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The cases that the doctor can most readily help are those of vaginal anaesthesia where clitoral orgasm would be attainable if an adequate 54 ANY WIFE OR A N Y H U S B A N D technique were being employed. " Whatever is the most acceptable type of pleasure to a woman, it is necessary for her happiness and health that she should have it. A woman cannot usually expect to experience clitoral orgasm during union; it is not often that the clitoris can be directly stimulated by the penis which indeed is seldom as competent in arousing this feeling as the gentle use of finger-tips.

But if after adequate experience the condition has not resolved, and if psychotherapy cannot be undertaken, the outlook— judging from the cases I have been able to follow up—is not very favourable. Nevertheless, women make their individual adjustments, and marriages can yet be happy and successful in spite of this impediment. It would be interesting to know what type of early experience is most likely to precipitate a disorder of this sort. Judging from patients I have questioned, I have the impression that most have undergone some fairly overwhelming, dramatic experiences.

Vaginismus, "Flinching" or Vaginal Cramp Painful intercourse is a feature in many sexual problems of women. Sometimes it is the main complaint, as when it occurs at the beginning of marriage and even prevents its consummation. Sometimes the symptom is less severe and merely causes a persistent coital discomfort which can, however, last throughout married life and go far to spoil the sexual relationship. Incomparably the commonest cause of painful intercourse is vaginal flinching or cramp. This is a most important disorder, and one that is commonly misunderstood both by wife, husband COMMON D I S O R D E R S IN WOMEN 6l and even sometimes by the doctor.

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