The last one examined was then thirty-six years of age. (Hammond: "Male Impotence.") The foregoing detailed description shows an extreme degree of results produced by an equally extreme degree of intense and persistent irritation applied to the genital organs, purposely employed to obtain certain results. In the cases cited the irritation or excitation is directly applied, but it is safe to assume that reflex irritability from the anus or rectum, or from that of a stricture or of a prepuce, will in some cases produce a certain degree of excitation in the testicles that may result in their functional or organic derangement, in a degree proportionate to that of the amount of excitation from which they have suffered. That the testicles are very apt to suffer from the existence of a stricture is a well-known fact. I have myself worried over a case of stricture, in whom the attempted passage of a filiform bougie was always immediately followed by a severe attack of epididymitis, and who had always been afflicted with a tenderness and a tendency to inflammation of the testes. I have also noticed a much greater tendency to orchitis in the wearer of an irritating prepuce than where it was absent; so that the presence of a satyriacal tendency, no matter in what proportion of a degree it may be present, can safely be assumed to result in a corresponding degree of apathy, due to an actual physical degeneration of the parts. That these conditions, when present in any degree of permanency or persistence, will in the end induce early impotence, I have no reason to doubt. In this regard we must not overlook the fact that persons with phimosis, stricture, or other genital irritants and impediments, are more liable to be afflicted with haemorrhoids, prolapsus ani, or other anal and rectal irritation, which retroactively assist in bringing about the condition under question. How much this may have to do with certain prolific peculiarities among the Jews may well be questioned; it is a well-known fact that in London the Jewish excess of male births has been as high as eighteen per cent., while among the Christian or Gentile population it is only six and one-half per cent.,--a somewhat analogous condition of proportion being also observable in the United States. Here, it is accounted for, in a measure, by Dr. Billings, in the following words: "This comparatively large proportion of males among the Jews is probably due to the fact that the death-rate of their infants is less for males, as compared with females, than it