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There are certain affections not at all uncommon and as a rule producing rather serious effects upon the social body, of which, though their existence is well known to all, very little is said. It is certain that what is considered the more severe of these venereal diseases may be acquired quite innocently. Indeed, many thousands of cases of this affection, acquired innocently, have now been reported by medical men in this country alone. If the statistics of all the world were gathered together, there would probably be a hundred thousand cases of this dreadful affection, which have been acquired without any blame on the part of the sufferer. It has become the custom, especially in English speaking countries, to ignore the presence of these diseases, and this has led to a multiplication of opportunities for their spread to such a degree that now the condition of affairs, for those who know it best, is rather alarming. It is with the intention that a few definite ideas, given absolutely without exaggeration and without any striving after effect, may enlist clergymen, as well as physicians, in a crusade against these diseases, that the present chapter is written.
It has been said over and over again at medical society meetings that it is a very unfortunate thing that universities in these modern times are situated in large cities. The young man just freed from the restraints of home life, or of the seclusion of a college, is at once without any preliminary training, exposed to all the dangers, moral and physical, of large city life. Not only is this true, but he is even not properly warned of the dangers that lie so close to his path. Our prudery has gone so far that the very names of these{318}affections are tabooed and above all must not be mentioned before the young. As to the awful evils that such diseases may cause, as to the lifelong suffering, even to mental degeneration and early death, that they may involve, not even a hint is considered to be proper. The consequence is that young men expose themselves not infrequently to danger, absolutely unknowing the significance that such diseases have in recent years acquired in the minds of modern physicians, and it is usually not until a serious mistake has been made that the young man is brought in contact with the physician who may be frank in pointing out evils utterly unknown before.
This state of affairs has come to be considered as so irrational in many foreign universities that now a special course of lectures is given every year on the significance of what may be called the social diseases. The students are told very frankly what the possibilities of danger for them in certain excesses may be, so that at least the young man can not say "I knew nothing about it," when the risk becomes an actual reality of danger. At the University of Berlin the first course of such lectures was established, and the interest aroused and the results obtained were such as to make other universities consider the advisability of such lectures for their students. Even here in prim and prude America, one or two of the great universities have come to the realisation that the physical well being of their students is committed to their care, as well as their intellectual development, and at least a beginning of that precious wisdom that comes from the fear of the physical evils of sin has been acquired because of opportunities provided by the faculty.
It is well admitted now by all that ignorance is not innocence and that knowledge of the consequences of social diseases is likely to be a very important factor in preventing young men from taking risks that would otherwise be considered very slight, perhaps. As a matter of fact, nothing can be more helpful from the ethical standpoint than this knowledge of how closely may follow the wages of sin, which is death. It is for this reason that clergymen would seem to owe it, as a duty to themselves and their position in social{319}life, to acquire a certain knowledge of these affections. A very great change has come over the attitude of the medical profession towards the so-called venereal diseases in recent years. A quarter of a century ago they were considered to be not very serious after all, and indeed in some cases to be no more serious than a cold, a mere passing incident in life. Now it is well recognised that almost never do they leave their victim in the state of health in which he was before, and that unfortunately the deterioration of tissues which has taken place is likely to be enduring. Even many years afterwards there may be serious complications involving health or even life.
For instance, it is now very generally conceded that paresis, or what is sometimes called general paralysis of the insane,—a progressive mental and nervous disease, which invariably ends fatally in from three to seven years,—is always due to one of the so-called social or venereal diseases. How important this affection has become in modern life can be best appreciated from the fact that in Europe nearly one in four of those who die in the insane asylums are sufferers from paresis. In this country the disease is not so frequent, the proportion being less than one in five or even one in six. The disease is becoming more and more common, however, as large city life becomes more prominent, and as the possibility of infection with social diseases is more widespread.
Paresis is what is sometimes called softening of the brain, and it attacks by preference men under thirty-five. The first symptoms of it as a rule are not alarming. A young man's disposition changes, so that an individual heretofore rather stingy becomes extravagant, while occasionally a prodigal becomes very saving and considers that he has already a large sum of money to his credit. The most prominent feature of the early stage of the disease is the occurrence of delusions of grandeur, that is to say, the patients get the idea that they are important personages, or that they have fallen heirs to a large sum of money, or that they have been appointed to high salaried positions. As a consequence of these delusions, they may make expensive presents to their friends. Occasionally there are other changes in disposition. A young{320}man, for instance, who has been of genial character becomes morose and hard to live with. The opposite change to greater liveliness of disposition is not unknown, but is more infrequent. Sometimes there are marked excesses, high living, luxurious habits, and the like, before the existence of disease is recognised.
The mental stigmata of the disease at the beginning are not alarming at all. There are slight lapses of memory. A man who has hitherto been known as an accurate mathematician, makes frequent mistakes in adding or multiplying. The physical signs are even slighter. In using long words, syllables are omitted from them. A favourite method of testing the speech of a person suspected of beginning paresis is to ask for the pronunciation of a word like Constantinople. Usually a syllable will be elided, and the reply will be "Constanople," or something similar. There is a slight tremulousness of the hands and usually a rather easily marked tremor of the lips, especially when the tongue is protruded. Often in the very earliest stage of the disease, there are changes in the pupils. They may be unequal, or may fail entirely to react to light.
When these signs are positive, that is, when there is a change in disposition and then the physical stigmata that we have gone over appear, the diagnosis of the disease is almost certain. The physician is able to say, with considerable assurance, that the young, strong, healthy-looking patient, who has often had to be tempted to come to see the doctor by some specious reason, because he does not consider himself that he has anything wrong with him, will have to be confined in an asylum within a year, or at most, two, and will die in a state of dementia within five years. This, of course, is an awful picture. This is the course of the disease in nearly 20 per centum of the inmates of our asylums. Almost without exception there is a history of syphilis in these cases, and the medical world is now persuaded that this is the most important factor in the production of paresis.
Another nervous disease, corresponding in some of its features to paresis and indeed sometimes spoken of as a spinal form of paresis, is locomotor ataxia. This affection{321}begins usually with loss of sensation in the soles of the feet so that the patient thinks that he is walking on carpet all the time. Before this there may have been some disturbance of vision. The pupils may fail to react to light. Occasionally the first symptoms are motor, that is, the man notices that he is not able to walk as readily as before. He staggers easily. If he tries to turn round while walking he is apt to lose his balance. If he tries to walk in the dark, he is almost sure to have so great a sense of insecurity that he dare not go far from the wall. Occasionally the first sign is a sinking of the limbs on the way down stairs. In certain very sad cases, the first and only symptom is a failure of sight which goes on progressively, until the optic nerve is completely destroyed and sight forever rendered impossible.
All these symptoms are traceable directly to certain changes which have been noted in the spinal cord. These changes are due to disturbance of the blood and lymph supply of the nervous tissue. Once the changes have taken place, there is no hope of the patient ever recovering the normal use of his limbs. Not infrequently he becomes bedridden and can not walk at all because he is not able to steady himself. He may not suffer in his general health, however, to any serious extent, and may live on for twenty years, though usually his resistive vitality is lowered and he is carried off by some intercurrent disease.
At times locomotor ataxia begins with very severe pain seizures, known as crises. These may occur in the legs or arms or in the stomach or sometimes in other organs. Occasionally they are the first symptoms of the disease that are noticed, and they may continue for months or even years before other symptoms manifest themselves. This sometimes makes it difficult to recognise the disease for what it really is. The pains are usually most excruciating, are tearing or boring in character, and are sometimes described by the patient as being similar to the sensation that would be felt if a red hot iron were forced into them, or if a knife were inserted and then twisted round. Hence the descriptive name which has been applied to them of "lightning pains" which describes the suddenness of their onset and the intensity of their character.{322}Most of the ordinary anodyne or pain-killing medicines fall to influence them, and the patient is one of the most pitiable of objects while they last.
It is now conceded on all sides that at least 75 per centum of the cases of tabes are directly due to syphilis. Indeed this affection and paresis are sometimes spoken of as parasyphilitic affections. Unfortunately the ordinary treatment for syphilitic manifestations does not affect them in the least. So far as we know at the present time, there is nothing that will hinder the course or prevent the progress or alleviate the symptoms or have any curative action on either of these dreadful diseases. They are much more common in Europe than they are in this country, but have been seen here with quite sufficient frequency in recent years to make physicians, at least, realise the necessity for having young men appreciate the dangers they invite in thoughtlessly yielding to the temptations of great city life.
There are other affections which can be traced directly to the social diseases. One of the most important of these consists of certain brain tumours which may even cause death if not properly treated. These syphilitic brain tumours frequently cause paralysis and may lead to permanent changes in the nervous system with consequent loss of motor power. Whenever the symptoms of brain tumour occur, careful inquiry is made as to the previous existence of syphilis in the case, in order to determine, if possible, if this is the morbid agent at work. If there is a history of syphilis it is usually said to be fortunate, for brain tumours due to syphilis may be made to disappear by the proper use of mercury and the iodides. If the treatment of the case is delayed, however, alterations in the nerve substance take place which can not be improved.
This disease affects especially the blood vessels and, as a consequence of the thickening of the coats of the arteries, blood may be shut off from certain portions of the brain entirely. This will, of course, produce symptoms of paralysis. Indeed, whenever paralytic symptoms manifest themselves under forty years of age, the physician's first thought is sure to be that there is syphilis in the case. This is not always{323}true, for by heredity and very hard work occasionally arteries become so degenerate that they rupture before a patient has reached many years beyond forty, but the case is always suspicious. In this, as in the corresponding instance of brain tumour, treatment, if applied sufficiently early, may not only give relief of all the symptoms, but produce a complete cure. That is, at least the symptoms are relieved for the time, though there may be relapses. Usually these relapses are quite amenable to treatment, but sometimes they get beyond the control of the physician and death ensues. It is almost the rule where there have been serious nervous symptoms once, that recurrences of them must be feared, and they will eventually shorten the patient's life.
Syphilitic manifestations of serious character develop, however, not only in the nervous system, but also in certain of the important internal organs. The liver may become so much affected as to refuse to do its work. Solid tumours may develop in the stomach, or along the course of the intestines, resembling cancer so much that occasionally operations are performed for their removal. As a rule, however, these yield quite promptly to proper antisyphilitic treatment. Whenever an obscure intraabdominal tumour is present, accordingly, it has become the custom among physicians and surgeons not to make an absolute diagnosis nor to perform any serious operation until antisyphilitic treatment has been tried. The surprises of such treatment constitute a very interesting chapter in obscure diseases in medicine.
As we said at the beginning, it is perfectly possible to have contracted the disease innocently, and indeed, the first manifestations may be so mild as to fail to attract the patient's attention. In these cases there will be no history of syphilis, yet the test of antisyphilitic treatment will demonstrate that the disease has been present. Not a few physicians have died from these serious manifestations of syphilis after having contracted the disease through a cut on the finger or the prick of an infected needle in the ordinary course of their professional work. Some of these cases in young men prove to be especially malignant and fail to react to treatment, so that a fatal issue takes place within a few years.
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On the other hand, in general it may be said that the disease is eminently curable, though it may require great care on the part of the patient and the avoidance of all excesses either of work or indulgence for the rest of life. It has often been noted that people who live in the midst of serious emotional strain are most likely to suffer from manifestations of syphilis in their nervous system. Hence it is that paresis and locomotor ataxia are comparatively quite common among actors, brokers, and financiers. They are also quite common among sea captains and military men who are exposed to severe hardships and have to assume weighty responsibilities. In such men the previous attack of syphilis has so weakened the nervous system that it degenerates under the strain placed upon it by the subsequent responsibilities. These diseases are very uncommon among clergymen and are less common in Ireland than in any other country in the world, which would serve to confirm the opinion that the venereal disease is a prominent factor in their causation.
We would not have the idea be assumed that syphilis is an incurable disease and is bound to be followed in all cases by the awful manifestations that we have described. There are many thousands of cases of syphilis that never have any of these serious manifestations at all. It is evident that some cases are completely cured and that no deleterious influence remains. On the other hand, it must not be forgotten that the presence of this disease in the tissues of either parent during the first five years of its course are almost sure to affect offspring born at this time. The children may suffer from the skin lesions of syphilis in their early life, may suffer from serious eye diseases a little later, and then eventually succumb to nervous and mental diseases resembling paresis and locomotor ataxia in early adult life. In fact it is this transmission of the disease that constitutes one of its saddest pictures, and the sins of the parents are indeed visited on the children.
Besides this severer type of social disease, there is what has been called sometimes a milder form. It consists only of a discharge with some fever, which is considered to last not more than a few weeks. As a matter of fact, however, the disease may continue to exist, though the symptoms become latent{325}and the patient may infect others when he least suspects it. This form of disease gives rise to many sad complications in family life. Practically all the severe eye diseases of newly born children, the ophthalmia from which so many eyes are lost, is due to this disease. Special medical care is now taken of these cases, and the serious consequences are not so often seen as used to be the case. Within a score of years, however, about one-half of the inmates of blind asylums owed their loss of sight to this disease. At the present time there still remains a very notable proportion of persons blind from early childhood whose infirmity must be attributed to the sad consequences of the social disease.
Most of the sterility in families is due to the same cause. There is an unfortunate impression that usually the woman is responsible in these cases, and not a little sympathy is wasted on the man, because of the absence of children in the family. Almost invariably, however, the real cause of the family misfortune is to be traced to an infectious disease in the man contracted perhaps many years before, of whose presence he may be more or less unconscious, the symptoms have become so slight, but this has proved sufficient to infect the wife and bring about serious changes that preclude all possibility of the procreation of children.
These statements may seem exaggerated. On the contrary, they are rather understatements of actualities. No one who knows the real state of the case will fail to realise this. Physicians themselves have only come properly to appreciate the true state of affairs in the last twenty years. We need a coordination of all the forces that make for social amelioration in modern life to correct present false impressions.
JAMES J. WALSH.
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Hoc argumentum praecipue ad juris consultos ecclesiasticos et civiles pertinet; et quamvis differentia sit inter jurisdictionem judicis civilis et ecclesiastici tamen judicium utriusque quatenus necessario pendet ab existentia conditionum physicalium in medici consilio situm est. Obscuritas doctrinae et quidem gravis de hoc impedimento, libris moralistarum, medicorum et juris consultorum perlectis, invenitur; et quamvis, elapsis perpaucis annis, fere omnis liber tractans de scientia medicinali parva fide dignus, tamen multa ex editis physiologorum veterum tanquam vera a moralistis praesertim promulgantur. Hae difficultates per ignorantiam anatomiae et physiologiae genitalium non minuuntur. Ut auxilium, si quid sit, ad difficultates solvendas feram, species et gradus Impotentiae hie collegi tanquam medicus, eo modo ut conditio physica clarius cognoscatur.
In unoquoque Statuum Foederatorum Americae Septentrionalis impotentia ratio sufficiens divortium obtenendi est, in plurimis autem matrimonium irritum ab initio non reddit. Impotentia vel temporanea causa divortii esse potest si impotens intra spatium temporis rationabile remedium medicinale recuset. Sub lege civili Americana contrahens qui tempore matrimonii ineundi certior erat de impotentia consortis jus divortii petendi propter abnormalitatem istam amittit. Procrastinatio longa et inexplicabilis divortii petendi, et etiam inscitia culpabilis impotentiae consortis divortium impossibile coram judice civili reddunt.
Conditio haec etiam impedimentum dirimens matrimonii sub lege canonica Ecclesiae est. Si impotentia contractum matrimonii anteat et perpetua sit, matrimonii contractus{327}solvitur ipso facto, quandocumque detegitur. Procrastinatio aut ignorantia culpabilis non excusant.
Jurgia oriuntur ex eo quod impotentia cum sterilitate saepius confunditur. Juris consulti civiles infrequenter hoc modo offendunt, medici autem et moralistae crebro in errore isto versantur. Juris consulti Americani et medici de impotentia doctrinam accipiunt librorum praesertimOn Domestic Relations, auctore Irving Browne (Boston. 1890),A System of Legal Medicine, auctore Allen MacLean Hamilton (Neo-Eboraci, 1897), etA Manual of Medical Jurisprudence, auctore A. S. Taylor (Neo-Eboraci, 1897). Irving Browne (op. cit.) ait: "Ubi Impotentia adsit nullum habetur matrimonium validum. Impotentia autem incapacitatem prae se fert physiciam, non meram frigitatem, declinationem seu repugnantiam, neque etiam recusationem absolutam coitus sexualis. Neque sterilitas nec malformatio quae copulam non impediant, neque infirmatio quaecumque sanabilis incapacitatem gignunt. Impotentiam tempore ineundi matrimonii exstitisse necesse est." Eadem est doctrina Schouleri et Baldwinii.
White et Martin, medici, (Genito-Urinary and Venereal Diseases. Philadelphiae. 1897.) impotentiam ita definiunt: "Inabilitas actus sexualis perficiendi. Non necessario cum sterilitate consociatur, neque necesse est quod sterilis impotens sit." Et ita alii omnes.
Significatio vocis Impotentiae sub lege canonica deducitur, (1), ex dijudicationibus Pontificum Romanorum, aut (2), ex judiciis Congregationis Sancti Officii, tribunalis ad sententias hujus generis pronuntiandas instituti, aut, (3), ex legis interpretatione a moralistis scientia praeditis.
Sixtus V, Pontifex Romanus, (Const.Cum frequenter, anno 1587) decrevit eunuchos impotentes esse sensu legis canonicae de Impotentia, nullum autem judicium papale totam questionem conficit. Congregatio etiam Sancti Officii in perpaucis casibus particularibus dijudicavit sed legem nullomodo distincte definiebat. Norma igitur a nobis sequenda ex interpretatione moralistarum est depromenda.
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Lex non est decretum mere disciplinare: e natura ipsa contractus matrimonialis desumitur. Ballerini (Theol. Mor., vol. 6, p. 658) scribit matrimonium consistere "in mutua traditione potestatis ad copulam conjugalem." S. Thomas (Supplem. Sum, Theol., q. 58, a. 3) ait: "In matrimonio est contractus quidam, quo unus alteri obligatur ad debitum carnale solvendum: unde sicut in aliis contractibus non est conveniens obligatio si aliquis se obliget ad hoc quod non potest dare vel facere, ita non est conveniens matrimonii contractus, si fiat ab aliquo qui debitum carnale solvere non possit; et hoc impedimentum vocaturimpotentia coeundi."
Antequam explicationem a moralistis pleniorem vocum "Impotentia coeundi" dabamus, attendendum accurate est ad definitionem matrimonii finum a S. Alphonso Liguorio (Theol. Mor., lib. vi., n. 882) datam. "Fines," inquit, "intrinseci essentiales [sc. matrimonii] sunt duo: traditio mutua cum obligatione reddendi debitum, et vinculum indissolubile.Fines intrinseci accidentalespariter sunt duo: procreatio prolis et remedium concupiscentiae.Finesautemaccidentales extrinseciplurimi esse possunt, ut pax concilianda, voluptas captanda, etc. His positis, certum est quod si quis excluderet duos fines intrinsecos accidentales, non solum valide, sed etiam licite posset quandoque contrahere; prout si esset senex et nuberet sine spe procreandi prolem, nec intenderet remedium concupiscentiae; sufficit enim ut salventur fines substantiales, ut supra."
Haec sententia S. Alphonsi magni momenti est, et in ea solutio multarum difficultatum inveniri potest. Dicit hic (1) fines intrinsecos essentiales matrimonii esse traditionem mutuam cum obligatione reddendi debitum, et vinculum indissolubile, atque illis demptis nullum matrimonium; (2) procreationem autem prolis et remedium concupiscentiae abesse posse, et tamen matrimonium esse validum si duo fines essentiales adsint.
Sanctus hoc loco infert, ut patet e contextu alibi (e. g., lib. vi., n. 1095, res. 2), traditionem mutuam potestatis ad copulam carnalem necessario potentiam coeundi supponere, potentiam autem generandi non esse necessariam nec remedium concupiscentiae. In libro vi., n. 1096, ait: "Impotentia est illa propter quam conjuges non possunt copulam habere per se aptam ad generationem; unde sicut validum est matrimonium{329}inter eos qui possunt copulari, esto per accidens nequeunt generare, puta quia steriles aut senes, vel quia femina semen non retinet, ita nullum est matrimonium inter eos qui nequeunt consummare eo actu, quo ex se esset possibilis generatio."
Distinctio haec inter potentiam coeundi et potentiam generandi a moralistis omnibus datur; illa autem data, plurimi distinctionem obliviscuntur et sterilitatem simplicem cum impotentia confundunt.
A. Konings, C.SS.R., (Theol. Mor., ed. 7, vol. 2, p. 276) haec habet: Impotentia est "incapacitas ad copulam carnalem, per se aptam ad generationem." In n. 1619, § 5, ait: "Non est confundenda impotentia coeundi cum impotentia generandi. Hinc steriles et senes qui matrimonium consummare valent, valide contrahunt, item mulieres quae possunt semen excipere, etsi illud non retineant." Hanc doctrinam S. Alphonso refert (Theol. Mor., lib. 4, n. 1095, ed. Mech. 1845), et paragraphum hoc modo complet: "Non tamen carentes utero vel vagina." Hoc est, tenet mulierem utero et vagina carentem impotentem esse. Unusquisque carentiam vaginae impotentiam esse admittit; mulier autem sine utero semen excipiendi capax est, concupiscentiam quoque maris satiare potest. Sterilis tantum est. Potentiam etiam habet coeundi, semen excipere potest et retinere, concupiscentiam quoque satiare potest, etiamsi uterus, ovaria et tubi Fallopiani absint. Praeterea,illi duo fines intrinseci essentiales matrimonii existunt.
Augustinus Lehmkuhl, S.J., (Theol. Mor.), alius illustris discipulus S. Alphonsi est Impotentiam definit: "Defectus propter quern conjuges non possunt copulam habere per se aptam ad generationem." Alibi (American Ecclesiastical Review, vol. 28, n. 3), de impotentia excisioneque ovariorum scribens, ait: "Puto, questionem propositam, utrum excisio ovariorum vel uteri constituat impedimentum dirimens necne,theoreticenondum esse plane solutam." Existimat autem questionempracticesolutam esse judiciis Congregationis S. Officii, d. 3 Februarii, 1887, et d. 30 Julii, 1890, editis, matrimonium mulieris ovariis carentis et mulieris utero et ovariis carentis, permittentibus. Etiamsi haec judicia non edarentur tanquam leges formaliter generales, Lehmkuhl opinatur in{330}casibus ejusdem generis aptari posse. Re quidem vera illa doctrina sequi potest practice et theoretice; nulla enim est quaestio seria de impotentia in muliere carente ovariis.
Joseph Antonelli tamen (De Conceptu Impotentiae et Sterilitatis relate ad Matrimonium, Romae, 1900) tenet carentiam ovariorum esse impotentiam sub lege; et Casacca (Amer. Eccl. Rev., vol. xxvii, n. 6, et alibi) eamdem opinionem sequitur. E contra, Marc (Inst. Mor. Alphon.) docet carentiam ovariorum uterique non esse impotentiam.
Joseph Hild (Amer. Ecc. Rev.vol. xxviii., n. 6) optime vindicat opinionem, nempe, carentiam ovariorum non esse impotentiam, et in corpore tractatus citat definitiones impotentiae a moralistis egregiis prolatas.
Schmalzgrueber (Theol. Mor., lib. iv., tit 15, n. 31) dicit: "Sola impotentia ad copulam dirimit matrimonium, non vero impotentia ad generationem."
Coninck (De Sacr., vol. ii., d. 31, dub. 7, n. 86) ita habet: "Steriles … si aliter potentes sint ad usum matrimonii, valide contrahunt; quia nec generatio nec potestas generandi est de essentia matrimonii."
Mastrius (Dis. de Matr., q. v., n. 114) ait: "Impotentia est inhabilitas perpetua ad consummandum matrimonium … non est ex eo praecise quod alteruter conjugum aut uterque sint steriles, quia impotentia ad generandum seu ad prolificandum, dummodo adsit potentia ad copulam carnalem et seminationem, non est impedimentum dirimens, ut omnes passim concedunt cum Scoto … et ubi est certa impossibilitas ad bonum prolis, tunc matrimonium est ibi in remedium, non in officium."
Vincentius de Justis (De Dispens. Matr.lib. ii, c. 17, nn. 1, 2, 3) scribit: "Impotentia ad matrimonium est duplex. Prima, quaesterilitasdicitur, efficit ut proles generari non possit, ex se tamen matrimonium nec impedit nec dirimit, ut docent Sanchez, Guttier, Coninck. … Ratio est, quia nec generatio, nec generandi potestas sunt de essentia matrimonii."
S. Thomas (Supplem, q. 58, a. 1) in articulo de Impotentia, quamFrigiditatemetImpotentiam Coeundinuncupat, nihil de sterilitate scribit, nec de impotentia generandi tanquam quid impotentiae coeundi oppositum.
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In omnibus hisce definitionibus verbade se, ex se, per se,et alia similia, adhibentur de copula carnaliqua copula. Amort (De Matr, q. 101) de his verbis loquens ait: "Impotentia est inhabilitas corporalis ad copulam carnalemde sead generationem prolis idoneam.—Dicitur:de se;potest enim contingereper accidens, v. g., ob debilitatem spirituum seminalium in viro aut femina, vel obindispositionem matricisin muliere, quod copula carnalis, etiam perfecta, hoc est,per effusionem seminis in vaginamulieris completa, non sit idonea ad generationem prolis." Loquuntur moralistae, ut dixi, de copula carnali quatenus copula est sine respectu ad possibilitatem generandi.
Hisce omnibus positis, rogamus:
(1), Quid sit impotentia sub lege in muliere?
(2), Estne mulier carens ovariis, utero vel tubis Fallopianis impotens?
(3), Quid sit impotentia sub hac lege in viro?
(4), Estne vir aspermatosus impotens, et quid de viris semen sterile habentibus?
I.Impotentia Mulieris.Mulieres steriles frequentius quam viris, viri autem impotentes frequentius quam mulieres sunt. Impotentia absoluta et perpetua raro in mulieribus, in viris crebro invenitur.
In fundo pelvis femineae septum est a latere in latus, rectum inter et vesicam urinariam, et in medio hujus partitionis uterus, qui piroformis est, quasi ad perpendiculum jacet et cervix sua in vaginam intrat.
A cornibus uteri, i.e., ab angulis superioribus, tubi Fallopiani procedunt ad libellam, et apud terminos tuborum ovarium est in utroque latere. Tubi aperti sunt prope ovaria, et non substantiae ovariorum continui. Si unum ovarium et tubus oppositi lateris demantur, vel si tubus iste occludatur, ovum ex ovario manente migrare per partem exteriorem uteri et foecundari potest.
Genitalia externa mulieris e labiis majoribus praecipue constant; intra et inter haec labia minora seu nymphae sunt. Intra labia minora ad summum versus clitoris est; infra hanc est meatus urinarius; infra meatum, orificium vaginae. Per imam partem orificii in virginibus extenditur pellicula tenuis quae hymen vocatur. Haec communiter in coitu primo rumpitur.
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Tempore mensium praesertim ova egrediuntur ex ovariis in tubos Fallopianos et inde in uterum. Si ova non foecundentur per vaginam amittuntur. Foecundatio in tube Fallopiano fit.
In muliere impotentia temporanea aut perpetua oriri potest e causis sequentibus:
(1), propter hymenem imperforabilem aut cribriformem, aut septatum aut annularem;
(2), propter vaginam duplicem;
(3), propter vaginismum aut dolorem;
(4), propter uterum prolapsum aut productionem cervicis uteri;
(5), propter atresiam vaginae aut labia adhaerentia;
(6), propter orificium vaginae in loco abnormali;
(7), propter arctationem vaginae;
(8), propter tumores aut incrementum morbidum intra vel circa genitalia;
(9), propter Sadismum;
(10), propter Masochismum;
(11), propter Sodomiam gradus secundi seu defeminationem; Sodomiam gradus tertii; Sodomiam cum horrore; Urningismum; Androgyniam.
1. Aliquando vice hymenis normalis invenitur membrana densa seu cartilaginosa, aut membrana continua, aut cribro similis, aut tanquam septum, aut annularis, quae impediat intromissionem. Operatione simplici chirurgica conditio removetur.
2. Raro septum adest quod vaginam in duas partes dividit et impotentiae causa est. Chirurgus septum removere potest.
3. Vaginismus contractio spasmodica musculorum ad orificium vaginae est, et haec vaginam claudit. Frequenter inter neuroses ideopathicas includitur, scrutinium autem diligens locum inflammationis detegit qui origo est spasmi reflexi. Insolenter conditio ex hyperaesthesia murorum vaginalium inducitur.
Medicatio vaginismi examen expertum supponit et quandoque scrutinium endoscopicum vesicae urinariae. Fissurae in ano, endometritis chronica, urethritis granosa circa cervicem vesicae urinariae, causae principales sunt vaginismi, et istae{333}causae sanabiles sunt. Inflammatio acuta vulvae, vaginae, uteri, tuborum aut ovariorum, carunculae urethrales, urethritis, fissurae cervicis vesicae urinariae, haemorrhoides, fissurae recti, coccygodinia, ulcera uteri et amotio uteri vel ovariorum e loco debito, possunt tantum dolorem in coitu infligere ut mulier practice impotens fiat. Morbi autem isti fere omnes medicabiles sunt, sed tamen aliqui omnino pervicaces sunt. In vaginismo hysterico et in aliis casibus insanabilibus intromissio fieri potest ope chloroformi ad evitandum divortium.
4. Quando uterus prolabitur vel cervix producitur ita ut copula impossibilis sit, chirurgus mederi potest.
5. Atresia vaginae est occlusio vaginae in longum perfecta vel imperfecta. Nullum orificium invenitur. Congenita esse potest, et tunc plerumque desunt omnia organa generativa. Atresia etiam consequitur vulnera et inflammationes morborum, ut diphtheritis et scarlatina.
Ubi atresia per totam vaginam extenditur nullum datur medicamentum, et impotentia absoluta et perpetua adest. Labia adhaerentia separari possunt.
6. Aliquando sed perraro vagina in rectum aperit. Possibilitas removendi impotentiam e loco orificii vaginae pendet.
7. Arctatio vaginae oritur ex causis atresiae, et remotio conditionis quum impotentia inducat impossibilis esse potest.
8. Tumores pudendi, vaginae et recti, hypertrophia labiorum et clitoridis, et elephantiasis labiorum copulam impedire possunt. Alii tumores et hypertrophiae removeri possunt, alii autem insanabiles sunt.
9. Dantur perversitates sexuales quae viros impotentes reddunt, et haec aliquando in mulieribus inveniuntur. Tales sunt Sadismus, Masochismus, et gradus Sodomiae praeter primum. Isti morbi animi causae sunt impotentiae in muliere propter aversionem ejus virorum etiamsi physice potens sit. Vix in matrimonium iniit talis mulier, et igitur perversitates istae parvi momenti relate ad mulieres, relate autem ad viros magni momenti sunt. De his quid infra dicendum erit.
10. Senectus nunquam reddit mulierem impotentem, virum autem reddit. Etiamsi nihil ad impotentiam pertineat, hic{334}juvat dicere in locis temperatis terrae parturitionem maxima ex parte desinere anno a natu quadragesimo-quinto. Cessare potest anno vicesimo-octavo, et perstare post annum quinquagesimum. J. Whitridge Williams (Obstetrics.Neo-Ebor. 1903), casum citat mulieris quae anno sexagesimo-tertio aetatis puerum vicesimum-secundum peperit et postea menses aderant. Parturitio aliquando decem vel duodecim annos post ultimos menses evenit.
Nunc, estne mulier ovariis carens impotens? Nullo modo: sterilis tantum est. Nam (1) Congregatio S. Officii in matrimonium duas mulieres ovariis orbatas inire permisit. (2) Talis mulier capax est copulae carnalis aeque ac mulier habens ovaria, et moralistae omnes concedunt nil amplius requirendum ut matrimonium validum fiat. (3) Si talis mulier impotens sit omnis mulier insanabiliter sterilis impotens esset, et discrimen a moralistis prolatum impotentiam inter et sterilitatem nugatorium esset et puerile. Mulier in qua tubi Fallopiani occludantur sterilis est perpetuo; idem dicendum de muliere habente uterum infantilem, vel ovaria rudimentaria, vel ovaria morbida, et ita porro. Nemo autem tales tanquam impotentes unquam tenet.
Aliquando mulier ovariis orbata sensationem sexualem possidet, vulgo autem non possidet. In utroque casu tamen remedium idem concupiscentiae mari perstat, et hoc sufficit pro viro ut matrimonium validum sit. Huc accedit, relate tum ad mulierem tum ad virum, quod duo fines intrinseci essentiales matrimonii, et fines sufficientes juxta S. Alphonsum, adsint, scilicet, traditio mutua cum obligatione et possibilitate reddendi debitum, et vinculum indissolubile.
Si in tali muliere existat sensatio sexualis, pro ea remedium concupiscentiae habetur, sin minus, dantur saltem duo fines essentiales intrinseci matrimonii. Re quidem vera mulier carens ovariis et eodem tempore expers sensationis sexualis differt a muliere quae parturit sed sine sensatione sexuali est; nihilominus semper manent illi ovariis carenti duo fines essentiales intrinseci matrimonii.
Vetula communiter nequit parire et expers sensationis sexualis est, sed licite matrimonium contrahit. Conditio vetulae est eadem ac conditio mulieris ovariis orbatae. Lehmkuhl{335}(Amer. Ecc. Rev.vol. 28, n. 3), in hanc assertionem urget excisionem ovariorum esse quid "positive actum contra primarium matrimonii finem," quum senectus conditio naturalis sit Chirurgus honestus aut inhonestus nunquam removet ovaria ut conceptio evitetur; operatio enim nimis periculosa est. Removentur ovaria primario ad morbum gravem medendum, et sterilitas consequens intenditur tantum per accidens. Remotio ovariorum igitur est quidper accidensactum contra "primarium finem matrimonii," (et iste non est finis essentialis intrinsecus) seu generationem prolis; et nihil refert etiamsi positive actum esset si non sit in fraudem legis. In casu mulieris habentis ovaria rudimentaria et nullam sensationem sexualem (casus enim quandoque contingit) quid sit "positive actum contra primarium finem matrimonii"? Estne una lex pro ista a natura castrata et alia pro muliere a chirurgo castrata et tertia pro vetula senectute castrata?
Inter ovaria et testiculos analogia est, etiamsi obstet D. Bossu, medicus Gallicus, a Professore Hild (Amer. Ecc. Rev.vol. 28, n. 1) et Eschbach citatus. Demptis ovariis sensatio sexualis destruitur haud secus ac quum testiculi removeantur, sed analogia incompleta est et claudit. Eunuchus insuper incapax est communiter intromissionis, et semper inseminationis. Moralistae vulgo docent inseminationem essentialem esse copulae carnali. Utcumque de inseminationis necessitate veritas sit (de qua infra) eunuchus nequit satisfacere primo matrimonii fini essentiali intrinseco, mulier expers ovariis satisdare potest.
Carentia aut occlusio tuborum Fallopianorum sterilitatem insanabilem efficit, sed usque adhuc nemo tenet illam carentiam vel occlusionem esse impotentiam. Conditio quoad potentiam generandi eadem est ac in carentia ovariorum, sensationem autem sexualem proprie carentia tuborum non efficit. Idem omnino dicendum est de carentia uteri. Si vagina remaneat capax talis mulier copulae carnalis est.
Mulier igitur impotens est sub lege ecclesiastica tantum in quinque casibus:
(1), ubi atresia vaginae aut adhaesio labiorum insanabiles sunt: haec atresia et adhaesio raro inveniuntur;
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(2), in casu rarissimo in quo vagina in rectum aperit insanabiliter;
(3), ubi arctatio vaginae immedicabilis sit: haec rara est;
(4), quando adsunt tumores maligni aut incrementa morbida quae nequeant removeri;
(5), in casibus defeminationis aut Urningismi (de quibus infra). Sadismus et Masochismus et aliae perversitates sexuales ita infrequenter observantur, in gradu saltem in quo impotentiam creant, ut negligi possint.
II.Impotentia Maris.Tractus genitalis viri, a testiculis ad meatum urinarium seu orificium penis, ad centimetra 81 (uncias fere 32) extenditur. Ex testiculis chorda spermatica per inguen infra cutem transit, murum abdominalem penetrat per annulum inguinalem, et sub vesica urinaria urethram juxta cervicem vesicae intrat. Semen non ex uno fonte provenit. Secretio ista fluida est et cinerea, partim ex testiculis qui in scroto sunt oriens et partim ex vesiculis seminalibus, prostate, glandulis Cowperi, et folliculis cryptisque urethrae, quae omnia extra scrotum sunt. Elementum essentiale in semine cellulae sunt quae spermatozoa vocantur, et haec ex testiculis proveniunt. Locomotionis potentiam habent spermatozoa et in foecundatione ovum penetrant. Secretio glandularum quae spermatozoa fert alkalina est et removet aciditatem urinae; acidus enim spermatozoa destruit.
Erectio penis praecedit ejectionem seminis, et centra nervosa erectionis et ejectionis in chorda spinale apud lumbos sunt. Erectio effectus est dilatationis arteriarum penis et occlusionis venarum quae congestionem sanguinis efficiunt; postea musculi perineales aliique musculi erectionem perficiunt.
Impotentia maris in tria genera dividi potest; videlicet: Impotentia Psychica, Impotentia Atonica, Impotentia Organica:
I. Impotentia Psychica.Species:
(1), Impotentia Psychica absoluta aut relativa;(2), Sadismus;(3), Masochismus;(4), Fetichismus;
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(5), Eviratio;(6), Urningismus;(7), Sodomia cum horrore;(8), Gynandria;(9), Metamorphosis Sexualis Paranoica;(10), Anaesthesia Sexualis;
II. Impotentia Atonica.Species:
(1), Impotentia Paralytica;(2), Impotentia e venenis;(3), Impotentia ex irritatione.
III. Impotentia Organica.Species:
(1), absentia penis;(2), penis multiplex;(3), hypertrophia aut magnitudo penis vel praeputii;(4), penis rudimentarius;(5), adhaesio penis scroto, ingueni vel abdomini;(6), hypospadias et epispadias;(7), distortiones penis ex podagra, lue, rheumatismo, gonorrhoea;(8), aneurysma corporum cavernosorum et varix venae dorsalis penis;(9), frenum nimis curtum;(10), anchylosis articulamenti coxendicis et abdomen permagnum;(11), tumores et incrementa morbida circa genitalia, sicut herniae, hydrocele, haematocele, elephantiasis, lipoma, carcinoma, sarcoma, cystoma, enchondroma et fibroma;(12), phthisis testiculorum et varicocele;(13), anorchismus et castratio;(14), prostratitis chronica;(15), senectus;(16), aspermia.
I. Impotentia Psychica.
1. Impotentia psychica ea est quae ex coercitatione inhibente cerebri in centrum genito-spinale exercitata devenit. "Impotentia ex maleficio" veterum moralistarum est. Timor, luctus, gaudium magnum, et aversio hanc impotentiam psychicam efficiunt. Quandoque{338}nuper maritus propter excitationem passionis ejectionem praecocem vel erectionem debilem vel nullam habet. In his casibus impotentia temporanea est si medicus peritus prudensque sit. Haec impotentia relativa esse potest.
2. Sadismus. Haec paraesthesia sexualis et aliae perversitates ex excessu venereo deveniunt et impotentiam gignunt. Sadismus nomen habet a quodem libidinoso Gallico marchione de Sade, saeculo duodevicesimo vigente. Datur libido magna erga alium sexum sed cum crudelitate in objectum uriginis, quae crudelitas usque ad homicidium cum mutilatione frequenter extendit, vel saltem adesse debet humiliatio personae amatae.
Sadistae erant Nero et Tiberius; et exemplum infame erat Giles de Laval, qui A.D. 1440, supplicium capitis affectus est, post trucidationem Sadisticam fere 200 liberorum inter octo annos. Occisiones apud White Chapel Londini probabiliter Sadisticae fuerunt.
Sadista impotens est exceptis casibus in quibus crudelis vel saltem contumeliosus simul esse potest. Haec crudelitas gradus habet a Sadismo symbolico, in quo crudelitas simulatur, vel mere dramatica est, per contumeliam veram usque ad homicidium et anthropophagiam. Formae etiam bestiales et sodomiticae inveniuntur. Sadista nullo modo tanquam semper insanus considerari debet, species autem suae pessimae paranoicae sunt, et degeneratio neurotica frequens est in familiis Sadistarum.
Sadismus maris frequens est, sed Kraft-Ebing (Psycopathia Sexualis, Philadelphiae, 1893) tantum duos casus inter mulieres invenit. Fictiones antiquae de Lamiis et Marmolycibus ex actibus mulierum Sadisticarum ortae sunt.
Necrophilia, seu libido erga cadavera cum propensione ad mutilationem, species est Sadismi quae vulgo paranoica est.
3. Masochismus. Haec degeneratio nomen habet a fabularum scriptore Sacher-Masoch. Conditio est Sadismo contraria. Masochista uriginem habet magnam uti Sadista, et nulla datur potentia sexualis sine crudelitate vel humiliatione; crudelitas autem vel humiliatio in Masochistam ipsum vertenda est. Hic homicidium non intrat. Masochismus, natura sua passiva, vitium feminarum esse debet, sed solummodo{339}casus unus in muliere inventus est a Kraft-Ebing. Valde communis est inter mares.
Masochismus Larvatus est species hujus degenerationis in qua sordes physicae sordibus adduntur moralibus.
4. Masochismus Symbolicus seu Fetichismus. Fetichista potens est tantum praesente parte vestium, e. g., calccus mulieris, vel aliud objectum seu "Fetich," quodcumque sit. Aliquando mera imaginatio sufficit. Tonsores furtivi capillorum puellarum quandoque Fetichistae sunt, et in capillis longis virorum attractio sexualis quandoque est mulieribus. Virtus musicorum saepe in capillis Samsoniis est plus quam arte. Westermarck (History of Human Marriage.Neo-Eboraci. 1891) describit seditionem gravem mulierum in Madagascar quum Rex Radàma capillos longos militum tonderi jusserit. Relatio etiam est odores inter et passionem sexualem. Si nervi olfactorii catelli scindantur catellus nunquam canem femineam recognoscit. Meretrices gaudent odoramentis pungentibus, e.g., moscho.
5. Eviratio. Haec degeneratio gradus est Sodomiae. In gradu primo Sodomiae impotentia non necesse adest, in gradu autem secundo semper adest. In hoc secundo gradu homo Sodomiticus meretrix masculina evadit cum maribus, atque transformatio profunda et stabilis animi supervenit, ita ut mas se feminam esse in actu sexuali sentit. Hic est effeminatio usque ad statum criminalem pregrediens. Gradus initialis hujus status est amicitia inordinata inter duos pueros aut duas puellas.
In casibus firmatis evirationis, Sodomista agit tanquam pellex masculina aliis Sodomistis, aut in vestibus femineis ut uxor se gerit. Coloniae sunt Sodomistarum hujus generis in fere omne urbe magna; se invicem cognoscunt, societates, choreas publicas, et dialectum completam habent, praesertim Berolini, Lutetiae-Parisiorum, Neapolis et Washingtonii. Impotentes sunt ad copulam carnalem naturalem.
Sodomia cum effeminatione seu viraginitate frequens est inter mulieres. Hie degenerata marem mente evenit. Impotens vix dici potest, nisi propter aversionem sexualem a maribus.
6. Urningismus.Urningest vox Germanica ab Ulrichs inventa. Urningismus idem est in re ac Sodomia primi et{340}secundi gradus, sed additur mollitia scriptionis poesis, ambulationum imminente luna, et aliorum hujusmodi.
7. Sodomia cum horrore est similis evirationi et defeminationi, sed vice frigiditatis adest horror alterius sexus.
8. Gynandria et Androgynia. In istis degenerationibus transformatio ita profunda est ut Sodomista masculinus circa pectus et in modo se gerendi feminae similis sit physice, et virago virum evadat aspectu. Exempla suntbote et mujeradointer Sioux et Pueblos Indos Americanos.
9. Metamorphosis Sexualis Paranoica species insaniae est in qua patiens imaginat sexum suum mutatum esse. Insanabilis est.
Degenerationes istae fere omnes cum masturbatione incipiunt. Medicatio moralis esse debet, sed Kraft-Ebing et von Schrenk-Notzing sanationem obtinuerunt ope hypnosis.
10. Anaesthesia Sexualis status est in quo vir aut mulier omnino caret sensatione sexuali. Illi secus habent corpora normalia. Conditio valde infrequens est. Kraft-Ebing enumerat decem casus congenitos in maribus, et duos in feminis. Anaesthesia sexualis acquisita etiam invenitur.
II. Impotentia Atonica.
1. Impotentia Paralytica. Centra nervosa sexualia in chorda spinale apud lumbos atonica esse possunt propter morbum generalem, aut venena, aut paralysem. Impotentia atonica frequens est in anaemia, diabete mellito, uraemia, cholaemia, lepra, rheumatismo, ataxia lumbali, lue chordae spinalis, myelitide, parese, et haemorrhagia cerebrali.
Aliqui tumores cerebrales impotentiam gignunt, paralysis diphtheritica causa est impotentiae temporaneae, et conditio invenitur in cachexia alicujus morbi tabescentis. Phthisicus autem saepe potens est usque ad finem vitae. Utrum impotentia perpetua sit necne ex natura morbi dependet.
2. Impotentia ex venenis. Potentia sexualis minuitur vel destruitur abusu venenorum vel absorbendo eadem, uti opium, morphina, chloral, potassii bromidum et iodidum, cannabis Indica, carbonei sulphidum, arsenium, antimonium, plumbum et iodum. Fabri, ut pictores (house-painters) et typographi, qui plumbo utuntur hoc modo patiuntur. Alcohol frequenter origo est impotentiae, et quandoque tabacum eumdem{341}affectum habet sine alio indicio physico. Impotentia pervicax esse potest ex utraque causa.
3. Impotentia ex irritatione. Irritatio chronica urethrae prostaticae e libidine, gonorrhoea, masturbatione, urina acida aut neurosibus genito-urinariis impotentiam inducit. Neuroses centrorum sexualium sensibiles aut motoriae esse possunt, et neuroses motoriae quandoque impotentiam creant. Prognosis hujusmodi impotentiae fausta est nisi adsint spermatorrhoea et genitalium atrophia. Prostatorrhoea quoque impotentiae causa esse potest, et hic prognosis melior quam in spermatorrhoea est. Athletae, ut pugil, cursor, et alii ejusdem classis temporaliter impotentes esse possunt
III. Impotentia Organica. Mas impotens esse potest propter malformationes congenitas aut acquisitas, morbos et defectus genitalium.
1. Absentia congenita aut postnatalis penis impotentiam insanabilem creat.
2. Penis rudimentarius causa impotentiae est, sed casus amplificationis post matrimonium habentur.
3. Penis multiplex rarissime impotentiam creat.
4. Hypertrophia penis aut praeputii, et magnitudo relativa penis rarissime efficiunt hominem impotentem.
5. Adhaesio penis scroto, ingueni vel abdomini reddit hominem impotentem; sanabilis autem est conditio.
6. Impotentiam quandoque creat hypospadias, seu absentia partis inferioris urethrae, et epispadias, seu absentia partis dorsalis urethrae; sed conditiones a chirurgo sanari plerumque possunt, quandoque autem nequeunt.
7. Distortiones penis e podagra, lue, rheuraatismo, et gonorrhoea impotentem faciunt virum quandoque immedicabiliter.
8. Aneurysma corporum cavernosorum et varix venae dorsalis penis impotentiae a chirurgo sanabilis causae sunt.
9. Frenum glandulae penis curtum nimis incurvat penem, et ita vir impotens est. Conditio facile a chirurgo removeri potest.
10. Rarissime anchylosis articulamenti coxendicis et venter pinguedineus impotentem virum reddit. Anchylosis insanabilis est.
11. Tumores et incrementa morbida circa genitalia, ut{342}herniae, hydrocele, haematocele, elephantiasis, lipoma, carcinoma, sarcoma, cystoma, enchondroma, et fibroma causae sunt impotentiae. Herniae, lipoma, hydrocele, haematocele, et quandoque elephantiasis scroti sanari possunt; tumores benigni et maligni aliquando removentur sed vulgo amputatione penis aut testiculorum.
12. Testiculi marcescunt in varicocele et impotentia sequitur. Varicocele amoveri potest, et si mature operetur chirurgus impotentia evitatur. Lues testiculorum destrui potest substantiam testiculorum nisi morbus mature sanetur, et impotentia potest esse absoluta. Tuberculosis testiculorum destruit organum.
13. Anorchismus seu absentia testiculorum bilateralis et congenita, idem efficit ac castratio. Conditio rara est Cryptorchismus, seu retentio testiculorum in abdomine, plerumque sterilitatem gignit non necessario impotentiam.
Castratio completa, morbo vel secus, impotentiae causa est, sed non necessario statim post castrationem. Gross (A Practical Treatise on Impotence, Philadelphiae. 1890) citat quattuor casus in quibus erectio permanebat, in uno homine usque ad decennium. Krügelstein (Henke's Zeitschrift.1842. vol. I, p. 348) dicit virum quemdam post amissionem testiculorum uxorem foecundavit. Si casus revera contigerit, spermatazoa in vesciculis seminalibus permanserant.
14. Prostatitis chronica causa est impotentiae et plerumque insanabilis est.
15. Nulla regula firma dari potest de impotentia physiologica senectutis in maribus. Viri sexto et octogesimo anno non solum potentes inventi sunt sed etiam liberos generaverunt. Potentia generandi in maribus vulgo circa annum sexagesimum-secundum cessat, exceptiones autem multae inveniuntur. Potentia coeundi permanere potest longe post annum sexagesimum-secundum. Ecclesia igitur senes cujuscumque aetatis ad matrimonium admittit; et confessarius nihil rogat de potentia nisi ab ipso sene interrogatur. Si confessarius sciat senem revera impotentem esse, non permittere debet matrimonium ejus.
16. Opinio videtur esse moralistarum ad habendam copulam carnalem necessariam esse non solum erectionem et{343}intromissionem sed ettam inseminationem plus minusve perfectam.
Laymann (De Imped. Matr.,cap. 11) ait: "Impotentia perpetua ad copulam perfectam dirimit matrimonium subsequens." Et addit: "Dixiperfectam,id est, quae fit cum effusione veri seminis in vas muliebre." Mastrius (loco jam citato) tenet inseminationem esse necessariam.
Lehmkuhl (Theol. Mor.) in definitione impotentiae absolutae dicit talem esse impotentiam quae "aliquem ad quamlibet copulam consummatam inhabilem reddit." Hic utitur vocibtis,copula consummata,in qua Ballerini requirit inseminationem quasi perfectam (op, cit., vol. 6, p. 178), et Sanchez (De Matr.,lib. 2, disp. 21, n. 5) inseminationem imperfectam. Petrus de Ledesma quoque (apud Eschbach.Disputationes Physico-Theologiae.Disp. 200) de senibus loquens ait: "Si enim senes ita senio confecti et exhausti, quod nullo modo semine valeant, quamvis possint erigere membrum et penetrare vas, non possunt contrahere, et si contrahunt, matrimonium est invalidum."
Qui steriles sunt ita sunt ex tribus causis: (1) Aspermia, seu absentia absoluta seminis; (2) Azoospermia, seu absentia spermatozoon in semine; (3) Oligospermia, seu carentia alicujus partis seminis.
Aspermia vulgo efficitur occlusione urethrae vel obliteratione partis ejusdem. Defectus isti congeniti esse possunt vel ex morbo aut vulnere. Tumores tractus generativi claudere possunt aditum inter testiculos meatumque urinarium et ita aspermia efficitur. Spadones, etiamsi raro potentiam habeant intromissionis, aspermia afflictantur quoad partem seminis ex testiculis provenientem (in qua spermatozoa sunt), sed humor ex parte anteriori tractus generativi adesse aliquo modo potest.
Azoospermia fere eodem modo oritur, obstructio autem vel destructio prope testiculos est, et ita secretio aliarum partium tractus generativi exire potest, sed sine spermatozois.
In Oligospermia spermatozoa adesse possunt, sed quia aliud elementum seminis deest spermatozoa inertia sunt.
Casus inveniuntur in quibus propter malformationem semen perfectum in vesicam urinariam ejactatur.