The fist number of L. refer to the standard CtP edition published in 1987. The following number shows correspondence between letters in the new 2010 edition. Note that on this website CtP is available only 1987 edition with minor additions.

[L. 19 | 26] 11 December 1962

My present situation is this. As you will remember, I first got this affliction (satyriasis?) last June, and I fear that it is still with me. During the first two months, certainly, it became much less acute, and I had hopes that it would altogether disappear. But for the last three and a half months I have noticed no further improvement. With an effort I can ignore it for a few days at a time, but it remains always in the background, ready to come forward on the slightest encouragement.

I find that, under the pressure of this affliction, I am oscillating between two poles. On the one hand, if I indulge the sensual images that offer themselves, my thought turns towards the state of a layman; if, on the other hand, I resist them, my thought turns towards suicide. Wife or knife, as one might say. For the time being, each extreme tends to be checked by the other, but the situation is obviously in unstable equilibrium. (Mental concentration, which affords relief, is difficult for me on account of my chronic digestive disorders, as you already know; and I cannot rely on it for support.) I view both these alternatives with distaste (though for different reasons); and I am a faintly nauseated, but otherwise apathetic, spectator of my oscillations between them. Sooner or later, however, unless my condition much improves, I may find myself choosing one or the other of these unsatisfactory alternatives; and a fresh attack of amoebiasis, which is always possible, might well precipitate a decision.