It may occur spontaneously immediately after accident
involving the cord, and is then probably due to undue excitement
of the portion of the cord below the lesion, which is deprived of
the regulating influence of the brain. Priapism may also develop
spontaneously at a later period, and is then due to central
irritation from extravasation into the substance of the cord, or
to some reflex cause. It may also occur from simple concussion,
as shown by a case reported by Le Gros Clark. Pressure on the
cerebellum is supposed to account for cases of priapism observed
in executions and suicides by hanging. There is an instance
recorded of an Italian "castrate" who said he provoked sexual
pleasure by partially hanging himself. He accidentally ended his
life in pursuance of this peculiar habit. The facts were elicited
by testimony at the inquest.
There are, however, in literature, records of long continued
priapism in which either the cause is due to excessive
stimulation of the sexual center or in which the cause is obscure
or unknown. There may or may not be accompanying voluptuous
feelings. The older records contain instances of continued
infantile priapism caused by the constant irritation of ascarides
and also records of prolonged priapism associated with intense
agony and spasmodic cramps.
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