may be added
that still-births and abortion and miscarriage may result from
syphilitic infection either of the mother or of the embryo. Or the child
may be born alive, but suffering from syphilitic infection. Even when no
actual infection of the offspring results, syphilis favours the
occurrence of a general degeneration of the progeny. If we desire to
safeguard human beings against such dangers as these, we shall feel it
necessary to enlighten them before it is too late; and in view of the
fact that from a single act of intercourse infection may result by which
the health may be permanently injured, such enlightenment is no less
necessary for girls than for boys.

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 mas