Next to excesses, gonorrhoea, in a great many cases, leaves the genitals in a similar weakened condition. Gonorrhoea often causes acute inflammation of the prostatic urethra, and the mucous membrane not seldom undergoes the changes characteristic of chronic catarrh. The sensory nerves reflexly keep the centres for erection and ejaculation in a condition of hyperesthesia. This condition finally leads to the paralysis of the centres and nerves, and reflex-erection cannot be produced. Psychic causes of impotence are mental fatigue, overwork, preoccupation with mathematical or financial problems, fear,[AU] anger, grief, and disgusting sights or odors. Prolonged excitement before attempting coition may also lead to temporary impotence. The other causes of impotence are the symptomatic ones. Impotence is met with in tabes dorsalis, diabetes, nephritis, obesitas, oxalic diathesis, haemorrhoids, fissures of the anus, seat worms, etc. Excesses in the consumption of certain drugs may also lead to impotence. Such drugs are alcohol,[AV] morphine, cocaine, tobacco and the bromides. _Etiology of impotence in women._—The same causes, at work in producing impotence in men, are also affecting impotence in women. The only modification lies in the fact that impotence of copulation, which is the impotence par excellence in men, is of a negligible quantity in women. The main mode of impotence found in women is that of experiencing libido. This impotence may be either idiopathic or also caused by excesses as the impotence of copulation in men. Idiopathic impotence of libido is oftener met with in women than in men. Still even in women this insensibility is much rarer than is generally believed. The explanation for the greater frequency of impotence of libido in women than in men has first been given by Freud (Sig. Drei Abhandlungen über Sexualtheorie).