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286                                               MEDICAL JURISPRUDENCE

A case8 is recorded in which a man, aged 26 years, had two penes lying side by
side. The right penis was attached at the normal site in the midfine, had a foreskin
and was normal in all respects, except for a slight hypospadias, while the second or
accessory organ was attached 5 cm. to the left of the other, was smaller and had no
urethra or foreskin. There was a small meatus from which a slight mucous discharge
came out on sexual excitement.

(T) Hypospadias, a congenital deformity of the penis, which is characterized
by the uret^raF orifice being situated on the undersurface, does not, as a
rule, produce incapacity for sexual intercourse, unless it is associated with
a marked deformity of the penis which may interfere with its intromission
into the vagina. Sterility in such a case depends upon the position of the
urethral orifice, and it is assumed if the urethral orifice is so placed as to
prevent the deposition of semen within the labia of the vulva. Spermatozoa,
if deposited within the labia, can certainly travel upwards into the vaginal
canal owing to their mobile power.

jsp^ias, a deformity in which the urethra opens on the dorsum of the
is, is extremely rare, and is often associated with the rudimentary and
stunted penis and extroversion of the bladder rendering sexual intercourse

The congenital absence of the testicles produces sterility and impotence,
but it is possible for a man to impregnate a woman after double castration
if semen had already been present in the vesiculae seminalis before the
operation ; he becomes permanently sterile after this stock of semen has
been exhausted.

* Monorchids. i.e. those who have one testicle only are physiologically
quite potent ; whereas1' cryptorchids,. i.e. those who have undescended
testicles, are usually, but not invariably, impotent and sterile. Some may
be quite potent and fertile. A case 9 is recorded in which a cryptorchid who
was married at the age of eighteen years had five children born to him, tiU
he was thirty-four years old.

3.    Local Diseases. — A large hvdrocele or scrotal hernia? elephantiasis,
phimosis,   paraphimosis^nd   adherent   prepuce   may   cause   temporary
impotence by mechanical obstruction to coitus, as these conditions can be
remedied by proper surgical treatment.   Marked diseases of the penis or
of the testicles,  such as  syphilis,  cancer^and tuberculosis^ may lead to
impotence  or sterility  or both!   Ij^ammatory  affections  of  the testicles,
epididymis, prostatic gland and seminal vesicles of gonorrhoeal origin are
the frequent causes of impotence and sterility.   The ejaculatory ducts may
be obliterated by chronic gonorrhoea, so that the seminal discharge may be
prevented from flowing into the uretfira.   A±rophy of the testicles occurring
after mumps may produce impotence or sterility.   An operation of lithotomy
sometimes causes sterility from injury to the ejaculatory ducts.

4.    General   Diseases. — En^ognae^disturbances   may   produce   sexual
infantilism,  rendering  an  individual  impotent.   Certain  general  diseases,
such  as -diabete^   pulmonary  tubermilosi.^   chronic  nephritis,   etc.   which
occasion extreme debility, may produce impotence, temporary or permanent,
through the weakness to which they give rise, though the genital organs are
apparently quite normal.   It is difficult to sa^ which of the nervous and
mental diseases weaken the sexual power, vinflammation of the brain and
its meninges generally produces more or less paralysis of the genital organs.
It   is   said   that   hemiplegia,   paraplegia   and   locomotor   ataxy   produce
impotence, but this is not always the case.   Increased sexual activity is
occasionally   noticed  in  the  early   stages   of  these   diseases, ^Temporary
impotence is fdnad in a neurasthenic condition.

8.   Seth and Peacock, Urolog. mid ,Cwt . Rev.> Sep. 1932, p. 580.

9.   Taylor, Princ. <md Prod oj KecL Jims., VoL H Ed- X» P- 16.