IMPOTENCE. 105 



of the coitus. Erections not only come without the influence of the 

 will, but the ardent desire for -them interferes with their occurrence. 

 The more unconcerned the individual, the less attention he pays to the 

 erections, the more certain and permanent they will be when there is 

 sexual excitement. The patients usually volunteer the information, 

 that they have powerful and continued erections at times when they 

 are of no use, but have none when there is an opportunity for coitus, 

 or that, if erections occur, they pass off even during the coitus, before 

 the ejaculation has taken place. Even when such patients have re- 

 gained their self-confidence by one successful coitus, and have then re- 

 tained their virile power for some time, they often have long relapses 

 of their impotence from a single failure of the act. There arc also 

 cases where the virile power of the patients returns perfectly when 

 they have intercourse with their wives, and they can even visit them 

 at very short intervals ; but it always fails if they make the attempt 

 with some other women with whom they have not previously had con- 

 nection: 



The most frequent cause of this diminished power is onanism ; 

 sexual excess or repeated pollutions far more rarely cause it. But the 

 diminished power of the onanist is usually first increased to temporary 

 impotence by reading popular and medical treatises on the results of 

 masturbation. In those writings the loss of manhood is described as 

 the inevitable result of onanism, and the readers are thus robbed of 

 all self-confidence. If both the depressing effect of onanism and the 

 despondency from reading these papers act on the same person, the 

 first attempt at coitus almost always fails. But, as we have already 

 said, the effect of this first failure is to induce subsequent ones for a 

 long time. Other persons, not debilitated by onanism, and under- 

 taking coitus with perfect confidence, fail in the act from being intox- 

 icated at the time ; but even such persons may become temporarily 

 impotent from the disturbance of self-confidence by the failure, and 

 from paying too much attention to the success of the next attempt, 

 for fear it also will fail. 



In still other cases the only causes for the failure of the first coitus 

 are excessive excitement and a certain embarrassment and anxiety. 

 Such persons have often led an unusually chaste life, and, with a rare 

 innocence after marriage, they have attempted coition, being perfectly 

 ignorant of the process. In the first weeks of their married life they 

 are greatly depressed and troubled by their sad experiences. If we 

 meet them a few years subsequently, when they have healthy, bloom- 

 ing children, they laugh freely over the mishaps of their honey-moon. 



Besides the numerous cases of deficient power and temporary im- 

 potence under the above classes, we must mention the rarer cases, 



