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 University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    these cases from the gonorrhoea spreading backwards and settling in the posterior part of the urethra, where it sets up an irritation communicated. to the seminal vesicles, whence arises spermatorrhoea ? Plausible as this style of argument may appear, it rests on a train of statements which have yet to be thoroughly examined. In the first place, when the action of gonor- thoea extends to the ejaculatory ducts at all, so that its presence can be determined, either the suppurative inflammation spreads, and then it rarely stops short of producing swelled testicle, or it is a rai)ifl transient irritation, like that producing chordee and irritable bladder, which, though it may ag- gravate, can rarely, I think, liring on sjierma- torrhoca. In the second place, it has to be shown that the seminal vesicles have any- thing to do with this disease. Tliere, are, however, certainly cases in which the gonorrhccal action is kept up in the posterior part of the urethra, and where at the same time the sperniatorrluEa has be- come worse after the infection has taken place. Mere cauterization may be productive of benefit. I have succeeded with it myself; but I have succeeded still better with other means, and in more than one instance, when I had proposed first to blister the penis, and then to resort to the caustic, found the latter no longer necessary after the blister had been applied. As there can only be two sides to a question of this kind, it follows either that the arguments I have used are wrong, or that the invariable employment of caustic, the opinion that it is a specific for spermatorrhoea, nmst fall to the ground. Instead of Lallemand's instrument, I very often make use of one I had constructed for the purpose. It consists of a platinum canula and a stilet. The instrument is passed down to the diseased part, and the stilet being withdrawn, a small flexible bougie is introduced armed in the following way : the tip being scraped so as to make it rough, it is dipped in fused caustic, and then in melted tallow; by this means a thin film of caustic is secured, which acts on every part, without the risk of excessive cauterization at any one point. A large opium plaster to the loins will generally allay the aching pain so much com- plained of; I have often added a scruple of camphor to the plaster, without being able to give any good reason for so doing beyond the beneficial effect which resulted from it. The chief remedy in cases comphcaled with gleet, severe pain, and pundent dis- charge fi om the posterior i)art of the urethra, is blistering, which is even more called for than in the other forms of the disease. It very frqguently not only relieves the seminal discharges, but it reUeves the cause, and I know of no other remedy which does both at the same time. In every diseased action there appears to be increased vital action at the parts at- tacked ; and as all the functions demand the presence of a certain amount of vital power for their due performance, there is a con- stant tendency to restore the balance.de- ranged by flisease. In chronic disorder the strain on the economy seems too slight to rouse up any violent action in the other parts, and we can only effect a cure by irri- tants, which carrj' the vital action so high, that when the rebound takes place it reverts to the normal state; like a bent spring, wliich, when bent still further, straightens itself by the recoil. Along with blistering I have sometimes used injections of nitrate of silver to any part of the urethra which seemed diseased, employing a syringe with a button at either eiui of the part perforated for the passage of the injections. By this means the urethra is kept sufficiently on the stretch to admit of the injection penetrating into every nook of the diseased part, while the buttons pre- vent its escape. The injection ought to be allowed to remain in contact till the nitrate is decomposed, so that the anterior part of the urethra may not be affected by it. In all forms of spermatorrhoea, the food ought to be as plain but as nourishing as it can be procured; no pastry, pickles, or beer ought to be admitted into it, but plenty of meat and potatoes, or bread, for dinner, with a little tea or coffee morning and evening; if possible, meat twice a day. The worst cases have always seemed to be more bene- fited by a fuU meat diet than by any medi- cines ; and it is not uncommon to find that a patient has grown worse in every symptom in proportion as he has become a more tho- rough vegetarian. The further south we go, the more do we find a vegetable diet sup- planting the animal food of northern nations, and the more prominent a place does sper- matorrhoea assume in the catalogue of dis- eases. Difference of race I shall be told is sufficient to account for this : the Spaniard and the Moor are by nature more ardent than the Esquimaux; the Persian and the Arab than the Livonian. True, but not therefore by nature more prone to sperma- torrhoea ; it is, that, degenerating by civili- zation, they fly more readily to that kind of . diet and to those habits which jjroduce sper- matorrhoea. From what I have been told of those going to hotter climates, and using the diet prevailing there, it so invariably aggra- vates the symptoms, that it seems only