A Medical Professor's Advice to Physicians Treating ED

ADVICE TO PHYSICIANS TREATING ED:

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In 1918 Irvin S. Koll, M.D., wrote a medical book entitled "Diseases of the Male Urethra - Including Impotence and Sterility."

The author was both a surgeon and Professor of Genito-Urinary Diseases at the Post Graduate Medical School and Michael Reese Hospital in Chicago.

In the following passage he offers advice to physicians treating ED, advising them how to adapt the proper "bedside manner" when addressing patients suffering from impotence.

Dr. Koll's Advice To Physicians Treating ED- 1918

TREATMENT - In discussing the treatment of impotence it is well to adhere to the classification adopted for the etiology. The first consideration, therefore, is the cases of psychic impotence.

It will require the utmost unlimited amount of patience to handle these cases.

The first point in attaining a cure is to obtain the absolute confidence of the patient. He should not be laughed at when he relates his story, which often contains humorous touches; give him your sympathy.

Assure him that there is something the matter with him, but that you can cure him, or at least improve his condition.

In all probability he has been through the hands of a number of medical men before he has reached you; probably the charlatan, faith healer, and Christian Scientist have also had their fling at him.

Above all, gain his confidence and make sure that there is no real, underlying pathologic condition.

In the absence of any organic lesion the question is one of instituting a regime of good hygiene, regular habits, and strict sexual abstinence, both mental and physical.

I have always found it of value to urge some form of athletic exercise, swimming, gymnasium work, tennis, etc.; a simple tonic, attention to the bowels, and occasionally the passage of a sound and light prostatic message.

The latter procedures are employed more for their psychic effect than in the hope of any actual therapeutic benefit.

It will be of value to make out a detailed schedule, giving the number of hours necessary for sleep, the diet, amount of exercise, etc.

Remember these patients are suffering from a distinct form of neurasthenia and should be advised even in minor details. Persistence will in the end produce good results.

If there is distinct atrophy of one or both testes and no associated lesion the outlook is bad. I know of no treatment that will improve sexual power under these circumstances. The electric current can do no harm, but rarely does any good.

Fortunately, as before stated, by far the greater number of cases of premature impotence are caused by chronic inflammation of the veruontanum. I say fortunately, because the results of proper treatment are most gratifying, and within the safe age limit one may without fear give a favorable prognosis.

The first point is removal of the cause. Careful regulation of the bowels is of prime importance. Accumulations of hard feces in the rectum increase the state of congestion in the prostatic region. A non-acid diet is probably of value. In addition, bicarbonate of sodium in dram doses twice daily is an advisable adjunct to the regime.

Before a patient is dismissed he should be warned that indulgence in any of the abuses which were the cause of his impotence will surely bring on a recurrence which will be much more difficult to relieve.

Advice to Physicians Treating ED from Irvin S. Koll, M.D. - 1918

P.S.

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