According to Wichmann, the semen never escapes with the urine: thus, it is not a seminal discharge which comes from persons affected with external or internal hemorrhoids, who pass off with their urine a milky fluid. He, however, admits, with Hippocrates, that the straining of persons at stool often occasions, in those affected with diurnal pollution, the discharge of a greater or less quantity of semen. When the existence of this affection is suspected, we must attempt to ascertain its truth; and for this purpose, the patient should be made to urinate freely; and then, in passing the feces, he should sit in such a manner that the penis may be outside, and one can see all that escapes from it in the efforts at stool. In a diurnal pollution, there is rarely as much semen lost as in a nocturnal pollution. The disease is quite as serious, if it be semen which escapes--if it occurs once a-day, and even more frequently; and at the lightest effort to stool, and without any pleasure, to inform one of the risk which is run.
Thus, then, involuntary emissions of semen, while the patient is awake, without erection, without pleasure, and while the patient is ignorant of it; an emission which takes place, not drop by drop, but at one time, and especially while at stool, are, according to Wichmann, specific characters of involuntary diurnal pollution.
The general effects of this diurnal pollution, as he has often observed them, are those seen in onanists. He remarks:--When you see a man extremely thin, pale, stupid, enervated, complaining of great debility, especially in the thighs and loins, lazy in his actions, and with sunken eyes, you have reason to suspect this cause.
Patients in this state never complain of any absolute pain. Their digestive powers are ruined: the appetite, however, continues--even increases, and sometimes becomes voracious. After taking food, they seem to have more strength; but this advantage is soon paid for, by the inconveniences resulting from digestion--especially if that variable appetite be too much indulged. As the stomach and most of the other viscera do not perform their functions properly, the more that is eaten the more the belly is tumefied, by the relaxation of the digestive organs. This swelling is attended with a painful feeling of anxiety, which exists in these unfortunates at other periods of the day, and impels them to avoid society. They are more disposed to sorrow than to joy--that is, the news of an unfortunate event brings with it more sorrow than that of a happy event causes pleasure. In them, as in onanists, there is a want of intelligence; they are stupid; natural sleep does not refresh them; the memory and sight are particularly debilitated. And this is the state of things, until the patient becomes affected with phthisis. At first, neither moral causes, nor affections of the soul, nor disappointment, can be suspected. There is apparently no viscus affected; nor can we ascribe the disease to any deleterious substance concealed in the body, and consuming the flesh. The patient has no pain, excepting that obtuse, compressive pain, which is referred to the hypochondria, and which depends on the swelling of the weak intestines. If you add to the characters the absence of fever, and of the ordinary causes of exhaustion, you may be persuaded that diurnal pollution exists--that it is the hidden cause of all the symptoms. This is a general description of the disease, drawn up from a considerable number of cases which we have observed.