These are medicines which diminish the sexual passion. The agents employed as anaphrodisiacs are :Ice.

Cold baths, local and general. Bromides of potassium and ammonium. Iodide of potassium.

Conium.

Camphor.

Digitalis.

Purgatives.

Nauseants.

Bleeding.

Anaphrodisiacs may act locally on the genital organs, or may act upon the genital nerve-centres.

The effect on the nervous system may be directly exerted on the nervous structures themselves, on the circulation, nutrition, and general surroundings. Amongst the most powerful local anaphrodisiacs is the continuous application of cold by means of ice. Bromide of potassium possibly has also a local as well as a general action.

When the lumbar portion of the cord is abnormally stimulated reflexly, the stimulus ought to be removed: thus, in warm countries, where smegma may accumulate around and irritate the glans penis, very careful washing is requisite and circumcision is an advantage. Both in warm and cold countries circumcision, either general or partial, is useful if the prepuce be very long and its orifice much contracted.

When the irritation appears to arise from the presence of very acid urine, or of crystals of uric acid, irritating the bladder or urethra, as in gouty persons, potash or lithia should be employed to lessen the acidity of the urine, or to render it neutral. Where abnormal irritation of the genitals is present the urine should be examined for sugar as well as for uric acid, as the sugar may cause local irritation of the prepuce or vulva.

Distension of the bladder ought also to be avoided, and in persons who suffer from seminal emissions, occurring in the morning, it is occasionally advisable that they should be awakened and empty the bladder an hour or more before their usual time of rising.

If stone in the bladder is acting as an irritant, surgical treatment should be employed, but in cases where this is inadvisable, or where the irritation is dependent on enlarged prostate, general anaphrodisiacs must be used, such as bromide of potassium in large doses, care also being taken that the condition of the urine is not abnormally acid or alkaline. Ascarides in the rectum must be treated with anthelmintics. When irritation arises from piles the use of sulphur internally is often beneficial, though surgical interference may be necessary both for them and for fissure.

When irritation arises from faecal accumulations in the rectum or colon, they should be removed and their return prevented by the careful use of aperients.

Flatulent distension of the stomach or intestines may be removed by alkalis and cholagogues, bitters (p. 378), and especially by strychnine, which gives tone to the intestine. It thus happens that, notwithstanding the tendency of strychnine to cause sexual excitement and produce emissions by its action on the nerve-centres, it may sometimes effectually relieve these conditions by its action on the intestine.

As anything which tends to increase the flow of blood to the genital organs or the lumbar portion of the spinal cord heightens their excitability, care should be taken not only to avoid this, but also to direct as much as possible the current of blood to other parts of the body. Thus, warm and heavy clothing or pads about the hips or loins should be avoided, and a hard mattress should be used in the place of a feather bed. Sometimes patients suffer from emissions in consequence of lying on their back. This is probably due to the effect of warmth on the spinal cord, and in order to avoid it, a towel or girdle should be put around the loins with a knot tied in it, or some hard substance fastened on it opposite the spine, so that the person would, even during sleep, be prevented from lying on his back. Walking exercise is not so useful as exercise of the arms, as in rowing, gymnastics, or mechanical occupations, such as those of a carpenter or blacksmith, because, in walking, the current of blood passes towards the lower extremities and part of it may become directed to the pelvis. In the other occupations just mentioned, the current of blood is, on the contrary, directed to the upper extremities. Working a treadle, as in turning a lathe or sewing-machine, is objectionable, both because the blood is directed towards the lower extremities generally and because it may become specially directed to the genitals by occasional friction of the clothes.

Hard mental work has also a similar effect to that of bodily exercise. In addition to these measures, a meagre diet, and especially a vegetable diet, with the avoidance of stimulants, is of considerable service.