_Clinical Illustrations――Case._――Mr. X. came from the South with his brother to consult a physician in St. Louis. I found the patient, who was aged 24 years, feeble and wan. He wore a thin, scraggy beard, about an inch long, over his chin and under his maxilla, but the side of his face contained only a little furze. When I entered the room it was not necessary to inquire which one of the young men had come to consult me, as his general aspect told me that he was a sick man. He was cadaverous in looks, staggering in gait, anæmic and haggard. He had been a masturbator, and practiced it as long as he could obtain erection, which had been until within a year; although I learned that for five years previous his erections had been only occasional and feeble. His semen was wasting nocturnally and his genitals flabby, cold and damp: his scrotum especially was relaxed and pendant. The spinal cord was very tender to the touch, giving great pain upon examination, over the lumbar, dorsal and cervical vertebræ. He complained of a sensation of constriction (girdle) around the body, painful digestion, constipation of the bowels, and talked incoherently. His mind wandered: he had no wishes to go home, or to stay, or to live, and became quite passive. He failed fast, and I soon lost sight of him, as he was placed in an insane asylum. All treatment failed to benefit him. I might enumerate scores of similar cases, in which it is impossible to see any cause but abuse of the sexual function, in which spermatorrhœa and impotence blend in a very obscure manner, but combined with other phenomena prove, beyond a doubt, the existence of a sexual neurosis, peculiar to itself, which needs study as to pathological anatomy; when it will be discovered that more than mere cause for general neurosis is found in the sexual abuse so lightly spoken of by authors in treatises on diseases of the nervous system. It will not require an accurate observer to discover signs of myelitis and softening in the above case; but his symptoms had been, long before, markedly those of anæmia, as related to me by his brother. Many cases selected for this section are in the advanced stage that I may the better show the termination of some of these cases. The majority of the cases that I have observed have been wanting in these distinctly organic features, _only_ for the reason that they were not so far advanced, and their indulgences had been limited to a more careful habit of pollution and sexual congress. The usual course of lesions appears in the following order after sexual excesses and pollution: Nervous weakness (neurasthenia), anæmia or congestion, myelitis, and softening. These may point either to the brain or spinal cord, or both associated, in any given case, in accordance with compatibility of lesions and conditions.