Chapter XVI · (continued 2)

Quite recently Eulenburg, Posner, Nevinny, and others, have warmly recommended as a true specific in cases of functional impotence a combination of lecithin with the active principle of the Brazilian plant Muira Puama. This new drug is by Eulenburg termed “muiracithin.”

From the above-described individual troubles (masturbation, sexual hyperæsthesia, sexual anæsthesia, pollutions, and impotence) is composed the clinical picture of sexual neurasthenia, which, however, is manifested also by other symptoms, among which we must mention certain perceptions of anxiety and certain coercive ideas, such as the condition, known also to the laity, of agoraphobia, which is very frequently met with in sexual neurasthenia; also the fear of travelling alone by railway, or sudden anxiety in the theatre or concert-hall, in the form of the fear of fire, with the accompanying irresistible impulse to rush out into the open; further, lumbar pains and neuralgia of the genital organs, and anomalies and pains connected with the evacuation of urine; an inclination to sexual perversions; gastric affections,[454] such as nervous retching and vomiting, painful cramps of the stomach, loss of appetite, also excessive hunger, nervous dyspepsia, etc.; migraine and heart troubles of manifold kinds. It is not to be wondered at that when sexual neurasthenia is markedly developed, and when several of the above-described manifestations occur, the disease may pass on into a condition of complete mental exhaustion, associated with morbid irritability and hypochondriacal and melancholy ideas. We then ultimately see the development of typical sexual hypochondria.

The treatment of sexual neurasthenia—which in the last-described general symptom-complex occurs also in women, associated in their case with amenorrhœa, dysmenorrhœa, or menorrhagia[455]—consists for the most part in the already described treatment of the individual symptoms. In addition, we have to make use of hyperalimentation, hydro-therapeutic methods, gymnastic treatment, general massage, and climatic cures.