Other Physical Causes.--Constipation, piles, irritable bladder, fissure of the anus, local uncleanliness, and pruritis of the genital organs, will produce the habit in both males and females in the manner described. Sleeping on feather beds increases the local congestion, and thus favors the exciting influences of any of the above-named causes. It may, perhaps, itself be the exciting cause. We once treated a patient who was affected with stone in the bladder, and who asserted that the constant irritation which he suffered in the end of the penis was only relieved by friction. This might readily be the cause of masturbation, though in this case the vice had been acquired many years before, and was still continued in spite of all efforts to reform. Lying upon the back or upon the abdomen frequently leads to self-abuse by provoking sexual excitement. Certain kinds of exercises, as climbing, in particular, have been attended by the same results. It is said that children sometimes experience genital excitement amounting to pleasure as the result of whipping. Influence of Stimulants.--The use of stimulants of any kind is a fruitful cause of the vice. Tea and coffee have led thousands to perdition in this way. The influence of tobacco is so strongly shown in this direction that it is doubtful if there can be found a boy who has attained the age of puberty and has acquired the habit of using tobacco, who is not also addicted to this vile practice. Candies, spices, cinnamon, cloves, peppermint, and all strong essences, powerfully excite the genital organs and lead to the same result. It should be further added that there is evidence that a powerful predisposition to this vice is transmitted to the children of those who have themselves been guilty of it. Signs of Self-Abuse.--The net which this vice weaves around its victims is so strong, and its meshes are so elaborately interwoven with all his thoughts, his habits, and his very being, when it has been long indulged, that it is important to be able to detect it when first acquired, as it may then be much more easily overcome than at any subsequent period. It is often no easy matter to do this, as the victim will resort to all manner of cunning devices to hide his vice, and will not scruple to falsify concerning it, when questioned. To be able to accomplish this successfully, requires a careful study, first, of the signs by which those who indulge in the practice may be known, and, secondly, of the habits of the individuals. In considering the subject it will be found that there are two classes of signs, as follows:-- 1. Those which may arouse suspicion, but any one of which, taken singly, would not be an evidence of the practice. 2. Those which may be regarded as positive. Several suspicious signs together may constitute a positive sign. Under these two heads, we will consider the signs of this vile habit.