In a considerable number of cases the sexual impulse was thus found by _Gläveke_, not indeed to be entirely extinguished, but still notably diminished. In another set of cases, the sexual impulse was entirely extinguished, but only in one case was there actual aversion to coitus. The women readily permitted intercourse when their husbands desired it, but remained themselves quite indifferent. The greater number of these women stated that the specific sensation of pleasure during coitus was markedly weakened, but not entirely lost; in a small proportion, this sensation was completely extinguished. In the case of seven women who complained that coitus was very painful, _Gläveke_ found that the calibre of the vagina was much diminished. In these cases, the sensation of pleasure during coitus was either greatly diminished or completely extinguished. The women permitted intercourse very unwillingly, their unwillingness arising, not from any actual aversion, but because they dreaded the pain which coitus produced. An extremely hysterical woman, affected with severe prolapse of the uterus, stated that every attempt at intercourse was frustrated by violent hysterical convulsions. The sexual impulse appears always to suffer first and most severely, and only after this is the sensation of pleasure during coitus affected. In a few women only, according to the experience of this author, was the sexual impulse quite unaffected by the removal of the ovaries. Amputation of the clitoris appears notably to diminish both the sexual impulse and the sensation of sexual pleasure, but the results of clitoridectomy for the cure of masturbation are by no means always favorable. In the women of the Russian sect of the _Skopstki_, the clitoris, the nymphæ, and a part of the labia majora are removed, in order to destroy sexual desire. According to _von Krafft-Ebing_ it is probable that in the virgin the clitoris is the only erotogenic zone, that is to say, that only by the stimulation of the clitoris can erection, the orgasm, and the sensation of ejaculation be induced. It is probable that the vagina becomes erotogenic only as a result of coitus; thenceforward, however, the erotogenic significance of the clitoris is notably lessened, and in multiparæ may entirely disappear. NYMPHOMANIA, ANÆSTHESIA AND PSYCHOPATHIA SEXUALIS. The sexual impulse in women is subject to morbid changes, both in the way of increase and of diminution, exhibiting abnormal violent increase (nymphomania), or declining to the state of complete frigidity and sexual indifference, or, finally, manifesting itself in some perverse manner (psychopathia sexualis).