The glycerin extract is freshly prepared from bulls’ testicles in exact accordance with the directions of the discoverer.  It is used hypodermatically every other day, beginning with a diluted ten-minim dose and increasing by two or three drops up to about forty minims.  The effect is at its height twelve to twenty-four hours after the administration in most patients, hence the reason for using it only once in two days.  The skin is prepared, the needles and syringe disinfected, and the tiny puncture sealed afterwards with as minute care as would be given to a surgical operation.  By these precautions the danger of abscess, always considerable if hypodermics are carelessly given, is minimized.  As the dose is large, a site must be selected for the injection where the tissue is loose, otherwise the pain will interfere with the desired frequency of use.  The buttocks serve best, or the outer masses of the pectoral muscles, or the abdominal muscles.  If the administration causes pain (due in part to the large quantity used and in part to the local effect of glycerin), a fraction of a grain of cocaine may be added to the solution when measured out for use.

It may at once be said, emphatically, that in some cases remarkable results have followed the use of this material, while in others no good has been done; but the same may be said of most plans of treatment in this disorder.  As to possible danger from it, no harm has been done to any patient known to me, except that abcesses have occurred sometimes, though very rarely, for in many hundreds of injections it has been my good fortune to see abscesses form only three or four times, two of these instances, by curious ill luck, being in physicians.  Patients describe a stimulating effect not unlike that of strong coffee, following a few hours after use and lasting for a day.  The sexual appetite, if present, is increased; if absent, it is often renewed, sometimes in elderly men to an inconvenient extent.  In one tabetic subject who had lost desire and ability for more than three years both returned in sufficient force to allow him to beget a child.  This patient, like most of the others, was ignorant of what drug was being used and of what effects might be expected, so suggestion played no part.  Apart from this special effect, the solution acts only as a highly stimulating tonic.

The full dose of forty minims or thereabouts is maintained for a fortnight or less, and then gradually diminished in the same way that it was increased.  Sometimes, when the effect has been good, a second “course” may be given after two or three weeks’ interval.

During the treatment by hypodermic the masseur should be told to avoid rubbing where the injections have been given.  A few trials with the fluid internally have produced so little result of any kind that I am inclined to think the gastric juices must alter it so as to lessen or wholly destroy its power.