A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Science
A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Medicine -- Practice
Of the local causes referable to the genitalia, by far the most
important and most frequent are hyperæsthesia and inflammation of the
prostatic portion of the urethra, which are generally induced by
masturbation. These lesions constitute the primary source of the
trouble in the large majority of cases, and tend not only to excite
reflex pollutions, but to maintain the disorder by keeping the mind
occupied with sexual matters. Other common local causes are found in
congenital narrowing of the meatus, organic stricture of the urethra, a
redundant prepuce, balanitis, and the accumulation of smegma. Among the
more infrequent etiological factors may be mentioned herpes of the
prepuce, congenital shortness of the frenum, spasmodic stricture,
polypus of the deep urethra, spermato-cystitis, and epididymitis.
Among the remaining exciting causes of pollutions are diseases of the
anus and rectum, as hemorrhoids, morbid growths, ascarides, fissures,
ulcers, pruritus, and painful eruptions. The nerves of the rectum and
anus being derived from the same region as those of the genitalia, it
is not surprising that the ejaculatory centre should respond to an
impulse transmitted from them. In habitual constipation straining at
stool may also excite an emission through the consentaneous action of
the muscles of the abdomen, rectum, and seminal vesicles; but this is
only observed when the orifices of the ejaculatory ducts are paralyzed
and patulous.
ANATOMICAL CHARACTERS.--There are no records of the morbid appearances
which appertain to seminal incontinence in its early stage, but that
the hyperæsthesia of the prostatic urethra depends upon chronic or
subacute inflammation is rendered certain by the concomitant symptoms,
by exploration with the sound, aided by the finger in the rectum, and
by the results of treatment. In the advanced stage, post-mortem
inspection has disclosed stricture of the urethra, injection of the
mucous membrane of the deep portion of the urethra, dilatation and
excoriation of the orifices of the ejaculatory ducts, and suppuration
of the prostate and the seminal vesicles. The changes which occur in
the nervous centres are unknown.
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