Practical remarks on the treatment of spermatorrhoea and some forms of impotence / by John L. Milton.

  • Milton, J. L. (John Laws), 1820-1898
Date:
1854
Catalogue details

Licence: Public Domain Mark

Credit: Practical remarks on the treatment of spermatorrhoea and some forms of impotence / by John L. Milton. Source: Wellcome Collection.

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    ON IMPOTENCE. There are one or two points connected with the pathology of impotence which are not so clear as one might wish; or rather, to speak more plainly, respecting which con¬ siderable confusion seems to prevail. The function of generation being the most truly remittent of all we are acquainted with, being liable to cease for years or even for life without any injury to the health, may be supplanted by disordered innervation of some other part. By disordered innervation, I mean pain, either gouty, neuralgic, &c., in some near part, especially about the neck of the bladder, or else exalted function in some distant part, as indigestion, cerebral excite¬ ment ; and by supplanted I mean, that when these actions are set up, the function of ge¬ neration ceases, as if the vital force neces¬ sary for it were absorbed by the diseased action. Thus— Obs. 1. From Neuralgic Pain.—A patient, an elderly man, had suddenly become impo¬ tent ; it had not occurred, as it mostly does on the advance of old age, with a gradual decay, the emissions becoming less and less frequent; on the contrary, it had com© on quite suddenly, and at the same time severe pain had set in at the neck of the bladder. This continued, with great irritability of the bladder and pain at the glans penis; some¬ times a little blood came after passing urine. He was sounded for stone, but none being found, it was considered ulcer of the neck of the bladder. To relieve this, injections of nitrate of silver were tried ; the first pro¬ duced great pain, but some relief followed, and a second was given ; the pain after this grew more severe, and now never left him day or night. While at the height of his sufferings, he was attacked with dysentery. I was in the country at the time, and on my return to town 1 found him rapidly sinking. He died shortly after, and I examined the body. Great part of the colon, and about eighteen inches of the ileum, were almost gangrenous ; but nothing abnormal was dis¬ covered in the genito-urinary organs, except that the mucous membrane of the prostatic part of the urethra was of a vivid red; the testes, ducts, &c., seemed quite natural. When Rosseau, in whom both cerebral excitement and spasmodic pain at the neck of the bladder, with retention of urine, oc- curi*ed at a very early age, producing tem¬ porary impotence, died after a life of suffering, no organic change was found, although the organs were examined with the greatest care, so that the physicians concluded that his sufferings had been occasioned by a spas¬ modic state of the parts near the neck of the bladder, or of the neck itself. Obs. 2. From Gouty Pain.—A gentleman, a strong, healthy, active man, in the prime of life, consulted me respecting impotence, of which he gave the following account After having been long tormented with flying gout, notwithstanding a very temperate life, he had been suddenly relieved from it in the great toe, the last spot it had settled in, and had been attacked with great pain in the urethra, and some difficulty in passing urine. A bougie was passed, and as the obstruction yielded and recurred very suddenly, the disease was pronounced spasmodic stricture; but from the history of the case, and having met with several very analogous instances, I am induced to suspect that gout in the urethra was the disease, and the stricture and impotence (which was not caused here by the stricture) were its effects. Obs. 3. From heightened Function in other Parts. — A gentleman applied in extreme terror at having become suddenly impotent. As he appeared young and healthy, I felt surprised at this. It turned out that having neglected his studies until his examination was close at hand, he had become alarmed, and had betaken himself to them in the most irrational manner, going to bed with his book in his hand, ready to begin in the morning, and sitting up in bed to sleep, for fear, if he lay down, he should sleep too long. He had become exceedingly nervous, and found that on thinking of connexion, vigo¬ rous erections came on; but that on attempt¬ ing connexion they’ immediately subsided, and, while subsiding, emission took place. Quiet, relaxation, and mild aperients, soon restored the balance of the functions. From Stricture.—When impotence comes on gradually in patients still in the prime of life, as from forty to fifty years of age, the emissions growing gradually more feeble and fewer in number, a mere sensation accom¬ panying them, like that of evacuating urine or passing faeces, stricture may often be sus¬ pected. It is the more important to attend to this, as many of these patients persist in stating that the stream of urine is as large as ever it was; or never having had gonorrhoea,
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