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 ;
 
 PSYCHOPATHIA SeXUALIS, 
 
 WITH ESPECIAL BEPEKENCE TO 
 
 Contrary Sexual Instinct: 
 
 A MEDICO-LEGAL STUDY. 
 
 By Dr. PS., -u-oro. PCK.-2Ps.FFT-H:BI]SCG-, 
 
 Professor of Psychiatry and Neurology, University of Vienna. 
 
 AUTHORIZED TRANSLATION 
 
 SEVENTH ENLARGED AND REVISED GERMAN EDITION, 
 
 CHARLES GILBERT CHADDOCK, M.D., 
 
 Frofeuor of Nervous and Mental Diseases, Marion-Sims College of Medicine, St. Louis ; Fellow of the Chicago Academy 
 
 o( Medicine; Corresponding Memlier of the Detroit Academy of Medicine; Associate 
 
 Member of the American Medico-Psychological Association, etc. 
 
 PHILADELPHIA AND LONDON : 
 
 THE F. A. DAVIS CO., PUBLISHERS. 
 
 1893,
 
 Entered according to Act of Congress, in the year 1892, by 
 
 THE F. A. DAVIS COMPANY, 
 
 In the Of&ce of the Librarian of Congress, at Wasliington, D. C, U. S. A. 
 
 All rights reserved. 
 
 Philadelphia, Pa., U. S. A.: 
 
 The Medical Bulletin Printing Hous«, 
 
 1916 Cherry Street.
 
 PREFACE TO THE FIRST EDITION. 
 
 Very few ever fully appreciate the powerful influence which 
 sexuality exercises over feeling, thought, and conduct, both in 
 the individual and in society, Schiller, in his poem, " Die Welt- 
 weisen," recognizes it with the words : — 
 
 * Einstweilen bis den Bau der Welt 
 Philosopliiie zusammenhalt, 
 Erhalt sie das Getriebe 
 Durch Hunger und durch Liebe."* 
 
 It is remarkable that the sexual life has received but a 
 very subordinate consideration on the part of philosophers. 
 
 Schopenhauer (" The World as Will and Idea ") thought 
 it strange that love had been thus far a subject for the poet 
 alone, and that, with the exception of superficial treatment by 
 Plato, Rousseau, and Kant, it had been foreign to philosophers. 
 
 What Schopenhauer and, after him, the Philosopher of the 
 Unconscious, E. v. Hartmann, philosophized concerning the sex- 
 ual relations is so imperfect, and in its consequences so distaste- 
 ful, that, aside from the treatment in the works of Michelet 
 ("L'amour") and Mantegazza ("Physiology of Love"), which 
 are to be considered more as brilliant discussions than as scien- 
 tific treatises, the empirical psychology and metaphysics of the 
 sexual side of human existence rest upon a foundation which is 
 scientifically almost puerile. 
 
 The poets may be better psychologists than the psychol- 
 ogists and philosophers ; but they are men of feeling rather than 
 of understanding, and at least one-sided in their consideration of 
 the subject. They cannot see the deep shadow behind the light 
 and sunny warmth of that from which they draw their inspira- 
 tion. The poetry of all times and nations would furnish inex- 
 haustible material for a monograph on the psychology of love ; 
 but tlifi great problem can be solved only with the help of 
 
 1 " Meanwhile, until Philosophy shall at last unite and maintain the world, Hunger 
 and Love impel it onward." 
 
 (iii)
 
 iv PREFACE TO THE FIRST EDITION. 
 
 Science, and especially with the aid of Medicine, which studies 
 the psychological subject at its anatomical and physiological 
 source, and views it from all sides. 
 
 Perhaps it will be possible for medical science to gain a 
 stand-point of philosophical knowledge midway between the 
 despairing views of philosophers like Schopenhauer and Hart- 
 mann ^ and the gay, naive views of the poets. 
 
 It is not the intention of the author to lay the foundation 
 of a psychology of the sexual life, though without doubt psycho- 
 pathology would furnish many important sources of knowledge 
 to psychology. 
 
 The purpose of this treatise is a description of the patho- 
 logical manifestations of the sexual life and an attempt to 
 refer them to their underlying conditions. The task is a diffi- 
 cult one, and, in spite of years of experience as alienist and 
 medical jurist, I am well aware that what I can offer must be 
 incomplete. 
 
 The importance of the subject for the welfare of society, 
 especially forensically, demands, however, that it should be ex- 
 amined scientifically. Only he who, as a medico-legal expert, 
 has been in a position where he has been compelled to pass 
 judgment upon his fellow-men, where life, freedom, and honor 
 were at stake, and realized painfully the incompleteness of our 
 knowledge concerning the pathology of the sexual life, can 
 fully understand the significance of an attempt to gain definite 
 views concerning it. 
 
 Even at the present time, in the domain of sexual crimi- 
 nality, the most erroneous opinions are expressed and the most 
 unjust sentences pronounced, influencing laws and public opinion. 
 
 He who makes the psychopathology of sexual life the 
 object of scientific study sees himself placed on a dark side of 
 human life and misery, in the shadows of which the god-like 
 
 * Hartmann's philosophical view of love, in the " Philosophy of the Unconscious," 
 p. 583, Berlin, 1869, is the following : " Love causes more pain than pleasure. Pleasure is 
 illusory. Reason would cause love to be avoided if it were not for the fatal sexual instinct ; 
 therefore, it would he best for a man to have himself castrated." The same opinion, minus 
 the consequence, is also expressed by Schopenhauer (" Die Welt als Wille und Vorstellung," 
 3. Aufl., Bd. ii, p. 586 u. flF.).
 
 PREFACE TO THE FIRST EDITION. V 
 
 creations of the poet become liideous masks, and morals and 
 aesthetics seem out of place in the " image of God." 
 
 It is the sad province of Medicine, and especially of Psy- 
 chiatry, to constantly regard the reverse side of life, — human 
 weakness and misery. 
 
 Perhaps in this difficult calling some consolation may be 
 gained, and extended to the moralist, if it be possible to refer 
 to morbid conditions much that offends ethical and aesthetic 
 feeling. Thus Medicine undertakes to save the honor of man- 
 kind before the Court of Morality, and individuals from judges 
 and their fellow-men. The duty and right of medical science 
 in these studies belong to it by reason of the high aim of all 
 human inquiry after truth. 
 
 The author would take to himself the words of Tardieu 
 (" Des attentats aux moeurs"): "Aucune misere physique on 
 morale, aucune plaie, quelque corrompue qu'elle soit, ne doit 
 effrayer celui qui s'est voue a la science de I'homme et le min- 
 istere sacre du medecin, en I'obligeant a tout voir, lui permet 
 aussi de tout dire." ^ 
 
 The following pages are addressed to earnest investigators 
 in the domain of natural science and jurisprudence. In order 
 that unqualified persons should not become readers, the author 
 saw himself compelled to choose a title understood only by the 
 learned, and also, where possible, to express^ himself in terminis 
 tecJinicis. It seemed necessary also to give certain particularly 
 revolting portions in Latin ^ rather than in German. 
 
 It is hoped that this attempt to present to physician and 
 jurist facts from an important sphere of life will receive kindly 
 acceptance and fill an actual hiatus in literature; for, with the 
 exception of certain single descriptions and cases, the literature 
 presents only the writings of Moreau and Tarnowsky, which 
 cover but a portion of the field.^ 
 
 * " No physical or moral misery, no sufferina;, however corrupt it may be, should 
 frighten him who has devoted himself to a knowledge of man and the sacred ministry of 
 medicine ; in that he is obliged to see all things, let him be permitted to say all things." 
 
 2 Tire Latin is left untranslated. 
 
 ' The works of Moll and von Schrenck-Notzing have since appeared. — Trans.
 
 TRANSLATOR'S PREFACE. 
 
 The distinguished author of " Psychopathia Sexualis " 
 speaks for himself and his work in its preface ; but there are 
 not wanting others to speak for him. 
 
 Dr. A. von Schrenck-Notzing, of Munich, writes ^ : — 
 
 " It may be questioned whether it is justifiable to discuss 
 the anomalies of the sexual instinct apart, instead of treating 
 of them in their proper place in psychiatry. As a rule, they 
 are certainly only symptoms of a constitutional malady, or of a 
 weakened state of the brain, which manifest themselves in the 
 various forms of sexual perversion. 
 
 " Moreover, attention has been directed to the baneful influ- 
 ence possibly exerted by such publications as ' Psychopathia 
 Sexualis.' To be sure, the appearance of seven editions of 
 that work could not be accounted for were its circulation con- 
 fined to scientific readers. Therefore, it cannot be denied that 
 a pornographic interest on the part of the public is accountable 
 for a part of the wide circulation of tlie book. But, in spite of 
 this disadvantage, the injury done by implanting knowledge of 
 sexual pathology in unqualified persons is not to be compared 
 with the good accomplished. History shows that uranism was 
 very wide-spread long before the appearance of ' Psychopathia 
 Sexualis.' The courts have constantly to deal with sexual 
 crimes in which the responsibility of the accused comes in 
 question. 
 
 "For the physician himself, sexual anomalies, treated as 
 they are in a distant manner in text-books on psychiatry, are 
 in greater part a terra incognita. Exact knowledge of the 
 causes and conditions of development of sexual aberrations, 
 
 * Die Suggestions-Therapie, etc., F. Enke, Stuttgart, 1893. 
 
 (Vii)
 
 viii translator's preface. 
 
 and of the influence on them of hereditary constitution, educa- 
 tion, the impressions of every-day life, and modern refined civil- 
 ization, is the prerequisite for a rational prophylaxis of sexual 
 aberrations, and for a correct sexual education. Without care- 
 ful study of the circumstances which attend the development of 
 sexual anomalies, we should never be in a position to use eflect- 
 ual therapeusis. The majority of these unfortunates — Krafft- 
 Ebing calls them Nature's step-children — are devoid of insight 
 into their malady ; like insane patients destitute of understand- 
 ing of the ethical development of man, they are happy in their 
 abnormal instinctive tendency. For this reason, in spite of the 
 great prevalence of uranism, very few of its subjects seek med- 
 ical treatment. While the terminal forms of sexual aberrations 
 end in asylums for the insane, the doubtful cases, in which 
 incompleteness of development or apparent viciousness render 
 correct diagnosis difficult, make up the majority. But a thorough 
 knowledge of the aberrations of the sexual instinct is absolutely 
 indispensable to the jurist. The reasons given are thus suffi- 
 ciently important to demonstrate the need of a hand-book on 
 ' psychopathia sexualis.' " 
 
 These words also hold true for English-speaking physicians 
 and jurists, — who can scarcely fail to welcome the translation 
 of a work so systematic and comprehensive as " Psychopathia 
 Sexualis " ; a work conceived and executed in the highest scien- 
 tific and humane spirit ; a work which not only broadens and 
 systematizes our knowledge of psycho-sexual phenomena, but also 
 demonstrates, in the results of hypnotic suggestion, how impor- 
 tant mental therapeusis must ultimately become in the hands of 
 the physician ; a work which is a trustworthy guide in the 
 study of the concrete case of sexual crime, and a philosophical 
 treatise on the inter-relations of sexual criminality, disease, and 
 criminal anthropology. 
 
 The difficulties of translation have not been slight; but 
 minor errors cannot destroy the author's meaning. 
 
 For much encouragement in the work of translation my 
 gratitude to Dr. James G. Kiernan and Dr. G. Frank Lydston, 
 of Chicago, both well-known investigators in this domain of
 
 translator's preface. ix 
 
 psychopathology, is here expressed ; and to Dr. William A. 
 Stone, Assistant Superintendent at the Michigan Asylum, Kal- 
 amazoo, I am greatly indebted for assistance in the preparation 
 of the manuscript. 
 
 Charles Gilbert Chaddock. 
 
 St. Louis, Mo., 
 
 November, 1892.
 
 TABLE OF CONTENTS. 
 
 PAGE 
 
 I. Fragment of a Psychology of the Sexual Life, ... 1 
 
 Power of the sexual instinct, 1 
 
 Sexuality as the foundation of ethical feeling, .... 1 
 
 Love as a passion, 2 
 
 History of development of sexuality, 2 
 
 Modesty, 2 
 
 Christianity, 4 
 
 Monogamy, 4 
 
 Woman's place in Islam, 5 
 
 Sensuality and morality, 5 
 
 Decadence of sexual morality, 6 
 
 Development of sexual feelings in the individual ; puberty, . T 
 
 Sensuality and religious enthusiasm, ..... 9 
 
 Relations between the spheres of religion and sexuality, . . 9 
 
 Sensuality and art, 10 
 
 Idealizing tendency of first love, 11 
 
 True love, 11 
 
 Sentimentality, 11 
 
 Platonic love, 12 
 
 Love and friendship, 12 
 
 Difierence between male and female love, . . . . .13 
 
 Celibacy, 14 
 
 Unfaithfulness, 15 
 
 Marriage, 15 
 
 Desire for adornment, . . . . . . . .16 
 
 Facts of physiological fetichism, IT 
 
 Religious and erotic fetichism, 17 
 
 Eyes, odors, voices, and mental qualities as fetiches, . . 21 
 
 Hair, hand, and foot of woman as fetiches, .... 22 
 
 II. Physiology, 23 
 
 Sexual maturity, 23 
 
 Duration of sexual instinct, 23 
 
 (xi)
 
 xu 
 
 TABLE OF CONTENTS. 
 
 Sexual sense, 
 
 Localization (?), 
 
 Physiological development of sexuality, 
 Erection ; erection-centre, . 
 Sexuality and the olfactory sense. 
 Flagellation an excitant of sexual desire. 
 Sects of flagellants, .... 
 Paullini's " Flagellum Salutis," 
 Erogenous zones, .... 
 Control of the sexual instinct, . 
 Cohabitation, ..... 
 Ejaculation, 
 
 III. General Pathology, 
 
 Frequency and importance of pathological manifestations, 
 
 Schema of the sexual neuroses. 
 
 Spinal neuroses. 
 
 Cerebral neuroses, 
 
 Paradoxia sexualis, . 
 
 Anaesthesia sexualis (congenital). 
 
 Anaesthesia sexualis (acquired), 
 
 Hyperaesthesia sexualis, 
 
 Paraesthesia sexualis. 
 
 Perversion and perversity, 
 
 Sadism, .... 
 
 An attempt to explain sadism. 
 
 Sadistic lust-murder, . 
 
 Anthropophagy, 
 
 Violation of corpses, . 
 
 Injury of women. 
 
 Defilement of women, 
 
 Symbolic sadism, 
 
 Sadism with any object. 
 
 Whipping of boys. 
 
 Sadistic acts with animals, 
 
 Sadism in woman, 
 
 Mosochism, 
 
 Relation of passive flagellation to masochism,
 
 TABLE OF CONTENTS. 
 
 Ideal masochism, 
 
 Symbolic masochism, 
 
 Rousseau, . ' , 
 
 Larvated masochism, . 
 
 Feminine masochism, . 
 
 An attempt to explain masochism. 
 
 Masochism and sadism, 
 
 Fetichism, 
 
 Part of the female body as a fetich, 
 
 Female attire as a fetich, , 
 
 Special materials as fetiches, 
 
 Contrary sexual instinct, or homo-sexuality, 
 
 Acquired homo-sexuality, . 
 
 Simple reversal of sexual feeling. 
 
 Eviration and defemination. 
 
 Transition to metamorphosis sexualis paranoi 
 
 Metamorphosis sexualis paranoica, 
 
 Congenital homo-sexuality, 
 
 Psychical hermaphroditism, 
 
 Urnings, 
 
 Effemination and viraginity. 
 
 Androgyny and gynandry. 
 
 Diagnosis, prognosis, and" therapy of contrary 
 
 ica 
 
 sexuality. 
 
 IV. Special Pathology, 
 
 Pathological sexuality in the various forms of mental dis 
 
 Imbecility, 
 
 Dementia, . 
 
 Paretic dementia, 
 
 Epilepsy, . 
 
 Periodical insanitj'^, 
 
 Psychopathia sexualis periodica 
 
 Mania, .... 
 
 Satyriasis and nymphomania, 
 
 Melancholia, 
 
 Hysteria, .... 
 
 Paranoia, .... 
 
 Xlll 
 
 PAGE 
 
 115 
 116 
 119 
 123 
 13t 
 139 
 148 
 152 
 151 
 167 
 180 
 185 
 188 
 191 
 197 
 202 
 216 
 222 
 230 
 255 
 279 
 304 
 319 
 
 358 
 
 358 
 359 
 361 
 363 
 364 
 370 
 371 
 372 
 373 
 374 
 375 
 376
 
 xiv TABLE OF CONTENTS. 
 
 PAGE 
 
 V. Pathological Sexuality in its Legal Aspects, . . . 3t8 
 
 Dangers to society from sexual crimes, 378 
 
 Increase of sexual crimes, ....... 378 
 
 Causes, 378 
 
 Defective appreciation of such crimes by jurists, . . . 379 
 Conditions necessary to remove legal responsibility, . .381 
 
 Exhibition, 382 
 
 Violation of statues, 396 
 
 Rape and lust-murder, 397 
 
 Bodily injury, injury to property, and torture of animals de- 
 pendent on sadism, 401 
 
 Eetichism, 401 
 
 Yiolation of children, 402 
 
 Sodomy, ..." 404 
 
 Pederasty, 408 
 
 Cultivated pederasty, 414 
 
 Social life of pederasts, 415 
 
 Ball of the woman-haters, . . 417 
 
 Paedicatio mulierum, ......... 420 
 
 Lesbian love, 428 
 
 Necrophilia, 430 
 
 Incest, 431 
 
 Immoral acts with persons in the care of others, , . . 432
 
 I. A FRAGMENT 
 
 OF A 
 
 PSYCHOLOGY OF THE SEXUAL LIFE. 
 
 The propagation of the human species is not committed 
 to accident or to the caprice of the individual, but made secure 
 in a natural instinct, which, with all-conquering force and 
 might, demands fulfillment. In the gratification of this natural 
 impulse are found not only sensual pleasure and sources of 
 physical well-being, but also higher feelings of satisfaction in 
 perpetuating the single, perishable existence, by the transmission 
 of mental and physical attributes to a new being. In coarse, 
 sensual love, in the lustful impulse to satisfy this natural instinct, 
 man stands on a level with the animal ; but it is given to him 
 to raise himself to a height where this natural instinct no 
 longer makes him a slave : higher, nobler feelings are awakened, 
 which, notwithstanding their sensual origin, expand into a 
 world of beauty, sublimity, and morality. 
 
 On this height man overcomes his natural instinct, and 
 from an inexhaustible spring draws material and inspiration 
 for higher enjoymeiit, for more earnest work, and the attainment 
 of the ideal. Maudsley {Deutsche Klinik, 1873, 2, 3) rightly 
 calls the sexual feeling the foundation for the development of 
 the social feeling. " Were man to be robbed of the instinct 
 of procreation and all that arises from it mentally, nearly all 
 poetry and, perhaps, the entire moral sense as well, would be 
 torn from his life." 
 
 Sexuality is the most powerful factor in individual and 
 social existence; the strongest incentive to the exertion of 
 strength and acquisition of property, to the foundation of a 
 home, and to the awakening of altruistic feelings, first for a 
 person of the opposite sex, then for the offspring, and, in a 
 wider sense, for all humanity. 
 
 (1)
 
 2 PSYCHOPATHIA SEXUALIS. 
 
 Thus all ethics and, perhaps, a good part of sDsthetics 
 and religion depend upon the existence of sexual feeling. 
 
 Though the sexual life leads to the highest virtues, even to 
 the sacrifice of the ego, yet in its sensual force lies also the danger 
 that it may degenerate into powerful passions and develop the 
 grossest vices. 
 
 Love as an unbridled passion is like a fire that burns 
 and consumes everything ; like an abyss that swallows all, — 
 honor, fortune, well-being. 
 
 It seems of high psychological interest to trace the devel- 
 opmental phases through which, in the course of the evolution 
 of human culture to the morality and civilization of to-day, the 
 sexual life has passed.^ On primitive ground the satisfaction 
 of the sexual appetite of man seems like that of the animal. 
 Openness in the sexual act is not shunned ; man and woman 
 are not ashamed to go naked. To-day we see savages in this 
 condition (comp. Ploss, "Das Weib," p. 196, 1884); as, for 
 example, the Australians, the Polynesians, and the Malays of 
 the Phillipines. The female is the common property of the 
 males, the temporary booty of the strongest, who strive for the 
 possession of the most beautiful of the opposite sex, thus carry- 
 ing out instinctively a kind of sexual selection. 
 
 Woman is a movable thing, a ware, an object of bargain 
 and sale and gift ; a thing to satisfy lust and to work. 
 
 The appearance of a feeling of shame before others in 
 the manifestation and satisfaction of the natural instinct, and 
 modesty in the intercourse of the sexes, form tlie beginning of 
 morality in the sexual life. From this arose the effort to con- 
 ceal the genitals ("And they knew that they were naked") 
 and the secret performance of the sexual act. 
 
 The development of this degree of culture is favored hy 
 the rigors of climate and the necessity for complete protection 
 of the body thus entailed. Thus in part the fact is explained 
 that among northern races modesty may be proved anthropo- 
 logically earlier than among southern races. 
 
 A further stage in the development of culture in sexual 
 
 * Comp. Lombroso, " The Criminal."
 
 PSYCHOLOGY OF THE SEXUAL LIFE. 3 
 
 life is marked when the female ceases to be a movable thin^. 
 She becomes a person ; and if still for a long time placed ftir 
 below the male socially, yet the idea that the right of disposal 
 of herself and her favors belongs to her is developed. 
 
 Thus she becomes the object of the male's wooing. To 
 the barbarous sensual feeling of sexual desire the beginnings of 
 ethical feeling are added. The instinct is intellectualized. Pro|)- 
 erty in women ceases to exist. Individuals of the opposite sexes 
 feel themselves drawn toward each other by mental and physi- 
 cal qualities, and show love for each other only. At this stage 
 woman has a feeling that her charms belong only to tlie man 
 of her choice, and wishes to conceal them from others. Thus, 
 by the side of modesty, the foundations of cliastity and faith- 
 fulness — as long as the bond of love lasts — are laid. 
 
 Woman attains this degree of social elevation earlier 
 when, at the transition from nomadic life to a state of fixed 
 habitation, man obtains a house and home, and the necessity 
 arises for him to possess in woman a companion for the house- 
 hold, — a housewife. 
 
 Among the nations of the East, the Egyptians, the Israelites, 
 and the Greeks, and among those of the West, the Germans, 
 early attained this stage of culture. Among all these races, at 
 this stage of advancement, the esteem in which virginity, 
 chastity, modesty, and sexual faithfulness are held is in marked 
 contrast with other nations which offer the female of the house 
 to the guest for his sexual enjoyment.^ 
 
 That this stage in the culture of sexual morality is quite 
 high and makes its appearance much later than other de\elop- 
 mental forms of culture — as, for example, aesthetics — is seen 
 from the condition of the Japanese, with whom it is the custom 
 to marry a woman only after she has lived for a year in the 
 tea-houses (which correspond with European houses of prosti- 
 tution), and to whom the nakedness of women is nothing shock- 
 ing. At all events, among the Japanese every unmarried woman 
 can prostitute herself without lessening her value as a future 
 wife, — a proof that with this remarkable people woman possesses 
 
 1 Comp. Westermarck, " History of Humau Marriage." McMillan & Co., 1891.
 
 4 PSYCHOPATHIA SEXUALIS. 
 
 no ethical worth, but is valued in marriage only as a means of 
 enjoyment, procreation, and work. 
 
 Christianity gave the most powerful impulse to the moral 
 elevation of the sexual relations by raising woman to social 
 equality witli man and elevating the bond of love between 
 man and woman to a religio-moral institution/ 
 
 The fact that in higher civilization human love must be 
 monogamous and rest on a lasting contract was thus recognized. 
 If nature does no more than provide for procreation, a common- 
 wealth (family or state) cannot exist without a guaranty that 
 the offspring shall flourish physically, morally, and intellectually. 
 Christendom gained both mental and material superiority over 
 
 1 This generally entertained idea, also held by many historians, requires some limita- 
 tion, in that the symbolic and sacramental character of marriage was first made clear and 
 unequivocal by the Council of Trent, even though there was ever in the spirit of Christianity 
 that which would free woman and raise her from the inferior position occupied by her in the 
 ancient world and the Old Testament. 
 
 That this took place so late may well be due in part to the traditions of Genesis of 
 the secondary creation of woman from the rib of man, and of her part in the Fall, and the 
 consequent curse : " Thy will shall be to thy husband." Since the Fall, for which the Old 
 Testament made woman responsible, became the corner-stone of the fabric of church- 
 teachings, the wife's social position could but remain inferior until the spirit of Christianity 
 had gained a victory over tradition and scholasticism. 
 
 It is remarkable that, with the exception of the interdiction of putting away a 
 wife (Matt, xix, 9), the gospels contain nothing favoring woman. Gentleness toward the 
 adulteress and the repentant Magdalene does not aflect the position of the wife in itself. 
 The Epistles of Paul specifically declare that the position of woman shall not be altered 
 (II Corinth, xi, 3-13 ; Ephes. v, 23 : " Wives, submit yourselves unto your husbands ;" and 
 33, " And the wife see that she reverence her husband "). 
 
 Passages in Tcrtullian show how the Fathers of the Church were prejudiced against 
 woman by Eve's guilt : " Woman, thou shouldst forever go in sorrow and rags, thy eyes 
 filled with tears 1 Thou hast brought man to the ground 1" St. Hierouymus lias nothing 
 good to say of woman. He says, " Woman is a door for the devil, a way to evil, the sting 
 of the scorpion." (" De cultu feminarum," i, 1.) 
 
 Canonical Law declares : " Only man was created in the image of God, not woman ; 
 therefore, woman should serve him and be his maid 1" 
 
 The Provincial Council of Macon, in the sixth century, earnestly debated the ques- 
 tion whether woman had a soul. 
 
 The effect of these ideas in the Church on the peoples embracing Christianity was 
 direct. Among the Germans, after the acceptance of the new faith, for the foregoing reason, 
 the weregild for a wife — the simple expression of her value — decreased (J. Falke, " Die 
 ritterliche Gesellschaft," p. 49. Berlin, 1863). Concerning the value of each sex among 
 the Jews, vide Leviticus, xxvii, 3 and 4. 
 
 Moreover, polygamy, which is expressly recognized in the Old Testament (Deut. xxl, 
 15), is nowhere explicitly interdicted in the New Testament. Christian princes {e.g., tlie 
 Marovingian kings, Clotar I, Childebert I, Pepin I, and many of the royal Franks) lived in 
 polygamy; and at that time the Church made no opposition to it (Weinhold, " Die deut- 
 schen Frauen Im Mlttelalter," ii, p. 1.5). Comp. also linger, " Die Ehc," etc., and the excel- 
 lent work by Louis Bridel, " La femme et le droit," Paris, 1884,
 
 PSYCHOLOGY OF THE SEXUAL LIFE. 5 
 
 the polygamous races, especially Islam, through the equalization 
 of woman and man, and by establishing monogamous marriage 
 and securing' it by legal, religious, and moral ties. 
 
 If Mohammed was actuated by a desire to raise woman 
 from her place as a slave and means of sensual gratification to 
 a higher social and matrimonial plane, nevertheless, in the 
 Mohammedan world woman remained far below man, to whom 
 alone divorce was allowed and also made very easy. 
 
 Islam kept woman from any participation in public life 
 under all circumstances, and thus hindered her intellectual and 
 moral development. In consequence of this the Mohammedan 
 woman has ever remained essentially a means of sensual gratifi- 
 cation and procreation ; while, on the other hand, the virtues 
 and capabilities of the Christian woman, as housewife, educator 
 of children, and equal companion of man, have been allowed 
 to unfold in all their beauty. Islam, with its polygamy and 
 harem-life, is glaringly contrasted with the monogamy and 
 family life of the Christian world. 
 
 The same contrast is apparent in a comparison of the two 
 religions with reference to the conception of the hereafter. The 
 picture of eternity seen by tlie faith of the Christian is that of a 
 paradise freed from all earthly sensuality, promising the purest 
 of intellectual happiness ; the fiincy of the Mussulman fills the 
 future life with the delights of a harem full of houris. 
 
 In spite of all the aids which religion, law, education, and 
 morality give civilized man in the bridling of his passions, he is 
 always in danger of sinking from the clear height of pure, chaste 
 love into the mire of common sensuality. 
 
 In order to maintain one's self on such a height, a con- 
 stant struggle between natural impulses and morals, between 
 sensuality and morality, is required. Only characters endowed 
 with strong wills are able to completely emancipate themselves 
 from sensuality and share in that pure love from which spring 
 the noblest joys of human life. 
 
 It is yet questionable whether, in the course of the later 
 centuries, mankind has advanced in morality. It is certain, 
 however, that the race has become more modest ; and this phe-
 
 6 PSYCHOPATHIA SEXUALIS. 
 
 iiomenon of civilization — this hiding of the animal propensities — 
 is, at least, a concession that vice makes to virtue. 
 
 From a reading of Scherr's works (" History of German 
 Civilization ") one would certainly gain the impression that, in 
 comparison with those of the Middle Ages, our own ideas of 
 morals have become refined, even when it must also be allowed 
 that in many instances finer manners, without greater morality, 
 have taken the place of earlier obscenity and coarseness of 
 expression. 
 
 When widely separated periods of history are compared, no 
 doubt is left that public morality, in spite of occasional temporary 
 retrogression, makes continuous progress, and tliat Christianity is 
 one of the most powerful of the forces favoring moral progress. 
 
 To-day we are far beyond the sexual conditions which, as 
 shown in the sodomitic worship of the gods, in the life of the 
 ])eople, and in the laws and religious practices, existed among the 
 ancient Greeks, — to say nothing of the worship of Phallus and 
 Priapus among the Athenians and Babylonians, of the bacchanals 
 of ancient Rome, and the prominent place prostitutes took among 
 these peoples. In the slow and often imperceptible progress 
 which human morality makes there are variations or fluctuations, 
 just as in the individual sexuality manifests an ebb and flow. 
 
 Periods of moral decadence in the life of a people are 
 always contemporaneous with times of effeminacy, sensuality, 
 and luxury. These conditions can only be conceived as occur- 
 ring witli increased demands upon the nervous system, which 
 must meet these requirements. As a result of increase of 
 nervousness, there is increase of sensuality, and, since this leads 
 to excesses among tlie masses, it undermines the foundation of 
 society, — the morality and purity of family life. When this is 
 destroyed by excesses, unfaithfulness, and luxury, then the de- 
 struction of the state is inevitably compassed in material, moral, 
 and political ruin. Warning examples of this character are 
 presented by Rome, Greece, and France under Louis XIV 
 and XV.^ In such times of political and moral destruction 
 
 1 Comp. Fiiecllander " Sittengeschichte Roms." Wiedemeister, " Der Casaren- 
 wahnsinn." Suetonius. Moreau, " Des aberrations du sens g6n6sique."
 
 PSYCHOLOGY OF THE SEXUAL LIFE. 7 
 
 monstrous perversions of the sexual life were frequent, which, 
 however, may in part be referred to psycho-pathological or, 
 at least, neuro-pathological conditions existing in the people. 
 
 It is shown by the history of Babylon, Nineveh, Rome, 
 and also by tlie " mysteries " of life in modern Capitals, that 
 large cities are the breeding-places of nervousness and degen- 
 erate sensuality. The fact which may be learned from reading 
 Floss's work is remarkable, viz., that perversion of the sexual 
 instinct (save among tlie Aleutians, and in the form of mastur- 
 bation among the females of the East and the Nama Hottentots) 
 does not occur in uncivilized or half-civiUzed races.^ 
 
 The study of the sexual life in the individual must begin 
 at its development at puberty, and follow it through its different 
 phases to the extinction of sexual feelings. In liis " Physiology 
 of Love," Mantegazza describes the longings and impulses of 
 awakening sexual life, of wliich presentiments, indefinite feel- 
 ings, and impulses have existed long before the epoch of 
 puberty. This epoch is, physiologically, the most important. 
 In tlie abundant increase of feelings and ideas wliich it en- 
 o-enders is manifested the significance of the sexual factor in 
 
 mental life. 
 
 These impulses, at first vague and incomprehensible, arising 
 from the sensations which are awakened by organs which were 
 previously undeveloped, are accompanied by a powerful excita- 
 tion of the emotions. The psychological reaction of the sexual 
 impulse at puberty expresses itself in a multitude of manifesta- 
 tions which have in common only the mental condition of emo- 
 tion and the impulse to express in some way, or render objective, 
 the strange emotionality. Religion and poetry He close to it, 
 which, after the time of sexual development is past and these 
 originally incomprehensible feelings and impulses have cleared 
 up, receive ^wwerful incentives from the sexual sphere. He 
 who doubts this has only to think how often religious enthusiasm 
 occurs at the time of puberty ; how frequent sexual episodes are 
 
 1 These statements, however, are opposed to Friedreich ("Hdb. d. gerlchtsarztl 
 Praxis," 1, p. 371, 18-43), and also Lombroso (op. cit., p. 42), according t« whom pederasty 
 is very frequent among the uncivilized Americans.
 
 8 PSYCHOPATHIA SEXUALIS. 
 
 in the lives of the saints;^ how powerfully sensuality expresses 
 itself in the histories of religious fanatics ; and in what revolting 
 scenes, true orgies, the religious festivals of antiquity, no less 
 tlian the " meetings " of certain sects in modern times, express 
 themselves, — to say nothing of the lustful mysteries which char- 
 acterized the cults of the ancients. On the other hand, we see 
 that unsatisfied sensuality very frequently finds an equivalent in 
 religious enthusiasm.^ 
 
 This relation between religious and sexual feeling is also 
 shown on the basis of unequivocal psycho-pathological states. 
 It suffices to recall how intense sensuality makes itself manifest 
 in the clinical histories of many religious maniacs ; the motley 
 mixture of religious and sexual delusions that is so frequently 
 observed in psychoses {e.g., in maniacal women, who think they 
 are or will be the Mother of God), but particularly in mastur- 
 batic insanity ; and, finally, the sensual, cruel self-punishments, 
 injuries, self-castrations, and even self-crucifixions resulting from 
 abnormal sexual-religious feeling. 
 
 Any attempt to explain the relations between religion and love has 
 diflieulties to encounter. Many analogies present themselves. The feeling 
 of sexual attraction and religious feeling (considered as a psychological 
 fact) consist of two elements. 
 
 In religion the primary element is a feeling of dependence, — a fact 
 which Schleiermacher recognized long before the later studies in anthro- 
 pology and ethnography, founded on the observation of primitive condi- 
 tions, had led to the same conclusion. It is only at a higher stage of cul- 
 ture that the second and essentially ethical element — love of God — enters 
 
 1 Comp. Friedreich, "gerichU. Psychologic, " p. 389, who has collected numerous 
 examples. Thus the nun Blanbekin was always troubled with the thought about what had 
 become of the part lost at the circumcision of Christ. Veronica Juliani, canonized by Pope 
 Pius II, in memory of the divine lion, took an actual lion in her bed and kissed it, and let 
 it suck from her breast ; and even secreted a few drops of milk for it. St. Catherine, of 
 Genoa, often burned with such inward Are that, in order to cool herself, she would He down 
 on the ground and cry " Love, love, I can endure it no longer 1 " At the same time she 
 felt a peculiar inclination for her confessor. One day she lifted his hand to her nose and 
 smelled an odor wliich penetrated to her heart, " a heavenly perfume, so delightful that it 
 would wake the dead." St. Armelle and St. Elizabeth were troubled with a similar 
 longing for the child Jesus. The temptations of St. Anthony, of Padua, are well known. 
 An old prayer is significant: " O, that I had found thee. Holy Emanuel ; O, that I h.ad thee 
 in my bed to bring delight to body and soul. Come and be mine, and my heart shall be 
 thy resting-place." 
 
 2 Comp. Friedreich, " Diagnostik der psych. Krankheiten," p. 247 u.ff. ,- Neumann, 
 "Lehrb.d. Psychiatric," p. 80.
 
 PSYCHOLOGY OF THE SEXUAL LIFE. ' 9 
 
 into religious feeling. In the place of the evil spirits of the primitive 
 peoples came the two-faced — now kind, now angry — creations of the more 
 complicated mythologies, until, finally, the God of love, as the giver of 
 eternal happiness, is reverenced, whether this be hoped for from Jehovah, 
 as a blessing on earth ; from Allah, as a ph^'sical blessing in Paradise ; 
 from Christ, as eternal bliss in heaven ; or as the Nirvana of the Buddhists. 
 
 In sexual desire, love, the expectation of unbounded hapjjiness is the 
 primary element. The feeling of dependence is of secondar^^ develop- 
 ment. The nucleus of this feeling exists in both parties, but it may re- 
 main undeveloped in one. As a rule, owing to her passive part in 
 procreation and social conditions, it is more pronounced in woman ; but 
 excei)tionally this is true of men having minds that approach the feminine 
 type. 
 
 In both the religious and sexual spheres love is m^^stical, trans- 
 cendental. In sexual love the real purpose of the instinct, the propaga- 
 tion of the species, does not enter into consciousness ; and the strength 
 of the desire is greater than any that consciousness of purpose could 
 create. In religion, however, the good sought and the object of devotion 
 are of such nature that they cannot become a part of empirical knowledge. 
 Therefore, both mental processes give unlimited range to the imagination. 
 
 But both have an immortal object, in as far as the bliss which the 
 sexual sentiment creates in fancy seems incomparable and infinite in con- 
 trast with all other pleasurable feelings; and the same is true of the 
 promised blessings of faith, which are conceived to be eternal and supreme. 
 
 From the correspondence between the two states of conscious- 
 ness, with reference to the commanding importance of their objects, it 
 follows that they both often attain an intensity that is« irresistible, and 
 which overcomes all opposing motives. Owing to their similarity in that 
 their objects cannot be attained, it follows that both easily degenerate 
 into silly enthusiasm, in which the intensity of feeling far surpasses the 
 clearness and constancy of the ideas. In both cases, in this enthusiasm, 
 with the expectation of a happiness that cannot be attained, the necessity 
 of unconditional submission plays a part. 
 
 Owing to the correspondence in many points between these two 
 emotional states, it is clear that when they are very intense the one may 
 take the place of the other ; or one may appear by the side of the other, 
 since every intensification of one element of mental life also intensifies its 
 associations. The constant emotion thus calls into consciousness now 
 one and now the other of the two series of ideas with which it is con- 
 nected. Either of these mental states may become transformed into the 
 impulse to cruelty (actively exercised or passively suffered). 
 
 In the religious life this is expressed by sacrifice. Primarily this is 
 done with the idea that the victim is materially enjoyed by the deity ; 
 then, in reverence, as a sign of submission, as a tribute ; and, finally, with 
 the belief that sins and transgressions against the deity are thus atoned
 
 10 PSYCHOPATHIA SEXUALIS. 
 
 for and blessing obtained. If, however, the offering consist of self-punish- 
 ment, which occurs in all religions, in individuals of very excitable re- 
 ligious nature, it serves not only as a symbol of submission and as an 
 equivalent in the exchange of present pain for future bliss, but everything 
 that is thought to come from the deity, all that happens in obedience to 
 divine mandate or to the honor of the godhead, is felt directly as pleasure. 
 Thus religious enthusiasm leads to ecstasy, to a condition in which con- 
 sciousness is so preoccupied with feelings of mental pleasure that the 
 concept of suffering endured can only be apperceived without its painful 
 quality. 
 
 The exaltation of religious enthusiasm may lead actively to pleasure 
 in the sacrifice of another, if pity be overcompen sated by feelings of 
 religious pleasure. 
 
 Sadism, and particularly masochism (v. infra), show that in the 
 sphere of the sexual life there may be similar phenomena. Thus the 
 well-established relations between religion, lust, and cruelty ^ may be 
 comprehended in the following formula : States of religious and sexual 
 excitement, at the acme of their development, maj^ correspond in the 
 amount and quality of excitement, and, therefore, under favoring cir- 
 cumstances, one may take the place of the other. Both, in pathological 
 conditions, may become transformed into cruelty. 
 
 The sexual factor proves to be no less influential in awaken- 
 ing gesthetic feelings. AVliat would poetry and art be without a 
 sexual foundation 1 In (sensual) love is gained that warmth of 
 fancy witliout which a true creation of art is impossible ; and in 
 the fire of sensual feelings its glow and warmth are preserved. 
 It may thus be luiderstood why great poets and artists have 
 sensual natures. 
 
 This world of ideals reveals itself with the inception of the 
 processes of sexual development. He who, at this period of life, 
 cannot become enthusiastic for all that is great, noble, and 
 beautiful, remains a Philistine all his life. At this epoch does 
 not the least of natural poets forge verses ] 
 
 At the limits of physiological reaction there are events 
 which take place at the time of puberty in which these obscure 
 feelings of longing express themselves in paroxysms of despair 
 
 1 The relation of this trio finds its expression not only in the events of real life, as 
 above indicated, but also in romance, and even in the sculpture of degenerate eras. As an 
 example we may point to the group of St. Theresa, by Bernini, who " sinks in an hysterical 
 faint on a marble cloud, with an amorous angel plunging the arrow (of divine love) into 
 her heart" (Llibke).
 
 PSYCHOLOGY OF THE SEXUAL LIFE. 11 
 
 of self and tlie world, which may go on to tcedium vitce, and are 
 often accompanied by a desire to do harm to others (weak 
 analogies of a psychological connection between lust and 
 cruelty). 
 
 Youthful love has a romantic, idealistic character. It 
 elevates the beloved object to apotheosis. In its inception it is 
 platonic, and turns to forms of poetry and romance. With the 
 awakening of sensuality there is danger that this idealizing 
 power may be brought to bear upon persons of the opposite sex 
 who are mentally, physically, and socially of inferior station. 
 Thus there may occur messaUiances, seductions, and errors, with 
 the whole tragedy of a passionate love that comes in conflict with 
 the dictates of social position and prospects, and sometimes 
 terminates in suicide or double suicide. 
 
 Over-sensual love can never be lasting and true. For this 
 reason the first love is, as a rule, very fleeting ; because it is nothing 
 else than the flare of a passion, the flame of a Are of straw. 
 
 Only the love tliat rests Tipon a recognition of the social 
 qualities of the beloved person, only a love which is willing not 
 only to enjoy present pleasures, but to bear suftering for the 
 beloved object and sacrifice all, is true love. The love of a 
 strongly constituted man shrinks before no difliculties or dangers 
 in order to gain and keep possession of its object. 
 
 Love expresses itself in acts of heroism and daring. Such 
 love is in danger, under certain circumstances, of becoming 
 criminal, if moral principles be weak. Jealousy is an ugly spot 
 in this love. The love of a weekly constituted man is senti- 
 mental. It sometimes leads to suicide when it is not returned 
 or meets with obstacles, while, under like conditions, the strongly 
 constituted man may become a criminal. 
 
 Sentimental love is in danger of becoming a caricature, i.e., 
 when the sensual element is weak (the Knight of Toggenburg, 
 Don Quixote, many minnesingers and troubadours of the Middle 
 Ages). 
 
 Such love is flat and soft, and may be even silly ; but tlie 
 true expression of this powerfid feeling awakens appropriate 
 pity, respect, or sorrow in the hearts of others.
 
 12 PSYCOPATHIA SEXUALIS. 
 
 Frequently this weak love expresses itself in equivalents — 
 in poetry, which, however, under such circumstances, is effemi- 
 nate ; in aesthetics which are overdrawn ; in religion, in which 
 it gives itself up to mysteries and religious enthusiasm ; or, 
 where there is a more powerful sensual foundation, founds sects 
 or expresses itself in religious insanity. The immature love 
 of the age of puberty has something of all this in it. Of all the 
 poems and rhymes written at this time of life, they only are 
 readable that are the product of poets divinely endowed. 
 
 Notwithstanding all the ethics which love requires in order 
 to develop into its true and pure form, its strongest root is still 
 sensuality. Platonic love is an impossibility, a self-deception, a 
 false designation for related feelings. 
 
 In as far as love rests upon sensual desire, it is only con- 
 ceivable in a normal way as existing between individuals of 
 opposite sex and capable of sexual intercourse. If these con- 
 ditions are wanting or destroyed, then, in the place of love, 
 comes friendship. 
 
 The role which the retention of sexual functions plays in 
 the case of a man, both in originating and retaining the feeling 
 of self-respect, is remarkable. In the deterioration of manliness 
 and self-confidence which the onanist, in his weakened nervous 
 state, and tlie man that has become impotent, present, may be 
 estimated the significance of this factor. 
 
 Gyurkovechky (miinnl. Inipotenz. Vienna, 1889) sa^ys, very justly, 
 that old and young men essentially differ mentally, on account of the con- 
 dition of their virility, and that impotence has a detrimental effect upon 
 the feeling of well-being, mental freshness, activity, self-confidence, and the 
 play of fancy. This loss becomes the more important the younger a man 
 is when he loses his virility and the more sensuall3' he was constituted. 
 
 Under such circumstances a sudden loss of virility may induce severe 
 melancholia, and even lead to suicide. For such natures life without love 
 is unbearable. 
 
 But, also, in cases where the reaction is not so deep, the man bereft 
 of his virility is morose and spiteful, egotistic, jealous, contrary, listless, 
 has but little self-respect or sense of honor, and is cowardly. Analogies 
 are seen in the Skopzens,^ who, after their castration, change for the 
 worse. 
 
 * A Russian religious Beet.
 
 PSYCHOLOGY OF THE SEXUAL LIFE. 13 
 
 The loss of virility is still more noticeable in certain v,eekly con- 
 etituted individuals, where it expresses itself in formal effemination (v. 
 infi'a). 
 
 In a woman who has become a matron the condition is of 
 much less importance psychologically, thouij;h it is noticeable. 
 If the past period of sexual life has been satisfactory, if chil- 
 dren delight the heart of the aging mother, tlien she is scarcely 
 conscious of the change of her personality. 
 
 The situation is different, however, where sterility or circum- 
 stances have kept a woman from the performance of her natural 
 functions and denied her that happiness. 
 
 These facts place in a clear light the differences which exist 
 between man and woman in the psychology of the sexual life, 
 and in all the sexual functions and desires. 
 
 Undoubtedly man has a much more intense sexual appetite 
 than woman. As a result of a powerful natural instinct, at a 
 certain age, a man is drawn toward a woman. lie loves sen- 
 sually, and is influenced in his choice by physical beauty. In 
 accordance with the nature of this powerful impulse, he is 
 aggressive and violent in his wooing. At the same time, this 
 demand of nature does not constitute all of his mental existence. 
 AVhen his longing is satisfied, love temporarily retreats behind 
 other vital and social interests. 
 
 With a woman it is quite otherwise. If she is normally 
 developed mentally, and well bred, her sexual desire is small. 
 If this were not so the whole world would become a brothel 
 and marriage and a family impossible. It is certain that the 
 man that avoids women and the woman that seeks men are 
 abnormal. 
 
 Woman is wooed for her favor. She remains passive. 
 This lies in her sexual organization, and is not foiuided merely 
 on the dictates of good breeding. 
 
 Nevertheless, the sexual sphere occupies a mucli larger place 
 in the consciousness of woman than in that of man. The need 
 of love in her is greater than in man, and is continual, not inter- 
 mittent ; but this love is rather more spiritual than sensual. 
 While a man loves a woman first as wife and then as mother of
 
 14 PSYCHOPATHIA SEXUALIS. 
 
 his children, a Avoman is primarily conscious of a man as the 
 father of her children and then as husband. In the choice of a 
 life-companion a woman is influenced much more by the mental 
 than the physical qualities of a man. When she has become 
 a mother she divides her love between child and husband. 
 Sensuality disappears in the mother's love. Thereafter, in 
 marital intercourse, the wife finds less sensual satisfaction than 
 proof of the love of her husband. 
 
 A woman loves with her whole soul. To her love is life ; 
 to a man it is the joy of life. To him misfortune in love is a 
 Avound ; but it costs a woman her life, or at least her happiness. 
 A psychological question worthy of consideration is whether a 
 woman can truly love twice in her life. Certainly the mental 
 inclination of woman is monogamous, while in man it is 
 polygamous. 
 
 The weakness of men in comparison with women lies in the 
 great intensity of their sexual desires. Man becomes dependent 
 upon woman, and the more, the weaker and more sensual he 
 becomes; and this just in proportion as he becomes neuropathic. 
 Thus may be understood the fact that, in times of efFeminateness 
 and luxury, sensuality flourishes luxuriantly. Then arises the 
 danger to society that mistresses and their dependents may rule 
 the state and compass its ruin (the mistresses of the courts of 
 Louis XIV and XV ; the prostitutes of ancient Greece). 
 
 The biographies of many statesmen of ancient and modern 
 times show that they were the instruments of women, owing to 
 their great sensuality, which had its foundation in their neuro- 
 pathic constitutions. The fact that the Catholic Church enjoins 
 celibacy upon its priests, in order to emancipate them from 
 sensuality and preserve them entirely for the purpose of their 
 calling, is an example of discerning psychological knowledge 
 of mankind ; but it is unfortunate that the priests, living in 
 celibacy, lose the elevating effect which love and matrimony 
 exert upon the development of character. 
 
 From the fact that man by nature plays the aggressive 
 role in sexual life, he is in danger of overstepping the limits 
 which morality and law have set. The unfaithfulness of a wife,
 
 PSYCHOLOGY OF TUE SEXUAL LIFE. 15 
 
 in comparison with that of a husband, is morally much more 
 weighty, and should be more severely punished legally. The 
 unfaithful wife dishonors not only herself, but also her husband 
 and her family, not to speak of the possibility o^ pater incertus. 
 Natural instinct and social position favor unfaithfulness on the 
 part of a husband, while the wife is aftbrded much protection. 
 In the case of an unmarried woman, sexual intercourse is some- 
 thing quite different from what it is in an unmarried man. Of 
 a single man society demands decency ; of a woman, also 
 chastity. In the cultivated social life of to-day, woman, occupy- 
 ing a sexual position and concerning lierself in the interests of 
 society, can only be thought of as a wife. 
 
 The aim and ideal of woman, even when she is sunken in' 
 the mire of vice, is, and remains, marriage. Woman, as Man- 
 tegazza justly remarks, desires not only satisfaction of her sexual 
 feeling, but also protection and support for herself and her chil- 
 dren. A man of right feeling, no matter how sensual he may 
 be, demands a wife that has been, and is, chaste. The emblem 
 and ornament of a woman seeking this, her only worthy purpose 
 in life, is modesty. Mantegazza finely characterizes modesty 
 as " one of the forms of psychical self-respect " in woman. This 
 is not the place for anthropological and historical consideration 
 of this, the most beautiful attribute of woman. Probably, 
 feminine modesty is an hereditarily evolved product of the 
 development of civilization.^ 
 
 In remarkable contrast with it, there is occasional exposi- 
 tion of physical charms, conventionally sanctioned by the law 
 of fashion, in which even the most discreet maiden allows her- 
 self to indulge in the ball-room. The reasons which lead to 
 this display are evident. Fortunately the modest girl is as little 
 conscious of them as of the reason for the occasionally recur- 
 ring mode of making certain portions of the body more promi- 
 nent (panniers) ; to say nothing of corsets, etc. 
 
 1 Westermarck {op. cit., p. 211), after a careful review of the evidence, says : " Tliese 
 facts appear to prove that the feeling of shame, far from being the original cause of man's 
 covering his body, is, on the contrary, a result of this custom ; and that the covering, if not 
 used as a protection from climate, owes its origin, at least in a great many cases, to the 
 desire of men and women to make themselves attractive."— Trans,
 
 16 PSYCHOPATHIA SEXUALIS. 
 
 <f- 
 
 In all times, and among all races, women show a desire to 
 adorn themselves and be charming/ In the animal kingdom 
 
 nature lias distinguished the male with the greater beauty. Men 
 designate women as the beautiful sex. This gallantry clearly 
 arises from the sensual desire of men. As long as this personal 
 adornment has a purpose only in itself, or the true psychological 
 reason of the desire to please remains unknown to the woman, 
 nothing can be said against it. AVhen it is done with knowl- 
 edge, the effort is called flirting. 
 
 Under all circumstances a dandified man is ridiculous. We 
 are accustomed to this slight weakness in a woman, and find no 
 fault with it, so long as it is but a subordinate manifestation. 
 When it has become the all-absorbing aim, the French apply to 
 it the word coquetry. 
 
 Woman far surpasses man in the natural psychology ol' 
 love, partly because, through heredity and education, her native 
 element is love ; and partly because she has finer feelings (Man- 
 tegazza). Even in a man of the very highest breeding, it cannot 
 be found objectionable that he recognizes woman as a means of 
 satisfying his natural instinct. But it becomes his duty to belong 
 only to the woman of his choice. In a civilized state this 
 becomes a binding social obligation, — marriage ; and, inasmuch 
 as the wife requires for herself and children protection and sup- 
 port, it becomes a marriage right. 
 
 It is of great importance psycliologically, and, for certain pathologi- 
 cal manifestations to be later describee', indispensable, to examine the psy- 
 chological events which draw a man and a woman together and unite them ; 
 so that, of all other persons of the same sex, only the beloved one seems 
 desirable. 
 
 If one could demonstrate design in the processes of nature, — adapta- 
 tion cannot be denied them, — the fact of fascination by a single person of 
 the opposite sex, with indifference toward all others, as it occurs between 
 true and happy lovers, would appear as a wonderful creative provision to 
 insure monogamous unions for the promotion of their object. 
 
 1 This is not literally the case. "It is expressly stated, of the women of several 
 savage peoples, that they are less desirous of self-decoration than the men." — Westermarck, 
 op. cit., p. 184. And the same writer (p. 183) says that " it is a common notion that vi^omen 
 are by nature vainer and more addicted to dressing and decorating themselves than men. 
 This certainly does pot hold good for savage and barbarous peoples in general,"— Trans.
 
 PSYCHOLOGY OF THE SEXUAL LIFE. 17 
 
 To tho scientific observer, however, this love, or " harmony of souls," 
 this " heart-bond," does not, by any means, appear as a " soul-mystery ;" 
 but, in the majority of cases, it may be referred to certain physical or 
 mental peculiarities, as the case may be, by which the attractiveness of 
 the beloved person is exerted. 
 
 Thus we speak of what is called fetich and fetichism. In the 
 term fetich we are wont to comprehend objects, or parts, or simply pecu- 
 liarities of objects, which, by virtue of associative relations to an intense 
 feeling, or to a personality or idea that awakens deep interest, exert a 
 kind of charm {^'' fetisso^''"' Portuguese), or, at least, owing to peculiar 
 individual coloring, produce a very deep impression which does not belong 
 to the external sign (symbol, fetich) in itself.^ 
 
 The individual valuation of the fetich, which may go to the extent 
 of an unreasoning enthusiasm in the individual affected, is called fetichism. 
 This interesting psychological phenomenon is explicable by an empirical 
 law of association, — the relation of a particular to a general concept, — in 
 which, however, the essential thing is the pleasurable emotional coloring 
 of the particular concept peculiar to- the individual. It is most common 
 in two related mental spheres, — those of religious and erotic feelings and 
 ideas. Religious fetichism differs in. relation and significance from sexual 
 fetichism, for it found, and still finds, its original motive in the delusion 
 that the object of the fetichism, or the idol, possesses divine attributes, 
 and that it is not simply a symbol ; or peculiar wonder-working (relics) 
 or protective (amulet) virtues are superstitiously ascribed to the fetich. 
 
 It is otherwise with erotic fetichism, which finds its ps3^chological 
 motive in fetiches which consist of physical or mental qualities of a 
 person, or even merely of objects which a person has used. These 
 always awaken intense associative ideas of the personality as a whole, 
 and, moreover, are always colored with a lively feeling of sexual pleasure. 
 Analogies with religious fetichism are always discernible; for, under 
 certain circumstances, in the latter,, the most insignificant o])jects (bones, 
 nails, hair, etc.) become fetiches, and are associated with pleasurable 
 feelings which may reach the intensity of ecstasy. 
 
 With respect of the development of physiological love, it is 
 probable that its nucleus is always to be found in an individual 
 fetich (charm) which a person of one sex exercises over a person 
 of the opposite sex. 
 
 The case is the simplest where the sight of a |>erson of the 
 opposite sex occurs simultaneously with sensual excitement, and 
 the latter is thus increased. 
 
 1 Comp. Max Miiller, who derives the word fetich etymologlcally from factitious (arti- 
 ficial, an insignificant thing).
 
 18 PSYCOPATHIA SEXUALIS. 
 
 Emotional and visual impressions are brought into associa- 
 tive connection, and this association is strengthened in propor- 
 tion as the recurring emotion awakens the visual memory-picture, 
 or the latter (another meeting) renews sexual excitement, which 
 may possibly reach the intensity of orgasm and pollution (dream- 
 picture). In this case the whole physical personality has the 
 effect of a fetich. 
 
 As Binet and others show, merely parts of the whole, 
 simply peculiarities, either physical or mental, may affect the 
 person of the opposite sex as a fetich, when the perception 
 of them is associated with (accidental) sexual excitement (or 
 induces it). 
 
 It is well known from experience that accident determines 
 this mental association, that the objects of the fetich may be 
 individually very diverse, and that thus the most peculiar sym- 
 pathies (and antipathies) arise. 
 
 These physiological facts of fetichism explain the individual 
 sympathies between husband and wife; the preference of a 
 certain person to all others of the same sex. Since the fetich 
 represents a symbol that is purely individual, it is clear that its 
 effect must be individual. Since it is colored by the most intense 
 pleasurable feeling, it follows that possible faults in the beloved 
 object are overlooked ("Love is blind"), and an exaltation of it 
 is induced that to others is incomprehensible, and even silly 
 imder some circumstances. Thus it is clear why lovers are not 
 understood by their unaffected fellow-men ; and why they deify 
 their idols, develop a true cult of devotion, and invests them 
 with attributes which objectively they do not possess. Thus we 
 may understand why love appears sometimes more like a passion, 
 sometimes as a formal, exceptional mental state, in which the 
 unattainable seems attainable, the ugly beautiful, the profane 
 sacred, and every other interest, every duty, disappears. 
 
 Tarde {Archives de Vanthropologle criminelle, v year. No. 
 30) rightfully emphasizes the fact that the fetich may vary with 
 nations as well as with individuals, but that the general ideal 
 of beauty remains the same among civilized people of the same 
 era.
 
 PSYCHOLOGY OF THE SEXUAL LIFE. 19 
 
 Binet deserves great credit for having studied and analyzed 
 in detail the fetichism of love. The particular sympatliies all 
 spring from it. Thus one is attracted to slender, another to 
 plump beauties, to blondes or brunettes. For one a peculiar 
 expression of the eyes ; for another a peculiar tone of the voice, 
 or a particular (even an artificial) odor (perfume) ; or the hand, 
 the foot, the ear, etc., may be' the individual fetich (charm), — 
 the beginning of a complicated chain of mental processes which, 
 as a whole, represent love, i.e., the longing to possess, physically 
 and mentally, the beloved object. 
 
 This fact is important, as showing a condition for the orighi 
 of a fetichism that falls within physiological limits. The fetich 
 may constantly retain its significance without being pathological ; 
 but this is possible only when the particular concept is developed 
 to a general concept ; when the resulting love comes to take as 
 its object the whole mental and physical personality. 
 
 Normal love can be nothing but a syntliesis, a generaliza- 
 tion. Ludwig Brunn,^ under the heading, " The Fetichism of 
 Love," cleverly says : — 
 
 "Thus normal love appears to us as a symphony of tones 
 of all kinds. It results from the most various stimuli. It is 
 likewise polytheistic. Fetichism recognizes only the tone of 
 a single instrument; it results from a certain stimulus; it is 
 monotheistic." 
 
 On slight reflection any one Avill see that real love (this 
 word is only too often abused) can be spoken of only when th(! 
 whole person is both physically and mentally the object of 
 adoration. Love must always have a sensual element, i.e., the 
 desire to possess the beloved object, to be united with it and 
 fulfill the laws of nature. But when merely the body of the 
 person of the opposite sex is the object of love, when satisfaction 
 of sensual pleasure is the sole object, without desire to possess 
 the soul and enjoy mutual communion, love is not genuine, no 
 more than that of platonic lovers, who love only the soul and 
 avoid sensual pleasure (many cases of contrary sexualit}). For 
 the former merely the body, for the latter simply the soul, is a 
 
 1 Deutsches Moutagsblatt, Berlin, August 20, 1888, \
 
 20 PSYCHOPATHIA SEXUALIS. 
 
 fetich, and the love fetichism. Such cases certainly represent 
 transitions to pathological fetichism. This assumption is even 
 more justified when, as a further criterion of real love, mentaP 
 satisfaction must be given by the sexual act. 
 
 There remains to be mentioned, within the physiological 
 phenomena of fetichism, the fact that among the many things 
 that may become fetiches there are certain ones that gain such 
 significance for a majority of persons. 
 
 As such for a man may be mentioned the hair, the hand, 
 the foot of a woman, the expression of her eyes. Certain ones 
 of these gain a remarkable significance in the pathology of 
 fetichism. These facts clearly play a role in the feminine mind, 
 either consciously or unconsciously. 
 
 One of the greatest cares of women is the cultivation of the 
 hair, to which often an unreasonable amount of time and money 
 is devoted. How a mother cares for her little daughter's hair ! 
 What a part the hair-dresser plays! Falling of the hair would 
 cause despair in a young lady. I recall a proud lady who 
 became insane over it, and died by suicide. Young ladies like 
 to talk of coifl:\ires, and are envious of beautiful hair.^ 
 
 ^ Magnan's " spinal cerebral posterieur," who fiuds pleasure in every woman, and on 
 whom every woman looks with favor, has only desire to satisfy his lust. Purehased or 
 forced love is not real love (Mantegazza). The one who originated the saying, " Sublata 
 lucerna nullum discrimen inter feminas," must have been a cynic indeed. Power in a man 
 to perform love's act is no proof that this makes possible the greatest pleasure of love. 
 There are, indeed, urnings who are potent for women, — men who do not love their wives, 
 but who arc still able to perform the marital " duty." In most cases of this kind, indeed, 
 there is no lustful pleasure ; it is essentially a kind of onanistic act, for the most part made 
 possible by means of help of imagination that calls up another beloved person. By this 
 deception sensual pleasure can be induced, but this rudimentary psychical satisfaction is 
 the result of a mental trick, just as in solitary onanism, where fancy has to assist in order 
 to induce sensual pleasure. As a rule, the degree of orgasm necessary as a means to the 
 attainment of lustful pleasure seems attainable only when the imagination intervenes. 
 Where mental impediments exist (Indifference, repugnance, disgust, fear of infection or 
 pregnancy, etc.), sensual pleasure seems usually wanting. 
 
 2 "The important part played by the hair of the head as a stimulant of sexual 
 passion appears in a curious way from Mr. Sibree's account of King Radama's attempt to 
 introduce European customs among the Hovas of Madagascar. As soon as he had adopted 
 the military tactics of the English, he ordered that all his officers and soldiers should have 
 their hair cut, but this command produced so great a disturbance among the women of 
 the capital that they assembled in great numbers to protest against the king's order, and 
 could not be quieted until they were surrounded by troops, and their leaders cruelly 
 speared." — Westermarck, op. cit. 
 
 Here male hair was a physiological fetich of females. It represents a relation of 
 the Bexes that civilization has gradually reversed. While in civilized society woman exer-
 
 PSYCHOLOGY OF THE SEXUAL LIFE. 21 
 
 Beautiful hair is a powerful fetich witli many men. In 
 the legend of the Loreley, wlio lured men to destruction, the 
 golden hair, whicli slie combs with a golden comb, appears as a 
 fetich. Frequently the hand and foot possess an attractiveness 
 no less powerful, when, indeed, often (though by no means in- 
 variably) masochistic and sadistic feelings aid in determining 
 the peculiar kind of fetich. 
 
 By a transference through association of ideas, tlie gloves 
 or shoes may obtain the significance of a fetich. 
 
 Brunn {op. cit.) justly points out that among the customs 
 of the Middle Ages drinking from tlie shoe of a beautiful woman 
 (still to be found in Poland) played a remarkable part in gal- 
 lantry and homage. The shoe also plays an important 7'6le in 
 the leeend of Aschenbrodel. 
 
 The expression of the eyes is particularly important as a 
 means of kindling the sparks of love. A neuropathic eye fre- 
 quently affects persons of both sexes as a fetich. " Madame, vos 
 beaux yeux me font mourir d'amour " (Moliere). 
 
 There is superfluity of examples showing that odors of the 
 body may become fetiches. 
 
 This fact is also taken advantage of in the ars amcmdi of 
 woman, either consciously or unconsciously. Ruth sought to 
 attract Boaz by perfuming herself The demi-momle of ancient 
 and modern times is noted for its use of perfume. Jiigcr, in 
 his " Discovery of the Soul," calls attention to many olflictory 
 sympathies. 
 
 Cases are known where men have married ugly women 
 simply because their personal odors were exceedingly pleasing. 
 
 Binet makes it probable that the voice may also become a 
 fetich. He relates a case in point of Dumas, who used it in his 
 
 cises her ingenuity to increase her attractiveness, among savages it is the men who are 
 anxious to Increase their physical charms. This reversal of the primitive relation is a very 
 interesting fact, and is probably to be explained by the transference of the " liberty of 
 choice " from woman to man which civilization has gradually induced. Westermarck {op. 
 cit., p. 185) says: " It should be noted that it is, as a rule, the man only that runs tlie risk 
 of beino- obliged to lead a single life. Hence it is obvious that, to the best of his ability, 
 he must endeavor to be taken into favor by making himself as attractive as possible. In 
 civilized Europe, on the other hand, the opposite occurs. Here it is the woman that Las 
 the greatest difficulty in getting married, and she is also the vainer of the two."— Trans.
 
 22 PSYCHOPATHIA SEXUALIS. 
 
 novel, " La Maison du Vent." It was the case of a wife who 
 fell in love with a tenor's voice, and thus became untrue to her 
 husband. Belot's romance, " Les Baigneuses de Trouville," 
 speaks in favor of this assumption. Binet thinks that many 
 marriages with singers are dae to the fetich of their voices. He 
 also calls attention to the interesting ilict that among singing- 
 birds the voice has the same sexual significance as odors among 
 quadrupeds. The birds allure by their song, and the male that 
 sings most beautifully flies at night to his charmed mate. 
 
 The patliological facts of masochism and sadism show that 
 mental peculiarities may also act as fetiches in a wider sense. 
 
 Thus the fact of idiosyncrasies is explained, and the old 
 saying, " De gustihiis non est disputandum,^^ retains its force.
 
 II. PHYSIOLOGY. 
 
 During the time of the physiological processes in the reproductive 
 glands, desires arise in the consciousness of the individual which have for 
 their purpose the perpetuation of the species (sexual instinct). 
 
 Sexual desire during the years of sexual maturit^^ is a physiological 
 law. The duration of the physiological processes in the sexual organs, 
 as well as the strength of the sexual desire manifested, vary, both in indi- 
 viduals and in races. Race, climate, heredity, and social circumstances 
 have a very decided influence upon it. The greater sensuality of southern 
 races .as compared with the sexual needs of those of the North is well 
 known. Sexual development in the inha])itants of tropical climes takes 
 place much earlier than in those of more northern regions. In women 
 of northern countries ovulation, recognizable in the development of the 
 body and the occurrence of a periodical flow of blood from the genitals 
 (menstruation), usually begins about the thirteenth or fifteenth year; in 
 men puberty, recognizable in the deepening of the voice, the appearance 
 of hair on the face and the mons veneris, and the occasional occurrence 
 of pollutions, etc., takes place about the fifteenth year. In the inhabit- 
 ants of tropical countries, however, sexual development takes place 
 several years earlier in women, — sometimes as early as the eighth year. 
 
 It is worthy of remark that girls who live in cities develop about 
 a year earlier than girls living in the country, and that the larger the 
 town the earlier, ceteris paribus, the development takes place. 
 
 Heredity, however, has no small influence on libido and sexual 
 power. Thus there are families in which, with great physical strength 
 and longevity, great libido and virility are preserved until a great age, 
 while in other families the vita sexualis develops late and is early 
 extinguished. 
 
 In women the time of the activity of the reproductive glands is 
 shorter than in men, in whom the sexual function may last until a great 
 age. Ovulation ceases about tliirty years after puberty. This period of 
 cessation of activity of the ovaries is called the change of life (climac- 
 terium). This biological phase does not represent merely a cessation of 
 function and final atrophy of the reproductive organs, but also a trans- 
 formation of the whole organism. In Middle Europe the sexual maturity 
 of men begins about the eighteenth year, and their virility reaches its 
 acme at forty. After that age it slowly declines. 
 
 The potentia generandi ceases usually at the age of sixty-two, but 
 potentia cceundi may be present even in old age. The existence of the 
 
 (23)
 
 24 PSYCHOPATHIA SEXUALIS. 
 
 sexual instinct is continuous during the time of sexual life, but it varies in 
 .intensity. Under physiological conditions it is never intermittent (period- 
 ical), as in animals. In men it manifests an organic variation of intensity 
 in consonance with the collection and expenditure of semen ; in women 
 the increase of sexual desire coincides with the process of ovulation, and 
 in such a way that libido sexualis is greater after the menstrual period. 
 
 Sexual instinct — as emotion, idea, and impulse — is a function of the 
 cerebral cortex. Thus far no definite region of the cortex has been 
 proved to be exclusively the seat of sexual sensations and impulses,^ 
 
 Owinof to the close relations which exist between the sexual instinct 
 and the olfactory sense, it is to be presumed that the sexual and olfactory 
 centres lie close together in the cerebral cortex. The development of the 
 sexual life has its beginning in the organic sensations which arise from 
 the developing reproductive glands. These excite the attention of the 
 individual. Readings and the experiences of every-day life (which, un- 
 fortunately, to-daj' are too early and too frequently suggestive) convert 
 these notions into clear ideas. These become accentuated by organic sen- 
 sations which are pleasurable. With this accentuation of erotic ideas by 
 lustful feelings, an impulse to induce these (sexual desire) is developed. 
 
 Thus there is established a mutual dependence between the cerebral 
 cortex (as the place of origin of sensations and ideas) and the reproduc- 
 tive organs. The latter, by reason of physiological processes (hyper- 
 emia, secretion of semen, ovulation), give rise to sexual ideas, images, 
 and impulses. 
 
 The cerebral cortex, by means of apperceived or reproduced sensual 
 ideas, reacts on the reproductive organs, inducing hyper.iemia, secretion 
 of semen, erection, ejaculation. This results by means of centres for 
 vasomotor innervation and ejaculation, which are situated in the lumbar 
 portion of the cord and lie close together. Both are reflex centres. 
 
 The erection-centre (Goltz, Eckhard) is an intermediate station 
 placed between the brain and the genital apparatus. The nervous paths 
 which connect it with the brain })robably run through the pedunculi 
 cerebri and the pons. This centre may be excited by central (psychical 
 and organic) stimuli, by direct irritation of the nerve-tract in the pedun- 
 culis cerebri, pons, or cervical portion of the cord, as well as by periph- 
 eral irritation of the sensory nerves (penis, clitoris, and annexa). It is 
 not directly subordinated to the will. 
 
 The excitation of this centre is conveyed to the corpora cavernosa 
 by means of nerves (nervi erigentes — Eckhard) running in the first three 
 sacral nerves. 
 
 The action of the nervi erigentes, which renders erection possible. 
 
 » The olfactory centre is presumed by Ferrier (" Functions of the Brain ") to be in 
 the region of the gynts wicinatus. Zuckerkandl (" Ueber das Riechceutrum," 1887), from 
 researches in comparative anatomy, concludes that the olfactory centre has its seat in 
 Ammon's horn.
 
 PHYSIOLOGY. 25 
 
 is an inliibitoiy one. They inhibit the ganglionic nervous mechanism in 
 the corpora cavernosa upon the action of which the smooth muscle-fibres 
 of the corpora cavernosa are dependent (Kolliker and Kolilrausch). 
 Under the influence of the action of the nervi erigentes these fibres of the 
 corpora cavernosa become relaxed and their spaces fill with ])lood. Simul- 
 taneously, as a result of the dilatation of the capillary net-work of the 
 corpora cavernosa, pressure is exerted upon the veins of the penis and 
 the return of blood is impeded. This eflect is aided by contraction of 
 the bulbo cavernosus and ischio cavernosus muscles, which are inserted 
 by means of an aponeurosis on the dorsal surface of the penis. 
 
 The ei-ection-centre is under the influence of both exciting and in- 
 hibitory innervation arising in the cerebrum. Ideas and sense-j)ercep- 
 tions of sexual content have an exciting eflect. Also, according to 
 observations made on men that have been hung, it is evident that the 
 erection-centre may be excited by excitation of the tract in the spinal 
 cord. Observations on the insane and those suffering with cerebral dis- 
 ease show that this is also possible as a result of organic irritation in the 
 cerebral cortex (psycho-sexual centre ?). Spinal diseases (tabes, especially 
 myelitis) aflecting the lumbar portion of the cord, in tlieir earlier stages, 
 may directly excite the erection-centre. 
 
 Reflex excitation of the centre is possible and frequent in the fol- 
 lowing ways : by irritation of the (peripheral) sensory nerves of the 
 genitals and surrounding parts by friction ; by irritation of the urethra 
 (gonorrhoea), of the rectum (hannorrhoids, oxyuris), of the bladder 
 (distension with urine, especially in the morning, irritation of calculi); 
 by distension of the vesicular seminales with semen ; b}- hypera'mia of 
 the genitals, occasioned by lying on the back, and thus inducing pressure 
 of the intestines upon the blood-vessels of the pelvis. 
 
 The erection-centre may also be excited by irritation of the nervous 
 ganglia which are so abundant in the prostatic tissue (prostatitis, intro- 
 duction of catheter, etc.). 
 
 The experiment of Goltz, according to whom, when (in dogs) the 
 lumbar portion of the cord is severed, erection is more easily induced, 
 shows that the erection-centre is also subject to inhibitory- influences from 
 the brain. 
 
 In men the fact that the will and emotions (fear of unsuccessful 
 coitus, surprise inter actum sexualem, etc.) may inhibit the oecurrence 
 of erection, and cause it, when present, to disappear, also indicates this. 
 
 The duration of erection is de]iendent upon the duration of its ex- 
 citing causes (sensory stimuli), tlie absence of inhibitory influmices, the 
 nervous energy of the centre, and the early or late occurrence of ejacu- 
 lation (v. infra). 
 
 The central and highest portion of the sexiial mechanism is the 
 cerebral cortex. It is justifiable to presume that there is a definite region 
 of the cortex (cerebral centre) which gives rise to sexual feelings, ideas.
 
 26 PSYCHOPATHIA SEXUALIS. 
 
 and impulses, and is the place of origin of the psycho-somatic processes 
 which we designate as sexual life, sexual instinct, and sexual desire. This 
 centre is excitable to both central and peripheral stimuli. 
 
 Central stimuli, in the form of organic excitation, may be due to 
 diseases of the cerebral cortex. Physiologically they consist of psy- 
 chical stimuli (memory and sensory perceptions). 
 
 Under physiological conditions these stimuli are essentially visual 
 perceptions and memory-pictures {i.e., lascivious stories) and also tactile 
 impressions (touch, pressure of the hand, kiss, etc.). 
 
 Within physiological limits auditory and olfactory perceptions cer- 
 tainly play but a very subordinate i^ole. Under pathological conditions 
 (v. infra) the latter have a very decided influence in inducing sexual 
 excitement. 
 
 Among animals the influence of olflxctory perceptions on the sexual 
 sense is unmistakable. Althaus (" Beitrage zur Phj^siol. und Pathol, des 
 Olfactorius." Archiv fur Psych., xii, H 1) declares that the sense of 
 smell is important with reference to the reproduction of the species. He 
 shows that animals of opposite sexes are drawn to each other by means 
 of olfactory perceptions, and that almost all animals, at the time of rut- 
 ting, emit a very strong odor from their genitals. An experiment by 
 Schiff is confirmatory of this. He extirpated the olfactory nerves in 
 puppies, and found that, as the animals grew, the male was unable to 
 distinguish the female. On the other hand, an experiment by Mante- 
 gazza ("Hygiene of Love "),who removed the eyes of rabbits and found 
 that the defect constituted no obstacle to procreation, shows how im- 
 portant in animals the olfactor}^ sense is for the vita sexualis. 
 
 It is also remarkable that many animals (musk-ox, civet-cat, 
 beaver) possess glands on their sexual organs, which secrete materials 
 having a verj' strong odor. 
 
 Althaus also shows that in man there are certain relations existing 
 between the olfactory and sexual senses. He mentions Cloquet (" Osphrd- 
 siologie," Paris, 1826), who calls attention to the sensual pleasure excited 
 by the odors of flowers, and tells how Richelieii lived in an atmosphere 
 loaded with the heaviest perfumes, in order to excite his sexual functions. 
 
 Zippe (Wien. Med. Wochey\schrift, 1819, Nr. 24), in connection with 
 a case of kleptomania in an onanist, likewise establishes such relations, 
 and cites Hildebrand as authority, who in his popular physiology says : 
 " It cannot be doubted that the olfactory sense stands in remote connec- 
 tion with the sexual apparatus. Odors of flowers often occasion pleasur- 
 able sensual feelings, and when one remembers the passage in the ' Song 
 of Solomon,' ' And my hands dropped with myrrh and my fingers with 
 sweet-smelling myrrh upon the handles of the lock,' one finds that it did 
 not escape Solomon's observation. In the Orient the pleasant perfumes 
 are esteemed for their relation to the sexual organs, and the women's 
 apartments of the Sultan are filled with the perfumes of flowers."
 
 PHYSIOLOGY. 27 
 
 Most, professor in Kostock (coinp. Zippo), relates : " I learned from 
 a sensual young peasant that he had excited many a chaste girl sexually-, 
 and easily gained his end, by carrying his handkerchief in his axilla for a 
 time, while dancing, and then wiping his partner's perspiring face with it." 
 
 The case of Henry III shows that contact with a person's perspira- 
 tion may be the exciting cause of passionate love. At the betrothal 
 feast of the King of Navarre and Margaret of Yalois, he accidentally 
 dried his face with a garment of Maria of Cleves, which was moist with 
 her perspiration. Although she was the bride of the Prince of Conde, 
 Henry conceived immediately such a passionate love for her that he 
 could not resist it, and made her, as history shows, very unhajipy. An 
 analogous instance is related of Henry I\^, whose passion for the beauti- 
 ful Gabriel is said to have originated at the instant when, at a ball, he 
 wiped his brow with her handkerchief. 
 
 Professor Jiiger, the "discoverer of the soul," refers to the same 
 thing in his well-known book (2d ed., 1880, clinp. xv, p. 173); for he 
 regards the sweat as important in the production of sexual effects and 
 as being especially seductive. 
 
 One learns from reading the work of Ploss (" Das Weib ") that 
 attempts to attract a person of the opposite sex by means of the perspi- 
 ration may be discerned in many forms in popular psychology. 
 
 In reference to this, a custom which holds among the natives of the 
 Philippine Islands when they become engaged, as reported by Jager, is 
 remarkable. When it becomes necessary for the engaged pair to separate, 
 they exchange articles of wearing-apparel, l)y means of which each be- 
 comes assured of faithfulness. These objects are carefully preserved, 
 covered with kisses, and smelled. 
 
 The love of certain libertines and sensnal women for perfumes* 
 indicates a relation between the olfactor}^ and sexual senses. 
 
 A case mentioned by Ileschl ( Wiener Zeitschrift f. pract. Heil- 
 kunde, March 22, 1861) is remarkable, where the absence of both olfac- 
 tory lobes was accompanied l)y imperfectly developed genitals. It was 
 the case of a man aged 45, in all respects well developed, with the excep- 
 tion of the testicles, which were not larger than beans and contained no 
 seminal canals, and the larynx, which seemed to ])e of feminine dimen- 
 sions. Every trace of olfiictory nerves was wanting, and the trigona 
 olfactoria and the furrow on the under surface of the anterior lobes 
 were absent. The perforations of the ethmoid plate were sparingly 
 present, and occupied by nerveless processes of the duia instead of by 
 nerves. In the mucous membrane of the nose there was also an absence 
 of nerves. Finally, the clearly-defined relation of the olfactory and sexual 
 senses in mental diseases is worthy of notice, in that in llic psychoses of 
 
 1 Comp. Laycock, who (" Nervous Diseases of Women," 1840) found that iu women 
 the love for musk and similar perfumes was related to sexual excitement.
 
 28 PSYCHOPATHIA SEXUALIS. 
 
 both sexes dependent on masturbation, as well as in insanity due to 
 disease of the sexual organs of the female, or during the climacteric, ^ 
 olfactory hallucinations are especially frequent, while in cases where a 
 sexual cause is wanting they are very infrequent. 
 
 I am inclined to doubt ^ that olfactory impressions in man, under nor- 
 mal conditions, as in animals, play an important role in the excitation of 
 the sexual centre. On account of the importance of this consensus for the 
 understanding of pathological cases, it is necessary here to thoroughly 
 consider the relations existing between the olfactory and sexual senses. 
 
 The sexual sphere of the cerebral cortex may be excited, in the 
 sense of an excitation of sexual concepts and impulses, by processes in 
 the generative organs. This is possible as a result of all conditions 
 which also excite the erection-centre by means of centripetal influence 
 (stimulus resulting from distension of the seminal vesicles ; enlarged 
 Graafian follicle; any sensory stimulus, however produced, about the 
 genitals ; hypersemia and turgescence of the genitals, especially of the 
 erectile tissue of the corpus cavernosum of the penis and clitoris, as a 
 result of luxurious, sedentary life; plethora abdominalis, high external 
 temperature, warm beds, clothing ; taking of cantharides, pepper, and 
 other spices). 
 
 Libido sexualis may also be induced by stimulation of the gluteal 
 region (castigation, whipping).^ 
 
 This fact is not unimportant for the understanding of certain patho- 
 logical manifestations. It sometimes happens that in boys the first 
 excitation of the sexual instinct is caused by a spanking, and they are 
 thus incited to masturbation. This should be remembered by those who 
 have the care of children. 
 
 On account of the dangers to which this form of punishment of 
 children gives rise, it would be better if parents, teachers, and nurses 
 were to avoid it e^tirel3^ 
 
 Passive flagellation raay excite sensuality, as is shown by the sects 
 of flngellants, so widespread in the thirteenth and fifteenth centxiries. 
 They were accustomed to whip themselves, partly as atonement and 
 partly to kill the flesh (in accordance with the principle of chastity 
 
 * Also in the. insanity of gestation. — Trans. 
 
 2 Tlie following case, reported by Binet, seems to be in opposition to this idea. 
 Unfortunately nothing is said concerning the mental characteristics of the person. In 
 any event, it is certainly confirmatory of the relations existing between the olfactory and 
 sexual senses : — 
 
 D., a medical student, was seated on a bench in a public park, reading a book (on 
 pathology) . Suddenly a violent erection disturbed him. He looked up and noticed that a 
 lady, redolent with perfume, had taken a seat upon the other end of the bench. D. could 
 attribute the erection to nothing but the unconscious olfactory impression made upon him. 
 
 3 Meibomius, " De flagiorum usu in re medica," London, 1765 ; Boileau, " The His- 
 tory of the Flagellants," London, 1783.
 
 PHYSIOLOGY. 29 
 
 promulgated by the Church, — i.e., the emuuciputiou of the soul from 
 sensuality). 
 
 These sects were at first favored by the Church; but, since sensu- 
 ality was only excited the more by flagellation, and the fact became ap- 
 parent in unpleasant occurrences, the Church was finally compelled to 
 oppose it. The following facts from the lives of the two heroines of 
 flagellation, Maria Magdalena of Pazzi and Elizabeth of Genton, clearly 
 show the significance of flagellation as a sexual excitant. The former, a 
 child of distinguished parents, was a Carmelite nun in Florence (about 
 1580), and, by her flagellations, and, still more, through the results of 
 them, she became quite celebrated, and is mentioned in the Annals. It 
 was her greatest delight to have the prioress bind her hands behind her 
 and have her whipped on the naked loins in the presence of the asseml)led 
 sisters. 
 
 But the whippings, continued from her earliest youth, quite de- 
 stroyed her nervous system, and perhaps no other heroine of flagellation 
 had so many hallucinations (" Entziickungen "). While being whipped her 
 thoughts were of love. The inner fire threatened to consume her, and she 
 frequently cried, " Enough ! Fan no longer the flame tliat consumes me. 
 This is not the death I long for ; it comes with all too nuich jjleasure and 
 delight." Thus it continued. But the spirit of impurity wove the most 
 sensual, lascivious fancies, and she was several times near losing her 
 chastity. 
 
 It was the same with Elizabeth of Genton. As a result of whipping 
 she actually passed into a state of bacchanalian madness. As a rule, she 
 rested when, excited by unusual flagellation, she believed herself united 
 with her " ideal." This condition was so exquisitely pleasant to her that 
 she would frequently cry out, " love, eternal love, O love, you 
 creatures 1 cry out with me, love, lovel" 
 
 It is known, on the authority of Taxil (op. cit., p. 175), tliat rakes 
 sometimes have themselves flagellated, or pricked until blood flows, just 
 before the sexual act, in order to stimulate their diminished sexual power. 
 
 These facts find an interesting confirmation in the following experi- 
 ences, taken from Baullini's " Flagellum Salutis"(lst ed., IG'JS; repro- 
 duction, Stuttgart, 1847): — 
 
 *' There are some nations, viz., the Persians and Russians, where the 
 women regard blows as a peculiar sign of love and favor. Strangely 
 enough, the Russian women are never more pleased and delighted tliiin 
 when they receive hard blows from their husbands, as John Barclay 
 relates in a remarkable narrative. A German, named Jordan, went to 
 Russia, and, pleased with the country, he settled there and took a Russian 
 wife, whom he loved dearly and to whom he was always kind in every- 
 thing. But she always wore an expression of dissatislaction, :\\u\ went 
 about with sighs and downcast eyes. The husband asked the reason, for 
 he could not understand what was wrong. < Aye,' she said, ' though you
 
 30 PSYCHOPATHIA SEXUALIS. 
 
 love me you do not show me any sign of it.' He embraced her and 
 begged to be told what he had carelessly and unconsciously done to hurt 
 her feelings, and to be forgiven, for he would never do it again. ' I want 
 nothing,' was the answer, 'but what is customary in our country, — the 
 whip, the real sign of love.' Jordan observed the custom and accustomed 
 himself to it, and then his wife began to love him dearly. Similar stories 
 are told by Peter Petrius, of Erlesund, with the addition that the 
 husbands, immediately after the wedding, among other indispensable 
 household articles, provide themselves with whips." 
 
 On page IS of this remarkable book, the author says further: " The 
 celebrated Count of Mirindula, John Picus, relates of one of his intimate 
 acquaintances that he was an insatiable fellow, but so lazy and incapable 
 of love that he was practically impotent until he had been roughly 
 handled. The more he tried to satisfy his desire, the heavier the blows 
 he needed, and he could not attain his desire until he had been whipped 
 until the blood came. For this purpose he had a suitable whip made, 
 which was placed in vinegar the day before using it. He would give this 
 to his companion and on bended knees beg her not to spare him, but to 
 strike blows with it, the heavier the better. The good count thought 
 this singular man found the pleasure of love in this punishment. While 
 in other respects he was not a bad man, he understood and hated his 
 weakness. Coelius Rhodigin relates a similar story, as does also the 
 celebrated jurist, Andreas Tiraquell. In the time of the skillful physician, 
 Otten Brunfelsen, there lived in Munich, then the Capital of the Bavarian 
 Electorate, a debauchee who could never perform his [sexual] duties 
 without a severe preparatory beating. Thomas Barthelin also knew a 
 Venetian who had to be beaten and driven before he could have inter- 
 course, — just as Cupid himself moved reluctantly driven by his followers 
 with sprays of hyacinth. A few years ago there was in Liibeck a cheese- 
 monger, living on Mill Street, who, on a complaint to the authorities of 
 unfoithfulness, was ordered to leave the city. The prostitute with whom 
 he had been went to the judges and begged in his behalf, telling how dif- 
 flcult all intercourse had become for him. He could do nothing until he 
 had been mercilessly beaten. At first the fellow, from shame and to avoid 
 disgrace, would not confess, but after earnest questioning he could not 
 deny it. There is said to have been a man in the Netherlands who was 
 similarly incapable, and could do nothing without blows. On the decree 
 of the authorities, however, he was not only removed from his position, 
 but also properly punished. A credible friend, a physician in an im- 
 portant city of the kingdom, told me, on July 14th, last year, how a 
 woman of bad character had told a companion, who had been in the hos- 
 pital a short time before, that she, with another woman of like character, 
 had been sent to the woods by a man Avho followed them there, cut rods 
 for them, and then exposed his nates, commanding them to belabor him 
 well. This they did. It is easy to conclude what he then did with them.
 
 PHYSIOLOGY. 31 
 
 Not only men have been excited and inflamed to lasciviousness, but also 
 women, that they too might experience greater intensity of pleasure. 
 For this reason the Roman woman had herself whipped and beaten by 
 the lupercis. Thus Juvenal writes : — 
 
 " ' Steriles moriuntur, et illis 
 Turgida non prodest coiidila psycido Lyde : 
 Nee prodest agili palinas praebere Lupeico.' " 
 
 In men, as well as in women, erection and orgasm, or even ejacu- 
 lation, may be induced by irritation of various other regions of the skin 
 and mucous membrane. These " erogenous " zones in woman are, while 
 she is a virgin, the clitoris, and, after defloration, the vagina and cervix 
 uteri. 
 
 In woman the nipple particularly seems to i)ossess this quality. 
 Titillatio hujus regionis plays an important i)art in the ars erotica. In 
 his " Typograpical Anatomy," 1865, Bd. i, p. 552, Hyrtl cites Val. llilde- 
 brandt, who observed a peculiar anomaly of the sexual instinct in a girl, 
 which he called suctusstupratio. She had her mammse sucked by her 
 lover, and finally, by gradually drawing on her nipples, she became able 
 to suck them herself, — an act that gave her most intense ])leasure. Ilj'rtl 
 also calls attention to the fact that cows sometimes suck the milk from 
 their own udders. L. Brunn {Zeilg.f. Literatui^, etc., d. Hamburg. Cor- 
 respondent, 1889, ISTr. 21), in an interesting article on " Sensuality and 
 Love of Kin," points out how zealously the nursing mother gives herself 
 to nursing the babe, " for love of the weak, undeveloped, helpless being." 
 
 It is easy to assume that, by the side of the ethical motives, the fact 
 that the sucking may be attended liy feelings of physical i)leasure plays a 
 part. The remark of Brunn, which is correct in itself, but one-sided, that, 
 according to Houzeau's experience, among the majority of animals it is 
 only during the time of nursing that the relations between mother and 
 offspring are close, and thereafter indifterent, also speaks in favor of this 
 assumption. 
 
 Bastian found the same thing (blunting of the feeling for the ofl- 
 spring after weaning) among savages. 
 
 Under pathological conditions, as is shown by Chambard, among 
 others, in his thesis for the doctorate, other portions of the body (in 
 hysterical persons) about the mammae and genitals may attain the signifi- 
 cance of " erogenous " zones. 
 
 In man, physiologically, the only " erogenous " zone is the glans 
 penis, and, perhaps, the skin of the external genitals. 
 
 Under pathological conditions the anus may become an " erogenous 
 area. Thus anal auto-masturbation, which seems to be only too frequent, 
 and passive pederasty would be explained. (Comp. Garnier, " Anomalies 
 sexuelles," Paris, p. 514 ; F. Moll, " Contriire Sexualempfindung," p. 163.) 
 
 The psycho-physiological process comprehended in the idea of sexual 
 
 c. "
 
 32 PSYCHOPATHIA SEXUALIS. 
 
 instinct is composed of (1) concepts awakened centrally or peripherally ; 
 (2) the pleasurable feelings associated with them. 
 
 The longing for sexual satisfaction (libido sexualis) arises from 
 them. This desire grows stronger constantly, in proportion as the ex- 
 citation of the cerebral sphere accentuates the feeling of pleasure by 
 appropriate concepts and activity of the imagination ; and the pleasurable 
 sensations are increased to lustful feeling by excitation of the erection 
 centre and the consequent hyperffiuiia of the genitals (entrance of liquor 
 prostaticus into the urethra, etc.). 
 
 If circumstances are favorable for the performance of the sexual act 
 satisfactorily, the constantly-increasing desire is complied with ; if, how- 
 ever, conditions are unfavorable, inhibitory concepts occur, overcome the 
 sexual longing, and prevent the sexual act. 
 
 To civilized man cultivation of a readiness with ideas which inhibit 
 sexual desire is necessary and distinctive. The moral freedom of the 
 individual, and the decision whether, under certain circumstances, excess, 
 and even crime, be committed or not, '^'epend, on the one hand, upon the 
 strength of the instinctive concepts and the accompanying organic sen- 
 sations; on the other, upon the power of the inhibitory concepts. Con- 
 stitution and, especially, organic influences have a marked effect upon 
 the instinctive impulses ; education and cultivation of self-control have a 
 decisive influence on the opposing concepts. 
 
 The exciting and inhibitory powers are variable quantities. Over- 
 indulgence in alcohol in this respect is very fatal, since it awakens 
 and increases libido sexualis, while at the same time it reduces moral 
 resistance. 
 
 The Act of Cohabitation.^ 
 
 The essential condition for the man is sufficient erection. Anjel 
 (Arch, fur Psych., viii, II. 2) calls attention to the fact that in sexual 
 excitement the erection centre is not alone influenced, — the nervous ex- 
 citement is distributed to the entire vasomotor system of nerves. The 
 proof of this is the turgescence of the organs in the sexual act, injection 
 of the conjunctiva, prominence of the eyes, dilatation of the pupils, and 
 cardiac palpitation (resulting from paralysis of the vasomotor nerves of 
 the heart, which arise from the cervical sjanpathetic, and the consequent 
 dilatation of the cardiac arteries, and the increased stimulation of the 
 cardiac ganglia induced by the consequent hypersemia of the cardiac 
 walls). The sexual act is accompanied by a pleasurable feeling, which, in 
 the male, is conditioned by the passage of semen through the ductus 
 ejaculatorii to the urethra, caused by sensor}^ stimulation of the genitals. 
 The pleasurable sensation occurs earlier in the male than in the female, 
 grows rapidly in intensity until the moment of commencement of ejacu- 
 
 * Comp. Roubaud, " Tralt6 de I'impuissance et de la 6t6nlit6." Paris, 1878.
 
 PHYSIOLOGY. 33 
 
 lation, reaching its lieight in the instant of free emission, and disappears 
 quickly post ejaculaiionem. 
 
 In the female the pleasurable feeling occurs later and comes on more 
 slowly, and generally outlasts the act of ejaculation. 
 
 The distinctive event iu coitus is ejaculation. This function is de- 
 pendent on a centre (genito-spinal), which Budge has shown to be situated 
 at the level of the fourth lumbar vertebra. It is a reflex centre. The 
 stimulus that excites it is the ejection of sperma from the vesicula; semi- 
 nales into the pars membranacea urethne, which follows reflexly from 
 stimulation of the glans penis. As soon as the collection of semen, with 
 ever-increasing pleasurable sensation, has reached a suflicient amount to 
 be effectual as a stimulus of the ejaculation-centre, the centre acts. The 
 reflex motor jxith lies in the fourth and fifth lumbar nerves. The action 
 consists of a convulsive excitation of the bulbo-cavernosus muscle (inner- 
 vated by the third and fourth sacral nerves), which forces the semen out. 
 
 In the female as well, at the height of sexual and pleasnra]>le ex- 
 citement, a reflex movement occurs. It is induced by stimulation of the 
 sensory genital nerves, and consists of a peristaltic movement in the tubes 
 and uterus as far down as the portio vaginalis, which presses out the 
 mucous secretions of the tubes and uterus. Inhibition of the ejaculation 
 centre is possible as a result of cortical influence (want of desire in coitus, 
 emotions in general ; influence of the will, in a measure). 
 
 Under normal conditions, with the completion of the sexual act, 
 libido sexualis and erection disappear, and the psychical and sexual 
 excitement gives place to a comfortable feeling of lassitude.
 
 III. GENERAL PATHOLOGY.' 
 
 (NEUROLOGICAL AND PSYCHOLOGICAL.) 
 
 Abnormality of the sexual functions proves to be especially 
 frequent in civilized races. This fact is explained in part by the 
 frequent abuse of the sexual organs, and in part by the circum- 
 stance that such functional anomalies are often the signs of an 
 abnormal constitution of the central nervous system, which is, for 
 the most part, hereditary (" functional signs of degeneration "). 
 
 Since the generative organs stand in important functional 
 connection with the entire nervous system, and especially with 
 its psychical and somatic functions, it is easy to understand the 
 frequency of general neuroses and psychoses arising in sexual 
 (functional or organic) disturbances. 
 
 Schema of the Sexual Neuroses. 
 
 I. Peeipheral.2 -^ 
 
 1. Sensory. 
 
 2. Secretory. 
 
 3. Motor. 
 
 II. Spinal. 
 
 III. Cerebral. 
 
 f 1 
 
 1 
 
 a. Anjesthesia. 
 
 b. HypeKKsthesia. 
 
 c. Neuralgia. 
 a. Aspermia. 
 
 \ h. Pol^'spermia. 
 
 ( a. Pollutions (spasm). 
 
 1 6. Spermatorrhoea (paralysis). 
 
 Affections of the erection centre. 
 Affections of the ejaculation centre. 
 
 Paradoxia. 
 
 2. Anaesthesia. 
 
 3. HyperiBsthesia. * 
 
 4. Paresthesia. 
 
 1 Literature : Parent-Duchatelet, Prostitution dans la ville de Paris, 1837. — Rosen- 
 baum, Entstehung der Syphilis, Halle, 1839; also, Die Lustseuehe ini Alterthum, Halle, 
 1839. — Descuret, La medecine des passions, Paris, 1860. — Casper, Klin. Novellen, 1863. — 
 Bastian, Der Mensch in der Geschichte. — Friedlander, Sittengeschichte Roms. — Wiede- 
 meister, Casarenwahnsinn. — Scherr, Deutsclie Cultur- und Sittenge- schichte, Bd. i. Cap. 9. 
 — Tardieu, Des attentats aux moeurs., 7 6dit., 1878. — Emminghaus, Psychopathol., pp. 98, 
 225, 230, 232. — Schii]e,Handbuch der Geisteskrankheiten, p. 114. — Marc, Die Geisteskrauk- 
 heiten, iibers v. Llcler, ii, p. 128. — v. Krafft, Lebrb. dtr Psycliiatrie, 4 Aufl., i, p. 90 ; Lehrb. 
 d. ger. Psychopathol., 2 Aufl., p. 234; Archiv f. Psychiatric, vii, 2. — Moreau, Des aberra- 
 tions du sens g6n6sique, Paris, 1880. — Kirn, Allg. Zeitschr. f. Psychiatric, xxxix. Heft 2 
 u. 3. — Lombroso, Geschlechtstrieb u. Verbrechen in ihren gegenseitlgen Beziehungen 
 (Goltdammer's Archiv, Bd. xxx.). — Tarnowsky, Die krankhaften Erscheinungen des 
 Geschlechtssiuns, Berlin, 1886. — Ball, La Folie drotique, Paris, 1888. — Serieux, Recberches 
 cliniqucssurlcs anomalies de I'instinct sexuel, Paris, 1888. — Hammond, Sexual Impotence. 
 
 2 Vide Ultzmann, Genito-Urinary Neui-oscs in the Male (published by The F. A. 
 Davis Co., Philadelphia), for discussion of peripheral neuroses. 
 
 (34)
 
 GENERAL PATHOLOGY. 35 
 
 11. SPINAL NEUROSES. 
 
 1. Affections of the Erection Centre. 
 
 (a) Irritation (priapism) arises reiiexly Iroin peripheral sensory 
 irritants {e.g., gonorrhcea) ; directly, from organic irritation of the nerve- 
 tracts from the brain to the erection centre (spinal disease in the lower 
 cervical and npper dorsal regions), or of the centre itself (certain poisons) ; 
 or from psychical irritation. In the latter case satyriasis exists, i.e., alj- 
 normal dnration of erection, with lil:)ido sexnalis. In simply reflex or 
 direct organic irritation, libido sexnalis may be wanting, and the prinpism 
 be accompanied by nnpleasant feelings. 
 
 (b) Paralysis from destruction of the centre or of the nerve-traots 
 (nervi erigentes), in diseases of the spinal cord (paralytic impotence). 
 A milder form is that of lessened excitability of the centre, resulting 
 from overstimulation (in sexual excesses, especially in onanism), or from 
 alcoholic intoxication, abuse of bromides, etc. It ma}' be accom])anied 
 by cerebral an;tsthesia, and often with anaesthesia of the external genitals. 
 Cerebral h^^penesthesia is here more frecpient (increased libido sexnalis, 
 lust). A peculiar form of diminished excitability is shown in those 
 cases where the centre responds only to certain stimuli. '^Flius tliere are 
 men for whom sexual contact with their virtuous wives does not supply 
 the necessary stimulus for the excitation of an erection, but in whom it 
 occurs when the act is attempted with a prostitute, or in the form of 
 some unnatural sexual act. As ftir as psychical stimuli are here con- 
 cerned, they may be inadequate {v. infra, paraesthesia and perversion of 
 sexual instinct). 
 
 (c) Inhibition. The erection centre may become functionally inca- 
 pable as a result of cerebral influence. This inhibitory influence is an 
 emotion (disgust, fear of contagion), or an idea^ of impotence. There 
 are many men in the first condition who have an unconcpiei-able loathing 
 for their wives, or fear of infection, or are suffering witli ])erverse sexual 
 feelings. In the latter condition are neuro})atliic individuals (neuras- 
 thenics, hypochondriacs), frequently weakened sexually (masturbators), 
 who have reason, or think they have, to mistrust their sexual power. 
 This idea acts as an inhibitory concept, and makes the act with the per- 
 son concerned of the o^jposite sex temporarily or absolutely impossil)le. 
 
 (d) Irritable weakness. In this condition there is abnormal im- 
 pressionability of the centre, but accompanied by rapid diminution of its 
 energy. There may be functional disturbance of the centre itsell", or weak- 
 ness of the innervation through the nervi erigentes ; or there may be 
 
 1 An interesting example of how an imperative conception of non-sexual content 
 can exert an influence is related by Magnan (Ann. m6d. psych., 1SS.5) : Student, aged 21, 
 strongly predisposed hereditarily, previously a niastnrbator, constantly struggles with the 
 number 13 as an imperative conception. As soon as he attempts coitus the Imperative 
 idea inhibits erection and makes the act impossible.
 
 36 PSYCHOPATHIA SEXUALIS. 
 
 weakness of the ischio-cavernosus muscle. Cases in which the erection 
 is ineffectual, on account of abnormally early ejaculation, form a transition 
 
 to the following anomalies : — 
 
 2. Affections of the Ejaculation Centre. 
 
 (a) Abnormally easy ejaculation from absence of cerebral inhibi- 
 tion, resulting from excessive psychical excitement or irritable weakness 
 of the centre. In this case, under certain circumstances, the simple con- 
 ception of a lascivious situation is sufficient to set the centre in action 
 (high degree of spinal neurasthenia, usually resulting from sexual abuse). 
 A third possibility is hypenesthesia of the urethra, by virtue of which, 
 when the semen enters it, an immediate and excessive reflex action of 
 the ejaculation centre is induced. In such a case, simple proximity to 
 the female genitals may be sufficient to induce ejaculation {ante portain). 
 
 In case of hyperaesthesia of the urethra as a cause, the ejacula- 
 tion may be accompanied by painful, instead of pleasurable, sensations. 
 Usually, in cases where there is hypenesthesia of the urethra, there 
 is, at the same time, irritable weakness of the centre. Both functional 
 disturbances are important in the production of pollutio nimia and diurna. 
 
 The accompanying pleasurable feeling may be pathologically ab- 
 sent. This occurs in defective men and women (anaesthesia, aspermia?), 
 and, further, as a result of disease (neurasthenia, hysteria) ; or (in pros- 
 titutes) it follows overstimulation and the blunting thus induced. The 
 intensity of the pleasural)le feeling depends on the degree of psychical 
 and motor excitement accompaming the sexual act. Under pathological 
 conditions this may become so pronounced that the movements of coitus 
 take on the character of involuntary convulsive movements, and even 
 pass into general convulsions. 
 
 (b) Abnormally difficult ejaculation. It is occasioned by inexcita- 
 bility of the centre (absence of libido, paral3^sis of the centre : organic, 
 from disease of brain or spinal cord ; functional, from sexual abuses, 
 marasmus, diabetes, morphinism), and, in this case, for the most part, 
 in connection with anaesthesia of the genitals and paralysis of the 
 erection centre. Or it is the result of a lesion of the reflex arc, or 
 of peripheral anaesthesia (urethra), or of aspermia. The ejaculation 
 occurs not at all, or tardily, in the course of the sexual act, or only 
 afterward, in the form of a pollution. 
 
 III. CEREBRAL NEUROSES. 
 
 1. Paradoxia, i.e., sexual excitement occurring independ- 
 ently of the period of the physiological processes in the 
 generative organs. 
 
 2. Ancestliesia (absence of sexual instinct). Here all
 
 GENERAL PATHOLOGY. 37 
 
 organic impulses arisiiii^- in the sexual organs, as well as all 
 concepts, and visual, auditory, and olfactory sense-impressions, 
 fail to excite the individual sexually. This is physiological in 
 childhood and old age. 
 
 3. Hypercesthesia (increased desire, satyriasis). In this 
 state there is an abnormally increased impressionability of 
 the vita sexualis to organic, psychical, and sensory stimuli 
 (abnormally intense libido, lustfulness, lasciviousness). The 
 stimulus may be central (nymphomania, satyriasis) or periph- 
 eral, functional or organic. 
 
 4. Parwstliesia (perversion of the sexual instinct, i.e., 
 excitability of the sexual functions to inadequate stimuli). 
 
 These cerebral anomalies fall within the domain of psycho- 
 pathology. The spinal and i)eripheral anomalies may occur 
 in combination with them, but these affect persons, as a rule, 
 that are free from mental disease. They may occur in various 
 combinations, and become the cause of sexual crimes. For this 
 reason, they demand consideration in the following description. 
 However, the cerebral anomalies claim the principal interest, 
 since they very frequently lead to the commission of perverse 
 and even criminal acts. 
 
 A. Paradoxia. Sexual Instinct Manifesting itself lNDEPENDENTL"k 
 
 OF Physiological Prooesses. 
 
 1. Sexual Instinct Manifested in Childhood. 
 Every physician conversant with nervous affections and 
 diseases incident to cliildhood is aware of the fact that mani- 
 festation of sexual instinct may occur in very young children. 
 The observations of Ultzmann concerning masturbation in 
 childhood^ are worthy of attention in relation to it. It is 
 necessary here to differentiate between the numerous cases 
 where, as a result of phimosis, balanitis, or oxyuris in rectum 
 or vagina, young children have itching of the genitals, and ex- 
 perience a kind of pleasurable sensation from manipulations 
 
 * Louyer-Villermay speaks of niMsturhatinn in a girl of ;> or 4 years, and Moreau 
 ("Aberrations clu sens genesique," 2 edit., p. 309) of the same in one of 2 years. See, 
 further, ALiudsley, "Physiology and Pathology of Mind;" Hirschsprung (Kopenhagen), 
 Berlin, kliu. Wochenschr., 1866, Nr. 38 ; Lombroso, " The Criminal," Cases 10, 19, aud 21.
 
 38 PSYCHOPATHIA SEXUALIS. 
 
 thus induced, and tlius come to practice masturbation ; and 
 those cases in which sexual ideas and impulses occur in the 
 child as a result of cerebral processes without peripheral causes. 
 It is only in this latter class of cases that we have to do with 
 the early manifestation of sexual instinct. In such cases it may 
 always be regarded as an accompanying symptom of a neuro- 
 psychopatliic constitutional condition. A case of Marc's ("Die 
 Geisteskrankheiten," etc., von Ideler, i, p. 66) illustrates very 
 well these conditions. The subject was a girl of eight years, 
 of respectable family, who was devoid of all child-like and moral 
 feelings, and had masturbated from licr fourth year; at the 
 same time she consorted with boys of the age of ten or twelve. 
 She had thouglit of killing her parents, that she might become 
 her own mistress and give herself up to pleasure with men. In 
 these cases of early manifestation of Hbido the children come also 
 to masturbate ; and, since they are greatly predisposed constitu- 
 tionally, they frequently sink into dementia, or become subjects 
 of severe degenerative neuroses or psychoses. 
 
 Lombroso (Archiv di Psichiatria^ iv, p. 22) has collected a number 
 of cases of children affected with very decided hereditary' taint, which 
 belong in this categor}-. One was that of a girl who masturbated shame- 
 lessly and almost constantly at the age of three. Another girl began at 
 the age of eight, and continued to practice masturbation when married, 
 and even during pregnane}'. She was pregnant twelve times. Five of 
 the children died earl}-, four were hydrocephalic, and two boys began to 
 masturbate, — one at the age of seven, the other at the age of four. 
 
 Zambaco {L^Encephale, 1882, Nr. 1, 2) tells the disgusting story of 
 two sisters alfected with premature and perverse sexual desire. The elder, 
 R., masturbated at the age of seven, practiced lewdness with boys, stole 
 wherever she could, seduced her four-year-old sister into masturbation, and 
 at the age of ten was given up to the practice of the most revolting vices. 
 Even ferrum candens ad clitoridem had no effect in overcoming the 
 practice, and she masturbated with the cassock of a priest while he was 
 exhorting her to reformation. 
 
 o 
 
 2. Be-aivakening of Sexual Indivrt in Old Age} 
 There are infrequent cases in which the sexual instinct per- 
 sists until a great age. " Senectus non quidem annis sed viribus 
 
 * Comp. Kirn, Zeitschr. f. Psych., Bd. xxxix. Legrand du Saulle, Annal. d'byg., 
 1868, Oct.
 
 GENERAL PATHOLOGY. 39 
 
 magis sestimatiir " (Zittmann). Oesterlen (Maschka, Handb., 
 iii, p. 18) mentions the case of a man aged 83, who was sentenced 
 to three years' imprisonment by a Wurtemberg court on account 
 of sexual misdemeanors. Unfortunately nothing is said of the 
 nature of the crime or of the mental condition of the criminal.^ 
 
 The manifestation of sexual instinct in old age is not in 
 itself pathological; but presumption of pathological conditions 
 must necessarily be entertained when the individual is decrepit 
 and his sexual life has already long become extinct; and when 
 the impulse, in a man whose sexual needs were in his early 
 life, perhaps, not very marked, manifests itself with greater 
 strength, and strives for even perverse satisfaction in a shame- 
 less and impulsive manner. In such cases there is at once 
 suggested a presumption of pathological conditions. Medical 
 science recognizes the fact that such an impulse depends upon 
 the morbid alterations of the brain which lead to senile dementia. 
 This abnormal manifestation of sexual life may be the precursor 
 of senile dementia, and make its appearance even long before 
 there are any well-defined manifestations of intellectual weak- 
 ness. The attentive and experienced observer will always be 
 able to detect in this prodromal stage an alteration of character 
 in pejus ^ and a deterioration of the moral sense accompanying 
 the peculiar sexual manifestation. 
 
 The libido of those passing into senile dementia is at first 
 expressed in lascivious speech and gesture. The next objects 
 of the attempts of these senile subjects of brain atrophy and 
 psychical degeneration are children. This sad and dangerous 
 fact is explained by the better opportunity they have of falling 
 in with children, but more especially by a feeling of imperfect 
 sexual power. Defective sexual power and greatly diminished 
 moral sense explain the additional fact of the perversity of the 
 
 1 The translator has lately seen a case of this kind that illustrates the lack of care 
 taken by our criminal courts. A very infirm man, aged 55 to 60, under favoring circum- 
 stances, made an unsuccessful sexual assault on a ffirl ag-od about 18. At his trial he made 
 full confession, and explained his act as due to ordinary sinfulness. He was the father of 
 a family and living with his wife, and up to that time blameless sexually. He was sentenced 
 to five years of hard labor ! He was incapable of almost the lijjhtest work. Conversation 
 with him while in jail showed at once that he was well advanced in senile dementia. Legal 
 question concerning his mental condition was not raised, — because he confessed, probably !
 
 40 PSYCHOPATHIA SEXUALIS. 
 
 sexual acts of these aged men. They are the equivalents of the 
 impossible physiological act. 
 
 The annals of legal medicine distinguish, as such, exhibition 
 of the genitals,^ lustful handling of the genitals of children,^ 
 inducing them to perform manustupration of the seducer, and 
 performing masturbation^ or flagellation on the victim. 
 
 In this stage the intellect may still be sufiiciently intact to 
 allow avoidance of publicity and discovery, while the moral sense 
 is too far gone to allow consideration of the moral significance 
 of the act and resistance to the impulse. With the progress of 
 dementia, these acts are more and more shamelessly committed. 
 Then care on account of- defective sexual power disappears, and 
 adults also become the objects of the senile passion ; but the 
 defective sexual power necessitates equivalents for coitus. Not 
 infrequently sodomy results, and, as Tarnowsky (op. ciV., p. 77) 
 ])oints out, in the sexual act performed with geese, chickens, 
 etc., the sight of the dying animal and its death-struggles at the 
 time of coitus afford complete satisfaction. The perverse sexual 
 acts with adults are quite as horrible, and may be explained 
 psychologically in the same way. 
 
 Case 49, in the author's "Text-Book of Legal Psycho- 
 pathology," second ed., p. 161, demonstrates how enormously 
 increased sexual lust may be during the course of senile 
 dementia. Quum senex libidinosus germanam suam filiam 
 semulatione motus necaret et adspectu pectoris sciosi puellae 
 moribundse delectaretur. 
 
 Erotic delirium and states of satyriasis may occur, in the 
 course of the malady, with or without maniacal episodes, as 
 the following case shows: — 
 
 Case 1. J. Rene, always given to indulgence in sensuality and sexual 
 pleasures, but ahvays with regard for decorum, has shown, since his 
 seventj^-sixth year, a progressive loss of intelligence and increasing per- 
 version of his moral sense. Previously bright and outwardly moral, he 
 now wasted his property- in concourse with prostitutes, frequented brothels 
 
 1 Cases, vide Las6gue : " Les exhibitionist.es," Union m^dicale, 1877, May 1st. 
 
 2 Legraud du Saulle, La folie devant les tribuuaux, p. 530. 
 
 ' Kiru, Maschka's Haudb. d. ger. Med., pp. 373, 374 ; Allg. Zeitscbrift f. Pgychiatrie, 
 Bd. xxxix, p. 220.
 
 GENERAL PATHOLOGY. 41 
 
 only, asked every woman on the street to marry him or allow coitus, and 
 thus became so publicly obnoxious that it was necessary to place him in 
 an asylum. There the sexual excitement increased to a veritable saty- 
 riasis, which lasted until he died. He masturbated continuously, even 
 before others ; took delight only in obscene ideas ; thought the men about 
 him were women, and followed them with indecent proposals (Legrand du 
 Saulle, " La Folic," p. 533). 
 
 Moreover, women previously moral, when affected with senile de- 
 mentia, may manifest similar conditions of great sexual excitement 
 (nymphomania, furor uterinus). 
 
 It may be seen from a reading of Schopenliauer,' that, as 
 a result of senile dementia, the abnormally excited and perverse 
 instinct may be directed exclusively to persons of tlie same sex 
 {v. infra). The manner of the satisfaction is liere passive 
 pederasty, or, as I ascertained in the following case, mutual 
 masturbation : — 
 
 Case 2. Mr. X.,aged 80, of high social position, from a family hav- 
 ing hereditary taint. He was always very sensual and a cynic, of uncon- 
 trollable temper, and, according to his own confession, as a 3'oung man, 
 preferred masturbation to coitus. However, he never showed signs of 
 contrary sexual instinct, and kept mistresses, raising a child bj^ one. At 
 the age of forty-eight he married, out of inclination, and begat six chil- 
 dren, and never gave his wife cause for complaint. I could ol)tain but an 
 incomplete history of his family. It was certain that his brother was 
 suspected of love for men, and that a nephew became insane as a result 
 of excessive masturlmtion. 
 
 The patient, alwaj^s peculiar and quick-tempered, for years has been 
 growing more extreme in character. He has become exceedingly sus- 
 picious, and slight opposition to his wishes induces attacks of anger 
 which may become actual raving, and in which he may raise his hand 
 ao"ainst his wife. For a year there have been unmistakable siirns of in- 
 cipient senile dementia. The patient has become forgetful, localizes ])ast 
 events incorrectly, and has false ideas of time. For fourteen months it 
 has been noticed that he manifests attection for certain male servants, 
 especially for a gardener's lioy. Otherwise rude and overbearing to 
 servants, he surfeits his favorite with favors and i)resents, and commands 
 his family and his house officials to treat the boj' with the greatest 
 respect. The aged patient awaits the hour of rendezvous in true sexual 
 excitement. He sends his family away, that he may l)e with his favorite 
 undisturbed, and remains shut up with him for hours ; and when the 
 
 1 Die Welt ale Wille uud Vorstellung, 1859, B. ii, p. 461 et seq.
 
 42 PSYCHOPATHIA SEXUALIS. 
 
 doors are opened again, lie is found \ying on the bed exhausted. Besides 
 this object of his passion, the patient had intercourse episodically with 
 other servaiits. It is certain that he enticed them, asked them for kisses, 
 exhibited himself, allowed manipulation ad genitalia, and practiced mutual 
 masturbation. By these practices absolute demoralization was brought 
 about. The family was powerless ; for any opposition caused violent 
 outbreaks of anger and even threats against his relatives. The patient 
 was completely without appreciation of his perverse sexual acts; and 
 therefore the only course left to the afflicted family was to remove all 
 authority from his hands and place him in an as^dum. No erotic inclina- 
 tion toward the opposite sex was observed, though the patient occupied a 
 sleeping-apartment with his wife. With reference to the perverse sexu- 
 ality and the defective moral sense of this unfortunate man, it is worthy 
 of note that he questioned the servants of his daughter-in-law as to 
 Tvhether she had a lover. 
 
 B. Anesthesia Sexualis (Absence op Sexual Feeling). 
 
 1. As a Congenital Anomaly. 
 Only those cases can be regarded as unquestionable exam- 
 ples of absence of sexual instinct dependent on cerebral causes, 
 in which, in spite of generative organs normally developed and 
 the performance of their functions (secretion of semen, menstrua- 
 tion), the corresponding emotions of sexual life are absolutely 
 wanting. These functionally sexless individuals are seldom seen, 
 and are, indeed, always persons having degenerative defects, 
 and in whom other functional cerebral disturbances, states of 
 psychical degeneration, and even anatomical signs of degenera- 
 tion, are observed. Legrand du Saulle describes a classical case 
 that falls under this head {Annales medico-psychol.^ May, 1876). 
 
 Case 3. D., aged 33, had a mother who suffered with insanity of 
 persecution. Tlie mother's fixther also suffered with persecutory insanity, 
 and committed suicide. Her mother was insane, and this woman's mother 
 Ijccame insane in the piierperal state. Three of her mother's children 
 died in babyhood, and tliose that lived longer had an abnormal character. 
 As early as his thirteenth year, D. was troubled with the thought of be- 
 coming insane. At fourteen he attempted suicide. Later, vagabondage, 
 and, as a soldier, repeated insubordination and craz}' pranks. His intel- 
 ligence was very limited ; no sign of degeneration, genitals normal. At 
 seventeen or eighteen he had eniissions of semen, had never mastur])ated 
 or had sexual feeling, and never had sought intercourse with women. 
 
 Case 4. P., aged 36, common laborer, was received at my clinic. in
 
 GENERAL PATHOLOGY. 43 
 
 the beginning of Novenil)or on account of spastic spinal paralysis. ITe 
 declares he comes of a healtliy family. A stutterer from his youth. 
 Cranium microcephalic (cf. 5.'} cm.). I'atient somewhat imbecile. He was 
 never sociable, never had a sexual emotion. The sight of a woman never 
 had anything enticing for him. He never had a desire to masturbate. 
 Erections frequent, but only on waiving in the morning with a full bladder, 
 
 and without a trace of sexual feeling. I'ollutions ver}' infrequent, aliout 
 
 once a year, in sleep, — and usuall}' while dreaining that he is concerned 
 with a female. These dreams, however, as his dreams in general, are not 
 markedly erotic. He says the act of pollution is not accompanied by an}- 
 pleasurable sensation. Patient does not feel this absence of sexual sensa- 
 tions. He gives the assurance that his brother, aged 34, is in exactly the 
 same sexual condition as himself, and he makes it seem probable that a 
 sister, aged 21, is in a similar state. A younger brother, he sa^^s, is normal 
 sexually. The examination of his genitals reveals nothing abnormal 
 besides phimosis. 
 
 Hammond ("Sexual Impotence"), even with his wide ex- 
 perience, reports only the following three cases of anaesthesia 
 sexualis : — 
 
 Case 5. Mr. W., aged 33 ; strong, healthy, with normal genitals. He 
 had never experienced libido, and had vainly sought to awaken his de- 
 fective sexual instinct b}' means of obscene stories and intercourse witli 
 prostitutes. On the occasion of such attempts he experienced only dis- 
 gust, with even a feeling of nausea, and ])ecame nervousl^^ and mentally 
 exhausted. Only once, when he forced the situation, did he have a tran- 
 sitory erection. AV. had never masturbated, and had had })ollutions about 
 once every two months from his seventeenth year. Important interests 
 demanded that he marry. He had no horror feminse^ and longed for a 
 home and a wife, but felt that he was incapable of the sexual act. He 
 died, unmarried, in the American civil w^ar. 
 
 Case 0. X.,aged 27; genitals normal ; never felt libido. Mechanical 
 or thermic stimuli easily induced erection, ])ut instead of liludo sexualis 
 there was regularly a desire for alcoholic indulgence. 8uch excesses also 
 induced erections, and he then sometimes masturbated. He had a dis- 
 inclination for w^omen and a loathing of coitus. If, with an erection, he 
 made an attempt at coitus, it disappeared at once. Death in coma during 
 an attack of cerebral hyperaemia. 
 
 Case Y. Mrs. 0., normally developed, healthy, menstruated regu- 
 larly; aged 35, fifteen years married. She never experienced libido, and 
 never had any erotic excitement in sexual intercourse with her husl)and. 
 She was not averse to coitus, and sometimes seemed to experience pleasure 
 in it, but she never had a wish for repetition of cohabitation.
 
 44 PSYCHOPATHIA SEXUALIS. 
 
 In connection with such pure cases of anaesthesia there 
 should be considered other cases in which the mental side of 
 the vita sexualis is a blank leaf in the life of the individual, 
 but where elementary sexual sensations manifest themselves at 
 least in masturbation (comp. the transitional Case 6). According 
 to Magnan's ingenious classification, which, however, is not 
 strictly correct and somewhat too dogmatic, in such cases the 
 sexual life is so limited as to be designated spinal. Possibly in 
 some such cases there exists virtually a mental side of the vita 
 sexualis, but it is very weak, and undermined by masturbation 
 before it attains development. These represent the transitional 
 cases from the congenital to the acquired (psychical) anaesthesia 
 sexualis. This danger threatens many masturbators of vicious 
 constitution. It is psychologically interesting that when the 
 sexual element is early vitiated, then an ethical defect is mani- 
 fested. 
 
 The two following cases, previously published by me in 
 the Archiv filr Psijchiatrle, vii, are given here as illustrations 
 worthy of consideration : — 
 
 Case 8. F. J., aged 19, student ; mother was nervous, sister epileptic. 
 At the age of four, acute brain affection, lasting two weeks. As a child 
 he was not affectionate, and was cold toward his parents ; as a student he 
 was peculiar, retiring, preoccupied with self, and given to much reading. 
 Well endowed mentally. Masturbation from fifteenth 3'ear. Eccentric 
 after puberty, with continual alternation between religious enthusiasm and 
 materialism, — now studying theology, now natural sciences. At the uni- 
 versity his fellow-students took him for a fool. He read Jean Paul almost 
 exclusivelj^, and wasted his time. Absolute absence of sexual feeling 
 toward the opposite sex. Once he indulged in intercourse, experienced 
 no sexual feeling in the act, found coitus absurd, and did not repeat it. 
 Without any emotional cause whatever, he often had a thought of suicide. 
 He made it the subject of a philosoi)hical dissertation, in which he con- 
 tended that it was, like masturbation, a justifiable act. After repeated ex- 
 periments, which he made on himself with various poisons, he attempted 
 suicide with fift^-seven grains of opium ; but he was saved, and sent to an 
 asylum. 
 
 Patient is destitute of moral and social feelings. His writings dis- 
 close incredible frivolit}^ and vulgarity. His knowledge is of a wide 
 range, but his logic is peculiarly distorted. There is no trace of emotion- 
 ality. He treats ever3'thing (even the sublime) with incomparable C3'ni-
 
 GENERAL PATHOLOGY. 45 
 
 cism and irony. He pleads for the justification of suicide with false 
 philosophical premises and conclusions, and, as one would speak of the 
 most indifferent atfair, he declares that he intends to accomplish it. lie 
 regrets (hat his penknife has been taken from him. If he had it he would 
 open his veins as Seneca did, — in the bath. A short time before a friend 
 had given him, instead of a poison as he supposed, a cathartic. Instead 
 of having been a means to send him to the other world, it liad sent him 
 to the water-closet. Only the Great Operator could eradiculc his foolish 
 and fatal idea l)y removing his senses, etc. 
 
 The patient has a large, rhombic, distorted skull, the left half of the 
 forehead being flatter than the right. The occiput is very straight. Ears 
 far back, widely projecting, and the external meatus forms a narrow slit. 
 Genitals very lax ; testicles unusually soft and small. 
 
 Now and then the patient suffers with onomatomania. He is com- 
 pelled to think of the most useless problems and give up to an inter- 
 minable distressing and worrying thought ; and is so fatigued after it 
 that he is no longer capable of any rational thought. Alter some inonths 
 the patient was sent home unimproved. There he spent his time in 
 reading and frivolities, and busied himself with the thought of founding 
 a new Christianity, because Christ had been subject to grand delusions 
 and had deceived the world with wonders (!). After remaining at home 
 some years the sudden occurrence of a maniacal outhn-ak brought him 
 again to the asylum. He presented a mixture of [)rimordial delirium of 
 persecution Cdevil, anti-christ, persecution, poisoning, persecutory voices) 
 and delusions of grandeur (Christ, redemption of the world), with im- 
 pulsive, incoherent actions. Alter five months there Avas a remission of 
 this intercurrent acute mental disease, and the patient returned to the 
 level of his original intellectual peculiarity and moral defect. 
 
 Case 9. E., aged 30, journeyman-painter, was arrested while trying 
 to cut oft' the scrotum of a l)oy he had caught in the woods, lie gave as 
 a motive for this act that he wished to cut into it in order that the world 
 should not multii)ly. Often in his youth, with like purpose, he had cut 
 into his own genitals. 
 
 It is impossible to learn anything of his ancestry. From his child- 
 hood he was mentally abnormal, violent, ncA'cr livel}', very irritable, 
 irascible, selfish, and weak-minded. He hated women, loved solitude, and 
 read much. He sometimes laughed to himself and did silly things. Of 
 late years his hatred of women had increased, especially of those that 
 were pregnant, they being responsible for the misery of the world. He 
 also hated children, and cursed his father. He entertained communistic 
 ideas, and berated the rich and the ministr}', and God, Avho had allowed 
 him to come into the world so poor. He declared that it would be better 
 to castrate all children than to alloAV others to come into the world that 
 could only be fated to endure poverty and misery. He had alwa^'s had 
 the intentio'i, from his fifteenth year, to castrate himself, in order to have
 
 46 PSYCHOPATHIA SEXUALIS. 
 
 no part in increasing unhappiness and adding to the number of men. He 
 hated tlie female sex because it was a means of procreation. Ouly twice 
 in his life had he allowed women to practice manustupration on him, and, 
 with the exception of this, he had never had anything to do with them. 
 Occasionally he had sexual desire, but never for a natural satisfaction of 
 it. When nature did not help him, he occasionally helped himself by 
 means of masturbation. 
 
 He is a powerful, muscular man. The formation of the genitals pre- 
 sents no abnormality. On the scrotum and penis are numerous scars, 
 which resulted from his attempts at self-emasculation, but which, he 
 asserts, were not carried out on account of pain. Genu valgum of right 
 limb. No evidence of onanism could be discovered. He is moody, 
 defiant, irritable. Social feelings are absolutely foreign to him. With 
 the exception of imperfect sleep and frequent headaches, there are no 
 functional disturbances. 
 
 From cases of this kind, depending on cerebral causes, 
 there must be distinguished others where the absence of func- 
 tion arises from an absence or malformation of the generative 
 organs, as in certain hermaphrodites, idiots, and cretins. A 
 case belonging here is found in Masclika's hand-book. 
 
 Case 10. Complainant pleads for divorce on account of impotence 
 of her husband, who has never had intercourse with her. She is thirty- 
 one years old, and a virgin. The husband is somewhat weak mentally, 
 physically strong ; the genitals well developed. He declares that he has 
 never had a complete erection or a flow of semen, and says that he is 
 totally inditi'erent about intercourse with women. 
 
 Ultzmann's^ observations show that anaesthesia sexuaUs is 
 not caused by aspermia simply. He shows that even in con- 
 genital aspermia the vita sexualis and sexual power may be 
 entirely satisfying ; an additional proof that defective libido ah 
 origme is to be sought for in cerebral conditions. 
 
 The naturoi frlgklas of Zacchias are examples of a milder 
 form of anaesthesia. They are met more frequently among 
 women than among men. The characteristic signs of this 
 anomaly are : slight inclination to sexual intercourse, or pro- 
 nounced disinclination to coitus without sexual equivalent, and 
 
 » " Ueber mannliche Sterilitat," Wiener med. Presse, 1878, Nr. 1. " Ueber Potentia 
 generandi et coeundi," Wiener Klinik, 1885, Heft 1, 8. 5. Translated under the title of 
 Genlto-Urinary Neuroses, etc. The F. A. Davis Company, Philadelphia,
 
 GENERAL PATHOLOGY. 4:7 
 
 failure of corresponding psychical, pleasurable excitation during 
 coitus, which is indulged in simply from sense of duty. I have 
 often had occasion to hear com[)laints froQi husbands about tliis. 
 In such cases the wives have always proved to be neuropathic 
 ah origine. Some were at the same time hysterical. 
 
 2. Acquired Aneesthesia. 
 
 Acquired diminution of sexual instinct, extending througli 
 all degrees to extinction, may depend on various causes. These 
 may be organic and functional, psychical and somatic, central 
 and peripheral. The diminution of libido, as age advances, and 
 its temporary disappearance alter the sexual act, are physio- 
 logical. The variations witli reference to tlie duration of the 
 sexual instinct are dependent upon individual factors. Educa- 
 tion and manner of life have a great influence upon the intensity 
 of the vita sexualis. Intense mental activity (hard study), physi- 
 cal exertion, emotional depression, and sexual continence de- 
 cidedly diminish sexual inclination. Continence at first induces 
 increase, but sooner or later, according to constitutional condi- 
 tions, the activity of the generative organs decreases, and with 
 it libido. At all events, in a person sexually mature, a close 
 connection exists between the activity of the generative glands 
 and the degree of libido. That this relation is not determinate 
 is shown by the cases of sensual women, who, after the climac- 
 terium, continue to have sexual intercourse, and may mani- 
 fest states of sexual excitement (cerebral). Also in eunuchs 
 it is seen that libido may long outlast the production of 
 semen. 
 
 On the other hand, however, experience teaches that libido 
 is essentially conditioned by the function of the generative 
 glands, and that the facts mentioned are exceptional manifesta- 
 tions. As peripheral causes of diminution or extinction of libido, 
 may be mentioned castration, degeneration of the sexual glands, 
 marasmus, sexual excesses in the form of coitus and masturba- 
 tion, and alcoholism [cocainism]. In the same way, the disap- 
 pearance of libido in general disturbances of nutrition (diabetes, 
 morphinism, etc.) may be explained. Finally, the atrophy of
 
 48 PSTCHOPATHIA SEXUALIS. 
 
 the testicles should be remembered, which has sometimes been 
 observed to follow focal lesions of the brain (cerebellum). 
 
 A diminution of the vita sexualis, from degeneration of the 
 tracts of the cord and genito-spinal centre, occurs in diseases of 
 the spinal cord and brain. A central interference with the 
 sexual instinct may be organically induced by cortical disease 
 (dementia paralytica in its advanced stages); functionally, by 
 hysteria (central anaesthesia ]) and emotional insanity (melan- 
 cholia, hypochondria). 
 
 C. Hyperesthesia (Abnormally Increased Sexual Desire). 
 
 Pathology has no easy task," in the single case, when it has 
 to decide whether the impulse to sexual satisfaction has reached 
 a pathological degree. Emminghaus (" Psycliopathologie," p. 
 225) declares that the immediate re-awakening of desire after 
 satisfaction, with its occu[)ation of the entire attention, and no 
 less the excitation of libido hj the siglit of persons and things 
 which in themselves should have but an indifferent sexual 
 effect, are decidedly abnormal. In general, sexual instinct and 
 its corresponding needs are in proportion to pliysical strength 
 and age. Sexual desire rapidly increases after puberty, until 
 it reaches a marked degree; is strongest from the twentieth to 
 the fortieth year, and then slowly decreases. Married life seems 
 to preserve and control the instinct. Sexual intercourse with 
 many persons increases the desire. 
 
 Since woman has less sexual need than man, a predominat- 
 ing sexual desire in her arouses a suspicion of its pathological 
 significance; and the more, when this finds expression in desire 
 for adornment, coquetry, or male society, which, passing beyond 
 the limits set by good breeding and manners, becomes quite 
 noticeable. 
 
 The constitution, in both sexes, is of the greatest signifi- 
 cance. An abnormally strong sexual instinct is frequently 
 accompanied by a neuropathic constitution ; and such individuals 
 pass a great part of their lives heavily burdened w ith the weight 
 of this constitutional anomaly of their sexual life. The power 
 of the sexual impulse in such cases may at times rise to the
 
 GENERAL PATHOLOGY. 49 
 
 importance of an organic necessity, and really endanger the 
 freedom of the will. The want of satisfaction of this impulsive 
 desire may, under such conditions, induce a condition allied 
 to actual rutting, or a psychical condition, accompanied by 
 emotions of fear, in which the individual gives up to tlie 
 impulse, and responsibility becomes doubtful. If the individual 
 does not give up to his powerful impulse, he is in danger, by 
 reason of his enforced abstinence, of ruining his nervous system 
 by inducing a neurasthenia, or seriously increasing such a con- 
 dition if it be already present. In normally constituted indi- 
 viduals, too, the sexual instinct is an inconstant quantity. 
 Aside from the temporary indifference following satisfaction, 
 and the diminution of sexual desire in long-continued con- 
 tinence after a certain reactionary stage of sexual desire is 
 overcome, the manner of life has a great influence. Those 
 living in large cities, who are constantly reminded of sexual 
 things and incited to sexual enjoyment, certainly have more 
 sexual desire than those living in the country. A dissipated, 
 luxurious, sedentary manner of life, preponderance of animal 
 food, and the consumption of spirits, spices, etc., have a stimu- 
 lating influence on the sexual life. In woman the sexual 
 inclination is post-menstrually increased. At this time, in 
 neuropathic women, the excitement may reach a pathological 
 degree. 
 
 The great libido of consumptives is remarkable. Hofmann 
 tells of a consumptive peasant who satisfied his wife sexually 
 on the evening before his death. 
 
 The sexual acts are coitus (eventually rape) and, fauie 
 cle mieux, masturbation ; and, with defective moral sense, 
 pederasty or bestiality. If sexual power is diminished or ex- 
 tinct, with excessive sexual desire, all manner of perversity of 
 sexual acts becomes possible. 
 
 Excessive libido may be peripherally or centrally induced. 
 The former manner of origin is the more infrequent. Pruritus 
 and eczema of the genitals may cause it ; and likewise certain 
 substances, like cantharides, which powerfully stimulate sexual 
 desire. Not infrequently, in women at the climacteric, sexual
 
 50 PSTCHOPATHIA SEXUALIS. 
 
 excitement occurs, occasioned by pruritus; and also in cases 
 where there is neuropathic taint. Magnan {Aiinales medico- 
 psycliol.^ 1885, p. 157) reports the case of a lady who was 
 afflicted mornings with attacks of frightful erethismus genitalis, 
 and the case of a man, aged 55, who was tormented at night 
 by unbearable priapism. In each case there was a neurosis. 
 
 The central origin of sexual excitement is of frequent 
 occurrence^ in persons having neurotic taint or hysteria, and 
 in conditions of psychical exaltation. Here, where the cortex 
 and the psycho-sexual centre are in a condition of hyperses- 
 thesia (abnormal excitability of the imagination, increased ease 
 of association), not only visual and tactile impressions, but 
 also auditory and olfactory sensations, may be sufficient to call 
 up lascivious concepts. 
 
 Magnan {op. cit.) reports the case of a young woman who had an 
 increasing sexual desire from puberty, and satisfied it by masturbation. 
 Gradually she grew to become sexually excited at the sight of any man 
 pleasing to her ; and, since she was unable to control herself, she would 
 some^mes shut herself up in a room until the storm had passed. At last 
 she gave herself up to men of her choice, that she might get i-est from 
 her tormenting desire ; but neither coitus nor masturbation brought relief, 
 and she went to an asylum. 
 
 The case of a mother of five children is added, who, in despair about 
 her inordinate sexual impulse, attempted suicide, and then songht an 
 asylum. There her condition improved, but she never trusted herself to 
 leave it. 
 
 There are several illustrative cases in men and women in 
 the author's article, " On Certain Anomalies of Sexual Instinct," 
 Cases 6 and 7 {ArcJiiv fiir Psycliiatrie^ vii, 2) ; Cases 3 and 5 are 
 given here. 
 
 * In individuals in whom intense sexual hypersesthesia is associated with acquired 
 irritable weakness of the sexual apparatus, it is possible that simply at tlie sight of a 
 pleasing female figure, without peripheral irritation of the genitals, not only the mechanism 
 of erection, but also that of ejaculation, may be excited to action from the psycho-sexual 
 centre. For such individuals, all that is necessary to induce orgasm, or even ejaculation, is 
 to imagine themselves in a sexual situation with a female that sits opposite them in railway- 
 coupe or drawing-room. Hammond {op. cit., p. 40) describes several cases of this kind 
 that came to him for treatment for impotence that followed ; and he mentions that these 
 Individuals used the term "ideal coitus " for the act. Dr. Moll, of Berlin, told me of a 
 similar case ; and in this instance the same designation was chosen for the act.
 
 GENERAL PATHOLOGY. 51 
 
 Case 11. On the afternoon of Jnly 7, 1874, Clemens, engineer, being 
 on his way, on business, from Trieste to Vienna, left the train at the town 
 of Brnck, and, passing through the town to the neighljoring village of 
 St. Ruprecht, attempted a rape on an old woman, aged 70, whom he found 
 alone in a house. He was seized by the neighljors and arrested l)y the 
 local })olice. At his hearing he declared that he had tried to find the 
 pound, in order to satisfy his sexual desire with a bitch. lie said that he 
 often suftered with such' sexual excitement. lie did not deny his act, 
 but excused it as the result of disease. The heat, the motion of the cars, 
 and anxiety al)Out his family, to which he wished to go, had confusc^d 
 him and made him ill. Shame and remorse were not sliowu. His con- 
 duct was open, his mien gay ; eyes red and ])right, head hot, tongue coated ; 
 pulse full, soft, beating over 100 ; fingers somewhat tremulous. The state- 
 ments of the accused were precise, but hurried; his glance uncertain, and 
 with an unmistakable expression of lasciviousness. To the medical expert 
 summoned to examine him, he gave the impression of one suli'ering with 
 disease, — as if he were in the beginning of alcoholic insanity. 
 
 C. is forty-five years old, married, father of one child. He does not 
 know what diseases his parents or other members of his I'amily have had. 
 In childhood he was weak and neuropathic. At the age of five his head 
 was injured by a blow with a hoe. A scar one-half cm. broad by one <ni. 
 long, situated on the right parietal and frontal bones, dates IVom that 
 injury. The bone is here somewhat depressed. The overlying skin is 
 united to the bone. Pressure at this point causes pain, which radiates 
 along the lower branch of the trigeminus. This sjwt is also frequently 
 spontaneously painful. In his youth he had frequent attacks of " faint- 
 ing"; before puberty, pneumonia, rheumatism, and intestinal catarrh. 
 At the age of seven he experienced a peculiar inclination for num, — i.e., for 
 a certain superior. Whenever he saw this man he had a |)eculiar feeling 
 in his heart; kissed the ground he walked on. At ten he fell in love with 
 a certain deputy. Later he had an enthusiasm for men, though it was 
 entirely platonic. He began to masturbate at the age of fourteen ; first 
 intercourse at seventeen. Then the earlier manifestations of contrary 
 sexual feeling disappeared entirely. At that time he passed through a 
 peculiar acute psychopathic cojidition, which he described as a kind of 
 clairvoyance. From fifteen, htemorrhoids, with symjitoms of plethora 
 abdominalis. When he had profuse hemorrhoidal luemorrhage, whicli 
 occurred usually every three or four weeks, he was better. At other 
 times he was constantly in a condition of painful sexual excitement, whieli 
 he satisfied partly by means of onanism and partly by coitus. Every 
 woman he met excited him ; even when he was among female relatives he 
 was impelled to make indecent proposals. Sometimes it was possible for 
 him to master his desire ; sometimes he was driven to indecent acts. If, 
 after these, he was kicked out-of-doors, it seemed perfectly right to him ; 
 for he thought that ne needed such correction and support against his
 
 52 PSYCHOPATHIA SEXUALIS. 
 
 powerful impulse, which was a burden to him. No periodicity in this 
 sexual excitement was recognizable. 
 
 Until 1861 he committed excesses in venery and was several times 
 infected with gonorrhoea and chancres. In 1861, marriage. He was 
 sexually satisfied, but became a burden to his wife on account of his great 
 sensuality. In 1864 he passed through an attack of mania in the hospital 
 at Fiume, and in the same year he again fell ill, and was taken to the 
 insane asylum at Ybbs, where he remained until 1867. There he suffered 
 with recurrent mania accompanied by great sexual excitement. He says 
 that intestinal catarrh and anxiety were the cause of his illness at that 
 time. 
 
 Thereafter he was well, but he suffered much on account of his 
 
 excessive sexual desire. If he were absent from his wife but a short time, 
 the impulse became so powerful that man or animal was indifferent to him 
 for the satisfaction of his lust. In summer these impulses were much 
 stronger, and were always accompanied by abdominal plethora. Some- 
 thing that he remembered in medical reading, made him think that in his 
 case the ganglionic sj'stem was more powerful than the cerebral. In 
 October, 1873, on account of business, he had to leave his wife. From 
 that time until Easter, with the exception of occasional masturbation, 
 there was no sexual indulgence. After that he made use of women and 
 bitches. From the middle of June until July 7, he had no opi)ortunity 
 for sexual indulgence. He felt nervously excited, relaxed, and as if he 
 were going crazy. Of late he had slept badl3\ A longing for his wife, 
 who lived in Vienna, drove him to leave his business. He obtained leave 
 of absence. The heat and the noise of the train confused him, and he 
 could no longer hold out against his sexual excitement and the pressure 
 of blood in his abdomen. Everything danced before his ej^es. He left 
 the car at Bruck, and was absolutely confused, not knowing where he 
 went ; and for a moment the thought came to him to throw himself in the 
 water ; all was like a mist before his eyes. Then he saw a woman, exposed 
 his genitals, and tried to embrace her. She cried for help, and thus he 
 was arrested. 
 
 After the attempt it suddenly became clear to him what he had 
 done. He openly confessed his crime, which he remembered in all its 
 details, but which seemed to him to be something abnormal. He could 
 not help it. For some days after this, C. suffered Avith headache and 
 congestions, and was now and then excited and restless, and slept badly. 
 His mental functions are undisturbed, but he is, nevertheless, a con- 
 genitally peculiar man, with a character weak and devoid of energy. The 
 facial expression has something lascivious and peculiar about it. He 
 suffers with haemorrhoids. The genitals present nothing abnormal. 
 The cranium is narrow and retreating at the forehead. Body large and 
 well nourished. With the exception of diarrhoea, there is no disturbance 
 of the vegetative functions.
 
 GENERAL PATHOLOGY. 53 
 
 Case 12. Mrs. E., aged 47. Uncle on father's side was insane; 
 father was sanguine, and given to excess in venery. Patient's brother 
 died of an acute cerebral affection. Patient from childhood has been ner- 
 vous, eccentric, and romantic, and while little more than a child mani- 
 fested excessive sexual desire, and at ten began sexual indulgence. At 
 nineteen, marriage. Unhappy married life ; her husband, who was nonnal, 
 did not satisfy her, and until recent years she constantly had other friends 
 besides her husband. She was well aware of the immorality of her life, 
 but felt her powerlessness against her insatiable desire, which she sought 
 to keep, at least outwardly, a secret. Later she thought that she had 
 suffered with a " mania for men." Patient has borne six children. Six 
 years ago she was thrown from a wagon and received a severe cerebral 
 concussion. Following this there was melancholia, with delusions of 
 persecution, which sent her to the as3dum. She is a]>proaching the 
 climacterium, and of late the menses have been profuse and too frequent. 
 Since this period she is pleased to note that the previously powerful 
 sexual impulse has declined. Proper behavior. Slight degree of 
 descensus uteri and prolapsus ani. 
 
 Hypersesthesia sexualis may be continuously present with 
 exacerbations, or it may be intermittent or periodic. In the 
 latter case it is a cerebral neurosis per se (vide " Special 
 Pathology"), or an accomi)anying symptom of a condition of 
 general psychical excitement (mania ; episodically in dementia 
 paralytica, dementia senilis, etc.). 
 
 Lentz has published a remarkable case of intermittent 
 
 satyriasis {BiiUefm de la societe de med. legale de Belgiqite, 
 
 Nr. 21):— 
 
 Case 13. For three years the generally respected farmer D., married, 
 aged 35, has manifested states of sexual excitement, with increasing fre- 
 quency and severity, which, during the past year, have liecome true 
 paroxysms of satj'riasis. It was impossible to discover hereditary or 
 other organic cause. D. was compelled, at times when his sexual ex- 
 citement was excessiA^e, to perform the sexual act from ten to fifteen 
 times in twenty-four hours, without deriving any feeling of satistaction. 
 Gradually he developed a condition of general nervous h3'per-irrital)ility 
 (erethisme. (jeneral) with increased emotional irritability to the extent of 
 pathologietil outbreaks of anger, and impulse to over-indulgence in alco- 
 hol, which induced s3'mptoms of alcoholism. His attacks of satyriasis 
 became so violent that consciousness was interfered with, and the patient 
 raged about in blind impulse to sexual acts. He demanded that his wife 
 give herself to other men or to animals in his presence ; that she allow 
 copulation with him^presentibus Jiliahus^hecsiXx^Q this would afford him
 
 54 PSYCHOPATHIA SEXUALIS. 
 
 greater enjoyment. Memory for the events at the height of these attacks, 
 in which the extreme irritability even led to outbreaks of maniacal rage, 
 was entirely wanting. D. himself thought tliat he must have had moments 
 in which he no longer had control of his senses, and without satisfaction 
 from his wife would have been compelled to seize the next best female. 
 After an attack of violent emotion, these attacks of sexual excitement 
 suddenly disappeared entirel3\ 
 
 The two following cases show how powerful, dangerous, 
 and painful sexvial hypersesthesia may become in those afflicted 
 with this anomaly : — 
 
 Case 14. Ht/peraesthesia Sexualis — Delirium Acutum ex Ahstinentia. 
 — On May 29, 1882, F., aged 29, single, shoemaker, was received at the 
 clinic. Father was of passionate temper; mother neuropathic, and had 
 an insane brother. Patient had never been seriously ill previously, and 
 was not a drinker, but had always been sexuall}- very passionate. Five 
 days before, he was taken acutel}" ill mentally. He made two attempts 
 at rape in broad daylight, before witnesses, and when arrested talked 
 in delirium onl^' of obscene things, and masturbated without stint, and 
 for three days had been raving mad. On admission lie presented the 
 picture of a severe acute delirium, with violent motor symptoms of irri- 
 tation, and fever. Under treatment with ergotin a cure was etfected. 
 
 On January 5, 1888, second admission, in a state of violent mania. 
 On January 4, he had become morose, irritable, whining, and sleepless ; 
 and then, after vain assaults on women, had manifested sjmptoms of 
 increasing angry excitement. 
 
 On January 6, progress of the condition to severe acute delirium 
 (great disturbance of consciousness, jactation, grinding of the teeth, 
 grimacing, and other motor symptoms of irritation ; temperature as high 
 as 40.7° C.) ; impulsive masturbation. Recovery was complete b}' January 
 11, under energetic treatment with ergotin. 
 
 After his recovery the patient gives an interesting account of the 
 cause of his illness. Always ver}' passionate sexually ; first coitus at 
 the age of sixteen. Continence caused headache, great psj'chical irrita- 
 bility, lassitude, great loss of pleasure in work, and sleeplessness. Since 
 he had few opportunities in the country to satisfy his desire, he had 
 recourse to mastiu'bation. It was necessary for him to masturbate once 
 or twice dail}'. No coitus in two months. Increasing sexual excitement ; 
 could think of nothing save means for the gratification of his impulse. 
 Masturbation was not suflScient to banish the constantly increasing 
 torment ex ahstinentia. During the last four days violent impulse to 
 coitus ; increasing sleeplessness and irritabilit}-. There was only a sum- 
 marj' recollection of the height of the illness. Patient recovered in
 
 GENERAL PATHOLOGY. 55 
 
 December. A very respectable man ; he considers his inordinate desire 
 decidedly pathological, and is anxious about his future. 
 
 Case 15. On July 11, 1884, K., aged 33, servant, was admitted sufter- 
 ing with paranoia persecutoria and neurasthenia sexualis. Mother was 
 neuropathic; father died of spinal disease. From childhood he luul :iii 
 intense sexual desire, of which he became conscious as early as his sixth 
 year. From tliis age, masturbation ; from fifteenth year, f ante de mieux, 
 pederasty ; occasionally, sodomitic indulgences. Later, abusus coitus in 
 marriage cum uxore. Now and then even perverse impulse to commit 
 eunnilingus and to administer cantharides to his wife, because her libido 
 did not equal his own. His wife died after a short i)eriod of married life. 
 Patient's circumstances became straightened, and he had no means to 
 indulge himself sexuall3^ Then masturbation again; employment of 
 lingua canis to induce ejaculation. At times, priapism and conditions 
 approaching satyriasis. He was then driven to masturbate, in order not 
 to become stuporous. Beneficial diminution of the libido nimia, with the 
 gradually predominating sexual neurasthenia and hypochondria. 
 
 The following case, valuable for an understanding of 
 many Messalinas, some of whom are historically celebrated, is a 
 classical example of pure hyperaesthesia sexualis, which I take 
 from Trelat's "Folic lucide": — 
 
 Case 16. Mrs. V. has suffered with a passion for men since her 
 earliest youth. Of good family, well l)red, of pleasant disposition, ex- 
 ceedingly modest, she was, as a little girl, a terror to her familj-, because 
 she could scarcely be alone with a person of the opposite sex, no matter 
 whether it was with child or man of any age, without exposing herself 
 immediately and demanding satisfaction for her sexual passion, even going 
 so far as to lay hold of him. An attempt was made to cure her by 
 marriage. She loved her husband passionately, but even with him she 
 could not keep from demanding coitus of every one with whom she could 
 be alone, no matter whether it was servant, laborer, or school-bo}'. 
 
 Nothing could cure her of this impulse. Even when she became a 
 grandmother, she was still a Messalina. One day she locked a twelve-j'ear- 
 old boy in her room and tried to seduce him. The boy defended himself 
 and escaped. She was scA'erely punished by his brother. All was in vain. 
 She was put in a cloister. There she was an example of morality, and 
 gave not the slightest cause for blame. Immediately after her return the 
 scandal began again. The family banished her, and set aside money to 
 support her. She earned by her own hand-work enough to buy herself 
 lovers. Any one seeing this neatly dressed matron, of good manners and 
 amiable disposition, would never suspect how recklessly passionate she 
 still was at the age of sixtj^-five. On January T, 1854, her family, in
 
 56 PSYCHOPATHIA SEXUALIS. 
 
 despair at new scandals, placed her in an asylum. She lived there until 
 May, 1858, when she died of apoplexia cerebri, in her seventy -third year. 
 Her conduct in the asylum was exemplary. Left to herself, and under 
 favorable conditions, her sexual impulses manifested themselves shortly 
 before her death. With the exception of this, during an observation of 
 four j'ears by physicians of the asylum, she never showed a sign of 
 mental abnormality. 
 
 D. Paresthesia op Sexual Feeling (Perversion op the Sexual 
 
 Instinct). 
 
 In this condition there is perverse emotional coloring of 
 the sexual ideas. Ideas physiologically and psychologically ac- 
 companied by feelings of disgust, give rise to pleasurable sexual 
 feelings ; and the abnormal association finds expression in 
 passionate, uncontrollable emotion. The practical results are 
 perverse acts (perversion of the sexual instinct). This is more 
 easily the case if the pleasurable feelings, increased to passionate 
 intensity, inhibit any opposing ideas with corresponding feelings 
 of disgust ; or the influence of sucli opposing concepts may be 
 impossible on account of the absence or loss of all ideas of 
 morality, aesthetics, and law. This loss, however, is only too 
 frequently found wliere the spring of ethical ideas and feelings 
 (a normal sexual instinct) has been poisoned from the begin- 
 ning. 
 
 With opportunity for the natural satisfaction of the sexual 
 instinct, every expression of it that does not correspond with the 
 purpose of nature, — i.e., propagation, — must be regarded as per- 
 verse. The perverse sexual acts resulting from paraesthesia are 
 of the greatest importance clinically, socially, and forensically ; 
 and, therefore, they must here receive careful consideration ; all 
 aesthetic and polite disgust must be overcome. 
 
 Perversion of the sexual instinct, as will be seen from what 
 follows, is not to be confounded with perversity in the sexual 
 act ; since the latter may be induced by conditions which are 
 not psych opathology. The concrete perverse act, monstrous as 
 it may be, is not decisive. In order to differentiate between 
 disease (perversion) and vice (perversity), one must investigate 
 the whole personality of tlie individual and the original impulse
 
 SADISM. 57 
 
 leading to the perverse act. Therein will be found the key of 
 diagnosis (v. infra). 
 
 Paraesthesia may occur in combination with h}']iera3sthesia. 
 Tliis association seems to be frequent clinically. Sexual acts 
 are then confidently to be expected. The perverse direction of 
 sexual activity may be toward sexual satisfaction with the 
 opposite or the same sex. Thus two great groups of perver- 
 sions of the sexual life may be distinguished. 
 
 7. Sexual Inclination toward Persons of the Opposite Sex, with Perverse 
 
 Activity of the Instinct. 
 
 1. Association of Active Cruelty and Violence irith Lnst — 
 Sadism} — That lust and cruelty frequently occur together is 
 a fact that has long been recognized and not infrequently 
 observed. Writers of all kinds have called attention to this 
 phenomenon.^ The not infrequent cases where individuals of 
 very excitable sexual natures bite or scratch the companion in 
 intercourse fall within physiological limits.^ The older authors 
 have called attention to the relation between lust and cruelty. 
 
 Blumroder (" TJeber Irresein," Leipzig, 1836, p. 51) saw a man who 
 had several wounds bitten into the pectoral muscle, which a woman, in 
 great sexual excitement, had given him at the acme of lustful feeling 
 during coitus. Blumroder (" Ueber Lust und Schmerz," Friedreich's 
 Magazin fur Seelenkunde, 1830, ii, 5) calls especial attention to the ps^'- 
 chological connection between lust and murder. In relation to this, he 
 especially refers to the Indian myths of Siva and Durga (Death and 
 Lust) ; to human sacrifice with sensual mysteries ; and to sexual instinct 
 at puberty with a lustful impulse to suicide, with whipping, pinching, and 
 pricking of the genitals, in the blind impulse to satisf^^ sexual desire. 
 Lombroso (" Verzeni e Agnoletti," Rome, 1874) also cites numerous exam- 
 ples of the occurrence of a desire to murder with greatl}' increased lust. 
 
 1 So named from the notorious Marquis de Sade, whose obscene novels treated of 
 lust and cruelty. In French literature the expression " Sadism "has been applied to this 
 perversion. 
 
 2 U. A. Novalis, in his " Fragments " \ Gorres, " Christliche Mystik," Bd. iii, p. 460. 
 ' Comp. also Alfred deMusset's famous verses to the Audalusian ^irl : — 
 
 " Qu'elle est superbe en son d6sordre — quand elle tonibe les seiiis nus — 
 Qu'on la volt, b^ante, se tordre — dans un baiser de rage et mordre — 
 En hurlant des mots inconnus I"
 
 58 PSYCHOPATHIA SEXUALIS. 
 
 On the other hand, when murderous hist has been excited, 
 lust itself often follows. Lombroso (ojJ. cit.) alludes to the fact, 
 mentioned by Mantegazza, that, with fea,r of being plundered 
 by bandits, there was always a dread of brutal lust.^ These 
 examples form transitions to the pronounced pathological cases. 
 
 The examples of the degenerate Caesars (Nero, Tiberius) are also 
 instructive. They took delight in having j'ouths and maidens slaughtered 
 before their eyes. Not less so is the history of that monster, Marsehalls 
 Gilles de Rays (Jacob, " Curiosit^s de I'histoire de France," Paris, 1858), 
 who was executed in 1440, on account of mutilation and murder, which he 
 had practiced for eight years on more than eight hundred children. As 
 the monster confessed it, it was from reading Suetonius and the djescrip- 
 tions of the orgies of Tiberius, Caracalla, etc., that the idea was gained 
 of locking children in his castles, torturing them, and then killing them. 
 This inhuman wretch confessed that in the commission of these acts he 
 enjoyed inexpressil:»Ie pleasure. He had two assistants. The bodies of 
 the unfortunate children were burned, and onl}' a number of heads of 
 particularly beautiful children were preserved — as memorials. 
 
 In an attempt to explain the association of lust and cruelty, 
 it is necessary to return to a consideration of the quasi-physio- 
 logical cases, in which, at the moment of most intense lust, very 
 excitable individuals, who are otherwise normal, commit such 
 acts as biting and scratching, wliich are usually the result of 
 anger. It must further be remembered that love and anger are 
 not only tlie most intense emotions, but also the only two forms 
 of active (sthenic) emotion. Both seek their object, try to 
 possess themselves of it, and naturally exhaust themselves in a 
 physical effect on it ; both throw the psycho-motor sphere into 
 the most intense excitement, and thus, by means of this excita- 
 tion, reach their normal expression. 
 
 From this stand-point it is clear how lust impels to acts 
 that otherwise are expressive of anger.^ The one, like the 
 
 1 During the excitement of battle the idea of lust forces its way into consciousness. 
 Comp. the description of a battle by a soldier, by Grillparzer : — 
 
 " And as the signal rang out, the armies met, breast to breast — lust of the gods I — 
 here, there, the murderous steel slays enemy, friend. Given and taken — death and life — 
 with wavering change — wildly raging in frenzy." 
 
 2 Schulz (Wiener Med. Wochenschrift, No. 49, 1869) reports a remarkable case of a 
 man, aged 28, who could perform coitus with his wife only after working himself into an 
 artificial fit of anger.
 
 SADISM. 59 
 
 other, is a state of exaltation, an intense excitation of tlie wliole 
 psycho-motor spliere. Thus tliere arises an impulse to react 
 on tlie object that induces the stimulus, in every possible way, 
 and with the greatest intensity. Just as maniacal exaltation 
 easily passes to furibund destructivencss, exaltation of the 
 sexual emotion often induces an impulse to expend itself in 
 senseless and apparently harmful acts. To a certain extent 
 these are psychical accompaniments; but it is not simply an 
 unconscious excitation of innervation of muscles (which also 
 sometimes occurs as blind violence) ; it is a true hyperbulia, a 
 desire to exert the most intense effect on the individual crivhiir 
 rise to the stimulus. The most intense means, however, is the 
 infliction of pain. 
 
 Through such cases of infliction of pain, during the most 
 intense emotion of lust, we approach the cases in which a 
 real injury, wound, or death, is inflicted on the victim.' In these 
 cases, the impulse to cruelty, which may accompany the emotion 
 of lust, becomes unbounded in a psychopathic individual; and, 
 at the same time, owing to defect of moral feeling, all normal 
 inhibitory ideas are absent or weakened. Such monstrous, 
 sadistic acts have, however, in men, in whom they are much 
 more fre(iuent than in women, another source in physiological 
 conditions. In the intercourse of the sexes, the active or aggres- 
 sive role belongs to man ; woman remains passive, defensive." 
 It affords a man great pleasure to wdn a woman, to conquer 
 her; and in the ars aimmdi^ the modesty of a w^oman who 
 keeps herself on the defensive until the moment of surrender, 
 is an element of great psychological significance and im- 
 portance. Under normal conditions a man meets obstacles 
 which it is his part to overcome, and for which nature has 
 given him an aggressive character. This aggressive char- 
 acter, however, under pathological conditions, may likewise 
 be excessively developed, and express itself in an impulse 
 
 * Concerning analogous acts in rutting animals, vide Lombroso, " The Criminal." 
 '■* Among- animals it is always the male who pursues the female with proffers of love. 
 
 Playful or actual flight of the female is not infrequently observed ; and then the relation is 
 
 like that between the beast of prey and the victim.
 
 60 PSYCHOPATHIA SEXUALIS. 
 
 to subdue absolutely the object of desire, even to destroy or 
 kill it.^'^ 
 
 If both these constituent elements occur together, — the 
 abnormally intensified impulse to a violent reaction toward the 
 object of the stimulus, and the abnormally intensified desire to 
 conquer the woman, — then the most violent outbreaks of sadism 
 occur. 
 
 Sadism is thus nothing else than an excessive and mon- 
 strous pathological intensification of phenomena, — possible, 
 too, in normal conditions in rudimental forms, — which accom- 
 pany the psychical vita sexualis, particularly in males. It is, 
 of course, not at all necessary, and not even the rule, that the 
 sadistic individual should be conscious of his instinct. What 
 he feels is, as a rule, only the impulse to cruel and violent 
 treatment of tlic opposite sex, and the coloring of the idea of 
 such acts with lustful feelings. Thus arises a powerful impulse 
 to commit the imagined deeds. When the actual motive of 
 this instinct is not comprehended by the individual, the sadistic 
 acts have the character of impulsive deeds. 
 
 When the association of lust and cruelty is present, not 
 only does the lustful emotion awaken the impulse to cruelty, 
 but vice versa ; cruel ideas and acts cause sexual excitement, 
 and in this way are used by perverse individuals.^ 
 
 1 The conquest of woman takes place to-day in the social form of courting, in seduc- 
 tion and deception. From the history of civilization and anthropology we know that there 
 have been times, as there are savages to-day that practice it, wliere brutal force, robbery, 
 or even blows that made a woman powerless, were made use of to obtain love's desire. It 
 is possible that tendencies to such outbreaks of sadism are atavistic. 
 
 2 In the Jahrbiicher fi\r Psychologic, ii, p. 128, Sehafer (Jena) refers to tlie reports 
 of two cases by A. Payer. In the first case states of great sexual excitement were induced 
 by the sitjht of battles or of paintings of them ; in the second, by cruel torturing of small 
 animals {vide Case 24). It is added : " The pleasure of battle and murder is so predomi- 
 nantly an attribute of the male sex throughout the animal kingdom, that there can be no 
 question about the close relation existing between this side of the masculine character 
 and male sexuality. I believe, too, that by unprejudiced observation I can show that, 
 in men who are absolutely normal mentally and physically, the first indefinite and incom- 
 prehensible precursors of sexual excitement may be induced by reading exciting scenes 
 of the chase and war, — i.e., they give rise to unconscious longings for a kind of satisfaction 
 in warlike games (wrestling), in which, also, the fundamental sexual impulse to the most 
 perfect and intense contact with a companion is expressed, with the more or less clearly 
 defined secondary thought of conquest." 
 
 3 It sometimes happens that an accidental sight of blood, etc., is what first excites 
 the preformed psychical mechanism of the sadistic individual, and awakens the instinct.
 
 SADISM. 61 
 
 A difFerentiation of original and acquired cases of sadism 
 is scarcely possible. Many individuals, tainted ah origine^ tor a 
 long time do every tiling to conquer the perverse instinct. If 
 they are potent, at first they arc able to lead a normal vita 
 sexualis, often with the assistance of subjective ideas of a per- 
 verse nature. Later, after the opposing motives of an ethical 
 and aesthetic kind have been gradually overcome, and after the 
 constantly repeated experience tliat the natural act does not 
 bring complete satisfaction, the abnormal instinct bursts forth. 
 Owing to this late expression, in acts, of an originally perverse 
 disposition, the appearances are those of an accjuired perversion. 
 As a rule, it may be safely assumed that this psychopathic state 
 exists ah origiue. 
 
 Sadistic acts vary in monstrousness with variation in 
 tlie power of the perverse instinct over the individual afflicted, 
 and with variation in the strength of opposing ideas that may be 
 present, which almost always are more or less weakened by 
 original ethical defect, hereditary degeneracy, or moral insanity. 
 Thus there arises a long series of forms which begins with 
 capital crime and ends with silly acts which afford the perverse 
 desires of the sadistic individual merely symbolic satisfaction. 
 
 Sadistic acts may be further differentiated with reference 
 to their nature : either as they are indulged in after consum- 
 mated coitus by which the libido nimia remains unsatisfied ; 
 or, with diminished virility, as they are used to stimulate tlie 
 diminished power ; or, finally, where virility is absolutely want- 
 ing, as tliey become an equivalent for the impossible coitus, for 
 the hiduction of ejaculation. In the last two cases, notwith- 
 standing the impotence, there is still intense libido ; or tliere 
 was, at least, intense libido in the individual at the time when 
 the sadistic acts became habitual. Sexual hypertesthesia is 
 always to be regarded as the basis of sadistic inclinations. The 
 impotence which occurs so frequently in the psychopathic and 
 neuropathic individuals here considered, as a result ol* excesses 
 indvdged in from early youth, is usually dependent upon spinal 
 weakness. Often, too, there is a kind of psychical impottMice, 
 induced by concentration of thought on the perverse act witli
 
 62 PSTCHOPATHIA SEXUALIS. 
 
 simultaneous fading of the idea of normal satisfaction. No 
 matter what the external form of the act may be, the mentally 
 perverse predisposition and instinct of the individual are 
 essential to an understanding of it. 
 
 (a) Lust-Murder^ {Lust Potentiated as Cruelty^ Murderous 
 Lust Extending to Anthropophagy). — The most horrible ex- 
 ample, and one which most pointedly shows the connection 
 between lust and a desire to kill, is the case of Andreas Bichel, 
 which Feuerbach published in his " aktenmiissige Darstellung 
 merkw iirdiger Verbrechen." 
 
 B. puellas stupratas necavit et dissecuit. With reference to one of 
 his victims, at his examination he expressed himself as follows : " I opened 
 her breast and with a knife cut through the fleshy parts of the body. 
 ' Then I arranged the body as a butcher does a beef, and hacked it with an 
 axe into })ieces of a size to fit the hole which I had prepared up iu the 
 mountain for burying it. I may say that while opening the bod}' I was 
 so greedy that I trembled, and could have cut out a piece and eaten it." 
 
 Lombroso, too (" Geschlechtstrieb und Verbrechen in ihren gegen- 
 seitigen Beziehungen." Goltdammer's Archiv, Bd. xxx), mentions cases 
 falling in the same category. A certain Phillipe indulged in choking 
 l)rostitutes, post-actum, and said : " I am fond of women, but it is sport 
 for me to choke them after having enjoyed them." 
 
 A certain Grassi (Lombroso, op. cit., p. 12) was one night seized 
 with sexual desire for a relative. Irritated by her remonstrance, he 
 stabbed her several times in the abdomen with a knife, and also stabbed 
 her father and uncle who attempted to hold him back. Immediately 
 thereafter he hastened to visit a prostitute in order to cool his sexual 
 passion in her arms. But this was not sufficient. He then murdered his 
 father and slaucfhtered several oxen in the stable. 
 
 '&' 
 
 It cannot be doubted, from what has gone before, tliat a 
 great number of so-called lust-murders depend upon a combi- 
 nation of hypersesthesia and parsesthesia sexualis. As a result 
 of this perverse coloring of tlie feelings, further acts of 
 bestiality with the body may result,— e.g., cutting it up and 
 wallowing in the intestines. The case of Bichel points to this 
 possibility. 
 
 A modern example is that of Menesclou {Amiales 
 
 ^Comp. Mctzgei's ger. Arzneiw., herausgegcben von Remer, p. 539 ; Klein's Aii- 
 naleu, x, \>. 176, xviii, p. 311; Hcinroth, System der psych, ger. Med., p. 270; Neuer 
 Pitaval, 1855, 23, Th. (Fall Blaize Ferrage).
 
 SADISM. 63 
 
 dlnjgiene piMlque), who was examined by Lasegue, Biouardel, 
 and Motet, declared to be mentally sound, and executed. 
 
 Case IT. A four-3'ear-old girl was missing from her parents' home, 
 April 15, 1880. On April 16th, Menesclou, one of the occupants of the 
 house, was arrested. The forearm of the child was found in his pocket, 
 and the head and entrails, in a half-burned condition, were taken from the 
 stove. Parts of the body were found in the water-closet. The genitals 
 could not be found. M., when asked their whereabouts, became eml)ar- 
 rassed. The circumstances, as well as an obscene poem found on his 
 person, left no doubt that he had violated the child and then nmrdered 
 her. M. expressed no remorse, asserting that his deed was an accident. 
 His intelligence is limited. He presents no anatomical signs of degen- 
 eration ; is somewhat deaf, and scrofulous. 
 
 M., aged 20 ; convulsions at the age of nine months. Later, he suf- 
 fered from poor sleep (enuresis nocturna) ; was nervous, and developed 
 tardily and imperfectly. From the time of puberty he was irritable, 
 showed evil inclinations ; was lazy ; could not be taught, and in all trades 
 proved to be of no use. He grew no better even in the House of Cor- 
 rection. He was made a marine, but there, too, he proved usi'less. When 
 he returned home he stole from his parents, and spent his time in bad 
 company. He did not run after women, but gave himself up passionate!}' 
 to masturbation, and occasionally indulged in sodomy with bitches. His 
 mother suffered with mania menstrualis periodica. An uncle was insane, 
 and another an inebriate. The examination of M.'s brain showed morbid 
 changes of the frontal lobes, of the first and second temporal convolutions, 
 and of a part of the occipital convolutions. 
 
 Case 18. Alton, a clerk in I]ngland, goes out of town for a walk. 
 He lures a child into a thicket, and returns after a time to his office, where 
 he makes this entry in his note-book : " Killed to-day a young girl ; it was 
 fine and hot." The child was missed, searched for, and found cut into 
 pieces. Many parts, and among them the genitals, could not be found. 
 A. did not show the slightest trace of emotion, and gave no explanation 
 of the motive or circumstances of his horrible deed. He was a psycho- 
 pathic individual, and occasionally subject to states of de[)ression with 
 tedium vitfie. His father had had one attack of acute mania. A near 
 relative suffered from mania with homicidal impulses. A. was executed. 
 
 In such cases it may even happen tliat appetite for lli(> tiesli 
 of the murdered victim arises, and, in consequence of this per- 
 verse coloring of the idea, parts of the body may be eaten. 
 
 Case 19. Leger, vine-dresser, aged 24. From youth moody, silent, 
 shy of people. He starts out in search of a situation. He wanders about 
 eight days in the forest, there catches a girl twelve years old, violates her,
 
 64 PSYCHOPATHIA SEXUALIS. 
 
 mutilates her genitals, tears out her heart, eats of it, drinks the blood, 
 and buries the remains. Arre-sted, at first he lied, but finally confessed 
 his crime with cynical cold-bloodedness. He listened to his sentence of 
 death with indifference, and was executed. At the post-mortem exami- 
 nation, Esquirol found morbid adhesions between the cerebral membranes 
 and the brain (Gorget, " Darstellung der Prozesse Leger, Feldtmann," 
 etc., Darmstadt, 1827). 
 
 Case 20. Tirsch, hospital beneficiary of Prag, aged 55, always silent, 
 peculiar, coarse, very irritable, grumbling, revengeful, was sentenced to 
 twenty j^ears' imprisonment, on account of violating a girl ten years old. 
 He had attracted attention on account of outbursts of anger from insig"- 
 nificant causes, and also on account of ta?dium vitae. In 1864, on account 
 of the refusal of an oflfer of marriage which he niade to a widow, he devel- 
 oped a hatred toward women, and on July 8th he went about with the 
 intention of killing one of this hated sex. Yetulam occurentem in silvam 
 allexit, coitum i)0})oscit, renitentem prostravit, jugulum feminte compressit 
 " furore captus." Cadaver virga betula? desecta verberare voluit neque 
 tamen id perfecit, quia conscientia sua haec fieri vetuit, cultello mammae 
 et genitalia desecta domi cocta proximis diebus cum globis comedit. On 
 September 12th, when he was arrested, the remains of this meal were found. 
 He gave as the motive of this act " inner impulse." He himself wished to 
 be executed because he had always been persecuted. In confinement 
 there were great emotional irritability and occasional outbursts of fury, 
 preceded by refusal of food, which made isolation, lasting several days, 
 necessary. It was authoritatively established that the most of his earlier 
 excesses were coincident with outbreaks of excitement and fury (Maschka, 
 Prager Vierteljahrsschrift^ 1866, i, p. 79). 
 
 The AVhitechapel murderer, who still eludes the vigilance 
 of the police, probably belongs in tliis category of psycho-sexual 
 monsters.^ The constant absence of uterus, ovaries, and labia, 
 in the victims (ten) of this modern Bluebeard, allows the pre- 
 sumption that he seeks and finds still further satisfaction in 
 'anthropo])liagy. • 
 
 In other cases of lust-murder, for physical and mental 
 reasons {vide supra), violation is omitted, and the sadistic crime 
 alone becomes the equivalent of coitus. The prototype of such 
 cases is the following one of Verzeni. The life of his victim 
 hung on the rapid or retarded occurrence of ejaculation. Since 
 
 ^ Comp. Spitzka, The Journal of Nervous and Mental Disease, December, 1888 ; 
 Kiernau, The Medical Standard, November, December, 1888.
 
 SADISM. 65 
 
 this remarkable case presents all the peculiarities which modern 
 science knows concerning the relation of lust to lust-murder 
 with anthropophagy, and especially since it was carefully studied, 
 it receives detailed description here : — 
 
 Case 21. Vincenz Verzeni, born in 1849; ^ince January 11, 1872, 
 in prison; is accused (1) of an attempt to strangle his nurse Marianne, 
 four years ago, while she lay sick in bed; (2) of a similar attempt on 
 a married woman, Arsulli, aged 27 ; (o) of an attempt to strangle a 
 married woman, Gala, by grasping her throat while kneeling on her body ; 
 (4) on suspicion of the following murders : — 
 
 In December a fourteen-year-old girl, Johanna Motta, set out for a 
 neighboring village between seven and eight o'clock in the morning. 
 Since she did not return, her master set out to find her, and discovered 
 her body near the village, lying by a path in the fields. The corpse was 
 frightfully mutilated with numerous wounds. The intestines and genitals 
 had been torn from the opened body, and were found near by. The naked- 
 ness of the body and erosions on the thighs made it seem probaljle that 
 there had been an attempt at rape ; the mouth filled with earth pointed to 
 suflbcation. In the neighborhood of the body, under a pile of straw, 
 were found a portion of flesh torn from the right calf, and pieces of 
 clothing. The perpetrator of the deed remained undiscovered. 
 
 On August 28, 1871, a married woman, Frigeni, aged 28, set out in 
 the fields early in the morning. Since she did not return by eight o'clock, 
 her husband started out to fetch her. He found her a corpse, lying naked 
 in the field, with the mark of a thong around her neck, with which she 
 had been strangled, and with numerous wounds. The abdomen had been 
 slit open, and the intestines were hanging out. 
 
 On August 29, at noon, as Maria Previtali, aged 19, went through a 
 field, she was followed by her cousin, Verzeni. He dragged her into a 
 field of grain, threw her to the ground, and began to choke her. As he let 
 go of her for a moment to ascertain whether there were any one near, the 
 girl got up and, by her supplicating entreaty, induced Verzeni to let her 
 go, after he had pressed her hands together for some time. 
 
 Verzeni was brought before a court. He is twenty -two years old. 
 His cranium is of more than average size, but asymmetrical. The right 
 frontal bone is narrower and lower than the left, the right frontal promi- 
 nence being less developed, and the right ear smaller than the left (by 
 1 centimetre in length and 3 centimetres in breadth) ; both ears are 
 defective in the inferior half of the helix ; the right temporal artery is 
 somewhat atheromatous. Bull-necked; enormous development of the 
 zygomee and inferior maxilla ; penis greatly developed, frffinum wanting ; 
 slight divergent alternating strabismus (insufficiency of the internal rectus 
 muscle, and myopia). Lombroso concludes, fi'om these signs of degenera-
 
 66 PSTCHOPATHIA SEXUALIS. 
 
 tion, that there is a congenital arrest of development of the right frontal 
 lobe. As seemed probable, Verzeni has a bad ancestry, — two uncles are 
 cretins ; a third, microcephalic, beardless, one testicle wanting, the other 
 atrophic. The father shows traces of pellagrous degeneration, and had an 
 attack of hypochondria pellagrosa. A cousin suffered from cerebral 
 hj'^perjemia ; another is a confirmed thief. 
 
 Verzeni's family is bigoted and low-minded. He himself has ordi- 
 nary intelligence ; knows how to defend himself well ; seeks to prove an 
 alibi and cast suspicion on others. There is nothing in his past that 
 points to mental disease, but his character is peculiar. He is silent and 
 inclined to be solitary. In prison he is cynical. He masturbates, and 
 makes every effort to gain sight of women. 
 
 Verzeni finally confessed his deeds and their motive. The com- 
 mission of them gave him an indescribably pleasant (lustful) feeling, 
 which was accompanied by erection and ejaculation. As soon as he had 
 grasped his victim by the neck, sexual sensations wei'e experienced. It 
 was entirel}' the same to him, with reference to these sensations, whether 
 the women were old, 3'ouug, ugly, or beautiful. Usually, simply choking 
 them had satisfied him, and he then had allowed his victims to live ; in 
 the two cases mentioned, the sexual satisfaction was delayed, and he had 
 continued to choke them until they died. His satisfaction in this garrot- 
 ing was greater than in masturbation. The abrasions of the skin on 
 Motta's thighs were produced b}^ his teeth, while sucking her blood in 
 most intense lustful pleasure. He had torn out a piece of flesh from her 
 calf and taken it with him to roast at home ; but on the way he hid it 
 under the straw-stack, for fear his mother would suspect him. He also 
 carried pieces of the clothing and intestines some distance, because it 
 gave him great pleasure to smell and touch them. The strength which 
 he possessed in these moments of intense lustful pleasure, was enormous. 
 He had never been a fool ; while committing his deeds he saw nothing 
 around him (apparently as a result of intense sexual excitement, annihila- 
 tion of apperception — instinctive action). After such acts he was always 
 very happy, enjoying a feeling of great satisfixction. He had never had 
 pangs of conscience. It had never occurred to him to touch the genitals 
 of the martyred women, or to violate his victims. It had satisfied him 
 to throttle them and suck their blood. These statements of this modem 
 vampire seem to rest on truth. Normal sexual impulses seem to have 
 remained foreign to him. Two sweethearts that he had, he was satisfied 
 to look at ; it was very strange to him that he had no inclinations to 
 strangle them or press their hands ; but he had not had the same pleasure 
 with them as with his victims. There was no trace of moral sense, — 
 remorse and the like. 
 
 Verzeni said himself that it would be a good thing if he were to be 
 kept in prison, because with freedom he could not resist his impulses. 
 Verzeni was sentenced to imprisonment for life (Lombroso," Verzeni e
 
 SADISM. 67 
 
 Agnoletti," Rome, 1873). The confessions which Yerzeni made after his 
 sentence, are interesting : — 
 
 "I had an unspeakable deliglit in strangling women, experiencing 
 during the act erections and real sexual pleasure. It was even a pleasure 
 only to smell female clothing. The feeling of pleasure while strangling 
 them was much greater than that which I experienced while mastur- 
 bating. I took great delight in drinking Motta's blood. It also gave me 
 the greatest pleasure to pull the hair-pins out of the hair of my victims. 
 
 " I took the clothing and intestines, because of the pleasure it gave 
 me to smell and touch them. At last my mother came to suspect me, 
 because she noticed spots of semen on my shirt after each nmrder or 
 attempt at one. I am not crazy, but in the moment of strangling my 
 victims 1 saw nothing else. After the commission of the deeds I was 
 satisfied and felt well. It never occurred to me to touch or look at the 
 genitals or such things. It satisfied me to seize the women by the neck 
 and suck their blood. To this very day I am ignorant of how a woman 
 is formed. During the strangling and after it, I pressed myself on the 
 entire body without thinking of one part more than another." 
 
 Verzeni arrived at his perverse acts entirely independently, after 
 having noticed, when he was twelve years old, that he experienced a 
 peculiar feeling of pleasure while wringing the necks of chickens. After 
 this he had often killed great numbers of them, and then said that a 
 weasel had been in the hen-coop (Lombroso, Goltdammer's Archiv^ J3d. 
 XXX, p. 13). 
 
 Lombroso mentions an analogous case (Goldtdammer's 
 Archiv) which occurred in Vittoria (Spain) : — 
 
 Case 22. A certain Gruj^o, aged 41, with a blameless past life, 
 having been three times married, strangled six women in the course of 
 ten years. They were almost all public prostitutes and quite old. After 
 the strangling he tore out their intestines and kidneys per vaginam. 
 Some of his victims he violated before killing, others, on account of the 
 occurrence of impotence, he did not. He set about his horrible deeds 
 with such care that he remained undetected for ten years. 
 
 (b) Mutilatimi of Corpses. — Following the preceding hor- 
 rible group of perversions of the sexual instinct, which arise 
 from hyperaesthesia and parsesthesia sexualis with retained 
 virility, come naturally the necrophiles ; for in these cases, 
 just as with lustful murderers and analogous cases, an idea 
 which in itself awakens a feeling of horror, and before which a 
 healthy person would shudder, is accompanied by lustful feel-
 
 68 PSYCHOPATHIA SEXUALIS. 
 
 ings, and thus leads to the impulse to indulge in acts of 
 necrophilia. 
 
 The cases of mutilation of bodies mentioned in literature 
 seem to be pathological ; but, with the exception of the cele- 
 brated one of Sergeant Bertrand {v. infra), they come far from 
 being- described and observed with exactness. In certain cases 
 there may be nothing more than the possibility that unbridled 
 desire sees in the idea of death no obstacle to its satisfaction. 
 The seventh case mentioned by Moreau is perhaps such a one : — 
 
 A man, aged 23, attempted to rape a woman, aged 53. Struggling, 
 lie killed her and then violated her, threw her in the water, and fished her 
 out again for renewed violation. The murderer was executed. The 
 meninges of the anterior lobes were thickened and adherent to the cortex. 
 
 French writers have recorded numerous examples of necrophilia. 
 Two cases concerned monks, where they were performing the watch for 
 the dead. In a third case the subject was an idiot, who also suffered from 
 periodical mania, and after commission of rape was sent to an insane 
 asylum, and there mutilated female bodies in the mortuary. 
 
 In other cases, however, there is undoubtedly direct prefer- 
 ence of a corpse to the living woman. When no other act of 
 cruelty — cutting into pieces, etc. — is practiced on the cadaver, 
 it is probable that the lifeless condition itself forms the stimulus 
 for the perverse individual. It is possible that the corpse — a 
 human form absolutely without will — satisfies an abnormal 
 desire, in that the object of desire is seen to be capable of 
 absolute subjugation, without possibility of resistance. 
 
 Brierre de Boismont (Gazette medicale, July 21, 1859) relates the 
 history of a corpse-violator who, after bribing the watchman, had gained 
 entrance to the corpse of a girl of sixteen, who belonged to a family of 
 high social position. At night a noise was heard in the death-chamber, 
 as if a piece of furniture had fallen over. The mother of the dead girl 
 effected an entrance, and saw a man dressed in his night-shirt springing 
 from the bed where the bod}' \a,y. It was at first thought that the man 
 was a thief, but the real explanation was soon discovered. It was after- 
 ward ascertained that the culprit, a man of good family, had often violated 
 the bodies of young women. He was sentenced to imprisonment for life. 
 
 The story of a prelate, reported by Taxil (" La prostitution 
 contemporaine," p. 171), is of great interest as an example of
 
 SADISM. 69 
 
 necrophilia. From time to time he would visit houses of prosti- 
 tution in Paris and order a prostitute, dressed in white like a 
 corpse, to be laid out on a bed. At the appointed hour he would 
 appear in the room, which, in the meantime, had been elaborately 
 prepared as a room of mourning ; then he would act as if read- 
 ing a mass for the soul, and finally throw himself on the girl, 
 who, during the whole time, was compelled to play the role of a 
 corpse.^ 
 
 The cases in which the perpetrator injures and cuts up the 
 corpse are clearer. Such cases come next to those of lust- 
 miu'der, in that, in these individuals, cruelty, or at least an 
 impulse to attack the female body, is connected with lust. It is 
 possible that a remnant of moral sense deters from the cruel act 
 on a living woman, and possibly the fancy passes beyond lust- 
 murder and rests on its result, the corpse. Here, also, it is 
 possible that the idea of defenselessness of the body plays a 
 role. 
 
 Case 23. Sergeant Bertrand, a man of delicate ph_ysical constitution 
 and of peculiar character; from childhood silent and inclined to solitude. 
 
 The details of the health of his family are not satisfactorily known; 
 but the occurrence of mental diseases in his ancestry is ascertained. It is 
 said that while he was a child he was affected with destructive impulses, 
 which he himself could not exjilain. He would ])reak whatever was at 
 hand. In early childhood, without teaching, he learned to masturbate. 
 At nine he began to feel inclinations toward persons of the opposite sex. 
 At tliirteen the impulse to sexual intercourse became powerfully awakened 
 in him. He now masturbated excessively. When he did tliis his fancy 
 always created a room filled with women. He would imagine that he 
 carried out the sexual act with them, and then killed them. Immediately 
 thereafter he would think of them as corpses, and of how he defiled them. 
 Occasionally, in such situations, the thought of carrying out a similar act 
 with male corpses would come up, but it was always attended with a 
 feeling of disgust. 
 
 In time he felt the impulse to carry out such acts with actual corpses. 
 For want of human bodies, he obtained those of animals. He would cut 
 open the al)domen, tear out the entrails, and masturbate during the act. 
 He declares that in this way he experienced inexpressible pleasure. In 
 
 1 Simon (Crimes et Dalits, p. 209) mentions an experience of Lacassague's, to whom 
 a respectable man said that he was never intensely excited sexually except when a spectator 
 at a funeral.
 
 70 PSYCHOPATHIA SEXUALIS. 
 
 1846 these bodies no longer satisfied him. He now killed dc^s, and pro- 
 ceeded with them as before. Toward the end of 1846 he first felt the 
 desire to make use of human bodies. At first he had a horror of it. In 
 1847, being b^^ accident in a grave-3'ard, he ran across the grave of a newly- 
 buried corpse. Then this impulse, with headache and palpitation of the 
 heart, became so powerful that, although there were people near by, and 
 he was in danger of detection, he dug up the body. In the absence of a 
 convenient instrument for cutting it up, he satisfied himself by hacking it 
 with a shovel. 
 
 In 1841 and 1848, during two weeks, as reported, the impulse, accom- 
 panied by violent headache, to commit brutalities on corpses, actuated 
 him. Amidst the greatest dangers and difficulties, he satisfied this im- 
 pulse some fifteen times. He dug up the bodies with his hands, in nowise 
 sensible, in his excitement, to the. injuries he thus inflicted on himself. 
 When he had obtained the body, he cut it up with a sword or pocket-knife, 
 tore out the entrails, and then masturbated. The sex of the bodies is said 
 to have been a matter of indifference to him, though it was ascertained that 
 this modern vampire had dug up more female than male corpses. During 
 these acts he declares himself to have been in an indescribable state of 
 sexual excitement. After having cut them up, he had sometimes re- 
 interred the bodies. 
 
 h\ July, 1848, he accidentally came across the body of a girl of 
 sixteen. Tlien, for the first time, he experienced a desire to carry out 
 coitus on a cadaver. " I covered it with kisses and pressed it wildly to 
 m}'^ heart. All that one coidd enjoy with a living woman is nothing in 
 comparison with tlie i)leasure I experienced. After I had enjoyed it for 
 al>out a quarter of an hour, I cut the bod^' up, as usual, and tore out the 
 entrails. Then I bnried the cadaver again." Onl^- after this, as B. de- 
 clares, had he felt the impulse to use the bodies sexually before cutting 
 them up, and thereafter he had done it in three instances. The actual 
 motive of the exhuming of the bodies, however, was then, as before, to 
 cut them up ; and the enjoyment in so doing was greater than in using 
 the bodies sexually. The latter act had alwa_ys been nothing more than 
 an episode of the princii)al one, and had never quieted his desires ; there- 
 fore, he had always cut up the body afterward or mutilated another body. 
 The medico-legal examiners gave an opinion of " monomania." Court- 
 martial sentence to one year's imprisonment. (Michea, Union med., 1 849 ; 
 Lunier, Aunal. med.-psychol.^ 1849, p. 153; Tardieu, "Attentats aux 
 moeurs," 1878, p. 114 ; Legrand, " La folie devant les tribun.," p. 524.) 
 
 (c) Injur ij of Women {Stdhhing, Flagellafion, etc.). — Fol- 
 lowing lust-murder and violation of corpses, come cases closely 
 allied to the former, in which injury of the victim of lust and 
 sight of the victim's hlood are a delight and pleasure for degener-
 
 SADISM. 71 
 
 ate men. . The notorious Marquis de Sade,^ after whom the com- 
 bination of lust and cruelty has been named, was such a monster. 
 Coitus only excited him when he could prick the object of his 
 desire until the blood came. His greatest pleasure was to in- 
 jure prostitutes and then bind their wounds. 
 
 Here also belongs the case of a captain mentioned by 
 Brierre de Boismont, who always compelled the object of his 
 affection to place leeches ad pudenda before coitus, which was 
 very frequent. Finally this woman became very anaemic and, 
 as a result of this, insane. 
 
 The following case, borrowed from my own clientele, very 
 clearly shows the connection between lust and cruelty, with 
 desire to shed and see blood : — 
 
 Case 24. Mr. X., aged 25 ; fiitber syphilitic, died of paretic de- 
 mentia ; mother hysterical and neurasthenic. He is a weak individual, 
 constitutionally neuropathic, and presents several anatomical signs of 
 degeneration. When a child, hypochondria and imperative conceptions ; 
 later, constant alternation of exaltation and depression. While yet a 
 child of ten, the patient felt a peculiar lustful desire to see blood 
 flow from his fingers. Thereafter he often cut or pricked himself in 
 the fingers, and took great delight in it. Very early, erections were 
 added to this, and also if he saw the blood of others ; for example, when 
 he saw a servant-girl cut her finger it gave him nn intense lustful feel- 
 ing. From this time his vita sexualis became more and more powerful. 
 Without any teaching he began to masturbate, and always during the 
 act there were memory-pictures of bleeding girls. It now no longer 
 sufliced him to see his own blood fiow ; he longed to see the l)lood of 
 young females, especially those tliat were attractive to him. Often he 
 could scarcely overcome the impulse to injure two cousins and a certain 
 servant. But also young women that were in themselves not attractive 
 induced this impulse when they excited him by some peculiarity of dress 
 or adornment, especially coral jewelry. It was necessary for him to 
 
 » Taxil {op. cit.) gives more detailed accounts of this sexual monster, which must 
 have been a case of habitual satyriasis, accompanied by perverse sexual instinct. Sade 
 was so cynical that he actually sought to idealize his cruel lasciviousness, and become the 
 apostle of a theory based upon it. He became so bad (among other things he made an in- 
 vited company of ladies and gentlemen erotic by causing to be served to them chocolate bon- 
 bons which contained cantharides) that he was committed to the insane asylum at Char- 
 enton. During the revolution of 1790, he escaped. Then he wrote obscene novels filled 
 with lust, cruelty, and the most obscene scenes. When Bonaparte became Consul, Sade 
 made, him a present of his novels magnificently bound. The Consul had the works de- 
 stroyed, and the author committed to Charenton again, where he died, at the age of sixty- 
 four.
 
 72 PSYCHOPATHIA SEXUALIS. 
 
 overcome these desires ; but in his imagination bloody thoughts were 
 constantl}" present, and induced lustful excitement. There was an inner 
 relation existing between both thoughts and feelings. Often there 
 were other cruel fancies. He imagined himself in the role of a tyrant 
 who had the people shot in crowds with grape-shot. He was compelled 
 to fanc3' a scene as it would be if enemies were to take a city and 
 mutilate, torture, kill, and rape the 3'oung women. In times of quiet this 
 patient, who had a mild disposition and was not morally defective, was 
 shamed and horrified by such cruel, lustful fancies, and thej^ always 
 became immediately latent as soon as his sexual excitement had been 
 satisfied by masturbation. 
 
 After a few years the patient became neurasthenic. Then simple 
 imaginary representation of blood and scenes of blood was sufficient 
 to induce ejaculation. In order to free himself from his vice and his 
 cruel imagination, he began to indulge in sexual intercourse with females. 
 Coitus was possible, but only when the patient called up the idea that 
 the girl's fingers were bleeding. Without the assistance of this idea no 
 erection was possible. The cruel thought of cutting was limited to the 
 woman's hand. At times of greatest sexual excitement, simpl}^ the sight 
 of the hand of an attractive woman was sufficient to induce violent erec- 
 tions. Frightened by the popular stories al)out the injurious results of 
 onanism, he abstained and fell into a condition of severe general neuras- 
 thenia, with hypochondriacal dj^sthymia and taedium vitfe. Careful and 
 watchful medical treatment cured the patient after a few months. He has 
 remained mentally well three j^ears ; but now, as before, he is very sensual, 
 though it is very seldom that he is troubled by his earlier bloody ideas. 
 X. has given up masturbation entirely. He finds satisfaction in natural 
 sexual indulgence, is virile, and it is no longer necessarj^ for him to call 
 up ideas of blood. 
 
 The following case, reported by Tarnowsky {pp. cit, p. 
 61), shows that such lustful, cruel impulses may be simply 
 episodical, and occur in certain exceptional states of mind 
 in neurotic individuals: — 
 
 Case 25. Z., physician; neuropathic constitution, reacting badly 
 to alcoliol. Under ordinary circumstances capable of normal coitus, as 
 soon as he has indulged in wine he finds that his increased libido is no 
 longer satisfied by simple coitus. In this condition he is compelled to 
 prick the nates puellas or to make stabs with the lancet, to see blood, 
 and feel the entrance of the blade into the living body, in order to have 
 ejaculation and experience complete satiety of his lust. 
 
 The majority of those afflicted with this form of the perver- 
 sion seem insensible to the normal stimulus of w^oman. In the
 
 SADISM. 73 
 
 first case (24), the assistance of the idea of blood was necessary 
 
 in order to obtain erection. The following case is that of a man 
 
 who, by masturbation, etc., hi early youth, had diminished his 
 
 ' power of erection so that the sadistic act took the place of coitus : 
 
 Case 26. The girl-stabher of Bpzen (reported by Demme, " Buch 
 der Verbrechen," Bd. ii, p. 341). In 1829, H., aged 30, soldier, became 
 the subject of legal investigation. At dilierent times and in different 
 places, he had wounded girls with bread-knives or pocket-knives, by stab- 
 bing them in the abdomen, i)robably in the region of the genitals. He 
 gave, as a motive for these acts, heightened sexual impulse, increasing to 
 the intensity of fury, Avhich found satisfaction only in the thought and 
 act of stabbing persons of the female sex. This impulse would pursue 
 him for days at a time. He would then pass into a confused mental 
 state, which would clear aAva}' only when the impulse had been satisfied 
 by the deed. In the. act of stabbing he had a satisfaction like that of 
 comi>leted coitus, which was increased by the sight of the blood that ran 
 from the knife. In his tenth year the sexual instinct became powerfully 
 manifest. At first he gave himself up to masturbation, and felt phj'sically 
 and mentally weakened by it. Before he became a girl-stabber he had 
 satisfied his sexual lust in violation of immature girls, by causing them 
 to practice masturbation on him, and by sodomy. Gradually the thought 
 came to him of how pleasurable it would be to stab a young and prett}' 
 girl in the region of the genitals, and take delight in the sight of the 
 blood running from the knife. 
 
 Among his effects were found copies of objects of art and obscene 
 pictures, painted by himself, of Mary's conception, and of the "congealed 
 thought of God" in the lap of the Virgin. He was considered a peculiar, 
 very irritable man, shy of people, given to women, moody, and glum. 
 He was apparently a person * that had become impotent through earlier 
 sexual excesses, and who was thus predisposed, by the continuance of 
 intense libido sexualis, and heredity, to perversion of the sexual life. 
 
 Case 27. In the " sixties " the inhabitants of Leipzig were frightened 
 by a man who was accustomed to attack .young girls on the street and 
 stab them in the upper-arm with a dagger. Finally arrested, he was 
 recognized as a sadist, who, at the instant of stabbing, had an ejacula- 
 tion, and with whom the wounding of the girls was an ecpiivalent for 
 coitus. (Wharton, " A Treatise on Mental Unsoundness," §623. Phila- 
 delphia, 1873.) 2 
 
 1 Comp. Krauss, Psychologic des Verbreehens, 1884, p. 188 ; Dr. Ilofer, Aunalen 
 der Staatsaizneikunde, 6 Jalirgang, Holt 3 ; Schmidt's Jahrbiicher, Bd. lix, y. 94. 
 
 2 According to newspaper reports, in December, 1890, several similar attacks were 
 made in Mainz. A young fellow between fourteen and sixteen years old pressed against 
 women and girls and stabbed them in the legs with a sharp-pointed instrument. He was 
 arrested, and seemed to be insane. Further details of the case are not known.
 
 74 PSYCHOPATHIA SEXUALIS. 
 
 Impotence exists, likewise, in the next three cases. It 
 may be psycnical, liowever, in that the principal tone of the vita 
 sexualis lies in the sadistic inclination, and the normal elements 
 are distorted : — 
 
 Case 28. The girl-cutter of Augsburg (reported by Demme, " Buch 
 der Yerbrechen," vii, p. 281). Bartle, wine-merehant. He was subject 
 to livel}^ sexual excitement at the age of fourteen, though decidedly 
 opposed to its satisfaction b}^ coitus, his aversion going so far as disgust 
 for the female sex. At that time he already had the idea to cut girls, 
 and thus satisfy his sexual desire. He refrained from it, however, on 
 account of lack of opportunity and courage. He practiced masturbation, 
 and now and then had pollutions with erotic dreams of girls that had 
 been cut. At the age of nineteen he first cut a girl. During the act he 
 had a seminal emission, and experienced intense pleasure. From that 
 time the impulse became constantl}^ more powerful. He chose only 
 young and pretty girls, and, as a rule, asked them before the deed 
 whether they were still single. The ejaculation or sexual satisfaction 
 occurred only when he was sure that he had actually wounded the girls. 
 After such an act he always felt tired and bad, and was also troubled 
 with qualms of conscience. Until thirty-two 3'ears old he carried on this 
 process of cutting, but always with care not to wound the girls dan- 
 gerously. From that time until his thirt3'-sixth year he was able to 
 control his impulse. Then he sought to satisfy himself by simply press- 
 ing the girls on the arm or neck ; but this gave rise to erections and not 
 to ejaculation. Then he sought to attain his object by pricking the girls 
 with a knife in its sheath ; but this did not suffice. Finally, he stabbed 
 with the open knife and had complete success, for he thought that a girl 
 when stabbed bled more and had more pain than one that was merely 
 cut. In iiis thirty-seventh year he was detected and arrested. In his 
 dwelling was found a collection of daggers, sword-canes, and knives. 
 He said that the mere sight of these weapons, and still more the grasping 
 of them, gave him an intense feeling of sensual pleasure, with violent 
 excitement. According to his confession he had injured, in all, fifty girls. 
 His external appearance was rather pleasing. He lived in very good 
 circumstances, but was peculiar and s\\y. 
 
 Case 29. J. H., aged 25, in 1883 came for consultation concerning 
 severe neurasthenia and hypochondria. Patient confesses that he has 
 practiced onanism since his fourteenth ,year, infrequentl}^ up to his 
 eighteenth year ; but since that time he has been unable to resist the 
 impulse. Up to that time he had no opportunity to approach females, 
 for he had been anxiously cared for and never left alone, on account of 
 his invalidism. He had had no real desire for this unknown pleasure ; 
 but he accidentallj' learned what it was when one of his mother's maids
 
 SADISM. 75 
 
 cut her hand severely on a pane of glass she had broken while washing 
 windows. While hel[)ing to stop the blood he could not keep from suck- 
 ing up the blood that flowed from the wound, and in the act he experi- 
 enced extreme erotic excitement, with complete orgasm and ejaculation. 
 
 From this time, in every possible way, he sought to see, and if 
 possible to taste, the fresh blood of females. That of 3'oung girls was 
 preferred by him. He spared no pains or expense to obtain this pleasure. 
 At first he availed himself of a young servant who allowed her finger to 
 be pricked with a needle or lancet at his request. When his mother 
 discovered this, she discharged the girl. Then he was driven to prosti- 
 tutes as a substitute, with success frequently enough, though with some 
 dilliculty. In the intervals he practiced onanism and manustupration 
 per feminam, which, however, never aftbrded him comi)lete satisfaction, 
 but, on the contrary, caused listlessness and self-reproach. On account 
 of his nervous difficulties he visited man}' sanitariums, and he was twice 
 a voluntary patient in institutions. He used hydrotherapy, electricit}^, 
 and strengthening cures, without particular success. For a time it was 
 possible, by means of cold sitz-baths, monobromate of camphor, and 
 bromides, to diminish his sexual excitability and onanistic imi)ulse. 
 However, when the patient felt himself free again, he would immediately 
 fall into his old passions and spare no pains or money in order to satisfy 
 his sexual desire in the abnormal manner described. 
 
 Case 30 (communicated by Dr. A, Moll, Berlin). L. T., aged 21 ; 
 merchant in a Rhenish city. He belongs to a family in which thei'e are 
 several nervous and ps3'chopathic members. A sister suffers with hysteria 
 and melancholia. 
 
 The patient was always of quiet disposition and timid. At school 
 he frequently kept apart from other pupils, particularly when they 
 talked about girls. In the presence of ladies he thought every expres- 
 sion he made was an offense against decency. Thus, for example, he 
 thought it very improper, in the presence of ladies, married or unmar- 
 ried, to speak of going to bed, rising, etc. In the elementary classes the 
 patient learned well. Later he became more indolent and did not make 
 good progress. 
 
 August 17, 1890, the patient visited Dr. Moll on account of abnor- 
 mal symptoms of a sexual kind. He did this on the advice of a phy- 
 sician, X., a relative, in whom he had previously confided. Tlie i)atient 
 conveys the impression of being very apprehensive and sh}-, and in 
 answer to questions says that he is very timorous, and that particularly 
 in the presence of others all his self-confidence and assurance leave him. 
 Dr. X. confirmed this statement. 
 
 The beginning of his sexual life the patient was able to refer to 
 his seventh year. At that age he frequently played with his genitals, 
 and was often punished for it. In this onanism, in which he said he had 
 erection, he constantly thought of whipping a woman on the naked
 
 76 PSYCHOPATHIA SEXUALIS. 
 
 nates with a rod until the skin raised in weals. " It delighted me," 
 said the patient, " when I thought that she was a proiid^ beautiful lady, 
 and that I performed the act in the presence of others, especially women, 
 particularly with the idea that she might feel the j^owe?' I had over her. 
 For this reason I early sought reading about punishment, e.g., about the 
 abuse of Roman slaves. However, I had erections only when the con- 
 ceived abuse consisted of blows delivered on the back or nates. At first 
 I thought this kind of excitement would disappear in time, and said 
 nothing about it to any one." 
 
 Masturbation, early indulged in, the patient continued to practice, 
 and alwa} s with the same thought. After his thirteenth or fourteenth 
 year he had ejaculation with the act. Decimum septimum annum agens 
 primum feminam adiit coeundi causa neque coitum perficere potuit libidine 
 et erectione deficientibus. Mox autem iterum apud alteram coitum cona- 
 tus est nullo succesu. Tum feminam per vim verberavit. Tantopere erat 
 excitatus ut mulierem dolore clamantem atque lamentantem verberare 
 non desierit. He never thought of any legal punishment for his acts, 
 and, in fact, escaped it. In this procedure erection, orgasm, and 
 ejaculation occurred. The patient performed the act in such a way that 
 he took the woman between his knees, with the penis in contact with 
 her body, but without emissio penis in vagiuam, which seemed entirely 
 superfluous to him. 
 
 But the patient afterward experienced such a feeling of shame about 
 the beating, and was overcome with such great depression, that he often 
 contemplated suicide. In the following three years he still visited 
 women occasionally. But he never again asked one to allow him to beat 
 her. He sought to obtain erection by thinking of the beating ; l)ut this 
 was without residt, and manustupration l)y the woman did not induce 
 erection. Finally, after an unsuccessful attempt of this kind, the patient 
 determined to give his confidence to a ph^-sician. 
 
 The patient made several other statements concerning his vita 
 sexualis. His abnormal sexual desire had troubled him by its intensity. 
 He went to sleep with sexual thoughts ; the^' troubled him through the 
 night and were still with him when he awoke. He was never safe for any 
 length of time from the impulsion of the abnormal ideas that excited 
 him; to which, indeed, he gave himself up willingly, and from which he 
 could free himself for a short time only by onanism. 
 
 In response to my question, the patient stated that any other 
 means of punishment of women than beating the back, and nates particu- 
 larly, had no charm for him. Neither binding them, walking on them, nor 
 striking them, gives him such pleasure. This is to be emphasized the 
 more, since the whipping given the woman affords him sexual pleasures 
 because its effect on her is " humiliating, mortifying," and because she 
 should " feel that she is completely in his power." Too, it would give 
 the patient no pleasure to beat a woman on an^^ other part of her body
 
 SADISM. 77 
 
 than those mentioned, or to cause her pain in any other way than by 
 blows. Mnltuni minorem ei aftert vohiptatem si nates suae a miiUere 
 verberantur; tamen ea res ssepe ejacuiationem seminis eflecit, sed hajc 
 fieri putat erectione deficienti. Inter verbera autem penem in vaginam 
 immittendo nullam volnptateni m habere ratus (pialibet parte coi-poris 
 feminte pene tacte semen ejaculat. Junt as in beating the looman his 
 pleasure lay in liumiliatimj her, so with the relations reversed he was 
 sexually excited by the fact that the beating humiliated him and he felt 
 himself to be completely in the womayVs power. No other personal humilia- 
 tion than a beating on his nates could excite him. To allow himself to 
 be bound or walked on by a woman is repugnant to him. 
 
 The patient's dreams, as far as they were of an erotic nature, were 
 directed in the same wa}' as his sexual inclinations while awake ; actual 
 ejaculation also often took place in dreams. Whether the perverse sexual 
 thoughts first occurred in dreams or the waking state, the patient is not 
 able to state, owing to the fact that his memory goes back so far, — to his 
 seventh year. But he thinks that these thoughts first occurred to him 
 while awake. In his dreams it frequently seemed to liini that he was 
 striking a man, which also caused ejaculation. In the waking state it 
 excited him but very little to think of striking a man. The nude form of 
 a man had no attraction whatever for him, while the nude form of a woman 
 had a decided charm for him, though his libido found its real satisfaction 
 only when the acts previously described took place ; and, as he states, he 
 feels no desire for coitus in vaginam. 
 
 The treatment of the patient is directed to the attainment of normal 
 coitus with normal desire, where possible ; for it may be assumed that, 
 with success in making his sexual life normal, the patient's sh3'ness and 
 apprehensiveness, which cause him great annoyance, may be much easier 
 removed. The treatment followed by me (Dr. Moll) during three months 
 and a half was as follows : — 
 
 1. The patient, who had a great desire to be cured, was most 
 strictly forbidden to give himself up to the perverse thoughts. Of course, 
 I did not give him the foolish advice not to think of blows at all. The 
 patient could not follow such advice, since the thoughts come to him 
 without any act of his own, even when he accidentally reads the word 
 " blow " (schlagen). I forbade him only ever to voluntarily give himself 
 to such thoughts. I advised him more particularly to do everj^thing in 
 order to turn his ideas in another direction. 
 
 2. I allowed him, commanded him even, to think of nude women, 
 because many nude females interested him, even though, as he thought, 
 they did not excite him sexually. 
 
 3. I sought, by means of hypnosis — which was hard to induce — 
 and suggestion, to fortify the patient in this as far as possible. All 
 attempts at coitus were forbidden in order to save the patient from a 
 discouraging result.
 
 78 PSYCHOPATHIA SEXUALIS. 
 
 Within two months and a half tliis treatment led to the result that, 
 as the patient stated, the perverse ideas occurred much less frequently 
 and were constantly retreating to the background ; indeed, according to 
 the patient's statement, erections occurred with the thoughts of nude 
 women, became more frequent, and often induced him to masturbate with 
 the thought of coitus without the occurrence of any idea of blows. 
 Erotic dreams occurred but infrequentl}'. These were concerned some- 
 times with normal coitus, sometimes with blows. 
 
 After two months and a half of the treatment I advised the patient 
 to attempt coitus. Since then he has tried four times. I advised him to 
 choose alwa^^s a woman who pleased him, and sought to increase his 
 sexual excitement before coitus by means of tincture of cantharides. 
 The four attempts, the last of which took place on November 29, 1890, 
 resulted as follows : At the first, prolonged manipulation of the penis by 
 the woman was necessary in order to induce erection. Then immisio in 
 vaginam and ejaculation with orgasm took place. During the whole act 
 there occurred no thought of beating the woman or being beaten, but the 
 woman in herself excited him sufficiently for the performance of coitus. 
 At the second attempt the result was better and more quickly attained ; 
 manipulation ad genitalia by the woman was not long required. In the 
 third attempt coitus was attained only after the patient had thought of 
 beating for a long time, and had thus induced erection ; but beating was 
 not indulged in. At the fourth attempt coitus was attained without 
 any thought of beating and without any manipulation ad genitalia. 
 
 Of course, the case described cannot yet be regarded in any way as 
 cured. Though the patient were able to perform coitus in a normal or 
 nearly normal way, that does not mean that he will alwa3^s be able to 
 do it in the future ; moreover, the thought of beating still affords him 
 great pleasure, even though it occurs much less frequently than for- 
 merly. Yet there is a possibility that the abnormal desire, which 
 has been weakened, will remain weakened in the future, and perhaps 
 disappear. 
 
 This carefully observed case is, for several reasons, particu- 
 larly interesting. It discloses clearly one of the hidden roots 
 of sadism, — the impulse to complete subjugation of the woman, 
 which here became consciously entertained. This is the more 
 remarkable since it occurred in an individual decidedly timid, 
 and in other respects modest and even apprehensive. The case 
 also shows clearly that powerful libido, which even impels the 
 individual to overcome all obstacles, may be present, while at 
 the same time coitus is not desired, because the principal inten- 
 sity of feeling is, ah oi'igine, connected with the cruel part of
 
 SADISM. 79 
 
 the sadistic (lustful and cruel) circle of ideas. This case also 
 contains weak elements of masochism {v. infra). 
 
 Cases are by no means iniiequent in which men witli 
 perverse inclinations induce prostitutes, by paying them high 
 prices, to allow themselves to be whipped and even wounded 
 by them. Works on prostitution contain reports of them {vide 
 Coffignon, '" La Corruption a Paris," etc.). 
 
 (d) DejUement of Women. — The perverse sadistic impulse, 
 to injure women and put contempt and humiliation upon them, 
 is also expressed in the desire to defile them with disgusting or, 
 at least, foul things. 
 
 The following case, published by Arndt ( Vierteljalirsschr. 
 f. ger. Medicln, N. F. xvii, H. 1), belongs here: — 
 
 Case 31. A., medical student at Greifswald, aecusatus quod iteium 
 iterumque puellis lionestis parentibus natis in publico genitalia sua e 
 bracis dependentia plane nudata qua3 antia sumnio aniiculo (overcoat) 
 tecta erant, ostenderat. Nonnunquani puellas fugientes secutus easque 
 ad se attractas urina oblivit. Hasc luce clara facta sunt ; nunquam aliquid 
 haec faciens locutus est. 
 
 A. is twenty-three years old, powerfully built, neat in dress, and 
 decent in manners. Indication of cranium progeneum ; chronic pneu- 
 monia of the apex of the right lung ; emphysema. Pulse, 60 ; in excite- 
 ment, not more than 70 to 80. Genitals normal. Conq)hunts of occa- 
 sional disturbances of digestion and hardness of the abdomen, vertigo ; 
 excessive excitement of the sexual desires, which early led to onanism. 
 The sexual desire has never been directed toward a natural method of 
 satisfaction. Complaints of occasional attacks of depression, or llioughts 
 of deprecation of self, and of perverse impulses, tor Avhich he could tind 
 no motive ; such as laughing at serious things, throwing his money in the 
 water, and running about in the pouring rain. The father of the culprit 
 is of a nervous temperament ; his mother is subject to nervous headache. 
 A brother suffered with epileptic convulsions. 
 
 From his youth the culprit presented a nervous temperament, 
 was inclined to convulsions and attacks of syncope, and when he was 
 severely scolded would fall into a state of momentary stillness. In 1869 
 he studied medicine in Berlin. In 1810 he went to the war as a hospital- 
 assistant. His letters at this time betray a peculiar torpidity and weak- 
 ness. On his return home, in 1811, his emotional irritability was noticed 
 by those about him. Thereafter frequent complaints of bodily ailments ; 
 unpleasantness resulting from a love aftair. In November, 1811, he 
 pursued his studies diligently in Greifswald. Uc was considered very
 
 80 PSYCHOPATHIA SEXUALIS. 
 
 gentlemanly. In confinement he is quiet, calm, and sometimes self- 
 absorbed. His acts he attributes to painful sexual excitement, which of 
 late had become excessive. He declared that he had been fully conscious 
 of his perverse acts, and had afterward been ashamed of them. He 
 had not experienced actual sexual satisfaction in their commission. He 
 obtained no correct insight into his position. He considered himself a 
 kind of martyr, — fallen a victim to an evil power. Presumption of 
 irresponsibility, as a result of absence of free will. 
 
 The impulse to defile occurs also, paradoxically, in the 
 aged, when there is a re-appearance of sexual instinct, which, 
 under such circumstances, is so often expressed in perverse 
 acts. Thus Tarnowsky reports (p. 76) the following case ; — 
 
 Case 32. I knew such a patient, who had a woman dressed in a 
 decollete ball-dress lie down on a low sofa in a brightly lighted room. Ipse 
 apud januam alius cubiculi obscurati constitit adspiciendo aliquantulum 
 feminam, excitatus in eam iusiluit excrementa in sinus ejus deposuit. 
 Hsec faciens ejaculationem quandam se sentire confessus est. 
 
 An officer of Vienna informs me that men, by means of 
 large sums of money, induce prostitutes to suffer ut ilU viri in 
 ora earum spuerent et faeces et urinas in ora explerent.^ 
 
 Tlie following case by Dr. Pascal (" Igiene dell' amore ") 
 seems also to belong here : — 
 
 Case 33. A man had an inamorata. His relation with her was that 
 he had her allow him to blacken her hands with coal or soot, and then she 
 had to sit before a mirror ia such a way that he could see her hands 
 in it. While conversing with her, which was often for a long time, he 
 looked constantly at her mirrored hands, and finally, after a time, he 
 would take his leave, fully satisfied. 
 
 The following case, communicated by a physician, may be 
 of interest in relation to this subject : — 
 
 An officer was known in a brothel in K. only by the name of " Oil." 
 " Oil " induced erection and ejaculation only by having puell. publ. nudam 
 step into a tub filled with oil, while he rubbed the oil all over her body. 
 
 These acts lead to the presumption that certain cases 
 of injury of females {e.g., sprinkling with sulphuric acid, ink, 
 
 * Leo Taxil (La Corruption, Paris, Noiret, p. 223) makes the same statements. 
 There are also men who demand introductio linguae meretricis in anum.
 
 SADISM. 81 
 
 etc.) depend upon a perverse sexual impulse; at least, here it is 
 a kind ol' injury, and those injured are always females, and the 
 perpetrators males. At least in the future, in crimes of this kind, 
 pains should be taken to examine the vita sexualis of tlie 
 culprits. 
 
 The case of Bachmann, given below, throws a clear light 
 on the sexual nature of such crimes; for, in this case, the 
 sexual motive in the deed is proven. 
 
 (e) Otiier Attacks on Females — SymhoUc Sadism. — The 
 foregoing groups do not exhaust the forms in which the sadistic 
 impulse toward women is expressed. If the ini})uLse is not 
 overmastering, or there is yet sufficient moral resistance, it 
 may happen that the perverse inclination is satisfied by an act 
 that is apparently quite senseless and silly, but which has a 
 symbolic meaning for the perpetrator. This seems to be the 
 meaning of the two following cases : — 
 
 Case 34. (Dr. Pascal, " Igiene dell'amore.") A man was accustomed 
 to go, on a certain day once a month, to an inamorata and cut her " bang." 
 This gave him the greatest pleasure. He made no other demands on 
 the girl. 
 
 Case 35. A man in Vienna regularly visits several prostitutes only 
 to lather their faces and then to remove the lather with a razor, as if he 
 were shaving them. He never hurts the girls, but becomes sexually 
 excited and ejaculates during the procedure. 
 
 The significance of the following cases, in which a sadistic 
 comedy is played, is clearer : — 
 
 Case 36. A man always announces to a puella publica his intended 
 visits. She must stand at the window, awaiting him, with her face done 
 up, and, on his entrance into the room, complain of severe toothache. 
 He is sorry for her, asks particularly about the pain, takes the cloth oil" 
 and puts it on again ; but he never has coitus, and finds his satisfaction 
 simply in this act.' 
 
 The following case, which, unfortunately, was not carefully 
 examined scientifically, is peculiar to itself: — 
 
 * Leo Taxil {op. cit., p. 324) relates that in Parisian brothels instruments are kept 
 ready which look like knouts, but which are merely tubes filled with air, such as clowns 
 use in circuses. Sadistic men use them to create for themselves the illusion that they are 
 whipping women. 
 
 6
 
 82 PSTCOPATHIA SEXUALIS. 
 
 In an examination before a criminal court in Vienna, the follow- 
 ing facts were brought to light : Count N., accompanied by a young 
 girl, appeared in the public garden of an hotel, and, by his actions there, 
 gave public offense. He demanded of his companion that she kneel down 
 before him and implore him with folded hands. Then she was comj^elled 
 to lick his boots. Finally, he demanded of her, publiclj^, " an unheard- 
 of thing " (osculum ad nates, or the like), and only desisted after she had 
 sworn to do it at home. 
 
 In this case, the most remarkable thing was the desire of 
 the perverse individual to humiliate the woman before witnesses 
 (comp. the fancies of sadists, Case 29) ; further, that the desire 
 to humiliate the woman came entirely into the foreground, and 
 acts of a purely symbolic nature were undertaken. Of course, 
 with these, in this imperfectly-observed case, acts of cruelty 
 were probable. 
 
 (f) Sadism with Other Objects — Wliipping of Boys. — 
 Besides the sadistic acts with females described, others occur 
 with other living, sensitive objects, — children and animals. 
 There may be a full consciousness that the impulse is really 
 directed toward women, and that only faute de mieux the next 
 attainable objects (pupils) are abused. But the condition of the 
 perpetrator may be such that the impulse to cruel acts enters 
 consciousness accompanied only by lustful excitement, while its 
 real object (which alone can explain the lustful coloring of such 
 acts) remains in the dark. 
 
 The first alternative suffices as an explanation of the cases 
 which Dr. Albert describes (Friedreich's Blatter f. ger. Med., 
 p. 77, 1859), — cases in which lustful teachers whipped their 
 pupils on the naked nates without cause. We must think of 
 the second alternative, the sadistic impulse with unconsciousness 
 of its object, when boys are immediately excited sexually at the 
 sight of punishment of their companions, and are thus deter- 
 mined in their later vita sexualis, as in the following cases : — 
 
 Case 37. K., aged 3T, merchant, applied to me in the fall of 1889 
 for advice concerning an anomaly of his vita sexualis, which made him 
 fear invalidism and impossibility of future happiness in marriage. 
 
 Patient came of a nervous famil3\ As a child he was* delicate, weak, 
 and nervous. Healthy except for measles ; he later became strong.
 
 SADISM. 83 
 
 At the age of fight, whih' at scliool, ho saw how the teacher imn- 
 ishecl the hoys by taking their heads between his thighs and spanking 
 them with a ferule. This sight caused the patient kistful excitement. 
 " Without any idea of the danger and enormity of onanism," he satisfied 
 himself with it, and from that time often masturbated, during which he 
 always calk'd uj) the nu'iu()rv-i)icture of a l)oy being punished. 
 
 Tlius it continued until ins twentieth year. Then he learned tiic 
 significance of onanism, was terribly frightened, and tried to overcome 
 his impulse to masturbate; but he fell into the ])ractice of j^sychical 
 onanism, which he regarded as innocuous :iiid morally defensilile, and 
 for which he made use of the memory-pictures of I)oys being whipped, 
 previously mentioned. 
 
 Patient now became neurasthenic, suffered with polbilions, and 
 tried to cure himself by visiting brothels; but he could not induce erec- 
 tion. Then he sought to obtain uormal sexual feelings by means of social 
 intercourse with ladies ; but he recognized that he was entirely insensible 
 to the charms of the fair sex. 
 
 The patient is an intelligent man, uonnally develojjed, :nid of 
 {esthetic taste. There is no inclination to persons of his own sex. My 
 advice consisted of means to comliat (lie ueuraslhenia and pollutions; 
 interdiction of psychical and manual onanism; avoidance of all sexual 
 excitants; aud, possibly, hypnotic treatment to ultimately induce a return 
 of the vita sexualis to its normal condition. 
 
 Case 38. Abortive sadism. N., student, came under observation 
 in December, 1890. He had practiced masturl)ation from early youth. 
 According to his statements, he became sexually excited when lie saw his 
 father whip the children, and, later, when he saw the teacher whij) liis 
 comi)anions. When a spectator of sucli scenes, he always experienced 
 lustful feelings. He could not ^ay exactly wheu this first occurred, but 
 it may have been at about the age of six. lie could not tell exactly when 
 he began to masturbate, but he stated with certainty that his sexual 
 instinct was first awakened by the punishment of others, and thus he un- 
 consciously came to practice onanism. The patient remembered clearly 
 that from the age of four to the age of eight he was freciuently spanked, 
 and that this caused him pain, never lustful pleasure. 
 
 Since he did not always have oi)portunity to see others whipped, he 
 began to imagine how others were punished. This excited his lust, and 
 he would then masturbate. Whenever he could, hv managed to see others 
 punished at school. Now and then he also felt desire to whip others. At 
 the age of twelve he induced a comrade to allow him to whip him. He 
 found great sexual pleasure in it. When, however, his companion beat 
 him in return, he experienced nothing but pain. 
 
 The impidse to beat others was never very strong. The patient ex- 
 perienced more satisfaction in filling his imagination with scenes of whip- 
 ping. He never indulged in any other sadistic acts, and never had any
 
 84 PSYCHOPATHIA SEXUALIS. 
 
 desire to see blood, etc. Until his fifteenth 3'ear his sexual indulgence 
 consisted of onanism, indulged in after such fancies. After that (dancing 
 lessons, association with girls), the early fancies disappeared almost en- 
 tirely, and were accompanied by but weak lustful feelings ; so that the 
 patient gave them up entirely. In their place came thoughts of coitus 
 in a natural way, without anything sadistic. 
 
 The patient indulged in coitus for the first time "on account of 
 his health." He then tried to abstain from onanism, but was not success- 
 ful, though he often indulged in coitus, and with more pleasure than he 
 had in onanism. He wished to be freed from onanism as somethina: 
 vicious. He had coitus once a month, but masturbated once or twice 
 every night. He was normal sexually, with the exception of the onanism. 
 There was no neurasthenia ; genitals normal. 
 
 Case 39. P., aged 15, of high social position, came of an h3'sterical 
 mother, whose brother and father died in an asjdum. Two children of the 
 family- died, in early childhood, of convulsions. The patient is talented, 
 virtuous, and quiet ; but at times he is very disobedient, stubborn, and 
 passionate. He has epilepsy, and practices onanism. One day it was 
 learned that P., with money, induced a comrade of fourteen, B., to allow 
 himself to be pinched on the arm, back, and thigh. When B. cried, P. 
 became excited and struck at B. with his right hand, while with his left 
 he made manipulations in the left pocket of his trousers. P. confessed 
 that to maltreat his friend, of whom he was very fond, gave him peculiar 
 delight ; and that ejaculation while hurting his friend gave him much 
 more pleasure than when he masturbated alone, (v. Gyurkovechky, 
 " Pathol, und Therapie der mannl. Impotenz.," p. 80, 1889.) 
 
 That in all these cases of sadistic abuse of boys there can 
 be no thought of a combination of sadism and contrary sexual 
 instinct, as often occurs {v. infra) in individuals of contrary 
 sexuality, is shown — aside from the absence of all positive signs 
 of it — by a study of the next group, where, in association with 
 the object of injury, — animals, — the instinct for women is seen 
 to appear repeatedly. 
 
 (g) Sadistic Acts urith Animals. — In numerous cases, sadist- 
 ically perverse men that are afraid of criminal acts with human 
 beings, or that care only for the sight of the suffering of a sen- 
 sitive being, make use of the sight of dying animals, or torture 
 animals, to stimulate or excite their lust. 
 
 The case of a man in Vienna, which is reported b}' Hofmami in 
 his " Text-Book of Legal Medicine," is noteworthy in relation to this. 
 According to the evidence of several prostitutes, before the sexual act he
 
 SADISM. 85 
 
 was accustomed to excite himself l)y torturing chickens and pigeons and 
 other birds, and, therefore, was called '' Ilendlmann " (chicken). 
 
 For the elucidation of such cases the observation of Lombroso is 
 of value, according to whom two men had ejaculation when they killed 
 chickens or pigeons, or wrung their necks. 
 
 The same author, in his " Uomo delinque'nte," p. 201, speaks of a 
 poet of some reputation, who became powerfully excited sexually 
 whenever he saw calves slaughtered, and also at the sight of bloody 
 flesh. 
 
 According to Mantegazza (op. cit.,]). 114), among degenerate China- 
 men, a horrible sport consists of committing sodomy with geese, and 
 cutting their necks otf tempore ejaculationis ! 
 
 Mantegazza (" Fisiologia del piacere," 5th ed., pp. 394, 395) men- 
 tions the c^ase of a man who once saw chickens killed, and from that 
 time had a desire to wallow in their warm, steaming entrails, because he 
 experienced a feeling of lust while doing it. 
 
 Thus, in these and similar cases, the vita sexnalis is so 
 constituted ab origine that the sight of blood, death, etc., excites 
 lustful feeling. It is so in the following case : — 
 
 Case 40. C. L., aged 42, engineer, married, father of two children; 
 from a neuropathic family ; father irascible, a drinker ; mother hysterical, 
 subject to eclamptic attacks. The patient remembers that in childhood 
 he took particular pleasure in witnessing the slaughtering of domestic 
 animals, especially swine. He thus experienced lustful pleasure and 
 ejaculation. Later he visited slaughter-houses, in order to delight in the 
 sight of flowing blood and the death throes of the animals. When he 
 could find opportunity, he killed the animals himself, which always aflbrded 
 him a vicarious feeling of sexual pleasure. 
 
 At the time of full maturity he first attained to a knowledge of his 
 abnormality. The patient was not exactly opposed in inclination to 
 women, but close contact with them seemed to him repugnant. On the 
 advice of a physician, at twentj^-five he married a woman who pleased 
 him, in the hope of freeing himself of his abnormal condition. Although 
 he was very partial to his wife, it Avas o\\\y seldom, and after great trouble 
 and exertion of his imagination, that he could perform coitus with her; 
 nevertheless, he begat two children. In 18G6 he was in the war in 
 Bohemia. His letters written at that time to his wife, were composed in 
 an exalted, enthusiastic tone. He was killed in the battle of Koniggriitz. 
 
 If, in this case, the capability of normal coitus was much 
 impaired by the predominance of perverse ideas, in the next it 
 seems to have been entirely repressed : —
 
 86 PSYCHOPATHIA SEXUALTS. 
 
 Case 41, (Dr. Pascal, " Igiene dell' amore.") A gentleman visited 
 prostitutes, had them purchase a living fowl or rabbit, and required them 
 to torture the animal. He had in mind the head and tearing out the 
 eyes and entrails. If he found a girl who would consent, and go about 
 it right cruelly, he was delighted, and paid her and went his way without 
 asking anything more or touching her. 
 
 The last two sections show that the suffering of any living 
 being may become a source of perverse sexual enjoyment to 
 sadistically constituted persons, and that there may be sadism 
 with almost any [living] object. However, it would be errone- 
 ous and an exaggeration to try to explain by sadistic perversion 
 all the remarkable and surprising acts of cruelty that occur ; 
 and, in the innumerable cruelties, as they here and there occur 
 in history or in certain psychological manifestations among the 
 people at the present time, it would be erroneous to assume 
 sadism as a motive. 
 
 Cruelty arises from various sources, and is natural to primi- 
 tive man. Compassion, in contrast with it, is a secondary 
 manifestation, and acquired late. The instinct to fight and 
 destroy, so important an endowment in prehistoric conditions, 
 is long afterwnrd operative ; and, in the ideas engendered by 
 civilization, like that of " the criminal," it finds new objects, 
 even though its original object — " the enemy " — still exists. 
 That not simply the death, but also torture, of the conquered is 
 demanded, is in part explained by the sense of power, which 
 satisfies itself in this way ; and in part by the insatiableness of 
 the impulse of vengeance. Thus all cruelty and all historical 
 enormities may be explained without recourse to sadism (which 
 may often have been in operation, but which cannot be assumed, 
 since it is relatively an infrequent perversion). 
 
 At the same time, there is still another powerful psychical 
 element to take into consideration, which explains the attraction 
 that is still exerted by executions, etc. ; and that is, the pleasure 
 there is in intense and unusual impressions and rare sights, in 
 contrast with which, in coarse and blunted beings, pity is silent. 
 
 But undouV)tedly there are individuals for whom, in spite 
 of, or even by reason of, their lively compassion, all that is con-
 
 SADISM. • 87 
 
 nectecl with deatli and suffering lias a mysterious attraction ; 
 who, with inward opposition, and yet following a dark impulse, 
 occupy themselves with such things, or at least with pictures and 
 notices of them. Still, this is not sadism, as long as no sexual 
 element enters into consciousness ; and yet it is possible that, in 
 unconscious life, slender threads connect such manifestations 
 with the hidden depths of sadism. 
 
 (h) Sadism 171 Wbinan. — That sadism — a perversion, as 
 we have seen, frequent in men — is much less frequent in women, 
 is easily explained. In the first place, sadism, in which the 
 need of subjugation of the opposite sex forms a constituent 
 element, in accordance with its nature, represents a pathological 
 intensification of the masculine sexual character ; in the second 
 place, the obstacles which oppose the expression of this mon- 
 strous impulse are, of course, much greater for a woman than 
 for a man. Yet sadism occurs in women ; and it can only be 
 explained by the primary constituent element, — the general 
 hyper-excitation of the motor sphere. Only two cases have thus 
 far been scientifically studied. 
 
 Case 42. A married man presented himself with nnmerons scars 
 of cnts on his arms. He told their origin as folloAvs : When he wished 
 to approach his wife, who was young and somewhat " nervous," he first 
 had to make a cut in his arm. Then she would suck the wound, and 
 during the act become violently excited sexually. 
 
 This case recalls the wide-spread legend of the vampires, 
 the origin of which may perhaps be referred to such sadistic 
 facts.^ 
 
 In a second case of feminine sadism, for which I am 
 indebted to Dr. Moll, of Berlin, by the side of the perverse im- 
 pulse, as so frequently occurs, there is anaesthesia for the nor- 
 mal activities of the sexual life ; and here there are also traces 
 of masochism (v. infra). 
 
 1 The legend is especially spread throughout the Balkan peninsula. Among 
 the Greeks it has its origin in the mj'th of the lamkp and marmolykea, — blood -sucking 
 women. Goethe made use of this in his "Bride of Corinth." The verses referring to 
 vampirism, "suck thy heart's blood," etc., can be thoroughly understood only when 
 compared with their ancient sources.
 
 88 • PSYCHOPATHIA SEXUALIS. 
 
 Case 43. Mrs. H., of H., aged 26, comes of a nervous family, in 
 which nervous or mental diseases are said not to have occurred ; but the 
 patient herself presents signs of hj'steria and neurasthenia. Although 
 eight years married, and the mother of a child, Mrs. H. never had desire 
 to perform coitus. Very strictly educated as a 3'oung girl, until her mar- 
 riage she remained almost innocent of any knowledge of sexual matters. 
 She has menstruated regularly since her fifteenth year. There does not 
 seem to be any essential abnormality of the genitals. To the patient 
 coitus is not only not a pleasure, but even an unpleasant act ; and re- 
 pugnance to it has constantly increased. The patient cannot understand 
 how any one can call such an act the greatest delight of love, which, to 
 her, is something far higher and unconnected with such a sensual impulse. 
 At the same time, it should be mentioned that the patient really loves her 
 husband. In kissing him, too, she experiences a decided pleasure, which 
 she cannot exactly describe. But she cannot conceive how the genitals 
 can have anything to do with love. In other respects Mrs. H. is a 
 decidedlj^ intelligent woman, of feminine character. 
 
 Si oscula dat conjugi, magnum voluptatem percipit in mordendo 
 eum. Gratissimum ei esset conjugem mordere eo modo ut sanguis fluat. 
 Contenta esset, si loco coitus morderetur a eonjuge ipsaeque eum mordere 
 liceret. Tamen eam poeniteret, si morsu magnum dolorem faceret. (Dr. 
 Moll.) 
 
 In otlier cases of sadism which histol-y and hterature afford, 
 we are compelled to think of a reversal of the feminine sex- 
 ual character, — a partial viraginity, — in order to explain the 
 sadistic acts. 
 
 In history there are examples of famous women who, 
 to some extent, had sadistic instincts. These Messalinas are 
 particularly characterized by their thirst for power, lust, and 
 cruelty. Among them are Valeria Messalina herself, and 
 Catherine de Medici, the instigator of the Massacre of St. 
 Bartholomew, whose greatest pleasure was found in having the 
 ladies of her court whipped before her eyes, etc. 
 
 The gifted Henry von Kleist, who was undoubtedly ment- 
 ally abnormal, gives a masterly portrayal of complete feminine 
 sadism in his " Penthesilea." In scene xxii, Kleist describes his 
 heroine with Achilles, whom she had been pursuing in the fire 
 of love, betrayed into her hands, as, overcome with lustful, 
 murderous fury, she tears him in pieces and sets her dogs on 
 him: "She strikes, tearing the armor from his body; they set
 
 MASOCHISM 89 
 
 their teeth in his wliite hreast, — she and her dogs, the rivals, 
 Oxus and Sphynx, — they on the right side, she on the left; and 
 as I approached hlood dripped from her hands and moutli." 
 And later, when Penthesilea becomes satiated : " Did I kiss him 
 to death'? No. Did I not kiss him 1 Torn in pieces'? Then 
 it was a mistake; kissing rhymes with biting, and one who 
 loves with the whole heart might easily mistake the one for the 
 other." ' 
 
 2. The Association of Passively Endured Cruelty mid 
 Violence, with Lust — Masochism.^ — Masochism is the opposite of 
 sadism. While the latter is the desire to cause pain and use force, 
 the former is tlie wish to suffer pain and be subjected to force. 
 
 By masochism 1 luiderstand a peculiar perversion of the 
 psychicfil vita sexualis, in which the individual affected, in 
 sexual feeling and thought, is controlled by the idea of being 
 completely and unconditionally subject to the will of a person 
 of the opposite sex ; of being treated by this person as by a 
 roaster, — humiliated and abused. Tliis idea is colored by lustful 
 feelinir; the individual affected lives in fancies, in whicli he creates 
 situations of this kind, and often attempts to realize them. By 
 this perversion his sexual insthict is not uifrequently made 
 more or less insensible to the normal stimulus of tlie opposite 
 sex, — incapable of a normal vita sexualis, — psydiically impo- 
 tent. But this psychical impotence does not in any way depend 
 upon a horror sexus alterius, but upon the fact that this per- 
 verse instinct finds an adequate satisfaction differing from the 
 normal, — in woman, to be sure, but not in coitus. 
 
 But cases also occur, in which, with the perverse impulse, 
 there is also sensibility, in a measure, to normal stimuH, and 
 intercourse under normal conditions takes ])lace. In other 
 cases the impotence is not ])urely psychical, but physical, i.e., 
 spinal; for this perversion, like almost all other perversions of 
 the sexual instinct, is developed only on the basis of a psycho- 
 
 1 In the latest literature we find the matter treated, but particularly in Sacher- 
 Masoch's novels, which are hereafter to be alluded to, and in Ernest von Wildenbruch's 
 <' Brunhilde," Rachilde's " La Marquise de Sade," etc. 
 
 2 So named from the writer, Saclier-Masoeh, whose romances and novels have as 
 \h<iir particular object the description of this perversion.
 
 90 PSYCHOPATHIA SEXUALIS. 
 
 pathic and, for the most part, hereditarily predisposed indi- 
 viduahty ; and, as a rule, such individuals give themselves up 
 to excesses, particularly masturbation, to which the difficulty 
 of attaining what their fancy creates, drives them again and 
 again. 
 
 The number of cases of undoubted masochism thus far 
 observed is very large. Whether masochism occurs associated 
 with normal sexual instincts, or exclusively controls the indi- 
 vidual ; whether, and to what extent, the individual subject to 
 this perversion strives to realize his peculiar fancies or not; 
 whether he has thus more or less diminished his virility or not, — 
 depends upon the degree of intensity of the perversion in the 
 single case, and upon the strength of the opposing ethical and 
 aesthetic motives, as well as the relative power of the |)hysical 
 and mental organization, of the affected individual. The essen- 
 tial thing, from the psychopathic point of view, and the common 
 element in all these cases, is the fact that the sexual instinct is 
 directed to ideas of suhjugation and abuse hij the opposite sex. 
 
 What has been said with reference to the impulsive char- 
 acter (indistinctness of motive) of the resulting acts, and with 
 reference to the original (congenital) nature of the perversion 
 in sadism, is also true in masochism. 
 
 In masochism there is also a gradation of the actg from the 
 most repulsive and monstrous to the silliest, in accordance with 
 the degree of intensity of the perverse instinct, and the power of 
 the remnants of moral and aesthetic motives that oppose it. The 
 ultimate consequences of masochism, however, are opposed by 
 the instinct of self-preservation, and, therefore, murder and 
 serious injury, which may be committed in sadistic excitement, 
 have here, as far as known, no passive equivalent in reality; but 
 the perverse desires of masochistic individuals may, in imagina- 
 tion, attain these extreme consequences {v. infra^ Case 5-i). 
 
 Moreover, the acts to which masochists give themselves up, 
 are performed in some cases in connection with coitus, i.e., as 
 preparatory measures ; in others, as substitutes for coitus when 
 that is impossible. Here, too, this depends only upon the con- 
 dition of sexual power, which has been diminished for the most
 
 MASOCHISM. 91 
 
 part physically and mentally by the activity of the sexual ideas 
 in the perverse direction, and not upon the nature of the act 
 itself. 
 
 (a) The Desire for Abuse and HiimiUation as a Means of 
 Sexual /Satisfaction. — The following detailed autobiography of 
 a masochist, gives an exhaustive description of a typical case of 
 this remarkable perversion : — 
 
 Case 44. I come of a neuropathic family, in which, with all kinds 
 of peculiarities of character and manner of life, there are several almor- 
 malities of a sexual nature. My imagination has alwaj-s been very lively-, 
 and was very early directed to sexual matters. As far as I can i-ememlter, 
 I was much given to onanism long before puberty. Even at that time my 
 thoughts were, for hours at a time, directed to intercourse with females. 
 But the relations in which I placed myself with the oi)posite sex were 
 entirely peculiar. I fancied that I was a prisoner and absolutc^ly in a 
 woman's power, and that this womnn used her powcsr to hurt and al»use 
 me in ever}' way possible. In this, whipping and blows played an im- 
 portant part in mj' fanc}', and there were many other acts and situations 
 which all expressed the condition of vassalage and subjection. I saw my- 
 self constantly kneeling before mj- ideal, trod upon, loaded with chains, 
 and imprisoned. Severe punishments of all kinds were inflicted on me, to 
 test my obedience and please my mistress. The more severely I was 
 humiliated and abused, the more I indulged in these thoughts. (At the 
 same time I developed a great preference for velvet and fur, which I 
 liked to touch and smooth, and which likewise excited me sexually.) 
 
 I remember well that when a child I received manj^ actual whip- 
 pings at the hands of females. They never caused me any other feeling 
 than pain and shame ; never have I thought to connect such realities 
 with my fancies. A threat to punish me severely and correct me agitated 
 me painfully; but in my fancy I assumed a desire on the part of my 
 " mistress " to enjoy my suffering and humiliation, which entranced me. 
 Too, I have never brought into relation with my fancies the acts and 
 orders of the females that have taken care of me. I was early able to 
 discover the truth about the relation of the sexes; bat this knowledge 
 made no impression on me. The idea of sensual pleasure remained con- 
 nected with the fancies with which it was originally associated. I also 
 had the desire to touch females, to embrace and kiss them, but I looked 
 for the greatest delight only in their maltreatment, and in situations in 
 which they would cause me to feel their power. I soon came to realize 
 that I differed from other men, and preferred to be alone and absorbed 
 in my dreams. In my boyhood, real girls and women had but little in- 
 terest for me ; for I saw no possibilit}' of having them act in the way I 
 desired. On lonely paths in the forest I whipped myself with branches
 
 92 PSTCHOPATHIA SEXUALIS. 
 
 that had fallen from the trees, and allowed my imagination to play in 
 the habitual way. I reveled in the sight of pictures of commanding 
 women, particularly if, like queens, they wore furs. I read everything 
 related to my cherished ideas. " Rousseau's Confessions," which then 
 fell into my hands, was a great discovery. I found a condition described 
 that resembled mine in essentials. I was still more astonished at the 
 similarity of my ideas to those I read of in the writings of Sacher-Masoch. 
 I devoured them all with avidity, though the blood-curdling scenes often 
 far outdid my imagination, and then excited my aversion. Later, in 
 order to supply new food for my fancy, I began to write descriptions of 
 erotic scenes to my taste, and to make drawings of situations which, up 
 to this time, I had painted only in imagination. In this, reality was 
 entirely an indifferent matter to me. In the presence of a woman I was 
 devoid of every sensual feeling ; at most, at the sight of a feminine foot, 
 there would come a fleeting wish to be trod upon by it. 
 
 This indifference, however, was only in relation to pure sensuality. 
 In late bo^iiood and earlj^ youth I was subject to an enthusiastic par- 
 tiality for young girls of my acquaintance, with all the extravagances 
 common to this youthful enthusiasm. But it never occurred to me to 
 connect the world of my sensual thoughts with these pure ideals. I 
 never had to overcome such a thought ; one never came to me. This is 
 the more remarkable, since to me my lustful fancies seemed very strange 
 and unattainable in reality, but in no wise vile or obnoxious. This, too, 
 was a kind of poetrj^ with me ; but it was divided into two worlds, — on 
 the one hand was my heart, or, rather, my lestheticall}" excited fancy ; 
 on the other, my sensually inflamed imagination. While my " elevated " 
 feeling always had a certain young girl for its object, at other times I 
 saw myself at the feet of a mature woman, who treated me as previously 
 described. I never placed any lady of m^^ acquaintance in this role. 
 In dreams the two spheres of my erotic ideas occurred alternately, 
 but never combined. Onl}' the images of the sensual sphere induced 
 pollutions. t 
 
 In my nineteenth j^ear I alloAved myself, with outward reluctance, 
 but with inward desire, to be taken by friends to visit prostitvites. But 
 thei-e I experienced nothing but repugnance and aversion, and left as 
 soon as possible, without having felt the faintest trace of sensual excite- 
 ment. Later, on my own initiative, I repeated the attempt, in order to 
 convince myself as to whether I was impotent or not ; for I was much trou- 
 bled by m}'^ unexpected failure in the first instance. The result was 
 always the same, — I felt no excitement at all, and had not the slightest 
 erection. In the first place, it was not possible for me to regard a real 
 woman as an object of sensual gratification ; and, furthermore, I could 
 not renounce the conditions and situations which were the principal things 
 in sexualihus for me, and about which nothing could induce me to speak 
 a word. Imissio penis — the act to be undertaken by me — seemed to me
 
 MASOCHISM. 93 
 
 absolutely senseless and unclean. Again, in the second place, there was 
 also my repugnance for common women, and fear of infection. 
 
 In the meantime, in secret, my sexual life went on in the old fjishion. 
 Whenever my old fancies came to mind, violent erection occurred, and I 
 provoked ejaculations almost daily. I began to suffer with all kinds of 
 nervous troubles, and now regarded myself as impotent, in spite of power- 
 ful erections and intense desire when I was alone. Nevertheless, from 
 time to time I continued my experiments with prostitutes. In time I 
 overcame my timidity, and in part my aversion to contact with common 
 women ; but I remained absolutely cold. 
 
 After I had, with advancing jears, overcome to some extent my 
 shyness and my inclination to indulge in dreams, in my sexual thought 
 there was an approach to the normal, as I began to direct my interest to 
 real persons. I was even successful in directing sensiud thoughts to 
 women of my acquaintance, without carrying over any of my peculiar ideas 
 from the other sphere. Thus I had some alfairs with resi)ectable girls. 
 Embracing and kissing occurred; desire was excited, but not the power, 
 — at least, it was too weak to allow me to think that under normal circum- 
 stances I should be virile. Of course, the attention I gave to the excita- 
 tion of my sexual power was not calculated to favor this. Thus, always 
 greatly ashamed, I broke olF the relations. 
 
 With this, ray old habit continued. I was still a great onanist, even 
 though with lessened power. But my lanc}^ no longer satisfied me en- 
 tirely. I now began to follow both respectable women and others on the 
 street ; in winter, particularly those wearing velvet and furs. I often 
 followed prostitutes to their lioraes, and had them perform mauustupra- 
 tion. I always thought I should find more real i)leasure in that than in 
 my fancies ; but it was always less. When the woman took olf her 
 garments, my interest followed them. The empty clothing has never 
 attracted me very strongly, but more than the nude female. The real 
 object of my interest was the attired woman. ,In this, velvet and furs 
 play the most important part; but also all other articles of attire 
 attracted me, and particularly the form as brought out by lacing and 
 padding. I had scarcely any other interest in the nude female form than 
 an aesthetic one. I have always had a very great interest in the shoes 
 of women, particularly in slippers with high heels, which is always con- 
 nected with the thought of being trod upon, or of submissively' kissing 
 the foot. 
 
 At last I overcame the last vestige of my shyness, and one day, to 
 realize my dreams, had myself whipped, trod upon, etc., by a prostitute. 
 The result was a great disappointment. What was done to me I felt to 
 be rough, repugnant, and silly. The blows caused me nothing but pain ; 
 the situation, repugnance and shame. Nevertheless, I induced an ejacu- 
 lation mechanically, with which, with the help of my imagination, I trans- 
 formed the real situation into that for which I longed. This — the really
 
 94 PSYCHOPATHIA SEXUALIS. 
 
 desired situation — differed from the actual essentially in that I created 
 in imagination a woman who abused me with the same pleasure that I 
 experienced in her maltreatment of me. 
 
 All my sexual fancies were erected on the assumption in the woman 
 of a tyrannical, cruel disposition, to which I wished to be subject. The 
 act expressing the relation was a secondary matter to me. After the 
 first attempt at an impossible realization, it was perfectly clear to me 
 toward what n\y longing was directed. To be sure, in my lustful dreams, 
 I had often passed beyond all ideas of abuse, and conceived a command- 
 ing woman, with an imperious mien, a word of command, a kiss on the 
 foot, etc ; but now I fully realized what it was that attracted me, and 
 that flagellation was onl}-^ the strongest means of expressing the principle, 
 and in itself secondary'. 
 
 In spite of this disappointment, after the first step, I did not 
 abandon ray efforts to realize my erotic ideas. I was confident that, 
 when once accustomed to the new reality, my fancy would find food in it 
 for more intense activity. For my purpose I sought the most suitable 
 women, and instructed them carefully in a complicated comedy. In this 
 I occasionally found that the way liad been prei)ared for me by prede- 
 cessors of like disposition. The value of these comedies, for the efl'ect 
 of my fancy on my sensuality, remained problematical. What these acts 
 and scenes did for me, in the way of intensifying the subsidiary circum- 
 stances of the desired situation, caused a diminution of the intensity of 
 the principal element, which my unaided fancy, without the conscious- 
 ness of planned, coarse deception, could more easily bring up before 
 me. My ph3'sical sensations, under the various punishments, were change- 
 able. The more perfect the self-deception, the more perfectly the pain 
 was felt as pleasure. 
 
 Or, more correctly, the punishment was then conceived as a sym- 
 bolic act. From this arose the illusion of the desired situation, which 
 was then accompanied by an intense ps3'chical feeling of pleasure. The 
 lustful feeling then spread out over the whole body in lustful [)hysical 
 sensations, and thus the perception of the painful qualit}- of the punish- 
 ment was overcome. The process in the moral punishments — the humili- 
 ations to which I subjected myself — was similar, but simpler ; because it 
 was confined to the mental sphere. These were also attended with 
 pleasurable feeling when the self-deception succeeded. It was seldom, 
 however, that it succeeded well, and never perfectly ; tliere always 
 remained a disturbing element in consciousness. Therefore, in the 
 intervals, I returned to solitar}^ onanism. Moreover, in the other case, 
 the conclusion of the act was usually an ejaculation provoked b}^ onanism ; 
 often an ejaculation without the aid of mechanical means. 
 
 Thus I went on for man^'^ years, with diminishing power, but with 
 slightly diminished desire, and with the power of m}^ peculiar sexual 
 idea over me unchanged. And at present the condition of my vita se^s-
 
 . MASOCHISM. 95 
 
 ualis is the same. Coitus, which I have never performed, still seems to 
 me a strange and unckan act. I learned about it from descriptions of 
 sexual dissipations. My own sexual ideas seem natural, and do not in 
 the least offend my sensitive taste. Their realization, as previously men- 
 tioned, for various reasons, leaves me unsatisfied. I am pleased with 
 pretty girls and women of respectability, but for a long time I have 
 ceased to approach them. I have never attained, not even partial!}', a 
 direct, actual realization of m}^ sexual fanc3^ As often as 1 have come 
 into close relation with females, I have felt the woman's will to be 
 beneath mine, never vice versa. I have never met a woman manifesting 
 a desire of mastery in sexual things. Women who wish to rule in the 
 household and exercise petticoat sovereigntj' are entirely different from 
 my erotic ideals. 
 
 My whole personality presents many abnormalities besides the 
 perversion of my vita sexualis ; my neuropathic condition is expressed 
 in many mental and physical symptoms. Besides, I think I recognize 
 in myself an original abnormality of character in the nature of a re- 
 semblance to the feminine type ; at least, I regard as of this nature my 
 great weakness of will, and my great lack of courage in the presence of 
 men and animals, which is in contrast with my coolness in the face of 
 peril. My external appearance is entirely masculine. 
 
 The author of this autobiography also made me tlie 
 following iCommunication : — 
 
 " I always sought to find out whether the peculiar ideas that ruled 
 me sexually were entertained by other men. Since the first stories 
 about it accidentally came to my ears, I have sought everywhere to learn 
 of it. Since it is really a process of inner consciousness, it is, of course, 
 not easy to identify it, and it cannot always be done with certainty ; but 
 I assume the existence of masochism where I find perverse sexual acts 
 that cannot be explained except by this dominating idea. 1 look upon 
 this anomaly as wide-spread. 
 
 " I have heard numerous stories about it from prostitutes here in 
 Berlin, and in Vienna; and I thus learned how numerous my fellow-suf- 
 ferers are. I am always careful not to describe my own experiences, 
 or ask whether they know of such ; but I allow these persons to relate 
 their experiences just as they will. 
 
 " Simple flagellation is so common that almost every prostitute is 
 familiar with it ; but cases of real masochism are very frequent. The 
 men subject to this perversion submit themselves to the most refined 
 cruelties. In this they always act the same farce with the instructed 
 prostitutes,— humiliating subjection of the man, treading upon him, com- 
 mands, threats, and scoldings that have been committed to memory ; 
 then flagellation, blows on various portions of the body, and all kinds of 
 
 /-^
 
 96 PSYCHOPATHIA SEXUALIS. 
 
 punishment, pricking witli needles, etc. The scenes often end with coitus 
 but more frequently with ejaculation without it. Twice prostitutes have 
 shown me heavy iron chains with handcuffs, which their patrons had 
 made for them to put on them ; and the dried peas, on which they 
 kneeled ; the seat set with needles, on which they sat at command ; and 
 many other similar things. Often the perverted man wishes the woman 
 to tie his penis so tightly as to cause pain ; to prick it with needles, 
 make cuts in it with a knife, or beat it with a stick. Even the act of 
 hanging is indulged in, it being cut short at just the Kight moment. 
 Others have themselves scratched with a knife or dagger, but in the act 
 the woman must threaten them with death. In all these things the 
 symbolism of subjection is the most important factor. The woman is 
 usually called ' mistress'; the man, ' slave.' 
 
 " A man of high social standing, dressed as a servant, sat on the 
 box of a carriage and drove his mistress about. Here there may have 
 been a conscious imitation of the ' Venus in Furs.' It seems to me that 
 the writings of Sacher-Masoch have done much to develop this perversion 
 in those predisposed. It is peculiar that the inexplicable enthusiasm for 
 furs is so frequently combined with this perversion. It, as well as that 
 for velvet, has been peculiar to me from my earliest j^outh. 
 
 " All these comedies with prostitutes are for masochists only trouble- 
 some substitutes. Whether there is such a thing as a realization of 
 masochistic dreams in love relations or not, I do not know. If it occur, 
 it is certainl}' very infrequent ; for this taste in women (sadism in women, 
 as described by Sacher-Masoch) is very difficult to find ; and, too, the 
 expression of sexual abnormalities finds greater obstacles in the modesty 
 of women, etc., than in men. I myself have never noticed the slightest 
 indications of anything of this kind, and have never been able to attempt 
 an actual realization of ni}' fancies. Once a man confidingly told me of 
 his masochistic perversion, and said he had found his ideal." 
 
 The two following cases are similar to the foregoing : — 
 
 Case 45. Mr. Z., aged 29, technicist, came for consultation because 
 of a fear of tabes. Father was nervous and died tabetic. Father's 
 sister was insane. Several relatives are very nervous and peculiar. On 
 closer examination the patient is found to have sexual, spinal, and cerebral 
 asthenia. He presents no symptoms of tabes dorsalis, nor does he give 
 a history of them. Questions concerning abuse of the sexual organs 
 bring out a confession of masturbation practiced since youth. In the 
 course of the examination the following interesting ps3'cho-sexual anoma- 
 lies came out: At the age of five the vita sexualis began with the 
 impulse to whip himself, as well as with the desire to see others whipped. 
 In this he never thought of individuals as of one sex or the other. Faute 
 de mieux he practiced flagellation on himself and, in time, this induced 
 
 X
 
 MASOCHISM. 97 
 
 ejaculation. Long before this he had liegun to satisfy himself with mas- 
 turbation, and always during the act reveled in imaginary scenes of 
 whipping. After growing up he twice visited brothels to have himself 
 flogged by prostitutes. For this purpose he chose the prettiest girl he 
 could find; but he was disappointed, and did not even have an erection 
 to say nothing of ejaculation, lie recognized that the flagellation was 
 subsidiary, and that the idea of subjection to the woman's will was the 
 important thing. He realized this on the second trial. When he iiad 
 the "thought of subjection," he was perfectly successful. In time, by 
 straining his imagination with masochistic ideas, he ])erformed coitus 
 without flagellation ; but he found little satisfaction in it; so that he per- 
 formed sexual intercourse in a masochistic way. He found pleasure in 
 masochistic scenes, in the sense of his original desire for flagellation 
 only when he was flagellated ad podicem, or, at least, only when he called 
 up such a situation in imagination. At times of great excitability it was 
 even sufficient if a prett}^ girl told stories of such scenes. He would thus 
 have an orgasm, and usually ejaculation. 
 
 A very effectual fetichistic idea was early associated with this. He 
 noticed that he was attracted and satisfied only by women wearing hi""li 
 heels and short jackets (" Hungarian ftishion "). He does not know how 
 he arrived at this fetichistic idea. Boys' legs with high heels also 
 pleased him, but this charm was purely aesthetic, without an^' sensual 
 coloring; and he said he had never noticed anything homosexual in him- 
 self. The patient referred his fetichism to his partiality for calves (legs). 
 He is charmed by ladies' calves onl}^ when elegant shoes are on the 
 feet. Nude legs — feminine nudity in general — do not in the least attect 
 him sexually. A subordinate fetichistic idea for the patient is the mas- 
 culine ear. It is a lustful pleasure for liim to pet the ears of handsome 
 men, i.e., men having beautiful ears. With men this pleasure is slight, 
 but with women it gives him great enjoyment. 
 
 He also has a weakness for cats. He thinks them simply beautiful ; 
 and their movements are very attractive to him. The sight of a cat can 
 raise him from a feeling of the deepest depression. Cats seem to him 
 sacred ; he sees something divine in them I He does not know the 
 reason for this idiosyncrasy. 
 
 Of late he has also frequently had sadistic ideas about punishing 
 boys. In these imaginary flagellations both men and women play a part, 
 but particularly the latter ; and then his enjoyment is much more intense. 
 
 The patient finds that, with that which he recognizes and feels 
 as masochism, there is something else wliich he prefers, to designate 
 '' pageism." 
 
 While his masochistic fancies and acts are entirel3' of a coarse, 
 sensual nature, his " pageism " consists of the idea of being a page to a 
 beautiful girl. He conceives her as perfectly chaste, but piquant ; his re- 
 lation to her, that of a slave, but perfectly chaste, — a purely platonic
 
 98 PSYCHOPATHIA SEXUALIS. 
 
 submission. Tliis reveling in the idea of serving such a " beautiful crea- 
 ture " as a page, is colored by a pleasurable feeling ; but this is in no way 
 sexual. He experienced in it an exquisite feeling of moral satisfaction, 
 in contrast with the sensually -colored masochism; and, therefore, he 
 could but regard it as something of a different nature. 
 
 At first sight there was nothing remarkable in the patient's appear- 
 ance; but his pelvis is abnormally broad, the ilia are flat, and the pelvis, 
 as a whole, tilted and decidedly feminine. Eyes, neuropathic. He also 
 mentions that he often has itching and lustful irritation at the anus, and 
 that there (" erogenous " area), ope digiti, he can satisfy himself. 
 
 The patient is troubled about his future. Help would be possible 
 for him if he could but excite in himself an interest in women, but his 
 will and imagination were too weak for that. 
 
 What the patient designates as "pageism" does not differ 
 in any way from masochism, as may be seen when it is com- 
 pared with the following cases of symbolic masochism, and 
 others ; and, further, upon the consideration that in this per- 
 version coitus is avoided as an inadequate act ; and from the 
 fact that in such cases there is often a fantastic exaltation of 
 the perverse ideal : — 
 
 Case 46. X, writer, aged 28, predisposed. Sexually hj'^peraesthetic 
 from childhood. At the age of six he had dreams of being whipped 
 ad vates by a woman. After them he would awake in intense lustful 
 excitement ; and thus he came to practice onanism. When eight years 
 old he once asked the cook to wliip him. From his tenth year, neu- 
 rasthenia. Until his twent3^-fiftli ^--ear he had dreams of flagellation, or 
 similar waking fancies, and indulged in onanism, Tliree years ago he 
 had an impulse to have himself whipped by a puella. The patient was 
 undeceived, for neither erection nor ejaculation occurred. At twenty- 
 seven, another etfort, witli the thought to enforce erection and ejacula- 
 tion. This was finally made possible by the following artifice : While 
 coitus was attempted, the puella had to tell him how she had mercilessly 
 flogged other impotent men, and threaten him with the same. Besides 
 this, it was necessary for him to fanc^^ that he was bound, entirely 
 in the woman's power, helpless, and most painfully beaten by her. Oc- 
 casionally, in order to become potent, it was necessary to have himself 
 actually bound. Thus coitus was possible. Pollutions were accompa- 
 nied b}^ lustful feeling only when he (infrequentl}^) dreamed that he was 
 abused, or that he looked on while a puella whipped others. He never 
 had an intense, lustful pleasure in coitus. The only things in women that 
 interest him are the hands. Powerful women with big fists are his 
 preference. At the same time, his desire for flagellation is only ideal ; for 
 
 K
 
 MASOCHISM. 99 
 
 with his great cutaneous sensitiveness, at the inost, a few strokes are 
 suflicient. 13lq,vvs from men were repugnant to him. He wislies to 
 marry. From tlie impossibility ol' asking a decent woman to perform 
 flagellation, and the doubt al)out l)eing potent with such a woman, 
 spring his embarrassment and desire to recover. 
 
 In the foregoing three cases, for the most part, passive 
 flagellation serves the incUvidnal suhject to this perversion of 
 masochism as an expression of the desired situation of subjection 
 to the woman. The same means is needed by a large number 
 of masochists. But passive flagellation is a process whicli, as is 
 known, has a tendency to induce erection reflexly by irritation 
 of the nerves of the nates.^ This eftect of flagellation is used 
 by weakened debauchees to help their diminislied power; and 
 this perversity — not perversion — is very common. It is, there- 
 fore, necessary to ascertain in what relation the passive flagella- 
 tion of the masochists stands to these dissipated individuals who 
 are not psychically perverse, but physically weakened. 
 
 It is not diflicult to show that masochism is something 
 essentially diflerent from flagellation, and more comprehensive ; 
 that flagellation is rather a by-play, — one of the many means 
 used for the purpose of masochistic gratification in tlie sense of 
 subjection to the woman. For the masochist the principal 
 thing is subjection to the woman ; the punisliment is only tlie 
 expression of this relation, — the most intense effect of it lie 
 can bring upon himself For him the act has only a symbolic 
 value, and is a means to the end of mental satisfaction of his 
 peculiar desires. The essential thing is the desire for ill-treat- 
 ment, as a sign of this subjection. Besides flagellation, and 
 often without it, there are many other things which serve to 
 express this subjection ; as is shown by the following series of 
 cases. This fact establishes a presumption of the existence of 
 an original anomaly of sexual feeling, — a para3sthesia sexualis. 
 On the other hand, the individual that is weakened and not a 
 subject of masochism, and who has himself flagellated, desires 
 only a mechanical irritation of his spinal centre. 
 
 Whether, in a given case, it is simple (reflex) flagellation 
 
 1 Comp. . supra, Introduction, p. 28. 
 
 y
 
 100 PSYCHOPATHIA SEXUALIS. 
 
 or masochism, is made clear by the individual's statements, and 
 often by the secondary circumstances. The determination de- 
 pends upon the following facts : — 
 
 In the Jirst place, the impulse to passive flagellation exists 
 ab origine in the masochist. The desire is felt before there 
 has been any experience of the reflex effect, often first in 
 dreams ; as, for example, in Case 48. Secondhj, with the maso- 
 chist, as a rule, the flagellation is only one of many and various 
 punishments which come into his mind as fancies and are often 
 realized. In these other punishments, and the frequent acts 
 expressing purely symbolic humiliations, which occur by the 
 side of flagellation, there can, of course, be no thought of a 
 reflex physical irritative effect. Thlrdhj^ it is significant that, 
 in the masochist, when the desired flagellation is carried out, it 
 need have no aphrodisiac eflect at all. Very often, indeed, 
 there is a more or less perfect disappointment ; in fact, always, 
 if the masochist is not successful in his desire to create, by 
 means of the pre-arranged programme, the illusion of the desired 
 situation (to be in the woman's power), so that the woman 
 ordered to carry out the act seems to be nothing more than the 
 executive agent of his own will. If one cannot tickle one's 
 self, no more can one feel one's self subject to a woman 
 directed by one's own will. In reference to this important point, 
 compare the three foregoing cases and Case 50. 
 
 Between masochism and simple (reflex) flagellation, there 
 is a relation somewhat analogous to that existing between con- 
 trary sexual instinct and acquired pederasty. It does not lessen 
 the Value of this opinion that, in the masochist, the flagellation 
 may also have the known reflex effect ; or that a whipping 
 received in childhood may have aroused lust for the first time, 
 and thus simultaneously excited the latent masochistically-consti- 
 tuted vita sexualis. In this event, the case must be characterized 
 by the conditions mentioned above, under the heads of '"''secondly " 
 and " iliirdly^'* in order to be masochistic. If the details of the 
 origin of the case are not known, other circumstances, such as 
 those mentioned above under '-'• secondly^'* would make it clearly 
 masochistic. This is illustrated in the two following cases: —
 
 MASOCHISM. 101 
 
 Case 47. A patient of Turiiowsk^'s liad a person in his Confidenoe 
 rent a house during his attacks, and instruct its personnel (three pros- 
 titutes) in what was to he done with him. He wouhl come there, and 
 was there undressed, manustuprated, and liagelUited, as ordered. He pre- 
 tended to oiler resistance, and begged for mercy ; then, as ordered, he 
 was allowed to eat and sleep. But in spite of i)rotest he was kept 
 there, and beaten if he did not submit. Tlius the affair would go on 
 for some days. When the attack was over, he was dismissed ; and he re- 
 turned to his wife and children, who had no suspicion of his disease. 
 Tlie attacks occurred once or twice a year. (Tarnowsky, op. cit.) 
 
 Case 48. X., aged 34, greatly predisposed, sullers with contrary 
 sexual instinct. For various reasons he had no opportunit}- to satisfj' 
 himself with men, in s|)ite of great sexual desire. Occasionally he 
 dreamed that a woman whipped him, and then had a pollution. 
 
 Through this dream he came to have prostitutes beat him as a sub- 
 stitute for love with men. Occasionall3^ he would obtain a prostitute, 
 undress himself completely (while she was not to take oir a thing), and 
 have her tread upon him, whip, and beat him. Qua re summa libidine 
 aft'ectus pedem femina? lambit quod solum eum libidinosum facere potest: 
 tuni ejaculationem asse(]uitur. Then disgust at the morally-debasing 
 situation occurred, and he retired as quickly as possible. 
 
 Cases occur, however, in which passive flagellation alone 
 constitutes the entire content of the masochistic fancies, with- 
 out other ideas of humiliation, etc., and without any clear con- 
 sciousness of the real nature of this expression of submission. 
 Such cases are difficult to differentiate from those of simple 
 reflex flagellation. A knowledge of the primary orighi of the 
 desire, before any experience of reflex stimuli {v. supra, under 
 ''■first"), is the only thing that makes the differential diagnosis 
 certain; taken with the circumstance that genuine masochists 
 are perverse in their youth, and that the realization of their 
 desires usually comes late, or undeceives them (v. supni, under 
 ''thirdhj''); for the whole thing, for the most part, belongs to 
 the sphere of the imagination. 
 
 The following case is of this nature : — 
 
 Case 49. Autohiograp)hy. — In January, 1891 , 1 received the following 
 letter from a gentleman in Hung:irv : " In deijression and despair of a 
 life that shuts me out from all that makes linnian happiness, I come to 
 you with the last gleam of hope of rescue from a condition which, if it 
 continue, can end only tragically.
 
 102 PSYCHOPATHIA SEXUALIS. 
 
 " I am thirty years old, and come of a mother who suffered with 
 periodical insanity. As early as ra}- fourteenth j^ear abnormal sexual 
 tendencies were noticeable in me. It always gave me a certain lustful 
 pleasure to be whipped l>y boys of my own age, particularly when I was 
 taken over the knee and spanked. It particularly delighted me when 
 this was done by handsome 3'oung persons or bo3's having well formed 
 legs and closely-fitting trousers. Bj- means of such ideas I also came to 
 masturbate; and I practiced onanism quite frequently, — almost dail}'^, 
 and, in fact, in absolute ignorance of the terrible results of the vice. 
 Thus it continued until my eighteenth year, when, thus far absolutely 
 unsuspecting, I was made aware of the vicious results of the practice. 
 
 " From this time began the terrible struggle with the desire to give 
 it up, whicli I only too often abandoned. The fancies mentioned did not 
 leave me ; I longed to be whipped b}' handsome young persons aged from 
 twenty to twent3'-two years, wearing tight trousers. My fancy was filled 
 especially with 3'oung soldiers and hussars. At times I was able to re- 
 press my imagination and avoid onanism ; but I then had pollutions with 
 dreams of the same nature. 
 
 " After my twentieth year, to my astonishment, the sexual in- 
 clination toward women, which I had noticed in comrades of m3' own 
 age, and the occurrence of which I expected in myself, did not appear. 
 I was cold toward women, and embarrassed in tlieir [)resence. At the 
 same time, feminine nudit3'^ was not unpleasant; on the contrary, there 
 was something attractive about it, but m3" sensuality was not excited. 
 
 " I twice attempted coitus ; I was not troubled about being i^n l>ed 
 with tlie girl, but rather kissed and embraced her with pleasure, and even 
 had traces of erection, but that was all. Since then I have had no hope, 
 and occasionally returned to onanism, which I had avoided for some 
 months previousl3\ Nevertheless, I cultivated social intercourse with 
 ladies, and particularh' 3'oung girls ; and I was esteemed in societ3', and 
 liked for mv graceful dancing. I was always hoping that in this wa3'^ 
 m3' unhai)p3' tendenc;' would be overcome successfull3', but in vain ; it 
 grew constantly stronger. Thus I have lived hours of wretchedness ; 
 and the ghost of suicide has passed before me. I once confided in a 
 ph3'sician in Pesth, but he had only the usual remedies for persons suf- 
 fering with sexual weakness, — cold baths, quieting medicines, intercourse 
 with women, etc. 
 
 "I tried ever3'thing in vain, until b3' accident a book on contrar3'^ 
 sexual instinct fell into m3^ hands, and gave me the last ra3^ of hope. I 
 have a respected position as a merchant, and api)reciate thoroughly the 
 joys of family life ; and I have an opportunity- to marry', under the most 
 favorable circumstances, a young girl whom I love, and who loves me. 
 But I feel the cruel impossibilit3^ of this step. I suffer terribl3' in think- 
 ing about these repulsive abnormalities. M3' onl3' hope lies in a cure by 
 means of hypnosis. Ma3' it not be in vain 1 "
 
 MASOCHISM. 103 
 
 Pity and a scientific interest induced me to invite the writer of the 
 preceding lines to come to see me. Early in February Mr. D. came. 
 He was distinguislied, pleasing, and masculine in appearance. Exam- 
 ination of the case showed it to be one of masocliisni. He distinctly 
 remembered that, when he once saw fellow-pupils whipped b3' the teacher, 
 it gave him a feeling of lustful pleasure. He cannot remember that he 
 was ever whipped by a teacher. His masochism had been an absolidely 
 primary manifestation, and incomprehensible to him. Only gradually 
 and/aute de mieux had he come to practice onanism, during which ideas 
 of flagellation, in which he played the passive role, filled his mind. He 
 had never had desire to be whipped by the teacher; he always wished to 
 be flogged by fellow-pupils and well-grown young persons. Since ma- 
 turity he had never been able to induce himself to satisfy' his masochistic 
 inclinations. 
 
 In intercourse with puellis he had repeatedly had the thought to 
 have himself whipped by them ; but since this was not accompanied by 
 sensual feeling, it was not carried out. The patient declares that his in- 
 clinations toward persons of his own sex are purelj' masochistic. In 
 other respects he finds nothing interesting in men. Until his eighteenth 
 year the patient had also sadistic tendencies. He was enthusiastic about 
 the position of the pedagogue and wanted to be a teacher in order to be 
 able to flog boys. This ideal sadism later disappeared entirely. The 
 patient complains that he feels alone in the world, like a pariah, and that 
 he is different from other men. But his libido toward women had much 
 diminished, possibly as a result of his masturbation. He had no erec- 
 tion at the sight of feminine charms, but the sight of a riding-whip or a 
 cane excited him powerfully sexually. When he attempted coitus, no 
 masochistic ideas occurred. Such ideas aroseiniowever, whenever he 
 saw attractive 3'oung men. He believed that if he were freed from his 
 ideas of flagellation, he would be helped; for his sensuality would then 
 direct itself in a normal path. 
 
 The patient has neuropathic eyes, but is free from all degenerative 
 signs. In the direction of hereditar}^ taint, it is noteworthy that his 
 maternal grandfather was peculiar, and shot himself while in a psycho- 
 pathic condition. The patient feels well, save for slight neurasthenic 
 troubles. Patellar reflex increased. The genitals are {)erfectly normal. 
 His dreams with pollutions are exclusively about flagellation by 3'oung 
 persons, particularly soldiers with tight trousers. 
 
 The principles of treatment laid down were : 1. Removal of the 
 symptoms of neurasthenia. 2. Suggestive treatment looking to (a) 
 avoidance of onanism ; (/>) indifierence toward his own sex and the 
 disappearance of thoughts of flagellation, both while awake and asleep; 
 (c) libido exclusively toward persons of the opposite sex, the occurrence 
 of erections at siglit of beautiful women, complete power with women, 
 and dreams of women exclusivel}'. At the first sitting, by means of
 
 104 PSTCHOPATHIA SEXUALlS. 
 
 Bernlieim's method, the patient passed quickly into a state of deep 
 lethargy. At the second sitting (February 5) a cataleptic condition 
 of the muscles was induced. Sittings almost daily. It was seen that 
 stroking the brow induced deeper hypnosis with catalepsy, which, how- 
 ever, did not go beyond deep lethargy. Suggestion was begun in the 
 third sitting. 
 
 Februar}' 10. The patient says that he has no longer any interest 
 in men, but a growing interest in women. He begins to dream of 
 women. 
 
 February 13. He feels himself free from masochism during the 
 day, and canes and whipping do not interest him any more. At night he 
 still has "weak" dreams of flagellation concerning men, but without 
 lustful feeling or pollution. A short time ago he had had a dream that 
 was entirely strange, and without erotic coloring, to the eflect that he 
 whipped himself. 
 
 February 19. The patient attempted coitus with a puella pleasing 
 to him. Erection was incomplete, and ejaculation did not occur; so he 
 gave up the attempt. The patient finds that his libido toward women is 
 still very slight. He was not discouraged b}' his failure, and expected 
 ultinmte success; for he felt free from his abnormal tendencies, and like 
 another man. On February 20, unfortunately, the patient had to dis- 
 continue treatment, being called home bj^ duties there. 
 
 The foct that traces of sadism (y. infra) were simultaneously 
 present, lends certainty to the diagnosis of this rudimentary case 
 as one of masochism. The purely psychical character of this lat- 
 ter perversion is uHQuestionahle. At the same time, the case is 
 comhined with incompletely developed contrary sexual instinct, 
 an association not infrequent in masochists and sadists. 
 
 In contrast with this case of rudimentary masochism, in 
 which there is some difficulty of diagnosis, follows a typical 
 case of masochism, in which the whole circle of ideas peculiar 
 to this perversion appears completely developed. This case, in 
 which there is a detailed personal description of the whole psy- 
 chical state, is different from Case 44 only in that here there is no 
 thought of a realization of the perverse fancies ; and that, not- 
 withstanding the perversion of the vita sexualis, normal stimuli 
 are so far effectual that sexual intercourse is possible under 
 normal conditions. 
 
 Case 50. I am thirt^'-flve 3'ears old, mentall}' and physically normal. 
 Among all my relatives, in the direct as well as in the lateral line, I know
 
 MASOCHISM. 105 
 
 of no case of mental disease. M}^ father, who, at ni}- birth, was thirty 
 years old, as far as I know, had a preference for voluptnous, large women. 
 
 Even in my early childhood I loved to revel in ideas about the 
 absolute mastery of one man over others. The thought of slavery had 
 something exciting in it for me, and alike whether from the stand-point 
 of master or servant. That one man could possess, sell, or whip another, 
 caused me intense excitement ; and in reading " Uncle Tom's Cabin " 
 (which I read at about the beginning of puberty), I had erections. Par- 
 ticularly exciting for me was the thought of a man's being hitched up 
 before a wagon in which another man sat with a whip, driving and whip- 
 ping him. Until my twentieth year these ideas were purely objective and 
 sexless, — i.e., the one in subjugation in my faiic}' was another (not 
 myself), and the master was not necessarily a woman. These ideas were, 
 therefore, without effect on my sexual instinct, — i.e., on the way in which 
 it was expressed. Though these ideas caused erections, yet I have never 
 masturbated in nw life ; and from my nineteenth year I had coitus with- 
 out the help of these ideas and without any relation to them. I always 
 had a great preference for elderly, voluptuous, large women, though I 
 did not scorn younger ones. 
 
 After my twenty-first year my ideas became objective, and it 
 became an essential thing that the '' mistress " should be a woman over 
 forty years old, tall, and powerful. From this time I tms always, in my 
 fancies, the snbject ; the " mistress " was a rough woman, who made use 
 of me in every way, also sexually ; who harnessed me before a carriage, 
 and made me take her for a drive; whom I must follow like a dog; at 
 whose feet I must lie naked, and be punished — i.e., whipped — by her. 
 This was the constant element in my ideas, around which all others were 
 grouped. In these fancies I always found endless pleasure, which caused 
 erection, but never ejaculation. As a result of the induced sexual ex- 
 citement, I would immediately seek a woman, preferably one correspond- 
 ing exteriorly with my ideal, and have coitus with her without any actual 
 imitation of my fancies, and sometimes also without any thought of them 
 during the act. At the same time, I also had inclination toward women 
 of a different kind, and had coitus with them without being impelled to 
 it by my fancy. 
 
 Notwithstanding all this, my life was not exceedingly abnormal 
 sexually ; yet these ideas were certain to occur periodically, and they have 
 remained essentially unchanged. With growing sexual desire, the inter- 
 vals constantly grew shorter. At the present time the ideas come every 
 two or three weeks. If I have had coitus, the occurrence of the fancies 
 is perhaps postponed. I have never attempted to realize my very definite 
 and characteristic ideas, — i.e., to connect them with the objective world, 
 
 but I have contented myself with reveling in the thoughts; because I 
 
 was convinced that my ideal would not allow even an approach to realiza- 
 tion. The thought of a comedy with paid prostitutes always seemed to
 
 106 PSTCHOPATHIA SEXUALlS. 
 
 me silly and purposeless ; for n person hired b}^ me could never take the 
 place in my imagination of a " cruel mistress." I doubt whether there 
 are sadistically constituted women like Sacher-Masoch's heroines. But, 
 if there were such women, and I had the fortune (I) to find one, still, in a 
 world of reality, intercourse with her would alwa^'S seem only like- a 
 farce to me. Indeed, I can sa}^ that, were I to become the slave of a 
 Messalina, I believe that, owing to the other necessar^^ renunciations, 
 my desired manner of life would soon pall on me, and in my lucid 
 intervals I should try to obtain my freedom at all hazards. 
 
 Yet I have found a way in which to induce, in a certain sense, a 
 realization. After my sexual desire has been intensely excited by revel- 
 ing in my fancj^, I go to a prostitute and there call up before my mind's 
 eye, with great intensity, some scene of the kind mentioned, in which I 
 play the principal role. After thinking of such a situation for about 
 half an hour, with a constantly resulting erection, I perform coitus with 
 increased lustful pleasure and strong ejaculation. After the latter, the 
 vision fades awa3\ Ashamed, I depart as quickl}^ as possible, and try 
 not to think of the affair. Then, for about two weeks, I have no more 
 such ideas ; indeed, after a particularly satisfactory coitus, it may happen 
 that, until the next attack, I have no sympathy' whatever with masochistic 
 ideas. But the next attack is sure to come sooner or later. I must, 
 however, state that I also have coitus without being prepared by such 
 ideas, especially, too, with women that are acquainted with me and m}' 
 position, and in whose presence I abhor such fancies. Under the latter 
 circumstances, hoivever, I am not always potent, while, with masochistic 
 ideas, my virility is perfect. It does not seem superfluous to add that 
 otherwise, in my thought and feeling, I am very esthetic, and despise 
 anything like maltreatment of a human being. Finally, I will not leave 
 unmentioned the fact that the form of address is of importance. In ni}' 
 fancies it is essential that the " mistress " address me in the second per- 
 son (Da), while I must address her in the third (Sie). This circum- 
 stance of being thus familiarly addressed (I)u) by a person so inclined, 
 as the expression of absolute mastery, has, from my youth, given me 
 lustful pleasure, and does to-day. 
 
 I had the fortune to find a wife who is in everj'thing, but especially 
 sexually, attractive to me ; though, as I scarcely need say, she in no way 
 resembles my masochistic ideal. She is gentle, but proud ; for without 
 the latter characteristic I cannot conceive such a thing as sexual charm. 
 The first few months of married life were normal sexually ; the maso- 
 chistic attacks did not occur, and I had almost lost all thought of maso- 
 chism. Then came the first confinement and the necessary abstinence. 
 Punctually, then, with the occurrence of libido, came the masochistic 
 fancies again, which, in spite of my great love for ni}' wife, necessitated 
 coitus with another, with the accompaniment of masochistic ideas. It 
 is here worthy of note that coitus maritalis, which was later resumed,
 
 MASOCHISM. 107 
 
 did not prove sufficient to banish the masochistic ideas, as masochistic 
 coitus alwa3's does. As for the essential element in masochism, I am 
 of the opinion that the ideas, — i.e., the mental element, — are the end 
 and aim. 
 
 If the realization of the masochistic ideas {i.e., passive flagellation, 
 etc.) be the desired end, then it is in oi)position with the fact that the 
 majority of niasochists never attempt realization ; or, when this is 
 attempted, great disappointment occurs, or at least the desired satisfac- 
 tion is not obtained. 
 
 Thus the reveling in imagination is the principal thing ; and, in fact, 
 this gives an unspeakable delight that takes its subject beyond external 
 things, beyond all troubles and cares. 
 
 It is an astonishing fact that there is an author, who, instead of 
 keeping them to himself, as others do, discloses his imaginar}^ ideals to 
 the world in novels and romances. In " Venus in Furs," we find those 
 that are like us in feeling, — word for word, line for line, are expressed 
 the ideas so familiar to us, which we believe to be our own exclusive 
 discovery. 
 
 Until then I did not think it possible that there could be, in an)'- 
 other brain than mine, the lustful thought of being harnessed to a plow 
 and made to work like a draught-horse. 
 
 And the ill-temper of the mistress to be served at the toilet and 
 bath ; the imprisonment, — ah, how familiar such ideas are to us from 
 childhood I 
 
 Therefore, perhaps by reason of this open disclosure of things that 
 should be secret, the reading of this book shocks masochists, undeceives 
 them, and exerts a curative influence. 
 
 Finally, I shouUl mention that, according to m}' experience, the 
 number of masochists, especially in large cities, seems to be quite large. 
 The only sources of such information are — since men do not reveal 
 these things — words of prostitutes; and, since they agree on the essen- 
 tial points, it may be concluded that certain facts ai-e proved. 
 
 Thus there is the fact that every experienced prostitute is accus- 
 tomed to keep some suitable instrument (usually a whip) for flagellation ; 
 but it must be remembered that there are men who have themselves 
 whipped simply to increase their sexual pleasure; who, in contrast with 
 masochists, regard flagellation as a means to an end. 
 
 On the other hand, almost all prostitutes agree that there are 
 many men who like to play " slave," — i.e., like to be so called, and have 
 themselves scolded and trod upon and beaten. As has been said, the 
 number of masochists is larger than has yet been dreamed. 
 
 As you can imagine, reading the "New Investigations "Mnade a 
 
 1 The autlior's " Neue Forsehun.?en auf d. Gebiet d. Psychopathia Sexualis," Stutt- 
 gart, 1891, which is, for the most part, incorporated iu this edition of " Psychopathia Sex- 
 ualis."
 
 108 PSYCHOPATHIA SEXUALIS. 
 
 great impression on me. I slionld like to have faith in a cure, in a logical 
 cure, so to speak, in accordance with the motto : '' Tout comprendre c'est 
 tout gue'rir." (To understand all is to cure all.) 
 
 Of course the word cur-e is to be taken with some limitation, and 
 there must be a distinction made between general feelings and concrete 
 ideas. The former can never be overcome ; they come like a stroke of 
 liohtnino- are there, and one does not know whence or how. 
 
 But this practice of masochism in imagination, by means of con- 
 crete, associated ideas, can be avoided, or at least restricted. 
 
 Now the thing is changed. 1 say to myself: What! you bus3'yonr 
 mind with things whicli not only the aesthetic sense of others, but also 
 your own, disapproves? You regard that as beautiful and desirable 
 which, in your own judgment, is at once ugl}', coarse, sill3^, and impos- 
 sible? You long for a situation which in reality' you can never obtain? 
 This opposing idea has an immediate inhibitory and undeceiving effect, 
 and takes the edge off the fancy. Too, since reading the " New In- 
 vestigations " (early tliis year), I have actuallj^ not reveled in my 
 fancy once, though the masochistic tendenc}' has occurred with regu- 
 larity. 
 
 I must also confess that, in spite of its marked pathological char- 
 acter, masochism is not only incapable of destroying my pleasure in life, 
 but it does not in the least affect my outward life. When not in a maso- 
 chistic state, as far as feeling and action are concerned, I am a perfectly 
 normal man. During the activity of the masochistic tendencies there is, 
 of course, a great revolution in my feeling, but my outward manner of 
 life suffers no change ; I have a calling that makes it necessary for me to 
 move much in public, and I pursue it in the masochistic condition as 
 well as ever. 
 
 The autlior of the foregoing lines also sends me the follow- 
 ing notes : — 
 
 1. Masochism, according to my experience, is, under all circum- 
 stances, congenital, and never acquired by the individual. I know posi- 
 tively that I was never spanked; that my masochistic ideas were mani- 
 fested from my earliest youtii ; and that, as long as I have been capal)le 
 of tliinking, 1 have had such thoughts. If the origin of them had 
 been tlie result of a particular event, especially of a beating, I siiouid 
 certainly not have forgotten it. It is characteristic that the ideas were 
 present before there was any libido. At that time the ideas were abso- 
 lutely sexless. I remember tliat, when a bo}', it affected (not to say 
 excited) me intensely when an older boy addressed me in the second 
 person (D//), wliile I spoke to iiim in tlie third (»S'?>). I would keep up a 
 conversation with him, and have tiie excliange of address take place as 
 often as possible. Later, when I had become more mature sexually, such
 
 MASOCHISM. 109 
 
 things uffected me only when tlie^- occurred wiUi a married woman, and 
 one rehitively old. 
 
 2. Pliysically and mentally I am in all respects masculine. I have 
 a superabundant growth of beard, and my whole body is very hairy. In 
 my relations to the female sex that are not masochistic, the dominating 
 position ol" the man is an indispensible condition, and any attempt to 
 change it v/ould meet with my energetic opposition. I am energetic, if 
 not over-courageous ; but the want of courajiC is not manifest when my 
 pride is injured. I am not sensitive to events in nature (thunder-storms, 
 storms at sea, etc.).* 
 
 Too, my masochistic tendencies have nothing feminine or efiemi- 
 nate about them (?). To be sure, in these the inclination to be sought and 
 desired by the woman is dominant; but the general relation desired 
 with her is not that in which a Avoman stands to a man, but that of tlie 
 slave to the master, tiie domestic animal to its owner. If one regards 
 the ultimate aim of masochism without prejudice, it must be acknowl- 
 edged that its ideal is the position of a dog or horse. Both are owned 
 by masters, and punished by them ; and the masters are responsible to no 
 one. Just this unlimited power of life and death, as exorcised over 
 slaves and domestic animals, is the end and aim of all masochistic ideas. 
 
 3. The foundation of all masochistic ideas is libido ; and as this ebbs 
 and flows, so do the masochistic fancies. On the other hand, as soon a^ 
 the ideas are present, they greatly intensify tlie libido. I am by no 
 means excessively sensual naturally. However, when the masochistic 
 ideas occur, I am impelled to coitus at any cost (for the most pait I am 
 driven to the lowest women); and if these impulses are not soon obeyed, 
 libido soon becomes almost satyriasis. One is almost justified in look- 
 ing upon this as a circuius viliosus. 
 
 Libido occurs eitlier in the course of time, or as the result of espe- 
 cial excitement (also ol" a kind that is not masochistic, — e.g., kissing). 
 In spite of its manner of origin, this libido, by virtue of the masochistic 
 ideas it engenders, is soon transformed into a masochistic and impure 
 libido. 
 
 Moreover, there is no doubt that external, accidental impressions, 
 particularly loitering in the streets of a large city, greatly intensily the 
 desire. The sight of beautiful and imposing fenuvle forms, in imtui^e as 
 well as in art, is exciting. For those subject to masocliisin, — at least 
 during the attacks, — the whole external world becomes masochistic. 
 The box on the ear administered by the teacher to the pupil and the crack 
 of the driver's whip make deep imi)ressions on the masochist, while they 
 leave him inditferent or annoy him when he is not in the masochistic state. 
 
 1 This difference of courage in the face of events in nature, on the one hand, and 
 in the face of personal conflict, on the other, is certainly remarkable (comp. Case 4-1), eveo 
 though it is the only indication of effemination mentioned in this case.
 
 110 PSYCHOPATHIA SEXUALIS. 
 
 4. An example of masochistic ideus follows : " Slie " is a peasant 
 woman, — a roiigli, tall, large-boned woman of forty or fifty years. She is 
 the possessor of a small, remote farm, which she works with the help of 
 her slave alone. The work begins before sunrise. At four o'clock in 
 the morning she opens the shed where she has kept me shut up over 
 night, and wakens me, as I lie on the ground, with a kick ; then she leads 
 me out and liarnesses me to a milk-cart bound for town. She leads me 
 by a halter, and urges me along. On the road she gets on the heavily- 
 loaded wagon, and sleeps until the destination is readied. There, in the 
 open market-place of the town, still harnessed to the wagon, I lie down 
 on the bare ground to rest. Those passing knock against me or step on 
 me, with Mit giving me any attention. After the stock is sold, we start 
 homeward. After a short rest the work begins again, always under 
 the direction of the mistress, who holds me by the halter and urges me 
 on. At seven or eight o'clock at night I am put up to rest, and sleep 
 until the next morning, when the same thing begins again. Work and 
 blows, blows and work; no pleasure, no recreation, day in and day outl 
 
 Another time I fancy myself in the ro/e of a paid lover of an 
 elderly female roue, who makes use of me, sexuallj^, in the most reckless 
 manner; and in this direction makes the most shameful demands on me. 
 If I do not submit to these willingly, I am beaten and punished ; and, at 
 the same time, she despises me unspeakably ; gives me the lowest house- 
 work to do ; and on every occasion shows me how low an opinion she 
 has of m}'^ manhood, 
 
 I cannot clothe the character of masochism in any better formula 
 than the following : A real masochist, without reflection, prefers the 
 kick of a low woman to tlie embrace of a Venus. 
 
 5. In reading Sacher-Masoch, it struck me that in masochists, now 
 and then, there was also an undercurrent of sadistic feeling. Too, I 
 have now and then discovered in m^'self sporadic feelings of sadism. 
 I must remark, however, tiiat the sadistic feelings are not so marked as 
 the masochistic; and that, aside from the fact that they are infrequently 
 accessory, the sadistic fancies never leave the spliere of abstract feeling, 
 and, above all, never take the form of concrete, connected ideas (like 
 tliose above mentioned). The effect on libido, however, is the same with 
 both. 
 
 If this case is remarkable on account of the complete de- 
 velopment of the psychical state that constitutes masochism, the 
 following one is noteworthy because of the great extravagance 
 of the acts resulting from the perversion. The case is also par- 
 ticularly suited to make clear the reason for the subjection and 
 humiliation at the hands of the woman, and the peculiar sexual 
 coloring of the resulting situations : —
 
 MASOCHISM. Ill 
 
 Case 61. Masochism. — Mr. Z., ofllcial, aged 50; tall, muscular, 
 healthy. He is said to come of heallhy parentage, but his father was 
 thirty j^ears older than his mother. A sister, two years older than Z., 
 suffers with delusions of persecution. There is nothing reinarkal)le in 
 Z.'s external appearance. Skeleton entirely masculine; abundant beard, 
 but no hair on trunk. He characterizes himself as a num of sanguine 
 temperament, whom no one can depress ; though irascible and quick- 
 temi)ered, he is quick to regret outbursts. 
 
 Z. says he has never masturbated. From his youth there have been 
 nightly pollutions, in which girls i)lay a i)art ; but the sexual act, never. 
 For example, he dreams that a pleasing woman lies heavily on him, or 
 that, as he lies sleeping on the grass, she playfully walks up his back. 
 Z. had always been averse to coitus with a woman. This act seemed 
 animal to him. Nevertheless, he was drawn to women. It was onl}- in 
 the society of beautiful women and girls that he felt well and in his place. 
 He was very gallant without being forward. 
 
 A voluptuous woman of beautiful form, and particularly with a 
 pretty foot, when seated, had the power to throw him into intense ex- 
 citement. He was impelled to offer himself as a chair, in order " to 
 offer so much devotion." A kick, a box on the ear from her, would be 
 heaven to him. He had a horror at the thought of coitus with her. 
 He felt the need to serve the woman. He thought how ladies liked to 
 ride. He reveled in the thought of how fine it would be to be wearied 
 by the burden of a beautiful woman, in order to give her pleasure. He 
 painted the situation in all colors; thought of the beautiful foot armed 
 with spurs, the beautiful legs, and the soft, full thighs. Every beautiful 
 mature woman, every pretty female foot, always excited his imagina- 
 tion; but he never betrayed the peculiar feelings that seemed to him 
 abnormal, and was able to control himself. But he felt no need 'to fight 
 against them ; on the contrary, it would have hurt him had he been com- 
 pelled to give up the feelings that had become so dear to him. 
 
 At the age of thirty-two Z. happened to make the acquaintance of 
 an attractive woman, aged twenty -seven, who had been separated from 
 her husband, and whom he found in need. He took her, and worked for 
 her, without any selfish motive, for months. One evening she impatiently 
 demanded sexual satisfaction from him, and almost used violence. Coitus 
 was successful. Z. took the woman, lived with her, and indulged in 
 coitus moderately ; but coitus was more a burden than a pleasure; erec- 
 tions became weak, and he could no longer satisfy the woman. She 
 finally declared that she would not have intercourse with him, because he 
 only excited without satisfying her. Though he loved the woman very 
 much, he could not give up his peculiar fancies. After this he lived 
 with her only in friendly relations, and deeply regretted that he could 
 not serve her in the way she desired. 
 
 Fear of how she would receive his propositions, and a feeling of
 
 112 PSYCHOPATHIA SEXUALIS. 
 
 sbaine, kept him from confessing. He found a substitute in his dreams. 
 Thus, for example, he dreamed that he was a proud, fiery steed, ridden 
 by a beautifid lady. He felt her weight, the bit he had to obey, the press- 
 ure of the thighs on his flanks; he heard her beautiful, joyous voice. 
 The exertion threw him into a perspiration ; the touch of the spurs 
 did the rest, and always induced pollution with great lustful pleasure. 
 At other times he dreamed that he was a small, weak horse. Then a 
 large, heavy woman came and mounted the horse, and set off on a long 
 journey in the mountains. Recklessly, and without mercy, she allowed 
 the poor animal to feel her weight; she made herself comfortable 
 on his back; while he threatened to give out under her, she had the 
 greatest enjoyment, and Avith calm mind enjoyed the beautiful scenery. 
 Under the influence of such dreams, seven years ago Z. overcame his 
 reluctance, in order to experience such things in reality. He was suc- 
 cessful in creating suitable opportunity. He speaks of it as follows : " I 
 knew how to arrange it so that on an occasion she would, of her own 
 will, seat herself on my back. Then I endeavored to make this situation 
 as pleasant as possible, and easily made it so that on the next occasion 
 she said, spontaneous!}- : ' Come, give me a little ride 1 ' Swelling with 
 pride, and with both hands braced on a chair, I made my back horizontal, 
 and she mounted astride, after the manner of a man. I then did the best 
 I could to imitate the movements of a horse, and loved to have her treat 
 me like a horse, without any thought of me. She could beat, prick, 
 scold, or caress me, just as she felt inclined. I could carry on my back 
 persons weighing from sixty to eighty kilos, for half or three-quarters of 
 an hour, without interruption. At the end of this time I usually asked 
 for a rest. During this the intercourse between the mistress and me was 
 perfectly harmless and without any relation to what had preceded. After 
 about a quarter of an hour I was always rested, and placed myself at the 
 disposal of the mistress again. When time and circumstances allowed it, I 
 did this three or four times in succession. It sometimes happened that 
 I ])racticed it both in the morning and afternoon. After it I never felt 
 wear\' or had any uncomfortable feeling ; but on such days I had very little 
 ap[)etite. When possible, I liked best to bare my trunk, that I might feel 
 the rider more perfectly. The mistress had to be decent. I liked her 
 best in pretty shoes and stockings, with short, closed drawers, reaching 
 to the knee ; with the upper portion of her person completely dressed, 
 and with hat and gloves." 
 
 Mr. Z. further sa,ys that he has not performed coitus in seven years ; 
 but he thinks he is potent. The riding was a perfect substitute for that 
 " animal act," even when ejaculation was not induced. 
 
 For eight months Z. had determined to give up his masochistic play, 
 and had kept his determination. But he thought that if a woman only 
 half-way pretty were to address him directly, and say, " Come, I want 
 to ride you," he would not be strong enough to withstand the tempta-
 
 MASOCHISM. 113 
 
 tion. Z. wishes to know whether his nbnormality is curable; wliether 
 he is uuworthy as a vicious man, or an uivalicl deserving pity. 
 
 The following case seems very similar : — 
 
 Case 52. A man finds satisfaction in the following manner : Occa- 
 sionally he goes to a puella publica. Here he has a porcelain ring, like 
 those used in hanging curtains, put on his penis. Two cords are attached 
 to the ring and drawn backward between his legs and attached to the 
 bedstead. Then he tells the woman to beat him mercilessly with a whip 
 and cry "whoa" to him constantly, and treat and abuse him as if he 
 were an unruly horse. The more the woman spurs him on to pull, with 
 shouts and blows, the greater his sexual excitement becomes. Erection 
 occurs (probably mechanically favored by compression of the dorsal 
 vein of the penis, which, when the cords are strained, must be closed by 
 the pressure of the hard ring). With increasing erection, the whole 
 member is compressed by the ring, and finally ejaculation occurs, with 
 lustful feeling. 
 
 Even in the foregoing series of cases, witli other things, 
 the act of being walked upon has played a role as a means of 
 expressing the masochistic situations of humiliation and pain. 
 The exclusive and most extensive use of this means for perverse 
 excitation and satisfaction is shown in the following classical 
 case of masochism, which Hammond reports {op. cit, p. 28) 
 from an observation by Dr. Cox,^ of Colorado : — 
 
 Case 53. X., a model husband, very moral, the father of several 
 children, has times— i.e., attacks— in which he visits brothels, chooses 
 two or three of the largest girls, and shuts himself up with them. He 
 bares the upper portion of his body, lies down on the floor, crosses his 
 hands on his abdomen, closes his eyes, and then has the girls walk over 
 his naked breast, neck, and face, urging them at every step to press hard 
 on his flesh with the heels of their shoes. Sometimes he wants a heavier 
 girl, or some other act still more cruel than this procedure. After two 
 or three hours he has enough. He pays the girls willi wine and money, 
 rubs his blue bruises, dresses himself, pays his bill, and goes back to his 
 business, only to give himself the same strange pleasure again after a 
 
 few weeks. 
 
 Occasionally it happens that he has one of the girls stand on his 
 breast; and the others then turn her around until his skin is torn and 
 bleeding from the turning of the heels of her shoes. Frequently one of 
 
 1 Transactions of the Colorado State Medical Society, quoted in the Alienist and 
 Neurologist, 1883, p. 345. 
 
 8
 
 114 PSYCHOPATHIA SEXUALIS. 
 
 the girls has to stand on him in such a way that one shoe is over the 
 eyes, with its heel pressing on one eye, while the other rests across his 
 neck. In this position he endures the pressure of a person weighing 
 about one hundred and fifty pounds for four or five minutes. The author 
 speaks of dozens of similar cases that are known to him. Hammond 
 presumes, with reason, that this man had become impotent for inter- 
 course with women; that, in this strange procedure, he found an equiva- 
 lent for coitus ; and that, when the heels drew blood, he had pleasant 
 sexual feelings, accompanied by ejaculation. 
 
 The ten cases of masochism thus far described, and the 
 numerous analogous cases mentioned by those who report them, 
 form a counterpart to the previously described group "c" of 
 sadism. Just as in sadism men excite and satisfy themselves by 
 maltreating women, so in masochism the same effect is sought 
 in the passive reception of similar abuse. But group "a" of the 
 sadists, — that of lust-murder, — strange as it may seem, is not 
 without its counterpart in masochism. In its extreme conse- 
 quences, masochism must lead to the desire to be killed by a 
 person of the opposite sex, in the same way that sadism has its 
 acme in active lust-murder. But the instinct of self-preservation 
 opposes such a result ; so that the extreme is not actually car- 
 ried out. When, however, the whole structure of masochistic 
 ideas is purely psychical, in the imagination of such individuals, 
 even the extreme may be reached; as the following case 
 shows : — 
 
 Case 54. A middle-aged man, married and the father of a family, 
 who has alwa3's led a normal vita sexualis, but who says he comes of a 
 very nervous family, makes the following communication : In his early 
 youth he was powerfully excited sexually at the sight of a woman 
 slaughtering an animal with a knife. From that time, for many years, 
 he had reveled in the lustfullj'-colored idea of being stabbed and cut 
 and even killed b}^ women with knives. Later, after the beginning of 
 normal sexual intercourse, these ideas lost completely their perverse 
 stimulus for him. 
 
 This case should be compared with the statements made 
 under Case 44, according to which men find sexual pleasure in 
 being lightly pricked with knives in the hands of women, who, 
 at the same time, threaten them with death. 
 
 Such fancies, perhaps, give the key to an understanding of
 
 MASOCHISM. 115 
 
 the following strange case, for which I am indebted to a com- 
 munication from Dr. Korber, of Uankau : — 
 
 Case 55. A lady iiifikes nie the following coinnuinicatioii : While 
 still a young and innocent girl, she was married to a man of al)out thirty 
 years. On their wedding-nigiit he forced a towel and soap into her 
 hands, and, without any other expression of love, wanted her to lather 
 his chin and neck (as if for shaving). The inexperienced young 
 wife did it, and was not a little astonished, during the first weeks 
 of married life, to learn its secrets in absolutely no other form. Her 
 husband always told her tiiat it gave him the greatest delight to have 
 his face lathered by her. Later, after she had sought the advice of 
 friends, she induced her husband to perform coitus, and iiad three chil- 
 dren in the course of time (by him, she states with everj^ assurance). The 
 husband is industrious and reliable, but a moody man, with little perse- 
 verance ; by occupation a merchant. 
 
 It may be inferred that this man conceived the act of being 
 shaved {i.e., the lathering as a preparatory measure) as a rudi- 
 mentary, symbolic realization of ideas of injury or death, or of 
 fancies about knives; like those the man previously mentioned 
 had had in his youth, and by means of which he had lieen 
 sexually excited and satisfied. The perfect sadistic counterpart 
 to this case, looked upon in this light, is offered by Case 35, 
 which is a case of symbolic sadism. 
 
 At any rate, there is a whole group of masochists who 
 satisfy themselves with the symbolic representations of situations 
 corresponding with their perversion ; a group that corresponds 
 w^ith group "e" of "symbolic" sadists, just as the previously 
 mentioned cases of masochism correspond with the groups "c" 
 and " a " of sadism. Thus, just as the perverse longings of the 
 masochist may, on the one hand, advance to "passive lust- 
 murder" (to be sure, only in imagination); so, on the other 
 hand, they may be satisfied with simple symbolic representations 
 of the desired situations, which otherwise are expressed in acts 
 of cruelty (this, of course, taken objectively, goes much further 
 than the idea of being murdered, but in fact not so far, owing 
 to the determining subjective conditions). 
 
 With Case 55, other similar cases should be here described, 
 in which the acts desired and planned by the masochist have a
 
 116 PSTCHOPATHIA SEXUALIS. 
 
 purely symbolic character, and, to a certain extent, serve to indi- 
 cate the desired situation. 
 
 Case 56. (Pascal, " Igiene dell' amore.") Every three months a 
 man of about fort}' -five years would visit a certain prostitute, and pay 
 her ten francs for the following act. The puella had to undress him, tie 
 his hands and feet, bandage his eyes, and draw the curtains of the win- 
 dows. Then she would have her guest sit down on a sofa, and had to 
 leave him there alone. After half an hour she had to come back and un- 
 bind him. Then the man would pay her and leave perfectly satisfied, to 
 repeat his visit in about three months. 
 
 In the dark this man seems to have extended this situation, 
 of being helpless in the hands of a woman, further in imagina- 
 tion. The followuig case, in which again a complicated comedy, 
 in the sense of masochistic desires, is played, is still more pecu- 
 liar : — 
 
 Case 57. (Dr.' Pascal, ibid.) A gentleman in Paris was accustomed 
 to call on certain evenings at a house where a woman, the owner, acceded 
 to his peculiar desire. He entered the salon in full-dress, and she, 
 likewise in evening toilette,\ia.d to receive him with a very haughty manner. 
 He addressed her as " Marquise," and she had to call him "dear Count." 
 Then he spoke of his good fortune in finding her alone, of his love for 
 her, and of a lover's rendezvous. At this the lad}' had to feel insulted. 
 The pseudo-count grew bolder and bolder, and asked the pseudo-mar- 
 quise for a kiss on her shoulder. There is an angry scene ; the bell is 
 rung; a servant, ju'epared for the occasion, appears, and throws the 
 count out of the house. He departs well satisfied, and paj'S the actors 
 in the farce handsomel3^ 
 
 In connection with this case of symbolic masochism, two 
 more are here given, in which the psycliical perversion was en- 
 tirely confined to the sphere of thouglit and imagination, and no 
 realization was attempted. The first is that of an individual, 
 mentally and physically predisposed, bearing degenerative signs, 
 in whom mental and physical impotence occurred early : — 
 
 Case 58.. Mr. Z., aged 22, single, was brought to me I)}' his father 
 for medical advice, because he was very nervous and apparently abnoi*- 
 raal sexually. Mother and maternal grandmother were insane. His 
 father begat him at a time when he was suffering severely nervously. 
 
 Patient is said to have been a very lively and talented child. At the 
 age of seven he was noticed to practice masturbation. After his ninth
 
 MASOCHISM. 117 
 
 year he became inattentive, forgetful, and did not progress in his studies, 
 constant!}^ requiring iielp and protection. With diflicult}' he got tlirough 
 the Gymnasium, and during his time of freedom had attracted attention 
 by his indolence, absent-mindedness, and various foolish acts. 
 
 Consultation was occasioned by an occurrence on the street, in 
 which Z. had forced himself on a young girl in a very impetuous manner, 
 and in great excitement had tried to have a conversation with her. 
 
 The patient gave as a reason, that, by conversing with a respectable 
 girl, he wished to excite himself so that he could be potent in coitus with 
 a prostitute I 
 
 His father characterizes him as a man of perfectl}^ good disposition, 
 moral, but lazy, and dissatisfied with himself; as one often in despair 
 about his want of success in life ; as indolent, and interested in nothing 
 but music, for which he possesses great talent. 
 
 The patient's exterior — his plagiocephalic head ; his large, promi- 
 nent ears; the deficient innervation of the right facialis about the mouth ; 
 tiie neuropathic expression of the eyes — indicates a degenerate, neuro- 
 pathic individual. 
 
 Z. is tall, of powerful frame, and, in all respects, of masculine ap- 
 pearance. Pelvis masculine; testicles well developed ; penis remarkably 
 large ; mons veneris with abundant hair. The right testicle hangs much 
 lower than the left; the cremasteric reflex is weak on both sides. The 
 patient is below the average intellectually. He feels his deficiency, 
 complains of his indolence, and asks to have his will strengthened. 
 His awkward, emltarrassed manner, timid glances, and relaxed attitude, 
 point to masturbation. The patient confesses that from his seventh 
 year, until a year and a half ago, he practiced it, years at a time, from 
 eight to ten times daily. Until a few years ago, when he became neuras- 
 thenic (cephalic pressure, loss of mental power, spinal irritation, etc.), 
 he says he always found great sensual pleasure in it. Since then this had 
 been lost, and the desire to masturbate had disappeared. He had con- 
 stantly grown more bashful and indolent, less energetic, and more 
 cowardly and apprehensive. He had lost interest in ever3'thing, and did 
 his business only from a sense of duty, feeling very low-spirited. He 
 had never thought of coitus, and, from his stand-point as an onanist, he 
 could not understand how others could find pleasure in it. 
 
 Investigations in the direction of contrary sexual instinct gave a 
 negative result. He says he never was drawn toward persons of his 
 own sex ; he rather thinks that he has now and then had a weak inclina- 
 tion for females. He asserts that he came to masturbate independentlv- 
 In his thirteenth year he first noticed ejaculations as a result of mastur- 
 batic manipulations. 
 
 It was onl}' after long persuasion that Z. consented to entirely 
 unveil his vita sexualis. As his statements, which follow, show, he may 
 be classified as a case of ideal masochism, with rudimentary sadism.
 
 118 PSTCHOPATHIA SEXUALIS. 
 
 The putient distinctl}' remeuibers that, at the age of six, without any 
 cause, he had " ideas of violence." He was compelled to imagine that a 
 servant-girl spread his legs apart and showed his genitals to another ; 
 that she tried to throw him into cold or hot water, in order to cause him 
 pain. These " ideas of violence " were attended with lustful feeling, and 
 became the cause of masturbatic manipulations. Later the patient 
 called them up voluntarilj', in order to incite himself to masturbation. 
 They also played a part in his dreams ; but they never induced pollution, 
 apparently because the patient masturbated excessively during the day. 
 
 In time, to these masochistic " ideas of violence," others of a sadistic 
 nature were added. At first they were scenes in which boys forcibly 
 practiced onanism on one another, or cut off the genitals. He often 
 imagined himself such a bo}', now in an active, now in a passive, role. 
 Later he busied himself with mental pictures of girls and women that 
 exhibited themselves to one another. He reveled in the thought, for 
 example, of a servant-girl spreading another girl's legs apart and pulling 
 the genital hair; or in the thought of boys treating girls cruell}', and 
 pricking and pinching their genitals. 
 
 Such ideas also always induced sexual excitement, but he never 
 experienced any impulse to carr^' them out actively or to have them 
 performed on himself passivel}'. It satisfied him to use them for mastur- 
 bation. Since a year and a half ago, with diminishing sexual imagination 
 and libido, these ideas and impulses had become infrequent, but their 
 content remained unchanged. The masochistic " ideas of violence " pre- 
 dominated over the sadistic. Now, when he sees a lad}', he has the 
 thought that she has sexual ideas like his own. In this way, in part, he 
 explains his embarrassment in social intercourse. Owing to the fact 
 that he had heard that he would get rid of his burdensome sexual ideas, 
 if he were to accustom himself to natural sexual indulgence, during the 
 last year and a half he has twice attempted coitus though he only 
 experienced repugnance, and was not confident of success. On both 
 occasions the attempt was a fiasco. The second time he made the 
 attempt, he felt sucli aversion that he pushed the girl awa}'^ and fled. 
 
 The second case is tlie following one, placed at my disposal 
 by a colleague. Even though it be aphoristic, it seems particu- 
 larly suited to throw a clear light on the distinctive element of 
 masochism, — the consciousness of subjection, in its peculiar 
 psycho-sexual effect : — 
 
 Case 59. Masochism. — Z., aged 27, artist. He is powerfully built, 
 of pleasing appearance, and is said to be free from hereditarj^ taint. 
 Healthy in 3'OuLh, since his twent3'-third year he has been nervous and 
 inclined to be h3'pocliondriacal. Though inclined to indulgence sexuall}-,
 
 MASOCHISM. 119 
 
 he is not veiy virile. In spite of associations with females, his relations 
 with tliem are limited to innocent attentions. At the same time, his 
 desire to devote himself to women that are cold toward him is remark- 
 able. Since his twenty-fifth year he has noticed that females, no matter 
 how ugl}', always excite him sexually-, whenever he discovers anything 
 domineering in their character. An angry word from the lips of such a 
 woman is suflicient to give him the most violent erections. Thus, one 
 day, he sat in a cafe and heard the (ngly) female cashier scold the waiters 
 in a loud voice. This threw him into the most intense sexual excite- 
 ment, which soon induced ejaculation. Z. requires the women, with 
 whom he is to have sexual intercourse, to repulse and annoy him in 
 various ways. He thinks that only a woman like the heroines of Sacher- 
 Masoch's romances could charm him. 
 
 Cases like this, in which the whole perversion of the vita 
 sexualis is confined to tlie sphere of imagination, — to the inner 
 world ot thought and instinct, — and only accidentally comes to 
 the knowledge of others, do not seem to be infrequent. Their 
 practical significance, like that of masochism in general (which 
 has not the great forensic importance of sadism), is confined to 
 the psychical impotence to which such individuals, as a rule, 
 become subject ; and to the intense impulse to solitary indul- 
 gence, with adequate imaginary ideas, and its results. 
 
 That masochism is a perversion of uncommonly frequent 
 occurrence is sufficiently shown by the relatively large number 
 of cases that have thus far been studied scientifically, as well as 
 by the agreement of the various statements reported. 
 
 The works concerning prostitution in large cities also con- 
 tain numerous statements concerning this matter, 
 
 Leo Taxil (op. ciL, p. 228) describes masocliistic scenes in 
 Parisian brothels. The man affected with this perversion is 
 there also called " slave." 
 
 Coffignon (" La corruption a Paris ") has a chapter in his 
 book entitled " Les Passionels," which contains contributions to 
 this subject. 
 
 It is interesting and worthy of mention, that one of the 
 most celebrated of men was subject to tliis perversion, and 
 describes it ui his autobiography (tliough somewhat erroneously). 
 From " Jean Jacques Rousseau's Confessions " it is evident that 
 he was affected with masochism.
 
 120 PSYCHOPATHIA SEXUALIS. 
 
 Rousseau, with reference to whose life and malady Mobius (" J. J. 
 Rousseau's Krankengeschichte," Leipzig, 1889) and Chatelain (" La folie 
 de J. J. Rousseau," Neuchatel, 1890) may be consulted, tells, in his " Con- 
 fessions" (part i, book i), how Miss Lambercier, aged thirt}^ greatly im- 
 pressed him wlien he was eight yeai-s old and lived with her brother as 
 his pupil. Her solicitude, when he could not immediately answer a 
 question, and her threats to punish him if he did not learn well, made 
 the deepest impression on him. Wlien,one day, he had blows at her 
 hands, with the feeling of pain and shame, he also experienced sensual 
 pleasure tliat incited a great desire to be whipped by her again. It was 
 only for fear of disturbing the lady, that Rousseau failed to make other 
 opportunities to experience this lustful, sensual feeling. One da^^, how- 
 ever, he unintentionally gave cause for a whipping at Miss Lambercier's 
 hands. This was the last ; for Miss Lambercier must have noticed 
 something of the peculiar effect of the punishment ; and from this time 
 on she did not allow the eight-year-old bo}' to sleep in her room. From 
 this time Rousseau felt a desire to have himself punished by ladies 
 pleasing to him, a la Lambercier; but he asserts that until his youth he 
 knew nothing of the relation of the sexes to each other. As is known, 
 Rousseau was first introduced to the real mystei'ies of love in his 
 thirtieth 3^ear, and lost his innocence through Madame de Warrens. 
 Until that time he had had only feelings and impulses attracting him to 
 woman, in the nature of passive flagellation and other masochistic ideas. 
 
 Rousseau describes, in exfenso, how he suffered, with his 
 great sexual desires, by reason of his pecuhar sensuaUty, which 
 had undoubtedly been awakened by his whippings; for he 
 reveled in desire, and could not disclose his longings. It would 
 be erroneous, however, to suppose that liousseau was concerned 
 merely with flagellation. Flagellation only awakened ideas of a 
 masochistic nature. At least, in these ideas lies the psychological 
 nucleus of his interesting study of self The essential element 
 with Rousseau was the feeling of subjection to the woman. This 
 is clearly shown by the "Confessions," in which he expressly 
 emphasizes that " Eire mix genoiix cVune maitresse imperieuse^ 
 obeir a ses ordres, avoir des pardons a lui demander, — etaient 
 pour moi de tres douces jouissances.^^ ^ 
 
 This passage proves that the consciousness of subjection and 
 humiliation before the woman was the most important element. 
 
 ' " To be at the feet of an imperious mistress ; to obey her orders ; to be compelled 
 to sue her for pardon, — these things are my most intense delight."
 
 MASOCHISM. 121 
 
 To be sure, Rousseau was liimself in error in supposing 
 that this impulse to be humiliated before a woman had arisen 
 by association of ideas from the idea of flagellation : — 
 
 " N'osant jamais declarer mon gout, je I'amusais du moins 
 par des rapports qui m'en conservaient I'idee." ^ 
 
 It is only in connection with the numerous cases of maso- 
 chism, the existence of which has now been established, and 
 among which there are so many that are in nowise connected 
 with flagellation, showing the primary and pure psychicnl char- 
 acter of this histinct of subjection, — it is only in connection with 
 these cases that a complete insight into Rousseau's case is ob- 
 tained, and the error detected into which he necessarily fell in 
 the analysis of his own condition. 
 
 Binet {Revue Antlirop6logiq}ie, xxiv, p. 256), who an- 
 alyzes Rousseau's case in detail, also justly calls attention to its 
 masochistic significance, when he says : " Ce qu'aime Rousseau 
 dans les femmes, ce n'est pas seulement le sourcil fronc6, la 
 main levee, le regard severe, I'attitude imperieuse, c'est aussi 
 I'etat emotionnel, dont ces faits sont la traduction exterieure ; 
 il aime la femme fiere, dedaigneuse, I'ecrasant a ses pieds du 
 poids de sa royale colere."^ 
 
 The solution of this enigmatical psychological fact Binet 
 finds in his assumption that it is an instance of fetichism, only 
 with the difference that the object of the feticliism — /.<?., the 
 object of individual attraction (fetich) — is not a portion of the 
 body, like a hand or foot, but a mental pecvdiarity. This 
 enthusiasm he calls " amour spiritualiste,^^ in contrast with 
 '■'' mnoiir plasfique,^'' as manifested in ordinary fetichism. 
 
 This deduction is acute, but it gives only a word with 
 which to designate a fact, not a solution of it. AVhcther an 
 explanation is possible will later occupy our attention. 
 
 There were also elements of masochism (and sadism) in the 
 
 * " Never daring to express my desire, I at least gave it rein under circumstances 
 that served to preserve in me the idea of it." 
 
 2 " What Rousseau loves in women is not only the frowning brow, the threatening 
 hand, the angry glance, the imperious attitude, but it is also the emotional state of which 
 these are the objective translation ; he loves the fierce, disdainful woman who crushes him 
 at her feet with the weight of her royal displeasure."
 
 122 PSYCHOPATHIA SEXUALIS. 
 
 celebrated, or notorious, French writer, C. P. Baudelaire, who 
 died insane. 
 
 Baudelaire came of an insane and eccentric famih\ From his youtli 
 he was mentally abnormal. His vita sexualis was decidedly abnormal. 
 He had love-affairs with ugly, repulsive women, — negresses, dwarfs, 
 giantesses. About a very beautiful woman, he expressed the wish to see 
 her hung up by her hands, and to kiss her feet. This enthusiasm for the 
 naked foot also appears in one of his glowing poems as the equivalent of 
 sexual indulgence. He said women were animals who had to be shut up, 
 beaten, and fed well. The man displaying these masochistic and sadistic 
 inclinations died of paretic dementia. (Lombroso, " The Man of 
 Genius.") 
 
 In scientific literature, the conditions that constitute maso- 
 chism have not received attention until recently. All there is 
 to mention is that Tarnowsky (" die Krankhaflen Erscheinungen 
 des Geschlechtssinns," Berlin, 1886) relates that he has known 
 happily married, intellectual men, who from time to time felt an 
 irresistible impulse to subject themselves to the coarsest, cynical 
 treatment, — to scoldings or blows from passive or active peder- 
 asts, or prostitutes. It is worthy of remark that, in Tarnow- 
 sky 's observation, in certain cases blows, even when they draw 
 blood, do not bring the result desired (virility, or at least ejac- 
 ulation during flagellation) by those given to passive flagel- 
 lation. " The individual must then be undressed by force, his 
 hands tied, fastened to a bench, etc., during which he fancies 
 that he makes opposition, scolds, and pretends to resist. Only 
 under such circumstances do the blows induce excitement that 
 leads to ejaculation." 
 
 O. Zimmermann's work, " Die Wonne des Leids," Leipzig, 
 1885, also contributes much to this subject,^ taken from the 
 history and literature. 
 
 Of late the subject has been given much attention. 
 
 1 However, the domain of masochism must be sharply difiFerentiated from the prin- 
 cipal subject of that work, which is, that love contains an element of sufierine. Unre- 
 quited love has always been described as "sweet, but sorrowful ;" and poets have spoken 
 of "blissful pain" or "painful bliss." This must not, as it is by Z., be confounded with 
 the manifestations of masochism, any more than the characterization of an unyielding 
 lover as "cruel" should be. It is remarkable, however, that Haraerling (" Amor und 
 Psyche," iv, Gesang) uses perfect masochistic pictures, flagellation, etc., to express this 
 feeling.
 
 MASOCUISM. 123 
 
 A. Moll, in his work, " DieContnire Sexualempfinduiig," pp. 
 133 and 141 et seq., Berlin, 1891, gives a number of cases of com- 
 plete masochism in individuals of contrary sexuality, and among 
 them the case of a man suffering with contrary sexual instinct, 
 who sent written instructions, containing twenty paragraphs, to 
 a man engaged for his purpose, who was to treat and abuse him 
 like a slave. 
 
 In June, 1891, Mr. Dimitri von Stefanowsky, Deputy Gov- 
 ernment Attorney in Jaroslaw, Russia, informed me that, about 
 three years before, he had given his attention to the perversion 
 of the vita sexualis, designated " masochism " by me, and called 
 " passivism " by him ; that a year and a half previously he had 
 prepared a paper on the subject for Professor von Kowalewsky 
 for the Russian Archives of Psycldatry ; and that in Novem- 
 ber, 1888, he had read a paper on tliis subject, considered in 
 its legal and psychological aspects, before the Legal Society of 
 Moscow (printed in the Juridischen Boten^ the organ of the 
 society, in numbers 6 to 8). 
 
 In later fiction the psycho-sexual perversion which forms 
 the subject of this study has been treated by Sacher-Masoch, 
 whose writings, already frequently alluded to, aftbrd typical 
 pictures of the perverse mental life of men of this kind. Many 
 affected with this perversion refer directly to the writings of 
 Sacher-Masoch, as is seen from the foregoing cases, as typical 
 descriptions of their own psychical condition. 
 
 In " Nana," Zola has a masochistic scene, and likewise in 
 " Eugene Rougon." The latest " decadent " literature of 
 France and Germany is also largely concerned with the themes 
 of sadism and masochism. According to von Stefanowsky's 
 statement, the modern Russian novel frequently treats the sub- 
 ject ; but the statements of the writer of travels, Johnnn Georg 
 Forster (1754-1794), show that this subject also played a role in 
 Russian folk-songs. 
 
 (b) Foot- and Shoe-Fetichists — Larvated Masochisrn. — Fol- 
 lowing the above-mentioned group of " symbolic " masochisms, 
 who do not exactly desire abuse by women as the means of ex- 
 pression of subjection, but all kinds of silly acts that can be
 
 124 PSYCHOPATHIA SEXUALIS. 
 
 understood only through an acquaintance witli the masochistic 
 circle of ideas, comes the very numerous class of foot- and shoe- 
 fetichists. 
 
 By fetichists {v. iftfra, 3) I understand individuals whose 
 sexual interest is confined exclusively to parts of the female body,^'» 
 or to certain portions of female attire. One of the most fre- 
 quent forms of this fetichism is that in which the female foot or 
 shoe is tlie fetich, and becomes the exclusive object of sexual 
 feeling and desire. It is highly probable, and shown by a cor- 
 rect classification of the observed cases, that the majority — and 
 perliaps all — of the cases of shoe-fetichism rest upon a basis of 
 more or less conscious masochistic desire for self-humiliation. 
 
 In Hammond's case (Case 53) the satisfaction of a maso- 
 chist was found in being trod upon. In Cases 44 and 48, 
 tlie-y also had themselves trod upon ; in Case 51, equus erotlcus^ 
 the person loved a woman's foot, etc. In the majority of cases 
 of masochism, the act of being trod upon with feet plays a 
 part^ as an easily accessible means of expressing the relation 
 of subjection. 
 
 Of the numerous established cases of shoe-fetichism, the 
 following one, reported by Dr. A. Moll, of Berlin, which corre- 
 sponds in many respects with Hammond's case, but wliich is 
 described in more detail and more carefully observed, seems 
 especially suited to show the connection between masochism 
 and shoe-fetichism: — 
 
 Case GO. O. L., aged 31, book-keeper in a city cff Wurtemburg; 
 comes of a tainted family. 
 
 The patient is a large, powerful man, of ruddy appearance. In 
 general he is of a quiet temperament, but ma}' become very violent on 
 occasion; lie says himself that lie is quarrelsome and inclined to assert 
 himself. L. is of a kindly disposition and generous; easily made to 
 weep. At school he passed for a talented pupil, with good powers of 
 comprehension. The patient at times has congestion of the head, but is 
 otherwise healthy, except that he is much depressed and melancholic as 
 a result of his sexual perversion, here to be described. 
 • But little can be learned of Viwy hereditary taint. 
 
 1 The desire to be trod upon also occurs in religious entliueiasta (comp. Turgenjew, 
 " Sonderbare Geschichten ").
 
 MASOCHISM. 125 
 
 The following facts concerning the development of his sexual life 
 are gathered from the patient's own statements : — 
 
 In very early youth — in fact, when he was eight or nine years old — 
 L. had the desire to lick his teacher's boots like a dog. L. thinks it pos- 
 sible that this thought was excited in him by his once seeing a dog 
 actually do this, but he cannot state this with certainty ; and it seems 
 much more certain to the patient that the first ideas of this kind came 
 in a waking state, not in dreams. 
 
 From his tenth to his fourteenth year he constantly sought to 
 touch the shoes of his fellow-[)Ui)ils, and also those of little girls; but 
 for this purpose he always chose boys who had wealthy and [)rominent 
 parents. One of these, the son of a rich landed proprietor, had riding- 
 boots; in the boy's absence L. took these in his hands, struck himself 
 with them, and pressed them against his face. L. did the same thing with 
 the elegant boots of an officer of dragoons. 
 
 After the beginning of puberty the desire was transferred exclusively 
 to the boots of females. Thus, while skating, tiie patient's attention was 
 entirely occupied with putting on and taking otf skates for ladies ; but he 
 always chose only such women as were rich and prominent socially, wear- 
 ing elegant boots. In the street and everywhere L. constantly looked for 
 elegant boots. His love for them went so far that he often put in his 
 purse, and even in his mouth, the sand and mud that bore their imprints. 
 As a boy of fourteen L. visited brothels; and he often visited a cafe 
 chantant solely to excite himself with the sight of elegant boots (low shoes 
 were less attractive). In his school-books and on the walls of closets, 
 L. drew boots. In the theatre he saw nothing but the shoes of the ladies. 
 For hours at a time, in the street and on board steam-boats, L. would run 
 after ladies wearing elegant boots ; and he thought with delight of how 
 he might get a chance to touch the boots. This peculiar love for boots 
 remains unchanged. The thought to have himself trod upon by ladies in 
 their boots, or to kiss the boots, gives L. the most intense sensual delight. 
 Before shoe-stores he will stand and stand, merely to look at the boots. 
 He is particularly excited by their elegance. 
 
 The patient prefers high buttoned or laced boots Avitli high heels; 
 but less elegant boots, even with low heels, also excite him, if their wearer 
 is a wealthy, distinguished, and proud lady. 
 
 At the age of twenty L. attempted coitus; but, " in spite of the 
 greatest efforts," as he believes, he was not successful. During the 
 attempt the patient had no thought of shoes; on the contrary, he had 
 first sought to excite himself sexually with shoes, and he asserts that 
 too great excitement was to blame for his want of success in coitus. Up 
 to this time, being thirty-one years old, he has attempted coitus only four 
 or five times, and always in vain. 
 
 On one occasion the patient, already much to be pitied on account 
 of his disease, had the misfortune to contract syphilis. In reply to the
 
 126 PSTCHOPATHIA SEXUALIS. 
 
 question as to what he regarded as the most lustful act, the patient said : 
 " It is my greatest delight to lie naked on the jloor and have myself trod 
 upon by girls wearing elegant boots ; but, of course, this is possible only 
 in brothels." Moreover, according to the patient's statements, these 
 sexual perversions of men are well known in mau}^ houses of prostitu- 
 tion, — a proof that these are not so very infrequent. The prostitutes 
 call these men " boot-lovers." But the patient has only ver^^ infre- 
 quently had the lustful act actually performed, notwithstanding the fact 
 that it is most beautiful and pleasant to him. The patient has no 
 thoughts that impel to intercourse ; at least, not in the sense of im- 
 missio penis in vagina, — an act that affords him no pleasure whatever. 
 Indeed, he has gradually developed a fear of coitus, which may be 
 sufficiently explained b}^ his numerous unsuccessful attempts ; for the 
 patient says himself that his inability to complete coitus embarrassed 
 him exceedingly. The patient has never practiced real onanism. With 
 the exception of a few occasions on which the patient satisfied his 
 sexual desire by onanism with boots or in a similar way, he is innocent 
 of such satisfaction ; for, in the excitement with boots, there is scarcely 
 ever anything more than erection ; at most, only a slight discharge of 
 fluid takes place slowl^', which the patient takes to be semen. 
 
 Simply a shoe, worn b}^ no one, excites him when he sees it, but 
 not nearly as intensel}'' as when it is worn by a woman. New shoes that 
 have not been worn excite him much less than those that have been 
 used ; but they must be free from wear and look as new as possible. 
 Shoes of this kind excite him the most. As has been said, ladies' boots 
 excite him when they are not on the feet. Under such circumstances, 
 in fancy, L. creates a lady for them ; he presses them to his lips and on 
 his penis. He would " die with delight " if a proud, respectable lady 
 were to tread upon him with her shoes. 
 
 Aside from the previously mentioned characteristics of the women 
 (pride, wealth, social prominence), which, in connection with the elegance 
 of the boots, constitute an especial stimulus, the patient is by no means 
 indifferent to the physical charms of the female sex. He is enthusiastic 
 about beautiful women without thinking of boots, but this love is not 
 directed to sexual satisfaction. The bodily charms play a part even in 
 connection with the boots; a homely old woman, even wearing the most 
 elegant boots, cannot affect the patient. The rest of the attire and other 
 circumstances also pla}^ an essential role, as is shown by the fact that 
 tlegant boots worn by proud, distinguished women especially excite tlie 
 patient. A common servant-girl, in her working-dress, even in the most 
 elegant shoes, would not excite him. Men's shoes and boots no longer 
 affect the patient ; and he never in the slightest degree feels himself 
 attracted to men sexually. 
 
 Yet the patient has erections very easily. When lie takes a child 
 in his lap, when he pats a dog or horse for some time, when he travels
 
 MASOCHISM. 127 
 
 on the cars, or when he rides, — erections occur. In the latter case he 
 thinlvs it is due to the shaking. He has erections every morning; and 
 he can induce erection in a very short time by thinking of the act with 
 boots tliat is so pleasing to him. Pollutions formerl}' occurred fre- 
 quently at night — about every three or four weeks ; now they are more 
 infrequent, occurring once about every three months. 
 
 In his erotic dreams the patient is almost always sexually excited 
 by the same thoughts that excite him in the waking state. For some 
 time he thinks he has felt ejaculation during erection ; but he draws this 
 conclusion only from feeling a little moisture at the end of the penis. 
 Books touching the sphere of the patient's sexual ideas especially excite 
 him. Thus, in reading " Venus in Furs,"^ by Sacher-Masoch, lie is so 
 excited "that the semen just runs away from him." Moreover, with 
 L., this kind of ejaculation, while reading, is a decided satisfaction of 
 his sexual desire. My question, whether blows received from a woman's 
 hand would also excite him, the patient thinks he would have to answer 
 in the affirmative. The patient has never made any such trial, but phi}'- 
 ful taps had, at any rate, always been very pleasing to him. 
 
 It would afford the patient a particularly intense pleasure if he 
 were to be kicked by a woman, even without shoes, and with bare feet. 
 He does not think that the blows, as such, would cause the excitement, 
 but rather the thought of being maltreated by a woman ; and this might 
 follow scolding as well as actual blows. Besides, blows and cross words 
 had an exciting effect only when they came from a proud and distin- 
 guished lady. In general it is the feeling of humiliation and slavish 
 subjection that gives the patient lustful pleasure. " Were a lady," the 
 patient tells me, " to command me to wait on her, even with distant cold- 
 ness, I should, nevertheless, feel sensual pleasure." 
 
 To the question, whether with boots the feeling of humiliation came 
 over him, the patient answers : " I think that this general passion for self- 
 humiliation has been concentrated especially on ladies' boots ; for it is 
 symbolic of one's being ' unworthy to loosen the latchet of another's 
 shop'; and, besides, a subject kneels." 
 
 Women's stockings also have an exciting effect on the patient, but 
 only to a slight extent, and perhaps only through awakening an idea of 
 boots. The patient's passion for ladies' boots had constantly increased, 
 but of late years he thought he had noticed a diminution of it. He 
 seldom visits public women, and is also more capable of self-restraint. 
 Yet this passion still rules him absolutely, and every other pleasure is 
 spoiled by it. A pretty female boot could attract his glance from the 
 
 * In this story the writer describes a man whose greatest pleasure lies in being 
 treated like a slave by a beautiful woman, whom he loves. Besides numerous scenes In 
 which the man is whipped by the woman, there are others in which he is trod upon by her. 
 It is this act that forms the principal means of excitement in the case above described.
 
 128 PSTCHOPATHIA SEXUALIS. 
 
 most beautiful landscape. At the present time he often goes about at 
 night in the corridors of hotels,^ seeking elegant ladies' shoes, which he 
 kisses and presses against his face and neck, but principally against his 
 penis. 
 
 The patient, who is very well-to-do, a short time ago went volun- 
 tarily to Italy, only with the thought of becoming the servant of a rich 
 and distinguished lady unacquainted with him ; but the plan failed. The 
 patient, who came only for consultation, has not yet been treated 
 medically. 
 
 The foregoing history reaches almost to the present time, and in the 
 interval he has made me communications by letter concerning his condi- 
 tion. It does not require an extensive commentary. It seems to me to 
 be one of the best cases to illustrate the relationship between shoe- 
 fetichism and masochism, as set forth by von Kratft-Ebiug.^ The i)rincipal 
 charm for the patient, as he, without leading questions, always em- 
 phasizes, is his subjection to a woman, who, in pride and position, must 
 be as far above him as possible. 
 
 Sucli cases, in which, within a fully-developed circle of 
 masochistic ideas, the foot and the slioe or boot of a woman, con- 
 ceived as a means of liumiliation, have become the objects of 
 especial sexual interest, are numerous. Through numerous de- 
 grees that are easily discriminated, they form tlie demonstrable 
 transition to other cases in which the masochistic inclinations 
 retreat more and more to the background, and little by little pass 
 beyond the threshold of consciousness; while the interest in 
 women's shoes, apparently absolutely inexplicable, alone remains 
 in consciousness. The latter are the numerous cases of shoe- 
 fetichism. These very frequent cases of shoe-lovers, which, like 
 all cases of fetichism, possess forensic interest (theft of shoes), 
 occupy a position midway between masochism and fetichism. 
 The majority or all may be looked upon as instances of larvated 
 masochism (the motive remaining unconscious) in which the 
 
 * In Continental hotels the guests are accustomed to put their shoes in the corridors 
 at night, to be cleaned. 
 
 2 However, against the theory that foot- and shoe- fetichism is a manifestation of 
 (latent) masochism, Dr. Moll {op. cit., p. 136) raises the objection that it is still unex- 
 plained why the fetichist so often prefers boots with high heels, then boots and shoes of a 
 particular kind — buttoned or laced. To this objection it may be remarked that, in the first 
 place, the high heels characterize the shoes as feminine ; and, in the second place, that in 
 spite of the sexual character of his inclination, the fetichist demands all kinds of aesthetic 
 qualities in his fetich (comp. Case 90).
 
 MASOCHISM, 129 
 
 female foot or slioe^ as tlie masoc-Jusfs fetich, has acquired an 
 independent significance. 
 
 Next come two cases in wliicli tlie female shoe possesses 
 a subordinate interest, but in which unmistakable masochistic 
 desires play an important part (comp. Case 44) : — 
 
 Case 61. Mr. X. aged 25, parents health}-, never sick before, phices 
 the following autobiography at my disposal : " I began to practice onanism 
 at the age of ten, without ever having an}' lustful thoughts during 
 the act. Yet at that time — I am sure of this — the sight and touch of 
 girls' elegant boots had a peculiar charm for me ; my greatest desire 
 was also to wear sucii shoes, — a wish that was occasionally fulfdled at mas- 
 querades. But I was also troubled by a very ditierent thought: Mi/ ideal 
 ivas to see myself in a position of huniilialion ; I ivould gladly have been 
 a slave, and whipped ; in short, I wished to receive the treatment that one 
 finds described in many stories of slavery. I do not know whether the 
 reading of such stories gave rise to my wish, or whether it arose spon- 
 taneousl}'. 
 
 " Puberty began at the age of thirteen ; with the occurrence of ejac- 
 ulation lustful pleasure increased, and I masturbated more frequently, 
 often two or three times a da}'. From my twelfth to my sixteenth year, 
 during the act of onanism, I always had the idea that 1 was forced to 
 wear girls' boots. The sight of an elegant boot, on the foot of a girl 
 at all pretty, intoxicated me ; I inhaled the odor of the leather with 
 avidity. In order to smell leather during the act of onanism, I bought 
 a pair of leathern cuffs, which I smelled while I masturbated. M}'^ en- 
 thusiasm for ladies' leathern shoes remains the same to-day ; only, since 
 my seventeenth 3'ear, it has been coupled with the wish to become a ser- 
 vant, to blacken shoes for distinguished ladies, to put on and take off 
 their shoes for them, etc. 
 
 " M}^ dreams at night are made up of shoe-scenes : either I stand 
 before the show-window of a shoe-store regarding the elegant ladies' 
 shoes, — particularly buttoned shoes, — or I lieat a lady's feet and smell and 
 lick her shoes. For about a year I have given up onanism and go ad 
 puellas; coitus takes place through intense thought of ladies' buttoned 
 shoes ; or, if necessary, I take the shoe of the puella to bed with me. 1 
 have never suffered from my former onanism. I learn easily, have a good 
 memory, and have never had headache in my life. This much concerning 
 myself. 
 
 " A few words about m}'^ brother : I am thoroughly convinced that 
 
 he is also a shoe-fetichist. Of the man}- facts that demonstrate this to 
 
 me, it is only necessar}' to mention that it is a great pleasure for him to 
 
 have a certain cousin (a very beautiful girl) tread upon him. As for the 
 
 rest, I might undertake to tell whether a man who stands before a shoe- 
 
 9
 
 130 PSYCHOPATHIA SEXUALIS. 
 
 store, and regards the shoes on exhibition, is a " foot-lover " or not. This 
 anomaly is iincommonl}'^ frequent. When in the circle of my acquaint- 
 ance I turn the conversation to the question of what woman's charm is, 
 I very frequently hear it said that it is much more in attire tlian in 
 nudit}'; but every one is careful not to reveal his especial fetich. I 
 think an uncle of mine is also a shoe-fetichist." 
 
 Case. 62. Reported by Mantegazza in his " Anthropological Stud- 
 ies," 1886, p 110. X., American, of good family, mentally and morally well 
 constituted ; from the beginning of puberty capable of being excited sex- 
 ually only by a woman's shoe. Her body and naked or stockinged foot 
 made no impression on him ; but the foot, when covered with the shoe, or a 
 shoe alone, induced erection and even ejaculation. Sight alone was suf- 
 ficient for him in the case of elegant shoes, — i.e., shoes of black leather, 
 buttoning up the side, and having very high heels. His sexual desire 
 was powerfully excited by touching, kissing, or drawing on such shoes. 
 His enjoyment was increased by driving nails through the soles so that 
 their points would penetrate his feet while walking. This caused him 
 terrible pain, but he had real lustful feeling at the same time. His greatest 
 enjoyment was to kneel down before the elegantly-clad feet of ladies and 
 have them step on him. If the wearer were an ugly woman, the shoes 
 would not atfect him, and his fancy would cool. If the patient had shoes 
 alone at his disposal, his fancy would create a beautiful woman wearing 
 them, and ejaculation would result. His nightly dreams were of the shoes 
 of beautiful women. He considered the exposure of ladies' shoes in show- 
 windows immoral ; while talk about the nature of woman seemed to him 
 harmless, but in bad taste. X. attempted coitus several times without 
 success ; ejaculation never occurred. 
 
 In the following case the masochistic element is also plain 
 enough, as is also the sadistic (comp. " Torture of Animals," 
 under "Sadism"): — 
 
 Case 63. A young, powerful man, aged 26. Nothing in the oppo- 
 site sex excites his sensual feeling except elegant shoes on the feet of a 
 handsome woman, especially when they are made of black leather and 
 have high heels. The shoes without the wearer are sufficient. It gives 
 him the greatest pleasure to see, touch, and kiss them. The feminine 
 foot, when bare or covered with a stocking, has no effect on him. Since 
 childhood he has had a weakness for ladies' fine shoes. 
 
 X. is potent ; during the sexual act the female must be elegantly 
 dressed and, above all, have on pretty shoes. At the height of sensual 
 excitement cruel thoughts about the shoes arise. He is forced to think 
 with delight of the death-agonies of the animal from which the leather 
 was taken. Sometimes he is impelled to take chickens and other animals 
 with him to Phryne, in order to have her tread on them with her pretty
 
 MASOCHISM. 131 
 
 shoes for his pleasure. lie calls this '' saeriticing to the feet of Venus." 
 At other times he has the woman walk on him with her shoes on, the 
 harder the better. 
 
 Until the last year it was sufficient — since he did not take the slight- 
 est sensual pleasure in women — to caress ladies' shoes that pleased him, 
 thus attaining ejaculation and complete satisfaction (Lombroso, Archiv 
 di Fsichiab'ia, ix, fascic. iii.) 
 
 The following case reminds one of the third of this series, 
 on account of the interest in the nails of the shoes (as capable of 
 inflicting pain) ; and of the fourth, on account of the slight 
 accompanying sadistic element ; — 
 
 Case 64. X., aged 34, married; of neuropathic parentage; suffered 
 severely froln convulsions as a child ; remarkably precocious, but one-sided 
 in development (could read at age of three) ; nervous from childhood. At 
 the age of seven he manifested an inclination to handle shoes, especially 
 the nails of women's shoes. The mere sight, but still more the touching, 
 of the shoe-nails and counting them, gave him indescribable pleasure. 
 
 At night he gave himself up to imagining how his cousins had 
 their measures taken for shoes ; how he nailed horse-shoes on to one of 
 them or cut her feet off". In time the shoe-scenes came upon him during 
 the day, and involuntarily induced erection and ejaculation. Frequently 
 he took the shoes of female occupants of the house ; and if he touched 
 them with his penis he had an ejaculation. For a long time, when a 
 student, it was possible for him to control his ideas and inclinations ; but 
 there came a time when he was compelled to listen to female footsteps on 
 the pavements, which, like the sight of the nail-marks in ladies' shoes, or 
 the sight of shoes in the windows of the shoe-shops, alwaj^s gave him a 
 feeling of lustful pleasure. He married, and during the first months of 
 his married life was free from these desires. 
 
 Gradually he became hysteropathic and neurasthenic. At this stage 
 he began to have hysterical attacks when the shoemaker spoke to him of 
 nails in ladies' shoes or of driving nails in the same. The reaction was 
 still greater if he chanced to see a pretty lady with shoes well beset with 
 nails. In order to induce ejaculation it was only necessary for him to cut 
 soles out of pasteboard and beset them with nails ; or he would buy ladies' 
 shoes, have them beset with nails in the store, and at home scrape them 
 on the ground, and finally touch the end of his penis with them. More- 
 over, lustful shoe-visions occurred spontaneously, in which he satisfied 
 himself by masturbation. 
 
 X. is otherwise intelligent, skillful in his calling, but powerless in 
 combating his perverse inclinations. He presents phimosis; penis short, 
 expanded at the root, and incapable of complete erection. One day the
 
 132 PSYCHOPATHIA SEXUALIS. 
 
 patient allowed himself to masturbate when excited by the sight of ladies' 
 shoes beset with nails in the window of a shoe-shop, and thus became a 
 criminal. (Blanche, Archiv. de Neurologie, 1882, Nr. 22.) 
 
 Reference may be made here to a case of contrary sexual- 
 ity, to be described later, in which the principal sexual interest 
 was in the boots of male servants. The desire was to be trod 
 upon by them. 
 
 Case 65. (Dr. Pascal, " Igiene dell' amore.") X., merchant, from 
 time to time (but particularly in bad weather) had the following desire : 
 He would accost some prostitute and ask her to go to a shoe-shop with 
 him, where he would buy her the handsomest pair of shoes of patent 
 leather, under the condition that she would put them on immediately. 
 After this took place, she had to go about in the street, walking in 
 manure and mud as much as possible, in order to soil the shoes. After 
 this, X. would lead the person to an hotel, and, almost before thej' had 
 reached a room, he would cast himself on her feet, feeling an extraordi- 
 nary pleasure in applying his lips to them. When he had cleansed the 
 shoes in this manner, he paid her and went his way. 
 
 From these cases it may be plainly seen that the shoe is the 
 fetich of the masochist, and apparently because of the relation 
 of the dressed female foot to the idea of being trod upon and 
 other acts of humiliation. When, therefore, in other cases of 
 shoe-fetichism, the female shoe appears alone as the excitant 
 of sexual desire, one is justified in presuming that masochistic 
 motives have remained latent. The idea of being trod upon, 
 etc., remains in the depths of unconscious hfe, and the idea of 
 the shoe alone, the means for such acts, rises into consciousness. 
 Cases that are otherwise wliolly inexplicable are thus sufficiently 
 explained. Here one lias to do with larvated masochism ; and 
 this may always be assumed as the unconscious motive, when, 
 as occurs not exceptionally, the origin of the fetichism, from an 
 association of ideas on the occasion of some particular event, 
 can be proved, as in Cases 87 and 88. 
 
 Such cases of desire for ladies' shoes, without conscious 
 motive and without demonstrable origin, arc really innumera- 
 ble.^ Three cases are here given as examples : — 
 
 1 There is apparently a connection between foot-fetichlsm and the fact that certain 
 persons of this kind, whom coitus does not satisfy, or who are unable to perform it, find a 
 substitute for it in tritus membri inter pedes mulieris,
 
 MASOCHISM. 133 
 
 Case 66. Minister, aged 50. From time to time he goes to houses 
 of prostitution and asks to rent a room. He enters it with a girl. Tlien 
 he lustfully regards her shoes, takes one off and kisses and bites it. 
 Finally, he puts it ad genitalia and ejaculat semen semiueque ejaculato 
 axillas pectusque terit ; then he comes out of his sensual ecstasy. He 
 begs the woman to allow him to keep the shoe for a few days, and always, 
 at the appointed time, returns it with thanks (Cantarauo, La Psichiatria^ 
 V, p. 205). 
 
 Case 67, Student, Z., aged 23 ; comes of a tainted family. Sister 
 was insane ; brother suffered with hysteria virilis. The patient, peculiar 
 from childhood, has fre(|uent attacks of h^'pochondriacal depression, 
 ta?dium vitiie, and feels that he is persecuted. In a consultation on 
 account of mental trouble, I find him a very perverse, hereditarily pre- 
 disposed man, with neurasthenic and hjqjochondriacal symptoms. A 
 suspicion of masturbation is confirmed. Patient makes interesting dis- 
 closures concerning his vita sexualis. At the age of ten he was power- 
 fully attracted by the foot of one of his comrades. At twelve he became 
 an enthusiast for ladies' feet. It gave him a delightful sensation to revel 
 in the sight of them. At fourteen he began to masturbate, thinking, at 
 the same time, of the beautiful foot of a lady. From this time on he 
 was taken with the feet of his three-year-old sister. The feet of other 
 females that attracted him induced sexual excitement. Only women's 
 feet — no other part of them — interested him. The thought of sexual 
 intercourse with women excited his disgust. He had never attempted 
 coitus. After his twelfth year he had no interest in the feet of male 
 individuals. The style of covering of the female foot is indifterent to 
 him ; it is only necessary that the person seem to be sympathetic. The 
 thought of enjoying the feet of prostitutes was disgusting to him. For 
 years he had been in love with his sister's feet. If he could but obtain 
 her shoes, the sight of them powerfully excited his sensuality. Kissing 
 or embracing his sister did not have this effect. His greatest delight 
 was to embrace and kiss the foot of a sympathetic woman, when ejacula- 
 tion would result with a lively pleasuraljle sensation. Often he was 
 impelled to touch his genitals with one of his sister's shoes ; but he had 
 been able, thus far, to master this impulse, especiallj' for the reason that 
 for two years (owing to progressive irritable weakness of the genitals) 
 the simple sight of the foot had induced ejaculation. From his relatives 
 it is ascertained that the patient has a silly admiration for the feet of 
 his sister; so that she avoids him and seeks to hide her feet from him. 
 The patient looks upon his perverse sexual impulse as pathological, and 
 is painfully affected by the fact that his vile fancy has for its object his 
 sister's foot. He avoided opportunity as much as he could, and sought 
 to help the matter by masturbation when, as in dreams accompanied by 
 pollution, ladies' feet filled his imagination. However, when the inq)ulse 
 became too powerful he could not avoid gaining a partial sight of his
 
 134 PSTCHOPATHIA SEXUALIS. 
 
 sister's foot. Immediately after ejaculation he would become angry 
 with himself at having been weak again. His partiality for his sister's 
 foot had cost him many a sleepless night. He often wondered that he 
 could still love his sister. Although it seemed right to him that she 
 should conceal her feet from him, yet he was often irritated because 
 the concealment caused him to have pollutions. The patient gives 
 assurances of being moral in other respects, which are confirmed by his 
 relatives. 
 
 Case 68. S., New York, is accused of being a street-thief. Numer- 
 ous cases of insanity in his ancestry ; father, brother, and sister men- 
 tally abnormal. At seven years, violent cerebral concussion twice. At 
 thirteen, struck with a beam. At fourteen S. had violent attacks of 
 headache. Accompan^nng these attacks, or immediately after them, pecu- 
 liar impulse to take the shoes of female members of the family — as a 
 rule, those belonging to one member — and hide them in some out-of-the- 
 way corner. Taken to task, he would lie, or declare that he had no 
 memory of the affair. The passion for shoes was unconquerable, and 
 made its appearance every three or four months. On one occasion he 
 attemi)ted to take the shoe from the foot of one of the servants, and on 
 another he stole his sister's shoe from her sleeping-apartment. In the 
 spring two ladies had their shoes torn from their feet in the open street. 
 In August S. left his home early in the morning to go to his work as a 
 printer. A moment afterward he tore the shoe from a girl's foot in 
 the open street, fled to his place of work, and there was arrested as a street- 
 thief He declared that he did not know much of his act ; that it had 
 come upon him like a stroke of lightning, at the sight of a shoe, that he 
 must possess himself of it, but for what purpose he did not know. He 
 had acted while in a state of unconsciousness. The shoe, as he correctly 
 indicated, was found in his coat. In confinement he was so much excited 
 mentally that an outbreak of insanity was feared. Discharged, he stole 
 his wife's shoes while she slept. His moral character and habits of life 
 were blameless. He was an intelligent workman ; but irregularity of 
 employment, that soon followed, made him confused and incapable of 
 work. Pardoned. (Nichols, Am. Journal of Insanity, 1859; Beck, 
 " Med. Jurisprudence," vol. i, p. 732, 1860.) 
 
 Dr. Pascal {op. elf.) has some similar cases, and many others 
 have been mentioned to me by colleagues and patients, 
 
 (c) Disgusting Acts for the Purpose of Self-Hnmiliation 
 and Sexual Gratification — Larvated Masochism. — There are 
 numerous established cases in which perverted men are thrown 
 into sexual excitement by the secretions, or even the excretions, 
 of women, and try to see and touch them. Probably in these 
 cases there is almost always an unconscious masochistic impulse,
 
 MASOCHISM. 135 
 
 — pleasure in tlie most extreme humiliation of self, and desire 
 to experience it. 
 
 This connection is made perfectly clear by the confessions 
 of those affected with this repugnant perversion. Case 88 of 
 the sixth edition — tliat of an indivi(hial affected with con- 
 trary sexuality, which is later described — is here instructive. 
 The subject of this case not only revels in the thought of being 
 the slave of the beloved man, and refers on this point to Sacher- 
 Masoch's "Venus in Furs," sed etiam sibi fingit amatum pos- 
 cere ut crepidas sudore difHuentes olfaciat ejusque stercore 
 vescatur. Deinde narrat, quia non habeat, quae confingat et 
 exoptet, eorum loco suas crepidas sudore infectas olfacere suoque 
 stercore vesci, inter quae facta pene errecto se voluptate pertur- 
 bari semen que ejaculari. 
 
 The masochistic significance of a disgusting act in the follow- 
 ing case, communicated by a professional friend, is clear: — 
 
 Case 69. H. v. G., landed proprietor ; major ; died in his sixtieth 
 year; came of a family in which irresponsilnlity, tendency to run in del)t, 
 and defect of morals are hereditary. In his 3'outh he was given to most 
 reckless dissipation (he was known as the leader of " naked bnlls"). He 
 was always of a cynical and brutal nature, though punctilious and exact 
 in his military service, which, on account of a disreputable affair that 
 was not made known, he had to leave, and he lived in private life seven- 
 teen years. Untramraeled by the necessity to earn his living, he led everj^- 
 where the life of a raan-of-the-town, and was everj^where avoided on 
 account of his lascivious nature. His ostracism by the best society', 
 which, in spite of his independence, he noticed, caused him to prefer the 
 ordinary society of fakirs, artisans, and loafers. It cannot be ascertained 
 that he had sexnal intercourse with men, but it is certain that in his 
 later years he arranged symposiums with mixed company and was known 
 as a rone. In the last few years of his life he was accustomed to hang 
 about new buildings in the evening, and of the women working there he 
 would ask the dirtiest to accompany him. It is certain that he had the 
 woman undress, and then he would suck her toes, his libido being ex- 
 cited and satisfied Ijy the act. 
 
 Cantarano also reports a case in La PsicJiiatria, v year, p. 
 207, in which, preceding the act, apparently from a similar 
 cause, there was biting and sucking of a woman's toes in as 
 filthy a state as possible.
 
 136 PSYCHOPATHIA SEXUALIS. 
 
 Several cases have come to my knowledge in which, with 
 other masochistic acts (maltreatment, humiliation), such disgust- 
 ing desires were entertained; and the confessions of the indi- 
 viduals left no doubt of their significance. 
 
 Such cases prepare the way to an understanding of others 
 which are absolutely incomprehensible without the connection 
 with the masochistic desire for humiliation.^ It is probable, how- 
 ever, that this impulse, in its actual significance, remains unknown 
 to the perverted individual, and only the desire for disgusting 
 things rises into consciousness, — again larvated masochism. 
 
 Other cases of Cantarano's (Joe. cit.) belong here : mictio 
 even defsecatio puellse ad linguam viri ante actum ; consumption 
 of confects smelling like faeces, in order to become potent ; and 
 also the following case, likewise communicated to me by a 
 physician : — 
 
 Case 10. A Russian prince, who was ver}^ decrepit, was accustomed 
 to have his mistress turn her back to him and defecate on his breast ; this 
 being the only way in which he could excite the remnant of libido. 
 
 Another supported a mistress in unusually brilliant style, with the 
 condition that she eat marchpane exclusively. Ut libidinosus fiat et ejac- 
 ulare possit excrementa feminsB ore excipit. A Brazilian physician tells 
 me of several cases of deftiecatio feminae in os viri that have come to his 
 knowledge. Such cases occur everywhere, and are not at all infrequent. 
 All kinds of secretions — saliva, nasal mucus, and even aural cerumen 
 — are used in this way and swallowed with pleasure ; and oscula ad 
 nates and even ad anum are indulged in. Dr. Moll (op. cit., p. 135) 
 reports the same thing of a man affected with contrary sexuality. The 
 perverse desire to practice cunnilingns, which is very wide-spread, proba- 
 bly frequently has its root in masochistic impulses. 
 
 Palanda {Archivio di PsicMatria. x, fascicolo 3, 4) relates 
 the following case: — 
 
 Case 71. W., aged 45, predisposed, was given to masturbation at 
 the age of eight. A decimo sexto anno libidines suas bibendo recentem 
 feminarum urinam satiavit. Tanta erat A'oluptas urinam bibentis ut nee 
 aliquid olfaceret nee saperet, hific faciens. After drinking he always 
 
 * Analogy with tbe excesses of religious enthusiasm is found even here. The religi- 
 ous enthusiast, Antoinette Bouvignon de la Porte, mixed her food with fseces to punish her- 
 self (Zlmmermann, op. cit., p. 124). The beatified Marie Alacoque, to " mortify " herself, 
 licked up with her tongue the dejections of patients, and sucked their toes covered with 
 sores.
 
 MASOCHISM. 137 
 
 experienced disgust and ill-feeling, and made firm resolutions to do it no 
 more in the future. Once he had the same pleasure in drinking the urine 
 of a nine-year-old boy, with whom he once practiced fellatio. The patient 
 suffers with epileptic insanity. 
 
 The cases described in this group form the complete coun- 
 terpart to group " d " of the sadists. 
 
 Still other older cases belong here, which Tardieu (" Etude mddico- 
 l^ale sur les attentats aux moeurs," p. 206) observed in senile individuals. 
 He describes as " Renifleurs " persons " qui in secretos locos uimirum 
 theatrorum pasticos convenientes quo complures feminae ad micturi- 
 endum festinant, per nares urinali odore excitati, illico se invicem pol- 
 luunt." The " Stercoraires " that Taxil (" La prostitution contem- 
 poraine") mentions are, in relation to this subject, unique. 
 
 Finally, space is here given to the following case, reported 
 to me by a physician : — 
 
 Case 72. A notary, known from his youth to those about him as 
 peculiar and misanthropic. During his school-days he was given to 
 masturbation. According to his own story, he excited his sexual desire 
 by spreading out on the cover of his bed pieces of toilet-paper that he 
 had used, induced erection by regarding and smelling them, and then 
 practiced masturbation. After his death, by the side of his bed, there 
 was found a large basket of such papers, with the dates marked on them. 
 Here there were probably fancies of the nature of the above-mentioned acts. 
 
 (d) Masochism in Women. — In woman voluntar}' subjection 
 to the opposite sex is a physiological phenomenon. Owing to 
 her passive role in procreation and long-existent social condi- 
 tions, ideas of subjection are, in woman, normally connected 
 with the idea of sexual relations. So to speak, they form the 
 harmonics whicli determine the tone-quality of feminine feeling. 
 
 Any one conversant with the history of civilization knows 
 in what a state of absolute subjection woman was always kept 
 until a relatively high degree of civilization was reached ;' and 
 an attentive observer of life may still easily recognize how the 
 custom of unnimibered generations, in connection with the 
 
 1 The laws of the early Middle Ages gave the husband the right to kill the wife ; 
 those of the later Middle Ages, the right to beat her. Tlie latter right was used freely, 
 even by those of high standing (comp. Sehultze, Das hofische Lebeu zur zeit des Min- 
 neeangs, Bd. i, p. 163 et seq.). Yet, by the side of this, the paradoxical chivalry of tlie 
 Middle Ages stands unexplained.
 
 138 PSYCHOPATHIA SEXUALIS. 
 
 passive role with which woman has been endowed by Nature, 
 has given her an instinctive incUnation to vokintary subordina- 
 tion to man ; he will notice that exaggeration of customary 
 gallantry is very distasteful to women, and that a deviation 
 from it in the direction of masterful behavior, though loudly 
 reprehended, is often accepted with secret satisfaction.^ Under 
 the veneer of polite society the instinct of feminine servitude is 
 everywhere discernible. 
 
 Thus it is easy to regard masochism in general as a patho- 
 logical growth of specific feminine mental elements, — as an 
 abnormal intensification of certain features of the psycho-sexual 
 character of woman, — and to seek its primary origin in that 
 sex {v. infra., p. 145). It may, however, be held to be estab- 
 lished that, in woman, an inclination to subordination to man 
 (which may be regarded as an acquired- purposeful arrange- 
 ment, a phenomenon of adaptation to social requirements) is to 
 a certain extent a normal manifestation. 
 
 The reason that, under such circumstances, the " poetry " 
 of the symbolic act of subjection is not reached, lies partly in 
 the fact that man has not the vanity of that weakling who 
 would use blows to display his power (as the love-serving 
 kniglits did with the ladies of the Middle Ages), but prefers 
 to demonstrate his real advantages. The barbarian has his wife 
 plow for him, and the civilized lover speculates about her dowry ; 
 she willingly endures both. 
 
 Cases of pathological increase of this instinct of subjection, in 
 the sense of feminine masochism, are probably frequent enough, 
 but custom represses their manifestation. Many young women 
 like nothing better than to kneel before their hitsbands or lovers. 
 Among all Slavs of the lower classes it is said that the wives 
 feel hurt if they are not beaten by their husbands. A Hunga- 
 rian officer informs me that peasant women of the Somogy'er 
 Comitates do not think they are loved by their husbands until 
 they have received the first box on the ear as a sign of love. 
 
 1 Comp. Lady Milford's words in Schiller's " Kabale und Liebe " : "We women 
 can only choose between ruling and serving ; but the highest pleasure power affords is but 
 a miserable substitute, if the greater joy of being the slaves of a man we love is denied ust"
 
 MASOCHISM. 139 
 
 It would probably be difficult for tbe physician to find 
 cases of feminine masochism. Subjective and objective re- 
 straints — modesty and custom — naturally constitute, in women, 
 insurmountable obstacles to the expression of perverse sexual 
 instinct. Thus it happens that, up to the present time, but one 
 case of masochism in a woman has been scientifically estab- 
 lished ; and this is accompanied by circumstances that obscure it. 
 
 Case 73. Miss v. X., Russian, aged 35 ; of greatl}' predisposed family. 
 For some years slie has been in tbe initial stage of paranoia persecutoria. 
 This sprang from cerebro-spiual neurasthenia, the origin of which is found 
 to be sexual hyper-excitation. Since her twenty -fourth year she has l)een 
 given to masturbation. As a result of disappointment in an engagement 
 and intense sexual excitement, she began to practice masturbation and ps}'- 
 chical onanism. Inclination toward j^f'rsons of he?' own sex neve?' occurred. 
 The patient sa^-s : " At the age of six or eight I conceived a desire to V)e 
 whipped. Since I had never been whipped, and had never been present 
 when others were thus punished, I cannot understand how I came to 
 have this strange desire. I can only think that it is congenital. With 
 these ideas of being whipped I had a feeling of actual delight, and pict- 
 ured in my fancy how fine it would be to be whipped by one of my 
 female friends. I never had any thought of being whipped b}- a man. I 
 reveled in the idea, and never attempted any actual realization of my 
 fancies. These disappeared after my tenth j^ear. Only when I read 
 " Rousseau's Confessions," at the age of thirty-four, did I understand 
 what my longing for whippings meant, and that my abnormal ideas were 
 like those of Rousseau. Since my tenth year I have never had any 
 more such fancies." 
 
 On account of its original character and the reference to 
 Rousseau, this case may with certainty be called a case of 
 masochism. The fact that it is a female friend that is conceived 
 in imagination as whipping her, is explained by the circum- 
 stance that the masochistic desire was here present in the mind 
 of a child before the psychical vita sexualis had developed and 
 the instinct for the male had been awakened. Contrary sexual 
 instinct is here expressly excluded. 
 
 An Attempt to Explain Masochism. 
 
 The facts of masochism are certainly among the most in- 
 teresting in the domain of psychopathology. An attempt to
 
 140 PSYCHOPATHIA SEXUALIS. 
 
 explain them must first seek to distinguish in them the essential 
 from the unessential. The distinguishing characteristic in maso- 
 chism is certainly the unlimited subjection to the will of a person 
 of the opposite sex (in sadism, on the contrary, the unlimited 
 mastery of this person), with the awakening and accompani- 
 ment of lustful sexual feelings to the degree of orgasm. From 
 all that has preceded it is clear that the particular manner in 
 which this relation of subjection or domination is expressed {v. 
 supra)^ whether in simply symbolic acts, or whether there is 
 also a desire to suffer pain at the hands of a person of the opposite 
 sex, is a subordinate matter. 
 
 While sadism may be looked upon as a pathological inten- 
 sification of the masculine sexual character in its psychical 
 peculiarities, masochism rather represents a pathological degen- 
 eration of the distinctive psychical peculiarities of woman. But 
 masculine masocliism is undoubtedly frequent; and it is this that 
 most frequently comes under observation and almost exclusively 
 makes up the series of observed cases. The reason for this has 
 been previously stated (p. 139). 
 
 Two sources of masochism can be distinguished in the 
 sphere of normal phenomena. The first is, that in the state 
 of lustful excitement every impression made by the person 
 giving rise to the sexual stimulus, independently of the nature 
 of its action, is pleasing to the individual excited. 
 
 It is entirely physiological that playful taps and light blows 
 should be taken for caresses, 
 
 "Like the lover's pinch which hurts and is desired."^ 
 
 From here the step is not long to a state where the wish to experi- 
 ence a very intense impression at the hands of the consort leads 
 to a desire for blows, etc., in cases of pathological intensification 
 of lust ; for pain is always a ready means for producing an intense 
 bodily impression. Just as in sadism the sexual emotion leads 
 to a state of exaltation in which the excessive motor excitement 
 implicates neighboring nervous tracts ; so in masochism an 
 ecstatic state arises, in which the rising flood of a single emotion 
 
 ^ Anthony and Cleopatra, v. 2.
 
 MASOCHISM. 141 
 
 ravenously devours and covers with lust every impression coming 
 from the beloved person. 
 
 Tlie second and, indeed, the most important source of 
 masochism is to be songlit in a wide-spread plienomenon, which, 
 though it is extraordinary and abnormal, by no means lies 
 within the domain of sexual perversion. 
 
 I here refer to the very prevalent fact that in innumerable 
 instances, which occur in all varieties, one individual becomes 
 dependent on another of the opposite sex, in a very extraordi- 
 nary and remarkable manner, — even to the loss of all independ- 
 ent will ; a dependence which forces the party in subjection to 
 acts and suffering which greatly prejudice personal interest, and 
 often enough to offense against both "morality and law. 
 
 This dependence, however, differs from the manifestations 
 of normal life only in the intensity of the sexual feeling that 
 here comes in play, and in the slight degree of will-power neces- 
 sary for the maintenance of its equilibrium. The difference is 
 one of intensity, not of quality, as in masochistic manifestations. 
 
 This dependence of one person upon another of tlie oppo- 
 site sex, that is abnormal but not perverse, — a phenomena pos- 
 sessing great interest when regarded from a forensic stand-point, 
 — I designate " sexual bondage ;" ^ for the relations and circum- 
 stances attending it hav^e in all respects the character of bondage. 
 The will of the ruling individual dominates that of the person 
 in subjection, just as a master's does his bondsman's.^ 
 
 This " sexual bondage," as has been said, is certainly an 
 abnormal phenomenon. It begins with the first deviation from 
 the normal. Tlie degree of dependence of one person upon 
 another, or of two upon each other, resulting from individual 
 peculiarity in the intensity of motives that in themselves are 
 
 1 Comp. the author's article, " iiber geschlechtliche Horigkeit und Masoi lii^mns," 
 in the Ps_ychiatrischeu Jahrbiicher, Bd. x, p. 169 et seq., where this subject is treated in 
 detail, and particularly from the forensic stand-point. 
 
 2 The expressions "slave" and "slavery," though often used metaphorically under 
 such circumstances, are avoided here because they are the favorite expressions of maso- 
 chism, from which this " bondage " must be strictly differentiated. 
 
 The expression "bondage" is not to be construed to mean J. S. Mill's " Bondage 
 of Woman." What Mill designates with this expression are laws and customs, social and 
 historical facts. Here, however, we always speak of facts having peculiar individual 
 motives that even conflict with prevalent customs and laws,
 
 142 PSYCHOPATHIA SEXUALIS. 
 
 normal, constitutes the normal standard established by law and 
 custom. Sexual bondage is not a perverse manifestation, how- 
 ever ; the instinctive activities at work here are the same as 
 those that set in motion — even though it be with less violence 
 — the psychical vita sexualis which moves entirely within normal 
 limits. 
 
 Fear of losing the companion and the desire to keep him 
 always satisfied, amiable, and inclined to sexual intercourse, are 
 here the motives of the individual in subjection. An extraor- 
 dinary degree of love — which, particularly in woman, does not 
 always indicate an unusual degree of sensuality — and a weak 
 character are the simple elements of this extraordinary process/ 
 
 The motive of the dominant individual is egoism, which 
 finds unlimited room for action. 
 
 The manifestations of sexual bondage are various in form, 
 and the cases are very numerous." At every step in life we find 
 men that have fallen into sexual bondage. Among married 
 men, hen-pecked husbands belong to this category, particu- 
 larly elderly men who marry young wives and try to overcome 
 the disparity of years and physical defects by unconditional 
 submission to the wife's every whim ; and unmarried men of 
 ripe maturity, who seek to better their last chance of love by 
 unlimited sacrifice, are also to be enumerated here. Here 
 belong, also, men of any age, who, seized by hot passion for a 
 woman, meet coldness and calculation, and have to capitulate 
 on hard conditions ; men of loving natures who allow them- 
 selves to be persuaded to marriage by notorious prostitutes ; 
 men who, to run after adventuresses, leave everything and 
 
 1 Perhaps the most important element is, that by the habit of submission a kind of 
 mechanical obedience, without consciousness of its motives, which operates with automatic 
 certainty, may be established, having no opposing motives to contend with, because it lies 
 be}'ond the threshold of consciousness ; and it may be used by the dominant individual 
 like an inanimate instrument. 
 
 2 Sexual bondage, of course, plays a role in all literatures. Indeed, for the poet, the 
 extraordinary manifestations of the sexual life that are not perverse form a rich and open 
 field. The most celebrated description of masculine " bondage " is that by Abbe Prevost, 
 "Mano Lescault." An excellent description of feuiiiiine "bondage" is that of "Leone 
 Leoni," by George Sand. But first of all comes Kleist's " Kathchen von Heilbronn," who 
 himself called it the counterpart of (sadistic) " Penthesilea." Halm's " Griseldis " and 
 many other similar poems also belong here.
 
 MASOCHISM. 143 
 
 jeopardise their future ; hufsbands and fatliers who lea^ e wife 
 and child, to lay the income of a family at the feet of a harlot. 
 
 But, numerous as the examples of masculine " bondage " 
 are, every observer of life, who is at all unprejudiced, must 
 allow that they are far from equalling, in number and impor- 
 tance, the cases of feminine " bondage." This is easily ex- 
 plained. For a man, love is almost always only an episode, 
 and he has many other and important interests; lor a woman, 
 on the other hand, love is the principal thhig in life, and, until 
 the birth of children, always her first interest. After this it is 
 still often her first thought, but always, at least, takes the 
 second place. But, what is still more important, the man ruled 
 by this impulse easily satisfies it in embraces for which he finds 
 unlimited opportunities. A woman in tlie upper classes of 
 society, if she have a husband, is bound to him alone ; and 
 even in the lower classes there are still great obstacles to poly- 
 andry. Therefore, a woman\s hnsband means for her the ichole 
 sex, and his importance to her becomes very great. It must 
 also be considered that the normal relation established by law 
 and custom between husband and wife is flir from being one of 
 equality. In itself it expresses a sufficient predominance of 
 woman's dependence. The concessions she makes to her lover, 
 to retain the love which it would be almost impossible for her to 
 replace, only plunge her deeper in bondage ; and this increases 
 the insatiable demands of husbands resolved to use their advan- 
 tage and traffic in woman's readiness to sacrifice herself. 
 
 Here may be placed the fortune-hunter, who for money 
 allows himself to be enveloped in the easily created illusions of 
 a maiden ; the seducer, and the man who compromises wives, 
 calculating on blackmail ; the gilded army officer and the 
 musician with the lion's mane, who know so well how to 
 stammer " Thee or death ! " as a means to pay debts and 
 provide a life of ease. Here, too, belong the kitcluMi-soldicr. 
 whose love the cook returns with love plus means to satisfy ;t 
 different appetite; the drinker, who consumes the savings of 
 the mistress he marries; and the man who with blows compels 
 the prostitute on whom he lives to earn a certain sum for him
 
 144 PSYCHOPATHIA SEXUALIS. 
 
 daily. These are only a few of the innumerable forms of bond- 
 age into which woman is forced by her greater need of love and 
 the difficulties of her position. 
 
 The subject of " sexual bondage " must here receive brief 
 consideration ; for in it may be clearly seen the soil from which 
 the main root of masochism springs. The relationship of these 
 two phenomena of psychical sexual life is immediately apparent. 
 Bondage and masochism both consist of the unconditional sub- 
 jection of the individual affected with the abnormality to a 
 person of the opposite sex, and of domination of the former by 
 the latter.^ The two plienomena, however, must be strictly 
 differentiated ; they are not different in degree, but in quality. 
 
 Sexual bondage is not a perversion and not pathological ; 
 the elements from which it arises — love and weakness of will — 
 are not perverse ; it is only their simultaneous activity that pro- 
 duces the abnormal result which is so opposed to self-interest, 
 and often to custom and law. The motive, in obedience to 
 which the subordinated individual acts and endures tyranny, is 
 the normal instinct toward woman (or man) ; the satisfaction of 
 which is the price of bondage. The acts of the person in sub- 
 jection, by means of which tlie bondage is expressed, are per- 
 formed at the command of tlie ruling individual, to satisfy self- 
 ishness, etc. For the subordinated individual they have no 
 independent purpose ; tliey are only the means to an end, — to 
 obtain or retain possession of the ruling individual. Finally, 
 bondage is a result of love for a particular person ; it first 
 appears when this love is awakened. 
 
 In masochism, which is decidedly abnormal and a perver- 
 sion, this is all very different. The motive of the acts and suf- 
 fering of the person in subjection is here the charm afforded by 
 the tyranny in itself. There may, at the same time, be a desire 
 for coitus with the dominant person ; but the impulse is 
 directed to the acts which serve to express the tyranny, as the 
 immediate objects of gratification. Tliese acts in which maso- 
 
 1 Cases may occur in which the sexual bondage is expressed in the same acts that 
 are common in masochism. When rough men whip their wives, and the hitter suffer for 
 love, without, however, having a desire for blows, we have a pseudo form of bondage that 
 may simulate masochism.
 
 MASOCHISM. 145 
 
 chism is expressed arc, for the individual in subjection, not means 
 to an end, as in bondage, but the end in themselves. Finally, in 
 masochism the longing for subjection occuys a jjrioH, before the 
 occurrence of an inclination to any particular object of love. 
 
 The connection between bondage and masochism may be 
 assumed by reason of the correspondence of the two phenomena 
 in the objective condition of dependence, notwithstanding tlie 
 difference in their motives ; and the transformation of the abnor- 
 mality into the perversion probably takes place in tlic following 
 manner : Any one living for a long time in sexual bondage be- 
 comes disposed to acquire a slight degree of masochism. Love 
 that willingly bears tlie tyranny of the loved one then becomes 
 an immediate love of tyranny. When tlie idea of being tyran- 
 nized over is long closely associated icitli the lustful thougJit of 
 the beloved person, the lustful emotion is finally connected ivith 
 the tyranny itself, and the transformation to perversion is com- 
 pleted. This is the manner in which masochism may be acquired 
 by cultivation.^ 
 
 1 It is very interesting, and dependent upon the nature of bondage and masocliism, 
 which essentially correspond in external efl'ects, that to illustrate the former certain playful, 
 metaphorical expressions are in general use; suoli as "slavery," "to bear chains," 
 " bound," " to hold the whip over," "to harness to the triumphal car," "to lie at the 
 feet," " hen-pecked," etc., — all things which, literally carried out, form the objects of the 
 masochist's desire. Such similes are frequently used in daily life and have become trite. 
 They are derived from the language of poetry. Poetry has always recognized, within the 
 general idea of the passion of love, the element of dependence in the lover, who practices 
 self-sacrifice spontaneously or of necessity. The facts of " bondage " have also always 
 presented themselves to the poetical imagination. When the poet chooses such expressions 
 as those mentioned, to picture the dependence of the lover in striking similus, he proceeils 
 exactly as docs the masocMst, who, to intensify the idea of his dependence (his ultimate aim), 
 creates such situations in reality. In ancient poetry, the expression " domina" is used to 
 •signify the loved one, with a preference for the simile of " casting in chains " (c.r/., Horace, 
 Od. iv, 11). From antiquity through all the centuries to our own times (conip. Grillparzer, 
 " Ottokar," Act v : "To rule is sweet, al-most as sweet as toobey"), the poetry of love is filled 
 with similar phrases and similes. The histfjry of the word " mistress " is also interesting. 
 But poetry reacts on life. It is probable that the courtly chivalry of the Middle Ages arose 
 in this way. In its reverence for women as " mistresses " in society and in individual love- 
 relations ; its transference of the relations of feudalism and vas.«alage to the relation between 
 the knight and his lady ; its submission to all feminine whims ; its love-tests and vows ; its 
 duty of obedience to every command of the lady,— in all this, chivalry appears as a sys- 
 tematic, poetical development of the " bondage " of love. Certain extreme manifestations, 
 like the deeds and sufiering of Ulrich von Lichtenstein or Pierre Vidal in the service of 
 their ladies; or the practice of the fraternity of the "Galois" in France, whose members 
 sought martyrdom in love and subjected themselves to all kinds of suffering,— these clearly 
 have a masochistic character, and demonstrate the natural trausformatiou of one phenom- 
 enon into the other. 
 
 10*
 
 146 PSYCHOPATHIA SEXUALIS. 
 
 Thus a mild degree of masochism may arise from " bondage," 
 — become acquired; but genuine, complete, deep-rooted maso- 
 chism, with its feverish longing for subjection from the time of 
 earliest youth, is congenital. 
 
 The explanation of the origin of the infrequent perversion 
 of fully developed masochism is most probably to be found in 
 the assumption that it arises from the very frequent abnormality 
 of " sexual bondage"; in that now and then this ahnormality is 
 hereditarily transferred to a ■psychopathic individual in such a 
 way that it becomes transformed into a perversion. It has been 
 previously shown how a slight displacement of the psychical 
 element under consideration may effect tliis transition. 
 
 This transformation of the abnormality into the perversion, 
 through hereditary transference, would take place very easily 
 where the psycho})atliic constitution of the descendant presented 
 the other factor of masochism, — i.e., what has been previously 
 called its main root, — the tendency of sexually hypersesthetic 
 natures to assimilate all impressions coming from the beloved 
 person with the sexual impression. 
 
 From these two elements, — from " sexual bondage " on the 
 one hand, and from the above-mentioned disposition to sexual 
 ecstasy, which apperceives even maltreatment with lustful emo- 
 tion, on the other, — the roots of which may be traced back to 
 the field of physiological facts, masochism arises on the basis 
 of psychopathic predisposition ; in that its sexual hypertesthesia 
 intensifies first all the physiological accessories of the vita 
 sexualis and, finally, only its abnormal accompaniments, to the 
 pathological degree of perversion.^ 
 
 * If it be considered that, as shown above, "sexual bondage "is a phenomenon 
 observed much more frequently and in a more pronounced degree in the female sex than in 
 the male, the thought arises that masochism (if not always, at least as a rule) is an inher- 
 itance of the " bondage" of feminine experience. Thus it comes into a relation — though 
 distant — with contrary sexual instinct, as a transference to the male of a perversion really 
 belonging to the female. This conception of masochism as a rudimentary contrary sexual 
 instinct, as a partial effemiuation, here affecting only the secondary sexual character of the 
 vita sexualis (a theory still more unconditionally expressed in the sixth edition of this 
 work) finds its support in the statements of the subjects of Case 44 and Case 50, who pre- 
 sent other features of effemination, and give as their ideal a relatively old woman who 
 seeks and wins them ; and, further, in the fact that the (potent) masochist prefers the role 
 of succubus, as shown by statements referring to this. 
 
 It must, however, be emphasized that " bondage " also plays no unimportant role in
 
 MASOCHISM. 147 
 
 At any rate, masochism, as a congenital sexual perversion, 
 constitutes a functional sign of degeneration in (almost exclus- 
 ively) hereditary taint ; and this clinical deduction is confirmed 
 in my cases of masochism and sadism. It is easy to demon- 
 strate that the peculiar, psychically-anomalous direction of the 
 vita sexualis which masochism represents, is an orighial abnor- 
 mality, and not, so to speak, cultivated in a predisposed indi- 
 vidual by passive flagellation, through association of ideas, as 
 Rousseau and Binet suppose. Tins is shown by the numerous 
 cases of masochism — in fact, the majority — in which flagellation 
 never appears ; in which the perverse impulse is directed ex- 
 clusively to purely symbolic acts expressing subjection without 
 any actual infliction of pain. This is demonstrated by the 
 whole series of cases, from Case 53, given here. 
 
 The same result — namely, that passive flagellation is not 
 the nucleus around which all the rest is gathered — is rea(;lied 
 when closer study is given to the cases in which passi\e flagel- 
 lation plays a ro/e, as in Case 44 and Case 50. Case 51 is 
 particularly instructive in relation to this ; for in this instance 
 there can be no thought of a sexually-stimulathig eftect of 
 punishment received in youth. Moreover, in this case, connec- 
 tion with an early experience is not possible ; lor the situation 
 constituting the object of principal sexual interest is absolutely 
 incapable of being carried out by a cliild. 
 
 Finally, the origin of masochism in purely psychical ele- 
 ments, on confronting it with sadism {v. infra), is convincingly 
 demonstrated. That passive flagellation occurs so frequently in 
 masochism is explained simply by the fact that it is the most 
 extreme means of expressing the relation of subjection. 
 
 I repeat that the decisive points, in the difterentiation of 
 simple passive flagellation from flagellation dependent upon 
 masochistic desire, are that, in the former, the act is a means to 
 make coitus, or at least ejaculation, possible ; and that, in the 
 latter, it is a means of gratification of masochistic desires. 
 
 the iiiasculine vita sexualis, and that masochism in man may also be explained without any 
 such transference of feminine elements. It must also be remembered here that masocliit-m, 
 as well as its counterpart, sadism, occurs in irregular combination with contrary sexual 
 instinct.
 
 148 PSTCHOPATHIA SEXUALIS. 
 
 As we have already seen, masochists subject themselves to 
 all other kinds of maltreatment and suffering in which there 
 can be no question of reflex excitation of lust. Since such 
 cases are numerous, in such acts (and in flagellation in maso- 
 chists, having like significance) we must seek to ascertain in 
 what relation pain and .lust stand to each other. From the 
 statement of a masochist it is as follows: — 
 
 The relation is not of such a nature that that which 
 causes physical pain is here simply perceived as physical pleas- 
 ure ; but the person in a state of masochistic ecstasy feels no 
 pain ; either because, by reason of his emotional state (like that 
 of the soldier in battle), the physical effect on his cutaneous 
 nerves is not apperceived ; or because (as with religious martyrs 
 and enthusiasts), with the preoccupation of consciousness with 
 lustful emotion, the idea of maltreatment remains merely a 
 symbol, without its quality of pain. 
 
 To a certain extent there is over-compensation of physical 
 pain in psychica,l pleasure ; and only the excess remains in con- 
 sciousness as psychical lust. This also undergoes an increase ; 
 since, either through reflex spinal influence or through a pecu- 
 liar coloring in the sensorium of sensory impressions, a kind of 
 hallucination of bodily pleasure takes place, with a vague local- 
 ization of the objectively projected sensation. 
 
 In the self-torture of religious enthusiasts (fakirs, howling 
 dervishes, religious flagellants) there is an analogous state, only 
 with a dift'erence in the quality of pleasurable feeling. Here the 
 conception of martyrdom is also apperceived without its pain ; 
 fbr consciousness is tilled with the pleasurably colored idea of 
 serving God, atoning for sins, deserving heaven, etc., through 
 martyrdom. 
 
 Masochism and Sadism. 
 
 The perfect counterpart of masochism is sadism. While 
 in the former there is a desire to sufter and be subjected to vio- 
 lence, in the latter the wish is to inflict pain and use violence. 
 
 The parallelism is perfect. All tlie acts and situations 
 used by the sadist in the active role become the object of the
 
 MASOCHISM AND SADISM. 149 
 
 desire of the mosochist in the passive role. In both perver- 
 sions these acts advance from purely symbolic acts to severe 
 maltreatment. Even murder, in which sadism reaches its acme, 
 finds, as is shown by Case 54, — of course, only in ftmcy, — its 
 passive counterpart. Under favoring conditions, both perver- 
 sions may occur with a normal vita sexualis ; in botli, the acts 
 in which they express themselves are preparatory for coitus or 
 substitutes for it.^ 
 
 But the analogy does not exist simply in external manifes- 
 tation ; it also extends to the subjective character of both per- 
 versions. Both are to be regarded as original psychopathies iu 
 mentally abnormal individuals, who, in particular, are affected 
 with psychical hyperaesthesia sexualis, and, as a rule, also with 
 other abnormalities ; and for each of these perversions two con- 
 stituent elements may be demonstrated, which have their roots 
 in psycliical facts lying within physiological limits. For maso- 
 chism, as shown above, these elements lie in the fact (1) that 
 in the state of sexual emotion every impression produced by 
 the consort, independently of the manner of its production, is, 
 per se, attended with lustful pleasure, which, where there is 
 hypergesthesia sexualis, may go so far as to over-compensate all 
 painful sensation ; and in the fact (2) that " sexual bondage," 
 dependent on mental lactors that are in themselves not perverse, 
 may, under pathological conditions, become a perverse, pleasur- 
 able desire for subjection to the opposite sex, which — even if it 
 be quite unnecessary to assume its inheritance from the female 
 side — represents a pathological degeneration of the character 
 belonging to woman, — of the instinct of subordination, physio- 
 logical in woman. 
 
 In harmony with this, there are, likewise, two constituent 
 elements explanatory of sadism, the origin of which may also be 
 
 1 Of course, both have to contend with opposiiif;; ethical and a?sthetic motives in 
 foro interno. After tiiese have been overcome and sadism appears, it immediately comes iu 
 conflict with the law. This is not the case with masochism ; which accounts for the greater 
 frequency of masochistic acts. But the instinct of self-preservation and fear of pain oppose 
 <.he I'ealizatioii of the latter. The practical sij^nificauce of masochism lies only iu its rela- 
 tions to psychical impotence ; while that of sadism lies beyond that, and is principally 
 forensic.
 
 150 PSYCHOPATHIA SEXUALIS. 
 
 traced back within physiological limits. These are : the fact (-1) 
 that in sexual emotion, to a certain extent, as an accompany- 
 ing psychical excitation, an impulse may arise to influence 
 the object of desire in every possible way and with the greatest 
 possible intensity, which, in individuals sexually hyperaes- 
 tlietic, may become an impulse to inflict pain; and the fact 
 (2) that, under pathological conditions, the man's active role 
 of winning woman may become an unlimited desire for sub- 
 jugation. 
 
 Thus masochism and sadism represent perfect counterparts. 
 It is also in harmony with this that the individuals afl"ected with 
 these perversions regard the opposite perversion in the other 
 sex as their ideal, as shown by Case 44 and Case 50, and also by 
 " Rousseau's Confessions." 
 
 But the contrast of masochism and sadism may also be used 
 to invalidate the assumption that the former has its origin in the 
 reflex effect of passive flagellation ; and that all the rest is the 
 product of associations of related ideas, as Binet, in explanation 
 of Bousseau's case, thinks, and as Bousseau himself believed. 
 
 In the active maltreatment forming the object of the 
 sadist's sexual desire there is, in fact, no irritation of his 
 own sensory nerves by the act of maltreatment ; so that there 
 can be no doubt of the purely psychical character of the origin 
 of this perversion. Sadism and masochism, however, are so 
 related to each other, and so correspond in all points with each 
 other, that the one allows, by analogy, a conclusion for the other; 
 and this is alone suflicient to establish the purely psychical 
 character of masochism. 
 
 According to the above-detailed contrast of all the elements 
 and phenomena of masochism and sadism, and as a resume of 
 all observed cases, lust in the infliction of pain and lust in in- 
 flicted pain appear but as two different sides of the same 
 psychical process, of which the primary and essential thing is 
 the consciousness of active or passive subjection, in which the 
 combination of cruelty and lustful pleasure has only a secondary 
 psychological signiflcance. Acts of cruelty serve to express this 
 subjection ; first, because they are the most extreme means for
 
 MASOCHISM AND SADISM. 151 
 
 the expression of this relation; and, again, because they represent 
 the most intense effect that one person, eitlier with or without 
 coitus, can exert on another. 
 
 Tlie cases in which sadism and masochism occur simid- 
 taneously in one individual are interesting, but they pre- 
 sent some difficulties of explanation. Cases 49, 50, 58, etc., 
 are of this kind, and also particularly Case 30. From the 
 latter it is evident that it is especially the idea of subjection 
 that, both actively and passively, forms the nucleus of the 
 perverse desires. Traces of the same thing are also to be 
 observed, with more or less clearness, in many other cases. 
 At any rate, one of the two perversions is always markedly 
 predominant. 
 
 Owing to this marked predominance of one perversion, 
 and the later appearance of the other, in such cases it may 
 well be assumed that the predominating perversion is orir/inaJ, 
 and that the other has been acquired in the course of time. 
 The ideas of subjection and maltreatment, colored with lust- 
 ful pleasure, either in an active or passive sense, have be- 
 come deeply impressed in such an individual. 
 
 Occasionally the imagination is tempted to try the same 
 ideas in an inverted 7-6Ie. There may even be realization of 
 this inversion. Such attempts in imagination and in acts, 
 however, are usually soon abandoned as inadequate for the 
 original inclination. 
 
 Masochism and sadism also occur in combination with con- 
 trary sexual instinct, and, too, in association with all forms and 
 degrees of this perversion. The individual of contrary sexuality 
 may be a sadist as well as masochist (comp. Cases 48 and 49 and 
 numerous cases in the following series of cases of contrary 
 sexual instinct). 
 
 Wherever a sexual perversion has developed on the basis 
 of a neuropathic individuality, sexual hypera3sthesia, which may 
 always be assumed to be present, may induce the phenomena 
 of masochism and sadism — now of the one, now of both com- 
 bined, one arising from the other. Thus masochism and sadism 
 appear as the fundamental forms of psycho-sexual perversion,
 
 152 PSYCHOPATHIA SEXUALIS. 
 
 which may make their appearance at any point in the domain 
 of sexual aberration.^ 
 
 3. The Association of Lust with the Idea of Certain Por- 
 tions of the Female Person^ or loith Gertain Articles of Feynale 
 Attire — Fetichism. — In the considerations concerning the psy- 
 chology of the normal sexual life in the introduction to this 
 work {vide p. 17), it was shown that, within physiological limits, 
 the pronounced preference for a certain portion of tlie body of 
 persons of the opposite sex, particularly for a certain form of 
 this part, may attain great psycho-sexual importance. Indeed, 
 the especial power of attraction possessed by certain forms and 
 peculiarities for many men — in fact, tlie majority — may be 
 regarded as the real principle of individualization in love. 
 
 This preference for certain particular physical characteristics 
 in persons of the opposite sex, — by the side of which, likewise, 
 a marked preference for certain psychical characteristics may be 
 demonstrated, — following Binet (" du Fetischisme dans 1' amour," 
 Revue pliilosophique^ 1887) and Lombroso (Introduction to 
 the Italian edition of the second edition of this work), I have 
 called "fetichism"; because this enthusiasm for certain portions 
 
 1 Every attempt to explain the facts of either sadism or ma.socliism, owing to the 
 close connection uf the two phenomena demonstrated here, must also be suited to explain 
 the other perversion. Au attempt to offer an explanation of sadism, by J. G. Kiernan (Chi- 
 cago) {vide " Psychological Aspects of the Sexual Appetite," Alienist and Neurologist, 
 St. Louis, April, 1891) meets this requirement, and for this reason may be briefly mentioned 
 here. Kiernan, who has several authorities in Anglo- American literature for his theory, 
 starts from the assumption of several naturalists (Dallinger, Drysdale, Rolph,Cienkowsky) 
 which conceives the so-called conjugation, a sexual act in certain low forms of animal life, 
 to be cannibalism, a devouring of the partner in the act. He brings into immediate con- 
 nection with this the well-known facts that at the time of sexual union crabs tear limbs from 
 their bodies and spiders bite olf the heads of the males, and other sadistic acts performed 
 by rutting animals >vith their consorts. From this he passes to lust-murder and other lustful 
 acts of cruelty in man, and assumes that hunger and the sexual appetite are, in their origin, 
 identical ; that the sexual cannibalism of lower forms of animal life has an influence in 
 higher forms and in man, and that sadism is an example of atavism. 
 
 This explanation of sadism would, of course, also explain masochism ; for if the 
 origin of sexual intercourse is to be sought in cannibalistic processes, then both the sur- 
 vival of one sex and the destruction of the other would fulfill the purpose of nature, and 
 thus the instinctive desire to be the victim would be explained. But it must be stated in 
 objection that the basis of this reasoning is Insufficient. The extremely complicated pro- 
 cess of conjugation in lower organisms, into which science has really penetrated only 
 during the last few years, is by no means to be regarded as simply a devouring of one indi- 
 vidual by another (comp. Weismann, Die Bedeutung der Sexuellen Fortpflanzung fiirdie 
 Selectionstheorie, p. 51, Jena, 1886).
 
 FETICHISM. 153 
 
 of tlie body (or even articles of attire) and the worsliip of thorn, 
 in obedience to sexual impulses, frequently call to mind the 
 reverence for relics, holy objects, etc., in religious cults. This 
 physiological fetichism has already been described in detail on 
 page 11 et seq. 
 
 By the side of this physiological fetichism, however, there 
 is, in the psycho-sexual sphere, an undoubted pathological, erotic 
 fetichism, of which there is already a numerous series of cases 
 presenting phenomena having great clinical and psychiatric 
 interest, and, under certain circumstances, forensic importance. 
 This pathological fetichism does not confine itself to certain parts 
 of the body alone, but it is even extended to inanimate objects, 
 which, however, are almost always articles of female wearing- 
 apparel, and thus stand in close relation with the female person. 
 
 This pathological fetichism is connected, through gradual 
 transitions, with physiological fetichism ; so that (at least in 
 body-fetichism) it is almost impossible to sharply define the 
 beginning of the perversion. Moreover, the whole field of 
 body-fetichism does not really extend beyond the limits of 
 things which normally stimulate the sexual instinct. Here the 
 abnormality consists only in the fact that the whole sexual 
 interest is concentrated on the impression made by a part of 
 the person of the opposite sex, so that all other impressions 
 fade and become more or less indifferent. Therefore, the body- 
 fetichist is not to be regarded as a monstrum per excessum^ like 
 the sadist or masochist, but rather as a monstrum per defectum. 
 What stimulates him is not abnormal, but rather what does not 
 affect him, — the limitation of sexual interest that has taken 
 place in him. Of course, this limited sexual interest, within its 
 narrower limits, is usually expressed with a corresi)ondhigly 
 greater and abnormal intensity. 
 
 It would seem reasonable to assume, as the distinguishing 
 mark of patliological fetichism, the necessity for the presence of 
 the fetich as a conditio sine qua non for the possibility of per- 
 formance of coitus. But when the facts are more carefully 
 studied, it is seen that this limitation is really only indefinite. 
 There are numerous cases in which, even in the absence of the
 
 154 PSYCHOPATHIA SEXUALIS. ., 
 
 fetich, coitus is possible, but it is iucomplete and forced (often 
 with the help of fancies relating to the fetich), and particularly 
 unsatisfying and exhausting ; and, too, closer study of the dis- 
 tinctive subjective psychical conditions in these cases shows that 
 there are transitional states, passing, on the one hand, to mere 
 physiological preferences, and, on the other, to psychical impo- 
 tence in the absence of the fetich. It is therefore better, per- 
 haps, to seek the pathological criterion of body-fetichism in 
 purely subjective psychical states. The concentration of the 
 sexual interest on a certain portion of the body that has 
 no direct relation to sex (as have the mammae and external 
 genitals) — a peculiarity to be emphasized — often leads body- 
 fetichists to such a condition that they do not regard coitus as 
 the real means of sexual gratification, but rather some form of 
 manipulation of that portion of the body that is effectual as a 
 fetich. This perverse instinct of body-fetichists may be taken 
 as the patliological criterion, no matter whether actual coitus is 
 also possible or not. 
 
 Fetichism of inanimate objects or articles of dress, how- 
 ever, in all cases, may well be regarded as a pathological phe- 
 nomenon; since its objects fall without the circle of normal 
 sexual stimuli. But even here, in the phenomena, there is a 
 certain outward correspondence with processes of the normal 
 psychical vita sexualis ; the inner connection and meaning of 
 pathological fetichism, however, are entirely different. In the 
 ecstatic love of a man mentally normal, a handkerchief or shoe, 
 a glove or letter, the flower " she gave," or a lock of hair, etc., 
 may become the object of worship, but only because they repre- 
 sent a mnemonic symbol of the beloved person — absent or dead 
 — whose whole personality is reproduced by them. The patho- 
 logical fetichist has no such relations. The fetich constitutes 
 the entire content of his idea. When he is possessed by it, 
 sexual excitement occurs, and the fetich makes itself felt.^ 
 
 According to all observations thus, far made, pathological 
 
 1 In Zola's " ThereseRaquiu," where the lover repeatedly kisses his mistress's boot, 
 the case is quite diflTereut from that of shoe- and boot- fetichists, who, at the sight of every 
 boot worn by a lady, or even alone, are thrown into sexual excitement, even to the extent 
 of ejaculation. '
 
 FETICHISM. 155 
 
 feticliism seems to arise only on the basis of a psychopathic con- 
 stitution tliat is for the most part hereditary, or on the basis of 
 existent mental disease. 
 
 Thus it happens that it not infrequently appears combined 
 with the other (original) sexual perversions that arise on the 
 same basis. Not infrequently feticliism occurs in the most various 
 forms in combination with contrary sexuality, sadism, and maso- 
 chism. Indeed, certain forms of body-fetichism (hand- and 
 foot- feticliism) probably have a more or less distinct connection 
 with the latter two perversions {v. infra). 
 
 But if feticliism also rests upon a congenital general psycho- 
 pathic disposition, yet this perversion is not, like those previously 
 considered, essentially of an original nature ; it is not congeni- 
 tally perfect, as we may well assume sadism and masochism to 
 be. While in the sexual perversions thus far described we 
 have met only cases of a congenital nature, here we meet only 
 acquired cases. Aside from the fact that in feticliism the causa- 
 tive circumstance of its acquirement is often demonstrable, here 
 the physiological conditions are wanting, which in sadism and 
 masochism, by means of sexual hyperaesthesia, are intensified to 
 perversions, and justify the assumption of congenital origin. In 
 feticliism, every case requires an event which affords the subject 
 of perversion. As has been said, it is, of course, physiological 
 in sexual life to be partial to one or another of woman's pecu- 
 liarities, and to be enthusiastic about it ; but concentration of 
 the entire sexual interest on such partial impressions is here the 
 essential thing ; and for this concentration there must be a par- 
 ticular reason in every individual affected. Therefore, we may 
 accept Binet's conclusion that in the life of every fetichist there 
 may he assumed to have been some event which determined the 
 association of lustful feeling ivith the single impression. This 
 event is to be referred to the time of early youth, and, as a rule, 
 occurs in connection with the first awakening of the vita sexualis. 
 This first awakening is associated with some partial sexual im- 
 pression (since it is always something standing in some relation 
 to woman), and stamps it for life as the principal object of sexual 
 interest. The circumstances under which the association arises
 
 156 PSYCHOPATHU SEXUALIS. 
 
 are usually forgotten. It is only the result of the association 
 that is retained. The general predisposition to psychopathic 
 states and the sexual hypersesthesia of such individuals are all 
 that is original liere.^ 
 
 Like the other perversions thus far considered, erotic (patho- 
 logical) fetichism may also express itself in strange, unnatural, 
 and even criminal acts : gratification with the female person loco 
 indebito, theft and robbery of objects of fetichism, pollution of 
 such objects, etc. Here, too, it only depends upon the intensity 
 of the perverse impulse and the relative power of opposing 
 ethical motives, whether and to what extent such acts are per- 
 formed. These perverse acts of fetichists, like those of other 
 sexually perverse individuals, may either alone constitute the 
 entire external vita sexualis, or occur together with the normal 
 sexual act. This depends upon the condition of physical and 
 psychical sexual power, and the degree of excitability to normal 
 stimuli that has been retained. Where excitability is dimin- 
 ished, not infrequently the sight or touch of the fetich serves as 
 a necessary preparatory act. 
 
 The great practical importance which attaches to the facts 
 of fetichism, in accordance with what has been said, lies in two 
 factors. First, pathological fetichism is not infrequently a cause 
 o{ psychical impotence} Since the object upon which the sexual 
 interest of the fetichist is concentrated stands, in itself, in no 
 immediate relation to the normal sexual act, it often happens 
 that the fetichist diminishes his excitability to normal stimuli 
 
 1 Though Biuet {op. cit.) declares that every sexual perversion, without exception, 
 depends upon such an " accident acting on a predisposed subject " (where, under predis- 
 position, only hyperjesthesia in general is understood), yetsuch an assumption for other per- 
 versions than letichism is ueitlier necessary nor satisfactory. For example, it is not clear 
 how the sight of another's punishment could excite sexually even a very excitable individual, 
 if the physiological relationship of lust and cruelty had not been developed into original 
 sadism in an abnormally excitable individual. 
 
 2 When young husbands who have associated much with prostitutes feel impotent 
 in the face of the chastity of their young wives — a thing that frequently occurs — the con- 
 dition may be regarded as a kind of (psychical) fetichism in a wider sense. One of my 
 patients was never potent with his beautiful and chaste young wife, because he was accus- 
 tomed to the lascivious methods of prostitutes. When he now and then attempted coitus 
 with puellis he was perfectly potent. Hammond (op. cit.) reports a very similar interesting 
 case. Of course, in such cases, a bad conscience and hypochondriacal fear of impotence 
 play an important part.
 
 FETICHISM. 157 
 
 by his perversion, or, at least is capable of coitus only by means 
 of concentration of liis fancy U[)on his fetich. In this perver- 
 sion, and in the difficulty of its adequate satisfaction, just as in 
 the other perversions of the sexual instinct, lie conditions favor- 
 ing psychical and physical onanism, which again reacts dele- 
 teriously on the constitution and sexual power. Tliis is 
 especially true in the case of youthful individuals, and par- 
 ticularly in the case of those who, on account of opposini^ 
 ethical and aesthetic motives, shrink from the realization of 
 their perverse desires. Secondly, fetichism is of great forensic 
 importance. Just as sadism may extend to murder and the 
 infliction of bodily injury, fetichism may lead to theft and even 
 to robbery for the possession of the desired articles. 
 
 Erotic fetichism has for its object either a certain portion 
 of the body of a person of the opposite sex, or a certain arti- 
 cle or material of wearing-apparel of the opposite sex, (Only 
 cases of pathological fetichism in men have thus far been ob- 
 served, and therefore only portions of the female person and 
 attire are spoken of here.) In accordance with tliis, fetichists 
 fall into three groups. 
 
 (a) The Fetich is a Part of the Female Body. — Just as, in 
 physiological fetichism, the eyes, the hand, the foot, and the 
 hair of woman very frequently become fetiches, so, in tlie patli- 
 ological domain, the same portions of the body become the sole 
 objects of sexual interest. This exclusive concentration of 
 interest on these parts, by the side of which everything else 
 feminine fades, and all other sexual value of woman may sink 
 to m/, so that, instead of coitus, strange mani[)ulations of the 
 fetich become the object of desire, — this it is that makes these 
 cases pathological. 
 
 Case 74. (Binet, op. cit.) X., aged 34, teacher in a G^imiasiiun. 
 In childhood he snftered with convnlsions. At the age of ten he began 
 to masturbate, with histful feelings, which were connected witii very 
 strange ideas. He was particularly partial to women's eyes ; but since 
 he wished to imagine some form of coitus, and was absolutely innocent 
 in sexual matters, to avoid too great a separation from the eyes, he 
 evolved the idea of making the nostrils the seat of the female sexual 
 organs. Then his lively sexual desires were connected with this idea, lie
 
 158 PSYCHOPATH I A SEXUALIS. 
 
 sketched drawings representing correct Greek profiles of female heads, but 
 the nostrils were so large that immissio penis would have been possible. 
 
 One day, in an omnibus, he saw a girl in whom he thought he rec- 
 ognized his ideal. He followed her to her home and immediately pro- 
 posed to her. Shown the door, he returned again and again, until 
 arrested. X. never had sexual intercourse. 
 
 Hand-fetichists are very numerous. The following case is 
 not really pathological. It is given here as a transitional case : — 
 
 Case 75. B., of neuropathic family, very sensual, mentally intact. 
 At the sight of the hand of a beautiful young lady he is always charmed 
 and feels sexual excitement to the extent of ejaculation. It is his de- 
 light to kiss and press such hands. As long as they are covered with 
 gloves he feels unhappy. By pretexts he tries to get hold of such hands. 
 He is indifferent to the foot. If the beautiful hands are ornamented with 
 rings, his lust is increased. Only the living hand, not its image, causes 
 him this lustful excitement. It is only when he is exhausted sexually 
 by frequent coitus that the hand loses its sexual charm. At first the 
 memory-picture of female hands disturbed him even while at work. 
 TBinet, op. cit.) 
 
 Binet states that such cases of enthusiasm for the female 
 hand are numerous. Here it may be recalled that, according 
 to Case 24, a man may be partial to the female hand as a result 
 of sadistic impulses ; and that, according to Case 46, the same 
 thing may be due to masochistic desires. Thus such cases have 
 more than one meaning. But this is by no means to say that 
 all, or even a majority, of the cases of hand-fetichism allow or 
 require a sadistic or masochistic explanation. 
 
 The following interesting case, that has been studied in 
 detail, shows that, in spite of the fact that at first a sadistic or 
 masocliistic element seems to have exercised an influence, at the 
 time of the individual's maturity and the complete development 
 of the perversion, the latter contained nothing of these elements. 
 Of course, it is possible that, in the course of time, these disap- 
 peared ; but here the assumption of the origin of the fetichism 
 in an accidental association meets every requirement : — 
 
 Case 76. A case of hand-fetichism, communicated by Albert Moll. 
 P. L., aged 28, a merchant of Westphalia. Aside from the fact that the 
 patient's father was remarkably moody and somewhat quick-tempered, 
 nothing of an hereditary nature could be proved in the family. At
 
 FETICHISM. 159 
 
 school the patient was not very diligent; he was never able to concen- 
 trate his attention on any one subject for any length of time ; on the 
 other hand, from childhood he had a great inclination for music. His 
 temperament was always nervous. 
 
 In August, 1890, he came to me complaining of headache and 
 abdominal pain, which in every way gave the impression of being neu- 
 rasthenic. The patient also said he was destitute of energy. Only after 
 accurately directed questions did the patient make the following state- 
 ments concerning his sexual life. As far as he could remember, tlie 
 beginnings of sexual excitement occurred in his seventh year. When- 
 ever he saw a boy of his own age urinate and caught sight of his geni- 
 tals, he became lustfully excited. L. states with certainty that this 
 excitement was associated with very evident erections. Led astray by 
 another boy, L. learned to masturbate at the age of seven or eight. 
 "Being of a very excitable nature," said L., "I practiced masturbation 
 very frequently until my eighteenth year, without gaining any clear idea 
 of the evil results or the meaning of the practice." He was particular!}' 
 fond of practicing mutual onanism with i^me of his school-friends, but 
 it was by no means an indifterent matter who the other boy was ; on the 
 contrary, only a few of his companions could satisfy him in this respect. 
 To the question as to what particularly caused him to prefer this or that 
 boy, L. replied that a white, beautifully-formed hand in his school-fellows 
 impelled him to practice mutual onanism with them. L. further remem- 
 bered that frequently, at the beginning of the g3'mnastic lesson, he 
 would exercise by himself on a bar standing apart. He did this for the 
 purpose of exciting himself as much as })ossible ; and he was so success- 
 ful that, without using his hand and without ejaculation, — L. was still 
 too young, — he had lustful pleasure. Another early event which L. 
 remembers is interesting. One day his favorite companion, N., who 
 practiced mutual onanism with him. proposed that L. should try to get 
 hold of his (N.'s) penis, and he would do all he could to prevent it. L. 
 acquiesced. In this way the onanism wau directly coml»ined with a 
 struggle between both parties, in which N. was always overcome. The 
 struggle always finally ended in N.'s being compelled to allow L. to 
 practice onanism on him. L. assured me that this kind of masturbation 
 had given him, as well as N., especial pleasure.' In this way L. contin- 
 ued to practice masturbation very frequently until his eighteenth year. 
 Warned by a friend, he then began to struggle with all his might against 
 his evil habit. He became more and more successful, and finally, after 
 the first performance of coitus, he stopped the practice of onanisui 
 entirely. But this was only accomplished in his twenty -second year. It 
 now seems incomprehensible to the patient — and he says he is filled with 
 disgust at the thought of it — how he could ever have found pleasure in 
 
 1 A kind of rudimentary sadism in L. and masochism in N.
 
 160 PSYCHOPATHIA SEXUALIS. 
 
 performing masturbation witla other boys. Now, nothing could induce 
 him to touch another man's genitals, the sight of which is even unpleas- 
 ant to him. He has lost all inclination for men, and feels attracted by 
 women exclusively. 
 
 It must be mentioned, however, that, though L. has a decided 
 inclination for the female sex, he presents an abnormal phenomenon. 
 
 The essential thing in woman that excites him is the sight of her 
 beautiful hands ; L. is by far more impressed when he touches a beautiful 
 female hand than he would be were he to see its possessor in a state of 
 complete nudity. The extent to which L.'s preference for beautiful female 
 hands goes is shown by the following incident : — 
 
 L. knew a beautiful young lady possessed of every charm, but her 
 hands were quite large and not beautifully formed, and often they were 
 not as clean as L. could wish. For this reason it was not only impossible 
 for L. to conceive a deeper interest in the lady, but he was not able even 
 to touch her. L. believes that there is nothing more disgusting to him 
 than dirty finger-nails ; this alone would make it impossible for him to 
 touch a woman who in all other respects was most beautiful. L. for- 
 merly, as a substitute for coitus, had the puella perform genital manipu- 
 lation with her hand until ejaculation took place. 
 
 To the question as to what there was about a woman's hand that 
 attracted him in particular, whether he saw in it a symbol of power, and 
 whether it gave him pleasure to be directly humiliated by a woman, the 
 patient answered that only the beautiful form of the hand charmed him; 
 that it afforded him no gratification to be humiliated by a woman ; and 
 that he had never had any thought to regard the hand as the symbol or 
 instrument of a woman's power. The preference for the hand is still 
 so great that the patient has greater pleasure when his genitals are 
 touched by it than when he performs coitus in vaginam. Yet, the 
 patient prefers to perform the latter, because it seems to him to be 
 natural, while the former seems abnormal. The touch of a beautiful 
 female hand on his body immediately causes him to have erection ; he 
 thinks that kissing and other contacts do not exert nearly so strong an 
 influence. It is only of late years that the [)atient has performed coitus 
 frequently, but it has always been very ditlicult for him to determine to 
 do it. Too, in coitus, he did not find the complete satisfaction he sought. 
 However, when he finds himself near a woman whom he would like to 
 possess, sometimes, at mere sight of her, his sexual excitement becomes so 
 intense that ejaculation results. L. says expressly that during this he 
 does not intentionally touch or press his genitals ; ejaculation under such 
 circumstances affords him much more pleasure than he experiences in 
 actual coitus.^ 
 
 To go back, the patient's dreams were never about coitus. When 
 
 1 Great sexual hyperaesthesia. Comp. uote on p. 50.
 
 FETICHISM. 161 
 
 he had polhitions tit night, they were ahiiost always associated with other 
 thoughts than those that occur in the normal man. The patient's dreams 
 are of events of his school-days. During his school-days, besides the 
 mutual onanism described, he had ejaculations whenever he became 
 anxiously excited. When, for example, the teacher dictated an extem- 
 l)oraneous exercise, and Ij. w:is unable to follow in translation, ejaculation 
 often occurred. 1 The pollutions that now occur occasionally, at night, 
 are only accompanied by dreams that have the same or a simihir subject, — 
 the events at school just mentioned. On account of liis unnatural feeling 
 and sensibility, the patient thinks he is incapable of loving a Avoman long. 
 Treatment of the patient's perversion has not yet been possible. 
 
 This case of haiid-ll'ticliisin certainly does not depend on 
 masochism or sadism, but is to be explained simply by early in- 
 dulgence in mutual onanism. There is here, also, quite as little 
 of contrary sexual instinct. Before the sexual appetite was 
 clearly conscious of its object, the hands of school-fellows were 
 used. As soon as the instinct for the opposite sex Decame evi- 
 dent, the interest for the hand was transferred to woman. 
 
 In hand-fetichists, who, according to Binet, are so numer- 
 ous, it is possible that other associations lead to the same result. 
 
 Next to the hand-fetichists, naturally come the foot-fetich- 
 ists. While glove-fetichism, which belongs to tlie next group 
 of object-fetichism, seldom takes the place of hand-fetichism, we 
 find shoe- and boot- fetichism, of which there are innumerable 
 cases occurring everywhere, taking the place of enthusiasm for 
 the naked female foot. There are only here and there traces of 
 the latter enthusiasm, and these are scarcely pathological. It is 
 easy to see the reason for tliis. Th(> I'emale hand is usually seen 
 uncovered ; the foot, covered. Thus the early associations 
 which d(>termhie the direction of tlie vita sexualis are naturally 
 connected with the naked hand, but with the covered foot. 
 
 Shoe-fetichism also finds its place in the following group 
 of dress-fetichism ; however, on account of its demonstrable 
 
 ^ This is also sexual liypercesthcsia. Any intense excitement affects the sexual 
 sphere (Binet's "djnamogeuie g6nerale")- Concerning this, Dr. Moll communicates the 
 following case : " A similar thing is described by Mr. E., aged 27; merchant. While at 
 school, and afterward, he often had ejaculation with pleasurable feeling when he was 
 seized with a feeling of intense anxiety. Besides, almost every other physical or mental 
 pain exerted a similar influence. E., as he states, has a normal sexual instinct, but suffers 
 with neiTous impotence." 
 
 11
 
 162 PSYCHOPATHIA SEXUALIS. 
 
 masochistic character in the majority of cases, it has been, for 
 the most part, described already (p. 123 et seq.). 
 
 Besides the eyes, hand, and foot, the mouth and ears often 
 play the role of a fetich. Among others, Moll (oj). cit.) men- 
 tions such cases. (Comp. also Belot's romance, " La Bouche de 
 Madame X.," vvliich, B. states, rests upon actual observation.) 
 
 The following remarkable case came under my personal 
 observation : — 
 
 Case 77. A gentleman of very bad heredity consulted me concern- 
 ing impotence that was driving him almost to despair. While he was 
 young, his fetich was women of plump form. He married such a lady, 
 and was hapi)y and potent with her. After a few months the lady fell 
 very ill, and lost much flesh. When, one day, he tried to resume his 
 marital dut}', he was absolutely impotent, and remained so. If, however, 
 he attempted coitus with plump women, he was perfectly potent. 
 
 Even bodily defects may become fetiches. 
 
 Descartes, who himself (" Traite des Passions," cxxxvi) expresses 
 some opinions concerning the origin of peculiar atfections in associations 
 of ideas, was always partial to cross-eyed women, l)ecause the object of 
 his first love had such a defect. (Binet, op. cit.) 
 
 Lydston ("A Lecture on Sexual Perversion," Chicago, 1890 ^) reports 
 the case of a man who had a love-afiair with a woman whose right lower 
 extremity had been amputated. After separation from her, he searched 
 for other women with a like defect.^ — A negative fetich. 
 
 When the part of the female body forming the fetich is 
 capable of removal, like the hair, the most extravagant acts 
 may be performed. Therefore, hair-fetichists form an in- 
 teresting and forensically-important category. While such 
 admirers of female hair are probably not infrequent within 
 physiological limits, and possibly various senses (sight, smell, 
 and hearing, through crepitant sounds, — and certainly touch, 
 just as with velvet- and silk- fetichists, v. infra) are thus excited 
 with an accompaniment of lustful feeling ; yet, a series of 
 similar pathological cases has also been observed, in which the 
 hair-fetichism had become an overpowering impulse, and driven 
 
 1 Phila. Med. and Surg. Rep., Sept. 7, 1889. 
 
 2 This ease was originally reported by Dr. A. R. Reynolds, Chicago (Western Med. 
 Reporter, Nov., 1888).
 
 FETICHISM. 163 
 
 the iiulividuals to commit crimes.^' •^ These form the group of 
 hair-iU'spoilers. 
 
 Cuse IS. A hair-deapoiler. P., aged 40, artistic locksmitli, single. 
 His father was tciiii)or:irily insane, and his niotlier was very nervous. 
 He developed well, and was intelligent ; but he was early affected with 
 tics and imperative ideas. He had never masturbated. He loved pla- 
 tonically, and often busied himself with matrimonial i)lans. He hud 
 coitus infrequently^ with prostitutes, but never felt satisfied with such 
 intercourse — rather, disgusted. Three years ago he was overtaken )>y 
 misfortune (financial ruin), and, besides, he had a fel)rile disease, with 
 delirium. These things had a very bad effect on his liercditarily-[)re- 
 disposed nervous system. On August 28, 1881), P. was arrested at the 
 Trocadero, in Paris, in flagranti, as he forcibly cut off a young girl's 
 hair. He was arrested with the hair in his hand and a pair of shears in 
 his pocket. He excused himself on the ground of momentary mental 
 confusion and an unfortunate, irresistible passion; he confessed that he 
 had ten times cut olf hair, which he took great delight in keeping at 
 home. On searching his home, sixty-five switches and tresses of hair 
 were found, assorted in packets. P. had already been once arrested, on 
 December 15, 1886, under similar circumstances, but was released for 
 lack of evidence. 
 
 P. states that, for the last three years, when he is alone in his room 
 at night, he feels ill, anxious, excited, and dizzy, and then is troubled by 
 the impulse to touch female hair. When it happened that he could act- 
 ually take a young girl's hair in his hand, he felt intensely excited sexu- 
 ally, and had erection and ejaculation without touching the girl in any 
 
 1 Moll (ojj. cit., p. 181) reports: " A man, X., becomes inteusely excited sexually 
 whenever he sees a woman with the hair iu a braid ; loose hair, no matter how beautil'ul, 
 cannot produce this effect." 
 
 Of course, it is not justifiable to consider all hair-despoilers feticliists, for in a few 
 cases such acts are done for the purpose of gain,— i.e., the stolen hair is not a fetich. 
 
 2 Magnan (Arch, dc Neurologic, vol. xxxiii, No. 09, 1892) gives the details of a case 
 of sexual perversion in a degenerate individual, where the elements of fetichisin and sadism 
 were combined, and/rt?«ie de mieux the sadistic impulse found satisfaction in self-mutilation. 
 The perverse impulse began at the age of six ; the sight of a boy or girl with a delicate, 
 white skin awakened in him sexual appetite, with a desire to bite and eat a piece of the 
 skin. While caressing a horse, the impulse to bite the soft skin of its nostrils arose, and 
 afterward the memory of this became associated with the act of onanism. Later, he began 
 to prick himself with pins, knives, etc., while masturbating. The desire to bite and eat 
 skin was also provoked by the sight of shining blades, like those of scissors. He was 
 always able to resist the impulse to attack young girls ; but the struggle was hard, and for 
 eight months he hesitated before venting his passion on his own person. He Mas finally 
 arrested in the act of cutting a large piece of skin from his arm with scissors. Asked the 
 motive of his self-mutilation, he stated that for several hours he had been following a young 
 girl who had a fine, white skin, and was burning with desire to cut out a piece of it and eat 
 it. On his person there were many scars of previous mutilations. The impulse was devoid 
 of natural sexual desire. Chewing the piece of skin provoked ejaculation, — Trans.
 
 164 PSYCHOPATHIA SEXUALIS. 
 
 other way. On reaching home, he would feel ashamed of what had taken 
 place ; but the wish to possess hair, always accompanied by great sensual 
 pleasure, became more and more powerful in him. He wondered that pre- 
 viously, even in the most intimate intercourse with women, he had ex- 
 perienced no such feeling. One evening he could not resist the impulse 
 to cut off a girl's hair. With the hair in his hand, at home, the sensual 
 process was repeated, lie was forced to rub his body with the hair and 
 envelop his genitals in it. Finally, quite exhausted, he grew ashamed, 
 and could not trust himself to go out for several days. After months of 
 rest he was again impelled to possess himself of female hair, indifferent as 
 to whose it might be. If he attained his end, he felt himself possessed by 
 a supernatural power and unable to give*up his booty. If he conld not 
 attain the object of his desire, he l)ecarae greatly depressed, hurried home, 
 and there reveled in his collection of hair. He combed and fondled it, and 
 thus had intense orgasm, satisfying himself l)y masturbation. Hair ex- 
 posed in the cases of hair-dressers made no impression on him ; it required 
 hair hanging down from a female head. 
 
 At the height of his act, he states, he is in such a state of excite- 
 ment that he has only imperfect appercei)tion and snbsequent memory of 
 what he does. When he touches the hair with the shears he has erection, 
 and, at the instant of cutting it off", ejaculation. Since liis misfortune, 
 about three years ago, he states that he has had weakness of memory, is 
 easily exhausted mentally, and has been troubled by sleeplessness and 
 night-terrors. P. deeply regrets his crime. 
 
 Not only hair, but a number of hair-pins, ribbons, and other articles 
 of the feminine toilet, were found in his possession, which he had had 
 presented to him. He had always had an actual mania for collecting 
 such things, as well as newspapers, pieces of wood, and other worthless 
 trash, which he would never give up. He also had a strange and, to him, 
 inexplicable fear of passing a certain street ; if he ever tried it, it made 
 him ill. 
 
 The opinion (medico-legal) showed him to be hereditarily predis- 
 posed, and proved the imperative, impulsive, and decidedly involuntary 
 character of the criminal acts, which had the significance of an impera- 
 tive act, induced by an imperative idea, with an accompaniment of over- 
 powering abnormal sexual feeling. Pardon ; asylum for insane. (Voisin, 
 Socquet, Motet, Annales dliygiene, April, 1890.) 
 
 Following this case, is a similar one which also deserves 
 attention ; for it has been well studied, and may be called almost 
 classical ; and, too, it places the fetich, as well as tlie original 
 associative awakening of the idea, in a clear light : — 
 
 Case 79. A hair-despoiler. E., aged 25. Maternal aunt, epileptic ; 
 brother had convulsions. E. says he was fairly healthy as a child^ and
 
 FETICHISM. 165 
 
 learned quite easily. At the a.<:^e of fifteen lie had a sensual feeling of 
 pleasure, with erection, at tlie sight of one of the village beauties combing 
 her hair. Until that time persons of the opposite sex had made no impres- 
 sion on him. Two months later, iu Paris, the sight of young girls with 
 their hair llowing down over their slioulders ahvays excited him intensely. 
 One day he could not resist an opportunity to twist a young gill's hair in 
 his fingers. For this he was arrested and sentenced to imprisonment for 
 three months. After that he served five 3'ears as a soldier. During tliis 
 time hair was not dangerous for him, though also not very accessible ; but 
 he dreamed sometimes of female heads witli the hair braided or flowing. 
 Occasional coitus with women, but without having their hair effective as 
 a fetich. Once more in Paris, he again dreamed as before, and )>ecame 
 greatly excited l)y female hair. He never dreamed about the wliole form 
 of a womon, only of heads with braids of hair. His sexual excitement 
 due to this fetich had become so intense of late that he had resorted to 
 masturbation. The idea of touching female hair, or, better, of jiossessing 
 it to masturbate while hamlling it, grew more and more powerl'ul. Of late, 
 when he had female hair in his fingers, ejaculation was induced. One 
 day he succeeded in cutting hair, about 25 centimetres long, from three 
 little girls in tlie street, and keeping it in his possession, wlien he was 
 arrested in a fourth attempt. Deep regret and shame. He was not sen- 
 tenced. Since spending some time in the asylum, he has so far improved 
 that female hair no longer excites him. Set at liberty, he tliought of 
 going to his native place, where the women wear their hair done up. 
 (Magnan, Archiv. de Vanthropol. criminelle, v, Nr. 28.) 
 
 A third case is the following, which is likewise suited to 
 illustrate the psychopathic nature of such phenomena ; and the 
 remarkahle means which induced a cure are worthy of note : — 
 
 Case 80. Hair-felichiHin. Mr. X., between thirty and forty years 
 old ; from the higher class of society ; single. He says that ho comes of 
 a healthy family, but from childhood has been nervous, vacillating, and 
 peculiar ; that since his eighth year he has been powerfully attracted 
 by female hair. This was particularly true in the ca'Se of .young girls. 
 When he was nine years old, a girl of thirteen seduced him. He did not 
 understand it, and was not at all excited. A twelve-}' ear-old sister of 
 this girl also courted, kissed, and hugged him. He allowed this quietly, 
 because this girl's hair pleased him so well. When about ten years old, he 
 began to have sensual feelings at the sight of female liair that i)leased him. 
 Gradually these feelings occurred spontaneously, and memor3"-pictures 
 of girls' hair were always immediately associated with them. At the age 
 of eleven he was taught to mnsturbate by school-mates. The associative 
 connection of sexual feelings and a fetichistic idea was already established, 
 and always appeared when the patient indulged in evil practices with his
 
 166 PSYCHOPATIIIA SEXUALIS. 
 
 companions. With advancing years, the fetich grew more and more power- 
 ful. Even false hair began to excite him, but he always preferred natural 
 hair. When he could touch or kiss it, he was perfectly happy. He 
 wrote essays and poems on the beauty of female hair ; he sketched heads 
 of hair and masturbated. After his fourteenth 3'ear he became so power- 
 fully excited by his fetich that he had violent erections. In contrast with 
 his early taste while a boy, he Avas now charmed only by luxuriant, thick 
 black hair. He experienced intense desire to kiss such hair, particularly 
 to suck it. To touch such hair aflbrded him but little satisfaction ; he 
 obtained much more pleasure in looking at it, but particularly in kissing 
 and sucking it. If this were impossible, he would become unhappy, even 
 to the extent of ta^dium vitffi. Then he would attempt to relieve himself, 
 imaofinino; fantastic " hair-adventures " and masturliating. Not infre- 
 quently, in the street and in crowds, he could not keep from imprinting 
 a kiss on ladies' heads. He would then hurry home to masturbate. 
 Sometimes he could resist this impulse ; but it was then necessary for 
 him, filled with feelings of fear, to run away as quickly as possible, in 
 order to escape the domination of his fetich. He was only once im- 
 pelled to cut off a girl's hair in a crowd. In the act he was seized with 
 fear, and was not successful with his pocket-knife; and, by flight, he nar- 
 rowly escaped detection. 
 
 When he became mature, he attempted to satisfy himself in coitus 
 with puellis. He induced powerful erection by kissing the hair, but could 
 not induce ejaculation. Therefoi-e, he was unsatisfied by coitus. At the 
 same time, his favorite idea was coitus with kissing of hair; but even 
 this did not satisfy him, because it did not induce ejaculation. Faute 
 de rtiieux^ he once stole the combings of a lady's hair, put it in his mouth, 
 and masturbated while calling its owner up in imagination. In the dark 
 a woman could not interest him, because he could not then see her hair. 
 Flowing hair also had no charm for him ; nor did the hair about the 
 genitals. His erotic dreams were all about hair. Of late the patient 
 had become so excited that he had a kind of sat3a'iasis. He was incapa- 
 ble of business, and felt so unhappy that he sought to drown his sorrow 
 in alcohol. He drank large quantities, had alcoholic delirium, an attack 
 of alcoholic epilei)sy, and required hospital treatment. After the intoxi- 
 cation had passed away, under appropriate treatment, the sexual excite- 
 ment soon disappeared ; and when the patient was discharged, he was 
 freed from his fetichistic idea, save for its occasional occurrence in 
 dreams. The physical examination showed normal genitals and no 
 degenerative signs whatever. 
 
 Such cases of hair-feticliism, wliich lead to attacks on 
 female hair, seem to occur everywhere, from time to time. In 
 November, 1890, according to reports in American newspapers,
 
 FETICHISM. 167 
 
 several cities in tlie United States were troubled by such liair- 
 despoilers. 
 
 (b) The Fetich is an Article of Female Attire. — Tlie great 
 importance of adornment, ornament, and dress, in tlie normal 
 vita sexualis of man, is very generally recognized. Culture and 
 fashion^ have, to a certain extent, endowed woman with arti- 
 ficial sexual characteristics, the removal of which, when woman 
 is seen unattired, in spite of the normal sensual effect of this 
 sight, may exert an opposite influence.^ It should not be over- 
 looked that female dress often shows a tendency to emphasize 
 and exaggerate certain sexual peculiarities, — secondary sexual 
 characteristics (bosom, waist, hips). In most individuals the 
 sexual instinct awakes long before there is any possibility or op- 
 portunity of intimate intercourse, and the early desires of youth 
 are concerned with tlie ordinary appearance of the attired female 
 form. Thus it happens that not infrequently, at the beginning 
 of the vita sexualis, ideas of the persons exerting sexual charms 
 and ideas of their attire become associated. This association 
 may be lasting — tlie attired woman may be always preferred — 
 if the individuals dominated by this perversion do not in other 
 respects attain to a normal vita sexualis, and find gratification in 
 natural charms. 
 
 In psychopathic individuals, sexually hyperoesthetic, as a 
 result of this, it actually happens that tlie dressed woman is 
 always preferred to the nude female form. It may be recalled 
 that in Case 48 the woman was not to take off a garment, and 
 
 * The frequent changes of style of dress wliich fasliion dictates may be referred to a 
 physiological law. The reaction of the nervous system to a constant stinuilus diminishes 
 in proportion to the duration of the action of the stimulus. Constant association with 
 nudity removes its power to excite sexually. Owing to this, the savage endeavors to attract 
 attention by changing his physical peculiarities ; he dresses his hair in some remarkable 
 way, or paints his body ; then he tattooes his skin, or performs striking sclf-mntilation, such 
 as half-castration and circumcision (comp. Westermarck, op. cit., p. 205). Finally, muti- 
 lation is replaced by movable appendages, upon which ornaments are worn ; and thus there 
 is affoi-ded opportunity for cliant/e, in obedience to the unconscious physiological require- 
 ment, which is called a " taste for change." Undoubtedly, woman's desire for changes of 
 fashion is primarily dependent upon man's desire to be j^leased ; and her function in this 
 direction has certainly been transferred from him to her by civilization (comp. p. ](!). 
 — Trans. 
 
 2 Comp. Goethe's remarks about his adventure in Geneva (" Briefe aus der Schweiz," 
 1. Abtheil., Schluss),
 
 168 PSTCHOPATHIA SEXUALIS. 
 
 that in Case 51, equus erotlcus, the woman was preferred dressed. 
 In Case 89, of the sixth edition, — that of a man manifesting 
 contrary sexuahty, — the same preference is expressed. 
 
 Dr. Moll {ojj. cit.) mentions a patient who could not per- 
 form coitus with puella nuda ; the woman had to have on a 
 chemise, at least. The same author {pp. cit., p. 129) mentions 
 a man affected with contrary sexuality, who was suhject to the 
 same dress-fetichism. 
 
 The reason for this phenomenon is apparently to^ be found 
 in the mental onanism of such individuals. In seeing innu- 
 merable clothed forms, they have cultivated desires before seeing 
 nudity.^ 
 
 A more marked form of dress-fetichism is that in which, 
 instead of the dressed woman, a certain kind of attire becomes 
 a fetich. One can understand how, witli an intense and early 
 sexual impression, combined with the idea of a particular gar- 
 ment on the woman, in hyperoesthctic individuals, a very intense 
 interest in this garment might be developed. 
 
 Hammond (op. cit.) reports tlie following case, taken from 
 Roubaud (" Traite de I'impuissance," Paris) : — 
 
 Case 81. X., son of a general. He was raised in the coiintr3\ At 
 the age of fonrteen he was initiated into the joys of love by a yonng 
 lady. This lady was a blonde, and wore her hair in ringlets; and, in 
 order to avoid detection in sexual intercourse with her 3'Oung lover, she 
 always wore her usual clothing, — gaiters, a corset, and a silk dress. 
 
 When his studies were completed, and he was sent to a garrison 
 where he could enjoy freedom, he found that his sexual desire could be 
 excited onl}- under certain conditions. A 1)runette could not excite him 
 in the least, and a woman in night-clothes could stifle every bit of love 
 in him. In order to awaken his desire, a woman had to be a blonde, and 
 wear gaiters, a corset, and a silk dress, — in short, she had to be dressed 
 like the lady who had first awakened his sexual desire. He was always 
 compelled to give up thoughts of matrimony, because he knew he would 
 be unable to fulfill his marital duty with a woman in night-clothes. 
 
 Hammond reports another case where coitus maritalis could be 
 performed only by the help of a certain costume; and Dr. Moll mentions 
 
 1 The fact that the partly-veiled form is often more charming than when it is per- 
 fectly nude, is, as far as object goes, similar, but quite different psychically. Tliis depends 
 upon the effect of contrast and expectation, which are common phenomena, and in no 
 sense pathological.
 
 FETICHISM. 169 
 
 several similar cases in individuals of lietero- and homo- sexuality-. The 
 cause may often be shown to be an early association, and such may 
 always be assumed. It is only in this way that one can explain why a 
 certain costume cannot be resisted by such individuals, no matter what 
 person wears the fetich. Thus one can understand wh3', as Coflignon 
 (op. cit.) I'elates, men at brothels demand that the women with whom 
 they are concerned put on certain costumes, such as that of a ballet- 
 dancer, or nun, etc. ; and why these houses are furnished with a com- 
 plete wardrobe for such puri)Oses. 
 
 Binet {op. cit.) relates the case of a judge who was exclusively in 
 love with Italian girls who came to Paris as artists' models', and their 
 peculiar costume. The cause was here demonstrabl}^ an impression made 
 at the time of the awakening of the sexual instinct. 
 
 st-jf 
 
 A third form of dress-feticliism, having a much higher 
 degree of pathological significance, is by (ar tlie most frequent. 
 In this form it is no longer the woman herself, dressed, or even 
 dressed in a particular fashion, that constitutes the principal 
 sexual stimulus, but the sexual interest is so concentrated on 
 some certain article of female attire that the lustful idea of this 
 object is entirely separated from the idea of woman, and thus 
 obtains an independent value. This is the real domain of dress- 
 fetichism, where an inanimate object — an isolated article of 
 wearing-apparel — is alone used for the excitation and satisfaction 
 of the sexual instinct. This third form of dress-fetichism is 
 also the one that is important forensically. 
 
 In a large number of these cases the fetiches are articles 
 of female underwear, whicli, owing to their private use, are 
 suited to occasion such associations. 
 
 Case 82. K., aged 45, shoemaker, is reported to be without hereditary 
 taint. He is peculiar, and has small mental endowment. He is of mascu- 
 line habitus and without signs of degeneration. Previously blameless 
 in conduct, on the evening of July 5, ISVG, he was detected taking stolen 
 female under-garments from a place of concealment. There wore found 
 with him about three hundred articles of the female toilet, among them, 
 besides chemises and drawers, night-caps, garters, and a female doll. 
 When arrested he was wearing a chemise. Since his thirteenth year he 
 had been a slave to an impulse to steal women's linen ; but, after his first 
 punishment for it, he had become very careful, and stolen with refinement 
 and success. When this longing came over him, he would grow anxious, 
 and his head would become heavy. Then he could not resist the impulse,
 
 170 PSYCHOPATHIA SEXUALIS. 
 
 cost what it might. He was indifferent to the source of the articles. At 
 night, on going to bed, he would put on the stolen clothing and create 
 beautiful women in imagination, thus inducing pleasurable feeling and 
 ejaculation. This was apparently the motive of his thefts ; at least, he 
 had never disposed of any of the articles, but had hidden them here and 
 there. 
 
 He declared that, earlier in his life, he had indulged in normal sexual 
 intercourse with women. He denied onanism, pederasty, and other sexual 
 acts. He said he was engaged at twenty-five, but the engagement was 
 broken through no fault of his. He was Incapable of insight into the 
 abnormality of his condition and the wrong of his acts. (Passow, Vie?'- 
 teljahrsschrift f. ger. Medic, N. F. xxviii, p. 61 ; Krauss, " Psychologic 
 des Yerbrechens," 1884, p. 100.) 
 
 Hammond {op. cit.) reports a case of passionate interest in 
 single articles of female wearing-apparel. Here, also, the 
 patient's pleasure consisted in wearing a corset and other 
 female garments (without any traces of contrary sexual 
 instinct). The pain of tight lacing, experienced by himself 
 or induced in women, is a delight to him, — sadistic-masochistic 
 element. 
 
 A case probably belonging here is one reported by Diez 
 ('"Der Solbstmord," 1838, p. 24), where a young man could not 
 resist the impulse to tear female linen. While tearing it, he 
 always had ejaculation. 
 
 A combination of fetichism with an impulse to destroy the 
 fetich (in a certain sense, sadism with inanimate objects) seems 
 to occur quite frequently (comp. Case 98). 
 
 An article of dress, which, though it has not really a pri- 
 vate character, by its material and color, as well as by the place 
 where it is worn, recalls under-garments, and hence has sexual 
 relations, is the apron (comp. also the metonymic use of the 
 word " apron '^ for " petticoat " in the saying, " To chase every 
 apron," etc.). This explains the following case: — 
 
 Case 83. C, aged 37 ; of a badlj^ tainted family' ; of small mental en- 
 dowment ; plagiocephalic. At fifteen his attention was attracted by aprons 
 hung out to dry. He bound them about himself and masturbated behind 
 the fence. From that time he could not see aprons without repeating the 
 act. If any one — no matter whether man or woman — with an apron on 
 came near him, he was compelled to run after the person. In order to free
 
 FETICHISM. 171 
 
 him from this constant stealing of aprons, he was sent as a marine in his 
 sixteenth year. In this calling he saw no aprons, and had continnal rest. 
 When, at nineteen, he returned home, he was again compelled to steal 
 aprons, and, as a result, got into serious complications, and was several 
 times locked up. He sought to free himself of his weakness b^^ a 
 sojourn of several years in a cloister. When he came out, he was just 
 as bad as before. As a result of a new theft, he underwent a medico-legal 
 examination, and was committed to an asylum. He never stole anj'thing 
 but aprons. It was a pleasure to him to revel in the memory of the first 
 apron he ever stole. His dreams were filled with aprons. He occasion- 
 ally used the memory of his thefts to make coitus possible, or for mastur- 
 bation. (Charcot and Magnan, Arch, de neurolog., 1882, Nr. 12.) 
 
 In a case reported by Lombroso (" Amori anomali precoci nei 
 pazzi," Arch, di psich., 1883, p. 17), analogous to those of this series, a 
 boy of very l.)ad heredit}^, at the age of four, had erections and great 
 sexual excitement at the sight of 'white garments, particularly under- 
 clothing. He was lustfully excited by handling and crumpling them. At 
 the age of ten he began to masturbate at the sight of white, starched linen. 
 He seems to have been affected with moral insanity, and was executed 
 for murder. 
 
 The following case of petticoat-fetichism is combined with 
 peculiar circumstances : — 
 
 • Case 84. Z., aged 35 ; official ; the only child of a nervous mother 
 and healthy father. From childhood he was " nervous," and at the con- 
 sultation his neuropathic eyes, delicate, slender body, fine features, very 
 thin voice, and sparse growth of beard attracted attention. The patient 
 presents nothing abnormal except symptoms of slight neurasthenia. 
 Genitals and sexunl functions normal. Patient states that he has only 
 masttu'bated four or five times, and that when he was ver}' young. As 
 early as at the age of thirteen, the patient was powerfully excited sex- 
 ually l)y the sight of wet female dresses ; while the same dresses, when 
 dry, had no effect upon him. His greatest delight was to look at women 
 with wet garments in tiie rain. If he met a woman having a pleasing 
 face under sucIl circumstances, he experienced an intense feeling of lust- 
 ful })leasure, had erection, and felt impelled to perform coitus. He states 
 that he has never had any desire to wet female dresses or to throw water 
 on women. He can give no ex])lanation of the origin of his peculiarity. 
 It is possible that, in this case, the sexual instinct was first awak- 
 ened b}^ the sight of a woman as she exposed her charms by raising lier 
 skirts in wet weather. The obscure instinct, not yet conscious of its 
 object, then became directed to the wet garments, as in other cases. 
 
 Lovers of female handkerchiefs are frequent, and, there-
 
 172 PSYCHOPATHIA SEXUALIS. 
 
 fore, im[)ortaut foreiisically. As to the frequency of liandker- 
 eliief-feticliism, it may be remarked that the handkerchief is the 
 one article of feminine attire which, outside of intimate associa- 
 tion, is most frequently displayed, and which, with its warmth 
 from the person and specific odors, may by accident fall into the 
 hands of otliers. The frequency of early association of lustful 
 feelings with the idea of a handkerchief, which may always be 
 presumed to have occurred in such cases of fetichism, probably 
 is due to this. 
 
 Case 85. A baker's assistant, aged 32, single, previously of good 
 repute, was discovered stealing a handkerchief from a lad3\ In sincere 
 remorse, he confessed that he had stolen from eighty to ninetj^ such hand- 
 kerchiefs. He had cared only for handkerchiefs, and, indeed, only for 
 those belonging to young women attractive to him. In his outward appear- 
 ance the culprit presents nothing peculiar. He dresses himself with much 
 taste. His conduct is peculiar, anxious, depressed, and unmanly, and he 
 often lapses into whining and tears. Lack of self-reliance, weakness of 
 comprehension, and slowness of perception and reflection, are noticeable. 
 One of his sisters is epileptic. He lives in good circnmstances ; was 
 never severely sick ; developed well. In relating his history, he shows 
 weakness of memory and lack of clearness ; calculation is hard for him, 
 though when young he learned and comprehended easily. His anxiousr, 
 uncertain state of mind gives rise to a suspicion of onanism. The culprit 
 confessed that he had been given to this practice excessively since his 
 nineteenth j^ear. For some years, as a result of his vice, he had suffered 
 with depression, lassitude, trembling of the limbs, pain in the back, and 
 disinclination for work. Frequently a depressed, anxious state of mind 
 came over him, in which he avoided people. He had exaggerated, fan- 
 tastic notions about the results of sexual intercourse with women, and 
 could not bring himself to indulge in it. Of late, however, he had thought 
 of marriage. AVith great remorse and in a weak-minded wa}^, X. now 
 confessed that six months before, while in a crowd, he became violently 
 excited sexually at the sight of a pretty young girl, and was compelled to 
 crowd up against her. He felt an impulse to compensate himself for the 
 want of a more complete satisfaction of his sexual excitement, by stealing 
 her handkerchief. Thereafter, as soon as he came near attractive females, 
 with violent sexual excitement, palpitation of the heart, erection and 
 impetus coeundi^ the impulse would seize him to crowd up against them 
 a\\(\,faule de mieux^ steal their handkerchiefs. Although the conscious- 
 ness of his criminal act never left him for a moment, he was unable to 
 make any resistance to the impulse. During the act he felt an anxiety 
 which was in part due to his inordinate sexual impulse, and partly to the
 
 FETICHISM. 173 
 
 fear of detection. The medico-legal opinion riglitly gave weight to the 
 congenital mental enfeeblement and tlie pernicious influence of masturba- 
 tion, and referred the abnormal imi)ulses to a perverse sexual impulse, 
 calling attention to the presence of an interesting and well-known })hysio- 
 logical connection between tlie olfactory and sexual senses. The iiial)ility 
 to resist the pathological impulse was recognized. X. was not punished. 
 (Zippe, W'iene?- Med. Wochenschrift, 1879, Nr. 23.) 
 
 I am indebted to the kindness of Dr. Fritscli, of Vienna, 
 for further facts concerning tliis liandkercliief-fetichist, who was 
 again arrested in August, 1890, in tlie act of taking a handker- 
 chief from a kidy's pocket : — 
 
 On searching his house, four hundred and forty-six ladies' handker- 
 chiefs were found. Hi3 stated that he had bui'ued besides two bundles 
 of them. In the course of the examination, it was further shown that 
 X. had been })unished with imprisonment for fourteen days, in 1883, for 
 stealing twenty-seven handkerchiefs, and again with imprisonment for 
 three weeks, in 1886, for a similar crime. Concerning his relatives, nothing 
 more could be learned than that his lather was subject to congestions, 
 and that a brother's daughter was weak-minded and constitutionally neuro- 
 pathic. X. had married in 1879, and embarked in an independent business, 
 and in 1881 he made an assignment. Soon after that, his wife, who could 
 not live with him, and with whom he did not perform his marital duty 
 (denied by X.), demanded a divorce. Thereafter he lived as assistant baker 
 to his brother. He complained bitterly of an impulse for ladies' handker- 
 chiefs, but when opportunity olfered, unfortunately, he could not resist it. 
 In the act he experienced a feeling of delight, and felt as if some one were 
 forcing him to it. Sometimes he could restrain himself, but, when the 
 lady was pleasing to him, he yielded to the lirst impulse. He would be 
 wet with sweat, partly from fear of detection, and partly on account of 
 the impulse to perform the act. He says he has been sensually excited, 
 by the sight of handkerchiefs belonging to women, since puberty. He 
 cannot recall the exact circumstances of this fetichistic association. The 
 sensual excitement, occasioned by the sight of a lady with a handkerchief 
 hanging out of her pocket, had constantly increased. This had repeatedly 
 caused erection , but never ejaculation. After his twenty-first year, he says, 
 he had inclination to normal sexual indulgence, and had coitus without 
 difficulty without ideas of handkerchiefs. With increasing fetichism, the 
 appropriation of handkerchiefs had afforded him much more satisfaction 
 than coitus. The appropriation of the handkerchief of a lady attractive 
 to him was the same to him as intercourse with her would have been. In 
 the act he had true orgasm. 
 
 If he could not gain possession of the handkerchief he desired, he
 
 174 PSTCHOPATHIA SEXUALIS. 
 
 would become painfully excited, tremble, and sweat all over. He kept 
 separate the handkerchiefs of ladies particularly pleasing to him, and 
 reveled in the sight of them, taking great pleasure in it. The odor of 
 them also gave him great delight, though he states that it was really the 
 odor peculiar to the linen, and not the perfume, which excited him sen- 
 sually. He had masturbated but very seldom. 
 
 X. comj)laiued of no physical ailments except occasional headache 
 and vertigo. He greatly regretted his misfortune, his abnormal impulse, — 
 the evil spirit that impelled him to such criminal acts. He had but one 
 wish : that some one might help him. Objectively there are mild neuras- 
 thenic symptoms, anomalies of the distribution of blood, and unequal 
 pupils. 
 
 It was proved that X. had committed his crimes in obedience to an 
 abnormal, irresistible impulse. Pardon. 
 
 Such cases of handkerchief-fetichism, where an abnormal 
 mdividual is driven to tlieft, are very numerous. They also 
 occur in combination with contrary sexuahty, as is proved by 
 the following case, which I borrow from page 125 of Dr. Moll's 
 Irequently-cited work ^ : — 
 
 Case 86. Handkei' chief -fetichism in a Case of Contrary Sexual 
 Instinct. — K., aged 38 ; mechanic ; a powerfully built man. He makes 
 numerous complaints, — weakness of the legs, pain in the back, headache, 
 want of pleasure in work, etc. The complaints give the decided impres- 
 sion of neurasthenia with tendency to hy})ochondria. Only after the 
 patient had been under my treatment several months did he state that he 
 was also abnormal sexually. 
 
 K. had never had any inclination whatever for women ; but hand- 
 some men, on the other hand, had a peculiar charm for him. Patient 
 had masturbated frequently until he came to me. He had never prac- 
 ticed mutual onanism or pederasty. He did not think that he would 
 have found satisfaction in this, because, in spite of his preference for 
 men, an article of white linen was his chief charm, though the beauty 
 of its owner played a role. The handkerchiefs of handsome men particu- 
 larly excite him sexually. His greatest delight is to masturbate m men's 
 handkerchiefs. For this reason he often took his friend's handkerchiefs. 
 
 ^ On page 134 {op. cit.) Dr. Moll writes concerning this impulse in hetero-sexual 
 individuals : " The passion for handkerchiefs may go so far that the man is entirely under 
 their control. A woman tells me : ' I know a certain gentleman, and when I see liim at a 
 distance I only need to draw out my handkerchief so that it peeps out of my pocket, and I 
 am certain that he will follow me as a dog follows its master. Go where I please, this gen- 
 tleman will follow me. He may be riding in a carriage or engaged in important business, 
 and yet, when he sees my handkerchief he drops everything in order to follow me, — i.e., my 
 handkerchief.' "
 
 FETICHISM. 175 
 
 In order to save himself from detection, he always left one of his own 
 handkerchiefs with his friend in place of the one he stole. In tliis way 
 he sought to escape the suspicion of theft, by creating the ap[)earance of 
 a mistake. Other articles of men's linen also excited K. sexually, but 
 not to the extent handkerchiefs did. 
 
 K. had often performed coitus with women, having erection and 
 ejaculation, but without lustful pleasure. There was also nothing which 
 could stimulate the patient to the performance of coitus. Erection and 
 ejaculation occurred only when, during the act, he thought of a man's 
 handkerchief; and this was easier for the patient when he took a friend's 
 handkerchief with him, and had it in his hand during coitus. In accord- 
 ance with his sexual perversion, in his nightly pollutions with lustful 
 ideas, men's linen played the principal I'ole. 
 
 It is possible that, in this interest in (used) handkerchiefs, 
 elements of feeling in the sense of masochism, group " c." are also 
 often at work. 
 
 Still far more frequent than the fetichism of linen garments 
 is that of women's shoes. These cases are, in fact, almost 
 innumerable, and a great many of them have been scicnitifically 
 studied; but I have but a few reports at second hand of the 
 similar glove-fetichism (concerning the reason for the relative 
 infrequency of glove-fetichism, vide p. 161). 
 
 In shoe-fetichism the close relationship of the object to tlie 
 feminine person, which explains linen-fetichism, is absolutely 
 wanting. For this reason, and because there is a large number 
 of well-observed cases at hand, in which the fetichistic enthusi- 
 asm for the female shoe or boot consciously and undoubtedly 
 arises from masochistic ideas, an origin of a masochistic nature, 
 even when it is concealed, may always be assumed in shoe- 
 fetichism, when, in the concrete case, no other manner of origin 
 is demonstrable. For this reason the majority of the cases of 
 shoe- or foot- fetichism have been given under " Masochism." 
 There the constant masochistic character of this form of erotic 
 fetichism has been sufficiently demonstrated by means of tran- 
 sitional conditions. This presumption of the masochistic char- 
 acter of shoe-fetichism is weakened and removed only where 
 another accidental cause for an association between sexual 
 excitation and the idea of women's shoes — the occurrence of 
 which is quite improbable a priori — is demonstrable. In the
 
 176 PSYCHOPATHIA SEXUALIS. 
 
 two following cases, however, there is such a demonstrable 
 connection : — 
 
 Case 87. Shoe-feticnism. Mr. v. P., of an old and honorable fam- 
 ily, Pole, aged 32, consulted me, in 1890, on account of " unnaturalness " 
 of his vita sexualis. He gave the assurance that he came of a perfectly 
 healthy family. He had been nervous from childhood, and had suffered 
 with chorea minor at the age of eleven. For ten years he had suftered 
 with sleeplessness and various neurasthenic ailments. From his fifteenth 
 year he had recognized the ditference of the sexes and been capable of 
 sexual excitation. At the age of seventeen he had been seduced by a 
 French governess, but coitus was not permitted ; so that intense mutual 
 sensual excitement (mutual masturbation) was all that was possible. In 
 this situation his attention was attracted by her very elegant boots. 
 They made a very deep impression. His intercourse with this lewd 
 person lasted four months. During this association her shoes became a 
 fetich for the unfortunate boy. He began to have an interest in ladies' 
 shoes in general, and actually went about trying to catch sight of ladies 
 wearing pretty l)Oots. The shoe-fetichism gained great power over his 
 mind. He had the governess touch his penis with her shoes, and thus 
 ejaculation with great lustful feeling was immediately induced. After 
 separation from the governess, he went to puellis, whom he had perform 
 the same mani})ulation. This was usually sufficient for satisfaction. 
 Only seldom did he resort to coitus as an auxiliary, and inclination for 
 it grew less and less. His vita sexualis consisted of dream-pollutions, 
 in which women's shoes played the exclusive role ; and of gratification 
 with women's shoes apposita ad mentulam, but this had to be done by 
 the puella. In the society of the opposite sex the only thing that in- 
 terested him was the shoe, and that only when it was elegant, of the 
 French style, with heels, and of a brilliant black, like the original. 
 
 In the course of time the following conditions have become acces- 
 sory : A {)rostitute's shoe that is elegant and chic ; starched petticoats, 
 aud black hose, if possible. Nothing else in woman interests him. He 
 is absolutely indifferent to the naked foot. Women have not the slightest 
 mental charm for him. He had never had masochistic desires, in the 
 sense of being trod upon. In the course of years his fetichism had 
 gained such power that when he saw a lady on the street, of a certain 
 appearance and with certain shoes, he was so intensely excited that 
 he had to masturbate. Slight pressure on the penis suflSced to induce 
 ejaculation, in his state of severe neurasthenia. Shoes displayed in 
 shops, and, of late, even advertisements of shoes, sufficed to excite him 
 intensely. In states of intense libido he made use of onanism, if slioes 
 were not at his immediate command. The patient quite early recog- 
 nized the pain and danger of his condition, and, even when he was free 
 from neurasthenic ailments, he was morally very much depressed. He
 
 FETICHISM. 177 
 
 sought help of various physicians. Cohl-water cures and hypnotism 
 were unsuccessful. The most celebrated physicians advised him to 
 marry, and assured him that, as soon as he once really loved a girl, he 
 would be free from his fetichism. The patient had no confidence in his 
 future, but he followed the advice of the physicians. He was cruelly 
 disappointed in the hope which the authority of the physicians had 
 aroused in him, though he led to the altar a lady distinguished by both 
 mental and i)liysical charms. The wedding-night was terrible; he felt 
 like a criminal, and did not approach his wife. The next day he saw a 
 prostitute with the required chic. lie was weak enough to have inter- 
 course with her in his way. Then he bought a pair of elegant ladies' 
 boots, and hid them in bed, and, by touching them, while in marital 
 embrace, after a few days, he was able to perform his H)arital duty. He 
 ejaculated tardily, for he had to force himself to coitus ; and, after a few 
 weeks, this artifice ftiiled, because his imagination failed. He felt 
 unspeakably miserable, and would have preferred to make an end of 
 himself. He could 'no longer satisfy his wife, who was sensual, and 
 much excited by their previous intercourse; and he saw her suffering 
 severely, both mentally and morally. He could not, and would not, dis- 
 close his secret. He experienced disgust in marital intercourse; he felt 
 afraid of his wife, and feared the coming of night and being alone with 
 her. He could no longer induce erection. 
 
 He again made attempts with prostitutes, and satisfied himself by 
 touching their shoes. Then the puella had to touch his penis, when he 
 would have ejaculation ; but, if this did not take place, he would 
 attempt coitus with the lewd woman ; without success, however, for 
 ejaculation would occur immediately. In absolute despair, the patient 
 comes for consultation. He deeply regretted that, against his inner 
 conviction, he had followed the unfortunate advice of the physicians, 
 and made a virtuous wife unhappy, having deeply injured her, both 
 mentally and morally'. Could he answer God for continuing such a 
 marriage? Even if he were to discover himself to his wife, and she 
 were to do everything for him, it would not help him; for the familiar 
 perfume of the demi-monde was also necessary. 
 
 Aside from his mental pain, this unfortunate man presented no 
 remarkable symptoms. Genitals perfectly normal. Prostate somewhat 
 enlarged. He complained that he was so under the domination of his 
 boot-ideas that he would even blush when boots were talked about. His 
 whole imagination was given up to such ideas. When he was on his 
 estate, he often suddenly had to go a distance of ten miles to the city, 
 to satisfy his fetichism with shoe-stores or with puellis. 
 
 This pitiable man could not bring himself to take treatment ; for 
 his faith in physicians had been greatly shaken. An attempt to ascer- 
 tain whether hypnosis and a removal of the fetichistic association by 
 this means, were possible, increased the mental excitement of the unfor-
 
 178 PSYCHOPATHIA SEXUALIS. 
 
 tuiiate man, who was exclusively controlled by the thought that he had 
 made his wife unhappy. 
 
 Case 88. X., aged 24, from a badly-tainted family (mother's brother 
 and grandfather insane, one sister epileptic, another sister subject to 
 migraine, parents of excitable temperament). During dentition he had 
 had convulsions. At the age of seven he was tauglit to masturbate by 
 a servant-girl. X. first experienced pleasure in these manipulations 
 when this girl occasionally stroked his penis with he?' foot with her shoe 
 on. Thus, in the predisposed bo^^ an association was established, as a 
 result of which, from that time on, merely the sight of women's shoes, 
 and, finall}^, merely the idea of them, sufficed to induce sexual excite- 
 ment and erection. He now masturbated while looking at women's 
 shoes, or while calling them up in imagination. At school the teacher's 
 shoes excited him intensely', and in general he was aff"ected by shoes that 
 were partly concealed by female garments. One day he could not keep 
 from grasping the teacher's shoes, — an act that caused him great sexual 
 excitement. In spite of punishment he could not keep from performing 
 this act repeatedly. Finally, it was recognized that there must be an 
 abnormal motive in play, and he was sent to a male teacher. He then 
 reveled in the memory of shoe-scenes with his former school-mistress, 
 and thus had erections, orgasm, and, after his fourteenth 3'ear, ejacula- 
 tion. At the same time, he masturbated while thinking of a woman's 
 shoe. One day the thought came to him to increase his pleasure b}' 
 using such a shoe for masturbation. Thereafter he freq[uently took 
 shoes secretly, and used them for that purpose. 
 
 Nothing else in a woman could excite him ; the thought of coitus 
 filled him with horror. Men did not interest him in any way. At the 
 age of eighteen he opened a general store, and, among other things 
 handled ladies' shoes. He was excited sexually by fitting shoes for his 
 female patrons, or by manipulating shoes that the}- had worn. One day, 
 while doing this, he had an epileptic attack, and, soon after, another, 
 while practicing onanism in his customar>' ^vay. Then he recognized, 
 for the first time, the injury to health caused by his sexual practices. 
 He tried to overcome his onanism, sold no more shoes, and strove to 
 free himself from the abnormal association between women's shoes and 
 the sexual function. Then frequent pollutions, with erotic dreams 
 about shoes, occurred, and the ejjileptic attacks continued. Though 
 devoid of the slightest feeling for the female sex, he determined on 
 marriage, Avhich seemed to him to be the only remedy. 
 
 He married a pretty young lady. In spite of lively erections 
 when he thought of his wife's shoes, in attempts at cohabitation he was 
 absolutely impotent ; for his distaste for coitus, and for close intercourse 
 in general, was far more powerful than the influence of the shoe-idea, 
 which induced sexual excitement. On account of his impotence, the 
 patient applied to Dr. Hammond, who treated his epilepsy with bromides,
 
 FETICHISM. 179 
 
 and advised bim to hang a shoe up over his bed, and looiv at it fixedly 
 during coitus, at the same time imagining his wife to be a slioe. The 
 patient became free from epile[)tic attacks, and potent so that lie could 
 have coitus about once a week. Too, his sexual excitation by women's 
 shoes grew less and less. (Hammond, " Sexual Impotence.") 
 
 Following these two cases of slioe-l'eticliism, which appar- 
 ently depend merely upon accidental association, and are not 
 favored by any inner relation between the things themselves, is 
 given the very strange case of a fetichist who was excited sexu- 
 ally only by the idea of a night-cap on the head of an ugly 
 old woman ; also a case arising apparently from merely 
 accidental association : — 
 
 Case 89. L., aged 3T, clerk, from tainted family, had his first erec- 
 tion at five years, when he saw his bed-fellow — an aged relative — put on 
 a night-cap. The same thing occurred later, when he saw an old servant 
 put on her night-cap. Later, simi)ly the idea of an old, ugly woman's 
 head, covered with a night-cap, was sufficient to cause an erection. 
 Simply the sight of a cai), or of a naked woman or man, made no im[)res- 
 sion, but the mere touch of a night-cap induced erection, and sometimes 
 even ejaculation. L. was nota masturbator,and had never been sexually 
 active until his thirty-second year, when he married a young girl with 
 whom he had fallen in love. On his marriage-night he remained cold 
 until, from necessit}^ he brought to his aid the memory-[)icture of an 
 ugly woman's head with a night-cap. Coitus was innned lately suc- 
 cessful. Thereafter it was always necessar}^ for him to use this means. 
 Since childhood he had been subject to occasional attacks of depression, 
 with tendency to suicide, and now and then to frightful hallucinations 
 at night. When looking out of windows, he became dizzy and anxious. 
 He was a perverse, peculiar, and easily embarrassed man, of bad mental 
 constitution. (Charcot and Magnan, Arch, de neural., 1882, No. 12.) 
 
 In this very peculiar case, the simultaneous coincidence of 
 the first sexual excitation and an absolutely heterogeneous 
 impression seems to have determined the association. 
 
 Hammond (o/>. cit.) also mentions a case of accidental 
 associative fetichism that is quite as peculiar. A married man, 
 aged 30, who, in other respects, was healthy, physically and 
 mentally, is said to have suddenly lost his sexual power, after 
 moving to another house, and to have regained it as soon as the 
 furniture of the sleeping-room had been arranged as it was 
 before.
 
 180 PSTCHOPATHIA SEXUALIS. 
 
 (c) Tlie Fetich is Some Special Material. — There is a third 
 principal group of fetichists who have as a fetich neither a por- 
 tion of the female body nor a part of female attire, but some 
 particular material which is so used, not because it is a material 
 for female garments, but because in itself it can arouse or in- 
 crease sexual feelings. In many cases of this kind, the act of 
 feeling of such material during the sexual act seems indis- 
 pensable, in order to make the latter possible, or at least satis- 
 factory. Such materials are furs, velvet, and silk. 
 
 These cases differ from the foregoing instances of erotic 
 dress- fctichism, in that these materials, unlike female linen, do 
 not liave any close relation to the female body ; and, unlike 
 shoes and gloves, they are not related to certain parts of the 
 person whicli have peculiar symbolic significance. Moreover, 
 this fetichism cannot be due to an accidental association, like 
 that in the cases of the night-caps and the arrangement of the 
 sleeping-room ; for these cases form an entire group liaving the 
 same object. It must be presumed that certain tactile sensa- 
 tions (a kind of tickling wliicli stands in some distant relation 
 to lustful sensations]), in hyper^esthetic individuals, furnish the 
 occasion for the origin of this fetichism. 
 
 The following is a personal observation of a man affected 
 with this peculiar fetichism : — 
 
 Case 90. N. N., aged 37 ; of a neuropathic femil}^ ; neuropathic 
 constitution. He makes the following statement : " From my earliest 
 youth I have always had a deeply -rooted partialit}^ for furs and velvet, in 
 that these materials cause me sexual excitement, and the sight and touch 
 of them give me lustful pleasure. I can recall no event that caused this 
 peculiarity (such as the simultaneous occurrence of the first sexual ex- 
 citation and an impression of these materials, — i.e., first excitation by a 
 woman dressed in them) ; in fact, I cannot remember when this enthusiasm 
 began. However, by this I would not exclude the possibility of such an 
 event, — of an accidental connection in a first impression and consequent 
 association ; but I think it verj' improbable that such a thing took place, 
 because I believe such an occurrence would have deepl}' impressed me. All 
 I know is, that even when a small child I had a lively desire to see and 
 stroke furs, and thus had an obscure sensual pleasure. With the first 
 occurrence of definite sexual ideas,— -i.e., the direction of sexual thoughts to 
 woman, — the peculiar preference for women dressed in such materials was
 
 FETICH ISM. 181 
 
 present. Since then, up to mnturo mnnliood, it has remn,ine<l unchanged. 
 A woman wearing furs or velvet, or, l)etter, both, excites me much more 
 quickly and intensely than one devoid of these auxiliaries. To be sure, 
 these materials are not a conditio sine qua non of excitation ; the desire 
 occurs also without them, in response to the usual stimuli ; but the sight 
 and, particularly, the touch of these fetich-materials form for me a 
 powerful aid to other normal stimuli, and intensify erotic pleasure. Often 
 merely the sight of only a passably pretty girl, dressed in these materials, 
 causes me lively excitement, and overcomes me completely. Even the 
 sight of my fetich-materials gives me pleasure, but the touch of tiiem 
 much more. (To the penetrating odor of furs I am indilferent — rather, 
 it is unpleasant — and it is endural)le only b}^ reason of the association 
 with pleasing visual and tactile impressions.) I have an intense longing 
 to touch these materials while on a woman's person, to stroke and kiss 
 them, and bury my face in them. My greatest pleasure is, inter actum, 
 to see and feel my fetich on the woman's shoulder. 
 
 " Fur, or velvet alone, exerts on me the effect described, the former 
 much more intensely than the latter. The combination of the two has 
 the most intense effect. Too, female garments of velvet and fur, seen and 
 touched without the wearer, cause me sexual excitement ; indeed, though 
 to a less extent, the same effect is exerted by furs or robes having no 
 relation to female attire, and also by the velvet and plush of furniture 
 and drajiery. Merely i)ictures of costumes of furs and velvet are ol)jects 
 of erotic interest to me ; indeed, simply the word " fur " has a magic charm 
 for me, and immediately calls up erotic ideas. 
 
 " Fur is such an ol)ject of sexual interest for me that a man wearinsf 
 fur that is effective (o. infra) makes a very unpleasant, repugnant, and 
 disgusting impression on me; such as would be made on a normal person 
 by a man in the costume and attire of a ballet-dancer. Similarly repug- 
 nant to me is the sight of an old or ugly woman clad in beautiful furs; 
 because opposing feelings are thus aroused. 
 
 " This erotic delight in furs and velvet is something entirely differ- 
 ent from simple aesthetic pleasure. I have a very lively appreciation of 
 beautiful female attire, and, at the same time, a particular partiality for 
 point-lace; Imt it is purely of an ivsthetic nature. A woman dressed in 
 a point-lace loilct/e (or in other elegant, elaborate attire) is more beautiful 
 than anotlier; but one dressed in my fetich-material is more charming. 
 
 " But furs exercise on me the effect descril>ed only when the fur has 
 very thick, fine, smooth, and rather long hair, that stands out like that of 
 the so-called bearded furs. I have noticed that the effect depends upon 
 this. I am entirely indifferent not only to the common coarse, bushy 
 furs, l>ut also to those that are commonl}' regarded as beautiful and 
 precious, from which the long hair has been removed (seal, beaver), or 
 of which the hair is naturally short (ermine) ; and likewise to those of 
 which the hair is over-long and lies down (monkey, bear). The specific
 
 182 PSYCHOPATHIA SEXUALIS. 
 
 effect is exerted onlj^ l)y tbe standing long liair of the sable, marten, 
 skunk, etc. But velvet is made of thick, fine, standing hairs (fibres) ; 
 and its effect may be due to this. The effect seems to depend upon a 
 very definite imj^ression of the points of thick, fine hair upon the end- 
 organs of the sensory nerves. 
 
 " But how this peculiar impression on the tactile nerves is related to 
 sexual instinct is a perfect enigma to me. The fact is, that this is the 
 case with many men. I would also state expressly that beautiful female 
 hair pleases me, but plays no more important part than the other charm ; 
 and that while touching fur I have no thought of female hair. The tac- 
 tile sensation, also, has not the least resemblance to that imparted by 
 female hair. There is never association of any other idea. Fur, per se, 
 arouses sensuality in me, — how, I cannot explain. 
 
 " The mere aesthetic effect, the beauty of costly furs, to which every 
 one is more or less susceptible; which, since Raphael's Fornarina and 
 Reuben's Helene Fourment, has been used as the foil and frame of 
 female beauty by innumerable painters; and which plays so imi>ortant a 
 role in fiishion, — the art and science of female dress, — this aesthetic effect, 
 as has been remarked, explains nothing here. Beautiful furs have the 
 same aesthetic effect on me as on normal individuals, and aftect me in the 
 same way that flowers, ribbons, precious stones, and other ornaments 
 affect every one. Such things, when skillfully used, enhance female 
 beauty, and thus, under certain circumstances, may have an indirect sen- 
 sual effect. They never have a direct, powerful, sensual effect on me, as 
 do the fetich-maferials mentioned. 
 
 '' Though in me, and, in fact, in all ' fetichists,' the sensual and aes- 
 thetic effect must be strictly dift'erentiated, nevertheless, that does not 
 prevent me from demanding in my fetich a whole series of aesthetic qual- 
 ities in form, style, color, etc. I could give a very lengthy description 
 of these qualities that my taste demands ; but I omit it as not ])eing 
 essential to the real subject in hand. I would onlj- call attention to the 
 fact that erotic fetichism is complicated with purely aesthetic tastes. 
 
 " The specific erotic effect of my fetich-materials can be explained no 
 better by the association with the idea of the person of the female wear- 
 ing them, than by their resthetic impression. For, in the first place, as 
 has been said, these materials, as such, affect me when entirely isolated 
 from the body ; and, in the second place, articles of clothing of a much 
 more private nature, and which undoubtedl}' call up associations, exert a 
 much weaker influence over me. Thus the fetich-materials have an inde- 
 pendent sensual value for me ; why, is an enigma to me. 
 
 " Feathers in women's hats, fans, etc., have the same erotic fetichistic 
 effect on me as furs and velvet (similar tactile sensation of airy, peculiar 
 tickling). Finally, the fetichistic effect, with much less intensity, is 
 exerted b}' other smooth materials (satin and silk) ; but rough goods 
 (cloth, flannel) have a repelling effect.
 
 FETICH ISM. 183 
 
 " In conclusion, T will mention that somewhere I read an article by- 
 Carl Vogt on mierocei)halic inoii, aceortlin<i; to which these creatures, at 
 the sight ol' fnrs, rushed for them and stroked them with every manil'es- 
 tation of delight. I am far from any thought, on this ground, to see in 
 wide-spread fur-fetichism an atavistic retrogression to the taste of our 
 hairy ancestors. Every cretin, with that simplicity belonging to his con- 
 dition, touches anj^thing that pleases him ; and the act is not necessarily 
 of a sexual nature; just as many normal men like to stroke a cat and 
 the like, or even velvet and furs, and are not thus excited sexually." 
 
 In the literature of this suhject, tliere are a few cases 
 belonging here : — 
 
 Case 91. A boy, aged 12, became powerfully excited sexually when 
 he chanced to put on a I'ox-skin. From that time there was masturl)ation 
 with the employment of furs, or by means of talcing a furry dog to bed. 
 Ejaculation would I'esult, sometimes followed by an hysterical attack. 
 His nocturnal pollutions were induced by dreaming tliat he lay entirely 
 covered up in a white skin. He was absolutely insusceptible to stimuli 
 coming from men or women. He was neurasthenic, suffered with delu- 
 sions of being watched, and thought that every one noticed his sexual 
 anomaly. He had tjiedium vit» on account of this, and fnially became 
 insane. He had marked taint ; his genitals were imperfectly formed, and 
 he presented otlier signs of degeneration. (Tarnowskj^, op. cit., p. 22.) 
 
 Case 92. C. is an especial lover of velvet. He is attracted in a 
 normal wa}' by beautiful women, but it particularly excites him to have 
 the person with whom he has sexual intercourse dressed in velvet. In 
 this, it is remarkable that it is not so much the sight as the touch of the 
 velvet that causes the excitation. C. told me that stroking a woman's 
 velvet jacket would excite him sexually to an extent scarcely possible in 
 any other vfny. (Dr. Moll, op. cit., p. 127.) 
 
 The following is a very peculiar case of material-fetichism. 
 It is combined with the impulse to iujurc the fetich, which, in 
 this case, represents an element of sadism toward the woman 
 wearing the fetich, or impersonal sadism toward objects, which 
 is of frequent occurrence in fetichists (comp. p. 170). This 
 impulse to injure made this a remarkable criminal case : — 
 
 Case 93. In July, 1891, Alfred Bachmann, aged 25, locksmith, was 
 brought before Judge I., in the second term of the criminal court, in 
 Berlin. In April, 1891, the police had had numerous complaints, accord- 
 ing to which some evil hand had cut women's dresses witli a very sharp 
 instrument. On April 25, they were successful in arresting the perpe-
 
 184 PSYCHOPATIIIA SEXUALIS. 
 
 trator in the person of the accused. A policeman noticed how the ac- 
 cused pressed, in a remarkable manner, against a lady in the company of 
 a gentleman, while they were going through a passage. The officer 
 requested the lady to examine her dress, while he held the man under 
 suspicion. It was ascertained that the dress had received quite a long 
 slit. The accused was taken to the station, where he was examined. 
 Besides a sharp knife, which he confessed he used for cutting dresses, 
 two silk sashes, such as ladies wear on their dresses, were found on him ; 
 he also confessed that he had taken these from dresses in crowds. Finally, 
 the examination of his person brought to light a lady's silk neck-cloth. 
 The accused said he had found this. Since his statement in this case 
 could not be refuted, complaint was therefore made to rest on the result 
 of the search ; in two instances in which complaint was made b}" the 
 injured parties his acts were designated as injury to property, and in two 
 other instances as theft. The accused, a man who had been often pun- 
 ished before, with a pale, expressionless face, before the judge, gave a 
 strange explanation of his enigmatical action. A major's cook had once 
 thrown him down-stairs when he was begging of her, and since that time 
 he had entertained great hatred of the whole female sex. There was a 
 doubt about Ws res})onsibility, and he was therefore examined by a phy- 
 sician. The medical expert gave the opinion, at the final trial, that there 
 was no reason to regard the accused as insane, though he was of low 
 intelligence. The culprit defended himself in a peculiar manner. An 
 irresistible impulse forced him to approach women wearing silk dresses. 
 The touch of silk material gave him a fceli^ig of delight, and tlui^ yvent 
 so far that, while in prison for examination, he had been excited if a silk 
 thread happened to pass through his fingers while raveling rags. Judge 
 Miiller considered the accused to be simply a dangerous, vicious man, 
 who should be made harmless for a long time. He advised imprison- 
 ment for one year. The court sentenced him to six months' imprisonment, 
 with loss of honor for a j-ear. 
 
 The following case was communicated to me by a phy- 
 sician : — 
 
 In a brothel a certain man was known by the name of " Velvet." 
 He dressed a puella pleasing to him in a black velvet dress, and excited 
 and satisfi6<,|, his sexual appetite simply by stroking his face with a part 
 of tlie velvet skirt, touching the woman in no other way, 
 
 I am assured by an officer that, among masochists, a 
 partiality for furs, velvet, and feathers, is very frequent (comp. 
 Case 44). In the novels of Sacher-Masoch, fur plays an im- 
 portant part ; indeed, it furnishes a title to some of them. The 
 explanation given there seems far-fetched and unsatisfactory, —
 
 HOMO-SEXUALTTY. 185 
 
 that fur (ermine) is tlic symbol of royalty, and therefore the 
 fetich of the men described in the novels. 
 
 II. Great Diminution or Complete Absence of Sexual Feeling for the 
 Opposite Sex^ with Substitution of Sexual Feeling and Instinct for the 
 Same Sex. {Homo-sexuality , or Contrary Sexual Instinct). 
 
 After the attainment of complete sexual development, 
 amon<2: the most constant elements of self-consciousness in the 
 individual, are the knowledge of representing a definite sexual 
 personality and the consciousness of desire, during the period 
 ol' physiological activity of the reproductive organs (production 
 of semen and ova), to perform sexual acts corresponding with 
 that sexual personality, — acts which, consciously or uncon- 
 sciously, liave a procreative purpose. 
 
 The sexual instinct and desire, save for indistinct feelings 
 and impulses, remain latent until the period of development of 
 the sexual organs. The child is generis oieutrlus ; and though, 
 during tliis latent period, — when sexuality has not yet risen into 
 clear consciousness, is but virtually present, and unconnected 
 with powerful organic sensations, — too early excitation of the 
 genitals may occur, either spontaneously or as a result of ex- 
 ternal influence, and find satisfaction in masturbation; yet, 
 notwithstanding this, the ])sycldcal relation to persons of the 
 opposite sex is still absolutely wanting, and the sexual acts 
 during this period partake more or less of a reflex spinal nature. 
 
 The fact of innocence, or of sexual neutrality, is the more 
 remarkable, since very early, in education, employment, dress, 
 etc., the child undergoes a difF(>rentiation from children of the 
 opposite sex. These impressions, however, n^main destitute of 
 mental meaning, because they apparently are without sexual 
 coloring ; for the central organ (cortex) of sexual emotions and 
 ideas is not yet capable of activity, owing to its undeveloped 
 condition. 
 
 With the inception of anatomical and functional develop- 
 ment of the generative organs, and the differentiation of form 
 belonging to each sex, which goes hand in hand with it in the 
 boy or girl, rudiments of a mental feeling corresponding with
 
 186 PSYCHOPATHIA SEXUALIS. 
 
 the sex are developed ; and in this, of course, education and 
 external influences in general have a powerful efl"ect upon the 
 individual, who is now all attention. 
 
 If the sexual development is normal and undisturbed, a 
 definite character, corresponding with the sex, is developed. 
 Certain definite inclinations and reactions in intercourse with 
 persons of the opposite sex arise ; and it is psychologically 
 worthy of note with what relative rapidity the definite mental 
 type corresponding with the sex is evolved. 
 
 While modesty, for example, during childhood, is essen- 
 tially but an uncomprehended and incomprehensible exaction of 
 education and imitation, and in the innocence and naivete of 
 the child but imperfectly expressed ; in the youth and maiden it 
 becomes an imperative requirement of self-respect; and, if in any 
 way it is offended, intense vasomotor reaction (blushing) and 
 psychical emotion are induced. 
 
 If the original constitution is favorable and normal, and 
 factors injurious to the psycho-sexual development exercise no 
 influence, then a psycho-sexual personality is developed that is so 
 unchangeable, and corresponds so completely and harmoniously 
 with the sex the individual represents, that subsequent loss of 
 the generative organs (as by castration), or the climacteric or 
 senility, cannot essentially alter it. But this, of course, is not 
 to declare that the castrated man or woman, the youth and 
 the aged man, the maiden and matron, the impotent and the 
 potent man, do not differ essentially from one another mentally. 
 
 An interesting and important question for what follows 
 is, wlietlicr the peri])]ieral influences of the generative glands 
 (testes and ovaries), or central cerebral conditions, are the 
 determining Ihctors in psycho-sexual development. The fact 
 that congenital deficiency of the generative glands, or removal 
 of tliein before puberty, has a great influence on physical and 
 psycho-sexual development, so that the latter is distorted and 
 assumes a type more closely resembling the opposite sex 
 (eunuchs, certain viragoes, etc.), betokens their great importance 
 in this respect. 
 
 But that the physical processes taking place in the genital
 
 HOMO-SEXUALITY. 187 
 
 organs are only co-operative, and not the exclusive factors in 
 the process of development of the psycho-sexual character, is 
 shown hy the fact that, notwithstanding a normal anatomical 
 and physiological state of these organs, a sexual instinct may 
 be developed which is the exact opposite of that characteristic 
 of the sex to which the individual belongs. 
 
 In this case, the cause is to be sought only in an anomaly 
 of central conditions, — in an abnormal psycho-sexual consti- 
 tution. This constitution, as far as its anatomical and functional 
 foundation is concerned, is absolutely unknown. Since, in 
 almost all such cases, the individual subject to the perverse 
 sexual instinct displays a neuropathic predisposition in several 
 directions, and the latter may be brought into relation with 
 hereditary degenerate conditions, this anomaly of psycho-sexual 
 feeling may be called, clinically, a functional sign of degeneration. 
 This perverse sexuality appears spontaneously, witliout external 
 cause, with the development of sexual life, as an individual 
 manifestation of an abnormal form of the vita scxualis, and 
 then has the force of a congenital phenomenon ; or it develops 
 upon a sexuality the beginning of which was normal, as a result 
 of very definite injurious influences, and thus appears as an 
 acquired anomaly. Upon what this enigmatical phenomenon 
 of acquired homo-sexual instinct depends is still inexplicable, 
 and only a matter for hypothesis. Careful examination of the 
 so-called acquired cases makes it probable that the predisposition 
 also present here consists of a latent homo-sexuality, or, at least, 
 bi-sexuality, which, for its manifestation, requires the influence 
 of accidental exciting causes to rouse it from its slumber. 
 
 In so-called contrary sexual instinct there are degrees of 
 the phenomenon which quite correspond with the degrees of 
 predisposition of the individuals. Thus, in the milder cases, 
 there is simple herraapliroditism ; in more pronounced cases, only 
 homo-sexual feeling and instinct, but limited to the vita sexualis; 
 in still more complete cases, the whole psychical personality, and 
 even the bodily sensations, are transformed to correspond with 
 the sexual perversion ; and, in the complete cases, the physical 
 form is correspondingly altered.
 
 188 PSYCHOPATHIA SEXUALIS. 
 
 The following division of the various phenomena o, this 
 psycho-sexual anomaly is made, tlierefore, in accordance with 
 these clinical facts : — 
 
 A. Homo-sexual Feeling as an Acquired Manifestation. — 
 The determining condition here is the demonstration of per- 
 verse feeling for the same sex ; not the proof of sexual acts with 
 the same sex. These two phenomena must not be confounded 
 with each other ; perversity must not be taken for perversion. 
 
 Perverse sexual acts, not dependent upon perversion, often 
 come under observation. This is especially true with reference 
 to sexual acts between persons of the same sex, particularly 
 pederasty. Here paraesthesia sexualis is not necessarily at 
 work ; but hypereesthesia, with physical or mental impossi- 
 bility of natural sexual satisfaction. Thus we find homo- 
 sexual intercourse in impotent masturbators or debauchees, or 
 faute de mieux in sensual men and women in imprisonment, on 
 ship-board, in garrisons, bagnios, boarding-schools, etc. 
 
 There is an immediate return to normal sexual intercourse 
 as soon as obstacles to it are removed. Very frequently the 
 cause of such temporary aberration is masturbation and its 
 results in youtliful individuals. 
 
 Nothing is so prone to contaminate — under certain circum- 
 stances, even to exhaust — the source of all noble and ideal 
 sentiments, which arise of themselves from a normally develop- 
 ing sexual instinct, as the practice of masturbation in early 
 years. It despoils the unfolding bud of perfume and beauty, 
 and leaves behind only the coarse, animal desire for sexual sat- 
 isfaction. If an individual, spoiled in tliis manner, reaches an 
 age of maturity, there is wanting in him that aesthetic, ideal, 
 pure, and free impulse which draws one toward the opposite 
 sex. Thus the glow of sensual sensibility wanes, and the 
 inclination toward the opposite sex becomes weakened. This 
 defect influences the morals, character, fancy, feeling, and 
 instinct of the youthful masturbator, male or female, in an 
 unfavoral)le way, and, under certain circumstances, allows the 
 desire for the opposite sex to sink to nil ; so that masturbation is 
 preferred to the natural mode of satisfaction.
 
 ACQUIRED HOMO- SEXUALITY. 189 
 
 Sometimes the development of liiylier sexual feelings 
 toward the opposite sex suffers, on account of hypochondriacal 
 fear of infection m sexual intercourse; or on account ol" an 
 actual infection ; or they suffer as a result of a faulty education 
 which points out such dangers and exaggerates them. Again 
 (especially in females), fear of the result of coitus (pregnancy), 
 or ahhorrence of men, by reason of mental or moral weakness, 
 may direct into perverse channels an instinct that makes itself 
 felt with abnormal intensity. But too early and perverse sexual 
 satisfaction injures not merely the mind, but also the body; inas- 
 much as it induces neuroses of the sexual apparatus (irritable 
 weakness of the centres governing erection and ejaculation ; 
 defective pleasurable feeling in coitus), while, at the same 
 time, it maintains the imagination and libido in continuous 
 excitement. 
 
 Almost every masturbator at last reaches a jioint where, 
 frightened on learning the results of the vice, or on expcuiencing 
 them (neurasthenia), or led by example or seduction to the op- 
 posite sex, he wishes to free himself of the vice and re-instate his 
 vita sexualis. The moral and mental conditions are the most un- 
 favorable possible. The pure glow of sexual feeling is destroyed ; 
 the fire of sexual instinct is wanting, and self-confidence, no 
 less ; for every masturbator is more or less timid and cowardly. 
 If the youthful sinner at last comes to make an attem[)t at 
 coitus, he is either disappointed because enjoyment is wanting, 
 on account of defective sensual feeling, or he is lacking in the 
 mental strength necessary to accomplish the act. The fiasco 
 has a fatal effect, and leads to absolute psychical impotence. A 
 bad conscience and the memory of past failures prevent success 
 in any further attempts. The constant libido sexualis, however, 
 demands satisftiction ; but this moral and mental perversion 
 separates him further and further from women. For various 
 reasons, however (neurasthenic complaints, hypochondriacal 
 fear of the results, etc.), the individual is kept from masturba- 
 tion. Occasionally, under such circumstances, there may be 
 bestiality. Intercourse with the same sex is then near at 
 hand, — as a result of occasional seduction or of the feelings of
 
 190 PSTCHOPATHIA SEXUALIS. 
 
 friendship which, on tlie level of pathological sexuality, easily 
 associate themselves with sexual feelings. Passive and mutual 
 onanism then becomes the equivalent of the avoided act. If 
 there is a seducer, — which, unfortunately, is so frequent, — then 
 the cultivated pederast is produced, — i.e., a man who performs 
 quasi acts of onanism with persons of his own sex, and, at the 
 same time, feels and prefers himself in an active role correspond- 
 ing with his real sex ; who is mentally indifferent not only to 
 persons of the opposite sex, but also to those of his own sex. 
 
 Sexual aberration in the normally constituted, untainted, 
 mentally healthy individual, reaches this degree. No case has 
 been demonstrated in which perversity has been transformed 
 into perversion, — into a reversal of the sexual instinct.^ 
 
 With tainted individuals, the matter is quite different. The 
 latent j)erverse sexuality is developed under the influence of 
 neurasthenia induced by masturbation, abstinence, or otherwise. 
 
 Gradually, in contact with persons of the same sex, sexual 
 excitation by them is induced. Related ideas are colored with 
 
 1 Garnior (Anomalies Sexuelles, Paris, pp. 508, .509) reports two cases (Cases 223 
 and 23o) tliat are apparently opposed to this assumption, particularly tlie first, in Avhieh 
 despair about the unfaithfulness of a lover led the individual to submit to the seductions 
 of men. But the case itself clearly shows that this individual never found pleasure in 
 homosexual acts. In Case 233, the individual was effeminated ab oriijine, or was at least a 
 psychical hermaphrodite. 
 
 Those who hold to the opinion that the origin of homo-sexual feelings and instinct 
 is found to be exclusively in defective education and other psychological influences are 
 entirely in error. 
 
 An untainted male may be raised never so much like a female, and a female like a 
 male, but they will not become homo-sexual. The natural disposition is the determining 
 condition ; not education and other accidental circumstances, like seduction. There can be 
 no thought of contrary sexual instinct save when tiie person of the same sex exerts a 
 psycho-sexual influence on the individual, and thus brings about libido and orgasm, — i.e., 
 has a psychical attraction. Those cases arc quite different in which, /awZe de mieux, with 
 great sensuality and a defective ?estlietic sense, the body of a person of the same sex is used 
 for an onanistic act (not for coitus in a psychical sense). 
 
 In his excellent monograph, Moll shows very clearly and convincingly the impor- 
 tance of original predisposition in contrast with exciting causes (coinp. i>/j. cit., pp. 1.5(>- 
 175). He knows " many cases where early sexual intercourse with men was not capable 
 of inducing perversion." Moll significantly says, further: " I know of such an epidemic 
 (of mutual onanism) in a Berlin school, where a person who is now an actor shamelessly 
 introduced mutual onanism. Though I now know the names of very many urnings in 
 Berlin, yet I could not ascertain, even with anything like probability, that among all the 
 scholars of that school at that time there was one that had become an urning ; but, on the 
 other hand, I have quite certain knowledge that many of those scholars are now normal 
 sexually, in feeling and intercourse."
 
 ACQUIRED HOMO-SEXUALITY. 191 
 
 lustful feelings, and awaken corresponding- desires. This 
 decidedly degenerate reaction is tlie beginning of a process of 
 physical and mental transformation, a description of which is 
 attempted in what follows, and which is one of the most inter- 
 esting psychological phenomena that has been observed. This 
 metamorphosis presents different stages, or degrees. 
 
 /. Degree: Simple Reversal of Sexual Feeli/ng. — This 
 degree is attained when persons of the same sex have an 
 aphrodisiac effect, and the individual has a sexual feeling for 
 them. Character and feeling, however, still correspond with 
 the sex of the individual {)resenting the reversal of sexual feel- 
 ing. He feels himself in the active role ; he recognizes his 
 impulse toward his own sex as an aberration, and finally seeks 
 aid. With episodical improvement of the neurosis, at first even 
 normal sexual feelings may re-appear and assert themselves. 
 The following case seems well suited to exemplify this stage of 
 the psycho-sexual degeneration : — 
 
 Case 94. Acquired Contrary Sexual Instinct. — " I am an official, and, 
 as far as I know, come of an nntainted family. My father died of an acute 
 disease ; my mother is living and is quite nervous. A sister has been very 
 intensely religious for some years. 
 
 " I myself am tall, and, in speech, gait, and manner, give a perfectly 
 masculine impression. Measles is the only disease I have had ; but since 
 my thirteenth year I have suffered with so-called nervous headache. 
 My sexual life began in my thirteenth year, when I became acquainted 
 with a boy somewhat older than myself, with whom 1 toolv pleasure in 
 mutual fondling of the genitals. I had the first ejaculation in my four- 
 teenth year. Seduced to onanism by two older school-mates, I practiced 
 it partly with others and partlj^ alone ; in the latter case, however, always 
 with the thought of persons of the female sex. My libido sexualis was 
 very great, as it is to-day. Later, I tried to win a pretty, stout servant- 
 girl who had very large mamma? ; id solum assecutus sum, ut me praesente 
 superiorem corporis sui partem enudaret mihique concederet os mam- 
 masque osculari, dum ipsa penem meum valde erectum in mauum suam 
 recepit eumque trivit. 
 
 " Notwithstanding my urgent demand for coitus, she would not 
 allow it ; but she finally permitted me to touch her genitals. 
 
 " After going to the University, I visited a brothel and succeeded 
 without especial effort. 
 
 " There an event occurred which brought a change in me. One
 
 192 PSTCHOPATHIA SEXUALIS. 
 
 evening I accompanied a friend home, and in a mild state of intoxication 
 I grasped him ad genitalia. He made bnt slight opposition. I then went 
 up to his room with him, and we practiced mutual masturbation. From 
 that time we indulged in it quite frequently ; in fact, it came to immissio 
 penis in os, with resultant ejaculations. But it is strange that I was not 
 at all in love with this person, but passionately in love with another 
 friend, near wliom I never felt the slightest sexual excitement, and whom 
 I never connected with sexual matters, even in thought. My visits to 
 brothels, where I was gladly received, became more infrequent ; in my 
 friend I found a substitute, and did not desire sexual intercourse with 
 women. 
 
 "We never practiced pederasty, and that word was not even known 
 between us. From the beginning of this relation with my friend, I again 
 masturbated more frequentl}', and naturally the thought of females re- 
 ceded more and more into the background, and I thought more and 
 more about young, handsome, strong men with the largest genitals. 
 I preferred young fellows, from sixteen to twenty -five 3'ears old, without 
 beards, but they had to be handsome and clean. Young laborers dressed 
 in trousers of Manchester cloth or English leather, particularly masons, 
 especially excited me. 
 
 " Persons in my own position had hardly any effect on me; but, at 
 the sight of one of those strapping fellows of the lower class, I experi- 
 enced marked sexual excitement. It seems to me that the touch of such 
 trousers, the opening of them, and the grasping of the penis, as well as 
 kissing the fellow, would be the greatest delight. My sensibility to female 
 charms is somewhat dulled ; yet in sexual intercourse with a woman, par- 
 ticularly when she has well-developed mammae, I am always potent 
 without the help of imagination. I have never attempted to make use 
 of a young laborer, or the like, for the satisfaction of my evil desires, and 
 never shall ; but I often feel the longing to do it. I often impress on 
 myself the mental image of such a man, and then masturbate at home. 
 
 "I am absolutely devoid of taste for female work. I rather like to 
 move in female societ}^, ])ut dancing is repugnant to me. I have a lively 
 interest in the fine arts. That my sexual sense is partly reversed is, I 
 believe, in part due to greater convenience, which keeps me from entering 
 into a relation with a girl ; as the latter is a matter of too mnch trouble. 
 To be constantly visiting houses of prostitution is, for aesthetic reasons, 
 repugnant to me; and thus I am always returning to solitary onanism, 
 which is very difficult for me to avoid. 
 
 " Hundreds of times I have said to myself that, in order to have a 
 normal sexual sense, it would be necessary for me, first of all, to over- 
 come my irresistible passion for onanism, — a practice so repugnant to my 
 {esthetic feeling. Again and again I have resolved with all my might to 
 fight this passion ; but I am still unsuccessful. When I felt the sexual 
 impulse gaining strength, instead of seeking satisfaction in the natural
 
 ACQUIRED HOMO-SEXUALITY. 193 
 
 manner, I preferred to masturbate, because I felt that I would thus have 
 more enjoyment. 
 
 " And yet experience has taught me that I am always potent with 
 girls, and that, too, without trouble and without the help of imagining mas- 
 culine genitals. In one case, liowever, I did not attain ejaculation because 
 the woman — it was in a brothel — was devoid of every charm. I cannot 
 avoid the thought and severe self-accusation that, to a certain extent, my 
 contrary sexiuilily is the result of excessive onanism ; and this especially 
 depresses me, because I am compelled to acknowledge that I scarcely 
 feel strong enough to overcome this vice by the force of my own will. 
 
 " As a result of my relations with m}' fellow-student and^ school- 
 mate for years, mentioned in this communication, — which, however, 
 beaaa while we were at the Universitv, and after we had been friends 
 for seven 3'ears, — the impulse to unnatural satisfaction of libido has 
 grown much stronger. I trust 3'ou will permit the description of an 
 incident which occupied me for months : — 
 
 " In the summer of 1882, I made the acquaintance of a companion 
 six years younger than myself, who, with several others, had been intro- 
 duced to me and my acquaintances. I very soon felt a deep interest in 
 this handsome man, who was unusuall}^ well proportioned, slim, and full 
 of health. After a few weeks of association, this feeling became friend- 
 ship, and at last passionate love, with feelings of the most intense jealousy. 
 I very soon noticed that, in this, sexual excitation was also very marked ; 
 and, notwithstanding my determination, aside from all others, to keep 
 myself in check in relation to this man, whom I respected so highly for 
 his superior character, one night, after free indulgence in beer, as we were 
 enjoying a bottle of champagne in my room and drinking to good, true, 
 and lasting friendship, I yielded to the irresistible impulse to embrace 
 him, etc. 
 
 " When I saw him, next day, I was so ashamed that I could not look 
 him in the face. I felt the deepest regret for my action, and accused 
 myself bitterlj^ for having thus sullied this friendship, which was to be 
 and remain so pure and precious. In order to prove to him that I had 
 lost control of myself only momentarily, at the end of the semester I 
 uroed him to make an excursion with me : and after some reluctance, the 
 reason of which was only too clear to me, he consented. Several nights 
 we slept in the same room without any attempt on my part to repeat my 
 action. I wished to talk with him about the event of that night, but I 
 could not bring myself to it; even when, during the next semester, 
 we were separated, I could not induce myself to write to him on the 
 subject ; and when I visited him, in March, at X., it was the same. And 
 yet I felt a great desire to clear up this dark point by an open statement. 
 In October of the same year, I was again in X., and this time found 
 courage to speak without reserve ; indeed, I asked him why he had not re- 
 sisted me. He answered that, in part, it was because he wished to please 
 
 13
 
 194 PSYCHOPATHIA SEXUALIS. 
 
 me, find, in part, owing to the fact that he was somewhat apathetic as a 
 result of being a little intoxicated. I explained to him my condition, 
 and also gave him " Ps3'chopathia Sexualis " to read, expressing the hope 
 that by the force of mj^ own will I should become fully and lastingly 
 master of my unnatural impulse. Since this confession, the relation be- 
 tween this friend and me has been the most delightful and happ^- possible ; 
 there are the most friendly feelings on both sides, which are heart-felt 
 and true; and it is to be hoped that the3' will endure. 
 
 " If I should not improve my abnormal condition, I am deter- 
 mined to put myself under your treatment; the more because, after a 
 careful study of your work, I cannot count myself as belonging to the 
 category of so-called urnings; and, too, because I have the firm conviction, 
 or hope, at least, that a strong will, assisted and combined with skillful 
 treatment, could transform me into a man of normal feeling." 
 
 Case 95. lima 8.,^ aged 29 ; single ; merchant's daughter. She comes 
 of a family having bad nervous taint. Father was a drinker and died by 
 suicide, as also did the patient's brother and sister. A sister suffers with 
 convulsive hysteria. Mother's father shot himself while insane. Mother 
 was sickly, and died paralyzed after apoplexy. The patient never had 
 any severe illness. She is bright, enthusiastic, and dreamy. Menses at 
 the age of eighteen without difficulty ; but thereafter they were very 
 irregular. At fourteen, chlorosis and cataleps}^ from fright. Later, hys- 
 teria gravis and an attack of hysterical insanity. At eighteen, relations 
 with a young man which were not platonic. This man's love was pas- 
 sionately returned. From statements of the patient, it seems that she 
 was very sensual, and after separation from her lover practiced mastur- 
 bation. After this she led a romantic life. In order to earn a living, she 
 put on male clothing, and became a tutor ; but she gave up her place because 
 her mistress, not knowing her sex, fell in love with her and courted her. 
 Then she became a railway -emplo3'e. In the company of her companions, 
 in order to conceal her sex, she was compelled to visit brothels with them, 
 and hear the most vulgar stories. This became so distasteful to her that 
 she gave up her place, resumed the garments of a female, and again 
 sought to earn her living. She was arrested for a theft, and on account 
 of severe hystero-epilepsy was sent to the hospital. There, inclination 
 and impulse toward the same sex were discoA'ered. The patient became 
 troublesome on account of passionate love for female nurses and patients. 
 
 Her sexual perversion was considered congenital. With regard to 
 this the patient made some interesting statements : — 
 
 " I am judged incorrectly, if it is thought that I feel myself a man 
 toward the female sex. In my whole thought and feeling I am much 
 more a woman. I loved my cousin as only a woman can love a man. 
 
 1 Comp. author's Experimental Study iu the Domain of Hypnotism, 1889. G. P. 
 Putnam's Sous, New York.
 
 ACQUIRED HOMO-SEXUALITY. 195 
 
 " The change of my feeling oiiginated in this, tliat, in Pesth, dressed 
 as a man, I had an opportunity to observe my cousin. I saw that I had 
 wholly deceived myself in him. That gave me terrible heart-[)angs. I 
 knew that I could never love another man ; that I belonged to those who 
 love but once. Of simihir ellect was the fact that, in the society of my 
 companions at the railway, 1 was coini)elled to hear the most ottensive 
 language and visit the most disreputable houses. As a result of the in- 
 sight into men's motives, gained in this way, I took an unconquerable 
 dislike to them. However, since I am of a very passionate nature and 
 need to have some loving person on whom to depend, and to whom I can 
 wholly surrender myself, I felt myself more and more jJowerfuUy drawn 
 toward intelligent women and girls who were in sympathy Avith me." 
 
 The contrary sexual instinct of this patient, wliich was 
 clearly acquired, expressed itself in a stormy and decidedly 
 sensual way, and was further augmented by masturbation ; be- 
 cause constant oversight in liospitals made sexual satisfaction 
 witli the same sex impossible. Character and occupation re- 
 mained feminine. There were no manifestations of viraginity. 
 According- to information lately received by the author, this 
 patient, after two years of treatment in an asylum, was entirely 
 freed from her neurosis and sexual perversion, and discharged 
 cured. 
 
 Case 96. X., aged 19; mother nervous; two sisters of mother's 
 father were insane. Patient of nervous temperament ; well endowed 
 mentally ; well developed ; normally formed. When he was twelve years 
 old, he was seduced into mutual onanism by an elder brother. 
 
 After this, the patient continued the vice alone. In the last three 
 years, during the act of masturbation, he had had peculiar fancies in the 
 sense of "contrary sexual instinct." 
 
 He fancies himself a female ; as, for example, a ballet-dancer in the act 
 of coitus with an oflicer or circus rider. These perverse fancies have ac- 
 companied the act of masturbation since the patient became neurasthenic. 
 He understands the harm of masturbation, fights desperately against it, 
 but always gives up to the impulse. 
 
 If he is able to withstand the impulse for a few daj^s, a normal desire 
 for sexual intercourse with females is awakened ; but a certain fear of 
 infection holds these desires in check, and always drives him again to 
 masturbation. 
 
 It is worthy of remark that this unfortunate's lascivious dreams 
 concerned only females. 
 
 In the course of the last few months, the patient had become very 
 neurasthenic and hypochondriacal. He feared tabes,
 
 196 PSYCHOPATHIA SEXUALIS. 
 
 I advised treatment of the neurasthenia, suppression of mastur- 
 bation, and marital cohabitation, if possible, after improvement of the 
 neurasthenia. 
 
 Case 97. Mr. X, aged 35, single, official ; mother insane, brother 
 hypochondriacal. 
 
 Patient was healthy, strong, of lively sensual temperament. He 
 had manifested powerful sexual instinct abnormall}- early, and mastur- 
 bated while yet a small boy. He had coitus the first time at the age of 
 fourteen, he says, with enjo^^ment and complete power. When fifteen 
 years old, a man sought to seduce him, and performed manustupration 
 on him. X. experienced a feeling of repulsion, and freed himself from 
 tlie disgusting situation. At maturity he committed excesses in libido, 
 with coitus ; in 1880 he became neurasthenic, being afflicted with weak- 
 ness of erection and ejaculatio prsecox. He tlius became less and less 
 potent, and no longer experienced pleasure in the sexual act. At this 
 time of sexual decadence, for a long time, he still had what was previ- 
 ously foreign to him, and is still incompreliensible to him, — an inclina- 
 tion for sexual intercourse witli immature girls of the age of twelve or 
 thirteen. His libido increased as virility diminished. 
 
 Graduall}' he developed inclination for boys of thirteen or fourteen. 
 He was impelled to approach them. 
 
 Quodsi ei occasio data est ut tangere posset pueros qui ei placuere, 
 penis vehementer se erexit tum maxinie quuni crura puerorum tangere 
 potuisset. Abhinc feminas non cupivit. Nonnunquam feminas ad coitum 
 coegit sed erectio debilis, ejaculatio prjematura enit sine ulla voluptate. 
 
 Now only yowths interested him. He dreamed about them and had 
 pollutions. After 1882 he now and then had opportunity coucumbere 
 cum juvenibus. This led to powerful sexual excitement, which he satis- 
 fied by masturbation. It was only exceptional for him to venture to 
 touch his bed-fellow and indulge in mutual masturbation. He shunned 
 pederast}'. For the most part, he was compelled to satisfy his sexual 
 needs by means of solitary masturbation. In the act he called up the 
 vision of pleasing boys. After sexual intercourse with such boys, he 
 always felt strengthtoed and refreshed, but morally depressed; because 
 there was consciousness of having performed a perverse, indecent, and 
 punishable act. He found it painful that his disgusting impulse was 
 more powerful than his will. 
 
 X. thinks that his love for his own sex has resulted from great 
 excess in natural sexual intercourse, and bemoans his situation. On the 
 occasion of a consultation, in December, 1889, he asked whether there 
 were any means to bring him back to a normal sexual condition, since he 
 had no real horror feminse, and would very gladly marry. 
 
 This intelligent patient, free from degenerative signs, presented no 
 abnormal symptoms except those of sexual and spinal neurasthenia of 
 moderate degree.
 
 ACQUIRED HOMO-SEXUALITY. 197 
 
 //. Degree: Eviration and Defcminatlon. — If, in cases of 
 contrary sexual instinct thus developed, no restoration occurs, 
 then deep and lasting- transformations of the psychical person- 
 ality may occur. The process completing- itself in tliis way may 
 be briefly designated eviration. The patient undergoes a deep 
 change of character, particularly in his feelings and inclinations, 
 which become those of a female. After this, he also feels him- 
 self to be a woman during the sexual act, has desire only for 
 passive sexual indulgence, and, under certain circumstances, 
 sinks to the level of a prostitute. In this condition of deep 
 and more lasting psycho-sexual transformation, the individual 
 is like the (congenital) urning of high grade. The possibility 
 of a restoration of the previous mental and sexual personality 
 seems, in such a case, excluded. 
 
 The following case is a classical example of this variety of 
 lasting acquired contrary sexual instinct: — 
 
 Case 98. Sch., aged 30, ph3-sician, one day told me the story of his 
 life and malady, asking explanation, and advice concerning certain anom- 
 alies of his vita sexiialis. The following description gives, for the most 
 part verbatim, the details of the autobiography; only in some portions is 
 it shortened : — 
 
 " My parents were healthy. As a child I was sickly ; but with 
 good care I thrived^ and got on well in school. When eleven years old, I 
 was taught to masturbate by my playmates, and gave myself np to it pas- 
 sionately. Until I was fifteen, I learned easily. On account of frequent 
 pollutions, I became less capable, did not get on easily in school, and was 
 uncertain and embarrassed when called on by the teacher. Frightened 
 by my loss of capabilit}^, and recognizing that the loss of semen was 
 responsible for it, I gave np masturbation; but the pollutions became 
 even more frequent, so that I often had two or tliree in a night. In 
 despair, I now consulted one physician after another. None were able 
 to help me. 
 
 " Since I grew weaker and weaker, by reason of the loss of semen, 
 with the impulse to sexual satisfoction growing more and more pow- 
 erful, I sought houses of prostitution. But I was there unable to find 
 satisfaction ; for, even though the sight of a naked female pleased me, 
 neither orgasm nor erection occurred ; and even manustupration hy the 
 puella was not capable of inducing erection. Scarcely would I leave 
 the house, when the impulse would seize me again, and I would have vio- 
 lent erections. I grew ashamed before the girls, and ceased to visit such 
 houses. Thus a couple of years passed. My sexual life consisted of
 
 198 PSYCHOPATHIA SEXUALTS. 
 
 pollutions. My inclination toward the opposite sex grew less and less. 
 At nineteen I went to the University. The theatre had more attractions 
 for me. I wished to become an actor. My parents were not willing. At 
 the Capital I was compelled now and then to visit girls with my com- 
 rades. I feared such a situation ; because I knew that coitus was impos- 
 sible for me, and because my friends might discover my impotence. 
 Therefore, I avoided, as far as possible, the danger of becoming the butt 
 of jokes and ridicule. 
 
 " One evening, in the opera-house, an old gentleman sat near me. 
 He courted me. I laughed heartily at the foolish old man, and entered 
 into his joke. Exinapinato genitalia mea prehendit, quo facto statim 
 penis mens se erexit. Frightened, I demanded of him what he meant. 
 He said that he was in love with me. Having heard of hermaphrodites 
 in the clinics, I thought I had one before me, and became curious to see 
 his genitals. The old man was verj' willing, and went with me to the 
 water-closet. Sicuti penem maximum ejus erectum adspexi, perter- 
 ritus effugi. 
 
 " This man followed me, and made strange proposals which I did not 
 understand, and repelled. He did not give me any rest. I learned the 
 secrets of male love for males, and felt that my sexuality was excited by 
 it. But I resisted the shameful passion (as I then regarded it), and, for 
 the next three years, I remained free from it. During this time I repeat- 
 edly attempted coitus with girls in vain. My attempts to free myself of 
 my impotence l)y means of medical treatment were also vain. Once, 
 when my libido sexualis was troubling me again, I recalled what the old 
 man had told me : that male-loving men were accustomed to meet on the 
 E. Promenade. 
 
 " After a hard struggle, and with beating heart, I went there, made 
 the acquaintance of a blonde man, and allowed myself to be seduced. 
 The first step was taken. This kind of sexual love was satisfactory to 
 me. I always preferred to be in the arms of a strong man. The satis- 
 faction consisted of mutual manustupration ; occasionally in oscidum ad 
 penem alterius. 1 was then twenty -three years old. Sitting, together 
 with my comrades, on the beds of patients in the clinic during the lec- 
 tui-es, excited me so intensely that I could scarcel^^ listen to the lectures. 
 In the same year 1 entered into a formal love-relation with a merchant 
 of thirty -four. We lived as man and wife. X. plaj^ed the man, and fell 
 more and more in love. I gave up to him, but now and then I had to 
 play the man. After a time I grew tired of him, became unfaithful, and 
 he became jealous. There were terrible scenes, which led to temporary 
 separation, and finallj' to actual rupture. (The merchant afterward 
 became insane, and died by suicide.) 
 
 " I made many acquaintances, and loved the most ordinary people. 
 I preferred those having a full beard, and who were tall and of middle age, 
 and able to play the active role well. 1 developed a proctitis. The pro-
 
 ACQUIRED IIOMO-SEXUALITY. 199 
 
 fessor thought it was the result of sitting too much while preparing for 
 exaininations. I developed a fistula, and had to undergo an operation ; 
 but this did not cure me of my desire to allow myself to be used passively. 
 I became a physician, and went to a provincial city, where I had to live 
 like a nun. I developed a desire to move in ladies' society, and was 
 gladly welcomed there ; because it was found that I was not so one-sided 
 as most men, and was interested in toilettes and such feminine things. 
 However, I felt very unhappy and lonesome. P^ortunately, in this town, 
 I made the acquaintance of a man, a ' sister,' who felt like me. For some 
 time I was taken care of by him. When he had to leave, I had an 
 attack of despair, with depression, which was accompanied by thoughts 
 of suicide. 
 
 " When it became impossible for me to longer endure the town, I 
 became a military surgeon in the Capital. There I began to live again, 
 and often made two or three acquaintances in one day. I had never 
 loved boys or young people ; only fully-developed men. The thought of 
 falling into the hands of the police was frightful. Thus I have escaped 
 the clutches of the blackmailer. At the same time, I could not keep 
 myself from the satisfaction of my impulse. After some months I fell in 
 love with an official of forty. I remained true to him for a year, and we 
 lived like a pair of lovers. 1 was the wife, and was formally courted by 
 the lover. One day I was transferred to a small town. We were in 
 despair. The last night was spent in continually kissing and caressing 
 one another. 
 
 " In T. I was unspeakably unhappy, in spite of some ' sisters' whom 
 I found. I could not forget my lover. In order to satisfy my sexual 
 desire, which cried for satisfaction, I chose soldiers. Money obtained 
 men; but tliey remained cold, and I had no enjoyment with them. I was 
 successful in being re-transferred to the Capital. There, there was a new 
 love-relation, but much jealousy; because my lover liked to go into the 
 society of ' sisters,' and was proud and coquettish. There was a rupture. 
 I was very unhappy and very glad to be transferred from the Capital. I 
 now stayed in C, alone and in despair. Two infantry privates were 
 brought into service, but with the same misatisfactory result. When 
 shall I ever find true love ngain ? 
 
 " I am over medium height, well developed, and look somewhat 
 aged ; and, therefore, when I wish to make conquests I use the arts of the 
 toilet. My manner, movements, and face are masculine. Phj^sically I 
 feel as youthful as a boy of twenty. I love the theatre, and especially 
 art. My interest in the stage is in the actresses, whose every move- 
 ment and gesture I notice and criticise. 
 
 " In the society of gentlemen I am silent and embarrassed, while 
 in the society of those like mj'self I am free, witty, and as tawning as a 
 cat, if a man is sympathetic. If I am without love, I become deeply 
 melancholic; but the favors of the first handsome man dispel m^'^depres-
 
 200 PSYCHOPATHIA SEXUALIS. 
 
 sion. In other ways I am frivolous ; anything but ambitious. My 
 profession is nothing to me. Masculine pursuits do not interest me. 
 I prefer novels and going to the theatre. I am effeminate, sensitive, 
 easily moved, easily injured, and nervous. A sudden noise makes my 
 whole body tremble, and I have to collect myself in order to keep from 
 crying out." 
 
 Remarks: The foregoing case is certainly one of acquired con- 
 trary sexual instinct, since the sexual instinct and impulse were origi- 
 nally directed toward the female sex. Sch. became neurasthenic through 
 masturbation. 
 
 As an accompanying manifestation of the neurasthenic neurosis, 
 lessened impressionability of the erection-centre and consequent rela- 
 tive impotence came on. As a result of tliis, sexual sensibility toward 
 the opposite sex was lessened, with simultaneous persistence, of libido 
 sexualis. The acquired contrarj^ sexual instinct must be abnormal, since 
 the first touch by a person of the same sex is an adequate stimulus for 
 the erection-centre. The perverse sexual feeling became complete. At 
 first Sch. felt like a man in the sexual act; but more and more, as the 
 change progressed, the feeling and desire of satisfaction changed to the 
 form which, as a rule, characterizes the (congenital) urning. 
 
 This eviration induces a desire for the passive role, and, further, for 
 (passive) pederasty. It makes a deeper impress on the character. The 
 character becomes feminine, inasmuch as Sch. now prefers to move in the 
 society of actual females, has an increasing desire for feminine occupa- 
 tions, and, indeed, makes use of the arts of the toilet in order to improve 
 his fading charms and make " conquests." 
 
 The foregoing facts, concerning acquired contrary sexual 
 instinct and efFemination, find an interesting confirmation in the 
 following ethnological data : — 
 
 Even Herodotus describes a peculiar disease which frequently 
 aflfected the Scythians. The disease consisted in this : that men became 
 effeminate in character, put on female garments, did the work of 
 women, and even became effeminate in appearance. As an explanation 
 of this insanity of the Sc3thians,^ Herodotus relates the myth that 
 the goddess Venus, angered b}' the plundering of the temple at Ascalou 
 by the Scythians, had made women of these plunderers and their 
 posterity. 
 
 iComp. Sprengel, " Apologie des Hippokrates," Leipzig, 1792, p. 611; Friedreich, 
 " Literiirgeschichte dcr psych. Krankheiten," 1830, p. 31; Lallemand, "Des pertes s6mi- 
 nales," Paris, 1836, i, p. 581 ; Nysten, "Dictionn. de ra6decine," xi edit., Paris, 18.58, Art. 
 " eviration et Maladie des Scythes " ; Marandon, ' De la maladie des Scytlies"; "Amial. 
 m6dico-psychol.," 1877, Mars, p. 161 ; Hammoud, American Journal of Neurology £^nd 
 Psychiatry, August, 1882.
 
 ACQUIRED HOMO-SEXUALITY. 201 
 
 Hippocrates, not believing in supernatural diseases, recognized 
 that impotence was here a causative factor, and explained it, though in- 
 correctly, as due to the custom of the Scythians, by attributing it to dis- 
 ease of the jugular veins induced by excessive riding. He thought that 
 these veins were of great importance in the preservation of the sexual 
 powers, and that when they were severed, impotence was induced. Since 
 the Scythians considered their impotence due to divine punishment, and 
 incurable, they put on the clothing of females, and lived as women among 
 women. 
 
 It is worthy of note that, according to Klaproth (" Reise in den 
 Kaidcasus," Berlin, 1812, v, p. 285) and Cliotomski, even at the present 
 time impotence is very frequent among the Tartars, as a result of riding 
 unsaddled horses. The same is observed among the Apaches and Nava- 
 jos of the Western Continent, who ride excessively, scarcely ever going 
 on foot, and are remarkable for small genitals and mild libido and 
 virility. Sprengel, Lallemand, and Nysten recognized the fact that ex- 
 cessive riding may be injurious to the sexual organs. 
 
 Hammond reports analogous observations of great interest con- 
 cerning the Pueblo Indians of New Mexico. These descendants of the 
 Aztecs cultivate so-called " mujerados," of which ever^' Pueblo tribe re- 
 quires one in the religious ceremonies (actual orgies in the spring), in 
 which pederasty i)la3's an important part. In order to cultivate a "mu- 
 jerado," a very powerful man is chosen, and he is made to masturbate ex- 
 cessivel}^ and ride constantly. Gradually such irritable weakness of the 
 genital organs is engendered that, in riding, great loss of semen is induced. 
 This condition of irritability passes into paralytic impotence. Then the 
 testicles and penis atroph}-, the hair of the beard falls out, the voice loses 
 its depth and compass, and physical strength and energy decrease. In- 
 clinations and disposition become feminine. The " mujerado " loses his 
 position in society as a man. He takes on feminine manners and customs, 
 and associates with women. Yet, for religious reasons, he is held in 
 honor. It is probable that, at other times than during the festivals, he 
 is used by the chiefs for pederasty. Hammond had an opportunity to ex- 
 amine two " mujerados." One had become such seven 3'ears before, and 
 was tiiirty-five years old at the time. Seven years before, he was entirely 
 masculine and potent. He had noticed gradual atrophy of the testicles 
 and penis. At the same time he lost libido and the power of erection. 
 He differed in nowise, in dress and manner, from the women among 
 whom Hammond found him. The genital hair was wanting, the penis 
 was shrunken, the scrotum lax and pendulous, and the testicles were 
 very much atrophied and no longer sensitive to pressure. The 
 " mujerado " had large mamm» like a pregnant woman, and asserted 
 that he had nursed several children whose mothers had died. A 
 second '^mujerado," aged thirty-six, after he had been ten years in 
 the condition, presented the same peculiarities, though with less de-
 
 202 PSYCHOPATHIA SEXUALIS. 
 
 A'eloptnent of mammae. Like the first, the voice was high and thin. 
 The body was plump.^ 
 
 III. Degree: Stage of Transition to Metamorphosis 
 Sexualis Paranoica. 
 
 A further degree of development is represented by those 
 cases in which bodily sensation is also transformed in the sense 
 of a transmutatio sexus. In this respect the following case is 
 unique : — 
 
 1 The following description of the " bote" is taken from Di-. J. G. Kiernan's article 
 on " Responsibility lu Sexual Perversion," read before the Chicago Medical Society, March 7, 
 1893 : "In accordance with the well-known physiological law, that too frequent excitation 
 of a nerve exhausts the reaction of that nerve to that excitant, sexual excess exhausts the 
 normal reaction, whence it occurs that abnormal stimulus is required and the vice type of 
 sexual perversion results. Such vice types crop up among savages. Dr. A. B. Holder (N. 
 Y. Med. Jour., 1889) describes a sexual pervert called the 'bote' by the Montana and the 
 ' burdach ' by the Washington Indians. Such a pervert is found among all the tribes of the 
 Northwest. Like all other sexual perverts, these 'botes 'can recognize each other. Dr. 
 Holder has found that the ' bote ' wears the squaw dress, parts his hair like a squaw, and 
 assumes feminine speech and manners. Their features are often masculine. In childhood 
 feminine dress and manners are assumed, but not until puberty do ' bote ' practices result. 
 These consist in taking the male organ of the active party in the lips of the ' bote,' who 
 experiences the sexual orgasm at the same time. A ' bote ' examined by Dr. Holder was a 
 splendidly formed fellow, of prepossessing face, in perfect health, active in movement, and 
 happy in dispo.sition. By oflering payment, he induced him to submit himself, though with 
 considerable reluctance, to a thorough examination. He was five feet eight inches high, 
 weighed one hundred and fifty-eight pounds, and had a frank, intelligent face, — being an 
 Indian, of course beardless. He was thirty-three years of age, and had worn woman's 
 dress for twenty-eight years. His dress was the usual dress of the Indian female, consist- 
 ing of four articles, — a single dress or gown of half a dozen yards of cloth, made loose 
 with wide sleeves, and skirt reaching to the ankles, the skirt and body of one piece, very 
 much like the 'Mother Hubbard ' nerjligee worn by ladies ; a beaded belt loosely confining 
 this at the waist ; stockings from government annuity goods, and buckskin moccasins 
 extending above the ankles. The hair, twenty-four or twenty-six inches long, was parted 
 in the centre and allowed to hang loose in two masses behind the shoulders. Since among 
 the Sioux and some other tiibes it is usual for men to wear their hair in this way, it is well 
 to observe that in this tribe (Absaroke) the men usually wear the hair in long braids, and 
 always part it on the side and ' roach ' the front. His skin was smooth and free from hair, 
 there being absolutely none on the legs, arms, or breast, or in the arm-pits. This is of no 
 special siginficance, as male and female Indians are both free from hair on these parts of the 
 body. The mamniiB were as rudimentary as those of the male. When he removed his dress 
 he threw his thighs together so as to completely conceal the organs, whether male or female ; 
 such a movement is made by timid women under examination, — a movement usually suc- 
 cessful in the female, owing to the non-projecting character of the genitals and to the 
 rotundity of the thighs ; but not usually easy, for the reverse reasons, in the male. In this 
 the 'bote' — either from the conformation of the thighs, which had the feminine rotundity, 
 or from skill acquired by habit — succeeded completely. When he separated his thighs, 
 male organs came into view, in size perhaps not quite so large as the physique of the man 
 would indicate, but in position and shape altogether normal. The penis was flaccid. The 
 ' bote ' in habits very closely resembles a class described by Hippocrates among the Scyth- 
 ians of Caucasus, called by the Greeks anandreis, a word strikingly similar in meaning to 
 'bote.'"— Tran8.
 
 ACQUIRED IIOMO-SEXUALITY. 203 
 
 Case 99. Autobiography. " Born in Hungary in 1844, for many 
 years I was the onl}' cliild of my parents ; for the other children died for 
 the most part of general weakness. A brother came late, who is still 
 living. 
 
 " I come of a family in which nervous and mental diseases have 
 been numerous. It is said that I was very pretty as a little child, with 
 blonde locks and transparent skin ; very obedient, quiet, and modest, so 
 that I was taken everywhere in the society of ladies without any offense 
 on my part. 
 
 " With a very active imagination — my enem}'^ tlirougli life — my 
 talents developed rapidly. I could read and write at the age of four; 
 my memory reaches back to my third year. I i)la3'ed Avith everything 
 that fell into my hands, — with leaden soldiers, or stones, or ribbons from 
 a children's store; but a machine for working in wood, that was given 
 to me as a present, I did not like. I liked best to be at home with my 
 mother, who was ever3'thing to me. I had two or three friends, with whom 
 I got on good-naturedly; but I liked to play with their sisters quite 
 as well, w4io always treated me like a girl, which at first did not eml)ar- 
 rass me. I must have already been on the road to become just like a 
 girl ; at least, I can still well remember how it was always said : ' He is 
 not intended for a boy.' At this I tried to play the bo}^, — imitated my 
 companions in everything, and tried to surpass them in wildness. In 
 this I succeeded. There was no tree or buildino; too hio;h for me to 
 reach its top. I took great delight in soldiers. I avoided girls more, 
 because I did not wish to play with their play-things; and it always 
 annoyed me that they treated me so much like one of themselves. 
 
 " In the society of mature people, however, I was always modest, 
 and, also, always regarded with favor. Fantastic dreams about wild 
 animals — which once drove me out of 1>ed without wakino- me — fre- 
 quentlj' troubled mo. I was always very simply, but very elegantly, 
 dressed, and thus developed a taste for beautiful clothing. It seems 
 peculiar to me that, from the time of my school-days, I had a partiality 
 for ladies' gloves, wdiich I put on secretly as often as I could. Thus, 
 when once mj' mother was about to give away a pair of gloves, I made 
 great opposition to it, and told her, when she asked why I acted so, that 
 I wanted them mj'self. I was laughed at; and from that time I took 
 good care not to display my preference for female things. Yet m^- 
 delight in them was very great. I took especial pleasure in masquerade 
 costumes, — i.e., only in female attire. If I saw them, I envied their 
 owners. What seemed tome the prettiest sight was : two young men, 
 beautirully dressed as white ladies, with masks on; and yet I would not 
 have shown mjself to others as a girl for anything; I was so afraid of 
 being ridiculed. At school I worked very hard, and was always among 
 the first. From childhood my parents taught me that duty came first; 
 and they always set me an example. It was also a pleasure for me to
 
 204 PSYCHOPATHIA SEXUALlS. 
 
 attend school ; for the teachers were kind, and the elder scholars did not 
 plague the younger ones. We left my first home ; for my father was 
 compelled, on account of his business, — which was dear to him, — to sep- 
 arate from his family for a yea,v. We moved to Germany. Here there 
 was a stricter, rougher manner, partly in teachers and partly in scholars ; 
 and I was again ridiculed on account of m}' girlishness. My school- 
 mates went so far as to give a girl, who had exactly my features, m3' 
 name, and me hers ; so that I hated the girl. But I later came to be on 
 terms of friendship with her after her marriage. My mother tried to 
 dress me elegantly ; but this was repugnant to me, because it made me the 
 object of joke. So, finally, I was delighted when I had correct trousers 
 and coats. But with these came a new annoyance. Thej^ irritated my 
 genitals, particularly when the cloth was rough ; and the touch of tailors 
 while measuring me, on account of their tickling, which almost con- 
 vulsed me, was unendurable, particularly about the genitals. Then I 
 had to practice gymnastics ; and I simplj^ could do nothing at all, or only 
 indifferently the things that girls cannot do easily. While bathing I 
 was troubled b}^ feeling ashamed to undress ; but I liked to bathe. Until 
 my twelfth j-ear I had a great weakness in my back. I learned to swim 
 late, but ultimately so well that I took long swims. At thirteen I had 
 pubic hair, and was about six feet tall ; but my face was feminine until 
 my eighteenth year, when my beard came in abundance and gave me rest 
 from resemblance to woman. An inguinal hernia that was acquired in 
 my twelfth year, and cured when I was twentj'^, gave me much trouble, 
 particularly in gymnastics. Besides, from my twelfth year on, I had, 
 after sitting long, and particularly while working at night, an itching, 
 burning, and twitching, extending from the penis to my back, which the 
 acts of sitting and standing increased, and which was made worse by 
 catching cold. But I had no suspicion whatever that this could be 
 connected with the genitals. Since none of mj' friends suffered in this 
 way, it seemed strange to me ; and it required the greatest patience to 
 endure it ; the more owing to the fact that my abdomen troubled me. 
 
 " In sexualibus I was still perfectly innocent ; but now, as at the 
 age of twelve or thirteen, I had a definite feeling of preferring to be a 
 young lady. A young lady's form was rnore pleasing to me; her quiet 
 manner, her deportment, but particularly her attire, attracted me. But 
 I was careful not to allow this to be noticed; and yet, I am sure that I 
 should not have shrunk from the castration-knife, could I have thus 
 attained my desire. If I had been asked to say why I preferred female 
 attire, I could have said nothing more than that it attracted me power- 
 fully ; perhaps, too, I seemed to myself, on account of my uncommonly 
 white skin, more like a girl. The skin of my face and hands, particu- 
 larly, was very sensitive. Girls liked my society; and, though I should 
 have preferred to have been with them constantly, I avoided them when 
 I could ; for I had to exaggerate in order not to appear feminine. In
 
 ACQUIRED HOMO-SEXUALITT. 205 
 
 my heart I always envied them. I was particularly envious when one 
 of my young girl friends got long dresses and Vore gloves and veils. 
 When, at the age of fifteen, I was on a journey, a 30ung lady, with whom 
 I was hoarding, proposed that I mask as a lad}' and go out with her; l)ut, 
 owing to the fact that she was not alone, I did not acquiesce, niiicli as 1 
 siiould have liked it. Others stood on very little ceremony with me. 
 Wiiile on this journey, I was pleased at seeing boys in one cit}'' wearing 
 blouses with short sleeves, and the arms bare. A lady elaborately 
 dressed was like a goddess to me; and if even her hand touched me 
 coldly I was happy and envious, and only too gladly would have put 
 myself in her place in the beautiful garments and lovely form. Never- 
 theless, I studied assiduously, and passed through the Realschule and 
 the Gymnasium in nine years, passing a good final examination. I 
 remember, when fifteen, to have first expressed to a friend the wish to be 
 a girl. In answer to his question, I could not give the reason why. At 
 seventeen I got into fast society; I drank beer, smoked, and tried to 
 joke with waiter-girls. The latter liked my society, but they always 
 treated me as if I wore petticoats. I could not take dancing lessons, 
 they repelled me so; but if I could have gone as a mask, it would have 
 been different. My friends loved me dearly ; I hated only one, who 
 seduced me into onanism. Shame on those days, which injured me for 
 lifel 1 practiced it quite frequently, but in it seemed to myself like a 
 double man. I cannot describe the feeling; I think it was masculine, 
 but mixed with feminine elements. I could not api)roach girls; I feared 
 them, but they were not strange to me. They impressed me as being 
 more like myself; I envied them. I would have denied myself all 
 l)leasures if, after my classes, at home I could have been a girl and thus 
 have gone out. Crinoline and a smoothly-fitting glove were my ideals. 
 With every lady's gown I saw I fancied how I should feel in it, — i.e., as a 
 lady. I had no inclination toward men. But I remember that I was 
 somewhat lovingly attached to a very handsome friend with a girl's face 
 and dark hair, though 1 think I had no other wish than that we both 
 might be girls. 
 
 "At the high-school I finally once had coitus; hoc modo sensi, 
 me libentius sub puella concubuisse et penem meum cum cunno mutatum 
 maluisse. To my astonishment, too, the girl had to treat me as a girl, 
 and did it willingly ; but she treated me as if I were she (she was still 
 quite inexperienced, and, therefore, did not laugh at me). 
 
 "When a student, at times I was wild, but I always felt that I 
 assumed this wildness as a mask. I drank and duelled, but I could not 
 take lessons in dancing, because I was afraid of betraying myself. My 
 friendships were close, but without other thoughts. It pleased me most 
 to have a friend masked as a lady, or to study the ladies' costumes at a 
 ball. I understood such things perfectly. Gradually I began to feel 
 like a girl.
 
 206 PSYCHOPATHIA SEXUALIS. 
 
 " On account of unhappy circumstances, I twice attempted suicide. 
 Without any cause I once slept fourteen days, liad many hallucinations 
 (visual and auditory- at the same time), and was with both the living and 
 the dead. The latter liahit of thought remains. I also had a friend (a 
 lady) who knew my hobby and put on my gloves for me ; but she always 
 looked upon me as a girl. Thus I understood women better than other 
 men did, and in what the}' differed from men ; so I was always treated 
 more feminarum, — as if they had found in me a female friend. On the 
 whole, I could not endure obscenity, and indulged in it myself only out 
 of brao<>adocio when it was necessary. I soon overcame mv aversion to 
 foul odors and blood, and even liked them. I was wanting in onl^' one 
 respect: I could not understand my own condition. I knew that I had 
 feminine inclinations, but believed that I was a man. Yet I doubt 
 whether, with the exception of the attempts at coitus, which never gave 
 me pleasure (which I ascribe to onanism), I ever admired a woman with- 
 out wishing I were she ; or without asking myself whether I should not 
 like to be the woman, or be in her attire. Obstetrics I learned with dif- 
 ficulty (I was ashamed for the exposed girls, and had a feeling of pity 
 for them) ; and even now I have to overcome a feeling of fright in 
 obstetrical cases; indeed, it has happened that I thought I felt the trac- 
 tion myself After filling several positions successfully as a physician, 
 I went through a militar}^ campaign as a volunteer surgeon. Riding, 
 whicli, while a student, was painful to me, because in it the genitals had 
 more of a feminine feeling, was difficult for me (it would have been 
 easier in the female style). 
 
 " Still, I always thought I was a man with obscure masculine feel- 
 ing ; and whenever I associated with ladies, I was still soon treated as an 
 inexperienced lady. When I wore a uniform for the first time, I should 
 have much preferred to have slipped into a lady's costume, with a veil ; 
 I was disturbed when the statel}' uniform attracted attention. In pri- 
 vate practice I was successful in the three principal branches. Then I 
 made another military campaign ; and during this I came to understand 
 my nature; for I think that, since the first ass, no beast of burden has 
 ever had to endure with so much patience as I have. Decorations were 
 not wanting, but I was indiflTerent to them. 
 
 " Thus I went through life, such as it was, never satisfied with 
 myself, full of dissatisfaction with the world, and vascillating between 
 sentimentality and a wildness th-at was for the most part affected. 
 
 " My experience as a candidate for matrimou}'^ was very peculiar. I 
 should have preferred not to marry, but famil}^ circumstances and prac- 
 tice forced me to it. I married an energetic, amiable lad}', of a family in 
 which female government was rampant. I was in love with her as much 
 as one of us can be in love, — i.e., what we love we love with our whole 
 hearts, and live in it, even though we do not show it as much as a gen- 
 uine man does. We love our brides with all the love of a woman, almost
 
 ACQUIRED HOMO-SKXUALITY. 207 
 
 as a woman might love her bridegroom. But I cannot say this for 
 myself; for I still believed that I was but a depressed man, who would 
 come to iiimself, and find himself out by marriage. But, even on my 
 marriage-night, I felt that 1 was only a woman in man's form ; sub femina 
 locum meum esse mihi visum est. On the whole, we lived contented and 
 happy, and for two years were childless. After a difficult pregnancy, 
 during which I was in mortal fear of death, the (irst boy was born in a 
 ditllcult labor, — a boy on whom a melancholy nature still hangs; who is 
 still of melancholy disposition. Then came a second, who is ver3' quiet; 
 a third, full of peculiarities ; a fourth, a fifth ; and all have predisposition 
 to neurasthenia. Since I always felt out of my own place, I went much 
 in gay society' ; but I always worked as much as human strength would 
 allow. I studied and operated ; and I experimented with many drugs 
 and methods of cure, always on myself. I left the regulation of the 
 house to my wife, as she understood house-keeping very well. M3' mar- 
 itaV duties I performed as well as I could, but without personal satisfac- 
 tion. Since the first coitus, the masculine position in it has been repug- 
 nant, and, too, diflicult for me. I should have much preferred to have 
 the other i^ole. When I had to deliver my wife, it almost broke my 
 heart; for I knew how to appreciate her pain. Thus Ave lived long- 
 together, until severe gout drove me to various baths, and made me 
 neurasthenic. At the same time, 1 became so amemic that everj' few 
 months I had to take iron for some time ; otherwise I would be almost 
 chlorotic or hysterical, or both. Stenocardia often troubled me; then 
 came unilateral cramps of chin, nose, neck, and lar^'nx ; hemicrania and 
 cramps of the diaphragm and chest-muscles. For about three ytnirs I 
 had a feeling as if the prostate were enlarged, — a bearing-down feeling, 
 as if giving birth to something; and, also, pain in the hips, constant 
 pain in the back, and the like. Yet, with the strength of despair, I 
 fought against these complaints, which impressed me as being female or 
 effeminate, until three years ago, when a severe attack of arthritis 
 completely broke me down. 
 
 "But before this terril)le attack of gout occurred, in despair, to 
 lessen the pain of gout, I had taken hot baths, as near the temperature 
 of the body as possible. On one of these occasions it happened that I 
 suddenly changed, and seemed to be near death. I sprang with all my 
 remaining strength out of the bath : I had felt exactly like a woman 
 with libido. Too, at the time when the extract of Indian hemp came 
 into vogue, and was highly j)rized, in a state of fear of a threatened 
 attack of gout (feeling perfectly indilferent about life), I took three or 
 four times the usual dose of it, and almost died of haschisch poisoning. 
 Convulsive laughter, a feeling of unheard of strength and swiftness, a 
 peculiar feeling in brain and eyes, millions of sparks streaming from the 
 brain through the skin, — all these feelings occurred. But I could not 
 force myself to speak. All at once I saw myself a woman from my toes
 
 208 PSTCHOPATHIA SEXUALIS. 
 
 to m}' breast; I felt, as before while in the bath, that the genitals had 
 shrunken, tlie pelvis broadened, the breasts swollen out; a feeling of 
 unspeakable delight came over me. I closed my eyes, so that at least 
 I did not see. the face changed. My physician looked as if he had a 
 gigantic potatoe instead of a head ; my wife had the full moon on her 
 nates. And yet I was strong enough to briefly record my will in my 
 note-book when both left the room for a short time. 
 
 " But who could describe m3' fright, when, on the next morning, I 
 awoke and found myself feeling as if completely changed into a woman ; 
 and when, on standing and walking, I felt vulva and mammas 1 When at 
 last I raised myself out of bed, I felt that a complete transformation 
 had taken place in me. During my sickness a visitor said : ' He is too 
 patient for a man.' And the visitor gave me a plant in bloom, which 
 seemed strange, but pleased me. From that time I was patient, and 
 would do nothing in a hurry ; but I became tenacious, like a cat, 
 though, at the same time, mild, forgiving, and no longer bearing enmity, 
 — in short, I had a woman's disposition. During the last sickness I had 
 many visual and auditor^' hallucinations, — spoke with the dead, etc. ; saw 
 and heard familiar spirits; felt like a double person; but, while lying ill, 
 I did not notice that the man in me had been extinguished. The change 
 in my disposition was a piece of good fortune which came over me like 
 lightning, and which, had it come with me feeling as I formerly did, 
 would have killed me; but now I gave myself up to it, and no longer 
 recognized myself. Owing to the fact that I still often confounded neu- 
 rasthenic symptoms with the gout, I took many baths, until an itching 
 of the skin with the feeling of scabies, instead of being diminished, was 
 so increased that I gave up all external treatment (I was made more and 
 more anosmic by the baths), and hardened myself as best I could. But 
 the imperative female feeling remained, and became so strong that I wear 
 only the mask of a man, and in everything else feel like a woman ; and 
 gradually' I have lost memory of the former individuality. What was 
 left of me from the gout, the influenza ruined entirely. 
 
 " Present Condition: I am tall, slightly bald, and the beard is grow- 
 ing gray. I begin to stoop. Since having the influenza, I have lost 
 about a quarter of m^'^ strength. Owing to a valvular lesion, my face 
 looks somewhat red; full beard; chronic conjunctivitis; more muscular 
 than fat. The left foot seems to be developing varicose veins, and it 
 often goes to sleep; but it is not really thickened, though it seems to be. 
 
 " The mammar}^ region, though small, swells out perceptibl}'. The 
 abdomen is feminine in form ; the feet are placed like a woman's, and the 
 calves, etc., are feminine ; and it is the same with arms and hands. I 
 can wear ladies' hose, and gloves, 7^ to V| in size. I also wear a corset 
 without annoyance. My weight varies between 168 and 184 pounds. 
 Urine without albumen or sugar, but it contains an excess of uric acid. 
 But if there is not too much uric ficid in it, it is clear, and almost as
 
 ACQUIRED nOMO-SEXUALITY. 209 
 
 clear as water after any exciteiuont. Bowels usually regular; but should 
 they not be, then come all the symptoms of female obstipation. Sleep 
 is poor, — for weeks at a time only two or three hours long. Appetite 
 quite good ; but, on the whole, ray stomach will not bear more than that 
 of a strong woman, and reacts to irritating food with cutaneous eruption 
 and burning in the urethra. The skin is white, and, for the most part, 
 feels quite smooth ; there has been unbearable cutaneous itching for the 
 last two 3'ears ; but during the last few weeks it has diminished, and is 
 now present only in the popliteal spaces and on the scrotum. 
 
 " Tendency to perspire. Perspiration was previously as good as 
 wanting, but now there are all the odious peculiarities of the female per- 
 spiration, particularly about the lower part of the bod3- ; so that I have 
 to keep myself cleaner than a woman. (I perfume my handkerchief, and 
 use perfumed soap and eau-de-Cologne.) 
 
 " General Feeling : I feel like a woman in a man's form ; and even 
 though I often am sensible of the man's form, yet it is always in a fem- 
 inine sense. Thus, for example, I feel the penis as clitoris ; the urethra 
 as urethra and vaginal orifice, which always feels a little wet, even when 
 it is actually dry; the scrotum as labia majora ; in short, I alwaj'^s feel 
 the vulva. And all that that means one alone can know who feels or has 
 felt so. But the skin all over my body feels feminine; it receives all 
 impressions, whether of touch, of warmth, or whether unfriendly, as 
 feminine, and I have the sensations of a woman. I cannot go with bare 
 hands, as both heat and cold trouble me. When the time is past 
 when we men are })ermitted to carry sun-umbrellas, I have to endure 
 great sensitiveness of the skin of my face, until sun-umbrellas can again 
 be used. On awaking in the morning, I am confused for a few moments, 
 as if I were seeking for niyself ; then the imperative feeling of being a 
 woman awakens. I feel the sense of the vulva (that one is there), and 
 always greet the day with a soft or loud sigh ; for I have fear again of 
 the play that must be carried on throughout the da}'. I had to learn 
 everything anew ; the knife — apparatus, everything — has felt different 
 for the last three years ; and with the change of muscular sense I had to 
 learn everything over again. I have been successful, and only the use 
 of the saw and bone-chisel are difficult; it is almost as if my strength 
 were not quite sufficient. On the other hand, I have a keener sense of 
 touch in working with the curette in the soft parts. It is unpleasant 
 that, in examining ladies, I often feel their sensations ; but this, indeed, 
 does not repell them. The most unpleasant thing I experience is foetal 
 movement. For a long time — several months — I was troubled by read- 
 ing the thoughts of both sexes, and I still have to fight against it. I 
 can endure it better with women ; with men it is repugnant. Three 
 years ago I had not yet consciously seen the world with a woman's eyes ; 
 this change in the relation of the e3'es to the brain came almost sud- 
 denly, with violent headache. I was with a lady whose sexual feeling 
 
 u
 
 210 PSTCHOPATHIA SEXUALIS. 
 
 was reversed, when suddenl}^ I saw Ler changed in the sense I now feel 
 m3'self, — viz., she as man, — and I felt myself a woman in contrast with 
 her; so that I left her with ill-concealed vexation. At that time she had 
 not yet come to understand her own condition perfectly. 
 
 " Since then, all my sensory impressions are as if they were 
 feminine in form and relation. The cerebral system almost immedi- 
 ately adjusted itself to the vegetative ; so that all my ailments were 
 manifested in a feminine way. The sensitiveness of all nerves, particu- 
 larl}' that of the auditory and olfactory' and trigeminal, increased to a 
 condition of nervousness. If only a window slammed, I was frightened 
 inwardly ; for a man dare not tremble at such things. If food is not 
 absolutely fresh, I perceive a cadaverous odor. I could never depend 
 on the trigeminus; for the pain would jump whimsically from one 
 branch of it to another; from a tooth to an eye. But, since m}' trans- 
 formation, I bear toothache and migraine more easil}^, and have less feel- 
 ing of fear with stenocardia. It seems to me a strange fact that I feel 
 myself to be a fearful, weak being, and yet, when danger threatens, I am 
 much rather cool and collected ; and this is true in dangerous operations. 
 The stomach rebels against the slightest indiscretion (in female diet) 
 that is committed without thought of the female nature, either by ructus 
 or other symptoms ; but particularl}'^ against abuse of alcoholics. The 
 indisposition after intoxication that a man who feels like a woman expe- 
 riences is much worse than any a student could get up. It seems to me 
 almost as if one feeling like a woman were entirely controlled by the 
 vegetative system. 
 
 " Small as my nipples are, they demand room, and I feel them as 
 mammae ; just as during the beginning of puberty, the nipples swelled and 
 pained. On this account, the white shirt, the waistcoat, and the coat 
 troul)le me. I feel as though the pelvis were female ; and it is the same with 
 the anus and nates. At lirst the sense of a female abdomen was trouble- 
 some to me ; for it cannot bear trousers, and it always possesses or in- 
 duces the feminine feeling. I also have the imperative feeling of a waist. 
 It is as if I were robbed of my own skin, and put in a woman's skin that 
 fitted me perfectly, but which felt everything as if it covered a woman ; and 
 whose sensations passed through the man's body, and exterminated the 
 masculine element. The testes, even though not atrophied or degenerated, 
 are still no longer testes, and often cause me pain, with the feeling that they 
 belong in the abdomen, and should be fastened there ; and their mobility 
 often bothers me. 
 
 " Every four weeks, at the time of the full moon, I have the moli- 
 men of a woman for five days, physically' and mentall}^, only I do not 
 bleed ; but I have the feeling of a loss of fluid; a feeling that the genitals 
 and abdomen are (internally) swollen. A very pleasant period comes 
 when, afterward and later in the interval for a day or two, the physiologi- 
 cal desire for procreation comes, which with all power permeates the
 
 ACQUIRED HOMO-SEXUALITY. 211 
 
 woman. M3' whole body is tlien filled with this sensation, as an immersed 
 piece of sugar is filled with water, or as full as a soaked sponge. It is 
 like this : first, a woman longing for love, and then, for a man ; and, in fact, 
 the desire, as it seems to me, is more a longing to be possessed than a 
 wish for coitus. The intense natural instinct or the feminine concupis- 
 cence overcomes the feeling of modesty, so that indirectly coitus is 
 desired. I have never felt coitus in a masculine way more than three 
 times in my life ; and even if it were so in general, I was always indifferent 
 about it. But, during the last three years, I have experienced it passively, 
 like a woman ; in fact, oftentimes with the feeling of feminine ejaculation; 
 and I always feel that I am impregnated. 1 am always fatigued as a 
 woman is after It, and often feel ill, as a man never does. Sometimes it 
 caused me so great pleasure that there is nothing with which I can com- 
 pare it ; it is the most blissful and powerful feeling in the world ; at that 
 moment the woman is simply a vulva that has devoured the whole 
 person. 
 
 " During the last three years I have never lost for an instant the 
 feeling of being a woman, and now, owing to habit, this is no longer an- 
 noying to me, though during this period I have felt debased ; for a man 
 could endure to feel like a woman without a desire for enjoyment; but 
 when desires come ! The happiness ceases ; then come the burning, the 
 heat, the feeling of turgor of the genitals (when the penis is not in a state 
 of erection the genitals do not play any part). In case of intense desire, 
 the feeling of sucking in the vagina and vulva is really terrible — a hellish 
 pain of lust hardly to be endured. If I then have opportunity to per- 
 form coitus, it is better; but, owing to defective sense of being possessed 
 by the other, it does not afford complete satisfaction ; the feeling of 
 sterility comes with its weight of shame, added to the feeling of passive 
 copulation and injured modesty. I seem almost like a prostitute. Reason 
 does not give any help; the imperative feeling of femininity dominates 
 and rules everything. The difficulty in carrying on one's occupation, 
 under such circumstances, is easily appreciated ; but it is possible to force 
 one's self to it. Of course, it is almost impossible to sit, walk, or lie down ; 
 at least, any one of these cannot be endured long ; and with the constant 
 touch of the trousers, etc., it is unendurable. 
 
 "Marriage then, except during coitus, where the man has to feel 
 himself a woman, is like two women living together, one of whom re- 
 gards herself as in the mask of a man. If the periodical molimen fail to 
 occur, then come the feelings of pregnancy or of sexual satiety, which a 
 man never experiences, but which take possession of the whole being, 
 just as the feeling of femininity does, and are repugnant in themselves ; 
 and, therefore, I gladly welcome the regular molimen again. When erotic 
 dreams or ideas occur, I see myself in the form I have as a woman, and 
 see erected organs presenting. Since the anus feels feminine, it would not 
 be hard to become a passive pederast ; only positive religious command
 
 212 PSTCHOPATHIA SEXUALIS. 
 
 prevents it, as all other deterrent ideas would be overcome. Since such 
 conditions are repugnant, as they would be to any one, I have a desire to 
 be sexless, or to make myself sexless. If I had been single, I should long 
 ago have taken leave of testes, scrotum, and penis. 
 
 " Of what use is female pleasure, when one does not conceive ? 
 What good comes from excitation of female love, when one has only 
 a wife for gratification, even though copulation is felt as though it were 
 with a man ? What a terrible feeling of shame is caused by the feminine 
 perspiration ! How the feeling for dress and ornament lowers a man ! 
 Even in his changed form, even when he can no longer recall the mascu- 
 line sexual feeling, he would not wish to be forced to feel like a woman. 
 He still knows very well that, before, he did not constantly feel sexually ; 
 that he was merely a human being uninfluenced by sex. Now, sud- 
 denly, he has to regard his former individuality as a mask, and constantly 
 feel like a woman, only having a change when, every four weeks, he has 
 his periodical sickness, and in the intervals his insatiable female desire. 
 If he could but awake without immediately being forced to feel like a 
 woman! At last he longs for a moment in which he might raise his 
 mask ; but that moment does not come. He can only find amelioration 
 of his misery when he can put on some bit of female attire or finery, an 
 under-garment, etc. ; for he dare not go about as a woman. To be com- 
 pelled to fulfill all tlie duties of a calling with the feeling of being a 
 woman costumed as a man, and to see no end of it, is no trifle. Religion 
 alone saves from a gi'eat lapse ; but it does not prevent the pain when 
 temptation affects the man who feels as a woman ; and so it must be felt 
 and endured ! When a respectable man who enjo3's an unusual degree of 
 public confidence, and possesses authority, must go about with his vulva — 
 imaginary though it be; when one, leaving his arduous daily task, is com- 
 pelled to examine the toilette of the first lady he meets, and criticise her 
 with feminine eyes, and read her thoughts in her face; when a journal of 
 fashions possesses an interest equal to that of a scientific work (I felt 
 this as a child) ; when one must conceal his condition from his wife, 
 whose thoughts, the moment he feels like a woman, he can read in her 
 face, while it becomes perfectly clear to her that he has changed in body 
 and soul, — what must all this be? The misery caused by the feminine 
 gentleness that must be overcome ! Oftentimes, of course, when I am 
 away alone, it is possible to live for a time more like a woman ; for ex- 
 ample, to wear female attire, especialty at night, to keep gloves on, or to 
 wear a veil or a mask in my room, so that thus there is rest from exces- 
 sive libido. But when the feminine feeling has once gained an entrance, 
 it imperatively demands recognition. It is often satisfied with a moder- 
 ate concession, such as the wearing of a bracelet above the cuff"; but it 
 imperatively demands some concession. My only happiness is to see 
 myself dressed as a Avoman without a feeling of shame ; indeed, when m}'^ 
 face is veiled or masked, I prefer it so, and thus think of mj'self. Like
 
 ACQUIRED HOMO-SEXUALITY. 213 
 
 every one of Fashion's fools, I h.ave a taste for the prevailing mode ; 
 so greatly am I transformed . 'I'o become accustomed to the thought of 
 feeling only like a woman, and only to remember the previous manner of 
 thought to a certain extent in contrast with it ; and, at the same time, to 
 express one's self as a man, — it re(iuircs a long time and an infinite 
 amount of persistence. 
 
 " Nevertheless, in spite of everything, it will happen that I betray 
 m3'self by some expression of feminine feeling, either in sexiialibus^ when 
 I say that I feel so and so, expressing what a man without the female 
 feeling cannot know; or when I accidentally betray that female attire 
 is my talent. Before women, of course, this does not amount to an}-- 
 thing ; for a woman is greatly flattered when a man understands some- 
 thing of her matters; but this must not be displayed to my own wife. 
 How frightened I once was when my wife said to a friend that I had 
 great taste in ladies' dress 1 How a haughty, stylish lady was astonished 
 when, as she was about to make a great error in the education of her little 
 daughter, I described to her in writing and verbally all the feminine 
 feelings ! To be sure, I lied to her, saying that my knowledge had been 
 gleaned from letters. But her confidence in me is as great as ever; and 
 the child, who was on the road to insanity, is rational and happy. She 
 had confessed all the feminine inclinations as sins ; now she knows what, 
 as a girl, she must bear and control 1)y will and religion; and she feels 
 that she is human. Both ladies would laugh heartily, if they knew that 
 I had onl^^ drawn on my own sad experience. I must also add that I 
 now have a finer sense of temperature and, besides, a sense of the 
 elasticity of the skin and tension of the intestines, etc., in patients, that 
 was unknown to me before ; that in operations and autopsies, poisonous 
 fluids more readily penetrate my (uninjured) skin. Every autopsy causes 
 me pain; examination of a i)rostitute, or a woman having a discharge, a 
 cancerous odor, or the like, is actually repugnant to me. In all respects 
 I am now under the influence of antipathy and sympathy, from the sense 
 of color to my judgment of a person. Women usually see in each other 
 the periodical sexual disposition; and, therefore, a lady wears a veil, if 
 she is not always accustomed to wear one, and usually she perfumes her- 
 self, even tliough it be only with handkerchief or gloves; for her olfactor}' 
 sense in relation to her own sex is intense. Odors have an incredible 
 eflTect on the female organism ; thus, for example, the odors of violets and 
 roses quiet me, while others disgust me ; and with ihlang-ihlang I cannot 
 contain myself for sexual excitement. Contact with a woman seems 
 homogeneous tome; coitus with my wife seems possible tome because 
 she is somewhat masculine, and has a firm skin ; and yet it is more an 
 amor lesbicus. 
 
 " Besides, I always feel passive. Often at night, when I cannot 
 sleep for excitement, it is finally' accomplished, si femora mea distensa 
 habeo, sicut mulier cum viro concumbens, or if I lie on my side ; but an
 
 214 PSYCHOPATHIA SEXUALIS. 
 
 arm or the bed-clothing must not touch the mammae, or there is no sleep; 
 and there must he no pressure on the abdomen. I sleep best in a chemise 
 and night-robe, and with gloves on ; for m}^ hands easily get cold. I am also 
 comfortable in female drawers and petticoats, because they do not touch 
 the genitals. I liked female dresses best when crinoline was worn. Female 
 dresses do not annoy the feminine-feeling man ; for he, like ever^^ woman, 
 feels them as belonging to his person, and not as something foreign. 
 
 " My dearest associate is a lady suffering with neurasthenia, who, 
 since her last confinement, feels like a man, but who, since I explained 
 these feelings to her, coitu abstinet as much as possible, a thing I, as a 
 husband, dare not do. She, by her example, helps me to endure my con- 
 dition. She has a more perfect memory of the female feelings, and has 
 often given me good advice. Were she a man and I a j^oung girl, I 
 should seek to win her ; for her I should be glad to endure the fate of a 
 woman. But her present appearance is quite different from what it 
 formerly was. She is a very elegantly dressed gentleman, notwithstand- 
 ing bosom and hair ; she also speaks quickly and concisely, and no longer 
 takes pleasure in the things that please me. She has a kind of melan- 
 choly dissatisfaction with the world, but she bears her fate worthily and 
 with resignation, finding her comfort only in religion and the fulfillment 
 of duty. At the time of the menses, she almost dies. She no longer 
 likes female society and conversation, and has no liking for delicacies. 
 
 " A youthful friend felt like a girl from the very first, but he had 
 inclinations toward the male sex. His sister had the opposite condi- 
 tion ; and when the uterus demanded its right, and she saw herself as a 
 loving woman, in spite of her masculinity, she cut the matter short, and 
 committed suicide by drowning. 
 
 " Since complete effemination, the principal changes I have observed 
 in myself are : — 
 
 " 1. The constant feeling of being a woman from top to toe. 
 
 " 2. The constant feeling of having female genitals. 
 
 " 3. The periodicity of the monthly molimen. 
 
 " 4, The regular occurrence of female desire, though not directed to 
 any particular man. 
 
 " 5. The passive female feeling in coitus. 
 
 " 6. After that, the feeling of impregnation. 
 
 " 7. The female feeling in thought of coitus. 
 
 " 8. At the sight of women, the feeling of being of their kind, and 
 the feminine interest in them. 
 
 " 9. At the sight of men, the feminine interest in them. 
 
 " 10. At the sight of children, the same feeling. 
 
 "11. The changed disposition and much greater patience. 
 
 " 12. The final resignation to my fate, for which I have nothing to 
 thank but positive religion ; without it I should have long ago committed 
 suicide.
 
 ACQUIRED HOMO-SEXUALITY. 215 
 
 " To be a man and to be compelled to feel that cliaque ferame est 
 futuee on elle dc'sire d'etre, is hardly to be eudured." 
 
 The foregoiii*;- uutobiograpliy, scientifically so important, 
 was accompanied by the following no less interesting letter : — 
 
 " Sir : I must next beg 3'our indulgence for troubling 3'ou with my 
 communication. I lost all control, and thought of mj'self only as a 
 monster before which I myself shuddered. Then your work gave me 
 courage again ; and I determined to go to the bottom of the matter, and 
 examine my past life, let the result be what it might. It seemed a dut}^ of 
 gratitude to you to tell you the result of my recollection and observation, 
 since I had not seen any description by you of an analogous case; and, 
 finally, I also thought it might perhaps interest you to learn, from the pen 
 of a physician, how such a worthless human, or masculine, being thinks 
 and feels under the weight of the imperative idea of being a woman. 
 
 " It is not perfect ; but I no longer have the strength to reflect more 
 upon it, and have no desire to go into the matter more deeply. Much is 
 repeated ; but I beg 3^ou to rememljer that any m:isk may be allowed to 
 fall off, i)articularly when it is not voluntarily worn, but enforced. 
 
 " After reading your work, I hope that, if I fulfill my duties as 
 phj'sician, citizen, father, aud husband, I may still count myself among 
 human beings who do not deserve merely to be despised. 
 
 " Finally, I wished to lay the result of my recollection and reflec- 
 tion before you, in order to shoAV that one thinking and feeling like a 
 woman can still be a physician. I consider it a great injustice to debar 
 woman from Medicine. A woman, through her feeling, gets on the track 
 of many ailments which, in spite of all skill in diagnosis, remain obscure 
 to a man ; at least, in the diseases of Avomen and children. If I could have 
 my way, I should have every physician live the life of a woman for three 
 months ; then he would have a better understanding and more considera- 
 tion in matters atfecting the half of humanity from which he comes ; then 
 he would learn to value the greatness of women, and appreciate the 
 diflSculty of their lot." 
 
 Bemarkn: The badly-tainted patient is originally psycho-sexually 
 abnormal, in that, in ('hanicter and in the sexual act, he feels as a female. 
 This abnormal feeling remained purely a ps3xhical anomaly' until three 
 years ago, when, owing to severe neurasthenia, it received overmastering 
 support in imperative bodily sensations of a transmutatio sexus, which now 
 dominate consciousness. Then, to the patient's horror, he felt bodily' 
 like a woman ; and, under the impulse of his imperative femiuine sensa- 
 tions, he experienced a comi)lete transformation of his former masculine 
 feeling, thought, and will ; in fact, of his whole vita sexualis, in the sense 
 of eviration. At the same time, his ego is able to control these abnormal 
 psycho-physical manifestations, and prevent descent to paranoia, — a
 
 216 PSYCHOPATHIA SEXUALIS. 
 
 remarkable example of imperative feelings and ideas on the basis of 
 neurotic taint, which is of great value for a comprehension of the way in 
 which the psycho-sexual transformation may be accomplished. 
 
 IV. Degree: Metamorphosis Sexucdis Paranoica. — A final 
 possible stage in this disease-process is the delusion of a trans- 
 formation of sex. It arises on the basis of sexual neurasthenia 
 that has developed into neurasthenia universaHs, resulting in a 
 mental disease, — paranoia. 
 
 The following cases show the development of the inter- 
 esting neuro-psychological process to its height : — 
 
 Case 100. K., aged 36, single, servant, received at the clinic on 
 February 26, 1889, is a typical case of paranoia persecutoria, resulting 
 from neurasthenia sexualis, with olfactory hallucinations, sensations, 
 etc. lie comes of a predisjiosed family. Several brothers and sisters 
 were ps3'choi)athic. Patient has an hydrocephalic skull, depressed in the 
 region of the right fontanelle ; eyes neuropathic. He has always been 
 very sensual ; began to masturbate at nineteen ; had coitus at twenty- 
 three ; begat three illegitimate children. He gave up further sexual 
 intercourse, on account of fear of begetting more children, and of being 
 unable to provide for them. Abstinence proved very painful to him. He 
 also gave up masturbation, and was then troubled with pollutions. A 
 year and a half ago he became sexually neurasthenic, had diurnal pollu- 
 tions, became thereafter ill and miserable, and, after a time, generally neu- 
 rasthenic, finally developing paranoia. A 3'ear ago he began to haA'e 
 parsesthetic sensations, — as if there were a great coil in the place of his 
 genitals ; and then he felt that his scrotum and penis were gone, and that 
 his genitals were changed into those of a female. He felt the growth of 
 his breasts ; that his hair was that of a woman ; and that feminine gar- 
 ments were on his bod}^ He thought himself a woman. The people in 
 the street gave utterance to corresponding remarks : " Look at the 
 woman ! The old blowhard ! " In a half dreamy state, he had the feeling 
 as if he played the part of a woman in coitus with a man. During it 
 he had the most lively' feelings of pleasure. During his stay at the 
 clinic, a remission of the paranoia occurred, and, at the same time, a 
 marked improvement of the neurasthenia. Then the feelings and ideas 
 due to a developing metamorphosis sexualis disappeared. 
 
 A more advanced case of eviration, on the way to a trans- 
 formatio sexus paranoica, is the following : — 
 
 Case 101. Franz St., aged 33; school-teacher; single; prol)ably of 
 tainted family ; always neuropathic ; emotional, timid, intolerant of alco-
 
 ACQUIRED HOMO-SEXUALITY. 217 
 
 hoi; began to masturbate at eighteen. At thirty there were manifesta- 
 tions of neurasthenia sexualis (pollutions with consequent ftitigue, which 
 at last began to occur during the day ; pain in the region of the sacral 
 plexus, etc.). Graduall}^, spinal irritation, pressure in the head, and cere- 
 bral neurasthenia were added. Since the beginning of 1885 the patient 
 had given up coitus, in which he no longer experienced pleasurable feel- 
 ing. He masturbated frecpiently. 
 
 In 1888 he began to have delusions of suspicion. He noticed that 
 he was avoided, and that he had unpleasant odors about him (olfactory 
 hallucinations). In this way he explained the altered attitude of people, 
 and their sneezing, coughing, etc. He smelled corpses and foul urine. 
 He recognized the cause of his bad smells in inward pollutions. He 
 recognized these in a feeling he had as if a fluid flowed up from the sym- 
 physis toward the breast. Patient soon left the clinic. 
 
 In 1889 he was again received in an advanced stage of paranoia 
 masturbatoria persecutoria (delusions of physical persecution). 
 
 In the beginning of May, 1889, the patient attracted notice, in that 
 he was cross when he was addressed as " mister." He protested against 
 it, because he was a woman. Voices told him this. He noticed that his 
 breasts were growing. Some weeks Ijefore, others had touched him in a 
 sensual manner. He heard it said that he was a whore. Of late, dreams 
 of pregnancy. He dreamed that, as a woman, he indulged in coitus. He 
 felt the immissio penis, and, during the hallucinatory^ act, also a feeling 
 of ejaculation. 
 
 Head straight ; facial form long and narrow ; parietal eminences 
 prominent; genitals normally developed. 
 
 The following case, observed in the asylum at Illenaii, is a 
 pertinent example of lasting delusional alteration of sexual 
 consciousness : — 
 
 Case 102. Metamorphosis Sexualis Paranoica. — N., aged 23, single, 
 pianist, was received in the asylum at Illenau in the last part of October, 
 1865. He came of a family in which there was said to be no hereditary 
 taint ; but it was tuberculous (father and brother died of pulmonar}'^ 
 tuberculosis). Patient, as a child, was weakly and dull, though especially' 
 talented in music. He was always of abnormal character; silent,* retir- 
 ing, unsocial, and sullen. He practiced mastin-liation after fifteen. After 
 a few 3^ears neurasthenic symi)toms (palpitation of the heart, lassitude, 
 occasional pressure in the head, etc.), and also hypochondriacal symp- 
 toms, were manifested. During the last year he had worked with great 
 difficulty. For about six months neurasthenia had increased. He com- 
 plained of palpitation of the heart, pressure in the head, and sleep- 
 lessness; was very irritable, and seemed to be sexually excited. He 
 declared that he must marry for his health. He fell in love with an
 
 218 PSYCHOPATHIA SEXUALIS. 
 
 artist, but almost at the same time (September, 1865) he fell ill with 
 paranoia persecutoria (ideas of enemies, derision in the street, poison in 
 food ; obstacles were placed on the bridges to keep him from going to his 
 inamorata). On account of increasing excitement and conflicts with those 
 about him that he considered inimical to him, he was taken to the asy- 
 lum. At first he presented the picture of a typical paranoia persecutoria 
 with symptoms of sexual, and later general, neurasthenia, though the 
 delusions of persecution did not rest upon this neurotic foundation. 
 It was only occasionally that the patient heard such sentences as this : 
 " Now the semen will be drawn out of him. Now the bladder will be 
 cut out." 
 
 In the course of the years 1866-68, the delusions of persecution be- 
 came less and less apparent, and were for the most part replaced by 
 erotic ideas. The somatic and mental basis was a lasting and powerful 
 excitation of the sexual sphere. The patient fell in love with every 
 woman he saw, heard voices which told him to approach her, and begged 
 to be allowed to marry, declaring that, if he was not given a wife, he 
 would waste away. With continuance of masturbation, in 1869, signs of 
 future effemination made themselves manifest. " He would, if he should 
 get a wife, love her ouly platonicall3\" The patient grows more and more 
 peculiar, lives in a circle of erotic ideas, sees prostitution practiced in 
 the asylum, and now and then hears voices which impute immoral con- 
 duct with women to him. For this reason he avoids the society of 
 women, and only associates with them for the sake of music when two 
 witnesses are with him. 
 
 In the course of the year 1872, the neurasthenic condition became 
 markedly increased. Now paranoia persecutoria again comes into the 
 foreground, and takes on a clinical coloring from the neurotic basis. 
 Olfoctory hallucinations occur. Magnetic influences are at work on him 
 (false interpretation of sensations due to spinal asthenia). With con- 
 tinued and intense sexual excitement and excess in masturbation, the 
 process of effemination constantly progresses. Only episodically is he a 
 man and inclined toward a woman, complaining that the shameless pros- 
 titution of the men in the house makes it impossible for a lad}^ to come to 
 him. He is djang of magnetically poisoned air and unsatisfled love. 
 Without love he cannot live. He is poisoned by lewd poison that affects 
 his sexual desire. The lady that he loves is sunk in the lowest vice. 
 The prostitutes in the house have fortune-chains ; that is, chains in which, 
 without moving, a man can indulge in lustful pleasure. He is ready now 
 to satisfy himself with prostitutes. He is possessed of a wonderful ray 
 of thought that emanates from his eyes, which is worth twenty millions. 
 His compositions are worth 500,000 francs. With these indications of 
 delusions of grandeur, there are also those of persecution — the food is 
 poisoned by venereal excrement ; he tastes and smells poison, hears 
 infamous accusations, and asks for instruments to close his ears. From
 
 ACQUIRED HOMO-SEXUALITY. 219 
 
 August, 1872, however, the signs of effemination become more aud more 
 fre(][uent. He acts somewhat afl'ected, declaring that he can no longer 
 live among men that drink and smoke. He thinks and feels like a 
 woman. He must thenceforth be treated like a woman and ti'ansferred 
 to a female ward. He asks for confections and delicate desserts. Occas- 
 ionall}^, on account of tenesmus and cystospasm, he asks to be transferred 
 to a lying-in hospital and treated as a woman very ill in pregnancy. The 
 abnormal magnetism of masculine attendants has an unfavorable effect on 
 him. At times he still feels himself to be a man, but in a way which in- 
 dicates his abnornmlly altered sexual feeling. He pleads only for satis- 
 faction by means of masturbation, or for marriage without coitus. Mar- 
 riage is a sensual institution. The girl that he would take for a wife 
 must be a masturbator. About the end of December, 1872, his personality 
 became completely feminine. From that time he remained a woman. He 
 had always been a woman, but in his babyhood a French Quaker, an 
 artist, had put masculine genitals on hun, and by ru1)bing and distorting 
 his thorax had prevented the development of his breasts. After this 
 he demanded to be transferred to the female department, protection from 
 men that wished to violate him, and asked for female clothing. Eventually 
 he also desired to be given employment in a t03^-shop, with crocheting and 
 embroidery work to do, or a place in a dress-making establishment with 
 female work. From the time of the transformatio sexus, the patient 
 begins a new reckoning of time. He conceives his previous personality 
 in memory as that of a cousin. 
 
 He always speaks of himself in the third person, and calls himself 
 the Countess V., the dearest friend of the Empress Eugenie; asks for 
 perfumes, corsets, etc. He takes the other men of the ward for girls, tries 
 to raise a head of hair, and demands " Oriental Hair-Remover," in order 
 that no one may doubt his gender. He takes delight in praising onanism, 
 for " she had been an onanist from fifteen, and had never desired any 
 other kind of sexual satisfaction." Occasionally neurasthenic symptoms, 
 olfactory hallucinations, and persecutory delusions are observed. All 
 the events up to the time of December, 1872, belong to the personality 
 of the cousin. 
 
 The patient's delusion that he is the Countess V. can no longer be 
 corrected. She proves her identity by the fact that the nurse has ex- 
 amined her, and finds her to be a lady. The countess will not marry, 
 because she hates men. Since he is not provided with female clothing 
 and shoes, he spends the greatest part of the day in bed, acts like an 
 invalid lady of position, affectedly and modestly, and asks for bon-bons 
 and the like. His hair is done up in a knot as well as it allows, and the 
 beard is pulled out. Breasts are made out of biscuits. 
 
 In 1874 caries began in the left knee-joint, to which pulmonary 
 tuberculosis was soon added. Detith on December 2, 1874. Skull 
 normal. Frontal lobes atrophic. Brain anaemic. Microscopical (Dr.
 
 220 PSYCHOPATHIA SEXUALTS. 
 
 Scbiile) : In the superior layer of the frontal lo1je, ganglion cells some- 
 what shrunken; in the adventitia of the vessels, numerous fat-corpuscles; 
 glia unchanged ; isolated pigment particles and colloid bodies. The lower 
 layers of the cortex normal. Genitals very large ; testicles small, lax, 
 and show no change macroscopically on section. 
 
 The delusion of sexual transformation, displayed, in its con- 
 ditions and phases of development, in the foregoing case, is a 
 manifestation remarkably infrequent in the pathology of the 
 human mind. Besides the foregoing cases, personally observed, 
 1 have seen such a case, as an episodical phenomenon, in a lady 
 having contrary sexuality (Case 92 of the sixth edition of this 
 work), one in a girl affected with original paranoia, and another 
 in a lady suffering witli original paranoia. 
 
 Save for a case briefly reported by Arndt, in his text-book 
 (p. 172), and one quite superficially described by Serieux 
 ("Recherches Clinique," p. 33), and the two cases known to 
 Esquirol, I cannot recall any cases of delusion of sexual trans- 
 formation in literature. Arndt's case may be briefly given here, 
 though, like Esquirol's cases, it gives nothing concerning the 
 genesis of the delusion : — 
 
 Case 103. A middle-aged woman in the asylum at Greifswald 
 thought she was a man, and acted out her belief She cut her hair short, 
 and parted it on one side in the military fashion. A sharply-cut pro- 
 file, a nose somewhat large, and a certain heaviness of all the features 
 gave the face something characteristic, and, in combination with the 
 short hair combed smoothl}^ over the ears, gave the whole head a decid- 
 edly masculine appearance. She was tall and lean ; her voice low and 
 rough ; the larynx angularly prominent ; her attitude erect ; her gait, 
 like all her movements, heavj^, but not awkward. She looked like a man 
 in female dress. Asked how she had come to think she was a man, she 
 would almost always cry excitedl}' : " Just look at me ! Don't I look 
 like a man ? I feel like a man, too. I have always felt so, but I only 
 gradually came to understand it clearly. The man who should be my 
 husband is not a real man. I raised my children mj'self. I always felt 
 somewhat like this, I>ut I came to understand later. Did I not alwaj^s 
 work like a man? The man who passed for my husband only helped. 
 He did what I planned. From my youth I have been more masculine 
 than feminine. I have always had more liking for the garden and farm 
 than for work in the house and kitchen. But I never understood the 
 reason. Now I know I am a man, and I shall bear mj'self like one. It 
 is a shame to make me always wear women's clothes."
 
 ACQUIRED HOMO-SEXUALITY. 221 
 
 Case 104. X., aged 26, tall, and of handsome appearance. Since 
 his earliest youth he has loved to wear female attire. As he grew up, he 
 managed it so that, when he was a participant in theatricals, he always 
 had a female part. After an attack of mental excitement, he imagined 
 that he was actually a woman, and tried to convince others of it. 
 
 He liked to undress himself, and dress his hair and put on female 
 clothing. In this state he wished to go out on the street. In other 
 respects he was i^erfectly reasonable. He would spend the whole day 
 arranging his hair and looking at himself in the glass, costuming himself 
 in a night-dress as much like a woman as possible. In walking he 
 imitated women. One day, when Esquirol acted as if a])0iit to lift up 
 his dress, he flew into a passion and upbraided him for his want of 
 modesty (Escpiirol). 
 
 Case 105. Mrs. X., widow. Owing to the death of her husband 
 and loss of fortune, she had been greatly trouT)led in mind. She became 
 disturbed mentally, and was admitted to the Salpetrifere after attempting 
 suicide. 
 
 Mrs. X., lean, thin; constantly maniacal; she believes herself a 
 man, and flies angry if she is addressed as " madam." Once, when male 
 clot hing was placed at her disposal, she was beside herself with joy. She 
 died, in 1S02, of a consumptive malady; and she expressed her delusion 
 of being a man until shortly before her death (Esquirol). 
 
 I liave already mentioned the interesting- relations existing 
 between tlie facts of delusional transformation of sex and the 
 so-called insanity of the Scythians. 
 
 Marandon (" Annak^s medico-psychologiques," 1877, p. 
 161), hke others, has erroneously presumed that with the ancient 
 Scythians there was an actual delusion, and that the condition 
 was not merely that of eviration. According to the law of em- 
 pirical actuality, the delusion, so infrequent to-day, must also have 
 been very infrequent in ancient times. Since it can only be con- 
 ceived as arising on the basis of a paranoia, there can be no 
 thought of its endemic occurrence ; it can only be regarded as 
 a superstitious manifestation of eviration (tlie result of anger 
 of the goddess), as is also evident from the statements of 
 Hippocrates. 
 
 The facts of the so-called Scythian insanity, as well as the 
 facts lately learned about the Pueblo Indians, are also note- 
 worthy anthropologically, in that atrophy of the testes and geni- 
 tals in general, and approximation to the female type, physically
 
 222 PSTCHOPATHIA SEXUALIS. 
 
 and mentally, were observed. This is the more remarkable, since, 
 in men who have lost their procreative organs, snch a reversal 
 of instinct is quite as unusual as in women, mutatis mutandis^ 
 after the natural or artificial climacteric. 
 
 B. Homo- Sexual Feeling as an Abnormal Congenital 
 Manifestation} — The essential feature of tliis strange manifesta- 
 tion of the sexual life is the want of sexual sensibility for the 
 opposite sex, even to the extent of horror, while sexual inclina- 
 tion and impulse toward the same sex are present. At the same 
 time, the genitals are normally developed, the sexual glands 
 perform their functions properly, and the sexual type is 
 completely differentiated. 
 
 Feeling, thought, will, and the whole character, in cases of 
 the complete development of the anomaly, correspond with 
 the peculiar sexual instinct, but not with the sex which the 
 individual represents anatomically and physiologically. This 
 abnormal mode of feeling may not infrequently be recognized 
 in the manner, dress, and calling of the individuals, who may 
 go so far as to yield to an impulse to don the distinctive clothing 
 corresponding with the sexual role in which they feel them- 
 selves to be. 
 
 Anthropologically and clinically, this abnormal manifesta- 
 tion presents various degrees of development : — 
 
 1. Traces of hetero-sexual, with predominating homo- 
 sexual, instinct (psycho-sexual hermaphroditism). 
 
 2. There exists inclination only toward the same sex 
 (homo-sexuality). 
 
 1 Bibliography (besides works mentioned hereafter) : Tardieu, Des attentats aux 
 moeurs, 7 6dit., 1878, p. 210.— Hofmann, Lehrb. d. ger. Med., 3 Aufl., pp. 172, 850.— Gley, 
 Revue pbilosophique, 188-t, Nr. 1. — Magnau, Aunal. med.-psychol., 1885, p. 458. — Shaw and 
 Ferris, Journal of Nervous and Mental Disease, 1883, April. — Bernhardi, Der Uraulsmus, 
 Berlin (Volksbuchhandlung), 1882. — Chevalier, De I'inversion de I'instinct sexual, Paris, 
 1885. — Ritti, Gaz. hebdom. de m^decine et de chirurg., 1878,4. Januar. — Tamassia, Rivista 
 sperim, 1878, pp. 97-117. — Lombroso, Archiv. di Psichiatr., 1881. — Charcot et Magnan, 
 Archiv. de neurologie, 1882, Nr. 7, 12. — Moll, Die contrare Sexualerapfinduug, Berlin, 1891 
 (numerous bibliographic references). — Chevalier, Archives de 1 'anthropologic criminelle, 
 vol. V, No 27 ; vol. vl, No. 31. — Reuss, " Aberrations du sens g6nerique," Annales d'hygi&ne 
 publique, 1886. — Saury, Etude clinlque sur la folic h6r6ditaire, 1886. — Brouardel, Gaz. des 
 liopiteaux, 1886 and 1887. — Tiller, L'instiiict sexuel chez I'honime et chez les animaux, 
 1889. — Carlier, Les deux prostitutions, 1887. — Lacassagne, art. " Pederastie,"in the Diction, 
 eocyclopfedique. — Vibert, art. " Pederastie," iu the Diction. pi6d. et de chirurgie, .
 
 CONGENITAL UOMO-SEXUALITY. 223 
 
 3. The entire mental existence is altered to correspond 
 with the abnormal sexual instinct (effemination and viraginit} ). 
 
 4. The form of the body approaches that which corresponds 
 to the abnormal sexual instinct. However, actual transitions 
 to hermaphrodites never occur, but, on the contrary, completely 
 differentiated genitals ; so that, just as in all pathological per- 
 versions of the sexual life, the cause must be sought in the 
 brain (androgyny and gynandry). 
 
 The first definite communications * concerning this enigmatical plie- 
 nomenon of Nature are made by Caspar (" Ueber Nothzucht und Piider- 
 astie," Caspar's Vierteljahrsschrift, 1852, i), who, it is true, classes it 
 with pederasty, but makes the pertinent remark that this anomaly is, in 
 most cases, congenital, and, at the same time, to be regarded as a mental 
 hermaphroditism. There exists here an actual disgust of sexual contact 
 with women, while the imagination is filled with beautiful young men, 
 and with statues and pictures of them. It did not escape Casper that in 
 "^nch cases emissio penis in anum (pederasty) is not the rule, but that, by 
 means of other sexual acts (mutual onanism), sexual satisfaction is 
 sought and olttained. 
 
 In his " Clinical Novels " (18(53, p. 33) Casper gives the interesting 
 confession of a man showing this perversion of the sexual instinct, and 
 does not hesitate to assert that, aside from vicious imagination and Aice, 
 as a result of over-indulgence in normal sexual intercourse, there are 
 numerous cases in which pederasty has its origin in a remarkable, obscure 
 impulse, which is congenital and inexplicable. About the middle of the 
 " sixties," a certain assessor, Ulrichs, himself subject to this perverse 
 instinct, came out and declared, in numerous articles,^ that the sexual 
 
 1 Dr. Moll, of Berlin, called my attention to the fact that iu Moritz's Magazin f. 
 Erfahrungsseeleukuude, vol. viii, Berlin, 1791, there are references to contrary sexual 
 instinct in man. In fact, there two biographies of men are reported who manifested an 
 enthusiastic love for pensons of their own sex. In the second case, which is particularly 
 noteworthy, the patient himself explains his aberration by the fact that, as a child, he was 
 caressed only by grown persons, and, as a boy of ten or twelve years, only by his school- 
 fellows. " This, and the want of association with persons of the ojjpositc sex, in nie, 
 caused the natural inclination toward the female sex to be entirely diverted to the male sex. 
 I am still quite indifferent to women." 
 
 It cannot be determined whether such a case is one of congenital (psycho-sexual 
 hermaphroditism ?) or acquired contrary sexual instinct. The oldest case of contrary 
 sexual instinct, that has thus far been proved in Germany, is that of a woman who was 
 married to another, and gratified herself sexually with a leathern priapus. A case of vira- 
 ginity, historically and legally interesting, derived from the legal proceedings, which took 
 place early in the eighteenth century, is reported by Dr. Miiller (Alexandersbad), in Fried- 
 rich's Blatter f. ger. Medicin, 1891, part iv. 
 
 2 " Vindex, Inclusa, Vindicta, Formatrij., Ara spei, Gladius furens, kritische Pfeile," 
 Leipzig (Otto u. Kadler), 186-1-1880.
 
 224 PSTCHOPATHIA SEXUALIS. 
 
 mental life was not connected with the bodily sex ; that there were male 
 individuals that felt like women toward men (" anima muliebris in corpore 
 virili inclusa "). He called these people " urnings,'' and demanded nothing 
 less than the legal and social recognition of this sexual love of the urn- 
 ings as congenital and, therefore, as right ; and the permission of mar- 
 riage among them. Ulrichs failed, however, to prove that this certainly 
 congenital and paradoxical sexual feeling was physiological, and not 
 pathological. 
 
 Griesinger (Archiv f. Fsychiatrie, i, p. 651) threw the first ray 
 of light on these facts, anthropologically and clinically, by pointing out 
 the marked hereditary taint of the individual, in a case which came under 
 his own observation. 
 
 We have Westphal (Archiv f. Psxjchiatrie, ii, p. 13) to thank 
 for the first systematic consideration of the manifestation in question, 
 which he defined as " congenital reversal of the sexual feeling, with 
 consciousness of the abnormality of the manifestation," and designated 
 with the name, since generally accepted, of contrary sexual instinct. At 
 the same time, he began a series of cases,' which, up to this time, has 
 reached ninety-three, those reported in this monograph not being included.- 
 
 Westphal leaves it undecided as to whether contrary sexual feeling 
 is a symptom of a neuropathic or of a psychopathic condition, or whether 
 
 1 In male individuals: (1) Casper, Klin. Novellen, p. 36 (Lehrb. d. ger. Med., 7 
 Aufl., p. ITfi); (2) Westphal, Archiv f. Psyth., ii. p. 73; (3) Schralnke, id., iii, p. 235; 
 (4) Scholz, Vierteljahrsschr. f. ger. Med., xix ; (.5) Goek, Arch. f. Psych., v., p. 5f>i ; (6) Ser- 
 vaes, icZ., vi, p. 484; (7) Westphal, id.,vi, 620; (8,9, 10) Stark, Zeitsch. f. Peychiatrie, 
 Bd. 31 ; (11) Linian (Casper's Lehrb. der ger. Med., 6 Aufl., p. 509), p. 291 ; (12) Legrand 
 du Saullc, Aiinal. nied.-psychol., 1876, May ; (13) Sterz, Jahrb. f. Psychiatric, iii, HeftS ; (14) 
 Krueg, Brain, 1884, Oct. ; (15) Charcot et Maguan, Arch, de ncurolog., 1882, Nr. 9; (16, 
 17, 18) Kirn, Zeitsc.hr. f. Psych., Bd. 39, p. 216; (19) Rabow, Erlenmeyer's Centralb.,1883, 
 Nr. 8 ; (20) Bluuier, Americ. Journ. of Insanity, 1882, July ; (21) Savage, Journal of 
 Mental Science, 1884, October; (22) Scholz, Vierteljahrsschr. f. ger. Med., N. F. Bd. 43, 
 Heft. 7; (23) Magnan, Ann. mcd. psychol., 1885, p. 461 ; (24) Chevalier, De Tinversion 
 de I'instinct sexucl, Paris, 1885, p. 129 ; (25) Mor.selli, La Riforraa medica, iv, March ; (26) 
 Leonpacher, Friedreich's Blatter, 1888, H. 4 ; (27) Hollander, Allg. Wiener Med. Zeitg., 
 1882; (28) Krcise, Erlenmeyer's Centralblatt, 1888, Nr. 19; (29, 30, 31, 32) v. Krafft, Psy- 
 chopathia sexualis, 3 Aufl., Beob. 32, 36, 42, 43 ; (.33) Golenko, Russ. Archiv f. Psychiatric, 
 Bd. ix, H. 3 (v. Rothe, Zeitschr. f. Psychiatric) ; (34) v. Krafft, Internationales Centralblatt 
 f. d. Physiol, u. Pathologic der Harn-u. Sexual organc, Bd. 1, H. 1; (35) Cantarano, La 
 Psichiatria, 1887, v., p. 195; (36) Serieux, Recherches cliniques sur les anomalies de 
 I'instinct sexuel, Paris, 1888, obs. 13; (37-42) Kiernan, The Medical Standard, 1888, 7 
 cases ; (43-46) Rabow, Zeitschr. f. klin. Mediciu, Bd. xvii, Suppl. ; (47-51) v. Krafft, Neue 
 Forschungen, Beob. 1, 3, 4, 5, 8) ; (52-61) v. Krafft, Psychopath. Sexualis, 5 Aufl., Beob. 
 53, 61, 64, 66, 73, 75, 78, 84, 85, 87 ; (62-65) v. Krafft, Neue Forschungen, 2 Aufl., Beob. 3, 
 4, 5,6; (66, 67) Hammond, Sexual Impotence; (68-71) Garnicr, Anomalies sexuelles, 
 1889, Obs. 227, 228, 229, 230; (72) Muller, Friedreich's Blatter, 1891; (7:^87) v. Krafft, 
 Psychopathia Sexualis, 6 Aufl. , Beob.78, 81 , 82, 84, 85, 86, 87, 89, 93, 94, 96, 97, 98, 101 , 102. 
 
 In female individuals : (1) Westphal, Arch. f. Psych., ii, p. 73 ; Gock, op. cit., Nr. 
 1 ; (3) Wise, The Alienist and Neurologist, 1883, January ; (4) Cantarano, La Psichiatria, 
 1883, p. 201 ; (5) Serieux, op. cit., obs. 14; (6) Kiernan, op. cit.
 
 CONGENITAL HOMO-SEXUALITY. 225 
 
 it may occur ns an isolated manifestation. He holds fast to the oi)iiiion 
 that the condition is congenital. 
 
 From the cases ])iil)lislied up to 1877, I have designated 
 this peculiar sexual feeling as a timctional sign of degeneration, 
 and as a partial manifestation of a neuro-psychopathic state, in 
 most cases hereditary, — a supposition which has found renewed 
 contirmation in a consideration of additional cases. The follow- 
 ing peculiarities may be given as the signs of this neuro- 
 psychopathic taint : — 
 
 1. The sexual life of individuals thus organized manifests 
 itself, as a rule, abnormally early, and thereafter with abnormal 
 power. Not infrequently still other perverse manifestations are 
 presented besides the abnormal method of sexual satisfaction, 
 which in itself is conditioned by the peculiar sexual feeling. 
 
 2. The psychical love manifest in these men is, lor the most 
 part, exaggerated and exalted in the same way as their sexual 
 instinct is manifested in consciousness, with a strange and even 
 compelling force. 
 
 3. By the side of the functional signs of degeneration 
 attending contrary sexual leeling are found other functional, 
 and in many cases anatomical, evidences of degeneration. 
 
 4. Neuroses (hysteria, neurasthenia, epileptoid states, etc.) 
 co-exist. Almost always the existence of temporary or lasting 
 neurasthenia may be proved. As a rule, this is constitutional, 
 having its root in congenital conditions. It is awakened and 
 maintained by masturbation or enforced abstinence. 
 
 Tn male individuals, owing to these practices or to congeni- 
 tal disposition, there is finally neurasthenia sexualis, Avhich mani- 
 fests itself (essentially in irritable weakness of the ejaculation 
 centre. Thus it is explained that, in most of the cases, simply 
 embracing and kissing, or even only the sight of the loved per- 
 son, induce the act of ejaculation. Frequently this is accom- 
 panied by an abnormally pow^crful feeling of lustful pleasure, 
 which may be so ^intense as to suggest a feeling of magnetic 
 currents passing through the body. 
 
 5. In the majority of cases, psychical anomalies (brilliant 
 endowment in art, especially music, poetry, etc., by the side of 
 
 15
 
 226 PSTCHOPATHIA SEXUALIS. 
 
 bad intellectual powers or original eccentricity) are present, 
 which may even go so far as pronounced conditions of mental 
 degeneration (dementia, moral insanity). 
 
 In many urnings, either temporarily or permanently, in- 
 sanity of a degenerative character (pathological emotional states, 
 periodical insanity, paranoia, etc.) makes its appearance. 
 
 6. In almost all cases where an examination of the physical 
 and mental peculiarities of the ancestors and blood-relations has 
 been possible, neuroses, psychoses, degenerative signs, etc., have 
 been found in tlie families.^ 
 
 The depth of congenital contrary feeling is shown by 
 the fact that the lustful dream of the male-loving urning has 
 for its content only male individuals ; that of the female-loving 
 woman, only female individuals, with corresponding situations. 
 
 The observation of Westphal, that the consciousness of one 
 congenitally defective in sexual desires toward the opposite sex 
 is painfully affected by the impulse toward the same sex, is 
 true in only a number of cases. Indeed, in many instances, 
 the consciousness of the abnormality of the condition is want- 
 ing. The majority of urnings are happy in their perverse sex- 
 ual feeling and impulse, and unhappy only in so far as social 
 and legal barriers stand in the way of the satisfaction of their 
 instinct toward their own sex. 
 
 The study of contrary sexual feeling points directly to 
 anomalies of the cerebral organization of the affected individu- 
 als. Gley {Revue philosoph., January, 1884) believes that he is 
 able to solve the riddle by the theory that the individuals have 
 a female brain and male sexual glands ; and, further, that path- 
 ological brain conditions determine the sexual life, while nor- 
 mally the sexual organs determine the sexual functions of the 
 brain. 
 
 One of my patients offered me an interesting theory in 
 
 1 Tarnowsky (op. cit., p. 34) records a case which shows that contrary sexual feeling, 
 as a concomitant manifestation with neurotic degeneration, may "also affect the descendants 
 of parents having no neurotic taint. In this instance, lues of the parents played a part, as 
 in a similar case of Scholz (Vierteljahrsschr. f. ger. Med.), in which the perversion of the 
 sexual desires stood iu causal relation with an arrest of psychical development, caused by 
 tr^umatisni.
 
 CONGENITAL HOMO-SEXUALITY. 227 
 
 explanation of original contrary sexual instinct. He started 
 with the actual bi-sexuality shown by the Ibetus anatomically 
 up to a certain age. While normally the organs which attain 
 complete development exclusively condition and determine the 
 sexual type, and the influence of tlie opposite organs, which 
 remain rudimentary, is nil, it is conceivable tliat, under the 
 influence of a factor inimical to the normal development of 
 the brain (hereditary taint, etc.), these rudimentary organs like- 
 wise exercise an influence which, under certain circumstances, 
 may be even greater than that of the fully developed organs 
 Avhicli determine the external sexual type. 
 
 In a similar manner, Kiernan {Medical Standard^ 1888) 
 and G. Frank Lydston {PhiJa. Med. and Surg. Reporter, 1888) 
 attempt to explain a part of the cases of congenital sexual 
 paranoia. Magnan, too {Ann. med. psycliol.., 1885, p. 458), 
 writes, in all earnestness, of the brain of a woman in the body 
 of a man, and vice versd.^ 
 
 The attempted explanations of congenital urnings are not 
 less superficial ; for instance, that of Ulrichs, who, in his 
 " Memnon," 1868, speaks of an "anima muliebris virili corpore 
 inclusa (virili corpori innata)," and thus tries to explain the 
 congenital origin and the female character of his abnormal sex- 
 ual instinct. The idea of the patient, the subject of Case 124, 
 is original. He supposes that when his father begat him he 
 thought to beget a girl, but, instead of a girl, a boy resulted. 
 One of the strangest explanations of congenital contrary sexual 
 feeling is made by Mantegazza {o}}. cit., p. 106, 1886). 
 
 According to this author, in such individuals there exist 
 anatomical anomalies which, by an error of Nature, consist in a 
 distribution to the rectum of the nerves intended for the geni- 
 tals; so that only in this situation the lustful sensation is 
 aroused which otherwise results from stimulation of the geni- 
 tals. But how does this author, in other ways so acute, ex- 
 plain the great majority of cases, where pederasty is abhorred by 
 those aflected with contrary sexual feeling'? Besides, Nature 
 
 1 This supposition is overthrown by the result of the post-mortem of my case (118), 
 where the brajn-weight was 1150 gramnjes, and of Case 130, where it was 1175 grammes.
 
 228 PSTCHOPATHIA SEXUALIS. 
 
 never makes such leaps. Mantegazza rests his hypothesis upon 
 the statements of an acquaintance, a celebrated writer, who 
 assured him that he was not sure that he took a greater pleasure 
 in coitus than in defecation ! Allowing the correctness of his 
 experience, still it would only prove that the man was sexually 
 abnormal, and that his pleasure in coitus was reduced to a 
 minimum. 
 
 An explanation of congenital contrary sexual feeling may 
 perhaps be found in tlie fact that it represents a peculiarity bred 
 in descendants, but arising in ancestry. The hereditary factor 
 might be an acquired abnormal inclination for the same sex 
 in the ancestors {v. infra), found fixed as a congenital ab- 
 normal manifestation in the descendants. Since, according 
 to experience, acquired physical and mental peculiarities, not 
 simply improvements, but essentially defects, are transmitted, 
 this hypothesis becomes tenable. Since individuals affected 
 with contrary sexual feeling not infrequently beget children, — 
 at least, they are not absolutely impotent (women never are), — 
 a transmission to descendants is ])ossible. 
 
 This supposition is decidedly favored by Case 124, in 
 which the eight-year-old daughter of an individual affected 
 with contrary sexual feeling, practiced mutual masturbation — 
 a sexual act — at an age which permits the presumption of con- 
 trary sexual feeling. No less significant is the communication 
 made to me by a young man of twenty-six, who belongs to the 
 third group of contrary sexuality. He knew with certainty 
 that his father, who had died some years before, was also sub- 
 ject to contrary sexuality. An informant assured me, at least, 
 that he knew many other men with whom his father had sus- 
 tained "relations." Wliether, in the case of the father, it was 
 an acquired or a congenital contrary sexual instinct, and to 
 what group he belonged, could not be ascertained. 
 
 The foregoing hypothesis seems tlie more plausible, when 
 it is considered that the first three degrees of congenital con- 
 trary sexual instinct correspond exactly witli tlie developmental 
 stages which are discoverable in the development of the 
 acquired anomaly. One, therefore, feels inclined to designate
 
 CONGENITAL HOMO-SEXUALITY. 229 
 
 the various degrees of cong-enital contrary sexual instinct as 
 various degrees of an hereditarily-induced sexual anomaly, 
 acquired from the progenitors or otherwise developed. Here, 
 too, the law of progressive heredity must be taken into con- 
 sideration. 
 
 The sexual acts, by means of which male urnings seek and 
 find satisfaction, are multifarious. There are individuals, of fine 
 feeling and strength of will, who sometimes satisfy themselves 
 with platonic love, with the risk, however, of becoming nervous 
 (neurasthenic) and insane, as a result of this enforced absti- 
 nence. In other instances, for the same reasons which may 
 lead normal individuals to avoid coitus, onanism, /rn*^ de mieux, 
 is indulged in. 
 
 In urnings with nervous systems congenitally irritable, or 
 injured by onanism (irritable weakness of tlie ejaculation 
 centre), simple embraces or caresses, with or without contact of 
 the genitals, are sufiicient to induce ejaculation and consequent 
 satisfaction. In less irritable individuals, the sexual act consists 
 of manustupration by the loved person, or mutual onanism, or 
 imitation of coitus between the tliighs. In urnings morally 
 perverse and potent, quoad erectionem, the sexual desire is satis- 
 fied by pederasty, — an act, liowever, which is repugnant to per- 
 verted individuals that are not defective morally, much in the 
 same way as it is to normal men. The statement of urnings is 
 remarkable, that the sexual act with persons of the same sex, 
 which is adequate for them, gives them a feeling of great satis- 
 faction and accession of strength, while satisfaction by solitary 
 onanism, or by enforced coitus witli a woman, afl^ects them in an 
 unfavorable way, making them miserable and increasing their 
 neurasthenic symptoms. The manner of satisfaction of the female 
 urning is little known. In one of my cases, the girl mastur- 
 bated, and during the act felt herself to be a man ; and her 
 fiincy created a beloved female person. In another case, the act 
 consisted of practicing onanism on the person loved, and fond- 
 ling her genitals. 
 
 Amor lesh'iGus is presumably not infrequent here, for which 
 an enlarged clitoris or an artificial priapus may be used.
 
 230 PSYCHOPATHIA SEXUALIS. 
 
 As to the frequency^ of the occurrence of the anomaly, it 
 is difficult to reach a just conclusion, since those affected with 
 it break from their reserve only very inlrequently ; and in crimi- 
 nal cases the urning with perversion of sexual instinct is usually 
 classed with the person given to pederasty for simply vicious 
 reasons. According to Casper's and Tardieu's, as well as ray 
 own, experience, this anomaly is much more frequent than 
 reported cases would lead us to presume. 
 
 Ulrichs ("Kritische Pfeile," p. 2, 1880) declares that, on 
 an average, there is one person affected with contrary sexual 
 instinct to every two hundred mature men, or to every eight 
 hundred of the population ; and that the percentage among the 
 Magyrs and South Slavs is still greater, — statements which may 
 be regarded as untrustworthy. The subject of one of my cases 
 knows personally, at his home (13,000 inliabitants), fourteen 
 urnings. He further declares that he is acquainted with at least 
 eighty in a city of 60,000 inliabitants. It is to be presumed 
 that this man, otherwise worthy of belief, makes no distinction 
 between the congenital and the acquired anomaly. 
 
 1. Psijchlcal HermaphroJltism.'^ — The characteristic mark 
 of this degree of inversion of the sexual instinct is that, by the 
 side of the pronounced sexual instinct and desire for the same 
 sex, a desire toward the opposite sex is present ; but the latter 
 is much weaker and is manifested episodically only, while the 
 homo-sexuality is primary, and, in time and intensity, forms the 
 most striking feature of the vita sexualis. 
 
 1 That Inversiou of the sexual instinct is not infrequent is proved, amongother things, 
 by the circumstance that it is frequentl}' a subject in novels. Chevalier {op. cit.) points 
 out in Fivnch literature, besides tlie novels of Balzac, like " La Passion au Desert " (treating 
 of bestiality) and " Sarrazine" (treating of tlie love of a woman for a eunuch), Diderot's " La 
 Religieuse " (a story of one given to amor lesbuvis) ; Balzac's " La Fille aux Yeux d'Or " (amor 
 lexbicus); Th. Gautier's " Mademoiselle de Maupin " ; Feydeau's " La Comtesse de Chalis " ; 
 Flaubert's " Salammbo," etc. Belot's " Mademoiselle Giraud, Ma Femme" may also be men- 
 tioned (now translated into English). It is interesting that the heroines of these (Lesbian) 
 novels appear in the character and role of the husband of a lover of the same sex, and that 
 their love is extremely passionate. Moreover, the neuropathic foundation of this sexual per- 
 version does not escape the writers. This theme is treated, in German literature, in " Fri- 
 dolin's heimliche Ehe," by Wilbrand ; in " Brick and Brack oder Licht in Schatten," by 
 Emerich Graf Stadion. The oldest urning's romance is probably that published by Petronius 
 at Rome, under tlie Empire, under the title Satyricon. 
 
 2 Comp. author's work, " Ueber psychosexuales Zwitterthum," in the internationalen 
 Centralblatt f. d. Physiologic u. Pathologic der Harn und Sexualorgane, Bd. i, Heft 3.
 
 CONGENITAL HOMO-SEXUALlTY. 231 
 
 The hetero-sexual instinct may be but rudimentary, mani- 
 festing itself simply in unconscious (dream) liie; or (episodically, 
 at least) it may be powerfully exhibited. 
 
 The sexual instinct toward tlie opposite sex may be strength- 
 ened by the exercise of will and self-control; by moral treatment, 
 and possibly by hypnotic suggestion ; by improvement of the 
 constitution and the remo^al of neuroses (neurastlienia) ; but 
 especially by abstinence from masturbation. However, there is 
 always the danger that homo-sexual feelings, in that they are 
 the most powerful, may become permanent, and lead to endur- 
 ing and exclusive contrary sexual instinct. This is especially to 
 be feared as a result of the influences of masturbation (just as 
 in acquired inversion of the sexual instinct) and its neurasthenia 
 and consequent exacerbations ; and, further, it is to be found 
 as a consequence of unfavorable experiences in sexual inter- 
 course with persons of the opposite sex (defective feeling of 
 pleasure in coitus, failure in coitus on account of weakness of 
 erection and premature ejaculation, infection). On the other 
 hand, it is possible tliat aesthetic and ethical sympathy with 
 persons of the opposite sex may favor the development of hetero- 
 sexual desires. Thus it happens that the individual, according 
 to the predominance of favorable or unfavorable influences, 
 experiences now hetero-sexual, now homo-sexual, feeling. 
 
 It seerrjs to me probable that such hermaphrodites from 
 constitutional taint are not infrequent.^ Since they attract very 
 little attention socially, and since such secrets of married life 
 are only exceptionally brought to the knowledge of the phy- 
 sician, it is at once apparent why this interesting and practically 
 important transitional group to the group of absolute contrary 
 sexuality, has thus far escaped scientific investigation. Many 
 cases of frigiditas uxoris and mariti may possibly depend upon 
 this anomaly. Sexual intercourse with the opposite sex is, in 
 itself, possible. At any rate, in cases of this degree, no horror 
 sexus alterius exists. Here is a fertile field for the application 
 
 1 This idea is supported by the statements of an unmarried urning which Dr. Moll, 
 of Berlin, kindly communicated to me. He could report a number of cases of his acquaint- 
 ance, in which married men at the same time had " relations " with men.
 
 232 PSYCHOPATHIA SEXUALIS. 
 
 of medical and moral therapeutics (^v. iiifrci). The differential 
 diagnosis from acquired contrary sexual: instinct may present 
 difficulties ; for in such cases, as long as the vestiges of a 
 normal sexual instinct are not absolutely lost, the actual symp- 
 toms are the same {v. infra). In the first degree, the sexual 
 satisfaction of homo-sexual impulses consists in passive and 
 mutual onanism and coitus inter femora. 
 
 Case 106. Psychical Hermaphroditism in a Lady. — Mrs. M., aged 
 44, exemplifies the fact that an inverted and a normal sexual instinct 
 may be united in one person, be it in man or woman. The father of this 
 lady was very musical, and very talented as an artist. He took life easily ; 
 and to his extraordinary beauty was added a great admiration for the 
 opposite sex. After several apoplectic attacks, he died demented in an 
 asylum. Father's brotlier was neuro-psycho()athic,and when a child was a 
 somnambulist ; and all his life he was afflicted with hyperesthesia sexualis. 
 Thus, although married and the father of married sons, he tried to seduce 
 his niece, Mrs. M., with whom he was wildly in love, when she was 
 eighteen years old. Father's father was very eccentric and a distin- 
 guished actor. He first studied theology, but, as a result of partiality' 
 for the dramatic muse, he became an actor and singer. He committed 
 excesses in baccho et venere ; was a spendthrift .and luxurious. He died 
 at forty-nine, of apoj)lexia cerebri. Mother's father and mother died of 
 tuberculosis of the lungs. 
 
 Mrs. M. was one of eleven children, of whom six are still liv- 
 ing. Two brothers, who resembled the mother physically, died, at six- 
 teen and twenty, of tuberculosis. A brother suffoi-s with laryngeal 
 phthisis. Four living sisters and Mrs. M. resemble the father physi- 
 call}'^, and the eldest is unmarried, very nervous, and shy of people. Two 
 younger sisters are married, healthy, and have healthy children. The 
 other is unmarried, and suffers with nervous complaints. Mrs. M. has 
 four children, several of whom are delicate and neuropathic. 
 
 The patient can tell nothing of importance concerning her child- 
 hood. She learned easily, and was festheticall}'^ and poetically inclined. 
 She was considered a little high-strung, and too much given to novel- 
 reading and sentimentality. Her constitution was neuropathic, and she 
 was extremely sensitive to changes of temi)orature, sometimes having 
 annoj'ing cutis anserina as a result of slight draughts. It is remark- 
 able that one daj', when she was about ten years old, she thought that 
 her mother no longer loved her; and she put matches in her coffee 
 to make herself really sick, that she might thus excite her mother's 
 love for her. 
 
 Pubert}' began, without difficulty, at the age of eleven. Thereafter 
 the menses were regular. Before the time of puberty sexuality raani-
 
 CONGENITAL HOMO-SEXUALITY. 233 
 
 fested itself, and, according to the opinion of the patient, its promptings 
 have been abnoruially intense all her life. The first feelings and impulses 
 were decidedly inverted. She conceived a passionate but platonic love 
 for a young lady. She wrote verses and sonnets to her, and was per- 
 fectly happy if she could admire "the entrancing charms" of her god- 
 dess in the bath, or steal a glimpse of her neck, shoulders, and 
 breast while she was dressing. The wild impulse to touch these physi- 
 cal charms was always overcome. While a j'oung girl, she bad actually 
 been in love with Madonnas of Raphael and Guido Reni. In all kinds 
 of weather she would run after pretty girls and ladies for hours at a 
 time, admiring their beauty, losing no opportunity to please them, offer- 
 ing tliem bouquets, etc. The patient asserted that, until tiie age of nine- 
 teen, she was absolutely without a suspicion of a difference of sex; 
 because she had been educated as in a cloister by a very prudish aunt, 
 who was an old maid. As a result of this great ignorance, the patient 
 became the victim of a man who was passionately' in love witli her, and 
 who had coitus with her b}' means of stratagem. She became the wife of 
 this man, bore one child, and lived an " eccentric" sexual life with him. 
 She felt perfectl}^ satisfied with married intercourse. After a few years 
 she became a widow. Since then, women have again been the object of 
 her love, primarily, as the i)atient thinks, from fe:ir of the results of 
 sexual intercourse witii a m:in. 
 
 At twenty-seven, second marriage, without love, to a phthisical 
 husband. Patient was three times confined, and fulfilled her maternal 
 duties. Iler physical healtii failed, and in the later j'ears of this mar- 
 ried life she had an increasing aversion for her husband, partly due to 
 a sense of his disease, though, at the same time, there was constantly 
 present an intense desire for sexual indulgence. 
 
 Three years after the death of her second husband, the patient dis- 
 covered tiie fact that her nine-year-old daughter, by her first husband, 
 was given to masturbation, and that she was failing in physical health. 
 The patient read of this vice, and could not overcome the impulse to 
 indulge in the practice, becoming, in consequence, an onanist. She is 
 unable to bring herself to give the details of this period of her life. She 
 says that she was frightfully excited sexually, and had to send her 
 daughters from home to save them from terrible consequences ; but the 
 two boys she was able to keep at home. 
 
 Patient became neurasthenic ex mastnrliatione (spinal irritation, 
 feeling of pressure in head, weariness, lack of mental control), and, at 
 times, had d3'sthymia and painful ta^dium vit». Her sexual feeling- 
 would be directed at one time to women, at another to men. She was 
 able to restrain herself, and suffered much from abstinence, especially 
 because, on account of her neurasthenic troubles, she sought to obtain 
 relief in masturbation, though only in case of great necessity. At the 
 present time, though forty-four jears old, and menstruating regularly,
 
 234 PSYCHOPATHIA SEXUALIS. 
 
 she suffers intensely with a passion for a 3'oung man whose presence she 
 cannot avoid on account of the exigencies of occupation. 
 
 Patient presents nothing remarkable in external appearance. She 
 is gracefully formed, ])ut the muscular system is not strongly developed. 
 Pelvis is, in all respects, that of a female, but the arms and legs are de- 
 cidedly large and of masculine form. Ladies' shoes do not fit her, but, 
 being opposed to exciting attention, she forces her feet into female shoes, 
 and they are, therefore, much deformed. Genitals normally developed, 
 and present no other abnormality than descent of the uterus, with hyper- 
 trophy of the vaginal portion. On thorough examination it is seen that 
 the patient is essentially homo-sexual, and that the desire for the oppo- 
 site sex is but episodical and sensual. Thus, at present, she suffers 
 intensely with sexual desires for every man with whom she comes in con- 
 tact, but it is a more refined and higher pleasure for her to imprint a kiss 
 on the soft, round cheek of a maiden. This pleasure is one she often 
 enjoys, because she is mucli beloved as the " dear aunt " by all the 
 " sweet creatures " ; for she voluntarily does them the most various 
 chivalrous favors, always feeling herself at such times as a man. 
 
 Case 107. Contrary Sexual Instinct loith Sexual Satisfaction in 
 Hetero-Sexual Intercourse. — Mr. Z.,aged 36, Hollander, consulted me, in 
 1888, on account of an anomalj^ of his sexual feelings, which had become 
 a matter of anxiety" to him in connection with an intended marriage. 
 Patient's father was neuropathic, and suffered with nightmare and night- 
 terrors. Grandfather was mentally unsound ; father's brother an idiot. 
 Patient's mother and her family were healthy and normal mentally. The 
 patient had four sisters and one brother, tlie latter being subject to moral 
 insanity. Three sisters are healthy, and living happ^' married lives. 
 
 As a child, the patient was weak, nervous, and subject to night-ter- 
 rors, like his father ; but lie ncA'er had any severe sickness except coxitis, 
 as a result of which he limps slightly. Sexual impulses were manifested 
 early. At eiglit, without any teaching, he began to masturbate. From 
 his fourteenth year, ejaculation. He was mentally well endowed, and his 
 principal intei'est was in art and literature. He was alw.ays weak mnscn- 
 larly, and had no inclination for boyish sports and later for manly occu- 
 pations. He had a certain interest for female toilettes^ ornaments, and 
 occupations. From the time of puberty the patient noticed in himself 
 an inexplicable inclination toward male persons. Youths of the lowest 
 classes were especially attractive to him. Cavahymen especially excited 
 his interest. He experienced a lustful desire to press himself against 
 such individuals from behind. Occasionally, in crowds, it was possible 
 for him to do this ; and in such an event an intense feeling of pleasure 
 passed over him. After his twenty-second 3'ear, on such occasions, he 
 now and then had an ejaculation. From that time ejaculation occurred 
 when a sympathetic man laid his hand on the patient's thigh. He was 
 now in gi-eat anxiety lest he might sometime assault a man sexually.
 
 CONGENITAL HOMO-SEXUALITV. 235 
 
 People of the lower classes, wearing tight, brown trousers, were especiall}' 
 dangerous for him. His greatest pleasure would be: to embrace such a 
 man and press himself on him ; but, unfortunately, the morality of his 
 country did not allow such a thing. Pederast^^ seemed disgusting to him. 
 
 It gave him great pleasure to gain a sight of the genitals of males. 
 He was always compelled to look at the genitals of ever}' man he met. 
 In circuses, theatres, etc., only male performers interested him. Patient 
 has never noticed any inclination for women. He does not avoid them, 
 even dances with them on occasion, but he never feels the slisfhtest 
 sensual excitation under such circumstances. 
 
 At the age of twent3-eight the patient was neurasthenic as a result 
 of his excessive masturbation. 
 
 Then frequent pollutions in sleep occurred, which weakened him 
 very much. It was only occasionally that he dreamed of men when he had 
 pollutions ; and never of women. A lascivious dream-picture (pederasty) 
 had occurred but once. He dreamed of d3'ing-scenes, of being attacked 
 by dogs, etc. After these, as before, he suffered with great libido sexualis. 
 Often there came up before him such lascivious thoughts as gloating over 
 the death of animals in the slausxhter-house, or allowing: himself to be 
 whipped by boys; but he always overcame such desires, and also the 
 impulse to dress in a military uniform. 
 
 In order to cure himself of masturbation, and to thoroughly satisfy 
 his libido, he determined to frequent brothels. He first attempted 
 sexual intercourse with a woman when twenty-one, after over-indulgence in 
 wine. The beauty of the female form, and female nudity in general, made 
 no impression on him. However, he was able to enjoy the act of coitus, 
 and thereafter he visited brothels regularly for " purposes of health." 
 
 From this time he took great pleasure in hearing men tell stories 
 of their sexual relations with the opposite sex. 
 
 Ideas of flagellation would also come to him while in a brothel, but 
 the retention of such fancies was not essential for the performance of 
 coitus. He considered sexual intercourse with prostitutes onl}^ a remedy 
 against the desire for masturbation and men, — a kind of safety-valve to 
 prevent compromising himself with some man. 
 
 The patient now wishes to marry, but fears not onl^^ that he could 
 have no love for a decent woman, but also that he might be impotent for 
 intercourse with one. Hence his thought and need of medical advice. 
 
 The patient is very intelligent, and is, in all respects, of masculine 
 appearance. In dress and manner he presents nothing that would attract 
 attention. Gait, voice, and skeleton, — the pelvis especiall}', — masculine 
 in character. Genitals of normal deveIoi)ment, The normal growth of 
 hair for a male is abundant. The patient's relatives and friends have not 
 the slightest suspicion of his sexual anomalies. In his inverted sexual 
 fancies, he has never felt himself in the role of a woman toward a man. 
 For some years he has been entirely free from neurasthenic troubles.
 
 236 PSTCHOPATHTA SEXUALIS. 
 
 The question as to whether he considered himself a subject of coti- 
 genital inversion of sexual instinct he could not answer. It seems prob- 
 able that there was a congenital weak inclination for the opposite sex, 
 with a greater one for the same sex, which, as a result of early mastur- 
 bation in consequence of the homo-sexual instinct, was still more weak- 
 ened, but not reduced to nil. With the cessation of masturbation, the 
 feeling for women became in a measure more natural, but only in a 
 coarsely sensual way. 
 
 Since the patient explained that, for reasons of family and business, 
 it was necessary' for him to marry, it was impossible to avoid this delicate 
 question. 
 
 Fortunatel}'^, the patient limited his inquiries to the question as to 
 his virility as a husband ; and it was necessar}' to reply that he was virile, 
 and that lie would probal)ly be so in conjugal intercourse with the wife 
 of his choice, — at least, if she were to be in mental sympathy with him ; 
 besides, that he could at all times improve his power by exercising his 
 imagination in the right direction. 
 
 The main thing was to strengthen the sexual inclination for the 
 opposite sex, which was defective, but not absolutely wanting. This 
 could be done by avoiding and opposing all homo-sexual feelings and 
 impulses, possibly with the help of the artificial inhibitory influences of 
 hypnotic suggestion (removal of homo-sexual desires by suggestion); by 
 the excitation and exercise of normal sexual desires and impulses ; b^' 
 complete abstinence from masturbation, and eradication of the remnants 
 of the neurasthenic condition of the nervous system by means of hydro- 
 therapy, and possibl}^ general faradization, 
 
 I am indebted to a physician, aged thirty, Tor the following 
 autobiography, which in another respect is noteworthy : — 
 
 Case 108. Mental Hermaphroditism; Abortive Contrary Sexual 
 Instinct. — " In my ancestry I am somewhat predisposed hereditarily. My 
 gi'and father on my father's side was a high-liver and a speculator. My 
 father was a man of character, but for more than thirty ^-ears he has 
 suftered with folic circulaire, without, however, being much hindered by 
 it in business. M3' mother, like her father before her, suffers with steno- 
 cardiac attacks. My mother's father and brother are said to have been 
 sexually hyperaesthetic. My onl}' sister, about nine years older than 
 myself, was twice subject to attacks of eclampsia, and during puberty was 
 religiouslj'^ exalted, and probably also sexually hyperaesthetic. During 
 many years she had to suffer w itli a severe hysterical neurosis, but she is 
 now completel}' well. 
 
 "As an only son, and born late, I was the apple of mj' mother's 
 eye ; and I have her indefatigable care to thank that I survived childhood, 
 after having passed through all the possible diseases of children (hydro-
 
 CONGENITAL HOMO-SEXUALITY. 237 
 
 cephalus, measles, eroiii), siii:ill-[)ox, iuul, :it Uiirteeii, cliroiiic intestinal 
 catarrh that lasted a year). My mother, being herself very religious, 
 raised me, without spoiling me, in a religious way, and implanted in me, 
 as the guiding moral principle, an unyielding devotion to duty, whicii 
 was furtlier carried to an extreme in me by a teacher whom I still call a 
 friend. Owing to m^^ delicate health, my childhood, in greater part, 
 was spent in bed ; and I was thus given to quiet occupations, esi)ecially 
 reading; and thus as a boy I came to be — if not blase — premature at 
 least. As earl}' as eight or nine the parts of books tliat excited me 
 most were those where injuries or operations that had to be endured 
 by beautiful girls or ladies, were described. Thus I was thrown into 
 great excitement by a story in which was pictured a maiden that had 
 run a thorn into her foot, with a boy taking it out for her. Indeed, 
 every time that I looked upon this picture, which was in nowise las- 
 civious, I h:id an erection. Whenever possible, I went to see chickens 
 killed; and if I had missed that, I looked at tiie spots of blood, and 
 stroked the warm bodies of the birds, with pleasurable shudders. 1 
 would emphasize the ftict that I have always been a great lover of :uii- 
 mals, and have felt disgust and pity while killing larger animals, and 
 even in the vivisection of frogs. 
 
 " The killing of chickens is still a great sexual stimulus for me, and 
 especially holding them, during whicli I have palpitation of the heart 
 and precordial oppression. It is of interest that m^^ father had a passion 
 for binding together the hands of girls and young women. 
 
 " I think that another of my sexual abnormalities is attributable to 
 this strain of cruelty. As I shall clearly describe later, one of m}^ fa- 
 vorite games was that of an improvised doll theatre, where I prescribed 
 the parts of my companions. Almost always it was a young girl who, 
 at the command of her papa, wliom I represented, had to have a pain fid 
 operation done on her foot. The more the girl cried, the more satisfac- 
 tion I had. How I came to hit upon the foot as the constant object of 
 operation will be seen from the following: When a verj^ young boy, I 
 happened to see my eldest sister«change her stockings. When she hastily 
 hid her feet, my attention was attracted, and immediately the sight of her 
 bare feet to the ankles came to be the ideal of my longing. Naturally, 
 this made my sister very careful ; and thus there was occasioned a con- 
 stant quarrel, which, on my part, was kept up with all the wiles of cun- 
 ning and flattery, and with even explosions of anger, until my seventeenth 
 yeai'. In otlier respects my sister was very indifferent. Indeed, her kiss 
 is repugnant to me. Faute de mieux, I made use of tlie feet of ser- 
 vants; masculine feet had no effect on me. My greatest desire would 
 have been to cut the nails, or, sit venia verbo, the corns, on the beautiful 
 foot of a woman. My lustful dreams were concerned with these things. 
 Indeed, I applied myself to the study of medicine really in the expec- 
 tation of gaining an opportunity to satisfy my desires, or cure them.
 
 238 PSYCHOPATHIA SEXUALIS. 
 
 Thank God, I attained the latter. After undertaking the first dissection 
 of the lower extremity of a female, this unhappy desire was removed 
 from me. I was unhappy because I was always deeply ashamed of this 
 impulse. I think 1 may spare further details concerning it, since this 
 peculiar enthusiasm, which even inspired me to write verses, has been 
 sufficiently described by others. 
 
 " Now, concerning the last phase of my sexual errors : I was about 
 thirteen, and had just begun to mature, when a school-mate, who hap- 
 pened to be our guest, teased me one night by kicking me wath his bare 
 feet under the covers. I seized his foot, and immediately became greatly 
 excited, and had a pollution after it, — the first that I had. The boy was 
 peculiarly girlish in form, and was also mentally effeminate. Too, another 
 comrade who had very small and delicate hands and feet, whom I once 
 saw in a bath, caused unusual excitement in me. I thought it a great 
 piece of good fortune to be in bed with either of these, though any 
 nearer sexual intercourse than eml)racing them never came into my 
 mind. Moreover, I always thrust such thoughts aside with aversion. 
 Some 3^ear8 later, when about sixteen or eighteen, I made the acquaint- 
 ance of two other boys that awakened my sexual feeling. When I played 
 with either of these, I immediately had an erection. Both were very 
 energetic and lively, but delicately formed and child-like. At the occur- 
 rence of puberty I lost interest in both of them, though a warm friend- 
 ship was preserved. I should never have allowed myself to have indulged 
 in vicious practices with them. 
 
 " When I went to the Universit}'^, I forgot completely these errors 
 of ray libido sexualis, and from principle I kept from sexual intercourse 
 until I was twent3'-four, in spite of the contempt of my companions. 
 When pollutions became too frequent, and I began to fear cerebral neu- 
 rasthenia ex abstinentia, I gave myself up to normal sexual indulgence, 
 thougli somewhat mechanically ; and it was, of course, very beneficial 
 to me. 
 
 " The especial field of work to which I have devoted myself is re- 
 sponsible for the fact that I am almost* impotent with puellis publicis, 
 and also for the fact that the naked form of a woman disgusts rather 
 than excites me. The act always satisfies me the most, if, during it, 
 I can keep the vision of the face before me ; but since, on the other 
 hand, the idea that the girl near me is enjoyed by another is unbearable, 
 for years I have found it absolutely necessary for my mental comfort, 
 in spite of the pecuniary sacrifice, to keep a mistress, and, indeed, a 
 virgin. Otherwise the most terrible jealousy made me absolutely in- 
 capable of work. I must also mention that, at thirteen, I fell in love 
 platonically for the first time; and since then I have often pined in 
 chaste love. What distinguishes my case from all others is the fact that 
 I have never once masturbated in my life. 
 
 " Some weeks ago, in sleep, I was frightened by a dream of a naked
 
 CONGENITAL UOMO-SEXUALITY. 239 
 
 boy, from which I awoke with an erection. In conclusion, I venture to 
 undertake the diflicull task of describing my present condition : Medium 
 height, gracefully formed. Skull dolichocephalic, with prominence in 
 the occipital region ; circumference, 59 centimetres ; frontal prominence 
 marked; glance somewhat neuropathic; pu[)ils medium ; teeth very de- 
 fective ; musculature strong and tense ; abundant hair, blonde. Varicocele 
 on the left side ; frenulum too short, which hindered me in coitus. I 
 severed it myself three years ago. Since then ejaculation is retarded, 
 and pleasurable feeling much diminished. Temperament choleric. Quick 
 of comprehension; good at drawing conclusions; energetic; for one 
 hereditarily predisposed, very persevering. I learn languages easily, 
 and have a good ear for music, but otherwise I have no talent for the arts. 
 I am always ambitious to do my duty, but I am constantl}^ troubled with 
 taedium vitae, and only kept from attempts at suicide by m}' religion and 
 the thought of m^' mother. Otherwise I am a t3pical candidate for 
 suicide. I am ambitious, jealous, have a fear of i)aral3'sis ; left-handed. 
 I am filled with socialistic ideas. I like adventures, and I am courageous. 
 I have decided never to marry." 
 
 Case 109. Psychical Herviaphroditism. Autobiography. — " I was 
 born in 1868. The families of both my parents are healthy ; at any rate, 
 mental disease has never occurred in them. My father was a merchant ; 
 he is now sixty-five years old, and for years has been nervous and espe- 
 cially inclined to be melancholic. Before his marriage, mj' father is said 
 to have lived fast. My mother is healthy, though not \eYy strong. 
 There are two other healthy children. • 
 
 " I was very early developed sexually, and in my fourteenth year 
 was so much troubled by pollutions that I was frightened. Under what 
 circumstances they occurred, particularly the nature of the dreams that 
 were connected with them, I am no longer able to state. The fact is, 
 that for years I have only felt myself drawn toward men sexually ; and, 
 with ever}' effort and a terrible struggle, I am still unable to overcome 
 this unnatural impulse that is so repugnant to me. It is said that I had 
 many severe illnesses in my childhood, and that my life was often de- 
 spaired of. To this was probably due the fact that I was spoiled and 
 made very delicate. I was alwaj's much in tlie house, preferred to pla}' 
 with dolls rather than with soldiers, and I liked to play quietly in the 
 bouse better than to play noisily in the streets. I entered the Gymna- 
 sium at the age of ten. Though I was lazy, I was among the best 
 scholars ; for I learned very easil}^, and was the favorite of my teacher. 
 From my earliest childhood (seventh year), I took pleasure in little 
 girls. I remember that, even until my thirteenth year, I had formal love- 
 affairs with them, and was jealous of those who associated with them ; 
 that I took pleasure in looking under the petticoats of ni}' sister's friends 
 and the servants ; and that I had erections when touching the persons 
 of my female playmates. I can, however, recall with certainty that boys
 
 240 PSYCHOPATHIA SEXUALIS. 
 
 attracted and excited me sexually just as early and powerfully. I always 
 took great delight in reading and in the theatre. I had a doll-theatre, 
 with which I plaj^ed by preference. I knew whole pieces by heart, and 
 copied the actors I saw, taking especially the female parts, in which I 
 was delighted to put on female attire. 
 
 "As my sexual life became more pronounced, my inclination for 
 boj's won the upper hand. I fell corapletelj' in love with my compan- 
 ions, and had lustful feeling if one of them who pleased me touched my 
 body. I became very shy, and refused to take gymnastic and swimming 
 lessons. I thought I was different from my comrades, and did not like 
 to undress before them. I liked to look at the penes of m}' companions, 
 and easily had erections. I masturbated but once, and that in my youth. 
 When a friend told me that one could have pleasure without women, I 
 likewise tried it; but I found no pleasure in it. At that time, also, a 
 book fell in my hands which warned against the effects of onanism. 
 After that one trial I never did it again. In my fourteenth or fifteenth 
 year, I made the acquaintance of two younger boys who excited me sex- 
 ually to the highest degree. I was especially in love with one of them. 
 I became sexually excited in his presence, and was restless when I did 
 not have him near me. I was jealous of those who associated with him, 
 and embarrassed in his presence. He had no suspicion of my condition. 
 I felt very unhappy, and often wept gladly, feeling then relieved. Yet I 
 could not understand this feeling, and always felt its irregularity. I was 
 also especially unhappy because my ability to work disappeared all at 
 once. I, who before- had learned with ease, suddenly had difficulty; 
 m}' thoughts were never on the subject. Only by straining every nerve 
 could I get anything through mj' head. I always had to study aloud, in 
 order to keep my attention on the matter in hand. My memory, whicii 
 was previously excellent, often left me in the lurch. Nevertheless, I 
 continued to be a good scholar, and I still pass for a talented man ; but 
 I have terrible difficulty in learning anything. I exerted all my energy 
 to free myself from this sad condition. Daily I went swimming; I 
 practiced turning, rode much, and practiced fencing, in all of which I 
 enjoyed myself very much. I still like to be on a horse's back, though I 
 know nothing about horses, and have no particular talent for physical 
 exercises. I was never absent from a drinking-party, and I smoked. I 
 was much liked. In cafes I associated much with waitresses, and liked 
 to amuse mj^self with them, without, however, being sexuall}'^ excited b^'^ 
 them. Among my friends and teachers, I passed for a man who was 
 much with women, and spoiled by them. Unfortunately, this was not 
 true. 
 
 " At the age of nineteen I went to the Universit3^ M}^ first semester 
 was spent at the University of B., and it is still terrible to recall it. 
 My sexual appetite powerfully excited me, and at night, for hours at a 
 time, I ran about looking for men, especially when I was intoxicated.
 
 CONGENITAL HOMO-SEXUALITY, 2-41 
 
 The next morning I would be crazy about in3'self. Fortunately, I found 
 no one. In the second semester, I went to M. This was my happiest 
 time. I had pleasant friends, and, for a wonder, took pleasure in women, 
 and was ver}^ happy about it. I had a love-alfair with a young girl of 
 spoiled character, with whom I spent wild nights. I was extraordinarily 
 virile. I, who had formerly beeu chaste, also associated with other 
 women, as never before. 1 felt fresh and well after coitus. I was not 
 charmed so much by the female figure, which was never beautiful to me, 
 as by — I know not what. In short, I knew women whose touch imme- 
 diately induced erection. This joy and state of delight did not last 
 Ions. I was so foolish as to take rooms with a friend. We had one 
 sleeping-room. M3' friend was very talented and amiable, and a favorite 
 with women ; and it was by these characteristics that he at first so 
 strongly attracted me. In fact, I love only highly-educated men ; unedu- 
 cated, powerful persons are able to excite me intensely only for the 
 moment, and cannot retaiu my affections. I soon fell in love with my 
 friend. Then came the terrible time that destroyed my health. I slept 
 in the same room with my friend, aud had to see him undress dail}' ; so 
 that it required all my strength to keep from betraying m3'self. I be- 
 came nervous, cried easilv, aud was jealous of those who associated with 
 my friend. I still associated with women ; but it was only with difficulty 
 that I could perform coitus, which, like woman, was repugnant to me. 
 The same women who had excited me intensely, no longer had any eflTect 
 on me. I followed my friend to W., where he met an earlier friend, 
 with whom he associated. I became jealous and sick with love and 
 longiug. At the same time, I associated with women again, but seldom, 
 and onl}^ with difficulty, indulged in coitus. I became terriblj^ depressed 
 and almost insane. Work was out of the question. I led a foolish, 
 wild life, and spent a great amount of money, almost throwing it away. 
 Then, after six weeks of it, I broke down, and had to visit a water-cure, 
 where I spent many months. There I came to myself again, and soon 
 became much liked ; for I can be very gay, and I take great pleasure in 
 the society of educated ladies. In conversation, I prefer married women 
 to younger girls ; I am also very gay in the society of gentleuien at the 
 beer-table and bowling-alley. 
 
 " At this sanitarium I met a man of twenty-nine, who was appar- 
 ently constituted like myself. The fellow forced himself upon me, and 
 wanted to embrace and kiss me ; but he was very repugnant to me, though 
 he excited me, and his touch caused erection, and even ejaculation. One 
 evening he got me to perform mutual onanism. After it I spent a most 
 frightful, sleepless night ; I was terribly disgusted with the whole affair, 
 and thought I should never do such a thing with a man again. All da^^ 
 long I could get no rest. It was terrible to me that, in spite of this, and 
 against my will, this man so excited me sexually; 3'et, on the other hand, 
 it gave me satisfaction that he was in love with me, aud apparent!}' had 
 
 16
 
 242 PSYCHOPATHIA SEXUALIS. 
 
 to go through struggles similar to my earlier ones. From that time I 
 was successful in keeping him away from me. 
 
 " I again went to various Universities, and also visited many water- 
 cures, with temporary, but never permanent, benefit. I fell in love, top, 
 with many friends, but never so deeply as with the friend at M. I no 
 longer had sexual intercourse, neither with women — I was incapable of 
 it — nor with men ; for I had no opportunity for it with the latter, and I 
 forced myself to avoid it. I still often met my friend of M. ; we are as 
 good friends as ever, and, much to my delight, he no longer excites me. 
 It is usually so ; when for a long time I have not seen a person who 
 excites me, the sexual influence disappears. 
 
 " I passed ray examinations with distinction. During the last j^ear 
 before they took place, — when I was twenty-three, — I began to practice 
 masturbation ; for I could find no other way in which to gratify my 
 burdensome sexual appetite. Still, I did it very infrequently ; for after 
 it I was always disgusted, and spent a sleepless night. But when I 
 have drunk much, I lose all strength; and then I run about for hours, 
 seeking men, and finally come to onanism, to awake the next day with a 
 dull head and a horror of mj'self, and go about all day in a melancholy 
 state. As long as I have control of myself, I use all m^^ strength to 
 combat my nature. It is terrible when one can have no pleasure in asso- 
 ciating with friends, and ever^^ erect soldier or butcher-bo}^ makes one 
 tremble and throb. It is frightful when night comes, and I watch at 
 the window for some one to urinate against a wall across the way, and 
 give me an opportunity to see his genitals. These thoughts are terrible ; 
 and besides, there is the consciousness of the immorality and criminality 
 of my state of mind and my longing. I have a repugnance for myself that 
 I cannot describe. I consider vay condition abnormal ; I cannot think that 
 it is congenital, but I believe that the impulse was bred in me by faulty 
 education. My suffering makes me reckless and egotistical ; it takes 
 away all kindness of disposition, and makes me careless about mj^ family. 
 I am moody, and often almost insane ; often I am so depressed that I 
 know not what to do, and then am easil}- moved to tears. And yet I have a 
 horror of sexual intercourse with men. One evening when I came from 
 a drinking-party, drunk and excited and in a half-conscious state, and, 
 full of desire, was wandering about, I met a young man, who got me to 
 perform mutual masturbation. Though he excited me, after the act I was 
 beside myself. To-day, when I go by tlie place, I am overcome with 
 horror ; and latelj^, when riding by it, without any cause, I fell from my 
 gentle horse, that I know so well, — I was so overcome hy the memory 
 of my unworthy deed. 
 
 " I love family life and children, and social intercourse ; and, with 
 my position in societj'^, I am suited to have a family. But I must give 
 up all that ; and yet, I cannot abandon hope of cure. And so I vacillate 
 between hopeful gaiety and frightful hopelessness, and neglect business
 
 CONGENITAL HOMO-SEXUALITY. 243 
 
 and famil3^ Indeed, I do not ask that I may niarrj and found a familj- ; 
 I wish only to overcome the terrible inclination for the male sex ; only 
 to associate qnietlj' with my friends, and to learn to respect myself again. 
 
 " No one has any suspicion of my condition ; I pass rather for a 
 great roue^ — a reputation I try to maintain. I often try to have relations 
 with girls, for which I often have opportunity. I have known many who 
 loved me, and who would have sacrificed their honor for me; but I have 
 no love to ofler them, and nothing sexual to give. And yet I can love a 
 man. I am excited only l)y young men, — /.e., aged from seventeen to 
 twenty-live, without full beards, and preferablj^ with no beards at all. I 
 can love only those that are educated, respectable, and amiable. I am, in 
 short, very proud, and quick; I am also enthusiastic, and easily led by 
 persons who please me. These I try to imitate, but I am very sensitive 
 with them, and easily hurt. I put much value on appearances, love 
 beautiful fui'niture and dress, and assume a distinguished manner and 
 elegant address. I am unhappy in that my neurasthenic condition keeps 
 me from doing and learning what I should like." 
 
 Last fall I made the patient's acquaintance. He is destitute of 
 degenerative signs, and of perfectly masculine appearance, even though 
 he is delicately formed and slender. Genitals perfectly normal. Appeai-- 
 ance distinguished, with nothing striking. He is much troubled about 
 Ids sexual perversion, and wishes to be freed from it at any price. In 
 spite of the greatest effort on the part of both physician and patient, 
 only a slight degree of hypnosis, insufficient for suggestive treatment, 
 could be induced. 
 
 Case 110. Psychical Hermaphroditism — Mouth-fetichism. — "I am 
 thirty-one 3'ears old, and an official in a manufactory. My parents are 
 healthy, and have nothing abnormal about them. My paternal grand- 
 father is said to have had brain disease ; my maternal grandmother 
 died melancholic; a cousin of my mother was given to drink; several 
 other blood-relations are abnormal mentally. 
 
 " I was four years old when my sexual appetite awoke. A man 
 between twenty and thirty years old, who played with us children, and 
 took us in his arms, excited in me the desire to embrace and kiss him 
 passionately^ This desire for sensual kissing on the mouth is character- 
 istic of me, and it still forms the chief charm of my sexual gratification. 
 
 " I experienced a similar excitation in about my ninth year. A 
 man who was ugly and dirty, and had a red beard, likewise excited in 
 me this desire for him. Here was manifested, for the first time, a char- 
 acteristic peculiar to me, which is still present, — i.e., the peculiar 
 stimulus which coarseness — the filthiness of a person in dress and con- 
 duct — is to my senses at times. 
 
 "While in the Gymnasium, from my eleventh to my fifteenth year, 
 I was affected with a passion for a comrade. In this case, it was also my 
 greatest pleasure to embrace him, and kiss liim on the mouth. I was
 
 244 PSTCHOPATHIA SEXUALIS. 
 
 often seized with a, desire for him as intense as that I now have for per- 
 sons I love. I think, however, that I first had erections in my thirteenth 
 year. During these years, as I have said, I had only the desire to 
 embrace and kiss ; ciipiditas videndi vel tangendi aliorum genitalia mihi 
 plane deerat. I was a perfectly innocent, naive boy, and, until Biy fif- 
 teenth year, did not know the meaning of an erection; indeed, I never 
 once ventured to kiss the beloved person ; for I felt that it would be 
 doing something strange. I felt no desire to masturbate, and also had 
 the good fortune not to be seduced to it by older comrades. I have 
 never yet masturbated ; I feel a certain repugnance for it. 
 
 " In my fourteenth and fifteenth years I was seized with a passion 
 for several young persons, some of whom still attract me. Thus I was 
 very much in love with a boy with whom I had never spoken. It was 
 even a delight to meet him on the street. 
 
 " That my passions were of a sensual nature is shown by the foct 
 that, when I pressed and caressed the hands of those I loved, I had pow- 
 erful erections. But it has always been my greatest pleasure amplecti 
 et OS osculari ; I desired nothing else. 
 
 " I did not know that what I experienced was sexual love ; I only 
 said to myself that it was impossible that I alone felt such stimuli. 
 
 " Until my fifteenth year a woman had never excited me; but one 
 evening, when I was alone with our servant-girl in a room, I experienced 
 the same desire that I had for many boys. At first I played with her ; 
 and, when I found that she liked to be kissed, I covered her with kisses. 
 I felt such sensual pleasure in it as I now seldom experience. Mouth to 
 mouth, we kissed each other, and after about ten minutes ejaculation 
 occurred. Thus I gratified myself two or three times a week. I soon 
 began a similar relation with our cook, and with other servant-girls. 
 Ejaculation always took place after kissing for about ten minutes. 
 
 " In the meantime, I had taken dancing-lessons. There I was first 
 charmed by a nice girl ; but this love soon disappeared, and I fell in 
 love with another girl, with whom I never became acquainted, but at 
 the sight of whom I felt an attraction like that of boys, and unlike the 
 purely brutal passion I felt for other girls. At this time my impulse 
 for girls was at its acme ; I was pleased by about an equal number of 
 girls and boys. As mentioned above, I gratified my sensuality by kiss- 
 ing the servant-girl and inducing ejaculation. Thus I spent the time 
 from my sixteenth to m}^ eighteenth year. The departure of the servant 
 deprived me of opportunity. 
 
 " Then came two or three years during which I had to give up 
 sexual pleasure. In general, girls pleased me less; and, too, now that I 
 had grown older, I was ashamed to surrender myself to the servant-girls. 
 
 " It was not possible for me to obtain a mistress ; for, notwith- 
 standing my years, I was carefull}'^ watched by my parents, and asso- 
 ciated but little with young men, and thus had but little independence.
 
 CONGENITAL HOMO-SEXUALITY. 245 
 
 With tlie (liminution in the desire for women, the attractiveness of youths 
 increased. 
 
 " Since I had had, since my sixteenth year, frequent pollutions at 
 night with dreams, — in part of women and in part of men, — which weak- 
 ened and depressed me exceedingly, I desired to make an end of them 
 by means of normal coitus. But scruples and the belief that prostitutes 
 would have no eflect on me, kept me from the brothel until my twenty- 
 first year. For two or three 3'ears I went through a daily struggle (if 
 there had been male houses of prostitution, no scruples would have 
 hindered me). Finally I visited a brothel. I could not even induce 
 erection ; for one reason because the girl, though she was unusually 
 fresh and pretty for a prostitute, did not affect me ; but really because 
 she would not kiss me on the mouth. I was very much depressed, and 
 thought I was Impotent. Three weeks afterward I visited another pros- 
 titute, and she immediately induced erection by her kiss. She was 
 erect and had thick lips, and was much more sensual than the first 
 one. After only three minutes of simple kissing, mouth to mouth, ejac- 
 ulation was induced, — of course, ante portam. Thus it was only after I 
 had visited prostitutes about seven times that I was successful in coitus. 
 
 " At one time I would have no erection at all, because the girl made 
 no impression on me ; again I would ejaculate prematurely. The first 
 times I was reluctant penem introducere ; and, too, even after I was suc- 
 cessful in normal coitus, 1 found no pleasure in it. Sensual satisfac- 
 tion comes with kissing on the mouth; for me this is the principal 
 thing, coitus serving onl}' as something secondary to embracing. 
 Coitus, no matter how much the woman might charm me, would be 
 an indifferent matter without kissing; indeed, erection disappears, or 
 does not occur at all, when the woman will not kiss on the mouth. Yet, 
 I cannot kiss every woman, but only such as have faces pleasing to me ; 
 a prostitute, the sight of whom is repugnant to me, with any amount of 
 kissing, which then only disgusts me, cannot excite rae. 
 
 "Thus, during the last four years, I have visited brothels about 
 every ten days or two weeks. Only seldom does coitus fail ; for I have 
 learned m^- peculiarities, and in the choice of a prostitute know imme- 
 diately whether she will excite me or have no effect. Of late, however, 
 it has again hapi)ened that I thought the woman would stimulate me, and 
 yet no erection occurred. This happened when, the day before, I had to 
 repress too forcibly' the desire for men. 
 
 "At first, when I went to brothels, the sensual pleasure was very 
 slight; only a very few times did I have true lustful feeling (as in kiss- 
 ing previousl}^). Now, on the contrary, for the most part I experience 
 sensual pleasure. The lower houses have a particular charm for me ; 
 for of late the coarseness of the women, the dark entrance, the yellow 
 light of the lamps, and all the surroundings, have a peculiar charm for 
 me; probably because my sensuality is unconsciously excited by meet-
 
 246 PSTCHOPATHIA SEXUALIS. 
 
 ing soldiers, who frequent such places, and who at the same time lend a 
 certain charm to the women. If I but find a woman whose face attracts 
 me, I can have intense lustful pleasure. Besides by prostitutes, my de- 
 sire can be excited by peasant-girls, servant-girls, working-women, and 
 o-irls of the lower classes, — in general, by those in common dress. Red 
 cheeks, thick lips, and erect forms please me particularly. I am abso- 
 lutely indifferent to res[>ectable women and young ladies. 
 
 " M}' pollutions are usually without lustful pleasure, and often occur 
 with dreams of men, but very seldom — almost never — with dreams of 
 women. As is shown by the last circumstance, in spite of regular coitus, 
 my desire is still for young men. Indeed, I may say that it has only in- 
 creased, and that very markedly. Though immediately after coitus 
 the girls have no charm for me, yet the kiss of a pleasing woman could 
 immediately induce erection again. For the first few days after coitus, 
 3'oung men seem the most attractive to me. 
 
 " Sexual congress with women does not satisfy all my sensual desire. 
 I have days when I frequently have erections with an intense desire for 
 young men ; then come quieter days, with moments of complete indiffer- 
 ence for women and latent desire for men. On the other hand, too great 
 sensual rest makes me melancholy ; viz., when such rest follows moments 
 of repressed excitement. Onl}', then, when the thought of beloved 
 3^out]is again causes erection, do I feel liglit-liearted again. Then the 
 rest changes to intense nervousness ; I feel depressed, and sometimes 
 have headache (after repressed erection). This nervousness often in- 
 creases to ungovernable restlessness, which I then seek to overcome by 
 coitus. 
 
 " Last 3'ear an essential change took place in my sexual life, when 
 I dared to enjoy male love for the first time. In spite of pleasurable 
 coitus with women (more correctly, pleasurable kissing with resultant 
 ejaculation), my desire for young men gave me no peace. I determined 
 to go to a brothel much frequented by soldiers, and, in extremity, to 
 buy a soldier for myself. I had the good luck to meet immediately one 
 like myself, who, notwithstanding his much lower station, in character 
 and behavior was not unworthy of me. What I experienced (and still 
 experience) with this young man is sometliing different from what I feel 
 with women. The sensual pleasure is not greater than with prostitutes, 
 whose kisses and embraces excite me extraordinarily ; but I can experi- 
 ence lustful pleasure with him at any time, and for him I have a feeling 
 that is wanting for women. Unfortunatel3', I have been able to embrace 
 and kiss him on-ly about eight times. 
 
 " Thougli we have been separated many months, he having been 
 sent to a garrison in Hungar}', we have not forgotten eacli other, and 
 keep up a regulaV correspondence. In order to possess him, I dared to 
 go to a brothel and there embrace him, being in danger of being 
 betraj'ed.
 
 CONGENITAL HOMO-SEXUALITY. 247 
 
 " Early in our aeqiifiintance there came a time when I heard 
 nothiiio' more of him ; for he did not think he could trust me. Durino: 
 these weeks I endured anxiet}' and pain that brought me into a state of 
 depression and anxious restlessness, such as I had never before expe- 
 rienced. Scarcely to have found a lover and then to be compelled to 
 lose him, seemed the greatest misfortune to me. When, thanks to my 
 efforts, we met again, my joy was unbounded ; indeed, I was so excited 
 that, in his embrace again for the first time, in spite of my sensual lust, 
 I could not induce ejaculation. 
 
 " Usus sexualis in osculis et amplexionibus soils constltit, pene 
 meo ludere ei licebat (while the touch on it of a woman's hand is unen- 
 durable to me, and I never allow it). It is also to be noted that, in the 
 company of my lover, I immediately have an erection; the pressure of 
 his hand, or even his look, is sufficient. Evenings, for hours at a time, 
 I have gone about with him, never tiring of his society for a moment, 
 despite his inferior station. With him I feel liappy, and the sexual 
 satisfaction is merely the crowning of our love. Although I had finally 
 found the man like myself, whom I had so long sought, and I could at 
 last enjo}!- male love, yet I have not become insensitive to women ; and I 
 visit brothels when I am too sorely troubled by desire. I had hoped to 
 be able to spend this winter in the city where m^^ lover is ; but this is, 
 unfortunately', impossible, and I am now forced to be separated from 
 him for an indefinite period. Nevertheless, we shall try to see each 
 other, if only for a sliort time, and only once or twice a 3'ear; at least, I 
 hope that in the future we may again be together for a longer time. 
 Thus, for this winter, I am again compelled to be without a friend like 
 myself. I had, indeed, resolved, on account of the danger of discovery, 
 never to try to find another urning ; but this is impossible. Sexual 
 intercourse with women does not satisfy me, and my desire for young 
 men constantly increases. I am often afraid of myself; afraid that, in 
 asking all prostitutes, as I do, whether the}^ know others like me, I 
 might be discovered. Yet I cannot keep from seeking a 3-outh like 
 myself; indeed, I know that in case of necessit}^ I shall buy a soldier, 
 though I know perfectly well the penalty meted out to one caught in 
 such circumstances. 
 
 " I can no longer do witliout male love ; without it I should always 
 be out of harmony with myself. My ideal would be to be associated 
 with a number hke myself; but I should be satisfied if I could have 
 unrestrained intercourse with one lover. I could easily dispense with 
 women, if I had regular male satisfaction ; but I think that at long inter- 
 vals I should embrace a woman for the sake of variety, as my nature is 
 absolutely hermaphroditic in a jisycho-sexual sense (women I can only 
 desire sensually, but I can love and sensually* desire young men). If 
 there were marriage between men, I think I should not avoid a life-long 
 union ; while marriage with a woman seems to me something impossible.
 
 248 PSYCHOPATHIA SEXUALIS. 
 
 For, in the fir.st place, though the woman charmed me, the charm wonld 
 soon be lost in regular intercourse, and then all sexual indulgence, if not 
 impossible, would certainly be devoid of pleasure for me ; and, in the 
 second place, true love for the wife would be wanting — the attraction that 
 I feel with young men I love, and which makes the intercourse that is 
 not simply sensual seem desirable to me. The constant association with 
 a 3'outh physically pleasing and in mental harmony with me, and who 
 could understand all my feelings and share my intellectual opinions and 
 desires, would, it seems to me, be the greatest happiness. 
 
 " The young men who please me must be between eighteen and 
 twenty-eight. As I have grown older, the limit of age in those pleasing 
 to me has increased ; otherwise, I am pleased with the most various 
 forms. The principal 7'ule, if not the exclusive one, is played by the face. 
 Blondes excite me more than dark persons ; the}^ must have no beard, 
 but merel}' a small moustache that is not too thick, or none at all. As 
 for the rest, the onl}^ thing I can say is, that certain kinds of faces please 
 me. Faces with large, straight noses are excluded, as are also pale 
 cheeks; but there are exceptions. I regard soldiers with favor, and 
 many please me when in uniform who do not affect me when in civil 
 dress. Just as in women certain ordinary' articles of dress (like light- 
 colored jackets) please me, so the military costume attracts me. To go 
 to dance-halls — usually beer-halls — where there are many soldiers, and 
 mix with the crowd of soldiers and bo3^s that please me, and try to get a 
 kiss and embrace, — this mingling with them would, of course, be an 
 excitant only of sensuality ; intellectually and sociallj^, everj'thing com- 
 mon in speech and conduct is repugnant to me. 
 
 " With young men of higher position, my sensual desire is less 
 prominent. 
 
 " What I have said of the attractiveness of certain kinds of dress 
 is not to be understood in the sense that they attract me in themselves. 
 This charm only means that the dress ma}^ help to strengthen or make 
 prominent the attraction exerted by the face, when, perhaps, the same 
 face in itself would not attract me to the same extent. I may say the 
 same thing, though with a different meaning, of the odor of lighted 
 cigars. In indifferent persons the odor of cigars is rather repugnant 
 than pleasing to me, but exciting in those sexuall}' attractive. The kiss 
 of a prostitute smelling of cigar-smoke, affords greater pleasure (because, 
 even though in part unconsciously, I am reminded of the kiss of a man). 
 Therefore, I took pleasure in kissing my lover just after he had smoked. 
 (It is to be noted that I myself have never smoked a cigar or cigarette, 
 and have never even tried to smoke.) I am tall and thin ; mj'^ face is 
 masculine ; ni}^ eyes are restless ; and in my whole form I often have 
 something girlish. My health leaves much to be desired. It is much 
 influenced by my sexual anomaly. As previously mentioned, I am very 
 nervous, and I often have paroxysms of onomatomania. At times, I also
 
 CONGENITAL HOMO-SEXUALITY. 249 
 
 liave terrible depression and meLaneholia, Avlien I see the difTicult}' of 
 gratification corresponding with my niale-loving nature ; and when I am 
 greatl}^ excited sexually, and have overcome the desire, owing to impos- 
 sibility of male gratification. In such conditions, often the depression 
 is associated with absolute lack of sexual desire. In work I am indus- 
 trious, but often too quick ; for I am inclined to work too rapidly and 
 violently'. I have a lively interest in art and literature. Among poets 
 and writers of fiction, I prefer, for the most part, those who describe 
 refined feelings, peculiar passions, and far-fetched impressions ; an arti- 
 ficial or hyper-artificial style pleases me. Likewise in music, it is the 
 nervous, exciting music of a Chopin, a Schumann, a Schubert, or a 
 Wagner, etc., that is in most perfect harmony with me. Everything in 
 art that is not onlj^ original, but bizarre, attracts me. 
 
 " I do not like pl^ysical exercise, and do not practice it. 
 
 "In character I am kind and compassionate; and, though I have 
 much to suffer with m}' anomaly, I am not unhapp}- because I love 
 young men, but because the satisfaction of such love is considered 
 improper, and because I cannot gratify it without restraint. I cannot 
 regard male love as a vice, though I can well understand why it is 
 considered vicious. But, since this love is regarded as criminal, in 
 gratifying it I am in harmony with myself, but not with our age of the 
 world; and, therefore, I must, necessarily, be somewhat depressed ; the 
 more, since I have a frank character that hates a lie. The pain of having 
 alwaj^s to hide it all in m5^self has induced me to confess my anomaly to 
 a few friends, of whose silence and appreciation I am confident. Never- 
 theless, my situation often seems sad. On account of the diflSculty of 
 gratification and the general abhorrence of male love, I am often a little 
 proud that I have such anomalous feelings. Of course, I shall never 
 marry. This does not seem any misfortune, even though I love family 
 life, and have thus far lived only with my parents. I live in the hope 
 that later I shall have a lover; I must have one; witliout one, the future 
 seems dark and barren, and all the ambitions usually cherished — honor, 
 position, etc. — seem empty and unattractive. If I should not have this 
 hope fulfilled, I know I shall be unable to long devote myself to my busi- 
 ness with pleasure, and I shall soon be in a condition to sacrifice ever}^- 
 thing to obtain male loA'e. I no longer have au}' moral scruples on account 
 of m}^ anomalous inclination ; I have, in fact, never been troubled 
 because I felt attracted to boys. I am much more inclined to judge 
 morality and immorality in accordance with my feelings than in accord- 
 ance with fixed principles; for I have always been given to skepticism, 
 and have never yet studied out a fixed belief for myself. As yet, only 
 what injures others seems to me to be evil and immoral, and that that I 
 would not have inflicted on myself; and, in this direction, I may say that 
 I try to infringe on the rights of others as little as possible, and that I 
 am capable of great indignation at injustice inflicted on another. But,
 
 250 PSYCHOPATHIA SEXUALIS. 
 
 why love of men should be something immoral, I cannot understand; 
 purposeless activity of the sexual instinct (if the immoral is to be seen 
 in all that is useless and unnatural) is also found in intercourse with 
 prostitutes, and even in marriage where means to prevent conception are 
 used; and it seems to me that the sexual intercourse of men must be 
 placed on the same level with all sexual congress that has not procrea- 
 tion as an end. But that only sexual gratification that lias this pur- 
 pose is moral, seems to me to be questionable. Certainly, sexual satis- 
 faction that is not directed to procreation is not contrary to nature; and, 
 whether it has not other purposes unknown to us, is uncertain ; and, 
 even if it were purposeless, it would not necessarily be despicable (it is 
 not certain that the measure of a moral act is its usefulness). 
 
 " I am very certain that present prejudice will disappear, and that 
 when once such individuals experience male-love, the right of unrestricted 
 love will be acknowledged. For the possibilit}' of such recognition one 
 need but recall the Greeks and their friendships, which were nothing but 
 sexual love; and one has only to think that, despite such unnatural vice, 
 practiced by their greatest men in intellectual and aesthetic matters, the 
 Greeks are still regarded as an unatta,inable example, and held up for 
 imitation. 
 
 " I have already thought j)f having my anomaly cured b}^ h3q3no- 
 tism. If it were to be of any use, which I doubt, j^et I should certainl^^ 
 desire to be assured of a lastino- love for women. For even though I 
 cannot satisfy myself with men, yet I prefer to feel this capability of in- 
 ordinate lust and love, even ungratified, to being absolutely' without feel- 
 ing. Thus I still have the hope that I shall find opportunity to satisfy 
 the love I desire, the love that would make me happy; and I should not 
 prefer the suggestive removal of homo-sexual feelings, without the simul- 
 taneous substitution of a hetoro-sexual equivalent, to ni}' present con- 
 dition. Finally, I should like to add, in contrast with the statements of 
 urnings in the published biographies, that I, at least, find it very diflficult 
 to recognize those like myself Though I have described my sexual 
 anomaly somewhat in detail, it seems to me that the following notes are 
 important for a better understanding of mj' condition : — 
 
 " Of late I have given up immissio penis, and confined myself 
 to coitus inter femora? puellre. Ejaculation occurs earlier than with 
 conjunctio membrorum, and I experience a certain lustful feeling in the 
 penis itself If this manner of sexual intercourse is quite pleasant to 
 me, it is, perhaps, in part to be referred to the fact that in this kind of 
 sexual indulgence the sex is quite indifferent, and I am, perhaps, uncon- 
 sciously reminded of masculine embrace. But this memory is abso- 
 lutely unconscious, and but obscurely felt; for I am not indebted to my 
 imagination for my pleasure, but it is due immediately to kissing the 
 woman's mouth. I feel that the charm which the brothel and prostitutes 
 have for me also begins to fade; but I am sure certain women will
 
 CONGENITAL HOMO-SEXUALITY. 251 
 
 alwa3'S be able to excite me by their kisses. Still, no woman is, or ever 
 will be, so attractive as to induce me to overcome obstacles in winning 
 ber ; but even the clanger of discovery and disgrace could only with 
 difficulty restrain me from seeking a man's embraces. 
 
 " Thus I lately allowed myself to be induced to bu}' a soldier at a 
 prostitute's house. The lustful pleasure was very great, but the subse- 
 quent feeling of satisfaction was especially very exhilarating. The next 
 day I felt similarly strengthened (capable of erection at any moment) ; 
 and though I have not yet been able to meet the soldier again, the 
 thought that I shall venture to purchase another gives me peace. But I 
 could be perfectly satisfied only in finding one feeling like myself, of my 
 own position and education. 
 
 " I have not yet mentioned that the female form (with the exception 
 of the face) and genitals have no attraction for me (to touch the latter 
 with my hand would be disgusting to ine) ; but membrum virile me 
 tangere dum os meum os ejus osculatur, mihi exoptatum esse ; indeed, 
 to kiss tluit of a very pleasing man would not be disgusting to me. 
 Onanism, as has been said, would be quite impossible for me." 
 
 Case 111. Psychical Hermaphroditism. — Hetero-sexual feeling early 
 interfered with by masturbation, but episodically very intense. Homo- 
 sexual feeling ah origine perverse (sexual excitation by men's boots). 
 
 Mr. X., of high social position, Russian, aged 28, came to me in 
 September, 1887, in a despairing mood, to consult me on iiccount of a 
 perversion of his vita sexnalis, which made life seem almost unbearable to 
 him, and which had repeatedly brought him near to suicide. The patient 
 comes of a family in which neuroses and psychoses have been of frequent 
 occurrence. In the father's family there had been consanguineous mar- 
 riages for three generations. The father is said to have been a healthy 
 man, and to have lived morally in marriage. However, his father's 
 preference for fine-looking servants seems remarkable to the son. The 
 mother's family is described as eccentric. The mother's grandfather and 
 great-grandfather died melancholic ; her sister was insane ; a daughter 
 of the grandfather's brother was hysterical, and had nymphomania. Only 
 three of the mother's twelve brothers and sisters married. Of these, one 
 brother was homo-sexual, and always nervous as a result of excessive 
 masturbation. 
 
 The patient's mother is said to be a bigot, and of small mental 
 endowment, nervous, irritable, and inclined to melancholia. Patient 
 has a sister and a brother. The brother is frequently melancholy, 
 and, though mature, has never shown the slightest trace of sexual 
 inclinations. The sister is an acknowledged beauty, and much sought 
 by gentlemen. This lady is married, but childless, as reported, owing to 
 the impotence of her husband. She has always been indirterent to the 
 attentions shown her by men, but is charmed by female beauty, and 
 actually in love with some of her female friends.
 
 252 PSYCHOPATHIA SEXUALIS. 
 
 With respect of himself, the patient asserts that, when four jj'ears 
 old, he dreamed of handsome jockeys wearing shining boots. Too, he 
 never dreamed of women when he grew older. His nightlj' pollutions 
 were always induced by " boot-dreams." From his fourth j^ear he had a 
 peculiar partiality for men, or, more correctly, for lackeys wearing 
 shining Jboots. At first they only excited his interest, but, with devel- 
 opment of his sexual functions, the sight of them caused powerful 
 erections and lustful pleasure. It was only servants' boots that affected 
 him ; the same kind of boots on persons of like social station were with- 
 out effect on him. In a liomo-sexual sense, there was no sexual impulse 
 connected with these situations. Even the thought of such a possibility 
 was disgusting to him. At times, however, he had sensually-colored 
 ideas, — like being his servant's servant, and drawing off his boots ; but 
 the idea of being stepped on by him, or of having to blacken his boots, 
 was most pleasing. The pride of the aristocrat rose up against such 
 thoughts. In general, these notions about boots were disgusting and 
 painful to him. 
 
 Sexual instinct was early and powerfull}' developed. It first found 
 expression in indulgence in sensual thoughts about boots, and, after 
 puberty, in dreams accompanied b^' pollutions ; otherwise, the mental and 
 ph3'sical development was undisturbed. Patient was well endowed men- 
 tally, — learned easily, finished his studies, and became an officer. On 
 account of his distinguished, manly appearance and his high position, he 
 was much sought in society. 
 
 He characterizes himself as a clever, quiet, strong-willed, but super- 
 ficial man. He asserts that he is a passionate hunter and rider, and that 
 he has never had au}^ inclination for feminine pursuits. In the society 
 of ladies he has always been reserved ; dancing alwaA's tired him. He 
 had never had any interest in a lady of high social position. As for 
 Avomen, only the buxom peasant girls, such as are the models of painters 
 in Rome, had interested him. He had, however, never felt any sexual 
 interest in such representatives of the female sex. In the theatre and 
 circus only male performers had excited his interest ; but, at the same 
 time, thej' had caused him no sensual feelings. As for men, onl}- their 
 boots excited him, and, indeed, only when the wearers belonged to the 
 servant class and were handsome men. Men of his own position, wear- 
 ing never so fine boots, were absolutely indifferent to him. 
 
 With reference to his sexual inclinations, the patient is still uncer- 
 tain whether he feels more inclination towai'd the opposite sex or toward 
 his own sex. He is inclined to think that originally he had more in- 
 clination for women, but that this sympathy was, in any case, very weak. 
 He states with certainty' that the sight of a naked man made no impres- 
 sion on him, and that the sight of male genitals was even repugnant to 
 him. In the case of women, this was not exactly- the case, but he was 
 not excited sexually even by the most beautiful feminine form. When a
 
 CONGENITAL HOMO-SEXUALITY. 253 
 
 young officer, he was now ami then compelled to accompany his comrades 
 to brotliels. He was the more easily persuaded to this, since he hoped by 
 this means to be rid of his vile partiality for boots ; but he was impotent 
 unless he brought the thought of boots to his aid. Under such circum- 
 stances, the act of cohabitation was normally performed, but without 
 pleasurable feeling. Tatieut felt no impulse to intercourse with women, 
 always requiring some external cause, — t.e., persuasion. Left to himself, 
 his vita sexualis consisted in reveling in ideas about boots, and in corre- 
 sponding dreams with pollutions. Since more and more there became 
 connected with them the impulse to kiss his servant's boots, to draw 
 them off, etc., the patient determined to use every means to rid himself 
 of this disgusting desire, which deeply wounded his pride. At that 
 time, being in his twentieth year, and in Paris, he recalled a very beautiful 
 peasant girl, who lived in his distant home. He hoped, with her assist- 
 ance, to free himself of his perverse sexual inclination. He went directly 
 home, and tried to win the girl's favor. It seems that the patient was 
 not naturally homo-sexual. He asserts that at that time he was actually 
 in love with this person, and that her glance, or the touch of her dress, 
 gave him sensual i)leasure; and, when she once kissed him, he had a 
 powerful erection. After about a year and a half, the patient succeeded 
 in gaining his desires with this person. 
 
 He was potent, but ejaculated tardily (ten to twenty minutes), and 
 never had a pleasurable feeling in the act. 
 
 After about a year and a half of sexual intercourse with this 
 girl, his love for her grew cold, because he did not find her so " fine 
 and pure " as he wished. From this time it was necessary for him to 
 call upon ideas about boots for help, which had been latent, in order 
 to be potent in sexual intercourse with her. In proportion as his power 
 failed, these ideas arose spontaneously. Thereafter he had coitus with 
 other women. Now and then, especially when the woman was in sym- 
 pathy with him, the act took place without any assistance of imagina- 
 tion. It once happened that the patient committed a rape. It is 
 remarkable that on this single occasion he had a pleasurable feeling 
 in the (forced) act. Immediately after the deed he had a feeling of 
 disgust. When, an hour after the forced indulgence, he had coitus with 
 the same woman, with her consent, he experienced no feeling of 
 pleasure. 
 
 With decrease of virility, — i.e., when it was preserved only in con- 
 nection with ideas about boots, — libido for the opposite sex decreased. 
 The patient's slight libido and weak inclination for women are evidenced 
 by the fact that, while he still sustained sexual relations with the peasant 
 girl, he began to masturbate. He learned the vice from " Rousseau's 
 Confessions," the book accidentally falling into his hands. Tlie boot- 
 fancies immediately linked themselves with corresponding impulses. 
 His then had violent erections, masturbated, and ejaculation aflbrded
 
 254 PSTCHOPATHIA SEXUALIS. 
 
 liim a lively feeling of pleasure, which was denied to him in coitus; and 
 at first he felt himself fresher and brighter, as a result of the masturba- 
 tion. 
 
 In time, however, symptoms of sexual, and, later, of general, 
 neurasthenia, with spinal irritation, appeared. He then at first gave 
 up masturbation, and sought his first love; but she was now more than 
 ever indifferent to him. Since he finally became impotent, even when he 
 called ideas of boots to his assistance, he gave up women entirely, and 
 again practiced masturbation ; by which he felt himself protected from 
 the impulse to kiss and blacken servants' boots. At the same time, he 
 continued to feel that his sexual position was a painful one. He again 
 occasionally attempted coitus, and was successful in it as soon as he 
 thought of blackened boots. Too, after continued abstinence from mas- 
 turbation, he was sometimes successful in coitus without any artificial 
 aid. 
 
 The patient says that his sexual needs are intense. If he has not 
 had an ejaculation in a long time, he becomes congestive and psychically 
 much excited, and tormented by repugnant images of boots, so that he 
 is forced to have coitus, or, preferably, to masturbate. 
 
 For some time his moral position has been complicated most pain- 
 fully by the fact that, as the last of a wealthy line of high position, and 
 at the importunate desire of his parents, he must marry. The bride is 
 of rare beauty, and mentally in perfect sympathy' with him ; but, as a 
 woman, she is as indifferent to him as any other. J^sthetically she sat- 
 isfies him " as a work of art ; " in his eyes, she is an ideal. To honor 
 her in a platonic way would be happiness worth striving for; but to 
 possess her as a wife is a painful thought. He is certain beforehand 
 that with her he will be impotent, save with the help of ideas of boots. 
 To use such means, however, is in opposition to his respect and his 
 moral and aesthetic feeling for the lady. Were he to soil her with such 
 thoughts, she would lose, in his e3'es, all her aesthetic value; and then he 
 would become impotent for her, and she would become repugnant to 
 him. The patient considers his position one of despair, and confesses 
 that he has latel}' been repeatedly near suicide. 
 
 He is a man of much intelligence, and decidedly of masculine appear- 
 ance, with abundant growth of beard, deep voice, and normal genitals. 
 The eye has a neuropathic expression. No signs of degeneration. 
 Symptoms of spinal neurasthenia. It was possible to reassure the 
 patient, and give him hope of his future. 
 
 The medical advice consisted in means for combating the neuras- 
 thenia, and the interdiction of masturbation and indulgence of the fanc^'^ 
 in images of boots, in the hope that, with the removal of the neuras- 
 thenia, cohabitation without ideas of boots would become possible ; and 
 that, in time, the patient would become morally and physically capable 
 of marriage.
 
 URNINGS. 255 
 
 In the latter part of October, 1888, the patient wrote me that he 
 had resolutely resisted masturbation aiul his imagination. In the inter- 
 val he had had but one dream about boots, and scarcely a pollution. 
 He had been free from homo-sexual inclinations, but, in spite of this, 
 there was often considerable sexual excitement, witliout anything like 
 adequate libido for women. In this deplorable situation, he was com- 
 pelled, by circumstances, to marry in three months. 
 
 2. Homo-Sexual Individuals^ or Urnings. — In distinction 
 from the preceding group of psycho-sexual liermaplirodites, 
 there are here, ah origlne, sexual desires and inclinations for 
 persons of the same sex exclusively ; but, in contrast with the 
 following group, the anomaly is limited to the vita sexualis, and 
 does not more deeply and seriously affect the character and 
 mental personality. 
 
 The vita sexualis of these urnings, mutatis 7nufandis, is 
 entirely like that in normal hetero-sexual love ; but, since it is 
 the exact opposite of tlie natural feeling, it becomes a carica- 
 ture, and this the more, since these individuals, at the same time, 
 as a rule, are subject to hyperaesthesia sexualis, and, therefore, 
 their love for their own sex is emotional and passionate. 
 
 The urning loves and deifies the male object of his affec- 
 tions, just as a man idealizes the woman he loves. He is 
 capable of the greatest sacrifice for him, and experiences the 
 pangs of unfortunate, often unrequited, love ; suffers from the 
 unfaithfulness of the beloved object, and is subject to 
 jealousy, etc. 
 
 The attention of the male-loving man is given only to male 
 dancers, actors, athletes, statues, etc. The sight of female 
 charms is indifferent to him, if not repulsive. A naked woman 
 is disgusting to him, ^vhile the sight of male genitals, hips, etc., 
 affords him infinite pleasure. 
 
 The bodily contact of a sympathetic man induces a thrill 
 of delight ; and, since such individuals are mostly sexually 
 neurasthenic, congenitally or from onanism or enforced absti- 
 nence from sexual intercourse, under such circumstances ejac- 
 ulation is very easily induced, which, in the most intimate 
 intercourse with women, cannot be induced at all, or only 
 by mechanical means. The sexual act with a man, in many
 
 256 PSTCHOPATHIA SEXUALIS. 
 
 instances, affords pleasure, and leaves behind a feeling of well- 
 being. Should the urning be able to force himself to coitus, in 
 which, as a rule, disgust has the effect of an inhibitory con- 
 cept, and makes the act impossible, then his feeling is something 
 like that of a man compelled to take disgusting food or drink. 
 However, experience teaches that not infrequently urnings 
 falling in this group marry, either out of ethical or social con- 
 siderations. 
 
 Such unfortunates are relatively potent, in that in marital 
 intercourse they incite their imagination, and, instead of think- 
 ing of their wives, they call up the image of some loved male 
 person. But for them coitus is a great sacrifice, and no pleasure; 
 and it makes them, for days after, nervous and miserable. If 
 such urnings, by means of powerful excitation of their imagina- 
 tion, or under the influence of alcoholic drinks, or by erections 
 induced by an overfilled bladder, etc., are enabled to overcome 
 the inhibitory feelings and ideas, then they are still entirely im- 
 potent ; Avhile simply the touch of a man may induce powerfid 
 erection, and even ejaculation. 
 
 Dancing with a woman is unpleasant to an urning, but to 
 dance with a man, especially one with an attractive form, seems 
 to him the greatest of pleasures. The male urning, in so far as 
 he possesses higher culture, is not opposed to non-sexual inter- 
 course with women, when by mind and refinement they make con- 
 versation pleasant. It is only of woman in her sexual role that 
 he has a horror. The homo-sexual woman offers the same mani- 
 festations, mutatis mutandis. In this degree of sexual degen- 
 eration, character and occupation correspond Avith the sex which 
 the individual represents. The sexual perversion remains iso- 
 lated, but an anomaly of the mental being of the individual 
 which deeply affects the social existence. In accordance with 
 this, many of these individuals, in the sexual act, feel themselves 
 in the role which would naturally belong to them in hetero- 
 sexual intercourse. 
 
 However, transitions to group 3 occur, in as much as some- 
 times the passive role which corresponds with the homo-sexual 
 manner of feeling, is thought of or desired, or at least forms
 
 URNINGS. 257 
 
 the subject of dreams. Moreover, inclinations for occupations 
 and tendencies of taste are manifested, which do not correspond 
 with the sex of the individual. In many cases, one gets the 
 impression that such symptoms are artificial, the result of educa- 
 tional influences; in otlier cases, that they represent deeper 
 acquired degenerations of the original anomaly, induced by the 
 perverse sexual activity (masturbation), analogous to the signs 
 of progressive degeneration observed in acquired inversion of 
 the sexual instinct. 
 
 With regard to the manner of sexual satisfaction, it must 
 be stated that with many male urnings simple embraces are 
 sufficient to induce ejaculation, since they are subject to irritable 
 weakness of the sexual apparatus. In case of sexual hyperaes- 
 thesia, ^nd where there is para^sthesia of the moral sense, great 
 pleasure is afforded by intercourse with persons of the lowest 
 condition. On the same basis, desires to commit pederasty 
 (active, of course) and other similar acts occur, though it is but 
 seldom, and apparently only in cases of moral defect, and by 
 reason of libido nimia hi individuals especially passionate, that 
 pederasty is indulged in. The sensual desire of mature urnings, 
 in contradistinction from old and decrepit dehaiichees, iclio 
 prefer hoys (and indidge in pederasty hy preference), seems 
 never to he directed to immature males. Only lor want of better 
 material, and in case of violent passion, does the urning become 
 dangerous to boys. The manner of sexual satisfaction in female 
 urnings may be mutual and passive masturbation. To them 
 coitus is quite as disgusting, wearisome, and inadequate as it is 
 to the male urning. 
 
 Case 112. The following is an extract from a very circumstantial 
 autobiography whicli a physician affected with contrary sexual instinct 
 has put at my disposal : — 
 
 "I ain now forty years old, of healthy family, ^ and have always 
 been healthy and considered a model of physical and mental strength 
 and energy. I am of powerful build, but have only a moderate beard, 
 and^with the exception of hair in the axilla and on tlie mons veneris, 
 
 1 Later it became known that a near relative died insane, and, further, that eight of 
 his parent's children had died of acute or chronic hydrocephalus at ages ranging from one 
 to fifteen. 
 
 IT
 
 258 PSYCHOPATHIA SEXUALIS. 
 
 my body is hairless. The penis, even soon after birth unusually large, 
 measures, in statu erectionis, 24 centimetres long by 11 centimetres in 
 circumference. I am a skillful rider, athlete, and swimmer, and have 
 passed tlirough two great campaigns as a military surgeon. I never 
 experienced any taste for female attire and vocation. Up to the time 
 of puberty I was shy toward the female sex, and I am yet sh}^ with new 
 acquaintances. 
 
 " I have always had a distaste for dancing. In my eighth year an 
 inclination for m}^ own sex made its appearance. I next experienced 
 pleasure in regarding my brother's genitals, I induced my brother to 
 indulge with me in mutual fondling of the genitals, as a result of which 
 I had an erection. Later, in l)atliing with the school-children, the boys 
 excited a lively interest in me ; the girls, none at all. I had so little in- 
 terest in them that, as late as my fifteenth j^ear, I believed tlmt they also 
 had a penis. In company with bo3'S like m3'self, I took pleasure in 
 mutual manustupration. At eleven and a half ^^ears I was given a strict 
 tutor, and thereafter could steal to my friends but seldom. I learned 
 very easily', but could not get along with my teacher ; and when one day 
 he made it too hard for me, I became furious and struck at him with a 
 knife, and would have gladly stabbed him, if he had not fallen into my 
 arms. In my thirteenth year, for a similar cause, I escaped from the 
 teacher, and "wandered about for six weeks in the neighboring countr3% 
 
 " I now entei'ed the G^^mnasium. At that time I was already 
 sexually developed, and amused myself while bathing with mj' comrades 
 in the way above mentioned, and later by imitatio coitus between the 
 thighs. I was then thirteen years old. I took absolutely no pleasure 
 with girls. Violent erections caused me to play with my genitals, and I 
 came to take m^' penis in my mouth, wdiich I succeeded in doing by 
 bending over. This induced ejaculation. I thus learned masturbation. 
 I was much frightened, looked upon m^'self as a criminal, and confessed 
 to a companion of sixteen. lie encouraged and quieted me, and entered 
 into a love-bond with me. We were happ}', and satisfied ourselves by 
 mutual onanism. At the same time, I masturbated. After two years 
 the bond was broken ; but to this day, Avhen we occasionally meet, — my 
 friend is a high official, — the old fire lights up anew. 
 
 " That time with m}- friend H. was a happj^ one, the return of which 
 I would gladly buy with my heart's blood. Then life was a pleasure, 
 learning was mere play, and I had a feeling for everything beautiful. 
 
 " During this time a physician, a friend of my father's, seduced me 
 b^'^ caressing me and practicing masturbation on me on the occasion of 
 a visit, and by explaining the sexual act to me. He advised me never 
 to practice manustupration, since it was injurious to health. He then 
 practiced mutual onanism with me, and explained that this was tlie only 
 wa}^ in which he could perform the sexual function. He had a horror 
 of women, and, therefore, had lived unhappily with his deceased wife.
 
 URNINGS. 259 
 
 He gave me a pressing invitation to visit him as often as possible. The 
 physician was a pompous man, and the father of two sons aged fourteen 
 and fifteen resi)ectively, with whom in the following year I entered into 
 love-relations similar to those I had with my friend H. 
 
 " I was ashamed of my unfaithfulness to him, but at the same time 
 continued my relations witli the physician. He practiced mutual mas- 
 turbation with me, showed me our spermatozoa under the microscope, and 
 pornographic works and i)ictures, which, however, did not please me, be- 
 cause I had interest only for male forms. On the occasion of later visits, 
 he asked me to do him a favor which he had never yet enjoyed, and which 
 he very much desired. Since I loved him, I acquiesced in everything. He 
 dilated my anus with instruments, and practiced pederasty on me, and at 
 the same time performed masturbation, so that I experienced pleasure 
 and pain at once. After this discovery I went immediatel}' to my friend 
 H.,witli the thought that this beloved man would be able to give me still 
 greater pleasure. We practiced pederasty on each other, but were both 
 deceived, and did not repeat it; for passively I had only pain, and 
 actively no pleasure, while mutual onanism gave us both the greatest 
 enjoyment Thereafter, out of gratitude, I was still frequently at the 
 disposal of the physician onl3^ Up to my fifteenth year I practiced 
 passive or mutual onanism with my friend. Now I was quite grown, 
 and had all kinds of signs made to me by women and girls ; but I fled 
 from them as Joseph did from Potiphar's wife. At fifteen I came to 
 the Capital. I had but infrequent opportunity for the satisfaction of my 
 sexual inclination. I reveled in the sight of pictures and statues of 
 male forms, and could not keep from kissing the beloved statues. The 
 fig-leaves on the genitals were my principal annoyance. 
 
 " At seventeen I went to the University. There, again, I lived two 
 years with m^^ friend H. 
 
 " When I was in my eighteenth 3'ear, while in a state of mild intox- 
 ication, I was set on to have coitus with a woman. I forced myself to 
 it, but immediately afterward I fled the house, overcome with disgust. 
 Just as after the first active manustupration, I had a feeling as if I had 
 committed a crime. On the occasion of another attempt, while in a 
 sober condition, in spite of every eflbrt of a beautiful naked girl, I could 
 not get an erection ; though the mere sight of a boy or the touch of a 
 man's hand on my thigh, would always throw my penis into violent 
 erection. A short time before, my friend H. had had a similar expe- 
 rience. In vain w^e racked our brains to discover the reason for it. 
 Now I let women alone, and found enjoyment with friends in passive 
 and mutual onanism, among others with both the sons of the physician, 
 who had used them for pederasty after my departure. 
 
 " When nineteen years old, I made the acquaintance of two genuine 
 urnings : — 
 
 '' A., aged 56, of etfeminate appearance, beardless, of small endow-
 
 260 PSYCHOPATHIA SEXUALIS. 
 
 ment mentally, possessing a powerful sexual desire that had been mani- 
 fested abnormally early, had indulged in urnings' love since his sixth 
 yeai'. Once a raontli he visited the Capital. I had to sleep with him. 
 He was insatiable in mutual onanism, and made me take part in active 
 and passive pederasty, which was an unpleasant part of the bargain 
 for me." 
 
 " B., a merchant, aged 36, of masculine appearance, was as passionate 
 as I was. He knew iiow to make his manipulations on me such a stim- 
 ulus that I had to serve him passively in pederasty. He was the only 
 one with whom I ever had any pleasure in passive pederasty. He con- 
 fessed to me that when he but knew tliat I was near, he had the most 
 painful erections; and that when I could not serve him, he was compelled 
 to satisfy himself bj' masturbation. 
 
 " While pursuing these love-aftairs, I was clinical assistant in hos- 
 pital, and was considered ambitious and skillful in my work. I naturally 
 sought throughout literature for an explanation of my sexual peculiarity. 
 I found it in part as a crime deserving punishment, while for myself I 
 could onlj' recognize in it the natural satisfixction of my sexual desire. 
 I was aware that this was congenital with me. But feeling myself in oppo- 
 sition to tlie whole world, often near insanity and suicide, I again sought 
 to satisfy my powerful sexual desire with women. The result was always 
 the same, — either want of suHicient erection, or, when it became possible, 
 to force myself to the act, disgust and horror of its repetition. As a 
 military surgeon, I suffered terribly from the sight and touch of thousands 
 of naked male forms. Fortunately, I formed a love-bond with a lieu- 
 tenant affected similarly, and passed again a time of liappiness. For 
 love of him I consented to pederasty, for which he longed. We loved 
 each other until he lost his life at Sedan. From tliat time I never gave 
 myself to active or passive pederast}^ although I had many love-affairs, 
 and was a person much sought. 
 
 "At twent^'-three I went to the countr}' as a phj'sician, and was 
 sought and esteemed. I satisfied myself with boys over fourteen. I 
 interested myself in political affairs, and made an enemy of the clergy- 
 man, and, being betrayed by one of my lovers, was denounced and com- 
 pelled to flee. The legal investigation, fortunately, did me no harm. I 
 was able to return, but I was greatl}' shaken; and I went to the war 
 (18V0) as a soldier, in the hope of meeting my death. I returned, how- 
 ever, with many distinctions, much matured; and I found still more 
 pleasure in earnest work in my profession. I hoped that the extinction 
 of my excessive sexual desire was near at hand, exhausted by the great 
 hardships of the campaign. 
 
 " Scarcel}^ had I recovered, when the old unbounded desire again 
 appeared, and led to new unbridled satisfaction. Of course, I often 
 thought of it; but my inclination, so revolting to the world, did not seem 
 so to me.
 
 URNINGS. 261 
 
 " For a 3'ear, by means of the greatest exercise of mj'^ will, I ab- 
 stained ; tlien I went to the Capital to force ni^'self to cohabit with a 
 woman. T, who at the sight of the dirtiest raganiiitlin had painful erec- 
 tions, could scarcely induce one with the most beautiful woman. Over- 
 come, I returned home and obtained a young man-servant for my personal 
 service and satisfaction. 
 
 "The solitude of life as a country physician, and the longing for 
 children, drove me to marriage; besides, I wished to make an end to 
 gossip, and I hoped finally to triumph over my fatal desire. 
 
 " I knew a young girl, of whose respect and love for me I was con- 
 vinced. Through my esteem and honor for ni}' wife, I was enabled to 
 perform the conjugal duties, and begat four boys. The boyish appear- 
 ance of my wife was of effectual assistance. I called her my ' Raphael.' 
 I forced into my fancy images of boys, in order to. induce erection. If 
 my fancy ceased for a moment, the erection failed. I was unable to 
 sleep with my wife. Within the last few years coitus has become con- 
 stantly more difficult to attain, and for two 3'ears we have given up all 
 'attempts. My wife knows my mental condition, and her esteem and 
 love for me may become estranged. 
 
 "My sexual inclination for ni}^ own sex is unchanged, and, unfor- 
 tunately, too often forces me to become untrue to m\^ wife. To this da}', 
 the sight of a youth of sixteen puts me into violent sexual excitement 
 with painful erections, so that occasionally I am compelled to help myself 
 with manustupration of him and onanism on myself. 
 
 " The sufferings I endure are indescrible. Faitte de mieux, I have 
 my wife practice manustupration on me ; but what my wife's hand accom- 
 plishes with great elfovt in half an hour is produced by the hand of a 
 boy in a few seconds. Thus I live, miserable, a slave of the law and of 
 my duty to m}^ wife ! I never had pleasure in active or passive pederast}'. 
 If I ever practiced or suffered it, it was only from gratitude or desire to 
 please." 
 
 The physician to whom I owe the preceding antobiography 
 assures me that he, up to this time, has had sexual intercourse 
 with at least six liundred urnings. There were, indeed, many 
 among them who to-day occupy high and respected positions. 
 Only about ten per cent, of them came later to love women. 
 Another portion did not avoid women, but were more inclined 
 to their own sex ; the remainder were exclusively and lastingly 
 Tunings. 
 
 This physician asserted that among the six hundred he 
 never found abnormal formation of the genitals ; but there were, 
 however, frequent approaches to the female form, as well as in-
 
 262 PSYCHOPATHIA SEXUALIS. 
 
 complete growth of liair, delicate complexion, and higher voice. 
 Development of the mammse was not infrequent. He asserted 
 that from his thirteenth to his fifteenth year he had milk in his 
 mammae, which his friend H. sucked out. Only about ten per 
 cent, of this number showed inclination for female occupations, 
 etc. All his acquaintances were affected with a sexual desire 
 that was abnormally powerful, and made its appearance abnor- 
 mally early. The vast majority felt themselves as the man in 
 their relations with the other, and satisfied themselves bv mutual 
 onanism, or by manustupration on the person of the lover, or by 
 masturbation at his hands. The majority were inclined to active 
 pederasty ; but very frequently the law and sesthetic feeling were 
 reasons for the non-performance of the act. Those feeling them- 
 selves toward the others as women were few, and the inclination 
 to passive pederasty was very infrequent. 
 
 In the beginning of 1887, this ph\"sician was arrested for having 
 coinniited acts of indecency on the persons of two boys under fourteen 
 years. The crime consisted in his having first rubbed nientulani pro- 
 priam inter femora viri until ejaculatio, and the same procedure cum 
 mentiila propria inter femora pueri. At the examination it was recog- 
 nized tliat an abnormal instinct was in play, though, at the same time, it 
 was shown tliat the culprit was not mentally unsound, and not deprived 
 of free will ; at least, he had not acted in obedieuce to an uncontrollable 
 impulse. Therefore, he was sentenced to prison for one 3'ear, the mildest 
 possible punishment. 
 
 Case 113. Mr. X., Hungarian, merchant, consulted me on account 
 of neurasthenia and sleeplessness, which had existed for j'ears. The in- 
 vestigation of the cause of his trouble led the patient to confess that he 
 had an al)normal sexual instinct for his own sex, that he was very pas- 
 sionate, and that his nervous trouble might well come from that. The 
 following, taken from the history of this intelligent patient, possesses 
 scientific interest: — 
 
 " My abnormal sexual instinct reaches back to my childhood. 
 When three 3'ears old, I got hold of a journal of fashions. The beautiful 
 pictures of the men I kissed until the i)aper was torn to tatters, but I 
 paid no attention to the female figures. I did not like to plaj^ with boys. 
 I preferred to play with girls, because they always had dolls. I espe- 
 cially liked to cut out dolls' clothes ; and to-da}-, in spite of ray thirt3'^- 
 three j'^ears, dolls still possess an interest for me. When a boy, for 
 hours I would liirk about available places, in order to get a sight of male 
 genitals. When I succeeded, a strange, dizzj^ feeling came over me.
 
 URNINGS. 263 
 
 Weak, unattractive men or l)03's made no impression on me. At thirteen 
 I began to masturbate. From my thirteenth till my fifteenth year, I 
 slept with a handsome young man. That was happiness. Hours at a 
 time at night, with erections, I would wait for his return. If in bed he 
 chanced to touch my genitals, it gave me delight. At fourlet'ii I had a 
 school-mate whose instincts were like my own. For hours at a time, dur- 
 ing school-hours, we held each other's genitals. Ah, those were happy 
 hours 1 As often as I could, I lingered in bath-houses. That was 
 always a feast for me. The sight of male genitals induced violent erec- 
 tions. At sixteen I came to the metropolis. Seeing so many hand- 
 some men charmed me. In my eighteenth year I attempted coitus 
 with a prostitute, but disgust and fear made it impossible. Other 
 attemjits were lailures, until m}^ nineteenth year, when I tried again 
 with success ; but the act afforded me no pleasure, rather inducing a 
 feeling of disgust. I conquered myself, and was proud of my success 
 at being a man, which I had gradually begun to doubt. 
 
 " Subsequent attempts were no longer successful. The disgust was 
 too great. When the woman was undressing, it became necessary, on 
 account of my feeling of repugnance, to put out the light. I now con- 
 sidered mj'self impotent, consulted physicians, and visited baths and 
 sanitariums to cure m}' supposed impotence; for I still did not know 
 what to think of it. I took pleasure in the society of ladies, perhaps 
 out of conceit ; for I impressed most ladies as being sympathetic and 
 amiable; but I valued in them nothing more than mental and aesthetic 
 qualities. I liked to dance with them ; but if one pressed against me in 
 dancing, I experienced a feeling of repugnance, and even disgust, and 
 felt like striking her. If in joke I happened to dance with a gentleman, 
 I always took the part of the lady. I would press and rub against him, 
 and take a perfect delight in it. When I was eighteen, a gentleman who 
 came into the office, said, ' That is a fine 3'outh ; in the East he would 
 bring a pound sterling eveiy time 1 ' I puzzled my head over that. 
 Another gentleman liked to joke with me, and steal kisses of me as he 
 was going away, which I would have given him only too gladl3^ He 
 afterward became ray lover. These circumstances excited m3' attention, 
 and I waited for an opportunity. 
 
 " When I was twenty-five years old, it happened that a man wdio was 
 formerly a Capucine monk became attracted to me. For me he was like 
 a Mephistopheles. Finally he spoke to me. To this day I can almost 
 feel the beating of my heart that he caused me ; I almost fainted. He 
 made a rendezvous for that evening at a public house. I went, but at the 
 threshold I turned back, afraid. On the next evening he met4ne again. 
 He overcame my scruples, and took me to his room. I was scarcel}' able 
 to walk for excitement. My seducer made me sit on his sofa, and, smil- 
 ing at me, he fixed his wonderful black eyes on me, and I lost conscious- 
 ness. This delight, this ideal, divine sense of pleasure that filled my
 
 264 PSYCHOPATHIA SEXUALIS. 
 
 whole being, — I conld write too mnoh about it. I think only an innocent 
 youth, over head and eai's in love, who for the first time has his love's 
 longing fulfilled, could be as happy as I was that night. My seducer 
 demanded my life, in joke; but I at fii'st thought him in earnest. I 
 begged him to let me be happy for a time, and then, united to him, I 
 would end my life. It would have been entirely in accordance with the 
 high-flown ideas I entertained at that time. For five j^ears after that, I 
 kept up a relation with the man, who is still so dear to me. Oh, how 
 liappy, and 3'et, often, how unhapp^'^, I was during those years 1 If I but 
 saw him speak to a handsome young man, I became wildly jealous. 
 
 " When twenty-seven, I became engaged to a young lad3'. Her 
 mind and aesthetic feeling, as well as financial considerations, induced me 
 to think of marriage. At the same time, I am very fond of children, and, 
 whenever I meet even the commonest day-laborer and his wife and a 
 prett}' child, I envy the man his good fortune. Thus I made a fool of 
 myself I managed to get through the time of courtship; when kissing 
 my bride I felt more anxiety and fear than pleasure. On one or two 
 occasions, however, after luxurious dinners, while kissing her passion- 
 ately, I had erections. How happ}' I was at that ! I saw mj^ self already 
 a father. I twice came near breaking oft' the engagement. On m^' mar- 
 riage-da}', when all the guests had assembled, I locked myself in a room, 
 cried like a child, and felt that I could not proceed with the ceremony. 
 At the persuasion of all the relatives, to whom I made the best excuses 
 that occurred to me, I allowed myself to be taken, in ordinary street- 
 costume, to the altar. 
 
 " As great good fortune would have it, at the time of the marriage, 
 my wife was menstruating. Oh, how thankful I was for this excuse ! 
 I am now convinced that this circumstance is all that made later cohab- 
 itation possible. How it later became possible for me to cohabit with 
 my wife, and have a lovel}' boy, I do not know. He is the comfort of 
 ray ruined life. I can onl}' thank God for the happiness of having a 
 child. I was a cheat, so to speak, in the marriage-bed. My wife, whom 
 I respect for her high qualities of character, has no suspicion of my 
 condition, but she often complains of mj'^ coldness. AVith her goodness 
 of heart and simplicity, it was possible for me to make her think that 
 the conjugal duty should be performed but once a month. Since she is 
 in nowise sensual, and I can find excuse in mj' nervousness, I am 
 successful in keeping up the swindle. Cohabitation is the greatest sac- 
 rifice for me. B3' taking considerable wine, and bj' making use of the erec- 
 tions which occur in the morning, as the result of an overfilled bladder, 
 it is possible for me to perform coitus once a month ; but it affords me 
 no pleasurable feeling, and I am worried and experience an increase of 
 my nervous difficulties all day long after it. The consciousness of 
 having fulfilled my duty toward my wife, whom in all other respects I 
 love, affords me moral consolation and satisfaction. With a man, it is
 
 URNINGS. 265 
 
 otherwise. With him I can perform the act several times in a night, 
 always taking the sexual role of a man. In this, I experience the great- 
 est pleasure, the purest happiness. I feel myself refreshed and invigor- 
 ated by it. Of late, my desire for men lias somewhat decreased ; in 
 fact, I have courage even to avoid a handsome young man that 
 approaches me. Will it last? I fear not. I am absolutelv unable to do 
 without male love; if I am compelled to forego it, I become depressed, 
 feel wear^' and miserable, and have pain and pi*essure in my head. I 
 have always regarded my pitiable peculiarity as something congenital, 
 and I would feel happy if I had only not married. I pity my good wife. 
 Often the fear seizes me that I cannot endure it with her longer; then 
 thougiits about divorce, suicide, and flight to America come to me." 
 
 No one seeing the patient to whom I owe this communication 
 would suspect his condition. His outward appearance is, in all respects, 
 masculine ; he has a well-developed, full beard, strong and deep voice, and 
 normal genitals. The cranium is normally formed ; signs of degenera- 
 tion are absolutely wanting, and only an exquisitely nervons e^'C makes 
 one suspect a neuropathic condition. The vegetative organs perform 
 their functions normally. The patient presents the usual symptoms of 
 a neurasthenia, which ma}', in all essentials, be ascribed to sexual 
 excesses with persons of his own sex, in a man abnorinall}'^ passionate ; 
 and to the injurious influences of forced, though infrequent, coitus with 
 the wife where horror feminse exists. 
 
 The patient declares that he comes from healthy parents, and that 
 he knows of no neuroses or mental disease in his ancestry. His elder 
 brother was married three years. There was a separation, because the 
 husband never had sexual intercourse with his wife. He married a 
 second time. The second wife also complained of neglect on the part of 
 the husband ; but she had four children, concerning whose legitimac}' no 
 doubt was ever raised. A sister is hysteropathic. 
 
 The pntient says that, when a young man, he suffered with momen- 
 tary attacks of dizziness, during which it seemed to him as if he were 
 about to die. He says that he has always been very excitable and 
 emotional, and an enthusiast for the arts, especially poetr}- and music. 
 He himself designates his chai-acter as enigmatical, abnormal, nervous, 
 restless, extravagant,. and undecided. He is often exalted without real 
 reason, and then again depressed, even to thoughts of suicide. He may 
 pass through quick and sudden changes, — " religious and frivolous, 
 optimistic and cynical, cowardly and brave, credulous, amiable, and sus- 
 picious ; inclined to do others harm, and sorrowful to tears over the 
 misfortunes of others; and with this, generous to excess, and then again 
 miserly a la Harpagon.''^ The patient is certainly a tainted individual. 
 He seems to be very well endowed intellectually, and, as he says, to have 
 learned easily, and been among the first at school. 
 
 The marriage of this man was not happ}-. Notwithstanding the
 
 266 PSYCHOPATHIA SEXUALIS. 
 
 fact that it was but very infrequently that lie performed the inadequate 
 and injurious sexual act with his wife, aud that he sought and found a 
 substitute in male lovers, he remained neurasthenic. His disease, at 
 times, presents marked exacerbations, even manifesting itself in despair- 
 ing depression about his matrimonial, sexual, and mental condition, 
 wliicli even extends to violent tedium vitoe. 
 
 His wife became hysteropathic and anaemic, and the patient attributed 
 this to sexual abstinence. Try as he would to force himself, of late years 
 he has not been able to perform coitus, erection failing completely ; 
 while, in intercourse with male lovers, he is very potent. 
 
 The son of these unfortunate parents, who is now over nine j'ears 
 old, develops well. Tlie patient adds that formerly, in coitus with his 
 wife, he was potent only when he thought of a beloved man. (From the 
 author's " Lehrb. der Psychiatric. ") 
 
 Case 114. Autobiography. " The writer of this is a congenital 
 urning. If I have not consorted with other urnings, nevertheless, I am 
 fully informed of my condition ; for it has been my lot to see almost all 
 literature on the subject. A short time ago, your work, ' Psychopathia 
 Sexualis,' was sent to me. I saw in it that j'ou were working and study- 
 ing without })rejudice in the interest of science and humanit}'. 
 
 " If I cannot tell you much that is new, yet I will speak of a few 
 things which I trust you will receive as one more stone to be used by 
 you in your work; which, I am confident, will, in your hands, aid in 
 savin o- us. 
 
 " Wiien you presume that there is often an liereditary tainted con- 
 dition, perhaps 3'ou are right. My father was subject to spinal disease 
 before my birth ; later, lie became mentally unsound, and took his own life. 
 
 " Another point, which I am inclined to doubt, is the one mentioned 
 by you in another place, — i.e., that onanism practiced from youth may 
 lead to perverse instinct. 
 
 " I (merchant, owner of a small business, unmarried) am in the be- 
 ginning of my thirtieth year. I am apparentl}' healthy, and show scarcel}^ 
 a deviation from tlie normal masculine type. The first sexual impulses 
 were immediately and exclusively directed to the male sex, and I experi- 
 enced them from my tenth year. I have masturbated since my twelfth 
 year. Since, in spite of all attempts, coitus with ^ women was always 
 absolutely impossible for me ; and since I have ncA^er had desire for 
 women — on the contrary, rather aversion; and since my attempts have 
 never resulted in the slightest erection, I have been compelled to satisfy 
 myself by onanism. 
 
 "If now I am to confess the manner of my sexual satisfaction, I 
 may say that in my earlier years my fellow-pupils and companions ex- 
 cited me sexually. Now my impulse consists in a desire for boj^s of 
 about ten, but mostly for youths of from fifteen to twenty ^^ears. 
 
 *' For a long time, strong and healthy cadets, of fine form, have had
 
 URNINGS. . 267 
 
 a particular charm for me ; and b}^ their handsome uniforms and fine pres- 
 ence they especially excite m^^ desire. I have no opportunity to approach 
 then), or even to enter into distant social intercourse with them ; but I am 
 compelled to satisfy myself with following them in the streets and 
 squares ; or in restaurants, horse-cars or railway's, by sitting near them, 
 and, when it is possible to do it unnoticed, under such circumstances, 
 by practicing onanism. My most ardent wish has often been to become 
 the friend, servant, or slave of such a young man. 
 
 " I have never even dreamed of direct pederasty ; vay desire has 
 always been bodily contact, embrace, manustupration of my genitals by 
 my lover, and, on my part, a kiss on his genitals or podex. 
 
 " I often have the desire, however, to represent Sacher-Masoch in 
 his ' Venus in Purs.' There a man makes himself the voluntary slave 
 of a woman, and feels an intense thrill of lustful pleasure, if he is onl}^ 
 chastised and humiliated by her. But I naturally feel that I could, under 
 no circumstances, become the slave of a woman, but only of a man ; more 
 correctly, of a young man ; one, however, for whom I should have such 
 an infinite love that I could give myself up entirely to his mercy or 
 'cruelty. 
 
 " The lustful images that float before my mind in masturbation are 
 those of this or that 30ung man that I have just seen. As a sad and 
 incomplete substitute, I practice this onanism constantl3\ 
 
 " I pass into a lustful dream in this way (and I say all here, because 
 I wish to write only the truth and the whole truth) : I choose a young 
 man that pleases me by his form, and in imagination give m^'self np to 
 involuntary obedience to him. I imagine that he wishes to humiliate me, 
 and that he commands me, for example, to kiss his feet; or compels me 
 to smell his socks. For want of the desired actuality, I take my own 
 socks, smell of them, take them into my mouth, rub them over m3^ geni- 
 tals, and immediately erection and ejaculation, with sensual pleasure, 
 take place, 
 
 " Yes, I am so dominated by this mental imager}' that I imagine 
 that the young man is my confessor, and, in order to humiliate me, orders 
 me to eat of his excrement. Here again, in want of actuality, I eat of 
 my own excrement, but only in small quantit^y. Then, with an imperfect 
 feeling of disgust and violent palpitation of the heart, erection and 
 ejaculation take place, 
 
 " However, I come to this vile, feverish imagery and the perform- 
 ance of these acts, only when it has not been possible for me for a long 
 time to satisfy myself by onanism in the immediate vicinity of a young 
 man. 
 
 " This is for me more natural, because I then have more pleasure, and 
 experience a more perfect physical and mental benefit, even though m}' 
 ideal of actual and direct satisfaction in mutifal understanding were 
 never to be accorded me.
 
 268 PSYCHOPATHIA SEXUALIS. 
 
 "I ciimost believe that tlie above-mentioned disgnsting imagery is 
 only the evil result of constant want of normal satisfaction, — i.e., of my 
 normal satisfaction as an urning ; and that with a regular satisfaction, 
 body to body, the imagery that becomes almost insane would be less 
 intense, and certainly would not go to such extravagance. Or it is the 
 ultimate result of an attempt at abstinence ; for these idiotic, sensual 
 images only come after a long period of it. 
 
 " I believe, indeed, that, under other social conditions, I should be 
 capable of great and noble love and self-sacrifice. My thoughts are in 
 no way exclusively carnal or diseased. How often, at the sight of a 
 handsome young man, a deep feeling of impatience seizes me, and I 
 breathe at once the sweet words of Heine : — 
 
 " ' Du bist wie eine Blume, so hold, so schon, so rein,' etc.* 
 
 " And once, when I was compelled to part with a young man who 
 had honored and valued me as his friend and protector, though my love 
 had remained unknown to him, those fine verses b}^ Scheffel kept passing 
 through my mind, especially' the last, — mutatis mutandis : — 
 
 " ' Grau wie der Himmel, steht vor mir die Welt, 
 Doch wend' es sich zum Guten oder Bosen, 
 Du, lieber Freuud, in Treuen denk' ieh Dein ! 
 Behiit Dich Gott 1 es war' zu schon gewesen, 
 Behiit Dich Gott, es hat nieht sollen sein I '' 
 
 " I have never independently revealed my love to a young man, and 
 have never spoiled or injured one morally ; but I have, now and then, 
 made the way easy for many. Under such circumstances, nothing is too 
 much trouble, and I obtain victims as only I can. 
 
 "When I have an opportunity to have such a beloved friend about 
 me, to educate, protect, and help, if my recognized love find a (natural, 
 unsexual) return, then all my disgusting mental imagery grows less and 
 less intense ; then my love becomes almost platonic and ennobled, to sink 
 again into the mire when this worthy satisfaction is removed. 
 
 "As for the rest, and without over-estimating mj^self, I may say 
 that I am not one of the worst of men. Brighter mentall}- than the 
 avei'age man, I take interest in all that moves humanity. I am amiable, 
 and easil}' moved to pity, and am incapable of doing any animal, much 
 less a man, an injury ; but, on the contrarj', do good wherever I can. 
 
 " When I have nothing to reproach myself with in my own con- 
 science, and must, at the same time, set myself in opposition to the 
 
 1 " Thou art like any flower, so sweet, so beautiful, so pure," etc. 
 
 2 " Lowering like the heavens, frowns the world on me, 
 
 Tet blest or cursed will be the fate I meet. 
 With trusting heart, dear friend, I think of thee I 
 God keep thee, dear ! it would have been too sweet 1 
 God keep thee, dear ! such happiness was not to be 1"
 
 URNINGS. 269 
 
 I 
 
 judgment of the world, I suffer very imicli. Indeed, I have done no 
 one harm, and I consider my love, in its noblest activity, to be quite as 
 holy as that of a normal man ; but, with the unhappy lot which impa- 
 tience and ignorance cast upon us, I sutler even to the extent of tsedium 
 vitae. 
 
 "No pen, no tongue can describe all the misery' , all the unhapp^'^ 
 situations, the constant fear of having this peculiarit}' recognized, and 
 of being cast from society. The one thought that, as soon as recognized, 
 one's existence would be lost, and he would be cast away from all, is as 
 terrible as any thought can be. Then all the good that one had ever 
 done would be forgotten ; then, in the pride of his great moralit}', every 
 normal man would be moved to scorn, even though he himself had been 
 never so frivolous in his own love. 
 
 "Then what does our misery amount to? We ma^^ cursing man, 
 end our unhappy lives. Truly, I often long for the quiet of an asylum. 
 My life may end when it will, the quicker the better; I am ready. 
 
 " To refer to one more point : I also believe, like the others that 
 have written to you, that our nervousness is first acquired as a result 
 of our unhai)py, unspeakably miserable life among our fellow-creatures. 
 
 " And still another : You write, at the conclusion of your work, 
 concerning the repeal of the legal enactments concerned. Indeed, 
 humanity would not be destro3^ed if they were repealed. In Italy there 
 is no such law, as far as I know ; and Italy is not a wilderness, but a 
 cultivated nation. 
 
 " As for myself, compelled as I am to undermine my life by onan- 
 ism, the law could not touch me ; for I have never sinned against it in a 
 letter. But, at the same time, I suffer under the accursed scorn to 
 which we are subjected. How can the ideas of society be changed, so 
 long as there is a law which strengthens it in its immorality? The law 
 must, of course, correspond with public opinion; but it should not be in 
 harmony with the erroneous opinion of ignorance, but only in accord 
 with the ideas of the best and most scientific thinkers, — not with the 
 wish and prejudice of the vulgar. True thinking minds cannot much 
 longer be satisfied with the old idea. 
 
 " Pardon me, Professor, if I close without a signature. Do not 
 try to find me. I could tell you nothing more. I give 3'ou these lines 
 in the interest of future suflferers. Publish from them, in the interest 
 of science, truth, and justice, what seems to you to be necessarv." 
 
 Case 115. On a summer evening, at twilight, X. Y., a physician of 
 a city in North Germany, was detected by a watchman while committing 
 a misdemeanor with a countr3'man in a field. He was practicing mastur- 
 bation on him, and then mentulam alius in os suum immisit. X. escaped 
 legal prosecution by flight. The authorities dismissed the complaint, 
 because there had been no publicity, and because immissio membri in 
 anum had not taken place. Among X.'s effects was found an extensive
 
 270 PSYCHOPATHIA SEXUALIS. 
 
 correspondence of a. perverse sexual charjicter, which showed that he 
 had had perverse intercourse for years witli all classes of people. 
 
 X. came of a neurotic family. His paternal grand fatlier died by 
 suicide while insane. His father was a weak, peculiar man. One l)rother 
 masturbated at the age of two. A cousin was sexuallj- perverse, and 
 practiced perverse acts, similar to tliose of X., while a youth ; he became 
 weak-minded, and died of spinal disease. A paternal great-uncle was an 
 hermaphrodite. His mother's sister was insane. His mother is said to 
 have been healtliy. X.'s brother is nervous and irascible. 
 
 X., likewise, was nervous as a child. The mewing of a cat would 
 create great fear in him ; and if one but imitated the voice of a cat, he 
 would cry bitterly, and run to others for protection. Slight physical dis- 
 turbance caused violent fever. He was a quiet, dreamy child, of excita- 
 ble imagination, but of slight mental capabilities. He did not indulge 
 much in boyish games; he preferred feminine pursuits. It gave him 
 especial pleasure to curl the hair of the houso-maid or of his brother. 
 
 At thirteen X. went to an Institute. Tliere he practiced mutual 
 masturbation, seduced his comrades, and, by his cynical conduct, made 
 them unmanageable ; so that he had to be taken home. At that time 
 the parents found love-letters with lascivious contents, showing perverse 
 sexuality. From the age of seventeen he studied under the strict sur- 
 veillance of a professor in a Gymnasium. He made but sad progress in 
 learning. He had only a talent for music. 
 
 After finishing his studies, the patient entered the University', at 
 the age of nineteen. There he attracted attention by his cynical charac^ 
 ter and his association with young persons who were thought to be given 
 to masculine love. He began to be dandified ; wore striking cravats, and 
 shirts that were low cut ; he forced his feet into narrow shoes, and curled 
 his hair in a remarkable wa3^ This peculiarity disappeared when he left 
 the school, and had returned home. 
 
 At the age of twenty-four he was for a long time neurasthenic. 
 From that time until his twenty -ninth year, he was earnest and skill- 
 ful in his profession ; but he avoided the society of the opposite sex, and 
 constantly associated with men of doubtful character. 
 
 The patient would not allow a personal examination. In writing, 
 he made the excuse for this that it would be of no use, because his 
 impulse to his own sex had existed from his earliest childhood, and was 
 congenital. He had always had horror feminse, and had never been 
 inclined to avail himself of the charms of women. Toward men he felt 
 himself in the role of a man. He recognized his impulse toward his own 
 sex as abnormal, and excused his sexual indulgence as being the result 
 of an abnormal natural condition. 
 
 Since his flight X. lives out of Germany, in Southern Italy, and, as 
 I learned from a letter, now, as before, he indulges in perverse love, X, 
 js an ef^rngst, stately man, of ma,sculine features, well-growii bea^d, and
 
 URNINGS. 271 
 
 normally developed genitals. Dr. X. furnished me, a short time ago, 
 with his autobiography, of wiiich the following is worthy of mention : — 
 
 " When, at the age of seven, I entered the private school, I felt 
 very uncomfortable, and found very little sym[)athy with m3' companions. 
 Only toward one of them, who was a very huntlsome child, did I feel 
 attracted, and I loved him wildl3^ In ciiildish games I always knew 
 how to arrange it so that I could appear in feminine attire ; and my 
 greatest pleasure was to form intricate coiffures for our servant-girls. I 
 often regretted that I was not a girl. 
 
 "My sexual instinct awakened when I was thirteen, and from the 
 moment of its appearance was directed toward youthful, strong men. 
 At first I was not reall}' certain tliat this was abnormal, but conscious- 
 ness of it came when I saw and heard how my companions were charac- 
 terized sexuall3\ I began to masturbate at the age of thirteen. At 
 seventeen I left home and went to the Gymnasium of a large Capital, 
 where I was put to board with a married professor of the Gymnasium, 
 with whose son I afterward had sexual relations. It was with him that 
 I first had sexual satisfaction. Thereafter I made the acquaintance of a 
 3'oung artist, who very soon noticed that I was abnormal, and confessed 
 to me that he was in the same condition. I learned from him that this 
 abnormality was very frequent ; and this knowledge overcame the trouble 
 that I had had in supposing that I was alone in my abnormality. Tliis 
 yonng man had an extensive acquaintance with persons in like condi- 
 tion, to which he introduced me. There I became the object of general 
 attention, for on all sides I was declared to be very attractive physically. 
 I soon became insanely loved by an old gentleman ; but, not finding him 
 to my taste, I endured him but a short time, and then gave ear to a 
 young and handsome officer who lay at my feet. He was really my 
 first love. 
 
 "After passing my final examination, at the age of nineteen, free 
 from the discipline of school, I made the acqnaintance of a great number 
 of people like myself, and among them Karl Ulrichs (Numa Numan- 
 tinus). 
 
 " When, later, I took up the study of medicine, and associated with 
 many normal youths, I was often in a position where I was compelled to 
 visit public prostitutes. After having consorted to no purpose with 
 various prostitutes, some of whom were ver}^ beautiful, the opinion was 
 spread among my acquaintances that I was impotent, and I strengthened 
 this by telling of previous sexual excesses. At thnt time I had numerous 
 external relations with persons who prized my ph^^sical peculiarities, 
 which were considered very beautiful. The result of this was, that I was 
 exciting somebody all the time ; and I received such a mass of love-letters 
 that I was often in emltarrassment. The acme of this was reached later, 
 when, as a phj^sician, I lived in the hospital. There I moved about like 
 a celebrated person, and the scenes of jealousy that took place, on my
 
 272 PSYCHOPATHIA SEXUALIS. 
 
 account, almost led to the discovery of the whole thing. Shortly after 
 this, I fell ill with an inflammation of my shoulder-joint, from which I 
 recovered after three months. During this illness I received subcu- 
 taneous injections of morphine several times daily, which were suddenly 
 discontinued, and which I practiced thereafter secretly after my recovery. 
 For the purpose of special study, I spent some mouths in Yienna, before 
 entering into private practice, and there, by means of some recommenda- 
 tions, I gained entrance to various circles of people like mj^self I there 
 learned that the abnormality in question, in its various forms, is spread 
 through the lower classes as well as the higher, and that those who are 
 approachable for money are not infrequently met among the higher 
 classes. 
 
 " When I established myself in the country, I hoped to cure myself 
 of the morphine habit by means of cocaine ; and then I became a victim 
 of cocaine, which, only after three relapses, I was able to rid mj^self of 
 (about two years ago). In my position, it was impossible for me to find 
 sexual satisfaction, and I noticed with pleasure that the use of cocaine 
 had overcome my desire. When, on the first occasion, at the urgent 
 request of my aunt, I had emancipated myself from cocaine, I traveled 
 for a few weeks, in order to improve my health, the perverse impulses 
 were again awakened in their old strength, and, one evening, while out in 
 the fields by the city amusing myself with a man, I noticed that I had 
 been detected by the authorities and advertised ; but that the act of which 
 I was accused was not punishable, in accordance with the opinion ex- 
 pressed by the highest court of the German kingdom. I had, therefore, 
 to be careful ; for already the announcement of the crime had been heralded 
 on all sides. I saw that, after this, I would be compelled to leave Germany, 
 and find a new home where neither the law nor public opinion would be 
 opposed to that impulse, which, like all abnormal instincts, could not be 
 overcome by the will. Since I was never deceived for a moment about 
 the matter, in recognizing my impulses as opposed to social usages, I 
 repeatedly attempted to become master of them ; but by these efforts they 
 were increased in power. This same observation has been communicated 
 to me by acquaintances. Since I was exclusively drawn toward strong, 
 youthful, and masculine individuals, and they were very seldom inclined 
 to yield to my wishes, I was compelled to bu}^ them. Since my desire 
 was limited to persons of the lower classes, I was always able to find 
 such as were purchasable with money. I hope that the following state- 
 ments will not awaken jour repugnance. At first I intended to omit 
 them ; but, for the completeness of this communication, I may include 
 them, since they serve to enrich the clinical material. I am compelled 
 to perform the sexual act in the following way : — 
 
 " Pene juvenis in os recepto, ita ut commovendo oi'e meo eflecerira, 
 ut is quern cupio, semen ejaculaverit, sperma in perineum exspuo, femora 
 comprimi jubeo et penem meum adversus et intra femoi'a compressa
 
 URNINGS. 273 
 
 immitto. Dum haec Hunt, necesse est, ut jiivenis me, quantum potest, 
 ampleetatur. Quae prius me lecisse narravi, eanclem mihi aft'erunt volup- 
 tatem, acsi ipse ejaculo. Ejaculationem pene in anum immittendo vel 
 manu terendo assequi, milii nequaquam amoinum est. 
 
 " Sed inveni, qui penem meum receperint atque ea facientes, quae 
 supra exposui, eft'ecerint, ut libidines meae plane sint saturatae. 
 
 " Concerning my person, I must still mention the following : I am 
 186 centimetres tall, of masculine appearance, and, with the exception of 
 abnormal irritability of the skm, healthy. My hair and beard are black 
 and thick. My genitals are of medium size and normally formed. I 
 am able, without any trace of fatigue, to perform the sexual act from four 
 to six times in twenty -four hours. My life is very regular. I use alcohol 
 and tobacco very sparingly. I play the piano quite well, and some of 
 my unpretentious compositions have been much applauded. I have 
 lately finished a novel, which, as m}- first w^ork, has been verj^ favora])l3^ 
 criticised by my friends. The story has several problems taken from the 
 life of urnings in the subject-matter. 
 
 "Among the large number of fellow-sufferers that are personally 
 known to me, I have naturally been in a position to make observations 
 concerning the condition and the degrees of abnormality ; and, perhaps, 
 the following communications may be of service to you : — 
 
 " The most abnormal thing that I am acquainted with, was the 
 impulse of a gentleman who lived in Berlin. He preferred, above all 
 others, young fellows with unwashed feet, wdiich he would lick passion- 
 ately. A gentleman in Leipzig was similar to him ; who, where it was 
 possible, would linguam in anum immittere, preferring the parts to be 
 uncleaned. Several have assured me that the sight of riding-boots or of 
 parts of military uniforms, induced such excitement in them that ejacula- 
 tion resulted. A man in Paris compelled a friend ut in os ei mingat. 
 
 " With reference to the degree in which many feel themselves as 
 women, which is with me not the case, two persons in Vienna are ex- 
 amples. They bore feminine names. One is a barber who calls himself 
 'French Laura'; the other w^as formerl}- a butcher, who calls himself 
 ' Selcher-Fanny.' Both of them never missed an opportunity', during the 
 carnival time, to show themselves in very fantastic feminine masks. In 
 Hamburg there is a person that many people believe to be a woman, be- 
 cause he always goes about the house in feminine attire, and only occa- 
 sionally leaves the house, and always in such clothing This man wished 
 to stand as godmother at a christening, and, as a result of it, gave rise to 
 great scandal. 
 
 " Feminine timidit}^, frivolity, obstinacy, and weakness of character, 
 are the rule in such individuals. 
 
 " Several cases of perverse sexuality are known to me where epileps}^ 
 and ps3'choses are present. Hernias are remarkably frequent. In prac- 
 tice many persons come to me to be treated for diseases of the anus, 
 
 18
 
 274 PSYCHOPATHIA SEXUALIS. 
 
 because of recommendation by friends. I saw two syphilitic and one 
 local chancre, and several fissures ; and at present I am treating a 
 gentleman for condylomata of the anus, which form a rounded tumor as 
 large as a fist. One case of primary aff"ection of the soft palate I saw in 
 Vienna, in a 3roung man who was accustomed to frequent mask-balls 
 dressed as a girl, and entice young men ; he would then pretend that he 
 was menstruating, and thus induce the others to use him per os. The 
 assertion was made that in this way he had deceived fourteen men in one 
 evening. Since, in none of the publications concerning contrary sexuality 
 that I have seen, I have found anything concerning the intercourse of 
 pederasts among themselves, 1 venture to communicate something con- 
 cerning it in conclusion : — 
 
 "As soon as individuals that are affected with contrary sexuality 
 become acquainted, there is a detailed narration of their experiences, 
 loves, and seductions, as far as the social diflference between them allows 
 such entertainment. Onl}^ in very few cases is tliis amusement uncom- 
 mon witli new acquaintances. Among themselves, they call themselves 
 ' auuts ' ; in Vienna, ' sisters ' ; and two very masculine public prostitutes 
 in Vienna, wliom I accidentally became acquainted with, and who lived 
 in a perverse sexual relation with each other, told me that for the cor- 
 responding condition in women the name ' uncle' was used. Since be- 
 coming conscious of my abnormal instinct, I have met thousands of such 
 individuals. 
 
 " Almost every large city has some meeting-place, as well as 
 a so-called promenade. In smaller cities there are relativel3'^ few ' aunts,' 
 thougli in a small town of 2300 inliabitants I found eight, and in one of 
 7000 eigiiteen of whom I was absolutely' sure, — to say nothing of those 
 wliom I suspected. In my own town of 30,000 inhabitants, I personally 
 know about one hundred and twenty 'aunts.' Tlie greater number of 
 them, and I especially, possess the capability of judging anotlier imme- 
 diately as to whether they are alike or not, whicli, in the language of the 
 ' aunts,' is called ' reasonable ' or ' unreasonable.' My acquaintances are 
 often astounded at the certainty' of my judgment. Individuals that are 
 apparentl}^ absolutelj^ masculine I recognize as 'aunts' at the first 
 sight. On the other hand, I am able to behave myself in such a mascu- 
 line way that, in circles to which I have been introduced by acquaintances, 
 there is a doubt as to my genuineness. When I am in the mood, I can 
 act exactly like a girl. 
 
 " Since the majority of ' aunts,' like myself, in no wa^^ regret their 
 abnormality, but would be sorry if the condition were to be changed ; 
 and, moreover, since the congenital condition, according to my own and 
 all other experience, cannot be influenced ; therefore, all our hope rests 
 upon the possibility of a change of the laws with reference to it, so that 
 only rape or the commission of public off'ense, when this can be proved 
 at the same time, shall be punishable."
 
 URNINGS. 275 
 
 Case 116. GonWary Sexual Im^Hnct in a Woma7i. — S, J., aged 38, 
 governess, eunie to nie for advice about a nervous trouble. Her father 
 was temporarily insane, and died of a Ijrain disease. The patient is an 
 only child, and even when quite young she suftered with feelings of 
 anxiety and painful ideas. She thought, for example, that she would 
 awake in her coflin after it had been closed ; that at confession she 
 might forget something, and make a sinful confession. She suffered 
 much with headache. She was always very much excited and appre- 
 hensive, but yet she had to see horrible things, like corpses, etc. 
 
 Even in her earliest childhood, the patient was excited sexually, 
 and began to masturbate without any teaching. The menses began at 
 fourteen, and were always accompanied by colicky pains, violent sexual 
 excitement, migraine, and depression. After her eighteenth year she 
 learned to repress her impulse to masturbate. 
 
 The patient has never felt any inclination toward persons of the 
 opposite sex. If she thought of marriage, it was only because she 
 sought in matrimony a means of being supported. On the other hand, 
 she felt powerfully attracted by girls. At first she regarded this inclina- 
 tion as friendship; but in the depth of her attachment to female friends, 
 and in the longing she constantly felt for them, she recognized that the 
 feeling was something more than friendship. 
 
 The patient cannot understand how a girl can love a man, but she 
 can easily see how a man might love a girl. She always has a lively 
 interest in beautiful women and girls, and is powerfully excited at sight 
 of them. Her longing had always been to kiss and embrace such dear 
 creatures. She had never dreamed of a man, but only of girls. Her 
 delight had been to revel in the sight of them. Separation from such 
 female friends had always made her desperate. 
 
 The patient, whose appearance is perfectly feminine and very 
 respectable, states that she has never felt herself in an}- particular ro/e 
 with her friends, not even in dreams. Female pelvis; large mammae; no 
 sign of beard. 
 
 Case in. Mrs. R., Russian, aged 35, of high social position, was 
 brought to me, in 1886, by her husband for advice. 
 
 Father was a physician, and very neuropathic. Paternal grand- 
 father was health}' and normal, and reached the age of niuet^^-six. Facts 
 concerning paternal grandmother are wanting. All the children of 
 father's family are said to have been nervous. The patient's mother 
 was nervous, and suffered with asthma. The mother's parents were 
 healthy. One of the mother's sisters had melancholia. 
 
 From her tenth year patient has been subject to habitual headache. 
 With the exception of measles, she has had no illness. She was capable, 
 and enjoyed the best of training, having especial talent for music and 
 languages. It became necessary for her to prepare herself for the work of 
 a governess, and during her earlier years she was mentally overworked.
 
 276 PSYCHOPATHIA SEXUALIS. 
 
 She passed through an attack of melancholia sine delirio, of some 
 months' duration, at seventeen. The patient asserts that she has alwaj^s 
 had sympathy only for her own sex, and found only an aesthetic interest 
 in men. She never had any taste for female work. As a little girl, she 
 preferred to play with boys. 
 
 She says she remained well until her twenty-seventh year. Then, 
 without external cause, she became depressed and considered herself a bad, 
 sinful person, had no pleasure in anything, and was sleepless. During 
 this time of illness she was also troubled witli imperative conceptions : 
 that she must think of the death of herself and her relatives. Recovery 
 after about five moifths. She then became a governess, was overworked, 
 but remained well, except for occasional neurasthenic symptoms and 
 spinal irritation. 
 
 At twenty-eight she made the acquaintance of a lady five years 
 younger than herself. She fell in love with her, and her love was 
 returned. The love was verj' sensual, and satisfied by mutual mastur- 
 bation. "I loved her as a god ; her's is a noble soul," she said, when she 
 mentioned this love-bond. It lasted four years, and was ended by the 
 (unfortunate) marriage of her friend. 
 
 In 1885, after much emotional strain, the patient became ill with 
 symptoms of hystero-neurasthenia (dyspepsia, spinal irritation, and tonic 
 spasmodic attacks; attacks of hemiopia with migraine and transitory 
 aphasia; pruritus pudendi et ani). In Februarys, 1886, these symptoms 
 disappe:ired. 
 
 In March she became acquainted with her present husband, and 
 married liim without taking much time for reflection ; for he was rich, 
 much in love with her, and his character was in sympathy with her own. 
 
 On April 6th, she read the sentence, " Death misses no one." Like 
 a flash of lightning in a clear sky, the former imperative conceptions of 
 death returned. She was forced to meditate on the most horrible manner 
 of death for herself and those about her, and constantly imagine death- 
 scenes. She lost rest and sleep, and took no pleasure in anything. Her 
 condition improved. Late in May, 1886, she was married, but was still 
 troubled by painful thonghts at that time: that she would bring mis- 
 fortune on her husband and those about her. 
 
 First coitus on June 6, 1886. She was deepl}^ depressed morally by 
 it. She had had no such conception of matrimou}'. The husband, who 
 really loved his wife, did all he could to quiet her. He consulted phy- 
 sicians, who thought all would be well after pregnanc3^ The husband 
 was unable to explain the peculiar behavior of his wife. She was friendly 
 toward him, and suffered his caresses. In coitus, which was actuallj'^ 
 carried out, she was entirel}'^ passive, and after the act she was tired, 
 exhausted all day long, nervous, and troubled with spinal irritation. 
 
 A bridal tour brought about a meeting with her old friend, who had 
 lived in an unhappy marriage for three years. The two ladies trembled
 
 URNINGS. 277 
 
 with joy and excitement as they sank iiit<j each other's arms, and became 
 inseparable. The husband saw that this friendly- rehition was a peculiar 
 one, and hastened their departure. He had an opportunity to ascertain, 
 through the correspondence of his wife with this friend, that the letters 
 interchanged were like those of two lovers. 
 
 Mrs. R. became pregnant. During pregnane}^ the remains of depres- 
 sion and imperative ideas disappeared. In September, during about the 
 ninth week of pregnane}^, abortion took place. After that, renewed symp- 
 toms of hystero-neurasthenia. In addition to this, there were anteflexio 
 et latero-positio dextra uteri, anaemia, and atonia ventriculi. 
 
 At the consultation the patient gave the impression of a very 
 neuropathic, tainted person. The neuropathic expression of the eyes 
 cannot be described. Appearance entirely feminine. With the exception 
 of a very narrow, arched palate, there was no skeletal abnorraalit}'. With 
 dilHculty the patient could be brought to give the details of her sexual 
 abnormalit}'. Siie complained that she had married without knowing 
 what marriage between men and women was. She loved her husband 
 dearly for his mental qualities, but marital intercourse was a pain to her; 
 she did it unwillingly, without ever finding any satisfaction in it. Post 
 actum, all day long she was weary and exhausted. Since the abortion 
 and tlie interdiction of sexual intercourse b}' tlie physicians, she had 
 been better; but she thought of the future with horror. She esteemed 
 her husband, and loved him mentally; but she would do anything for 
 him, if he would but avoid her sexually in the future. She hoped to 
 have sensual feeling for him in time. When he plajed the violin, she 
 seemed to feel the beginning of an inclination for him that was some- 
 thing more than friendship; but it was only transitory, and she could 
 get no assurance for the future in it. Her greatest happiness was in cor- 
 respondence with her former lover. She felt that this was wrong, but 
 she could not give it up; for to do so made her miserable. 
 
 It is remarkable that the anomaly may be long limited to 
 mere perversion of the sexual instinct, and that the impulse to 
 perverse indulgence may make its appearance after some acci- 
 dental cause, — e.fj.^ seduction, or some neurosis. Such cases 
 might easily be mistaken for acquired contrary sexual instinct 
 {v. supra)^ if, with reference to the sexual feeling, they should 
 not be demonstrated by the history to be original and con- 
 genital. 
 
 Case 118. Mrs. C.,aged 32, wife of an official, a large, not uncomel}' 
 woman, feminine in appearance, comes of a neuropathic and emotional 
 mother. A brother was psychopathic, and died of drink. Patient was 
 always peculiar, obstinate, silent, quicktempered, and eccentric. The
 
 278 PSYCHOPATHIA SEXUALIS. 
 
 brothers and sisters are excitable people. Piilmonar3' phthisis has been 
 frequent in her farail}'. Wlien only a girl of thirteen, with signs of great 
 sexual excitement, she attracted attention b}- enthusiastic love for a 
 female friend of her own age. Her education was strict, though the 
 patient secretly read man}- novels, and wrote innumerable poems. She 
 married at eighteen to free herself from unpleasant circumstances at 
 home. 
 
 She says she has alway^s been indifferent toward men. In fact, she 
 avoided balls. Female statues pleased her. Her greatest happiness was 
 to think of marriage with a beloved woman. She was not aware of her 
 sexual peculiarity until marriage, and the thing had remained inexplica- 
 ble to her. Patient did her marital duty, and bore three children, two of 
 whom were subject to convulsions. She lived pleasantly with her hus- 
 band, but she esteemed him only for his moral qualities. She gladly 
 avoided coitus. " I should have preferred intercourse with a woman." 
 
 Until 1878 she had been neurasthenic. On the occasion of a sojourn 
 at a watering-place, she made the acquaintance of a female urning, whose 
 history I have reported as Case 6, in the Irrenfre-und, No. 1, 1884. 
 
 The patient came home a changed person. Her husband says : " She 
 was no longer a woman, no longer had any love for me and the children, 
 and would have no more of marital approaches. She was inflamed with 
 passionate love for her female friend, and had taste for notliing else." 
 After the husband forbade her lover the house, there was interchange of 
 letters with such expressions in them as " My dove ! I live onl}' for you, my 
 soul." There were meetings and frightful excitement when an expected 
 letter did not come. The relation was in nowise platonic. From certain 
 indications it is presumable that mutual masturbation was the means of 
 sensual satisfaction. This relation lasted until 1882, and made the patient 
 decidedly neurasthenic. 
 
 She absolutely neglected the house, and her husband hired a woman 
 of sixty years as a house-keeper, and also a governess for the children. 
 The patient fell in love with both, who, at least, allowed caresses, and 
 profited materially through the love of their mistress. 
 
 In the latter part of 1883, on account of developing pulmonary 
 tuberculosis, she had to go south. There she became acquainted with a 
 Russian lady of forty 3'ears, and fell passionately^ in love with her ; but 
 she did not meet with a return of love in her sense. One day insanity 
 became manifest. She thought the Russian lad}^ a nihilist ; that she was 
 magnetized by her; and she presented formal persecutor}^ delusions. She 
 fled, and was caught in an Italian cit}^, and placed in a hosi)ital, where she 
 soon became quiet. Again she followed the lady with her love, felt herself 
 ver^^ unhappy, and planned suicide. 
 
 When she returned home, she was greatly depressed because she did 
 not have the lad}-, and was contrary toward her family. A delusive, erotic 
 state of excitement came on about the end of May, 1884. She danced,
 
 EFFEMINATION AND VIRAGINITY. 279 
 
 shouted, mid called herself a man ; demanded her former lovers, and said 
 she was of royal blood. Slie escaped from the house in male attire, and was 
 taken to the asylum in a state of eroto-maniacal excitement. After a few 
 days the exaltation disappeared. The [)atient became quiet, and made a 
 despairing attempt at suicide ; and after it she was in great anguish of 
 mind with tjvdium vitffi. The perverse sexual feeling grew less and less 
 noticeable, and the tuberculosis progressed. The patient died of phthisis 
 in the beginning of 18X5. 
 
 The examination of the brain presented nothing imusual as far as 
 architecture and arrangement of convolutions were concerned. Weight 
 of brain 1150 grammes. Skull slightly asymmetrical. No anatomical 
 signs of degeneration. External and internal genitals without anomaly. 
 
 3. Effemlnation and Vlraginlfi/. — There are various tran- 
 sitions from the foregoing cases to those making- up this category, 
 characterized by the degree in which the psychical personahty, 
 especially in general manner of feeling and inclinations, is in- 
 fluenced by the abnormal sexual feeling. In this group, fully- 
 developed cases in men are females in feeling ; in women, males. 
 This abnormality of feeling and of development of the character 
 is often apparent in cliildhood. The boy likes to spend his time 
 with girls, play witli dolls, and help his mother about the house ; 
 he likes to cook, sew, knit, and develops taste in female toilettes^ 
 so that he may even become the adviser of liis sisters. As he 
 grows older he eschews smoking, drinking, and manly sports, 
 and, on tlie contrary, finds pleasure in adornment of person, art, 
 belles-lettres^ etc., even to the extent of giving himself entirely 
 to the cultivation of the beautiful. Since women possess cor- 
 responding inclinations, he prefers to move in the society of 
 women. 
 
 If he can assume the role of a female at a masquerade, it 
 is his greatest delight. He seeks to please his lover, so to 
 speak, by studionsly trying to represent what pleases the female- 
 loving man in the opposite sex,^-s\veetness, sympathy, taste for 
 aesthetics, poetry, etc. Efforts to approach the female appear- 
 ance in gait, attitude, and style of dress are frequently seen. 
 
 The female urning, even when a little girl, presents the 
 reverse. Her favorite place is the play-ground of boys. She 
 seeks to rival them in their games. The girl will have nothing 
 to do with dolls ; her passion is for playing horse, soldier, and
 
 280 PSYCHOPATHIA SEXUALIS. 
 
 robber. For female employments there is manifested not merely 
 a lack of taste, but often unskillfulness in them. The toilette 
 is neglected, and pleasure found in a coarse, boyish life. Instead 
 of an inclination for the arts, there is manifested an inclination 
 and taste for the sciences. Occasionally there may be attempts 
 to smoke and drink. Perfumes and cosmetics are abhorred. 
 The consciousness of being born a woman, and, therefore, of 
 being compelled to renounce the University, with its gay life, 
 and the army, induces painful reflections. 
 
 In the inclinations of the amazon for manly sports, the mas- 
 culine soul in the female bosom manifests itself; and not less in 
 the show of courage and manly feeling. The female urning 
 loves to wear her hair and have her clothing in the fashion of 
 men ; and it is her greatest pleasure, when opportunity offers, 
 fto appear in male attire. Her ideals are historical and contem- 
 porary feminine personalities distinguislied for mind and energy. 
 
 With reference to the sexual feeling and instinct of these 
 urnings, so thoroughly permeated in all their mental being, the 
 men, without exception, feel themselves to be females; the 
 women feel themselves to be males. Thus they feel themselves 
 to be antagonistic to persons of their own sex constituted like 
 themselves ; for, of course, they are like tliem in form. But, 
 on the other hand, they are drawn toward those of their OAvn 
 sex that are homo-sexual or sexually normal. The same jeal- 
 ousy which occurs in normal sexual life also occurs here, when 
 rivahy is threatened ; and, indeed, since they are, as a rule, 
 hypersesthetic sexually, this jealousy is oflten boundless. 
 
 In cases of completely-developed contrary sexuality, hetero- 
 sexual love is looked upon as a thing absolutely incomprehensi- 
 ble ; sexual intercourse with a person of the opposite sex is 
 unthinkable, impossible. Such an attem])t brings on the inhib- 
 itory concept of disgust or even horror, which makes erec- 
 tion impossible. Only two of my transitional cases to the third 
 category were able, with the help of their imagination, by thuik- 
 ing of themselves as men with reference to the woman, to have 
 cohabitation ; but the act, which was inadequate for them, was 
 a great sacrifice, and afforded them no pleasure, j
 
 EFFEMINATION AND VIRAGINITT. 281 
 
 In homo-sexual intercourse the man always feels himself, in 
 the act, as a woman ; the woman, as a man. The means of in- 
 dulgence, in the case of a man, where there is irritable weakness 
 of the ejaculation centre, are simply siiccuhus, or passive coitus 
 inter femora ; in other cases, passive masturbation, or ejaculatio 
 viri dilecti in ore proprio. Many have a desire for passive 
 pederasty ; occasionally a desire for active pederasty occurs. In 
 one attempt of this kind, the man desisted because of the disgust 
 which seized him when the act reminded him of coitus. 
 
 There was never inclination for immaiure persons (hoy- 
 love). Not infrequently there were only platonic desires. The 
 sexual satisfaction of the female probably consists of amor 
 leshiciis, or active masturbation. 
 
 Case 119. Autobiography. '' 1. Descent: I am now in my twenty 
 third 3^ear. I have chosen the study of the technical arts as an occupa- 
 tion, and am completely satisfied with it. I had but the mild diseases 
 of children, while the other children, who are now healthy, had to pass 
 through severe illnesses. My parents are both living, and my lather is an 
 advocate. He, like my mother, is, as we say, nervously hyper-sensitive. 
 In my father's family there were two other children, who died eai-ly. 
 
 " 2. My person : As for my physical peculiarities, I am of robust 
 figure, without being of especially handsome form ; eyes, gray ; hair,, 
 blonde ; hair and beard correspond with my sex and j'^ears. The mamma? 
 and genitals are normally developed. My gait is firm and almost heavy ; 
 my bearing, careless. It is remarkable that the breadth of the pelvis is 
 exactly equal to that of the shoulders. 
 
 " I am natui'ally well endowed mentally. In one of my certificates 
 my talents are, in fact, called ' excellent.' Without any particular desire 
 to excel in them, I passed my examinations with distinction. I have an 
 interest in everything that concerns the well-being of humanity, and in 
 science, art, and industry. With my energy it is comparatively easy to 
 postpone for a time the satisfaction of my desires, which will be described 
 hereaftei-. Intentionally and consciously, I curse the morality of to-day, 
 which forces those who are abnormal sexually to break laws that are 
 voluntarily established, and regards sexual congress of two persons of the 
 same sex as a matter depending on the choice of the individual, and 
 a matter in which law-makers have a right to interfere. From my 
 studies I have found the most earnest incentives to construct, on the 
 basis of the Darwinian theory, after Carneri's method, a system of morals, 
 which, to be sure, does not harmonize with the prevailing system, but 
 which seeks to elevate and improve mankind in accordance with nat- 
 ural law.
 
 282 PSYCHOPATHIA SEXUALIS. 
 
 " I think that there are not many marks of hereditary taint in me. 
 There is a certain hj^jDer-sensitiveness. A ver}^ intense dream-life is per- 
 haps important. In general, it is occupied with indifferent matters, and 
 never has so-called sensual images as a subject ; at most, in this direction, 
 it is concerned only with female attire and putting it on, which for me is 
 a lustful thought. At the same time, until my sixteenth j'ear, it often 
 went to the extent of somnambulism, or, very frequently', as is still often 
 the case, to loud talking in sleep. 
 
 "3. My inclinations: The above-mentioned abnormal proclivitj^ is 
 the fundamental factor in my sexual feeling. When I am dressed like a 
 woman, I feel perfectly satisfied. A peculiar feeling of peace and comfort 
 comes over me, which allows me to work mentally' with greater ease. 
 My libido for indulgence in sexual intercourse is extremely slight. Too, 
 I have much love and taste for female handiwork, and, without assist- 
 ance, I learned to crochet and embroider, and I like to do these things in 
 secret. I also like other female employments, like sewing, etc. ; so that 
 at home, where I keep my proclivity perfectlj^ concealed, and guard 
 against indulging it by involuntary activit}'^, I have often won the praise 
 of being as good as a servant-girl ; which did not make me ashamed, but, 
 on the contrary, filled me with secret pride. I can make nothing out of 
 dancing with women ; I liked to dance only with my school-fellows, for 
 which the manner of our instruction in dancing gave opportunity. But 
 in this it gave me pleasure only when I could dance as a lady. A multi- 
 tude of other desires and dreams, which seem to have something typical 
 about them, I pass over, because they seem exactl}' similar to those 
 described in ' Psychopathia Sexualis.' .... In other respects my 
 inclinations are not different from those of my sex. I smoke and drink 
 moderately, love delicacies, and have no pleasure in physical exercises. 
 
 "4. Development : After this brief description of m3^ personality, 
 I may pass on to an analysis of the developmental history of my abnor- 
 mality. As soon as I was able, to some extent, to think independently, 
 and I understood the difference between the sexes, it was my secret and 
 fixed desire to be a girl. In fact, I believed I was one. But when in 
 the bath I saw the same genitals on otlier bo^'s, the imi)ossibility of my 
 thought became apparent. I reduced my wish, and hoped that I was at 
 least an lierniaphrodite. And, owing to the fact that I had a certain 
 shyness about looking closely at pictures or descriptions of the genitals, 
 this hope was entertained, notwithstanding the fact that I had abundant 
 opportunify lo read writings on the subject, until m}^ studies compelled 
 me to make a closer acquaintance with the matter. During this time I 
 read everything I could get about hermaphroditism, and longed to be in 
 tlie place of the female who, as the newspapers often reported, had been 
 raised as a male and been restored to her sex by accident. The recog- 
 nition of my masculinity made an end of this dreaming, and did not fill 
 me with any especial delight. I tried to destroy ray sexual glands by
 
 EFFEMINATION AND VIRAGINITY. 283 
 
 gradual pressure, but pain soon caused me to desist. M^^ longing is 
 still for the external characteristics of the female sex, — for a pretty 
 coiHiire, a rounded breast, a slim waist. 
 
 "At the age of twelve I first had an opportunity to put on female 
 attire ; and I soon came to drape myself, by means of bed-clothes, bed- 
 linen, etc., with female petticoats. When I grew older, it was my great- 
 est delight to put on my sister's dresses secretly, even if it could be but 
 for a few moments, and with constant danger of detection. Later, much 
 to my delight, I had an opportunity to play a female role in a love-scene ; 
 and it is said that I was not at all bad in the part. When I began to 
 lead an independent life as a student, I immediately obtained female 
 dresses and linen, which I kept in order myself When at night, safe 
 from discovery, I can put on one article after another, from corset to 
 apron and bracelet, I am perfectly satisfied, and devote myself to some 
 quiet emplo3'ment, inwardly happy and full of delight in doing it. 
 While dressing, an erection usually occurs, but it is never followed by 
 an ejaculation, and soon disappears. I also try to approximate the 
 female appearance in externals, by arranging my hair appropriately and 
 removing the beard, which I should have preferred to tear out. 
 
 "5. Sexual inclinations: In passing to the description of my 
 sexual proclivities, I desire, first, to note, in general, that puberty 
 occurred normally, as I judge from the pollutions that occurred, the 
 change of voice, etc. Pollutions still occur regularl}'^ once every three 
 weeks, seldom more frequently. With them I never experience any lust- 
 ful feeling. I have never practiced onanism ; until lately I knew 
 nothing more of it than its name, and I had to seek direct information 
 about it, in order to understand it. An^' touch on the erect penis is 
 disturbing and painful to me, and without lustful feeling. 
 
 "Previously I behaved ver}' shyly toward women, but I now act 
 quietl3% and associate with them as with my kind. Direct excitation, in 
 a sexual sense, by a woman , sometimes occurred ; but when I try to analyze 
 this, it seems to me that it was never her person, but rather her attire 
 alone, that was effectual. I fell in love with her dress, and the thought 
 of wearing one like it was heavenly. Thus sexual excitation never took 
 place, not even in brothels where I was led by friends, in spite of the 
 sight of the greatest voluptuousness and beaut3^ But friendly feelings 
 for the female sex were in my heart. I imagined how, dressed as a woman 
 and unrecognized, I could stay with them, associate with them, and take 
 pleasure with them. I prefer the impression made on me by girls whose 
 breasts have not yet fully developed, particularly those wearing the hair 
 short; for such girls are more nearly like me and my aspect. Once I was 
 so fortunate as to find a girl who felt unhappy in her sex. We formed a 
 firm bond of friendship with one another, and we often took delight in 
 the idea of exchanging places. Perhaps it is not inappropriate or 
 unimportant for the characterization, to record the following : Some
 
 284 PSYCHOPATHIA SEXUALIS. 
 
 months ago, when the story was running through the newspapers of 
 an Hungarian countess who, dressed as a man, had married, and felt 
 like a man, in all earnestness, 1 thought of offering myself to her, in 
 order to contract an inverted marriage, — she as husband, I as wife. 
 . . . I have never attempted coitus, and have never felt any desire 
 for it. But since I foresaw that the erection necessarj- with a woman 
 would be wanting, I thought of putting on some of her clothing ; and I 
 think that then the expected result would occur. 
 
 " As for my behavior toward male persons, first of all, it is to be 
 emphasized that I had the warmest friendships during my school-days. 
 My heart was full of happiness, if I could do some small service for the 
 object of my devotion. I really worshiped him passionately. But, on 
 the slightest occasion, I evinced terrible jealousy ; and while my anger 
 lasted I felt as if I could neither live nor die. When reconciliation oc- 
 curred, for a short time I was the happiest of creatures. I also tried to 
 make friends of boys, whom I bribed with sweetmeats, and whom I should 
 gladly have kissed. Though my love always remained platonic, j^et it is 
 abnormal. An expression that I unconsciously made at that time about 
 an elder friend, whom I worshiped, shows that. I said I loved him so 
 that I should have liked to marry him. And even now, when I indulge 
 but little in intercourse, I am easily taken with a handsome man with 
 a fine beard and refined features. Yet 1 have never met a being feeling 
 like myself, whom I could confide in, and with whom I could live as a 
 female friend. I never attempted to exercise my inclinations directly, 
 and never committed any foolish act of this kind. Finally I ceased to 
 visit museums where nude male figures were displayed; for the erec- 
 tions, which were sure to occur, were exceedinglj^ annoying. I had 
 often secretly wished to sleep with a man, and often found oppor- 
 tunity. I was asked by a rather unattractive elderly man to sleep with 
 him. Cum eo concubui, ille genitalia mea tetigit ; and though his 
 person was unattractive to me, I was filled with an intense feeling of 
 lust. I felt as if completely surrendered to him ; in a word, I felt like a 
 woman. 
 
 " If I may be permitted to add a concluding word to what I have 
 already said, I wish to state expressely that, though I am conscious of 
 the abnormalit}' of my inclinations, I have no desire to change them ; I 
 long only for a time when, more easily and with less danger of discover}^, 
 I can give rein to my desires and experience a delight that will harm 
 no one." 
 
 Case 120. Miss Z., aged 31, artist, comes for consultation on ac- 
 count of neurasthenic symptoms. She is remarkable for coarse, mascu- 
 line features, a deep voice, short hair, a masculine style of dress, mascu- 
 line gait, and self-consciousness. In other respects she is feminine, with 
 well-developed mammae and a female pelvis, and without any indication 
 of beard.
 
 EFFEMINATION AND VIKAGINITY. 285 
 
 Examination with reference to contrary sexual instinct gives a 
 positive result : — 
 
 The patient states that even when a little girl she preferred to play 
 with boys, and particularly " soldier," " merchant," and "robber." She 
 was very wild and unrestrained in these games with boys, but never had 
 any proclivity for dolls or female employment, of which she learned only 
 the most ordinary things (knitting, sewing). 
 
 In school she made good progress, being especially interested in 
 mathematics and chemistry. She early had a desire for sculpture, and 
 showed talent for it. Her greatest ambition was to become a real artist. In 
 her dreams of the future, she never thought of marriage. As an artist, she 
 was interested in handsome men, but she was really attracted only by 
 female forms ; she saw male forms only " in the distance." She could 
 never endure " trumpery " ; " manly dress " was all that pleased her. 
 The ordinar}^ societ}^ of girls was repugnant to her, because their talk 
 about ioilettes, ornaments, and love-affairs with men, seemed stale and 
 tiresome to her. On the other hand, since her childhood she had had 
 enthusiastic friendsliips witii certain girls ; :it tlie age of ten she was in 
 love with a girl companion, and wrote her name everywhere. Since then 
 she had had numerous female friends, with whom she had indulged in 
 passionate kissing. She pleased the girls, as a rule, because of her mas- 
 culine bearing. She wrote poems to her female friends, and could have 
 done anything out of love for them. To her it was very remarkable that 
 she was embarrassed before girls, especially when they were friends. 
 She could not undress before them. The more she loved a friend, the 
 more modest she was before her 
 
 At the present time she has such a relation. She kisses and em- 
 braces her Laura, walks by her window, and suffers all tlie pangs of 
 jealousy, particularly when she sees her conversing with men. Her only 
 wish is to live always with this female friend. 
 
 The patient states, however, that twice in her life men have made 
 an impression on her. She thinks that if she had been really sought, 
 there would have been a marriage ; for she is very fond of family life and 
 children. If a man wished to possess her, it would be necessary for him 
 to win her ; she herself would i)refer to win a female friend. Siie thinks 
 woman is more beautiful and ideal than man. In her infrequent erotic 
 dreams, the subject had always been a female. She had never dreamed 
 of men. She does not think that she could now love a man ; for men 
 are false, and she herself is nervous and anaemic. 
 
 She considers herself a woman in all respects, but regrets that she 
 is not a man. Even at the age of four it had been her greatest ))leasure 
 to put on boys' clothes. She certainly had a masculine chariicter, and, 
 too, had never wept. Her greatest passion was for riding, gymnastics, 
 fenciu":, and drivino;. She suffered much because no one about her 
 understood her. It seemed silly to her to talk about feminine things.
 
 286 PSYCHOPATHIA SEXUALIS. 
 
 Many of her ucquaintances had thought that she should really have 
 been a man. 
 
 The patient says that she was never sensual. In embracing 
 female friends, she had often experienced a peculiar lustful feeling. 
 Embracing and kissing had been her only manner of expressing her 
 friendship. 
 
 The patient states that she comes of a nervous father, and an insane 
 mother who, as a young girl, had been passionatel}' in love with her own 
 brother, and had tried to induce him to flee with her to America. The 
 patient's brother is a ver^'^^ eccentric, peculiar man. 
 
 The patient presents no external degenerative signs ; head regular. 
 She says the menses began at fourteen, and that they have been regular, 
 but always painful. 
 
 Case 121. " In order to designate at once my unhappy diseased 
 condition with its correct name, I will state at the beginning that it bears 
 all the marks of what, in your work, ' Psychopathia Sexualis,' 3'ou have 
 named effemination. 
 
 " I am now thirty -eight years old, and, thanks to my abnormality, 
 I look back on a life that has been full of indescribable suffering ; so 
 that I am often astonished to think what capacity for sulfering a man has. 
 Of late consciousness of the suffering I have endured has become the 
 source of a kind of self-respect, which, in itself, makes my life, in a measure, 
 endurable. 
 
 " But I shall now endeavor to describe my condition with all truth. 
 I am physically health}^, and, as far as I can remember, have never had 
 any severe illness. I come of a healthy family. But my parents are 
 both of a very excitable nature, my father being of the so-called choleric, 
 and m3' mother of the sanguine, temperament; she has a strong tendency 
 to mild melancholia. She is a lively woman, loved for her good-hearted- 
 ness and active benevolence ; but she is still very dependent and deficient 
 in self-confidence. All these peculiarities were marked in her father. I 
 mention this fact, because I am told that I resemble them both ; and as 
 far as the last two peculiarities are concerned, I can myself acknowledge 
 the resemblance. But when I made attempts, by means of my inner 
 strength and by thinking of my own power, to rend the bond that, with 
 magic force, draws me to men, there was always a residuum left that 
 I could not eradicate. As fiir as I can remember, I have alwajs had this 
 elenientar}' longing for a male lover. To be sure, its first expressions 
 Avere of a coarse, sensual nature, I do not know whether I was yet ten 
 years old, when, while lying in bed in the day-time, I suddenly discovered 
 how, by pressure on my genitals, I induced a new and intoxicating feeling, 
 while fancying that a man of my acquaintance performed sensual manip- 
 ulations on me. It was onl}' many years afterAvard that I learned that 
 this was onanism. At first I was so frightened and so depressed by the 
 inexplicableness of my longing, that I then made my first attempt at
 
 EFFEMINATION AND VIRAGINITY. 287 
 
 suicide. If I luul only put it into execution ! For since then there has 
 been sucii frequeut violent agitation of mind and body that my heart has 
 beeu bound as with a chain, and made cold. I may say at once that, up 
 to the present time, onanism has not loosened me from its clutches; it 
 has overcome all attempts and efforts to escape, and my desire to resist 
 it is almost destroyed. Three or four times I have given it up for a 
 month at a time, usually under the influence of mental excitement. 
 
 " When about thirteen, I had mj^ first love. To-day it seems as if 
 my greatest wish then was to kiss my school-fellow's fresh, rosy lips. It 
 was a passion full of romantic dreams. At the age of fifteen or sixteen 
 it became more violent, when I first experienced the insane pangs of a 
 jealousy which is more terrible than that of natural love can be. This 
 second period of my life lasted for years, though I spent but a few dajs 
 with the object of my passion ; and then we did not see each other for 
 fifteen years. Gradually my feeling cooled, and I then fell passionately in 
 love several times with other men, who, with the exception of one, were 
 about my own age. 
 
 " My love — if you will kindly allow this expression for a feeling con- 
 demned by the majority of mankind — has never been returned ; I have 
 never had intercourse with a man in any way that would not bear the 
 light of day ; never has any one shown even extraordinar}' interest in me, 
 though one of my friends discovered my secret longing ; and yet I have 
 had a burning desire for masculine love. In this longing my feelings 
 seem to me to be entirely those of a loving woman ; and I notice, with 
 horror, that my sensual ideas grow more and more like those of a woman. 
 During the periods when I am free from any particular love, my long- 
 ing degenerates so that, in my onanistic manipulations, I conjure up only 
 coarse, sensual ideas. But I am still finally able to overcome these. My 
 efforts to repress the love, however, are absolutely vain. At the present 
 time I am again suffering with such an exaggerated state of feeling that 
 has existed for months ; and I have pondered so much over its peculiari- 
 ties that I think I can describe my feelings truthfully. In this way I 
 have made the peculiar observation that I have never loved a bearded 
 man. From this it might easily be presumed that I am given to so-called 
 boy -love ; but that is not the case. For, to the sensual charm, on closer 
 association, a mental interest is added. With this begins the mental 
 pain. I am seized with such a passionate longing that I am willing to 
 sacrifice myself, in away. I excite confidence in myself; and from this 
 mutual feeling a heart-felt friendship might be engendered, if deep down 
 in my soul were not sleeping the demon which impels me to the closest 
 of relationships, which is allowed only between human beings of op- 
 posite sex. My whole being, every fibre of my body, longs for it, and 
 I am consumed by a hot, glowing passion. I wonder that here I can again 
 describe in unfeeling words the feelings that coursed through my whole 
 being. Of course, by the struggle of years, I have been forced to learn
 
 288 PSYCHOPATHIA SEXUALIS. 
 
 to conceal my inclination, and smile when torn by pain. For, in never 
 having my love returned, I have learned to know all the sufferings of 
 love. Jealousy — insane, blinding jealousy — of any and every body who 
 casts but a friendly glance at the object of my secret love! 
 
 " I have emphasized the mental element, in order to show how 
 deeply rooted my abnormal impulse is, I have never felt the slightest 
 touch of sensual love for the opposite sex. The idea of being forced to 
 associate sensually with women is repugnant to me. At times I have 
 suffered enough on being assured of the love of young girls. Like every 
 young man, I have had abundant opportunity to enjoy the modern social 
 pleasures, dancing among them. I like to dance ; but if I could dance 
 with men, as a girl, I should be reall}^ happy. 
 
 " I wish once more to remark that my love is entirely sensual. 
 How could I otherwise explain the fact that the pressure of my lover's 
 hand, often merely his glance, causes palpitation and erection I I have 
 done everything to eradicate this love from ray — let us say ' heart.' I 
 have tried to still it b}' means of onanism; to drag it in the mire, in 
 order to raise myself above it. (About ten years ago, during such a 
 time of love, I avoided onanism, and felt th.at my feeling of love elevated 
 me.) I still entertain the delusion that if the object of my love were to 
 tell me he loved me, that he loved me, and only me, I should willingly 
 give up sensual gratification to repose in faithful arms. But that is 
 certainly a self-deception. 
 
 " Honored sir, I have a responsible occupation, and I think I can 
 give the assurance that my abnormal inclination has never, even in a 
 hair's breadth, caused me to deviate from the duty imposed on me. 
 Aside from this abnorraalit}^ I am not insane, and I might ultimately 
 become contented ; but I have, particularly of late years, suffered too 
 much not to look on the future with painful feeling. For bhe future will 
 certainly not bring fulfillment of the desire which constantly glows 
 under the ashes, — the desire to possess a lover who understands and 
 returns my love. Such a relation would make me truly happy. I have 
 thought much about the origin of my abnormality, particularly because 
 I think I am forced to assume that it was not inherited. I believe that 
 onanism h:is changed the inborn feeling into a burning passion. I might 
 long ago have put an end to my miser}', since I have no fear of death, 
 and since in religion — which, strange to say, has not departed from my 
 impure heart — I find no warning against suicide. But the conscious- 
 ness that I am not alone responsible, and that a worm has nipped my 
 whole life in the bud, — a certain comfort that has sprung up of late out 
 of indescribable suffering, — leads me to see whether comparative happi- 
 ness in life cannot be obtained on an entirely new basis : sometliing 
 which fills the whole heart. I think I could be happy under the influence 
 of quiet family life. But I dare not conceal from you the fact that tlie 
 thought of married life with a wife is terrible to me, and that I make the
 
 EFFEMINATION AND YIRAGINITY. 289 
 
 ittempt of a change of life with a bleeding heart; for thns I absoliitelj^ 
 ibandon the hope that is always awake ; namely, the delusion tliut fate 
 may j'^et bring me the desired happiness. 
 
 " This delusion is so deeply rooted in me that I think nothing but 
 
 hypnotic suggestion could help nie. If you could advise me, you w^ould 
 
 make me unspeakably happy. Of course, your strictest injunction would 
 
 he to abandon onanism, llow gladly I would follow it! But if I were 
 
 not to have direct physical, some mechanical, means at hand to help me, 
 
 1 should certainly be unable to free myself from this vice ; :uid this the 
 
 more, because I fear that, by long years of habit, my nature has become 
 
 :ii!Customed to it. Of course, I have not escaped the effects of it, even 
 
 1 uough they are not so terrible as they are often pictured. T suffer with 
 
 1 ild nervousness, am, indeed, weakened, and have periodical disturbance 
 
 ( ■ digestion; but I can still endure hard work, and take a certain 
 
 pleasure in it, wiien it is not too great. I am depressed, but I can be 
 
 (,ppy, and, fortunately, I take pleasure in my calling, and am interested 
 
 various things, particularly music, art, and belles-lettres. I have never 
 
 dulged in female pursuits. 
 
 " As may be seen from the foregoing, I like to associate with 
 I en, especially with those who are handsome ; but I have never 
 d intimate relations with them. A wide gulf separates me from 
 em I 
 
 ^'■Postscript: I feared that in the foregoing I had not described my 
 t- 'cual life with sufficient exactness. It consists only in onanism; but in 
 it I abandon myself to almost all the repugnant acts that are compre- 
 hended under coitus inter femora, ejaculatio in ore, etc. 
 
 " M}^ 7'ole is passive. When I am seized by a passion, the ideas 
 change, and become entirely a desire to be impregnated. The struggle 
 against such a passion is so terrible, because my mind is also impli- 
 cated. I long for the closest, the most complete union that can be 
 conceived as existing between two men, — always together, common in- 
 terests, unlimited confidence, sexual union. I think that natural love 
 is different from this only in its degree of warmth ; it does not reach 
 the boiling-point of our passion. Just now I am fighting the battle 
 over again ; with force I stifle the insane passion that has so long 
 enthralled me. All night long I walk about, followed by the image of 
 him I love ; for love of whom I would give up all I possess. How sad 
 it is that the noblest feeling given to man — friendship — is sullied by 
 common sensual feeling 1 
 
 " I wish once more to state that I cannot come to the determination 
 to transform my sexual life by means of sexual intercourse with the 
 opposite sex. TJie thought of such intercourse fills me with repugnance 
 and disgust." 
 
 Case 122. " I write, as well as I can, the history of my suffering, 
 actuated only by the desire, by this autobiography, to clear w^ to some 
 
 19
 
 290 PSYCHOPATHIA SEXUALIS. 
 
 extent the misunderstanding and errors concerning ' contrary sexual 
 instinct ' which are still so widely prevalent. 
 
 " I am thirty-seven years old, and come of healthy parents, both of 
 whom were A^ery nervous. I onl}^ mention this, because I have often had 
 the thought that my contrary sexual instinct came by way of inheritance ; 
 but this is nothing more than vague. Of my grandparents, whom I did 
 not know, the only remarkable thing I can mention is, that my maternal 
 grandfather was known as a great Don Juan. 
 
 "I was rather a weak child, aud during my first two j-ears suffered 
 severely with fits, as a result of which my understanding and memory 
 may have suffered ; for I learn but slowly things which do not particularly 
 interest me, and easily forget them. I may also mention that, during 
 the time before I was born, my mother was subject to violent mental 
 excitement, and was often friglitened. From my third year I have been 
 perfectly well, and have escaped severe illness. Only when a boy, from 
 the age of twelve to sixteen, I had peculiar, indescribable nervous sen- 
 sations, which made themselves felt in my head and finger-tips, and in 
 which it seemed to me as if my whole being were about to cease. For 
 many years, however, these attacks have ceased to occur. I am rather a 
 powerful man, with abundant growth of hair, and in all respects 
 masculine. 
 
 " Even when a boy of six j^ears, I came independently^ to mastur- 
 bate, and, until my nineteenth j'^ear, I practiced the vice quite persistently' ; 
 and even now, faute de mieiix, I quite frequently resort to it, notwith- 
 standing the fact that I understand the vileness of the passion, and 
 always feel somewhat weakened after it. But sexual intercourse with a 
 man does not affect me in the least ; on the contrarj', it gives me a feel- 
 ing of being strengthened. I began school at the age of seven, and 
 soon experienced an intense feeling of sympath3^ for my companions, 
 which, however, made no other impression on me. In the Gymnasium, 
 at the age of fourteen, my companions explained to me the sexual life 
 of man, which, up to that time, was absolutely unknown to me ; but I 
 was not much interested in the matter. At this time I also practiced 
 mutual onanism with two or three friends who liad seduced me into it; 
 and it had an extraordinary charm for me. I was still perfectly uncon- 
 scious of the perversity of my sexual instinct, and considered my vices 
 as sins of youth, like those committed by all boys of the same age. 
 Interest in the female sex I thought would come in time. Thus I 
 became nineteen ^ears old. During the following years I fell insanely 
 in love three times, — once with a very handsome actor, then with a bank 
 emploj^e, and with one of ni}- friends, the last two being men who were 
 nothing less than beautiful, and calculated to excite sensual feeling. But 
 this love was merely platonic, and occasionally found expression in glow- 
 ing poetr}'. It was, perhaps, the most perfect period of my life; for I 
 regai'ded everything with pure, innocent eyes. In my twenty-first year
 
 EFFEMINATION AND VIRAGINITY. 291 
 
 I gradually hegan to notice that I was not constituted exactl_y like my 
 conirades; for 1 found no pleasure in masculine pursuits. I had but 
 little liking for smoking, driiikiug, and card-playing, and I was frightened 
 to death by a brothel. I have never been in one; I was always able to 
 avoid visiting one on some pretext or other. But I now began to think 
 !'')out myself; 1 often felt terribly lonesome, miserable, and uuha[)py, 
 aid longed for a friend constituted like myself, without, however, ever 
 thinking that there could be other men like me. At twenty-two I made 
 the acquaintance of a 3'oung man who finally explained to me contrary 
 sexual instinct and the individuals affected with it. He, being also an 
 urning, was in love with me. It was as if scales had fallen from my eyes ; 
 n!ul 1 bless the day this explanation came to me. From that time I saw 
 tne world with different eyes; I saw that many others were given the 
 same fate ; and I began to learn to content myself with this lot as well as 
 I could. Unfortunately, I did not succeed ver}' well, and I am still often 
 seized with bitterness and a deep hatred of the modern ideas which treat 
 us poor urnings with such terrible harshness. For what is our fate? In 
 most cases we are not understood, and are derided and despised ; and 
 even when all goes well, and we are understood, we are still pitied like 
 invalids or the insane, — and pity was always sickening to me. I now 
 began to play a part, in order to deceive my fellow-men as to my state 
 of mind ; and it always gave me great satisfaction to succeed in this. I 
 made the acquaintance of several men like m3'self, with whom I pstab- 
 lished relations, which, however, never lasted long; for I was ver^ 
 fearful and cautious ; but, at the same time, I was very particular and 
 easily wearied. 
 
 " I have always absolutely despised pederasty as something un- 
 w^orthy a man, and I only wish that all those like me would do the same ; 
 but, unfortunately, with many this is not the case. If all like me thought 
 as I do, then the contempt and scoffing of men that feel differently would 
 be a still greater injustice to us than it now is. 
 
 "Toward the man I love I feel completely like a woman, and, there- 
 fore, in the sexual act I am quite passive. In general, my whole sensibility 
 and feeling are feminine. I am vain, coquettish, fond of ornament, and 
 like to please others. I love to dress myself beautifully, and, in cases 
 where I wish to please, I even make use of the arts of the toilet, in which 
 I am quite skilled. 
 
 "While I have but little interest in politics, I am passionately fond 
 of music and an inspired follower of Richard Wagner. I have noticed 
 this preference in the majorit}^ of us; I find that this music is perfectly 
 in accord with our nature. 
 
 " I play the violin quite well ; I like reading, and read much, but I 
 have little interest in anything else. Everything else in life is quite in- 
 different to me, owing to the deep resignation that more and more takes 
 possession of me.
 
 292 PSTCHOPATHIA SEXUALIS. 
 
 " Even though I should have reason to be satisfied with my fate, in 
 that I have an assured position in a technical emplojanent in a large city 
 of Germany, still I take no pleasure in my calling. I should be best 
 suited if, independent and free, I could travel about with a handsome 
 lover, and live for music and literature, particularly for the theatre, which 
 seems to me to be one of the greatest pleasures. A connection with a 
 court theatre I think of as being very acceptable. 
 
 " The only position or calling that seems really desirable to me is 
 that of a great artist, — singer, actor, painter, or sculptor ; and it seems 
 to me that it would be even finer to be born to the throne of a knig, — a 
 wish that is in harmony with my pronounced desire for power. (If there 
 is really such a thing as transmigration of souls, a subject I have studied 
 much, and which seems to me to clear up much, I must have lived at one 
 time as an emperor, or ruler of some kind.) But a man must be born to 
 all this ; and since I am not, I am without ambition for so-called social 
 honors and distinctions. 
 
 " As to my tastes, I must mention a painful dissension there is in 
 them. Handsome, intellectual young men of at least twenty years, who 
 must be of my own social station, seem to me to be suited rather for 
 platonic love ; but with them I satisfy myself completely with a straight- 
 forward, though ideal, friendship, which seldom goes beyond a few kisses. 
 But I can be excited sensually only by coarse, powerful men that are at 
 least of my own age, and mentally and socially beneath me. The reason 
 f*". tnis strange phenomenon may be that my pronounced feeling of shame 
 and my innate apprehensiveness, with m}^ cautious disposition, have the 
 effect of an inhibitory idea with men of my own social position; so 
 that with them it is with difficulty and seldom that I can induce sexual 
 excitement in myself. That this diversity is painful to me is owing to 
 the fact that I am always afraid to discover myself to these simple men, 
 below me in station, who may often be bought with mone}^ But I can- 
 not imagine anything worse than a scandal, which would at once drive me 
 to suicide. For I can think of nothing more terrible than, through some 
 slight act of carelessness or the enmity of any man, suddenly to be 
 branded before the world, and to be powerless to avert it. But what is it 
 that we do that is so diflerent from what normall}' constituted men can 
 do, at least, quite as frequently without embarrassment, and without 
 shame ? That we do not feel as the crowd feels is not our fault, but a 
 cruel trick of Nature. 
 
 " Innumerable times I have puzzled my brain to know whether 
 science, or any of her free and unprejudiced devotees, could think of any- 
 way in which to give us step-children of Nature a more endurable posi- 
 tion before the law and mankind. But I have always reached the same 
 sg,d conclusion, that when one enters the lists in behalf of anything, he 
 must first know thoroughly, and be able to explain, that for which he 
 contends. And who is to-day able to perfectly explain and define con-
 
 EFFEMINATION AND VIRAGINITV. 293 
 
 trary sexual instinct ? Yet there must be some correct explanation of 
 it; there must be some way in which the mass of mankind can be 
 brought to a milder and more reasonable judgment of it; and, first of 
 all, there must be some way to show that contrary sexual instinct should 
 not be regarded as meaning the same as pederasty, as the majority of 
 men — I may say all — regard it. By such an act a man might erect for 
 himself an immortal monument in the gratitude of thousands of men of 
 present and future generations; for there have been, are, and will ever 
 be, urnings, and in greater number than perhaps has been suspected. 
 
 " In Wilbrand's work, ' Fridolin's Secret Marriage,' I find a very 
 plausible theory given in explanation of this matter ; for I myself have 
 repeatedly had opportunity to observe that all urnings do not love men 
 with the same intensity, but that there are innumerable sub-varieties, — 
 from the most feminine man to the man of contrary sexuality who is 
 ecpially sensitive to female charms. This may also account for the so- 
 called difference between congenital and acquired contrary sexual instinct, 
 which, in my inadequate oi)inion, does not exist. Yet, in all the' fifty-five 
 individuals I have become acquainted with in the three year* since I came 
 to understand this matter, I have met the same peculiarities of tempera- 
 ment, disposition, and character. Almost all of them are more or less 
 idealists : they smoke but little, or not at all ; they are bigoted, vain, 
 desirous of admiration, and superstitious ; and, unfortunately, I must 
 confess that they combine more the defects and the reverse sides of both 
 sexes than their good qualities. For woman in a sexual 7-dle I expe- 
 rience a feeling of true horror, which I could never overcome, even with 
 the help of my extremely lively imagination. I have never attempted it, 
 because I am thoroughly convinced of the fruitlessness of such an 
 attempt, that seems to me unnatural and sinful. 
 
 " In purely social and friendly relations, I like to associate with 
 ladies and girls, and I am gladly welcomed in ladies' society ; for I am 
 much interested in the fashions for ladies, and know how to talk of such 
 things witli great skill. When I wish to, I can l)e very gay and amiable ; 
 but my faculty fur conversation is, for tlie most part, only assumed, and 
 it always tires me. I have alwa^'s had great skill in female work, and 
 shown interest in it. As a child, and up to my thirteenth year, I was 
 passionatel}' fond of plajing with dolls, whose clothes I made mj^self ; 
 and it still afl'ords me much pleasure to work at beautiful embroider}', 
 which, unfortunately, I can do only in secret. I have the same prefer- 
 ence for knick-knacks, photographs, flowers, sweetmeats, toilet-ai'ticles, 
 and such feminine things ; and my room, which I arranged and decorated 
 myself, is like the over-crowded boudoir of a lady. 
 
 "As particularly remarkable, I wish still to mention that I have 
 never suffered with pollutions. I dream very much, and intensel}-, 
 almost every niglit ; occasionally I have lascivious dreams, which have 
 only men as subjects, but I always wake out of them before it comes to
 
 ^94 PSYCfiOPATHIA SEXUALlg. 
 
 ejaculation. In realit}' I am not very passionate sexually, and 1 have 
 periods lasting from four to six weeks, in which I have almost no sexual 
 desire. Unfortunately, these periods are infrequent, and they are usually 
 followed by an awakening of my intense sexual desire that is only the 
 more violent ; which, when it is unsatisfied, causes intense phj'sical and 
 mental suffering. I then become moody, depressed, sensitive, irritable, 
 and retiring; peculiarities, however, which, with the first opportunity' I 
 have for sexual gratification, again disappear. I must mention, also, 
 that often, on the slightest occasion, my mood ma^' change several times 
 during the day ; it is like April weather. 
 
 " I dance well, and like to ; but I love dancing only for its rhythmi- 
 cal movement, and because of my partiality for music. 
 
 " In conclusion, I wish to speak of something that always arouses 
 repugnance in me. We are usually considered diseased, and that is 
 absolutely incorrect. For in every disease there is a means of cure 
 or amelioration ; but no power in the world can take from an urning his 
 perverse natural constitution. Even suggestion, which has been used 
 with so much apparent success, cannot induce any enduring change in 
 the mental life of an urning. In us, effect is mistaken for cause. We 
 are considered diseased, because in time the majority of us really become 
 ill. I am almost convinced that two-thirds of U6, in later life, when we 
 really live so long, have a mental defect of one kind or another ; and 
 this is only too easily explained. For, what strength of will and nerves 
 is required for one to constantly dissimulate, lie, and play the hypocrite all 
 his life'! How often in the society of normal men, when the conversation 
 turns to contrary sexual instinct, must one agree with the words of abuse 
 and contemi)t, while every one of them wounds the heart. On the 
 other hand, there are alwa3's the tiresome and indecent jokes and talk 
 about women, etc., that must be heard ; and which to-day, in so-called 
 ' good society,' are popular — and to show interest and give attention to 
 them ! Daily and hourly to see so many handsome men to whom one 
 cannot reveal himself; to be compelled to go without a friend, inter- 
 course with whom we desire so much ; and besides, constantly the fear- 
 ful anxiety of betraying one's self before the eyes of the world, and then 
 standing covered with ignominy and shame ! It is really no wonder that 
 the majority of us are incapable of real work ; for we need all our 
 strength of will and power of endurance for the struggle with our own 
 fate. How injurious it is to our nerves constantly to be compelled to 
 shut up all these thoughts and feelings in our hearts ; where our lively 
 fancy, feeding on it all, plays all the more intensely, so that we go about 
 with a burning fire within us that only too often threatens to consume us ! 
 Happy are those of us that are never denied the strength to lead such a 
 life; but those, too, are happy that have passed beyond it." 
 
 Case 123, Autobiography. " In what follows, you will find the de- 
 scription of the character, as well as the mental and sexual disposition,
 
 EFFEMINATION AND VIRAGINITY. 295 
 
 of an urning, — i.e.^ of an individiuil who, in spite of liis masenline form, 
 feels as a woman, whose senses women do not excite, and whose sexual 
 desires are constantly directed toward men. 
 
 " Convinced that the enigma of our existence can be solved, or, at 
 least, illuminated, only by the unprejudiced thought of scientific men, I 
 describe my life only with the aim of perhaps clearing up this cruel error 
 of Nature, and possibly doing a kindness to people like me to come in later 
 generations ; for there will be urnings as long as men are born, just as it 
 is a fact that they have existed in every age. With the progress of 
 'science in our epoch, men will see in me and those like me not objects of 
 hatred, but objects of pity, which deserve not the odium, but the com- 
 passion, of their more fortunate brothers. I shall t)e as brief as possible 
 in my communication, and also objective; and, with reference to my 
 caustic, often cynical, style, I may note that, above all, I shall be honest, 
 and, therefore, not avoid strong expressions ; for the3^ are most happil}' 
 suited to the subject in hand. 
 
 " I am in my thirt,y -fifth year ; a merchant, with a fair income ; 
 somewhat above average height, slim, weak of muscle, with full beard, and 
 quite ordinary face, and, at first sight, in nowise different from ordinary 
 men. On the other hand, my gait is feminine, and particularl}^ mincing 
 in fast walking ; the movements are awkward and displeasing, indicative 
 of a want of manly feeling. The voice is neither feminine nor shrill, but 
 rather a baritone. 
 
 " This is m}^ external appearance. 
 
 " I do not smoke or drink, and can neither whistle, ride, do gym- 
 nastic feats, fence, nor shoot. I have absolutely no interest in horses or 
 dogs, and have never had a gun or sword in my hand. In inner feeling 
 and sexual desire, I am completely a woman. Without thorough educa- 
 tion, — I passed through but few classes in the Gymnasium, — I am yet 
 intelligent, like to read well-written, improving books, and have good 
 judgment ; but I allow mj^self to be carried away by the feelings of the 
 moment, and I am easily influenced by any one who knows my weakhess 
 and how to make use of it. Constantl}^ making resolves, I have never 
 the energy to carry them out ; like a woman, I am moody and nervous, 
 often irritated without reason, and sometimes mean. Toward persons 
 that do not please me, I am arrogant, unjust, and often shamefully 
 insulting. 
 
 " In all my conduct I am superficial, and often frivolous, and I have 
 no deep moral feeling. I have little consideration for parents and 
 brothers and sistei's. I am not egotistic, but, on occasion, self-sacri- 
 ficing. I cannot withstand tears, and can — like a woman — be won by 
 amiability and entreaty. 
 
 " In my earliest years I avoided playing soldier, gjaiinastics, or the 
 rough games of my manly comrades, and ran about with little girls, with 
 whom I was much more in sympathy than with boys. I was retiring,
 
 296 PSYCHOPATHIA SEXUALIS. 
 
 bashful, and often blushing. When no more than twelve or thirteen 
 years old, the close-fitting uniform of a handsome soldier gave me the 
 most peculiar feeling ; and while, during the next few years, my comrades 
 were always talking about girls, and even engaged in love-affairs, I could, 
 for hours at a time, run after a well-built man with well-rounded hips, 
 and feast m}^ ej^es on the sight. 
 
 " Without thinking much of these impressions, so different from the 
 feelings of my comrades, I began to masturbate, always during the act 
 thinking of a heroic, handsome form ; and this continued until my 
 seventeenth year, when I learned from a companion constituted like my-' 
 self a true explanation of my condition. Since that time I have been 
 with girls eight or td^i times ; but, in order to have an erection, it was 
 always necessary to think of a handsome man of my acquaintance. And 
 I am thoroughly convinced that to-daj^, even with the help of imagination, 
 I should be unable to have intercourse with a girl. 
 
 " Shortly after my discover}' I preferred to associate with mature, 
 powerful urnings ; for at this time I had neither mind nor opportunity to 
 associate with real men. Since this my taste has changed entirely, and 
 men, real men, of twenty-fiA^e or thirty-five 3'ears, with supple, powerful 
 forms, are the only ones that ravish mj^ senses, and charm me as if I 
 were a woman. Circumstances have allowed me, during these years, to 
 make about a dozen male acquaintances that would serve my purpose foi' 
 a gulden or two a visit. If I am alone in a room with a handsome ^^outh, 
 my greatest pleasure is membrum ejus vel maxime si magnum atque 
 crassum est, manibus capere et apprehendere et premere, turgentes nates 
 femoraque tangere atque totum corpus manibus contrectare et, si con- 
 ceditur, os faciem atque totum corpus, immovero nates, ardentibus 
 osculis obtegere. Quodsi membrum magnum purumque est, dorainusque 
 ejus mihi placet, ardente libidine mentulam ejus in os meum receptam 
 complures horas sugere possum, neque autem delector, si semen in os 
 meum ejaculatur, cum maxima eorum qui " urnings " nominantur pars 
 hac re non modo delectatur, sed etiam semen nonnunquam devorat. 
 
 " The most intense delight, however, is experienced when I find a 
 real man, qui membrum meum in os recepit et erectionem in ore suo con- 
 cedit. 
 
 " Improbable as it sounds, I am yet able to find some coarse fellows 
 who will allow themselves to be used for this purpose. Thej^ learn the 
 thing while in military service, for urnings know that under such circum- 
 stances they can be made to do the most for mone}^ ; and when the fel- 
 lows are once trained, circumstances often compel them, in spite of their 
 passion for the opposite sex, to continue the practice. 
 
 " With certain exceptions, urnings make no impression on me, be- 
 cause everything feminine is repugnant t6 me. At the same time, there are 
 some that know how to give me the most intense pleasure, just as a real 
 man can ; and I prefer to consort with them, for the reason that sometimes
 
 EFFEMINATION AND VIRAGINITY. 297 
 
 they return my passionate caresses. In tete-a-tete with such a person, I 
 throw all chock from my excited senses, and give my animal passions free 
 rein, osculor, premo, amplector eum, linguam meam in os ejus immitto ; 
 ore cupiditate tremente ejus labrum superius sugo, faciem meam ad ejus 
 nates adpono et odore voluptari e natibus emanente voluptate obstupe- 
 scor. Real men, in close-fitting uniform, make the deepest impression on 
 me ; and if I have an opportunity to embrace and kiss such a ravishing 
 fellow, ejaculation takes place at once, — a weakness which I attribute to 
 my frequent masturbation. In my earlier years I practiced it very fre- 
 quently, almost every time I saw a man pleasing to me, whose image I 
 kept before my eye during the act. For this my taste is in nowise diffi- 
 cult to please — like that a servant-girl might have in finding her ideal in 
 a dragoon guard. A handsome face is a pleasant supplement, inflaming 
 my sensual desire, but in no respect an essential. The requisite remains : 
 vir inferiore corporis parte robusta et bene formosa, turgidis femoribus 
 durisque natibus, while the upper portion of the body may be slim. Cor- 
 pulence disgusts me. A sensual mouth with pretty teeth affects me more 
 intensely ; and if the person has also a membrura pulchrum magnum 
 et sequaliter formatum, all my demands — the most far-reaching — are 
 fulfilled. 
 
 " When I was younger, with men that pleased me and excited ray 
 passions intensely, ejaculation took place from five to eight times in a 
 night, and now it occurs from four to six times ; for I am unusually 
 strong sensually, and, as an example, even the clinking of a hussar's 
 sword may excite me. At the same time, I have a very lively fancy, and 
 spend most of my leisure hours thinking of handsome men with strong 
 limbs ; and I would be delighted to look on when a powerful fellow, using 
 force, magna mentula proeditus me prsesente puellam futuat ; mihi per- 
 suasum est, fore ut hoc aspectu sensus mei vehementissima perturbatione 
 afliciantur et dum futuit corpus adolescentis pulchri tangam et, si liceat, 
 ascendam in eum dum cum puella concumbit atque idem cum eo faciam et 
 membrum meum in ejus anum immittam. The accomplishment of these 
 cynical ideas — with which my mind is often filled — is hindered only by 
 my limited means ; otherwise, I should long ago have had the reality. 
 
 " Soldiers have the greatest charm for me, but I have also a weak- 
 ness for butchers, fakirs, drivers, circus-riders, and boat-captains ; and all 
 these must be supple and powerfully built. Urnings I hate in intimate 
 relation, and for the majority of them I have an inexplicable aud unjust 
 aversion, I have never had but one urning for an intimate friend. On 
 the other hand, the most affectionate and enduring ties bind me to men of 
 my own age, in whose company I delight, but with whom I have no 
 sexual relations, and who have no idea of my condition. 
 
 " Talk on politics and economics, like every other earnest subject, I 
 hate ; though I gossip with considerable sense and peculiar pleasure about 
 the theatre. At operas I see myself on the stage, feel myself applauded
 
 298 PSYCHOPATHIA SEXUALIS. 
 
 by the public, and would prefer to sing as a passive heroine, or in the 
 dramatic role of a woman. » 
 
 " The most interesting subject of conversation for me, and those 
 like me, is, however, always — men ; for us this is inexhaustible. Their 
 secret charms are described in the most minute details, mentulae aestiman- 
 tur, quanta sint magnitudine, quanta, crassitudine ; de forma earum atque 
 rigiditate conferimus, alter ab altero cognoscit cujus semen celerius, cujus 
 tardius ejaculetnr. I may add that, of my four brothers, one gave himself 
 to the service of urnings, without himself being ow^; and all four are 
 ladies' men, and indulge in sexual excesses. The genitals of the men of 
 our family are, without exception, unusually developed. 
 
 " In conclusion, I repeat the words with which I began these lines. 
 I could not choose my expressions, because my object in the foregoing 
 has been to afford material for the study of the urning's existence, and 
 absolute truth was essential. I beg the numerous cj-nics to keep this 
 circumstance in mind." 
 
 In October, 1890, the writer of the foregoing lines presented himself 
 to me. In all essentials his appearance corresponded with his description. 
 Genitals large, with abundant growth of hair. His parents had been 
 well nervously. One brother had shot himself on account of nervous 
 trouble; three others were intensely nervous. The patient came to'me 
 in a state of despair. He could not endure such a life any longer ; for 
 he had been admonished about intercourse with men that could be 
 bought ; and with his extreme sensual nature he was unable to abstain. 
 Too, he could not understand how he could be made to love women, 
 and enjoy the nobler joj's of life. He had had love for men since his 
 thirteenth year. 
 
 He felt in all respects like a woman, and longed to be won by men 
 that were not urnings. When he was with an urning, it was just as if 
 two girls were together. He would prefer being sexless to living longer 
 as he was. Would not castration help him ? 
 
 An attempt at hj'pnosis with the highly excited patient induced 
 only a very slight degree of lethargy. 
 
 Case 124. B., waiter, aged 42, single, was sent to me by his phy- 
 sician, with whom he was in love, as one who was suffering from contrary 
 sexual feeling. B. very willingly, and in a decent manner, gave a history 
 of his past life, especiall}- of his sexual life, and was glad at least to have 
 an authoritative opinion concerning his sexual condition, which had 
 always appeared to him abnormal. 
 
 B. knew nothing to report of his grandparents. His father had 
 been a passionate, excitable man, a driuker, and alwaj's very sensual. 
 After he had begotten twenty -four children by one wife, he was divorced 
 from her ; and after that his landlady became three times pregnant by 
 him. His mother was healthy. 
 
 Of the twenty-three children, but six were living; several were
 
 EFPEMINATION AND VIRAGINITY. 299 
 
 nervous, but not sexuall}- abnormal, with the exception of one sister, who 
 always sought men. 
 
 B, asserts that from childhoocl he was sickly. At eight his sexual 
 life began. He masturbated, and became possessed of the idea penem 
 aliorura puerorum in os arrigere, which gave him the greatest pleasure. 
 At twelve he began to fall in love with men, usually with those between 
 thirty and forty, with moustaches. Even at that time his sexual desire 
 was greatly developed, and he had erections and pollutions. From that 
 time, indeed, he masturbated daily, and during the act thought of a beloved 
 man. Yet his greatest delight had been penem viri in os arrigere. During 
 the act he had ejaculation, with an intense feeling of pleasure. Only about 
 twelve times had he had this pleasure. He had never felt disgust with 
 the penis of another S3nnpathetic man ; quite the contrary. He had never 
 accepted proffers of pederasty; actively or passively, it was very dis- 
 gusting to him. In the perverse sexual act he had always thought of 
 himself in the role of a woman. His passion for men in sympathy with 
 him had been unbounded. He would have done everj^thing for a lover ; 
 even at the sight of him he would tremble with excitement and joy. 
 
 At nineteen he often allowed himself to be taken by his comrades 
 to houses of prostitution. He never had pleasure in coitus, and only in 
 the moment of ejaculation felt satisfaction. In order to get an erection 
 with a woman, it was always necessary, in the act, for him to think of a 
 beloved man. He would always have preferred to have the woman allow 
 immissio penis in os, which, however, was always denied him. Faute de 
 mieiix, he had practiced coitus, and, indeed, twice became a father. The 
 last child, a girl of eight, had already begun to practice masturbation and 
 mutual onanism, which troubled him very much as a father. He wished 
 to know whether there was any remedy for it. 
 
 The patient asserted that he always felt himself toward men in a 
 feminine 7'6Ie (also in sexual intercourse). He had always thought that 
 his sexual perversion had resulted from his father's wishing to beget a 
 girl when he begat him. His brothers and sisters had alwaj^s joked him 
 on account of his feminine manners. Sweeping and house-cleaning had 
 always been pleasant occupations for him. His activities in this direc- 
 tion had often been wondered at, and he was considered more skillful 
 than a girl. Whenever he could, he dressed like a woman. At the 
 carnival he appeared at the dances masked as a female. He was very 
 successful at coquetry on such occasions, because he had a feminine 
 nature. 
 
 He had never had real pleasure in drinking, smoking, or in mascu- 
 line occupations or pleasures ; but, on the other hand, he loved to sew, 
 and as a child had often been scolded for his playing with dolls. His 
 interest at the circus or theatre was confined to men. Frequently he 
 could not overcome the impulse to hang around water-closets, in order to 
 get sight of male genitals.
 
 300 PSYCHOPATHIA SEXUALIS. 
 
 Feminine charms had never pleased him. Coitus had been possible 
 only when he thought of a beloved man. Nocturnal pollutions were 
 always induced by lascivious dreams of men. 
 
 In spite of much sexual excess, B. had never suffered from neuras- 
 thenia sexualis, and, besides, there was not a symptom of neurasthenia 
 discoverable in him. 
 
 Patient is delicate, and his whiskers and moustache, which made 
 their appearance in his twentj'-eighth year, are thin. Externally, with 
 the exception of a weaving gait, he presents nothing which would 
 point to his feminine nature. He asserts that he has often been joked 
 about his feminine gait. His conduct is in all respects decent. His 
 genitals are large, well developed, and normal in all respects, and the 
 growth of genital hair is abundant ; the pelvis is masculine. The head is 
 rachitic, somewhat hj'drocephalic, with prominence of the parietal bones. 
 The face is remarkably small. The patient says that he is irritable and 
 easilj^ angered. 
 
 Case 125. On May 1, 1880, G., Ph.D., and a writer, was brought 
 to the clinic for mental diseases, at Graz, by the public authorities. 
 While on his return from Italy, G. found a soldier in Graz who, gave 
 himself up to him for hire, but ultimately denounced G. to the police, 
 because G. had openlj' confessed his love for men. The authorities con- 
 sidered his mental condition doubtful, and sent him to alienists for 
 examination. To the pliysicians G. related, with cynical openness, that 
 years before, in M., he had had just such an affair with the police, and was 
 in prison fourteen days. In the Soutli there was no danger from such 
 people ; it was only in Germany and Austria that the thing was regarded 
 as an evil. 
 
 G. is fifty 3^ears old, tall, powerful, and has a humerous expression, 
 and a cynical, coquettish manner ; the eye has a neuropathic, swimming 
 expression ; the teetli of the under jaw stand far back from those of the 
 upper jaw. The cranium is normal, the voice masculine, and the beard 
 abundant. The genitals are well formed, though the testicles are some- 
 what small. With the exception of slight emphysema of the lungs and 
 external fistula iu ano, there are no remarkable anomalies of the vegeta- 
 tive organs. G.'s father was subject to periodical insanity. His mother 
 was a high-strung person, and she had an insane sister. Of the children, 
 four died in childhood. 
 
 With the exception of scrofulosis, G. asserts that he was health3\ 
 He obtained the degree of Doctor of Philosophy- ; at twenty -five, he had 
 haemoptysis, and went to Italj", where he has since lived, with slight 
 interruption, by writing and by giving private lessons. G. says that he 
 often has congestions, and also some spinal irritation, — i.e., pain in his 
 back, — but otlierwise lie has a genial disposition ; only he is not much of 
 a financier; and at the same time, like all old prostitutes, he has a very 
 good appetite. Further, he states, with great satisfaction and remarkable
 
 EFFEMINATION AND VIRAGINTTY. 301 
 
 cynicism, that he has congenital contrary sexual instinct. When only 
 five years old, it was his greatest pleasure to get sight of a penis, and he 
 hnng about ajipropriate places, in order to enjoy that pleasure. Even 
 before puberty he practiced masturbation. At the time of puberty he 
 noticed an inward feeling for friends. An obscure impulse pointed out 
 to him the way his love would take. He was actually impelled to kiss 
 young men, and now and then to caress their genitals. When twenty- 
 six years old, he first began to have sexual intercourse with men, toward 
 whom he felt like a woman. Even as a child, it was his greatest delight 
 to put on female attire. He was often chastised b}^ his father because, 
 in the effort to satisfy this impulse, he put on his sister's clothing. 
 If he happened to see a ballet, only the male dancers interested him. 
 Since he could remember, he had had a horror feminae. If he happened to 
 visit a brothel, it was only to see young men. He was, indeed, a rival of 
 prostitutes. If he saw a young man, he just looked at his eyes ; in case 
 these pleased him, then came the mouth — whether it Avas well formed for 
 kissing ; then he would look at the genitals — whether they were well 
 developed. G. pointed, with great feeling of self-satisfaction, to his poeti- 
 cal works, and tried to make it appear that persons with natures like his 
 were poetically endowed. He gave as exami)les Voltaire, Frederick the 
 Great, Eugene of Savoy, and Plato, as well as numerous distinguished 
 men of the present, who, according to his oi)inion, were urniugs. His 
 greatest pleasure was to have a sympathetic young man read his verses 
 to him. During the last summer he had had such a lover. When 
 he had to part with him, he was quite undone, and he did not eat or sleep 
 until gradually he had regained liis former condition. He said that the 
 love of urniugs was a passionate, inner fire. According to his statement, 
 in Naples the effemineJli lived in a quarter together, just as in Paris the 
 grisettes live with their lovers. They sacrifice themselves for their lovers, 
 and care for the household, just as the grisettes do. Ou the other hand, 
 an urning repels an urning, "just as one prostitute does another— that is 
 the curse." 
 
 The need of intercourse with males occurs about once a week with 
 G. He is happy in his peculiar sexuality, which he, it is true, considers 
 peculiar, but which he will not regard as abnormal or wrong. He thinks 
 that nothing; remains for him and those like him but to raise what is un- 
 natural in themselves to the supernatural. He looks ui)ou the love of 
 urniugs as the higher, the ideal, as godlike, an abstract love. When 
 shown that such a love is far from the puri)Ose of Nature and the preser- 
 vation of the race, he expresses the pessimistic thought that the world 
 should die out, and the earth turn round its axis without men, who were 
 on it only for trouble. As reason and explanation of his unnatural 
 sexual feeling, G. refers to Plato, " who certainly was no beast." Plato 
 expressed allegorically the idea that men were originally balls. The 
 gods had divided these into two hemispheres. For the most part,
 
 302 PSYCHOPATHIA SEXUALIS. 
 
 man is suited to woman, but sometimes man to man. In the latter case, 
 the impulse to union is quite as powerful as in the former, and they 
 strengthen each other in the same way. G. further relates that his 
 dreams, when they were erotic, never had women, but only men, for their 
 subjects. Male-love was the only kind that could satisfy him. He con- 
 sidered it disgusting for one human being to be prodding about in the 
 abdomen of another with his penis, since he had heard that in this dis- 
 gusting fashion coitus was usually carried out. He had never had the 
 curiosity to inform himself concerning the female genitals ; the subject 
 was disgusting to him. The indulgence of his sexual appetite he did not 
 consider a vice, but the result of a natural impulse which compelled him 
 to it. It conduced to self-preservation. Onanism was a poor substitute, 
 and, moreover, injurious, while urning-love was morally elevating and 
 conducive to ph3^sical well-being. 
 
 With moral indignation, which in contrast with his cynicism in 
 other directions appeared ridiculous, he protested against the classifica- 
 tion of urnings with those who indulged in pederasty. He looked on the 
 podex with disgust, as it was a secretiug organ. The intercourse of 
 urnings always took place in front, and was combined onanism. 
 
 This was the extent of G.'s disclosures, whose mental condition was 
 certainly congenitall>^ abnormal. As proof of this, may be cited his 
 cynicism ; his incredible frivolity in his application of his vices to re- 
 ligion, in which direction we cannot follow him without overstepping the 
 bounds set by scientific inquiry'- ; his perverse philosophical ideas with 
 reference to his sexual perversion ; his perverse manner of looking at the 
 world ; his ethical defect in all directions ; his vagabondage ; and his per- 
 verse mind and exterior. G. makes the impression of an original 
 paranoiac. (Personal case. Zeitschrift fur Fsychiatrie.) 
 
 Case 126. Taylor had occasion to examine a certain Eliza Edwards, 
 aged 24. It was discovered that she was of masculine sex. E. had worn 
 female clothing from her fourteenth 3^ear, and also been an actress. The 
 hair was worn long after the manner of females, and parted in the middle. 
 The form of the face was feminine, but otherwise the body was masculine. 
 The beard was carefully pulled out. The masculine, well-developed geni- 
 tals were fixed in an upward position by an artful bandage. The con- 
 dition of the anus indicated passive pederasty. 
 
 Case 127. An official of middle age, who for some years had been 
 happy in family life, and was married to a virtuous woman, presented a 
 peculiar manifestation of contrary sexual feeling. 
 
 One day, through the indiscretion of a prostitute, the following 
 scandal became public : About once a week X. would api)ear in a house 
 of prostitution, and there dress himself up as a woman, always requiring, 
 as a part of his costume, a coiflliire. When his toilet was completed, he 
 would lie down on the bed, and have the prostitute perform manustupra- 
 tion. But he very much preferred to have a male person (a servant of
 
 EFFEMINATION AND VIRAGINITY. 303 
 
 the house). This man's father was hereditarily tainted, had been insane 
 several times, and was afflicted with hypertesthesia and pamesthesia 
 sexualis. 
 
 Case 128. C. R., maid-servant, aged 2fi, suffered from the time of 
 her development with original paranoia and hysteria. As a result oi" her 
 delusions, her life had been somewhat romantic, and in 1884, in Switzer- 
 land, where she had gone as a result of delusions of persecution, she came 
 under the observation of the authorities. On this occasion, it was ascer- 
 tained that R. was affected with contrar}^ sexual instinct. 
 
 Concerning her parents and relatives there is no information at 
 hand. R. asserted that, with the exception of an inflammation of the 
 lungs at the age of sixteen, she had never been severely ill. 
 
 First menstruation at fifteen, without any difficulties ; thereafter it 
 was very often irregular and abnormally excessive. The patient declared 
 that she never had had inclinations toward the opposite sex, and had never 
 allowed the approach of a man. She never could understand how her 
 friends could describe the beautj^ and amiability of men. But it was 
 charming and inspiring for her to imprint a kiss on the lips of a beloved 
 female friend. She had a love for girls that was incomprehensible to her. 
 She had passionately loved and kissed some of her female friends, and 
 she would have given up her life for them. Her greatest delight would 
 have been to have constantly lived with such a friend and absolutely 
 possessed her. 
 
 In this she felt toward the beloved girl like a man. Even as a 
 little child, she had an inclination only for the play of boys, and she 
 loved to hear shooting and military music, was always much excited by 
 them, and would gladly have gone as a soldier. The chase and war have 
 been her ideals. In the theatre only feminine performers interested her. 
 She knew very well that the whole of this inclination was unwomanly, but 
 she could not help it. It had always been a great pleasure for her to go 
 about in male clothing, and in the same way she had always preferred 
 masculine work, and had shown unusual skill in it; while with refer- 
 ence to feminine occupations, especially handiwork, she had to say the 
 contrary. The patient had also a weakness for smoking and spirits. On 
 account of persecutory delusions, in order to rid herself of her persecu- 
 tions, tbe patient had often gone about in male attire, and played the 
 part of a man. She did this with such (congenital) skill that, as a rule, 
 she was able to deceive peoi)le concerning her sex. 
 
 It is authoritatively established that in 1884, for a lonar time, the 
 patient went about in male attire, now in the garments of a civilian, now 
 in the uniform of a lieutenant; and in August of the same year, dressed 
 as a male servant, she fled to Switzerland as a result of delusions of per- 
 secution. There she found service in a merchant's family, and fell in love 
 with the daughter of the house, " the beautiful Anna," who, on her side 
 not recognizing the sex of R., fell in love with the handsome young man.
 
 304 PSYCHOPATHIA SEXUALIS. 
 
 Concerning this episode the patient makes the following character- 
 istic statement : " I was madly in love with Anna. I don't know how it 
 came about, and I cannot put myself right concerning this impulse. In 
 this fatal love lies the reason why I played the role of a man so long. I 
 have never yet felt any love for a man, and I believe that m}^ love is for the 
 female and not the male sex. I can in nowise understand my condition." 
 
 From Switzerland R. wrote letters home to her friend, Amelia, 
 which were produced at the examination. They are letters showing pas- 
 sionate love, which goes be^^ond the bounds of friendship. She apostro- 
 phizes her friend, " M}' flower, sun of my heart, longing of my soul." 
 She was her greatest happiness on earth ; her heart was hers. And in her 
 letters to her friend's parents she wrote : " You, too, should watch your 
 flower, for, if she should die, you also would be unable to endure life." 
 
 For the purpose of investigating her mental condition, R. remained 
 for some time in an asj'lum. On one occasion, when Anna was allowed 
 to pay R. a visit, there was no end of passionate embraces and kisses. 
 The visitor acknowlec^ed freely that they had before secretly embraced 
 and kissed in the same way. 
 
 R, is a tall, slim, stately person, of feminine form in all respects, 
 but with masculine features. Cranium regular; no anatomical signs of 
 degeneration. Genitals normal and indicative of virginity. All the 
 circumstances indicate that she has onl}^ indulged in platonic love. 
 Glance and appearance are indicative of a neuropathic person. Severe 
 hysteria, occasional cataleptoid attacks, with visionar}^ and delirious 
 states. The patient is very easily brought into a state of somnambulism 
 by hypnotic influence, and in this condition is susceptible to all possible 
 suggestions. (Personal case. FriedreiclVs Blatter, 1886, Heft 1.) 
 
 4. Androgijny and Gynandry. — Forming direct transitions 
 from the foregoing groups are those individuals of contrary sex- 
 uahty in whom not only the character and all the feelings are in 
 accord with the ahnormal sexual instinct, but also the skeletal 
 form, the features, voice, etc. ; so that the individual approaches 
 the opposite sex anthropologically, and in more than a psychical 
 and psycho-sexual way. This anthropological form of the cere- 
 bral anomaly apparently represents a very high degree of degen- 
 eration ; but that this variation is based on an entirely different 
 ground than the teratological manifestation of hermaphroditism, 
 in an anatomical sense, is clearly shown by the fact that thus far, 
 in the domain of contrary sexuality, no transitions to hermaph- 
 roditic malformation of the genitals have been observed. The 
 genitals of these persons always prove to be fully differentiated
 
 ANDROGYNY AND GYNANDRY. 305 
 
 sexually, though not infrequently there are present anatomical 
 signs of degeneration (epispadiasis, etc.), in the sense of arrests 
 of development in organs that are otherwise well differentiated. 
 
 There is yet wanting a sufficient record of cases belonging 
 to this interesting group of women in masculine attire with mas- 
 culine genitals, and men in feminine dress with the sexual or- 
 gans of the female. Every experienced observer of his fellow-men 
 remembers masculine persons that were very remarkable for their 
 womanish character and type (wide hips, form rounded by 
 abundant development of adipose tissue, absence or insufficient 
 development of beard, feminine features, delicate complexion, 
 falsetto voice, etc.) ; and, on the other hand, women that, by 
 reason of build, pelvis, gait, attitude, heavy and decidedly 
 masculine features, rough and deep voice, etc., had little to 
 remind one of femininity. 
 
 We have already met some indications of such an anthropo- 
 logical transformation in foregoing groups, as in Case 106, 
 where the woman had the feet of a man; and in Case 112, 
 where there was development of mammae and production of 
 milk during puberty. 
 
 In persons belonging to the fourth group, and in certain 
 ones in the third, forming transitions to the fourth, there seems 
 to be a feeling of shame (sexual) toward persons of the same 
 sex, and not toward those of the opposite sex. 
 
 Case 129. Androgyny. Mr. v. H., aged 30, single; of neuropathic 
 mother. Nervous and mental diseases are said not to have occurred in 
 the patient's family, and his only brother is said to be mentally and 
 physically completely normal. The patient developed tardily physically, 
 and, therefore, spent much of his time at the sea-shore and climatic 
 resorts. From childhood he was of neuropathic constitution, and, accord- 
 ing to the statements of his relatives, unlike other boys. His disinclina- 
 tion for masculine pursuits and his preference for feminine amusements 
 were early remarked. Thus he avoided all boyish games and gymnastic 
 exercises, while doll-play and feminine occupations were particularly 
 pleasing to him. Thereafter he developed well physically, and escaped 
 severe illnesses, Init he remained mentally abnormal, incapable of an 
 earnest aim in life, and decidedly feminine in thought and feeling. 
 
 In his seventeenth year pollutions occurred, became more frequent, 
 and finally took place during the day ; so that the patient grew weak, and 
 
 20
 
 306 PSYCHOPATHIA SEXUALIS. 
 
 manifested various nervous disturbances. Symptoms of neurasthenia 
 spinalis made tlieir appearance, and have lasted up to the last few years, 
 but they have become milder with the decrease in the number of pollu- 
 tions. Onanism is denied, but is very probable. An indolent, effeminate, 
 dreamy habit of thought has become more and more noticeable ever since 
 puberty. All efforts to induce the patient to take up an earnest pursuit 
 in life were vain. His intellectual functions, though formally quite 
 undisturbed, were never equal to the motive of an independent character, 
 and the higher ideals of life. He remained dependent, an overgrown 
 child ; and nothing more clearly indicated his original abnormal condi- 
 tion than an actual incapability to take care of money, and his own con- 
 fession that he had no ability' to use mone}- reasonably; that as soon as 
 he had money he wasted it for curios, toilet-articles, and the like. 
 
 Incapable as he was of a reasonable use of money, the patient was 
 nd more capable of leading a social existence; indeed, he was incapable 
 of gaining an insight into its significance and value. 
 
 He learned very poorl}^, spending his time in toilettes and artistic 
 nothings, particularly in painting, for which he evinced a certain capa- 
 bility ; but in this direction he accomplished nothing, since he was 
 wanting in perseverence. He could not be brought to take up any 
 earnest thought ; he had a mind only for externals, was alwaj-s distracted, 
 and serious things quickl}' wearied him. Preposterous acts, senseless 
 journeys, waste of money, and debts repeatedly occur throughout the 
 course of his later life; and even for these positive faults in his life he 
 was wanting in understanding. He was self-willed and intractable, and 
 never did well as soon as an attempt was made to put him on his feet and 
 point out to him his own interests. 
 
 With these manifestations of an original abnormal and defective 
 mind, there were notable indications of perverse sexual feeling, which 
 were also indicated in the somatic habitus of the patient. Sexually, the 
 patient felt like a woman toward men, and had inclinations toward peoi)le 
 of his own sex, with indifference, if not actual disinclination, for females. 
 
 In his twenty-second 3'ear it is asserted that he had sexual inter- 
 course with women, and was able to perform the act of cohabitation nor- 
 malij' ; but, partly on account of increase of neurasthenic symptoms 
 which was occasional after coitus, and partly on account of fear of infec- 
 tion, — but really by reason of a want of satisfaction, — he soon ceased to 
 induloe in such intercourse. Concernino- his abnormal sexual condition, 
 he is not quite clear; he is conscious of an inclination toward the male 
 sex, but confesses, only in a shame-faced way, that he has certain pleasur- 
 able feelings of friendship for masculine individuals, which, however, are 
 not accompanied b^' any sensual feelings. The female sex he does not 
 exactly abhor ; he could even bring himself to marry a woman who could 
 have an attraction for him, by means of similarity in artistic tastes, if he 
 could but be freed from conjugal duties, which were unpleasant to him,
 
 ANDROGYNY AND GYNANDRY. 307 
 
 and the performance of which made him tired and weak. He denied 
 having had sexual intercourse with men, but his blushing and embarrass- 
 ment, and, still more, an occurrence iu N., where the patient, some time 
 before, provoked a scandal by attempting to have sexual intercourse with 
 youths, gave him the lie. 
 
 Too, his external appearance, habitus, form, gestures, manners, and 
 dress are remarkal)le, and decidedly recall the feminine form and charac- 
 teristics. The patient, however, is over middle height, but thorax and 
 pelvis are decidedly of feminine form. The bod}' is rich in fat ; the skin is 
 well cared for, delicate, and soft. This impression of a woman in mascu- 
 line dress is further increased by a thin growth of hair on the face, which 
 is shaven, with the exception of a small moustache; bj^ the mincing gait; 
 the shy, effeminate manner; the feminine features; the swimming, neuro- 
 pathic expression of the eyes; the traces of powder and paint; the cur- 
 tailed cut of the clothing, with the bosom-like prominence of the upper 
 garments; the fringed, feminine cravat; and the hair brushed down 
 smoothly from the brow to the temples. The physical examination makes 
 undoubted the feminine form of the body. The external genitals are well 
 developed, though the left testicle has remained in the canal; the growth 
 of hair on the mons veneris is thin, and the latter is unusually rich in fat 
 and prominent. The voice is high, and without masculine timbre. 
 
 Too, the occupation and manner of thought of v. H. are decidedly 
 feminine. He has a boudoir and a well-supplied toilet-table, with which 
 he spends manj" hours in all kinds of arts for beautifying himself. He 
 abhors the chase, practice with arms, and such masculine pursuits, and 
 calls himself an seathete ; speaks with preference of his paintings and 
 attempts at poetry. He is interested in feminine occupations, which — 
 e.gr., embroidery — he engages in, and calls his greatest pleasure. He could 
 spend his life in an artistic and aesthetic circle of ladies and gentlemen, in 
 conversation, music, and aesthetics. His conversation is preferably about 
 feminine things, — fashions, needlework, cooking, and household work. 
 
 The i)atient is well nourished, but anjemic. He is of neuropnthi(! 
 constitution, and presents symptoms of neurasthenia, which are main- 
 tained by a bad manner of life, lying abed, living in-doors, and effemi- 
 nateness. He complains of occasional pain and pressure in the head, and 
 habitual obstipation. He is easily frightened ; complains of occasional 
 lassitude and fatigue, and drawing pains in the extremities, in the direc- 
 tion of the lumbo-abdominal nerves. After pollutions, and regularly 
 after eating, he feels tired and relaxed ; he is sensitive to pressure over 
 the spinous processes of the dorsal vertebr;^, as also to pressure along 
 accessible nerves. He feels peculiar sympathies and antipathies for cer- 
 tain persons, and, when he meets people for whom he has an antipathy, 
 he falls into a condition of peculiar fear and confusion. His pollutions, 
 though now they occur but seldom, are pathological, in that they occur 
 by day, and are unaccompanied by any sensual excitement.
 
 308 PSTCHOPATHIA SEXUALIS. 
 
 Opinion: 1. Mr. v. H., according to all observations and reports, is 
 mentally an abnormal and defective person, and that, in fact, ah origine. 
 His contrary sexual instinct represents a part of his abnormal phj'sical 
 and mental condition. 
 
 2. This condition, in that it is congenital, is incurable. There 
 exists defective organization of the highest cerebral centres, which renders 
 him incapable of leading an independent life, and of obtaining a position 
 in life. His perverse sexual instinct prevents him from exercising 
 normal sexual functions ; and this is attended by all the social conse- 
 quences of such an anomnly, and the danger of satisfaction of perverse 
 impulses arising out of his abnormal organization, with consequent 
 social and legal conflicts. Fear of the latter, however, cannot be great, 
 since the (perverse) sexual impulse of the patient is weak. 
 
 3. Mr. V. H,, in tlie legal sense of the word, is not irresponsible, and 
 neither fit for, or in need of, treatment in a hospital for the insane. It is 
 possible for him — though but an overgrown child, and incapable of per- 
 sonal independence — to live in society, though under the care and guid- 
 ance of normal individuals. Too, to a certain extent, it is possible for 
 him to respect the laws and restrictions of societ}^, and to judge his own 
 acts ; but, with respect of possible sexual errors and conflicts with crimi- 
 nal laws, it must be emphasized that his sexual instinct is abnormal, 
 having its origin in organic pathological conditions ; and this circum- 
 stance should eventually be used in his favor. On account of his notorious 
 lack of independence, he cannot be discharged from parental care or 
 guardianship, inasmuch as otherwise he would be ruined financially. 
 
 4. Mr. V, H. is also phj^sically ill. He presents signs of slight 
 anjemia and of neurasthenia spinalis. A rational regulation of his man- 
 ner of life and a tonic regimen, and, if possible, hydro-therapeutic treat- 
 ment, seem necessary. The suspicion that this trouble has its origin in 
 early masturbation should be entertained, and the possibilit}^ of the 
 existence of spermatorrha?a, that is of importance etiologically and thera- 
 peutically, lies near. (Personal case. Zeitschv. f. Psychiatrie.) 
 
 Case 130. Miss X.,aged 38, consulted me, late in the fall of 1881, on 
 account of severe spinal irritation and obstinate sleeplessness, in combat- 
 ing which she had become addicted to morphine and chloral. Her mother 
 and sister were nervous sufterers, but the rest of the family were healthy. 
 The trouble dated from a fall on her back in 1872, at which time the 
 patient was terribly frightened, though, when a girl, she had been subject 
 to muscular cramps and hysterical symptoms. Following this shock, 
 a neurasthenic and hysterical neurosis developed, with predominating 
 spinal irritation and sleeplessness. Episodically, h3'sterical paraplegia, 
 lasting as long as eight months, and hysterical hallucinatory delirium, 
 with convulsive attacks, occurred. In the course of this, symptoms of 
 morphinism were added. A stay of some months in the hospital relieved 
 the latter, and considerably^ improved the neurasthenic neurosis, in the
 
 ANDROGYNY AND GYNANDRT. 309 
 
 treatment of which general faradization exerted a remarkably favorable 
 influence. 
 
 Even at the first meeting, the patient produced a remarkable im- 
 pression by reason of her attire, features, and conduct. She wore a 
 gentleman's hat, her hair closely cut, eye-glasses, a gentleman's cravat, a 
 coat-like outer garment of masculine cut that reached well down over her 
 gown, and boots with high heels. She had coarse, somewhat masculine 
 features ; a harsh, deep voice ; and made rather the Impression of a man in 
 female attire than that of a lady, if one but overlooked the bosom and 
 the decidedly feminine form of the pelvis. During the long time that 
 she was observed, there were never signs of erotocism. When questioned 
 concerning her attire, she would only respond that the style she chose 
 suited her better. Gradual!}' it was ascertained from her that, even when 
 she was a small girl, she Imd had a preference for horses and masculine 
 pursuits, and never any interest in feminine occupations. Later she 
 developed a particular pleasure in reading, and prepared herself to be a 
 teacher. Dancing had never pleased her ; it had always seemed silly to 
 her. Too, the ballet had never interested her. Her greatest pleasure 
 had always been in the circus. Until her sickness, in 1812, she had 
 neither had inclination for persons of the opposite nor for those of her 
 own sex. From that time she had, what was remarkable to herself, a 
 peculiar friendship for females, particularly for 3'oung ladies ; and she 
 had a desire, and satisfied it, to wear hats and coats of masculine st3ie. 
 Since 1869, besides, she had worn her hair short, and parted it on the 
 side, as men do. She asserts that she was never sensually excited in the 
 company of men, but tliat her friendship and self-sacrifice for sj^mpathetic 
 ladies was unbounded ; while from that time she also experienced repug- 
 nance for gentlemen and their societ}^ 
 
 Her relatives report that, before 1812, the patient had a proposal of 
 marriage, which she refused; and that when she returned from a sojourn 
 at a watering-place, in 1814, she was sexually changed, and occasionally 
 showed that she did not regard herself as a female. 
 
 Since that time she would associate only with ladies, and has had a 
 kind of love-relation with one or another, and made remarks which indi- 
 cated that she looked upon herself as a man. This predilection for 
 women ^as decidedly more than mere friendship, since it expressed itself 
 in tears, jealousy, etc. 
 
 When, in 1814, she was stopping at a watering-place, a 3'oung 
 lady, who took her for a man in disguise, fell in love with her. When 
 this lady married, later, the patient was for a long time depressed, 
 and spoke of unfaithfulness. Moreover, since her sickness, her relatives 
 were struck by her desire for masculine attire, her masculine conduct, and 
 disinclination for feminine pursuits ; while previously, at least sexually, 
 she had presented nothing unusual. 
 
 Further investigations showed that the patient had a love-relation,
 
 310 PSTCHOPATHIA SEXUALIS. 
 
 which was not purely platonic, with the lady described in Case 118 ; and 
 that she wrote her affectionate letters like those of a lover to his beloved. 
 In 1881 I again saw the patient in a sanitarium, where she had been 
 placed on account of hystero-epileptic attacks, spinal irritation, and 
 morphinism. The contrary sexual feeling existed unchanged, and only 
 by the most careful watching was the patient kept from improper advances 
 toward her fellow-patients. 
 
 Her condition remained quite unchanged until 1889. Then the 
 patient began to fail, and she died of " exhaustion," in August, 1889. 
 The autopsy showed, in the vegetative organs, amyloid degeneration of 
 the kidneys, fibroma of the uterus, and cyst of the left ovary. The frontal 
 bone was much thickened, uneven on the inner surface, with numerous 
 exostoses ; dura adherent to vault of cranium. Long diameter of skull, 
 175 millimetres; lateral diameter, 148 millimetres; weight of the oedema- 
 tous, but not atrophied, brain, 1175 grammes. The meninges delicate, 
 easil}^ removed. Cortex pale. Convolutions broad, not numerous, 
 regularly arranged. Nothing abnormal in cerebellum and great ganglia. 
 
 Case 131. Gynmidry} History: On November 4, 1889, the step- 
 father of a certain Count Saudor Y. complained that the latter had 
 swindled him out of 800f , under the pretense of requiring a bond as 
 secretary of a stock company. It was ascertained that Sandor had 
 entered into matrimonial contracts and escaped from the nuptials in the 
 spring of 1889 ; and, more than this, that this ostensible Count Sandor 
 was no man at all, but a woman in male attire, — Sarolta (Charlotte), 
 Countess Y. 
 
 S. was arrested, and, on account of deception and forgerj" of public 
 documents, brought to examination. At the first hearing S. confessed 
 that she was born on Sept. 6, 1866; that she was a female. Catholic, 
 single, and worked as an authoress under the name of Count Sandor Y. 
 
 From the autobiography of this man-woman I have gleaned the 
 following remarkable facts that have been independently confirmed : — 
 
 S. comes of an ancient, noble, and highly-respected famil}^ of Hun- 
 gary, in which there haA'e been eccentricity and family peculiarities. A 
 sister of the maternal grandmother was hysterical, a somnambulist, and 
 lay seventeen jears in bed, on account of fancied pai'alysis. A second 
 great-aunt spent seven years in bed, on account of a fancied fatal, illness, 
 and at the same time gave balls. A third had tlie whim that a certain 
 table in her salon was bewitched. If anything were laid on this table, she 
 would become greatl^^ excited and cry, " Bewitched I bewitched 1" and run 
 with the object into a room which she called the "Black Chamber," and 
 the key of Avhich she never let out of her hands. After the death of this 
 lady, there were found in this chamber a number of shawls, ornaments, 
 
 1 Comp. the expert medical opinion of this ease, by Dr. Birnbacher, in Friedreich's 
 Blatter f. ger. Med., 1891, H. 1.
 
 ANDROGYNY AND GYNANDRY. 311 
 
 bank-notes, etc. A fourtli great-aunt, during two 3^ears, did not leave 
 her room, and neither washed herself nor combed her hair ; tlien she 
 again made her appearance. All these ladies were, nevertheless, intel- 
 lectual, finely educated, and amiable. 
 
 S.'s mother was nervous, and could not bear the light of the moon. 
 
 From her father's family it is said she had a trace too much. One 
 line of the family gave itself up almost entirely to spiritualism. Two 
 blood-relations on the father's side shot themselves. The majority of her 
 male relatives are unusually talented ; the females are decidedly narrow 
 and domestic. S.'s lather had a high position, which, however, on account 
 of his eccentricity and extravagance (he wasted over a million and a half), 
 he lost. 
 
 Among many foolish things that her father encouraged in her was 
 the fact that he brought her up as a boy, called her Sandor, allowed her 
 to ride, drive, and hunt, admiring her muscular energy. 
 
 On the other hand, this foolish father allowed his second'son to go 
 about in female attire, and had him brought up as a girl. This farce 
 ceased in his fifteenth year, when the son was sent to a higher school. 
 
 Sarolta-Sandor remained under her father's influence till her twelfth 
 year, and then came under the care of her eccentric maternal grand- 
 mother, in Dresden, b}^ whom, when the masculine play became too ob- 
 vious, she was placed in an Institute, and made to wear female attire. 
 
 At thirteen she had a love-relation with an English girl, to whom 
 she represented herself as a boy, and ran away with her. 
 
 Sarolta returned to her mother, who, however, could do nothing, and 
 was compelled to allow her daughter to again become Sandor, wear male 
 clothes, and, at least once a year, to fall in love with persons of her own 
 sex. 
 
 At the same time, S. received a careful education, and made long 
 journeys with her father, — of course, always as a young gentleman. She 
 early became independent, and visited cafes^ even those of doubtful char- 
 acter, and, indeed, boasted one day that in a brothel she had had a girl 
 sitting on each knee. S. was often intoxicated, had a passion for mascu- 
 line sports, and was a very skillful fencer. 
 
 She felt herself drawn particularly toward actresses, or others of 
 similar position, and, if possible, toward those who were not ver}' young. 
 She asserts tliat she never had any inclination for a young man, and that 
 she has felt, from year to 3'ear, an increasing dislike for young men. 
 
 "I preferred to go into the society of ladies with ugly, ill-favored 
 men, so that none of them could put me in the shade. If I noticed that 
 any of the men awakened tlie sjanpathies of the ladies, I felt jealous. I 
 preferred ladies who were bright and prettj' ; I could not endure them 
 if they were fat or much inclined toward men. It delighted me if the 
 passion of a lady was disclosed under a poetic veil. All immodest}^ in a 
 woman was disgusting to me. I had an indescribable aversion for female
 
 312 PSYCHOPATHIA SEXUALIS. 
 
 attire, — indeed, for everything feminine, — but only in as ftxr a,s it con- 
 cerned nie ; for, on tbe other hand, I was all enthusiasm for the beau- 
 tiful sex." 
 
 During the last ten j'ears S. had lived almost constantl}'^ away from 
 her relatives, in the guise of a man. She had had many liaisons with 
 ladies, traveled much, spent much, and made debts. 
 
 At the same time, she carried on literary work, and was a valued 
 collaborator on two noted journals of the Capital. 
 
 Her passion for ladies was very changeable ; constancy in love was 
 entirely wanting. 
 
 Onl}' once did such a liaison last three years. It was years before 
 that S., at Castle G., made the acquaintance of Emma E., who was ten 
 years older than herself. She fell in love with her, made a marriage- 
 contract with her, and they lived together, as man and wife, for three 
 years at the Capital. 
 
 A new love, which S. regarded as a fate, caused her to sever her 
 matrimonial relations with E. The latter would not have it so. Only 
 with the greatest sacrifice was S. able to purchase her freedom from E., 
 who, it is reported, still looks upon herself as a divorced wife, and regards 
 herself as the Countess Y. I Tiiat S. also had the power to excite 
 passion in other women is shown by the fact that when she (before her 
 marriage with E.) had grown tired of a Miss D., after having spent 
 thousands of guldens on her, she was threatened with shooting by D. if 
 she should become untrue. 
 
 It was in the summer of 1887, while at a watering-place, that S. 
 made the acquaintance of a distinguished official's family. Immediatel}' 
 she fell in love with the daughter, Marie, and her love was returned. 
 
 Her mother and cousin tried in Aain to break up this affair. During 
 the winter, the Jovers corresponded zealousl}'. In April, 1888, Count S. 
 paid her a visit, and in Ma}', 1889, attained her wish; in that Marie — 
 who, in the meantime, had given up a position as teacher — became her 
 bride in the presence of a friend of her lover, the ceremony being per- 
 formed in an arbor, by a false priest, in Hungary. S., with her friend, 
 forged the marriage-certificate. The pair lived happily, and, without the 
 interference of the step-father, this false marriage, probably, would have 
 lasted much longer. It is remarkable that, during the comparatively 
 long existence of the relation, S. was able to deceive completely the 
 family of her bride with regard to her true sex. 
 
 S. was a passionate smoker, and in all respects her tastes and pas- 
 sions Avere masculine. Her letters and even legal documents reached her 
 under the address of " Count S." Slie often spoke of having to drill. 
 From remarks of the father-in-law, it seems that S. (and she afterward 
 confessed it) knew how to imitate a scrotum with handkerchiefs or gloves 
 stuffed in the trousers. The father-in-law also, on one occasion, noticed 
 something like an erected member on his future son-in-law (probably a
 
 ANDROGYNY AND GYNANDRY. 313 
 
 priapus). She also occasionally remarked that she was obliged to wear a 
 suspensory bandage while riding. The fact is, S. wore a bandage around 
 the bod}^ possibly as a means of retaining a priapus. 
 
 Though S. often had hersell" shaved pro forma^ the servants in the 
 hotel whei'e she lived were convinced that she was a woman, because the 
 chambermaids found traces of menstrual blood on her linen (which S. 
 explained, however, as hsemorrhoidal) ; and, on the occasion of a bath 
 which S. was accustomed to take, they claimed to have convinced them- 
 selves of her real sex by looking through the key-hole. 
 
 The family of Marie make it seem probable that she for a long time 
 was deceived with regard to the true sex of her false bridegroom. The 
 following passage in a letter from Marie to S., August 26, 1880, speaks 
 in favor of the incredible simplicity and innocence of this unfortunate 
 girl : " I don't like children any more, but if I had a little Bezerl or 
 Patscherl by vay Sandi, — ah, what happiness, Sandi minel" 
 
 A large number of manuscripts allow conclusions to be drawn 
 concerning S.'s mental individuality. The chirography possesses the 
 character of firmness and certainty. The characters are genuinely mas- 
 culine. The same peculiarities repeat themselves everywhere in their 
 contents, — wild, unbridled passion ; hatred and resistance to all that 
 opposes the heart thirsting for love ; poetical love, which is not marred 
 by one ignoble blot ; enthusiasm for the beautiful and noble ; appreciation 
 of science and the arts. 
 
 Her writings betray a wonderfullj'^ wide range of reading in classics 
 of all languages, in citations from poets and prose writers of all lands. 
 The evidence of those qualified to judge literary work shows that S.'s 
 poetical and literary ability is by no means small. The letters and 
 writings concerning the relation with Marie are psychologically worthy 
 of notice. 
 
 S. speaks of the happiness there was for her when by M.'s side, 
 and expresses boundless longing to see her beloved, if only for a moment. 
 After such a happiness, she could have but one wish, — to exchange her 
 cell for the grave. The bitterest thing was the knowledge that now 
 Marie, too, hated her. Hot tears, enough to drown herself in, she had 
 shed over her lost liappiness. Whole quires of paper are given up to 
 the apotheosis of this love, and reminiscences of the time of the first 
 love and acquaintance. 
 
 S. complained of her heart, that would allow no reason to direct it ; 
 she expressed emotions which were such as onl}^ could be felt, — not sim- 
 ulated. Then, again, there were outl)reaks of most silly passion, with 
 the declaration that she could not live without Marie. " Thy dear, sweet 
 voice ; the voice whose tone perchance would raise me from the dead ; 
 that has been for me like the warm breath of Paradise I Thy presence 
 alone were enough to alleviate my mental and moral anguish. It was a 
 magnetic stream ; it was a peculiar power your being exercised over
 
 314 PSYCHOPATHIA SEXUALIS. 
 
 mine, which I cannot quite define ; and, therefore, I cling to that ever- 
 true definition : I love you because I love you. In the night of sorrow 
 I had but one star, — the star of Marie's love. That star has lost its 
 light; now there remains but its shimmer, — the sweet, sad memory 
 which even lights with its soft ray the deepening night of death, — a ray 
 
 of hope." 
 
 This writing ends with the apostrophe : " Gentlemen, you learned in 
 the law, psychologists and pathologists, do me justice! Love led me to 
 take the step I took ; all my deeds were conditioned by it. God put it 
 
 in my heart. 
 
 " If He created me so, and not otherwise, am I then guilty ; or is it 
 the eternal, incomprehensible way of fate ? I relied on God, that one day 
 my emancipation would come; for m}^ thought was only love itself, 
 which is the foundation, the guiding principle, of His teaching and His 
 kingdom. 
 
 "O God, Thou All-pitying, Almighty One! Thou seest my dis- 
 tress ; Thou knowest how I sufter. Incline Thyself to me ; extend Thy 
 helping hand to me, deserted by all the world. Only God is just. How 
 beautifully does Victor Hugo describe this in his ' Legendes du Sifecle ' I 
 How sad do Mendelssohn's words sound to me : ' Nightly in dreams I 
 
 see thee 'I" 
 
 Though S. knew that none of her writings reached her lover, she 
 did not grow tired writing of her pain and delight in love, in page after 
 page of deification of Marie. And to induce one more pure flood of 
 tears, on one still, clear summer evening, when the lake was aglow with 
 the setting sun like molten gold, and the bells of St. Anna and Maria- 
 Worth, blending in harmonious melancholy, gave tidings of rest and 
 peace, she wrote : " For that poor soul, for this poor heart that beat^ 
 for thee till the last breath." 
 
 Personal Examination : The first meeting which the experts had 
 with S. was, in a measure, a time of embarrassment to both sides; for 
 them, because perhaps S.'s somewhat dazzling and forced masculine car- 
 riage impressed them ; for her, because she thought she was to be marked 
 with the stigma of moral insauit3^ She had a pleasant and intelligent 
 face, which, in spite of a certain delicacy of features and diminutive- 
 ness of all its parts, gave a decidedly masculine impression, had it not 
 been for the absence of a moustache. It was even difficult for the experts 
 to realize that they were concerned with a woman, despite the fact of 
 female attire and constant association ; while, on the other hand, inter- 
 course with the man Sandor was much more free, natural, and apparently 
 correct. The culprit also felt this. She immediately- became more open, 
 more communicative, more free, as soon as she was treated like a man. 
 
 In spite of her inclination for the female sex, which had been 
 present from her earliest years, she asserts that in her thirteenth 3'ear 
 she first felt a trace of sexual feeling, which expressed itself in kisses,
 
 ANDROGYNY AND GYNANDRY. 315 
 
 embraces, and caresses, with sensual pleasure, and this on the occasion 
 of her elopement with tlie red-haired English girl from the Dresden 
 Institute. At that time feminine forms exclusively appeared to her in 
 dream-pictures, and ever since, in sensual dreams, she has felt herself in 
 the situation of a man, and occasionally, also, at such times, experienced 
 ejaculation. 
 
 She knows nothing of solitary or mutual onanism. Such a thing 
 seemed very disgusting to her, and not conducive to manliness. She 
 had, also, never allowed herself to be touched ad genitalia by others, 
 because it would have revealed her great secret. The menses began at 
 seventeen, but were always scanty, and without pain. It was plain to 
 be seen that S. had a horror of speaking of menstruation ; that it was a * 
 thino; repuonant to her masculine consciousness and feelin<>\ She recoa^- 
 nized the abnormality of her sexual inclinations, but had no desire to 
 have them changed, since in this perverse feeling she felt both well and 
 happy. The idea of sexual intercourse with men disgusted her, and she 
 also thought it would be impossible. 
 
 Her modesty was so great that she would prefer to sleep among 
 men rather than among women. Thus, when it was necessarj^ for her to 
 answer the calls of nature or to cliange her linen, it was necessary for her 
 to ask her companion in the cell to turn her face to the window, that she 
 might not see her. 
 
 When occasionally S. came in contact with this companion, — a 
 woman from the lower walks of life, — she experienced a sexual excite- 
 ment that made her blush. Indeed, without being asked, S. related that 
 she was overcome with actual fear when, in her cell, she was compelled 
 to force herself into the unusual female attire. Her only comfort 
 was, that she was at least allowed to keep a shirt. Remarkable, and 
 what also speaks for the significance of olfactory' sensations in her vita 
 sexualis, is her statement that, on the occasions of Marie's absence, she 
 had sought those places on which Marie's head was accustomed to 
 repose, and smelled of them, in order to experience the delight of inhal- 
 ing the odor of her hair. Among women, those who are beautiful, or 
 voluptuous, or quite young do not particularly interest her. The physical 
 charms of women she makes subordinate. As by magnetic attraction, 
 she feels herself drawn to those between twenty-four and thirty. She 
 found her sexual satisfaction exclusivel}' in corpora feminae (never in 
 her own person), in the form of raannstupration of the beloved woman, 
 or cunnilingus. Occasionally she availed herself of a stocking stuffed 
 with oakum as a priapus. These admissions were made only unwillingl}' 
 by S., and with apparent shame; just as in her writings, immodesty or 
 cynicism are never found. 
 
 She is religious, has a lively interest in all that is noble and beau- 
 tiful, — men excepted, — and is very sensitive to the opinion others ma}'^ 
 entertain of her morality.
 
 316 PSYCHOPATHIA SEXUALIS. 
 
 She deeply regrets that in her passion she made Marie unhappy, 
 and regards her sexual feelings as perverse, and such a love of one woman 
 for another, among normal individuals, as morall}' reprehensible. She 
 has great literary talent and an extraordinary" memor3^ Her only weak- 
 ness is her great frivolity and her incapability to manage money and 
 property reasonably. But she is conscious of this weakness, and does 
 not care to talk about it. 
 
 She is 153 centimetres tall, of delicate skeleton, thin, but remark- 
 ably muscular on the breast and thighs. Her gait in female attire is 
 awkward. Her movements are powerful, not unpleasing, though they 
 are somewhat masculine, and lacking in grace. She greets one with a 
 ' firm pressure of the hand. Her whole carriage is decided, firm, and 
 somewhat self-conscious. Her glance is intelligent; mien somewhat 
 diffident. Feet and hands remarkably small, having remained in an 
 infantile stage of development. Extensor surfaces of the extremities 
 remarkably well covered with hair, while there is not the slightest trace 
 of beard, in spite of all shaving experiments. The hips do not corre- 
 spond in any way with those of a female. Waist is wanting. The pelvis 
 is so slim, and so little prominent, that a line drawn from the axilla to 
 the corresponding knee is straight, — not curved inward b}' a waist, or 
 outward by the pelvis. The skull is sliglitly oxycephalic, and in all its 
 measurements falls below the average of the female skull by at least one 
 centimetre. 
 
 The circumference of the head is 52 centimetres ; the occipital half- 
 circumference, 24 centimetres ; the line from ear to ear, over the vertex, 
 23 centimetres ; the anterior half-circumference, 28.5 centimetres ; the 
 line from glabella to occiput, 30 centimetres ; the ear-chin line, 26.5 
 centimetres; long diameter, 17 centimetres; greatest lateral diameter, 
 13 centimetres; diameter at auditory nieati, 12 centimetres; zygomatic 
 diameter, 11.2 centimetres. The upper jaw projects strikingly, its alveolar 
 process projecting beyond the under jaw about 0.5 centimetre. The 
 position of the teeth is not fullj'^ normal ; the right upper canine has not 
 developed. Mouth remarkably small. Ears prominent ; lobes not diffei'- 
 entiated, passing over into the skin of the cheek. Hard palate narrow 
 and high ; voice rough and deep ; mamma? fairl}" developed, soft, and 
 without secretion. Mons veneris covered with thick, dark hair. Gen- 
 itals completel}' feminine, without trace of hermaphroditic appearance, 
 but at the stage of development of those of a ten-year-old girl. The labia 
 majora touch each other almost completely ; labia minora have a cock's- 
 comb-like form, and project under the labia majora. The clitoris is small, 
 and very sensitive. Frenulum delicate ; perineum very narrow ; introitus 
 vaginse narrow ; mucous membrane normal. Hymen wanting (probabl}^ 
 congenitally) ; likewise, the caruncula? myrtiformes. Vagina so narrow 
 that the insertion of a membrum virile would be impossible, and it is also 
 very sensitive ; certainly coitus had not taken place. Uterus is felt,
 
 ANDROGYNY AND GYNANDRY. 317 
 
 through the rectum, to be about tlie size of a wahiut, immovable, and 
 retroflected. 
 
 The pelvis appears generally narrowed (dwarf-pelvis), and of decid- 
 edly masculine type. The distance between anterior superior spines is 
 22.5 centimetres (instead of 26.3 centimetres). Distance between the 
 crests of the ilii, 2G.5 centimetres (instead of 29.3 centimetres) ; between 
 the trochanters, 2*7.7 centimetres (31); the external conjugate diameter, 
 17.2 centimetres (19 to 20) ; therefore, pri?sumably, the internal conju- 
 gate would be 7.7 centimetres (10.8). On account of narrowness of the 
 pelvis, the direction of the thighs is not convergent, as in a woman, but 
 straight. 
 
 The opinion given showed that in S. there was a congenitally 
 abnormal inversion of the sexual instinct, which, indeed, expressed 
 itself, anthropologically, in anomalies of development of the body, 
 depending upon great hereditary taint ; further, that the criminal acts 
 of S. had their foundation in her abnormal and irresistible sexualit}". 
 
 S.\s characteristic expressions — " God put love in my heart. If He 
 created me so, and not otherwise, am I, then, guilty' ; or is it the eternal, 
 incomprehensible way of fate?" — are really justified. 
 
 The court granted pardon. The " countess in male attire," as she 
 was called in the newspapers, returned to her home, and again gave her- 
 self out as Count Sandor. Her only distress is her lost happiness with 
 her beloved Marie. '**^)C^ 
 
 A married woman, in Brandon, Wisconsin, whose case is reported 
 by Dr. Kiernan ( The Medical Standard^ 1888, November and December), 
 was more fortunate. She eloped, in 1883, with a young girl, married her, 
 and lived with her as husband undisturbed. 
 
 An interesting " historical " example of androgyny is a case reported 
 by Spitzka {Chicago Medical Review^ August 20, 18^1). It was that of 
 Lord Cornbury, Governor of New York, who lived in the reign of Queen 
 Anne. He was apparently affected with moral insanity ; was terribly 
 licentious, and, in spite of his high position, could not keep himself from 
 going about in the streets in female attire, coqvietting with all the allure- 
 ments of a prostitute. 
 
 In a picture of him that has been preserved, his narrow brow, 
 asymmetrical face, feminine features, and sensual mouth at once attract 
 attention. It is certain that he never actually regarded himself as a 
 woman. 
 
 Moreover, in individuals afflicted with contrary sexual 
 instinct, in themselves, the perverse sexual feeling and inclina- 
 tion may be complicated with other perverse manifestations. 
 Thus here, with reference to the activity of the instinct, there
 
 318 PSYCHOPATHIA SEXUALIS. 
 
 may be acts quite analogous to acts indulged in by individuals 
 in perverse satisfaction of the instinct, but who, at the same 
 time, have a natural inclination toward persons of the opposite 
 sex. 
 
 Owing to the circumstance that abnormally increased sex- 
 uality is almost a regular accompaniment of contrary sexual 
 feeling, acts of lustful crVielty in the satisfaction of libido are 
 easily possible. A remarkable example of this is the case of 
 Zastrow (Casper-Liman, 7. Auflage, Bd. i, p. 190; ii, p. 487), 
 who bit one of his victims (a boy), tore his prepuce, slit the anus, 
 and strangled the child. 
 
 Z. came of a psychopathic grandfather and melancholic mother. 
 His brother indulged in abnormal sexual pleasures, and committed 
 suicide. 
 
 Z. was a congenital urning, and in habitus and occupation mascu- 
 line. There was phimosis. Mentally, he was a weak, perverse, unsocial 
 man. He had horror feminge, and, in his dreams, he felt himself like a 
 woman toward a man. He was painfull}^ conscious of his want of normal 
 sexual feeling and his perverse instinct, and sought satisfaction in mutual 
 onanism, with frequent desire for pederasty. 
 
 Similar sadistic feelings of this kind, in those afflicted with 
 contrary sexual instinct, are found in some of tlie foregoing his- 
 tories (comp. Cases 107 and 108 of this edition, and Case 96 of 
 the sixth edition). But masochism also occurs (comp. Case 43, 
 sixth edition ; Cases 111 and 114 of this edition; and Case 3, in 
 the first edition of " Neue Forschungen "). 
 
 As examples of perverse sexual satisfaction dependent on contrary 
 sexual instinct, ma}^ be mentioned the Greek, who, as Athenaus reports, 
 was in love with a statue of Cupid, and defiled it, in the temple of Delphi ; 
 and besides the monstrous cases reported b^^ Tardieu (" Attentats," p. 
 272), the terrible one reported b}- Lombroso (" L'uomo delinquente," p. 
 200), of a certain Artusio, who wounded a boy in the abdomen, and abused 
 him sexually by means of the incisions. 
 
 Cases 86, 110, and 111, also, show that fetichism may also occur 
 with contrary sexual instinct.
 
 DIAGNOSIS AND PROGNOSIS. 319 
 
 DIAGNOSIS, PROGNOSIS, AND TUERAPY OF CONTRARY 
 
 SEXUAL INSTINCT. 
 
 While up to this time contrary sexual instinct has had but 
 an anthropological, clinical, and forensic interest for science, 
 now, as a result of the latest investigations, there is some 
 thought of therapy in this incurable condition, which so heavily 
 burdens its victims, socially, morally, and mentally. 
 
 A preparatory step for the application of therapeutic meas- 
 ures is the exact differentiation of the acquired from tlie con- 
 genital cases ; and among the latter, again, the assignment of 
 the colicrete case to its proper position in the categories that 
 have been established empirically. 
 
 The diagnostic differentiation of the acquired from the 
 congenital condition is made without difficulty in the early stages 
 of the anomaly. 
 
 If sexual inversion has already taken place, then the history 
 of the development of the case will throw light upon it. 
 
 The important decision, prognostically, as to whetlier the 
 contrary sexual instinct is congenital or acquired, can only be 
 made in such cases by means of the most minute details of the 
 history. 
 
 The establisliment of the fact that contrary sexual instinct 
 existed before indulgence in masturbation is of great importance 
 with reference to deciding wliether the anomaly is congenital or 
 not. In this, however, a difficulty arises, owing to the possibility 
 of imperfect localization of past events (illusions of memory). 
 
 For the presumption of acqidred contrary sexual instinct, 
 it is important to prove the existence of hetero-sexual instinct 
 before the beginning of solitary or mutual onanism. 
 
 In general, the acquired cases are characterized in that : — 
 
 1. The homo-sexual instinct appears secondarily, and 
 always may be referred to influences (masturbatic neurasthe- 
 nia, mental) which disturbed normal sexual satisfaction. It is, 
 however, probable that here, in spite of powerful sensual libido, 
 the feeling and inclination for the opposite sex are weak ah 
 origine, especially in a spiritual and aesthetic sense.
 
 320 PSYCHOPATHIA SEXUALIS. 
 
 2. The homo-sexual instmct, as long as inversio sexUalis 
 has not taken place, is looked upon, by the individual affected, 
 as vicious and abnormal, and yielded to only /ante de mieux. 
 
 3. The hetero-sexual instinct long remains predominant, 
 and the impossibility of its satisfaction gives pain. It weakens 
 in proportion as the homo-sexual feeling gains in strength. 
 
 On the other hand, in congenital cases (a) the homo-sexual 
 instinct is the one that occurs primarily, and becomes dominant 
 in the vita sexualis. It appears as the natural manner of satis- 
 faction, and also dominates the dream-life of the individual. 
 (/?) The hetero-sexual instinct fails completely, or, if it should 
 make its appearance during the life of the individual (psycho- 
 sexual hermaphroditism), it is still but an episodical phenomenon 
 which has no root in the mental constitution of the individual, 
 and is essentially but a means of satisfaction of sexual desire. 
 
 The differentiation of the above groups of congenital con- 
 trary sexuality from one another, and from the cases in which 
 the anomaly is acquired, will, after the foregoing, present no 
 difficulties. 
 
 The prognosis of the cases of acquired contrary sexual 
 instinct is, at all events, much more favorable than that of the 
 congenital cases. In the former, the occurrence of effemination 
 — the mental inversion of the individual, in the sense of per- 
 verse sexual feeling — is the limit beyond which there is no 
 longer hope of benefit from therapy. In the congenital cases, 
 the various categories established in this book form as many 
 stages of psycho-sexual taint, and benefit is prohahle only 
 within the category of the psycliical hermaphrodites, though 
 possible (vide the case of Schrenk-Notzing) in that of the urnings. 
 
 The prophylaxis of these conditions becomes thus the 
 more important, — for the congenital cases, prohibition of the 
 reproduction of such unfortunates ; for the acquired cases, pro- 
 tection from the injurious influences which experience teaches 
 may lead to the fatal inversion of the sexual instinct. 
 
 Numerous predisposed individuals meet this sad fate, be- 
 cause parents and teachers have no suspicion of the danger 
 which masturbation brings in its train to such children.
 
 THERAPY. 321 
 
 In many scliools and academies masturbation and vice are 
 actually cultivated. At present much too little attention is 
 given to the mental and moral peculiarities of the pupils. If 
 only the tasks are done, nothing more is asked. That many 
 pupils are thus ruined in body and soul is never considered. 
 In obedience to affected prudery, the vita sexualis is veiled 
 lioni the develo[)hig youth, and not the slightest attention given 
 to the excitations of his sexual instinct. How few family 
 physicians are ever called in, during the years of development 
 of children, to give advice to their patients that are often so 
 greatly predisposed ! 
 
 It is thought that all must be left to Nature; in the mean- 
 time, Nature rises in her power, and leads the helpless, unpro- 
 tected innocent into dangerous by-paths. 
 
 A more detailed treatment of this prophylactic side of the 
 subject is impossible liere.^ 
 
 To parents and teachers, the experiences detailed in this 
 work, and numerous scientific works on masturbation, give 
 suggestions. 
 
 The lines of treatment, when contrary sexual instinct ex- 
 ists, are the following : — 
 
 1. Prevention of onanism, and removal of other influences 
 injurious to the vita sexualis. 
 
 2. Cure of the neurosis (neurasthenia sexualis and univer- 
 salis) arising out of the unhygienic conditions of the vita 
 sexualis. 
 
 3. Mental treatment, in the sense of combating homo- 
 sexual, and encouraging hetero-sexual, feelings and impulses. 
 
 The most important part of the treatment lies in fulfilling 
 the third indication, particularly with reference to onanism. 
 
 Only in very few cases, where acquired contrary sexual 
 
 1 With reference to prophylaxis, the following words, which were written to me by 
 the subject of Case 88 of the sixth edition, are noteworthy : "If it were only possible that 
 — not as among the Spartans, where the weaklings were allowed to perish for the sake of 
 perfect selection, in accordance with the Darwinian idea — our contrary sexual instincts 
 might be recognized early in youth ; and if it were only possible that, at this time of life, 
 the worst of all diseases could be cured by suggestion ! Probably cure could be more 
 easily effected in youth than later." 
 
 21
 
 322 PSYCHOPATHIA SEXUALIS. 
 
 instinct has not progressed far, can the fulfillment of 1 and 2 
 be sufficient, as the following case, fully reported by the author 
 in the Irrenfreund, 1884, No. 1, proves: — 
 
 Case 132. Count Z., aged 51, of psychopathic mother, was early 
 sent to a military school, and there was taught onanism. He developed 
 well, and had normal sexual feelings, })ut, as a result of mastui'bation, he 
 became somewhat neurasthenic in his seventeenth year. He enjoyed 
 intercourse with women, was married at twenty-five, but after a year 
 more became neurasthenic, and absolutely lost his inclination for 
 women. In its place came contrary sexual instinct. Involved in 
 an accusation for high treason, he was sent to prison for two years, 
 and then to Siberia for five years. In these seven years, under the 
 influence of continued masturbation, neurasthenia and contrary sexual 
 instinct constantly increased. With his freedom restored at the age of 
 thirty-five, the patient began to visit all kinds of health-resorts on account 
 of his great neurasthenia ; and this has since been his occupation. In all 
 these years his abnormal sexual feeling has not changed in any way. 
 For the most part, he lived away from his Avife, whom, it is true, he 
 esteemed for her mental qualities ; though he avoided her, as he did every 
 other woman. His contrary sexual feeling is purely platonic. " Friend- 
 ship," sweet embraces, and kisses sufficed him. Pollutions, which occasion- 
 ally occurred, were induced by lascivious dreams which had for subject 
 persons of his own sex. Also, during the day, the most beautiful woman 
 had no charm for him, while simply the sight of handsome men induced 
 erection and ejaculation. Only athletes and male dancers in the circus 
 and ballet interested him. At times of greater excitability, even masculine 
 statues gave him erections. Now and again he resumed his old vice of 
 masturbation. This man of aesthetic culture had a horror of pederasty. 
 
 He felt, always, that his perverse sexual feeling was something 
 abnormal, without, however, in his aj^parently much weakened libido and 
 virility, feeling unhappy. 
 
 The examination gave the usual findings of neurasthenia. De- 
 velopment, manner, and attire presented nothing remarkable. Electrical 
 massage was unusually successful. After a few sittings the patient was 
 mentally and physically much better. After twenty sittings libido was 
 again awakened, not in the same way, but normally, as the patient had 
 felt until his twenty-fifth year. Lascivious dreams were concerned only 
 with women; and one day the patient joyfully gave the information that 
 he had had coitus, and that he had had the same natural feeling in it that 
 he had had twenty-six j^ears before. He then began to live with his wife 
 again, and hoped that he was lastingly freed from neurasthenia and con- 
 trary sexual instinct. His hope was fulfilled for the six years during 
 which I was able to keep the patient under observation.
 
 THERAPY. 323 
 
 As a rule, physical tieatment, even tliough it be re-iiiforced 
 morally by good advice with reference to the avoidance of mas- 
 turbation, tlio repression of homo-sexual feelings and impulses, 
 and the encouragement of hetero-sexual desires, will not prove 
 sufficient, even in cases of acquired contrary sexual instinct. 
 
 Here a method of mental treatment — hypnotic suggestion 
 — is all that can bring benefit. 
 
 The foHowing case is interesting ; and it is an example of 
 successful auto-suggestion that gives encouragement for the 
 milder forms of the anomaly : — 
 
 Case 133. Aatobiograpln/ of a Psijchical Hermai>hrodite. Success- 
 ful Straggle against Homosexual Inclinations made by the Patient himself. 
 — " My father once had a stroke, but has recovered save for paralj'sis 
 of the face. My mother was very aneemic and melancholic. Both suf- 
 fered severely with hemorrhoids, and my father ascribed to this trouble 
 the lumbar pain with which he suffered from time to time after his 
 marriage. 
 
 " I am, if I may so express myself, a passive character. When a 
 child, I indulged in all kinds of fancies, religious as well as others. I 
 suffered with incontinence of urine, and it is said that in sleep I handled 
 my genitals, so that my father fastened my hands to the bed! (I was 
 then a mere child, and had not masturl)ated.) I was always very shy and 
 embarrassed in social intercourse. When about fourteen or fifteen 3'ears 
 old, I was seduced into onanism. The impulse and desire for women, 
 occurring in connection with the aw\akening sexual feeling, were, in 
 reality, only of a platonic nature ; I was also without the society of 
 ladies. When about eighteen, I attempted to satisf}^ my sexual desire in 
 the natural way, more in obedience to a feeling of curiosity than from 
 inner longing. Since that time, without having experienced any real in- 
 clination for women, as often as possible I have satisfied my desire by 
 means of sexual intercourse. 
 
 " Soon after puberty I became very anremic, and appeared much 
 older than I really was. Then came melancholic and i)eculiar ideas. It 
 was a delight to me to fancy myself humiliated in tlie extreme. It may 
 be of interest to add that, at that time, I was troubled with religious 
 doubts, and only later found the courage to rise above religions. I fell 
 in love with young men. At first I opposed these ideas ; later they be- 
 came so powerful that I became a genuine urning. Women seemed to me 
 to be human beings of the second class. I was in a state of despair. My 
 sickened soul was filled with tsedium vitae and thoughts inimical to 
 humanity. One day I read : ' What will it come to ? ' And ere I knew it, I 
 was a socialist ; but an ideal one. Life again had value for me, for I had
 
 324 PSYCHOPATHIA SEXUALIS. 
 
 an ideal, — the joyous struggle for the social elevation of the proletariat. 
 This caused a powerful revolution in me. As in my best years (from 
 the age of sixteen to seventeen), I took interest in art, particularly in 
 dramatic art. I am, at the present time, writing a play and a story, and 
 I am occupied with the grandest thoughts. I read a remark of Schlegel's 
 concerning Sophocles, who was indebted to his physical exercise for his 
 energy and creative power, and to music for his artistic proportions. In 
 another place I read : ' The dramatist must, above all things, be mentally 
 intact.' This depressed me ; for my contrary sexual feelings could not 
 arise in a perfectly normal mind. 
 
 " I thought of having myself treated hjqmotically ; but shame held 
 me back. Then I said to myself that I was a weakling, indeed, to have so 
 little confidence in myself, and began in earnest to combat my abnormal 
 desires. At the same time, I struggled against my nervousness by lead- 
 ing the projier kind of a life. I rowed, fenced, and was much in the open 
 air ; and 1 was delighted when, at last, I awoke and seemed to be an 
 entirely different man. When I thought of the time from my twentieth 
 to my twenty-sixth year, it seemed to me that, during those j^ears, a 
 strange and depressive being had been dwelling within me. 
 
 " I was astonished that the handsomest rider or the trimmest waiter 
 excited in me almost no interest ; even the muscular masons had no effect 
 on me. I was disgusted when I thought that, at one time, such men had 
 seemed handsome to nie. M3- self-respect increased ; I am good-natured, 
 but my character is entirely active. Since my twentieth year my ap- 
 pearance has steadily improved. My appearance now corresponds per- 
 fectly with my years. There were recurrences of my abnormal inclina- 
 tions, to be sure ; but I struggled against them energetically. I satisfy 
 my libido only by means of natural intercourse, and I hope that, by con- 
 tinuing to lead a proper life, my pleasure in natural coitus will increase." 
 
 As a rule, only suggestion coming from a second person, 
 and that by means of hypnosis, promises any success. In such 
 cases, the object of post-hypnotic suggestion is to remove the 
 impulse to masturbation and homo-sexual feelings and impulses, 
 and to encourage hetero-sexual feelings ■with a sense of virility. 
 A prerequisite is, of course, the possibility to induce hypnosis 
 of sufficient intensity. It is, unfortunately, in these very cases 
 of neurasthenia that this is impossible, since they are often 
 excited, embarrassed, and in no condition to concentrate their 
 thoughts. 
 
 Thus, in a case reported by me in the Internailonal. Cen- 
 tralhlatt fur die Pliyslologie und Pathologle der Ham- und
 
 THERAPY. 325 
 
 Sexualorgane, Bd. i, Heft 2, p. 58, it was impossible for me to 
 induce liypnosis, thouglr the patient desired it, and did every- 
 thing to malve it successfid. By reason of the great benefit 
 that can be given to such unfortunates, and with Ladame's 
 case in view (v. infra), in the future, in all such cases, every- 
 thing should be done to bring about hypnosis, — the only 
 means of salvation. The result, in the three following cases, 
 was satisfactory : — 
 
 Case 134. Contrary Sexual Instinct Acquired through Masturba- 
 tion. — Mr. X., merchant, aged 29. Father's parents healtliy. Notliiiig 
 nervous in father's family'. Father was an irritable, peevish old man. 
 One brother of the father was a man-about-town, and died unmarried. 
 Motlier died in third confinement, when the patient was six years old ; 
 she had a deep, rougii, masculine voice, and coarse appearance. Of tiie 
 children, one brother is irritable, "melancholic," and indifferent to 
 women. 
 
 When a child patient had scarlet fever with delirium. Until his 
 fourteenth year he was light-hearted and social, but, after that, quiet, 
 solitary, and " melancholic." The first trace of sexual feeling appeared 
 in his tenth or eleventh year, and at that time he lenrned masturbation 
 from other boys, and practiced mutual onanism with them. At the age 
 of thirteen or fourteen, ejaculation for the first time. Patient has felt 
 no evil results of onanism until the last three months. 
 
 In school he learned easily, but was troubled with headaches. 
 After the age of twenty, pollutions, in spite of daily practice of onanism. 
 With pollutions, " procreative " dreams, as man and wife might perform 
 the act, occurred. In his seventeenth j'ear he was seduced into mutual 
 onanism by a man having a love for men. He found satisfaction in this, 
 inasmuch as he Avas always very passionate sexually. It was a long time 
 before the patient again souglit new opportunities for intercourse with 
 males. He did it simply to rid himself of semen. He felt no friendship 
 or love for the person with whom he had intercourse. He felt satisfac- 
 tion only when he played the passive role, — when manustupration was 
 practiced on liim. When the act was once completed, he had no respect 
 for the individual. If it liai)pened that, later, he came to respect the 
 man, then he ceased to indulge in the act with liim. Later it became 
 indifferent to him whether he mastin-bated or had masturbation practiced 
 on him. When he himself practiced onanism, he always thought of 
 pleasing men practicing onanism on him during the act. He preferred 
 a hard, rough hand. 
 
 The patient thought that, had he not been led astraj% he would have 
 arrived at a natural mode of satisfaction of his sexual desires. He
 
 326 PSYCHOPATHIA SEXUALIS. 
 
 never felt love for his own sex, tliongb lie liad pleased liimself with the 
 thought of loving men. At first lie had had*sensual inclinations toward 
 the opposite sex. He 'had taken pleasure in dancing, and he had been 
 pleased with women, hut he had taken more pleasure in the figure than 
 the face. Too, he had had erections at the sight of women that pleased 
 him. He had never attempted coitus, for fear of infection ; whether he 
 was potent or not with women, he did not know. He thought he could 
 be so no longer, because his feeling for women had grown cold, especially 
 during late years. 
 
 While previously, in his sensual dreams, he had had ideas of both 
 men and women, of late years he had dreamed only of approaches to men ; 
 he could not remember that he had dreamed, m late years, of sensual rela- 
 tions with a woman. At the theatre, as well as in the circus and ballet^ 
 the feminine figure had always interested him. In museums masculine 
 and feminine statues had aftected him equal!}'. 
 
 Patient is a great smoker, a beer-drinker, loves male societ}', and is 
 a gymnast and skater. Anything dandified was repugnant to him, and 
 he had never felt any desire to please men ; he would even have preferred 
 to please women. 
 
 He now felt his position to be painful, because onanism bad ob- 
 tained the upper hand. Masturbation, that had previously been practiced 
 without evil etfects, now began to disclose its bad results. 
 
 Since Jul}', 1889, he had suffered with neuralgia of the testicles. 
 The pain occurred particularly at night ; and at night there was also 
 trembling (increased reflex excitability). 
 
 Sleep was not refreshing, and he would wake up with pain in the 
 testicles. He was inclined, now, to indulge more frequently in onanism. 
 He was afraid of the consequences of the habit. He hoped that his 
 sexual life might still be turned into normal channels. Now, he thought 
 of the future; he had a relation with a girl, who was attractive to him, 
 and the thought to possess her as a wife was pleasing. 
 
 For five days he had abstained from onanism, but he could scarcely 
 believe that he would be able, with his own strength, to overcome the 
 habit. Of late he had been ver}^ much depressed, having lost all desire 
 for work, and become tired of life. 
 
 Patient is tall, powerful, well nourished, and has a thick growth of 
 beard. Skull and skeleton normal. Knee-jerks very prompt ; deep re- 
 flexes in upper extremities much increased. Pupils dilated, equal, and 
 act promptly. Carotids of equal calibre ; hyperaesthesia urethrse ; cords 
 and testicles not sensitive ; genitals normal. 
 
 The patient was calmed, and given hope for the future, provided 
 that he give up onanism and attempt to transfer his sexual desires from 
 persons of his own sex to females. 
 
 Hip-baths (24° to 20° R.) ; ext. secal. count, aquos., 0.5; antipj'rin, 
 1.0 {pro die) ; pot. brom., 4.0 (evenings), were ordered.
 
 THERAPY. 327 
 
 December 13th. To-day the patient came, in a disturbed condition 
 of mind, complaining that, unaided, he was unable to resist the impulse 
 to masturbate, and he asked for help. 
 
 A trial of hypnosis induced a condition of deep lethargy in the patient. 
 
 He was given the following suggestions : — 
 
 1. I can not, must not, and will not masturbate again. 
 
 2. I abhor the love for my own sex, and shall never again think 
 men handsome. 
 
 3. I shall and will become well again, fall in love with a virtuous 
 woman, be happy, and make her happy. 
 
 December 14th. While out walking to-day, patient saw a handsome 
 man, and felt himself powerfully drawn toward him. 
 
 From this time there were hypnotic sittings every second day, 
 With the above suggestions. 
 
 December 18th (fourth sitting), somnambulism occurred; the im- 
 pulse to onanism and interest in men disajipear. 
 
 At the eighth sitting " complete virilit}' " was added to the above 
 suggestions. The patient feels himself morally elevated and physically 
 strengthened. The neuralgia of the testicles has disappeared. He now 
 found that he was without sexual feeling. 
 
 He now believed himself free from masturbation and contrary 
 sexual inclination. 
 
 After the eleventh sitting he thought that further help was un- 
 necessary. He wished to go home, and marry. He felt well and potent. 
 Early in January, 1890, treatment ceased. 
 
 In March, 1890, the patient wrote : " I have since had several occa- 
 sions on which it has been necessary for me to use all ni}^ moral strength 
 in order to overcome my habit, and, thank God, I have been successful 
 in freeing mj'self from this vice. Several times I have had opportunity 
 for sexual intercourse, and I have found pleasure in it. I look calmly 
 on my happy future." 
 
 Case 135. Acquired Contrary Sexual Tnslinct. Marked Improve- 
 ment tinder Hypnotic Treatment. — Mr. P., born in 1863, official in a 
 manufactory. He comes of a highly respected patrician family of 
 Middle German}^, in which nervousness and insanity have been of 
 frequent occurrence. 
 
 His great-grandfather on the father's side and his sister died in- 
 sane ; the grandmother died of apoplexy ; father's brother died insane, 
 and a dauo;hter of the latter died of cerebral tuberculosis. The maternal 
 grandmother was melancholic for j^ears ; maternal grandfather, insane. 
 A maternal uncle took his life in an attack of insanity. The patient's 
 father is very nervous. An elder brother is very neurasthenic, and has 
 anomalies of the vita sexualis; another is the subject of Case 155 ; a third 
 is eccenti'ic in conduct, and is said to be subject to fixed ideas. A sister 
 suffers with convulsions, and another died of them when a little child.
 
 328 PSYCHOPATHIA SEXUALIS. 
 
 The patient is constitutionally predisposed ; for he was early very 
 peculiar, irritable, irascible, and impressed those around him as being 
 abnormal. 
 
 His vita sexualis appeared very early and in great intensity, and 
 was satisfied, without any seductions, in onanism. From his sixteenth 
 year the prematurely developed boy visited brothels of the Capital, using 
 his permissions to go out on Sundays and holidays for that purpose. He 
 toolv pleasure in coitus, but during the week he satisfied himself with 
 onanism. After his twentieth year, when he became independent, the 
 patient indulged with prostitutes excessively, and fell ill with neurasthe- 
 nia sexualis, becoming relatively impotent and unsatisfied in coitus, owing 
 to weakness of erection and premature ejaculation. His sexual libido 
 became more powerful than ever, and was satisfied in onanism. Early in 
 1888 the patient made the acquaintance of a young man. " By his pleas- 
 ing face, his attractive manner, and his beautiful form, he conquered me 
 entirely. I wished to speak to him, and was happ}' at mere sight of him. 
 I was completely in love with him. With this, my love for women was 
 extinguished. Any man could excite me to such an extent that, for some 
 moments, I would feel ray memory fail, and I would stammer. 
 
 " Soon after this I made the acquaintance of a gentleman who was 
 likewise very attractive, and who had a decided influence on my future 
 life. He was male-loving. I confessed to him that I no longer felt any- 
 thing but aversion for the female sex, and that I was attracted to men. 
 
 " When I once asked my companion how he brought it about that 
 soldiers would surrender themselves to him, he answered that the princi- 
 pal thing was skill ; almost any of them could be brought to it. Late in 
 1888, thinking of these words, I was attracted by an officer's servant, and 
 was intensely excited by him, but ejaculation never occurred. Since I 
 saw tliat the soldier would surrender himself without trouble, I ap- 
 proached him. Alium quondam militem in cubiculum allectum rogavi 
 ut veste exuta mecum in lectum concumberet. Rogatus fecit quae volui 
 et alter alterius penem trivit. 
 
 " Though after this success I misused manj^ persons, I was never 
 really in love, so to speak, with but one. He was a very handsome young 
 fellow of seventeen. His voice was so attractive to me, and his manner 
 was so delicately proper, that I cannot forget him. In my dreams I 
 thought only of handsome young men, and often for whole nights I could 
 not sleep, owing to sensual feeling." 
 
 Early in 1889 the patient's conduct awakened a suspicion of male- 
 love. A threatening communication frightened him, and plunged him in 
 deep depression, so that he contemplated suicide. At the advice of the 
 family physician, he came to the Capital. Since the patient was unable 
 to overcome his habitual desires by his own will, hypnotic treatment 
 was undertaken. It induced but mild lethargy, and, in opposition to the 
 seduction of former lovers, it had but little effect.
 
 THERAPY. 329 
 
 At that time the patient was wanting in earnest desire. There was 
 some improvement in matters, in the faee of the disgrace to relatives and 
 the prospect of a legal examination that was actually threatening. The 
 patient determined to attempt a cure with the author. 
 
 I found him to be a delicate, pale, very neurasthenic man, much de- 
 pressed, and despairing about the future. He was without degenerative 
 signs. He realized his perverted situation, and seemed to be willing to 
 do an3"thing in order to become again a decent, moral man. 
 
 He regretted exceedingly his sexual perversion, which he regarded 
 as abnormal, but also as having been acquired. He made no attempt to 
 conceal the fact tliat he could not control himself with young men, and 
 likewise he would not say that he could abstain from onanism, to which, 
 faute de mieux, he was driven. Onl,y a powerful, imperious will could 
 keep him from it. 
 
 Thus far his male-love had consisted exclusively of mutual onanism. 
 Erections occurred only when touching men he loved ; ejaculation re- 
 sulted early, but simple embrace was not sufficient. He had never felt 
 himself in any particuhir sexual role toward a man. Genitals and 
 vegetative organs normal. 
 
 In addition to treatment directed to his neurasthenia, on April 8, 
 1890, hypnotic suggestion was begun. Hypnosis was easily induced by 
 simpl}^ looking at him, with verbal suggestion. After a half-minute the 
 patient passed into deep lethargy, with a cataleptiforra state of the 
 muscles. The awakening was brought about b}' suggesting it at count- 
 ing three. Post-hypnotic suggestions were alwaj's successful. The 
 intra-hypnotic suggestions were : — 
 
 1. The interdiction of onanism. 
 
 2. The command that male-love should be felt to be disgraceful and 
 despicable, and that it should be impossible. 
 
 3. The command to regard only women as beautiful; to approach 
 them, to dream of them, and to have libido and erection at sight of 
 them. 
 
 The sittings occurred daily. On April 14th, the patient announced, 
 with thankfulness and a kind of moral satisfaction, that he had had 
 pleasure in coitus, and had ejaculated tardily. On April 16th, he felt 
 free from inclination to masturbate, attracted to women, and perfectly 
 indifferent to men. He dreamed of female charms and coitus with 
 women. May 1st, the patient seemed and felt himself to be normal 
 sexually. He has become a ditferent man mentally, full of courage and 
 self-confidence. He has coitus with complete satisfaction, and thinks 
 that he is insured against relapse. 
 
 In a later letter Mr. P. writes : " As was only to be expected, I 
 find myself lastingly freed from my errors. All that remains to remind 
 me of my unhappy time are the dreams, which, though they are 
 infrequent, come from my past, which I have no power to banish, and
 
 330 PSYCHOPATHIA SEXUALIS. 
 
 which sometimes, indeed, pleasantly occupy my thoughts. But by my 
 own will I yet hope soon to succeed in freeing m3fself absolutely from 
 them. Should I ever become weak again, the ideas you have im- 
 pressed on me would, I am sure, make an energetic resistance, and I 
 should not succumb." 
 
 On October 20, 1890, P. wrote me: " I am completely cured of 
 onanism, and I have no pleasure in male-love. Yet complete virility 
 does not seem to have been re-established, notwithstanding the fact that 
 I lead a virtuous life. Nevertheless, I feel satisfied." 
 
 Case 136. Acquired Contrary Sexual Instinct. — Mr. Z., aged 32, 
 divorced. He comes of a hysteropathic mother. Maternal grandmother 
 suffered with hysteria, and her brothers and sisters were neurotic. One 
 brother is an urning. Z. was but poorly endowed mentally, and did not 
 learn easil}'. No sickness besides scarlatina. When thirteen, he was 
 tauglit to masturbate by companions in a school. Sexually, he was 
 hyperaesthetic, and, at seventeen, began to indulge in coitus, with full 
 pleasure and power. For reasons of position and mone}', he married at 
 twenty-six. The marriage was very unhappy. After a year Mrs. Z. 
 became incapable of coitus, by reason of uterine disease. Z. satisfied 
 his inordinate desires with other women, faute de mieux, by masturba- 
 tion. Besides, he gave himself up to pla3', led an absolutely dissolute 
 life, became exceedingly neurasthenic, and sought to strengthen his 
 weakened nerves b}'^ drinking great quantities of wine and brandy. To 
 his essential cerebral asthenia were added peripheral alcoholic cramps 
 and globus, and lie became very emotional. His libido nimia continued 
 unabated. On account of his disgust of prostitutes and fear of infection, 
 satisfaction b^^ coitus was exceptional. For the most part, the patient 
 helped himself with onanism. 
 
 Four years ago he noticed weakening of erection and decrease of 
 libido for women. He began to feel himself drawn toward men, and his 
 lascivious dreams were no longer concerned with women, but with men. 
 
 Three j'ears ago, while being rubbed by a batli-attendant, he became 
 powerfully excited sexually (the attendant also had an erection, to pa- 
 tient's surprise). He could not keep from embracing and kissing the 
 attendant, and allowing liim to perform masturbation on him, the 
 attendant doing it most willingly. From this time this mode of sexual 
 indulgence was all that he cared for. Women became a matter of entire 
 indifference to him ; he devoted himself exclusively to men. With them 
 he practiced mutual masturbation, and had a longing to sleep with them. 
 He abliorred pederasty. He was entirel3^ satisfied until (August, 1890) 
 an anonymous letter, warning him to be careful, brought him to his 
 senses. He was much frightened, had hysterical attacks, and became 
 much depressed. He was embarrassed before men, seemed like a pariah 
 in society, contemplated suicide, and finally confessed to a priest, who 
 comforted him. He now fell into a religious state (equivalent), and, out
 
 THERAPY, 331 
 
 of remorse and to cure himself of his abnormal sexual inclinations, wished 
 to go into a cloister. While in this state, my " Psychopathia Sexnalis " 
 fell into liis hands. He was frightened and filled with shame, but found a 
 comfort in it, inasmuch as he concluded that he must have some malady. 
 His first thought was to rehabilitate himself sexually in his own eyes. 
 He overcame all disinclination, and visited a brothel. At first he was 
 not successful, on account of great excitement, but he fiuallj' succeeded. 
 
 Since, however, his contrary sexual inclinations were not overcome, 
 in spite of all his efforts to put them down, he finally came to me, asking 
 for assistance. He felt himself to be terribly unfortunate, and very near 
 to despair and suicide. He saw destruction before him, and would be 
 saved at any price. 
 
 His confession was interrupted by numerous hysterical attacks. 
 Comforting and encouraging words about his future had a calming 
 influence. 
 
 Physically, patient presented a slightly retreating brow, with no 
 other anatomical signs of degeneration. Spinal irritation, exaggerated 
 deep reflexes, and a sense of pressure in the head pointed to a neuras- 
 tiienic condition. No genital anomalies, though there was hyperaesthesia 
 urethras. Mien distressed ; attitude relaxed ; mind distracted and vacil- 
 lating. 
 
 Hipbaths, massage, ergot with antipyrin and pot. brora., ordered, 
 with interdiction of onanism, intercourse with men, and lascivious 
 thoughts of them. 
 
 After a few days the patient came complaining that he was not 
 equal to the task. He said his will was too weak. In this precarious 
 situation, it seemed that nothing but hypnotic treatment could bring 
 improvement, 
 
 September 11, 1889. First sitting. Bernheim's method used, in 
 order to induce lethargy as quickl_y as possible. 
 
 Suggestions : — 
 
 1. I abhor onanism, and will not masturbate again, 
 
 2. I regard the inclination for men disgusting, — horrible; and I 
 shall never think men handsome and enticing. 
 
 3. Women alone I find enticing. Once a week I shall cohabit, 
 with full pleasure and power. 
 
 The patient received these suggestions, and repeated them in a 
 drawling tone. 
 
 The sittings took place every second day. After the fifteenth, it 
 was possible to induce the somnambulic stage of hypnosis with au}^ post- 
 hypnotic suggestions desired. 
 
 The patient improved morally and mentall}^, but symptoms of cere- 
 bral neurasthenia troubled him still, and, now and then, dreams of men 
 occurred ; and there were, also, in the waking state, inclinations toward 
 men, which depressed him exceedingly.
 
 332 PSYCHOPATHIA SEXUALIS. 
 
 Treatment until September 24th. Result : Free from onanism ; 
 no longer excitable to men, though impressionable to women. Normal 
 coitus once in eight days. Hysterical symptoms absent ; neurasthenic 
 symptoms much ameliorated. 
 
 On October 6th tlie patient reported by letter that he was feeling 
 well, and expressed his gratitude for his salvation; he felt as if given a 
 new life. 
 
 December 9, 1889, patient again came for treatment. Of late he 
 had had lascivious dreams of men twice, but had experienced no inclina- 
 tion toward men in the waking state. He had also resisted the impulse 
 to masturbate, though, while living alone in the country, he had had no 
 opportunity for coitus. He had inclinations only for the opposite sex, 
 and, as a rule, dreamed only of females. Returned to the cit}"^, he had 
 indulged in coitus with pleasure. The patient felt himself morally 
 rehabilitated, being almost free from neurasthenic symptoms; and, after 
 three more hypnotic sittings, he declared himself perfectly well, and 
 confident that he would not relapse. Such a relapse occurred, however, 
 in September, 1890, when, after over-exertion on an excursion into the 
 mountains, and emotional strain with want of opportunity for coitus, he 
 had again become neurasthenic. 
 
 Again he had dreams of men, and felt drawn toward attractive 
 male forms; he ma^sturbated many times, and, after returning to the 
 city, found no real pleasure in coitus. B^^ means of anti-neurasthenic 
 treatment and hypnosis, it was possible soon to restore the previous 
 condition. 
 
 In the course of the years 1890 and 1891 the patient now and then 
 had contrary sexual feelings and dreams, but only when, as a result of 
 emotional strain or excesses, his neurosis re-appeared. At such times 
 satisfaction in coitus was wanting. He would then find it necessary to 
 undergo a few hypnotic sittings, in order to restore his equilibrium — 
 always with success. 
 
 At the end of 1891 the patient pointed with satisfaction to the 
 fact that, since treatment, he had been able to avoid masturbation and 
 male-intercourse, and liad regained his self-confidence and self-respect. 
 
 The foreg-oing details of the successful results of hypnotic 
 suggestion, in cases of acquired contrary sexual feeling, make it 
 seem possible that those unfortunates that are afflicted with the 
 congenital perversion may be helped in some degree by the 
 same means. 
 
 To be sure, here the condition is entirely different, since a 
 congenital condition must be combated, an abnormal psycho- 
 sexual life annihilated, and a new one created, A prioi'i this
 
 THERAPY. 333 
 
 task seems impossible; at least, in the perfect urniiig. That the 
 apparently impossible is artificially possible may be seen from 
 the case of Schrenk-Notzing, wliich follows below. It fjir sur- 
 passes the case reported by me {v. infra), in which at least the 
 homo-sexual feelings and impulses were removed by means of 
 liyi)iiotic suggestion. 
 
 The case of Ladame (v. infra) is an analogous one. The 
 conditions are more favorable in psycho-sexual hermaphrodites, 
 where at least there are rudiments of hetero-sexual feelings that 
 may be strengthened and made operative by suggestion. 
 
 Case 137. " I was born in 1858, out of wedlock. It was only late 
 that I was able to trace my obscure origin, and obtain knowledge of my 
 parents; and this knowledge is, unfortunately, very obscure and imper- 
 fect. My father and mother were cousins. My father died three years 
 ago. He had later married, and, as far as I know, had several healthy 
 children. 
 
 " I do not think that my father had contrarj' sexual feelings. 
 Without knowing him as my father, I often saw him when I was a child. 
 He was a powerful, masculine man. As for the rest, it is said that, at 
 the time of my birth, or before, he was sexually ill. 
 
 " I have often seen my mother on the street, but I did not then 
 know that she was my mother. At the time of my birth she may have 
 been about twenty-four years old. She was tall, and quick and energetic 
 of movement, and her character was decided. At the time of my birth 
 she is reported to have gone about much in male attire, to have worn 
 short hair, to have smoked a long pipe, and in general to have been re- 
 markable for her eccentric character. She was exceedingly well edu- 
 cated, and is said to have been beautiful in her youth. She left a for- 
 tune, — considerable even when measured b^^ our })resent ideas, — but she 
 died unmarried. 
 
 " In any case, all this would point to homo-sexual inclinations, or, 
 at least, to abnormalities. On the other hand, several years before my 
 birth, my mother took care of a little girl. This step-sister, whom I 
 never knew, married young, but early in her married life, for reasons 
 unknown to me, she poisoned herself. 
 
 " I am 1.7 metres tall, measure 92 centimetres around the waist, 
 and 102 centimetres around hips, and, therefore, I think my pelvis is 
 somewhat over-developed. The subcutaneous fat has always been abund- 
 ant. Skeletal form is strong. The muscular system is well formed, but, 
 from lack of exercise, perhaps owing to the influence of early, long- 
 continued, and frequent indulgence in onanism, it is not well developed ; 
 so that I appear stronger than I really am. Hair of head and f:ice is
 
 334 PSYCHOPATHIA SEXUALIS. 
 
 normal ; genital hair, somewhat thin. The upper portion of the body is 
 as good as without hair. In all other wa3's my appearance is fully mas- 
 culine. Gait, attitude, and voice are those of a fully developed man, and 
 other urnings have often told me that they would never have suspected 
 my passion. I served in the army, and always found pleasure in all 
 knightly exercises, — riding, fencing, swimming, etc. 
 
 " My early training was under a priest. I had but few real play- 
 mates. The famil}' life of my foster-parents was faultless. In October, 
 1861, 1 entered the Institute. Here I indulged in my first perverse acts, 
 which I shall describe more fully when I come to the development of my 
 sexual life. 
 
 " I finished the G^'mnasium, served my voluntary years in the army, 
 and then studied forestry, being now a director of estates. During my 
 early years my mental development Avas very slow. I first learned to 
 speak in my third year, and tlius the supposition that I had hydrocepha- 
 lus was strengthened. Prom the time of beginning school, mj' mental 
 development was abnormal ; indeed, I learned easily, but I have never 
 been able to concentrate my activity on any particular subject. I have 
 a great interest in art and aesthetics, but almost none in music. In early 
 years my character was the worst possible. Without being able to give 
 an}' reason for it, during the last twelve years there has been an entire 
 transformation. Now, there is nothing I hate more than a lie, and 1 
 never speak untruth even in jest. In financial matters, without being 
 avaricious, I have become an economical manager. 
 
 " It is enough that, with a deep feeling of shame, I look back on 
 my past; and, if I could be freed from m^' unhappy sexual perversion, or 
 perversity, I should justly' regard myself as a true gentleman. I am 
 kind, and always ready to be charitable to the extent of m^^ means ; I 
 am gay-spirited, and regarded with favor socially. I have no trace of 
 that nervous irritability which is so often noticeable in others like me. 
 Too, I am not wanting in personal courage. There is nothing in the 
 early period of my development that points to abnormality. To be 
 sure, as a child, I liked to lie in bed on my abdomen, and, of a morning, 
 I often took deliglit in rolling about on my abdomen, much to the 
 amusement of my foster-parents; but I cannot recall that, at such times, 
 I ever had sensual feeling. I never sought much to play with girls, and 
 I never pla3red with dolls. I early heard talk about sexual matters; but 
 I never thought an3thing about it. In my dreams, too, at that time, 
 there was nothing sexual ; and, in my association with boys of my own 
 age, there was nothing of that kind. I think I may say that my vita 
 sexualis was really first awakened after I had been seduced into mutual 
 masturbation, in my thirteenth j'ear, by a room-mate at the Institute. 
 At that time ejaculation did not take place, but first about a year later. 
 Nevertheless, I gave myself up to the vice of onanism passionately. At 
 this time, however, the first signs of homo-sexual inclination were mani-
 
 THERAPY. 335 
 
 fested. Youthful, powerful men, market-helpers, workmen, and soldiers 
 took possession of my dreams, and played an important rule in my 
 fancy while masturbating. At this time was also first shown the ten- 
 dency to pederasty, especially passive. Up to m^^ fourteenth year I 
 frequently made mutual attempts :it pederasty witli my seducer, but 
 neither of us were successful in bringing about immissio. At the same 
 time, there was also a weak inclination for the female sex. About a year 
 after the first indulgence in onanism, I was once with a puella publica, 
 but 1 had neither ejaculation nor any especial feeling of sensual pleasure. 
 Thereafter, and up to my nineteenth year, I performed coitus in public 
 houses about six times. Erection and ejaculation occurred i)romptly, 
 but without marked sensual pleasure. At least onanism, particularly 
 mutual onanism, I liked quite as much. I have never had any love 
 for athletes. About ten years ago, while at II., a watering-place, I 
 thought I was in love with a beautiful lady of a highly respectable 
 family ; I was happy in her presence, and thought myself h:ippy in find- 
 ing my love returned. For a time this affair kept me from mastur- 
 bating ; I was only afraid that, weakened by onanism that had been 
 practiced for years, I should be incapable of performing my marital 
 duty. When we became widely separated, my feeling quickly cooled ; I 
 found that I had deceived myself; and, after about two years, without 
 jealousy, 1 was able to hear that the lady had married. My inclination 
 for women — if, in reality, I have ever had an}' — grew colder and colder. 
 Two and a half years ago, when I visited a public house with very virile 
 friends, I last performed coitus. There was erection, but no ejaculation. 
 Women have become indifferent to me. A prostitute wdio acts coarsely 
 excites my repugnance. With intellectual women, i)articularl3^ when 
 they are elderly, I like to converse, but in their society I am often un- 
 skillful and awkward, often devoid of tact. I have never been able to 
 find any charm in woman's physical form. 
 
 " But, to return to the perverse inclinations. When, at the age of 
 fourteen, I went to H., I lost sight of my lover and seducer. He was 
 some years older than I, and was an official ; and, in this capacity, when 
 I was nineteen, I again met him once on the railwa}^ We immediately- 
 cut the journey short, and lodged together, attemi)ting mutual pederasty ; 
 but, on account of pain, immissio was not successful. We amused our- 
 selves in mutual onanism. In H. I had sexual intercourse with two 
 fellow-students, but this intercourse was confined to frequent mutual 
 onanism, owing to the fact that they w'ere not inclined to pederasty. 
 During the last year of my stay (when I was nineteen), I had intercourse 
 with another person, which likewise consisted of onanism ; but our inter- 
 course was more intimate, and we always retired, and practiced mutual 
 onanism in bed. From Easter, 1869, until July, 1870, I had no lover. I 
 practiced onanism alone. When the war broke out, I ofl'ered myself as a 
 volunteer, but was not accepted. At the same time a former school-
 
 336 PSYCHOPATHIA SEXUALIS. 
 
 mate offered himself. He had developed into a remarkably handsome 
 man. I had to spend one night with him in an over-crowded hotel. 
 Though as students we had never associated sexually", he was not 
 averse to my desire, and attempted pederast}'. In tliis instance pain 
 prevented success; but, in the attempt, ejaculatio ante anum meum oc- 
 curred. Even now I can recall the pleasurable feeling I had in it, — a 
 feeling previously unknown. After the war I frequently met this friend, 
 but our intercourse was later limited to onanism. During the following 
 eighteen j^ears I had but two opportunities for homo-sexual intercourse. 
 The first was in the winter of 1879, on the occasion of meeting a hand- 
 some hussar in a railway carriage. I induced him to sleep with me at an 
 hotel. Later he confessed to me that he had previously practiced mutual 
 masturbation with the son of a landed proprietor of his town. I could 
 not bring him to pederast}'. On the other hand, I induced ejaculation in 
 him b}'^ receptio penis ejus in os meum. This caused me no satisfaction, 
 but rather disgust. I have never tried it again ; and, too, I have never 
 allowed receptio penis mei in os alterius. In 1887, likewise on the rail- 
 way, I made the acquaintance of a sailor, and induced him to stay with 
 me at an hotel. He said he had never practiced pederasty, but he was 
 ready for it. He was apparently sensuall}' excited ; he had an erection 
 immediately, and performed the act with evident passion. It was the first 
 time that pederast}^ was successfully performed. I had terrible pain, but 
 also indescribable pleasure. 
 
 "With my sojourn here, m^' vita sexualis has undergone a complete 
 change. I have learned how easy it is to find persons who, partly for 
 money and partly from desire, yield to our inclinations. I have also not 
 been spared annoying experiences with cheats. Until the end of the last 
 year (since tlien, owing to fear of venereal infection, I have not gone 
 beyond mutual masturbation), I enjoyed male-love to the full extent, 
 particularly in passive pederasty. I have never practiced active peder- 
 ast}^, because I have found no one able to endure the pain. 
 
 " Generally, I seek my lovers among cavalrymen and sailors, and, 
 eventual!}', among workmen, especially butchers and smiths. Robust 
 forms, with healthy facial complexions, attract me especially. Leathern 
 riding-trousers have a particular charm for me. I have no partiality for 
 kissing and the like. I also love large, hard, and calloused hands. 
 
 "I do not wish to leave unmentioned that, under certain circum- 
 stances, I have great control of myself. 
 
 " As director of an estate, I lived in a large house. My personal 
 servant was a very handsome young man who had served in the hussars. 
 After once having spoken with him, in general terms, on the subject, and 
 found that he could not be approached, for years I lived in close intimacy 
 with him, and enjoyed his beauty, but never touched him. I think that, 
 to this day, he knows nothing of my passion. Likewise, two and a half 
 years ago, in C, I made the acquaintance of a sailor, who is still regarded
 
 TUERAPY. 337 
 
 by me and my acquaintances as one of the handsomest men we know. 
 After an absence of moie than two years, on invitation, he visited me a 
 few weelvs ago. I knew how to arrange matters so that we slept in the 
 same room, and I burned with desire to be nearer to him. As a prelim- 
 inary, however, I sounded him in confidential talk ; and, when I found 
 that he despised everything connected with male-love, I had not the 
 heart to ai)proach him more closely. For weeks we slept in the same 
 room, and I took constant delight in his divine form (at first, was 
 sexually excited, in fact) ; I bathed with him, in the Roman manner, in 
 order to see his beautiful form naked, — but he never learned anything of 
 my passion. I still have an ideal, platonic relation with this young man, 
 who, for one of his position, has an unusual education and line talent for 
 poetry. 
 
 " Until my thirty -eighth 3'ear I had not a clear understsinding 
 of my condition. I always thought that, by early and frequent mastur- 
 bation, I had become averse to women, and hoped alwaj's that, when the 
 right woman came, I should be able to abandon onanism and find 
 pleasure in her. Here it was that I first came to fully understand my 
 condition, after making the acquaintance of others suffering and feeling 
 like myself. At first I was frightened ; laterj^ came to look upon my 
 fate as something not dependent on myself. Too, 1 made no further 
 eflTort to resist temptation. 
 
 " Two or three weeks ago ' Psychopathia Sexualis ' fell into my 
 hands. The work has made an unexpectedly deep impression on me. 
 At first I read the work with an interest that was undoubtedly lasciv- 
 ious. The description of the cultivation of mujei'ados, for example, 
 excited me uncommonly. The thought of a young, powerful man being- 
 emasculated in this manner, in order, later, to be used for })ederast3^ by 
 a whole tribe of wild, powerful, and sensual Indians, so excited me that 
 I masturbated five times during the next two days, fancying myself such 
 a presumptive mujerado. The farther I read in the book, however, the 
 more I saw its moral earnestness; the more I felt disgust with m^^ con- 
 dition ; and the more I saw that I must do everything, if it were possible, 
 to bring about a change in my condition. When I had finished the 
 book, I was determined to seek assistance from its author. 
 
 " The readino; of this work had an undoubted effect. Since then I 
 have masturb;ited only twice, and have practiced onanism with cavalry- 
 men only twice. In every instance I have had really less pleasure and 
 satisfaction than before, and I always have the feeling: ' Ah, if I could 
 only be free from it 1 ' Nevertheless, I confess that, even now, in the 
 society of handsome soldiers, I immediately have erection. 
 
 " In conclusion, I may add that, in spite of, or, perhaps, on account 
 of, onanism, I have never had pollutions. The ejaculation of semen, 
 which usually consists of only a few drops, and it has always been so, 
 takes place only after prolonged friction. If, for any reason, I have not 
 
 23
 
 338 PSYCHOPATHIA SEXUALIS. 
 
 masturbated for a long time, the ejaculation takes place quickly, and is 
 more abundant. About twelve years ago Hansen tried in vain to 
 liypnotize me." 
 
 In the spring of 1891 the writer of the foregoing autobiography 
 visited me, with the declaration that he could live no longer in his con- 
 dition ; that he looked to hypnotic treatment as the only hope of salva- 
 tion, for he had not strength enough to resist his impulse to masturba- 
 tion and satisfaction with persons of his own sex. He felt like a pariah ; 
 like an unnatural man ; like one outside the laws of nature and society, 
 and in danger of criminal prosecution. He felt moral repugnance when 
 lie performed the act with a man, but 3 et the sight of any handsome 
 soldier actually electrified him. For years he had not had the slightest 
 S3'mpathy with women, not even mentalh'. 
 
 The patient looked to be exactly the person, ph3^sically and mentall}", 
 described by himself in his autobiography. His head was exquisitely 
 hydrocephalic, and also i>lagioceplialic. At first attempts at h^'pnosis 
 met with difficulties. Only by Braid's method, with the help of a little 
 chloroform, was deep lethargy attained at the third sitting. From that 
 time simpl}' looking at a shining object was sufficient. The suggestions 
 consisted of tlie comman^ to avoid masturbation, the removal of homo- 
 sexual feelings, and the assurance that the patient would have inclination 
 for women and be virile, and have pleasure onlj' in hetero-sexual inter- 
 course. Masturbation was indulged in but once; after the eighth sitting 
 the patient dreamed of a woman. 
 
 When, after the fourteenth sitting, the patient had to return, on 
 account of pressing business, he declared that he was quite free from 
 any inclination to masturbate or to indulge in mule-love, but that he was 
 by no means absolutely free from his partiality for men. He felt a 
 returning interest in the female sex, and hoped to be freed finally from 
 bis unhappy condition by continuance of the treatment. 
 
 Case 138. Psychical Hermaphroditism. — Mr, von P., aged 25, 
 single, comes of a neuropathic ft\mil3'. As a child he had convulsions. 
 He recovered, but remained weak, emotional, and irritable. No severe 
 illnesses. Before his tenth year sexuality was manifested. His earliest 
 remembrance concerning it was tliat of lascivious feelings in company 
 with the servants of the house. When older, he had sensual dreams 
 which were of intercourse with men. In circuses the male performers 
 alone interested him. 
 
 Youthful, powerful men were most enticing to him. Often, he 
 could scarcelj'^ resist the longing to fall ou their necks and kiss them. 
 Of late simply' the touching of such persons had become sufficient to give 
 him pleasure and induce ejaculation. The impulse to engage in " affairs " 
 with men he had, thus far, fortunately resisted. The patient is a psy- 
 chical hermaphrodite, in so far as he is not insensitive to the charms of 
 women, and finds men more pleasing than women. In fact, feminine
 
 THERAPY. 339 
 
 nudity had never pleased him, and he can remember only to have 
 dreamed once of coitus with a woman. 
 
 On account of his great sexual desire, and because he was ashamed 
 to give himself up to men, after his twentieth year he began to have 
 sexual intercourse with women. Since then, he has very seldom indulged 
 in manual onanism, but often in mental masturbation, during which the 
 forms of handsome men float through his fiuicy. 
 
 He had coitns with success, but without pleasure or sensual 
 feeling. On account of circumstances, he was forced to abstain from 
 his twenty-second until his twenty-fourth year. This abstinence was 
 painful, and he relieved himself, now and then, by mental onanism. 
 
 When, a year ago, he had opportunity again for coitus, he noticed 
 failure of libido for women, imperfect erection, and premature ejaculation. 
 Finally he gave up coitus; then liliido for men was manifested. 
 
 In the condition of irritable weakness of the ejaculatory centre, 
 mere touching of sympathetic men was suflicient to induce ejacula- 
 tion. 
 
 Patient is an only child. The circumstances of his ftimilj^ demand 
 that he marr^-. He justly hesitates to do this, thinks he is mentally 
 impotent, and asks for advice and help. 
 
 He points out that his feeling for men must be eradicated in order 
 to help him. 
 
 Patient's appearance is, in all respects, masculine. His head is 
 slightly hydrocephalic and rliombic. Abundant growth of beard. Geni- 
 tals normal; cremasteric reflex cannot be excited. No manifestations 
 of neurasthenia. Neuropathic eyes. Pollutions infrequent. Erections 
 occur only as a result of contact with men. 
 
 July 16, 1889, hypnotic suggestion, after Bernheim's method, was 
 begun. It was first at the third sitting that deep lethargy was induced. 
 
 Suggestions : " You have no longer any desire for men. Only 
 woman is beautjful and desirable. You will love a woman, marry, be 
 happ3', and make her happ3\ You are fully potent; you feel that 
 already." 
 
 In daily h^'pnosis, which never goes beyond lethargy, the patient 
 accepts the suggestions. On July 24th, he announces that he has had 
 pleasure in coitus ; and the male servants no longer interest him. At 
 the same time, he still finds men more beautiful than women. On August 
 1, 1889, it was necessary to discontinue treatment. Result : Completely 
 potent ; entire indifference for men, but also for women. 
 
 The same treatment met with decided success in a case of 
 psycho-sexual hermaphroditism, reported by me in vol. i of the 
 Internat. Centralhlatt filr die Physiol, u. Path, der Ham- und 
 Sexualorgane.
 
 340 PSTCHOPATHIA SEXUALIS. 
 
 Case 139. Mr. von X., aged 25, landed proprietor. He comes of a 
 neuropathic, passionate father. Father is said to have been noi'mal 
 sexually. His mother was nervous, as were her two sisters. Maternal 
 grandmother was nervous, and his maternal grandfather was a 7'oue, 
 much given to venery. Patient is like his mother, and an only child. 
 From birth he was weak, suffered much with migraine, and was nervous. 
 He passed through several illnesses. At fifteen he began masturbation, 
 without having been taught it. 
 
 Until his seventeenth year he says he never had feeling for men, 
 or, in fact, anj^ sexual inclination ; but at this time desire for men arose. 
 He fell in love with a comrade. His friend returned his love. They 
 embraced and kissed and indulged in mutual onanism. Occasionally 
 patient practiced coitus inter femora viri. He abhorred pederasty. Las- 
 civious dreams were concerned only with men. In the circus and 
 theatre males alone interested him. The inclination was for those of 
 about twenty years. Handsome, tall forms were enticing to him. Given 
 these conditions, he was quite iuditferent to other characteristics of tlie 
 men. In his sexual affairs with men his part was always that of a man. 
 
 After his eighteenth year the patient was always a source of 
 anxiety to his highly respected parents, for he then began a love-affair 
 with a male waiter, who fleeced him and made him an object of remark 
 and ridicule. He was taken home. He consorted with servants and 
 hostlers. He caused a scandal. He was sent away for travel. In 
 London he got into a " blackmailing scrape," but succeeded in escaping 
 to his home. 
 
 He profited in no wa3' by this bitter experience, and again showed 
 disgraceful inclinations toward men. Patient was sent to me to be cured 
 of his fatal peculiarity (December 12, 1888). Patient is a tall, stately, 
 robust, well-nourished young man, of musculine build ; large, well-formed 
 genitals. Gait, voice, and attitude are masculine. He has no pro- 
 nounced masculine passions. He smokes but little, and only cigarettes ; 
 drinks little, and is fond of confectioner}'. He loVes music, arts, 
 aesthetics, flowers, and moves in ladies' society b}'^ preference. He wears 
 a moustache, the face being otherwise cleanly shaved. His garments 
 are in nowise remarkable. He is a soft, blase fellow, and a do-nothing. 
 He lies abed mornings, and can scarce!}' be made to rise before noon. 
 He says he has never regarded his inclination toward his own sex as 
 abnormal. He looks 'upon it as congenital; but, taught by his evil 
 experiences, he wishes to be cured of his perversion. He has little 
 faith in his own will. He has tried to help.himself, but always begins to 
 masturbate. This he finds injurious, inasmuch as it causes slight neuras- 
 thenic symptoms. There is no moral defect. The intelligence is a little 
 below the average. Careful education and aristocratic manners are 
 apparent. The exquisite neuropathic eye betraj'S the nervous constitu- 
 tion. The patient is not a complete and hopeless urning. He has hetero-
 
 THERAPY. 341 
 
 sexual feeling.'^, hut his sensual inclinations toward the opposite sex are 
 manifested weakhj and infrequently. When nineteen, he was first taken 
 to a brothel by friends. He experienced no liorror feminju, had eflicient 
 erections, and some pleasure in coitus, but not tlie instinctive delight he 
 experienced while embracing men. 
 
 Since then, patient asserts that he has had coitus six times, twice 
 sua sjionte. He gives the assurance that he is always capable of it, but 
 he does it only faute de mieux^ as he does masturbation, when tlie sexual 
 impulse troubles him, as a substitute for intercourse with men. He has 
 thonght of the possibility of finding a sympathetic lady and marrying 
 her. He would regard marital cohabitation and abstinence from inter- 
 course with men as hard duties. 
 
 Since there were rudiments of hetero-sexual feelings present, and 
 the case could not be looked upon as hopeless, it seemed tliat treatment 
 was indicated. Tlie indications were clear enough, but there was no 
 support for them in the will of the indolent patient, so unconscious of 
 his own position. It lay near to seek support for the moral intluence in 
 hypnosis. The fulfillment of this hope seemed doubtfid, because the 
 famous Hansen had tried several times, in vain, to hypnotize him. 
 
 At the same time, by reason of the most important social interests 
 of the patient, it was necessary to make another attemi)t. To my great 
 surprise, Bendieim's procedure induced immediately a condition of deep 
 lethargy, with possil)ility of post-hypnotic suggestion. 
 
 At the second sitting somnambulism was induced by merely look- 
 ing at him. The patient is obnoxious to suggestions of all kinds ; indeed, 
 contractures are induced by stroking him. He is awakened by counting- 
 three. Awakened, patient li:is amnesia for all the events of the hypnotic 
 state. Hypnosis is induced every second or third day for the communi- 
 cation of hypnotic suggestions. At the same time, moral and hydro- 
 therapeutic measures are employed. 
 
 The hypnotic suggestions were as follow: — 
 
 1. I al)hor onanism, because it makes me sick and miserable. 
 
 2. I no longer have inclination toward men ; for love of men is 
 against religion, nature, and law. 
 
 3. I feel an inclination toward women ; for woman is lovely and 
 desirable, and created for man. 
 
 During the sittings the patient always repeats these suggestions. 
 After the fourth sitting it was noticeable that, when taken into societ}', 
 he paid court to ladies. Shortly after that, when a famous prima-donna 
 sang, he was all enthusiasm for her. Some days later the patient sought 
 the address of a brothel. 
 
 At the same time, he preferred the societ}^ of young gentlemen ; 
 but the most careful watching failed to reveal anything suspicious. 
 
 February iTth. Patient asks to be allowed to indulge in coitus, and 
 is very well satisfied with his experience with one of the demi-monde.
 
 342 PSTCHOPATHIA SEXUALIS. 
 
 Miircli 16th. Up to this time, hypnosis twice a week. The patient 
 always passes into deep somnambulism by simpl}' being looked at, and, 
 at request, repeats the suggestions. He is obnoxious to all kinds of 
 post-hypnotic suggestion, and, in the waking state, knows not the 
 least of the influences exerted on him in the hypnotic state. In the 
 h3'pnotic condition he alwa^^s gives the assurance that he is free from 
 onanism and sexual feeling for men. Since he gives the same answers 
 in hypnosis, — e.g., that on such and such a date he practiced onanism 
 for the last time, and that he is too much under the will of the physician 
 to be able to lie, — his assertions deserve belief; the more, since he looks 
 well and is free from all neurasthenic symptoms, and, in the society of 
 men, not the slightest suspicion rests on him. An open, free, and manlj' 
 bearing is developed. 
 
 Moreover, since, of his own will, he now and then indulges in coitus 
 with pleasure, and occasional pollutions are induced l)y lascivious dreams 
 which concern women, there can be no douljt of the favorable change of 
 his vita sexualis ; and it is presumable that the hypnotic suggestions 
 liave developed into auto-suggestive inclinations, which direct his feel- 
 ings, thoughts, and will. ProbabI}' the patient will always remain a 
 uatura frigid a ; but he more often speaks of marriage, and of his inten- 
 tion to win a wife as soon as he has become acquainted with a s^Mupa- 
 thetic lady. 
 
 In July, 1889, I received a letter from his father, which told me of 
 his good health and conduct. 
 
 On Ma}' 24, 1890, by chance, I met m}' former patient, while on a 
 journey. His bright, healthful appearance allowed the most favorable 
 opinion of his condition. He told me that he still had sympathetic 
 feeling for some men, but never anything like love. He occasional!}' had 
 pleasurable coitus with women, and now thought of marriage. 
 
 I hy})notized him, in tlie former manner, to try iiim, and asked 
 for the commands 1 had given him. In a deep condition of somnam- 
 bulism, and in the same tone of voice as formerl}', tlie patient repeated 
 the suggestions he had received in December, 1888, — an excellent example 
 of the possible duration and power of post-hypnotic suggestion. 
 
 Case 140. Psychical Hermaphroditism ; Improvement ivith Hypnotic 
 Treatment.— Mr. von K.,ii<iei\ 23; of distinguished family ; well endowed 
 mentally ; scrofulous as a child. His father is said to have been dissi- 
 pated. His father's brother is said to have been subject to contrary 
 sexualit}'. 
 
 The patient states that, when only seven 3'^ears old, be had a pecu- 
 liar inclination for male persons. It was particularly coachmen and 
 servants having moustaches for whom he showed partialit}' at that time. 
 He experien(ied a peculiar delightful sensation when he pressed him- 
 self against such persons. 
 
 The patient entered the cadet corps early, and there he was seduced
 
 THERAPY. 343 
 
 into mutual onanism, and also leanuHl imitatio coitus inter femora viri. 
 At the age of seventeen he had coitus with a prostitute for the first 
 time. He performed the act perfectl}', but had not the slightest pleasure 
 in it; and he learned that this kind of gratification amounted to uothin"-, 
 or that he must be different from other young men. 
 
 Nevertheless, he often had coitus, and contracted gonorrhoea. 
 After this he experienced an increasing aversion for the female sex, and 
 indulged in coitus less and less frequently ; in fact, only when, with 
 intense libido, he could not gain oi)portanit3' for intercourse with men. 
 His inclination for men predominated more and more, and he was 
 attracted exclusively by those handsomely formed, and having as little 
 beard as possible. He descended to the most revolting practices, — 
 coitus buccalis, active and passive pederasty. 
 
 The patient was deeply ashamed of such depravity, and was con- 
 stantly endeavoring to get into better ways by means of coitus with 
 women. But he came to the despairing conclusion that his moral 
 strength was insufficient, that he was inditlerent about intercourse with 
 women, or that it was repugnant to him; and that he was created for 
 sexual intercourse with persons of liis own sex. In fact, he had never 
 dreamed of women, but always of men ; and that at a time, too, when he 
 had no suspicion of the difference between the sexes. 
 
 The i)atient comes for consultation, because he sees that he is 
 jeopardizing the happiness of his whole life, and recognizes the unnatu- 
 ralness and immorality of his sexual life. He does not regard his con- 
 dition as hopeless ; for lie has no horror of women, and three weeks ago 
 he had successful coitus with one, though it was devoid of all pleasure 
 and mental satisfaction. He has no doubt that he was reallj' created to 
 love men ; but, owing to acquired neurasthenia, in the sexual act with a 
 man he experiences no such pleasure as formerly-. He had given np his 
 position as an officer, because the soldiers excited him so sexually that 
 he feared he migiit compromise himself. 
 
 The patient is devoid of degenerative signs. His appearance is 
 perfectly masculine, and his genitals are normal. Examination of the 
 semen revealed al)undance of spermatozoa. The penis is large and well 
 developed ; the growth of hair ad genitalia, as well as on the rest of the 
 body, is abundant. The patient has masculine tastes, but has never been 
 partial to drinking and smoking. A neuropathic e3'e is all that points 
 to a nervous constitution. 
 
 In his sexual acts with men, he states that, as a rule, he has felt as 
 a man, only now and then as a woman. 
 
 An attempt at hypnosis le.ads to lethargy, with cataleptic condition 
 of the muscles, and the opportunity is used to impart suitable suggestions. 
 
 After the fourtli sitting he expressed himself as satisfied, and 
 wondered that men made no impression on him. He wished to- tr}' his 
 fortune with women, but was afraid that he was impotent.
 
 344 PSYCHOPATHIA SEXUALIS. 
 
 After the sixth sitting, without advice, he attempted coitus cum 
 rauliere. His libido was very great, but inter actum this and erection 
 left him. 
 
 After the ninth sitting the patient was forced to discontinue treat- 
 ment, owing to business that called him home. He was satisfied, in that 
 he felt indifferent and capable of resistance to men. He felt sure that 
 he would not relapse into his former vices. At the same time, he had 
 not the slightest interest in the female sex. 
 
 Case 141. Mr. X., aged 31, chemist, comes of a neuropathic family', 
 and from childliood has been nervous, emotional, and apprehensive, and 
 afflicted with migraine. He remembers distinctly that, when a very 
 small boy, he had a lustful feeling at the sight of the half-naked persons 
 in the work-sliop at his father's house, and felt drawn to them. When 
 he began school, he felt in the same way toward his companions. At the 
 age of eleven, without teaching, he began to masturbate, during which 
 he thought of his comrades. Later there were enthusiastic friendships. 
 His vita sexualis gained the upper hand. As he grew up, women also 
 interested him, but his chief interest was in men of the higher circles of 
 society. He felt that this inclination was abnormal, and sought the 
 acquaintance of puellis ; he often had coitus, but never with any real 
 pleasure. Thus he became more and more given to contrar}^ sexuality, 
 practiced mutual masturl)ation and coitus inter femora viri, and occasion- 
 ally gave himself up to passive pederasty ; but he soon abandoned this, 
 on account of the pain it caused him. 
 
 He asserts that he feels perfectly masculine, and has never had 
 female inclinations. Skeleton and attitude perfectl}^ masculine ; strabis- 
 mus ; abundant beard; genitals entirely normal. No aversion to the 
 female sex. Occasional coitus with puellis, but without satisfaction. 
 The patient feels exceedingly unhapp3',and clearly recognizes his abnor- 
 mal position ; at any price, he wishes to be freed from his homo-sexual 
 inclination, and made capaltle of marriage. " It is terrible to have to 
 . act a farce constantl}'." At the first attempt at hypnosis, after Bern- 
 heim's method, the patient passes into a state of deep letharg}'. He 
 proves to be very susceptible to suggestion, and suitable suggestions are 
 imparted. After tlie fourth sitting, he states, with gratitude, tliat men 
 become indifferent, and he begins to have pleasure in coitus ; but he did 
 not feel mentally satisfied, owing to the fact that he was limited to 
 puellffi publicne. After the fourteenth sitting he declared that he re- 
 quired no more treatment. He was in love with a 3'oung lad}', and 
 thought of marrying her. He asked for her hand, and was refused. 
 Soon after, while he was on a journey in Ital}', men interested him again. 
 He had a relapse, and asked for further treatment. A few sittings re- 
 established the status quo ante. 
 
 Case 142. Psychical Hermaphroditism; Successful Treatment by 
 Hypywtic Suggestion. — Mr. von Z., aged 29. He asserts that he comes
 
 THERAPY. 345 
 
 of healthy grandparents; of a liealthy father, but of a nervous mother. 
 He is an only child, and was petted by his mother. At the age of eight 
 he was powerfully excited sexually by a male servant, who showed him 
 pornographic pictures and his penis. 
 
 When twelve years old, Z. fell in love with his tutor. On going to 
 sleep, the naked form of this man appeared before him. He thought of 
 himself as in a female role in relation to him, and thought to marry him 
 some time. 
 
 At the age of thirteen, at a private ball, his fancy was excited by a 
 young governess, and, at fifteen, he fell in love with a young lad^-. He 
 remained ver3' excitable sensually ; but, thereafter, exclusivel}'^ so to men 
 pleasing to him. Masturbation was not practiced. 
 
 At the age of twenty the patient became neurasthenic (ex absti- 
 nentia?). He now attempted coitus, but was not successful. On the 
 other hand, he had intense desire on an occasion when he saw a naked 
 man in a steam-bath. The latter noticed his excitement, appi-oached 
 him, and performed masturbation on him, giving the patient intense 
 delight. He felt powerful!}^ attracted to this man, and, thereafter, 
 allowed him to repeat the act. In the meantime, there were attempts at 
 coitus with females, which alwa^'s ended in a fiasco. The patient was 
 much troubled by this, and consulted phj'sicians, who explained his im- 
 potence as due to nervousness, and thought that it would soon pass off". 
 
 Until his twenty-fifth year his sexual indulgence consisted of mas- 
 turbation by the beloved man about once a month. At this time he last 
 felt attracted to a woman. It was to a young peasant-girl. She would 
 not accede to his wishes. Since his lover was also unattainable, the pa- 
 tient began to masturbate alone. With this, his neurasthenia increased. 
 For this reason he was unable to finish his studies; he became shy, 
 dysthymic, abulic, and now vainly tried cures at various h3'dropathic 
 establishments. On account of continued severe (cerebro-spinal) neu- 
 rasthenia, the patient came to me for advice, in the latter part of 
 February, 1890 
 
 A tall, slim man, of aristocratic and decidedly masculine manners. 
 Neuropathic appearance ; large ears, the lobes of which run into and lose 
 themselves in the skin of the cheeks. Genitals perfectly normal. The 
 usual picture of cerebro-spinal neurasthenia of moderate degree. Great 
 depression ; complaint of being dissatisfied with life, even to taedium 
 vitai ; he is pained l)y his sexual anomaly, especiall}^ because he is urged 
 by his family to marry. 
 
 He is interested in women only mentally, not physically. Sexually, 
 his only interest is in men of distinction. His dreams have never been 
 about persons of the opposite sex, but of those of his own sex. In these 
 lascivious dreams he has always seen himself in the role of a woman. 
 
 The most refined woman has never been able to induce erection or 
 even libido in him.
 
 34:6 PSYCHOPATHIA SEXUALIS. 
 
 His sexual intercourse with men lias consisted of passive or mutual 
 masturbation. He had practiced solitar}- onanism only infrequently and 
 f aide de 7)116 ax. During the last five months he had abstained, and had 
 had no male intercourse since August, 1889. 
 
 An attempt at hypnosis, after Bernheim's method, failed ; prolonged 
 stroking of the brow induced deep lethargy, with catalepsy. 
 
 This method is used, in order to carry out suggestive treatment of 
 this patient, who is so worthy of compassion. The hypnotic state is 
 always the same ; he cannot be brought into a state of somnambulism. 
 
 At the third sitting the patient is given the suggestions : ever de- 
 spise onanism and male love ; find women beautiful, and dream of them. 
 
 After the sixth sitting (March 10th). a moral transformation takes 
 place in his mind. The patient becomes quieter, feels more free, and 
 dreams now and then of women, and no longer of men, finding that the 
 latter have become indifferent to him. He gratefully states that he has 
 no more inclination to masturbation. He approaches women, but he 
 notices that they have not the least attraction for him. 
 
 On March 19th, business called the patient home ; so that the treat- 
 ment had to be discontinned. 
 
 On May 17, 1890, the patient returned for treatment. He asserted 
 that he had not masturl>ated in the interval, and that he had resisted his 
 inclination to men. Too, he had not dreamed of men, but twice of 
 women, though only platonically. His cerebral asthenia (ex abstinentia ?) 
 had increased. He apparently suffers for the want of mental and sensual 
 satisfaction of his vita sexualis ; for homo-sexual love and masturbation 
 have become impossible for him, and intercourse with women is denied 
 him. The patient is thus painfull}^ depressed to the extent of taedium 
 vitjie. 
 
 He is now subjected to anti-neurasthenic treatment (hydro-thera- 
 peutic and electro-therapeutic), and the treatment by hypnosis is re- 
 sumed. Only after ten weeks of painstaking treatment did the neuras- 
 thenic symptoms disappear. Progressing parallel with this, there was 
 a change of his mental personality. 
 
 The patient was gratified to note that he grew stronger ; that his 
 sexual life no longer plaj-ed a dominating part. Though he felt more 
 drawn toward men than women, yet he easily resisted homo-sexual 
 desires. His former boudoir became a work-room ; instead of to adorn- 
 ment and frivolous reading, he gave himself to walks in the mountains 
 and forests. On account of the danger of a fiasco, the initiative in 
 hetero-sexual attempts was left to the patient. 
 
 It was not until the fourteenth week of treatment that the patient 
 made an attempt. It was perfectly successful. The patient became 
 happy, and sound in body and mind, and expressed the best hope of his 
 future, even having thoughts of marriage. 
 
 He experienced increasing pleasure in normal sexual intercourse;
 
 THERAPY. 347 
 
 he occnRionall}^ bad lascivious dreams of women, and no longer dreamed 
 of men. 
 
 The patient stopped treatment at the end of September. He felt 
 perfectly normal in hetero-sexual intercourse, devoid of neurasthenia, and 
 had thoughts of marriage. Yet he freel}' confessed that he still alwaj^s 
 had erections at the sight of a naked, handsome man ; though he could 
 easily resist the desires that arose, and in dreams had exclusivel}^ " rela- 
 tions avec la femme.'''' 
 
 In April, 1891, I again saw the patient, and he was in the best of 
 health. He regarded his vita sexualis as perfectly normal ; for he had 
 coitus regularly with pleasure and full virility, dreamed only of women, 
 and had no inclination to masturbation. Yet he made the interesting 
 confession that frequently, post coitum, he still had a temporary " gout 
 jMur riiomme,^^ which he could easily control. He thought he was last- 
 ingly cured, and was occupied with thoughts of marriage. 
 
 Case 143. Congenital Contrary Sexual Feeling. Successful Be- 
 moval of Homo-Sexual Feelings by Suggestions. — L., doctor of philoso- 
 phy, aged 34, Grerman, consulted me, in the spring of 1888, on account 
 of perversion of his vita sexualis, and asked whether he could not be 
 freed from it b}^ means of hypnotic treatment. 
 
 Patient came of a health}^ mother, in whose family, for genera- 
 tions, there had been neither insanity nor nervous disease. He, like 
 his only brother, is much like his father mentally. His brother is very 
 sensual, and also psychically abnormal, and given to over-indulgence in 
 drink. 
 
 His father was a neuropathic, eccentric man. Nothing is known 
 of any abnormal sexual manifestations in him, though, like all his 
 brothers, he had a tendency to over-indulgence in alcohol. 
 
 This vice seems to have been inherited from his mother (grand- 
 mother of patient), who was a notorious drinker. The father of this 
 woman (great-grandfather of patient) was also a great drinker. No other 
 ancestral history was obtainal)le. 
 
 Patient states that from childhood he was nervous and easily ex- 
 cited. He learned very easily, and had a talent for languages. He was 
 always interested in art, particularly in music and poetry. His education 
 was excellent, and given at home. When he was thirteen, his father told 
 him that he should never touch his genitals, for it was wrong to do so, 
 and to do it might bring unhappiness. 
 
 Occasionally his father showed him pictures of syphilitic diseased 
 conditions, etc., in an anatomical museum, and the patient was disgusted 
 and frightened. He believed that his later fear of sexual intercourse 
 with women was partly nourished by this early erroneous teaching. 
 
 However, the patient seeks the principal cause of his sexual per- 
 version in a defect of organization. When a small boy, he had a silly en- 
 thusiasm for companions. He also remembers that, at that time, he had a
 
 348 PSYCHOPATHIA SEXUALIS. 
 
 desire only for girlish games, and preferred the society' of girls. When 
 a boy, he had a passion for crocheting and embroidering. At fourteen he 
 was still without an}^ sexual knowledge, and fell into the hands of a 
 pederast. He ran away, frightened, when he learned what was to be done 
 with him. When fifteen, a sympathetic companion was accustomed to lay 
 his head in the patient's lap. This gave the patient a peculiar pleasurable 
 feeling, but he knew no explanation of it. At sixteen he had the first 
 erections — at the sight of men. 
 
 At twenty he first learned that his sexual condition was perverse, 
 and recognized the fact that what he had taken for friendship was love. 
 He was much frightened at the discovery, and much pjuned. His sympa- 
 thies were directed toward young men of the upper class that were 
 handsomely formed and of pleasing appearance. 
 
 The society of ladies had no effect on him. He was never attracted 
 by the charms of the opposite sex. In his fifteenth 3'ear he had a sensual 
 dream, in which he thought a girl of elegant figure sat opposite him, on 
 a sofa. 
 
 In the theatre it was only the art of the actresses that he admired ; 
 the actors excited his real interest. 
 
 Drinking and smoking had always been very repugnant to him. 
 Hunting and gymnastics, and other masculine occupations, had no 
 interest for him. He did not enter the army, because his general ph}- sieal 
 weakness precluded it. 
 
 The patient has but little sexual desire. He has never had any im- 
 pulse to satisfy himself with persons of his own sex. Some j-ears ago, 
 when he first tried to embrace a man lovingly, he had powerful erection and 
 became greatl^^ excited ; but he was able to control himself and to repel 
 his lover. Thereafter he always avoided such attempts. It was only 
 seldom that he became powerfully excited sexually, and even then he was 
 not driven to satisf3' himself. He was never given to onanism. During 
 the establishment of puberty, the patient liad frequent dreams with pol- 
 lutions, but these were not induced by erotic fancies of any kind. 
 
 Some years ago, for a long time, ejaculation was alwaj's induced by 
 the embrace of a S3'mpathetic man, but this condition of irritable weak- 
 ness disappeared. As years passed, the patient, who had always had a 
 desire for mariiage and a fomily, became anxious on account of the con- 
 viction that tlie inclination toward females, for which he had hoped, 
 would never come. It became more and more clear to him that he was 
 abnormal, and he began to have fears about his virility and his future 
 happiness in life. 
 
 In order to test the matter, he sought a brothel. He foinid a pros- 
 titute of beautiful form ; he had the best will to satisfy himself that he 
 was virile ; the woman did all she could, but in vain. There was no 
 erection, and he withdrew, ashamed. New attempts, under the most 
 favorable circumstances, were likewise failures, though the patient
 
 THERAPY. 349 
 
 brought his imagination to his aid, and thought liimsclf to be embracing 
 a man instead of a woman. 
 
 lie now realized that his ideal — to consummate marriage — was 
 impossible. He felt himself very unfortunate, and dissatisfied with life. 
 Besides, it forced itself upon him that morally he was lowered, because 
 he could not overcome his inclination for his own sex, and his friendship 
 for respectable men of his circle was degraded by sexual feelings. In 
 his consultation with me, the patient was unending in the description of 
 his painful situation. His ideal was marriage. He longed for it, for 
 l)urely ethical reasons. He thought of it as something holy; but the 
 begetting of children, the sexual act, was very repugnant to' him. At 
 the same time, he saw that he could not really mai'ry without being 
 potent. Would not hypnotic suggestion exercise a favorable influence 
 on his sexual life ? He had not the energy of a man of normal sexual 
 condition. He seemed to himself to be all Avrong. He would endure all — 
 to be poor and miserable — if he could but have a normal sexual inclination. 
 When the patient was gently told of the congenital and deep con- 
 stitutional significance of his sexual anomaly, and shown that, therefore, 
 the creation of a normal sexual condition was doubtful, he tliought tliat 
 he would be satisfied to remain in his condition. But he wished to know 
 whether it were not possible to eradicate his inclination for men, without 
 attempting to create an ecpiivalent for women ; and if, in hypnosis, it could 
 not be suggested to him that, in the future, men be a matter of indiflerence 
 to him, and that, in intercourse with his friends, he no longer be excited 
 sexually. Such a result would elevate very much his moral feeling, and 
 make him satisfied and unembarrassed in social relations with hi^ friends. 
 The possibility of such suggestive removal of feelings by hypnosis 
 could not be gainsaid, though he was in doubt as to whether he could be 
 hypnotized or not, since the hypnoscope had proved to have no eflect 
 u[)on him. 
 
 Out of pity and scientific interest, I decided to make an immediate 
 attempt at hypnosis, after Bernheim's method. 
 
 The patient passed easily into a condition of deep lethargy, and, in 
 a drawling voice, repeated the following suggestion : " I feel that, from 
 this time, I am sexually indifl'erent to men; and, that a man is as sexually 
 indifferent to me as a woman." 
 
 When I counted three, — having suggested previously that he awake 
 at three, — the patient came to himself, as if out of a deep sleep, and per- 
 formed immediately the post-hypnotic suggestion to oi)en the door of 
 the stove. He said that he had not lost consciousness entirely, that he 
 had felt as one paralyzed and without will, and that he hud felt a 
 peculiar creeping sensation in all his limbs. 
 
 After five days the patient came again. In manner he was a 
 difierent person, and he said, joyfully, that he felt like another man. 
 Energy and will-power — the loss of which he had felt so keenly — had
 
 350 PSYCHOPATHIA SEXUALIS. 
 
 returned. He felt, now, entirely unembarrassed toward men, and had a 
 new joy in living. 
 
 The following seven days he was hypnotized. Hypnosis is no 
 longer as deep as at first, though the suggestion is always accepted and 
 repeated. However, he is quite profoundly influenced ; for, the sugges- 
 tion given, he sleeps on, in a state of lethargy, for ten minutes, and has 
 to be awakened by suggestion. This alwaj-s occurs as if from a deep 
 sleep, — slowly, and through a stage of somnolence. 
 
 After the eighth sitting the patient found himself well and happy, 
 and in possession of full self-confidence. He had the feeling and the 
 evidence that men had no influence on him. 
 
 He thought he could dispense with h3'pnotic treatment, and grate- 
 fully took his leave, with the promise that, should the influence of the 
 suggestion fade, he would come again. Since then, I have heard nothing 
 more of this interesting patient, and I have reason to hope that he 
 remains improved. 
 
 The patient is, in all respects, of masculine appearance; beard 
 abundant. Physically, with the exception of slight neurasthenic s^mp- 
 toms,he presents nothing remarkable. Genitals normal. (Personal case. 
 Internal. Gentralblatt, etc., Bd. i. Heft 1.) 
 
 Case 144. X., aged 33; single; tall. Mentally, of small endow- 
 ment ; comes of tainted famil3^ Paternal grandfather died at thirty -four 
 with a mental disease, which is said to have developed as a result of 
 onanism and spermatorrhoea. His father and brother suffered with dis- 
 turbances of the sexual functions. There was insanity in the mother's 
 family ; other branches of the family were noted for their irritable and 
 eccentric character. 
 
 The patient has too small a head, a retreating brow, abnormal ears, 
 sparse growth of hair, and a hernia, which is probably congenital. 
 Genitals large, and normall}^ developed. 
 
 Great impressionability ; neiiropathic constitution ; occasional tse- 
 dium vitJB. For several 3'ears, peculiar, imperative ideas : that he is a 
 locomotive ; a horse ; a velocipede ; and, that he must act accordingly. 
 From his earliest youth, contrary sexual feeling (congenital). Horror 
 feminse ; sexual inclination toward boys ; satisfaction by sensual contact, 
 and, faute de mieux, masturbation. One day he had an aftair with a 
 boy dressed in gray, Avhich made a deep impression on him. Since then, 
 while masturbating, the image of the boy comes into his mind ; and he 
 cannot see gra}' clothes without having powerful erections. On the 
 advice of phj'sicians whom he consulted, he attempted coitus with 
 women, but was cold and impotent, notwithstanding the assistance of 
 memory -pictures of the boy dressed in gray ; and he finally gave up the 
 efforts. 
 
 March 27th, first hypnotic sitting. Small result. He resists, and 
 says his fancy keeps him from going to sleep.
 
 THERAPY. 351 
 
 In a further series of sittings he declares that he experiences un- 
 favorable effects, — is more excited, and trouljled by imperative ideas and 
 the desire to masturbate. He maizes fun of the physician and hypnotism, 
 and offers much resistance, with the expression that hypnotism is good 
 for nothing, and only makes people crazy. 
 
 However, gradually it became possible to induce somnambulism. 
 After twenty-flve sittings the patient confessed that he was better, and 
 that he was less troubled with imperative ideas and onanism. The sit- 
 tings were repeated ever}^ week or two. The patient felt mentally and 
 morally well, ceased to masturbate, but, at the end of treatment, was in- 
 different toward the opposite sex (Dr. Ladame, Beuue de Vhyjmotisme, 
 September 1, 1889). 
 
 In the two foregoing cases there was successful suggestive 
 removal of homo-sexual feelings, — a result which, as Case 143 
 sliows, means a great improvement for such unfortunate indi- 
 viduals, in that it protects them from shame and the law. An 
 entirely different and phenomenal result is presented hy the 
 following case, reported hy Dr. v. Schrenk-Notzing in the 
 Wiener internat. Idin. Rwulsehmi, October 6, 1889, No. 40, 
 which is a case of effemination. It discloses a new method 
 of treatment of urnings ; but it is necessary to guard against 
 illusions. Only where hypnosis can be deepened to somnam- 
 bulism, are decided and lasting results to be expected: — 
 
 Case 145. Gomjenital Contrary Sexual Instinct Improved by 
 Hypnotic Suggestion. — R., official, aged 28. January 20, 1888, he sought 
 medical advice. He is the brother of the patient who is the subject of 
 Case 135, and, therefore, of a badly tainted fomily (u. supra). Toward the 
 end of treatment, he confessed that he was the author of the autobiography 
 which was pviblished as Case 83 in the fifth edition of this work, and it 
 is here reproduced : — 
 
 " In brief, my abnormality consists of this, that in sexual relations I 
 feel myself to be completely feminine. Since my earliest youth, in my 
 sexual acts and fancies, I have always had before my eyes only images 
 of masculine beings and masculine genitals. 
 
 " Until I went to the University, 1 found nothing in this (I had never 
 spoken with others about my fancies, but rather, while at the Gymnasium, 
 lived a silent and retired life). 
 
 " While at the University, it struck me that female persons made not 
 the slightest impression on me. Since then, in houses of prostitution, 
 etc., I have attempted coitus, or only to obtain an erection, with women, 
 but always in vain.
 
 352 PSYCHOPATHIA SEXUALIS. 
 
 " Erection ceased immediately, as soon as I was in a room alone with 
 a woman. At first I considered it impotence, though, at the same time, I 
 was so excited sexually that I had to masturbate several times during the 
 day in order to sleep. 
 
 " Quite different, however, has been the development of my feel- 
 ings toward the masculine sex, and it has grown stronger every year. 
 At first they expressed themselves in extraordinary, enthusiastic friend- 
 ship for certain persons, under whose windows at night I would wait 
 for hours ; whom in all possible ways I would try to meet on the streets, 
 and with whom I sought to come in contact. I wrote such persons 
 the most passionate letters, in which, however, I was shy in express- 
 ing my feelings too plainly. Later, after my twentieth year, I came 
 to understand the essential nature of my inclinations, particularly from 
 the sensual pleasure I experienced as soon as I came in direct contact 
 with any of these friends. These persons were all finely built men, 
 with dark hair and eyes. I have never had my feelings excited by boys. 
 Real pederasty is absolutely incomprehensible to me. About this time 
 (twenty-second to twenty-third year) the circle of my beloved friends 
 grew more and more extensive. Now I can scarcely see a handsome man 
 on the street without having the wish to possess him excited in me. The 
 fact is, I especially love persons of the lower classes, whose powerful 
 forms attract me, — soldiers, policemen, car-drivers, etc., — i.e., all that wear 
 uniforms. If one of these returns my look, I feel a kind of thrill go 
 through my whole body. I am especially excitable in the evening, and 
 merely the heavy tread of a soldier is alone sufllcient to induce the 
 most powerful erections. I take a very peculiar pleasure in following 
 such persons and looking at them. As soon as I learn that they are 
 married, or that they consort with girls, my excitement very frequently 
 ceases. 
 
 *' A few months ago I became able to control my inclinations to 
 such an extent that they were not directly noticeable. About this time I 
 followed a soldier who seemed likely to acquiesce in my desire, and spoke 
 to him. For money he was ready for anything. At once I was filled 
 with a most violent longing to embrace and kiss him, and the danger of 
 being noticed did not deter me from doing it. lie had scarcely grasped 
 my genitals when ejaculation followed. With this meeting, I had finally 
 attained the long-desired goal of my life, I knew that my whole nature 
 would find its happiness and satisfaction in it, and from this time I gave 
 myself up entirely to the effort to find a person whom I could love, and 
 from whom I should never part. For my acts I do not experience the 
 slightest twinge of conscience. 
 
 " To be sure, in quiet moments, I very well appreciate the difference 
 between my way of thinkmg and the way of the world ; as a lawyer, too, 
 I naturally recognize the dangers of a relation of the kind I desire ; 
 but, as long as my entire nature does not change, I shall not be able to
 
 THERAPY. 353 
 
 give up the opportunities offered me. Nevertheless, I should be willing 
 to undergo any cure to be freed from my abnormal condition. 
 
 " I recognize my feminine feeling, among otlier things, in tlie fact 
 that any sensual idea in connection with a woman must be forced, and 
 seems unnatural to me. I am also sure that my respect for a woman — 
 I move much in the society of ladies, and enjoy it — would change imme- 
 diately to repugnance, were I to notice any sensual inclination in her 
 toward me. In my di'eams and sensual fancies of men, I always think 
 of myself in such positions with them that their faces are always toward 
 mine. My greatest delight would be to have a powerful man, undressed, 
 take me in his arms with a force 1 could not resist. In such situations 
 I always think of myself in a passive role, and have to force my feelings, 
 in order to think of myself in any other position. In this, I am truly 
 feminine. Great as my desire may be to a|)proach certain persons, my 
 struggle is as great not to allow this to be noticed. Moustaches, abund- 
 ance of hair, and even dirt, seem to be especially enticing. It is hardl>' 
 necessary to say that, to me, mj^ condition, with reference to society, is 
 absolutely desperate ; and, if I had not the hope of finding a l)eing that 
 would understand me, life would be scarcely endurable. I feel that 
 sexual commerce with a man is the only means of successfully combating 
 my impulse to onanism. Though this has a very bad effect on me, I 
 cannot keep myself from it constantly, because, as I have ©ften found, 
 I will be even more weakened by pollutions at night and persistent 
 erections during the day. 
 
 " Up to this time I have truly loved but two men. Both were 
 ofBcers, remarkably endowed mentally, handsomely and gracefully formed, 
 and of dark skin and eyes. I became acquainted with the first at the 
 University. I was madly in love with him, and suffered unspeakably on 
 account of his indifference. I spent nights under his window, simply 
 to be near him. When he was oflicially transferred, I was in despair. 
 
 " Soon after, I became acquainted with an officer that resembled 
 him, who likewise enchained me at first sight. I sought every opportu- 
 nity to meet him, spent the day in the streets, and at places where I 
 hoped to get a sight of him. I knew how the blood came into my face 
 when, unsuspected, I saw him. When I saw him friendly with others, 
 I could scarcely contain myself for jealous}-. When I sat near him, I 
 was impelled to touch him. I could scarcely conceal my excitement 
 when I touched his knee or thigh. I never ventured, however, to express 
 my feelings to him ; for, from his conduct, I was convinced that he would 
 not understand them or share them. 
 
 " I am twenty-seven years old, of medium height, and well-developed, 
 and would be considered handsome. My chest is somewhat narrow, 
 hands and feet small, and voice weak. Mentally, I think I am well en- 
 dowed ; for I passed the State examination with distinction, speak several 
 languages, and am a good painter. 
 
 23
 
 354: PSTCHOPATHIA SEXUALIS. 
 
 " In my calling I pass for one that is industrious and conscientious. 
 My acquaintances think me cold and peculiar. I do not smoke, do not 
 pla^' games, and cannot sing or whistle. My gait, like my voice, is some- 
 what aflected. I have much taste for elegance, love adornment, sweet- 
 meats, and perfumes, and prefer the society of ladies." 
 
 From Dr. von Schrenk's notes of the case, it is learned, further, 
 that social and criminal deterrents, on the one hand, and uncontrollable 
 desire for his own sex, on the other, caused violent mental struggles, and 
 made life unendurable. For this reason the patient confided in the 
 ph3"sician. January' 22, 1889, hypnotic treatment, with suggestion, after 
 the method of Nancy, was begun with the patient. Gradually it became 
 possible to induce somnambulism. 
 
 The suggestions were made with reference to indifference to men, 
 and ability to resist them, and to increase of interest in women ; mastur- 
 bation was thus forbidden, and women substituted for men in lascivious 
 dreams. After a few sittings pleasure at sight of women was induced. 
 At the seventh sitting successful coitus was suggested; this was fulfilled. 
 
 During the next three months the patient renuiined, under the in- 
 fluence of occasional hj'pnotic suggestions, in the full possession of 
 normal sexual functions, April 22, 1889, there was a relapse, induced by 
 a companion. At the next sitting, remorse and shame. As expiation, 
 coitus with'a woman in the presence of his seducer. 
 
 The patient complained that coitus with women below him in station 
 did not satisfy his sesthetic feelings. He hoped to find satisfaction in a 
 happ3' marriage. After fort3'-five sittings (Maj^ 2, 1889) the patient con- 
 sidered himself cured. Treatment ceased. He became eno-aoed to a 
 young lad}' some weeks later, and presented himself again, after six 
 months, as a happy bridegroom. He thought that, in his happiness with 
 his wife, he had a sure preventive against relapse. 
 
 The author emphasizes the fact that the hj'pnotic treatment had 
 no injurious collateral effect, and leaves undecided the question as to 
 whether the cure is permanent or not, with R.'s ver^' bad heredit3% 
 But he expresses the conviction that, in case of relapse, renewed hj^p- 
 notic treatment would not be contra-indicated. 
 
 Since the incredible result of this case interested me exceed- 
 ingly, as did its further course, I wrote to the autlior, requesting 
 information concerning liis patient. 
 
 Dr. V. Schrenk very kindly placed at my disposal the follow- 
 ing letter, which he had received from the patient in January, 
 1890:— 
 
 " B}^ means of suggestive treatment given me by Baron Schrenk, 
 for the first time I became possessed of the psychical condition that
 
 THERAPY. 355 
 
 permitted me to have intevcouvse wM,li a woman, which, up to that time, 
 in spite of repeated efforts, I had been unable to do successfull3\ 
 
 " Since my itsthetic needs were unsatisfied by intercourse with 
 prostitutes, I thought to find ni}' real salvation in matrimony. The 
 earlier friendly inclination toward a lady known in my youth oftered me 
 the opportunity, the more because I believed that she, of all others, would 
 be in a position to awaken feelings for the opposite sex which were abso- 
 lutely foreign to me. Her character, — i.e., our harmony, — is in such 
 accord with my inclinations that I am full}^ convinced that I shall also 
 find complete psycliical satisfaction. This conviction has not changed 
 during the eight months of my engagement. 
 
 " I intend to be married in about four weeks. 
 
 " As far as my position with respect of ni}^ own sex is concerned, 
 my power of resistance — and this is the lasting positive result of this 
 treatment — is absolutely changed in degree. While previously it was 
 impossible for me to overcome an intense sexual excitation when I saw a 
 finely formed car-driver, to-dny, in the company of my former lovers, I 
 am without sexual excitement. At the same time, I must add that now, 
 as formerly, their society has a certain attraction for me, though it is 
 not to be compared with my earlier passion. 
 
 " On the other hand, I have refused repeated persuasions to indulge 
 in sexual intercourse with men, without expending much force in resist- 
 ance, — persuasions which formerly I should have been unable to resist. 
 I may say, indeed, that it is a feeling of compassion for my former lovers, 
 that have proved their passionate devotion to me, which keeps me from 
 directly repulsing them. My action seems to be due to a feeling of duty, 
 rather than to inner need. 
 
 " Since the conclusion of treatment, I have not consorted with pros- 
 titutes. This circumstance, and the numerous letters and persuasions 
 from my former lover, may well be the reason why, in the eight months 
 that have elapsed, I have allowed him to persuade me to sexual intercourse 
 on three or four occasions. At these times I have always been conscious 
 of being completely master of myself, as compared with my earlier pas- 
 sionate condition in like situations, as the violent reproaches of my friend 
 convinced me. I always feel a certain unconquerable rejnignance, which 
 cannot he based on moral grounds, but which, I believe, must be attributed 
 to the treatment. I no longer feel a love for him in the former sense. 
 Besides, since the treatment, I have sought no opportunities for sexual 
 intercourse with men, and I feel no need of it. But, formerly, not a day 
 passed on which I did not feel impelled to it, so that at times I was 
 unable to think of anything else. Aw^ake or dreaming, ideas of sexual 
 content are very infrequent. 
 
 " I may express the belief that my marriage, that is to take place 
 in a few weeks, and the much desired change of place that is bound to it, 
 will entirely remove the residuum of my earlier condition. I conclude
 
 356 PSYCHOPATHIA SEXUALIS. 
 
 tliese lines with the honest assurance that, subjectively, I am another man, 
 and that this change has restored the mental equilibrium that was 
 previously wanting." 
 
 The foregoing words, which Dr. v. Schrenk completes with 
 the verbal statement of the patient that he had not practiced 
 onanism again, are a brilliant proof of the lasting effect of post- 
 hypnotic suggestion. I consider the hetero-sexual instinct of 
 the patient to be the artificial creation of his excellent physician ; 
 and the patient himself seems to recognize this, in tliat he 
 speaks of a repugnance which "docs not rest on moral grounds, 
 but which depends on the treatment." 
 
 The further fate of this interesting patient may be learned 
 from the following letter, kindly submitted by Dr. v, Schrenk: — 
 
 " Honored Sir : Having been home some days from my wedding- 
 journey, I wish to send you a short report of my present condition. 
 During the week before mj"^ wedding I was in great excitement, because 
 I feared that I should be unable to perform certain duties. The impelling 
 thoughts of my friend, who wished another meeting with me, at any 
 price, had no effect on me. We had not seen each other since I heard 
 from you last. [Receipt of the professor's letter.] However, I was 
 much troubled with the thought that my marriage must be unhapp}'. 
 Now, however, I have no anxiet3\ To be sure, on the first night, success 
 was difficult, — to induce sexual excitation in mj-self, — but on the follow- 
 ing night, and since, the influences needed for a normal man, I believe, 
 would have been sufficient for me. I am also convinced that the harmony 
 between us, which, of course, is mentally of long standing, will become 
 more and more complete. A relapse to the former condition seems 
 impossible. It is, perhaps, significant for my present condition, that I 
 one niglit dreamed of my former lover, and that the dream was not 
 sensual, and did not excite me sensually. 
 
 " I am satisfied with my present circumstances. I am, of course, 
 
 well aware that my present inclinations are far from being of a degree 
 
 equal to what they formerly were. I believe, however, that they will 
 
 daily grow stronger. Already ray former life is incomprehensible, and I 
 
 cannot understand why I did not earlier tliink to overcome the abnormal 
 
 sexual instinct by normal sexual indulgence. A relapse would now be 
 
 possible only with an entire change of my mental life; and, in a word, it 
 
 seems impossible. 
 
 " Your obedient servant, d." 
 
 From a letter of Dr. v. Schrenk's, of December 7th, I 
 extract the following : —
 
 THERAPY. 357 
 
 " In this case the cure seems to be of longer duration than I ex- 
 pected ; for, on speaking with tlie patient, some months ago, he said that 
 he was perfectly happy in marriage, and, as I hear, he expects soon the 
 happiness of a fatlier." 
 
 Dr. V. Schrenk has reported in the Wiener infernationalen klinischen 
 Eundschau, 1891, No. 26, hiter and very interesting facts concerning his 
 patient, which, therapeutically, are very satisfactor3^
 
 IV. SPECIAL PATHOLOGY. 
 
 THE MANIFESTATIONS OF ABNORMAL SEXUAL LIFE IN 
 THE VARIOUS FORMS AND STATES OF MENTAL 
 
 DISTURBANCE. 
 
 Arrest of Mental Development. 
 
 Sexual life in idiots is, in general, but slightly developed. 
 It is wanting entirely in idiots of high grade. In such instances 
 the genitals are frequently small and deformed, and menstrua- 
 tion is late or does not occur at all. There is impotence, or 
 sterility, as the case may be. Even in idiots of low grade, 
 sexuality is not prominent. In infrequent cases it is manifested 
 with a certain periodicity, and then with greater intensity. It 
 may then be expressed impulsively, and be violently satisfied. 
 Perversions of the sexual instinct do not occur at the lowest 
 levels of mental development. 
 
 When the desire for sexual satisfaction is opposed in these 
 cases, great passion is excited, with danger of murderous 
 assault on the persons attacked. It is to be expected that 
 idiots should not exercise choice, and they attempt to satisfy 
 the sexual instinct on their nearest relatives. 
 
 Tims Marc-Ideler reports the case of an idiot who attempted to 
 rape his sister, and had almost strangled her when he was discovered. 
 
 Friedreich reports an analogous case {Friedreich's Blatter, 1858, 
 p. 50). 
 
 I have repeatedly had occasion to give opinions in cases of attempts 
 to rape little girls. 
 
 Giraud (Annal. med. psych. ^ 1885, Nr. 1) also reports a case of this 
 kind. Consciousness of the significance of the act is alwa3's wanting; 
 an instinctive knowledge that such obscene acts are not publicly per- 
 mitted is often present, and causes the attempted sexual act to be 
 undertaken in a deserted place. 
 
 In imbeciles the sexual instinct is usually developed as in 
 normal individuals. The moral inhibitory ideas are cloudy, 
 (358)
 
 IMBECILITY. 359 
 
 and, therefore, the sexual impulse is more or less openly mani- 
 fested. For this reason imheciles are sources of disturbance in 
 society. Abnormal intensity and perversion of the sexual 
 instinct are infrequent. 
 
 The most frequent manner of satisfaction of the sexual 
 desire is onanism. The weak-minded seldom make sexual 
 attacks on adults of the opposite sex. 
 
 Sexual satisfaction witli -animals is frequently attempted. 
 The great majority of cases of injury (sexual) to animals must 
 be attributed to imbeciles. Children are quite often their 
 victims. 
 
 Einminghaus (Maschka's Haiulb. iv.,p. 234) draws attention to the 
 frequency of open manifestation of sexual instinct, wliicli comprises 
 open masturbation, exhibition of the genitals, attacks on children and 
 those of the same sex, and sodomy. 
 
 Giraud (AnnaJ. med. j^sycJioh, 1855, Nr. 1) has reported a 
 w^hole series of immoral attacks on children : — 
 
 1. H., aged 17, imbecile, enticed a little girl into a barn, by giving 
 her nuts. There he exposed her genitals and showed his own, making 
 movements of coitus on the child's abdomen. He had no idea of the 
 moral significance of the act. 
 
 2. L., aged 21 ; imbecile ; degenerate. While he was watching cattle, 
 his sister of eleven years, with a playmate of eight years, came and told 
 him how some unknown man had attempted to do them violence. L. 
 led the children to a deserted house and attempted coitus with the 
 jounger child, but let her go because no emission occurred, and because 
 the child cried out. On the way home lie promised to marr3' her if she 
 would not say anything. At the trial he tliought tliat by marriage he 
 could right the wrong he had done.^ 
 
 3. G., aged 21, microcephalic, imbecile, has masturbated since his 
 sixth year, and practiced active and passive pederasty. He has repeat- 
 edly tried to perform pederasty with boys, and attacked little girls. He 
 was absolutely witliout an understanding of his acts. His sexual desire 
 was manifested periodicall}^ and intensel}', as in animals.^ 
 
 1 For numerous cases, v. Henke's Zeitschr.,xxiii. — Erganzungsheft, p. 147. — Combes, 
 Annal. m^d. ps}'cliol., 18G0. — Liinan, Zweifelh. Geisteszustamlc, p. 389. — Casper-Liinau, 
 Lehrb., 7. Auflage, Fall 29.5.— Bartels, Friedreifh's Blatter f. geriehtl. Med., 1890, Heft 1. 
 
 2 Other cases of pederasty, v. Casper. Kliu. Novellen, Fall 5 ; Combes, Annal. m6d. 
 psycliol.
 
 360 PSYCSOfATHiA SEXUALlS. 
 
 4. B., aged 21 ; imbecile. While alone in a forest with his sister of 
 nineteen, he demanded that she allow coitus. She refused. He threat- 
 ened to strangle her, and stabbed her with a knife. The frightened girl 
 fondled his penis, and he then left her and quietly went on with his work. 
 B. has a deformed, microcephalic skull, and has no sense of the signifi- 
 cance of his act. 
 
 Emminghaus {pp. cit., p. 234) reports the case of an 
 exhibitionist : — 
 
 Case 146. A man, aged 40, married, had for sixteen j-ears been 
 accustonied to exhil)it himself in parks, at dusk, to little girls and ser- 
 vants, and drew tiieir attention to himself l\y whistling. After having 
 been frequently punished for it, he avoided the places, but he carried on 
 his practice elsewhere. H3^drocephalus. Mental weakness of slight 
 degree. Mild sentence passed. 
 
 Case 14Y. X., of tainted family ; imbecile; defective and perverted 
 in intellect, feeling, and will. For help and protection he was brought 
 before an officer. It was complained that he had repeatedly exposed 
 his genitals to servant-girls, and had shown himself at windows with 
 the ui)per ])ortion of his body naked. . No other manifestations of 
 sexual instinct. No onanism reported. (Sander, Archiv f. Psych., i, 
 p. 655.) 
 
 Case 148. PederaMyioith a Child. — On April 8, 1884, at ten o'clock 
 A.M., while X. was sitting on the street, holding a boy of eighteen months 
 on her lap, a certain Vallario approached and took the child from X., 
 saying he was going to take it for a walk. He went the distance of half 
 a kilometre, and returned, saying that the child had fallen from his arms, 
 and thus injured its anus. The anus was torn, and blood was pouring 
 from it. At the place where the deed was done, traces of semen were 
 found. V. confessed his horrible crime, and, at his final trial, be acted 
 so strangeh' that an examination of his mental condition was made. He 
 had impressed the prison attendants as being an imbecile. V., aged 
 45, mason, defective morally and intellectuall}^ is dolicho-microcephalic ; 
 has narrow, deformed facial bones, and the halves of the face and 
 the ears are asymmetrical; the brow is low and retreating; genitals 
 normal. Y. shows general diminution of cutaneous sensibility, is im- 
 becile, and lias no ideas. He lives in the present, has no ambition, and 
 does nothing of his own will. He has no desires and no emotional 
 feeling. He has never had coitus. Nothing more could be ascer- 
 tained about his vita sexualis. Proofs of intellectual and moral idiocy, 
 due to microcephal}^ ; the crime is referred to a perverse, uncontrollable 
 sexual impulse. Sent to an as^-lum. (Yirgilio, i7 il!/ameo7mo, V. ^^ear, 
 No. 3.)
 
 DEMENTIA. 361 
 
 A case mentioned by L. Meyer {Arch. f. Psych., Bd. i, p. 
 103) shows how female imbeciles may indulge in shameless 
 prostitution and immorality.^ 
 
 States of Acquired Mental Weakness. 
 
 The numerous anomalies of the vita sexualis in senile 
 dementia have been described in the section on " General 
 Pathology." In other conditions of acquired mental weakness, 
 — those due to apoplexy ; trauma capitis ; to the secondary 
 stages of psychoses ; or to inflammatory processes in the cortex 
 (lues, paretic dementia), — perversions of the sexual instinct 
 seem to be infrequent ; and here the immoral sexual acts seem 
 to depend on abnormally increased or uninhibited sexual feeling, 
 which, in itself, is not abnormal. 
 
 (1) Dementia Consecutive to Psychoses. 
 
 Casper {KUn. NoveUen., Fall 31) reports a case that belongs 
 here. It is tbat of a physician, aged 33, who attempted rape 
 on a child. He was weakened mentally, as a result of hypo- 
 chondriacal melancholia. He excused his deed in a very 
 silly way, and had no appreciation of the moral and criminal 
 meaning of the act, which was apparently the result of a sexual 
 impulse that could not be controlled on account of his mental 
 weakness. 
 
 Case 21, in Liman's ZweifeJhafte GeisteszusfdndeM, is an 
 analogous case (dementia after melancholia ; offense against 
 morals by exhibition). 
 
 (2) Dementia After Apoplexy. 
 
 Case 149. B., aged 52. He passed through a cerebral attack, and 
 was no longer al)le to carry on his business as a merchant. 
 
 One day, in the absence of his wife, he locked two girls in the 
 house, gave them liquors to drink, and then carried out sexual acts with 
 the children. He commanded them to say nothing, and went to his 
 business. The medical expert established mental weakness, resulting 
 from repeated apoplexies. B., who, up to this time, had been well- 
 
 » V. Sander, Vierteljahrsschr. f. ger M., xviii, p. 31. — Casper, Klin. Novellen, Fall 27.
 
 362 PSYCHOPATHIA SEXUALIS. 
 
 bebuved, says he committed the criminal act because of an uncontrollable 
 and incomprehensible impulse ; and that, when he came to himself, he 
 was ashamed, and sent the girls away. Since his apoplectic attack, B. 
 had been weak-minded, incapable of business, and hemiplegic; but, soon 
 after arrest, he made an unskillful attempt at suicide. He often cried 
 childishly. His moral and intellectual energy in opposing his sensual 
 impulses was certainl}^ much weakened. No sentence. (Giraud, Ann. 
 med. Ps<ychol. March, 1881.) 
 
 (3) Dementia After Injury of Head. 
 
 Case 150. K., when fourteen years old, was injured on the head by 
 a horse. The skull was fractured in several places, and several pieces of 
 bone required removal. 
 
 From that time K. was weak mentally, passionate, and ill-tempered. 
 Gradually he developed an inordinate and truly beastly sensuality, which 
 drove him to the most immoral acts. One day he raped a girl of twelve, 
 and strangled iier for fear of discovery. Arrested, he confessed. The 
 medical experts declared him responsible, and he was executed. 
 
 The autopsy revealed ossification of almost all the sutures, remark- 
 able asymmetry of the halves of the skull, and evidences of healed 
 fractures. The affected hemisphere had bands of cicatricial tissue run- 
 ning through it, and was one-third smaller than the other. (Friedreich's 
 Blatter, 1885, Heft G.) 
 
 (4) Acquired Mental Weakness, Probably Resulting from Lues. 
 
 Case 151. X., officer, had repeatedly committed immoral acts with 
 little girls ; among other things, he had induced them to perform manus- 
 tupration on him, had exposed his genitals, and handled theirs. 
 
 X., formerly healtiiy, and of blameless life, was infected with 
 syphilis in 1867. In 1879 paralj'sis of the left abducens occurred. 
 Thereafter mental weakness was noticed, with a change of his disposi- 
 tion and character. Headache, occasional incoherence of speech, failure 
 of power of thought and logic, occasional inequality of pupils, and 
 paresis of the right facial muscles, were observed. 
 
 X., aged 37, shows no trace of lues when examined. The paralysis 
 of the left abducens is still present. The left ej'e is amblj'opic. He is 
 mentally weak. Concerning tlie trial that was before him, he said it was 
 nothing but a harmless misunderstanding. Indications of aphasia. 
 Weakness of memory, particularly for recent events. Superficial emo- 
 tional reaction ; rapid exhaustion of memory and ability to speak. 
 Proved : that the ethical defect and the perverse sexual impulse are the 
 symptoms of an abnormal condition of brain induced by lues. 
 
 Suspension of criminal proceedings. (Personal case. Jahrbucher 
 fur Psychiatric.)
 
 DEMENTIA. 363 
 
 (5) Paretic Dementia. 
 
 Here the sexual life is usually abnormally affected ; in 
 the incipient stages of the disease, as well as in episodical 
 states of excitement, it is intensified, and sometimes perverse. 
 In the final stages libido and sexual power usually become 
 nil. 
 
 Just as in the prodromal stage of the senile forms, one 
 sees here, in connection with more or less evident losses in the 
 moral and intellectual spheres, expressions of an apparently 
 intensified sexual instinct (obscene talk, openness in intercourse 
 with the opposite sex, thoughts of marriage, frequenting of 
 brothels, etc.), which is characteristic of the clouding of con- 
 sciousness. 
 
 Seduction, abduction, and public scandal are here the order 
 of the day. At first there is still some appreciation of the 
 circumstances, though the cynicism of the acts is striking 
 enough. As the mental weakness increases, such patients 
 become criminal by reason of exhibition, masturbation in the 
 streets, and attempts at immoral acts with children. 
 
 If conditions of mental excitement come on, attempts at 
 rape are committed, or, at least, grossly immoral acts, — the 
 patient attacks women on the street, appears in public in very 
 imperfect dress ; or, half-clothed, tries to force his way into 
 strange houses, to cohabit with the wife of an acquaintance, or 
 to marry the daughter on the spot. 
 
 Numerous cases belongiug to this cfitegoiy are cited by Tardieu 
 (" Attentats aux moeurs ") ; Mendel (" Progressive Paralj'se der Irren," 
 1880, p. 123); Westphal {Arch. f. Psijch.,\\\,p. 622); and a case by 
 Petrucci {Annal. med. Psychol.^ 1875) shows that bigamy ma}' also occur 
 here. 
 
 The brutal disregard of consequences with which the patients in 
 the advanced stages attempt to satisfy' their sexual instinct, is charac- 
 teristic. 
 
 In a case reported b}^ Legrand (" La folic," p. 519), tlie father of a 
 family was found masturbating in the open street. After the act he 
 consumed his semen. 
 
 A patient seen b}' me, an officer, of a prominent famil}', in broad 
 daylight, made attacks on little girls at a watering-place.
 
 364 PSYCHOPATHIA SEXUALIS. 
 
 A similar case is reported by Dr. Regis (" De la dynamie ou exalta- 
 tion fonctionnelle au debut de la paral. gen,," 1878). 
 
 Cases reported by Tarnowsk}^ {op. cit., p. 82) show that also peder- 
 asty and bestiality may occur in the prodromal stages and course of 
 this malady. 
 
 Ejniepsy. — Epilepsy is allied to the acquired states of 
 mental weakness because it often leads to them, and then all 
 the possibilities of reckless satisfaction of the sexual impulse 
 that have been mentioned may occur. Moreover, in many 
 epileptics the sexual instinct is very intense. For the most 
 part, it is satisfied by masturbation, now and then by attacks 
 on children, and by pederasty. Perversion of the instinct with 
 perverse sexual acts seems to be infrequent. 
 
 Much more important are the numerous cases in literature 
 in which epileptics, who, during intervals, present no signs of 
 active sexual impulse, but manifest it in connection with epileptic 
 attacks, or during the time of equivalent or post-epileptic 
 exceptional mental states. These cases have scarcely yet been 
 studied clinically, and forensically not at all ; but they deserve 
 careful study. In this way certain cases of violence and rape 
 would be understood, and legal murders prevented. 
 
 From the following facts, it will certainly be clear that the 
 cerebral changes which accompany the epileptic outbreak may 
 induce an abnormal excitation of the sexual instinct. Besides, 
 in the exceptional mental states of epileptics, they are unable 
 to resist their impulses, by reason of the disturbance of con- 
 sciousness. 
 
 For years I have known a young epileptic, of bad heredity, who, 
 always after frequent epileptic seizures, attacks his mother, and tries to 
 violate her.^ After a time he comes to himself, and has no memory of 
 his acts. In the intervals he is very strict in morals, and has but slight 
 sexual inclination. 
 
 1 Arndt (Lelirb. d. Psj'ch., p. 410) especially emphasizes the passionate element In 
 epileptics : " I have known epilepsy that expressed itself in a most sensual way toward the 
 mother, and that that rested under a suspicion ou the part of fathers, concerning sexual 
 intercourse with the mothers." But when Arndt declares that, wherever there is a pecu- 
 liarity of the sexual life, thought of an epileptic element should come into consideration, 
 he is in error.
 
 EPILEPSY. 365 
 
 Some 3'ears ago I became acquainted with a young peasant, who, 
 during epileptic attacks, masturbated shamelessly', but during the inter- 
 vals was above reproach. 
 
 Simon (" Crimes et debts," p. 220) mentions an epileptic girl of 
 twenty-three, well educated, and (jf the best morals, who, in attacks ol" 
 vertigo, would shout out obscene words, then raise her dress, make las- 
 civious movements, and try to tear open her under-garments. 
 
 Kiernan (Alienist and Neurologist, January, 1884) reports the case 
 of an epileptic who alwn^'S had, as an aura, the vision of a beautiful 
 woman in lascivious attitudes, which induced ejaculation. After some 
 years, with treatment with potassium bromide, tlie vision was changed to 
 that of a devil attacking him with a pitchfork. The instant this reached 
 him, he became unconscious. 
 
 The same author speaks of a very respectable man who had, two 
 or three times a year, epileptic attacks of furor and dysthymia, with 
 impulses to pederasty, which lasted a week or two ; and of a lady who, 
 with epilepsy that came on during the climacterium, had sexual desire 
 for boys. 
 
 Case 152. W., of good heredity, previously healthy ; befoi'e and 
 after, sound mentally, quiet, kind, temperate. On April 13, 187*7, he had 
 no appetite. On the 14th, in the presence of his wife and children, he 
 demanded coitus, first of his wife's friend, who was present, then of his 
 wife. Taken aw\ay, he had an epileptoid attack ; after this he became 
 wildl}^ maniacal and destructive, threw hot water on those that tried to 
 approach him, and threw a child in the stove. Then he soon became 
 quiet, but for some days remained confused, and finally came to himself 
 with no memory of the events of his attack. (Kowalewsky, Jahrbucher 
 f. Psych., 1879.) 
 
 Another case, examined by Casper {Klin. Novellen, p. 267), may 
 be attributed to epilepsy (larvated). A respectable man attacked four 
 women, one after another, in the open street (once before two witnesses), 
 and violated one of them, " notwithstanding that his young, pretty, and 
 healthy wife " lived hard by. 
 
 The epileptic significance of the sexual acts in the follow- 
 ing cases is unequivocal : — 
 
 Case 153. L., oflflcial, aged 40; a kind husband and father. During 
 four years he has offended public morals twenty-five times, for which he 
 has had to endure long imprisonment. 
 
 In the first seven complaints he was accused of exposing his geni- 
 tals to girls from eleven to thirteen years old, while riding by them, and 
 calling their attention by obscene words. While in confinement, he had 
 exposed his genitals at a window which opened on a popular street.
 
 366 PSYCHOPATHIA SEXUALIS. 
 
 L.'s father was insane ; his brother was once met on the street 
 wearing only a shirt. During his military service L. had had two 
 attacks of severe fainting. Since 1859 he had suffered with peculiar 
 attacks of vertigo, at such times becoming weak, tremulous, and deathly 
 pale ; it grew dark before his e3-es, and he saw bright stars, and was 
 forced to get support in order to keep upright. After violent attacks, 
 great weakness, profuse SAveating. 
 
 Since 1861 he had been very irritable, which, respected though he 
 was as an official, caused him much trouble in his woi'k. His wife 
 noticed the change in him. He had da^^s when he would run about the 
 house as if insane, holding his head between his hands, striking the 
 wall, and complaining of headache. In 1864 he fell to the ground four 
 times, lying there stiff, with eyes open. Confused states of consciousness 
 were also proved to have occurred. 
 
 L. declared that he had not the slightest remembrance of the crime 
 of which he was accused. Observation showed further and more violent 
 attacks of epileptic vertigo. L. was not sentenced. In 1875 pai'etic 
 dementia developed with a rapidh* fotal result. (Westphal, Arck. f- 
 Psych., vii, p. 113.) 
 
 Case 154. A rich man of twenty-six had lived for a 3'ear with a 
 girl with whom he was very much in love. He cohabited infrequently, 
 and was never perverse. 
 
 Twice during the year, after excessive indulgence in alcohol, he 
 had had epileptic attacks. One evening after dinner, where he had 
 taken much wine, he hurried to the house of his mistress, and into 
 her sleeping-apartment, although the servant told him she was not at 
 home. From there he hastened into a room where a boy of fourteen 
 was sleeping, and began to violate him. At the cry of the child, whose 
 prepuce and hand he had injured, the servant hurried to them. He left 
 the boy and attacked the maid ; after that he went to bed and slept twelve 
 hours. When he awoke, he had an indistinct remembrance of intoxica- 
 tion and coitus. Thereafter there were repeated epileptic attacks. 
 (Tarnowsky, op. cit., p. 52.) 
 
 Case 155. X., of high social position, led a dissolute life for some 
 time, and had epileptic attacks. He became engaged. On his wedding- 
 da3% shortly before the ceremony, he appeared, ofi his brother's arm, 
 before the assembled guests. When he came before his bride, he exposed 
 his genitals and began to masturbate. He was at once taken to an expert 
 in mental disease. On the waj' he constantly masturbated, and for some 
 daj's was actuated by this impulse, which gradually decreased in intensity. 
 After this paroxysm the patient had only a confused memory of the 
 events, and could give no explanation of his acts. (Tarnowsky, op. cit., 
 p. 53.) 
 
 Case 156. Z., aged 21 ; very bad heredity ; epileptic. He violated a 
 girl of eleven, and then killed her. He lied about the deed. Absence of
 
 EPILEPSY. 367 
 
 memory, i.e., mental confusion at the time of the erime, was not proved. 
 (Pugliese, Arch, di Psich., viii, p. 622.) 
 
 Case IST. V., aged 60, physician, viohitcd children. Sentenced to 
 imprisonment for two years. Dr. Marandon later proved the existence 
 of epileptoid attacks of apprehensiveness, dementia, erotic and hypochon- 
 driacal delnsions, and occasional attacks of fear. (Lacassagne, Lrjon. 
 med., 1887, No. 51.) 
 
 Case 158. On August 4, 1878, H.,aged 15, was picking gooseberries 
 with several little girls and boys as her companions. Suddenly she 
 threw L., aged 10, to the ground and exposed her, and ordered A., aged 
 8, and 0., aged 5, to bring about conjunctio membrorum with the girl ; 
 and they obeyed. 
 
 H. had a good character. For five years she had been subject to 
 irritability, headache, vertigo, and epileptic attacks. Her mental and 
 physical development had been arrested. She had not menstruated, but 
 she manifested menstrual molimena. Her mother is suspected to be 
 epileptic. For three months H., after seizures, had frequently done 
 strange things, and afterward had no memory of them. 
 
 H. seems to have been deflowered. Mental defect is not apparent. 
 She said she had no memory of the act of which she was accused. Ac- 
 cording to her mother's testimony, she had an epileptic attack on the 
 morning of August 4th, and she had been, on that account, told by her 
 mother not to leave the house. (Piirkauer, FriedreicWs Blatter- f. ge?: 
 Med., 1879.) 
 
 Case 159, Immoral Acts of an Epileptic in States of Abnormal 
 Unconsciousness. — T., revenue -collector; aged 52; married. He is 
 accused of having practiced immorality with boys for about seventeen 
 years, by practicing masturbation on them, and l)y inducing them to 
 carr^' out the act on himself. The accused, a respected officer, is over- 
 come by the terrible crime attributed to him, and declares that he knows 
 nothing of the deeds of which he is accused. His mental integrit}' is 
 questionable. His family physician, who has known him twenty j'ears, 
 emphasizes his peculiar, retiring disposition and his mercurial moods. 
 His wife asserts that T. once tried to throw her in tiie water, and that 
 he sometimes had outbreaks in which he tore off his clothing, and tried 
 to throw himself out of windows. T. knew nothing of these attacks. 
 Other witnesses testified to strange changes of mood and peculiarities 
 of character. A physician reports the observation of occasional attacks 
 of vertigo and convulsions in him. 
 
 T.'s o;randmother was insane ; his father was affected with chronic 
 alcoholism, and of late years had had epileptiform attacks. The father's 
 brother was insane, and had killed a relative while in a delirious state. 
 Another uncle of T. had killed himself. Of T.'s three children, one was 
 weak-minded, another cross-eyed, and the third was subject to convul- 
 sions. The accused asserted that he had occasional attacks in which
 
 368 PSYCHOPATHIA SEXUALIS. 
 
 consciousness was so reduced that he did not know what he was about. 
 These attacks were ushered in by an aura-like pain in the back of his 
 neck. He was then impelled to go out in the air. He did not know 
 where he went. His wife had perfectly satisfied him sexually. For 
 eighteen years he had had chronic eczema (actual) of the scrotum, 
 which had often caused him to have extraordinary sexual excitement. 
 The opinions of the six experts were contradictory (sane, — attacks of 
 larvated epilepsy); the jur^- disagreed, so that he was dismissed. Dr. 
 Legrand du Saulle, who was called as an expert witness, found that, 
 until his twenty-second 3'ear, T. had urinated in bed from ten to eighteen 
 times a year. After that time the enuresis nocturna had ceased; but, 
 from that time, states of mental confusion, lasting from an hour to a 
 day, had occurred occasional!}', and they left the patient without any 
 memory of them. Soon again T. was arrested for public immorality, 
 and sentenced to itnprisonment for fifteen months. In prison he grew 
 sick, and apparently much weaker mentally. For this reason he was 
 pardoned, but the mental weakness increased. T. was noticed to have 
 repeated epileptoid convulsions (tonic convulsion with tremor and loss 
 of consciousness). (Auzou}', Annal. med. psychoL, 1874, Nov. ; Legrand 
 du Saulle, " Etude med. legale," etc., p. 99.) 
 
 The following case of immoral acts with children, observed 
 by the author and reported in Fnedrelcli's Blatter^ will serve to 
 conclude this group/ so important in its legal bearings. It is 
 the more important, in that a state of tuiconsciousness was 
 established at the time of tlie act, and because, for allied 
 reasons, the facts related in Latin, show how a complicated and 
 refined act becomes possible in such a state of unconsciousness. 
 
 Case 160. P., aged 49; married; hospital beneficiary. He was 
 accused of having committed the following terrible acts with two girls, 
 — D., aged ten, and G.,aged nine, — whom he had taken to his work-shop 
 on May 25, 1883. 
 
 D. testifies : " I was in the meadow with G. and my sister J., aged 
 three. P. called us into his shop and fastened the door. Tum nos exos- 
 culabatur, linguam in os meum demittere tentabat faciemque milii 1am- 
 bebat ; sustulit me in gremium, bracas aperuit, vestes meas sublevavit, 
 digitis me in genitalibus titillabat et membro femina mea fricabat ita ut 
 humida fierem. When I cried, he gave me twelve krenzers, and threat- 
 ened to shoot me if I told on him. At last he tried to persuade me to 
 come again the next day." 
 
 1 Comp. also Liman, Zweifelliafte Geisteszustaude, Fall 6. — Las^gue, Exhibitionists, 
 Union m6d., 1877.— Ball and Chambert, Art. Soiiinarabulisme (Diet, des scienc. in6d., 1881).
 
 EPILEPSY. 369 
 
 G. testified : " P. nates et gei)italia D. ae exoscnlatus, iisdem me 
 conatibus aggressus est. Deiiide filioliitii quoque tres annos initum in 
 maniis aeceptum osculatns est midatumque parti sua3 virili appressit. 
 Postea qiia^ nobis esscnt nomina inteirogavit ac censuit, genitalia D. ae 
 meis multo esse majora. Quin etiam nos iinpulit, ut niembrum snum 
 intueremur, manibus coniprehenderemus et videreuaus, quantopere id 
 esset erectum." 
 
 At his examination, Ma_y 29tli, P, said he had but an indistinct 
 recollection of having fondled, caressed, and made presents to a little 
 girl a short time before. If he had done anything more, it must have 
 been in an irresponsible condition. Besides, he had suflercd for years 
 with weakness in his head, as result of an injurj'. On June 22d he knew 
 nothing of the events of May 25th, and nothing of his examination on 
 May 29th. This amnesia was shown, also, on cross-examination. 
 
 P. comes of a family affected with cerebral disease; a brother was 
 epileptic. P. was formerly a drinker. Years before, he had actuall}^ 
 suffered an injury to his head. Since then, from time to time, he has had 
 attacks of mental disturbance, introduced by moroseness, irritability, 
 tendency to alcoholic excesses, apprehension, and delusions of persecu- 
 tion sufficient to induce threats and deeds of violence. At the same 
 time, he would have auditory hyperesthesia, vertigo, headache, and 
 cerebral congestion, — all this, with great mental confusion and amnesia 
 for the whole period of the attack, which would sometimes last for 
 weeks. 
 
 During the intervals he was subject to headache, which started 
 from the seat of injury on the head (a small scar in the skin over the 
 right temple), which was painful on pressure. With exacerbation of the 
 headache, he became very irritable, morose to an extent that inclined 
 him to suicide, and mentally like one drunk. In 1879, while in such a 
 state, he made an impulsive attempt at suicide, of which he afterward 
 had no memory. Soon after this, being sent to hospital, he gave the 
 impression of being epileptic, and, for a long time, was treated with pot. 
 bromide. At the end of 1879 he was taken to the infirmary, no actual 
 epileptic attack having been observed. 
 
 During his lucid intervals he was a virtuous, industrious, good- 
 natured man, and had never shown any sexual excitement; and, until 
 this time, never sexual inclinations, even during his mental confusion. 
 Moreover, until lately, he had lived with his wife. At the time of the 
 criminal act, he had shown signs of an approaching attack, and had 
 asked the physician to prescribe pot. bromide. 
 
 P. asserted that, since the injury' to his head, he had been intolerant 
 of heat and alcohol, which immediately brought on headache and confu- 
 sion. The medical examination proved the truth of his assertions about 
 mental weakness, irritability, and poor sleep. 
 
 If pi'essure were made at the seat of the trauma, P. became con- 
 
 u
 
 370 PSYCHOPATHIA SEXUALIS. 
 
 giested, irritable, confused, and trembled all over; he appeared excited; 
 consciousness was disturbed, and remained so for hours. 
 
 At times, when he is free fron\ the sensations that start from the 
 scar, he seems kind, free, willing, and open, though he is mentally weak 
 and cloudy. P. was not sentenced. ( Vide Friedreich's Blatter for full 
 report.) 
 
 Periodical Insanity. 
 
 Just as in cases of non-periodical mania, an abnormal in- 
 tensity or a noticeable prominence of the sexual sphere is very 
 often manifested in the periodical attacks {v. infra, "Mania"). 
 
 The following case, reported by Servaes {Arch. /. Psych.), 
 shows that it then may also be perverted : — 
 
 Case 161. Catharine W., aged 16; she has not j^et menstruated; 
 previously healthy. 
 
 Seven weeks before admission (December 3, 1872), melancholic 
 depi'ession and irritabilit}'. November 27th, maniacal outbreak, lasting 
 two days; thereafter, melancliolic. December 6th, normal condition. 
 
 December 24th (twenty-eight days after the first maniacal attack), 
 silent, shy, de])ressed. December 27tli, exaltation (jolly, laughing, etc.), 
 with violent love for an attendant (female). December 31st, suddenly 
 melancholic catalepsy, which disappeared after two hours. January 
 20, 1873, new attack like the previous one. A similar one on February 
 18th, with traces of menses. The patient had no memory whatever for 
 what occurred in the paroxj'sms, and blushed scarlet with astonishment 
 and shame when told about them. 
 
 Thei'eafter there were abortive attacks, which entirely disappeared, 
 to give place to the normal mental condition in June. 
 
 In a case reported by Gock {Arch. f. Psych., v), which was 
 probably circular insanity, in a man of very bad heredity, during 
 the stage of exaltation there was manifestation of sexual feeling 
 for men. In this case, however, the patient thought himself a 
 girl, and it is questionable whether the sexual inclination was 
 induced by the delusion or by a contrary sexual instinct. 
 
 In connection with these cases of abnormal manifestation 
 of the sexual instinct are those which,' as a symptom of mania, 
 manifest an abnormal and frequently a perverse sexual instinct in 
 an impulsive way, analogous to dipsomania, which forms the 
 nucleus of the psychical disturbance, while in the intervals the 
 sexual instinct is neither intense nor perverse.
 
 PERIODICAL INSANITY. 371 
 
 Quite a pure case of such periodical psychopatliia sexualis, 
 connected with the process of menstruation, is the following, 
 reported by Anjel {Arch./. Psf/ch., xv, H. 2): — 
 
 Case 1G2. A quiet lad}-, near the climacteric. Very bad heredity. 
 In her youth, attacks of petit uial. Always eccentric, quick-teiupered ; 
 very moral ; childless marriage. 
 
 Several years ago, after a violent emotional disturbance, a hystero- 
 epileptic attack, with post-epileptic insanity of several weeks' duration. 
 Thereafter there was sleeplessness for several months. Following this, 
 there was always menstrual insomnia, and the iminilse to embrace and 
 kiss boys of ten, and fondle their genitals. During this excitement there 
 was no desire for coitus ; certainly not for intercourse with adults. 
 
 The patient often speaks openly of this impulse, and asks to be 
 watched, as she is not to be trusted. In the intervals she anxiously 
 avoids all talk of it, is very modest, and in nowise passionate sexuall3^ 
 
 With reference to the still imperfectly-known cases of periodical 
 psychopatliia sexualis of this kind, Tarnowsky (op. cit., p. 38) has made 
 valuable contributions, though his cases were not all of a periodic 
 nature ; and one of tlie cases, taken from a work of the author's, is not 
 rightly understood (Case 8, p. 3Y), since sodomy was only subsidiary, 
 and the abnormal intense libido sexualis was not periodic. 
 
 Tarnowsky reports cases where married, cultured men, the fathers 
 of families, were, from time to time, compelled to perform the most 
 terrible sexual acts, while during the intervals they were sexuall3' nor- 
 mal, abhorred their paroxysmal sexual acts, and shuddered before the 
 expectation of their repetition. 
 
 If a new paroxysm came on, the normal sexual instinct disap- 
 peared; a state of mental excitement arose with insomnia, and thoughts 
 and impulses to commit the perverse sexual acts, with anxious confusion 
 and an increasing impulse to the abhorred indulgence. In this state the 
 act was a relief, because it ended the condition. The analogy with 
 dipsomania is complete. 
 
 For other cases (of periodical pederasty), vide Tarnowsky, 
 op. cit., p. 41. The case there reported, on page 46, belongs 
 in the category of epilepsy. 
 
 The following case, reported by Anjel (Arch. f. Psycli.^ 
 XV, H. 2), is one of the most typical of the convulsive-like 
 occurrence of sexual excitement: — 
 
 Case 163. A gentleman of iiigh social position, aged 45; generally 
 respected and beloved; heredity good; very moral; married fifteen 
 years. Previously normal sexually ; the father of several healthy chil-
 
 372 PSYCHOPATHIA SEXUALIS. 
 
 dren, and living in happj?^ matrimony. Eiglit years ago he suffered a 
 violent fright. For some weeks thereafter he had a feeling of apprehen- 
 sion and cardiac attacks. Then came attacks, at intervals of several 
 months or a year, of wliat the patient called his " moral catarrh." He 
 became sleepless. After three days, loss of appetite, increasing irrita- 
 bility, strange appearance ; fixed stare, staring into space ; paleness, 
 changing with redness; tremor of the fingers; red, shining e^'es, with 
 peculiar glassy expression ; and violent, quick manner of speech. There 
 was a desire for girls of from five to ten years, even for his own 
 daughters. He would beg his wife to guard the cliildren. For days at a 
 time, while in this state, he would shut himself in his room. Previously 
 he was compelled to pass school-girls on the street, and he found a 
 peculiar pleasure in exposing his genitals before them, by acting as if 
 about to urinate. 
 
 For fear of exposure, he shuts himself in his room, full of desire, 
 incapable of movement, and torn by feelings of fear. Consciousness 
 seems to be undisturbed. The attacks last from eight to fourteen days. 
 The cause of their return is not clear. Improvement is sudden; there 
 is great desire for sleep, and, after this is satisfied, he is again well. In 
 the interval there is nothing abnormal. The author assumes an epileptic 
 foundation, and considers the attacks to be the psychical equivalents of 
 epileptic convulsions (1). 
 
 Mania. — With the general excitation that here exists in 
 the psychical organ, the sexual sphere is likewise often impli- 
 •cated. In maniacal individuals of the female sex, tliis is tlie 
 rule. In certain cases, it may be questionable whether the 
 instinct, which, in itself, is not intensified, is simply recklessly 
 manifested, or wliether it is present in actual abnormal inten- 
 sity. For the most part, the latter is the true assumption, — 
 certainly so where sexual delusions and their religious equiva- 
 lents are constantly expressed. In accordance with the degrees 
 of intensity of the disease, the intensified instinct is expressed 
 in different forms. 
 
 In simple maniacal exaltation in men, courting, frivolity, 
 and lagciviousness in speech, and frequenting of brothels, are 
 observed ; in women, inclination for the society of men, per- 
 sonal adornment, perfumes, talk of marriage and scandals, 
 suspicion of the virtue of other women; or there is mani- 
 fested the religious equivalent, — pilgrimages, missionary work, 
 desire to go into a cloister or to become the servant of a
 
 SATYRIASIS AND NYMPHOMANIA. 373 
 
 priest ; and in this case there is mucli talk about innocence and 
 virginity. 
 
 At tlie heiglit of mania there may be seen invitations to 
 coitus, exhibition, obscenity, great excitation at siglit of women, 
 tendency to smear the person with saliva, urine, and even fseces; 
 religio-sexual delusions, — to be under the protection of the 
 Holy Ghost, to have given birth to Christ, etc. ; open onanism, 
 and pelvic movements of coitus. 
 
 In maniacal men care must be taken to prevent shameless 
 masturbation and sexual attacks on women. 
 
 Satyriasis and Nymphomania. 
 
 States of mental excitement, in which an abnormal intense 
 sexual impulse is prominent, are called satyriasis (in males) and 
 nymphomania (in women), or uteromania. 
 
 Moreau considers these cases peculiar to themselves, but 
 he is certainly in error. The sexual complexus of symptoms is 
 always but the partial manifestation of a general psychosis 
 (mania, hallucinatory insanity "?). 
 
 The essential element of the state of sexual excitement is 
 a condition of psychical liyperaesthesia with involvement of the 
 sexual sphere. The imagination calls up only sexual images, 
 which may lead to hallucinations, illusions, and true hallucina- 
 tory delirium. 
 
 The most indifferent ideas excite sensual association, and 
 the lustful coloring of the ideas and apperceptions is very much 
 intensified. 
 
 The abnormal state of consciousness implicates the whole 
 course of feeling and desire, and is accompanied by general 
 physical excitement like tliat that accompanies coitus (v. 
 "Physiology"). Often the genitals are in a constant state of 
 turgor (pria])ism in males). 
 
 The man affected with this sexual passion seeks to satisfy 
 his desire at any price, and, therefore, becomes very dangerous 
 to women. Faute de mieiix, he practices onanism or sodomy. 
 The nymphomaniacal woman seeks men by exhibition, or to 
 attract them by her sensual conduct ; at the sight of men she is
 
 374 PSYCHOPATHIA SEXUALIS. 
 
 intensely excited sexually, and satisfies herself by masturbation, 
 or by pelvic movements of coitus. 
 
 Satyriasis is infrequent. Nymphomania is more frequently 
 observed, and not seldom in the climacteric. It may occur in 
 senility. Abstinence, ^ with constant excitation of the sexual 
 sphere as a result of psychical or peripheral irritation (pruritus 
 pudendi, oxyuris, etc.), may cause these conditions, but probably 
 only in those predisposed. 
 
 The assertion that it may also result from poisoning by 
 cantharides seems to depend upon confounding it with priapism. 
 The primary lustful feeling that accompanies priapism due to 
 cantharides soon becomes painful. Satyriasis and nympho- 
 mania are acute abnormal psycho-sexual states. 
 
 There are also cases that, not witliout reason, might be 
 called chronic satyriasis or nymphomania. To these belong 
 the men who, for the most part as a result of abusus veneris, 
 or more particularly of masturbation, suffer with neurasthenia 
 sexualis, and at the same time have intense libido sexualis. 
 The imagination, as in acute cases, i^ in a state of excitement, 
 and the mind full of obscene images ; so that the most ele- 
 vated ideas are besmirched with the most cynical images and 
 thoughts. 
 
 The tliought and desire of such men are solely directed to 
 the sexual sphere ; and since their flesh is weak, led on by their 
 fancy, they come to indulge in the grossest perversions of the 
 sexual act. 
 
 Analogous cases in women may be called chronic nympho- 
 mania. They naturally lead to prostitution. Legrand du 
 SauUe (" La folic," p. 510) reports interesting cases which 
 apparently are pure. 
 
 Melancholia. — The thoughts and feelings of melancholiacs 
 are not favorable for the excitation of sexual desires. At the 
 same time, these patients sometimes masturbate. In my experi- 
 ence such cases have always been hereditarily predisposed and 
 previously given to onanism. The act did not seem to be so 
 
 1 Comp. the interesting cases of Mare-Ideler, ii, p. 137. — Ideler, " Grundriss der 
 Seelenheilkuude," ii, pp. 488-492.
 
 HYSTERIA. 375 
 
 much due to a lustful desire as to be induced by liabit, ennui, 
 anxiety, and the impulse to change temporarily the painful 
 mental condition. 
 
 Hysteria. — In this neurosis the sexual life is very frequently 
 abnormal ; indeed, always in predisposed individuals. All the 
 possible anomalies of the sexual function may occur here, with 
 sudden changes and peculiar activity; and, on an hereditary 
 degenerate basis and in moral imbecility, they may appear in 
 the most perverse forms. The abnormal change and inversion 
 of the sexual feeling are never without effect upon the patient's 
 disposition. 
 
 The following case, reported by Giraud, is one of this 
 nature worthy of repetition : — 
 
 Case 1G4. Marian L., of Bordeaux. At night, while the household 
 was asleep under the influence of narcotics she had administered, she 
 had given the children of the house to her lover for sexual enjo^niient, 
 and had looked on at the ininioi-al acts. It was found that L. was hys- 
 terical (hemiansesthesia and convulsive attacks), but before her illness 
 she had been a moral, trustworthy person. Since her illness she had 
 become a shameless prostitute, and lost all moral sense. 
 
 In the hysterical the sexual sphere is often abnormally 
 excited. This excitement may be intermittent (menstrual ?). 
 Shameless prostitution, even in married women, may result. In 
 a milder form the sexual impulse expresses itself in onanism, 
 going about in a room naked, smearing the person with urine 
 and other things, or wearing male attire, etc. 
 
 Schiile {Klin. Psycliiatrie, 1886, p. 287) finds very fre- 
 quently an abnormally intense sexual impulse " whicli disposes 
 girls, and even women living in happy marriage, to become 
 Messalinas." 
 
 The autlior cited kn'ows cases in which, on the wed- 
 ding-journey, attempts at Hight with men, who had been 
 accidentally met, were made ; and respected wives who en- 
 tered into liaisons, and sacrificed everything to their insatiable 
 impulse. 
 
 In hysterical insanity the abnormally intense sexual im- 
 pulse may express itself in delusions of jealousy, unfounded
 
 376 PSYCHOPATHIA SEXUALIS. 
 
 accusations against men for immoral acts,^ hallucinations of 
 coitus," etc. 
 
 Occasionally frigidity may occur, with absence of lustful 
 feeling, — due, for the most part, to genital anaesthesia. 
 
 Paranoia. — Abnormal manifestations in the sexual sphere, 
 in the various forms of paranoia, are not infrequent. Many of 
 these cases are developed on sexual abuse (masturbatic para- 
 noia) or sexual excitement ; and, according to experience, in 
 individuals psychically degenerate, with other functional signs 
 of degeneracy, the sexual sphere is, for the most part, deeply 
 implicated. 
 
 In paranoia religiosa and erotica the abnormally intense 
 and, under certain circumstances, perverse sexual instinct is 
 most clearly manifested. In the first variety, however, the 
 condition of sexual excitation is expressed not so much in a 
 direct method of satisfaction of the sexual desires as (there are 
 exceptions) in platonic love, — in enthusiastic admiration of a 
 person of the opposite sex who is pleasing aesthetically. Under 
 certain circumstances, the enthusiasm is for a fanciful person, a 
 portrait, or a statue. 
 
 A love for the opposite sex that is weak and purely mental, 
 too, often has its basis in weakness of the genitals due to long- 
 continued masturbation ; and, under tlie guise of virtuous admi- 
 ration of a beloved person, great lasciviousness and sexual per- 
 version are often concealed. Episodically, especially in women, 
 violent sexual excitement may occur as a nymphomania. 
 
 For the most part, paranoia religiosa rests upon sexuality 
 which manifests itself in a sexual impulse that is abnormally 
 early and intense. The libido finds satisfaction in masturba- 
 tion or religious enthusiasm, the object of which may be a 
 certain minister, saint, etc. 
 
 The psycho-pathological relations between the sexual and 
 religious domains have been described in detail on p. 8 et seq. 
 
 * Vide Fall Merlac, in the author's Lehrb. d. ger. PsychopathoL, 2 Aufl., p. 322. — 
 Morel, Traits des malad. mentales, p. 687. — Legrand, La folic, p. 337. — Process La Rondure, 
 in Annal. d'hyg., 1. Serie, iv ; 3. Serie, xxii. 
 
 2 The iucubus in the witch-trials of the Middle Ages depended on them.
 
 PARANOIA. 377 
 
 Apart from masturbation, sexual crimes are relatively fre- 
 quent in religious paranoia. 
 
 Marc's work (p. 160) contains a remarkable example of 
 religious insanity. 
 
 Giraud (A^inal. med. ^'^sycliol.') has reported a case of rape 
 of a little girl by a religious paranoiac, aged 43, who was tem- 
 porarily erotic. Here, also, belongs a case of incest (Liman, 
 Vierteljahrssclir. /. ger. Med.). 
 
 Case 165. M. impregnated his daughter. His wife, mother of eight- 
 een children, and herself pregnant by her husband, lodged the complaint. 
 M. had had religious paranoia for two years. " It was revealed to me 
 that I should beget the Eternal Son with my daughter. Then a man of 
 flesh and blood would arise by my faith, who would be eighteen hundred 
 years old. He would be a bridge between the Old and New Testaments." 
 This command, which he deemed divine, was the cause of his insane act. 
 
 Sexual acts that have a pathological motive sometimes 
 occur in persecutory paranoia. 
 
 Case 166. A married woman of thirty had, by means of money and 
 sweetmeats, enticed a boy of five, who pla3^ed near her, handled his gen- 
 itals, and then attempted coitus She was a teacher, who had been 
 betrayed and then cast off. Previously moral, for some time she had 
 given herself to prostitution. The explanation of her immoral change 
 was given, when it was found that she had various delusions of persecu- 
 tion, and thought she was under the secret influence of her seducer, who 
 impelled her to sexual acts. She also believed that the boy had been 
 put in her way by her seducer. Coarse sensuality as a motive for her 
 crime came less into consideration, as it would have been eas^' for her to 
 satisfy sexual desire in a natural wa3^ (Kiissner, Berl. klin. Wochen- 
 schrift.) 
 
 Cullerre (" Perversions sexuelles chez les persecutes," in 
 Annal. medico-psychol.^ March, 1886) has reported similar 
 cases, — the case of a patient who, suffering witli paranoia sex- 
 ualis persecutoria, tried to violate his sister, giving as a reason 
 that the impulse was given him by Bonapartists. 
 
 In another case a captain, suffering with delusions of per- 
 secution by electro-magnetism, was driven to pederasty, — a thing 
 he abhorred. In a similar case the persecutor impelled to 
 onanism and pederasty.
 
 V. PATHOLOGICAL SEXUALITY IN ITS 
 
 LEGAL ASPECTS. 
 
 The laws of all civilized nations punish those who commit 
 perverse sexual acts. Inasmuch as the preservation of chastity 
 and morals is one of the most important reasons for the exist- 
 ence of the commonwealth, the state cannot be too careful, as a 
 protector of morality, in the struggle against sensuality. This 
 contest is unequal ; because only a certain number of the sexual 
 crimes can be legally combated, and the infractions of the laws 
 by so powerful a natural instinct can be but little influenced by 
 punishment. It also lies in the nature of the sexual crimes, 
 that but a part of them ever reach the knowledge of the 
 authorities. PubHc sentiment, in that it looks upon them as 
 disgraceful, lends much aid. 
 
 Criminal statistics prove the sad fact tliat sexual crimes 
 are progressively increasing in our modern civilization. ' This 
 is particularly tlie case with immoral acts with children under 
 the age of fourteen. The moralist sees in these sad facts 
 nothing but the decay of general morality, and in some instances 
 comes to the conclusion that the present mildness of the laws 
 punishing sexual crimes, in comparison with their severity in 
 past centuries, is in part responsible for this. 
 
 The medical investigator is driven to the conclusion that 
 this manifestation of modern social life stands in relation to the 
 predominating nervousness of later generations, in that it begets 
 defective individuals, excites the sexual instinct, leads to sexual 
 abuse, and, with continuance of lasciviousness associated with 
 diminished sexual power, induces perverse sexual acts. 
 
 It will be clearly seen, from what follows, how such an 
 opinion is justified, especially with respect of the increasing 
 
 * Comp. Casper, Klin. Novellen. — Lombioso, Goltdammer's Archiv, Bd. xxx. — 
 Oettingeii, Moralstatistik, p. 494. 
 
 (378)
 
 SEXUAL CRIMES. 379 
 
 number of sexual crimes committed on children. It is at once 
 evident, from what has gone before, that neuropathic, and 
 even psychopathic, states are largely determinate for the com- 
 mission of sexual crimes. Here nothing less than the respon- 
 sibility of many of the men who commit such crimes is called 
 in question. 
 
 Psychiatry cannot be denied the credit of having recognized 
 and proved the psycho-pathological significance of numerous 
 monstrous, paradoxical sexual acts. Law and Jurisprudence 
 have thus far given but little attention to the facts resulting from 
 investigations in psychopathology. Law is, in this, opposed to 
 Medicine, and is constantly in danger of passing judgment on 
 individuals who, in the light of science, are not responsible for 
 their acts. 
 
 Owing to this superficial treatment of acts that deeply con- 
 cern the interests and welfare of society, it becomes very easy 
 for justice to treat a delinquent, who is as dangerous to society 
 as a murderer or a wild beast, as a criminal, and, after punish- 
 ment, release him to prey on society again ; on tlie otlier hand, 
 scientific investigation shows that a man mentally and sexually 
 degenerate ah origlne, and therefore irresponsible, must be re- 
 moved from society for life, but not as a punishment. 
 
 A judge who considers only the crime, and not its perpe- 
 trator, is always in danger of injuring not only important inter- 
 ests of society (general morality and safety), but also those of 
 the individual (honor). 
 
 In no domain of criminal law is co-operation of judge and 
 medical expert so much to be desired as in that of sexual delin- 
 quencies ; and here only anthropological and clinical investiga- 
 tion can afford light and knowledge. The nature of the act can 
 never, in itself, determine a decision as to whether it lies within 
 the limits of mental pathology, or within the bounds of mental 
 physiology. The perverse act does not indicate perversion of 
 instinct. At any rate, the most monstrous and perverse sexual 
 acts have been committed by persons of sound mind. The 
 perversion of feeling must be shown to be pathological. This 
 proof is to be obtained by learning the conditions attending its
 
 380 PSYCHOPATHIA SEXtTALlS. 
 
 development, and by proving the existence of a general neuro- 
 pathic or psychopathic condition. 
 
 The species facti is important; but it allows, however, only 
 presumptions, since the same sexual act, according as it is com- 
 mitted by an epileptic, paralytic, or a man of sound mind, takes 
 on other features and peculiarities, in accordance with the 
 manner in which it is done. 
 
 Periodical recurrence of the act under identical circum- 
 stances, and an impulsive manner in carrying it out, give rise to 
 weighty presumptions that it is of pathological significance. 
 The decision, however, must follow after referring the act to its 
 psychological motive (abnormalities of thought and feeling), 
 and after showing tliis elementary anomaly to be but one symp- 
 tom of a general neuropatliic condition, — either an arrest of 
 mental development, or a condition of psychical degeneration, 
 or a psychosis. 
 
 The cases discussed in the portion of this work devoted to 
 general and special pathology will certainly be useful to the 
 medical expert, in assisting him to discover the motive of tlie 
 act. To obtain the facts necessary to allow a decision of the 
 question whether immorality or abnormality occasioned the act, 
 a medico-legal examination is required, — an examination which 
 is made according to the rules of science ; which takes account 
 of both the past history of the individual and the present con- 
 dition, — the anthropological and clinical data. 
 
 The proof of the existence of an original, congenital anomaly 
 of the sexual sphere is important, and points to tlie need of an 
 examination in the direction of a condition of psychical degen- 
 eration. An acquired perversity, to be patliological, must be 
 found to depend upon a neuropatliic or psychopathic state. 
 
 Practically, paretic dementia and epilepsy must first come 
 to mind. The decision concerning responsibility will depend on 
 the demonstration of the existence of a psychopathic state in 
 the individual convicted of a sexual crime. 
 
 This is indispensable, to avoid the danger of covering 
 simple immoraUty with the cloak of disease. 
 
 Psychopathic states may lead to crimes against morality,
 
 SEXUAL CRIMES. 381 
 
 and at the same time remove the conditions necessary to the 
 existence of responsibility, under the following circumstances : — 
 
 1. To oppose tlie normal or intensified sexual desire, there 
 may be no moral or legal notions, owing to (<i) the fact that 
 they may never have been developed (states of congenital men- 
 tal weakness) ; or to (h) the fact that they have been lost (states 
 of acquired mental weakness). 
 
 2. When the sexual desire is increased (states of psychical 
 exaltation) and consciousness simultaneously clouded, the men- 
 tal mechanism is too much disturbed to allow the opposing 
 ideas, virtually present, to exert their influence. 
 
 3. When the sexual instinct is perverse (states of psychical 
 degeneration). It may, at the same time, be intensified. 
 
 Cases of sexual delinquency that occur outside of states of 
 mental defect, degeneration, or disease, can never be excused on 
 the ground of irresponsibility. 
 
 In many cases, instead of an abnormal psychical condition, 
 a neurosis (local or general) is found. Inasmuch as the transi- 
 tions from a neurosis to a psychosis are easy, and elementary 
 psychical distnrbances are frequent in the former, and constant 
 in profound perversion of the sexual life, the neurotic aftection 
 — e.g., impotence, irritable weakness, etc. — exerts an influence 
 on the motive of the incriminating act ; and a just judge, not- 
 withstanding the lack of legal irresponsibility due to mental de- 
 fect or disease, will recognize the circumstances which ameliorate 
 the heinousness of the crime. 
 
 For various reasons the practical jurist will, in all cases of 
 sexual crimes, call medical experts to make a psychiatric exam- 
 ination. 
 
 To be sure, his own conscience and judgment must be the 
 guides when necessity makes them his only reliance. Under 
 the following circumstances indices are given which point to a 
 pathological condition : — 
 
 The accused is senile. The sexual crime is committed 
 openly, with remarkable cynicism. The manner of obtaining 
 sexual satisfaction is silly (exhibition), or cruel (mutilation or 
 murder), or perverse (necrophilia, etc.).
 
 382 PSYCHOPATHIA SEXUALIS. 
 
 From what experience teaches, it may be said that, among 
 the sexual acts that occur, rape, mutilation, pederasty, amor 
 leshicus^ and bestiality may have a psycho-pathological basis. 
 
 In case of lust-murder, — in as far as it goes beyond murder 
 itself, — and likewise in case of mutilation of corpses, psycho- 
 pathic conditions are probable. 
 
 Exhibition and mutual masturbation make pathological 
 states seem very probable. Masturbation of another and passive 
 onanism may occur in connection with senile dementia and 
 contrary sexual feeling, but also with mere sensuality. 
 
 Cunnilingus and fellare (penem in os mulieris arrigere) 
 have not thus far been shown to depend upon psycho-patho- 
 logical conditions. 
 
 These horrible sexual acts seem to be committed only by 
 sensual men who have become satiated or impotent from exces- 
 sive indulgence in a normal way. Psedicatio mulierum does 
 not seem to be psychopathic, but rather a practice of married 
 men of low morality, who wish to prevent pregnancy ; and of 
 satiated cynics in non-marital sexual indulgence. 
 
 The practical importance of the subject makes it necessary 
 that the sexual acts tlireatened with punishment as sexual 
 crimes be considered by jurists from the stand-point of the 
 medico-legal expert. Thus there is an advantage gained, in 
 that the psycho-pathological acts, according to circumstances, 
 are placed in the right light by comparison with analogous acts 
 that fall witliin the domain of physiological psychology. 
 
 1. Offense Against Morality in the Form 'of Exhibition. 
 (Austrian Statutes, § 516 ; Abridgment, § 195. German Statutes, § 183.) 
 
 In man's present condition of civilization, modesty is a 
 characteristic and motive so firmly fixed by centuries of educa- 
 tion that presumption of a psycho-pathological element neces- 
 sarily arises when public decency is coarsely offended. 
 
 The presumption is justifiable that an individual who in 
 this way has offended public decency and his own self-respect 
 was incapable of moral feeling (idiots) ; or that it has been lost
 
 EXHIBITION. 383 
 
 (states of acquired mental weakness) ; or that he has acted 
 while in a clouded state of consciousness (transitory insanity, 
 states of partial consciousness). 
 
 A very distinctive act which belongs here is that of 
 exhibition (exposure). The cases thus far recorded are exclu- 
 sively those of men who ostentatiously expose their genitals to 
 persons of the opposite sex, in some instances following them, 
 witliout, liowevcr, becoming aggressive. 
 
 The silly manner of this sexual activity, or really sexual 
 demonstration, points to intellectual and moral weakness; or, at 
 least, to temporary inhibition of the intellectual and moral func- 
 tions, with excitation of libido dependent upon a decided dis- 
 turbance of consciousness (abnormal unconsciousness, mental 
 confusion) ; and, at the same time, the virility of these individ- 
 uals is called in question. Thus there are various categories 
 of exhibitionists. ^ 
 
 The first category includes states of mental weakness in 
 which, owing to the causative cerebral (or spinal) disease, con- 
 sciousness is clouded, and the ethical and intellectual functions 
 are interfered with ; and in wliich there can be no opposition 
 made to a sexual desire that has either always been intense, or 
 that has been intensified by the disease-process. At the same 
 time, impotence exists, and no longer permits expression of 
 the sexual instinct in violent acts (rape), but only in acts that 
 are silly. 
 
 The majority of reported cases ^ fall in tliis category. They 
 are those of individuals afflicted with senile dementia, paretic 
 dementia, or mental defects due to alcoholism, epilepsy, etc. 
 
 Case 167. Z., higb official, aged 60; widower; father of a famil3^ 
 He had excited offense in tliat, during fourteen days, he h:ul repeatedly 
 exposed his genitals at his window, to a girl of eight years who lived 
 opposite him. After a few months, under like circumstances, this man 
 repeated his indecent act. At his examination he acknowledged the 
 depravity of his action, and could give no excuse for it. Death, a year 
 later, due to cerebral disease. (Lasegue, op. cit.) 
 
 1 Las^gue, Union MMicale, 1877, May.— Laugier, Annal d'hygifene publ., 1878, No. 
 106. — Pelanda, " Pornopatlis," Archivio di Psichiatiia, viii. — Schuehardt, Zeitschr. f. Medi- 
 ciualbeamte, 1890, Heft 6.
 
 384 PSYCHOPATHIA SEXUALIS. 
 
 Case 168. Z., aged 78; seaman. He had repeatedly exhibited his 
 genitals on children's play-grounds, and in the neighborhood of girls' 
 schools. This was the only way in which he was active sexually'. He 
 was married, and the father of ten children. Twelve years before, he 
 had suffered a severe head-injury, since which he had had a deep scar, 
 which indented the bone. Pressure on this scar caused pain ; at the 
 same time his face would flush, his expression become fixed, and he 
 would grow somnolent, with convulsive movements in the right upper 
 extremity (apparently epileptoid state in connection with cortical dis- 
 ease). Besides, there was senile dementia and advanced senium. It is 
 not reported whether the exhibition coincided with epileptoid attacks or 
 not. Senile dementia proved ; pardoned. (Dr. Schuchardt, op. cit.) 
 
 Pelaiida {op. cit.) has reported a number of cases of this 
 kind : — 
 
 1. Paralytic, aged 60. At the age of fifty-eight he began to exhibit 
 himself to women and children. In the asylum at Verona, for a long 
 time thereafter, he was lascivious and also attempted /e//a/io. 
 
 2. A drinker, aged 66, suflering with folie circulaire. His exhibition 
 was first noticed in church during divine service. His brother was like- 
 wise an exhibitionist. 
 
 3. A drinker, predisposed, aged 49. He was always very excitable 
 sexually ; in an asylum on account of chronic alcoholism. He exhibited 
 himself whenever he saw a woman. 
 
 4. A man, aged 64 ; married ; father of fourteen children. Great 
 predisposition. Rachitic, microcephalic head. For years he had been 
 an exhibitionist, in spite of repeated punishment. 
 
 Case 169. X., merchant, born in 1833; single. He had repeatedly 
 exhibited himself to children, or even urinated at the same time ; once, 
 under these circumstances, he had kissed a little girl, driving her away. 
 Twenty years previously X. had had a severe attack of mental disease, 
 lasting two years, in which he is said to have had an apoplectic attack. 
 Later, after loss of his fortune, he gave himself to drink, and of late years 
 had often appeared absent-minded. His condition was that of alcoholism, 
 senium precox, and mental weakness. Penis small ; phimosis ; testicles 
 atrophic. Proof of mental disease ; pardoned. (Dr. Schuchardt, op. cit.) 
 
 Such cases recall the lasciviousness of youthful, sexually- 
 excited persons that are still more or less boyish ; but also that 
 of many mature cynics of low morality, who find pleasure in de- 
 filing the walls of public closets, etc., with drawings of male and 
 female genitals, — a kind of ideal exhibition which, however, is 
 still widely separated from actual exhibition.
 
 EXHIBITION. 385 
 
 Another category of exhibitionists is made up of epileptics. 
 This category is essentially to be distinguished from the fore- 
 going, in that a conscious motive for the exhibition is wanting ; 
 and it appears much more like an impulsive act which, without 
 any consideration of external circumstances, is performed as if 
 it were an abnormal organic necessity. 
 
 At the time of the act there is always a state of imperfect 
 consciousness ; and thus is explained the fact that the unfor- 
 tunate individual, without consciousness of tlie meaning of his 
 act, or, at least, without cynicism, does it in obedience to a 
 blind impulse. On regaining consciousness, he regrets and 
 abhors it if there is not permanent mental weakness. 
 
 The prime motive in this state of imperfect consciousness, 
 as with other impulsive acts, is a feeling of apprehensive oppres- 
 sion. If a sexual feeling become associated with it, then the 
 ideas are given a certain direction in the sense of a correspond- 
 ing (sexual) act. 
 
 How sexual ideas very easily arise temporarily, in epileptics 
 may be understood from the discussion under " Epilepsy." 
 
 If, however, such an association has once been formed ; if 
 a particular act has taken place in an attack, — it is the more 
 easily repeated in every subsequent attack ; for, so to speak, a 
 known tract has been established in the path of motivity. . 
 
 The feeling of anxiety, with the state of imperfect con- 
 sciousness, causes the associated sexual impulse to appear as a 
 command, — an inner force, which is acted upon in a purely 
 impulsive manner and in a state of absolute irresponsibility. 
 
 Case 170. K., a subordinate official, aged 29 ; of neuropathic family ; 
 living in happy marriage, and the father of one child. He lias repeatedly, 
 especially at dusk, exhibited himself to servant-girls. K. is tall, slim, 
 pale, nervous, and hasty in manner. There is impei^fect memory of the 
 crimes. Since childhood there have been frequent severe congestive 
 attacks, with intense flushing of the face, a rapid, tense pulse, and a 
 fixed, absent stare. At the same time there were, now and then, confusion 
 and vertigo. In this (epileptic) exceptional state K. would answer only 
 after repeated questioning, and then it was as if he were waking from a 
 dream. K. states that he has always felt excited and restless for some 
 hours before his criminal acts, and experienced a feeling of fear, with 
 
 25
 
 386 PSYCHOPATHIA SEXUALIS. 
 
 oppression, and congestion of the head. In this condition he had often 
 been gidd}', and experienced an indistinct feeling of sexual excitement. 
 At the height of such states he had left the house, without any purpose 
 in view, and exposed his genitals anywhere. When he had readied home 
 again, he had had but a dreamy remembrance of what had occurred, and 
 felt very weak and depressed. It is also remarkable that, while exhib- 
 iting his genitals, he had used lighted matches to make them visible. 
 The opinion was to the effect that the criminal acts depended upon 
 epilepsy, and were imperative impulses ; but he was, nevertheless, sen- 
 tenced, with the assumption of extenuating circumstances. (Dr. Schu- 
 chardt, op. cit.). 
 
 Case 171. L., aged 39; single; tailor. His father was probably a 
 drinker ; he had two epileptic brothers, one of whom was insane. The 
 patient himself has slight epileptic attacks, and from time to time states 
 of imperfect consciousness, in which he runs about aimlessly, and there- 
 after does not know where he has been. He was considered a moral 
 man, but he is now accused of having exhibited and played with his 
 genitals in a strange house five or six times. His memory of these acts 
 was very imperfect. 
 
 On account of repeated desertion from the ami}' (probably likewise 
 in epileptic states of imperfect consciousness), L. had been severely 
 punished. In imprisonment he became insane with " epileptic insanity," 
 was sent to the Charite, and from there dischai-ged " cured." As far as 
 the criminal acts were concerned, cynicism and wantonness could be ex- 
 cluded. That they were committed in a state of imperfect consciousness 
 is probable from the fact, among other things, that to the policeman who 
 arrested him, the " imbecile," who was then in a cloudy state of con- 
 sciousness, was in a remarkable mental state. (Limau, Vierteljahrsschrift 
 f. ger. Med., N. F. xxxviii, H. 2.) 
 
 Case 172. L., aged 37. From October 15th to November 2d, he 
 had many times given offense, by exhibiting himself to girls in daylight 
 on the open street, and even in schools, into which he forced himself. 
 It happened occasionally that he wanted the girls to perform manustu- 
 pration or allow coitus, and, when refused, he performed masturbation 
 before them. In G., in a public-house, he rapped on the window, with his 
 penis exposed, so that the children and servant-girl in the kitchen were 
 forced to see it. 
 
 After his arrest it was ascertained that since 1876 L. had very fre- 
 quently caused trouble by exhibitions, but had always escaped punish- 
 ment, oAving to the demonstration of mental disease by physicians. On 
 the other hand, he had been punished for desertion and theft in the army, 
 and, later, once, as a civilian, for stealing cigars. L. had repeatedly been 
 in asylums on account of insanity (attacks of insanity). Besides, he 
 was often remarkable on account of his changeable, quarrelsome character, 
 occasional excitement, and inconstancy.
 
 EXHIBITION. 387 
 
 L.'s brother died of paralysis, lie liimself presents no degenerative 
 signs; no epileptic antecedents. During the time of observation he is 
 neither insane nor mentally weakened. He behaves himself very well, 
 and expresses great regret for his sexual crimes. About himself he 
 states that, though no drinker, he occasionally has an impulse to drink. 
 Soon after beginning, congestion of the head, vertigo, restlessness, anxiety, 
 and oppression come on. lie then passes into a dreamy state. An irre- 
 sistible impulse now forces him to expose himself; and he then experi- 
 ences a feeling of I'elief and breathes more easily. When he has once 
 exposed himself, he knows nothing more of what he does. As precursors 
 of such attacks, he had often, a short time before, had flames before the 
 eyes, and vertigo. For the time of his clouded state of consciousness, 
 he had but a clouded, dreamy memory. 
 
 It was only after a time that sexual ideas and impidses had become 
 associated with these apprehensive, cloud}^ states of consciousness. Years 
 ago, in such states, without motive and with great danger, be had 
 deserted; once he had jumped from a third-story window ; on another 
 occasion he had left a good position to wander about aimlessly in a 
 neighboring country, wbere he was at once arrested for exhibition. 
 
 When, outside of his abnormal periods, L. once became intoxi- 
 cated, there was no exhibition. In the lucid state his sexual feeling and 
 intercourse are perfectly normal. (Dr. Hotzen, Friedreich''s Blatter^ 
 1890, H. 6). For other instances, vide Cases 153, 155. 
 
 A clinical group that very nearly approaches the epileptic 
 exhibitionists is made up of certain neurasthenic individuals, in 
 whom, likewise, there may occur attacks (epileptoid ]) of imper- 
 fect consciousness^ in connection with a feeling of apprehensive 
 oppression ; and with this sexual impulses may be associated, 
 resulting in acts of exhibition having an impulsive character. 
 
 Case 113. Dr. S., academic teacher, had aroused public indignation 
 by being seen repeatedly running about in the Zoological Garden at 
 Berlin, before ladies and children, with his genitals hanging out. S. 
 admitted this, but denied all thought or consciousness of causing public 
 offense, and excused himself by saying that his running about with 
 exposed genitals afforded him relief from nervous excitement. Mother's 
 father was insane, and died by suicide ; his mother was constitutionally 
 neuropathic, a somnambulist, and had been temporarily insane. The 
 culprit was neuropathic, had been a somnambulist, and had had contin- 
 uous aversion to sexual intercourse with females. In his youth he prac- 
 
 iComp. V. Krafft, "Ueber transitorisches Irresein bei Neurasthenischen," Irren- 
 freund, 1883, No. 8.
 
 388 PSTCHOPATHIA SEXUALIS. 
 
 ticed onanism. He was a neurasthenic man, shy, torpid, and easily 
 became embarrassed and confused. He was sexually always much 
 excited. Frequently he dreamed that he was running about with 
 exposed genitals, or that, dressed only in a shirt, he hung from a fence 
 with his head downward, so that the shirt fell down, exposing his erected 
 penis. His dreams would induce pollution, and he would then have rest 
 for a few days or an entire week. 
 
 Also, in his waking state, the impulse would often come upon him, 
 just as in his dreams, to run about with exposed genitals. As he was 
 about to expose himself, he would become very hot, and then he would 
 run aimlessly about. The member would become moist with secretion, 
 but polkition was never induced. Finally, when it had become flaccid, 
 he would put it up, and then come to himself, glad if no one had seen 
 him. In such conditions of excitement he seemed to be in a dream ; as 
 if intoxicated. He had never had the intention to offend women. S. 
 was not epileptic. His declarations had the impress of truth. He had 
 actually never followed or spoken to women while in this condition. 
 Frivolity and coarseness were excluded. In agreement with Westphal, 
 the author regards S. as belongiug " to a class of individuals of peculiar 
 hypochondriacal tendencies, in whom the attention is constantly directed, 
 in an abnormal way, to certain bodii}' sensations and processes ; who 
 brood over these, connecting all kinds of peculiar conceptions with them, 
 at last makiug nse of quite as strange means to combat the bodily 
 sensations and ideas." At least, S.'s act was due to pathological sensa- 
 tion and idea, and S. was in a condition of pathological disturbance of 
 mental action at the time of the commission of his acts. In the case of 
 this exhibitionist, the manner of satisfaction of the sexual instinct may 
 be considered as peculiar to the individual. (Liman, Vierteljahrsschrift 
 fur gerichlel. Med., N. F. xxxviii. Heft 2.) 
 
 Case 174. X., aged 38; married; father of one child. Always 
 sullen and silent. Sulfers frequently with headache. Very neurastlienic, 
 though not insane. He is troubled much at night by pollutions. He 
 has repeatedly followed shop-girls, for whom he liad lain in wait, expos- 
 ing and handling his genitals. In one case he even followed a girl into 
 a shop. (Trochon, Arch, de Vanlhropoloijie criminelle, iii, p. 25C.) 
 
 Ill the following case the exhibition seems subsidiary to 
 the impulsive desire to satisfy sudden, intense libido, by means 
 of masturbation : — 
 
 Case 175. R., coachman, aged 49, Yienna ; married since 1866; 
 childless. Father neuropathic and given to sexual excesses ; died of 
 cerebral disease. He presents no degenerative signs. 
 
 At the age of twenty-nine he suffered a severe concussion by fall- 
 ing from a height. Up to that time the vita sexualis had been normal.
 
 EXHIBITION-. 389 
 
 Since that time, every three or four luontlis, he has been seized with very 
 painful sexual excitement, accomi)anie(l l)y an intense desire to mastur- 
 bate. A feeling of weariness and discomfort, with a desire for alcoholic 
 indulgence, precedes this. In the intervals he is sexually cold, and has 
 but very infrequent desire for his wife, who, moreover, for five 3'ears has 
 been sick, and incapable of cohabitation. He gives the assurance that, as 
 a young man, he never masturbated, and that, in the intervals between his 
 attacks, he has never thought of satisfying himself sexually in this way. 
 
 The impulse to masturbation during the attack is alwaj's excited 
 by certain feminine charms, — short cloak, pretty foot and ankle, elegant 
 appearance. Age makes no difference ; even little girls excite him. The 
 impulse is sudden and unconquerable. R. describes the situation and 
 act as characteristically impulsive. He had often tried to resist it; 
 but then he would grow hot, terribly frightened, his head would burn, 
 and he would seem to be in a fog; but lie never lost consciousness. At 
 the same time he would have violent, darting puin in tlie testicles and 
 spermatic cords. He regretted it, but had to confess that the impulse 
 was stronger than his will. In such a situation it forced him to mastur- 
 bate, no matter where he might be. After ejaculation he would become 
 calm, and regain his self-control. He regarded it as a terrible affliction. 
 Defense shows that R. has been punished six times for similar offenses 
 — exhibition and masturl)ation in the open street. 
 
 On November 4, 1889, R., while in his worst condition, happened 
 to be in the street as a crowd of school-girls went by. This aw^akened 
 his unconquerable impulse. Tliere was not time to run to a closet, he 
 was so excited. There was immediate exhibition, masturbation in front 
 of a house, — great scandal and immediate arrest. R. is not weak- 
 minded, and has no ethical defect. He bemoans his fate, deeply regrets 
 his act, and fears new attacks. He regards his condition as abnormal, 
 — as a fate against whicli he is powerless. 
 
 He thinks himself still virile. Penis abnormally large. Cremas- 
 teric reflex present; patellar reflex increased. Weakness of the sphincter 
 of the bladder, that has existed for some j^ears. Various neurasthenic 
 difficulties. 
 
 The opinion showed that R. was subject to the influence of abnoi'- 
 mal conditions, and had acted impulsively. Patient was sent to an 
 asylum, from Avliich he was discharged after a few months. 
 
 In the foregoing case the important point, clinically, lies 
 not in the neurosis that is present, but ratlier in the impulsive 
 character of the act (exliibition dependent on masturbation). 
 
 With the enumeration of the categories of imbeciles, of 
 mentally weakened individuals, and of the exhibitionists that
 
 390 PSYCHOPATHIA SEXUALIS. 
 
 are in a neurotic (epileptic or neurasthenic) state of imperfect 
 consciousness, apparently the clinical and forensic side of this 
 phenomenon is still unexhausted ; in addition to these, there is 
 another class, the representatives of which, owing to deep hered- 
 itary taint (hereditary degenerative neurosis '?), are impelled to 
 periodical and very impulsive exhibition. 
 
 With reference to these conditions of psychopathia sexualis 
 periodica (comp. " Periodical Insanity"), in which the acci- 
 dentally-awakened impulse to exhibition is but a partial mani- 
 festation of a clinical whole, like dipsomania periodica, Magnan, 
 from whom I borrow the following instructive cases, justly lays 
 the greatest stress upon the impulsive, periodical feature of 
 these abnormal impulses ; and no less upon the fact that they 
 are often accompanied by terrible anxiety, which, after the reali- 
 zation of the impulse, gives place to a feeling of relief 
 
 These facts, and, no less, the clinical picture of degeneracy 
 tliat, for the most part, is referable to injurious conditions that 
 are hereditary, or that exercise an injurious effect on the devel- 
 opment of brain in early years (rachitis, etc.), are, medico- 
 legally, of decisive importance [with reference to the question 
 of responsibility]. 
 
 Case 176. G., aged 29, waiter in a cafe. In 1888, while standing 
 under a cliurch-door, lie exhibited himself to several girls working oppo- 
 site. He confessed the act, and also that, man}' times, in the same place 
 and at the same time of da}', he had been guilty of the same crime, having 
 been punished for it, the year before, with imprisonment for one month. 
 
 G. has very nervous parents. His father is mentally unstable and 
 veiy irascible. His mother is at times insane, and suffers with severe 
 nervous disease. 
 
 G. has always had nervous twitching of the face, and constant alter- 
 nation of causeless depression, with tsedium vitfe, and periods of elation. 
 At the ages of ten and fifteen, for slight cause, he wished to commit 
 suicide. When excited, he has similar twitching of the extremities. He 
 presents constant general analgesia. i\\ prison he was at first beside 
 himself with shame about the disgrace he had brought on his famil^'^jand 
 said he was tlie worst of men, deserving the severest punishment. 
 
 Until his nineteenth year G. had satisfied himself with solitary 
 and mutual masturbation, and, on one occasion, he had practiced onan- 
 ism with a girl. From that time, working in a ca/e, the female cus- 
 tomers had excited him so intensely that ejaculation was often induced.
 
 EXHIBITION. 391 
 
 He suffered with filuiost constsint priapism, and, as his wife stated, in 
 spite of coitus, it often disturbed liis rest at niglit. For seven j-ears he 
 had repeatedly exhibited himself at his window, and also exposed 
 himself naked to female neighbors living opposite. 
 
 In 1883 he married out of desire. Marital intercourse did not 
 satisfy his needs. At times his sexual excitement was so intense that 
 he had headache, and seemed confused, like one drunk, strange, and 
 incapable of work. 
 
 Case 177. B., aged 27 ; of neuropathic mother and alcoholic father. 
 He-has one brother who is a drinker; and an hysterical sistei'. 
 
 After his eleventh 3'ear, onanism, solitary or mutual. After his 
 fifteenth year, impulses to exhibition. He attempted it at a street- 
 urinal ; he felt pleasure in it, but also immediately twinges of con- 
 science. If he attempted to oppose his impulse thereafter, he became 
 apprehensive, and had a feeling of oppression in his chest. When a 
 soldier, he was often impelled to expose himself, under various 
 pretexts, to his comrades. 
 
 After his seventeenth 3'ear he had sexual congress with women. 
 It gave him great pleasure to show himself naked before them. He con- 
 tinued his exhibition on the street. Since he could but infrequentl}'' 
 count on female spectators at urinals, he changed his place to churches. 
 In order to exhibit himself at such places, he always had to strengthen 
 his courage by drinking. Under the influence of spirits, the impulse, at 
 other times controllable with difficulty, became irresistible. He was not 
 sentenced. He lost his position, and then drank more. Not long after, 
 he was again arrested for exhibition and masturbation in a church. 
 
 Case 178. X., aged 35; barber's assistant. Repeatedly punished 
 for offense against decency, he is again arrested ; for, during three 
 weeks, he had been hanging around girls' schools, trying to attract the 
 attention of the pupils, and, when he had succeeded in this, had exhib- 
 ited himself. Occasionally' he had promised them money, with the 
 words, " Habeo mentulam pulcherrimam, venite ad me ut earn lambatis." 
 At his examination X. confessed everything, but did not know how it 
 had come about. He was the most reasonable of men in other respects, 
 but had the impulse to commit this crime, and could not overcome it. 
 
 In 1879, when in the army, he was once out on leave, and had run 
 around exhibiting himself to children : imprisonment for a year. The 
 same crime in 1881. He chased the crying children, and " stared " at 
 them : imprisonment of one year and three months. Two days after his 
 discharge, he said to two little girls : " If you want to see my tail, come 
 with me to this (market) booth." He denied these words, and claimed 
 drunkenness : imprisonment for three months. 
 
 In 1883, renewed exhibition ; during the act he said nothing. At his 
 examination he stated that, since a severe illness, eight j'ears previously, 
 he had suffered with such excitations : imprisonment for one month.
 
 392 PSYCHOPATHIA SEXUALIS. 
 
 In 1884, exhibition before girls in a church-yard; again in 1885. 
 He declared : " I undei'stand my crime, but it is like a disease. When 
 it comes over me, I cannot keep from such acts. It sometimes happens 
 that, for quite a long time, I am free from these inclinations." Imprison- 
 ment for six months. 
 
 Discharged on August 12, 1885, he had a relapse on August 15. 
 The same excuse was sfiven. This time he underwent medical examina- 
 tion. The examination revealed no mental disturbance. Sentenced to 
 three years. After discharge, a series of new exhibitions. On this 
 occasion, examination revealed the following : — 
 
 His father suffered with chronic alcoholism, and is said to have 
 been guilty of the same crime. Mother and sister nervously ill, and the 
 whole famil}' of excitable temperament. 
 
 From his seventh to his eighteenth year X. suffered with epileptic 
 convulsions. First cohabitation at sixteen ; later, gonorrhoea and, it is 
 stated, syphilis. After that, normal sexual intercourse until his twentj-- 
 first year. At that time he often had to pass a pla^'-ground, and he 
 occasionally had to urinate there; and it happened tliat the children 
 looked at him, out of curiosity. 
 
 He noticed, occasionally, that this looking at him caused him sexual 
 excitement, and induced erection, and even ejaculation. He now found 
 more pleasure in this kind of sexual gratification, and became indifferent 
 about coitus, satisfying himself only in this manner. He felt that all his 
 thought was ruled b}'^ this, and he dreamed only of exhibitions, with 
 pollutions. His attempts to control his impulse became more and more 
 ineffectual. It came over him with such force tliat he noticed nothing 
 around him, and saw and heard nothing, and was like one " devoid of 
 reason," — like " a bull trying to butt his head through a wall." 
 
 X. has an abnormally broad head. Small penis ; the left testicle 
 deformed. Patellar reflex absent. Symptoms of neurasthenia, espe- 
 cially cerebral. Frequent pollutions. For the most part, his dreams 
 are about normal coitus, only infrequently about exhibition before little 
 girls. 
 
 With reference to his sexual acts, he states that the impulse to 
 seek and approach little girls is primary ; only when he has succeeded in 
 attracting their attention to his exposed genitals do erection and ejacu- 
 lation occur. He does not lose consciousness in the act. After it he is 
 troubled about his deed, and, if undiscovered, sa3's to himself, "Once 
 more I have escaped the authorities." 
 
 In prison he did not have the impulse ; there, he was troubled only 
 with dreams and pollutions. In freedom he had daily sought oppor- 
 tunity^ to satisf}^ himself witli exhibition. He would give ten 3'ears of 
 his life to be free from the thing; "this life of constant anxiety, this 
 alternation between freedom and imprisonment, is unendurable." 
 
 The opinion assumed a congenital (?) perversity of the sexual
 
 I 
 
 EXHIBITION. 393 
 
 instinct, with unmistakable hereditary taint, neuropathic constitution, 
 asymmetry of cranium, and defective development of the genitals. 
 
 It is also worthy of remark that the exhibition began when the 
 epile2)sy ceased ; so that one might think of a vicarious phenome7}07i. 
 
 The sexual perversity developed, with predisposition, through 
 accidental association of ideas of sexual content (children looking at 
 him while urinating) with an act that, in itself, was purposeless. 
 
 The patient was not sentenced, but sent to an asylum, (Dr. 
 Fre^^er, Zeitschr. f. 3Iedicinalbeamte , 3 Jahrg., No. 8.) 
 
 Case 179. At 9 o'clock at night, in the spring of 1891, a lad}', in 
 great trepidation, came to the policeman in the city park of X., with the 
 statement that a man, absolutely naked in front, had approached her 
 from the bushes, and she had run away, frightened. The oflicer went at 
 once to the place indicated, and found a man, who exposed ventrem et 
 genitalia nuda. He attempted to escape, but was overtaken and arrested. 
 He stated that he had been sexually excited by alcohol, and had been on 
 the point of going to a prostitute. On his way through the park, how- 
 ever, he recalled the fact that exhibition gave him much greater pleasure 
 than was afforded him by coitus, in which he seldom, and only /ante de 
 mieux, indulged. After drawing up his shirt, he posted himself in the 
 bushes, and, when two women came up the path, he approached them 
 with exposed genitals. In such exhibition he had a pleasurable feeling 
 of warmth, and the blood mounted to his head. 
 
 The accused works in a manufactory, and his employer states that 
 he is faithful, saving, sober, and intelligent. 
 
 In 1886 B. had been punished because he had twice exhibited 
 himself publicl}', — once in broad daj'light, and once at night, under a 
 lamp. 
 
 B., aged 37, single, makes a peculiar impression, owing to his dandi- 
 fied dress and affected manner. His eyes have a neuropathic, languishing 
 expression; around his mouth plays a smile of self-satisfaction. He is 
 said to come of healthy parents. A sister of his father, and one of his 
 mother, were insane. Others of their relatives were thought religiously 
 eccentric. 
 
 B. has never had any severe illness. From childhood he was 
 eccentric and imaginative. He loved romances about knights and 
 others, was entirely absorbed by them, and even went so far as to 
 identify himself in fanc}^ witii the heroes. He always thought himself a 
 little better than others, and thought much of elegant dress and orna- 
 ment ; and when he strutted about on Sundaj's, he imagined himself a 
 high official. 
 
 B. has never had epileptic symptoms. In youth, moderate in- 
 dulgence in masturbation ; later, moderate indulgence in coitus. Pre- 
 viously, never au}-^ perverse sexual feelings or impulses. Retired manner 
 of life; in leisure hours, reading (popular novels, heroic tales, Dumas,
 
 394 PSYCHOPATHIA SEXUALIS. 
 
 and others). B. was no drinker. Exceptional!}^ he made himself a kind 
 of punch, by which he was alwa3's excited sexnall}'. 
 
 For some years, witli marked decrease of libido, after such alco- 
 holic indulgence, he had had " accursedly silly thoughts," and developed 
 the desire genitalia adspectui feminarura publice exhibere. 
 
 If he got into this state, he felt warm, his heart beat violentlj^ 
 blood rushed to his head, and he could then no longer resist his imi)ulse. 
 He heard and saw nothing more, and was absolutely absorbed in his 
 lust. Afterward he had often pounded his crazy head with his fists, and 
 firmly resolved never to do such a thing again ; but the crazy ideas had 
 always returned. 
 
 In his exhibition his penis became only half-erected, and ejaculation 
 never occurred ; even in coitus it was always tard3\ In exhibition he 
 was satisfied with genitalia sua adspicere, and he had the lustful thought 
 that this sight must be very pleasant to women, since he liked so much 
 to see genitalia feniinarum. He was capable of coitus only when the 
 puella showed herself very partial to him ; without this, he preferred 
 rather to pay and go without doing anything. In his dreams he exhib- 
 ited himself to 3'oung, voluptuous women. 
 
 The medico-legal opinion recognized the hereditary- psychopathic 
 character of the culprit, and the perverse, impulsive desire to perform 
 the incriminating acts ; and pointed out, further, the remarkable fact 
 that in B., who was otherwise sober and saving, the impulses to indulge 
 in alcohol depended on abnormal conditions that recurred periodicalh', 
 and forced him to indulge. That, during his attacks, B. was in an 
 exceptional ps>-ciiical state, in a kind of mental confusion, and abso- 
 lutel}^ absorbed in his perverse sexual fancy, is clearly shown b^^ the 
 species facti. Thus is explained the fact that he became aware of the 
 approach of the police onl}- when it was too late to try to escape. In 
 this hereditary' and degenerate impulsive exhibitionism, it is interesting 
 to note how the perverse sexual impulse is awakened from its latency b}' 
 the influence of alcohol. 
 
 A forensically important variety of exhibition, which, clini- 
 cally, certainly rests upon a similar neurotic and degenerate 
 foundation, and which expresses itself in a peculiar act, con- 
 ditioned by violent libido (liypersesthesia sexualis), associated 
 with diminished virility, is made up of the so-c?i\\edi frotteurs. 
 
 The three following cases, borrowed from Magnan (op. cit.)^ 
 are typical : — 
 
 Case 180. D.,aged 44, hereditaril}' predisposed, drinker, and suffer- 
 ing with lead poisoning. Until the last 3'ear he had masturbated much, 
 and often drawn pornographic pictures, and shown them to his acquaint-
 
 FROTTAGE. 395 
 
 anees. He had repeatedly dressed himself as a woman in secret. For 
 two 3'ears, since becoming impotent, he had felt desire, while in crowds 
 at dnsk, mentulam denudare eamque ad nates mulieris crassissimne 
 terere. Once, when discovered in the act, he had been sentenced to 
 imprisonment for four months. 
 
 His wife kept a milk-shop. Iterum iterumque sibi teraperare non 
 potuit quin genitalia in ollam lacte completam mergeret. In the act he 
 felt lustful pleasure, "as if touched with velvet." He was cynical 
 enough to use this milk for himself and the customers. During impris- 
 onment alcoholic persecutory insanity developed in him. 
 
 Case 181. M., aged 31 ; married six years; father of four children; 
 badly predisposed; subject to melancholia at times. Three years before, 
 he was discovered by his wife with a silk dress on, masturbating. One 
 day he was discovered, in a store, in the act of froUage on a lady. He 
 was ver3'^ repentant, and asked to be severely punished for his irresistible 
 impulse. 
 
 Case 182. G., aged 33 ; badly predisposed hereditarily-. At an 
 omnibus-station he was discovered in the act of froltage with his penis 
 on a \iiiXy. Deep repentance ; but he stated that at the sight of a notice- 
 able posteriora of a lad}', he was irresistibly impelled to practice frot- 
 tage^ and that he became confused and knew not what he did. Sent to 
 an asylum. 
 
 Case 183. A frotteiir. Z., born in 1850; of blameless life previ- 
 ously ; of good famil}' ; private official. He is well-to-do financiall}^ ; 
 untainted. After a short married life he became a widower, in 1873. 
 For some tin7c he had attracted attention in churches, because he 
 crowded up behind women, both old and young indifferently, and toyed 
 with their tonrnures. He was watched, and one day he was arrested in 
 the act. Z. was terribly frightened, and in despair about his situation ; 
 and, in making a full confession, he begged for pardon, for nothing but 
 suicide remained for him. 
 
 For two years he had been subject to the unhappy impulse to go in 
 crowds of people, — in churches, at box-offices of theatres, etc, — and 
 press up behind females and manipulate the prominent portion of their 
 dresses, having orgasm and ejaculation during the act. 
 
 Z. states that he was never given to masturbation, and had never 
 been in any way perverse sexuallj^ Since the early death of his wife, 
 he had gratified his great sexual desire in temporary love-affairs, having 
 always had an aversion for i)rostitutes and brothels. The imi)ulse to 
 frottage had suddenly seized him, two years before, while he ha[)pened to 
 be in church. Though he was conscious that it was wrong, he could not 
 help yielding to it immediately. Since then he had been excitable to the 
 posteriora of females, and had been actually impelled to seek opportu- 
 nity for frottage. Tlie only thing on women that excited him was the 
 tournure ; every other part of the body and attire was a matter of indiff'er-
 
 396 PSYCHOPATHIA SEXUALIS. 
 
 ence to him; and it made no difference to him whether the woman was 
 old or young, beautiful or ugly. Since this began, he had had no more 
 inclination for natural gratification. Of late fr-ottage scenes had appeared 
 in his dreams. Daring his acts he was fully conscious of his situation 
 and the act, and tried to perform it in such a way as to attract as little 
 attention as possible. After his act he was alwaj^s ashamed of what he 
 had done. 
 
 The medical examination revealed no sign of mental disease or 
 mental weakness, but s3'niptoms of neurasthenia sexualis, — ex abstinentia 
 libidinosi (?), — which was also proved by the circumstance that even 
 simple touching of the fetich with the unexposed genitals sufficed to 
 induce ejaculation. Apparently Z., weakened sexually and distrusting 
 his virility, and yet libidinous, had come to practice frottage by having 
 the sight of posteriora feminae fall together accidentally with sexual 
 excitement ; and this associative combination of a perception with a 
 feeling permitted the former to attain the significance of a fetich. 
 
 As an act which offends pubhc morals, and which is, there- 
 fore, punishable, the violation of statues — a whole series of cases 
 of which Moreau {op. cit.) has collected from ancient and modern 
 times — may be enumerated here. They are, unfortunately, given 
 too much like anecdotes to allow satisfactory judgment of them. 
 They always give the impression of being pathological, — like the 
 stoiy of a young man (related by Lucianus and St. Clemens, of 
 Alexandria) who made use of a Venus of Praxiteles for the 
 gratification of his lust ; and the case of Clisyphus, who violated 
 the statue of a goddess in the Temple of Samos, after having 
 placed a piece of meat on a certain part. In modern times, the 
 Journal Vevenemeut of March 4, 1877, relates the story of a 
 gardener who fell in love with a statue of the Venus of Milo, 
 and was discovered attempting coitus with it. At any rate, 
 these cases stand in etiological relation with abnormally intense 
 libido and defective virility or courage, or lack of opportunity for 
 normal sexual gratification. 
 
 The same thing must be assumed in the case of the 
 so-called voyeurs^^ — i.e., men who are so cynical that they seek to 
 
 ^ Dr. Moll calls this perversion (?) mixoscopia (from tu^ts, cohabitation ; and 
 ffKeirreiv, to look). His assumption that it is related to masochism, in that there is a 
 stimulus for the voyeur in suffering at seeing a woman in the possession of another, does 
 not seem to me to be justified. For further details, vide Moll, " Die contrare Sexual- 
 empfindung," p. 137.
 
 LUST-MURDER. 397 
 
 get sight of coitus, in order to assist their virility; or who seek to 
 have orgasm and ejaculation at the sight of an excited woman. 
 Concerning this moral aberration, which, for various reasons, 
 cannot be further described here, it will suffice to refer to Coffig- 
 non's book, " La Corruption a Paris." The revelations, in the 
 domain of sexual perversity, and also perversion, which this book 
 makes, are horrible. 
 
 2. Rape and Lust-Murder. 
 
 (Austrian Statutes, § 125, 127 ; Austrian Abridgment, § 192 ; Germau 
 
 Statutes, § 177.) 
 
 By the term rape, the jurist understands coitus, outside of 
 the marriage relation, with an adult, enforced by means of 
 threats or violence ; or with an adult in a condition of defense- 
 lessness or luiconsciousness ; or with a girl under the age of 
 fourteen years. Immissio penis, or, at least, conjunctio mem- 
 brorum (Schiitze), is necessary to establish the fact. To-day, 
 rape on children is remarkably frequent. Hofmann C"' Ger. 
 Med.," i, p. 155) and Tardieu ("Attentats") report horrible cases. 
 
 The latter establishes the fact that, from 1851 to 1875 
 inclusive, 22,017 cases of rape came before the courts in France, 
 and, of these, 17,657 were committed on children. 
 
 The crime of rape presumes a temporary, powerful excita- 
 tion of sexual desire, induced by excess in alcohol, or by some 
 other condition. It is highly improbable that a man morally 
 intact would commit this most brutal crime. Lombroso (Golt- 
 damnier's Arch.) considers the majority of men who commit 
 rape to be degenerate, particularly when the crime is done on 
 children or old women. He asserts that, in many such men, 
 he has found actual signs of degeneracy. 
 
 It is a fact that rape is very ol'tcn the act of degenerate 
 male imbeciles,^ where, under some circumstances, the bond of 
 blood is not respected. 
 
 Cases as a result of mania, satyriasis, and epilepsy, have 
 occurred, and are to be kept in mind. 
 
 1 Anual. m6dico-psychol., 1849, p. 515; 1863, p. 57; 1864, p. 215; 1866, p. 253.
 
 398 PSYCHOPATHIA SEXUALIS. 
 
 The crime of rape may follow the murder of the victim.^ 
 There may be unmtentional murder, murder to destroy the only 
 witness of the crime, or murder out of lust {v. siqjva). Only 
 for cases of the latter kind should the term lust-murder'^ be 
 used. 
 
 The motives of lust-murder have been previously consid- 
 ered. The cases given in illustration are characteristic of the 
 manner of the deed. The presumption of a murder out of lust 
 is always given when injuries of the genitals are found, the 
 character and extent of which are such as could not be ex- 
 plained by merely a brutal attempt at coitus ; and, still more, 
 when the body has been opened, or parts (intestines, genitals) 
 torn out, and are wanting. ^ 
 
 Lust-murders dependent upon psychopathic conditions are 
 never committed with accomplices. 
 
 Case 184. Weak-mindedness^ Epilepsy. Attempt at Rape; Murder. 
 — On the evening of May 27, 1888, an eight-year-old boy, Blasius, was 
 playing with other children in the neighborhood of the village of S. 
 An unknown man came along and enticed the boy into the woods. The 
 next day the boy's body was found in a ravine, with the abdomen slit 
 open, an incised wound in the cardiac region, and two stab-wounds in the 
 neck. 
 
 Since, on May 21st, a man, answering to the description given 
 of the murderer by the children, had attempted to treat a six-year-old 
 girl in a similar manner, and had only accidentally been detected, it was 
 presumed to be a case of lust-murder. It was proved that the body 
 was found in a heap, with only the shirt and jacket on ; also, that there 
 was a long incision in the scrotum. 
 
 Suspicion fell upon a peasant, E. ; but, on confrontation with the 
 children, it was not possible to identify him with the stranger who had 
 enticed the boy into the woods. Besides, with the help of his sister, he 
 proved an alibi. The untiring efforts of the officers brought new evi- 
 dence to light, and finally E. confessed. He had enticed the girl into 
 the woods, thrown her down, exposed her genitals, and was about to 
 abuse her; but, as she had an eruption on her head, and was crying 
 loudly, his desire cooled, and he fled. 
 
 After he enticed the boy into the woods, with the pretext of show- 
 
 1 Comp. the cases of Tardieu, Attentats, p. 182-192. 
 
 2 Comp. Haltzeudorff, Psychologic des Mords. 
 ^ Tardieu, Attentats, Case 51, p. 188.
 
 LUST-MURDER. 399 
 
 ino- him a bird's nest, he was taken with a desire to abuse him. Since 
 the boy refused to take oft" his trousers, he did it for him; and when 
 the boy began to cry out, he stabbed him twice in the neck. Then he 
 made an incision, just above tlie pubes, in imitation of female genitals, 
 in order to use it to satisfy his lust. But, since the body grew cold 
 immediately, he lost his desire, and, cleaning his knife and hands near 
 the body, he fled. When he saw the boy dead, he was filled with fear, 
 and his limbs became weak. 
 
 During his examination E. looked apathetically at a garland. He 
 had acted in a state of mental weakness. He could not understand how 
 he came to do such a thing. He must have been beside himself; for he 
 often became senseless, so that he would almost fall down. Previous 
 employers report that he had periods when he was devoid of thought 
 and confused, doing no work all day, and avoiding others. His father 
 states that E. learned with difliculty, was unskillful at work, and often 
 so obstinate that one did not think to punish him. At such times he 
 would not eat, and occasionally run away and remained all day. At 
 such times he also seemed quite lost in thought, screwed his face up, 
 and said senseless things. When quite a boy, he still sometimes wet 
 the bed, and often came home from school with wet or soiled clothing. 
 He was very restless in sleep, so that no one could sleep beside 
 him. He had never had playmates. He had never been cruel, bad, or 
 immoral. 
 
 His mother gave similar testimony ; and further, that, in his fifth 
 year, E. first had convulsions, and once lost the power of speech for 
 seven days. Sometime about his seventh year he once had convul- 
 sions for fort}^ tlays, and was also dropsical. Later, too, he was often 
 seized in sleep, and he often then talked in his sleep ; and mornings, 
 after such nights, the bed was found wet. 
 
 At times it was impossible to do anything with him. Since his 
 mother did not know whether it was due to viciousness or disease, she 
 did not venture to punish him. 
 
 Since his convulsions, in his seventh year, he had failed so in mind 
 that he could not learn even the common prayers ; and he also became 
 very irascible. 
 
 Neighbors, persons prominent in the community, and teachers 
 state that E. was peculiar, weak-minded, and irascible ; that at times he 
 was very strange, and apparently in an exceptional mental state. 
 
 The examinations of the medical experts gave the following 
 results : — 
 
 E. is tall, slim, and poorly nourished. His head measures 53 centi- 
 metres in circumference. The cranium is rhombic, and in the occipital 
 region flattened. 
 
 His expression is devoid of intelligence ; his glance is fixed, 
 expressionless ; his attitude is careless, and his body is bent forward.
 
 400 PSYCHOPATHIA SEXUALIS. 
 
 Movements are slow and heavy. Genitals normally developed. E.'s 
 whole appearance points to torpidity and mental weakness. 
 
 There are no signs of degenerative marks, no abnormality of the 
 vegetative organs, and no disturbances of motility or sensibilit3\ He 
 comes of a perfectly healthy family. He knows nothing of convulsions 
 or of wetting his bed at night, but he states that, of late years, he has 
 had attacks of vertigo and loss of mind. 
 
 At first, in circumlocution, he denies the murder. Later, in great 
 contrition, before the examining judge, he confessed all, and gave a 
 clear motive for his crime. He had never had such a thought before. 
 
 He has been given to onanism for years ; he even practiced it twice 
 daily. He states that, for want of courage, he had never ventured to 
 ask coitus of a woman, though in dreams such scenes exclusively passed 
 before him. Neither in dreams nor in the waking state had he ever had 
 perverse instincts ; particularly no sadistic or contrary sexual feelings. 
 Too, the sight of the slaughter of animals had never interested him. 
 When he enticed the girl into the woods, his desire was to satisfy his 
 lust with her ; but how it happened that he tried such a thing with a 
 boy, he could not explain. He thought he must have been out of his 
 mind at that time. The night after the murder he could not sleep on 
 account of fear; he had twice confessed already, to ease his conscience. 
 He was only afraid of being hung. This should not be done, as he 
 had done the deed in a weak-minded condition. 
 
 He could not tell why he had cut open the boy's abdomen. It had 
 not occurred to him to handle the intestines, smell them, etc. He stated 
 that, after the attempt on the girl in the day-time, and in the night, after 
 the murder of the boy, he had convulsions. At the time of his crime he 
 was indeed conscious, but he had not thought at all of what he did. 
 
 He suffered much with headache; could not endure heat, thirst, or 
 alcohol ; there were times when he was perfectly confused. The test of 
 his intelligence showed a high grade of weak-mindedness. 
 
 The opinion (Dr. Kautzner, of Graz) showed the imbecility and 
 neurosis of the accused, and made it probable that his crime, for which 
 he had only a general recollection, had been committed in an exceptional 
 (pi'fe-epileptic) mental state, conditioned by the neurosis. Under all 
 circumstances, E. was considered dangerous, and probably would require 
 commitment to an asylum for life.
 
 SADISM AND FETICHISM. 401 
 
 3. Bodily Injury, Injury to Property, and Torture of Animals 
 
 Dependent on Sadism. * 
 
 (Austrian, § 152, 411; German, § 223 [bodily injury]. Austrian, § 85, 
 468; German, § 303 [injury to property]. Anstrian Police Regula- 
 tions; German Statutes, § 360 [torture of animals].) 
 
 Aside from lust-murder, described in the foregoing section, 
 as milder expressions of sadistic desires, impulses to stab, 
 flagellate, or defile females, to flagellate boys, to maltreat 
 animals, etc., also occur. 
 
 The deep degenerative significance of such cases is clearly- 
 demonstrated by the series of examples given under " General 
 Pathology." Such mentally degenerate individuals, should they 
 be unable to control their perverse impulses, could only be 
 objects of care in asylums. 
 
 4. Bodily Injury, Robbery, and Theft Dependent on Feticiiism. 
 
 (Austrian, § 190 ; German, § 249 [robbery]. Austrian, § 171, 460 ; 
 
 German, § 242 [theft].) 
 
 It is seen from the section on fctichism, under " General 
 Pathology," that pathological fetichism may become the cause 
 of crimes. There are now recognized, as such, hair-despoiling 
 (Cases 78, 79, 80); robbery or theft of female linen, handker- 
 chiefs, aprons (Cases 82, 83, 85, 86), shoes (Cases 68, 87, 88), 
 and silks (Case 93). It cannot be doubted that such individuals 
 are subjects of deep mental taint. But, for the assumption of an 
 absence of mental freedom and consequent irresponsibility, it 
 
 ^ Masochism may, under certain circumstances, attain forensic importance. Modern 
 criminal law no longer recognizes the principle, " volenti non fit injuria" ; and the present 
 Austrian statute, in § 4, says expressly : " Crimes may also be committed on persons who 
 demand their commission on themselves." 
 
 As Herbst (Handb. d. osterr. Strafrechts., Wien, 1878, p. 73) remarks, there are, 
 nevertheless, crimes conditioned by the absence of assent on the part of the injured indi- 
 vidual, which cease to be such as soon as the injured individual has given consent, — e.g., 
 theft, rape. 
 
 But Herbst also enumerates here the limitation of personal freedom (?). 
 
 Of late a decided change of views on this point has taken place. The German 
 criminal law regards the consent of a man to his own death of such importance that a very 
 difiFerent and much milder punishment is inflicted under such circumstances (§ 216) ; and 
 it is the same in Austrian law (Austrian Abridgment, § 233). The so-called double 
 suicide of lovers was the act considered. In bodily injury and deprivation of freedom, the 
 consent of the victim must also receive consideration at the hands of the judge. Certainly 
 a knowledge of masochism is of importance in making a judgment of the probability of 
 
 asserted consent. 
 
 26
 
 402 PSYCHOPATHIA SEXUALIS. 
 
 must be proved that there was an irresistible impulse, which, 
 either owing to the strength of the impulse itself, or to the 
 existence of mental weakness, made control of the punishable, 
 perverse impulsion impossible. Such crimes and the peculiar 
 manner in which they are performed, — in which they differ very 
 much from common robbery and theft, — always demand a 
 medico-legal examination. But that the eict per se does not, by 
 any means, necessarily arise from psycho-pathological conditions 
 is shown by the infrequent cases of hair-despoiling ^ simply for 
 the purpose of gain. 
 
 5. Violation of Individuals Under the Age of Fourteen. 
 
 (Austrian Statutes, § 128, 132; Austrian Abridgment, § 189, lOP; 
 
 German Statutes, § 174, ITG^.) 
 
 By violation of sexually immature individuals, the jurist 
 understands all the possible immoral acts with persons under 
 fourteen years of age that are not comprehended in the term 
 rape. The term violation, in the legal sense of the word, com- 
 prehends the most horrible perversions and acts, which are 
 possible only to a man who is controlled by lust and morally 
 weak, and, as is usually the case, lacking in sexual power. 
 
 A common feature of these crimes, committed on persons 
 that are more or less children, is that they are unmanly, childish, 
 and often silly. It is a fact that such acts, with exceptions in 
 pathological cases, like those of imbeciles, paretics, and senile 
 dements, are almost exclusively committed by young men who 
 lack courage or have no faith in their virility ; or by roues 
 who have, to some extent, lost their virility. It is psychologi- 
 cally incomprehensible that an adult of full virility, and mentally 
 sound, should indulge in sexual abuses with children. 
 
 The imagination of debauchees, in actively or passively 
 picturing tlie immoral acts, is exceedingly lively ; and that the 
 following enumeration of the sexual acts of this kind known to 
 law exhausts all the possibilities is questionable. Most fre- 
 quently the abuse consists of sexual handling (under some 
 
 ^ According to Austrian law, this crime should fall under §411, as slight bodily 
 injury; according to the German criminal law, it is bodily injury (comp. Liszt, p.325^.
 
 VIOLATION. 403 
 
 circumstances, flagellation ^), active manustupration, or seducing 
 children by inducing tliem to perform onanism, or lustful hand- 
 ling, on the seducer. Less frequent acts are cunnihngus, irru- 
 mare on boys or girls, psedicatio puellarum, coitus inter femora, 
 and exhibition. 
 
 In a case which Maschka reports (" Handb.," iii, p. 174), a young 
 man had naked girls, from eight to twelve years old, dance about in his 
 room, and urinate before him, until he ejaculated. Not infrequently bo3'8 
 are abused b}-^ sensual women, who undertake to bring about conjunctio 
 membrorum with them, in order to satisfy themselves b}' means of 
 friction or onanism.^ 
 
 Tardieu saw one of the most disgusting examples. A servant, in 
 company with her lover, masturbated children intrusted to them, per- 
 formed cunnilingus with a girl of seven, and introduced parsnips and 
 potatoes into her vagina, and put similar things into the rectum of a 
 baby of two years 1 
 
 Case 185. Z., aged 62; deeply tainted, masturbator. He states he 
 has never had coitus, but has frequently i)racticed fellatio. He is in an 
 asylum, on account of paranoia. It had been his greatest pleasure to 
 entice girls, aged from ten to fourteen j^ears, and practice cunnilingus 
 and other vile acts with them. In these acts he had orgasm and ejacu- 
 lation. Masturbation did not give him the same satisfaction, and induced 
 ejaculation only with difficult3^ Faute de mieux he also practiced fel- 
 latio with men ; occasionally an exhibitionist. Phimosis ; asj^mmetrical 
 cranium. (Pelanda, Arch, di Psichiatria, x, fascic. 3, 4.) 
 
 Case 186. X., priest, aged 40. He was accused of enticing girls, aged 
 from ten to thirteen, undressing and fondling them lustfully, and finally 
 masturbating. He is tainted, and has been an onanist from childhood ; 
 morally imbecile ; always very excitable sexually. Head somewhat small. 
 Penis unusually large; indications of hypospadiasis. (Pelanda, luc. cit.) 
 
 Case 187. K., aged 23 ; laborer. He was accused and convicted 
 of repeatedly enticing boys, and now and then girls, to an out-of-the- 
 way place, and practicing abuses with them (mutual masturbation, 
 fellatio puerorum, fondling of the genitals of the girls). 
 
 K. is an imbecile, and i)hysically deformed, being scarcely 1.5 
 metres tall ; cranium rachitic and hydrocephalic ; teeth bad, — furrowed, 
 defective, and irregular. Large lips, idiotic expression, stuttering 
 speech, and an awkward attitude complete the picture of ps3^cho- 
 physical degeneration. K. behaves like a child discovered in some 
 mischievous act. Scarcely any growth of beard. Genitals well and 
 
 1 Cases, i/i<i!e Friedreich's Blatter f. ger. Anthropologic, iii, p. 77. 
 
 2 Cases, Maschka, Handb., iii, p. 175. — Casper, Vierteljahrsschr., 1852, Bd. i.— . 
 Tardieu, Attentat^,
 
 404 PSYCHOPATHIA SEXUALIS. 
 
 normally developed. He has a superficial consciousness of having done 
 something improper, but he is unconscious of the moral, social, and 
 legal significance of his crimes. 
 
 K. comes of a drunken father, and a mother who became insane 
 from the abuse of her husband, and died in an asylum. In his baby- 
 hood the boy was almost blinded by corneal ulcers, and, after his sixth 
 year, he grew up with an almoner, and later with difficulty earned his 
 living as an organ-grinder. His brother is good for nothing, and the 
 culprit himself was considered a surl}', quarrelsome, evil, moody, irri- 
 table man. The opinion emphasized the intellectual, moral, and physical 
 defect of the culprit. 
 
 Unfortunately it must be admitted that the most revolting of 
 these crimes are done by sane individuals who, by reason of satiety 
 in normal sexual indulgence, lasciviousness, and brutality, and not 
 seldom during intoxication, forget that they are human beings. 
 
 A great number of these cases, however, certainly depend 
 upon pathological states. This is particularly true where old 
 men become the seducers of children.^ 
 
 I agree with Kirn, who, under all circumstances, in cases 
 of this kind, holds a mental examination to be always necessary ; 
 since, frequently enough, a re-awakened, perverse, abnormally 
 intense, and uncontrolable sexual desire is shown to be one of 
 the manifestations of a senile dementia. 
 
 6. Unnatural Abuse — Sodomy.^ 
 
 (Austrian Statutes, § 129 ; Abridgment, § 190 ; German Statutes, § 1*75.) 
 
 (a) Violation of Anivials — Bestiality.^ 
 
 Violation of animals, monstrous and revolting as it seems 
 
 to mankind, is by no means always due to psycho-pathological 
 
 1 Comp. Kirn, Allg. Zeitschr. f. Psych., 39, p. 217. 
 
 2 I follow the usual termiuology in describing bestiality and pederasty under the 
 general terra sodomy. In Genesis (chap, xix), whence this word comes, it signifies exclu- 
 sively the vice of pederasty. Later, sodomy was often used synonymously with bestiality. 
 The moral theologians, like St. Alphons of Liguori, Gury, and others, have always distin- 
 guished correctly, i.e., in the sense of Genesis, between sodomia, i.e., concubituscum persona 
 ejusdera sexus, and bestialitas, i.e., concubitus cum bestia (comp. Olfus, Pastoral medicin, 
 p. 78). 
 
 The jurists brought confusion into the terminology by establishing a " Sodomia 
 rations sexus" and a" S. ratione generis." Science, however, sliould assert'itself as 
 a7isilla theologice, and return to the correct usage. 
 
 3 For interesting histories, vide Krauss, Psychol, d. Verbrechens, p. 180. — Maschka, 
 Hdb. iii, p. 188. — Hofmann, Lehrb. d. ger. Med., p. 180. — Rosenbaum, Die Lustseuche.
 
 UNNATURAL ABUSE — SODOMY. 405 
 
 conditions. liOW morality and great sexual desire, with lack 
 ot" oi)[)ortunity of natural indulgence, are the principal motives 
 of this unnatural means of sexual satisfaction, which is resorted 
 to by women as well as by men. 
 
 To Polnk we owe the knowledge that in Persia bestiality is fre- 
 quently pvacticed because of the delusion that it cures gonorrhoea; just 
 as in Europe an idea is still prevalent that intercourse with children 
 heals venereal disease. 
 
 Experience teaches that bestiality with cows and horses is none 
 too infrequent. Occasionally the acts ma}' be undertaken with goats, 
 bitches, and, as a case of Tardieu's and one by Schauenstein show 
 (Lehrb., p. 125), with hens. 
 
 The action of Frederick the Great, in the case of a cavalryman who 
 had committed bestialit}' witii a mare, is well known : "The fellow is a 
 beast, and shall be reduced to the infantry." 
 
 The intercourse of females with beasts is limited to dogs. A mon- 
 strous example of the moral depravity in large cities is related by 
 Maschka (" Hand!).," iii), — the case of a Parisian female who showed 
 herself in tiic sexual act with a trained bull-dog, to a secret circle of 
 roues, at 10 francs a head. 
 
 '■> 
 
 There has been, heretofore, but little legal consideration of 
 the mental condition in those given to violation of animals. In 
 several cases known to tlie writer, tlie individnals were weak- 
 minded. In Schauenstein's case there was insanity. 
 
 The following case of bestiality is one that was certainly 
 conditioned by disease. He was an epileptic. In this case the 
 desire for animals appeared as an equivalent of the normal 
 sexual desire : — 
 
 Case 188. X., peasant, aged 40; Greek-Catholic. Father and 
 motner were hard drinkers. Since his fifth year patient has had epilep- 
 tic convulsions, — i.e., he falls down unconscious, lies still two or three 
 minutes, and then gets up and runs wildly about with staring eyes. Sex- 
 uality was first manifested at seventeen. The patient had inclinations 
 neither for women nor for men, but for animals (birds, horses, etc.). He 
 had intercourse with hens and ducks, and later with horses and cows. 
 Never any onanism. 
 
 The patient paints pictures of saints ; is of very limited intelligence. 
 For years, religious paranoia, with states of ecstasy. He has an " un- 
 speakable " love for the Virgin, for whom he would sacrifice his life. Taken 
 to hospital, he proves to be free from infirmity and signs of degeneration.
 
 406 PSYCHOPATHIA SEXUALIS. 
 
 He bad always had an aversion for women. In a single attempt at 
 coitus with a woman he was impotent, but with animals lie was alwa^'s 
 potent. He is ashamed before women ; coitus with women he regards 
 almost as a sin. (Kowalewsk3', Jahrh. f. Psychiatrie^ vii, Heft 3.) 
 
 Case 189. On the afternoon of September 23, 1889, W., aged 16, 
 shoe-maker's apprentice, caught a goose in a neighbor's garden, and 
 con)mitted bestiality on the fowl until the neighbor approached. On 
 being accused by the neiglibor, W, said, " Is there anything wrong with 
 the goose?" and then went away. At his examination he confessed the 
 act, but excused himself on the ground of temporary loss of mind. 
 Since a severe ilhiess, in his twelfth year, he several times a "month had 
 attacks, with heat in his liead, in which he was intensely excited sex- 
 nally, could not help himself, and did not know what he did. He had 
 done the act in such an attack. He answered for himself in the same 
 Ava^' at the trial, and stated that he knew nothing of the species facti 
 except from the statements of the neighbor. His father states that W., 
 who comes of a healthy family, has alwaj'S been sickly since an attack of 
 scarlatina in his fifth year, and tliat, at the age of twelve, he had a febrile 
 cerebral disease. W. had a good reputation, learned well in school, and, 
 later, helped his father in his work. He was not given to masturbation. 
 
 The medical examination revealed no intellectual or moral defect. 
 The ph3'sical examination revealed normal genitals; penis relatively 
 greatl^-^ developed ; marked exaggeration of the patellar reflexes. In 
 other respects, negative result. 
 
 The history of the condition at the time of the deed was not to be de- 
 pended upon. There was no histor}^ of previous attacks of mental disturb- 
 ance, and there were none during the six weeks of observation. There was 
 no perversion of tlie vita sexualis. The medical opinion allowed the pos- 
 sibility that some organic cause (cerebral congestion), dependent upon 
 cerebral disease, ma}' have exercised an influence at the time of the commis- 
 sion of the criminal act. (From the opinion of Dr. Fritsch, of Vienna.) 
 
 Case 190. Impulsive Sodomy. — A., aged 16; gardener's boy ; born 
 out of wedlock; fiither, unknown ; mother, deeply tainted, hystero-epi- 
 leptic. A. has a deformed, asymmetrical cranium, and deformity' and 
 asymmetry of the bones of the face ; the whole skeleton is also deformed, 
 asymmetrical, and small. From childhood he was a masturbator; always 
 morose, apathetic, and fond of solitude ; very irritable, and pathological 
 in his emotional reaction. He is imbecile, probably much reduced phys- 
 ically by masturbation, and neurasthenic. Besides, he presents In'stero- 
 pathic symptoms (limitation of the visual field, dyschromatopsia ; dimi- 
 nution of the senses of smell, taste, and hearing on the right side ; 
 anesthesia of the right testicle, clavus, etc.). 
 
 A. is convicted of having committed masturbation and sodomy on 
 dogs and rabbits. When twelve years old he saw how boys masturbated 
 a dog. He imitated it, and thereafter he could not keep from abusing
 
 UNNATURAL ABUSE — SODOMY. 407 
 
 clogs, cats, and ral)bits in this vile manner. Much more frequently, how- 
 ever, he committed sodomy on female rabbits, — the only animal that had 
 a cliarm for him. At dusk he was accustomed to repair to his master's 
 rabbit-pen, in order to gratify his vile desire. Rabbits with torn rectums 
 were repeatedly found. The act of bestiality was alwa^'S done in the 
 same manner. There were actual attacks which came on ever^^ eight 
 weeks, alwaj-s in the evening, and always in the same way. A. would 
 become very uncomfortable, and have a feeling as if some one were 
 pounding his head. He felt as if losing his reason. lie struggled 
 against the imperative idea of committing sodomy with the rabbits, and 
 thus had ^n increasing feeling of fear and intensification of headache, 
 until it became unbearable. At the height of the attack there was sound 
 of bells, cold perspiration, trembling of the knees, and, finally, loss of 
 resistive power, and impulsive performance of the perverse act. As soon 
 as this was done, he lost all anxiety ; the nervous C3'cle was completed, 
 and he was again master of himself, deepl}^ ashamed of the deed, and 
 fearful of the return of an attack. A. states that, in such a condition, 
 if called upon to choose between a woman and a female rabbit, he could 
 make choice only of the latter. In the intervals, of all domestic animals, 
 he is partial only to rabbits. In his exceptional states simple caressing 
 or kissing, etc., of the rabbit suffices, as a rule, to afford him sexual satis- 
 faction ; but sometimes he has, when doing this, such furor sexualis that 
 he is forced to wildly perform sodomy on the animal. 
 
 The acts of bestialit}' mentioned are the only acts which afford him 
 sexual satisfaction, and they constitute the only manner in which he is 
 capable of sexual indulgence. A. states that, in the act, he never had a 
 lustful feeling, but satisfaction, inasmucli as he was thus freed from the 
 painful condition into which he was brought b}- the imperative impulse. 
 
 The medical evidence easily proved that this human monster was a 
 psychically degenerate, irresponsible invalid, and not a criminal. (Boe- 
 teau, La France medicale, 38tli year. No. 38.) 
 
 The following case seems to be devoid of a psychopathic 
 basis : — 
 
 Case 191. Sodomy. — In a provincial town a man was caught in 
 intercourse with a hen. He was thirty years old, and of high social 
 position. The chickens had been dying one after another, and the man 
 causing it had been searched for a long time. To the question of the 
 judge, as to the reason for such an act, the accused said that his genitals 
 were so small that coitus with women was impossible. Medical exam- 
 ination showed that the genitals were actually extremely small. The 
 man was mentally entirely sound. 
 
 There were no statements concerning any abnormalities at the time 
 of puberty, etc. (Gyurkovechky, " Mannl. Impotenz," 1889, p. 82.)
 
 408 PSYCHOPATHIA SEXUALIS. 
 
 (b) Wit?i Persons of the Same Sex — Pederasty ; Sodomy in its Strict 
 
 Sense. 
 
 German law takes cognizance of unnatural sexual relations 
 only between men ; Austrian, between those of the same sex ; 
 and, therefore, unnatural relations between women are punish- 
 able. 
 
 Among the immoralities between men, pederasty (immissio 
 penis in anum) claims the principal interest. Indeed, the jurist 
 thought only of this perversity of sexual activity ; and, accord- 
 ing to the opinions of distinguished interpreters of the law 
 (OppenhofF, " Stgsb.," Berlin, 1872, p. 324, and Rudolf and 
 Stenglein, " D. Strafgesb. f. d. Deutsche Reich," 1881, p. 423), 
 immissio penis in corpus vivum belongs to the criminal act 
 covered by § 175. 
 
 According to this interpretation, legal punishment would 
 not follow other improper acts between male persons, so long as 
 they ioere not complicated with offense to imhlic decency., ivith 
 force., or iindertalcen with boys under the age of fourteen. Of 
 late this interpretation has again been abandoned, and the crime 
 of unnatural abuse between men has been assumed when merely 
 acts similar to cohahitation were performed.^ 
 
 The study of contrary sexual instinct has placed male love 
 of males in a very different light from that in which it, and 
 particularly pederasty, stood at the time the statutes were 
 framed. The fact that there is no doubt about the pathological 
 basis of many cases of contrary sexual instinct shows that 
 pederasty may also be the act of an irresponsible person, and 
 makes it necessary, in court, to examine not merely the deed, 
 but also the mental condition of the perpetrator. 
 
 The principles laid down previously must also be adhered 
 to here. Not the deed, but only an anthropological and clinical 
 judgment of the perpetrator can permit a decision as to 
 
 1 How difficult, unpleasant, and dangerous for the jurist judgment of these " coitus- 
 like " acts for the establisliment of the objective fact of the crime may be is well shown 
 by an article on the puuishableness of male intercourse, in the Zeitschr. f. d. gesammte 
 Strafrechtswissenschaft., Bd. vii, Heft 1, as well as by a similar one in Friedreich's 
 Blatter f. ger. Medicin, 1891, Heft 6. Vide, further, Moll, Coutrare Sexualempflndung, 
 p. 223 et seq., and Bernhardi, Der Uranism us, Berlin, 1882.
 
 UNNATURAL ABUSE — SODOMY. 409 
 
 whether we have to do witli a perversity deserving punishment, 
 or with an abnormal perversion of the mental and sexual life, 
 which, under certain circumstances, excludes punishment. The 
 next legal question to settle is whether the contrary sexual feeling 
 is congenital or acquired ; and, in the latter case, whether it is 
 abnormal perversion or moral perversity. 
 
 Congenital contrary sexual instinct occurs only in predis- 
 posed (tainted) individuals, as a jiartial manifestation of a 
 defect evidenced by anatomical or functional abnormahties, or 
 both. The case becomes clearer, and the diagnosis more certain, 
 if the individual, in character and disposition, seems to correspond 
 entirely with his sexual peculiarity; and if the inclination 
 toward persons of the opposite sex is entirely w^anting, and 
 horror of sexual intercourse with them is felt ; and if tlie indi- 
 vidual, in tlie impulses to satisfy the contrary sexual instinct, 
 shows other anomalies of tlie sexual sphere, sucli as more pro- 
 nounced degeneration in the form of periodicity of the impulse 
 and impulsive conduct, and is a neuropathic and psychopathic 
 person. 
 
 Another question concerns the mental condition of the 
 urning. If this be such as to remove the possibility of moral 
 responsibility, then tlie pederast is not a criminal, but an irre- 
 sponsible insane person. This condition in congenital urnings 
 is apparently less frequent than another. As a rule, these cases 
 •present elementary psychical disturbances, which do not remove 
 responsibility. . But this docs not settle the question of the 
 responsibility of the urning. The sexual instinct is one of the 
 most powerful organic needs. There is no law tliat looks upon 
 its satisfaction outside of marriage as punishable in itself; if 
 the urning feels perversely, it is not his fault, but the fault of a 
 condition natural to him. His sexual instinct may be aestheti- 
 cally very repugnant, but, from his stand-point, it is natural. 
 And, too, in the majority of these unfortunates, the perverse 
 sexual instinct is abnormally intense, and their consciousness 
 recognizes it as nothing unnatural. Thus they fail to have 
 moral and aesthetic ideas to assist them in resisting the instinct. 
 Innumerable normally constituted men are in a position to
 
 410 PSYCHOPATH! A SEXUALIS. 
 
 overcome the desire for satisfaction of their Ubido without suffer- 
 ing from it in health. Many neuropathic individuals, — and 
 urnings are almost always neuropathic, — on the contrary, become 
 nervously ill when they do not satisfy the sexual desire, either 
 as Nature prompts or in a way that is for them perverse. 
 
 The majority of urnings are in a painful situation. On 
 the one hand, there is an impulse toward persons of their own 
 sex that is abnormally intense, the satisfaction of which has a 
 good effect, and is natural to them ; on the other, is public 
 sentiment which stigmatizes their acts, and the law which 
 threatens them with punishment. Before them lies mental 
 despair, — even insanity and suicide, — at the very least, nervous 
 disease ; behind them, shame, loss of position, etc. It cannot 
 be doubted that, under these circumstances, states of necessity 
 and compulsion may be created by the unfortunate natural 
 disposition and constitution. Society and the law should under- 
 stand these facts. The former must pity, and not despise, such 
 unfortunates ; the latter must cease to punish them, — at least, 
 while they remain within the limits which are set for the activity 
 of their sexual instinct. 
 
 As a confirmation of these opinions and demands concerning these 
 step-children of Nature, it is permissible to reproduce here the memorial 
 of an urning to the author. Tiie writer of the following lines is a man 
 of high position in London : — 
 
 " You have no idea wliat a constant struggle we all — particularly 
 those of us that have the most mind and finest feelings — have to endure, 
 and how we suffer under the prevailing false ideas about us and our 
 so-called immorality. 
 
 "Your opinion that the phenomenon under consideration is pri- 
 marily due to a congenital ' pathological ' disposition will, perhaps, make 
 it possible to overcome existing prejudices, and awaken pity for poor, 
 ' abnormal ' men, instead of the present repugnance and contempt. Much 
 as I believe that the opinion expressed by 3'ou is exceedingly beneficial 
 to us, I am still compelled, in the interest of science, to repudiate the 
 word ' pathological' ; and j^ou will permit me to express a few thoughts 
 with respect of it. 
 
 " Under all circumstances the phenomenon is anomalous ; but the 
 word ' pathological ' conveys another meaning, which I cannot think 
 suits this phenomenon ; at least, as I have had occasion to observe it in 
 very manj' cases. I will allow, a priori, that, among urnings, a far
 
 UNNATURAL ABUSE — SODOMY. 411 
 
 liigher proportion of cases of insanitj^ of nervous exhaustion, etc., may 
 be observed than in other normal men. Does this increased nervousness 
 necessarily depend upon the character of urningism, or is it not, in the 
 majority of cases, to be ascribed to the effect of the laws and the preju- 
 dices of society, which prohibit the indulgence of their sexual desires, 
 depending on a congenital peculiarit}', while others are not thus 
 restrained ? 
 
 " The youthful urning, when he feels the first sexual promptings 
 and niiively ex])resses them to his comrades, soon finds that he is not 
 understood ; he shrinks into himself. If he tell his parents or teacher 
 what moves him, that which is as natural to him as swimming is to a 
 fish is described as wrong and sinful, and he is told it must be fought 
 and overcome at any price. Then an inner conflict begins, a powerful 
 repression of sexual inclinations ; and the more the natural satisfaction 
 of desire is repressed, the more lively the fancy becomes, and paints the 
 very pictures that the wish is to banish. The more energetic the charac- 
 ter that carries on this inner conflict, the more the whole nervous system 
 must suffer. Such a powerful repression of an instinct so deeply 
 implanted in us, in my opinion, develops the abnormal symptoms which 
 are observed in many urnings ; but this does not necessarily follow from 
 the urning's disposition. 
 
 " Some continue the conflict for a longer or shorter time, and thus 
 injure themselves; others at last come to the knowledge that the power- 
 ful instinct born in them cannot possibly be sinful, and, therefore, they ■ 
 cease to try to do the impossible, — the repression of the instinct. Then, 
 however, begin constant suffering and excitement. When a normal man 
 seeks satisfaction of sexual inclination, he knows how to find it easily ; it 
 is not so with the urning. He sees men that attract him, but he dares 
 not say — na}^ not even beti-a}' by a look — what his feelings are. He 
 thinks that he alone of all the world has such abnormal feelings. Natu- 
 rally he seeks the society of young men ; but he does not venture to confide 
 in them. Thus he comes to provide himself with a satisfaction that he 
 cannot otherwise obtain. Onanism is practiced inordinately, and fol- 
 lowed by all the evil results of that vice. When, after a time, the nerv- 
 ous system has been injured, the abnormality is again not the result of 
 urningism, but it is produced l)y the onanism to which the urning 
 resorts, as a result of the public sentiment that denies him opportunity 
 to satisfy the sexual instinct that is natural to him. 
 
 *' Or, let us suppose the urning has had the rare fortune to soon 
 find a person like himself; or, that he has been introduced by an experi- 
 enced friend to the events of the world of urnings. Then he is spared 
 much of the inner conflict; but, at the same time, fearful cares and 
 anxieties follow his footsteps. Now he knows that he is not the only 
 one in the world that has such abnormal feelings ; he opens his eyes and 
 wonders that he meets so many of his kind in all social circles and in all
 
 412 PSYCHOPATHIA SEXUALIS. 
 
 callings ; lie also learns that, in the world of urnings, as in the other, 
 there is prostitution, and that men as well as women can be bought. 
 Thus there is no longer anj^ want of opportunity for sexual satisfaction. 
 But here how differently the experience is gained from that obtained in 
 the normal manner of sexual indulgence ! 
 
 " Let us consider the happiest case. After longing all one's life, 
 the friend of like feeling is found. But he cannot be approached openly, 
 as a lover approaches the girl lie loves. In constant fear, both must con- 
 ceal their relations ; nay, even intimac}^ that might easily excite sus- 
 picion — especially should they not be of like age, or should the3" belong 
 to different classes — must be kept from the world. Thus, even in this 
 relation, is forged a chain of anxiety and fear that the secret will be 
 betrayed or discovered, which leaves them no J03" in the indulgence. The 
 slightest thing that would not affect others makes them tremble with 
 fear that suspicion might be excited and the secret discovered, and 
 destroy social position and business. Could this constant anxiety and 
 care be endured without leaving a trace, without exerting an influence 
 on the entire nervous system ? 
 
 " Another less fortunate man does riot find a friend of like feeling, 
 but falls into the hands of a handsome man, who sought him until the 
 secret was discovered. Now the most refined blackmail is extorted. The 
 unfortunate, persecuted man, brought to the alternative of paying or of 
 losing his social position, and bringing disgrace on himself and his family, 
 pays ; and the more he gives, the more voracious the vampire becomes ; 
 until at last there remains nothing but absolute financial ruin or dishonor. 
 Who can wonder that nerves are not equal to such a terrible struggle 1 
 
 " They give way; insanity comes on ; and the miserable man at last 
 finds the rest in an asylum that he could not find in the world. Another, 
 in the same situation, driven to despair, finds relief in suicide. It cannot 
 be known how many of the suicides of young men are to be attributed 
 to this combination of circumstances. 
 
 " I do not think that I am in error when I declare that at least one- 
 half of the suicides of young men are due to such conditions. Even 
 in those cases where urnings are not persecuted by a heartless villain, 
 but where a happy relation between two men exists, discovery, or even 
 the fear of it, very often leads to suicide. How many officers, how many 
 soldiers, having such relations with their subordinates or companions, in 
 the moment when they have believed themselves discovered, have sought 
 to escape the threatened disgrace by means of a bullet I And it is the 
 same in all callings. 
 
 " Therefore, if it must be admitted that, among urnings, more 
 mental abnormalities and more insanity are actually observed than among 
 other men, j^et this does not prove that the mental disturbance is a 
 necessary accompaniment of the urning's condition, and that the latter 
 induces the former.
 
 UNNATURAL ABUSE — SODOMY. 413 
 
 " According to my firm conviction, l)y far the greater number of 
 cases of mental disturbance or abnoruuxl disposition observed in urnings 
 are not to be attributed to the sexual anomaly ; but they are caused by 
 the existing notions concerning urnings, and the resulting laws, and 
 dominant public sentiment concerning the anomaly. Any one with an 
 adequate idea of the mental and moral suffering, of the anxiety and care, 
 that the urning must endure ; of the constant hypocrisy and secrecy 
 he must practice, in order to conceal his inner instinct ; of the difficulties 
 that meet him in satisfying his natural desire, — can only be suriuised 
 that more insanity and nervous disturbance does not occur in urnings. 
 The greater i)art of these abnormal states would not be developed, if the 
 urning, like another, could find a simple and easy way in which to satisfy 
 his sexual desire, — if he were not forever troubled by these anxieties 1 " 
 
 De lege lata, as far as the uriiiiig is concerned, the para- 
 graph with reference to pederasty must not be applied without 
 the proof of actual pederasty ; and psychical and somatic abnor- 
 malities must be examined by experts with respect of an esti- 
 mate in the individual of the question of guilt. 
 
 De lege ferenda, the urnings wish a repeal of the para- 
 graphs. The jurist could not consent to this, if he were to 
 remember that pederasty is much more frequently a disgusting 
 vice than the result of physical and mental intirmity ; and that, 
 moreover, many urnings, though driven to sexual acts with 
 their own sex, are yet in nowise compelled to indulge in peder- 
 asty, — a sexual act which, under all circumstances, must stand 
 as cynical, disgusting, and, when passive, as certainly injurious. 
 Whether for reasons of exp(xliency (difficulty of iixing tlie 
 guilt, encouragement of blackmail, etc.), it would not be oppor- 
 tune to strike from the statutes the legal punishment of the 
 male-loving man, and to protect youth by the use of the para- 
 graphs concerning sexual abuses, is a future question for jurists. 
 
 What has been said concerning congenital contrary sexu- 
 ality and its relation to the law is also applicable to the acquired 
 abnormality. The accompanying neurosis or psychosis should 
 have much diagnostic and forensic weight with reference to the 
 question of guilt. 
 
 It only remains to describe acquired non-pathological ped- 
 erasty, — one of the saddest pages in the history of human 
 delinquencies ; —
 
 414 PSYCHOPATHIA SEXUALIS. 
 
 Cultivated Pederasty.^ 
 
 The motives that bring to pederasty a man originally nor- 
 mal sexually and of sound mind are various. It is used tem- 
 porarily as a means of sexual satisfaction faute de mieux, — as 
 in infrequent cases of bestiality, — where abstinence from normal 
 sexual indulgence is a necessity.^ It thus occurs on shipboard 
 during long voyages, in prisons, in baths, etc. It is highly prob- 
 able that, among men subjected to such conditions, there are 
 single individuals of low morals and great sensuality, or actual 
 urnings, who seduce the others. Lust, imitation, and desire 
 further their purpose. 
 
 The strength of the sexual instinct is most markedly shown 
 
 by the fact that such circumstances are sufficient to overcome 
 repugnance for the unnatural act. 
 
 Another category of pederasts is made up of old i-oiies 
 that have become supersatiated in normal sexual indulgence, 
 and who find in pederasty a means of exciting sensual pleasure, 
 the act being a new method of stimulation. Thus they tem- 
 porarily renew their power, that has been psychically and phys- 
 ically reduced to so low a state. The new sexual situation 
 makes them, so to speak, relatively potent, and makes pleasure 
 possible that is no longer possible in normal intercourse. In 
 time power to indulge in pederasty is also lost. The individual 
 may thus finally be reduced to passive pederasty as a stimulus 
 to make possible temporary active pederasty ; just as, occasion- 
 ally, flagellation or looking on at obscene acts (Maschka's case 
 of mutilation of animals) is resorted to for the same purpose. 
 
 The termination of sexual activity expresses itself in all kinds 
 of abuse of children, — cunnilingus, fellare, and other enormities. 
 
 This kind of pederasts is the most dangerous, since they 
 deal mostly with boys, and ruin them in body and soul. 
 
 1 For interesting histories and notes, v. Krause, Psychol, des Verbrechens, p. 174. — 
 Tardieu, Attentats. — Maschka, Handb., iii, p. 174. This vice seems to have come through 
 Crete from Asia to Greece, and, in the times of classic Hellas, to have been wide-spread. 
 From there it spread to Rome, where it flourished luxuriantly. In Persia and China 
 (where it is actually tolerated) it is wide-spread, as it also is in Europe. (Comp. Tar- 
 nowsky et al.) 
 
 2 Lombroso (Der Verbrecher, p. 20 et seq.) shows that also, in case of animals, 
 Intercourge with the same sex occuis where normal indulgence is impossible.
 
 CULTIVATED TEDERASTY. 415 
 
 In reference to this, the experionees of Tarnowsky (op. cit., p. 53 
 et seq.), gathered from the society of St. Petersburg, are terrible. The 
 places where pederasty is cultivated are lustitutes. Old roues and urn- 
 ings play the role of seducers. At first it is difficult for the person to 
 carry out the disgusting act. Fancy is made to assist b3' calling up 
 the image of a woman. Gradually, with practice, the unnatural act be- 
 comes easy, and at last the individual, like one injured by masturbation, 
 becomes relatively impotent for women, and lustful enough to find pleas- 
 ure in the perverse act. Such individuals, under certain circumstances, 
 give themselves for money. 
 
 As Tardieu, Hofmann, Simon, and Taylor show, such individuals 
 are not infrequently fonnd in large cities. From numerous statements 
 made to me by urnings, it is learned that actual prostitution and houses 
 of prostitution for male-loving men exist in large cities. The arts of 
 coquetry used by these male prostitutes are noteworthy, — ornament, 
 perfumes, feminine styles of dress, etc., to attract pederasts and urnings. 
 This imitation of feminine peculiarities is spontaneous and unconscious 
 in congenital cases, and in many acquired cases of (abnormal) contrary 
 sexual instinct. 
 
 The following lines are of interest to the psychologist, and 
 offer the officers of the law important fects concerning the 
 social life and practice of pederasts :-.— 
 
 Coffignon, " La Corruption a Paris," p. 327, divides active peder- 
 asts into " amateurs,''^ " entreteneurs,^^ and " souteneurs.^'' 
 
 The " amateurs " (" rivettes ") are debauched persons, but also fre- 
 quently congenitally perverse sexually, of position and fortune, who are 
 forced to guard themselves against detection in the gratification of their 
 homo-sexual desires. For this purpose they visit brothels, lodging- 
 houses, or the private houses of female prostitutes, who are usually on 
 good terms with male prostitutes. Thus they escape blackmail. 
 
 Some of these " amateurs " are cunning enough to indulge their vile 
 desires in public places. They thus run the risk of arrest, but, in a 
 large city, little risk of blackmail. Danger is said to add to their secret 
 pleasure. 
 
 The '•'• entreteneurs'''' are old sinners who, even with the danger of 
 falling into the hands of blackmailers, cannot deny themselves the 
 pleasure of keeping a (male) mistress. 
 
 The " souteneurs " are pederasts that have been punished, who keep 
 their ^'- jesus^''"' whom they send out to entice customers {'■'■ faire chanter 
 les rivettes "), and who then, at the right moment, if possible, appear for 
 the purpose of plucking the victim. 
 
 Not infrequently they live together in bands, the members, in 
 accordance with individual desire, living together as husbands and wives,
 
 416 PSTCHOPATHIA SEXUALIS. 
 
 In such bands there are formal marriages, betrothals, banquets, and 
 introductions of brides and grooms into their apartments. 
 
 These " souteneurs'''' attach their ^'■jesus " to themselves. 
 
 The passive pederasts are '■'• petitsjusus,^^ "j'esus,'' or " aunts.'''' 
 
 The ^^ petits jesus " are lost, depraved children, whom accident places 
 in the hands of active pederasts, who seduce them, and reveal to them 
 the horrible means of earning a livelihood, either as " entretenus " or as 
 male street-wallcers, with or without " souleneurs." 
 
 The most suitable and promising " petits jesus " are given into the 
 
 hands of persons who instruct these children in the art of female dress 
 
 and manner. Gradually they then seek to emancipate themselves from 
 
 their teachers and masters, in order to become '•''femmes entretenues'" ; 
 
 and not infrequently by means of anonymous denunciation of their 
 " souteneurs " to the police. 
 
 It is the object of the '■'■ souteneur " and the '''' jjetit jesus " to mal^e 
 the latter appear 3'oung, as long as possible, by means of all the arts of 
 the toilet. 
 
 The limit of age is about twentj^-five j^ears ; then they all become 
 '•'■ jesus " and '■'^ femmes entretenues,^'' and are then sustained by several 
 " souteneurs.'''' The ^^ jesus " fall into three categories : '■' Jilles gallantes,^^ 
 i.e., those that have fallen again into the hands of a ^^ souteneur ^^ ] 
 "/jzerrewses" (orduiary street-walkers, like their female colleagues) ; and 
 '' domestics.''^ 
 
 The " domestics " hire out 'to active pederasts, either to gratify their 
 desires or to obtain ^^ petits jesus " for them. 
 
 A sub-group of these " doinestics " is formed by such of them as 
 enter the service of '■'■ ])etits jesus ''^ as '■^femmes de chambre."" The 
 principal object of these " domestics " is to use their positions to obtain 
 compromising knowledge, with which they later practice blackmail, and 
 thus assure themselves ease in their old age. 
 
 The most horrible class of active pederasts is made up of the 
 " awits,^^ — i.e., the " souteneurs " of (male) prostitutes, — who, though 
 normal sexnall}^, are morally depraved, and practice pederasty (passive) 
 only for gain, or for the purpose of blackmail. 
 
 The wealthy ''■amateurs''^ have their reunions and places of meeting, 
 where the passive ones appear in female attire, and horrible orgies take 
 place. The waiters, musicians, etc., at such gatherings, are all pederasts. 
 The '■'■ filles gallantes " do not venture, except during the carnival, to show 
 themselves on the street in female dress ; but the^^ know how to lend to 
 their appearance something indicative of their calling, by means of style 
 of dress, etc. The}^ entice b}^ means of gesture, peculiar movements of 
 the hands, etc., and lead their victims to hotels, baths, or brothels. 
 
 What the author saj^s of blackmail is generally known. There 
 are cases where pederasts have allowed their entire fortune to be wrung 
 from them.
 
 CULTIVATED PEDERASTY. 417 
 
 The following notice from a Berlin (National "?) newspaper, 
 of February, 1884, which fell into my hands by accident, seems 
 suited to show something of the life and customs of urnings : — 
 
 " The Woman- Haters'^ Ball. — Almost every social element of Berlin 
 has its social reunions, — the fat, the bald-headed, the young, — and why not 
 the woman-haters ? This species of men, so interesting psychologically 
 and none too edifying, had a great ball to-day. ' Grand Vienna Mask-Ball,' 
 — so ran the notice. The sale of tickets was very rigorous ; they wish to 
 be very exclusive. Their rendezvous was a well-known dance-hall. We 
 enter the hall about midnight. The graceful dancing is to the strains of 
 a fine orchestra. Thick tobacco-smoke, veiling the gas-lights, does not 
 allow the details of the moving mass to become obvious ; only during 
 the pause between the dances can we obtain a closer view. The masks 
 are by far in the majority ; black dress-coats and ball-gowns are seen only 
 now and then. 
 
 " But what is that ? The lady in rose-tarletan, that just now passed 
 us, has a lighted cigar in the corner of her mouth, and puffs like a 
 trooper ; and she also wears a small, blonde beard, lightly painted out. 
 And yet she is talking with a very decollete ' angel ' in t7-icots, who 
 stands there, with bare arms folded behind her, likewise smoking. The 
 two voices are masculine, and the conversation is likewise very mascu- 
 line ; it is about the ' d — tobacco, that permits no air.' Two men in 
 female attire. A conventional clown stands there, against a pillar, in 
 soft conversation with a ballet-dancer, with his arm around her faultless 
 waist. She has a blonde ' Titus-head,' sharp-cut profile, and apparently a 
 voluptuous form. The brilliant ear-rings, the necklace with a medallion, 
 the full, round shoulders and arms, do not permit a doubt of her ' genu- 
 ineness,' until, with a sudden movement, she disengages herself from the 
 embracing arm, and, yawning, moves away, saying, in a deep bass, 
 ' Emile, you are too tiresome to-day ! ' The ballet-dancer is also a male I 
 
 " Suspicious now, we look about further. We almost suspect that 
 here the world is topsy-turvy ; for here goes, or, rather, trips, a man — 
 no, no man at all, even though he wears a carefull}^ trained moustache. 
 The well-curled hair; the powdered and painted face with the blackened 
 eyebrows ; the golden ear-rings ; the bouquet of fiowers reaching from 
 the left shoulder to- the breast, ornamenting the elegant black gown ; the 
 golden bracelets on the wrists ; the elegant fan in the white-gloved hand, 
 — all these things are anything but masculine. And how he to^^s with 
 the fan ! How he dances and turns, and trips and lisps I And yet 
 kindly Nature made this doll a man. He is a salesman in a great milli- 
 nery store, and the ballet-dancer mentioned is his 'colleague.' 
 
 " At a little corner-table there seems to be a great social circle. 
 Several elderly gentlemen press around a group of decollete ladies, who 
 
 27
 
 418 PSYCHOPATHIA SEXUALIS. 
 
 sit over a glass of wine and — in the spirit of fun — make jokes that are none 
 too delicate. Who are these three ladies ? ' Ladies ! ' laughs my knowing 
 friend. ' Well, the one on the right, with the brown hair and the short, 
 fancy dress, is called " Butterrieke," and he is a hair-dresser ; the second 
 one — the blonde in a singer's costume, with the necklace of pearls — is 
 known here by the name of " Miss Ella of the tight-rope," and he is a 
 ladies' tailor; and the third, — that is the widelj' -celebrated " Lottie."' 
 
 " But that person cannot possibly be a man ? That waist, that 
 bust, those classic arms, the whole air and person are markedly feminine I 
 
 " I am told that ' Lottie ' was once a book-keeper. To-day she, or, 
 rather, he, is exclusively ' Lottie,' and takes pleasure in deceiving men 
 about his sex as long as possible. ' Lottie ' is singing a song that would 
 hardly do for a drawing-room, in a high voice, acquired by years of prac- 
 tice, which many a soprano might envy. ' Lottie ' has also ' worked ' as a 
 female comedian. Now the quondam book-keeper has so entered into the 
 female role that he appears on the street in female attire almost exclu- 
 sively, and, as the people with whom he lodges state, uses an embroidered 
 night-dress. 
 
 " On closer examination of the assembly, to my astonishment, I 
 discover acquaintances on all hands : ni}' shoe-maker, whom I should 
 have taken for anything but a woman-hater — he is a ' troubadour,' with 
 sword and plume ; and his ' Leonora,' in the costume of a bride, is accus- 
 tomed to place my favorite brand of cigars before me in a certain cigar- 
 store. ' Leonora,' who, during an intermission, removes her gloves, I 
 recognize with certainty by her large, blue hands. Right ! There is my 
 haberdasher, also ; he moves about in a questionable costume as Bac- 
 chus, and is the swain of a repugnantly bedecked Diana, who works as 
 a waiter in a beer-restaurant. The real ' ladies ' of the ball cannot be 
 described here. They associate only with one another, and avoid the 
 woman-hating men ; and the latter are exclusive, and amuse themselves, 
 absolutely ignoring the charms of the women." 
 
 These facts deserve the careful attention of the police, who 
 should be placed in a position to cope with male prostitution, as 
 they now do with that of women. 
 
 Male prostitution is certainly much more dangerous to 
 society than that of females; it is the darkest stain on the 
 history of humanity. 
 
 From the statements of a high police official of Berlin, I 
 learn that the police of Berlin are conversant with the male 
 demi-rnonde of the German Capital, and do all they can to sup- 
 press blackmail among pederasts, — a practice which often does 
 not stop short of murder.
 
 CULTIVATED PEDERASTY. 419 
 
 The foregoing facts justify the wish that the law-maker of 
 the future may, for reasons of utiHty, at least, abandon the 
 prosecution of pederasty. 
 
 With reference to tliis point, it is wortliy of note that the 
 French Code does not punish it so long as it does not become 
 an offense to public decency. Probably for politico-legal 
 reasons, the new Italian Penal Code passes over the crime of 
 unnatural abuse in silence, as do the statutes of Holland and, 
 as far as I know, Belgium and Spain. 
 
 In how far such cultivated pederasts are to be regarded as 
 mentally and morally sound may remain an open question. 
 The majority of them suffer with genital neuroses. At least, in 
 these cases, there are the stages of transition to acquired patho- 
 logical contrary sexual instinct. The responsibility of these 
 individuals, who are certainly much lower than the women who 
 prostitute themselves, in general cannot be questioned. 
 
 The various categories of male-loving men, with respect of 
 the manner of sexual indulgence, may be thus characterized in 
 general : — 
 
 The congenital urning becomes a pederast only exception- 
 ally, and eventually resorts to it after having practiced and 
 exhausted all the possible immoral acts with males. Passive 
 pederasty is for him the ideally and practically adequate form 
 of the sexual act. He practices active pederasty only to please 
 another. The most important point here is the congenital and 
 unchangeable perversion of the sexual instinct. 
 
 It is otherwise with the pederast by cultivation. He has 
 once acted normally sexually, or, at least, liad iionual incli- 
 nations, and occasionally has intercourse with the op})osite sex. 
 His sexual perversity is neither congenital nor unchangeable. 
 He begins with pederasty and ends in other perverse sexual acts, 
 induced by weakness of the centres for erection and ejaculation. 
 At the height of his power, his sexual desire is not for passive, 
 but for active pederasty. He yields himself to passive [)ederasty 
 only to please another ; for money, in the role of a male prosti- 
 tute ; or as a means, when virility is declining, to make active 
 pederasty still occasionally possible.
 
 420 PSTCHOPATHIA SEXUALIS. 
 
 A horrible act, that must be alluded to, in conclusion, is 
 psedicatio mulierum,^ and even uxorum. Sensual individuals 
 sometimes do it with hardened prostitutes, or even with their 
 wives. Tardieu gives examples where men, usually practicing 
 coitus, sometimes indulged in pederasty with their wives. Occa- 
 sionally fear of a repetition of pregnancy may induce the man 
 to perform, and the woman to tolerate, the act. 
 
 Case 192. Imputation of pederasty that was not proved. Resume 
 from the legal proceedings : — 
 
 On May 30, 1888, Dr. S., chemist, of H., in an anonymous letter, 
 was accused by his step-father of having immoral relations with G., aged 
 19, the son of a butcher. Dr. S. received the letter, and, astounded by 
 its contents, hastened to his law3'er, who promised to proceed discreetly 
 in the matter, and to ascertain from the authorities whether he would be 
 publicly prosecuted. 
 
 On the next morning, G., who lived in the house of Dr. S., was 
 arrested. At the time he was sick with gonorrhoea and orchitis. Dr. S. 
 tried to induce the authorities to release G., and advised caution, but he 
 was refused. In his statement to the judge, S. said that he became 
 acquainted with G. on the street, three years previously, and then saw no 
 more of him until the fall of 1887, when he met him in his father's shop. 
 After November G. supplied Dr. S.'s kitchen with meat, — coming in the 
 evening to get the order, and bringing the meats the next morning. 
 Thus S. gradually became well acquainted with G., and came to have a 
 very friendly feeling for him. When S. fell ill and was, for the most 
 part, confined to his bed until the middle of May, 1888, G. gave him so 
 much attention that S. and his wife were much attracted to him on 
 account of his harmless, child-like, and happy disposition. Dr. S. showed 
 and explained to him his collection of curiosities, and they spent the 
 evenings pleasantly together, the wife also being usually present ; besides, 
 S. and G. experimented in making sausages, jelly, etc. In February, 
 1888, G. fell ill with gonorrhoea. Dr. S., being his friend, and having 
 studied medicine for several terms, took care of G., procured medicine 
 for him, etc. In May, G. being still sick, and, for several reasons, inclined 
 to leave home, S. and his wife took him into their own home to care for 
 him. S. denied the truth of all the suspicions that had been raised by 
 this relation, and defended himself by pointing to his life of previous 
 respectability, his education, and to the fact that G., at the time, was 
 suffering with a disgusting, contagious disease, and that he himself had a 
 painful affection (nephritic calculus, with occasional attacks of colic). 
 
 * Comp. Tardieu, Attentats, p. 198. — Martineau, Deutsche Med. Zeitung, 1882, p. 9. 
 — Virchow's Jahrb., 1881, i, p. 533. — Coutagne, Lyon Medical, Nos. 35, 36.
 
 CULTIVATED PEDERASTY. 421 
 
 Opposed to this statement of Dr. S.'s must be mentioned the facts 
 that were brought out in court, and whicli led to conviction in the first 
 trial. 
 
 The relation of S. to G. had, by reason of its obviousness, given 
 cause for remark by private individuals, as well as by those in public 
 houses. G. spent almost all his evenings with S.'s family, and, finally, 
 came to be quite at home there. They took walks together. Once, while 
 out on such a walk, S. said to G. that he was a pretty fellow, and that he 
 (S.) was very fond of him. On the same occasion, there was also talk of 
 sexual matters, and also of pederasty. S. said he touched on these sub- 
 jects only to warn G. With reference to the intercourse at home, it was 
 proved that occasionally S., while sitting on a sofa, embraced G., and 
 kissed him. This happened in the presence of the wife, as well as of the 
 servant-girls. When G. was ill with gonorrhcea, S. instructed him in the 
 method of using a syringe, and, at the time, took the penis in his hand. 
 G. testified that S., in answer to his question why he was so fond of him, 
 said, " I don't know, myself" When, one day, G. remained away, S., with 
 tears in his eyes, complained of it to him when he returne<l. S. also told 
 him that his marriage was unhappy, and, in tears, begged G. not to leave 
 him ; that he must take the place of his wife. 
 
 From all this resulted the just accusation, that the relation between 
 the culprits had a sexual direction. The fact that all was open and 
 known to everybody', according to the complaint, did not speak for the 
 harmlessness of the relation, but more for the intensity of the passion of 
 S. The spotless life of the accused was allowed, as well as his honesty 
 and gentleness. The probability of an unhappy marriage, and that S. was 
 of a very sensual nature, was shown. 
 
 During the course of the trial, G. was repeatedly examined by the 
 medical experts. He is scared}' of medium size, pale, and of powerful 
 frame; penis and testicles are very perfectly developed (large). 
 
 In consonance with the accusation, it was found that the anus was 
 pathologically changed, in that there were no wrinkles in the skin about 
 it and the sphincter was relaxed ; and it was presumed that these changes 
 pointed to the probability of passive pederasty. 
 
 The conviction was based on these facts. The judgment passed 
 recognized that the relation that existed between the culprits did not 
 necessarily point to unnatural abuses, any more than did the phj'sical 
 conditions found on the person of G. 
 
 However, by reason of the combination of the two facts, the court 
 was convinced of the guilt of both culprits, and held it proved : " That 
 the abnormal condition of G.'s anus had been caused by the frequently 
 repeated introduction of the penis of S., and that G. voluntarily permitted 
 the performance of this immoral act on himself" 
 
 Thus the conditions of § 175, E.. St. G. B., seemed to be covered. 
 In passing sentence, there was consideration of S.'s education, which
 
 422 PSYCHOPATHIA SEXUALIS. 
 
 made him appear to be G.'s seducer; in G.'s case, this fact and his 3'outh 
 were given weight ; and the previous respectability of both was held in 
 view. Thus Dr. S. was sentenced to imprisonment for eight months, and 
 G. for four months. 
 
 The culprits appealed to the Supreme Court at Leipzig, and prepared 
 themselves, in case the appeal should be denied, to collect evidence 
 sufficient to call for a new trial. 
 
 They subjected themselves to examination and observation by dis- 
 tinguished experts. The latter declared that G.'s anus presented no 
 signs of indulgence in passive pederasty. 
 
 Since it seemed of importance to those interested to make clear the 
 psychological aspect of the case, which was not touched on at the trial, 
 the author was intrusted with the exnniinntion and observation of Dr. S. 
 and G. 
 
 liesuUs of the Personal Examination^ from December 11 to 13, 1888, 
 in Oraz. — Dr. S., aged 31 ; two 3'ears married, without children. Ex- 
 Director of the City Laboratory of H. He comes of a father who is 
 said to have been nervous, owing to great activity" ; who had an apoplec- 
 tic attack in his fifty-seventh year, and died, at the age of sixtj'-seven, of 
 another attack of apoplexy. His mother is living, and is described as a 
 strong person, who has been nervous for jears. Her mother reached 
 quite an old age, and is said to have died of a cerebellar tumor. A 
 brother of the mother's father is said to have been a drinker. The 
 paternal grandfxther died early, of softening of the brain. 
 
 Dr. S. has two brothers, who are in perfect health. 
 
 He states that he is of nervous temperament, and has been of strong 
 constitution. After articular rheumatism, which he had in his fourteenth 
 year, he suffered with great nervousness for some months. Thereafter he 
 often suftered with rheumatic pains, palpitation, and shortness of breath. 
 These symptoms gradually disappeared with sea-bathing. Seven years 
 ago he had gonorrhoea. This disease became chronic, and for a long time 
 caused bladder-difficulty. 
 
 In 1887 he had his first attack of renal colic, and he had such 
 attacks repeatedly during the winter of 1887 and 1888, until May 16, 
 1888, when quite a large renal calculus was passed. Since then his con- 
 dition had been quite satisfactory. While suffering with stone, during 
 coitus, at the moment of ejaculation, he felt severe pain in the urethra, 
 and the same pain on urinating. 
 
 With reference to his life, S. states that he attended the Gymnasium 
 until he was fourteen, but after that, owing to the results of his severe 
 illness, he studied privately. He then spent four years in a drug-store, 
 and then studied medicine for six semestei's at the University, serving, in 
 the war of 1870, as a voluntary hospital assistant. Since he had no cer- 
 tificate of graduation from the Gymnasium, he gave up the study of 
 medicine, and obtained the degree of doctor of philosophy. Then he
 
 CULTIVATED PEDERASTY. 423 
 
 served in the Museum of Minerals in K., and later as assistant in the 
 Mineralogical Institute of H. Thereafter he made special studies in 
 the chemistry of food-stufl's, and five 3'ears ago became Director of the 
 City Laboratory. 
 
 He makes all these statements in a prompt, precise manner, and 
 does not think long about his answers ; so that one is more and more led 
 to think that he is a man who loves and speaks the truth, — the more, 
 since, on the following day, his statements are identical. With reference 
 to his vita sexualis. Dr. S., in a modest, delicate, and open way, states 
 that, in his eleventh year, he began to have a knowledge of the difference 
 of the sexes, and for some time, until his fourteenth year, was given to 
 onanism. lie first had coitus at eighteen, and thereafter indulged mod- 
 erately. His sensual desire had never been very great, but, until lately, 
 the sexual act had been normal in every way, and accompanied by grati- 
 fying pleasurable feeling and full virility. Since his marriage, two years 
 ago, he had cohabited with his wife exclusively. He had married his 
 wife out of love, and still loved her, having coitus with her at least 
 several times a week. The wife, who was also at hand, confirmed these 
 statements. 
 
 All cross-questioning with reference to a perversion of sexual feel- 
 ing toward men Dr. S. answered repeatedly in the negative, to repeated 
 examination, and that without contradiction or any thought of the 
 answers. Even when, in order to trap him, he is told that the proof of 
 a perverse sexual instinct would be of avail in the trial, he sticks to his 
 statements. One gains the important impression that S. has not the 
 slightest knowledge of the facts of male-love. Thus it is learned that 
 his lascivious dreams have never been about men ; that he is interested 
 only in female nudity ; that he liked to dance with ladies, etc. No traces 
 of any kind of sexual inclination for his own sex can be discovered in S. 
 With reference to his relations with G., Dr. S. expresses himself exactly 
 as he did at his examination before the court. In explanation of his 
 partiality for G., he can only say that he is nervous, and a man of feeling 
 and great sensibility, and very sensitive to friendliness. During his 
 illness he had felt very lonesome and depressed ; his wife had frequentl}^ 
 been with her parents ; and thus it had hapi)ened that he had become 
 friendly with G., who was so gentle and kind. He still had a weakness 
 for him, and felt remarkably quiet and contented while in his societ3\ 
 
 He had had two such close friendships previously' : when he was 
 yet a student, with a corps-brotlier, a Dr. A. wliom he also embraced and 
 kissed ; later, with a Baron M. When it happened that he could not see 
 him for a few days, he became depressed, and even cried. 
 
 He also had a similar feeling and attachment for animals. Thus 
 he had a poodle that died a short time ago, mourned like a member of 
 the family; and he had often kissed the animal. (On relating this, the 
 tears came to his eyes.) His brother confirmed these statements, with
 
 424 PSYCHOPATHIA SEXUALIS. 
 
 the remark, with reference to his brother's remarkable friendship for A. 
 and M., that in these instances there was not the slightest suspicion of 
 sexual coloring or relation. Too, the most careful and detailed exami- 
 nation of Dr. S. gave not the slightest reason for such a presumption. 
 
 He states that he never had the slightest sensual feeling for G., to 
 say nothing of erection or sensual desire. His partiality for G., which 
 bordered on jealous}', S. explained as due merelj' to his sentimental 
 temperament and his inordinate friendship. G. was still as dear to him 
 as if he were his son. 
 
 It is worth}^ of note that S. stated that when G. told him about his 
 love-adventures with girls, it had hurt him only because G. was in danger 
 of injuring himself and ruining his health by dissipation. He had 
 neA'^er felt hurt himself bj' this. If he knew a good girl for G. he would 
 be glad to rejoice with him, and do all he could to promote their marriage. 
 
 S. states that it was first in the course of his legal examination that 
 he saw how he had been careless in his intercourse with G., by causing 
 gossip. His openness he explained as due to the innocence of the 
 friendship. 
 
 It is worthy of note that S.'s wife never noticed anj^thing suspicious 
 in the intercourse between her husband and G., though the most simple 
 wife would instinctively^ notice anj'thing of that nature. Mrs. S. had 
 also made no opposition to receiving G. into the house. On this point 
 she remarked that the guest-chamber in which G. ]^y ill, was on the 
 second floor, while the living apartments were on the fourth ; and, further, 
 that S. never associated alone with G. as long.as lie was in the house. She 
 states that she is convinced of her husband's innocence, and that she 
 loves him as before. 
 
 Dr. S. states freely that formerly he had often kissed G., and talked 
 with him about sexual matters. G. was much given to women, and in 
 friendship he had often warned him about sexual dissipation, particularly 
 when G., as often happened, did not look well. He had once said that 
 G. was a handsome fellow ; it was in a perfectl}' harmless relation. 
 
 The kissing of G. had been due to inordinate friendship, when G. 
 had shown him some particular attention, or pleased him especially. In 
 the act he had never had any sexual feeling. Too, when he had now and 
 then dreamed of G., it was in a perfectly harmless wa3\ 
 
 It appeared of great importance to the author to form also an 
 opinion of G.'s personality. On December 12th, the desired opportunity 
 was given, and G. was carefullj- examined. 
 
 G. is a young man, aged 20, of delicate build, whose development 
 corresponds with his j'ears ; and he appears to be neuropathic and 
 sensual. The genitals are normal and well developed. The author 
 thinks he may be permitted to pass over the condition of the anus, 
 as he does not feel called upon to pass judgment upon it. With pro- 
 longed association with G., one gets the impression that he is a harm-
 
 CULTIVATED PEDERASTY. 425 
 
 less, kind, and artless man, who is light-minded, but not morally depraved. 
 Nothing in his dress or manner indicates perverse sexual feeling. There 
 cannot be the slightest suspicion that he is a male courtesan. 
 
 When G. is introduced in medias res, he states that S. and he, feel- 
 ing their innocence, had told the matter as it actually was, and on this 
 the whole trial had been based. 
 
 At first, S.'s friendship, and especially the kissing, had seemed 
 remarkable, even to him. Later he had convinced himself that it was 
 merely friendship, and had then thought no more about it. 
 
 G. had looked upon S. as a father-like friend ; for he was so 
 unselfish, and loved him so. 
 
 The expression " handsome fellow " was made when G. had a love- 
 affair, and when S. expressed his fears about a happy future for G. At 
 that time S. had comforted him, and said that his (G.'s) appearance was 
 pleasing, and that he would make an eligible match. 
 
 Once S. had complained to him (G.) that his wife was inclined to 
 drink, and burst into tears. G. was touched by his friend's imhappiness. 
 On this occasion S. had kissed him, and begged for his friendship, and 
 asked him to visit him frequently. 
 
 S. had never spontaneously directed the conversation to sexual 
 matters. G. once asked what pederasty was, of which he had heard 
 much while in England ; and S. had explained it to him. 
 
 G. acknowledges that he is sensual. At the age of twelve he had 
 been made acquainted with sexual matters by schoolmates. He had 
 never masturbated, had first had coitus at the age of eighteen, and had 
 since visited brothels frequently. He had never felt any inclination for 
 his own sex, and had never experienced any sexual excitement when S. 
 kissed him. He had always had pleasure in coitus normall}^ performed. 
 His lascivious dreams had always been of women. With indignation, 
 and pointing to his descent from a healthy and respectable family, he 
 repels the insinuation of having been given to passive pederasty. 
 Until the gossip about them came to his ears, he had been innocent and 
 devoid of suspicion. The anal anomalies he tries to explain in the same 
 way that he did at the trial. Auto-masturbation in ano he denies. 
 
 It should be noted that Mr. J. S. claims to be no less astonished 
 by the charge against his brother of male-love than those more closely 
 associated with him. Yet he could not understand what attached his 
 brother to G. ; and all the explanations which S. made to him concerning 
 his relation to G. were vain. 
 
 The author took the trouble to observe Dr. S. and G., in a natural way, 
 while they were dining, in company with S.'s brother and Mrs. S., in Graz. 
 This observation revealed not the slightest sign of improper friendship. 
 
 The genea-al impression which Dr. S. made on me was that of a 
 nervous, sanguine, somewhat overstrained individual, but, at the same 
 time, kind, open-hearted, and very emotional.
 
 426 PSYCHOPATIIIA SEXUALIS. 
 
 Dr. S. is physically strong, somewhat corpulent, with a symmetri- 
 cal, brachycephalic cranium. The genitals are well developed ; the penis 
 somewhat bellied ; the prepuce somewhat h^^pertrophied. 
 
 Opinion. — Pederasty is, unfortunately, not infrequent among man- 
 kind to-day; but still, occurring among the peoples of Europe, it is an 
 unusual, perverse, and even monstrous manner of sexual gratification. 
 It presumes a congenital or acquired perversion of the sexual instinct, 
 and, at the same time, defect of moral sense that is either original or 
 acquired, as a result of pathological influences. 
 
 Medico-legal science is thoroughly conversant with the physical and 
 psj'chical conditions from which this aberration of the sexual instinct 
 arises ; and in the concrete and doubtful case it seems requisite to ascer- 
 tain whether these empirical, subjective conditions necessary for peder- 
 asty are present. Too, it is essential to distinguish between active and 
 passive pederasty. 
 
 Active pederasty occurs : — 
 
 I. As a non-pathological phenomenon : — 
 
 1. As a means of sexual gratification, in case of great sexual desire, 
 with enforced abstinence from natural sexual intercourse. 
 
 2. In old debauchees, who have become satiated with normal sexual 
 intercourse, and more or less impotent, and also morally depraved ; and 
 who resort to pederasty, in order to excite their lust with this new 
 stimulus, and aid their virilit}", that has sunk so low psychically and 
 physically. 
 
 3. Traditionally, among certain barbarous races that are devoid of 
 morality. 
 
 II. As a pathological phenomenon : — 
 
 1. Upon the basis of congenital contrary sexual instinct, with 
 repugnance for sexual intercourse with women, or even absolute incapa- 
 bility of it. But, as even Casper knew, pederasty, under such conditions, 
 is very infrequent. The so-called urning satisfies himself with a man by 
 means of passive or mutual onanism, or by means of coitus-like acts 
 (e.gr., coitus inter femora) ; and he resorts to pederasty only very excei> 
 tionall}', as a result of intense sexual desire, or with a low or lowered 
 moral sense, out of desire to please another. 
 
 2. On the basis of acquired contrary sexual instinct : — 
 
 (a) As a result of long years of onanism, which finally causes 
 impotence for women with continuance of intense sexual desire. 
 
 (6) As a result of severe mental disease (senile dementia, brain- 
 softening of the insane, etc.), in which, as experience teaches, an inversion 
 of the sexual instinct may take place. 
 
 Passive pederasty occurs : — 
 
 I. As a non-pathological phenomenon : — 
 
 1. In individuals of the lowest class, who, having had the misfortune 
 to be seduced in boyhood by debauchees, endured pain and disgust for
 
 CULTIVATED PEDERASTY. 427 
 
 the sake of money, and became depraved morally, so that, in more mature 
 years, they have fallen so low that they take pleasure in being male 
 prostitutes. 
 
 2. Under circumstances analogous to those of I, 1, — as a remunera- 
 tion to another for having allowed active pederasty. 
 
 II. As a pathological phenomenon : — 
 
 1. In individuals atfeeted with contrary sexual instinct, witii endur- 
 ance of pain and disgust, as a return to men for the bestowal of sexual 
 favors. 
 
 2. In urnings who feel toward men like women, out of desire and lust. 
 In such female-men there is horror feminae aud absolute incapability for 
 sexual intercourse with women. Character and inclinations are feminine. 
 
 The empirical facts that have been gathered by legal medicine and 
 psychiatry are all included in this classification. Before the court of 
 medical science, it would be necessary to prove that a man belonged to 
 one of the above categories in order to carry the conviction that he was 
 a pederast. 
 
 In the life and character of Dr. S., one searches in vain for signs 
 which place him in one of the categories of active pederasts which science 
 has established. He is neither one forced to sexual abstinence, nor one 
 made impotent for women by debauchery ; neither is he congenitall}^ 
 male-loving, nor alienated from women by masturbation, and attracted to 
 men through continuance of sexual desire ; and, finally, he is not sexually 
 perverse as a result of severe mental disease. 
 
 In fact, the general conditions necessary for the occurrence of 
 pederasty are wanting in him, — moral imbecility or moral depravity, on 
 the one hand, and inordinate sexual desire, on the other. 
 
 It is likewise impossible to classify the accomplice, G., in any of 
 the empirical categories of passive pederasty ; for he possesses neither 
 the peculiarities of the male prostitute nor the clinical marks of effem- 
 ination ; and he has not the anthropological and clinical stigmata of the 
 female-man. He is, in fact, the very opposite of all this. 
 
 In order to make a pederastic relation between the two plausible 
 medico-scientifically, it would be requisite for Dr. S. to present the ante- 
 cedents and marks of the active pederasts of I, 2, and G., those of the 
 passive pederasts of II, 1 or 2. 
 
 The assumption lying at the basis of the verdict is, from a psycho- 
 logical stand-point, legally untenable. 
 
 With the same right, every man might be considered a pederast. It 
 remains to consider whether the explanations given by Dr. S. and G. of 
 their remarkable friendship are psychologically valid. 
 
 Psychologically it is not without parallel that so sentimental and 
 eccentric a man as S. — without any sexual excitement whatever — should 
 entertain a transcendental friendship. It suflices to recall the friendship 
 of school-girls, the self-sacrificing friendship of sentimental young persons
 
 428 PSYCHOPATHIA SEXUALIS. 
 
 in general, and the partiality which this sensitive man sometimes showed 
 even for domestic animals, — where no one would think of sodomy. With 
 S.'s mental character, extraordinary friendship for the youth G. may be 
 easily comprehended. The openness of this friendship permits the con- 
 clusion that it was innocent, much rather than that it depended upon 
 sensual passion. 
 
 The defendants succeeded in obtaining a new trial. The new trial 
 took place on March T, 1890. There was much evidence presented in 
 favor of the accused. 
 
 The previous moral life of S. was generally acknowledged. The 
 Sister of Charity who cared for G. in S.'s house, never noticed anything 
 suspicious in the intercourse between S. and G. S.'s former friends tes- 
 tified to his morality, his deep friendship, and his habit of kissing them 
 on meeting or leaving them. The anal abnormalities previously found 
 on G. were no longer present. Experts called by the court allowed the 
 possibility that they had been due simply to digital manipulations ; their 
 diagnostic value in any case was contested by the experts called by the 
 defense. 
 
 The court recognized that the imputed crime had not been proved, 
 and exonerated the defendants. 
 
 Lesbian Love.^ 
 
 Where the sexual intercourse is between adults, its legal 
 importance is very slight ; it could come into consideration only 
 in Austria. In connection with urningism, this phenomenon is 
 of antliropological and clinical value. The relation is the same, 
 mutatis mutandis, as between men. Lesbian love does not 
 seem to approach urningism in frequency. The majority of 
 female urnings do not act in obedience to an innate impulse, 
 but they are developed under conditions analogous to those 
 which produce the urning by cultivation. 
 
 These "forbidden friendships" flourish especially in penal 
 institutions for females. 
 
 Kraussold {op. cit.) reports : " The female prisoners often have such 
 friendships, which, when possible, extend to mutual manustupration. 
 
 " But temporar}^ manual gratification is not the only purpose of 
 such friendships. They are made to be enduring, — entered into system- 
 atically, so to speak, — and intense jealousy and a passion for love are 
 
 1 Camp. Mayer, Friedreich's Blatter, 1875, p. 41.— Kraussold, Melancbolie und 
 Schuld, 1884, p. 20.— Andronico, Archiv di psich. scienze penali ed antbropol. crim., vol. 
 iii, p. 145.
 
 LESBIAN LOVE. 429 
 
 developed which could scarcely be surpassed between persons of opposite 
 sex. When the friend of one prisoner is merely smiled at by another, 
 there are often the most violent scenes of jealousy, and even beatings. 
 
 " When the violent prisoner has been put in irons, in accordance 
 witli the prison-regulations, she says ' she has had a child by her 
 friend.' " 
 
 We are indebted to Parent-Duchatelet (" De la prosti- 
 tution," 1857, vol. i, p. 159) for interesting communications con- 
 cerning Lesbian love. 
 
 According to this experienced author, repugnance for the most 
 disgusting and perverse acts (coitus in axilla, inter mamni.ie, etc.) which 
 men perform on prostitutes is not infrequently responsible for driving 
 these unfortunate creatures to Lesbian love. From his statements it is 
 seen that it is essentially prostitutes of great sensuality who, unsatisfied 
 with intercourse with impotent or perverse men, and impelled by their 
 disgusting practices, come to indulge in it. 
 
 Besides these, there are prostitutes who let themselves be known as 
 given to tribadism ; persons who have been in prisons for years, and in 
 these hot beds of Lesbian love, ex abstinentia, acquired this vice. 
 
 It is interesting to know that prostitutes hate those who practice 
 tribadism, — just as men abhor pederasts ; but female prisoners do not 
 regard the vice as indecent. 
 
 Parent mentions the case of a prostitute who, while intoxicated, 
 tried to force another to Lesbian love. The latter became so enraged that 
 she denounced the indecent woman to the police. Taxil {op. cit. p. 166, 
 170) reports similar instances. 
 
 Mantegazza (" Anthropol. cnlturhistorische Studien," p. 97) also 
 finds that sexual intercourse between women has especially the signifi- 
 cance of a vice which arises on the basis of unsatisfied hyperaesthesia 
 sexualis. 
 
 In many cases of this kind, however, aside from congenital contrary 
 sexual instinct, one gains the impression that, just as in men {vide 
 supra), the cultivated vice gradually leads to acquired contrary sexual 
 instinct, with repugnance for sexual intercourse with the opposite sex. 
 
 At least Parent's cases were probably of this nature. The corre- 
 spondence with the lover was quite as sentimental and exaggerated in 
 tone as it is between lovers of the opposite sex ; unfaithfulness and sepa- 
 ration broke the heart of the one abandoned ; jealousy was unbridled, and 
 led to bloody revenge. The following cases of Lesbian love, by Mante- 
 gazza, are certainly pathological, and possibly examples of congenital 
 contrary sexual instinct : — 
 
 1. On July 5, 1777, a woman was brought before a court in London, 
 who, dressed as a man, had been married to three ditferent women. She
 
 430 PSYCHOPATHIA SEXUALIS. 
 
 was recognized as a woman, and sentenced to imprisonment for six 
 months. 
 
 2. In 1773, anotlier woman, dressed as a man, courted a girl, and 
 asked for her hand ; but the tricli did not succeed. 
 
 3. Two women lived together as man and wife for thirty years. On 
 her death-bed the " husband " confessed her secret to those about her. 
 
 Coffignon {op. cit., p. 301) makes later statements worthy of notice. 
 
 He reports that this vice is, of late, quite the fashion, — partly owing 
 to novels on the subject, and partly as a result of excessive work on sew- 
 ing-machines, the sleeping of female servants in the same bed, seduction 
 in schools by depraved pupils, or seduction of daughters by perverse 
 servants. 
 
 The author declares that this vice (" saphism ") is met more 
 frequently among ladies of the aristocracy and prostitutes. 
 
 He does not differentiate physiological and pathological cases, 
 nor, among the latter, the acquired and congenital cases. The details 
 of a few cases, which are certainly pathological, correspond exactly 
 with the facts that are known about men of contrary sexuality. 
 
 The saphists have their places of meeting, recognize each other by 
 peculiar glances, carriage, etc. Saphistic pairs like to dress and orna- 
 ment themselves alike, etc. They are then called ^^ petites soeurs " (little 
 sisters). 
 
 7. Necrophilia.^ 
 
 (Austrian Statutes, § 306.) 
 
 This horrible kind of sexual indulgence is so monstrous 
 that the presumption of a psychopathic state is, under all cir- 
 cumstances, justified ; and Maschka's recommendation, that 
 the mental condition of the perpetrator should always be in- 
 vestigated, is well founded. In any case, an abnormal and 
 decidedly perverse sensuality is required to overcome the natu- 
 ral repugnance Avhich man has for a corpse, and permit a 
 feeling of pleasure to be experienced in sexual congress with a 
 cadaver. 
 
 Unfortunately, in tlie majority of the cases reported, the 
 mental condition was not examined; so that the question 
 whether necrophilia is compatible with mental soundness must 
 remain open. But any one having knowledge of the horrible 
 aberrations of the sexual instinct would not venture, without 
 further consideration, to answer the question in the negative. 
 
 » Comp. Maschka, Hdb., iii, p. 191 (good historical notes). — Legraud, La folic, p. 531.
 
 IKCEST. 431 
 
 8. Incest. 
 (Austrian Statutes, § 132 ; Abridgment, § 189 ; German Statutes, § 174.) 
 
 The preservation of the moral purity of family life is a 
 product of civilization ; ^ and feelings of intense displeasure 
 arise in an ethically intact man at thought of lustful feeling 
 toward a member of the same family. Only great sensuality 
 and defective ideas of laws and morals can lead to incest. 
 
 Both conditions may, in tainted families, be operative. 
 Drinking and a state of intoxication in men ; weak-minded- 
 ness which does not allow the development of the feeling of 
 shame, and which, under certain circumstances, is associated 
 with eroticism in females, — these facilitate the occurrence of 
 incestuous acts. External conditions which iacilitate their 
 occurrence are due to defective separation of the sexes among 
 the lower classes. 
 
 As a decidedly pathological phenomenon, the author has 
 found incest in states of congenital and acquired mental weak- 
 ness, and infrequently in cases of epilepsy and paranoia. 
 
 In many of the cases, probably a majority, it is not pos- 
 sible, however, to find a pathological basis for the act which so 
 deeply wounds not only the tie of blood, but also the feeling of 
 a civilized people. But in many of the cases reported in litera- 
 ture, to the honor of humanity, the presumption of a psychopathic 
 basis is possible. 
 
 In tlie Feldtniann case (Murc-Ideler, vol. i, p. 18), where a father 
 constantly made immoral attacks on his adult daughter, and finally' killed 
 her, the unnatural father was weak-minded and,ljesides, probably subject 
 to periodical mental disease. In another case of incest between father and 
 daughter {toe. ciL, p. 247), the latter, at least, was weak-minded. Lom- 
 broso {Archiv. di Fsichiat7-ia, viii, p. 519) reports the case of a peasant, 
 aged 42, who practiced incest with his daughters, aged, respectively, 22, 
 19, and 11 ; he even forced the youngest to prostitute herself, and then 
 visited her in a brothel. The medico-legal examination showed predis- 
 position, intellectual and moral imbecility, and alcoholism. 
 
 There was no mental examination in the case reported by Schlir- 
 meyer {Deutsche ZeitscJir. fur Staatsarzneikunde, xxii, II. 1), in Avhich a 
 
 1 Vide Westerinarck, History of Human Marriage, chap. xiv. McMillan & Co., 1891.
 
 432 PSYCHOPATHIA SEXUALIS. 
 
 mother laid her son of five and a half years on herself, and practiced abuse 
 with him ; and in that given byLafarque {Journ. Med. de Bordeaux, 1874), 
 where a girl, aged 17, laid her brother, aged 13, upon herself, brought 
 about membrorum conjunctionem, and performed masturbation on him. 
 
 The following cases are those of tainted individuals : Magnan {Ann. 
 med.-psych., 1885) mentions an unmarried woman, aged 29, who, though 
 indifferent toward other children or even men, suffered frightfully in the 
 presence of her nephew, and could scarcely control her impulse to cohabit 
 with him. This sexual peculiarity continued only as long as the nephew 
 was quite young. 
 
 Legrand (Ann. med.-psych., May, 1876) mentions a girl, aged 15, 
 who seduced her brother into all manner of sexual excesses on her per- 
 son ; and when, after two j-ears of this incestuous practice, her brother 
 died, she attempted to murder a relative. In the same article there is 
 the case of a married woman, aged 36, who hung her open breast out of 
 a window, and indulged in abuse with her brother, aged 18; and also the 
 case of a mother, aged 39, who practiced incest with her son, with whom 
 she was madly in love, became pregnant by him, and induced abortion. 
 
 Through Casper we kno^v that depraved mothers in large 
 cities sometimes treat their little daughters in a most horrible 
 fashion, in order to prepare them for the sexual use of de- 
 bauchees. This crime belongs elsewhere. 
 
 9. Immoral Acts with Persons in the Care of Others ; Seduction 
 
 (Austrian). 
 
 (Austrian Statutes, § 131 ; Abridgment, § 188 ; German Statutes, § 173). 
 
 Allied to incest, but still less repugnant to moral sensibility, 
 are those cases in which persons seduce those entrusted to them 
 for care or education, and who are more or less dependent upon 
 them, to commit or suffer vicious practices. Such acts, which 
 especially deserve legal punishment, seem only exceptionally to 
 have psychopathic significance.
 
 INDEX. 
 
 Abuse, unnatural, 404 
 
 Acts for self-humiliation, 134 
 
 ^Esthetics and sexuality, 10 
 
 Amor lesbicus, 428 
 
 Anaesthesia sexualis, acquired, 47 
 
 congenital, 42 
 Androgyny, 304 
 Areas, erogenous, 31 
 Attraction, sexual, 16 
 
 Baudelaire, 122 
 
 Binet, 18, 19, 21, 121 
 
 Bondage, sexual, 141 
 
 Bote, 202 
 
 Boys, whipping of (sadistic), 82 
 
 Brunn, 19 
 
 Caesars, 58 
 
 Capitals as breeding-places of sensuality, 7 
 
 Christianity, influence of, 4, 6 
 
 contrasted with Mohammedanism, 5 
 Cohabitation, 32 
 Contrary sexual instinct, 185 
 
 causes of, 188 
 
 degrees of, 187 
 Corpses, mutilation of, 67 
 Cruelty, passively endured, 89 
 
 and love, 9 
 
 and lust, 9 
 
 sources of, 86 
 
 Decadence, moral, 6 
 
 Defemination, 197 
 
 Defilement of women, 79 
 
 Delirium acutum, 54 
 
 Dementia and psychopathia sexualis, 361 
 
 paretic, and psychopathia sexualis, 363 
 Descartes, 162 
 
 28 
 
 Diagnosis of contrary sexuality, 319 
 Durga, 57 
 
 EfiFemination, 279 
 Ejaculation centre, 31 
 
 affections of, 3.6 
 Epilepsy and psychopathia sexualis, 364 
 Equus eroticus. 111 
 Erection centre, 24 
 
 affections of, 35 
 Esquirol, 220, 221 
 Eviration, 197 
 Exhibition, 382 
 Eyes, neuropathic, 21 
 
 Family life, 6 
 Fetichism, 17 
 
 and crime, 401 
 
 of apron, 170 
 
 of feathers, 182 
 
 of female attire, 167 
 
 of female person, 157 
 
 of foot and shoe, 123, 176 
 
 of furs, 181 
 
 of hair, 20 
 
 of hand, 158 
 
 of handkerchief, 171 
 
 of glove, 175 
 
 of material, 180 
 
 of odors, 21 
 
 of silk, 183 - 
 
 of velvet, 180 
 
 of voice, 22 
 
 religious, 17 
 Fiction and sexual perversion, 123 
 Flagellation, 28, 152 
 
 and masochism, 99 
 
 differentiation of, 100 
 
 (433)
 
 434 
 
 INDEX. 
 
 Flagellation, for reflex effect, 99 
 
 heroines of, 29 
 Flagellum salutis, 29 
 Friendship and love, 19 
 Frigiditas uxoris, 46 
 Frottage, 394 
 
 Gley, 226 
 Griesinger, 224 
 Gynandry, 304 
 
 Hair, as a fetich, 20 
 Hair-despoilers, 162, 164, 165 
 Herodotus, 200 
 Hermaphroditism, psychical, 230 
 
 cases of, 232-255 
 Hippocrates, 201 
 Homo-sexuality, 185, 255 
 
 acquired, 188 
 
 causes of, 188 
 
 congenital, 222 
 
 degrees of, I, 191; II, 197; III, 202; 
 IV, 216 
 
 explanation of, 227 
 Holder, 202 
 Hypersesthesia sexualis, 48 
 
 cases of, 51-55 
 Hypnosis, therapeutics, 322-357 
 Hysteria, 375 
 
 Idiocy and psychopathia sexualis, 358 
 Imbecility and contrary sexuality, 359 
 Ink, throwing of, 80 
 Insanity, and contrary sexuality, 358 
 
 periodical, 372 
 Incest, 431 
 
 Japanese women, 3 
 Juvenal, 31 
 
 Kiernan, 227 
 
 Kiernan's explanation of sadism, 152 
 
 Kleist, 88 
 
 Ladame's case, 344 
 Libido sexualis, 24-32 
 Love and cruelty, 9 
 
 and friendship, 19 
 
 and religion, 8 
 
 fetichism of, 19 
 
 Lesbian, 428 
 
 of man and woman compared, 15 
 
 platonic, 11, 12 
 
 true, 11 , 
 
 youthful, 11 
 Lust and cruelty, 10, 57 
 
 and battle, 58, 60 
 
 and murder, 62, 397 
 
 and the passive endurance of cruelty, 90 
 
 and plunder, 58 
 Lupercal, 31 
 Lydston, 162, 227 
 
 Magnan, 20, 227 
 Mania, 373 
 Mantegazza, 7, 227 
 Marschalls Gilles de Rays, 58 
 Maudsley, 1 
 Maeoch, Sacher-, 89 
 Masochism, 89 
 
 and flagellation, 99 
 
 and sadism, 148 
 
 explanation of, 139 
 
 in women, 137 
 
 larvated, 123 
 
 rudimentary, 101 
 
 symbolic, 115 
 Melancholia, 374 
 Messalinas, 88 
 Metamorphosis sexualis paranoica, 216 
 
 transition to, 202 
 Modesty, origin of, 2, 15 
 
 in women, 15 , 
 Mohammedan women, 5 
 Morality, progress in, 5 
 Morals, decadence of, and pathology, 6 
 Mujerados, 201
 
 INDEX. 
 
 435 
 
 Necropliilia, 430 
 Nervi erigentes, 24 
 Neuroses, cerebral, 36 
 
 sexual, 34 
 
 spinal, 35 
 Nymphomania, 373 
 
 Olfactory fetichism, 21 
 
 hallucinations and sexuality, 28 
 sense and sexual sense, 26 
 
 Paradoxia sexualis, 37 
 
 Paresthesia sexualis, 56 
 
 Paranoia, 376 
 
 Pathological sexuality in its legal aspects, 
 
 378 
 Pathology, general, 34 
 
 special, 358 
 Pederasty, 408 
 
 cultivated, 414 
 
 false imputation of, 420 
 Penthesilia, 88 
 Perfumes as a fetich, 21, 26 
 Physiology, 23 
 Priapism, 35 
 
 Prognosis of contrary sexuality, 319 
 Psychology, sexual, 1 
 Psychopathia sexualis periodica, 371 
 Puberty, its psychological importance, 7 
 
 relation to poetry, 7 
 to religious feeling, 7 
 Pueblo Indians, 201 
 
 Rape, 397 
 
 Religion and sensuality, 8 
 
 Reversal of sexual feeling, 191 
 
 Robbery, 401 
 
 Rousseau, 119 
 
 Sacher-Masoch, 89 
 Sade, Marquis de, 57, 71 
 Sadism, 57, 401 
 
 and masochism, 148 
 
 Sadism, atavistic, 1*52 
 
 cases of, 62-67 
 
 in women, 87 
 
 physiological relations of, 59 
 
 symbolic, 81 
 
 with animals, 84 
 
 with other objects, 82 
 Satyriasis, 37-3 
 
 Schema of sexual neuroses, 34 
 Schopenhauer, 41 
 Scythians, insanity of the, 200 
 Schrenk-Notzing's case, 351 
 Senile libido, 40, 41 
 Sensuality, 5 
 
 religious equivalent of, 8 
 Servants, immoral acts of, with children 
 
 432 
 Sexuality, source of ethical feeling, 1 
 
 and the social feeling, 1 
 
 simple reversal of, 191 
 Sexual attraction, 16 
 
 bondage, 141 
 
 desire, physiology of, 28 
 
 instinct in childhood, 37 
 in old age, 38 
 
 promptings, first, 7 
 
 satisfaction in received cruelty and 
 abuse, 91 
 
 selection, 2 
 Shoe-fetichism, 123 
 
 cases of, 124-134 
 Silk-fetichism, 183 
 Siva, 57 
 Sodomy, 404 
 Spanking, dangers of, 28 
 Stefanowsky, 123 
 Sterility, 13 
 
 Sulphuric acid, throwing of, 80 
 Suggestion, hypnotic, 322-357 
 
 Theft, 401 
 
 Torture of animals, 401 
 
 Therapy of contrary sexuality, 321
 
 436 
 
 INDEX. 
 
 Ulrichs, 227 
 
 Urning, memorial of one, 410 
 
 Urnings, 255 
 
 cases of, 257-279 
 laws concerning, 413 
 
 Vampirism, 87 
 Vanity, 16 
 Velvet-fetichism, 180 
 Violation of children, 402 
 Viraginity, 279 
 Virility, loss of, 12 
 Voice as a fetich, 22 
 
 Westermarck, 15, 16, 20 
 Westphal, 224 
 Whitechapel murderer, 64 
 Woman, elevation of, 3 
 
 in Old Testament and Gospels, 4 
 
 position of, 2 
 
 sexual appetite of, 15 
 role of, 13 
 Woman-haters' ball, 417 
 Women, defilement of, 79 
 
 injury of, 70 
 
 masochism in, 137 
 
 Zones, erogenous, 31
 
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 the upper curve being the Temperature, the middle the Pulse, and the lower the Respiration. By this method a full 
 record of each can easily be kept with but one color ink. . - .. • »• . 
 
 It is so .arranged that all practitioners will find it an invaluable aid m the treatment of their patients. 
 
 On the back of each chart will be found ample space conveniently arranged for recording " Clinical History and 
 Symptoms " and "Treatment." • »i, * 
 
 Bv its use the physician will secure such a complete record of his cases as will enable him to review them at any 
 time, thus he will always h.ave at hand a source of individual improvement and benefit in the practice of his profession, 
 the value of which caa hardly be overestimated.
 
 Medical Publications of The F. A. Davis Co., Philadelphia. 
 
 BOBNWING 
 
 A Text-Book on Practical Anatomy. 
 
 Including a Section on Surgical Anatomy. 
 
 By Henry C. Boenning, M.D., Lecturer on Anatomy and Surgery in 
 the Philadelphia Scliool of Anatomy ; Demonstrator of Anatomy in the Medico- 
 Chirurgical College, etc., etc. 
 
 Fully illustrated throughout with about 200 Wood-Engravings. In one 
 handsome Octavo volume, printed in extra-large, clear type, making it specially 
 desirable for use in the dissecting-room. Nearly 500 pages. Substantially bound 
 in Extra Cloth. Also in Oil-Clotli, for use in the dissecting-room without soiling. 
 
 Price, post-paid, in the United States, $2.50, net ; Canada (duty paid), $2.75, net ; 
 
 Great ."Britain, lis. ; France, 16 fr. 20. 
 
 This work is fully illustrated throughout 
 with clear and instructive engravings. It is 
 not a,s large as the usual text-books on anatomy, 
 nor yet so small as many of the ready reniem- 
 brances, but it occupies the middle ground, 
 and will find an aeceiitable place with many 
 students.— CoZM)>t&MS Med. Journal. 
 
 There is not an unnecessary word in this 
 book of nearly five hundred pages. As a typo- 
 graphical specimen it is elegant. Systematic, 
 comprehensive, and intensely pi'actical, we 
 heartily commend it to all medical students 
 and practitioners. — Denver Med. Times. 
 
 BOWBN 
 
 Hand-Book of Wlateria Wledica, Pharmacy, 
 
 and Therapeutics. 
 
 By CuTHBERT BowEN, M.D., B.A., Editor of "Notes on Practice." 
 The second volume in the Physicians' and Students' Ready Reference Series. 
 One 12mo volume of 370 pages. Handsomely bound in Dark -Blue Cloth. 
 
 Price, post-paid, in the United States and Canada, $1.40, net; in Great 
 Britain, 8s. 6d. ; in France, 9 fr. 25. 
 
 This excellent manual comprises ui its 
 366 pages about as much sound and vahi- 
 able information on the subjects indi- 
 
 cated in its title as could well be crowded 
 into the compass. — St. Louis Medical and 
 Surgical Journal. 
 
 BUBET 
 SYPHILIS '" Ancient and Prehistoric Times. 
 
 With a Chapter on the Rational Treatment of Syphilis in the 
 
 Nineteenth Century. 
 
 By Dr. F. Buret, Paris, France. Translated from tlie French, with the 
 author's permission, with notes, by A. H. Ohmann-Dumesnil, Professor of 
 Dermatology and Syphilology in the St. Louis College of Physicians and Surgeons. 
 
 No. 12 in the Physicians' and Students' Ready-Reference Series. 330 pages. 
 13mo. Extra Dark-Blue Cloth. 
 
 Price, post-paid, in the United States and Canada, $1.25, net; in Great 
 Britain, 6s. 6d. ; in France, 7 fr. 75. 
 
 This volume, which is one of a series of three (the other two, treating of Syphilis 
 in the Middle Ages and in modern times, now in active preparation), gives the most com- 
 plete history of Syphilis from prehistoric tilnes up to tlie Christian Era. 
 
 The subject throughout is treated in a clear, concise manner, and readers 
 will find manjr things which are historically new. 
 
 In order to give some idea of the contents of this first volume, the following 
 are cited as among tlie subjects treated : — 
 
 In What does SyjAilis Consist? Origin of the Word Syphilis. The Age of 
 Syphilis. Syphilis in Prehistoric Times. Tchoang. — Syphilis Among the Chinese 
 5000 Years Ago. Kasa. — Syphilis in Japan in the Ninth Century B.C. Syphilis 
 Among the Ancient Egyptians, 1400 B.C. Syphilis Among the Ancient Assyrians 
 and Babylonians. Syphilis Among the Hebrews in Biblical Times. Upadansn. — 
 Syphilis Among the Hindoos, 1000 B.C. Sukon. — Syphilis Among the Greeks. 
 Ficus. — Syphilis at Rome under the Caesars. Conclusion : Rational Treatment of 
 Byphilia in the Nineteenth Century. 
 
 C4)
 
 Medical Publications of The F. A. Davis Co., Philadelphia. 
 
 CAPJP 
 
 The Daughter: 
 
 Homely Suggestions to Mothers and Daughters. 
 
 Her Healtli, Hducation, and 
 "Wedlock. 
 
 By William M. Capp, M.D., Philadelphia. This is just such a book as a family 
 physician would advise his lady patients to obtain and read. It answers many questions 
 which every busy practitioner of medicine has put to him in the sick-room at a time when 
 it is neither expedient nor wise to impart the inlbrmatiou sought. 
 
 It is complete in one beautifully printed (large, clear type) 12mo volume of 150 pages. 
 Attractively bound in Extra Cloth. 
 
 Price, post-paid, in the United States and Canada, $1.00, net; in Great 
 Britain, 5s. 6d. ; France, 6 fr. 20. 
 
 In the 144 pages allotted to him he h.as com- 
 pressed an amount of homely wisdom on the 
 pliysieal, mental, and moral development of 
 the female child from birth to maturity which 
 is to be found elsewhere in only the great book 
 of experience. It is, of course, a book for 
 mothers, but is one so void of otfense in ex- 
 pression or ideas that it can safely be recom- 
 mended for all whose minds are sufficiently 
 developed to appreciate its teachings.— P/wto- 
 (lelphia Public Ledger. 
 
 Many delicate subjects are treated with 
 
 skill and in a manner which cannot strike any 
 one as improper or bolil. Tlie ahsolute igno- 
 rance in which most yunnggirls are allowed to 
 exist, even until adult life, is often productive 
 of mu<-h misery, both mental and physical. 
 Ciuite a numlier of books written by phy- 
 sicians for popular use liave lieen prepared in 
 snch a way that the professional man can read 
 between the lines strong bids for popular 
 favor, etc. These objectionable features will 
 not be fouiul in Dr. ("api)"s brochure, and for 
 this reason it is worthy the confidence of 
 physicians. — Medical Neivs. 
 
 A New 
 
 CATHELL 
 
 Book on the Physician Himself 
 
 And Things that Concern His Reputation and Success. 
 (Tenth) Edition, Author's Last Revision. 
 
 By D. W. Cathell, M.D., Baltimore, Md. This is the author's final revision of one 
 of the most useful, successful, and popular medical books ever published. It has been 
 wisely and carefully revised throughout. The well-known cliarming style of the author is 
 preserved intact, while the practical value of the book is truly enhanced by the addition of 
 much of the author's gathered wisdom not introduced into any previous edition. The 
 volume has been brought to perfection, as I'ar as human effort can achieve, and though 
 enlarged to 3.50 Royal Octavo Pages the price has not been increased. 
 
 Handsomely Bound in Extra Cloth, price, in the United States and Canada, post-paid, 
 $2.00,-net; in Great Britain, lis. Gd. ; in France, 12 fr. 40. 
 
 "The Physician Himself" interested me so 
 much that I actually read it through at one 
 sitting. It is brimlu'l of the very best advice 
 possible for medical men. I, for (uie, shall 
 try to profit by it.— Pro/. William Goodcll. 
 Philadelphia. 
 
 It is marked with good common sense and 
 rei)lete with excellent maxims and suggestions 
 for the guidance of medical men.— 2'/(e British 
 Medical Journal. 
 
 We advise our readers to buy it. It will 
 give them food for thought and show them 
 liow to and how not to achieve reputation and 
 success. — TTie Medical Age. 
 
 We cannot too strongly commend it to the 
 attention of every young doctor. M.any a 
 lesson is pleasantly and gently taught in its 
 pages which cannot otherwise" l)e learned un- 
 less by bitter experience. — Canada Medical 
 Record. 
 
 Of course, one reason for its occult power is 
 that it is written with admirable grace and 
 precision, besides presenting the ups and 
 downs of a pliysician's life in such a natural 
 and perfect way. The book will help any one 
 who will read it. It tells you how to begin 
 practice ; leads you into medical ethics 
 
 properly, and, careftilly studied, the pages of 
 this book will be of great l)enetit to the young 
 and o\i.\.— Charlotte Medical Journal. 
 
 This book is evidently the production of an 
 unspoiled mind and the fruit of a ripe career. 
 I admire its pure tone aud feel tlie value of its 
 lu-actical pouits. How I wisli I could liave 
 read such a guide at the outset of my career! 
 —Prof. James Neviyis Hyde, Chicago, III. 
 
 "The Physician Himself" is tiseful alike to 
 the tyro and the sage— the neophyte and the 
 veteran. It is ^headlight in tlie splendor of 
 whose beams a multitude of onr (irofession 
 shall find their way to success.— Pro/. J. M. 
 Bodine, Dean University of Louisville. 
 
 We have read one of the former, and smaller, 
 editions through very carefully, and know of 
 no work in nie<lical literature more profitable 
 for perusal and possession.— />t'nt'c;- Medical 
 Times. 
 
 This book will do a world of good, a good 
 that will be far-reaehing aud constant, and the 
 fact that it has reached its tenth edition proves 
 toward a higher aiul yet higher teaching, that 
 "the elevation of the profession" is a con- 
 sistent and timely aim. — Chicago Clinical 
 Review. 
 
 (5)
 
 Medical Publications of The F. A. Davis Co., Philadelphia. 
 
 CLJEVEWGEB 
 
 Spinal Concussion. 
 
 Surgically Considered as a Cause of Spinal Injury, and Neuro- 
 logic ally Restricted to a Certain Symptom Group, for which 
 IS Suggested the Designation Erichsen's Disease, 
 AS One Form op the Traumatic Neuroses. 
 
 By S. V. Clevenger, M.D., Consulting Physician Reese and Alexian 
 Hospitals ; Late Pathologist County Insane Asylum, Chicago, etc. 
 
 Special features consist in a description of modern methods of diag- 
 nosis b^' Electricity, a discussion of the controA^ersy concerning hj^steria, 
 and the author's original pathological view that the lesion is one involv- 
 ing the spinal sympathetic nervous system. 
 
 Every Physician and Laioyer should own this work. 
 
 In one handsome Ro3al Octavo Yolume of nearh' 400 pages, with 
 thirt}'^ Wood-Engravings. 
 
 Price, post-paid, in United States and Canada, $2.50, net; in Great 
 Britain, Hs. ; in France, 15 fr. 
 
 This work really does, if we may be per- 
 mitted to use a trite and hackneyed expres- 
 sion, "fill a long-felt want." The subject is 
 treated in all its bearings ; electro-diagnosis 
 
 receives a large share of attention, and the 
 chapter devoted to illustrative cases will be 
 found to possess especial importance. — Med- 
 ical Weekly Review. 
 
 COLT3IAW 
 
 THE CHINESE: 
 
 Their Present and Future; 
 Medical, Political, and Social. 
 
 By Robert Coltman, Jr., M.D., Surgeon in Charge of the Presby- 
 terian Hospital and Dispensary at Teng Chow Fu ; Consulting Ph}'- 
 sician of the American Southern Baptist Mission Societ}^ etc. 
 
 Beautifully printed in large, clear tj^pe, illustrated with Fifteen Fine 
 Engravings on Extra Plate Paper, from photographs of persons, places, 
 and objects characteristic of China. 
 
 In one Royal Octavo volume of 212 Pages. Ilandsomel}' bound in 
 Extra Cloth, with Chinese Side Stamp in gold. 
 
 Price, post-paid, in United States and Canada, $1.75, net; in Great 
 Britain, 10s. ; in France, 12 fr. 20. 
 
 The Chinaman is a source of absolute curi- 
 osity to the American, and anything in regard 
 to liis relationship to the medical profession 
 will prove more than usually attractive to the 
 average doctor. Such is the case with the 
 work before us. It is difficult to put it aside 
 after one has begun to read it. — Memphis Med. 
 Monthly. 
 
 Dr. Coltman has written a very readable 
 book, illustrated with reproductions of photo- 
 gi-aphs taken by himself. — Boston Med. and 
 Surg. Journal. 
 
 Attached to a number of hosi>it.als and dis- 
 pensaries, he has had ample opportunity to 
 observe the medical aspect of the Chinese. 
 The most prevalent diseases are such as affect 
 the alimentaiy tract and eye troubles. Renal 
 troubles are also frequent. Skin diseases are 
 abundant and syphilis is far from infrequent. 
 
 Erysipelas is rare and enteric fever infrequent. 
 Cholera appears in epidemics and is then 
 frightfully fatal. Leprosy, of course, is com- 
 mon, and the author states that it cannot be 
 contagious, as is supposed by many, or it 
 would assume a terriVile prevalence in China, 
 where lepers are permitted to go about free. 
 
 We will not further mention the subjects 
 discussed in this excellent book. The style of 
 the author is very interesting and taking, and 
 much information is given in an entertaining 
 manner. Tlie political situation is very intelli- 
 gently handled in its various bearings. The 
 photo-engravings are handsome and well-ex- 
 ecuted, the book in general being gotten up in 
 a very artistic manner. We can heartily com 
 mend this work not only to phvsicians. but to 
 intelligent lay readers.— /St. Louis Medical 
 Review. 
 
 (6)
 
 Medical Publications of The F. A. Davis Co., Philadelphia. 
 
 CONSUWIPTION: 
 
 nAvis 
 
 How to Prevent it and How 
 to l,ive witli it. 
 
 Its Nature, Causes, Preventioin, and the Mode of Life, Climate, 
 Exercise, Food, and Clothing Necessary for its Cure, 
 
 By N. S. Davis, Jr., A.M., M.D., Professor of Principles and Practice of Medicine, 
 Chicago Medical College; Physician to Mercy Hospital, Chicago ; Member of the American 
 Medical Association, etc. 
 
 This plain, practical treatise thoroughly discusses the prevention of Consumption, 
 Hygiene for Consumptives, gives timely suggestions concerning the diflerent climates and 
 the important part they play in the treatm'ent of this disease, etc., etc.,— all presented in 
 such a succinct and intelligible style as to make the perusal of the book a pleasant pastime. 
 
 12mo. 143 pages. Handsomely bound in Extra Cloth. 
 
 Price, post-paid, in United States and Canada, 75 Cents, net ; in Great 
 Britain, 4s. ; in France, 5 fr. 
 
 The questions of heredity, predisposition, 
 prevention, and hygienic treatment of con- 
 sumption are simply and sensibly dealt with. 
 The chapters on how to live with tuberculosis 
 are excellent. — Indiana Medical Journal. 
 
 The author is very thorough in his dis- 
 
 cussion of the subject, and the practical hints 
 which he gives are of real worth and value. 
 His directions are given in such a manner as 
 to make life enjoyable to a consumptive 
 patient, and not a burden, as is too frequently 
 the case. — Weekly Medical Review. 
 
 By the Sdtne Author 
 
 Diseases of the Lungs, Heart, and Kidneys. 
 
 By N. S. Davis, Jr., A.M., M.D. 
 
 The Nature, Patlwlogical Anatomy, Symptoms, Causes, Diagnosis, and Tfeatment of the 
 diseases of these important organs are comprehensively discussed in this conveniently 
 arranged volume. Special and careful attention is given to Treatment, while nothing else 
 is slighted. No. I4 in the Physicians' and Students' Ready -Reference Series. 12mo. 359 
 pages. Extra Dark-Blue Cloth. 
 
 Price, in United States and Canada, post-paid, $1.25, net; Great Britain, 
 
 6s. 6d. ; Pranoe, 7 fr. 75. 
 
 The author evidently knows how to put 
 "multum in parvo" vi'ithout omitting any- 
 thing essential to a clear understanding of the 
 subject discussed.— (St. Louis Medical Era. 
 
 It requires close thought, carefiiUy and 
 judiciously applied, to write a book as this one 
 IS written. A systematic treatise on the Dis- 
 
 eases of the Lungs, Heart, and Kidneys, and 
 their co-ordinate relation and sympathy, pre- 
 senting many of the main points of dependence 
 of one upon the other. This Dr. Davis has 
 succeeded in doing to a nice degree, handing 
 the student a book worthy of most serious 
 Sitxidy.— Medical Free Press. 
 
 On Oxygen. 
 
 DBMABQTTAY 
 
 A Practical Investig^ation of tlie Clinical 
 
 and Xherapeutic "Valne of tlie Gases 
 
 in Medical and Surgical Practice, 
 
 With Especial Reference to the Value and Availability of Oxygen, 
 Nitrogen, Hydrogen, and Nitrogen Monoxide. 
 
 By J. N. Demarquat, Surgeon to the Municipal Hospital, Paris, and of the Council 
 of State; Member of the Imperial Society of Surgery, etc. Translated, with notes, addi- 
 tions, and omissions, by Samuel S. Wallian, A.M., M.D., ex-President of the Medical 
 Association of Northern New York ; Member of the New York County Medical Society, etc. 
 
 Royal Octavo, 316 pages ; illustrated with 21 Wood-Cuts. 
 
 Price, post-paid, in United States and Canada, Cloth, $2.00, net; Half- 
 Eussia, $3.00, net. In Great Britain, Cloth, lis. 6d. ; Half-Russia, 
 17s. 6d. In France, Cloth, 12 fr. 40; Half-Russia, 18 fr. 60. 
 
 This is a handsome voluTue of 300 pages, 
 in large print, on good paper, and nicely illus- 
 trated. Although nominally pleading for the 
 use of oxygen inhalations, the author shows 
 in a philosop.hical manner how much greater 
 
 good physicians might do if they more fully 
 appreciated the value of fresh-aii- exercise and 
 water, especially in diseases of the lungs, kid- 
 neys, and skin. We commend its perusal to 
 our readers. — The Canada Medical Record. 
 
 <J)
 
 Medical Publications of The F. A. l)avis Co., Philadelphia. 
 
 Bacteriological Diagnosis. 
 
 Tabular Aids for Use in Practical Work. 
 
 By James Eisenberg, Ph.D., M.D., Vienna. Translated and augmented, 
 with the permission of the author, from the second German Edition, by Norval 
 H. Pierce, M.D., Surgeon to the Out-Door Department of Michael Reese 
 Hospital ; Assistant to Surgical Clinic, College of Physicians and Surgeons, 
 Chicago, 111. 
 
 Nearly 200 pages. In one Royal Octavo volume, handsomely bound in 
 Cloth and in Oil-Cloth (for laboratory use). 
 
 Price, post-paid, in the United States and Canada, $1.50, net; in Great 
 Britain, 8s. 6d. ; in France, 9 fr. 35. 
 
 This book is a novelty in Bacteriological Science. It is a work of great 
 importance to the teacher as well as to the student. It will be of inestimable 
 value to the private worker, and is designed throughout as a practical guide in 
 laboratory work. It is arranged in a tabular form, in which are given the specific 
 characteristics of the various well-established bacteria, so that the worker may, at 
 a glance, inform himself as to the identity of a given organism. 
 
 There is also an appendix, in which is given, in a concise and practical form, 
 the technique employed by the best laboratories in the cultivation and staining 
 of bacteria ; the composition and preparation of the various solid, semi-solid, and 
 fluid media, together with their employment ; a complete list of stains and re- 
 agents, with formuhe for same ; the methods of microscopic examination of 
 bacteria, etc., etc., etc. 
 
 EniJVGEB 
 
 Twelve Lectures on the Structure of the 
 Central Nervous System. 
 
 For Physicians and Students. 
 
 By Dr. Ludwig Edinger, Frankfort-on-the-Main. Second Revised Edi- 
 tion. With 133 Illustrations. Translated by Willis Hall Vittum, M.D., St. 
 Paul, Minn. Edited by C. Eugene Riggs, A.M., M.D., Professor of Mental and 
 Nervous Diseases, University of Minnesota ; Member of the American Neuro- 
 logical Association. 
 
 The illustrations are exactly the same as those used in the latest German 
 edition (with the German names translated into English), and are very satisfac- 
 tory to the Physician and Student using the book. 
 
 The work is complete in one Royal Octavo Volume of about 250 pages, 
 bound in Extra Cloth. 
 
 Price, post-paid, in the United States and Canada, $1.75, net ; in Great 
 Britain, 10s. ; in France, 12 fr. 20. 
 
 One of the most instructive and valnaLle 
 works on the minute anatomy of the human 
 brain extant. It is written in the form of 
 lectures, profusely illustrated, and in clear 
 language. — The Pacific Record of Medicine 
 and Surgery. 
 
 Since the first works on anatomy, up to the 
 present day, no work has appeared on the sub- 
 ject of the general and minute anatomy of the 
 central nerv(^us system so complete and ex- 
 haustive as this work of Dr. Ludwig Edinger. 
 Being himself an original worker, and having 
 the benefits of such masters as Stilling, Wei- 
 geit, Geilach, Meyuert, and others, he has 
 
 succeeded in traiisforming the mazy wilder- 
 ness of nerve-fibres and cells into a district of 
 well-marked pathways and centres, and by so 
 doing has made a pleasure out of an anatom- 
 ical bugbear.— 27ie Southern Medical Record. 
 
 Every point is clearly dwelt upon in the text, 
 and where description alone might leave a 
 subject obscure clever drawings and (flagrams 
 are introduced to render misconception of the 
 author's meaning impossibte. The book is 
 eminently practical. It unravels the intricate 
 entanglement of different tracts and paths in 
 a way that no other book has done so explic- 
 itly or so Goucis^Xy.—NorUhwestei-n Lancet. 
 
 (8)
 
 Medical ruhlications of the F, A. Davis Co., Philadelphia. 
 
 GOODELL 
 
 LESSONS IN GYNECOLOGY. 
 
 By William Goodell, A.M., M.D., etc., Professor of Clinical Gyne- 
 cology in the University of Pennsylvania,. 
 
 This exceedingly valuable work, from one of the most eminent 
 specialists and teachers in gynecology, embraces all the more important 
 diseases and the principal operations in the field of gynecology, and 
 brings to bear upon them all the extensive practical experience and wide 
 reading of the author. It is an indispensable guide to every practitioner 
 who has to do with the diseases peculiar to w'omen. Third Edition. 
 With 112 Illustrations. Thoroughly revised and greatly enlarged. 
 Royal octavo, 578 pages. 
 
 Price, in United States and Canada, Cloth, $5.00 ; Full Sheep, $6.00. Discount, 20 per 
 cent., making it, net, Cloth, $100 ; Sheep, $180. Postage, 27 cents estra. Great 
 Britain, Cloth, 22s. 6d. ; Sheep, 28s., post-paid. France, 30 fr. 80. 
 
 It is too good a book to have been allowed to [ important disease found in the female sex is 
 remain out of print, and it has unquestionably y taken up and discusst'd in a common-sense 
 
 been missed, the author has revised the work 
 with special care, adding to each lesson such 
 fresh matter as the progress in the art rendered 
 necessary, and he has enlarged it l)y the inser- 
 tion of six new lessons. — Amer. Jour, of Obstel. 
 
 Extended mention of the contents of the 
 book is unnecessary ; suffice it to say that every 
 
 kind of a way. We wish every physician in 
 America could read and carry out the sugges- 
 tions of the chapter on "the sexual relations 
 as causes of uterine disorders — conjugal onan- 
 ism and kindred sins." The department treat- 
 ing of nervous counterfeits of uterine diseases 
 is a most valuable one.— Kansas City Medical 
 Index. 
 
 GUBBNSBY 
 
 Plain Talks on Avoided Subjects. 
 
 By Henry N. Guernsey, M.D., formerly Professor of Materia Medica 
 and Institutes in the Hahnemann Medical College of Philadelphia; 
 author of Guernse3''s " Obstetrics," including the Disorders Peculiar to 
 Women and Young Children ; Lectures on Materia Medica, etc. The 
 following Table of Contents shows the scope of the book : 
 
 Contents. — Chapter I. IntrodTictory. II. The Infant. III. Child- 
 hood. IV. Adolescence of the Male. Y. Adolescence of the Female. 
 YI. Marriage: The Husband. YII. The Wife. YIII. Husband and 
 Wife. IX. To the Unfortunate. X. Origin of the Sexes. In one neat 
 16mo volume, bound in Extra Cloth. 
 
 Price, post-paid, in the United States and Canada, $1.00; Great Britain, 6s. ; 
 
 France, 5 fr. 20. 
 
 KEATING 
 
 Record-Book of Medical Examinations 
 
 For Life-insurance. 
 
 Designed by John M. Keating, M.D. 
 
 This record-book is small, compact, complete, and embraces all the 
 principal points that are required by the different companies. It is made 
 in two sizes, viz. : No. 1, covering one hundred (100) examinations, and 
 No. 2, covering two hundred (200) examinations. The size of the book 
 is 7x3| inches, and can be conveniently carried in the pocket. 
 
 U. S. and Canada. Great Britain. Franc'e. 
 
 No. 1. For 100 Examinations, in Cloth, - - $ .50, net 3s. 6d. 3 fr. 60 
 
 No. 2. For 200 Examinations, in Full 
 
 Leather, with Side Flap, .... 1.00, " 6s. 6 fr. 20 
 
 (9)
 
 Medical Publications of The F. A. Davis Co., Philadelphia. 
 
 SAJRB 
 
 Epilepsy: Its Pathology and Treatment. 
 
 Being an Essay to which was Awarded a Prize of Four Thousand 
 Francs by the Academie Royale de Medecine de Belgique, 
 
 December 31, 1889. 
 
 By HoBART Amort Hare, M.D. (Univ. of Penna.), B.Sc, Professor of Materia 
 Medlca and Therapeutics in the Jefferson Medical College, Phila. ; Physician to St. Agnes' 
 Hospital and to the Children's Dispensary of the Children's Hospital ; Laureate of the 
 Royal Academy of Medicine in Belgium, of the Medical Society of London, etc. ; Member 
 of the Association of American Physicians. 
 
 No. 7 in t?ie Physicimis' and Students' Ready-Reference Series. 12mo. 228 pages. 
 Neatly bound in Dark-Blue Cloth. 
 
 Price, post-paid, in United States and Canada, $1.25, net; Great Britain, 
 
 6s. 6d. ; France, 7 fr. 75. 
 
 views of the profession, and the subject is 
 pruned of the vast amount of superstition and 
 nonsense that generally obtains in connection 
 with epilepsy. — Medical Age. 
 
 The task of preparing the work must have 
 been most laborious, but we think that Dr. 
 Hare will be repaid for his efforts by a wide 
 appreciation of the work by the profession ; 
 for the book will be instructive to those who 
 have not kept abreast with the recent litera- 
 ture upon this subject. Indeed, the work is a 
 sort of dictionary of epilepsy— a reference 
 guide-book upon the subject. — Alienist and 
 Neurologist. 
 
 It is representative of the most advanced 
 
 Every physician who would get at the gist 
 of all that is worth knowing on epilepsy, and 
 who would avoid useless research among the 
 mass of literary nonsense which pervades all 
 medical libnaries, should get this work. — The 
 Sanitarian. 
 
 By the Sa^ne Author 
 
 Fever: Its Pathology and Treatment, 
 
 Being the Boylston Prize Essay of Harvard University for 1890. 
 Containing Directions and the Latest Information Con- 
 cerning THE Use of the So-Called Anti- 
 pyretics in Fever and Pain. 
 
 By HoBART Amory Hare, M.D. (Univ. of Penna.), B.Sc, etc., etc. 
 
 No. 10 in the Physicians' and Students' Ready -Refereivce Series. 12mo. Neatly bound 
 in Dark-Blue Cloth. 
 
 Illustrated with more than 2.5 new plates of tracings of various fever cases, showing 
 beautifully and accurately the action of the Antipyretics. Tlie work also contains .3.5 care- 
 fully prepared statistical tables of 249 cases showing the untoward effects of the antipyretics. 
 
 Price, post-paid, in the United States and Canada, $1.25, net; in Great 
 Britain, 6s. 6d. ; France, 7 fr. 75. 
 
 The author has done an able piece of work 
 in showing the facts as far as they are known 
 concerning the action of antipyrin, anti- 
 febrin, phenacetin, thallin, and salicylic acid. 
 
 The reader will certainly find the work one of 
 the most interesting; of its excellent group, 
 the Physiciatis' and Students'' Heady-Jte/er- 
 ence Series. — The Dosimetric Medical Review. 
 
 ivijsrs 
 
 Diseases of the IMose and Throat. 
 
 A Text-Book for Students and I*ractitioners. 
 
 By Horace F. Ivins, M.D., Lecturer on Laryngology and Otology in the Hahnemann 
 Medical College of Philadelphia ; Laryngological Editor of " The Journal of Ophthalmology, 
 Otology, and Laryngology " ; Member of the American Institute of Homoeopathy, of the 
 Homoeopathic Medical Society of the State of Pennsylvania, etc. 
 
 Royal Octavo, .507 Pages. With 139 Illustrations, Chiefly Original, includ- 
 ing Eighteen (18) colored figures from Drawings and Photographs of Anatomical Dissec- 
 tions, etc. 
 
 Price, in United States, Estra Cloth, $4.00, net; Half-Hussia, $5.00, net. 
 Canada (duty paid), Cloth, $4.i0, net ; Half-Eussia, $5.50, net. Qreat 
 Britain, Cloth, 22s. 6d. ; Sheep or Half-Eussia, 28s. France, Cloth, 
 24 fr. 60 ; Half-Russia, 30 fr. 30. 
 
 (10)
 
 Medical Publications of The F. A. Davis Co., Philadelphia. 
 
 MVinBKOPER 
 
 Age of the Domestic Animals. 
 
 Being a Complete Treatise on the Dentition of the Horse, Ox, 
 
 Sheep, Hoa, and Dog, and on the Various Other Means 
 
 OF Determining the Age of these Animals, 
 
 By Rush Shippen Huidekoper, M.D., Veterinarian (Alfort, France) ; Proftessor of 
 Sanitary Medicine and Veterinary Jurisprudeuce, American Veterinary College, New York ; 
 Late Dean of the Veterinary Department, University of Pennsylvania. 
 
 Royal Octavo, 225 pages, bound in Extra Cloth. Illustrated with 200 Engravings. 
 
 Price, post-paid, in the United States and Canada, $1.75, net; in Great 
 Britain, 10s. ; in France, 12 fr. 20. 
 
 This work presents a careful study of all that has been written on the subject from 
 the earliest Italian writers. The author has draAvn much valuable material from the ablest 
 English, French, and German writers, and has given his own deductions and opinions, 
 whether they agree or disagree with such investigators as Bracy Clark, Simonds (in Eng- 
 lish), Girard, Chauveau, Leyh, Le Coque, Goubaux, and Barrier (in German and French). 
 
 The literary execution of the book is very 
 satisfactory, the text is profusely illustrated, 
 and the student will find abundant means in 
 the cuts for familiarizing himself with the 
 various aspects presented hy the incisive 
 arches rturinp; the different "stages of life, 
 lllustr.itions do not always illustrate ; these 
 do. — Amer. Vet. Review. 
 
 Although written primarily for the veteri- 
 
 narian, this book will be of interest to the 
 dentist, physiologist, anatomist. and i)hysician. 
 Its wealth "of illustration and careful prepara- 
 tion are alike commendable. — Chicago Med. 
 Recorder, 
 
 It is profusely illustrated with 200 engrav- 
 ings, and the text forms a study well worth the 
 price of the book to every dental practitioner. 
 — Ohio Journal of Dental Sciences. 
 
 International System of Electro- 
 Therapeutics. 
 
 For Students, General Practitioners, and Specialists. 
 
 Chief Editor, Horatio R. Bigelow, M.D., Permanent Member of the American Med- 
 ical Association ; Fellow of the British Gynaecological Society ; Fellow of the American 
 Electro-Therapeutic Association ; Member of the Philadelphia Obstetrical Society; Member 
 of the Soci6te d'Electro-Th6rapie ; Author of " GynsEcological Electro-Therapeutics " and 
 " Familiar Talks on Electricity and Batteries," etc. Assisted by upward of Thirty Eminent 
 Specialists in Europe and America as Associate Editors. 
 
 The character of this work is such that the publishers confidently expect it will stand 
 unrivalled, and be the vade mecum of the profession, as well as the standard text-book in all 
 the colleges upon this important branch of medical science. 
 
 It will be handsomely and clearly printed, thoroughly illustrated with engravings, 
 colored drawings, and plates where these will elucidate the text, and at the close of the 
 volume there will be a full reference index. 
 
 Complete in One Royal Octavo Volume of Over 900 Pages. 
 
 Price, in United States, Estra Cloth, $5.50, net; Sheep, $6.50, net; Half- 
 Russia, $7.00, net. In Canada (duty paid). Cloth, $6.05, net; Sheep, 
 $7.15, net; Half-Russia, $7.70, net. In Great Britain, Cloth, 32s.; 
 Sheep, 37s. 6d. ; Half-Russia, 40s. In France, Cloth. 34 fr. 70. ; Sheep, 
 40 fr. 45 ; Half-Russia, 43 fr. 30. 
 
 Will be Publishes in September or October, 1893. 
 
 (11)
 
 ITedical Publications of The F. A. Davis Co.^ Philadelphia. 
 
 Journal of Laryngology, Rhinology, 
 
 and Otology. 
 
 An Analytical Record of Current Literature Relating to the 
 Throat, Nose, and Ear. Issued on the First of Each Month. 
 
 Edited by Dr. Norrvs Wolfenden, of London, and Dr. John Macinttre, of 
 Glasgow, with the active aid and co-operation of Drs. Dundas Grant, Barclay J. Baron, 
 and Hunter Mackenzie. Besides those specialists in Europe and America who have so 
 ably assisted in the collaboration of the Journal, a number of new coricspondents have 
 undertaken to assist the editors in keeping the Journal up to date, and furnishing it with 
 matters of interest. 
 
 Price, 13s. or $3.00 per annum, Strictly in Advance, Single copies. Is. 3d. 
 (30 Cents). Sample Copy, 25 Cents. 
 
 KEATING and EDWABDS 
 
 Diseases of the Heart and Circulation 
 
 In Infancy and Adolescence. With an ArpENDix Entitled 
 Studies on the PuLste in Childhood." 
 
 Clinical 
 
 By John M. Keating, M.D., Obstetrician to the Philadelphia Hospital, and Lecturer 
 on Diseases of Women and Children ; Surgeon to the Maternity Hospital ; Pliysician to St. 
 Joseph's Hospital ; Fellow of the College of Physicians of Philadelphia, etc. ; and 
 WiLi>iAM A. Edavards, M.D., Instructor in Clinical Medicine and Physician to the Med- 
 ical Dispensary in the University of Pennsylvania; Fellow of the College of Physicians; 
 formerly Assistant Pathologist to the Philadelphia Hospital, etc. 
 
 Illustrated by Photographs and VVood-Eugraviugs. About 225 pages. Octavo. 
 Bound in Cloth. 
 
 Price, post-paid, in the United States and Canada, $1.50, net; in Qreat 
 Britain, 8s. 6d. ; in France, 9 fr. 35. 
 
 Drs. Kcatinfi and Edwards have produced a 
 work that will give material aid to every 
 doctor in his practice among children. The 
 style of the book is graphic and pleasing, the 
 diagnostic points are explicit and exact, and 
 the therapeutical resources include the novel- 
 ties of medicine as well as the old and tried 
 agents. — Pittsburgh Med. Review. 
 
 It is not a mere compilation, but a systematic 
 treatise, and bears evidence of considerable 
 labor and observation on the part of the 
 authors. Two fine photographs of dissections 
 exhibit mitral stenosis and mitral regurgita- 
 tion; there are also a number of wood-cuts. 
 —Cleveland Medical Gazette. i 
 
 LIEBIG and BOHE 
 
 Practical Electricity in Medicine ^ Surgery. 
 
 By G. A. LiEBiG, Jr., Ph.D., Assistant in Electricity, Johns Hopkins University; 
 Lecturer on Medical Electricity, College of Physicians and Surgeons, Baltimore; Member 
 of the American Institute of Electrical Engineers, etc. ; and George H. Rome, M.D., Pro- 
 fessor of Obstetrics and Hygiene, College of Physicians and Surgeons, Baltimore ; Visiting 
 Physician to Bay View and City Hospitals ; Director of the Maryland Maternite ; Associate 
 Editor " Annual of the Universal Medical Sciences," etc. 
 
 Profusely illustrated by Wood-Engravings and Original Diagrams, and published in 
 one Royal Octavo volume of 383 pages, bound in Extra Cloth. 
 
 Price, post-paid, in the United States and Canada, $2.00, net; in Great 
 Britain, Us. 6d. ; in France, 12 fr. iO. 
 
 Any physician, especially if he be a beginner 
 in electro-therapeutics, will be well repaid by 
 a careful study of this work by I>iebig and 
 Robe. For a work on a special subject the 
 price is low, and no one can give a good ex- 
 cuse for remaining in ignorance of so impor- 
 tant a subiect as electricity in medicine. — 
 Toledo Medical and Surgical Reporter. 
 
 The entire work is thoroughly scientific and 
 practical, and is really what the authors have 
 aimed to produce, "a trustworthy guide to 
 the apphcation of electricity in the practice of 
 
 medicine and surgery."— iVew York Medical 
 Times. 
 
 In its perusal, with each succeeding page, 
 we have been more and more impressed with 
 the fact that here, at last, we have a treatise 
 on electricity in medicine and surgery which 
 amply fulfills its purpose, and which is sure of 
 general adoption by reason of its thorough 
 excellence and superiority to other works in- 
 tended to cover the same ^eld.— Pharmaceu- 
 tical Era. 
 
 (12)
 
 Medical Publications of The P. A. Davis Co., Philadelphia. 
 
 ' MASSBY 
 
 Electricity in the Diseases of Women. 
 
 With Special Reference to the Application of Strong Currents. 
 
 By G. Retton Masset, M.D., Pliysician to the Gynaroloffiral Department 
 of the Howard Hospital ; hxte Electro-therapeutist to the'Philadelpliia Ortliopivdic 
 Hospital and Infirmary for Nervous Diseases, etc. Second Edition. Revised 
 and Enlarged. With New and Original Wood-Engravings. Handsomely hound 
 in Dark-Blue Cloth. 240 pages. "iSnio. No. 5 in the Physicians' and Students' 
 Ready -Refer en re Series. 
 
 This work is presented to the profession as the most complete treatise yet 
 issued on the electrical treatment of the diseases of women, and is destined to 
 fill the increasing demand for clear and practical instruction in the handling and 
 use of strong currents after the recent methods first advocated by Apostoli. The 
 whole subject is treated from the present stand-point of electric science 'with new 
 and original illustrations, the thorough studies of the author and his wide clinical 
 experience rendering him an authority upon electricity itself and its therapeutic 
 applications. The author has enhanced the practical value of the work by 
 including the exact details of treatment and results in a number of cases taken 
 from his private and hospital practice. 
 
 Price, post-paid, in the United States and Canada, $1.50, net; in Great 
 Britain, 8s. 6d. ; in France, 9 fr. 35. 
 
 A new edition of tliis practical manual at- 
 tests the utility of its existence and the recog- 
 nition of its merits. The directions are simple, 
 easy to follow and to put into practice ; the 
 ground is well covered, and nothing is assumed, 
 the entire book being the record of ex\>e- 
 rience.— Journal of JVervous and Mental 
 Diseases. 
 
 It is only a few months since we noticed the 
 first edition of this little book ; and it is only 
 necessary to add now that we consider it the 
 
 best treatise on this subject we have seen, and 
 that the improvements introduced into this 
 edition make it more valuable still. — Boston 
 Medical and Surgical Journ. 
 
 The style is clear, but condensed. Useless 
 details are omitted, the reports of cases being 
 pruned of all irrelevant material. The book 
 is an exceedingly valuable one, and represents 
 an amount of study and experience which is 
 only appreciated after a careful reading.— 
 Medical Record. 
 
 Pliysicians' Interpreter. 
 
 In Four Languages (English, French, German, and Italian). 
 Specially Arranged for Diagnosis by M. von V. 
 
 The object of this little work is to meet a need often keenly felt by the 
 busy, physician, namely, the need of some quick and reliable method of com- 
 municating intelligibly with patients of those nationalites and languages unfa- 
 miliar to the practitioner. The plan of the book is a systematic arrangement of 
 questions upon the various branches of Practical Medicine, and each question is 
 so worded that the only answer required of the patient is merely Yes or No. 
 The questions are all numbered, and a complete Index renders them always 
 available for quick reference. The book is written by one who is well versed in 
 English, French, German, and Italian, being an excellent teacher in all those 
 languages, and who has also had considerable hospital experience. Bound in 
 Full Russia Leather, for carrying in the pocket. Size, 5x2f inches. 200 pages. 
 
 Price, post-paid, in the United States and Canada, $1.00, net; in Great 
 Britain, 6s. ; in France, 6 fr. 20. 
 
 difficulty in dealing with foreign-speaking 
 people, who are constantly coiBing into nur 
 city hospitals.— iN^'ew York'MedicalJournal. 
 
 Many other books of the same sort, with 
 more extensive vocabularies, have been pub- 
 lished, but, from their size, and from their 
 being usually devoted to equivalents in Eng- 
 lish and one other language only, they have 
 not had the advantage which is pr'e-emiiient in 
 this — convenience. It is handsomely printed, 
 and bound in flexible red leather in the form 
 of a diary. It would scarcely make itself felt 
 hi one's hip-pocket, and vrould insure its 
 bearer against any ordinary conversational 
 
 This little volume is oiio of the most inge- 
 nious aids to the physician which we have 
 seen. We heartily commend tlie book to any 
 one who, being without a knowledge of the 
 foreign languages, is obliged to treat those 
 who do not know our own language. — St. Louii 
 Courier of Medicine. 
 
 (13)
 
 Medical Publications of The F. A. Davis Co.. Philadelphia. 
 
 The Medical Bulletin Visiting-List or 
 Physicians' Call Record. 
 
 a.rranged upon an original and convenient monthly and weekly 
 Plan for the Daily Recording of Professional Visits. 
 
 Frequent Rewriting of Names Unnecessary. 
 
 THIS Visiting-List is arranged so thai the names of patients need be written 
 but ONCE a montji instead of four times a mouth, as in the old-style lists. 
 By means of a new feature, a simple device consisting of stub or half 
 LEAVES IN THE FORM OP INSERTS, the first Week's visits are recorded in the usual 
 way, and the second week's visits are begun by simply turning over the half-leaf 
 without the necessity of rewriting the patients' names. This very easily under- 
 stood process is repeated until the mouth is ended and the i-ecord has been kept 
 complete in every detail of visit, charge, credit, etc., and the labor and time 
 of entering and transferring names at least three times in the month has been 
 saved. There are no intricate rulings ; not the least amount of time can be lost 
 iu comprehending the plan, for it is acquired at a glance. 
 
 THE THREE DIFFERENT STYLES MADE. 
 
 The No. 1 Style of this List provides space for the daily record of seventy 
 diflferent names each month for a year ; for physicians who prefer a List that will 
 accommodate a larger practice we have made a No. 2 Style, which provides 
 space for the daily record of 105 different names each mouth for a year, and for 
 physicians who may prefer a Pocket Record-Book of less thickness than either of 
 these styles we have made a No. 3 Style, in which "The Blanks for the Record- 
 ing of Visits in " have been made into removable sections. These sections are 
 very thin, and are made up so as to answer iu full the demand of the largest 
 practice, each section providing ample space for the daily record of 210 dif- 
 ferent names for two months ; or 105 different names daily each month for four 
 months; or seventy different names daily each month for six mouths. Six sets 
 of these sections go with each copy of No. 3 Style. 
 
 SPECIAL FEATURES NOT FOUND IN ANY OTHER LIST. 
 
 In this No. 3 Style the printed matter, and such matter as the 
 blank forms for Addresses of Patients, Obstetric Record, Vaccination 
 Record, Cash Account, Birth and Death Records, etc., are fastened perma- 
 nently in the back of the book. The addition of a remov^able section does 
 not increase the thickness more than an eighth of an inch. This brings the 
 book into such a small compass that no one can object to it on account of 
 its thickness, as its bulk is very much less than that of any visiting-list 
 ever published. Every physician will at once understand that as soon as a 
 section is full it can be taken out, filed away, and another inserted without the 
 le<ist inconvenience or trouble. Extra or additional sections will be furnished at 
 (f^y time for 15 cents eacJt or ^1.75 per dozen. This Visiting-List contains calen- 
 dars, valuable miscellaneous data, important tables, and other useful printed 
 matter usually placed in Physicians' Visiting-Lists. 
 
 Physicians of many years' standing and with large practices pronounce it 
 THE Best List they have ever seen. It is handsomely bound in fine, strong 
 leather, with flap, including a pocket for loose memoranda, etc., and is furnished 
 with a Dixon lead-pencil of excellent quality and finish. It is compact and cou- 
 venient for carrying in the pocket. Size, 4 x 6| inches. 
 
 Iisr TH:I5.e:E ST-X1^ES- net prices. 
 
 No. 1. Regular size, to accommodate 70 patients daily each month for one year, . . . S1.25 
 
 No. %. Large size, to accommodate 105 patients daily each month for one year, .... $1.60 
 
 No. 3. In which the " Blanlcs for Recording Visits in" are in removable sections, . . . SI. 75 
 
 Special Edition for Great Britain, without printed matter, 48. 6d. 
 
 M, B.—The Recording of Visits In this List may be Commenced at any time during the Year. 
 
 (14)
 
 Medical Publications of The F. A. Davis Co., Philadelphia. 
 
 MICHENBB 
 
 II I r^ I t* w- t • OI^' NOXRS ABiD CASES 
 
 Hand-Book of Eclampsia ; ^^ rrKR^KRAi. 
 
 By E. MicHENEU, M.D. ; J. H. Stubbs, M.D. ; R. B. Ewing, M.D. ; B. Tuompson, 
 M.D. ; S. Stebbins, M.D. 16mo. Cloth. 
 
 Price, 60 cents, net ; in Great Britain, Is. 6d. ; in France, 1 fr. 20. 
 
 NISSBN 
 A MANUAL OF INSTRUCTION FOR GIUING 
 
 Swedish Movement ^ Massage Treatment 
 
 By Prof. Hartvig Nissen, late Director of the Swedish Health Institute, Wash- 
 ington, D.C.; late instructor in Physical Culture and Gymnastics at the Johns Hopkins 
 University, Baltimore, Md. ; Instructor of Swedish and German Gymnastics at Harvard 
 University's Sununer School, 1891, etc., etc. 
 
 This excellent little volume treats this very important subject in a practical manner. 
 Full instructions are given regarding the mode of applying the Swedish Movement and 
 Massage Treatment in various diseases and conditions of the human system with tlie 
 greatest degree of effectiveness. This book is indispensable to every physician who wishes 
 to know how to use these valuable handmaids of medicine. 
 
 Illustrated with 39 Original Wood-Engravings. In one 12mo volume of 128 Pages. 
 Neatly bound in Cloth. 
 
 Price, post-paid, in the United States and Canada, $1.00, net; in Great 
 Britain, 6s. ; in France, 6 fr. 20. 
 
 The present volume is a modest account of 
 the application of the Swedish Movement and 
 Massage Treatment, in which the technique 
 of the various procedures are clearly stated as 
 well as illustrated in a very excellent manner. 
 — North American Practitioner. 
 
 This manual is valuable to the practitioner, 
 as it contains a terse description of a subject 
 but too little luiderstood in this country. . . 
 The biiok is got up very creditably. — N. Y. 
 Med. Journal. 
 
 SAJOVS 
 
 %t w\\t E^ETltPn ^^^ '^^ Successful Treatment by Superficial 
 MMY rtiV/lLr% Organic Alteration of the ]Kasal 
 
 Mucous membrane. 
 
 By Charles E. Sajous, M.D., formerly Lecturer on Rhinology and Laryngology in 
 Jeflferson Medical College ; Chief Editor of the Annual of the Universal Medical Sciences, 
 etc. With 13 Engravings on Wood. 103 pages. 12mo. Bound in Cloth, Beveled Edges. 
 
 Price, post-paid, in the United States and Canada, $1.00, net; in Great 
 Britain, 6s. ; in France, 6 fr. 20. 
 
 SANNE 
 
 A Treatise on Diphtheria, Croup, 
 
 Tracheotomy, and Intubation. 
 
 Historically and Practically Considered. 
 
 By A. Sanne, Docteur en M6decine, ancien des Hopitaux de Paris, etc., etc. Trans- 
 lated, Annotated, and the Surgical Anatomy added by Henky Z. Gill, M.D., LL.D., late 
 Professor of Surgery in Cleveland, Ohio. 
 
 Facing the title-page is found a very fine Colored Lithograph Plate of the parts con- 
 cerned in Tracheotomy. Next follows an illustration of a cast of the entire Trachea and 
 Bronchi to the third or fourth division, in one piece, taken from a photograph of a case in 
 which the cast was expelled during life from a patient sixteen years old. This is the most 
 complete cast of any one recorded. There are also over fifty other illustrations in the work, 
 a full Index, and a List of Authors, making a very handsome octavo volume of over 080 
 pages. 
 
 United States. Canada (duty paid). Great Britain. France. 
 
 Price, post-paid, Cloth, $4.00, net $4.10, net 22s. 6d. 24 fr. 60 
 
 '' " Leather, 5.00 " 5.50 " 28s. 30 fr. 30 
 
 (15)
 
 Medical Publications of The F. A. Davis Co., Philadelphia. 
 
 Physician's All-Requisite Time- and Labor- 
 Saving Account-Book. 
 
 Being a Ledger and Account-Book for Physicians' Use, Meetipw 
 ALL THE Requirements of the Law and Courts. 
 
 Designed by William A. Seibert, M.D., of Easton, Pa. 
 
 Probably no class of people lose more money through carelessly kept 
 accounts and overlooked or neglected bills than physicians. Often detained at 
 the bedside of the sick until late at night, or deprived of even a modicum of rest, 
 it is with great difficulty that he spares the time or puts himself in condition to 
 give the same care to his own financial interests that a merchant, a lawyer, or 
 even a farmer devotes. It is then plainly apparent that a system of bookkeeping 
 and accounts that, without sacrificing accuracy, but, on the other hand, ensuring 
 it, at the same time relieves the keeping of a physician's book of half their 
 complexity and two-thirds the labor, is a convenience which will be eagerly 
 welcomed by thousands of overworked phj^sicians. Such a system has at last 
 been devised, and we take pleasure in offering it to the profession in the form of 
 The Physician's All-Requisite Time- and Labor- Saving Account-Book. 
 
 There is no exaggeration in stating that this Account-Book and Ledger 
 reduces the labor of keeping your accounts more than one-half, and at the same 
 time secures the greatest degree of accuracy. AVe may mention a few of the 
 superior advantages of The Physician's All-Requisite Time- and Labor- Saving 
 Account-Book, as follows : — 
 
 First — Will meet all the requirements 
 of the law and courts. 
 
 Second — Self-explanatory ; no cipher 
 code. 
 
 Third — Its completeness without sacri- 
 ficing anything. 
 
 Fourth — No posting ; one entry only. 
 
 Fifth — Universal ; can be commenced at 
 any time of the year, and can be 
 continued indefinitely until every 
 account is filled. 
 
 Sixth — Absolutely no waste of space. 
 
 Seventh — One person must needs be 
 sick every day of the year to fill 
 his account, or might be ten years 
 about it and require no more than 
 the space for one account in this 
 ledger. 
 
 Eighth — Double the number and many 
 times more than the number of ac- 
 
 counts in any similar book ; the 
 300-page book contains space for 
 900 accounts, and the 600-page' 
 book contains space for 1800 ac- 
 counts. 
 
 Ninth — There are no smaller spaces. 
 
 Tenth — Compact without sacrificing 
 completeness ; every account com- 
 plete on same page — a decided ad- 
 vantage and recommendation. 
 
 Eleventh — Uniform size of leaves. 
 
 Twelfth — The statement of the most 
 complicated account is at once be- 
 fore j^ou at any time of month or 
 year — in other words, the account 
 itself as it stands is its simplest 
 statement. 
 
 Thirteenth — No transferring of accounts, 
 balances, etc. 
 
 To all physicians desiring a quick, accurate, and comprehensive method of 
 keeping their accounts, we can safely say that no book as suitable as this one has 
 ever been devised. A descriptive circular showing the plan of the book will be 
 sent on application. 
 
 NET PRICES, SHIPPING EXPENSES PREPAID. 
 
 No. 1. 300 Pages, for 900 Accounts per Year, 
 
 Size 10^12, Bound in ^-Eussia, Raised 
 
 Back Bands, Cloth Sides, 
 No. 2. 600 Pages, for 1800 Accounts per Year, 
 
 Size 10zl2, Bound in ^-Russia, Eaised 
 
 Back-Bands, Cloth Sides, 
 
 (16) 
 
 
 Canada 
 
 Great 
 
 
 In U. S. 
 
 (duty paid). 
 
 Kritain. 
 
 France. 
 
 $5.00 
 
 $5.50 
 
 28s. 
 
 30 fi-. 30. 
 
 8.00 
 
 S.80 
 
 42s. 
 
 49 fr. 40
 
 Medical Publications of The F. A. Davis Co., Philadelphia. 
 
 PRICE mid EAGLETON 
 
 Three Charts of the Nervo-Uascular System. 
 
 Part I. — The Nerves. Part II. — The Arteries. 
 Part III. — The Veins. 
 
 A New Edition, Revised and Peifecled. Arranged by W. Henky Price, 
 M.D., and S. Potts Eagleton, M.D. Endorsed by leading anatomists. Clearly 
 Rnd beautifully printed upon extra durable paper. 
 
 PART I. Tlie Nerves Givos in a clear form not only the Cranial and Spinal Nerves, show- 
 ing the formation of the ditfeient Plexuses and their branches, but afco tlie complete 
 distribution of the Hympatiibjtic Nkuvks. 
 
 I'AKT II. The Arteries.— (jives a unifiue groui)ing of the Arterial system, showing the 
 divisions and subdivisions of all tlie vessels, l)eginning from the heart and tracing their 
 CONTINUOUS distribution to the periphery, and showing at a glance the terminal 
 branches of each artery. 
 
 PART III. The Veins.— Shows bow the blood frcm the periphery of the body is gradually 
 collected by the larger veins, and tliese coalescing forming stiil larger vessels, until they 
 finally trace themselves into the Right Auricle of the heart. 
 
 It is therefore readily seen that "The Kervo-Vascular System of Charts " 
 offers the following superior advantages : — 
 
 1. It is the o^nly arrangement which combines the Three Systems, and j^et 
 each is perfect and distinct in itself. 
 
 3. It is the only instance of the Cranial, Spinal, and Sympathetic Nervous 
 Sj^stems being represented on one chart. 
 
 3. From its neat size and clear type, and being printed only upon one side, 
 it may be tacked up in any convenient place, and is always ready for freshening 
 up the, memory and reviewing for examination. 
 
 Price, post-paid, in United States and Canada, 50 cents, net, complete ; in 
 Great Britain, 3s. 6d. ; in France, 3 fr. 60. 
 
 For the student of .anatomy there can pos- 
 silily be no more concise way of acquiring a 
 knowledge of the nerves, veins, and arteries 
 of the human system. It presents at a glance 
 their trunks and branches in the gre.at divis- 
 ions of the body. It will save a world of tedi- 
 ous reading, and will impress itself on the 
 mind as no ordinary vade mecuni, even, could. 
 
 Its price is nominal and its value inestimable. 
 No student should be without it.— Pacific 
 Record of Medicine and Surgery. 
 
 These are three admirably arranged charts 
 for the use of students, to assist in memor- 
 izing their anatomical sudies. — Buffalo Med, 
 and Surg. Jour. 
 
 JPURDY 
 
 Diabetes: Its Cause, Symptoms ani^ Treatment 
 
 By Chas. W. Purdy, M.D. (Queen's University), Honorary Fellow of tlie 
 Royal College of Physicians and Surgeons of Kingston ; Member of the College 
 of Physicians and Surgeons of Ontario ; Author of "Bright's Disease and Allied 
 Affections of the Kidneys ;" Member of the Association of American Physicians ; 
 Men^ber of the American Medical Association ; Member of the Chicago Academy 
 of Sciences, etc. 
 
 Contents.— Section I. Historical, Geographical, and Climatological Con- 
 siderations of Diabetes Mellitus. II. Physiological and Pathological Considera- 
 tions of Diabetes ]\Iellitns. III. Etiology of Diabetes Mellitus. IV. Morbid 
 .A na,,omy of Diabetes Mellitus. V. Symptomatology of Diabetes Mellitus. VI. 
 Treatment of Diabetes Mellitus. VII. Clinical Illustrations of Diabetes Mellitus. 
 VIII. Diabetes Insipidus ; Bibliography. 
 
 l3mo. Dark Blue Extra Cloth. Nearly 200 pages. 
 
 No. S in the PItysieians' and Students' Re ndy -Reference Series. 
 
 Price, post-paid, in the United States and Canada, $1.25, net; in Great 
 Britain, 6s. 6d. ; in France, 7 fr. 75. 
 
 This will prove a most entertaining as well 
 ns most interesting treatise upon a disease 
 M'hich frequently falls to the lot of every 
 practitioner. The work b.as been written with 
 a special view of bringing out the featuies of 
 tlie disease ;>s it occurs in the United States. 
 The author lias very judiciously arr.anged the 
 little volume, and it will offer inany pleasant 
 attractions to the practitioner.— A' as/ii'i7k' 
 Journal of Medicine and Surgery. 
 
 While many monographs have been pub- 
 
 lished which have dealt with the subject of 
 diabetes, we know of none which so thoroughly 
 considers its relations to the geographical 
 conditions which exist in the United States, 
 nor which is more complete in its summary of 
 the symptomatology .and treatment of tliis 
 ail'ection. A number of tables, sliowing the 
 Iterccntageof sugar in .a very large numl>er of 
 alcobolii! beverages, adds very considerably to 
 the value of the work.— il/edicai News. 
 
 (17)
 
 Medical Publications of The F. A. Davis Co., Philadelphia. 
 
 History of Circumcision. 
 
 From the Earliest Times to the Present. Moral and Physical 
 Reasons for its Performance ; with a History of Eunuchism, 
 Hermaphrodism, etc, and of the Different Opera- 
 tions Practiced upon the Prepuce. 
 
 By P. C. RemondinO; M.D. (Jefferson), Member of the American Med- 
 ical Association ; of the American Puljlic Health Association ; Vice- 
 President of California State Medical Society and of Southern California 
 Medical Society, etc. 
 
 In one neat 12nio volume of 346 pages. Handsomely bound in Extra 
 Dark-Bine Cloth, and illustrated with two fine wood-engravings, showing 
 tlie two principal modes of Circumcision in ancient times. No. 11 in the 
 Physicians'' and Students'' Ready-Reference Series. 
 
 Price, post-paid, in United States and Canada, $1.25, net; in Great Britain, 
 
 6s. 6d. ; in France, 7 fr. 75. 
 A Popular Edition (unabridged), bound in Paper Covers, is also issued. Price, 
 
 50 Cents, net ; in Great Britain, 3s. ; in France, 3 fr. 60. 
 
 Every physician should read this book; he will there find, in a 
 condensed and systematized form, what there is known concerning 
 Circumcision. The book deals with simple facts, and it is not a disserta- 
 tion on theories. It deals, in plain, pointed language, with the relation 
 that the prepuce bears to physical degeneracy and disease, bases all its 
 utterances on what has occurred and on what is known. The author has 
 here gathered from every source the material for his subject, and the 
 deductions are unmistakable. 
 
 This is a very full and readable book. To 
 the reader wlio wishes to know all about 
 the antiquity of the operation, with the views 
 jyro and con "of the riglit of this appendage to 
 exist, its advantages, dangers, etc., this is the 
 book. — T7ie Southern Clinic. 
 
 The oi^erative chapter will be particu- 
 larly useful and interesting to physicians, as 
 it contains a careful and impartial review of 
 all the operative procedures, from the most 
 
 simple to the most elaborate, paying particular 
 attention to the subject of after-dressings. It 
 is a very interesting and instructive work, and 
 should "be read very liberally by the profes- 
 sion. — The Med. Brief. 
 
 The author's views in regard to circum- 
 cision, its necessity, and its results, are well 
 founded, and its performance as a prophylactic 
 measure is well established. — Columbus Med. 
 Journal. 
 
 JBy the Same Author 
 
 The IVIediterranean Shores of America. 
 
 Southern California : Its Climatic, Physical, and Meteorological 
 
 Conditions. 
 
 By P. C. Remondino, M.D. (Jefferson), etc. 
 
 Complete in one handsomel}^ printed Octavo volume of nearly 1*75 
 pages, with 45 appropriate illustrations and 2 finely executed maps of 
 the region, showing altitudes, ocean currents, etc. Bound in Extra Cloth. 
 
 Price, post-paid, in United States and Canada, $1.25, net; in Great Britain, 
 
 6s, 6d. ; in France, 7 fr. 75. 
 Cheaper Edition (unabridged), bound in Paper, post-paid, in United States and 
 
 Canada, 75 Cents, net ; in Great Britain, 4s. ; in France, 5 fr. 
 
 Italy, of the Old World, does not excel nor even approach this region 
 in point of saluln-ity of climate and all-around healthfulness of environ- 
 ment. This book full}' describes and discusses this wonderfully charming 
 countr}'. The medical profession, who have long desired a trustworthy 
 treatise of true scientific value on this celebrated region, will find in this 
 volume a satisfactory response to this long-felt and oft-expressed wish. 
 
 (18)
 
 Medical Publications of The F. A. Davis Co., Pliiiadelpkia. 
 
 MOHB 
 
 Text-Book of Hygiene. 
 
 A Comprehensive Treatise on the Principles and Practice of 
 Preventive Medicine from an American Stand-point. 
 
 By George H. Roh6, M.D',, Professor of Obstetrics and Hygiene in 
 the College of Physicians and Surgeons, Baltimore ; Member of the 
 American Public Health Association, etc. 
 
 Eveiy Sanitarian should have Roh^'s " Text-Book of H3'giene " as a 
 work of reference. 
 
 Second Edition, thoroughly revised and largely rewritten, with 
 many illustrations and valuable tables. In one handsome Ro^-al Octavo 
 volume of over 400 pages, bound in Extra Cloth. 
 
 Price, post-paid, in United States, $2.50, net ; Canada (duty paid), $2.75, 
 net ; Great Britain, Hs. ; France, 16 fr. 20. 
 
 One prominent feature is tliat there are no 
 superfluous words ; every sentence is direct 
 to tlie point sought. It is, therefore, easy 
 reading, and conveys very much information 
 in little space.— 27ie Pacific Record of Medi- 
 cine and Surgery. 
 
 It is unquestionably a woi"k that should be 
 in the hands of every physician in the country, 
 and medical students will find it a most excel- 
 lent and valuable text-book. — The Southern 
 Practitioner. 
 
 The first edition was rapidly exhausted, and 
 the book justly became an authority to physi- 
 cians and sanitary officers, and a text-book 
 very generally adopted in the colleges through- 
 out America. The second edition is a great 
 
 improvement over the first, all of the matter 
 being thoroughly revised, much of it being 
 rewritten, and many additions being made. 
 The size of the l)ook is increased one hundred 
 pages. The book has the original recommenda- 
 tion of being a handsomely-liound, clearly- 
 printed octavo volume, profusely illustrated 
 with reliable references for every branch of 
 the subject mutter.— Medical Record 
 
 The wonder is how Professor Roh^ has made 
 the book so readable and entertaining with so 
 much matter necessarily condensed. Alto- 
 
 f ether, the manual is a good exponent of 
 ygiene and sanitary science from the present 
 American stand-point, and will repay with 
 pleasure and profit any time that may be given 
 to its perusaL — University Medical Magazine. 
 
 Hy the Same Author 
 
 A Practical Manual of Diseases 
 of the Skin. 
 
 By George H. Rome, M.D., Professor of Materia Medica, Thera- 
 peutics, and Hygiene, and formerly Professor of Dermatology in the 
 College of Ph3^sicians and Surgeons, Baltimore, etc., assisted b}- J. 
 Williams Lord, A.B., M.D., Lecturer on Dermatology and Bandaging 
 in the College of Physicians and Surgeons ; Assistant Phj'sician to the 
 Skin Department in the Dispensary of Johns Hopkins Hospital. 
 
 In one neat 12mo volume of over 300 pages, bound in Extra Dark-Blue 
 Cloth. No. 13 in the Physicial .s^ and Students'' Beady- Reference Series. 
 
 Price, post-paid, in the United States and Canada, $1.25, net; in Great 
 Britain, 6s. 6d. ; in France, 7 fr. 75. 
 
 The PRACTICAL character of this work makes it spec i all}' desirable 
 for the use of students and general practitioners. 
 
 The nearly one hundred (100) reliable and carefully prepared For- 
 mulae at tlie end of the volume add not a little to its practical value. 
 
 All the various forms of skin diseases, from Acne to Zoster (alpha- 
 betically speaking), are succinctly j-et amply treated of, and the arrange- 
 ment of the book, with its excellent index and unusually full table of 
 contents, goes to make up a truly satisfactory volume for ready reference 
 in daily practice. 
 
 (19>
 
 Medical Publications of The F. A. Davis Co., Philadelphia. 
 
 SBNN 
 
 Principles of Surgery. 
 
 By N. Senn, M.D., Ph.D., Professor of Practice of Surgery and Clinical Surgery in 
 Rush Medical College, Chicago, 111. ; Professor of Surgery in the Chicago Polyclinic ; At- 
 tending Surgeon to the Milwaukee Hospital ; Consulting Surgeon to the Milwaukee County 
 Hospital and to the Milwaukee County Insane Asylum. 
 
 This work, by one of America's greatest surgeons, is thoroughly complete ; its 
 clearness and brevity of statement are among its conspicuous merits. The author's long, 
 able, and conscientious researches in every direction in this important field are a guarantee, 
 of unusual trustworthiness, that every branch of the subject is treated authoritatively, and 
 in such a manner as to bring the greatest gain in knowledge to the practitioner and student. 
 
 In one Royal Octavo volume, with 109 fine Wood-Engravings and 624 pages. 
 
 Price, in Cloth, 
 " Sheep or i-PwUssia, 
 
 United States. 
 
 $150, net 
 5.50 " 
 
 Canad.-i (duty paid). 
 
 $5.00, net 
 6.10 " 
 
 Great Britaiti. 
 
 Ziz. 6d. 
 30s. 
 
 France. 
 
 27 fr. 20 
 33 fr. 10 
 
 Stephen Smith, M.D., Professor of Clin- 
 ical Snrgjery Medical Department University 
 of the City of New York, writes : " There has 
 long been great need of a work on tlie prin- 
 ciples of surgery which would fully illustrate 
 the present advanced state of knowlede of the 
 various subjects embraced in this volume. 
 The work seems to me to meet this want 
 admirably." 
 
 Frank J. Lutz, M.D., St. Ijouis, Mo., says : 
 " It seems incredible that those who pretend 
 to teach have done without such a guide 
 before, and I do not understand how our stu- 
 dents succeeded in mastering the principles of 
 modern surgery by attempting to read our 
 obsolete text-books. American surgery should 
 feel proud of the production, and the present 
 generation of surgeons owe you a debt of 
 gratitude." 
 
 The work is systematic and compact, without 
 a fact omitted or a sentence too much, and it 
 
 not only makes instructive but fascinating 
 reading. A conspicuous merit of Senn's work 
 is his method, his persistent and tireless search 
 through original investigations for additions 
 to knowledge, and the practical character of 
 his discoveiie.s.— 77ie Jieview of Insanity and 
 Nervous Diseases. 
 
 After perusing this work on several different 
 occasions, we have come to the conclusion that 
 it is a remarkable work, bv a man of unusual 
 ability. — HVie Canada Medical Jiecord. 
 
 The work is exceedingly jiractical, as the 
 chapters on the treatment "of the various con- 
 ditions considered are based on sound deduc- 
 tions, are complete, and easily carried out by 
 any painstaking surgeon. — Medical liecord. 
 
 The book throughout is worthy of the 
 highest praise. It should be adopted as a 
 text-book in all of our schools. — University 
 Medical Magazine. 
 
 By the Same Author 
 
 Tuberculosis of the Bones and Joints. 
 
 By N. Senn, M.D., Ph.D. 
 
 Illustrated with upwards of Que Hundred (100) Engravings and Plates, many of them 
 colored. Royal Octavo. Over 500 pages. 
 
 Price, Estra Cloth, 
 " Sheep or ^-Russia, 
 
 United States. Canada (duty paid). Great Britain. France. 
 
 $100, net $140, net 22s. 6i 24 fr. 60 
 
 5.00 " 5.50 " 28s. 30fr. 30 
 
 To get an idea of the scope of the work read the following titles of chapters : History. 
 Proofs which Establish the Tubercular Nature of the So-called Strumous Disease of Bones 
 and Joints. Bacillus Tuberculosis. Histology of Tubercle. Histogenesis of Tubercle. Casea- 
 tion. Tubercular Abscess. Topography of Bone and Joint Tuberculosis. Bone Tuberculosis. 
 Etiology of Bone Tuberculosis. Symptoms and Diagnosis of Tubercular Bone Affections. 
 Prognosis of Tvibercular Disease of Bone. Treatment of Tuberculosis of Bone. Tuberculosis 
 of Joints. Special Points in the Pathology of Synovial Tuberculosis. Etiology ; Symptoms 
 and Diagnosis, Prognosis. Treatment of Tuberculosis of Joints. Local Treatment. Tuberculin 
 Treatment. Treatment of Tubercidosis of Joints by Parenchymatous and Intra-articular 
 Injections. Operative Treatment. Resection. Atypical and Typical Resection. Immediate 
 and Remote Results of Resection. Amputation. Post-Operative Treatment. Tuberculosis 
 of Special Bones. Tubercidosis of the Bones of the Trunk. Tuberculosis of Pelvic Bones, 
 Scapula, Clavicle, Sternum, and Ribs. Tuberculosis of Joints of Upper Extremity. Tuber- 
 culosis of Hip-Joint. Tuberculosis of Knee-Joiut. Tuberculosis of Ankle-Joint and Tarsus. 
 
 All these subjects are handled in the 
 author's simple, direct, and vigorous style, 
 and always with the practical side of "the 
 question "kept in view, and leave nothing 
 necessary or desirable untouched. We know 
 of no book of equal learning, thoroughness, 
 and utility upon the common and important 
 
 class of cases composed luider Tuberculosis 
 of Bones and Joints. The illustrations are 
 numerous and good, and the printing and 
 other details of issuing a book have been 
 attended to with an enterprise and ambition 
 creditable to the publishers.— CTeveZaJid Med- 
 ical (Gazette. 
 
 (20)
 
 Medical Publications of TJie F. A. Davis Co., Philadelphia. 
 
 SB:OB3IAKEIt 
 
 JVIateria Medica and Therapeutics. 
 
 With Especial Reference to the Clinical Application of Drugs. 
 
 By John V. Shoemaker, A.M., M.D., Professor of Materia Medica, 
 Pharmacology, Therapeutics, and Clinical Medicine, and Clinical Pro- 
 fessor of Diseases of the Skin in the Medico-Chirurgical College of Phila- 
 delphia ; Physician to the Medico-Chirurgical Hospital ; Member of the 
 American Medical Association, of the Pennsylvania and Minnesota State 
 Medical Societies, the American Academy of Medicine, the British Med- 
 ical Association; Fellow of the Medical Society of London, etc. 
 
 Second Edition. Thoroughly revised. In two volumes. Ro^al 
 Octavo. Nearly 1100 pages. 
 
 Volume I is devoted to pharmacy, general pharmacology, and thera- 
 peutics, and remedial agents not properly classed with drugs. 
 
 Volume II is wholly taken up with the consideration of drugs, each 
 remedy being studied from three points of view, viz. : the Preparations, 
 or Materia Medica ; the Physiology and Toxicology, or Pliarmacology ; 
 and, lastly, its Therapy. Each volume is thoroughly and carefully indexed 
 with clinical and general indexes, and the second volume contains a most 
 valuable and exhaustive table of doses extending over several double- 
 column octavo pages. 
 
 The Volumes may be Purchased Separately. 
 
 
 
 VOL. 1. 
 
 
 
 United States. 
 
 Canada (duty paid). Great Britain. 
 
 France. 
 
 Extra Cloth, 
 
 $2.50, net 
 
 $2.75, net Hs. 
 
 16 fr. 20 
 
 Sheep, 
 
 3.25 " 
 
 3.60 " 18s. 
 VOL. II. 
 
 20 fr. 20 
 
 
 United States. 
 
 Canada (duty paid). Great Britain. 
 
 France. 
 
 Extra Cloth, 
 
 $3.50, net 
 
 $100, net 19s. 
 
 22 fr. 40 
 
 Sheep, 
 
 150 " 
 
 5.00 " 25s. 
 
 28 fr. 60 
 
 The well-known practical usefulness of this eminently st.indard work 
 is now greatly increased by the very recent and accurate information it 
 gives, from a clinical stand-point, concerning the new and useful drugs 
 introduced to the medical profession since the issue of the first edition, 
 two years ago ; so that it is thoroughly abreast of the progress of thera- 
 peutic science, and hence really indispensable to every student and 
 pi'actitioner. 
 
 RHVIBl^S OF THE FIRST EDITION. 
 
 The value of the book lies in the fact that 
 it contains all that is authentic and trnst- 
 woithy about the host of new remedies which 
 have deluged us in tlie last live years. The 
 pages are remarkably free from useless infor- 
 mation. The author has done well in following 
 the alphabetic;)! order. — N. Y. Med. Record. 
 
 In perusing the pages devoted to the special 
 consideration of drugs, their pharmacology, 
 physiological action, toxic action, and therapy, 
 one is constantly surprised at the amount of 
 
 material compressed in so limited a space. 
 The book will prove a valuable addition to the 
 physician's library. — Occidculttl Med. Thnex. 
 
 It is a meritorious work, with many unique 
 features. It is richly ilhistrated by well-tried 
 prescri]itions showing the practical api)lica- 
 tion of the various drugs discussed. In sliort, 
 this work makes a pretty complete en<^yclo- 
 pfedia of the science of therapeutics, conve- 
 niently arranged for handy reference.— J/cd. 
 World. 
 
 (21)
 
 J Medical Publications of The F. A. Davis Co., FhiladeljMa. 
 
 SHOEMAKUB 
 
 Heredity, Health, and Personal Beauty. 
 
 Including the Selection of the Best Cosmetics for the Skin, Hair, 
 Nails, and all Parts Relating to the Body. 
 
 By John V. Shoemaker, A.M., M.D., Professor of Materia Medica, Phar- 
 macology, Therapeutics, and Clinical Medicine, and Clinical Professor of Diseases 
 of the Skin in the Medico-Chirurgical College of Philadelphia; Physician to the 
 Medico-Chirurgical Hospital, etc., etc. 
 
 The health of the skin and hair, and how to promote them, are discussed; 
 the treatment of the nails; the subjects of ventilation, food, clothing, warmth, 
 bathing; the circulation of the blood, digestion. Ventilation.; in fact, all that in 
 daily life conduces to the well-being of the body and refinement is duly enlaiged 
 upon. To these stores of popular information is added a list of the best medicated 
 soaps and toilet soaps, and a whole chapter of the work is devoted to household 
 remedies. The work is largely suggestive, and gives wise and timely advice as 
 to when a physician should be consulted. This is just the book to place on the 
 waiting-room, table of every physician, and a work that will prove usefal in the hands 
 of your patients. 
 
 Complete in one handsome Royal Octavo volume of 435 pages, beautifully 
 and clearly printed, and bound in Extra Cloth, Beveled Edges, with side and 
 back gilt stamps and in Half-Morocco Gilt Top. 
 
 Price, in United States, post-paid, Cloth, *2.50; Half-Morocco, $3.50, 
 net. Canada (duty paid), Cloth, $2.75; Half-Morocco, $3.90, net. 
 Great Britain, Cloth, 14s. ; Half-Morocco, 19s. 6d. France, Cloth, 
 15 fr.; Half-Morocco, 22 fr. 
 
 The book reads not like the fulfillment of a 
 task, but like the researches and observations 
 of one thoroughly in love with his subject, 
 fully appreciating its importance, and writing 
 for the pleasure he experiences in it. The 
 work is very comprehensive and complete in 
 its scope.— 3/erftcai World. 
 
 The book before us is a most remarkable 
 
 Eroduction and a most entertaining one. The 
 ook is equally well adapted for the laity or 
 the profession. It tells us how to be healthy, 
 happy, and as beautiful as possible. We can't 
 review this book ; it is nifferent from anything 
 we have ever read. It runs like a novel, and 
 will be perused until finished with pleasure 
 and profit. Buy it, read it, and be surprised, 
 
 pleased, and improved. — The Southern Clinic. 
 
 This book is written primarily for the laity, 
 but will prove of interest to the phy.sician as 
 well. Though the author goes to some extent 
 into technicalities,lie confines himself to the 
 use of good, plain English, and in that respect 
 sets a notable example to many other writers 
 on similar subjects. Furthennorc, the book 
 is written from a thoroughly American stand- 
 point. — Medical Record. 
 
 This is an exceedingly interesting book, 
 both scientific and practical in character, in- 
 temded for both professional and lay readers. 
 The book is well written and presented in ad- 
 mirable form by the publisher. — Canadian 
 Practitioner. 
 
 SHOEMAKEJR 
 
 Ointments and Oleates 
 
 Especially in Diseases 
 of tlie Skin. 
 
 By John V. Shoemaker, A.M., M.D., Professor of Materia Medica, Phar- 
 macology, Therapeutics, and Clinical Medicine, and Clinical Professor of Diseases 
 of the Skin in the Medico-Chirurgical College of Philadelphia, etc., etc. 
 
 The author concisely concludes his preface as follows : "The reader may 
 thus obtain a conspectus of the whole subject of inunction as it exists to-day in 
 the civilized world. In all cases the mode of preparation is given, and the thera- 
 peutical application described seriatim, in so far as may be done without needless 
 repetition." 
 
 Second Edition, revised and enlarged. 298 pages. 12mo. Neatly bound 
 in Dark-Blue Cloth. No. 6 in the Physicians' and Students' Ready -Reference Series. 
 
 Price, post-paid, in the United States and Canada, $1.50, net; in Great 
 Britain, 8s. 6d. ; in France, 9 fr. 35. 
 
 It is invaluable .as a ready reference when 
 ointments or oleates are to be used, and is 
 serviceable to both druggist and physician. — 
 Canada Medical Jiecora. 
 
 To the physician who feels uncertain as to 
 
 the best form in which to prescribe medicines 
 by way of the skin the book will prove valu- 
 able, owing to the many prescriptions and 
 formulae which dot its pages, while the copious 
 index at the back materially aids in making 
 the book a useful one.— Medical News. 
 
 (22)
 
 Medical Publications of The F. A. Davis Co., rhiladelphia. 
 
 SMITS 
 
 Physiology of the Domestic Animals. 
 
 A Text-Book for Veterinary and Medical Students and Practitioners. 
 
 By Robert Meade Smith, A.M., M.D., Professor of Compiuative Physi- 
 ology in University of Pennsylvania; Fellow of the College of Piiysicians and 
 Academy of the Natural Sciefices, Philadelphia; of American Physiological 
 Society; of the American Society of Naturalists, etc. 
 
 This new and important work, the most tliorouglily complete in the 
 English language on this subject, treats of the physiology of the domestic animals 
 in a most comprehensive manner, especial prominence being given to the subject 
 of foods and fodders, and the character of the diet for the herbivora under 
 different conditions, with a full consideration of their digestive peculiarities. 
 Without being overburdened with details, it forms a conii)lete text-book of 
 physiology adapted to the use of students and practitioners of both veterinary 
 and human medicine. This work has alreadj^ been adopted as the Te.\t-Book on 
 Physiology in the Veterinary Colleges of tiie United States, Great Britain, and 
 Canada. In one Handsome Royal Octavo Volume of over 950 pages, profusely 
 illustrated with more than 400 Fine Wood-Engravings and many Colored Plates. 
 
 United States. Canada (duty paid) Great Britain. 
 
 Price, Cloth, - - $5.00, Net $5.50, Net 28s. 
 
 " Sheep, - - 6.00 " 5.60 " 32s. 
 
 France. 
 
 30 fr. 30 
 36 fr. 20 
 
 A. LiAUTARD, M.D., H.F.R.C, V.S., Pro- 
 fessor of Anatomy, Operative Surgery, and 
 Sanitary Medicine in the American Veterinary 
 College, New York, writes: — "I have exam- 
 ined the work of Dr. R. M. Smith on the 
 Thysiology of the Domestic .\nimals,' and con- 
 sider it one of the best additions to veterinary 
 literature that we have had for some time." 
 
 E. M. Reading, A.M., M.D., Professor of 
 Physiology in the Chicago Veterinary College, 
 writes: — "I have carefully examined tlie 
 'Smith's Physiology,' published by you, and 
 like it. It is comi l^ehensive, exhau.stive, and 
 complete, and is especially adapted to those 
 who desire to obtain a full knowledge of the 
 principles of physiology, and are not satisfied 
 with a mere smattering of the cardinal points." 
 
 Dr. Smith's presentment of his subject is as 
 brief as the status of the science permits, and 
 to this much-desired conciseness he has added 
 an egually welcome clearness of statement. 
 The illustrations in the work are exceedingly 
 good, and must prove a valuable aid to the 
 
 full undeist:mding <if the text. — Journal oj 
 Comparative Medicine and Surr/ery. 
 
 Veterinary practitioners and graduates will 
 read it with pleasure. N'cterinary students 
 will readily acquire needed knowledge fmm 
 its pages, and veterinary scliools, whicli would 
 be well einiipped for the work they aim to 
 perform, cannot ignore it as their tcxt-book 
 in physioVogy. — Americrni Veterinary Heview. 
 
 Altogether, Professor Sndth's "Physiology 
 of the Domestic Animals" is a happy produc- 
 tion, and will be hailed with delight in both 
 the human medical and veterinary medical 
 woilds. Itsiiduhl find its ]ilace, besides, in all 
 agricultural lilirarics.— I'aui. Paqpin, INI.I)., 
 \ .S., in the Weekly Medical Ji/view. 
 
 The author has iudiciou.'^ly made the nutri- 
 tive functions The strong point of the work, 
 and has devoted sjiecial attention to the sub- 
 ject of foods and digestion. In looking 
 through other sections of the work, it appears 
 to us that a just proportion of space is assigned 
 to each, in view of their relative importance 
 to the practitioner. — London Lancet. 
 
 SOZINSKBY 
 
 Medical Symbolism. 
 
 Historical Studies in tUe Arts 
 of Healing: and Hyg:iene. 
 
 By Thomas S. Sozinskey, M.D., Ph.D., Author of "The Culture of 
 Beauty," "The Care and Culture of Children," etc. 
 
 12mo. Nearly 200 pages. Neatly bound in Dark-Blue Cloth. Approini- 
 ately illustrated with upward of thirty (30) new Wood-Engravings. No. 'J in the 
 Physicians' and Students' Ready-Rej'erence Series. 
 
 Price, post-paid, in United States and Canada, $1.00, net ; Great 
 Britain, 6s. ; France, 6 fr. 20. 
 
 He who has not time to more fuUy stvidy the 
 more extended records of the past, will highly 
 prize this little book. Its interesting discourse 
 upon the past is full of suggestive thought. — 
 American Lancet. 
 
 Like an oasis in a dry and dusty desert of 
 medical literature, throiigli which we wearily 
 stagger, is this work devoted to medical sym- 
 bolism and mythology. As the author aptly 
 quotes: "What some light braines may esteem 
 as foolish toyes, deeper judgments can and 
 
 will value as sound and serious matter."— Ca?i- 
 adian Practitioner. 
 
 In the volume before us we have an admira- 
 ble and successful attemj)! to set forth in 
 order those medical symbols which have come 
 down to us. andtoexiiiain on historical grounds 
 their significance. An astonishing amount of 
 information is contained within the covers of 
 the book, and every page of the work bears 
 token of the painstaking genius and ertidite 
 mind of the now unhappily deceased author. 
 — London Lancet. 
 
 '23)
 
 Medical Publications of The F. A. Davis Co., Philadelphia. 
 
 STEWART 
 
 Obstetric Synopsis. 
 
 By John S. Stewart, M.D., formerly Demonstrator of Obstetrics and 
 Chief Assistant in the Gynaecological Clinic of the Medico-Chirurgical College 
 of Philadelphia: with an introductory note by William S. Stewart, A.M., 
 M.D., Professor of Obstetrics and Gynaecology in the Medico-Chirurgical College 
 of Philadelphia. 
 
 By students this work will be found particularly useful. It is based upon 
 the teachings of such well-known authors as Playfair, Parvin, Lusk, Galabin, 
 and Cazeaux and Tarnier, and contains much new and important matter of great 
 value to both student and practitionei'. 
 
 With 43 Illustrations. 202 pages. 12mo. Handsomely bound in Dark- 
 Blue Cloth. No. 1 in the Physicians' and Students' Ready -Reference Series. 
 
 Price, post-paid, in the United States and Canada, $1.00, net ; in Great 
 Britain, Ss. ; France, 6 fr. 20. 
 
 DeLaskie Miller, M.D., Professor of 
 Obstetrics, Rusli Medical College, Chicago, 
 111., says : — "I have examined the 'Obstetric 
 Synopsis,' by Jolin S. Stewart, M.D., and it 
 Kives me pleasure to characterize tlie work as 
 .systematic, concise, perspicuous, and authen- 
 tic. Among manuals it is one of the best." 
 
 It is well written, excellently illustrated, 
 and fully up to date in every respect. Here 
 we find all the essentials of Obstetrics in a 
 nutshell, Anatomy, Embryology, Physiology, 
 Pregnancy, Labor, Puerperal State, and Ob- 
 stetric Operations all being carefully and ac- 
 
 curately described. — Buffalo Medical and 
 Surgical Journal. 
 
 It is clear and concise. The chapter on the 
 development of the ovum is especially satis- 
 factory. The judicious use of bold-faced 
 type for headings and italics for important 
 statements gives the book a pleasing typo- 
 graphical appearance. — Medical Record. 
 
 This volume is done with a masterly hand. 
 The scheme is an excellent one. The whole 
 is freely and most admirably illustrated with 
 well-drawn, new engravings, and the book is 
 of a very convenient size. — St. Louis Medical 
 and Surgical Journal. 
 
 ULTZ3IANW 
 
 The Neuroses of tlie Genito-Urinary System 
 
 in the Male. 
 
 With Sterility and Impotence. 
 
 By Dr. R. Ultzmann, Professor of Genito-Urinary Diseases in the Uni- 
 versity of Vienna. Translated, witli the author's permission, by Gardner W. 
 Allen, M.D., Surgeon in the Genito-Urinary Department, Boston Dispensary. 
 
 Full and complete, yet terse and concise, it handles the subject with such 
 a vigor of touoh, such a clearness of detail and description, and such a directness 
 to the result, that no medical man who once takes it up will be content to lay it 
 down until its perusal is complete, — nor will one reading be enough. 
 
 Professor Ultzmann has approached the subject from a somewhat differct 
 point of view from most surgeons, and this gives a peculiar value to the worl^. 
 It is believed, moreover, that there is no convenient hand-book in English treat- 
 ing in a broad manner the Genito-Urinary Neuroses. 
 
 Synopsis of Contents. — First Part — I. Chemical Changes in the Urine in 
 Cases of Neuroses. II. Neuroses of the Urinary and of the Sexual Organs, 
 classified as : (1) Sensory Neuroses; (2) Motor Neuroses ; (3) Secretory Neuroses. 
 Second Part — Sterility and Im^wtence. The treatment in all cases is described 
 clearly and minutely. 
 
 Illustrated. 12mo. Handsomely bound in Dark-Blue Cloth. No. 4 i'^ the 
 Physicians' and Students' Ready-Reference Series. 
 
 Price, post-paid, in the United States and Canada, $1.00, net ; in Great 
 Britain, 6s. ; in Prance, 6 fr. 20. 
 
 minded of his" delightful inannerof presenting 
 his thoughts, which ever spnrkle with original- 
 ity and appositencss. — Weekly 3Icd. Hceicw. 
 
 It engenders sound pathological teaching 
 and will aid in no small degree in throwing 
 light on the management of many of the dil- 
 flcult and more refractory cases of the elas.^es 
 to which these essays especiaUv refer.— T/te 
 Medical Age. 
 
 This book is to be highly recommended, 
 owing to its clearness and brevity. Altogether, 
 we do not know of any book oi the same size 
 which contains so much useful information in 
 such a short space. — Medical Nctvs. 
 
 Its scope is large, not being confined to the 
 one condition, — neurasthenia, — but embracing 
 all of the neuroses, motor and sensory, of the 
 genito-urinary organs in the male. " No one 
 who has read after Dr. Ultzmann need bo re- 
 
 (24)
 
 Medical Publications of The F. A. Davis Co., Philadelphia. 
 WITHEBHTINE 
 
 The International Pocket Medical Formulary 
 
 Arranged Therapeutically. 
 
 By C. Sumner Witherstine, M.S., M.D., Associate Editor of the 
 "Annual of the Universal Medical Sciences ;" Visiting Physician of the Home 
 for the Aged, Germautown, Philadelphia ; Late House-Surgeon Charity Hospital, 
 New York. 
 
 More than 1800 formulse from several hundred well-known authorities. 
 With an Appendix containing a Posological Table, the newer remedies included ; 
 Important Incompatibles ; Tables on Dentition and the Pulse ; Table of Drops 
 in a Fluidrachm and Doses of Laudanum graduated for age ; Formulaj and Doses 
 of Hypodermatic Medication, including the newer remedies ; Uses of the Hypo- 
 dermatic Syringe ; Formulae and Doses for Inhalations, Nasal Douches, Gargles, 
 and Eye-washes ; Formulae for Suppositories ; Use of the Thermometer in Dis- 
 ease ; Poison's, Antidotes, and Treatment ; Directions for Post-Mortem and 
 Medico-Legal Examinations ; Treatment of Asphyxia, Sun-stroke, etc. ; Anti- 
 emetic Remedies and Disinfectants ; Obstetrical Table ; Directions for Ligations 
 of Arteries ; Urinary Analysis ; Table of Eruptive Fevers ; Motor Points for 
 Electrical Treatment, etc. 
 
 This work, the best and most complete of its kind, contains about 275 
 printed pages, besides extra blank leaves — the book being interleaved throughout 
 — elegantly printed, with red lines, edges, and borders; with illustrations. Bound 
 in leather, with side flap. 
 
 It is a handy book of reference, replete with the choicest formulas (over 
 1800 in number) of more than six hundred of the most prominent classical writers 
 and modern practitioners. 
 
 The remedies given are not only those whose efficiency has stood the test 
 of time, but also the newest and latest discoveries in pharmacy and medical 
 science, as prescribed and used by the best-known American and foreign modern 
 authorities. 
 
 It contains the latest, largest (G6 formulse), and most complete collection of 
 hypodermatic formuhie (including the latest new remedies) ever published, with 
 doses and directions for their use in over fifty different diseases and diseased 
 conditions. 
 
 Its appendix is brimful of information, invaluable in office work, emergency 
 cases, and the daily routine of practice. 
 
 It is a reliable friend to consult when, in a perplexing or obstinate case, the 
 usual line of treatment is of no avail. (A hint or a help from the best authorities, 
 as to choice of remedies, correct dosage, and the eligible, elegant, and most palat- 
 able mode of exhibition of the same.) 
 
 It is compact, elegantly printed and bound, well illustrated, and of conve- 
 nient size and shape for the pocket. 
 
 The alphabetical arrangement of the diseases and a thumb-letter index 
 render reference rapid and easy. 
 
 Blank leaves, judiciously distributed throughout the book, afTord a place to 
 record and index favorite formulte. 
 
 As a student, the physician needs it for study, collateral reading, and for 
 recording the favorite prescriptions of his professors, in lecture and clinic; as a 
 recent graduate, he needs it as a reference hand-book for daily use in prescribing 
 (gargles, nasal douches, inhalations, eye-washes, suppositories, incompatibles, 
 poisons, etc.); as an old practitioner, he needs it to refresh his memory on old 
 remedies and combinations, and for information concerning newer remedies and 
 more modern approved plans of treatment. 
 
 No live, progressive medical man can aflbrd to be without it. 
 
 Price, post-paid, in United States and Canada $2.00, net; 
 Great Britain, lis. 6d. ; France, 12 fr. 40. 
 
 It is sometimes important that such presciip- 
 tioiis as have been weU established in their 
 usefulness be preserved for reference, and 
 
 this little volume serves such a purpose better 
 than any otlier we have seen. — Columbus Med- 
 ical Journal. 
 
 To the young physiciun just starting out in 
 practice this little" book will prove an accept- 
 able companion. — Omaha Clinic. 
 
 As long as "combinations" are sought, such 
 a book will be of value, especially to those 
 who cannot spare the time required to learn 
 
 enough of incompatibilities before commenc- 
 ing practice t«» avoid writing incompatible and 
 dangerous prescriptions. The con.stant use of 
 such a book by such prescribers would save 
 the pharmacist much anxiety.— jfVie Drug- 
 gist Circular. 
 
 In judicious selection, in accurate nomen. 
 clature, in arrangement, and in style, it leaves 
 nothing to be desired. The editor and the 
 l)ublisher are to be congratiulateu on the pro- 
 duction of the verv best book of its class.— 
 Pittsburgh Medical Review. 
 
 (25)
 
 Medical Publications of The F. A. Davis Co., Philadelphia. 
 
 YOTTNG 
 
 Synopsis of Human Anatomy. 
 
 Being a Complete Compend op Anatomy, Including the Anatomy op 
 THE Viscera, and Numerous Tables, 
 
 By James K. Young, M.D., Instructor in Orthopaedic Surgery and 
 Assistant Demonstrator of Surgery, University of Pennsylvania ; At- 
 tending Orthopaedic Surgeon, Out-Patient Department, University 
 Hospital, etc. 
 
 While the author has prepared this work especially for students, 
 sufficient descriptive matter has been added to render it extremely valu- 
 able to the bus}" practitioner, particular^ the sections on the Viscera, 
 Special Senses, and Surgical Anatomy. 
 
 The work includes a complete account of Osteology, Articulations, 
 and Ligaments, Muscles, -Fascias, Vascular and Nervous Systems, 
 Alimentary, Vocal, and Respiratory and Genito-Urinary Apparatus, the 
 Organs of Special Sense, and Surgical Anatom3\ 
 
 In addition to a most carefully and accurately prepared text, wher- 
 ever possible, the value of the work has been enhanced b}^ tables to 
 facilitate and minimize the labor of students in acquiring a thorough 
 knowledge of this important subject. The section on the teeth has also 
 been especially prepared to meet the requirements of students of 
 dentistry. 
 
 Illustrated with 76 Wood-Engravings. 390 pages. 12mo. Bound 
 in Extra Dark-Blue Cloth. No. 3 in the Physicians' and Students'' 
 Ready- Reference Series. 
 
 Price, post-paid, in the United States and Canada, $l.iO, net; in Sreat 
 Britain, 8s. 6d-; in Prance, 9 fr. 25. 
 
 Every unnecessary word lias been excluded, 
 out of "regard to the very limited time at the 
 medical student's disposal. It is also good as 
 a reference-book, as it presents the facts about 
 which he wishes to refresh his memory in the 
 briefest manner consistent with clearness. — 
 Neiv York Medical Journal. 
 
 As a companion to the dissecting table, and 
 a convenient reference for the practitioner, it 
 
 has a definite field of usefulness. — Pittsburgh 
 Medical Review. 
 
 The book is much more satisfactory than the 
 "remembrances" in vogue, and yet is not too 
 cumbersome to be carried around and read at 
 odd moments — a property which the student 
 will readily appreciate. — Weekly Medical 
 Meview. 
 
 The Universal Medical Journal 
 
 (Formerly THE SATELLITE). 
 
 A Monthly Magazine op the Progress of Every Branch of Medi- 
 cine IN ALL Parts of the World. 
 
 Edited by Charles E. Sajous, M.D., Editor-in-Chief of The Annual 
 OF the Universal Medical Sciences, and C. Sumner Witherstine, 
 M.S., M.D., Associate Editor. ^ 
 
 Subscription Price, in the United States of America, $2.00 per year; in other 
 countries of the Postal Union, 8s. 6d. or 10 fr. 50c. 
 
 Subscribers to The Annual op the Universal Medical Sciences 
 will now receive The Universal Medical Journal free, as formerlj^ 
 the}'^ did The Satellite. The Universal Medical Journal contains 
 32 pages of Text, Original Articles (a New Feature), Clinical Notes, and 
 Correspondence by eminent foreign and American physicians, etc. The 
 Best Time to Subscribe is — Now! It is improved in appearance, matter, 
 style, size. 
 
 (26)
 
 Medical Publications of the F. A. Davis Co., Philadelphia. 
 
 Annual of the Universal Medical Sciences. 
 
 A Yearly Report of the Progress op the General Sanitary 
 Sciences Throughout the World. 
 
 Issue of 1893 Ready in June, 1893. 
 
 Edited by Charles E. Sajois, M.D., formerly Lecturer ou Laryngology and Rliinology 
 in Jefferson Medical College, Phihidelpliia, etc., and Seventy Associate Editors, assisted by over 
 Two Hundred Corresponding Editors and Collaborators in America, Europe, Asia, and Africa. 
 In Five Royal Octavo Volumes of aboi't .'500 Pages Eacu, bound in Cloth and Half- 
 Russia, Magnificently Illustrated with Chromo-Lithographs, Engravings, Maps, Charts, and 
 Diagrams. Being intended to enable any physician to possess, at a moderate cost, a com- 
 plete Contemporary History of Universal Medicine, edited by many of America's and Europe's 
 ablest teachers, and superior in every detail of i)rint, paper, binding, etc. 
 
 SOLD ONLY BY SUBSCRIPTION, OR SENT DIRECT ON RECEIPT OF PRICE, SHIPPING EXPENSES PREPAID. 
 
 Subscription Price per Year (including the << UJVIVERSAL, MEDICAL 
 JOUKNAL " for one year) : In U. S., 5 vols.. Cloth, S15.00; Half-Russia, 
 SS30.00. Canada (duty paid). Cloth, 8816.50; Half-Russia, !»32.<»(). Great 
 Britain, Cloth, S4 7s. ; Half-Russia, £5 158. France, Cloth, 93 fr. 95 ; 
 Half-Russia, 134 fr. 35. 
 
 The Universal Medical Journal is a Monthly Magazine of the Progress of Every 
 Branch of Medicine in Alb Parts of the World, Edited by the Chief Editor of the Annual and 
 C. Sumner Witherstine, M.S., M.D., Associate Editor. Supplied to subscribers to the 
 Annual free of charge ; to all others, $2.00 per year in advance. 
 
 EDITORIAL STAFF OF THE "ANNUAL OF THE UNIVERSAL MEDICAL SCIENCES." 
 Contributors to Series 1888, 1889, 1890, 1891. 1892. 
 
 Editor-in-Chief, CHARLES E. SAJOUS, M.D., Philadelphia. 
 
 SENIOR ASSOCIATE EDITORS. 
 
 Agnew, D. Hayes, M.D., LL.D., Philadelphia, 
 
 series of 18S8, 1889. 
 Baldy, J. M., M.D., Philadelphia, 1891, 1892. 
 Barton, J. M., A.M., M.D., Philadelphia, 1889, 
 
 1890, 1891, 1892. 
 
 BarucH, Simon, M.D., New York, 1892. 
 Birdsall, W. R., M.D., New York, 1889, 1890, 
 
 1891, 1892. 
 
 Booth, J. A., M.D., New York, 1892. 
 Brown, F. W., M.D., Detroit, 1890, 1891, 1882. 
 Bruen, Edward T., M.D., Philadelphia. 1889. 
 Brush, Edward N., M.D., Pliiladelphia, 1889, 
 
 1890, 1891. 
 Cattell, H. W., M.D., Philadelphia, 1892. 
 Cohen, J. Solis-, M.D., Philadelphia, 1888, 1889, 
 
 1890, 1891, 1892. 
 Cohen, S. Solis-, M.D., Philadelphia, 1892. 
 Conner, P. S., M.D., LL.D., Cincinnati, 1888, 
 
 1889, 1890, 1891, 1892. 
 
 Currier, A. F., A.B., M.D., New York, 1889, 
 
 1890, 1891, 1892. 
 
 Davidson, C. C, M.D., Philadelphia, 1888. 
 Davis, N. S., A.M., M.D., LL.D., Chicago, 1888, 
 
 1889, 1890, 1891, 1892. 
 Delafield, Francis, M.D., New York, 1888. 
 Delavan, D. Bryson, M.D., New York, 1888, 
 
 1889, 1890. 1891, 1892. 
 DoLLEY, C. S., M.D., Philadelphia, 1892, 
 Draper, F. Winthrop, A.M., M.D., New York, 
 
 1888, 1889, 1890, 1891, 1892. 
 
 Dudley, Edward C, M.D., Chicaa;o, 1888. 
 Ernst, Harold C, A.M., M.D., Boston, 1889, 1890, 
 
 1891, 1892. 
 
 Forbes, William S., M.D., Philadelphia, 1888, 
 
 1889, 1890. 
 
 Gakretson, J. E., M.D.. Philadelphia, 1888, 1889. 
 Gaston, J. McFaddi'n, M.D., Atlanta, 1890, 1891, 
 
 1892. 
 Gihon, Albert L., A.M., M.D., Brooklyn, 1888, 
 
 1889, 1890, 1891, 1892. 
 Goodell, William, M.D., Philadelphia, 1888, 
 
 1889, 1890. 
 
 Gray, Landon Carter, M.D., New York, 1890, 
 
 1891, 1892. 
 Griffith. ,Ii P. Crozer, M.D., Philadelphia, 1889, 
 
 1890, 1891, 1892. 
 
 Guilford, S. H., D.D.S., Ph.D., Philadelphia, 
 
 1888. 
 Guiteras, John, M.D., Ph.D., Charleston, 1888, 
 
 1889. 
 
 Hamilton, Jolm B.. M.D., LL.D., Washington, 
 
 1888, 1889, 1890,1891. 
 
 Hare, Hohart Amory, M.D., B.Sc., Philadel- 
 phia, 1888, 1889, 1890, 1891, 1892 
 Henry, Frederick P., M.D., Philadelphia, 1889, 
 
 1890 1891 1892 
 Holland, J. W.', M.D., Philadelphia, 1888, 1889. 
 Holt, L. Euimett, M.D., New York, 1889, 1890, 
 
 1891, 1892. 
 Hooper, Franklin H., M.D., Boston, 1890, 1891, 
 
 1892. 
 Howell, W. H., Ph.D., M.D., Ann Arbor, 1889, 
 
 1890, 1891, 1892. 
 Hun, Henry, M.D., Albany, 1889, 1890. 
 iNGAL.s, E. Fletcher, A.M., M.D., Chicago, 1889, 
 
 1890, 1891. 
 Jaggard, W. W., A.M., M.D., Chicago, 1890. 
 Johnston, Christopher, M.D., Baltimore, 1888, 
 
 1889. 
 John.ston, W. W., M.D., Washington, 1888, 1889, 
 
 1890, 1891, 1892. 
 Keating, John M., M.D., Philadelphia, 1889. 
 Kelsey, Charles B., M.D., New York, 1888, 1889, 
 
 1890, 1891, 1892. 
 Keyes, Edward L., A.M., M.D., New York, 1888, 
 
 1889, 1890, 1891, 1892. 
 
 Knapp, Philip Coombs, M.D., Boston, 1891, 1892. 
 Kyle, D. Braden, M.D., Philadelphia. 1892. 
 Laplace, Ernest, A.M., M.D., Philadelphia, 
 
 1890, 1891, 1892. 
 
 Lee, John G., M.D., Philadelphia, 1888. 
 
 Leidv, Joseph, M.D., LL.D., Philadelphia, 1888, 
 
 1889, 1890, 1891. 
 Longstreth, Morris, M.D., Philadelphia, 1888, 
 
 1889, 1890. 
 LooMis, Alfred L., M.D., LL.D., New York, 1888, 
 
 1889 
 Lyman, Henry M., A.M., M.D., Chicago, 1888. 
 McGuiRE, H'nnter, IM.D., LL.D., Richmond, 
 
 1888. 
 Manton, Walter P., M.D., F.R.M.S., Detroit, 
 
 1888, 1889, 1890, 1891, 1892. 
 Martin, H. Newell, M.D., M.A., Dr.Sc., F.R.S., 
 
 Baltimore, 1888, 1889. 
 Matas, Rudolph, M.D., New Orleans, 1890, 1891, 
 
 1892. 
 Mears, J. Ewing, M.D., Philadelphia, 1888, 1889, 
 
 1890 1891 
 MiLLS,'Charles K., M.D., Philadelphia, 1888. 
 
 (27)
 
 Medical Publications of The F. A. Davis Co., Philadelphia. 
 
 SENIOR ASSOCIATE EDITORS (continued). 
 
 MiNOT, Chas. Sedgwick, M.D., Boston, 1888, 1889, 
 
 1890, 1K91, 1892. 
 MONTGOMEKY, E. E., M.D., Philadelphia, 1891, 
 
 1892. 
 Morton, Thos. G., M.D., Philadelphia, 1888, 1889. 
 MtJNBE, Paul F., M.D., New York, 1888, 1889, 
 
 1890, 1891. 1892. 
 O'DWYER, Joseph, M.D., New York, 1892. 
 Oliver, Cliarles A., A.M.. M.D., Philadelphia, 
 
 1889, 1890, 1891, 1892. 
 
 Packard. .John H., A.M., M.D., Philadelphia, 
 
 18h8, 1889, 1890, 1891, 1892. 
 Parish, Wm. H., M.D., Philadelphia, 1888, 1889. 
 
 1890, 1892. 
 
 Parvin, Theophilus, M.D., LL.D., Philadelphia, 
 
 1888, 1889. 
 
 Peirce, C. N., D.D.S , Philadelphia, 1888. 
 Pepper, William, M.D., LL.D., Philadelphia, 
 
 1888. 
 Ranney, Ambrose L., M.D., New York, 1888, 
 
 1889, 1890. 
 
 Richardson, W. L., M.D., Boston, 1&S8, 1889. 
 Rockwell, A. D., A.M., M.D., New York, 1891, 
 
 1892. 
 ROHE, Geo. H., M.D., Raltimore, 1888, 1889, 1890, 
 
 1891 1892 
 SAJOU.S, Chas. E., M.D., Philadelphia, 1888, 1889, 
 
 1890, 1891, 1892. 
 
 Sayre, Lewis A., M.D., New York, 1890, 1891, 
 
 1892. 
 Seguin, E. C, M.D., Providence, 1888, 1889, 1890, 
 
 Senn, Nicholas, M.D., Ph.D., Milwaukee, 1888, 
 
 1889. 
 Shakspeare, B. O., M.D., Philadelphia, 1888. 
 Shattuck, F. C, M.D., Boston, 1890. 
 
 Smith, Allen J., A.M., M.D., Philadelphia, 1890, 
 
 1891, 1892. 
 Smith, J. Lewis, M.D., New York, 1888, 1889, 1890, 
 
 1891, 1892. 
 Spitzka, E. C, M.D., New York, 1888. 
 Starr, Louis, M.D., Philadelphia, 1888, 1889, 1890, 
 
 1891 1892 
 Stimso'n, Lewi.s A., M.D., New York, 1888, 1889. 
 
 1890, 1891, 1892. 
 Sturgis, F. R., M.D., New York, 1888. 
 SUDDUTH, P. X., A.M., M.D., F.R.M.S., Minne- 
 apolis, 1888, 1889, 1890, 1891, 1892. 
 Thom.son, William, M.D., Philadelphia, 1888. 
 Thomson, Wm. H., M.D., New York, 1888. 
 TiFFANV, L. McLane, A.M., M.D., Baltimore, 
 
 1890, 1891, 1892. 
 Turnbull. Chas. S., M.D., Ph.D., Philadelphia, 
 
 1888, 1889, 1890, 1891, 1892. 
 Tyson, James, M.D., Philadelphia, 188S, 1889, 1890. 
 Van Harlingen, Arthur, M.D., Philadelphia. 
 
 1888, 1889,1890, 1891,1892. 
 Vander Veer, Albeit, M D., Ph.D., Albany, 
 
 1890. . . , ^. 
 
 ViCKERY H. F., M.D., Boston, 1892. 
 
 White, J. William, M.D., Philadelphia, 1889, 
 
 1890, 1891, 1892. 
 Whittaker, Jas. T., M.D., Cincinnati, 1888, 1889, 
 
 1890 1891 1892 
 Whitt'ier. E. n!, M.D., Boston, 1890, 1891, 1892. 
 Wilson, James C, A.M., M.D., Philadelphia, 
 
 1888, 1889, 1890, 1891, 1892. 
 Wirgman, Chas., M.D., Philadelphia, 1888. 
 Witherstine, C. Sumner, M.S., M.D., PhUadel- 
 
 phia, 1888, 1889, 1890, 1891, 1892. 
 Wyman, Walter, M.D., Washington, 1892. 
 Young, Jas. K., M.D., Philadelphia, 1891, 1892. 
 
 JUNIOR ASSOCIATE EDITORS. 
 
 Balby, J. M., M.D., Philadelphia, 1890. 
 
 Bliss, Arthur Ames, A.M., M.D., Philadelphia, 
 
 1890, 1891, 1892. 
 Cattell, H. W., M.D., Philadelphia, 1890, 1891. 
 Cerna, D., M.D., Ph.D., Philadelphia, 1891, 1892. 
 Clark, J. Pavson, M.D., Boston. 1890, 1891, 1892. 
 Crandall, F. M., M.D., New York, 1891, 1892. 
 Cohen, Solomon Soils-, A.M., M.D., Philadelphia, 
 
 1890, 1891. 
 Cryer, H. M., M.D.. Philadelphia, 1889. 
 Deale, Henry B., M.D., Washingtcni, 1891. 
 DoLLEY, C. S., M.D., Philadelphia, 1889, 1890, 1891. 
 DOLLINGER, Julius, M.D., Philadelphia. 1889. 
 DoRLAND, W. A., M.D., Phil.idelphia, 1891, 1892. 
 ESHNER, A. A., M.D., Philadelphia, 1892. 
 Freeman, Leonard, M.D., Cincinnati, 1891, 1892. 
 Fuller, Eugene, M.D., New York, 1892. 
 GOODELL, W. (^onstantine, M.D., Philadelphia, 
 
 1888, 1889, 1890. 
 
 Gould, Geo. M.. M.D., Philadelphia, 1889, 1890. 
 Greene, E. M., M.D., Boston, 1891, 1892. 
 Griffith, J. P. Crozer, M.D., Philadelphia, 1888. 
 HOAG, Junius, M.D., Chicago, 1888. 
 Howell, W. H., Ph.D., B.A., Baltimore, 1888, 
 
 1889. , 
 
 Hunt, William, M.D.. Philadelphia, 1888, 1889. 
 Jackson, Henry, M.D., Boston, 1891, 1892. 
 KiKK, Edward C, D.D.S., Philadelphia, 1888. 
 Lloyd, James Hendrie, M.D., Philadelphia, : 
 McCarthy, N. I., Philadelphia, 1892. 
 McDonald, Willis G., M.D., Albany, 1890. 
 Penrose, Chas. B., M.D., Philadelphia, 1890. 
 Powell, W. M., M.D., Atlantic City, 1889, 1890, 
 
 1891, 1892. 
 Quimby, Chas. E., M.D., New York, 1889. 
 Rau, Leonard S., M.D., New York. 1892. 
 Sayre, R. H., M.D., New York, 1890, 1891, 1892. 
 Smith, Allen J., A.M., M.D., Philadelphia, 1889, 
 
 1890. 
 Stengel, Alfred, M.D., Philadelphia, 1892. 
 ViCKERY, H. F., M.D., Boston, 1891, 1892. 
 Warfield, Ridgely B., JSl.D., Baltimore, 1891, 
 
 1892. 
 Warner, F. M., M.D., New York, 1891, 1892. 
 Weed, Charles L., A.M., M.D., Philadelphia, 
 
 1888, 1889. 
 WELL.S, Brooks H., M.D., New York, 1888, 1889, 
 
 1890, 1891. ' 
 
 Wolff, Lawrence, M.D., Philadelphia, 1890. 
 Wyman, Walter, A.M., M.D., Washington, 1891. 
 
 ASSISTANTS TO ASSOCIATE EDITORS. 
 
 Baruch, S., M.D., New York, 1888. 
 Beatty, Franklin T., M.D., Philadelphia, 1888. 
 Brown, Dillon, M.D., New York, 1888. 
 Buechler, a. F., M.D., New York, 1888. 
 BUKR, Chas. W., M.D., Philadelphia, 1891. 
 Cohen, Solomon Soils-, M.D., Philadelphia, 1889. 
 Cooke, B. G., M.D., New York, 1888. 
 CoOLiDGE, Algernon, Jr., M.D., Boston, 1890. 
 Currier, A. P., M.D., Now York, 1888. 
 Daniels, F. H., A.M., M.D., New York, 1888. 
 Deale, Heury B., M.D., Washington, 1890, 1891, 
 
 1892. 
 EsHNER, A. A., M.D.. Philadelphia, 1891. 
 Gould, George M., M.D.. Philadelphia, 1888. 
 Grandin Egbert H., M.D., New York, 1888, 1889. 
 Greene, E. M., M.D., Boston, 1890. 
 Guiteras, G. M., M.D., Washington, 1890. 
 Hance, I. H., A.M., M.D., New York, 1891, 1892. 
 Klingenschmidt, C. H, A., M.D., Washington, 
 
 1890. 
 Kramer, S. P., M.D., Cincinnati. 1892. 
 Martin, Edward,: M.D., Philadelphia, 1891, 1892. 
 
 McKee, E. S., M.D., Cinci»nati, 1889, 1890, 1891, 
 
 1892. 
 Myek.s, F. H., M.D., New York, 1888. 
 Packard, F, A., M.D., Philadelphia, 1890. 
 Pritchard, W. B., M.D., New York, 1891, 1892. 
 Sangree, E. B., A.M., M.D., Philadelphia, 1890, 
 
 1892. 
 Sears, G. G., M.D., Boston, 1890. 
 Shultz, R. C, M.D.. New York, 1891, 1892. 
 SOUWERS, Geo. F., M.D., Philadelphia, 1888. 
 Taylor, H. L., M.D., ( 'ineinnati, 1889, 1890. 
 Vansant, Eugene L., M.D., Philadelphia, 1888. 
 ViCKERY, H. F., M.D., Boston, 1890, 
 Warner, F. M., M.D., New York, 1888, 1889, 
 
 1890. 
 Wells, Brooks H., M.D., New York, 1888. 
 Wendt, E. C. M.D., New York, 1888. 
 Westcott, Thompson S., I\I D., Philadelphia, 
 
 1892. 
 Wilder, W. H., M.D., Cincinnati, 1889. 
 Wilson, C. Meigs., M.D., Philadelphia, 1889. 
 Wilson, W. R., M.D., Philadelphia, 1891, 1892. 
 
 (28)
 
 Medical Publications of The F. A. Davis Co., Philadelpliia. 
 
 THE BIOGRAPHY OF A GREAT SURGEON. 
 
 Life of D. Hayes Agnew, JVI.D., LL.D. 
 
 By J. Howe Adams, M.D. 
 
 Tliis faciiuiting lite history of one of the world's greatest surgeons 
 is now ready. 
 
 Dr. J. Howe Adams, the author, has been for many yeai's a member 
 of Dr. Agnew's family, has had the valuable aid of Mrs. Agnew, and 
 also access to documents and papers of unusual value and interest that 
 would have been denied to most writers ; so that the biography here 
 presented is written, as it were, from the inside, and thus made doul)ly 
 interestino; anxl valuable as the narrative of the career of an eniineiit 
 physician, surgeon, and benefactor of mankind. Royal Octavo, 376 
 pages, handsomely printed, with Portraits and other illustrations. 
 
 Price, in United States, Eztra Cloth, $2.50 net; Half-Morocco, Crilt Top, $3.50 
 net, post-paid. In Canada (duty paid), Cloth, $2.75 net; Half-Morocco, 
 $3.90 net. Great Britain, Cloth, 14s.; Half-Morocco, 12s. 6d. France, 
 Cloth, 15 fr. ; Half-Morocco, 22 fr. 
 
 SOLD ONLY BY SUBSCRIPTION, OR SENT DIRECT ON RECEIPT OF PRICE, 
 
 SHIPPING EXPENSES PREPAID. 
 
 THE ONLY COMPLETE AND EXHAUSTIVE EXPOSITION OF THE SUBJECT. 
 
 Psychopathia Sexualis, 
 
 With Especial Reference to Contrary Sexual Instinct: A Medico- 
 Legal Study of "Sexual Insanity, 
 
 By Dr. R. von Krafft-Ebing, Professor of Psychiatry and Neu- 
 rology, University of Vienna. Authorized Translation of the Seventh 
 Enlarged and Revised German Edition, by Charles Gilbert Chaddock, 
 M.D., Professor of Nervous and Mental Diseases, Marion-Sims College 
 of Medicine, St. Louis; Fellow of the Chicago Academy of Medicine; 
 Corresponding Member of the Detroit Academy of Medicine ; Associate 
 Member of the American Medico-Psychological Association, etc. 
 
 Professor von Krafl't-Ebing's study of the psycliopathology of the 
 sexual life easily supersedes all previous attempts to treat this important 
 subject scientifically, and it is sure to commend itself to members of the 
 medical and legal professions as a scientific explanation of many social 
 and criminal enigmas to which no work in English ofiers a solution. 
 
 General Scheme of the Book. — I. Fragment of a Psychology of 
 the Sexual Life ; the Sexual Instinct ; Sensualit}^ and ]Moralit3'^ ; True 
 Love, etc. II. Physiological Facts; Sexual Maturity; Control of the 
 Sexual Instinct, etc. III. General Pathology ; Ini})orl.auce of Patho- 
 logical Manifestations; Sexual Perversion. IV. Special Pathology; 
 Abnormal Sexual Manifestations in Mental Diseases ; Insanity. V. Path- 
 ological Sexuality Before the Criminal Court ; Frequency of Sexual 
 Crimes; Increase; Loss of Responsibilit3^ 
 
 One Royal Octavo Volume. 432 pages. 
 
 United States. Canada (duty paid). Great Britain. France. 
 
 Cloth, 
 
 $3.00, net 
 
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 (29)
 
 Medical Publications of The F. A. Davis Co., Philadelphia. 
 
 Lectures on Nervous Diseases. 
 
 From the Stand-Point op Cerebral and Spinal Localization, and 
 
 THE Later Methods Employed in the Diagnosis and 
 
 Treatment of these Affections. 
 
 B}^ Ambrose L, Ranney, A.M., M.D., Professor of the Anatomy and 
 Phj'siolooy of the Nervous System in the New York Post-Graduate 
 Medical School and Hospital; Professor of Nervous and Mental Diseases 
 in the Medical Department of the University of Vermont, etc. ; Author 
 of" The Applied Anatom}- of the Nervous S3^stem," " Practical Medical 
 Anatomy," etc., etc. 
 
 It is now generally conceded that the nervous system controls all 
 of the physical functions to a greater or less extent, and also that most 
 of the symptoms encountered at the bedside can be explained and 
 interpreted from the stand-point of nervous physiology. 
 
 Profusely illustrated with original diagrams and sketches in color 
 by the author, carefully selected wood-engravings, and reproduced photo- 
 graphs of typical cases. One handsome royal octavo volume of 780 pages. 
 
 SOLD ONLY BY SUBSCRIPTION, OR SENT DIRECT ON RECEIPT OF PRICE, 
 
 SHIPPING EXPENSES PREPAID. 
 
 Price, in United States, Cloth, $5.50; Sheep, $6.50; Half-Russia, $7.00. 
 Canada (duty paid), Cloth, $6.05 ; Sheep, $7.15 ; Half-Russia, $7.70. 
 Great Britain, Cloth, 32s. ; Sheep, 37s. 6d. ; Half-Russia, 40s. France, 
 Cloth, Zi t. 70; Sheep, 10 ft. 15; Half-Russia, 13 fr. 30. 
 
 We are glad to note that Dr. Ranney has 
 published in book form his admirable lectures 
 on nervous diseases. His book contains over 
 seven hundred large pa^es, and is profusely 
 illustrated with original diagrams and sketches^ 
 in colors, and with many carefully selected 
 wood-cuts and reproduced photographs of 
 typical cases. A large amount of valuable 
 intormation, not a little of which has but 
 recently appeared in medical literature, is pre- 
 
 sented in compact form, and thus made easily 
 accessible. In our opinion. Dr. Ranney's book 
 ought to meet with a cordial reception at the 
 hands of the medical profession, for, even 
 though the author's views may be sometimes 
 open to question, it cannot be disyiuted that 
 his work bears evidence of scientific method 
 and honest opinion. — American Journal of 
 Insanity. 
 
 STjOlDNTTOHST^S 
 
 Practical and Scientific Physiognomy; 
 
 OR 
 
 I&3!o\3y- to IE^e:a.d. lE^sice^s. 
 
 Two large 
 
 By Mary Olmsted Stanton. Copiously illustrated. 
 Ro3'al Octavo volumes. 1220 pages. 
 
 The author, Mrs. Mary O. Stanton, has given over twenty years to 
 the preparation of this work. Her style is easN', and, by her happy 
 method of illustration of every point, the book reads like a novel and 
 memorizes itself. To physicians the diagnostic information conveyed is 
 invaluable. To the general reader each page opens a new train of ideas, 
 (This book has no reference whatever to phrenology.") 
 
 SOLD ONLY BY SUBSCRIPTION, OR SENT DIRECT ON RECEIPT OF PRICE, 
 
 SHIPPING EXPENSES PREPAID. 
 
 Price, in United States, Cloth, $9.00; Sheep, $11.00 ; Half-Russia, $13.00. 
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 $11.30. (}reat Britain, Cloth, 56s. ; Sheep, 68s. ; Half-Russia, 80s. 
 France, Cloth, 30 fr. 30; Sheep, 36 fr. 10; Half-Russia, 13 fr. 30. 
 
 (89)
 
 JUcdicai i'iibliCMlions of The F. A. JJavis Co., J'Juindeij'hia. 
 
 S A JO US 
 
 Lectures on the Diseases of the Nose 
 
 and Throat. 
 
 "^^ELIVERED AT THE JeFFERSON MeDIGAL COLLEGE, PhILADELI'JIIA 
 
 By Charles E. :^\jous, M.D., Formerly Lecturer on Rhlnology ami 
 Laryngology in Jeffers' : Medical College; Chief Editor of the Annual of t!i' 
 Universal Medical Scieii.es, etc., etc. 
 
 ^W Since the publisher brought this valuable work before the profession, it 
 has become : 1st, the text-book of a large number of colleges ; 2d, the reference-book 
 of the U. 8. Army, Navy, and the Marine Service ; and, 3d, an importnnt ^nnl 
 valued addition to the libraries of over 12,000 physicians. 
 
 This book has no^ only the inherent merit of presenting a clear expose of 
 the subject, but it is written with a view to enable the general practitioner to 
 treat his cases hibiself. To facilitate diagnosis, colored plates are introduced, 
 showing the appearance of the different parts in the diseased state as they appear 
 in nature by artificial light. No error can thus be made, as each affection of the 
 nose and throat has its representative in the 100 chromo-lithographs presented. In 
 the matter of treatment, the indications are so complete that even the slightest 
 procedures, folding of cotton for the forceps, the use of the probe, etc., are 
 clearly explained 
 
 Illustrated T^ith 100 chromolithographs, from oil paintings by the author, 
 and 93 engravings on w^ood. One handsome royal octavo volume. 
 
 SOLD ONLY BY SUBSCRIPTION, OR SENT DIRECT ON RECEIPT OF PRICE, 
 SHIPPING EXPENSES PREPAID. 
 
 Price, is I. . ■, Uates, Cloth, Royal Octavo, $i.OO; Half-Kussia, Royal 
 OctaTO, i,.jw. Canada (duty paid). Cloth, $i'10; Half-Russia, $5.50. 
 Great 2rit&ir., Cloth, 22.'. 6d. ; Sheep or Half-Russia, 28s. France, 
 Cloth, 2i fr. 50; Half-Russia, 30 fr. 30. 
 
 It is intended to furnish the general practi- 
 tioner not only with a guide for the treatment 
 of diseaov^c zi f^heuose aiid thro.at, hut also to 
 place before him a repic-. itation of tlie nor- 
 mal and diseased parts as i hey would appear 
 
 to him were they seen in the living sabject. 
 As a guide to the treatment of the nnse and 
 throat, we can cordi.ally recommend thi.'i work. 
 — Boston Medical und'Surgical Journal. 
 
 IMPORTANT ANNOUNCEMENT. IN PREPARATION. 
 
 SUGGESTIVE THERAPEUTICS IN PSYCHOPATHIA SEXUALIS. 
 
 By Db. a. ton Schrenck-Notzing, of Munich. Authorized Translation 
 of the Last Enlarged and Revised German Edition, by Charles Gilbkut 
 Chaddock. M.D., Professor of Nervous and Mental Diseases, IMarion-Sinis 
 College of Medicine, St. Louis; Fellow of the Chicago Academy of Medicine; 
 Corresponding Member o*" the Detroit Academy of Medicine; Associate 
 Member of the American Medico-Psychological Association, etc. 
 
 An invaluable supplementary volume to Dr. R. von Krafft-Ebing's 
 masterly treatise on "Psychopathia Sexualis" (also translated by Dr. Chad- 
 dock). A kind of hand-book of the treatment of Sexual Pathology upon 
 sound and effective principles. 
 
 (31)
 
 Medical Publications of The F. A. Davis Co., Philadelphia. 
 
 IMPORTANT BOOKS IN PRESS AND IN PREPARATION. 
 
 A CHAPTER ON CHOLERA FOR LAY READERS: The History, 
 Symptoms, Prevention, and Treatment of the Disease. 
 
 By Walter Vought, Ph.B., M.D., Medical Director aud Physician-in-Charge of 
 the Fire Island Quarantine Station, Port of N.Y. ; Fellow of the New York Academy 
 of Medicine, etc. Small 12mo, about 130 pages. Illustrated. Ready in May, 1893. 
 Price, 75 cents net. 
 
 AUTO-INTOXICATION: Self-Poisoning of the Individual. 
 
 Being a series of lectures on Intestinal aud Urinary Pathology. By Prof. Bou- 
 chard, Paris. Translated from the French, with an Original Appendix, by Thomas 
 Oliver, M.D., Professor of Physiology, University of Durham, England. In one 
 12mo volume. In Press. 
 
 THE URINE: NORMAL AND ABNORMAL; CHEMICALLY AND 
 CLINICALLY CONSIDERED. 
 
 By Charles W. Pukdy, M.D. (Queen's University), Honorary Fellow of the 
 Royal College of Physicians and Surgeons of Kingston; Author of "Diabetes: its 
 Cause, Symptoms, and Treatment;" " Bright's Disease aud Allied Affections of the 
 Kidneys ; " Member of the American Medical Association, of the Chicago Academy of 
 Sciences, etc., etc. 12mo. Illustrated. In Preparation. 
 
 A PRACTICE OF SURGERY. 
 
 By John II. Packard, A.M., M.D., Surgeon to the Pennsylvania Hospital and to 
 St. Joseph's Hospital, Philadelphia; Member of the American Surgical Association 
 and of the American Medical Association ; formerly Acting Assistant Surgeon U. S. 
 Army (lSGl-65), etc., etc. lu one large Royal Octavo volume. Handsomely illus- 
 trated. In Preparation. 
 
 PRACTICAL GYNAECOLOGY. 
 
 By E. E. Montgomery, A.^I., ^i.D., Professor of Clinical Gj-nfecologj' in the Jef- 
 ferson Medical College, Philadelphia ; Obstetrician to the Philadelphia Hospital ; 
 Gynaecologist to the St. Joseph Hospital ; Fellow and ex-President of the American 
 Association of Obstetricians and Gynaecologists, etc., etc. In one handsome Royal 
 Octavo volume. Thoroughly and beautifully illustrated. In Preparation. 
 
 CHILDBED: ITS MANAGEMENT; DISEASES AND THEIR TREAT- 
 MENT. 
 
 By Walter P. Mantox, M.D., Visiting Physician to the Detroit Woman's Hos- 
 pital ; Consulting Gynaecologist to the Eastern Michigan Asylum; President of the 
 Detroit Gynaecological Society ; Fellow of the American Society of Obstetricians and 
 Gynaecologists and of the British Gynaecological Society ; Member of the Michigan State 
 Medical Society, etc. In one neat 12mo volume. In Preparation. 
 
 SYPHILIS IN THE MIDDLE AGES and SYPHILIS IN MODERN TIMES. 
 
 Being Volumes II and III of a treatise on " Syphilis To-Day and Among the 
 Ancients." By Dr. F. Buret, of Paris. Translated from the French, with notes, by 
 A. H. Ohmann-Dumesnil, M.D., Professor of Dermatology and Syphilology in the St. 
 Louis College of Physicians and Surgeons ; Consulting Dermatologist to the St. Louis 
 City Hospital; Physician for Cutaneous Diseases to the Alexian Brothers' Hospital, 
 etc., etc. Each volume 12mo, Cloth. To be issued in the Physicians' and Students' 
 Ileady-Reference Series. In Preparation. -"^ " 
 
 (32)
 
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