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ed exposure at the time he lost his legs produced permanent injury to the blood…vessels and nerves of the penis。 There is a case on record in which； in a man of thirty…seven； gangrene of the penis followed delirium tremens； and was attributed to alcoholism。 Quoted by Jacobson； Troisfontaines records a case of gangrene of the skin and body of the penis in a young man； and without any apparent cause。 Schutz speaks of regeneration of the penis after gangrenous destruction。
Gangrene of the penis does not necessarily hinder the performance of marital functions。 Chance mentions a man whose penis sloughed off； leaving only a nipple…like remnant。 However； he married four years later； and always lived in harmony with his wife。 At the time of his death he was the father of a child； subsequent to whose birth his wife had miscarried； and at the time of report she was daily expecting to be again confined。
Willett relates the instance of a horseman of thirty…three who； after using a combination of refuse oils to protect his horse from gnats； was prompted to urinate； and； in so doing； accidentally touched his penis with the mixture。 Sloughing phagedena rapidly ensued； but under medical treatment he eventually recovered。
Priapism is sometimes seen as a curious symptom of lesion of the spinal cord。 In such cases it is totally unconnected with any voluptuous sensation and is only found accompanied by motor paralysis。 It may occur spontaneously immediately after accident involving the cord； and is then probably due to undue excitement of the portion of the cord below the lesion； which is deprived of the regulating influence of the brain。 Priapism may also develop spontaneously at a later period； and is then due to central irritation from extravasation into the substance of the cord； or to some reflex cause。 It may also occur from simple concussion； as shown by a case reported by Le Gros Clark。 Pressure on the cerebellum is supposed to account for cases of priapism observed in executions and suicides by hanging。 There is an instance recorded of an Italian 〃castrate〃 who said he provoked sexual pleasure by partially hanging himself。 He accidentally ended his life in pursuance of this peculiar habit。 The facts were elicited by testimony at the inquest。
There are； however； in literature； records of long continued priapism in which either the cause is due to excessive stimulation of the sexual center or in which the cause is obscure or unknown。 There may or may not be accompanying voluptuous feelings。 The older records contain instances of continued infantile priapism caused by the constant irritation of ascarides and also records of prolonged priapism associated with intense agony and spasmodic cramps。 Zacutus Lusitanus speaks of a Viceroy of India who had a long attack of stubborn priapism without any voluptuous feeling。 Gross refers to prolonged priapism； and remarks that the majority of cases seem to be due to excessive coitus。
Moore reports a case in a man of forty who had been married fifteen years； and who suffered spasmodic contractions of the muscles of the penis after an incomplete coitus。 This pseudopriapism continued for twenty…three days； during which time he had unsuccessfully resorted to the application of cold； bleeding； and other treatment； but on the twenty…sixth day； after the use of bladders filled with cold water； there was a discharge from the urethra of a glairy mucus； similar in nature to that in seminal debility。 There was then complete relaxation of the organ。 During all this time the man slept very little； only occasionally dozing。 Donne describes an athletic laborer of twenty…five who received a wound from a rifle…ball penetrating the cranial parietes immediately in the posterior superior angle of the parietal bone； and a few lines from the lambdoid suture。 The ball did not make egress； but passed posteriorly downward。 Reaction was established on the third day； but the inflammatory symptoms influenced the genitalia。 Priapism began on the fifth day； at which time the patient became affected with a salacious appetite； and was rational upon every subject except that pertaining to venery。 He grew worse on the sixth day； and his medical adviser was obliged to prohibit a female attendant。 Priapism continued； but the man went into a soporose condition； with occasional intervals of satyriasis。 In this condition he survived nine days； there was not the slightest abatement of the priapism until a few moments before his death。 Tripe relates the history of a seaman of twenty…five； in perfect health； who； arriving from Calcutta on April 12； 1884； lodged with a female until the 26th。 At this time he experienced an unusually fierce desire； with intense erection of the penis which； with pain； lasted throughout the night。 Though coitus was frequently resorted to； these symptoms continued。 He sought aid at the London Hospital； but the priapism was persistent； and when he left； on May 10th； the penis formed an acute angle with the pubes； and he again had free intercourse with the same female。 At the time of leaving England the penis made an angle of about 45 degrees with the pubes； and this condition； he affirmed； lasted three months。 On his return to England his penis was flaccid； and his symptoms had disappeared。
Salzer presents an interesting paper on priapism which was quoted in The Practitioner of London。 Salzer describes one patient of forty…six who awoke one morning with a strong erection that could not be reduced by any means。 Urine was voided by jerks and with difficulty； and only when the subject was placed in the knee and elbow position。 Despite all treatment this condition continued for seven weeks。 At this time the patient's spleen was noticed to be enormously enlarged。 The man died about a year after the attack； but a necropsy was unfortunately refused。 Salzer； in discussing the theories of priapism； mentions eight cases previously reported； and concludes； that such cases are attributable to leukemia。 Kremine believes that continued priapism is produced by effusion of blood into the corpora cavernosa； which is impeded on its return。 He thinks it corresponds to bleeding at the nose and rectum； which often occurs in perfectly healthy persons。 Longuet regards the condition of the blood in leukemia as the cause of such priapism； and considers that the circulation of the blood is retarded in the smaller vessels； while； owing to the great increase in the number of white corpuscles； thrombi are formed。 Neidhart and Matthias conclude that the origin of this condition might be sought for in the disturbance of the nerve…centers。 After reviewing all these theories； Salzer states that in his case the patient was previously healthy and never had suffered the slightest hemorrhage in any part； and he therefore rejects the theory of extravasation。 He is inclined to suppose that the priapism was due to the stimulation of the nervi erigentes； brought about either by anatomic change in the nerves themselves； or by pressure upon them by enlarged lumbar glands； an associate condition of leukemia。
Burchard reports a most interesting case of prolonged priapism in an English gentleman of fifty…three。 When he was called to see the man