Nocturnal emissions constitute the other anomaly of ejaculation. Physiologically all healthy continent men between the ages of fifteen to fifty, with very few exceptions, have nocturnal emissions at intervals of about four weeks (male menstruation). The pollutions arise during sleep and are accompanied by erotic dreams and erections. They usually awaken the sleeper. Normal pollutions occur only in sleep and are accompanied by vigorous erections, erotic dreams and orgasm. They also cause a sensation of relief. When pollutions are frequent, two or three times a week, they become pathological. They are then followed by lassitude, dizziness, faintness, dragging pains in the occipital region, mental depression, disinclination for mental effort, sense of fatigue, lessening of physical strength, pain in the back and reflex irritability. The patients are startled at the least noise. They change color every moment. The eyeballs run unsteadily. There is often found a disturbance of speech, difficulty in breathing, and palpitation of the heart. The following case will best illustrate the symptoms in nocturnal pollutions: Mr. A., 25 years of age, was always well and never had gonorrhoea or syphilis. When a boy he practised stuprum manu in a moderate degree, as he says. A few years ago he noticed a certain weakness in erection. The emission took place soon after the entrance into the vagina and was followed by the immediate flaccidity of the penis. Sometimes the ejaculation occurred ante portas. The patient, therefore, gave up trying intercourse. Since then he is suffering from nocturnal pollutions, which occur every night or at least three to four times a week. The following day the patient feels very weak, as to prevent him from performing his usual work in his trade. He suffers from headaches and pains in the lumbar region and in the legs. He is engaged to be married and is looking forward with great apprehension to the approaching time of this momentous event. Pathological pollutions are caused by a paralysis of the circular muscular fibres of the ejaculatory ducts. This paralysis may be either of a purely nervous nature or caused through inflammatory processes. Atony of the mouths of the ejaculatory ducts not seldom produces nocturnal pollutions. Sometimes pollutions are also due to a spasm of the detrusors of the seminal vesicles. When the seminal vesicles and the ejaculatory ducts are thus affected, very little is needed to cause a nocturnal emission. Any diurnal excitement will be followed by nocturnal erotic images and pollutions. Sleeping on the back, by causing a fluction of blood to the spinal cord, will also produce pollutions. Besides the genitals, the urinary system is also greatly affected in atonic impotence. The hyperaesthesia and hyperaemia of the prostatic urethra and of the colliculus, usually found in atonic impotence, are the cause of a continual irritation of the bladder.