If we thus decide to approach it, and if we have reached the conviction--which, in view of all the evidence we can scarcely escape--that, while sexual abstinence in so far as it may be recognized as possible is not incompatible with health, there are yet many adults for whom it is harmful, and a very much larger number for whom when prolonged it is undesirable, we encounter a serious problem. It is a problem which confronts any person, and especially the physician, who may be called upon to give professional advice to his fellows on this matter. If sexual relationships are sometimes desirable for unmarried persons, or for married persons who, for any reason, are debarred from conjugal union, is a physician justified in recommending such sexual relationships to his patient? This is a question that has frequently been debated and decided in opposing senses. Various distinguished physicians, especially in Germany, have proclaimed the duty of the doctor to recommend sexual intercourse to his patient whenever he considers it desirable. Gyurkovechky, for instance, has fully discussed this question, and answered it in the affirmative. Nyström (_Sexual-Probleme_, July, 1908, p. 413) states that it is the physician's duty, in some cases of sexual weakness, when all other methods of treatment have failed, to recommend sexual intercourse as the best remedy. Dr. Max Marcuse stands out as a conspicuous advocate of the unconditional duty of the physician to advocate sexual intercourse in some cases, both to men and to women, and has on many occasions argued in this sense (e.g., _Darf der Arzt zum Ausserehelichen Geschlechtsverkehr raten?_ 1904). Marcuse is strongly of opinion that a physician who, allowing himself to be influenced by moral, sociological, or other considerations, neglects to recommend sexual intercourse when he considers it desirable for the patient's health, is unworthy of his profession, and should either give up medicine or send his patients to other doctors. This attitude, though not usually so emphatically stated, seems to be widely accepted. Lederer goes even further when he states (_Monatsschrift für Harnkrankheiten und Sexuelle Hygiene_, 1906, Heft 3) that it is the physician's duty in the case of a woman who is suffering from her husband's impotence, to advise her to have intercourse with another man, adding that "whether she does so with her husband's consent is no affair of the physician's, for he is not the guardian of morality, but the guardian of health." The physicians who publicly take this attitude are, however, a small minority. In England, so far as I am aware, no physician of eminence has openly proclaimed the duty of the doctor to advise sexual intercourse outside marriage, although, it is scarcely necessary to add, in England, as elsewhere, it