The anomalies of the uterus are also sometimes responsible for sterility. Uterus foetalis and obliterations of the lumen of the uterus will result in absolute sterility. Uterus infantilis, hypoplasia of the uterus, atresia of the uterus or polypi, hypertrophic chronic metritis, degeneration of the uterus or uterine deviations may often be the cause of sterility. The anomalies of the tubes which cause sterility are absence of the tubes, rudimentary tubes, total or even partial obliteration of their lumen, as in salpingitis nodosa, closing of the ends of the tubes in bilateral salpingitis, and adherences of the tubes to the neighboring parts, as found in pelviperitonitis, perimetritis, perisalpingitis, and perioöphoritis. The anomalies of the ovaries, causing impotence of procreation, are absence of the ovaries, hypoplasia of the parenchymatous tissue of the ovaries, fibrous degeneration of the ovaries, alteration of their position, as extreme prolapsus and hernia of the ovaries. All these anomalies may produce either absolute or relative sterility. In regard to frequency they are of slight significance in comparison with endometritis and pelviperitonitis after gonorrhoea. The gonorrheic infection is, therefore, the cause par excellence of the impotence of procreation in women as in men. _Impotence of libido._—While in men the common form of impotence is inability of conjugation, the common form of impotence in women is failure to experience the orgasm, or the impotence of libido. In this anomaly two grades may be distinguished, total anaesthesia and partial anaesthesia or orgasmus retardatus. In absolute anaesthesia there is not even a vestige of a libidinous sensation during intercourse. The woman likes caressing, hugging, kissing, etc., because the potency of voluptas is intact. But there is no vestige even of the fore-pleasure, or the ant-orgastic libido. The woman is devoid of sexual sensation, her genitals have no more excitability for pleasurable sensations than her fingers. Hence no desire for coition exists. On the contrary, there is, as a rule, a pronounced disinclination to the act. Where there is complete absence of pleasurable feelings, the act becomes naturally loathsome to the individual. If coition is granted it is done either from a sense of duty or for gain. Physiological anaesthesia exists in children until puberty, and in adults in old age. Even after menstruation has set in, the girl is, as a rule, anaesthetic in regard to libido, although she may be erotic. “The girl has to be kissed into a woman.” After the climacterium the woman generally becomes again more or less anaesthetic. Some women may continue to experience libido years after this period, and may manifest symptoms of great sexual excitement as seen in the following case: