“I may summarize my own feelings thus:  First, exciting ideas alone produce, as a rule, merely the first stage of sexual excitement.  Second, the same ideas connected with a particular person will produce the second stage.  Third, the same may be said of the presence of the beloved person.  Fourth, actual contact appears necessary for the third stage.  If the first stage only be reached, the sensation is not pleasurable in reality, or would not be but for its association.  If produced, as I have sometimes found it to be, by a sense of mental incapacity, it is distinctly disagreeable, especially if one feels that the energy which might have been used in coping with the difficulty is being thus dissipated.  If it be produced, as it may be, as the result of physical or mental restraint, it is also unpleasant unless the restraint were put upon one by a person one loves.  Then, however, the second stage would probably be reached, but this would depend a good deal on one’s mood.  If the first stage only were reached, I think it would be disagreeable; it would mean a conflict between one’s will and sexual feeling.  Perhaps women who feel actual repugnance to the sexual act with a man they love have never gone beyond the first stage, when their dislike to it would be quite intelligible to me.

“Some time after the life in Italy had come to an end I became engaged.  There was considerable difficulty in the way of marriage, but we saw a good deal of each other.  My fiance often dined with us, and we met every day.  The result of seeing him so frequently was that I was kept in a constant state of strong, but suppressed, sexual excitement.  This was particularly the case when we met in the evening and wandered about the moonlit garden together.  When this had gone on about three months I began to experience a sense of discomfort after each of his visits.  The abdomen seemed to swell with a feeling of fullness and congestion; but, though these sensations were closely connected with the physical excitement, they were not sufficiently painful to cause me any alarm or make me endeavor to avoid their pleasurable cause.  The symptoms got worse, however, and no longer passed off quickly as at first.  The swelling increased; considerable pain and a dragged-down sensation resulted the moment I tried to walk even a short distance.  I was troubled with constant indigestion, weight in the chest, pain in the head and eyes, and continual slight diarrhea.  This went on for about nine months, and then my fiance was called away from the neighborhood.  After his departure I got a trifle better, but the symptoms remained, though in less acute form.  A few months later the engagement was broken off, and for some weeks I was severely ill with influenza and was on my back for several weeks.  When I could get about a little, though very weak, all the swelling was gone, but pain returned whenever