IMPUISSANCE, OR IMPOTENCE.

Uponpursuing the consideration of the following infirmities of the Reproductive System, a few prefatory observations are requisite. Perhaps of all the physical powers possessed by man, few are subject to so much abuse as the procreative organs—certainly none are more required to be, in a hygiænic point of view, held in a sounder condition of health, for upon their tone and perfect structure hinge the happiness and perpetuation of the human race. In this age of luxury and sensuality, however, the world seems untiringly hunting after, and more or less obtaining, sexual gratification. There can be no doubt, that a greater amount of this species of sensual enjoyment is indulged in before manhood arrives, than can be obtained when man should be in his vigor. The writer is not insensible to the many alluring publications upon this topic, the end and aim of which are not, honestly, to afford relief to the diffident sufferer, but to add to his misery, by draining his pocket. Of legitimate publications, alas! there are but few, for it appears that qualified medical men have, from some prudish or other such notions, kept aloof from entering the lists. Were it otherwise, many an unfortunate victim might be spared from the avaricious clutch of the empiric; but invalids, from such a knowledge of the absence of fair and honorable references, are obliged to seek (or despair of) relief from the unworthy class in question. How far the tendency of the present work may lead to a reformation, is left for the reader to decide. The novelty of the present compendium may subject it to invidious suspicion; the author but invites comparison, feeling convinced that the contents best bespeak its legitimacy and usefulness.

“Increase and multiply,” is the scriptural text. “Plant trees and beget offspring,” is the apothegm of the Magi. The perpetuation of the species being, with the great Designer of the universe, an object of the first interest, all living beings are mentally and physically formed with a view to this great end.

In the human species, procreation is effected by a congress of the two sexes, and a variety of organs are provided, upon whose condition the due performance of coition mainly depends. The male is destined to furnish a peculiar fecundating secretion, and is accordingly provided with glands to prepare such fluid, and a conduit to convey the same to its proper destination; while the female, being the recipient, possesses an organ capable of effecting a mysterious yet specific change upon the fluid so deposited: a failure, therefore, in any of the structures alluded to, is followed by impotence or sterility.

Impotence implies the incapability of sexual intercourse; sterility, the inability of procreation; the causes of either of which may be deemed organic, functional, or moral. The following section will be devoted, firstly, to its consideration in its relation to the male.

IMPOTENCE AND STERILITY OF THE MALE.

Wherethe hindrance to cohabitation arises from organic defect, congenital malformation, or diseases of some of the organs of generation, the disqualification may generally be considered absolute or irremediable. It is remarkable, however, to what extent mutilation or disease may occur, without total annihilation of the procreative powers; the smallest remnant of the penis, for instance, capable of entering the vagina, provided the testes be sound, being sufficient for impregnation.

A learned lecturer on medical jurisprudence gives it as his opinion, that the smallest quantity of seminal discharge, deposited in the lower part of the female generative apparatus,provided the female be apt to conceive, is sufficient for impregnation: and it is astonishing howminutea quantity of this plastic agent is necessary for that purpose in some species of creatures. Spallanzani took three grains by weight of the male fluid of the frog, and mixing it with seventeen ounces of water, found that impregnation of the eggs was produced by as much of this exceedingly weak mixture as would adhere to the point of a fine needle.

Although, in human formation, it is not essentially necessary that the male material should be deposited in the upper part of the vagina of the female, yet there is littledoubt that the deeper entrance of this substance conduces to impregnation.[13]

Malformation of the genital organs has already been stated as a cause of impotence. Such cases furnish much uneasiness at first, but are easily relievable. I have met with many instances, where consummation has been prolonged from months to years, which a slight knowledge of the functions of the parturient organs might have relieved in a few days; and with respect to the latter, it may be pardonable to mention that, as the husband should be the first to instruct his companion in what is to be expected, but little disappointment will be experienced, except with the vicious and unworthy.

There is room for much ingenuity in these matters; and as marriages are made for better or worse, there exist powerful inducements to resort to the contrivances of the ingenious and humane.

The following case of malformation fell under my own observation; the adjoining delineation is a true picture of the circumstance.

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The penis,b, at its under surface, was adherent, from birth, to the scrotumc, consequently, when erection ensued, it presented the form of a half circle; the urine escaped near the root of the penis,a. The penis itself was impervious, but sensible to the amative passion. The gentleman submitted to a division of the fold which united the penis with the scrotum, which former, on being thus released, assumed its proper position; sexual congress was thereby attainable, and during erection the orifice of the urethra was drawn sufficiently up to allow of the ejection of the semen into the vagina. Of the ultimate result I have yet to hear.

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It may appear almost incredible, that the sketch here presented can be a true one of the penis and testicles of a young man upward of 19 years of age. No less was it a source of wonderment to myself than it may afford a doubt to others. I carefully examined the individual, and saw him urinate; the stream was certainly small, but surprisingly large for so minute an organization.He was quite unconscious of amative feeling; the testicles were distinctly perceptible by the finger, but they certainly were not larger than cherry kernels. The young man, in other respects, preserved the male attributes; he had a slight beard, and his voice, though not powerful, was by no means effeminate. I had several interviews with him, and then lost sight of him.

I have elsewhere portrayed a relaxed state of the testicle, called varicocele: the accompanying draught exhibits the same in an aggravated form. The patient possessed but little amative power, and had also a thickened condition of the prepuce, which produced a perfectphymosis. The case, however, under treatment became considerably relieved. The phymosis required a division of the prepuce, an operation productive but of little and momentary pain, or rather twinge, and healed in a few days. Children are sometimes not procreated for want of sufficient erectile and consequently penetrative power of the male organ. Much and often needless misery results from this infirmity.

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The loss of erectile power is occasioned through more causes than one. Erection ensues independently of the will or imagination, as instanced on awaking in the morning—the cause is most probably a distended bladder; the phenomena may be a sympathetic irritability of the muscles of the perinœum, especially the erectores; there is a general pelvic disturbance, the nervous excitement is increased, and the rush of blood (obedient to that excitement) is sent to the penis: such, I believe, is the sympathy between all these structures. The will exercises the same, and the results of the imagination do not materially differ; consequently, where the mind fails in producing these effects, local excitants may be found to supply its office hence the usefulness of art in combating the eccentricities of nature. The mere handling of the testicles kindles desire, and in like manner, stimulatives applied over the scrotum generate amative heat.

A curve of the penis is sometimes an obstruction to connubial intercourse; this arises from adhesion or obliteration of the cells of theCorpora Cavernosaon one side only,preventing the uniform flow of blood into those structures, and consequently the equal distention of the penis. The curve is of course laterally, and occasions in the act of coition pain to both parties, or the power of penetration is insufficient. Occasionally this malformation is only temporary, and consequently remediable.

Franckgives an instance in which so considerable a portion of the penis had been carried away by a musket-shot, that when the wound healed, the organ remained curved, and yet proved adequate to the performance of its functions.

An opinion formerly prevailed, that the existence of the testes was unnecessary for effective copulation; but that is no longer a point of dispute: their absence, whether natural or artificial, invariably rendering the invalid unfruitful. It is not, however, to be inferred, that a person is impotent in whom no testicles are discovered in the scrotum, instances occurring where they do not descend from the abdomen (their embryotic abode) through the whole period of life. One testicle, provided it be sound, is sufficient for procreation. Complete extirpation of the testes, although destructive of procreative powers, does not extinguish venereal desire. Where the genital organs exist, but are malformed, or pathologically altered, their virility may be nullified.

The most frequent malformation is in theurethra, which sometimes opens in the perinœum—the part markedain the annexed cut; at others, on the dorsum of the penis, and not unfrequently under its surface: so long, however, as the orifice opens in that portion of the penis which enters the vagina, so that theemissio seminismay be therein deposited, impregnation may and will take place; and even in cases where artificial means have been employed to convey the fluid.

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A contracted state of the prepuce, its adherence to the glans, or that condition of it termed phymosis, form impediments to the emission of the semen which can only be removed by an operation; and if that be neglected, the evil continues through life.

Among the diseases which occasion sterility in the male, those affecting the penis and those incident to the testiclesmay be enumerated. With regard to the former, there often exists an excess or deficiency of muscular or nervous energy, inducingpriapismor permanent erection in some instances, or paralysis or permanent flaccidity in others. Inpriapism, the erection is so vigorous, and all the parts so distended, that the semen can not pass into the urethra; while inparalysis, from some inaptitude of nervous or muscular powers of the genital organs, thecorpora cavernosareceive but a limited supply of blood, insufficient to create erection, or provoke a seminal discharge.

Strictures of the urethra are among the barriers to sexual intercourse; but happily, only in extreme cases, where the urethra is all but closed, so as to oppose the passing of the finest bougie.

The testicle is subject to a variety of diseases, wherein such a relaxation or obliteration of its structure ensues, that the seminal fluid is no longer formed: and where both testicles are alike affected, sexual desire is most usually wholly extinguished—the smallest portion, however, of either gland remaining uninjured, may still be capable of secreting semen sufficient for impregnation.

Impotence may follow accidents to the testicles, such as produced by a bruise; or even a testicle, which shall have become inflamed from clap, shall become so chronically hardened as to be useless. Bruising the testicles was the mode adopted by the oriental courts for destroying masculine efficiency in the attendants of the harem.

There are certain conditions of health in which, although the genital organs may be perfect, yet, owing to some constitutional frigidity, there is an incapability of erection. The offspring of too young, or very aged, infirm persons, or of those worn down by debauchery, are but too common instances.

The appearance of persons of this temperament is thus described by a French writer: “The hair is white, fair, and thin; no beard, and countenance pale; flesh soft and without hair; voice clear, sharp, and piercing; the eyes sorrowful and dull; the form round, shoulders narrow; perspiration acid; testicle small, withered, pendulous, and soft; the spermatic chords small; the scrotum flaccid; the gland of the testicle insensible; no capillary growth on the pubis; a moral apathy; pusillanimity and fear on the least occasion.”

The most frequent cause of impotence, at that periodof existence when man should be in the zenith of his procreative power, is in a general weakness of the generative organs, induced by too early an indulgence in coition, the pernicious and demoralizing crime of masturbation, or the abuse of venereal pleasures. In these cases, erection will not take place, or but feebly, although the mind be highly excited by lascivious ideas. The erector muscles are paralysed from over-use, and the semen, if any is secreted, from the lax and withered state of the testes, is clear, serous, without consistence, and consequently deficient of prolific virtue. Sometimes there is a want of consent between the immediate and secondary organs of generation; thus, the penis acts without the testicles, and becomes erected when there is no semen to be evacuated; while the testicles secrete too quickly, and an evacuation takes place without any erection of the penis; the latter disappointment is of extensive prevalence.

Impotence is sometimes occasioned by particular diseases during their continuance, such as nervous and malignant fevers; while, strange to relate, an opposite effect is sometimes produced by other diseases, such as gout and rheumatism, hæmorrhoids, &c.; and instances are on record, that others produce such a change in the constitution, that an impotent man may find himself cured of his impotency on their cessation.

Of all the functions of the animal economy, none are so subservient to nervous influence as those of generation, which, when the organs are perfect, and respond not to the natural application of them, the cause may be classed among those impediments termed moral.

As the parts of generation are not necessary for the existence or support of the individual, but have a reference to something else in which the mind has a principal concern; so a complete action in those parts can not take place without a perfect harmony of body and mind, that is, there must be both a power of body and disposition of mind; for the mind is subject to a thousand caprices which affect the action of these parts.

As these cases do not arise from real inability, they are to be carefully distinguished from such as do; and, perhaps, the only way to distinguish them, is to examine into the state of mind respecting this act. So trifling often is the circumstance which shall produce this inability depending on the mind, that the very desire to please shallhave that effect, as in making the woman the sole object to be gratified.

IMPOTENCE AND STERILITY OF THE FEMALE.

A femalemay be impotent, and not sterile; and sterile, but not impotent. Impotence can only exist in the female, when there is an impervious vagina; but even this condition does not necessarily infer sterility, many cases being recorded, where the semen, by some means or another, through an aperture that would not admit a fine probe, has found entrance to the vagina and occasioned impregnation.

Impotence may arise from a malformed pelvis, the absence of a vagina, adhesion of its labia, unruptured hymen, or one of such strength as to resist intromission. In the two former instances, sterility is irremediable; but art, and indeed nature, may overcome the latter impediments.

Were these pages intended only for the surgery, instead of the public, the annexed wood cuts would be unnecessary, medical men being conversant with the inconvenience in question; but all the world not being blessed with similar anatomical information, the sketches are presented. The upper one represents the relative situation of the female urethra (1), and the contracted orifice of the hymen (2). In the cases of hardened obstruction, where the hymen assumes an almost cartilaginous texture, the attempts at marital consummation are fruitless, and often give rise to severe local inflammation. The infirmity, on the other hand, is easily and painlessly removable by surgical skill. The lower drawing represents a hymen with two apertures (2), which, if broken down by violence, leaves a troublesome lacerated wound. The surgeon’s assistance is indispensable.

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Where hermaphroditism exists, the sex is usually more masculine; it is a vulgar error to suppose that the two sexes exist entire, and that theyare capable of giving and receiving the offices of married life. The present sketch is merely introduced to show the more frequent malformation. The penis exists, but has no urethra: below is an opening resembling the vagina of the female, which is but of short length, at the bottom of which (in fact, the perineum) the urethra opens. The testicles are entire, and the individual from whom the draft was taken possessed somewhat the desire of the male, without the capability of penetration: the penis, when excited, from its attachment to the lips of the imaginary vagina, and also from its contracted form, presenting merely a kind of bulbous tumor. Even where hermaphroditism more closely partakes of the female, conception never takes place; hence all such parties are sterile.

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Nature, as if to atone for denying to some the delights of maternity, has been occasionally doubly bountiful to others. The annexed drawing exhibits a section of a double uterus. Cases are on record, where both have been impregnated.

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In the instance of a deceased married female, that fell under my observation, the uterus or womb presented the following appearances: The usual cavity was discoverable, but it was filled with acheesy-like substance, and also there were some ulcered-looking caverns filled with the same material. This female, while living, endured continued pains in the uterine region, was insensible to marital physical enjoyments, sterile, although a wife several years, and the constant sufferer from a vaginal discharge. Her death was consequent upon a severe cold that ended in consumption.

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Leucorrhœa is often attended with barrenness; at all events, it is very debilitating, and thus impedes conception. A notion once prevailed, that women who did not menstruate could not conceive; it has since been disproved, except in those instances where menstruation never occurred: a single monthly discharge indicates an aptitude for conception. It is observed that barren women have very small breasts. Women who are very fat are often barren, for their corpulence either exists as a mark of weakness of the system, or it depends upon a want of activity in the ovaria: thus spayed or castrated animals generally become fat. The same remarks apply to the male kind, who are outrageously corpulent. There are many other peculiarities in matrimonial life, fertile subjects for speculation; such as, for instance, the lapse of time that often occurs after marriage before conception takes place, and the space between each act of gestation; the solution of which may be, that these occurrences are modified by certain aptitudes, dispositions, state of health, &c.; the same may explain why persons have lived together for years in unfruitful matrimony, and who yet, after being divorced, and marrying others, have both had children.

It is not always that the most healthy women are more favorable to conception than the spare and feeble. High feeding and starvation are alike occasionally inimical to breeding. The regularity of the “courses” appears principally essential to secure impregnation; and the intercourse is generally held likely to be the more fruitful that takes place early after that customary relief.

Women in health are capable of bearing children, on an average, for a period of thirty years, from the age of fifteen to forty-five; but their incapacity to procreate does not deny them the sexual gratification, it being well accredited, that women upward of seventy years of age have been known, who have lost but little of the amative inclination and enjoyment which they possessed in their early days. Men certainly possess their procreative power to a longer period, it being common for men to become fathers at eighty, ninety, and one hundred—old Parr becoming a parent at the age of one hundred and thirty. Women rarely fall pregnant beyond fifty.

Some females endure intense pain during coition, so as to occasion fainting or great exhaustion. Such suffering is usually traceable to internal ailments—such aspiles,fistulousopeningsbetween therectumandvagina,ulcerated wombs,vaginal tumors or abscesses. Cases continually present themselves, where, on the removal of the cause, the effect is cured.

The number of children that women have individually given birth to is very variable. It is attested, among a collection of facts of this nature, that one female gave birth to eighteen children at six births; another, forty-four children in all, thirty in the first marriage and fourteen in the second; and in a still more extraordinary case, fifty-three children in all, in one marriage, eighteen times single births, five times twins, four times triplets, once six, and once seven.[14]Men have been known to beget seventy or eighty children in two or more marriages. With regard to the average proportion of male and female births, it appears that the males predominate about four or five only in one hundred. The average number of children in each marriage is, in England, from five to seven.

To a continual irritability of temper among females may be ascribed infertility. Independently of ever fostering domestic disquietude, it produces thinness and feeble health; and, where pregnancy does ensue, it most frequently provokes miscarriages, or leads to the birth of ill-conditioned and puny offspring.

Perhaps one of the most indispensable and endearing qualifications of the feminine character is an amiable temper. Cold and callous must be the man who does not prize the meek and gentle spirit of a confiding woman. Her lips may not be sculptured in the line of perfect beauty, her eye may not roll in dazzling splendor, but if the native smile be ever ready to welcome, and the glance fraught with clinging devotion, or shrinking sensibility, she must be prized far above gold or rubies. A few moments of enduring silence would often prevent years of discord and unhappiness; but the keen retort and waspish argument too often break the chain of affection, link by link, and leave the heart with no tie to hold it but a cold and frigid duty.

TREATMENT OF IMPOTENCE.

Inventuring upon this part of the subject, it will be as well, first, to distinguish those cases that are curable from those that admit of no relief. Among the latter may be enumerated all those arising from an original or accidental defect in the organs of generation. Where, also, old age is the cause, little is to be done: medicines are of no avail, and temporary stimuli not unfrequently worse.

That certain medicaments, aliments, and so forth, do possess anaphrodisiacpower, is not to be denied; but when adopted by those weak beings, whose bodies are either worn out by age or excess, and who pin their faith to such restoratives, the little remaining sensibility in their frames, the source of life and energy, can not sustain the shock of reaction; and the result is, total annihilation or death.

From what has already been stated, it will be perceived, that the mind exercises no inconsiderable influence over the functions of the organs of generation: and as the state of the mind depends upon the particular circumstances under which it may be placed, any attempt to establish a code of instructions, applicable to every instance in which a sportive fancy, or disturbed imagination, constituted the prevailing cause, would be abortive, and might be considered as pandering to a vicious and depraved appetite, whereas the object of this treatise is only to encourage the diffident, to assist the afflicted, and render a service to those legitimately deserving it.

As excess in sexual indulgence impairs the generative power, no less injurious may entire abstinence be considered. The due exercise of an organ tends to its perfection, as the neglect or misuse of it, to its impairment. Besides, there is not any wonderful virtue in abstaining from the proper use of the sexes. Why, in the name of morality, were such powerful impulses and desires bestowed upon us? Why were such wonderful organizationsgiven to us, if they were not originally designed to be used by every one who is possessed of them? Society, in its present form, is not perhaps constructed with a philosophical regard to our own natural instincts, and our own original rights.

Among the causes that induceimpuissance, or that distressing condition known under the cognomen ofnervous debility, there is not one more reprehensive than the unworthy and pernicious practice of self-abuse. It is much to be regretted, that some medical writer, of talent and estimation in society, has not turned his attention to the subject, and given the influence of his name in denouncing to the world the misery and devastation which are the unerring consequences of this sordid and solitary vice. It is indeed an unpleasant and thankless task; and there probably exists in most minds, an unwillingness to enter upon a subject in which there is so much difficulty in selecting language sufficiently appropriate to exhibit the folly in its true colors, without offending the ears of the chaste and virtuous.

But a question of such paramount importance should not be sacrificed to any false and prudish notions of delicacy; I shall therefore offer such observations, as I may think calculated to check the progress of a vice, that has done more to demoralize the human mind than the whole catalogue of existing causes besides. It may be deemed an exaggeration, when it is stated that full three fourths of the insane owe their malady to the effects of masturbation: but the assertion is corroborated by one of the first writers on medical jurisprudence, and is fully borne out by the daily experience of proprietors of lunatic asylums. The practice of self-abuse usually has its origin in boarding-schools, and other places where young persons congregate in numbers; and there are few of us who may have observed the vice practised, although it may be unpleasant to avow as much, that could resist the contamination.

“One sickly sheep infects the flock,And poisons all the rest.”

“One sickly sheep infects the flock,

And poisons all the rest.”

And thus it is, though ninety-and-nine be pure and spotless as the driven snow, if the hundredth be immoral, the poison is soon disseminated, and the whole flock become initiated into a vice, which, if indulged in, will blast theirintellectual faculties, and probably consign them as outcasts of society; rendering them slavering idiots, or the inmates of a lunatic asylum. It is not only in private schools that this sin rages, our public foundations and colleges are not exempt from it. The heads of our universities are particularly scrupulous in driving from their neighborhood the frail fair, lest they should contaminate the votaries of learning; while a vice far more degrading in its practice, and infinitely more baneful in its effects, rages within the very sanctuaries of classic lore. Many a brilliant genius has sunk into fatuity beneath its degrading influence. Loss of memory, idiocy, blindness,[15]total impotence, nervous debility, paralysis, strangury, &c., are among the unerring consequences of an indulgence in this criminal passion. I need not bring a greater proof of the dire effects of an indulgence in the practice of masturbation, than the deplorable state of mind to which it reduced one of our greatest poets.

The treatment of this delusive and mentally annihilating propensity, falls equally within the province of the philosopher and the physician. Without a total abandonment of the practice, the case is hopeless; and he to whom the consequences shall have been portrayed and heeds them not, is unworthy of our sympathy, but deserves the evils he entails upon himself.

Now, as the consequences of all criminalities continue to ensue so long as the provocative be kept up, it is very evident that, as a first step toward the restoration of order and health, the cause must be removed or withheld. The mere will or resolution is seldom sufficient: virtue, like vice, has its allurements, and those belonging to the former must be called into requisition as antagonists to the snares of the latter. Physic can not check bad principles, or bad indulgences. No method is or can be superior to that full employment of the mental faculties on noble and intellectual subjects, on objects worthy the high ends forwhich Nature has adapted them. And though the difficulty will be great in inducing new and good habits, to the exclusion of such as are unworthy and degrading, yet the effectual accomplishment of such a resolution is not of uncommon occurrence; and the sufferer may be placed under circumstances where good habits may be more frequently called into action naturally, to the exclusion of vicious propensities. The time should be well filled, so as to leave no room for flying to the various usual sources of amusement that fill up the life of the thoughtless and gay. Every hour and every minute should be provided for, so as to exclude the admission of idleness and sloth, the forerunners of mental and bodily disease. Studies connected with education should be encouraged. Modern languages have a great claim on the consideration of all who are engaged in business to any extent, and are of incalculable use after they have fulfilled the immediate end for which their culture is here recommended. The various sciences bearing more or less on the pursuits and employments of every man, are earnestly recommended to the choice of the unfortunate victim of sensuality. Geology and botany would call him into the healthful fields, or fill up his time by his fireside, in studying the many excellent works on those subjects: the still higher utility of chemistry, as being made of practical use in almost every business, and demonstrating the else unintelligible phenomena of a multitude of natural processes and changes, may be held up as another inducement to call forth his best energies.

Travelling, to those who can afford the expense or the time, is one of the best means of conquering this baneful habit. The numerous objects thereby presented to the eye of the invalid in the manners, government, and productions of art and nature, of the countries he visits, are an incessant source of pleasing and useful excitement, and can not fail, especially if the traveller be accompanied by an intelligent and moral friend, to weaken and eradicate the bad impressions of the past.

To diverge, and at the same time to conclude this part of the subject, I have only to offer a few remarks relative to the medical and therapeutic treatment of those cases of impuissance, that age, disorganization, and total incapacity, do not exclude from consideration. I have already expressed my belief that generative imbecility is consecutiveto general debility; hence, whatever tends to improve the latter, tends also to remove the former. The diet, therefore, should be full and generous, with a liberal proportion of spices; but all stimulating liquids, such as wine, brandy, and the rest, should be avoided.

Bathing, in its various forms, constitutes no unimportant feature in the treatment; the cold plunging, the tepid shower, the douche, the warm and the vapor baths, possess their several influences. The various medicines that come under the denomination of aphrodisiacs, are not wholly uninfluential, such as stomachics, aromatics, gums and balsams, oils, musk, opium, cantharides, strychnine, and others; but as their administration can only be permitted under professional direction, no real utility can follow any specification or formulary of their proportions.

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