SPERMATORRHCEA. 101 



who have consulted me for their pollutions have at last acknowledged 

 that they still masturbated. These persons seek aid because they 

 have been frightened by reading the miserable books which give such 

 overdrawn pictures of the results of onanism. They hope that it will 

 only be necessary to tell of the frequent occurrence of the emissions, 

 and that they may be silent concerning the cause. 



The case is somewhat different with a second class of persons who 

 seek medical aid for their pollutions. These also have masturbated 

 during youth, but have subsequently ceased to do so ; they also, how- 

 ever, have come across some bad book describing the terrible results 

 of the habit, and they have been greatly terrified, and have become 

 very hypochondriacal. They do not have nocturnal emissions oftener 

 than healthy persons, but each recurrence gives new stimulus to the 

 hypochondriasis ; they are considered very dangerous, and the patients 

 imagine they are experiencing the evil effects of which they have read. 

 The letters that such patients write often form a wonderful contrast 

 to theiF personal appearance. From the account of their case as given 

 in the letter, we may be prepared to meet a deplorable-looking being, 

 instead of whom comes in a hearty, robust man, that it is difficult to 

 recognize as the writer of the letter. 



A third class of persons who consult the physician for their pollutions 

 do suffer from general debility, are badly nourished and anaemic. They 

 have never been given to onanism ; nor do the emissions occur fre- 

 quently, but the day after their occurrence the patients feel peculiarly 

 dull and relaxed, and are inclined to refer the cachexia from which 

 they are suffering to their pollutions. It is well known that, in dis- 

 eased, exhausted persons, the excitability of the nervous system is 

 more apt to be abnormally increased than it is in strong and healthy 

 ones, and that inclination to pollutions, as one symptom of erethism, is 

 more frequently seen in the former than in the latter. We often find 

 that persons, who have never suffered from pollutions while in health, 

 are afflicted with them when attacked by severe disease or during con- 

 valescence. 



Besides the last class of persons, in whom the pollutions are not the 

 cause but the result of the diseased and exhausted constitution, and in 

 whom this exhaustion with its causes must be the objects of treat- 

 ment, there are patients in whom the repeated pollutions are the only 

 reasons we can find for a feeling of great debility and an unconquer- 

 able lassitude. Such patients are very peculiar : they cannot think 

 acutely, are sad, cannot work ; they are cowardly, easily frightened, 

 complain of trembling, noises in the ears, dizziness, neuralgic pain in 

 the back of the head, etc. Their complaints remind us most strikingly 

 of those of hysterical women, and it is perfectly justifiable to designate 



