It is important to remark that the evil results of sexual abstinence in women, in the opinion of many of those who insist upon their importance, are by no means merely due to unsatisfied sexual desire. They may be pronounced even when the woman herself has not the slightest consciousness of sexual needs. This was clearly pointed out forty years ago by the sagacious Anstie (_op. cit._) In women, especially, he remarks, "a certain restless hyperactivity of mind, and perhaps of body also, seems to be the expression of Nature's unconscious resentment of the _neglect of sexual functions_." Such women, he adds, have kept themselves free from masturbation "at the expense of a perpetual and almost fierce activity of mind and muscle." Anstie had found that some of the worst cases of the form of nervosity and neurasthenia which he termed "spinal irritation," often accompanied by irritable stomach and anæmia, get well on marriage. "There can be no question," he continues, "that a very large proportion of these cases in single women (who form by far the greater number of subjects of spinal irritation) are due to this conscious or unconscious irritation kept up by an unsatisfied sexual want. It is certain that very many young persons (women more especially) are tormented by the irritability of the sexual organs without having the least consciousness of sexual desire, and present the sad spectacle of a _vie manquée_ without ever knowing the true source of the misery which incapacitates them for all the active duties of life. It is a singular fact that in occasional instances one may even see two sisters, inheriting the same kind of nervous organization, both tormented with the symptoms of spinal irritation and both probably suffering from repressed sexual functions, but of whom one shall be pure-minded and entirely unconscious of the real source of her troubles, while the other is a victim to conscious and fruitless sexual irritation." In this matter Anstie may be regarded as a forerunner of Freud, who has developed with great subtlety and analytic power the doctrine of the transformation of repressed sexual instinct in women into morbid forms. He considers that the nervosity of to-day is largely due to the injurious action on the sexual life of that repression of natural instincts on which our civilization is built up. (Perhaps the clearest brief statement of Freud's views on the matter is to be found in a very suggestive article, "Die 'Kulturelle' Sexualmoral und die Moderne Nervosität," in _Sexual-Probleme_, March, 1908, reprinted in the second series of Freud's _Sammlung Kleiner Schriften zur Neurosenlehre_, 1909). We possess the aptitude, he says, of sublimating and transforming our sexual activities into other activities of a psychically related character, but non-sexual.