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
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Licence: Public Domain Mark

Credit: Practical remarks on the treatment of spermatorrhoea and some forms of impotence / 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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    ON SPERMATOKRH(EA. It has always appeared strange to me that this affection should remain abandoned by the profession to a few solitary speci- alists, and for the benefit of the vile harpies who prey on this class of victims. Surgery, which has wrested so much from empiri- cism and ignorance, seems disposed to jfield up this, as if it were debateable land, to cliance, philosophy, utter neglect, or quack- ery. Although of late years several publications have appeared, from men of the most un- questionable talent, such as Lallemand, Phillips, Curling, Russell, &c., yet I very much doubt if our knowledge of sperma- torrhoea is exactly what it should be, or if the treatment, except as regards the employ- ment of caustic, has advanced materially since the days of Hunter. Thus during three-fourths of a century the shadow has moved but once on the did. To the treatment alone, then, this paper refers, a branch of this art almost forsaken, I think, by the general practitioner, and not too well cared for by the pure surgeon. This neglect, and the twofold indisposition of the patient either to trust his ordinary medical attendant with the secret of his disease, or to permit him to exercise that operative interference which the specialist will perhaps insist on; the extent, the man- ner in which the question has been studiously burked, and the absence of any well-known source to which he can turn for information, have had the natural effect of driving him to those who will make it their business to let him know, that so long as he has money there is one city of refuge to which he can always fly, and that there are men who can treat his complaint with medicine alone, at the moderate rate of “ five guineesh de bottle.” Yet with strange inconsistency men won- der at and deplore the growth of quackery, though this hydra would soon perish of inanition if deprived of the food supplied by our neglect. Advance in the treatment of disease, aided by the revival of the pillory or stocks for the more audacious of the quacks, would do a good deal to strengthen the arm of medicine. As I have already stated that the treat- ment of the disease was to be the chief sub- ject of discussion, I shall delay no further than seems absolutely necessary to explain the plan of the remarks I wish to make. All questions as to the nature and causes of this affection I have left out, as too long for this paper, and I have only laid down di- visigns of this disease, in order to have something tangible to which the divisions of the treatment could be appended. Spermatorrhoea admits of a very natural division into—1. Night Discharges; 2. Day and Night Discharges; and 3. Imperfect Secretion of Semen. 1. Night Discharges.—These constitute the mildest form of the complaint, and are, as is well known, a common result of seminal plethora; they seldom require much treat, ment, unless in excess, or when complicated with gleet, stricture, or discharges in the daytime. 2. Night and Dag Discharges.—^A more ad- vanced grade, and in their worst form often bordering on the third class. The urethra is sometimes red and highly irritable, and the health severely impaired; but happily for the patient both varieties are for the most part easily curable. 3. Imperfect Seeretionof Semen.—The most severe of aU, and necessarily accompanied by temporary impotence. Instead of pro- perly eliminated, healthy, consistent semen, a thin, rank fluid, unaccompanied by almost any signs of erection of the penis, is thrown off under the influence of the slightest ex- citement. Intense irritability of the urethra, and a marked dread of examination, usually complicate this form. Gleet of the Prostate and Seminal Vesicles not a form of Spermatorrhoea.—There is a variety of the disease which is generally con- sidered as spermatorrhoea, and with which .most surgeons are familiar : I mean the dis- charge ^ter stool of large quantities of glairy, tenacious fluid, supposed to be the contents of the seminal vesicles. Now, I very much doubt if this be an evacuation of semen: part of it, I suspect, comes from the prostate; and in my w’ork on Gonorrhoea (p. 101), I adverted to the cure of a case of this kind as being probably an instance of prostatic gleet. And altliough it very likely comes in part from the seminal vesicles, I 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 ■Bccive the superabundant secretions of the testicle; but whatever it may be, it demands our urgent attention, in order as tvell to allay the patient’s uneasiness about so dis- agreeable a symi)tom, as also to leave no chance for the germs of disease to act upon.