Does repeated nocturnal emission without reaching orgasm necessitate ghusl, or is that considered a medical condition that permits prayer?

If seminal emission occurs during sleep, then finding semen necessitates ghusl (ritual bath), even if the person who experienced the wet dream does not remember having one. This is in accordance with what is stated in Ar-Rawd al-Murbi': "If a sleeper, or someone in a similar state, who could potentially have reached puberty, awakens and finds wetness. If it is confirmed to be semen, he must perform ghusl only, even if he does not recall a wet dream."

However, if semen is discharged while awake without pleasure (e.g., due to illness), ghusl is not required. But if it is discharged with pleasure, ghusl is obligatory. It is stated in Ar-Rawd al-Murbi' that among the things necessitating ghusl is "the forceful discharge of semen from its exit with pleasure, but not if it exits without pleasure from someone who is not asleep." The proof for this is the hadith of Ali: "If you forcefully discharge water, then perform ghusl; but if you do not discharge it forcefully, then do not perform ghusl."