Practical remarks on the treatment of spermatorrhoea and some forms of impotence : reprinted and enlarged from the original papers in the Lancet / by John L. Milton.

  • Milton, J. L. (John Laws), 1820-1898.
Date:
1856
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Licence: Public Domain Mark

Credit: Practical remarks on the treatment of spermatorrhoea and some forms of impotence : reprinted and enlarged from the original papers in the Lancet / by John L. Milton. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    belong to no one form or stage, while they partake of the character and symptoms of several. It is to be recollected that I do not profess to describe the symptoms and pa- thology, though, perhaps, the cases given further on would furnish a better picture than any mere description. Gleet of the Prostate and Seminal Vesicles not a form of Spennatorrhcea.—There is a variety of the disease which is generally con- sidered as spermatorrhoea, and with which most surgeons are familiar: 1 mean the discharge after stool of large quantities of glairy, tenacious fluid, supposed to be the contents of the seminal vesicles. Now, I very much doubt if tliis be an evacuation of semen: part of it, I suspect, comes from the prostate; and in my work on Gonorrlioea (p. 101), I adverted to the cure of a case of this kind as being probably an instance of prostatic gleet. And although it very likely proceeds in part from the .seminal vesicles, 1 should scarcely be disposed to admit it to be a discharge of semen, for I have not been able to satisfy myself that these receptacles receive the superabundant secretions of the testicle ; but whatever it may be, it demands our urgent attention, in order as well to allay the patient’s uneasiness about so dis- agreeable a symptom, as also to leave no chance for the germs of disease to act upon. Mr. Hunter, the Newton of medicine, whose true merits, to my thinking, even overshadow those of the giant of the physical sciences, says:—“ Di.seases of the vesiculs seniinales are very familiarly talked about, but I never saw one. In cases of very con- siderable induration of the prostate gland and bladder, where the surrounding parts have become very much affected, I have seen these bags also involved in the general disease, but I never saw a case where they appeared to be primarily affected.”* So far as I can learn, all other trustworthy obser- vations confirm this view. I have never heard of nor seen a case in which disease of the seminal vesicles alone was detected ; in a few rare instances they become mechanically involved by the spread of the destructive action, hut they generally remain free in the most extensive disease, either of the urinary or generative organs, f * On the Venereal, p. 283. i Mr. Uransby Cooper says, in ilic ■13rd volume o the '* .Mediea] Gazette—** The vesiculm semi- nales are but rarely attacked by disease, but they lave been found after death filled by scrofulous ueposils of tile cheesy matter so frequently met witii indiil'erent parts of the body in strumous dia- lesi.s; but where this condition exists, l/icrc arc no symptoms developed during life indicative of the ciiange that has occurred, 'i bis, however, probably .irises from so little being known of the true fuiic- liuiis of the oreuii. Bnt it would appear that at least two ca' er of disease of these vesicles have been le- ported on good authority. In one, where death ensued from abscess, reported by Mr. Mitchell Henry, in the Medico-Cliirnrgical Transactions, 1850, the seat of the abscess does not seem to have been detected till after death ; and in a case communicated to that gentleman by Mr. Cock, the seat and nature of the disease were only revealed at the end of three weeks, and then almost by aceident; there being in neither any very characteristic synvptoms. The principal argument made use of to prove that the seminal vesicles are the re- eeptacles of the semen is the presence of spermatozoa or zoo.spenns in them ; M. Lal- lemand, on examining thirty-three bodies, found spermatozoa in the seminal vesicles of thirty of tliem ; but only in the testicles of two, one of whom had died from a fall, the other of gastro-eiiteritis ; which he thinks would go to show that these animalculse are formed in the testes, and then pass into the seminal vesieles. The next argument is, that small, brilliant, granular bodies are found in the urine of spermatorrhoea patients j that they are met with in the masses of mucus squeezed out by these patients after going to stool; and as they are found in the seminal vesicles, of course these are receptacles of semen. These are also met with at all times in the semen of healthy men, and in great abundance in that of birds just before, the testes become ripe.* The third is, that sper- matozoa are wanting or few in the organs of castrated persons. Barbieri, who has adopted this view, contends that at the entrance from the vas deferens into the seminal vesicles there is no valve or fold, and the tube being wider, the path into it is much easier than along the ejaculating duct, the distal end of which, except under certain conditions, is probably closed. Mr. Pritchardf says, “The molecular motions of Dr. R. Brown—viz., those seen under a deep magnifier in a drop of water in which finely divided gamboge or other org.inic substances have been triturated; these motions have been compared with the spermatozoa of animals and plants, which arc now considered as physical vwtions only.” Here, then, we have the alpha and omega of scepticism and credulity ; the one elevating these little cells for they are nothing more —into the essential part of the most im- portant of all secretions, the other viewing them as a mere appearance, jiroduced; I pre- sume, by causes acting from without. * See a paper read by Mr. Gulliver at the Zoo- logical Society, .luly 28, 1812. + ■'A History ot jliifusonal Animalculus,'’ 1852.