of those institutions is illogical and confusing.  It is the physician’s business to give advice which is in accordance with the interests of the community as a whole, and those interests require that sexual relationships should be entered into between healthy men and women who are able and willing to accept the results of their union.  That should be the physician’s rule of conduct.  Only so can he become, what to-day he is often proclaimed to be, the leader of the nation."[98] This view is not, as we see, entirely in accord with that which assumes that the physician’s duty is solely and entirely to his patient, without regard to the bearing of his advice on social conduct.  The patient’s interests are primary, but they are not entitled to be placed in antagonism to the interests of society.  The advice given by the wise physician must always be in harmony with the social and moral tone of his age.  Thus it is that the tendency among the younger generation of physicians to-day to take an active interest in raising that tone and in promoting social reform—­a tendency which exists not only in Germany where such interests have long been acute, but also in so conservative a land as England—­is full of promise for the future.

The physician is usually content to consider his duty to his patient in relationship to sexual abstinence as sufficiently fulfilled when he attempts to allay sexual hyperaesthesia by medical or hygienic treatment.  It can scarcely be claimed, however, that the results of such treatment are usually satisfactory, and sometimes indeed the treatment has a result which is the reverse of that intended.  The difficulty generally is that in order to be efficacious the treatment must be carried to an extreme which exhausts or inhibits not only the genital activities alone but the activities of the whole organism, and short of that it may prove a stimulant rather than a sedative.  It is difficult and usually impossible to separate out a man’s sexual activities and bring influence to bear on these activities alone.  Sexual activity is so closely intertwined with the other organic activities, erotic exuberance is so much a flower which is rooted in the whole organism, that the blow which crushes it may strike down the whole man.  The bromides are universally recognized as powerful sexual sedatives, but their influence in this respect only makes itself felt when they have dulled all the finest energies of the organism.  Physical exercise is universally recommended to sexually hyperaesthetic patients.  Yet most people, men and women, find that physical exercise is a positive stimulus to sexual activity.  This is notably so as regards walking, and exuberantly energetic young women who are troubled by the irritant activity of their healthy sexual emotions sometimes spend a large part of their time in the vain attempt to lull their activity by long walks.  Physical exercise only proves efficacious in this respect when it is carried to an extent which produces general