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adopted this as the easiest and least embarrasing mode of telling an otherwise long and painful story.

I remain, my dear Sir, yours, &c. W. Acton, Esq.

The writer was a tall, gentlemanly young man.

He assured me that he masturbated himself in sleep in spite of all his efforts, and that it particularly occurred after taking wine. He did not find the desire irresistible during his waking moments, except after he had failed in attempting intercourse with women, when, in a kind of despair, he generally yielded to the old temptation. To avoid the practice during sleep, he had sometimes been compelled to tie his wrists together by a cord that passed round his neck, so as to prevent himself from touching the penis. I have known several such cases, where patients who wished to cure themselves of the habit of masturbation have, against their feelings, sought the society of women, have attempted connection in vain, and then have come to me, ashamed of their failure, disgusted with themselves for the vice, and apparently almost ready to commit suicide from despair and misery. Others have confessed to me that, though sexual intercourse has been attended with difficulty, still the act was accomplished, but that it was attended with no pleasure. As their own self-pollution could still afford them gratification, they acknowledged that they fell back to their old vice, of which they were all the time thoroughly ashamed.

This strange phenomenon, of self-abuse affording greater gratification than intercourse with the other sex, the idea of whom, after all, creates the excitement, is more common than is generally supposed, and more in accordance with what we should expect than at first sight appears. The confirmed masturbator, as Rousseau has described, has to picture in his imagination all the female charms that can exist, so as to be able to rouse his flagging sexual desires. But when he attempts for the first time, or at long intervals, to accomplish sexual intercourse, he finds much difficulty and very little pleasure. He is probably naturally timid, he dreads the exposure of his infirmities, he fears contamination, and is, on the whole, thoroughly ill at ease.

His ignor

ance, his conscience, the very novelty of his position, and the dread of consequences, tend, for the time, to paralyze his sexual desires.

Another explanation, also to some extent true, is that the nervous system, and particularly the sympathetic system, has been so often and repeatedly excited that it will only respond to the particular kind of stimulus to which it has become accustomed, and is proof against all others.

If, then, it be true that among single men we meet with cases of well-marked sexual indifference, lasting only for a short time, and giving rise to very little annoyance to the patient, so it is no less true that we more frequently than otherwise meet with cases where the assumed impotence exists only in the imagination of the married man, causing one of the most painful forms of monomania that it is the duty of the consulting surgeon to treat. These cases require more attention than has hitherto been given to them, and I shall now proceed to give my readers an account of the affection which they will often meet with in private practice.

SEXUAL INDIFFERENCE AMONG MARRIED MEN, as a temporary affection, is another cause of anxiety, which in some persons produces the greatest alarm.

Causes.—Men who gain their bread by the sweat of their brows or the exhausting labor of their brains, should be made aware that they cannot expect to be always ready to perform the sexual act. During certain periods, when occupied with other matters, man's thoughts dwell but little on sexual subjects, and no disposition exists to indulge anything but the favorite or absorbing pursuit, mental or physical as the case may be. After a lapse of time, different in various individuals, sexual thoughts recur, and the man who yesterday was so indifferent to sexual feelings, as practically to be temporarily impotent, now becomes ardent and sexually disposed, remaining so until the necessary and in fact, healthy lethargy of the organs follows the performance of the act.

This quiescent condition is much more persistent in some

married men than in others. There are persons (married as well as single) who only at very infrequent intervals feel any disposition for sexual intercourse, just as there are others who never feel

any such desire at all. Again, there are lethargic men, who, unless roused, will hardly do anything. It requires an effort in some men to eat. There is in some of these cases undoubtedly great sexual debility. Again, the habitual drinker cares little for sexual enjoyments. I am quite certain that some excessive smokers, if

very young, never acquire, and if older, rapidly lose any keen desire for connection. The pleasures of the table so monopolize many a man's thoughts that he is indifferent to all other indulgences. In all the above cases the sexual feelings occupy a secondary position, and never attain, or even approach, that tyrannous mastery from which the thorough voluptuary suffers. It is in these advanced stages of this condition, often difficult to say whether the sexual organization was originally weak, whether the other tastes have overpowered the sexual appetite, or whether the individual has not early in life abused his generative faculty.

Among the married we sometimes find men taking a dislike or even a disgust to their wives, and, as a consequence, there is an entire want of desire. A first failure will sometimes so annihilate men's sexual appetite that they are never able or anxious to attempt connection a second time. In many cases this arises from wounded amour propre, as they succeed with other women. Early excesses in married life will, in a certain number of cases, occasionally produce a temporary impotency later in life. Want of sympathy or want of sexual feeling on the woman's part, again, is not an unfrequent cause of apathy, indifference, or frigidity on the part of the husband. Lastly, there are cases of amiable men who carry their consideration for the women they love to such an extent as to render themselves practically impotent for very dread of inflicting pain. A singularly agreeable and gentlemanly, but very mild looking man, once called on me, saying that he had been lately married, and had not succeeded in performing his marital duties. I treated him in the usual way and he got better, but still the act was not satisfactorily performed, and my patient said enough to induce me to believe that the failure was not to be attributed to him alone. After some little hesitation the lady consulted me. I found her a pretty, pleasing, but excessively nervous and excitable person. At first the mere application of cold water to the generative organs could not be borne, but after some time, and after a good deal of careful management, an astringent lotion was used. When the morbid excitability was somewhat reduced, the hymen was found not only entire, but very tough, presenting the appearance of the finger of a kid glove on the stretchers. Division of the hymen and dilatation of the vagina at length accustomed the parts to bear contact, and a permanent cure was effected. I have reason to believe that cases of supposed impotence arising from this cause are not uncommon; cohabitation is, under these circumstances, not likely to be followed by impregnation when the husband has been previously continent, and his natural disposition renders him particularly unwilling to distress or hurt his wife while she is in this state of unnatural and morbid sensitiveness. It is not improbable that divorces have taken place before now from such causes as these, particularly when interfering friends have exaggerated and envenomed the painful difference between the young couple.

Want of Sexual Feeling in the Female a Cause of Impotence. -We have already mentioned lack of sexual feeling in the female as not an uncommon cause of apparent or temporary impotence in the male. There is so much ignorance on the subject, many

false ideas are current as to women's sexual condition, and are so productive of mischief, that I need offer no apology for giving here a plain statement that most medical men will corroborate.

I have taken pains to obtain and compare abundant evidence on this subject, and the result of my inquiries I may briefly epitomize as follows :- I should say that the majority of women (happily for society) are not very much troubled with sexual feeling of any kind.

kind. What men are habitually, women are only exceptionally. It is too true, I admit, as the divorce courts show, that there are some few women who have sexual desires so

and so

strong that they surpass those of men, and shock public feeling by their consequences. I admit, of course, the existence of sexual excitement terminating even in nymphomania,' a form of insanity that those accustomed to visit lunatic asylums must be fully conversant with; but, with these sad exceptions, there can be no doubt that sexual feeling in the female is in the majority of cases in abeyance, and that it requires positive and considerable excitement to be roused at all: and even if roused (which in many instances it never can be) it is very moderate compared with that of the male. Many persons, and particularly young men, form their ideas of women's sensuous feelings from what they notice early in life among loose or, at least, low and vulgar women. There is always a certain number of females who, though not ostensibly in the ranks of prostitutes, make a kind of trade of a pretty face. They are fond of admiration, they like to attract the attention of those immediately above them. Any susceptible boy is easily led to believe, whether he is altogether overcome by the syren or not, that she, and therefore all women, must have at least as strong passions as himself. Such women, however, give a very false idea of the condition of female sexual feeling in general. Association with the loose women of the London streets in casinos and other immoral haunts (who, if they have not sexual feeling, counterfeit it so well that the novice does not suspect but that it is genuine), seems to corroborate such an impression, and as I have stated above, it is from these erroneous notions that so many unmarried men think that the marital duties they will have to undertake are beyond their exhausted strength, and from this reason dread and avoid marriage.

1 I shall probably have no other opportunity of noticing that, as excision of the clitoris has been recommended for the cure of this complaint, Köbelt thinks that it would not be necessary to remove the whole of the clitoris in nymphomania, the same results (that is destruction of veneral desire) would follow if the glans clitoridis had been alone removed, as it is now considered that it is in the glans alone in which the sensitive nerves expand. This view I do not agree with, as I have already stated with regard to the analogous structure of the penis, p. 134. I am fully convinced that in many women there is no special sexual sensation in the clitoris, and I am positive that the special sensibility dependent on the erectile tissue exists in several portions of the vaginal canal.

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