The importance of a more intelligent effort on the part of the medical profession directed toward the guidance of the sexual instinct has assumed such a prominent relation to the successful employment of psychotherapy in the treatment of the psycho-neuroses, as has been clearly demonstrated by the work of Freud, of Vienna, and Jung, of Zurich, that no work purporting to be an elucidation of the subject can be considered complete unless this phase is also presented. The present status of the subject is such that it would be most reprehensible and cowardly to dodge the issue on account of the fear of antagonism by those who adhere to conflicting opinions.

That abnormalities of the sexual functions are among the most common causes of nervous and mental diseases, and that insanity, suicide, and death are often the final outcome, is today recognized by all who have given this question thoughtful consideration.

At the present time we are not content to say that some "functional disorder" is the cause of an abnormal nervous and mental condition, but we seek to discover the cause of this disorder, presented as a part of the complication to be treated.

Freud has brought forth a most convincing array of facts, based upon actual clinical experience, showing that the obstacles of a normal sexual life, or unhappy love, are frequently the cause of violent disturbances of the mind, and that often, as the result of these obstacles, mental disorders appear after a continued derangement of the organic functions.

Such obstacles, Freud considers, are the most important causes of the functional psychoneuroses, which have heretofore been considered to be the result of a constitutional taint. It is his conclusion that these obstacles are due more to the inherited environing and educational influences to which the individual has been subjected through life than to an inherited weakness of the physical organism at the time of birth.

This viewpoint is not to depreciate the inherited physical qualities or characteristics which we bring into the world as an endowment, but to give recognition to the potency of the influences brought to bear upon the human mind and body by environment and education after we are born, and to emphasize the importance of such influences in the determination of the mental and physical characteristics exhibited by the individual as a consequence.

With these preliminary remarks, let us consider the facts pertaining to the guidance of the sexual instinct as a preparatory measure to a useful, wholesome, happy life of the individual on the one hand, and as a preventive measure against untold unhappiness, with its consequent derangement of the normal functions of mind and body, resulting in mental and physical deterioration, suicide, divorce, death and insanity, on the other.

This discussion is not intended to cover the influence of pathological processes resulting from venereal disorders, which are already recognized as one of the most potent causes of the more serious nervous and mental diseases, nor to go into the abortion question, which has assumed the role of one of the most important problems confronting our American civilization. That story is best read in the history of a large proportion of the cases recorded in our annual list of suicides, insanities, death records, causes of the surgical operations in the numerous hospitals, and in the large infantile mortality list annually turned out-by many of our metropolitan cities. The results of physical degeneracy resulting from venereal disorders must not stop here. It is a large contributing factor in the annual mortality list resulting from tuberculosis, pneumonia, enteric fever, cancer, Bright's disease, and many other acute affections. That venereal diseases lessen the resistive powers of the individual, and render him comparatively an easy victim, and in all other ways handicap his usefulness in life, is not in the least degree questioned by our ablest clinicians at the present time.

In this era of enlightened civilization it is not enough to say that this or the other parasite, microbe, or abnormal cell was the cause of the physical manifestations of disease or pathological process presented. We must go back farther than that. We must consider the causation of the cause exhibited in the gross pathological mani-festation of diseased processes, and in thousands upon thousands of instances the primary cause, as every intelligent, conscientious physician must admit, is to be found only in the failure of the individual to live up to his highest privileges on account of the lack of proper education in early life to equip him to be qualified for the guidance of his sexual instinct.

One who seeks to better humanity by giving expression to his ideas concerning the guidance of the sexual instinct should be prepared by broad experience and deep study. He should know men and women as we find them in the common, every-day walks of life, from the lowest to the highest, and deal with facts as they are, considering sexual laws that govern the entire race of mankind; for otherwise he is not prepared to speak out on this subject, with opinions based upon real conditions and unprejudiced researches in the laws of natural morality, the necessary requisites in qualifying one to give advice which can be followed because in perfect harmony with the laws of nature.

People should be made to understand that nature's laws are God's laws; that the sexual instinct is a part of human nature, and is not in itself immoral; that a love connection is not in itself immoral, but that it may lead to unhappy consequences as the result of social conflicts. The unhappy consequences of ignorance in regard to the performance of the sexual act, even in marriage, is in evidence in the every-day experience of the observing physician. To enumerate these illustrations would require more pages than are to be devoted to this chapter.