Part 94

SECT. LV.—ON GONORRHŒA AND LIBIDINOUS DREAMS.

Gonorrhœa is an involuntary discharge of semen, taking place frequently without erection of the privy member, owing to weakness of the retentive faculty. In this case it will be proper to keep the patient in a state of rest, covering the loins and pubes with compresses out of wine, oil of apples, or that of the flowers of the wild vine; and cataplasms may be afterwards applied, made of dates, apples, flowers of the wild vine, acacia, hypocistis, sumach, and the like. He may also be made to sit in a hip-bath of the decoctions of lentisk, of bramble, and the like, in wine, or even in water, and use desiccative food. After a little while, he may take gymnastic exercises, by which both the general system and the affected parts will be restored to strength. Redundance of semen has been treated of sufficiently in the First Book, under the head of Hygiene; and there, too, impotence is treated of. A cool couch is beneficial in cases of libidinous dreams; also, laying on the right or left side; all medicines of a cold nature rubbed into the loins, such as coriander, hemlock, ceruse, and purslain, all of which are to be used with vinegar.

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COMMENTARY. Celsus recommends strong friction, affusion of cold liquids, swimming in cold water, food and drink of a cooling nature, avoiding everything flatulent and calculated to engender semen, applications such as rue and vinegar to the part, avoiding lying upon the back, and so forth.

Aretæus, in his chapter on Gonorrhœa, makes some very ingenious speculations on the effect which the semen genitale exerts upon the development of the moral character. He remarks that a long-continued draining of the semen sometimes occasions paralysis: he alludes to the tabes dorsalis, a disease well described by Hippocrates. He properly states that gonorrhœa proceeds from relaxation of the genital organs. With regard to the treatment, he recommends at first cooling and astringent applications to stop the flux, but these are afterwards to be exchanged for calefacients and rubefacients. Castor, mint, and the theriac are to be taken internally, along with strong exercise.

Galen defines gonorrhœa to be an involuntary emission of semen, arising from debility of the genital organs, especially of the spermatic vessels.

Aëtius gives a full account of gonorrhœa from Galen, and of oneirogmon from Philagrius, but his treatment is little different from our author’s. For the latter he directs the patient to take such things as are calculated to prevent the formation of semen, as rue, calamint, the chaste-tree, &c.; and further recommends astringent and refrigerant applications, lying on a hard bed, wearing a plate of lead on the loins, and abstaining from the usual provocatives to venery.

The practice of Alexander is exactly the same as that of Aëtius.

Cælius Aurelianus treats oneirogmon upon much the same principles, namely, by cooling applications and injections, the cold bath, astringent food, and so forth. He makes mention of a disease of the genital organs, which we have met with in practice, although we do not recollect to have seen it noticed in any modern author, unless Heberden alludes to it (Comment. 80.) It is an emission of bloody semen in actu venereo. He directs it to be treated by astringent and restorative remedies.

For oneirogmon, the Pseudo-Dioscorides recommends an infusion of the seed of lettuce and purslain, the decoction of nymphæa, &c. (Euporist. ii, 100.) Dioscorides himself recommends hemlock. (Meth. Med. iv, 79.)

Avicenna and Rhases follow the treatment of our author. For the oneirogmon, Haly Abbas recommends various refrigerant and sedative medicines, such as purslain, coriander, lentils, fleawort, poppies, roses, &c. For gonorrhœa he recommends bleeding; emetics if connected with repletion; sleeping in a cold place; various anodyne, astringent, and refrigerant medicines, such as henbane, poppies, roses, lettuce, &c. He also directs a plate of lead to be worn over the loins. Alsaharavius treats minutely of these complaints according to the nature of the exciting cause. His general remedies for gonorrhœa are of a refrigerant and cooling nature, such as citrons, pomegranates, lettuces, henbane, &c. with a plate of lead and other cooling applications. For oneirogmon he recommends liniments of camphor and opium, lying on a hard bed, and refrigerant medicines. Rhases recommends styptic applications, snow, the plate of lead, and the cold bath. He speaks also of rubbing the parts with myrrh, henbane, and opium.

On the pollutio nocturni somni referred to in Deut. xiii, 13, see Isidorus (Comment. in Deut. 20.) Pliny treats of certain herbs which excite, and others which dispel, the “somnia veneris.” Martial, in his epigram addressed to Ponticus, expresses himself in terms of just abhorrence against the detestable vice of manustupration. Galen, however, relates a story of it with disgusting sang froid.

SECT. LVI.—ON SATYRIASIS.

Satyriasis is a palpitation of the genital organ, accompanying some inflammatory affection of the spermatic vessels, with erection; and, if the palpitation do not cease, it is apt to terminate in paralysis of the spermatic vessels, or in spasms. Those affected with convulsion die speedily, having at last inflation of the belly and cold sweats. This complaint sometimes, though rarely, affects women. Wherefore we must open a vein without loss of time, keep the patient upon a spare diet without wine, and purge the belly, not freely but gently, every day. The best articles of food are beet, mallows, a little of the herb mercury, and the soup of the shell-fishes. A simple clyster is no bad remedy. Diuretics must be avoided; and medicines of a cold nature are to applied to the loins, such as the juice of nightshade, of purslain, of henbane, or of hemlock. It may be necessary, also, to rub the penis and the perineum with some soothing and cooling things, such as litharge, Cimolian earth, and ceruse, dissolved in vinegar, water, sweet wine, or rob. It is hurtful to lie on the back. He may drink of the root of water-lily, iris, and maiden-hair. Rue is beneficial both in gonorrhœa and satyriasis. Give, likewise, food from grain in small quantity, and do not gratify the thirst. When the affection is protracted, cupping with scarifications, may be had recourse to; or, if a plethora be present, we may evacuate by leeches. A cataplasm of raw barley-meal may also be applied to the belly.

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COMMENTARY. Aretæus has drawn a lively but disgusting picture of a person affected with this complaint, which it is to be hoped that the “march of improvement” in morals has now rendered of rare occurrence. He calls it a most unseemly disease. According to his account, it will even prove fatal occasionally, and that within the space of seven days. He says the natural cure of it is a diarrhœa coming on with bilious discharges. This venereal mania, he says, is to be cured by bleeding from the arm or ankle to deliquium animi, purging with hiera, and wrapping the genital organs and adjoining parts with wool dipped in rose-oil and wine, or in decoctions of such narcotics as hemlock, nightshade, mandrake or poppy; the applications in either case being frequently changed. When these things do not succeed, the neighbouring parts are to be cupped or leeched; and in case of necessity the afore-mentioned refrigerants are to be changed for calefacients, such as the oil of privet, or the Sicyonian oil. This treatment, he remarks, will prove soothing to the nerves. He also recommends castor and a refrigerant diet, from which wine and flesh are to be excluded. It appears, therefore, that our author’s treatment is mostly taken from him.

Oribasius pronounces satyriasis to be a fatal symptom in acute fevers; and Professor Sprengel confirms the justness of this observation. (Hist. de la Méd. t. ii, 188.)

Cælius Aurelianus gives a very circumstantial account of this disease. His treatment differs from that of Aretæus in this respect—that he disapproves entirely of the refrigerant applications, and, instead of them, recommends soothing ones, namely, emollient oils, a hip-bath of oil and water, and the like. He approves also of bleeding, cupping, and leeching.

Octavius Horatianus treats it upon nearly the same principles, that is to say, he recommends fomentations with the vapours of hypocistis or hemlock, hard friction, exercise, and astringent food.

There is nothing original in the treatment of the Arabians. Haly Abbas recommends calefacient and desiccative medicines internally, such as agnus castus, rue, cumin, &c. He also permits the use of narcotics with desiccants, such as coriander, henbane, lettuce, and opium. To the member he directs us to apply a cataplasm containing the oil of roses, lettuce, coriander, and camphor; and when this fails, some opium is to be added. He enjoins hard exercise.

Alsaharavius recommends much the same treatment as our author, namely, bleeding from the arm or foot, diluent and refrigerant draughts, cooling applications containing vinegar, ceruse, &c.; and, if these do not succeed, leeches.

SECT. LVII.—ON PRIAPISM.

Priapism is a permanent enlargement of the penis, which is swelled both in length and circularly, and there is no venereal appetite attending it. The part is swelled by a flatulent spirit engendered from viscid and gross humours by a moderate heat. It is clear, therefore, that the part is not to be heated but cooled moderately, with rose-cerate beat up with water, and with the cerate of chamomile applied to the penis and loins. The diet and medicines should be of an attenuant nature, without being manifestly heating. We must also apply those things which are found, by experience, to be naturally efficacious. We may, therefore, give them also to drink of the water-lily and the seed of the chaste-tree, and mix green rue with their condiments. Yet this must not be given at the commencement, since it is heating, but after the use of other attenuants. If we practise evacuation, it must be by vomiting; for that by the belly often occasions a defluxion to the neighbouring parts. Exercise and friction are to be had recourse to for dispelling the flatus. In none of the cases which we have been mentioning does coition answer, unless when we have reason to suppose that there is a redundance of semen owing to restraint from enjoyment.

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COMMENTARY. Many of the ancient authorities make no distinction between satyriasis and priapism, but, according to Cælius Aurelianus, the former is an acute and the latter a chronic disease. Prosper Alpinus, the modern Methodist, says, there is this difference between satyriasis and priapism—that in the former there is violent venereal desire, whereas, in the latter, there is continued erection, but no desire nor emission of semen. It seems, in short, to be a sort of chronic chordee.

Our author, Oribasius, Aëtius, and Actuarius, follow the principles of treatment laid down by Galen. The latter speaks of the anti-aphrodisiacal medicines mentioned by our author.

Alexander forbids the use of such things as are of an intensely cold nature, especially astringents and narcotics. He recommends friction, exercise of the upper parts of the body, and abstinence from flatulent food. All incentives to venery are of course to be avoided.

Avicenna agrees with the Greek authorities respecting the anti-aphrodisiastical properties of rue. Like them, he recommends emetics, but disapproves of drastic purgatives. When the affection is of an inflammatory kind, Haly Abbas recommends general bleeding, cupping, leeches, and applications of a cooling nature, such as vinegar, purslain, solatrum, gourd, &c. Alsaharavius recommends various refrigerant and anodyne remedies, internally and externally.