NERVOUS DISEASES RELATED TO THE MALE GENITAL FUNCTIONS.

By J. T. MCLAUGHLIN, M. D., Springfield, Ohio.

Diseases of the nervous system are usually complicated, and require the greatest skill in diagnosis. Especially is this the case with that class which arise from some hidden local derangement or functional disorder, and particularly the ones that spring from their relationship to the male genital functions. Persons exhibit delicacy in the matter of disclosing their true condition, and often a great unwillingness to admit a relationship between their ailment and the sexual system; or, as more frequently happens, they are ignorant that such a connection exists. The physician must, therefore, determine the primary source of the disorder from the general appearance and symptoms of the patient, as well as from the facts gathered during past experience.

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It is universally admitted that so far as woman is concerned, many nervous ailments arise from the female system, either from enforced continence, or abuse, or perversion. standard medical works refer faithfully to such disorders, and very properly ascribe them in detail to the cause producing them. The diagnosis, prognosis, etc., are carefully presented. But while the nervous disorders of woman are allotted so much space and detail, the diseases peculiar to man are dismissed or ignored, as if his nervous system was so matured by nature as to be impregnable against disorders incident to the sexual functions. It is true that under the diseases to which he is liable, reference may be made to the fact that the symptoms of such a disease may be aggravated by the use or the abuse of the function; and that in direct diseases of the genital organs, and in those which can be directly traced to their abuse, full mention is also made respecting the influence upon the nervous system. But a proper scientific tracing of nervous disorders, deducible from the condition of the male genital functions, is something lacking in medical literature. We have, for example, Diseases of the Genital Organs, and

under various heads as, for example, insanity, the relationship existing between the same and the genital function through the weakening and decay of nervous force is called to our notice. But in no work designed for the profession is considered, in a separate and logical form, the male genital function and its connection with nervous diseases. Here and there, indeed, we find some brief essay or attempt to direct attention to the subject, or to supply material for some future student to develop into a reliable treatise, of medical value, for the use of the profession. There may be publications extant which the writer has no knowledge of; but the effort that has thus far met his eye is Dr. Beard's article in The Medical Record. It is to be hoped that such studies will be prosecuted until man shall be presented to us prominently in this most important particular.

The object of this article, is simply to call attention to such existing nervous disorders, and to impress it upon our practitioners, that when they encounter well-marked cases, in which the connection between the disease and the male function is clearly and unmistakably madeo ut, a record ought to be made and reported to the profession. It is by the continued observation of the thousands of intelligent physicians, and the reporting of such publicly, that men specially engaged in the investigation of principles and their deductions, of diseases and their causes, of science and its fundamental facts, are enabled to prepare those valuable compendiums, which indicate and do so much honor to the progress of medical science. One fact well supported by critical observation, and attested by the confirmatory evidence in the practical experience of others, is worth far more than ten thousand mere guesses. Especially is this true of nervous diseases, many of which, as every physician knows, are exceedingly difficult to trace to their origin. So long as the proper diagnosis is not effected, and the exciting cause of disease unfolded, we cannot hopefully expect a successful treatment and cure. If help comes at all in such cases, it is by mere accident, or through nature helping herself. The physician has no valid title to credit in the matter. For example, if a nervous disorder arises from

the male genital function, and we attribute its origin to some other source, a grave mistake is made at the very outset. Our treatment, if it does no good, may seriously aggravate the trouble, or least aid in seating it so permanently as to make it chronic.

Within the limits of a single brief paper, it would be impossible to include the wide field opened before us, or discuss what are known in the profession as "knotty questions." The complexity of the subject, the conflicting opinions, the difficulty of answering inquiries, have, no doubt, led largely to the ignoring of the whole matter. But it cannot be safely passed by in this way. The physician who gives it the due attention in his daily practice will become able to detect the exciting causes of disturbance, which remain a profound mystery to others.

We may premise the subject by the following propositions: 1. Nervous energy, whatever we may consider or denominate it, is the potency which exists in and behind every physical function.

2. The exercise of every physical function is the employing and expending of nervous energy.

3. Every agency or influence tending to impair any physical function is associated with a corresponding disorder, of the nervous system, either as the occasion or the effect.

4. The sympathetic nervous system is more interior and vital to the physical structure, and is that part of the organism to which all emotional conditions pertain.

5. The cerebro-spinal axis is relatively exterior and is the nervous centre of all of the sensory, mental and intellectual nature.

6. The sexual organism is copiously supplied from both nervous systems; that of the female, which is mainly internal, having a larger relative proportion from the sympathetic, and that of the male from the cerebro-spinal.

7. Maladies of the female system are characterized by emotional derangement, and those of the male system by mental disorder and the affections which indicate the participation of the cerebro-spinal axis.

In view of these facts, it is apparent, a priori, that if the male function is not exercised in accordance with its natural purpose, or if it is abused or perverted, a detrimental influence will be reflected on the nervous system, which will in turn be disordered. Few medical men entertain any difference of judgment in regard to the above, consisting in excessive exercise, or perversion as by masturbation. The agency of these in disturbing the nervous system, and producing nervous disease is generally acknowledged. Analogy appears to confirm this idea. Digestion is as vitally related as the sexual function to the nervous system and its conditions, and in a corresponding manner will originate nervous disorders. The two functions are indispensable to the continuation of physical existence. They are created and maintained by the nervous energy, and by their proper action or their abuse a beneficial or injurious influence is imparted to the nervous system. But individuals differ widely from each other. There are various degrees of sensitiveness, grossness, etc., which render it impracticable to devise rules applicable alike to all men. In digestion, what appears to be wholesome for one is manifestly injurious to others. There exist like diversities in respect to the exercise of the sexual function. It seems necessary, therefore, for the physician to form his judgment in the individual cases. Some are so constituted as not to be able to endure what would appear to be moderation in others, and even conducive to health. It is a severe strain upon their powers of endurance, diminishing the vital energy, and seriously disturbing the nervous system. We must enforce great caution upon those who are so weak as to be seriously affected with depression of the nervous system by continued or absolute continence, or by sudden privation after prolonged association with the other sex.

In certain other cases, such continence is likely to be of serious injury; as, for example, where the food, the imagination, or other influences operate to rouse the natural passion. In other instances, where the nervous system is less impressible and the general health is good, these agencies and even involuntary seminal losses appear to produce no ill effects.

Sedentary or active pursuits constitute an important factor, and must be duly considered.

On the other hand, when the bodily condition is not equal to the tax, inordinate indulgence is very certain to act perniciously on the nervous system, impairing its energy, and entailing in a large degree, symptoms precisely like those noticed in women as pertaining to the morbid condition of their peculiar organism. To be sure these symptoms are more marked and traceable in them, owing to their more delicate organization; nevertheless, the fact that they exist in individuals of both sexes and originate from similar causes, was long ago remarked by eminent writers. The very complexity of the male organism, and its intimate relationship to the other parts of the body, as is the case with woman, must naturally cause aberrations, whether by inordinate or insufficient indulgence, that will involve the nervous system more or less generally. The effects of castration upon animals and men, the immediate consequences of excessive venery, the mental condition as influenced or induced by sexual passion, the neuroses sometimes exhibited by old maids and bachelors, and the neuroses and the peculiar nervous debility following as well as attending venereal diseases, are forcible illustrations of the very subject which we are endeavoring to treat. Sudden changes in a prolonged habit from one extreme to another, are well-known to exert a direct or reflex influence upon the nervous system. This must be especially true in connection with the sexual function, which rules so largely in man and woman, and to whose movements we are more or less subject, nolens volens.

We will append a few suggestions in relation to diagnosis. We may find a patient afflicted with some neurosis, like morbid fears, hypochondria, headache, insomnia, repugnance of society, profound exhaustion, tendency to suicide or insanity. Further inquiry will bring out some information like the following that there is enforced continence by reason of a wife's death, with whom he had lived many years; that he is a man with acute nervous sensibility, who is persistently continent; or that after long celibacy and attendant continence, he has