("Relations between Body and Mind,” Lancet, May 28, 1870).  By some it has been held that this cause may produce actual disease.  Thus, Tilt, an eminent gynecologist of the middle of the nineteenth century, in discussing this question, wrote:  “When we consider how much of the lifetime of woman is occupied by the various phases of the generative process, and how terrible is often the conflict within her between the impulse of passion and the dictates of duty, it may be well understood how such a conflict reacts on the organs of the sexual economy in the unimpregnated female, and principally on the ovaria, causing an orgasm, which, if often repeated, may possibly be productive of subacute ovaritis.”  (Tilt, On Uterine and Ovarian Inflammation, 1862, pp. 309-310.) Long before Tilt, Haller, it seems, had said that women are especially liable to suffer from privation of sexual intercourse to which they have been accustomed, and referred to chlorosis, hysteria, nymphomania, and simple mania curable by intercourse.  Hegar considers that in women an injurious result follows the nonsatisfaction of the sexual impulse and of the “ideal feelings,” and that symptoms thus arise (pallor, loss of flesh, cardialgia, malaise, sleeplessness, disturbances of menstruation) which are diagnosed as “chlorosis.” (Hegar, Zusammenhang der Geschlechtskrankheiten mit nervoesen Leiden, 1885, p. 45.) Freud, as well as Gattel, has found that states of anxiety (Angstzustaende) are caused by sexual abstinence.  Loewenfeld, on careful examination of his own cases, is able to confirm this connection in both sexes.  He has specially noticed it in young women who marry elderly husbands.  Loewenfeld believes, however, that, on the whole, healthy unmarried women bear sexual abstinence better than men.  If, however, they are of at all neuropathic disposition, ungratified sexual emotions may easily lead to various morbid conditions, especially of a hysteroneurasthenic character. (Loewenfeld, Sexualleben und Nervenleiden, second edition, 1899, pp. 44, 47, 54-60.) Balls-Headley considers that unsatisfied sexual desires in women may lead to the following conditions:  general atrophy, anemia, neuralgia and hysteria, irregular menstruation, leucorrhea, atrophy of sexual organs.  He also refers to the frequency of myoma of the uterus among those who have not become pregnant or who have long ceased to bear children. (Balls-Headley, art.  “Etiology of Diseases of Female Genital Organs,” Allbutt and Playfair, System of Gynaecology, 1896, p. 141.) It cannot, however, be said that he brings forward substantial evidence in favor of these beliefs.  It may be added that in America, during recent years, leading gynecologists have recorded a number of cases in which widows on remarriage have shown marked improvement in uterine and pelvic conditions.

The question as to whether men or women suffer most from sexual abstinence, as well as