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CAUSES OF IMPOTENCE AND STERILITY IN THE MALE 285
commences earlier and ceases later than the power of procreation. The
changes which occur in a boy at puberty are the development of the genital
organs, the ability to secrete semen, the growth of hair on the pubes, axillae
and chin, and the increase in size of the larynx leading to the deepening of
the pitch of the voice. When examining an individual for sexual capacity the
medical jurist * should depend more on physical development than on
Rarely, sexual development may occur at a very early age. Ram
Chandra Row 2 reports the case of precocious development of a boyj aged
aboul^months^whose penis and testicles were highly developed simulating
those ^f_an^adi4k anl£S5LJg^^
He possessed a very shrill voice, and his Erother7 4 years old, was terribly
afraid of him on account of his rough behaviour. A case3 is recorded in
which a boy, 13 years old, impregnated a girl, 13 years old. Gemmel * reports
a case in which ~a~boy,~~aged 14 years, impregnated a girl, 12 years and 11
months old, after a single coitus, and the girl at the age of 13 years and 8
months gave birth to a baby weighing 6J pounds.
It has been proved that precocious puberty is caused by interstitial-cell
tumours of the testes. A case5 is recorded in which a boy without any
important familial or hereditary history developed normally until the end
of the fourth year, when Jiisj£Sice began to become deeper sadJais penis.
increaseSln siza Tb£l]^
pEysiquF°wSTEat of 'a 15-year-old boyT^gweigKej. J2""kg. an?~was Jt40 crn.
tall. w"HaIFugr^wth^ areli~lEghs and legs. His face
had a velvety appe^^^e due to'Ti^^haff! No axillary^hair ^as present.
The penis was!5fl|3uT^^ teeth were normal for his truelige.
X-ray films^oOEeTSids sHowecl the bone formation of a 15-year-old boy.
The right testicle wasnoomiaL but the left testicle showed hard swelling,
the size ^F^asn^lajppIeT^vmch was due to a myeloid neoplasm, arising
obviously from the interstitial cells of the testicle. The left testicle was
removed. After about nine months of the operation the size of the penis
began to diminish.
Sexuaj^eveipjmieiit may be delayed .till late in lif e^ Curling6 quotes
the case of a man, wnose"sexual°^r^^ at tEe age of tweaty-six wer^Jike
those of JL jdnlo^^ organs assumed their
-e ^married and^becSie |he father jjf a famTjrT"
TEe"""power ofsexual intercourse and procreation
diminishes, but no limit can be assigned at which this power ceases, as men
of eighty years and over have been known to have begotten children. In
October 1924, I referred a case to Dr. Mukarji, where he found spermatozoa^
in a man of about ^^ ninetyvears of age^ Seymour and others report a case
ffiTwnicn^nian, ageS^^^^TclcLild BjThis wife, aged 27 years. His seminal
fluid contained motile spermatozoa of normal conformation and of average
2. Malformations. The absence or non-development of the penis
renders a man impotent, but the man is not sterile if semen can be deposited
into the vagina with the partially developed penis. The penis adherent to
the scrotum cannot be a plea for divorce if he can be remedied by a surgical
operation. The presence of double penis, although a rare occurrence, may
cause difficulty in sexual intercourse, but coition is, nevertheless, possible
in some cases.
2. Ind. Med. Go*., Feb. 1926, p. 70.
3. Fairfield, Lancet, Vol. II, 1940, p. 61.
4. Brit. Med. Jour., May 7, 1927, p. 862.
5. J. Anagnostou and G. J. Frangopoulos, Brit, Med. Jour., April 18, :
6. On Sterility in Man ; Collis Barry, Leg. Med., Vol. H, p. 45.
7. Jour. Amer. Med, Assoc,, Nov. 2, 1935, p. 1,423.