Page:The Texas Medical Journal, vol. 18.djvu/339

Rh doubtless familiar with a few of the mechanical devices designed to assist in bringing about a firm erection in an otherwise feeble organ, one of which I here exhibit. Its mechanism is simple and its therapeutic use, while questionable upon ethical grounds, is nevertheless based upon sound sense and mechanics. It performs its function by compressing the veins and preventing their too hurried emptying, thus maintaining erection. In atonic impotence there is a loss of tonicity in all of the tissues, and a relaxed, dilated condition of the veins and sinuses. The ligation of the dorsal vein cuts off the main exit of venous blood and collateral circulation eventually takes its place.

In case of the patient upon whom I tried this operation as advised and recommended by Broome, Murry and others, I had treated for hyperesthesia of the prostatic urethra and acute seminal vesiculitis, attended by nocturnal pollutions, the combined effect of the habit of masturbation. All local conditions were cured, the myelasthenia relieved and the patient’s general health restored. His urethral calibre was 27 French. His normal weight remained at 190 pounds. While sexual intercourse and sexual excitement were interdicted, as it should be in every case of sexual impotency, the patient persisted in ocasionally trying, only to result in partial or complete failure, emission always taking place. This period of impotency lasted altogether for about three years. Repeated suggestion was practiced, moral advice given, and finally resort to sleeping with a female companion—without attempt at coitus,—so as to overcome any psychical influence, was tried (partly at my suggestion), but with little satisfactory results. While in the metropolis of the East, he consulted an eminent genito-urinary specialist, who—as a last resort to do something—cut an imaginary stricture to 32 French sound. Several months after his return home, he again consulted me in reference to his case, and I then advised operative treatment, believing that the partial and incomplete erection, with precipitate emission, were the result of a too rapid emptying of the sinuses of the corpora and spongiosum. Open ligation with the cat-gut was done. For the first twenty-four or thirty-six hours the patient complained bitterly from painful erection, which was almost constant. Attempt at intercourse was prohibited for a period of two months, and the patient cautioned against its practice. It has been now about four months since the operation, and the party reported to me not long since that he had had for the first time in nearly three years complete and satisfactory coitus and was now willing to stop trying.