Priapism

“ Priapism is sometimes seen as a curious symptom of lesion of the spinal cord. In such cases it is totally unconnected with any voluptuous sensation and is only found accompanied by motor paralysis. It may occur spontaneously immediately after accident involving the cord, and is then probably due to undue excitement of the portion of the cord below the lesion, which is deprived of the regulating influence of the brain. Priapism may also develop spontaneously at a later period, and is then due to central irritation from extravasation into the substance of the cord, or to some reflex cause. ”

“ The persistent priapism which oftentimes results from riding with a wet seat and the inordinate morbid sensibility of the sexual organs that may result from the same cause or from spinal irritation are not to be allayed by any homily on morality or on the sanctifying attempts at keeping the animal passions under subjection, any more than will prayers or offerings to all the gods of Olympus restore the eunuchized, either through foolish civilized dress and customs or through excessive indulgence. ”

“ The genital organs may, from too much excitement, lose their sensibility, and waste. The manipulations, which at first were followed with the desired result, become unable to excite the genital sense. They may sometimes cause the erection of the penis, and even excite a painful or inconvenient priapism ”

“ Retention of urine and retention or incontinence of fæces are constant symptoms. In young men priapism is common—the corpus cavernosum penis is filled with blood without actual erection. There is other evidence of vaso-motor paralysis in the form of dilatation of the subcutaneous vessels, and local elevation of temperature in the paralysed parts. The deep reflexes, including the tendon reflexes, are permanently lost. ”

“ We know, too, that even in the adult, non-sexual erections may occur. The clearest instances of this are met with in the form of171 priapism, the principal characteristic of this condition being the occurrence of permanent erection which has nothing at all to do with the sexual impulse. The same is true for the most part of matutinal erections, the precise cause of which is not yet determined. They are commonly referred to distension of the bladder, which is supposed by reflex action to lead to distension of the corpora cavernosa of the penis. ”

“ At this time the patient's spleen was noticed to be enormously enlarged. The man died about a year after the attack, but a necropsy was unfortunately refused. Salzer, in discussing the theories of priapism, mentions eight cases previously reported, and concludes, that such cases are attributable to leukemia. Kremine believes that continued priapism is produced by effusion of blood into the corpora cavernosa, which is impeded on its return. He thinks it corresponds to bleeding at the nose and rectum, which often occurs in perfectly healthy persons. ”

“ Given our present mode of life, with the ubiquitous opportunities for such sights at all times, normal healthy men would have to walk around on the streets in a state of permanent priapism, but for the cerebral centre of inhibition. ”

“ During her youth, too, she had been affected with symptoms of scrofula, from which even now she is not entirely free, although twenty-two years old. Do not these circumstances, not generally coexistent with extreme sensibility, prove, that the extreme irritability of the uterine system is to be ascribed to her self-abuse?
Priapism, which signifies permanent erection of the penis, without pleasure, and even in some cases with pain, sometimes follows indiscretions. This has been seen particularly in young children, whose genital organs 127 have been excited: sometimes, too, it occurs in old men. ”

“ The primary lustful feeling that accompanies priapism due to cantharides soon becomes painful. Satyriasis and nymphomania are acute abnormal psycho-sexual states.
There are also cases that, not without reason, might be called chronic satyriasis or nymphomania. To these belong the men who, for the most part as a result of abusus veneris, or more particularly of masturbation, suffer with neurasthenia sexualis, and at the same time have intense libido sexualis. The imagination, as in acute cases, is in a state of excitement, and the mind full of obscene images ”

“ This is possible, particularly if you consider the advantages derived in involuntary pollution, priapism, and satyriasis, from douches of cold water along the vertebral column, particularly on the lumbar and sacral regions, and also from the application of ice to these parts. Sainte Marie has sometimes arrested 185 the spasm of the genital organs by frictions on the sacrum with bladders full of ice. We think, then, there are cases where these remedies may be used successfully to combat the habit of masturbation. ”

“ There was a similar case of priapism which lasted for three weeks, and was associated with hydrocele in a man of forty-eight.
Injuries of the testicle and scrotum may be productive of most serious issue. It is a well-known surgical fact that a major degree of shock accompanies a contusion of this portion of the body. In fact, Chevers states that the sensitiveness of the testicles is so well known in India, that there are cases on record in which premeditated murder has been effected by Cossiah women, by violently squeezing the testicles of their husbands. ”

“ Circumcised boys may, in individual cases, either through precept or example, physical or mental imperfection, be found to practice onanism, but in general the practice can be asserted as being very rare among the children of circumcised races, showing the less irritability of the organs in the class; neither in infancy are they as liable to priapism during sleep as those that are uncircumcised. ”

“ When the young person is disturbed suddenly, his hands, if he has not had time to remove them, will be found on or near the genital organs. The penis, also, may be found in a state of erection; or you may even find marks of recent pollution, which might be known by the peculiar odor arising from the semen, and which comes from the soiled fingers. Have an eye to those young persons, whose hands, when in bed, or during sleep, are in the position described: they are onanists, or will become so. The same is true in those who frequently have erections of the penis. ”

“ In the case of the male genital organs, the glans penis is the most sensitive portion, and mechanical stimulation of this structure in especial is likely to induce the practice of masturbation; in the case of the female genital organs, on the other hand, it is the clitoris which is most sensitive, and of which, therefore, we have especially to think in this connexion. But there is a tendency to overestimate the proportion of cases in which stimulation of the glans penis, in the male, or the clitoris, in the female, is the exciting cause of masturbation. ”

“ Then he tells the woman to beat him mercilessly with a whip and cry “whoa” to him constantly, and treat and abuse him as if he were an unruly horse. The more the woman spurs him on to pull, with shouts and blows, the greater his sexual excitement becomes. Erection occurs (probably mechanically favored by compression of the dorsal vein of the penis, which, when the cords are strained, must be closed by the pressure of the hard ring) . With increasing erection, the whole member is compressed by the ring, and finally ejaculation occurs, with lustful feeling. ”

“ During erection of the penis, the stricture is completely closed, and the semen accumulates in the urethra above it; when the penis becomes flaccid, the semen flows away, outside the vagina. In some such cases, the semen regurgitates into the bladder, and is not discharged until the patient makes water. Although the supposition is not one in which strict proof is obtainable, it is probable that the man is at fault in cases in which the wives of two or more brothers fail to conceive. ”

“ The scenes often end with coitus, but more frequently with ejaculation without it. Twice prostitutes have shown me heavy iron chains with handcuffs, which their patrons had made for them to put on them; and the dried peas, on which they kneeled; the seat set with needles, on which they sat at command; and many other similar things. Often the perverted man wishes the woman to tie his penis so tightly as to cause pain; to prick it with needles, make cuts in it with a knife, or beat it with a stick. Even the act of hanging is indulged in, it being cut short at just the right moment. ”

“ Man's penis, when quiet and unstimulated, is soft, small and drooping. But when stimulated, either by physical touch which acts through the nerves and muscles directly, or by the sight or nearness, or thought of some one lovely and beloved, which acts indirectly through messages from the brain, it increases greatly in size, and becomes stiff, turgid and erect. Many men imagine that the turgid condition of an erection is due to the local accumulation of semen, and that these can only be naturally got rid of by an ejaculation. ”

“ The patient had not been troubled with any more erections or annoyances of any kind. These are the points which often do more or less mischief: wet dressings are uncomfortable and favor erections, while the effect of the weight and action of the scrotum in drawing backward on the integument should not be overlooked; in addition, it should not be overlooked that we have it in our power to produce, so to speak, an artificial phimotic action, which has the same traction on the penis-integument that the natural phimosis induces. ”

“ The fear and anxiety from which such persons suffer has an inhibitory influence upon 336the erection of the penis. In some instances, this inhibitory influence is partial only, and the man thus affected, while perfectly competent in intercourse with a prostitute, who employs means of sexual stimulation to which he has become accustomed, is unable to complete intercourse with his wife, who is ignorant and innocent, and assumes a purely passive role; or it may be that erection is not sufficiently powerful to bring about rupture of the hymen, and thus to overcome the difficulties primae noctis. ”

“ The relative disposition in regard to the irritability of the external sexual organs as existing in the female, when contrasted with the male, is, for some reason, not sufficiently considered or understood. The idea of masturbation or of irritation from the genitals ending in reflex neuroses is always, as a rule, associated with the male, and that it has not been more associated with the female has deprived her of the same benefit that the prosecution of the study in this regard has been to the male sex. ”

“ It may be that the young husband is not fully instructed in sexual matters, and does not really know how coitus ought to be effected; in other cases there is some abnormality of the hymen, which has rendered the rupture of that membrane extremely difficult; in some cases there is partial impotence in the male, whose penis becomes semi-erect only, so that ever-renewed attempts at intercourse are followed by ever-renewed failure. Any of these causes may suffice, in susceptible women, to originate vaginismus. ”

“ Whilst complete impotentia coeundi, in which intromission of the penis is impossible, is a state about which neither husband and wife can fail to be fully informed, cases of partial impotence, with semi-erection of the penis or premature ejaculation, are often glozed over by the husband, ignored by the wife, and underestimated by the physician—and yet such incomplete intercourse entails a series of ill-consequences alike upon the genital organs and upon the nervous system of the wife. ”

“ The in-and-out motion is as easily performed in this position as in the other; and at the climax, the organs can be crowded together passionately, and still without hurting the woman. For she, being free to move, can so curve her hips that the pelvic bone, the mons veneris, as it is technically called, will receive the most of the pressure, and at the same time the angle which is thus made by the relative positions of the vagina and the penis will keep the latter from penetrating the vagina too far, and so will protect its rear walls and the womb from all danger of harm. ”

“ If the position with the husband superior is taken, let him, after he has gotten into place and before the organs are united, have his wife take his penis in her hand, and, as he moves his hips up and down, stroke her vulva, especially the clitoris, with the glans penis—not entering the vagina at once, but continuing this form of exterior contact of the organs, for a longer or shorter time—slipping past the wide open vaginal mouth, even when the wife raises her thighs and, as it were, begs for an entrance ”

“ Such person may not be impotent, and if the desire returns it manifests itself in the genitals as soon as the mind is allowed to dwell upon erotic thoughts; and if erection does not occur impotence is present.
The loss of semen often subsides in the aged, and atrophy of the testes is not an uncommon result; but some people live to be very old, and are never troubled with senile-impotence.
The penis is at all times flaccid, if impotence be complete. Often partial impotence will reveal itself, deviating peculiarly in its character. ”

“ This broadening of the penis results in the female's external genitals being subjected to much more pulling and pushing during the performance of pelvic thrusts. With each inward thrust of the penis, the clitoral region is pulled downwards and then with each withdrawal, it moves up again. Add to this the rhythmic pressure being exerted on the clitoris region by the pubic region of the frontally copulating male, and you have a repeated massaging of the clitoris that — were she a male — would virtually be masturbatory. ”