After briefly reviewing the problem of Gonorrhea in its different aspects, we shall discuss certain conditions which stand in very near relation to Gonorrhea. There are: Impotence, known under the common name of loss of manhood; sterility, loss of procreative power; and sexual neurasthenia, nervous debility developed on sexual ground. While these conditions may also develop independently without any Gonorrhea in the history, from other abuses and irregularities in the sexual sphere, yet in a very large number of cases they do develop, if not because of Gonorrhea, at least after it; in other words, Gonorrhea, by weakening general and specially sexual nervous apparatus, creates a certain predisposition for their development.
These diseases are worthy of serious consideration, as they are very widespread and are the cause of many unhappy homes, of untold family tragedies, and of much individual and moral suffering. These diseases do not cause physical pains, neither are they dangerous to life, but men afflicted with them feel so miserable, suffer such agonies of moral anguish, are so depressed in spirit and so despaired of life that they would prefer any acute pain or welcome any operation to relieve their misery.
Impotence, as mentioned above, is an inability to perform a normal sexual intercourse. The indispensable physical condition for a normal sexual intercourse is an erect position (erection of the penis) and a normal period of time before a seminal ejaculation takes place; hence Impotentia can be manifested either by partial or total power of erection, or premature ejaculation, or both. According to various causes leading to loss of erective power, three various kinds of Impotence should be considered—psychic, irritable, and paralytic.
Psychic impotence is a very peculiar condition strikingly illustrating a powerful influence of the mind over bodily functions. It usually attacks young men in perfect health who are of a worrying and brooding disposition, particularly so over sexual matters. They may have on their conscience the guilt of having indulged in masturbation years ago, or they may have had a gonorrheal infection some time before. As a result of this brooding over the sins of their youth, they work themselves into a suggestion that they have ruined their system and have lost their sexual power, and such is the power of self-suggestion that in spite of perfect health and the absence of any abnormal condition, all attempts at normal intercourse end in dismal failure, which in the case of newly-married people is naturally a very grave and distressing occurrence. Ordinarily these cases get well after a certain period of time under the influence and care of a physician without any local treatment, but under general tonic regime. The main danger of these cases is that this class of cases fall particularly easy prey to medical quack healers, who exploit the ignorant and terror-stricken victims to the limit of their ability to pay, by intensifying their fear and curing them from non-existing terrible diseases.
The second type of Impotence, irritative, is the most frequent of all. In this condition the power of erection may or may not be affected, but the main distressing feature is a premature ejaculation of seminal fluid, which may take place even before a man approaches the woman. This condition is caused by over-stimulation and over-irritation of the sexual nervous apparatus, and is mostly the result either of an old habit of masturbation (self-abuse) or a chronic inflammation in the deep urethra left after previous Gonorrhea. This class of patients is also suffering from frequent night emissions and general nervosity. They constitute the most pitiful and miserable group of all venereal cases. Weak and haggard-looking from loss of seminal fluid, broken in spirit as well as in body, they are haunted by a feeling of despair and utter annihilation; they are full of disgust with themselves, and are frequently incapable of pursuing their occupation. This class of men, as all the Impotentia cases, also fall easy prey to medical quacks, as they are often ashamed to go to a regular practitioner and family physician, and prefer to go to a stranger. Fortunately these cases are not difficult to cure, though it takes usually several months to effect a permanent cure. The treatment will vary according to the cause producing this hyperirritability of the nervous apparatus. It may require treatment of the deep urethra, prostate gland, or general tonic regime.
A common and one of the most distressing features of irritative impotence is Spermatorrhea, i. e., an involuntary loss of the seminal fluid, outside of night emissions. These seminal losses occur either as periodical oozing of a few drops at the end of urination and defecation, or as continual oozing as a result of muscular weakness and insufficient contraction of prostatic ducts. This continually oozing fluid is usually prostatic secretion, and is due to the existing chronic prostatitis. The cure of this condition is effected thru the treatment of the prostate gland.
It should be mentioned here that there is another condition resembling very much the above-described Spermatorrhea, a condition that scares the patients very much, who think they are suffering from seminal losses. This condition, Urorrhea, is very harmless, as the secretion oozing in these cases is plain water and mucus, due to excessive blood congestion in time of sexual excitement. But the difference between these two fluids and two conditions can be established only by a physician on microscopical examination, and should not be left to the judgment of the patient himself.
The last variety of impotence, Paralytic, presents a condition opposite that just described, and instead of irritation and over-stimulation of the nervous sexual apparatus, it shows its weakness and exhaustion down to complete paralysis.
It is understood that every man reaching a certain age gradually declines in vigor of sexual power. This age of sexual decline varies considerably with different people, from the ages of 45–70, depending on general health, and still more on the mode of life. This much is sure: that men who have led a regular and moderate sexual life and have married early retain their sexual power a good deal longer than men who have dissipated and indulged in various excesses.
Paralytic impotence may mean either complete loss of erection or partial. Most common causes of paralytic impotence in young men are a persistent and excessive masturbation habit and excessive sexual indulgence. The earlier in life these vicious habits and excesses are started and the longer they last, the harder and harder is the cure of the resulting sexual exhausting impotence. In fact, these cases are the most difficult of all to cure, and many of them are incurable. Men suffering with paralytic impotence present a truly pitiful picture. They lose every ambition in life, lose their energy and force of personality, lose mental and physical vigor and endurance, and become mere wrecks and shadows of their old selves. If boys and young men could only see these victims of their own ignorance and folly as the physician sees them in their desperate and hopeless fight to regain their lost manhood, surely thousands and thousands of young, happy lives could be saved to themselves and to society.
The treatment consists in general and local tonic treatment.
The foundation of society is a happy family and home life. The foundation of a happy home life is children. No home can be happy without the sunshine of the little ones, who are the dearest gifts of Nature to mankind. No marriage can be happy unless it fulfills its natural mission and reaches its full fruition by perpetuating the race of the parents thru children. The children are the greatest and most powerful incentive and inspiration for a man to work and to strive for a greater success in his chosen line. Children are a life mission and a life interest of a woman; they are the strongest and purest bonds of love between a man and a woman. Gloom and emptiness prevail in a home that is not blessed with children; there is no living interest and no natural attraction in such a home, and a childless couple is doomed to seek outside distractions and interests to fill up the natural void in their existence and to forget their heart-hunger.
No man who looks forward to a happy family life in the future can ignore the question and shirk the responsibility of producing healthy children. And yet so many men, thru light-mindedness or ignorance in younger years, are responsible for the tragedy of a barren home later in life, when it is too late to retrace their steps and to redeem their sins of youth. Public opinion commonly puts the blame on the woman for being childless, and only in exceptional cases considers the possibility of the man being responsible for it. How unjust and how far from the truth! The inability to bear children, medically known as sterility, in a very large number of cases, at least half, is directly or indirectly due to a man’s disease or an inborn defect. Leaving aside a rather small group of cases, where a woman is unable to bear children due to some inborn defect or disease, the largest class of cases of sterility is due to venereal poisons, Gonorrhea, or Syphilis contracted from their husbands. In Gonorrhea, due to chronic inflammation of organs of procreation or mutilating operations—necessary in these cases—no conception is possible. In Syphilis, conception is possible, but a woman is unable to bear living children.
In the cases of direct male sterility, the woman is perfectly healthy, and the fault lies with the man alone. It may be due either to some inborn anatomical defect, or, what is infinitely more common, to some venereal disease. In these cases, the male embryos-spermatozoa are either absent or unable to travel in normal channels and to penetrate in the female organs. This inability may be due to a different cause; the most common cause of all is Gonorrhea, or, more exactly, a gonorrheal epididymitis. As mentioned above, Epididymitis, if uncured, often leaves behind hard nodules which obliterate and obstruct the spermatic channel, partially or completely, thus blocking and preventing spermatozoa from passing from the testicles, where they are produced thru the urethral canal out of the body. A man who has had Epididymitis, with the complete obstruction of the spermatic channel only on one side, may yet have children, but if the obstruction is on both sides, he becomes absolutely sterile.
Another cause of male sterility, tho not as common, are strictures, which, by obstructing and twisting the urethral canal, may divert or weaken ejaculation of spermatozoa in such a way as to make conception impossible. It may happen also that tho all channels for the passage of spermatozoa are free, the spermatozoa themselves, due to a sexual or general exhaustion, are either missing or are of such low vitality as to give no hopes for living or healthy children.
Every man with a history of a venereal disease should have his seminal secretion examined under microscope before his marriage, to test its vitality. The knowledge of these facts and the application of these principles in practical life by the average man could save thousands of happy homes and prevent as many divorces.
The last complication to be developed in the course of Gonorrhea, but not by any means the last in importance, is sexual neurasthenia; i. e., a chronic state of nervous and mental weakness and irritability. Possibly no other condition illustrates so well how far and deep-reaching is the influence of Gonorrhea on the whole system, tho it is a local disease; how thoroughly it affects the entire mental and nervous system of a man; how much moral anguish and suffering it inflicts on its victims. The reason for such a powerful effect of Gonorrhea on the human mind and emotions has been explained before by the fact that the genito-urinary tract and different sexual glands which are usually affected by Gonorrhea are richly supplied with nerves and are most intimately and abundantly connected thru these nerves with the highest centers of the nervous system, controlling the mental and emotional activities.
It has been mentioned already that the nervous weakness can be brought about by various sexual abuses and irregularities, such as the masturbation habit, sexual excesses, or over-stimulated and ungratified desire, but the cases following in the wake of chronic Gonorrhea and its complications are so numerous, so persistent, and distressing as to deserve special prominence and consideration.
Sexual Neurasthenia develops as a rule slowly, and it comes either during the treatment or long after Gonorrhea has been cured. The predisposition to this condition is created by excessive worrying and brooding over the disease, and the basis of sexual Neurasthenia constitutes an idea slowly formed and fixed in the mind of the patient that he is “full of disease,” and that his condition is incurable. As a result of this self-suggestion and constant concentration of his mind on different parts of the body, he feels, or rather he thinks he feels, an endless variety of different painful and morbid sensations. There is not a single spot on his body, there is not a single kind of pain or discomfort that should not be complained of by this class of patients. It does not matter whether his case is improving or even cured and does not show a single positive symptom of the disease, the patient cannot be won over to the cheerful view of his condition. No amount of argument or persuasion on the part of the physician avails to shake off his gloom and despair. If the physician, after a careful examination, states to a sexual neurasthenic that he does not need any more treatment, the patient accuses the physician of being indifferent, and not taking sufficient interest in his case and goes elsewhere. If the physician yields to the pleadings of the patient and keeps up an active treatment, that makes matters only worse, and still more confirms the patient of the deep and dangerous character of his condition. The only way to break the eternal chain of fear and anxiety, which is the main basis of sexual neurasthenia, is to turn the mind of the patient away from his sickness by stopping treatment, sending him away, if possible, from old associations and surroundings, and by building up his general and nervous system. The treatment of this condition lasts several months, but they all recover in due course of time.
This class of patients, in their frantic search for a cure from the imaginary sickness, are naturally more exposed to the danger of drifting away into the hands of medical quacks, and are more exploited than any other class of venereal patients. A sympathetic attitude on the part of the physician and evidence of his sincere and earnest interest in the condition of the patient is the only thing that slowly gains the confidence of sexual neurasthenics, brings them back courage, ease of mind, and restores them to a healthy and happy life.