Part 26 (1/2)
[Footnote 57: Acton.]
Marriage.--Another cla.s.s of pract.i.tioners, with more apparent regard for morality, recommend matrimony as the sure panacea for all the ills of which the sufferers from self-abuse complain, with the possible exception of actual impotence. Against this course several objections may be urged; we offer the following:--
1. It is not a remedy, since, as in the case of illicit intercourse, ”legalized prost.i.tution” is only a subst.i.tution of one form of emissions for another, the ill effects of which do not differ appreciably.
2. If it were a remedy, it would not be a justifiable one, for its use would necessitate an abuse of the marriage relation, as elsewhere shown.
3. As another reason why the remedy would not be a _proper_, even if a _good_, one, it may well be asked, What right has a man to treat a wife as a vial of medicine? Well does Mr. Acton inquire, ”What has the young girl, who is thus sacrificed to an egotistical calculation, done that she should be condemned to the existence that awaits her? Who has the right to regard her as a therapeutic agent, and to risk thus lightly her future prospects, her repose, and the happiness of the remainder of her life?”
In cases in which seminal emissions occur frequently, the most reliable writers upon this subject, Copland, Acton, Milton, and others, advise, with reference to marriage, ”that the complaint should be removed before the married life is commenced.” Independent of the considerations already presented, the individual affected in this manner and contemplating marriage should carefully consider the possible and probable effects upon offspring, the legitimate result of marriage; these have been already described, and need not be recapitulated.
Local Treatment.--While it is true that general treatment alone is occasionally successful in curing the diseases under consideration, and that local treatment alone is very rarely efficient, it is also true that in many cases skillful local treatment is required to supplement the general remedies employed. While there has been a tendency on the part of the profession generally to depend wholly upon general treatment, on the part of a less numerous body of specialists there has been an opposite tendency to depend wholly, or nearly so, upon local measures. Both extremes are evidently wrong.
The object of local treatment for the relief of emissions, especially, is to remove the local cause of irritation, which, as previously shown, is one of the most active exciting causes of seminal losses. To effect this, both internal and external applications are useful. We will now consider some of these agents.
_Cool Sitz Bath_.--The cool or cold sitz bath is one of the most efficacious of all remedies. It should be taken daily, and may often be repeated, with benefit, several times a day. Its effect is to relieve the local congestion, and thus allay the irritability of the affected parts. When but one bath is taken daily, it should be just before retiring at night. Full directions for this and other baths are given in works devoted to the subject of bathing.
_Ascending Douche_.--This is also a very useful means of allaying irritation, especially the reflex excitability which is often present in the muscles in the vicinity of the perineum and prostate gland, and when there is pain and fullness in these parts.
_Abdominal Bandage_.--This may be worn nights to very great advantage by most patients. It not only allays the irritability of the nerve centers which are closely connected with the genital apparatus, but serves to keep the bowels in a healthy condition. It should not be applied so continuously as to produce a very profuse eruption on the skin. If such a symptom should appear, discontinue the bandage for a time. When worn during the day-time, it should be changed once in three or four hours. It is generally best to wear it only nights.
_Wet Compress_.--This is an application to be made to the lower part of the spine for the purpose of allaying the excessive heat and irritation which often exist there. It may also be worn nights, as it in some degree prevents the danger arising from sleeping upon the back.
_Hot and Cold Applications to the Spine_.--These are powerful remedies under appropriate conditions. Hot applications relieve congestion of the genital organs and allay irritation. Cold applications are useful when a condition of debility and relaxation is present. Alternate applications of heat and cold are very valuable, when skillfully applied, as a means of allaying reflex excitability and promoting healthy action. These applications are especially useful in cases in which there is heat and pain in the lower portion of the back. Their effects are greatly enhanced by administering a foot or leg bath at the same time.
_Local Fomentations_.--When great local irritation exists, with considerable pain and spasmodic muscular action, the application of hot fomentations to the perineum will be found the most effectual means of giving relief. The hot douche and hot sitz bath are useful under the same circ.u.mstances.
In some cases, alternate hot and cold applications are more effectual in allaying local irritation than hot fomentations alone.
_Local Cold Bathing_.--The genital organs should be daily bathed in cold water just before retiring. Simply das.h.i.+ng water upon the parts for two or three minutes is insufficient; more prolonged bathing is necessary. A short application of cold occasions a strong and sudden reaction which increases local congestion; hence, the bath should be continued until the sedative effect is fully produced, which will require at least fifteen minutes. The water must be cold; about 60 degrees is the best temperature. Ice should be used to cool the water in warm weather. It should be applied thoroughly, being squeezed from a sponge upon the lower part of the abdomen and allowed to run down.
_Enemata_.--The use of the enema is an important means of aiding recovery, but it has been much abused, and must be employed with caution.
When the bowels are very costive, relieve them before retiring by a copious injection of tepid water. The ”fountain syringe” is the best instrument to employ.
Useful as is the syringe when needed, nothing could be much worse than becoming dependent upon it. The bowels must be made to act for themselves without such artificial a.s.sistance, by the use of proper food, especially graham flour and oatmeal, and the avoidance of hot drinks, milk, sugar, and other clogging and constipating articles; by wearing the abdominal bandage; by thorough kneading and percussion of the abdomen several times daily for five minutes at a time; by taking one or two gla.s.ses of cold water half an hour before breakfast every morning; and by plenty of muscular exercise daily. The enema should be used occasionally, however, rather than allow the bowels to continue costive, and to avoid severe straining at stool.
A small, cold enema taken just before retiring, and retained, will often do much to allay local irritation.
_Electricity_.--Probably no single agent will accomplish more than this remedy when skillfully applied. It needs to be carefully used, and cannot be trusted in the hands of those not acquainted with the physical properties of the remedy and scientific methods of applying it.
_Internal Applications_.--Complete and rapid success greatly depends upon skillful internal treatment, in a large number of cases. We are aware that there is considerable prejudice, in certain quarters, against internal treatment; but having had the opportunity of observing the effects of careful treatment applied in this way, and having put to the test of practical experience this method, we feel justified in recommending that which is approved on both theoretical and practical grounds; for it is rational to suppose that proper treatment applied directly to the seat of disease must be at least equally efficacious with methods less direct.
As heretofore explained, in the more severe cases the urethra is found in a very irritable condition. It is hyper-sensitive, especially in that portion just in front of the bladder, where the ejaculatory ducts open into it. We have also seen how this condition is one of the chief exciting causes of emissions. The remedies described for allaying this irritation are all excellent and indispensable; but there is another method of great value. This consists in the pa.s.sage of a suitable instrument, a sound or bougie of proper size, two or three times a week.
By the aid of this means, the abnormal irritation will often diminish with magical rapidity. The pa.s.sage of the instrument of course needs to be done with great delicacy, so as to avoid increasing the irritation; hence it should not be attempted by a novice. Lack of skill in catheterism is doubtless the reason why some have seemed to produce injury rather than benefit by this method of treatment, they not recognizing the fact a.s.serted by Prof. Gross in his treatise on surgery, that skillful catheterism is one of the most delicate operations in surgery.
_Use of Electricity_.--The use of electricity in connection with that of the sound adds greatly to its utility. By means of the metallic instrument, also, electricity may be applied directly to the point of greatest irritation; and its soothing effect is sometimes really wonderful, as the following case will show:--
The patient, a man of unusual physical development, was suffering from nocturnal emissions and diminished s.e.xual power, the result of early indiscretions and marital excesses. One of his most unpleasant symptoms was severe pain in the portion of the urethra near the openings of the ejaculatory ducts. After he had been suffering more than usual for a few days, we applied the faradaic electric current in the manner indicated above, for about fifteen minutes. At the end of that time the pain was entirely removed, though considerable suffering had been caused by the pa.s.sage of the instrument, so sensitive was the congested membrane. The pain did not return again for two or three weeks, though treatment was necessarily suspended on account of absence.
In another case, that of a young man, a student, at the beginning of treatment emissions occurred nightly, and sometimes as many as four in a single night, according to his statement, which we had no reason to doubt. Under the influence of these local applications, combined with other measures of treatment and a measurably correct regimen, the number of emissions was in a few weeks reduced to one in two or three weeks.