It is owing to the fact that the sexual passivity of women is only an apparent, and not a real, passivity that women are apt to suffer, as men are, from prolonged sexual abstinence. This, indeed, has been denied, but can scarcely be said to admit of doubt. The only question is as to the relative amount of such suffering, necessarily a very difficult question. As far back as the fourteenth century Johannes de Sancto Amando stated that women are more injured than men by sexual abstinence. In modern times Maudsley considers that women "suffer more than men do from the entire deprivation of sexual intercourse" ("Relations between Body and Mind," _Lancet_, May 28, 1870). By some it has been held that this cause may produce actual disease. Thus, Tilt, an eminent gynecologist of the middle of the nineteenth century, in discussing this question, wrote: "When we consider how much of the lifetime of woman is occupied by the various phases of the generative process, and how terrible is often the conflict within her between the impulse of passion and the dictates of duty, it may be well understood how such a conflict reacts on the organs of the sexual economy in the unimpregnated female, and principally on the ovaria, causing an orgasm, which, if often repeated, may _possibly_ be productive of subacute ovaritis." (Tilt, _On Uterine and Ovarian Inflammation_, 1862, pp. 309-310.) Long before Tilt, Haller, it seems, had said that women are especially liable to suffer from privation of sexual intercourse to which they have been accustomed, and referred to chlorosis, hysteria, nymphomania, and simple mania curable by intercourse. Hegar considers that in women an injurious result follows the nonsatisfaction of the sexual impulse and of the "ideal feelings," and that symptoms thus arise (pallor, loss of flesh, cardialgia, malaise, sleeplessness, disturbances of menstruation) which are diagnosed as "chlorosis." (Hegar, _Zusammenhang der Geschlechtskrankheiten mit nervösen Leiden_, 1885, p. 45.) Freud, as well as Gattel, has found that states of anxiety (_Angstzustände_) are caused by sexual abstinence. Löwenfeld, on careful examination of his own cases, is able to confirm this connection in both sexes. He has specially noticed it in young women who marry elderly husbands. Löwenfeld believes, however, that, on the whole, healthy unmarried women bear sexual abstinence better than men. If, however, they are of at all neuropathic disposition, ungratified sexual emotions may easily lead to various morbid conditions, especially of a hysteroneurasthenic character. (Löwenfeld, _Sexualleben und Nervenleiden_, second edition, 1899, pp. 44, 47, 54-60.) Balls-Headley considers that unsatisfied sexual desires in women may lead to the following conditions: general atrophy, anemia,