When such a lesion has come on gradually and is of long standing, the prognosis is very unfavorable; as relapses will most generally occur with the slightest indulgence. But when the condition has made its advent suddenly, from inflammatory causes, the prognosis is very favorable. A gonorrhœal orchitis will often produce this condition, which is only transitory, or of a few months’ duration. This is only symptomatic, and very much unlike the true aspermatism of a neurotic origin.
A very extraordinary case has of late engaged my attention and curiosity. No case of the kind have I been able to discover, in medical literature or in the practice of my medical friends.
_Case._――A young married man consulted me with an affliction (as it were), much to the discomfort of himself and to the great injury of his wife. He never had passed the sexual orgasm, nor ejaculated semen during coition. He is very erotic, and has no difficulty in performing the marital act, but it is followed without the slightest satisfaction. He continues in the act of coition until exhausted, and retires with the wife very much in the same condition after repeated sexual orgasms. He informs me that one hour is not an uncommon length of time for him to occupy in the act of coition, participating in the sexual beatitude during the entire period, until gradually becoming exhausted, when the pleasure dwindles away, but his penis remains erect for some time after. He says that he has often applied cold water to facilitate flaccidity.
After the organ has been reduced he sometimes can detect semen, or prostatic fluid, on the glans and meatus, and he is very soon ready to perform the act again. I have often discovered spermatozoa in his urine. His testicles are well formed, and his penis is normal in appearance. He has never had a venereal disease, and has no stricture. Treatment has given no relief as yet. It will be observed that satyriasis is prominent in this case.
Galvanism will often be found of great service as a paliative measure, with phosphide zinc and nux vomica. If a few years’ continence can be obtained, a better prospect for recovery may obtain. When galvanism is used, an insulated electrode should be passed to the orifices of the ejaculatory ducts, with the anode attached, and the cathode applied to the cord with wet sponge. I have derived some benefit from localized and general Faradisation, after the manner heretofore mentioned.