_Symptomatic impotence._—The organic type of impotence is relatively very rare. The other type, symptomatic impotence, is oftener met with. It is found in cerebral diseases, diabetes, tabes dorsalis, chronic nephritis, extreme obesitas, chronic rheumatism, chronic alcoholism and in the cachexies of anaemia, cholaemia and uraemia. But since the desire fails with the failure of power, such patients rarely seek medical aid for this anomaly. They consult the physician for their original ailment which is of far greater importance to them than the loss of power. They mention this anomaly only in the course of the anamnesis. Symptomatic impotence is, as a rule, paralytic in form. Libido is more or less absent, and if emissions ever occur they take place without erection or pleasure. In the paralytic form of impotence nocturnal erections are absent, nor do erections occur at any other time. This sign is almost pathognomonic of this type. If the vagina is very wide, and intromission with semi-erection should be effected, ejaculation does not come in jets but slowly. The function of the bulbo-cavernosus muscle is impaired, hence no ejaculation with force in a jet is possible, but a slow dribbling from the meatus takes place. In paralytic impotence the genitals are more or less withered. The skin of penis and scrotum is almost anaesthetic. The entire urethra is insensible, the sound passes into the bladder with the greatest ease. The skin of the thigh in the vicinity of the genitals is more sensitive to electric currents than that of penis and scrotum. The following history well illustrates a typical case of paralytic symptomatic impotence: Mr. H., 45 years of age, a widower with one child, contracted lues fifteen years previously and was apparently cured after two years’ treatment. For the last two to three years he began to suffer from shooting pains around the abdomen (Gürtelschmerz) and in his legs. Micturition is frequently urging, and the stream is slow. The knee-jerks are greatly exaggerated. The patient’s gait is still normal, and he does not show any other sign of tabes dorsalis. About the time when the pains first appeared, he also noticed a certain weakness in erection and premature ejaculation. He began then to associate with meretricious women who practised on him fellatricia, or insertio fascini in os. From this time the impotence increased and is now complete. For the last two years he never had even nocturnal erections. The penis is in a state of atrophy, and is now of the size of a boy’s, fourteen to fifteen years of age. The skin of the penis is shriveled and cold. The glans is pale. The entire skin of the penis and scrotum is quite anaesthetic to the galvanic current. An application of about fifteen milliamperes in strength, which produced an ulceration by burning, was scarcely felt by the patient. The faradic reaction is normal.