is in the same position as if he had prescribed a quack medicine of which the composition was unknown to him, with the added disadvantage that the medicine may turn out to be far more potently explosive than is the case with the usually innocuous patent medicine.  The utmost that a physician can properly permit himself to do is to put the case impartially before his patient and to present to him all the risks.  The solution must be for the patient himself to work out, as best he can, for it involves social and other considerations which, while they are indeed by no means outside the sphere of medicine, are certainly entirely outside the control of the individual private practitioner of medicine.

Moll also is of opinion that this impartial presentation of the case for and against sexual intercourse corresponds to the physician’s duty in the matter.  It is, indeed, a duty which can scarcely be escaped by the physician in many cases.  Moll points out that it can by no means be assimilated, as some have supposed, with the recommendation of sexual intercourse.  It is, on the contrary, he remarks, much more analogous to the physician’s duty in reference to operations.  He puts before the patient the nature of the operation, its advantages and its risks, but he leaves it to the patient’s judgment to accept or reject the operation.  Lewitt also (Geschlechtliche Enthaltsamkeit und Gesundheitsstoerungen, 1905), after discussing the various opinions on this question, comes to the conclusion that the physician, if he thinks that intercourse outside marriage might be beneficial, should explain the difficulties and leave the patient himself to decide.

There is another reason why, having regard to the prevailing moral opinions at all events among the middle classes, a physician should refrain from advising extra-conjugal intercourse:  he places himself in a false relation to his social environment.  He is recommending a remedy the nature of which he could not publicly avow, and so destroying the public confidence in himself.  The only physician who is morally entitled to advise his patients to enter into extra-conjugal relationships is one who openly acknowledges that he is prepared to give such advice.  The doctor who is openly working for social reform has perhaps won the moral right to give advice in accordance with the tendency of his public activity, but even then his advice may be very dubiously judicious, and he would be better advised to confine his efforts at social reform to his public activities.  The voice of the physician, as Professor Max Flesch of Frankfort observes, is more and more heard in the development and new growth of social institutions; he is a natural leaders in such movements, and proposals for reform properly come from him.  “But,” as Flesch continues, “publicly to accept the excellence of existing institutions and in the privacy of the consulting-room to give advice which assumes the imperfection