I need not describe the dangers to health resulting from masturbation and sexual excesses, for these have previously been considered in detail; but it is necessary to allude to the exaggerated statements which are sometimes encountered regarding the dangers of masturbation, especially in popular works on the subject, so that the physician may be on his guard about this matter. A child who during and after the act of masturbation has a keen sense of wrong-doing, and consequently suffers much from self-reproach, may, if the fear is superadded of having done serious permanent injury to health, be affected with grave hypochondriacal manifestations. Many instances of this have come under my notice, in young men and young women of sixteen or thereabouts. Even when the practice of masturbation has long been discontinued, and the patient is quite grown up, such symptoms may arise, owing to the persistence of the fear of disastrous results, and the auto-suggestive influence of this fear. Nowhere is more tact required by the physician than in his dealings with those who masturbate or have masturbated. There is even a real danger that a moral lecture may cause a shock to the system; in the case of some young men it may sometimes be better to acquiesce in masturbation, rather than to alarm them by talking about the disastrous consequences of the indulgence. I refer to those unfortunate creatures who suffer from severe hyperaesthesia of the sexual impulse, and who for social reasons are not in a position to satisfy the impulse in any other way than by masturbation, or who refrain from illicit intercourse in the well-grounded fear of venereal infection. The physician who has seen a number of such cases, who has learned how they continually relapse into the practice of masturbation, notwithstanding all their good resolutions and their conviction that masturbation is at once dangerous and immoral, will be likely to feel that it is better, not indeed to recommend masturbation, but from time to time tacitly to permit it. To do in these cases what it is well to do in certain others, namely, to describe the bad effects of masturbation, may give rise to grave conditions of depression, and even to suicide. Certainly, in such cases, we must carefully avoid alarming the patients too seriously about the consequences of masturbation.