Chronic hydrocele frequently persists after epididymitis or orchitis, causing much inconvenience and pain and sterility. Neuralgia also frequently persists for a long time after such an attack. This testicular neuralgia is often agonizing in its intensity, causing insomnia, loss of appetite, dyspepsia, nervous excitability, hypochondriasis, emaciation, and profound depression of spirits. A man naturally prizes the integrity of his testicles to the last degree, and any serious damage to them is well calculated to reduce him to despair.
We see, then, that partial or complete sterility is liable to result from connective tissue thickenings in the course of these seminiferous tubes; the scar-like tissue tending to constantly become firmer and denser, so as hopelessly to put out of service one half or the whole of the man's reproductive organs: and, unfortunately, this complication is by no means a rare event among gonorrhceal patients, none having an assurance of escaping, no matter how mild the case.
INFLAMMATION OF THE SEMINAL VESICLES.
These membranous receptacles for the semen, it will be remembered, lie on the base of the bladder, between it and the rectum, and their excretory duets unite with the vasa deferentia to form the common ejaculatory ducts.
We saw how the gonococci spread by continuity down the whole length of the urethra and thence along the twenty four inches of the vas deferens to the epididymis and testicle, and, as might be expected, they also occasionally find their way into the seminal vesicles.
Like epididymitis, seminal vesiculitis usually occurs within from two to five weeks after the gonorrhceal infection. It is in almost all cases a complication of gonorrhceal invasion of the posterior urethra; though it may result, in milder form, from the passage of a bougie down the urethra, from injuries received by riding on an improper saddle, or from any cause which might excite inflammation in the genital sphere. The symptoms resemble those of posterior urethritis and inflammation of the prostate. In seminal vesiculitis there are almost constant erections, the penis sometimes remaining in a condition of priapism, or continual painful turgescence. There are frequent and involuntary seminal emissions, which, instead of being attended with any pleasurable sensation, cause a violent and burning pain during ejaculation. The emission is sometimes blood stained and partly composed of pus.
Such a patient presents a pitiable spectacle; his mind is riveted on his sexual apparatus to the exclusion of all other things; his sexual passion is enormously increased, but the gratification of the appetite, either by coitus or pollutions, is attended with severe pain; he is hot and feverish; it hurts him to allow his bladder to become filled and it hurts him to empty it; his sleep is much disturbed; he cannot have a movement of the bowels without severe pain, and he suffers with dull, throbbing pains, which he refers to the rectum, bladder, perineum, or spine. No wonder that such a patient becomes much depressed in spirits, hypochondriacal, and irritable.
Numerous cases are mentioned in medical literature where seminal vesiculitis has been followed by abscess formation, with subsequent rupture and discharge of the pus into the bladder, peritoneal cavity, or rectum, these cases ending sometimes in death, but usually in the formation of fistulous tracts which are very difficult to heal. As in all gonorrhoeal processes, there is a marked tendency for the condition to become chronic; but the symptoms are so vague and deep seated that they often pass undiagnosed.
If the seminiferous tubes have become occluded the patient will be impotent, and will soon lose the power of erection and all sexual desire.
These miserable individuals who have lost their sexual power will put forth their utmost efforts to regain it and hail with delight anything which will give them an erect penis. Some of them have a dribbling of a dirty grayish or brown mucus which stains their clothing, and sometimes they have emissions of gonococci containing semen mixed vith pus and bloody mucus.
Others, on the contrary, who have not arrived at this stage, have enormously increased sexual appetites. "Such is the erotic condition of these patients that the sight of a pretty woman, of her breast, or her ankle, throws them into a high state of nervousness and sexual erethism. I have known several instances in which one woman only exerted this morbid influence upon the man. Accidental slight contact, the glance of the eye, the sound of the voice, and the grasp of the hand served to so excite and exalt them sexually that an orgasm, with or without partial erection, would result".
This is the kind of men who are most dangerous to society. Their lust has been artificially magnified to so great a degree and the gratification of it has so prominently been the one idea of their lives that they are liable to become seducers, ravishers, and fathers of an unhealthy brood of illegitimate children. Such men are bewitched with the society of women, continually indulging in erotic fancies concerning them, frequenting dance halls, and consorting with many a pure girl who entirely fails to realize their motives.