A Contribution to the Physiol- 
ogy of Sexual Impotence. 
BY 
E. E. PALMER, M. IX, 
Professor of Physiology and Pathological Histology in 
the University of Louisville. 
TiEPlUNTKD FROM THE 
■Jfelu Yortt fvIcDical Journal 
for July 2. 1892. Reprinted from the New Yor~k Medical Journal 
for July 2, 1892. 
A CONTRIBUTION TO THE 
PHYSIOLOGY OF SEXUAL IMPOTENCE* 
By E. R. PALMER, M. D., 
PROFESSOR OF PHYSIOLOGY AND PATHOLOGICAL HISTOLOGY IN THE 
UNIVERSITY OF LOUISVILLE. 
I ask your attention to a subject full of interest and 
hard to handle, yet of paramount importance to every one. 
It lies in the borderland between the purely scientific on the 
one hand and the possibly prurient on the other. For want 
of a better title I have chosen as a somewhat paradoxical 
yet suggestive heading The Physiology of Impotence. If 
in what I may say I can formulate anything that shall make 
plainer than they are to-day the unwritten laws of healthy 
sexual living, I shall rest content. If I am not always 
rock-ribbed by the confines of cold science, I trust that 
the delicate nature of my theme will plead my excuse. 
By healthy sexual living I mean the legitimate pleasurable 
performance of the sexual act at proper intervals through 
life by both sexes without impairment of health and over 
a maximum period of time as time is measured by human 
life. 
We are met at the very outset by the problem of evolu- 
* Read before the American Society of Genito-urinary Surgeons. 
Copyright, 1892, by D. Appleton and Company. 2 
A CONTRIBUTION TO THE 
tion, and modifications under domestication confront the 
subject at every turn. Man, representing as he does the 
highest type of perversion by domestication, is to be studied 
as performing the sexual act in season and out of season, 
before puberty and in senility, irrespective of all laws either 
of Nature or of nation, at the risk of every loss, even that 
of honor, and least of all for the purpose of procreation. 
Beyond even the danger of a passing challenge it may be 
said of humanity that for more than any other finite pos- 
sibility it lives for sexual living, and so may he rank as most 
a benefactor who shall, respecting this phase of life, outline 
the measures most conducive to the attainment of the great- 
est pleasure for the greatest number. 
I would divide the subject into two sections : First, 
physiological impotence of the male without any regard to 
sterility ; and, second, physiological impotence of the fe- 
male with a like disregard of her procreative powers, avoid- 
ing as far as possible all of the many pathological influences 
and effects that are recognized by the profession as factors 
in this connection. 
Of the male human being it may be said that he begins 
sexual life as a masturbator. The various reasons that have 
been assigned as explanatory of this habit are possibly all 
more or less correct. Just here I shall attempt neither to 
explain nor to controvert them, but simply, accepting the 
fact, to deal with its bearing on the future sexual life of the 
individual. Given a youth of approaching maturity ; he 
has learned the evils of his way ; he wants to be a man ; 
he has quit, or at least has fully determined to do so, and 
he comes to the doctor for help. To his mind his case is 
indeed grave. He suffers with nocturnal pollutions, and, 
having read what he could find on the subject, he realizes 
what he deems the fearful error of his past life. He has 
attempted to perform the sexual act a la mode, but has PHYSIOLOGY OF SEXUAL IMPOTENCE. 
3 
failed most miserably, and so, with nothing left in life worth 
living for without sexual manhood, he tearfully begs for re- 
lief, hoping against hope that the great science to which he 
has appealed may possibly redeem him from that impotence 
that to his disturbed mind seems but to assure a future worse 
even than death. 
It is not alone from the pamphlet of the catchpenny 
quack, but from the teachings of the regular profession as 
well, that he gets at least a part of the groundwork of his 
despair. To say to such a youth that in absolute conti- 
nence, sedatives, circumcision, and the cold sound lie his 
only hope is, to my mind, whatever it may be from a moral 
standpoint, advice at variance with Nature and so in conflict 
with science; and, in face of the exceptional cases of phys- 
ical wreck that self-abuse has wrought, I would maintain 
that its influence, recognizing its almost universality of per- 
formance in boyhood, has been not only wrongly estimated, 
but most unwisely exaggerated. In explanation of this 
statement I would say : Given any healthy-born youth of 
twenty who began masturbation at, say, twelve and followed 
the habit with considerable frequency and regularity during 
the eight subsequent years, at the same time indulging in 
ball-playing, swimming, and studying, eating, sleeping, and 
living like his fellows—such a youth, were it possible to blot 
from his memory the recollection of his past self-abuse with 
his relinquishment of the habit, would, as a rule, retain but 
one of the evils it may entail, and that one I do not find 
emphasized in print either by moralists or by scientists— 
namely, to transmit the inclination to the habit to his off- 
spring. 
We do not have to study Zola’s history of the Rougon 
family or the annals of crime generally to be reminded of 
the transmissibility of the passions and their perversions in 
the germ-plasm from parent to offspring. It is thus largely 4 
A CONTRIBUTION TO THE 
that all vices are perpetuated. That such a youth as I have 
just described would suffer with pollutions, nocturnal, pos- 
sibly diurnal, is quite probable, but I can not agree either 
that this disgusting tendency is solely the fruit of masturba- 
tion or that the inability of a youth to properly perform the 
sexual act is necessarily due to his having been a masturba- 
tor in earlier years. If a man from childhood to the mar- 
riage hour lives a morally spotless life, it does not follow 
either that he will not have had involuntary emissions, or 
that he will be able to copulate successfully at the first or, 
for that matter, the tenth attempt on the marital couch. 
Cases demonstrative in both instances can be cited to prove 
the fallacy of such doctrines. 
We can not fail to recognize the habit of self-abuse as 
environed by numerous possible evils, but let us at least 
avoid the rule of portraying it as universally horrible and 
hurtful. Rather let us encourage and sustain the penitent 
with assurances of a manly future of physical well-being. 
What are the environing evils of masturbation ? I suppose, 
among different replies to the query, all would practically 
agree that the chief was excessive indulgence, exercising 
that same evil upon the young that tobacco, alcohol, all- 
night card-playing, excessive copulation, where possible, 
and the like exercise ; the manifest evil that any often re- 
peated and severe tax must exert on the plastic tissues of 
early life; and, accepting this view of the question, I am 
willing to place self-abuse first, with alcohol and tobacco 
running neck-and-neck at its saddle-girth for second place 
in the race of ruin. Yet even here must I take issue with 
the popular dictum. It is thus often said by those who 
agree that mere masturbation per se is not so hurtful, that 
it is the opportunity for excesses in that direction and the 
widespread abuse of such opportunity that make masturba- 
tion a common curse. In contradiction of this popular PHYSIOLOGY OF SEXUAL IMPOTENCE. 
5 
idea, I make free to state that, as a clinical fact, in only 
quite a small minority of instances is such excessive indul- 
gence the rule. The boy is father to the man ; his instincts 
with each added year point more and more that way. The 
very secrecy that the habit entails is his safeguard. That 
same spirit that leads him, almost before his feet touch the 
floor beneath the mahogany, to sip his post-prandial pousse- 
caf e with all the nonchalance of an old clubman or to puff 
his vile cigarette on the avenue, is a part of the same in- 
tuition that makes him despise the unmanly vice of mastur- 
bation, and as he emerges from childhood each indulgence 
comes only after la mental battle against its performance—a 
battle in which manliness loses in the indulgence and yet 
wins in the new resolve that is born of the malaise and dis- 
gust that follow, delaying its repetition to within almost 
physiological bounds and soon enabling him to throw off 
the habit altogether or, in manly resolve, seek the aid of 
our profession. 
What, then, is this impotence of youth for which we 
are so often consulted ? Wherein lies the fault ? Where- 
in is to be found the remedy ? The fault rests largely in 
the common misconception with which the emission of 
semen is viewed by nearly every one, the medical profes- 
sion included. The youth is taught that semen is a mar- 
velous product, a thousandfold more precious than even 
blood itself; that a definite, an inflexible limit is placed by 
Nature on man’s capacity to produce it; that he is charged, 
so to speak, at birth with a limited amount of the precious 
fluid ; and so, therefore, by the most natural logic of the 
case, he is led to believe that in the prodigality of his early 
solitary indulgences he has largely, if not wholly, expended 
his stock of this priceless fluid, until matrimony, with 
happy home and healthy family, is barred to him forever; 
so that, like the despairing soul at the gateway of Perdi- 6 
A CONTRIBUTION TO TIIE 
tion, he lifts his eyes but to read above the doorway of his 
future : “ All hope they leave behind who enter here.” That 
such should not only be a popular doctrine, but should se- 
cure at any rate the tacit indorsement of our profession, is, 
to my mind, not only an egregious error, hut a blunder un- 
warranted either by analogy or by fact. 
We see its teachings shown, not alone in the melan- 
choly youth, but in the adult of middle life also, who not 
only exercises his will power to economize his stock, but 
bemoans the involuntary nocturnal pollution that results, as 
another precious charge futilely expended from his rapidly 
ebbing magazine of pleasure. It is like the dread of the 
Bogie man that, taught to the child in the nursery, leads 
him to fear the dark in later years, a false tradition that 
the sooner we get rid of the better. What an anomaly it 
would be in the eternal fitness of things if there should be 
a special law in Nature thus confining that phase of life by 
which life itself is perpetuated ! A curse, rather, and its 
conception in human philosophy is as irrational as it is un- 
true. What evidence have we, either by analogy or by 
clinical facts, that in the regular use of the testicles they, 
like glands and organs generally, are not developed and 
strengthened rather than weakened and exhausted ? May 
we not say, rather, that within reasonable bounds a natu- 
ral, regular, and frequent use of the sexual organs tends 
to an increase of their power, and, accepting the fact of 
occasional instances of overtax, at the same time should 
we not equally recognize the hurtful influences of ir- 
regular use and continence in many cases of failure sexu- 
ally, rather than attribute all such failures to a worn-out 
condition of the sexual apparatus ? Want of use or un- 
physiological irregularity in that direction explains, to my 
mind, in a large degree that impotence of youth that other 
men, from a different standpoint, are prone to moralize PHYSIOLOGY OP SEXUAL IMPOTENCE. 
7 
about. The impotence of youth is the impotence of inex- 
perience, rather than incapacity. He tries and fails, not 
because of any previous exhaustion of his powers, but 
rather because of their imperfect development and training. 
As the single julep or the first cigar turns his stomach or 
splits his head throughout the restless night, so the early 
copulation, imperfectly performed, surrounded as it is by such 
strangely unnerving phases, drags at his loins and runs riot 
with his heart for more than one day after the indulgence. 
To such an abashed youth, depressed by his involuntary 
pollutions, overpowered by the Bogie-man idea, and be- 
cause of his failure, in despair of his manhood, I would 
speak somewhat after this fashion : My dear boy, you have 
not lost your manhood ; you rather have not found it. Your 
failure is the natural failure of the novice. One must learn 
to properly use, and in so using to develop, his physical 
powers sexually just as his other powers have been exer- 
cised and developed. You were a toddling infant once ; 
now you possess the graces of Delsarte. Be patient, and 
above all be not afraid, and in due time all will be well with 
you. Marry if you so desire ; better to marry than to burn, 
but, above all things, whether you marry or remain single, 
don’t be cast down ; cowardice begotten of sexual ignorance 
and fostered by false tradition is what impotence often 
means to the otherwise healthy youth. 
Turning from the physiological impotence of the male 
youth, we are confronted with the question of sexual failure 
in the otherwise healthy man in the prime of middle life— 
the man who between forty and fifty seeks our advice for 
relief of failing or lost virility. Here, again, is to be met 
and combated the common explanation: “You are reaping 
the fruits of the self-abuse of your youth or the excesses of 
your early life. You have, by one or both of these means, 
worn out your precious powers, and there is no hope for 8 
A CONTRIBUTION TO THE 
you.” Yet, in face of such doctrine, no commoner in- 
stances of early loss of virility can anywhere be found than 
in the ranks of those very men who not only were not 
addicted to excessive self-abuse in boyhood, and who have 
not been libertines in later years, but who instead justly 
enjoy in the community in which they live the reputation 
of being moral, orderly family men, noted for their always 
strict observance of all those laws that the most moral liv- 
ing enjoins. In such cases, and also, indeed, in those of a 
parallel age, where the accusation of early excesses is per- 
haps more tenable, omitting the influences of disease and 
perversion, what other causes of impotence than exhaustion 
may we recognize ? There are several: First, there is the 
not inconsiderable group represented by the man, not pas- 
sionate by nature, who, possessing the extremest conception 
of morality, has never exercised his sexual powers when he 
could help it, and then only in a perfunctory way. His- 
feeble physical development sexually is father to his pre- 
mature decay. Another class contains those who, recogniz- 
ing the partial waning of their powers, begin assiduously to 
practice economy in that direction, hoping to conserve 
wThere in reality they by continence destroy. 
The athlete would hardly shut himself in his room to 
save his muscles for the coming contest by so doing, yet 
that is practically what the economical middle-aged man is 
constantly doing sexually. The scholar does not sit down 
and gaze blankly into space to save the brain power he de- 
veloped at college, and yet men are doing the like con- 
stantly in their sexual living. The athlete may overtrain, 
the student break down from too close application to 
study, and yet the law maintains that by use, not by dis- 
use, by regular systematic exercise, are all of the organs 
of our bodies developed and kept at the fullness of their 
powers. PHYSIOLOGY OF SEXUAL IMPOTENCE. 
9 
Still another and probably the largest class of healthy 
middle-aged impotents is represented by the man who is 
absorbed in business cares and worries. He feels that he 
is no longer a hoy ; life has become to him a solemn reality, 
and so, whether weary from coupon-clipping or worn out 
from futile efforts at kiting accommodation paper, he feels 
anything but kittenish when bed-time comes. It is then my 
belief that, within confines broader than those encompass- 
ing the rules of orthodox practices, man may and does by 
use develop, strengthen, and preserve the integrity of his 
sexual organs, and that the integrity, requirements, and 
possibilities of the germ-plasm apparatus are regulated by 
the same physiological laws that govern the somatoplasm 
organs of the rest of the individual. 
Recognizing the high order of office allotted to the 
seminiferous organs and the consequent complex nervous 
relationship that they possess, I yet maintain that conti- 
nence means atrophy, that disuse means decay; and not 
only this, hut that the influence of persistent continence 
upon the individual, whether male or female, is to dwarf 
and in many respects destroy the breadth and fullness of 
physical and intellectual individuality. Some one has said 
that normal decay of virility is reached in the male human 
being at sixty-five. Individual instances of virility at four- 
score years or more abound; comparatively few men, how- 
ever, preserve such power beyond two and a half or three 
score years. Of those who do I may mention as illustrat- 
ing what I have said a class known to all of us as the “ men 
about town.” They are to be met with at the club, on the 
betting stand at the race-course, or on the avenue of a 
pleasant afternoon, well trimmed, well dressed, carrying 
none of life’s burdens they can possibly shift to other 
shoulders, living for themselves alone, and bent daily and 
nightly on getting all out of life they can—short-winded 10 
A CONTRIBUTION TO THE 
somewhat from their terrapin padding, with Burgundy 
twinges in their fingers and toes, yet for all this keeping 
up a fairly clever pace with the younger set, relying on the 
Turkish bath in winter and a sea voyage or mountain trip 
in summer to keep them on the turf for a few years longer. 
Come what may, they have learned the art, and so still en- 
joy the fruition of ideal sexual living. 
The male pervert has no place in the physiology of 
sexual living. To chronicle his vagaries as others have 
done would be hut to pander to pruriency and so to fur- 
ther foster unnatural vices. To make my object plain, 
which is a plea for healthier sexual living, the study of the 
maid, wife, and mother, from the standpoint of physiologi- 
cal impotence, is essential. The ideal young woman is al- 
most necessarily impotent. From time immemorial the 
prerequisites in her moral and social qualifications have 
been modesty and chastity. Those lapses from absolutely 
virtuous living that in the male are condoned as charming- 
little irregularities, when indulged in on her part, invariably 
call down upon her luckless pex-sonality a damnation worse 
than death, at the same time often barring her from - her 
highest mission—maternity. That a universal law, acting 
through the ages, calling for unquestioned chastity in the 
maid and mother, slioidd have had its effect in a large pro- 
portion of the sex in modifying the sexual organs and de- 
sires is not surprising; that it has not absolutely extirpated 
feminine sensuality is perhaps more surprising. The typi- 
cal female impotent, then, is by no means a rarity. To her, 
in her life as maid, wife, or mother, sensuality is an incon- 
ceivable possibility. She loves, marries, yields, and bears 
children, happy, in a quiet way, in making others happy, 
playing her unobtrusive part in the quiet drama of life in 
absolute ignorance, personally, of that passion that, more 
than all other things combined, has fostered the finer arts PHYSIOLOGY OF SEXUAL IMPOTENCE. 
11 
or pitted man against man in deadly strife. Without 
etfect on her procreative powers, her evolution has equipped 
her with rudimentary organs of copulation. With a 
cool, contracted ostium vaginae deep sunken beneath the 
symphysis, with pale, thin labia, and a clitoris scarcely dis- 
cernible by the most erudite touch, she represents the em- 
bodiment of the social ideal, whose happiness throughout 
life, at best of a negative type, is endangered only by her 
finding out her physical shortcomings and vainly striving 
toward its correction. This, however, is but an extreme 
ideal type; the opposite extreme, as previously indicated, 
is also often to be found, environed by dangers that only too 
often bear for the possessor most bitter fruits. It is 
neither with the hopeless first class nor with the often luck- 
less second that I would deal; both are practically beyond 
redemption. But of the great mass of femininity lying 
between these two I would speak as a class only too com- 
monly neglected, misunderstood, and misused by the over- 
developed male. 
The sexual phase of sociology in its evolution has drifted 
the sexes widely apart. In the typical male, physical exci- 
tation is no longer an essentiality. A thought, a passing 
phantasy suffices to give full play to his sexual powers, while 
with the average female not only is contact necessary, but 
a retardation of response and a limited area of receptive ex- 
citability are the rule. That in the wild state of vertebrates 
all the tangible sexual organs, and notably the vaginal tract, 
act responsively to masculine contact during congress is evi- 
dent, while the insensitive labia, vagina, and uterus of the 
average human female leave but the clitoris in its out-of- 
the-way location as an organ of possible excitation. To 
any one who has witnessed the evident mutual pleasure that 
occurs in the sexual congress of a stallion and mare, but one 
explanation of such result, viewed from the imperfect and 12 
PHYSIOLOGY OF SEXUAL IMPOTENCE. 
clumsy action of the male, is possible, and that is that the 
mere intromission of his organ into a sexually highly sensi- 
tive vagina supplies the one essential to mutual gratifica- 
tion. 
In conclusion, then, I would say that the primarily rul- 
ing causes in sexual impotence and incompatibility to-day 
are evolutional in their nature ; that in the average being 
the influence of heredity acting through the ages has made 
man abnormally and perversely sensual and woman sluggish 
to a degree little short of absolute incapacity ; that in this, 
as in other of the physical errors of our inheritances, the 
skill of science may and should he evoked for the common 
good. Necessarily it is through the male alone that such 
teachings may be brought to bear as shall correct this con- 
genital disparity. He should, before entering upon the mar- 
riage state, he instructed in the laws I have outlined. He 
should he counseled in those means best calculated to en- 
courage delay of the orgasm on his part, and the awaken- 
ing of desire and its physiological development upon the 
part of his mate. He should be taught that happy sexual 
living means something more than selfish personal enjoy- 
ment. He should be reminded that in the holy life in the 
marriage-bed, awaiting his touch, are chords that shall vi- 
brate in the years to come concordantly or discordantly, as 
he alone may determine. He should be impressed that, 
whatever the experiences of his past single life may have 
been, he has, in taking his marriage vows, assumed a sacred 
duty demanding on gentle, patient, and unselfish 
practices, by which may most certainly be assured that mu- 
tual happiness that, linked with mutual sexual pleasure, most 
strongly binds husband and wife together. REASONS WHY 
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