differences of opinion there may be on this matter, and they must needs be extreme, there will be thorough concurrence in the view that social purity and a very high standard of morality are absolutely essential to the well-being, to the happiness, and to the real progress of the community. Nay, this might be almost considered as the true test by which the value of systems and institutions, whether political, philosophical or religious, was to be determined. Not only is a low moral standard certain to be soon followed by disaster, but the tacit permission on the part of the many to allow a few to regulate their actions according to a low moral standard, would be condemned, whether the judges were religious, agnostic, or anti-religious, philosophical or opposed to philosophy, aristoctatic or democratic, nay, though they were composed of those only who had themselves passed through all the fiery evils of which a low moral standard is at once the cause and the result. There would be a unanimous agreement as to the pressing need of maintaining and raising the standard of public morality. Is it being raised, is it stationary, or is it being lowered at this time? The question is a difficult one to answer. Nay, it seems impossible to obtain the evidence which alone would enable us to form any general conclusion; but there is a vague impression that the true answer would not be satisfactory, while there is a certainty that the standard of social purity in all classes is far below what it might be and ought to be amongst us at this time, while it is also certain that in some parts of the country, but by no means only among the least informed and the least intellectual classes, the standard of morality could scarcely be lower than it is. The question concerns us all, and there ought to be remedial measures which the atheist, the agnostic, the skeptic would desire should be introduced, and would feel as anxious to see acted upon and carried into practice, as the religious man, the moral secularist, or the philosopher. Nevertheless, looking from the purely practical side, I cannot but regard with fear and sorrow the further evolution in thought development of the young agnostic, whose views are based upon the dim shadows of ideas and almost meaningless rhapsodical utterances of one or two self-confident, loud-talking enthusiasts, who seem

to be quite incapable of expressing anything more clearly than as vague longings and hopes and beliefs of what may be or might be, or is conceivable to a privileged imagination; and who are astonished that the doctrines they had vaguely propounded should have carried some of their unfortunate disciples so far in the direction of folly, that misery and ruin, and even crime, have, it is to be feared, been the result in some instances.

Hints on Medical Treatment.—I have spoken of the allimportance of prevention, and the general method to be pursued in the management of cases in which there is or has been much disturbance of function, with perhaps considerable derangement of the nervous system, and possibly also of digestion and general nutrition. It remains to be considered whether assistance may also be obtained from medicines. Medicine alone cannot effect changes which are due to inherited peculiarity, or to the circumstances under which the patient may have to live; but when the derangement in question is due to or is made worse by disturbances of the stomach, liver or urinary organs, much may be done to help the patient. Even in cases where the indications for medicinal treatment are very clear and distinct, the practitioner must always bear in mind that he may be of the greatest service to his patient if he will consider the points to which I have adverted concerning the general management of the case, as well as by prescribing any medicines which are likely to be of service.

In many instances the habit is unquestionably self-taught. It not unfrequently affects weak, sickly children, and is often to be traced to irritation about the prepuce or glans. Occasionally, accumulation of secretion between the prepuce and glans seems to be the exciting cause, and sometimes a superabundant prepuce, eczema, or an over-sensitive state of the delicate surface of the glans exists. In many of these cases a cure is easily effected by operation; and it has been remarked that masturbation is virtually unknown in Jewish schools. "Medical Times and Gazette,' Vol. XXXIV, p. 79, note. It sometimes happens that every boy in a family is born with a redundant prepuce, with an exceedingly small orifice, rendering surgical interference imperative.

Many boys and young men who have acquired the habit are weak, nervous, excitable creatures, with little real energy or power of self-control, and little love for bodily or mental work. It is thought by some that for these cases spiritual advice and confession is the proper curative method. Such persons could no doubt be easily persuaded to confess, but it is very doubtful whether more harm than good will not result. I much doubt whether confession of such things to a priest is either good for the patient or for the confessor. Whether confession is right for a healthy, vigorous-minded man I will not discuss, but certainly it is not very likely to cure a hypochondriac or encourage a weak-willed, nervous, lazy, fanciful fellow, full of himself, to exercise self-restraint and endeavor to do his work in this world honestly and well.

As for those sad cases which pass into our lunatic and idiot asylums, there is great reason for thinking that the masturbation, so far from being the cause of their sad fate, is but one of a long list of symptoms depending upon defects in the development of parts of the nervous system, or resulting from disease originating there. It is as much the consequence of disease as paralysis, loss of sight, or loss of consciousness. Such cases, although

incurable, are sometimes much benefited by proper medical treatinent carefully carried out for a considerable time. It is surprising what a considerable degree of improvement sometimes follows residence in a good locality under proper manage

ment.

Tincture of perchloride of iron, phosphate of iron, or reduced iron with mineral acids, quinine, various preparations of cinchona and nux vomica, are most useful in the treatment of these cases, especially where the health is low and the patient weak, and the digestive organs much deranged, as is not unfrequently the case. Mild purgatives are often required, and mercurials in small doses often act favorably. Like drinking habits, these are much under the control of the individual. If he wills to control them, he can do much, and it is important to exercise all the moral control we can, and encourage him to make strong efforts to regulate his conduct. When he first comes

under notice he may be in such low, weak health that there is no hope of him exercising the control desirable, but if we give tonics for a time and improve his general health, he will be able to follow our advice. We must do all we can to influence the patient for good, and we must get him to place confidence in us; and sometimes this is indeed a most difficult matter, while, strange to say, a very ignorant and perhaps very vulgar person may get such control over the patient, partly by threats, partly by persuasion, as to virtually get him completely into his power. What is most necessary is to find some means of thoroughly interesting the patient and occupying his thoughts till it is time to go to bed, and we should instruct him so to arrange that the exercise he takes shall be sufficient to tire him a little. He should put the feet in warm water just before he goes to bed, in order that he may go to sleep as soon as possible. Such little points as these are of great value in the treatment of this class of cases, and should be borne in mind. The patient should be instructed to rise as soon as he wakes in the morning, when a glass of Hunyadi or other purgative water, or Epsom salts, should be taken, unless the bowels act freely without medicine.

When the presence of spermatozoa is pretty constant, and is accompanied by various symptoms, such as extreme nervousness, dyspepsia, loss of flesh, weakness, anxiety and general disturbance of the health, the practitioner will be required to take the case in hand, but he must be very careful to exercise great care as to what he may say. The mere suggestion that spermatozoa are present in the urine may frighten a nervous patient who has studied quack books and visited the demoralizing museums, in a way that is quite extraordinary.

Spermatorrhea. The occasional, nay the frequent, presence of spermatozoa in urine must not be taken as evidence of the existence of that condition to which the name of "spermatorrhaa" has been applied—a term which I am sorry to employ at all, but which cannot be abolished. There is, in fact, no disease which can be correctly termed "spermatorrhoea." The secretion of the testicle, like that of other glands, must from time to time escape, and when it is formed in undue quantity and

discharged too frequently, it is usually but one of a train of symptoms possibly dependent upon general changes. Spermatozoa are very often found in the urine of young men in perfect health, in great numbers, and I have seen multitudes in the urine of a hale old man above 80 years of age. This was a decided case of " 'spermatorrhoea ;" and there is no doubt that if this old gentleman's urine had been examined by some of the quacks who pretend to make this "disease" a special study, he would have been favored with a description of the frightful consequences of this escape of the secretion of the testicle, and have been subjected to treatment. I have long ago expressed my own opinion about the careless use of the word "spermatorrhoea," and I have found no reason to alter it; but as there is some difference of opinion in the profession upon this matter, it is, perhaps, well that I should state more fully the reasons upon which my opinion is based.

One author has complained that some of our hospital physicians have fallen into the "error" of making too light of this affection, and that one or two in particular have even gone the length of ignoring its existence altogether. I am glad to say that I fall under this stigma, for I hold that there is no such disease as "spermatorrhoea," as usually defined. It has been truly stated, that charlatans, for their own selfish purposes, too often work upon the fears of their patients, and exaggerate the evil consequences to be anticipated; but what encouragement does the practitioner afford, who, under the head of " consequences of spermatorrhoea," includes "phthisis, cerebral congestion, epilepsy, general paralysis and insanity-lastly, enfeebled sexual power, and ultimately impotence?" These have been stated to be consequences of "spermatorrhoea," but we are not informed whether "possible" or "probable." Spermatorrhoea has been defined to be “all losses of seminal fluid not occurring as the result of sexual intercourse." Impotence, it is said, is not an uncommon consequence of " 'spermatorrhoea." I have seen many cases which have been called “spermatorrhœa,” but I never saw one which ended in any of the above terrible consequences. Impotence, not depending upon some congenital

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