Dr. Arthur E. Giles, Senior Surgeon to the Chelsea Hospital for Women, endorsed Dr. Gibbons's remarks as to the great unhappiness resulting from deliberately childless marriages, and he added that he had always warned patients of this. He believed that quinine had a permanently bad effect. Those who waited for a convenient season to have a child often laid up trouble for themselves. On the question of fibroid tumours he had come to the conclusion that these were not a cause but in a sense a consequence of sterility. Women who were subjected to sexual excitement with no physiological outlet appear to have a tendency to develop fibroids. He would like the opinion to go forth from the section that the use of contraceptives was a bad thing. All these authorities are agreed that the practice of artificial sterility during early married life is the cause of many women remaining childless, although later on these women wish in vain for children. To meet this difficulty one of the advocates of birth control advises all young couples to make sure of some children before adopting these practices; thus demanding of young parents, at the very time when it is most irksome, that very sacrifice of personal comfort and prosperity to prevent which is the precise object of the vicious practice. Nor is sterility the only penalty. The disease known as neurasthenia arises both in women _and in men_ in consequence of these methods. Dr. Mary Sharlieb, [67] after forty years' experience of diseases of women, writes as follows: "Now, on the surface of things, it would seem as if a knowledge of how to prevent the too rapid increase of a family would be a boon to over-prolific and heavily burdened mothers. There are, however, certain reasons which probably convert the supposed advantage into a very real disadvantage. An experience of well over forty years convinces me that the artificial limitation of the family causes damage to a woman's nervous system. The damage done is likely to show itself in inability to conceive when the restriction voluntarily used is abandoned because the couple desire offspring.