The reflex influence exercised on the heart and the general circulation has been shown also by the results of operations on the female genital organs. In cases in which the ovaries have been removed, or in which these organs have been roughly handled, _Hegar_ has noticed a great diminution in the frequency of the pulse, sometimes even cessation of the heart’s action. In similar circumstances _Champonière_ also observed as a rule diminished frequency of the pulse, but in some cases increased frequency. _Mariagalli_ and _Negri_ have described tachycardia following laparotomy and the extirpation of double pyosalpinx. _Bonvalot_ has published cases in which, in consequence of vaginal or intra-uterine injections, in consequence of simple examination, and in consequence of the performance of version, sudden death has resulted from cardiac syncope. The psychical influences which proceed from the female genital organs in the different periods of sexual life have also great significance for the organism as a whole. Manifold impulses both stimulating and depressing arising in the reproductive organs affect the workings of the mind. The maiden at puberty is affected by the knowledge of sexuality; the sexually mature woman, by the desire for sexual satisfaction, and by the yearning for motherhood; the wife, by the processes of pregnancy, parturition, and suckling, or, on the other hand by the distressing consciousness of sterility; the woman at the climacteric period, by the knowledge of the disappearance of her sexual potency. The mind is further sympathetically influenced by the stimulation of the terminals of the sensory nerves in the genital organs. Through the increase of such stimulation, through its spread to adjacent nerves and nerve tracts and to the entire nervous system, the mind is affected, directly by irradiation, or indirectly by vasomotor processes and spinal hyperæsthesia. Psychical manifestations and the nervous states associated with these are somewhat frequently, and even actual psychoses occasionally, encountered in the various phases of the sexual life of woman, sometimes taking the form of violent sexual storms, which may indeed, as ordinary menstrual reflexes, accompany every catamenial period.