quence patients believe themselves to be subjects of syphilis. In the hands of the ignorant or the unscrupulous these deluded victims often undergo specific treatment for long periods.

Diagnosis.-The excoriations of herpes can usually be distinguished from those of balanitis by the circular outline of the herpetic lesions, which is rarely entirely lost even when the vesicles have coalesced, and by the absence of more extended inflammation. When the excoriations suppurate and form superficial ulcers, it may be impossible to distinguish them from beginning chancroid, but by cleansing the parts and keeping them covered with iodoform or aristol herpetic ulcers will at once begin to improve, and in a few days will be entirely healed. An initial sclerosis may appear as a small excoriation, but underlying induration can be detected; the sore is indolent, and is soon accompanied by characteristic enlargement of the inguinal glands. In making a prognosis it must be remembered that chancre may follow in the site of an herpetic lesion if the longest period of incubation of syphilitic chancre has not elapsed between the date of exposure and that of the examination.

Treatment. The local treatment of herpes progenitalis is that of balanitis. Recurrences may often be avoided by improvement of the general health and by hygienic living, including abstinence from alcohol, tobacco, and highly seasoned food. Local and other conditions predisposing to congestion of the parts require treatment. Sexual hygiene is important. In obstinate cases the surface of the glans and prepuce may be hardened by the long-continued use of tannic acid or other astringent in powder or in solution of water and alcohol.

HYPOCHONDRIASIS.

THE morbid mental states produced by real or fancied venereal disease are numerous, and are equalled only by the hypochondriasis springing from ignorance and perversion of the physiological functions of the sexual organs. These morbid mental conditions are of occurrence in both sexes, far more frequently in men than in women, the subjects being generally near the puberal epoch. The symptoms presented differ in grade of severity, and when of marked character they may result in more physical distress than the maladies themselves, of which there is either slight evidence or a mere dread. For practical purposes the sexual hypochondriac and the patient in terror of a venereal disease, actual, possible, or wholly imaginary, may be considered in the same category.

It is a matter of common remark that the physiology of the generative organs of the male sex is less understood by the average physician than that of the corresponding functions in women. In the management of the youths, commonly unmarried, who are sufferers from the mental states here considered, it is important to recall the following facts:

Among the mammalia of the lower animals the sexual propensity is in general gratified with impunity in promiscuous relations, the young males copulating with individuals of the other sex freely on the earliest impulse, when not restrained by stronger adult males and by females who are not ready to accept approaches. From this event dates the sexual life of the animal, the male, when no longer capable of performing the sexual

act, being often killed by stronger and more ambitious rivals or being abandoned to die apart from the group of breeding animals. Throughout this sexual life the male animal has, in the state of nature, no seminal emissions and no perversion of controlling sexual instinct. As a rule, he refuses to solicit the female of his kind. when she is pregnant. In many cases the period of activity of the sexual impulse of the female corresponds with that of the other sex, and beyond that season the two often exist together in a harmonious asexual life. Obviously, this arrangement is designed solely with the view of reproducing the species.

The female, as a rule impregnated at the earliest ovulation, begins with this event a sexual life which thereafter consists of a series of pregnancies and sucklings of offspring until she is incapable of further conception, when she also either dies or is killed, having fulfilled her part in the struggle for existence. There is no history of menstruation-a function which, with its important accessory phenomena in generations of transmitted tendencies, distinguishes the female of man alone in the animal creation.

When man is studied in his artificial social surroundings, he is seen at once to be amply fitted for the part he is to play in life of a broader scope and deeper intent than that of the brutes. The young human male is required by the written and unwritten laws of most civilized countries to deny himself the gratification of his sexual appetite until he is capable of union with one woman and of providing for the support of a family. During the time which intervenes between the attainment of puberty and marriage there is a period of unrest, and in many cases even of physiological storms which ever and again disturb the tenor of his days. If he happens to be among the large number of lads who early in life have practised masturbation, a perusal of the advertisements of the charlatan, with their record of horrors, may awaken in his breast a

dread of a frightful future. He comes to his physician or friend (well for him if the former be also the latter) with a tale of involuntary seminal emissions at night, with and without erection; an escape of semen when straining at stool; "lost manhood;" defective memory; spots dancing before the eyes; "impotence;" sexual debility; general weakness; and disinclination for society.

With the trained physician it is scarcely necessary to discuss this group of "symptoms." Involuntary nocturnal discharges of semen occurring in a young man. several times during one night, or even on successive nights, are "unnatural" simply because the human male animal is not living in the state of nature briefly sketched above. These losses are of similar import whether occurring with erection and accompanied by a lascivious dream, or in the total unconsciousness of sleep. They are truly physiological, and amount to the price paid by the youth who is attempting to lead a correct life and who refuses to lower his moral standard. The frequency of these discharges has little bearing upon any question of disease, since in perfectly sound youths seminal losses may be even often repeated without detriment to the general health. A frequency at one time is usually compensated for by a relative absence at another. The emissions may be followed on the succeeding day by a feeling of lassitude, slight frontal headache, and mental dulness, but the balance is always struck by nature, as there is usually afforded a respite from the sexual fever (if such it may be called), when the discharge or the series of successive discharges is at length for the time being made to cease. These losses wholly correspond in physiological function and meaning with the menstruation of the young woman, whose monthly flux in a sense represents the price paid by her for virginity, clean living, and a delay of the performance of the sexual function until she is solicited in marriage by an acceptable suitor. It is true that after marriage menstruation may occur periodically, but,

as a rule, it is suspended during pregnancy. Married men also, temperately indulging in sexual relations, occasionally have periodical involuntary seminal losses. It is well known that the comeliness of a young girl is almost proportioned to the regularity and character of her monthly periods. None the less is it certain that the attractiveness of a youth leading a clean lifethat which makes the eye of man and woman dwell on his person with a sense of delight, the promise of manhood writ large on his features and figure-is to a degree proportioned to his involuntary losses at night.

Nor is the periodicity observed in menstruation not perceptible in the corresponding function of the other sex, seeing that not only are married men at certain seasons of the month specially disposed to the gratification of sexual desire, but that the unmarried also, at certain times in the month more than at others, have an access of similar import. There is, in fact, a prostatic no less than a uterine ebb and flow of sexual congestion, and the reverse, that is responsible for many phenomena of health and disease perceptible in the two sexes and often wretchedly misinterpreted. Many, indeed, of the "pollutions" of young men at night (suggesting the menstruation of women not accompanied by ovulation) are discharges largely made up of the prostatic fluid rather than of semen.

Much the same explanation can be given of the "losses at stool" on straining which are such a bugbear to the uninitiated. These losses, too, are largely made up of the fluids of the prostatic sinuses, expressed by pressure upon the gland exerted by a scybalous mass in the There is no evidence whatever that this "loss at stool" is, in the life of any continent man, a sign of disease. Men differ greatly in the quantity of prostatic secretion they furnish, precisely as they differ in the amount of salivary fluid supplied during mastication. There is no fixed standard for all men, as there is

rectum.