Here is a young man who applies for the treatment of gonorrhea one month after his marriage, stating that his wife had been contaminated by the infection. He "thought he had been cured," and begs that his wife be kept in ignorance of the nature of her disease. A pus tube operation, and the marred happiness of one of the purest and sweetest of the human race is likely to be the consequence of this disastrous blunder on the part of a boy who would gladly have sacrificed life itself rather than infect his innocent wife.

The sexual function of the natural instincts is the strongest of all the bodily appetites. It is a most important source of happiness and health, and its normal performance exercises the most beneficent influence upon all other bodily and mental functions. The want of the gratification of the normal sexual instinct is a source of deep moral and mental suffering, lessens the love of life, and induces a sad and despondent existence.

The participation of the opposite sexes in the sexual relation through the attraction of love is one of the most beautiful phenomena of existence, and, when properly conducted, is in no sense to be construed as vulgar or disgusting, which religious ascetics have described as lust.

Monogamy is the ideal of the sexual relation for all civilized races, but its performance without personal sympathy is only a physiological function as a means of purely animal gratification, and, whether in or out of marriage bonds, it is degraded into lust. But where the psychic elements of the two personalities are in perfect harmony, where the joining links in the chain of love are present, and where personal sympathy exists, the sexual function is something more than the expression of physiological desire. It is also the gratification of the desire to be in the embrace of and in intimate contact with the one beloved, and, not only is orgasm evoked, but the relation strengthens the bond of personal sympathy, conduces to health and happiness, and is the highest expression of true love. Without this higher attraction it is, as a consequence, only a temporary relation, and in no sense worthy of performance by the self-respecting individual. Under such conditions, instead of being attended by salutary results to the participants, the effects are those that leave the self-respecting person with a feeling of disgust - weakness, nervous irritability, and a feeling of self-condemnation. Whether in or out of the marriage relation, the sexual function under such inharmonious conditions is prostitution pure and simple, and is degrading to mind and body.

When engaged in between husband and wife while either is an unwilling participant, it is nothing more or less than legalized prostitution.

For a husband to force the act upon a self-sacrificing wife who feels that, though unpleasant to her, she is under obligation to yield to his desires, which she prefers rather than to cause him to have an excuse to seek sexual satisfaction elsewhere, and he forces her thus to submit to him, though positively detrimental to her health and happiness - under such conditions the sexual function becomes an act of forced legalized prostitution in the fullest sense of the expression.

My association with several thousand physicians, and the information communicated to me by many of them in seeking aid for some psychoneurotic manifestation, has coincided with my own observations that there are many married women who do not enjoy their conjugal relation with their husbands, and that this is one of the most fruitful causes of unhappy domestic relations extant, resulting in various functional disorders of the female generative organs, with its attendant insomnia, nervousness, and general psychoneurotic manifestations. Occasionally a case is presented where the most complete happiness in the conjugal relation can not be obtained because the psychic life of the woman is under the control of religious emotion, which is, on account of the psychical correlation of religious emotion and the sexual instinct, substituted for the normal sexual enjoyment which the wife should obtain from her husband.

When a female religious enthusiast has her psychic life abnormally influenced, her emotions being unduly stirred by her minister, and also enjoys the sexual relation with her husband, the sexual act is then more of a physiological response to the minister's psychic stimulation than the normal reaction to the personality of her husband, and intercourse under such conditions is most disastrous to both mind and body. She is, in reality, playing a dual role - psychically enjoying her minister, physically enjoying her husband - and this abnormal, unnatural situation degrades her marital relation, in effect, to an act of prostitution. The over-expenditure of nerve energy from this double situation entails a draught upon her reserved forces in excess of her recuperative powers, while she is in perfect innocence. But the violation of natural laws in innocence and ignorance are no less followed by nature's penalty than if violated intentionally. She becomes disqualified for her domestic duties and social responsibilities, becomes neurasthenic, psychasthenic, or hysterical, and this resulting train of psychoneurotic symptoms or functional disorders sometimes leads to insanity or bodily sickness, and even death may result indirectly therefrom.

Women are frequently observed who come out of a series of prolonged emotional religious services weak, nervous, pale, and bedridden, who passively yield to the physical and psychical reaction of such dissipations feeling that they have conscientiously performed their duty in "the Lord's work." On one occasion, when explaining to a religious devotee the disastrous effect of an emotional sermon, telling her that I believed death itself had frequently been caused by such emotional preaching, she replied that "it would be a lovely way to die." Her response reminded me of the answer given by a mentally decrepit old man seventy-six years of age, who, when told that if he was forced to satisfy the sexual requirements of a young woman twenty-six years of age, whom he was endeavoring to marry, for two weeks it would kill him, replied that if he could live with her for two weeks he would prefer to die rather than live twenty years without her. The manifestations of the sexual instinct exhibited by this woman in her religious emotion and by this man's desire to gratify his animal passion are here strikingly similar.