CAUSES OF IMPOTENCE A3STD STERILITY IN THE FEMALE 287 Some forms of mental disease, especially general paralysis of the insane, increase the sexual power in the beginning, though at a later advanced stage totally abolish the sexual instinct. Blows on the head or spine may produce temporary or permanent impotence by affecting the brain and spinal cord. A condition of temporary azoosperrnia (complete absence of spermatozoa in semen) unattended with any loss of sexual power is observed in individuals, who attend in the X-Ray department without proper protection. The excessive and continued use of some drugs, such as alcohol, opium, cannaBis" indica, tobacco, cocaine and bromides, may render a man impotent. 5. Psychical Influences.—A temporary absence of desire for sexual intercourse may result from fear, timidity, aversion, hypochondriasis, excessive passion, and sexual over-indulgence. Sometimes, an individual may be impotent with one particular woman, but not with another. It should be noted that in a divorce suit the question to be decided is the incapacity of the husband to sexual intercourse with his married partner; his capacity for intercourse with other women is of no consequence in deciding the case. Lord Birkenhead, the Lord Chancellor, granted divorce to a -woman who instituted a suit for nullity of marriage after ten years of married life on the ground that the husband was unable to consummate the marriage. It followed that although physically normal, he had always been incapable of consummating this particular union with this particular woman (impotence quoad Tumc).10 In an appeal from a divorce suit of Ibrahim v. Musammat Altaian heard before Mr. Justice Kanhaya Lai at the High Court of Allahabad in 1923, it was contended that no consummation of marriage had taken place although the parties had been married for years. Medical evidence proved beyond doubt that the husband had no malforma- tion of, or defect in, the male organ and that he was normally capable of performing the sexual act. The woman was also medically examined and certified to be a virgin, who had had no sexual intercourse with any man. This was a case of a man who might be impotent quoad his wife, but the learned Judge allowed him one year more to prove his potency with his wife. In the divorce suitn of R. R. Saraiya v. Kusum Madgavkar before the High Court of Bombay the Hon. Mr. Justice Coyajee passed a decree for nullity of marriage on the ground that the husband was impotent as regards his wife, although he was generally potent. CAUSES OF IMPOTENCE AND STERILITY IN THE FEMALE The causes which prevent sexual intercourse and conception in the female are the same as those of impotence and sterility in the male; viz., 1. Age. 4. General Diseases. 2. Malformations. 5. Psychical Influences. 3. Local Diseases. 1. Age.—Puberty in the female usually commences at the thirteenth or fourteenth yeafln India. It is generally believed that puberty commences at 1m earlier age in the tropics than in the temperate regions, "but I do not think that there is any difference in the age of puberty and Professor Crew12 expressed the same opinion at a meeting of the Social Hygiene Congress in London. From observations made in 479 cases amongst Indian women representing many different castes "and races, Miss Curjel13 has come to the conclusion that the average age of the onset of puberty (cata- menia) in an. Indian girl is 1&63 years. The signs of puberty in a girTare the development of the external and internal genitals, the appearance of menstruation, the growth of hair on the pubes and axillae, and the development of the breasts. There is a 10. Jour. Artier. Med. Assoc., July 23, 1921, p. 297. 11. Times Qf India, April 19, 1948. f» T-v»^o* Sep. ?"* 1Q2Q r>. 619. 13. Ind. Jour, of Med. Research, Oct. 1920, p. 306.