athie_, p. 31.)

Since Beard first described neurasthenia, many diverse opinions
have been expressed concerning the relationships of sexual
irregularities to neurasthenia. Gilles de la Tourette, in his
little monograph on neurasthenia, following the traditions of
Charcot's school, dismisses the question of any sexual causation
without discussion. Binswanger (_Die Pathologie und Therapie der
Neurasthenie_), while admitting that nearly all neurasthenic
persons acknowledge masturbation at some period, considers it is
not an important cause of neurasthenia, only differing from
coitus by the fact that the opportunities for it are more
frequent, and that the sexual disturbances of neurasthenia are,
in the majority of cases, secondary. Rohleder, on the other hand,
who takes a very grave view of the importance of masturbation,
considers that its most serious results are a question of
neurasthenia. Krafft-Ebing has declared his opinion that
masturbation is a cause of neurasthenia. Christian, Leyden, Erb,
Rosenthal, Beard, Hummel, Hammond, Hermann Cohn, Curschmann,
Savill, Herman, Fuerbringer, all attach chief importance to
neurasthenia as a result of masturbation. Collins and Phillip
(_Medical Record_, March 25, 1899), in an analysis of 333 cases
of neurasthenia, found that 123 cases were apparently due to
overwork or masturbation. Freud concludes that neurasthenia
proper can nearly always be traced to excessive masturbation, or
to spontaneous pollutions. (E.g., _Sammlung Kleiner Schriften zur
Neurosenlehre_, first series, p. 187.) This view is confirmed by
Gattel's careful study (_Ueber die Sexuellen Ursachen der
Neurasthenie und Angstneurose_, 1898). Gattel investigated 100
consecutive cases of severe functional nervous disorder in
Krafft-Ebing's clinic at Vienna, and found that in every case of
neurasthenia in a male (28 in all) there was masturbation, while
of the 15 women with neurasthenia, only one is recorded as not
masturbating, and she practiced _coitus reservatus_. Irrespective
of the particular form of the nervous disorder, Gattel found that
18 women out of 42, and 36 men out of 58, acknowledged
masturbation. (This shows a slightly larger proportion among the
men, but the men were mostly young, while the women were mostly
of more mature age.) It must, however, always be r