Some epispadias and hypospadias may cause impotence of procreation. When the opening is very far back, the emission will take place outside of the vagina. Aspermia, whether idiopathic or acquired, will always cause impotence of procreation. In the congenital form of aspermia all the genital organs seem to functionate normally, still no ejaculation takes place. In the acquired form of aspermia both ejaculatory ducts are obliterated, as a rule, through suppurative prostatitis or tuberculosis of the prostatic gland. In both diseases the glandular tissue is frequently destroyed. Aspermia may also be due to neurasthenia as the following case may show: Mr. S., twenty-four years of age, has been treated about two years previously for nocturnal pollutions. They happened every night once or twice and weakened the patient in such a degree that he was unable to perform any kind of work. Electric treatment, hydrotherapeutics, and some medicinal tonics restored him to health. The pollutions happened once in three to four weeks only. A year later the patient called again, this time complaining of weakness in sexual power. After a few weeks’ treatment the improvement was such that the patient was lost sight of. Six months later the patient returned with the complaint of suffering from aspermia and lack of orgasm. He is erotic, and he has strong vigorous erections, but no matter how long he remains in initu, ejaculation does not take place. The patient falls back from sheer exhaustion, sometimes mentulato membro, without being able to bring it to an ejaculation and orgasm. In this case the aspermia is due to a certain nervous weakness of a neurasthenic nature. The patient has no strictures, and his testicles are intact. Aspermia is sometimes found in strictures of the urethra. In such cases the semen flows backward into the bladder. In comparison with azoospermia, as a cause of impotence of procreation, all the other described anomalies are of a great rarity. In azoospermia ejaculation and orgasm are perfectly normal, but the semen shows, under the microscope, the absence of spermatozoa. Azoospermia is sometimes temporarily found after excesses in initu aut stupro manu. [Illustration: CUT XLII. _Azoospermia._ 1, Boettcher’s crystals; 2, amyloid bodies; 3, hyaline bodies; 4, lecithin; 5, testicular cells; 6, prostatic epithelium; 7, urethral epithelium.] Permanent azoospermia is, as a rule, caused by inflammations of the testicles or of the epididymis. These bilateral inflammations of the testicles or of the vasa epididymis are almost always the result of gonorrhoea. The vasa deferentia are obliterated and impervious. The ejaculated semen consists only of the secretions of the seminal vesicles, of the prostatic glands and of the urethral glands.