of seminal
or prostatic fluid; but as the latter will be treated in full
below, I shall first consider accidental discharges of semen as a
pseudo-spermatorrhœa. Impressions are wrought upon the nervous system,
sometimes of a stimulant character――other times like a shock――that are
followed by involuntary losses of semen. It is not uncommon for semen
to be found in the clothing of criminals hanged by the neck; or for
soldiers to ejaculate semen at the time of entering an expected battle.
Involuntary discharges as often occur from the bowels under similar
influences.
But mental shock is not essential to the production of such relaxation
of sphincters. I have on numerous occasions produced an ejaculation of
seminal fluid by the strong currents of electricity passed through the
genitals, localized.
A cold bath has not been uncommonly the cause of such losses, in
perfectly healthy subjects. I was once riding, in company with a
friend, through the country on horseback. My friend had suffered some
rheumatic pains, for which I gave him opium and quinine in large doses
which, under the influence of the friction of the saddle, caused an
ejaculation of semen without erection or erotic thoughts. He was a
robust fellow, and knew nothing of sexual weakness of any kind.
Young men sometimes, and married men that have been continent a long
time, and bachelors commonly, are subject to spermatic ejaculations
involuntary, without genital debility. It has been stated by authors,
high in authority, that seminal losses two or three times a week
were only physiological. From this I must dissent. I do not wish to
be understood as saying that occasional seminal losses are always
injurious, but I do not on the other hand believe, as do some, that
even occasional losses are really and always physiological.
To think that the disease exists entirely in the act of involuntary
emission, is as great an error; as it would seem only rational that,
if a larger quantity of semen was manufactured than the vesiculæ
seminales could hold, the natural result would be an evacuation. Again,
I have known males to live continent and have involuntary losses for
ten years, as often as weekly, and no evidence of any general or local
debility. Yet I believe this to be an exception worthy of note. It is
quite useless to attempt to effect a cure in some of these cases of
pseudo-spermatorrhœa, as no real disease exists. Some of them will
continue: others are only transitory, and need only to be assured that
no wrong exists. Even if it is not physiological or desirable that such
things should exist, yet it is not actually pathological.
Again, so-called mental spermatorrhœa partakes partly of this
character; especially when a young man is so pathophobic, from mere
book-reading fright, derived from specialists and impostors, whose main
business is to scare a young man to pay out his money and be humbugged.
If he has not had emissions oftener than monthly, and he is of a
confiding turn of mind, a troublesome mental disease may be founded.
If no marked physical disturbance follows these occasional losses, I
generally inform the young man that he has been mistaken as to the
gravity of his troubles; thus putting his mind at ease, and the patient
in a position for self-recovery.
_Case._――Not long since, a young man was under my care who was
pathophobic; his mind constantly dwelling upon what he had read; and
the occurrence to his mind, that he had losses of semen as often as
once in six weeks――although he was a vigorous blacksmith――caused him
to imagine himself suffering with all the usual bad feelings of an
advanced case of nightly seminal losses. He appeared in good health;
was able to do a day’s work, and to work well; but, nevertheless, he
was neurasthenic, and at times very feeble; or, at least, he thought
he was. When once he could be made to forget his imagination, he would
be as strong as ever. The simple assurance that he would recover with
simple treatment was unavailing; but when persuaded to think much was
being done, and that his medicine was very potent, he soon ceased to
be troubled with his worry and was quite well, although he had taken
only a simple bitter. He finally became afflicted with a sore upon
his prepuce, which was of a herpetic nature _only_, and for which
he consulted a score of doctors, as the sore would appear from time
to time. All informed him of the harmless nature of the eruption,
but he had faith in no one until a venereal specialist reduced his
purse to vacuity, when he returned to me for advice. He was simply
syphilophobic, and demanded only a deceptive treatment, with assurance
that his trouble was of a local character and never could grow upon
him; but shortly his herpetic trouble ceased to appear, and something
else victimized his imagination. Such is the mental predisposition of
the nervous, imaginative class who _only_ suffer, to any extent, with
what to them appears to be disease.
Such a case of pseudo-spermatorrhœa would not irritate, in body or
mind, any person of good reasoning capacity; but, unfortunately, such
persons are not as common as may be supposed; hence, the deceiving
specialist has many willing victims.
_Prostatorrhœa_, may exist as an independent, uncomplicated and local
disease, or in conjunction with spermatorrhœa. My experience leads me
to remark, that the latter seldom exists without the former, but that
prostatorrhœa commonly exists as an independent disease; and when the
flow of semen does not amount to sufficient, in frequency, to consider
it a cause or a consequence of disease. In my judgment, this flow of
glary, viscid fluid is most commonly observed while straining at stool
from constipation. Young men very commonly apply to specialists and
exhaust their funds and return to the less pretentious family doctor
for a more satisfactory and truthful statement. Even with this little
discharge of prostatic fluid, and when no sign of spermatorrhœa existed
with it, the young man may experience all the phenomena of true and
long-standing spermatorrhœa. His mind suffers, as well as his body,
with imaginary nervous phenomena too numerous to mention. But in
these conditions it is not uncommon to find very troublesome disease
of the prostate gland, brought on by gonorrhœa, sexual excesses or
masturbation, existing alone or with true spermatorrhœa.
An examination will reveal enlargement and tenderness of the gland,
commonly irritation of the neck of the bladder. If we make inquiry, the
history of prostatic inflammation will be obtained, and gonorrhœa or
venereal excesses. Pressure upon the prostate, through the rectum, will
not uncommonly cause a discharge of prostatic liquid, which is followed
by a smarting sensation. Copulation and ejaculation are sometimes
followed by a burning pain in the prostate gland, which lasts sometimes
a few hours――commonly a few moments. Prolonged erection is followed
by a discharge of viscid fluid, not ejaculated, but simply flowing
away. When the bowels are constipated, as scybala pass the gland, a
viscid fluid is pressed out and drips from the end of the penis with
a smarting soreness, prolonged in the gland. The fluid is not hurled
forth, or ejaculated in jets, like semen, but a thin glary fluid. The
disease is commonly only local, and needs very little constitutional
treatment.
The tinct. staphisagria, so highly recommended by many, will often
act very kindly as an adjunct, but will not cure the disease. Cascara
sagrada must be used for a long time, to regulate the bowels and
digestion. Faradisation, localized and general, is the only agency that
may at nearly all times be relied on for permanent relief.
When the disease exists with true spermatorrhœa the above treatment is
none the less essential, and only needs modification to meet special
indications.
The manner of using electricity for the relief of prostatic disease
is very simple. My experience has led me into the habit of placing
the positive pole as closely in contact as possible with the gland. I
sometimes introduce an electrode into the urethra――other times into the
rectum――connecting the anode, and with the cathode and large wetted
sponge stroking the lumbar and sacral regions, especially over the
origin of the hypogastric nerve and plexus. If there be tenderness over
any part of the spinal cord, I change the poles and apply the anode to
the spinal tenderness. Such tenderness is very common over the sacral
plexus. Again, it is important in the way of ascertaining causes, to
know which antedates the other, the prostatic tenderness or the spinal
tenderness; and the anode should be applied to that irritation which is
found to be the most ancient; as, commonly, upon the spinal tenderness
the prostatic irritation depends. But this rule is not always tenable,
yet will answer very well in a new case until an electric test, as it
were, is obtained.
Whenever unrest, pain or fulness follows the use of one pole to the
gland, it is safe to change; as such is not the desired effect. There
is no one thing so needful in the use of electricity as familiarity
with the physiological effects wrought. Every electrician has marked
out the management of a patient, and the course proper to pursue, only
to find an entire change necessary, after the first application. Many
cases are plain, but many more are wonderfully obscure; and only after
repeated practical tests, do we find the proper current, intensity and
quantity adapted to a given case.