When the cause of the atonic impotence was venereal excesses or gonorrhoeal prostatitis, the long-kept-up congestion of the prostatic urethra and of the colliculus leads to general reflex excitability, to a high degree of nervousness, cerebrasthenia, and neurasthenia. The colliculus being an organ which finds its analogue in the female uterus, its constant irritation will show phenomena in men, usually found in intensely hysterical women only. The impotent men generally change their entire psychic nature. They become timid, morose, solitary, melancholic, hypochondrical and despondent. They are discontented, peevish, ill-humored, and evince either blunted or inordinate sexual desires. They show profound agitation at the slightest excitement. The patients are troubled with insomnia or unrefreshed sleep and with a feeling of heaviness on rising. The mind is enfeebled and the memory impaired. The mental debility and dulness cause inability to collect their thoughts and thus enfeebles the mind in its power of concentration. The patients suffer from vertigo, singing in the ears, from a feeling of fulness in the head, from asthenopia, depression, anxiety and irritability. They often suffer from palpitation of the heart, sick headaches, coldness of the hands and feet, dull heavy feelings, a sense of fatigue and a loss of flesh. They also complain of creeping sensations in the loins, of pricking in the back, of twitching and jerking of the muscles, of muscular weakness, of lumbar pain and asthma. The intestinal canal shows a general derangement, as coated tongue, poor appetite, sense of weight in the epigastrium after eating, flatulence, sluggishness of the bowels and constipation. The general health of the patient is broken, the countenance is vacant and the gait feeble. Besides the general symptoms, the genito-urinary organs are especially affected in atonic impotence. The external genitals show a certain flaccidity, shrinkage, paleness of the mucous membranes and a diminution of the sensibility and electrical irritability. The skin of the penis is cold, shriveled and somewhat insensible to electrical stimulation. The electrical irritability of the skin of the two halves of the scrotum is of a different degree, the right half being sometimes more sensitive than the left. The testicles are often very painful and tightly drawn up against the external abdominal rings. The spermatic cord often shows an enlargement of the veins (varicocele). The vas deferens and the ampulla are in a state of inflammation.