the question whether definite morbid conditions are produced by such abstinence, remains, however, an obscure and debated problem.  The available data do not enable us to answer it decisively.  It is one of those subtle and complex questions which can only be investigated properly by a gynecologist who is also a psychologist.  Incidentally, however, we have met and shall have occasion to meet with evidence bearing on this question.  It is sufficient to say here, briefly, that it is impossible to believe, even if no evidence were forthcoming, that the exercise or non-exercise of so vastly important a function can make no difference to the organism generally.  So far as the evidence goes, it may be said to indicate that the results of the abeyance of the sexual functions in healthy women in whom the sexual emotions have never been definitely aroused tend to be diffused and unconscious, as the sexual impulse itself often is, but that, in women in whom the sexual emotions have been definitely aroused and gratified, the results of sexual abstinence tend to be acute and conscious.

These acute results are at the present day very often due to premature ejaculation by nervous or neurasthenic husbands, the rapidity with which detumescence is reached in the husband allowing insufficient time for tumescence in the wife, who consequently fails to reach the orgasm.  This has of late been frequently pointed out.  Thus Kafemann (Sexual-Probleme, March, 1910, p. 194 et seq.) emphasizes the prevalence of sexual incompetence in men.  Ferenczi, of Budapest (Zentralblatt fuer Psychoanalyse, 1910, ht. 1 and 2, p. 75), believes that the combination of neurasthenic husbands with resultantly nervous wives is extraordinarily common; even putting aside the neurasthenic, he considers it may be said that the whole male sex in relation to women suffer from precocious ejaculation.  He adds that it is often difficult to say whether the lack of harmony may not be due to retarded orgasm in the woman.  He regards the influence of masturbation in early life as tending to quicken orgasm in man, while when practised by the other sex it tends to slow orgasm, and thus increases the disharmony.  He holds, however, that the chief cause lies in the education of women with its emphasis on sexual repression; this works too well and the result is that when the external impediments to the sexual impulse are removed the impulse has become incapable of normal action.  Porosz (British Medical Journal, April 1, 1911) has brought forward cases of serious nervous trouble in women which have been dispersed when the sexual weakness and premature ejaculation of the husband have been cured.

The true nature of the passivity of the female is revealed by the ease with which it is thrown off, more especially when the male refuses to accept his cue.  Or, if we prefer to accept the analogy of a game, we may say that in the play of courtship the first move belongs to the male, but that, if he fails to play, it is then the female’s turn to play.