Pseudo-Spermatorrhoea.—A male, enjoying the best of health may, under certain influences, have an involuntary discharge of seminal or prostatic fluid; but as the latter will be treated in full below, I shall first consider accidental discharges of semen as a pseudo-spermatorrhoea. Impressions are wrought upon the nervous system, sometimes of a stimulant character—other times like a shock—that are followed by involuntary losses of semen. It is not uncommon for semen to be found in the clothing of criminals hanged by the neck; or for soldiers to ejaculate semen at the time of entering an expected battle. Involuntary discharges as often occur from the bowels under similar influences.

But mental shock is not essential to the production of such relaxation of sphincters. I have on numerous occasions produced an ejaculation of seminal fluid by the strong currents of electricity passed through the genitals, localized.

A cold bath has not been uncommonly the cause of such losses, in perfectly healthy subjects. I was once riding, in company with a friend, through the country on horseback. My friend had suffered some rheumatic pains, for which I gave him opium and quinine in large doses which, under the influence of the friction of the saddle, caused an ejaculation of semen without erection or erotic thoughts. He was a robust fellow, and knew nothing of sexual weakness of any kind.

Young men sometimes, and married men that have been continent a long time, and bachelors commonly, are subject to spermatic ejaculations involuntary, without genital debility. It has been stated by authors, high in authority, that seminal losses two or three times a week were only physiological. From this I must dissent. I do not wish to be understood as saying that occasional seminal losses are always injurious, but I do not on the other hand believe, as do some, that even occasional losses are really and always physiological.

To think that the disease exists entirely in the act of involuntary emission, is as great an error; as it would seem only rational that, if a larger quantity of semen was manufactured than the vesiculÆ seminales could hold, the natural result would be an evacuation. Again, I have known males to live continent and have involuntary losses for ten years, as often as weekly, and no evidence of any general or local debility. Yet I believe this to be an exception worthy of note. It is quite useless to attempt to effect a cure in some of these cases of pseudo-spermatorrhoea, as no real disease exists. Some of them will continue: others are only transitory, and need only to be assured that no wrong exists. Even if it is not physiological or desirable that such things should exist, yet it is not actually pathological.

Again, so-called mental spermatorrhoea partakes partly of this character; especially when a young man is so pathophobic, from mere book-reading fright, derived from specialists and impostors, whose main business is to scare a young man to pay out his money and be humbugged. If he has not had emissions oftener than monthly, and he is of a confiding turn of mind, a troublesome mental disease may be founded. If no marked physical disturbance follows these occasional losses, I generally inform the young man that he has been mistaken as to the gravity of his troubles; thus putting his mind at ease, and the patient in a position for self-recovery.

Case.—Not long since, a young man was under my care who was pathophobic; his mind constantly dwelling upon what he had read; and the occurrence to his mind, that he had losses of semen as often as once in six weeks—although he was a vigorous blacksmith—caused him to imagine himself suffering with all the usual bad feelings of an advanced case of nightly seminal losses. He appeared in good health; was able to do a day’s work, and to work well; but, nevertheless, he was neurasthenic, and at times very feeble; or, at least, he thought he was. When once he could be made to forget his imagination, he would be as strong as ever. The simple assurance that he would recover with simple treatment was unavailing; but when persuaded to think much was being done, and that his medicine was very potent, he soon ceased to be troubled with his worry and was quite well, although he had taken only a simple bitter. He finally became afflicted with a sore upon his prepuce, which was of a herpetic nature only, and for which he consulted a score of doctors, as the sore would appear from time to time. All informed him of the harmless nature of the eruption, but he had faith in no one until a venereal specialist reduced his purse to vacuity, when he returned to me for advice. He was simply syphilophobic, and demanded only a deceptive treatment, with assurance that his trouble was of a local character and never could grow upon him; but shortly his herpetic trouble ceased to appear, and something else victimized his imagination. Such is the mental predisposition of the nervous, imaginative class who only suffer, to any extent, with what to them appears to be disease.

Such a case of pseudo-spermatorrhoea would not irritate, in body or mind, any person of good reasoning capacity; but, unfortunately, such persons are not as common as may be supposed; hence, the deceiving specialist has many willing victims.

Prostatorrhoea, may exist as an independent, uncomplicated and local disease, or in conjunction with spermatorrhoea. My experience leads me to remark, that the latter seldom exists without the former, but that prostatorrhoea commonly exists as an independent disease; and when the flow of semen does not amount to sufficient, in frequency, to consider it a cause or a consequence of disease. In my judgment, this flow of glary, viscid fluid is most commonly observed while straining at stool from constipation. Young men very commonly apply to specialists and exhaust their funds and return to the less pretentious family doctor for a more satisfactory and truthful statement. Even with this little discharge of prostatic fluid, and when no sign of spermatorrhoea existed with it, the young man may experience all the phenomena of true and long-standing spermatorrhoea. His mind suffers, as well as his body, with imaginary nervous phenomena too numerous to mention. But in these conditions it is not uncommon to find very troublesome disease of the prostate gland, brought on by gonorrhoea, sexual excesses or masturbation, existing alone or with true spermatorrhoea.

An examination will reveal enlargement and tenderness of the gland, commonly irritation of the neck of the bladder. If we make inquiry, the history of prostatic inflammation will be obtained, and gonorrhoea or venereal excesses. Pressure upon the prostate, through the rectum, will not uncommonly cause a discharge of prostatic liquid, which is followed by a smarting sensation. Copulation and ejaculation are sometimes followed by a burning pain in the prostate gland, which lasts sometimes a few hours—commonly a few moments. Prolonged erection is followed by a discharge of viscid fluid, not ejaculated, but simply flowing away. When the bowels are constipated, as scybala pass the gland, a viscid fluid is pressed out and drips from the end of the penis with a smarting soreness, prolonged in the gland. The fluid is not hurled forth, or ejaculated in jets, like semen, but a thin glary fluid. The disease is commonly only local, and needs very little constitutional treatment.

The tinct. staphisagria, so highly recommended by many, will often act very kindly as an adjunct, but will not cure the disease. Cascara sagrada must be used for a long time, to regulate the bowels and digestion. Faradisation, localized and general, is the only agency that may at nearly all times be relied on for permanent relief.

When the disease exists with true spermatorrhoea the above treatment is none the less essential, and only needs modification to meet special indications.

The manner of using electricity for the relief of prostatic disease is very simple. My experience has led me into the habit of placing the positive pole as closely in contact as possible with the gland. I sometimes introduce an electrode into the urethra—other times into the rectum—connecting the anode, and with the cathode and large wetted sponge stroking the lumbar and sacral regions, especially over the origin of the hypogastric nerve and plexus. If there be tenderness over any part of the spinal cord, I change the poles and apply the anode to the spinal tenderness. Such tenderness is very common over the sacral plexus. Again, it is important in the way of ascertaining causes, to know which antedates the other, the prostatic tenderness or the spinal tenderness; and the anode should be applied to that irritation which is found to be the most ancient; as, commonly, upon the spinal tenderness the prostatic irritation depends. But this rule is not always tenable, yet will answer very well in a new case until an electric test, as it were, is obtained.

Whenever unrest, pain or fulness follows the use of one pole to the gland, it is safe to change; as such is not the desired effect. There is no one thing so needful in the use of electricity as familiarity with the physiological effects wrought. Every electrician has marked out the management of a patient, and the course proper to pursue, only to find an entire change necessary, after the first application. Many cases are plain, but many more are wonderfully obscure; and only after repeated practical tests, do we find the proper current, intensity and quantity adapted to a given case.