Frigidity after hysterectomy may happen, if the erotogenic zone of the anterior vaginal wall was removed at the time of the operation. The vaginal wall is preserved best by the abdominal subtotal hysterectomy, less by the total hysterectomy and least by vaginal hysterectomy when always large parts of the vagina are removed. That is the cause of vaginal frigidity after vaginal hysterectomy observed by LeMon Clark.

The uterus or the cervix uteri takes no part in producing orgasm, even though Havelock Ellis speaks of the sucking in of sperm by the cervix into the uterus. The non-existence of the uterine suction power was proved by a simple experiment, in which a plastic cervical cap was filled with a contrast oil (radiopac) and fitted over the cervix. The cap was left in for the whole interval between two menstrual periods. These women had frequent sexual relations with satisfying orgasm. Repeated X-ray pictures taken during the time when the cap was covering the cervix, never showed any of the contrast medium inside the cervix or in the body of the uterus. The whole contrast medium was always in the cap. The glands around the vaginal orifice, especially the large Bartholin glands, have a lubricating effect. Therefore they are located at the entrance of the vagina and produce their mucus at the beginning of the sexual relations and not synchronously with the orgasm. Sometimes the mucus is produced so abundantly and makes the vulva slippery, that the female partner is inclined to compare it with the ejaculation of the male. Occasionally the production of fluids is so profuse that a large towel has to be spread under the woman to prevent the bed sheets getting soiled. This convulsory expulsion of fluids occurs always at the acme of the orgasm and simultaneously with it. If there is the opportunity to observe the orgasm of such women, one can see that large quantities of a clear transparent fluid are expelled not from the vulva, but out of the urethra in gushes. At first I thought that the bladder sphincter had become defective by the intensity of the orgasm. Involuntary expulsion of urine is reported in sex literature. In the cases observed by us, the fluid was examined and it had no urinary character. I am inclined to believe that "urine" reported to be expelled during female orgasm is not urine, but only secretions of the intraurethral glands correlated with the erotogenic zone along the urethra in the anterior vaginal wall. Moreover the profuse secretions coming out with the orgasm have no lubricating significance, otherwise they would be produced at the beginning of intercourse and not at the peak of orgasm. The intensity of the orgasm is dependent on the area from which it is elicited. Mostly, cunnilingus leads to a more complete orgasm and (consequent) relaxation. The deeper the relaxation after intercourse the higher is the peak of the orgasm followed by depression and hence the students' joke: Post coitum omne animal triste est. The higher the climax the quicker is the reloading of the sexual potential.

Other somatic factors help to sexually stimulate the female partner. As was mentioned there is no spot in the female body, from which sexual desire could not be aroused. Some women have greater sexual desire at the ovulation time while others at the time of the menstrual period. It may be that during menstruation the sexual tension is higher, because the danger of unwanted pregnancy is lessened. The woman-on-top posture is more stimulating as the erotogenic parts come in contact better. The angle which is formed by the erected penis and the male abdomen has a great influence on the female orgasm. These mere somatic causes are often overshadowed by psychic factors, even the commonest automatic reflexes produce sexual reactions. It is possible to cause an orgasm merely by using some stimulating sentence. Such a reaction follows the laws of the unconditioned reflexes. The erotogenic zone on the anterior wall of the vagina can be understood only from a comparison with the phylogenetic ancestry. In the most commonly adopted position, where "the lady does lay on her back," the penis does not reach the urethral part of the vaginal wall, unless the angle of the erected male organ is very steep or if the anterior vagina is directed towards the penis as by putting the legs of the female over the shoulders of her partner. The contact is very close, when the intercourse is performed more hestiarum or a la vache i.e. a posteriori. LeMon Clark is right when he mentions that we were designed as quadrupeds. Therefore, intercourse from the back of the woman is the most natural one. This can be performed either in the side-to-side posture with the male partner behind, or better still with the woman in Sims', knee-elbow or shoulder position, the husband standing in front of the bed. The female genitals have to be higher than the other parts of her body. The stimulating effect of this kind of intercourse must not be explained away as LeMon Clark does by the melodious movements of the testicles like a knocker on the clitoris, but is merely caused by the direct thrust of the penis towards the urethral erotic zone. Certain it is that this area in the anterior vaginal wall is a primary erotic zone, perhaps more important than the clitoris, which got its erotic supremacy only in the age of necking. The erotising effect of coitus a posteriori is very great, as only in this position the most stimulating parts of both partners are brought in closest contact i.e., clitoris and anterior vaginal wall of the wife and the sensitive parts of the glans penis. This short paper will, I hope, show that the anterior wall of the vagina along the urethra is the seat of a distinct erotogenic zone and has to be taken into account more in the treatment of female sexual deficiency.