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 impossible. 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.