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Burchard reports a most interesting case of prolonged priapism in an English gentleman of fifty…three。 When he was called to see the man on July 15th he found him suffering with intense pain in the penis； and in a state of extreme exhaustion after an erection which had lasted five hours uninterruptedly； during the whole of which time the organ was in a state of violent and continuous spasm。 The paroxysm was controlled by 3/4 grain morphin and 1/50 grain atropin。 Five hours later； after a troubled sleep； there was another erection； which was again relieved by hypodermic medication。 During the day he had two other paroxysms； one lasting forty…five minutes； and another； three hours later； lasting eighteen minutes。 Both these were controlled by morphin。 There was no loss of semen； but after the paroxysms a small quantity of glairy mucus escaped from the meatus。 The rigidity was remarkable； simulating the spasms of tetanus。 No language could adequately describe the suffering of the patient。 Burchard elicited the history that the man had suffered from nocturnal emissions and erotic dreams of the most lascivious nature； sometimes having three in one night。 During the day he would have eight or ten erections； unaccompanied by any voluptuous emotions。 In these there would rarely be any emission； but occasionally a small mucous discharge。 This state of affairs had continued three years up to the time Burchard saw him； and； chagrined by pain and his malady； the patient had become despondent。 After a course of careful treatment； in which diet； sponging； application of ice…bags； and ergot were features； this unfortunate man recovered。
Bruce mentions the case of an Irishman of fifty…five who； without apparent cause； was affected with a painful priapism which lasted six weeks； and did not subside even under chloroform。 Booth mentions a case of priapism in a married seaman of fifty…five； due to local inflammation about the muscles； constricting the bulb of the penis。 The affection lasted five weeks； and was extremely painful。 There was a similar case of priapism which lasted for three weeks； and was associated with hydrocele in a man of forty…eight。
Injuries of the testicle and scrotum may be productive of most serious issue。 It is a well…known surgical fact that a major degree of shock accompanies a contusion of this portion of the body。 In fact； Chevers states that the sensitiveness of the testicles is so well known in India； that there are cases on record in which premeditated murder has been effected by Cossiah women； by violently squeezing the testicles of their husbands。 He also mentions another case in which； in frustrating an attempt at rape； death was caused in a similar manner。 Stalkartt describes the case of a young man who； after drinking to excess with his paramour； was either unable； or indifferent in gratifying her sexual desire。 The woman became so enraged that she seized the scrotum and wrenched it from its attachments； exposing the testicles。 The left testicle was completely denuded； and was hanging by the vas deferens and the spermatic vessels。 There was little hemorrhage； and the wound was healed by granulation。
Avulsion of the male external genitalia is not always accompanied by serious consequences； and even in some cases the sexual power is preserved。 Knoll described a case in 1781； occurring in a peasant of thirty…six who fell from a horse under the wheels of a carriage。 He was first caught in the revolving wheels by his apron； which drew him up until his breeches were entangled； and finally his genitals were torn off。 Not feeling much pain at the time； he mounted his horse and went to his house。 On examination it was found that the injury was accompanied with considerable hemorrhage。 The wound extended from the superior part of the pubes almost to the anus； the canal of the urethra was torn away； and the penis up to the neck of the bladder。 There was no vestige of either the right scrotum or testicle。 The left testicle was hanging by its cord； enveloped in its tunica vaginalis。 The cord was swollen and resembled a penis stripped of its integument。 The prostate was considerably contused。 After two months of suffering the patient recovered； being able to evacuate his urine through a fistulous opening that had formed。 In ten weeks cicatrization was perfect。 In his 〃Memoirs of the Campaign of 1811；〃 Larrey describes a soldier who； while standing with his legs apart； was struck from behind by a bullet。 The margin of the sphincter and； the skin of the perineum； the bulbous portion of the urethra； some of the skin of the scrotum； and the right testicle were destroyed。 The spermatic cord was divided close to the skin； and the skin of the penis and prepuce was torn。 The soldier was left as dead on the field； but after four months' treatment he recovered。
Madden mentions a man of fifty who fell under the feet of a pair of horses； and suffered avulsion of the testicles through the scrotum。 The organs were mangled； the spermatic cord was torn and hung over the anus； and the penis was lacerated from the frenum down。 The man lost his testicles； but otherwise completely recovered。 Brugh reports an instance of injury to the genitalia in a boy of eighteen who was caught in a threshing…machine。 The skin of the penis and scrotum； and the tissue from the pubes and inguinal region were torn from the body。 Cicatrization and recovery were complete。 Brigham cites an analogous case in a youth of seventeen who was similarly caught in threshing machinery。 The skin of the penis and the scrotum was entirely torn away； both sphincters of the anus were lacerated； and the perineum was divested of its skin for a space 2 1/2 inches wide。 Recovery ensued； leaving a penis which measured； when flaccid； three inches long and 1 1/2 inches in diameter。
There is a case reported of a man who had his testicles caught in machinery while ginning cotton。 The skin of the penis was stripped off to its root； the scrotum torn off from its base； and the testicles were contused and lacerated； and yet good recovery ensued。 A peculiarity of this case was the persistent erection of the penis when cold was not applied。
Gibbs mentions a case in which the entire scrotum and the perineum； together with an entire testicle and its cord attached； and nearly all the integument of the penis were torn off； yet the patient recovered with preservation of sexual powers。 The patient was a negro of twenty…two who； while adjusting a belt； had his coat （closely buttoned） caught in the shafting； and his clothes and external genitals torn off。 On examination it was found that the whole scrotum was wrenched off； and also the skin and cellular tissue； from 2 1/2 inches above the spine of the pubes down to the edge of the sphincter ani； including all the breadth of the perineum； together with the left testicle with five inches of its cord attached； and all the integument and cellular covering of the penis except a rim nearly half an inch wide at the extremity and continuous with the mucous membrane of the prepuce。 The right testicle was hanging by its denuded cord； and was apparently covered only by the tunica vaginalis as high up as the abdominal ring； where the elastic feelin