Dr. Ripping, in the “Zeitschrift für Psychiatrie (Band xxxix., Heft 1), considers the important clinical question of the relation of the diseases of the sexual organs in women to mental alienation. While he admits that changes in the uterus and its appendages, whether physiological or pathological, have an effect upon the mental susceptibilities of women, he is doubtful whether this effect is profound enough to become a potent cause of insanity. He is rather disposed to place such affections in the second or third line of causes as adjuvantia. The uterine diseases and the mental disturbance are sometimes the result of a common cause. “I have never observed,” writes Dr. Ripping, “a single case in which the insanity was a pure reflex neurosis of disease of the genital organs.” If in some patients this seemed to be probable, it was found on more careful examination that there were other circumstances which gave an easy and unforced explanation of the mental derangement. It is only after uterine disorders which, from their severity, implicate the whole organism, or lower the strength, as in continued bleedings, that insanity can be held to supervene as a result.