Out of the two functions constituting male sexual functions, the reproductive and the coital one, the author has made a clinical study on the latter, that is, insufficiency and impotence in the narrow sense, which has hitherto been paid little scientific attention to. The sutudy has been on psychic impotence which accounts for the most part of clinical cases and on endocrine (androgen deficient) impotence which were found conciderable in frequency.
(1) The author has defined impotence as the deficiency of one or two factors of sexual pattern, that is, sexual desire, erection, ejaculation, and orgasm.
(2) The author's causal classification of 130 cases he treated is as follows: -a) organic cause: -penile (malformation or disease) 1.5%: endocrine (pituitary, testicular, or adrenal deficiency) 21.5%: nervous (central or distal motility, or sensory nerve damage) 4.6%. b) functional cause: -psychic (psychological 8 cases, psychic 81 cases which is 62.3%) 68.5%. c) other causes (urological cause by the disease in the urethra, in the accessory sexual glands, or by operation or external injury, diabetes mellitus, chronic consumption, physiological defect) 3. 8%. It is notworthy that out of the urological out-patient the psychic cause accounts for more than 50%.
(3) Various psychic causes inhibiting the male sexual pattern were the basic factors, as the authors calls, of psychic impotence and the classification of 89 cases he treated is as follows: -sexual organ inferiority 6 cases, new marital condition 23 cases, abnormal sexual behavior 16 cases, disease anxiety or fear of disease 24 cases, suppression from the wife 3 cases, fear of conception 1 case, subconscious homosexuality 1 case, neurosis sign 8 cases, and unknown 5 cases.
(4) The classification by age groups of psychic impotence is as follows: -the young group below 30 years old 45 cases, the prime-of-life group between 30 to 40 years old 18 cases, the more elderly and old age group 26 cases.
(5) The author found that there was a characteristic difference between the basic factor of the young-group psychic impotence and that of the elderly-and-old-age-groups psychic impotence. The formation process of psychic impotence was that it originated from the individual's unconscious fear, doubt, anxiety, inhibitory idea about his own sexual function.
(6) The treatment of psychic impotence was conducted primarily by psychotherapy through the interview at a regular interval and secondarily by medical therapy as a kind of trigger to cure. This method was sufficient and the most suitable even for a urologist.
(7) The author's therapeutic result was that, out of 19 cases of new-marital impotence which is typical of young-group impotence, 10 cases were successful, 2 cases unsuccessful, and uncertain of result 7 cases: and that, out of 22 cases of elderly-and-old-age-group impotence, 10 cases were successful, 5 cases improved, 7 cases uncertain.
(8) Endocrine impotence he treated was 28 cases and the classification of factors were that 17 cases were counted for the upper-central-nervous disorder, out of which 13 cases eunuchoidism: testicular disorders were 11 cases, out of which 8 cases post-pubertal castration, and 3 cases testicular atrophy.
(9) The characteristic features of sexual pattern in endocrine impotence were that sexual desire generally declined, erotic erection and reflexible erection were damaged to various degrees, ejaculation decreasing and orgasm weakened.
(10) Sexual function of castrate could be maintened and kept under control by supplying him with androgen. The author made investigation on the most efficacious method for it.
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