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(1) Orchitis, in a young man, following muscular strain. Lesions: 4th lumbar posterior, 5th lumbar anterior, left iliac very painful. The left testicle was affected. The treatment at once gave relief. The lesion was corrected and the case was cured. (2) Orchitis due to lesion at the 10th and 11th dorsal vertebrae. The patient was in intense pain and the testicle was greatly swollen. Relief was immediate, and cure as well, upon removal of lesion. (3) Edematous swelling of the prepuce in a boy, following accident in which the innominate bone was luxated. Its correction cured the case. (4) Impotence; lack of power to secure erection in a man suffering from marked contracture and soreness of the lumbar muscles, due to being on the feet too much. One treatment relaxed the muscles and overcame the difficulty. (5) Impotence and splenitis. Lesions: 9th, 10th, and 11th left ribs depressed; posterior curvature in the dorso-lumbar region, prostate gland atrophied. The case was cured in four months. (6) Impotence in a man of fifty-one, of three to four months standing,. Lesions: 4th and 5th lumbar turned to the right, 1st lumbar to the left, 4th dorsal vertebra to the right. The patient had tried medicine, electricity, and hydrotherapy without avail. He was cured by six weeks treatment. (7) Varicocele in a case which had tried medical treatment without success, and in which operation was recommended. It was entirely cured by osteopathy in five weeks. (8) Enlarged prostate gland in a man of seventy-eight, causing retention of urine and cystitis, for which be had been unsuccessfully treated for many years. Treatment reduced the gland, and the case entirely recovered. (9) Enlarged prostate in a man of sixty-eight, who for several months had suffered with some retention of the urine. The prostate was reduced by a few treatments and the case was cured. (10) Prostatitis and stricture of the urethra in a man of forty. He had had an operation for the stricture, but it was unsuccessful. There was great pain upon urination, and weakened sexual power. The case was entirely cured in two months. (11) Gonorrheal prostatitis in a young man. Operation had been unsuccessful. The prostate was enlarged and hard. It was reduced by treatment and the case was cured. LESIONS AND ANATOMICAL RELATIONS in diseases in the male generative organs occur in positions corresponding to lesions pointed out in female pelvic diseases. These lesions occur from the 8th or 9th dorsal down, including the lumbar, lumbo-sacral, and innominate lesion. The lower lesions seem to be the more important ones. It is to be noted that vaso-motors for both external and internal genitals occur in the male in the same regions as described in female diseases, at the 2nd, 3rd, 4th and 5th lumbar and at the sacral nerves. The sympathetics convey to the prostate sensory fibres derived from the 10th, 11th, 12th dorsal; 1st, 2nd, 3rd sacral, and 5th lumbar; and to the prostate from the 10th dorsal. (Quain). For the epididymis sensory fibres are derived from the 11th and 12th dorsal and 1st lumbar. It is readily seen that the lesions usually found in male generative diseases fall within these areas of innervation. TREATMENT: In all these cases it is necessary, to bear in mind the anatomical relations of lesion to disease, and to see that such lesion is removed. In a good many of these conditions the removal of lesion is all that is required. After removal of the irritating cause, spinal and abdominal treatment of the kind described for female diseases is usually helpful. The treatment for the prostate has been described in Part I. In cases of prostatitis the treatment must be carefully applied locally, and it should be directed particularly to freeing the tissues about the gland. Great case is necessary not to irritate the structure. Abdominal and spinal treatment may be added. For Orchitis the treatment is mainly in removal of lesion. This immediately relieves and usually cures the case. Spinal and abdominal treatment may be directed to the relaxation of tissues, relief of tension, and correction of circulation. The tissues about the inguinal canal should be kept relaxed to maintain free drainage from the testicle. Treatments should be carried well up along the spermatic vein, terminating on the left in the renal vein and on the right in the inferior vena cava at about the same level. The abdominal viscera may be raised to aid free circulation. The patient should remain quiet. If the case is severe he may lie upon his back with hips elevated. The irritating pressure of clothing, etc., should be avoided. In case of Varicocele the object of the treatment is to empty the over-distended veins, to strengthen the vessels, and to remove the causes which obstruct the circulation. Lesion in the lower lumbar and sacral region is usually present and weakens the vaso-motor innervation of the parts, allowing of sluggish circulation and venous engorgement. The lesion must be removed, and spinal treatment is made to strengthen the vaso-motor supply. The veins are stripped to empty them, and the manipulation is carried up over the spermatic vein, to its connection with the renal vein. Care must be taken to see that the tissues about the inguinal canal do not obstruct the veins, also that pressure from the abdominal viscera is entirely removed. To this end the bowels must be kept free and the abdominal contents should be raised as before directed. In some cases surgical interference may be necessary, yet on the other hand cases have been saved from operation by the treatment. Impotence and Spermatorrhea have been very successfully treated. In some cases thorough relaxation and stimulation of the spinal musculature and nerves from the middle dorsal region down is the only treatment necessary. In other cases the removal of innominate lesion and the stimulation of the sacral nerves has been successful. It is well to have the patient lie on the side and then strong pressure is made with the knee in the sacroiliac articulations, springing them freely. In these cases lesion at the region of the genito-spinal center in the cord (1st and 2nd lumbar) is sometimes present and responsible for the trouble. A good point of treatment is to stimulate the perineal nerve where it crosses the spine of the ischium. This strengthens the erector muscle of the penis. Enlargement of the prostate gland is sometimes closely associated with these conditions, and it should be reduced according to directions given above. All causes of reflex irritation, as from an elongated prepuce, constipation, nervousness, etc., must be removed. It is quite necessary in most cases to direct general treatment to the quieting and strengthening of the nervous system. In these nervous cases it is well to place the patient upon a simple diet, with the avoidance of stimulants and excitement. Cold baths, exercise, and outdoor life are helpful. GONORRHEA AND SYPHILIS Some cases of syphilis and a number of cases of gonorrhea
have been treated osteopathically. Some success has been apparent in the
treatment of syphilis, the patient at the time being considerably bettered or
gaining entire relief from the symptoms with which be was suffering. Extended
observation of these cases, however, has not as yet become a matter of record.
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