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Throughout the early modern period medical treatises described a range of problems that could lead to male infertility. Unlike the legal setting, in medicine it was not automatically accepted that the presence of an erection and seed meant that a man was fertile or virile. Nor did medical writers always view impotence as simply erectile dysfunction. Heat was a vital element of seed's potency that made it able to spark a conception.

A key aspect of stimulating an erection according to medical writers was sexual desire, and for most authors this related to the nature of the seed:. Venery may be hindered, or weak in both Sexes, if there be either no seed, or at least such as will not provoke the act. For the sharpness of the Seed, causeth the Itch … and stirs up nature by the spirits, in the Arteries and fils the Spungy Body of the Yard and Glans therewith, so that it is enlarged, swollen, hard, red and hot, and fit for the action.

As is suggested here, medical writers and practitioners accepted that desire was precarious and could be diminished through disease or perturbations of the mind. The humoural model posited that sexual desire was driven by the heat of the body and the salinity of the seed. As men were considered to be innately hotter than women they were believed to be more prone to lust and more capable in sexual pursuits.

Medical writers also, however, emphasised that a loss of libido prevented men from having children. Without the desire to engage in intercourse men would never propagate the species. Many subscribe to this opinion. A lack of desire was not only thought to cause impotence but was also clearly related to infertility. James Marten, for example, described how a lack of desire was a sign of infertile seed, but did not always prevent intercourse, as men could still converse and dally with their wives:.

As Marten did here, authors nearly always acknowledged that infertility and impotence were connected and manifested together. Male infertility was usually considered to be a result of poorly concocted seed. Poor seed production, or concoction, was caused by humoural imbalance or a lack of adequate nutrition. Seed was the finest refinement of a man's blood, which was initially concocted from his food. Even if a man did produce seed there was no guarantee of its fertility; it was important that animal spirits and salt were distilled out of the blood to create fertile seed. The man's seed was believed to be the active element in conception; it sparked the new life and imparted to it a soul.

Vital spirits, created in the heart and dispersed around the body, were also crucial for potency. Overall though, the composition of the seed was important because if it was not correctly formulated it would never create a new life. Men with poor seed might still engage in intercourse, but would be unlikely to conceive children. The humoural balance and consistency of the seed was also crucial. Medical writers explained that some seed was too cold, too moist, or too hot and dry. Conversely, seed that was cold, thin and waterish did not contain enough heat to promote life and could easily slip out of the womb.

Seed that was too thick travelled too slowly and lost its innate heat before the moment of conception. Excessively thin seed was also thought to be a cause of premature ejaculation. It was important that intercourse lasted long enough to warm through friction the inherently cold female body, as heat created a fertile environment in the woman's womb and stimulated her to release her own seed, which mixed with the man's in order for conception to occur.

Thin seed was thought to run from the body without sensation or cause too much sexual excitement making the man ejaculate too soon. They whose Seed is sharp are excited to Venus of their own accord, and quickly emit their Seed, or it runs from them, because of its thinness, without any great sense, and the Member becomes detumescent and languid before … the Woman is ready for expulsion. Men who suffered from this particular problem were not impeded from engaging in sex, no matter how short-lived the experience may have been, but were unlikely to conceive.

Seed was the crucial element in men's sexual and reproductive capabilities. When the seed men produced was ineffective and intemperate they were considered to be barren, infertile and imperfect. The ability to produce fertile seed was dictated by the state of the testicles. Although there was some debate about the specifics of seed production, medical writers largely agreed that seed was created in the small twisting passages of the testicles. The testicles had to be well formed and properly situated for this process to occur unhindered; damaged or abnormally developed testicles were thought to be unable to produce fertile seed.

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In particular surgeons described the dangers that varicose hernias swellings caused by varicose veins in the testicles posed to male fertility. It is thus evident that medical treatises and writers accepted that the male body was liable to a range of reproductive failures which impeded the ability to engage in sexual activity and have children. Moreover, as will be seen in the last section of the article, both medical and surgical writers addressed the potential for certain diseases and treatments to damage male fertility.

This is further reinforced by the presence in medical treatises and midwifery manuals of remedies designed to raise the heat of the reproductive and sexual organs and encourage seed production, thus improving the potency and fertility of the male body. In the seventeenth century medical practitioners across London publicised their services through printed handbills. Collected versions of these advertisements are housed in the British Library. They are mostly one-sided or two-sided, with a few small booklets, and they describe the location of a practitioner, the cures they offered and the particular medications that they sold.

Only a few extant handbills focus solely on curing reproductive ills and these predominantly advertised the services of female practitioners who claimed to specialise in treating women's ailments none of these women, as far as I am aware, claimed explicitly to treat male barrenness and so they will not be discussed here. The evidence for male infertility in these advertisements is again limited but is importantly present.

Several of the handbills claimed that the practitioner treated both male and female barrenness.

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This of course would not have been necessary if society universally blamed women for childlessness. These authors were not particularly expressive or detailed, but the simple fact that they included men is significant, as many other advertisements specified that they treated female patients.

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In other advertisements the gender of the infertile patient was not alluded to. In a traditional reading of early modern infertility, it may have been assumed that advertisements like this were aimed at female readers and their bodies—an interpretation strengthened by the fact that barrenness was often listed next to abortiveness or miscarriage. However, it is evident in the descriptions above that those offering drugs and services of this kind did not exclude men as potential patients. These advertisements were designed to appeal to as wide a range of patients as possible and this included the infertile man.

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Other practitioners also offered non sex-specific remedies designed to improve seed production. A handbill for Saffold's best wonder-working pills claimed that, amongst its many effects, it increased sperm. A handbill for Dr Vanforce's Elixir Vitae also claimed that it improved vigour and liveliness, cleansing the blood of impurities and increasing seed production.

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The presence, albeit rare, of men as potential patients and customers in these advertisements suggests that those aiming to attract a wide range of patients expected their audience to know that men could be infertile. Moreover, it suggests that they expected that there were men, or possibly their wives, who had acknowledged that their childlessness was due to a problem with the male body, and would actively seek a remedy for this. The presence of men as potential patients and consumers in medical advertisements increased in the eighteenth century as patent drugs and medicines were offered for sale in the daily and weekly newspapers of the capital.

These advertisements aimed to reach a broad urban and rural audience of men and women; they were sometimes reproduced in the newspapers because they acted as agents for the sale of such drugs, although it is not always clear how popular any particular medicine was. Numbers of Gentlemen, who, by fast living, or otherwise, had rendered themselves incapable of Procreation, have soon been enabled by it to propagate their Species; insomuch, that very many illustrious Families, who, for want of Children, were almost inconsolable, are now blest with happy Issue, and are under Providence indebted to this Great Medicine for their Heirs.

Moreover, the very name of the drug invoked fertility; throughout the seventeenth and eighteenth century the word prolific was associated with being fertile. The sex of the patients is simply left undisclosed. Like the medical writers whose treatises addressed the causes of male infertility, medical practitioners and others who offered medicines for sale throughout the seventeenth and eighteenth centuries accepted the reality of male infertility and expected that the readers of handbills and newspapers would also recognise that men could need medical attention for this problem.

Even though men appeared rarely in these advertisements, those who did include this particular problem evidently felt that doing so could produce paying customers. They accordingly offered drugs that would restore and reinvigorate the male reproductive organs making them potent, prolific, and fertile. Childlessness was distressing both socially and medically for patients, and it would appear that medical practitioners were also anxious that a range of diseases and medical conditions could lead to male infertility.

External bodily afflictions, those not caused by internal humoural imbalance and disease, were commonly treated by surgeons, many of whom produced treatises that outlined the nature, symptoms, causes and cures of certain diseases and advertised their own abilities as a practitioner. It may be that one of the reasons why male infertility has been relatively neglected by scholars is that it was discussed and treated by surgeons rather than by physicians. Although physicians may have downplayed the possibility for male infertility to occur as a result of humoural imbalance, fertility was a concern for surgeons dealing with genital trauma and physical disorders of the reproductive organs.

Furthermore, several surgeons highlighted their skill in preserving male reproductive capabilities as a way of asserting the efficacy of their own practice, suggesting that it was indeed important to both patients and medical practitioners. Within these treatises, and a few medical texts, surgeons included observations and case histories of their patients, including those who had received treatment for ailments that affected the reproductive organs. Observations were a relatively common feature of surgical treatises, either copied from previous authors or recording the surgeon's own practice.

Nonetheless, these treatises grew out of a shared European medical culture facilitated by the publication of texts in the medical lingua franca, Latin. Their reproduction in England demonstrated that translators and publishers believed they would find an audience and would be intelligible to those practising medicine in the English setting.

One or two medical treatises included some case histories. Isbrand van Diemerbroeck's treatise, The Anatomy of Human Bodies , described the form and operation of the testicles. He wrote that. Captain Couper , becoming bursten, by reason of a violent fall from his Horse, and not being to be cur'd but by the taking away of one Stone, had afterwards by his Wife several Children of both Sexes. The same Accident happen'd to Bernard Z. Although he was using these observations to describe the form and function of the testicles, it is evident that Diemerbroeck was concerned that hernias, and plausibly other testicular disorders, could cause a man to lose his ability to produce offspring.

Unlike surgical writers however, this did not appear to be part of a strategy to enhance or advertise his reputation for healing particular disorders. He only suggested to the reader that he was adept at identifying whether or not a patient's reproductive organs were present or absent.

Surgical treatises often described the reproductive organs and distempers that afflicted men.

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And, like Diemerbroeck, these works expressed concern that diseases of and damage to the testicles would lead to male infertility. The ability of men to have sex and bear children needed to be considered and protected during surgical operations. Not all surgical treatises agreed that this was a matter of concern, however. Alexander Read, a surgeon and anatomist, argued that because wounds of this nature were not deadly and men could evidently live if their testicles were removed, it was unnecessary to examine their treatment in any detail.