ill. I am almost convinced that two-thirds of us, 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 contempt, while every one of them wounds the heart. On the other hand, there are always 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, intercourse with whom we desire so much; and besides, constantly the fearful 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 description of the character, as well as the mental and sexual disposition, of an urning,—_i.e._, of an individual who, in spite of his masculine 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 compassion, of their more fortunate brothers. I shall be 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 they are most happily suited to the subject in hand.

“I am in my thirty-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 particularly 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 my external appearance.

“I do not smoke or drink, and can neither whistle, ride, do gymnastic 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 education,—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 myself to be carried away by the feelings of the moment, and I am easily influenced by any one who knows my weakness and how to make use of it. Constantly 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 sisters. I am not egotistic, but, on occasion, self-sacrificing. I cannot withstand tears, and can—like a woman—be won by amiability and entreaty.

“In my earliest years I avoided playing soldier, gymnastics, 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, 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 my eyes 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 myself a true explanation of my condition. Since that time I have been with girls eight or ten 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-day, even with the help of imagination, I should be unable to have intercourse with a girl.

“Shortly after my discovery 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-five or thirty-five years, with supple, powerful forms, are the only ones that ravish my 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 for a gulden or two a visit. If I am alone in a room with a handsome youth, 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 conceditur, os faciem atque totum corpus, immovero nates, ardentibus osculis obtegere. Quodsi membrum magnum purumque est, dominusque 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 concedit.

“Improbable as it sounds, I am yet able to find some coarse fellows who will allow themselves to be used for this purpose. They learn the thing while in military service, for urnings know that under such circumstances they can be made to do the most for money; and when the fellows 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, because everything feminine is repugnant to 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 they return my passionate caresses. In _tête-à-tête_ with such a person, I throw all check 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 obstupescor. 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 frequently, 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 difficult 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. Corpulence disgusts me. A sensual mouth with pretty teeth affects me more intensely; and if the person has also a membrum pulchrum magnum et æqualiter formatum, all my demands—the most far-reaching—are fulfilled.

“When I was younger, with men that pleased me and excited my 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 præditus me præsente puellam futuat; mihi persuasum est, fore ut hoc aspectu sensus mei vehementissima perturbatione afficiantur 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 weakness 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 and 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 by the public, and would prefer to sing as a passive heroine, or in the dramatic _rôle_ 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, mentulæ æstimantur, quanta sint magnitudine, quanta, crassitudine; de forma earum atque rigiditate conferimus, alter ab altero cognoscit cujus semen celerius, cujus tardius ejaculetur. I may add that, of my four brothers, one gave himself to the service of urnings, without himself being one; 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 cynics 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 joys 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 hypnosis 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 physician, 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, especially 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 drinker, and always 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 nervous, but not sexually abnormal, with the exception of one sister, who always sought men.

B. asserts that from childhood he was sickly. At eight his sexual life began. He masturbated, and became possessed of the idea penem aliorum 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 sympathetic man; quite the contrary. He had never accepted proffers of pederasty; actively or passively, it was very disgusting to him. In the perverse sexual act he had always thought of himself in the _rôle_ of a woman. His passion for men in sympathy with him had been unbounded. He would have done everything 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 mieux_, 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 _rôle_ (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 always joked him on account of his feminine manners. Sweeping and house-cleaning had always been pleasant occupations for him. His activities in this direction 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 masculine 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.

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 neurasthenia 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 twenty-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 hydrocephalic, with prominence of the parietal bones. The face is remarkably small. The patient says that he is irritable and easily 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 openly confessed his love for men. The authorities considered his mental condition doubtful, and sent him to alienists for examination. To the physicians 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 South 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 years old, tall, powerful, and has a humerous expression, and a cynical, coquettish manner; the eye has a neuropathic, swimming expression; the teeth 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 somewhat small. With the exception of slight emphysema of the lungs and external fistula in ano, there are no remarkable anomalies of the vegetative 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 healthy. He obtained the degree of Doctor of Philosophy; at twenty-five, he had hæmoptysis, and went to Italy, 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 otherwise he 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 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 hung about appropriate 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 by 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 feminæ. 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 was 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 poetical works, and tried to make it appear that persons with natures like his were poetically endowed. He gave as examples Voltaire, Frederick the Great, Eugene of Savoy, and Plato, as well as numerous distinguished men of the present, who, according to his opinion, were urnings. 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 his former condition. He said that the love of urnings was a passionate, inner fire. According to his statement, in Naples the _effeminelli_ 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. On 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 unnatural in themselves to the supernatural. He looks upon the love of urnings as the higher, the ideal, as godlike, an abstract love. When shown that such a love is far from the purpose of Nature and the preservation 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, 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 considered 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 disgusting 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 physical well-being.

With moral indignation, which in contrast with his cynicism in other directions appeared ridiculous, he protested against the classification of urnings with those who indulged in pederasty. He looked on the podex with disgust, as it was a secreting 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 congenitally abnormal. As proof of this, may be cited his cynicism; his incredible frivolity in his application of his vices to religion, 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 perverse mind and exterior. G. makes the impression of an original paranoiac. (Personal case. _Zeitschrift für Psychiatrie._)

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 year, 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 genitals were fixed in an upward position by an artful bandage. The condition 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 appear in a house of prostitution, and there dress himself up as a woman, always requiring, as a part of his costume, a coiffure. When his toilet was completed, he would lie down on the bed, and have the prostitute perform manustupration. But he very much preferred to have a male person (a servant of the house). This man’s father was hereditarily tainted, had been insane several times, and was afflicted with hyperæsthesia and paræsthesia sexualis.

Case 128. C. R., maid-servant, aged 26, suffered from the time of her development with original paranoia and hysteria. As a result of her delusions, her life had been somewhat romantic, and in 1884, in Switzerland, where she had gone as a result of delusions of persecution, she came under the observation of the authorities. On this occasion, it was ascertained that R. was affected with contrary 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 beauty 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 reference 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 persecutions, the 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 people concerning her sex.

It is authoritatively established that in 1884, for a long 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 persecution. 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.

Concerning this episode the patient makes the following characteristic 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 _rôle_ of a man so long. I have never yet felt any love for a man, and I believe that my 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 passionate love, which goes beyond the bounds of friendship. She apostrophizes her friend, “My 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 asylum. On one occasion, when Anna was allowed to pay R. a visit, there was no end of passionate embraces and kisses. The visitor acknowledged 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 only indulged in platonic love. Glance and appearance are indicative of a neuropathic person. Severe hysteria, occasional cataleptoid attacks, with visionary 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. _Friedreich’s Blätter_, 1886, Heft 1.)

4. _Androgyny and Gynandry._—Forming direct transitions from the foregoing groups are those individuals of contrary sexuality in whom not only the character and all the feelings are in accord with the abnormal 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 cerebral anomaly apparently represents a very high degree of degeneration; 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 hermaphroditic malformation of the genitals have been observed. The genitals of these persons always prove to be fully differentiated 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 masculine genitals, and men in feminine dress with the sexual organs 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 anthropological 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 mammæ 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, according to the statements of his relatives, unlike other boys. His disinclination 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, but 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 manifested various nervous disturbances. Symptoms of neurasthenia spinalis made their appearance, and have lasted up to the last few years, but they have become milder with the decrease in the number of pollutions. 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 condition than an actual incapability to take care of money, and his own confession that he had no ability to use money 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 no more capable of leading a social existence; indeed, he was incapable of gaining an insight into its significance and value.

He learned very poorly, spending his time in _toilettes_ and artistic nothings, particularly in painting, for which he evinced a certain capability; 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 always distracted, and serious things quickly 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 people of his own sex, with indifference, if not actual disinclination, for females.

In his twenty-second year it is asserted that he had sexual intercourse with women, and was able to perform the act of cohabitation normally; but, partly on account of increase of neurasthenic symptoms which was occasional after coitus, and partly on account of fear of infection,—but really by reason of a want of satisfaction,—he soon ceased to indulge in such intercourse. Concerning 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 pleasurable feelings of friendship for masculine individuals, which, however, are not accompanied by 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, and the performance of which made him tired and weak. He denied having had sexual intercourse with men, but his blushing and embarrassment, and, still more, an occurrence in 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 remarkable, and decidedly recall the feminine form and characteristics. The patient, however, is over middle height, but thorax and pelvis are decidedly of feminine form. The body is rich in fat; the skin is well cared for, delicate, and soft. This impression of a woman in masculine dress is further increased by a thin growth of hair on the face, which is shaven, with the exception of a small moustache; by the mincing gait; the shy, effeminate manner; the feminine features; the swimming, neuropathic expression of the eyes; the traces of powder and paint; the curtailed 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 many hours in all kinds of arts for beautifying himself. He abhors the chase, practice with arms, and such masculine pursuits, and calls himself an _æsthete_; speaks with preference of his paintings and attempts at poetry. He is interested in feminine occupations, which—_e.g._, embroidery—he engages in, and calls his greatest pleasure. He could spend his life in an artistic and æsthetic circle of ladies and gentlemen, in conversation, music, and æsthetics. His conversation is preferably about feminine things,—fashions, needlework, cooking, and household work.

The patient is well nourished, but anæmic. He is of neuropathic constitution, and presents symptoms of neurasthenia, which are maintained by a bad manner of life, lying abed, living in-doors, and effeminateness. 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 direction 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 vertebræ, as also to pressure along accessible nerves. He feels peculiar sympathies and antipathies for certain 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.

_Opinion:_ 1. Mr. v. H., according to all observations and reports, is mentally an abnormal and defective person, and that, in fact, _ab origine_. His contrary sexual instinct represents a part of his abnormal physical 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 consequences of such an anomaly, 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 the 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 personal independence—to live in society, though under the care and guidance of normal individuals. Too, to a certain extent, it is possible for him to respect the laws and restrictions of society, and to judge his own acts; but, with respect of possible sexual errors and conflicts with criminal laws, it must be emphasized that his sexual instinct is abnormal, having its origin in organic pathological conditions; and this circumstance 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 physically ill. He presents signs of slight anæmia and of neurasthenia spinalis. A rational regulation of his manner of life and a tonic regimen, and, if possible, hydro-therapeutic treatment, seem necessary. The suspicion that this trouble has its origin in early masturbation should be entertained, and the possibility of the existence of spermatorrhœa, that is of importance etiologically and therapeutically, lies near. (Personal case. _Zeitschr. 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 combating which she had become addicted to morphine and chloral. Her mother and sister were nervous sufferers, 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, hysterical 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 treatment of which general faradization exerted a remarkably favorable influence.

Even at the first meeting, the patient produced a remarkable impression 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. Gradually it was ascertained from her that, even when she was a small girl, she had 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 1872, 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 young ladies; and she had a desire, and satisfied it, to wear hats and coats of masculine style. 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 that her friendship and self-sacrifice for sympathetic ladies was unbounded; while from that time she also experienced repugnance for gentlemen and their society.

Her relatives report that, before 1872, the patient had a proposal of marriage, which she refused; and that when she returned from a sojourn at a watering-place, in 1874, 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 indicated that she looked upon herself as a man. This predilection for women was decidedly more than mere friendship, since it expressed itself in tears, jealousy, etc.

When, in 1874, she was stopping at a watering-place, a young 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, 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 1887 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 œdematous, but not atrophied, brain, 1175 grammes. The meninges delicate, easily removed. Cortex pale. Convolutions broad, not numerous, regularly arranged. Nothing abnormal in cerebellum and great ganglia.

Case 131. _Gynandry._[117] History: On November 4, 1889, the step-father of a certain Count Sandor V. 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 V.

S. was arrested, and, on account of deception and forgery 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 V.

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 family of Hungary, in which there have been eccentricity and family peculiarities. A sister of the maternal grandmother was hysterical, a somnambulist, and lay seventeen years in bed, on account of fancied paralysis. 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 the whim that a certain table in her _salon_ was bewitched. If anything were laid on this table, she would become greatly excited and cry, “Bewitched! bewitched!” and run with the object into a room which she called the “Black Chamber,” and the key of which she never let out of her hands. After the death of this lady, there were found in this chamber a number of shawls, ornaments, bank-notes, etc. A fourth great-aunt, during two years, did not leave her room, and neither washed herself nor combed her hair; then she again made her appearance. All these ladies were, nevertheless, intellectual, 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 father 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 grandmother, in Dresden, by whom, when the masculine play became too obvious, 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 _cafés_, even those of doubtful character, 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 masculine 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 very young. She asserts that she never had any inclination for a young man, and that she has felt, from year to year, 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 the sympathies of the ladies, I felt jealous. I preferred ladies who were bright and pretty; 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 immodesty in a woman was disgusting to me. I had an indescribable aversion for female attire,—indeed, for everything feminine,—but only in as far as it concerned me; for, on the other hand, I was all enthusiasm for the beautiful sex.”

During the last ten years S. had lived almost constantly 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.

Only 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 V.! That 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. Immediately she fell in love with the daughter, Marie, and her love was returned.

Her mother and cousin tried in vain to break up this affair. During the winter, the lovers corresponded zealously. In April, 1888, Count S. paid her a visit, and in May, 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 performed 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 passions were masculine. Her letters and even legal documents reached her under the address of “Count S.” She 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 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 body, possibly as a means of retaining a priapus.

Though S. often had herself shaved _pro forma_, the servants in the hotel where 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 hæmorrhoidal); and, on the occasion of a bath which S. was accustomed to take, they claimed to have convinced themselves 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, 1889, 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 my Sandi,—ah, what happiness, Sandi mine!”

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 masculine. 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 wonderfully 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 happiness. 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 only could be felt,—not simulated. Then, again, there were outbreaks 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! 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 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 my 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 distress; Thou knowest how I suffer. 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 Siècle’! How sad do Mendelssohn’s words sound to me: ‘Nightly in dreams I see thee’!”

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-Wörth, 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 carriage impressed them; for her, because she thought she was to be marked with the stigma of moral insanity. She had a pleasant and intelligent face, which, in spite of a certain delicacy of features and diminutiveness 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, intercourse 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 year she first felt a trace of sexual feeling, which expressed itself in kisses, embraces, and caresses, with sensual pleasure, and this on the occasion of her elopement with the 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 thing repugnant to her masculine consciousness and feeling. She recognized 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 necessary for her to answer the calls of nature or to change 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 excitement 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 inhaling 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 exclusively in corpora feminæ (never in her own person), in the form of manustupration of the beloved woman, or cunnilingus. Occasionally she availed herself of a stocking stuffed with oakum as a _priapus_. These admissions were made only unwillingly 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 beautiful,—men excepted,—and is very sensitive to the opinion others may entertain of her morality.

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 morally reprehensible. She has great literary talent and an extraordinary memory. Her only weakness 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 remarkably 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 correspond 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 by a waist, or outward by the pelvis. The skull is slightly 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 meati, 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 fully normal; the right upper canine has not developed. Mouth remarkably small. Ears prominent; lobes not differentiated, passing over into the skin of the cheek. Hard palate narrow and high; voice rough and deep; mammæ fairly developed, soft, and without secretion. Mons veneris covered with thick, dark hair. Genitals completely 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 vaginæ narrow; mucous membrane normal. Hymen wanting (probably congenitally); likewise, the carunculæ 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, through the rectum, to be about the size of a walnut, immovable, and retroflected.

The pelvis appears generally narrowed (dwarf-pelvis), and of decidedly masculine type. The distance between anterior superior spines is 22.5 centimetres (instead of 26.3 centimetres). Distance between the crests of the ilii, 26.5 centimetres (instead of 29.3 centimetres); between the trochanters, 27.7 centimetres (31); the external conjugate diameter, 17.2 centimetres (19 to 20); therefore, presumably, the internal conjugate 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 sexuality.

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 herself out as Count Sandor. Her only distress is her lost happiness with her beloved Marie.

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, 1881). 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, coquetting with all the allurements 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 inclination may be complicated with other perverse manifestations. Thus here, with reference to the activity of the instinct, there 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 sexuality is almost a regular accompaniment of contrary sexual feeling, acts of lustful cruelty 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 masculine. There was phimosis. Mentally, he was a weak, perverse, unsocial man. He had horror feminæ, and, in his dreams, he felt himself like a woman toward a man. He was painfully 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 the foregoing histories (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, may be mentioned the Greek, who, as Athenäus reports, was in love with a statue of Cupid, and defiled it, in the temple of Delphi; and besides the monstrous cases reported by Tardieu (“Attentats,” p. 272), the terrible one reported by 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, PROGNOSIS, AND THERAPY 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 measures is the exact differentiation of the acquired from the congenital cases; and among the latter, again, the assignment of the concrete 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 whether 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 establishment of the fact that contrary sexual instinct existed before indulgence in masturbation is of great importance with reference to deciding whether 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 acquired 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 neurasthenia, 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 _ab origine_, especially in a spiritual and æsthetic sense.

2. The homo-sexual instinct, as long as inversio sexualis has not taken place, is looked upon, by the individual affected, as vicious and abnormal, and yielded to only _faute 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 satisfaction, and also dominates the dream-life of the individual. (_b_) 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 contrary 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 perverse 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 _probable_ only within the category of the psychical 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, protection from the injurious influences which experience teaches may lead to the fatal inversion of the sexual instinct.

Numerous predisposed individuals meet this sad fate, because parents and teachers have no suspicion of the danger which masturbation brings in its train to such children.

In many schools 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 from the developing 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 meantime, Nature rises in her power, and leads the helpless, unprotected innocent into dangerous by-paths.

A more detailed treatment of this prophylactic side of the subject is impossible here.[118]

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 exists, 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 universalis) 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 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, but, as a result of masturbation, 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 wife, 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. “Friendship,” sweet embraces, and kisses sufficed him. Pollutions, which occasionally 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 æsthetic culture had a horror of pederasty.

He felt, always, that his perverse sexual feeling was something abnormal, without, however, in his apparently much weakened libido and virility, feeling unhappy.

The examination gave the usual findings of neurasthenia. Development, 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 years before. He then began to live with his wife again, and hoped that he was lastingly freed from neurasthenia and contrary sexual instinct. His hope was fulfilled for the six years during which I was able to keep the patient under observation.

As a rule, physical treatment, even though it be re-inforced morally by good advice with reference to the avoidance of masturbation, the 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 following case is interesting; and it is an example of successful auto-suggestion that gives encouragement for the milder forms of the anomaly:—

Case 133. _Autobiography of a Psychical Hermaphrodite. Successful Struggle against Homo-sexual Inclinations made by the Patient himself._—“My father once had a stroke, but has recovered save for paralysis of the face. My mother was very anæmic and melancholic. Both suffered severely with hæmorrhoids, 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 masturbated.) I was always very shy and embarrassed in social intercourse. When about fourteen or fifteen years old, I was seduced into onanism. The impulse and desire for women, occurring in connection with the awakening sexual feeling, were, in reality, only of a platonic nature; I was also without the society of ladies. When about eighteen, I attempted to satisfy 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 inclination for women, as often as possible I have satisfied my desire by means of sexual intercourse.

“Soon after puberty I became very anæmic, and appeared much older than I really was. Then came melancholic and peculiar ideas. It was a delight to me to fancy myself humiliated in the 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 became 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 tædium vitæ 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 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 hypnotically; 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 leading the proper kind of a life. I rowed, fenced, and was much in the open air; and I 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 years, 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 me. My self-respect increased; I am good-natured, but my character is entirely active. Since my twentieth year my appearance has steadily improved. My appearance now corresponds perfectly with my years. There were recurrences of my abnormal inclinations, to be sure; but I struggled against them energetically. I satisfy my libido only by means of natural intercourse, and I hope that, by continuing 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 _International. Centralblatt für die Physiologie und Pathologie der Harn- und Sexualorgane_, Bd. i, Heft 2, p. 58, it was impossible for me to induce hypnosis, though the patient desired it, and did everything to make it successful. 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, everything 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 Masturbation._—Mr. X., merchant, aged 29. Father’s parents healthy. Nothing 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. Mother died in third confinement, when the patient was six years old; she had a deep, rough, masculine voice, and coarse appearance. Of the 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 learned 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 year he was seduced into mutual onanism by a man having a love for men. He found satisfaction in this, inasmuch as he was always very passionate sexually. It was a long time before the patient again sought 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 satisfaction only when he played the passive _rôle_,—when manustupration was practiced on him. When the act was once completed, he had no respect for the individual. If it happened that, later, he came to respect the man, then he ceased to indulge in the act with him. Later it became indifferent to him whether he masturbated 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 astray, he would have arrived at a natural mode of satisfaction of his sexual desires. He never felt love for his own sex, though he had pleased himself with the thought of loving men. At first he had had sensual inclinations toward the opposite sex. He had taken pleasure in dancing, and he had been pleased with women, but 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, in late years, of sensual relations 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 affected him equally.

Patient is a great smoker, a beer-drinker, loves male society, 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 had obtained the upper hand. Masturbation, that had previously been practiced without evil effects, now began to disclose its bad results.

Since July, 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 very 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 reflexes in upper extremities much increased. Pupils dilated, equal, and act promptly. Carotids of equal calibre; hyperæsthesia urethræ; 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. conut. aquos., 0.5; antipyrin, 1.0 (_pro die_); pot. brom., 4.0 (evenings), were ordered.

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 impulse to onanism and interest in men disappear.

At the eighth sitting “complete virility” 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 unnecessary. 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 occasions on which it has been necessary for me to use all my moral strength in order to overcome my habit, and, thank God, I have been successful in freeing myself 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 Instinct. Marked Improvement under Hypnotic Treatment._—Mr. P., born in 1863, official in a manufactory. He comes of a highly respected patrician family of Middle Germany, in which nervousness and insanity have been of frequent occurrence.

His great-grandfather on the father’s side and his sister died insane; the grandmother died of apoplexy; father’s brother died insane, and a daughter of the latter died of cerebral tuberculosis. The maternal grandmother was melancholic for years; 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 eccentric 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.

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 took 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 neurasthenia 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 pleasing face, his attractive manner, and his beautiful form, he conquered me entirely. I wished to speak to him, and was happy 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 my 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 anything 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 principal 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 that the soldier would surrender himself without trouble, I approached him. Alium quondam militem in cubiculum allectum rogavi ut veste exuta mecum in lectum concumberet. Rogatus fecit quæ volui et alter alterius penem trivit.

“Though after this success I misused many 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.

At that time the patient was wanting in earnest desire. There was some improvement in matters, in the face 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 depressed, and despairing about the future. He was without degenerative signs. He realized his perverted situation, and seemed to be willing to do anything 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 that 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. Only 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 resulted early, but simple embrace was not sufficient. He had never felt himself in any particular sexual _rôle_ 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 simply looking at him, with verbal suggestion. After a half-minute the patient passed into deep lethargy, with a cataleptiform state of the muscles. The awakening was brought about by suggesting it at counting three. Post-hypnotic suggestions were always 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 different 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 which sometimes, indeed, pleasantly occupy my thoughts. But by my own will I yet hope soon to succeed in freeing myself absolutely from them. Should I ever become weak again, the ideas you have impressed 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 easily. No sickness besides scarlatina. When thirteen, he was taught to masturbate by companions in a school. Sexually, he was hyperæsthetic, and, at seventeen, began to indulge in coitus, with full pleasure and power. For reasons of position and money, 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 masturbation. Besides, he gave himself up to play, led an absolutely dissolute life, became exceedingly neurasthenic, and sought to strengthen his weakened nerves by drinking great quantities of wine and brandy. To his essential cerebral asthenia were added peripheral alcoholic cramps and globus, and he became very emotional. His libido nimia continued unabated. On account of his disgust of prostitutes and fear of infection, satisfaction by 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 years ago, while being rubbed by a bath-attendant, he became powerfully excited sexually (the attendant also had an erection, to patient’s surprise). He could not keep from embracing and kissing the attendant, and allowing him 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 abhorred pederasty. He was entirely 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 of remorse and to cure himself of his abnormal sexual inclinations, wished to go into a cloister. While in this state, my “Psychopathia Sexualis” fell into his 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 finally 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 neurasthenic condition. No genital anomalies, though there was hyperæsthesia urethræ. Mien distressed; attitude relaxed; mind distracted and vacillating.

Hip baths, massage, ergot with antipyrin and pot. brom., 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 quickly 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 any post-hypnotic suggestions desired.

The patient improved morally and mentally, but symptoms of cerebral 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.

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 the 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 inclination 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 city, 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 masturbated many times, and, after returning to the city, found no real pleasure in coitus. By 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 had regained his self-confidence and self-respect.

The foregoing 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 priori_ this task seems impossible; at least, in the perfect urning. That the apparently impossible is artificially possible may be seen from the case of Schrenk-Notzing, which follows below. It far surpasses the case reported by me (_v. infra_), in which at least the homo-sexual feelings and impulses were removed by means of hypnotic 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 imperfect. 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 contrary 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 remarkable for her eccentric character. She was exceedingly well educated, and is said to have been beautiful in her youth. She left a fortune,—considerable even when measured by our present 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 abundant. 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 face is normal; genital hair, somewhat thin. The upper portion of the body is as good as without hair. In all other ways my appearance is fully masculine. 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 playmates. The family life of my foster-parents was faultless. In October, 1861, I 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 Gymnasium, served my voluntary years in the army, and then studied forestry, being now a director of estates. During my early years my mental development was very slow. I first learned to speak in my third year, and thus the supposition that I had hydrocephalus was strengthened. From the time of beginning school, my 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 æsthetics, but almost none in music. In early years my character was the worst possible. Without being able to give any 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 I 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 my 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 my 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 delight 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 played with dolls. I early heard talk about sexual matters; but I never thought anything 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 year, 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 manifested. Youthful, powerful men, market-helpers, workmen, and soldiers took possession of my dreams, and played an important _rôle_ in my fancy while masturbating. At this time was also first shown the tendency to pederasty, especially passive. Up to my fourteenth year I frequently made mutual attempts at pederasty with 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 I 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 promptly, 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 H., 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 happy in finding my love returned. For a time this affair kept me from masturbating; 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, I was able to hear that the lady had married. My inclination for women—if, in reality, I have ever had any—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 who acts coarsely excites my repugnance. With intellectual women, particularly when they are elderly, I like to converse, but in their society I am often unskillful 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 railway. We immediately cut the journey short, and lodged together, attempting mutual pederasty; but, on account of pain, immissio was not successful. We amused ourselves 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 were 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 intercourse 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 offered myself as a volunteer, but was not accepted. At the same time a former school-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 pederasty. In this instance pain prevented success; but, in the attempt, ejaculatio ante anum meum occurred. 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 years I had but two opportunities for homo-sexual intercourse. The first was in the winter of 1879, on the occasion of meeting a handsome 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 pederasty. On the other hand, I induced ejaculation in him by 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 railway, 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 sensually excited; he had an erection immediately, and performed the act with evident passion. It was the first time that pederasty was successfully performed. I had terrible pain, but also indescribable pleasure.

“With my sojourn here, my 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 then, 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 pederasty, because I have found no one able to endure the pain.

“Generally, I seek my lovers among cavalrymen and sailors, and, eventually, 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 circumstances, 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 by me and my acquaintances as one of the handsomest men we know. After an absence of more than two years, on invitation, he visited me a few weeks 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 preliminary, 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 approach 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 fine talent for poetry.

“Until my thirty-eighth year I had not a clear understanding of my condition. I always thought that, by early and frequent masturbation, I had become averse to women, and hoped always 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; later I came to look upon my fate as something not dependent on myself. Too, I made no further effort 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 lascivious. The description of the cultivation of _mujerados_, for example, excited me uncommonly. The thought of a young, powerful man being emasculated in this manner, in order, later, to be used for pederasty 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 my condition; 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 reading of this work had an undoubted effect. Since then I have masturbated only twice, and have practiced onanism with cavalrymen 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!’ 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 masturbated for a long time, the ejaculation takes place quickly, and is more abundant. About twelve years ago Hansen tried in vain to hypnotize 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 condition; that he looked to hypnotic treatment as the only hope of salvation, for he had not strength enough to resist his impulse to masturbation 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 he performed the act with a man, but yet the sight of any handsome soldier actually electrified him. For years he had not had the slightest sympathy with women, not even mentally.

The patient looked to be exactly the person, physically and mentally, described by himself in his autobiography. His head was exquisitely hydrocephalic, and also plagiocephalic. At first attempts at hypnosis 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 simply looking at a shining object was sufficient. The suggestions consisted of the command 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 only in hetero-sexual intercourse. 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 male-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 his unhappy condition by continuance of the treatment.

Case 138. _Psychical Hermaphroditism._—Mr. von P., aged 25, single, comes of a neuropathic family. 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 that 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 scarcely resist the longing to fall on 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 psychical hermaphrodite, in so far as he is not insensitive to the charms of women, and finds men more pleasing than women. In fact, feminine 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 fancy.

He had coitus 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 libido for men was manifested.

In the condition of irritable weakness of the ejaculatory centre, mere touching of sympathetic men was sufficient to induce ejaculation.

Patient is an only child. The circumstances of his family demand that he marry. 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 rhombic. Abundant growth of beard. Genitals 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 beautiful and desirable. You will love a woman, marry, be happy, and make her happy. You are fully potent; you feel that already.”

In daily hypnosis, 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. Centralblatt für die Physiol. u. Path. der Harn- und Sexualorgane_.

Case 139. Mr. von X., aged 25, landed proprietor. He comes of a neuropathic, passionate father. Father is said to have been normal sexually. His mother was nervous, as were her two sisters. Maternal grandmother was nervous, and his maternal grandfather was a _roué_, 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, any 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. Lascivious 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 indifferent to other characteristics of the 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 way 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 masculine build; large, well-formed genitals. Gait, voice, and attitude are masculine. He has no pronounced masculine passions. He smokes but little, and only cigarettes; drinks little, and is fond of confectionery. He loves music, arts, æsthetics, flowers, and moves in ladies’ society by preference. He wears a moustache, the face being otherwise cleanly shaved. His garments are in nowise remarkable. He is a soft, _blasé_ fellow, and a do-nothing. He lies abed mornings, and can scarcely 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 neurasthenic 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 betrays the nervous constitution. The patient is not a complete and hopeless urning. _He has hetero-sexual feelings, but his sensual inclinations toward the opposite sex are manifested weakly and infrequently._ When nineteen, he was first taken to a brothel by friends. He experienced no horror feminæ, had efficient erections, and some pleasure in coitus, but not the instinctive delight he experienced while embracing men.

Since then, patient asserts that he has had coitus six times, twice _sua sponte_. He gives the assurance that he is always capable of it, but he does it only _faute de mieux_, as he does masturbation, when the sexual impulse troubles him, as a substitute for intercourse with men. He has thought of the possibility of finding a sympathetic lady and marrying her. He would regard marital cohabitation and abstinence from intercourse 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 that treatment was indicated. The 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 influence in hypnosis. The fulfillment of this hope seemed doubtful, 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 attempt. To my great surprise, Bernheim’s procedure induced immediately a condition of deep lethargy, with possibility of post-hypnotic suggestion.

At the second sitting somnambulism was induced by merely looking 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 has amnesia for all the events of the hypnotic state. Hypnosis is induced every second or third day for the communication of hypnotic suggestions. At the same time, moral and hydro=therapeutic measures are employed.

The hypnotic suggestions were as follow:—

1. I abhor 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 society, 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 society of young gentlemen; but the most careful watching failed to reveal anything suspicious.

February 17th. Patient asks to be allowed to indulge in coitus, and is very well satisfied with his experience with one of the _demi-monde_.

March 16th. Up to this time, hypnosis twice a week. The patient always passes into deep somnambulism by simply 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 hypnotic condition he always 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 manly bearing is developed.

Moreover, since, of his own will, he now and then indulges in coitus with pleasure, and occasional pollutions are induced by lascivious dreams which concern women, there can be no doubt of the favorable change of his vita sexualis; and it is presumable that the hypnotic suggestions have developed into auto-suggestive inclinations, which direct his feelings, thoughts, and will. Probably the patient will always remain a natura frigida; but he more often speaks of marriage, and of his intention to win a wife as soon as he has become acquainted with a sympathetic lady.

In July, 1889, I received a letter from his father, which told me of his good health and conduct.

On May 24, 1890, by chance, I met my 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 occasionally had pleasurable coitus with women, and now thought of marriage.

I hypnotized him, in the former manner, to try him, and asked for the commands I had given him. In a deep condition of somnambulism, and in the same tone of voice as formerly, the 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 with Hypnotic Treatment._—Mr. von K., aged 23; of distinguished family; well endowed mentally; scrofulous as a child. His father is said to have been dissipated. His father’s brother is said to have been subject to contrary sexuality.

The patient states that, when only seven years old, he had a peculiar inclination for male persons. It was particularly coachmen and servants having moustaches for whom he showed partiality at that time. He experienced a peculiar delightful sensation when he pressed himself against such persons.

The patient entered the cadet corps early, and there he was seduced into mutual onanism, and also learned imitatio coitus inter femora viri. At the age of seventeen he had coitus with a prostitute for the first time. He performed the act perfectly, but had not the slightest pleasure in it; and he learned that this kind of gratification amounted to nothing, or that he must be different from other young men.

Nevertheless, he often had coitus, and contracted gonorrhœa. 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 opportunity 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 constantly 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 indifferent about intercourse with women, or that it was repugnant to him; and that he was created for sexual intercourse with persons of his 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 patient comes for consultation, because he sees that he is jeopardizing the happiness of his whole life, and recognizes the unnaturalness and immorality of his sexual life. He does not regard his condition as hopeless; for he 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 really 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 up his position as an officer, because the soldiers excited him so sexually that he feared he might compromise himself.

The patient is devoid of degenerative signs. His appearance is perfectly masculine, and his genitals are normal. Examination of the semen revealed abundance 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 eye 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 leads to lethargy, with cataleptic condition of the muscles, and the opportunity is used to impart suitable suggestions.

After the fourth sitting he expressed himself as satisfied, and wondered that men made no impression on him. He wished to try his fortune with women, but was afraid that he was impotent.

After the sixth sitting, without advice, he attempted coitus cum muliere. His libido was very great, but inter actum this and erection left him.

After the ninth sitting the patient was forced to discontinue treatment, 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 childhood 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-shop 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 contrary sexuality, practiced mutual masturbation and coitus inter femora viri, and occasionally 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 perfectly masculine; strabismus; abundant beard; genitals entirely normal. No aversion to the female sex. Occasional coitus with puellis, but without satisfaction. The patient feels exceedingly unhappy, and clearly recognizes his abnormal position; at any price, he wishes to be freed from his homo-sexual inclination, and made capable of marriage. “It is terrible to have to act a farce constantly.” At the first attempt at hypnosis, after Bernheim’s method, the patient passes into a state of deep lethargy. He proves to be very susceptible to suggestion, and suitable suggestions are imparted. After the fourth sitting, he states, with gratitude, that 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 puellæ publicæ. After the fourteenth sitting he declared that he required no more treatment. He was in love with a young lady, and thought of marrying her. He asked for her hand, and was refused. Soon after, while he was on a journey in Italy, 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 Hypnotic Suggestion._—Mr. von Z., aged 29. He asserts that he comes of healthy grandparents; of a healthy 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 _rôle_ 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 lady. He remained very excitable sensually; but, thereafter, exclusively so to men pleasing to him. Masturbation was not practiced.

At the age of twenty the patient became neurasthenic (ex abstinentia?). 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, approached him, and performed masturbation on him, giving the patient intense delight. He felt powerfully attracted to this man, and, thereafter, allowed him to repeat the act. In the meantime, there were attempts at coitus with females, which always ended in a fiasco. The patient was much troubled by this, and consulted physicians, who explained his impotence as due to nervousness, and thought that it would soon pass off.

Until his twenty-fifth year his sexual indulgence consisted of masturbation 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 patient 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 hydropathic establishments. On account of continued severe (cerebro-spinal) neurasthenia, 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 tædium vitæ; he is pained by his sexual anomaly, especially 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 _rôle_ of a woman.

The most refined woman has never been able to induce erection or even libido in him.

His sexual intercourse with men has consisted of passive or mutual masturbation. He had practiced solitary onanism only infrequently and _faute de mieux_. 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 despise 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 treatment had to be discontinued.

On May 17, 1890, the patient returned for treatment. He asserted that he had not masturbated 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 painfully depressed to the extent of tædium vitæ.

He is now subjected to anti-neurasthenic treatment (hydro-therapeutic and electro-therapeutic), and the treatment by hypnosis is resumed. Only after ten weeks of painstaking treatment did the neurasthenic 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 played 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 adornment 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; he occasionally had 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 freely confessed that he still always had erections at the sight of a naked, handsome man; though he could easily resist the desires that arose, and in dreams had exclusively “_relations 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 pour l’homme_,” which he could easily control. He thought he was lastingly cured, and was occupied with thoughts of marriage.

Case 143. _Congenital Contrary Sexual Feeling. Successful Removal of Homo-Sexual Feelings by Suggestions._—L., doctor of philosophy, aged 34, German, 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 by means of hypnotic treatment.

Patient came of a healthy mother, in whose family, for generations, 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 (grandmother 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 obtainable.

Patient states that from childhood he was nervous and easily excited. 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 perversion in a defect of organization. When a small boy, he had a silly enthusiasm for companions. He also remembers that, at that time, he had a 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 any 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 pained. His sympathies 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 year 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 physical weakness precluded it.

The patient has but little sexual desire. He has never had any impulse to satisfy himself with persons of his own sex. Some years ago, when he first tried to embrace a man lovingly, he had powerful erection and became greatly 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 satisfy himself. He was never given to onanism. During the establishment of puberty, the patient had frequent dreams with pollutions, but these were not induced by erotic fancies of any kind.

Some years ago, for a long time, ejaculation was always induced by the embrace of a sympathetic man, but this condition of irritable weakness disappeared. As years passed, the patient, who had always had a desire for marriage and a family, became anxious on account of the conviction that the 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 found a prostitute 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 brought his imagination to his aid, and thought himself to be embracing a man instead of a woman.

He 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 purely 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 marry 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 wrong. 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 constitutional significance of his sexual anomaly, and shown that, therefore, the creation of a normal sexual condition was doubtful, he thought that 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 equivalent for women; and if, in hypnosis, it could not be suggested to him that, in the future, men be a matter of indifference 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 his 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 effect upon 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 indifferent 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 performed immediately the post-hypnotic suggestion to open 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 had felt a peculiar creeping sensation in all his limbs.

After five days the patient came again. In manner he was a different 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 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 suggestion given, he sleeps on, in a state of lethargy, for ten minutes, and has to be awakened by suggestion. This always 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 hypnotic treatment, and gratefully 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 symptoms, he presents nothing remarkable. Genitals normal. (Personal case. _Internat. Centralblatt_, etc., Bd. i, Heft 1.)

Case 144. X., aged 33; single; tall. Mentally, of small endowment; comes of tainted family. Paternal grandfather died at thirty-four with a mental disease, which is said to have developed as a result of onanism and spermatorrhœa. His father and brother suffered with disturbances 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 normally developed.

Great impressionability; neuropathic constitution; occasional tædium vitæ. For several years, 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 feminæ; sexual inclination toward boys; satisfaction by sensual contact, and, _faute de mieux_, masturbation. One day he had an affair with a boy dressed in gray, which made a deep impression on him. Since then, while masturbating, the image of the boy comes into his mind; and he cannot see gray clothes without having powerful erections. On the advice of physicians 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.

In a further series of sittings he declares that he experiences unfavorable effects,—is more excited, and troubled by imperative ideas and the desire to masturbate. He makes 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-five sittings the patient confessed that he was better, and that he was less troubled with imperative ideas and onanism. The sittings were repeated every week or two. The patient felt mentally and morally well, ceased to masturbate, but, at the end of treatment, was indifferent toward the opposite sex (Dr. Ladame, _Revue de l’hypnotisme_, September 1, 1889).

In the two foregoing cases there was successful suggestive removal of homo-sexual feelings,—a result which, as Case 143 shows, means a great improvement for such unfortunate individuals, in that it protects them from shame and the law. An entirely different and phenomenal result is presented by the following case, reported by Dr. v. Schrenk-Notzing in the _Wiener internat. klin. Rundschau_, 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 somnambulism, are decided and lasting results to be expected:—

Case 145. _Congenital 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 family (_v. supra_). Toward the end of treatment, he confessed that he was the author of the autobiography which was published 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, I 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.

“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 feelings toward the masculine sex, and it has grown stronger every year. At first they expressed themselves in extraordinary, enthusiastic friendship 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 expressing 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 sufficient 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. He 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 thinking 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 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 other things, in the 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 immediately to repugnance, were I to notice any sensual inclination in her toward me. In my dreams 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 I could not resist. In such situations I always think of myself in a passive _rôle_, 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 approach certain persons, my struggle is as great not to allow this to be noticed. Moustaches, abundance of hair, and even dirt, seem to be especially enticing. It is hardly necessary to say that, to me, my condition, with reference to society, is absolutely desperate; and, if I had not the hope of finding a being 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 often 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 officers, 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 officially 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 opportunity 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 jealousy. 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 endowed; for I passed the State examination with distinction, speak several languages, and am a good painter.

“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 play games, and cannot sing or whistle. My gait, like my voice, is somewhat affected. I have much taste for elegance, love adornment, sweetmeats, 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 physician. 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; masturbation 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 remained, under the influence of occasional hypnotic 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 æsthetic feelings. He hoped to find satisfaction in a happy marriage. After forty-five sittings (May 2, 1889) the patient considered himself cured. Treatment ceased. He became engaged to a young lady 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 hypnotic treatment had no injurious collateral effect, and leaves undecided the question as to whether the cure is permanent or not, with R.’s very bad heredity. But he expresses the conviction that, in case of relapse, renewed hypnotic treatment would not be contra-indicated.

Since the incredible result of this case interested me exceedingly, as did its further course, I wrote to the author, requesting information concerning his patient.

Dr. v. Schrenk very kindly placed at my disposal the following letter, which he had received from the patient in January, 1890:—

“By means of suggestive treatment given me by Baron Schrenk, for the first time I became possessed of the psychical condition that permitted me to have intercourse with a woman, which, up to that time, in spite of repeated efforts, I had been unable to do successfully.

“Since my æsthetic needs were unsatisfied by intercourse with prostitutes, I thought to find my real salvation in matrimony. The earlier friendly inclination toward a lady known in my youth offered 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 absolutely foreign to me. Her character,—_i.e._, our harmony,—is in such accord with my inclinations that I am fully convinced that I shall also find complete psychical 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 my 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-day, 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 resistance,—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 prostitutes. 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 passionate condition in like situations, as the violent reproaches of my friend convinced me. _I always feel a certain unconquerable repugnance, which cannot be 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. Awake 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 these 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 that he speaks of a repugnance which “does 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 my 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 unhappy. Now, however, I have no anxiety. To be sure, on the first night, success was difficult,—to induce sexual excitation in myself,—but on the following 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 night 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 my former life is incomprehensible, and I cannot understand why I did not earlier think 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:—

“In this case the cure seems to be of longer duration than I expected; for, on speaking with the patient, some months ago, he said that he was perfectly happy in marriage, and, as I hear, he expects soon the happiness of a father.”

Dr. v. Schrenk has reported in the _Wiener internationalen klinischen Rundschau_, 1891, No. 26, later and very interesting facts concerning his patient, which, therapeutically, are very satisfactory.

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 menstruation 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.

Thus 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 Blätter_, 1858, p. 50).

I have repeatedly had occasion to give opinions in cases of attempts to rape little girls.

Giraud (_Annal. méd. psych._, 1885, Nr. 1) also reports a case of this kind. Consciousness of the significance of the act is always wanting; an instinctive knowledge that such obscene acts are not publicly permitted 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, and, therefore, the sexual impulse is more or less openly manifested. For this reason imbeciles 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 with 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.

Emminghaus (Maschka’s Handb. iv., p. 234) draws attention to the frequency of open manifestation of sexual instinct, which comprises open masturbation, exhibition of the genitals, attacks on children and those of the same sex, and sodomy.

Giraud (_Annal. méd. psychol._, 1855, Nr. 1) has reported a whole 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 younger child, but let her go because no emission occurred, and because the child cried out. On the way home he promised to marry her if she would not say anything. At the trial he thought that by marriage he could right the wrong he had done.[119]

3. G., aged 21, microcephalic, imbecile, has masturbated since his sixth year, and practiced active and passive pederasty. He has repeatedly tried to perform pederasty with boys, and attacked little girls. He was absolutely without an understanding of his acts. His sexual desire was manifested periodically and intensely, as in animals.[120]

4. B., aged 21; imbecile. While alone in a forest with his sister of nineteen, he demanded that she allow coitus. She refused. He threatened 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 significance of his act.

Emminghaus (_op. cit._, p. 234) reports the case of an exhibitionist:—

Case 146. A man, aged 40, married, had for sixteen years been accustomed to exhibit himself in parks, at dusk, to little girls and servants, and drew their attention to himself by whistling. After having been frequently punished for it, he avoided the places, but he carried on his practice elsewhere. Hydrocephalus. Mental weakness of slight degree. Mild sentence passed.

Case 147. 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 upper portion of his body naked. No other manifestations of sexual instinct. No onanism reported. (Sander, _Archiv f. Psych._, i, p. 655.)

Case 148. _Pederasty with 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, he acted so strangely 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 intellectually, 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. V. shows general diminution of cutaneous sensibility, is imbecile, and has 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 ascertained about his vita sexualis. Proofs of intellectual and moral idiocy, due to microcephaly; the crime is referred to a perverse, uncontrollable sexual impulse. Sent to an asylum. (Virgilio, _il Manicomio_, V. year, No. 3.)

A case mentioned by L. Meyer (_Arch. f. Psych._, Bd. i, p. 103) shows how female imbeciles may indulge in shameless prostitution and immorality.[121]

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 (_Klin. Novellen_, Fall 31) reports a case that belongs here. It is that of a physician, aged 33, who attempted rape on a child. He was weakened mentally, as a result of hypochondriacal 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 _Zweifelhafte Geisteszuständen_, 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 able 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 wellbehaved, 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 certainly much weakened. No sentence. (Giraud, _Ann. méd. Psychol._ 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 her 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, remarkable asymmetry of the halves of the skull, and evidences of healed fractures. The affected hemisphere had bands of cicatricial tissue running through it, and was one-third smaller than the other. (_Friedreich’s Blätter_, 1885, Heft 6.)

(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 manustupration on him, had exposed his genitals, and handled theirs.

X., formerly healthy, and of blameless life, was infected with syphilis in 1867. In 1879 paralysis of the left abducens occurred. Thereafter mental weakness was noticed, with a change of his disposition 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 eye is amblyopic. He is mentally weak. Concerning the 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 emotional 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. _Jahrbücher für Psychiatrie._)

(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 consciousness.

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 belonging to this category are cited by Tardieu (“Attentats aux moeurs”); Mendel (“Progressive Paralyse der Irren,” 1880, p. 123); Westphal (_Arch. f. Psych._, vii, p. 622); and a case by Petrucci (_Annal. méd. Psychol._, 1875) shows that bigamy may also occur here.

The brutal disregard of consequences with which the patients in the advanced stages attempt to satisfy their sexual instinct, is characteristic.

In a case reported by Legrand (“La folie,” p. 519), the father of a family was found masturbating in the open street. After the act he consumed his semen.

A patient seen by me, an officer, of a prominent family, in broad daylight, made attacks on little girls at a watering-place.

A similar case is reported by Dr. Régis (“De la dynamie ou exaltation fonctionnelle au début de la paral. gén.,” 1878).

Cases reported by Tarnowsky (_op. cit._, p. 82) show that also pederasty and bestiality may occur in the prodromal stages and course of this malady.

_Epilepsy._—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 consciousness.

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.[122] 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.

Some years ago I became acquainted with a young peasant, who, during epileptic attacks, masturbated shamelessly, but during the intervals was above reproach.

Simon (“Crimes et délits,” p. 220) mentions an epileptic girl of twenty-three, well educated, and of the best morals, who, in attacks of vertigo, would shout out obscene words, then raise her dress, make lascivious movements, and try to tear open her under-garments.

Kiernan (_Alienist and Neurologist_, January, 1884) reports the case of an epileptic who always had, as an aura, the vision of a beautiful woman in lascivious attitudes, which induced ejaculation. After some years, with treatment with potassium bromide, the 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; before and after, sound mentally, quiet, kind, temperate. On April 18, 1877, 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 away, he had an epileptoid attack; after this he became wildly 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, _Jahrbücher 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 following cases is unequivocal:—

Case 153. L., official, 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 genitals 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.

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 eyes, and he saw bright stars, and was forced to get support in order to keep upright. After violent attacks, great weakness, profuse sweating.

Since 1861 he had been very irritable, which, respected though he was as an official, caused him much trouble in his work. His wife noticed the change in him. He had days 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 paretic dementia developed with a rapidly fatal result. (Westphal, _Arch. f. Psych._, vii, p. 113.)

Case 154. A rich man of twenty-six had lived for a year 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 intoxication 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-day, shortly before the ceremony, he appeared, on 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 way he constantly masturbated, and for some days 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 27; very bad heredity; epileptic. He violated a girl of eleven, and then killed her. He lied about the deed. Absence of memory, _i.e._, mental confusion at the time of the crime, was not proved. (Pugliese, _Arch. di Psich._, viii, p. 622.)

Case 157. V., aged 60, physician, violated children. Sentenced to imprisonment for two years. Dr. Marandon later proved the existence of epileptoid attacks of apprehensiveness, dementia, erotic and hypochondriacal delusions, and occasional attacks of fear. (Lacassagne, _Lyon. méd._, 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 O., 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. According 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. (Pürkauer, _Friedreich’s Blätter f. ger. 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 by inducing them to carry out the act on himself. The accused, a respected officer, is overcome by the terrible crime attributed to him, and declares that he knows nothing of the deeds of which he is accused. His mental integrity is questionable. His family physician, who has known him twenty years, emphasizes his peculiar, retiring disposition and his mercurial moods. His wife asserts that T. once tried to throw her in the 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 grandmother 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 convulsions. The accused asserted that he had occasional attacks in which 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 jury disagreed, so that he was dismissed. Dr. Legrand du Saulle, who was called as an expert witness, found that, until his twenty-second year, 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 occasionally, and they left the patient without any memory of them. Soon again T. was arrested for public immorality, and sentenced to imprisonment 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). (Auzouy, _Annal. méd. psychol._, 1874, Nov.; Legrand du Saulle, “Étude méd. légale,” etc., p. 99.)

The following case of immoral acts with children, observed by the author and reported in _Friedreich’s Blätter_, will serve to conclude this group,[123] so important in its legal bearings. It is the more important, in that a state of unconsciousness was established at the time of the 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 exosculabatur, linguam in os meum demittere tentabat faciemque mihi lambebat; 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 kreuzers, and threatened to shoot me if I told on him. At last he tried to persuade me to come again the next day.”

G. testified: “P. nates et genitalia D. æ exosculatus, iisdem me conatibus aggressus est. Deinde filiolum quoque tres annos natum in manus acceptum osculatus est nudatumque parti suæ virili appressit. Postea quæ nobis essent nomina interrogavit ac censuit, genitalia D. æ meis multo esse majora. Quin etiam nos impulit, ut membrum suum intueremur, manibus comprehenderemus et videremus, quantopere id esset erectum.”

At his examination, May 29th, 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 suffered for years with weakness in his head, as result of an injury. 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 actually 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 persecution sufficient to induce threats and deeds of violence. At the same time, he would have auditory hyperæsthesia, 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 confusion. The medical examination proved the truth of his assertions about mental weakness, irritability, and poor sleep.

If pressure were made at the seat of the trauma, P. became congested, irritable, confused, and trembled all over; he appeared excited; consciousness was disturbed, and remained so for hours.

At times, when he is free from 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 Blätter_ for full report.)

PERIODICAL INSANITY.

Just as in cases of non-periodical mania, an abnormal intensity 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. f. Psych._), shows that it then may also be perverted:—

Case 161. Catharine W., aged 16; she has not yet menstruated; previously healthy.

Seven weeks before admission (December 3, 1872), melancholic depression and irritability. November 27th, maniacal outbreak, lasting two days; thereafter, melancholic. December 6th, normal condition.

December 24th (twenty-eight days after the first maniacal attack), silent, shy, depressed. December 27th, 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 paroxysms, and blushed scarlet with astonishment and shame when told about them.

Thereafter 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.

Quite a pure case of such periodical psychopathia sexualis, connected with the process of menstruation, is the following, reported by Anjel (_Arch. f. Psych._, xv, H. 2):—

Case 162. A quiet lady, near the climacteric. Very bad heredity. In her youth, attacks of petit mal. Always eccentric, quick-tempered; 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 impulse 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 sexually.

With reference to the still imperfectly-known cases of periodical psychopathia 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 the cases, taken from a work of the author’s, is not rightly understood (Case 8, p. 37), 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 sexually normal, abhorred their paroxysmal sexual acts, and shuddered before the expectation of their repetition.

If a new paroxysm came on, the normal sexual instinct disappeared; 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. Psych._, xv, H. 2), is one of the most typical of the convulsive-like occurrence of sexual excitement:—

Case 163. A gentleman of high social position, aged 45; generally respected and beloved; heredity good; very moral; married fifteen years. Previously normal sexually; the father of several healthy children, and living in happy matrimony. Eight years ago he suffered a violent fright. For some weeks thereafter he had a feeling of apprehension and cardiac attacks. Then came attacks, at intervals of several months or a year, of what the patient called his “moral catarrh.” He became sleepless. After three days, loss of appetite, increasing irritability, strange appearance; fixed stare, staring into space; paleness, changing with redness; tremor of the fingers; red, shining eyes, 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 children. 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 (!).

_Mania._—With the general excitation that here exists in the psychical organ, the sexual sphere is likewise often implicated. In maniacal individuals of the female sex, this is the rule. In certain cases, it may be questionable whether the instinct, which, in itself, is not intensified, is simply recklessly manifested, or whether it is present in actual abnormal intensity. For the most part, the latter is the true assumption,—certainly so where sexual delusions and their religious equivalents 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 lasciviousness in speech, and frequenting of brothels, are observed; in women, inclination for the society of men, personal adornment, perfumes, talk of marriage and scandals, suspicion of the virtue of other women; or there is manifested the religious equivalent,—pilgrimages, missionary work, desire to go into a cloister or to become the servant of a priest; and in this case there is much talk about innocence and virginity.

At the height of mania there may be seen invitations to coitus, exhibition, obscenity, great excitation at sight of women, tendency to smear the person with saliva, urine, and even fæces; 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 hyperæsthesia with involvement of the sexual sphere. The imagination calls up only sexual images, which may lead to hallucinations, illusions, and true hallucinatory 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 that that accompanies coitus (v. “Physiology”). Often the genitals are in a constant state of turgor (priapism 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 mieux_, 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 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,[124] 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 nymphomania are acute abnormal psycho-sexual states.

There are also cases that, not without 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, is in a state of excitement, and the mind full of obscene images; so that the most elevated ideas are besmirched with the most cynical images and thoughts.

The thought 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 nymphomania. They naturally lead to prostitution. Legrand du Saulle (“La folie,” 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 experience such cases have always been hereditarily predisposed and previously given to onanism. The act did not seem to be so much due to a lustful desire as to be induced by habit, _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 164. 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 enjoyment, and had looked on at the immoral acts. It was found that L. was hysterical (hemianæsthesia 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.

Schüle (_Klin. Psychiatrie_, 1886, p. 237) finds very frequently an abnormally intense sexual impulse “which disposes girls, and even women living in happy marriage, to become Messalinas.”

The author cited knows cases in which, on the wedding-journey, attempts at flight with men, who had been accidentally met, were made; and respected wives who entered into _liaisons_, and sacrificed everything to their insatiable impulse.

In hysterical insanity the abnormally intense sexual impulse may express itself in delusions of jealousy, unfounded accusations against men for immoral acts,[125] hallucinations of coitus,[126] etc.

Occasionally frigidity may occur, with absence of lustful feeling,—due, for the most part, to genital anæsthesia.

_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 paranoia) 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 æsthetically. 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 the guise of virtuous admiration of a beloved person, great lasciviousness and sexual perversion 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 masturbation 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._

Apart from masturbation, sexual crimes are relatively frequent in religious paranoia.

Marc’s work (p. 160) contains a remarkable example of religious insanity.

Giraud (_Annal. méd. psychol._) has reported a case of rape of a little girl by a religious paranoiac, aged 43, who was temporarily erotic. Here, also, belongs a case of incest (Liman, _Vierteljahrsschr. f. ger. Med._).

Case 165. M. impregnated his daughter. His wife, mother of eighteen 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 played near her, handled his genitals, 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 persecution, 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 easy for her to satisfy sexual desire in a natural way. (Küssner, _Berl. klin. Wochenschrift._)

Cullerre (“Perversions sexuelles chez les persécutés,” in _Annal. médico-psychol._, March, 1886) has reported similar cases,—the case of a patient who, suffering with paranoia sexualis 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 persecution 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 existence 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. Public sentiment, in that it looks upon them as disgraceful, lends much aid.

Criminal statistics prove the sad fact that sexual crimes are progressively increasing in our modern civilization.[127] This is particularly the 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 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 commission of sexual crimes. Here nothing less than the responsibility 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 concern 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 punishment, release him to prey on society again; on the other hand, scientific investigation shows that a man mentally and sexually degenerate _ab origine_, and therefore irresponsible, must be removed from society for life, but not as a punishment.

A judge who considers only the crime, and not its perpetrator, is always in danger of injuring not only important interests 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 delinquencies; and here only anthropological and clinical investigation 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 development, and by proving the existence of a general neuropathic or psychopathic condition.

The _species facti_ is important; but it allows, however, only presumptions, since the same sexual act, according as it is committed 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 circumstances, 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 this elementary anomaly to be but one symptom of a general neuropathic 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 the 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 condition,—the anthropological and clinical data.

The proof of the existence of an original, congenital anomaly of the sexual sphere is important, and points to the need of an examination in the direction of a condition of psychical degeneration. An acquired perversity, to be pathological, must be found to depend upon a neuropathic 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 immorality with the cloak of disease.

Psychopathic states may lead to crimes against morality, and at the same time remove the conditions necessary to the existence of responsibility, under the following circumstances:—

1. To oppose the normal or intensified sexual desire, there may be no moral or legal notions, owing to (_a_) the fact that they may never have been developed (states of congenital mental weakness); or to (_b_) 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 mental 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 transitions from a neurosis to a psychosis are easy, and elementary psychical disturbances are frequent in the former, and constant in profound perversion of the sexual life, the neurotic affection—_e.g._, impotence, irritable weakness, etc.—exerts an influence on the motive of the incriminating act; and a just judge, notwithstanding the lack of legal irresponsibility due to mental defect 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 examination.

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.).

From what experience teaches, it may be said that, among the sexual acts that occur, rape, mutilation, pederasty, _amor lesbicus_, 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, psychopathic 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-pathological conditions.

These horrible sexual acts seem to be committed only by sensual men who have become satiated or impotent from excessive indulgence in a normal way. Pædicatio 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 threatened 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 within 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 education that presumption of a psycho-pathological element necessarily 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 (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 exclusively those of men who ostentatiously expose their genitals to persons of the opposite sex, in some instances following them, without, however, 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 functions, with excitation of libido dependent upon a decided disturbance of consciousness (abnormal unconsciousness, mental confusion); and, at the same time, the virility of these individuals 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, consciousness is clouded, and the ethical and intellectual functions are interfered with; and in which 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[128] fall in this category. They are those of individuals afflicted with senile dementia, paretic dementia, or mental defects due to alcoholism, epilepsy, etc.

Case 167. Z., high official, aged 60; widower; father of a family. He had excited offense in that, during fourteen days, he had 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. (Lasègue, _op. cit._)

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 disease). 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._)

Pelanda (_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 _fellatio_.

2. A drinker, aged 66, suffering with folie circulaire. His exhibition was first noticed in church during divine service. His brother was likewise 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 præcox, and mental weakness. Penis small; phimosis; testicles atrophic. Proof of mental disease; pardoned. (Dr. Schuchardt, _op. cit._)

Such cases recall the lasciviousness of youthful, sexuallyexcited persons that are still more or less boyish; but also that of many mature cynics of low morality, who find pleasure in defiling 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.

Another category of exhibitionists is made up of epileptics. This category is essentially to be distinguished from the foregoing, 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 unfortunate individual, without consciousness of the 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 oppression. If a sexual feeling become associated with it, then the ideas are given a certain direction in the sense of a corresponding (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 consciousness, 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 has repeatedly, especially at dusk, exhibited himself to servant-girls. K. is tall, slim, pale, nervous, and hasty in manner. _There is imperfect 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 oppression, and congestion of the head. In this condition he had often been giddy, 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 reached 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 exhibiting 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, sentenced, with the assumption of extenuating circumstances. (Dr. Schuchardt, _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 thereafter 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 army (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 Charité, and from there discharged “cured.” As far as the criminal acts were concerned, cynicism and wantonness could be excluded. 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 consciousness, was in a remarkable mental state. (Liman, _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 manustupration 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 frequently caused trouble by exhibitions, but had always escaped punishment, owing 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.

L.’s brother died of paralysis. He himself 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. He then passes into a dreamy state. An irresistible impulse now forces him to expose himself; and he then experiences a feeling of relief 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 impulses had become associated with these apprehensive, cloudy states of consciousness. Years ago, in such states, without motive and with great danger, he 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, where he was at once arrested for exhibition.

When, outside of his abnormal periods, L. once became intoxicated, there was no exhibition. In the lucid state his sexual feeling and intercourse are perfectly normal. (Dr. Hotzen, _Friedreich’s Blätter_, 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 imperfect consciousness[129] 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 173. 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 continuous aversion to sexual intercourse with females. In his youth he practiced 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 pollution 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 belonging “to a class of individuals of peculiar hypochondriacal tendencies, in whom the attention is constantly directed, in an abnormal way, to certain bodily sensations and processes; who brood over these, connecting all kinds of peculiar conceptions with them, at last making use of quite as strange means to combat the bodily sensations and ideas.” At least, S.’s act was due to pathological sensation 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 für gerichtel. Med._, N. F. xxxviii, Heft 2.)

Case 174. X., aged 38; married; father of one child. Always sullen and silent. Suffers frequently with headache. Very neurasthenic, though not insane. He is troubled much at night by pollutions. He has repeatedly followed shop-girls, for whom he had lain in wait, exposing and handling his genitals. In one case he even followed a girl into a shop. (Trochon, _Arch. de l’anthropologie criminelle_, iii, p. 256.)

In 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, Vienna; 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 falling from a height. Up to that time the vita sexualis had been normal. Since that time, every three or four months, he has been seized with very painful sexual excitement, accompanied by an intense desire to masturbate. 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 years 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 always 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 he never lost consciousness. At the same time he would have violent, darting pain in the 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 masturbate, 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 masturbation 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 awakened his unconquerable impulse. There 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 which he is powerless.

He thinks himself still virile. Penis abnormally large. Cremasteric reflex present; patellar reflex increased. Weakness of the sphincter of the bladder, that has existed for some years. Various neurasthenic difficulties.

The opinion showed that R. was subject to the influence of abnormal conditions, and had acted impulsively. Patient was sent to an asylum, from which he was discharged after a few months.

In the foregoing case the important point, clinically, lies not in the neurosis that is present, but rather in the impulsive character of the act (exhibition dependent on masturbation).

With the enumeration of the categories of imbeciles, of mentally weakened individuals, and of the exhibitionists that 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 hereditary 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 accidentally-awakened impulse to exhibition is but a partial manifestation 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 realization of the impulse, gives place to a feeling of relief.

These facts, and no less, the clinical picture of degeneracy that, for the most part, is referable to injurious conditions that are hereditary, or that exercise an injurious effect on the development of brain in early years (rachitis, etc.), are, medicolegally, of decisive importance [with reference to the question of responsibility].

Case 176. G., aged 29, waiter in a _café_. In 1888, while standing under a church-door, he exhibited himself to several girls working opposite. He confessed the act, and also that, many times, in the same place and at the same time of day, 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 very irascible. His mother is at times insane, and suffers with severe nervous disease.

G. has always had nervous twitching of the face, and constant alternation of causeless depression, with tædium vitæ, 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. In prison he was at first beside himself with shame about the disgrace he had brought on his family, and said he was the 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 onanism with a girl. From that time, working in a _café_, the female customers had excited him so intensely that ejaculation was often induced. He suffered with almost constant priapism, and, as his wife stated, in spite of coitus, it often disturbed his rest at night. For seven years 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 sister.

After his eleventh year, 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 conscience. 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 year he had sexual congress with women. It gave him great pleasure to show himself naked before them. He continued his exhibition on the street. Since he could but infrequently 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 exhibited himself. Occasionally he had promised them money, with the words, “Habeo mentulam pulcherrimam, venite ad me ut eam 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 years previously, he had suffered with such excitations: imprisonment for one month.

In 1884, exhibition before girls in a church-yard; again in 1885. He declared: “I understand 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.” Imprisonment for six months.

Discharged on August 12, 1885, he had a relapse on August 15. The same excuse was given. This time he underwent medical examination. 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 family of excitable temperament.

_From his seventh to his eighteenth year X. suffered with epileptic convulsions._ First cohabitation at sixteen; later, gonorrhœa and, it is stated, syphilis. After that, normal sexual intercourse until his twenty-first year. At that time he often had to pass a play-ground, and he occasionally had to urinate there; and it happened that 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 by 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 that 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, especially 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 ejaculation occur. He does not lose consciousness in the act. After it he is troubled about his deed, and, if undiscovered, says 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 opportunity to satisfy himself with exhibition. He would give ten years 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 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 epilepsy ceased; so that one might think of a vicarious phenomenon_.

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. Freyer, _Zeitschr. f. Medicinalbeamte_, 3 Jahrg., No. 8.)

Case 179. At 9 o’clock at night, in the spring of 1891, a lady, 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 officer 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, however, he recalled the fact that exhibition gave him much greater pleasure than was afforded him by coitus, in which he seldom, and only _faute 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 publicly,—once in broad daylight, and once at night, under a lamp.

B., aged 37, single, makes a peculiar impression, owing to his dandified 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 fancy with the heroes. He always thought himself a little better than others, and thought much of elegant dress and ornament; and when he strutted about on Sundays, he imagined himself a high official.

B. has never had epileptic symptoms. In youth, moderate indulgence in masturbation; later, moderate indulgence in coitus. Previously, never any perverse sexual feelings or impulses. Retired manner of life; in leisure hours, reading (popular novels, heroic tales, Dumas, and others). B. was no drinker. Exceptionally he made himself a kind of punch, by which he was always excited sexually.

For some years, with marked decrease of libido, after such alcoholic indulgence, he had had “accursedly silly thoughts,” and developed the desire genitalia adspectui feminarum publice exhibere.

If he got into this state, he felt warm, his heart beat violently, blood rushed to his head, and he could then no longer resist his impulse. 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 tardy. 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 feminarum. 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 exhibited himself to young, 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 periodically, and forced him to indulge. That, during his attacks, B. was in an exceptional psychical state, in a kind of mental confusion, and absolutely absorbed in his perverse sexual fancy, is clearly shown by the _species facti_. Thus is explained the fact that he became aware of the approach of the police only 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 by the influence of alcohol.

A forensically important variety of exhibition, which, clinically, certainly rests upon a similar neurotic and degenerate foundation, and which expresses itself in a peculiar act, conditioned by violent libido (hyperæsthesia sexualis), associated with diminished virility, is made up of the so-called _frotteurs_.

The three following cases, borrowed from Magnan (_op. cit._), are typical:—

Case 180. D., aged 44, hereditarily predisposed, drinker, and suffering with lead poisoning. Until the last year he had masturbated much, and often drawn pornographic pictures, and shown them to his acquaintances. He had repeatedly dressed himself as a woman in secret. For two years, since becoming impotent, he had felt desire, while in crowds at dusk, mentulam denudare eamque ad nates mulieris crassissimæ 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 temperare 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 imprisonment 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 _frottage_ on a lady. He was very 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 _frottage_ with his penis on a lady. Deep repentance; but he stated that at the sight of a noticeable posteriora of a lady, he was irresistibly impelled to practice _frottage_, and that he became confused and knew not what he did. Sent to an asylum.

Case 183. A _frotteur_. Z., born in 1850; of blameless life previously; of good family; private official. He is well-to-do financially; untainted. After a short married life he became a widower, in 1873. For some time he had attracted attention in churches, because he crowded up behind women, both old and young indifferently, and toyed with their tournures. 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 sexually. Since the early death of his wife, he had gratified his great sexual desire in temporary love-affairs, having always had an aversion for prostitutes and brothels. The impulse to _frottage_ had suddenly seized him, two years before, while he happened 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 opportunity for _frottage_. The only thing on women that excited him was the tournure; every other part of the body and attire was a matter of indifference 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 _frottage_ scenes had appeared in his dreams. During 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 always ashamed of what he had done.

The medical examination revealed no sign of mental disease or mental weakness, but symptoms 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 feminæ 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 public morals, and which is, therefore, 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 story 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 L’événement_ 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_,[130]—_i.e._, men who are so cynical that they seek to 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 Coffignon’s book, “La Corruption à 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; German 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 defenselessness or unconsciousness; or with a girl under the age of fourteen years. Immissio penis, or, at least, conjunctio membrorum (Schütze), is necessary to establish the fact. To-day, rape on children is remarkably frequent. Hofmann (“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 excitation 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 (Goltdammer’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 often the act of degenerate male imbeciles,[131] 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.

The crime of rape may follow the murder of the victim.[132] There may be unintentional murder, murder to destroy the only witness of the crime, or murder out of lust (_v. supra_). Only for cases of the latter kind should the term _lust-murder_[133] be used.

The motives of lust-murder have been previously considered. 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 explained 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.[134]

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 evidence 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 showing him a bird’s nest, he was taken with a desire to abuse him. Since the boy refused to take off 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 the 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 difficulty, 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 ran 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 convulsions for forty days, 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 centimetres 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. 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 sensibility. 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 (præ-epileptic) mental state, conditioned by the neurosis. Under all circumstances, E. was considered dangerous, and probably would require commitment to an asylum for life.

3. BODILY INJURY, INJURY TO PROPERTY, AND TORTURE OF ANIMALS DEPENDENT ON SADISM.[135]

(Austrian, § 152, 411; German, § 223 [bodily injury]. Austrian, § 85, 468; German, § 303 [injury to property]. Austrian Police Regulations; 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 FETICHISM.

(Austrian, § 190; German, § 249 [robbery]. Austrian, § 171, 460; German, § 242 [theft].)

It is seen from the section on fetichism, 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, handkerchiefs, 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 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 act _per se_ does not, by any means, necessarily arise from psycho-pathological conditions is shown by the infrequent cases of hair-despoiling[136] simply for the purpose of gain.

5. VIOLATION OF INDIVIDUALS UNDER THE AGE OF FOURTEEN.

(Austrian Statutes, § 128, 132; Austrian Abridgment, § 189, 191^3; German Statutes, § 174, 176^3)

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, comprehends 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 _roués_ who have, to some extent, lost their virility. It is psychologically 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 the 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 frequently the abuse consists of sexual handling (under some circumstances, flagellation[137]), active manustupration, or seducing children by inducing them to perform onanism, or lustful handling, on the seducer. Less frequent acts are cunnilingus, irrumare on boys or girls, pædicatio 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 boys are abused by sensual women, who undertake to bring about conjunctio membrorum with them, in order to satisfy themselves by means of friction or onanism.[138]

Tardieu saw one of the most disgusting examples. A servant, in company with her lover, masturbated children intrusted to them, performed 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!

Case 185. Z., aged 62; deeply tainted, masturbator. He states he has never had coitus, but has frequently practiced fellatio. He is in an asylum, on account of paranoia. It had been his greatest pleasure to entice girls, aged from ten to fourteen years, and practice cunnilingus and other vile acts with them. In these acts he had orgasm and ejaculation. Masturbation did not give him the same satisfaction, and induced ejaculation only with difficulty. _Faute de mieux_ he also practiced fellatio with men; occasionally an exhibitionist. Phimosis; asymmetrical 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, _loc. 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 physically 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 psycho-physical degeneration. K. behaves like a child discovered in some mischievous act. Scarcely any growth of beard. Genitals well and 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 babyhood 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 surly, quarrelsome, evil, moody, irritable 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.[139]

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 uncontrollable sexual desire is shown to be one of the manifestations of a senile dementia.

6. UNNATURAL ABUSE—SODOMY.[140]

(Austrian Statutes, § 129; Abridgment, § 190; German Statutes, § 175.)

(a) _Violation of Animals—Bestiality._[141]

Violation of animals, monstrous and revolting as it seems to mankind, is by no means always due to psycho-pathological conditions. Low morality and great sexual desire, with lack of opportunity 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 Polak we owe the knowledge that in Persia bestiality is frequently practiced because of the delusion that it cures gonorrhœa; 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 may 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 bestiality with 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 monstrous example of the moral depravity in large cities is related by Maschka (“Handb.,” iii),—the case of a Parisian female who showed herself in the sexual act with a trained bull-dog, to a secret circle of _roués_, 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 the writer, the individuals 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 mother were hard drinkers. Since his fifth year patient has had epileptic convulsions,—_i.e._, he falls down unconscious, lies still two or three minutes, and then gets up and runs wildly about with staring eyes. Sexuality 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 “unspeakable” 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.

He had always had an aversion for women. In a single attempt at coitus with a woman he was impotent, but with animals he was always potent. He is ashamed before women; coitus with women he regards almost as a sin. (Kowalewsky, _Jahrb. f. Psychiatrie_, vii, Heft 3.)

Case 189. On the afternoon of September 23, 1889, W., aged 16, shoemaker’s apprentice, caught a goose in a neighbor’s garden, and committed bestiality on the fowl until the neighbor approached. On being accused by the neighbor, 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 illness, in his twelfth year, he several times a month had attacks, with heat in his head, in which he was intensely excited sexually, 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 way 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 always been sickly since an attack of scarlatina in his fifth year, and that, 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 physical examination revealed normal genitals; penis relatively greatly 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 depended upon. There was no history of previous attacks of mental disturbance, and there were none during the six weeks of observation. There was no perversion of the vita sexualis. The medical opinion allowed the possibility that some organic cause (cerebral congestion), dependent upon cerebral disease, may have exercised an influence at the time of the commission 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; father, unknown; mother, deeply tainted, hystero-epileptic. 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 physically by masturbation, and neurasthenic. Besides, he presents hysteropathic symptoms (limitation of the visual field, dyschromatopsia; diminution of the senses of smell, taste, and hearing on the right side; anæsthesia 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 dogs, cats, and rabbits in this vile manner. Much more frequently, however, he committed sodomy on female rabbits,—the only animal that had a charm 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 always done in the same manner. There were actual attacks which came on every eight weeks, always 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. He struggled against the imperative idea of committing sodomy with the rabbits, and thus had an 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 cycle was completed, and he was again master of himself, deeply 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 satisfaction; but sometimes he has, when doing this, such furor sexualis that he is forced to wildly perform sodomy on the animal.

The acts of bestiality 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, inasmuch as he was thus freed from the painful condition into which he was brought by the imperative impulse.

The medical evidence easily proved that this human monster was a psychically degenerate, irresponsible invalid, and not a criminal. (Boeteau, _La France médicale_, 38th 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 examination 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, “Männl. Impotenz,” 1889, p. 82.)

(b) _With 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 punishable.

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, according 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 were not complicated with offense to public decency, with force, or undertaken 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 cohabitation_ were performed.[142]

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 whether we have to do with 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 predisposed (tainted) individuals, as a partial manifestation of a defect evidenced by anatomical or functional abnormalities, 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 wanting, and horror of sexual intercourse with them is felt; and if the individual, in the impulses to satisfy the contrary sexual instinct, shows other anomalies of the sexual sphere, such as more pronounced 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 the pederast is not a criminal, but an irresponsible 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 does 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 that 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 æsthetically 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 æsthetic ideas to assist them in resisting the instinct. Innumerable normally constituted men are in a position to overcome the desire for satisfaction of their libido without suffering 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 understand 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. The writer of the following lines is a man of high position in London:—

“You have no idea what 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 primarily 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 you is exceedingly beneficial to us, I am still compelled, in the interest of science, to repudiate the word ‘pathological’; and you 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 many cases. I will allow, _a priori_, that, among urnings, a far higher proportion of cases of insanity, 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 prejudices of society, which prohibit the indulgence of their sexual desires, depending on a congenital peculiarity, while others are not thus restrained?

“The youthful urning, when he feels the first sexual promptings and näively expresses 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 character 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 powerful 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—nay, not even betray by a look—what his feelings are. He thinks that he alone of all the world has such abnormal feelings. Naturally 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 followed by all the evil results of that vice. When, after a time, the nervous system has been injured, the abnormality is again not the result of urningism, but it is produced by 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 experienced 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 callings; he 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 any 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 he loves. In constant fear, both must conceal their relations; nay, even intimacy that might easily excite suspicion—especially should they not be of like age, or should they 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 joy 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 not 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!

“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! 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, yet this does not prove that the mental disturbance is a necessary accompaniment of the urning’s condition, and that the latter induces the former.

“According to my firm conviction, by far the greater number of cases of mental disturbance or abnormal 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 surprised that more insanity and nervous disturbance does not occur in urnings. The greater part 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!”

_De lege lata_, as far as the urning is concerned, the paragraph with reference to pederasty must not be applied without the proof of actual pederasty; and psychical and somatic abnormalities must be examined by experts with respect of an estimate in the individual of the question of guilt.

_De lege ferenda_, the urnings wish a repeal of the paragraphs. 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 infirmity; and that, moreover, many urnings, though driven to sexual acts with their own sex, are yet in nowise compelled to indulge in pederasty,—a sexual act which, under all circumstances, must stand as cynical, disgusting, and, when passive, as certainly injurious. Whether for reasons of expediency (difficulty of fixing the guilt, encouragement of blackmail, etc.), it would not be opportune to strike from the statutes the legal punishment of the male-loving man, and to protect youth by the use of the paragraphs concerning sexual abuses, is a future question for jurists.

What has been said concerning congenital contrary sexuality 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 pederasty,—one of the saddest pages in the history of human delinquencies:—

CULTIVATED PEDERASTY.[143]

The motives that bring to pederasty a man originally normal sexually and of sound mind are various. It is used temporarily as a means of sexual satisfaction _faute de mieux_,—as in infrequent cases of bestiality,—where abstinence from normal sexual indulgence is a necessity.[144] It thus occurs on ship-board during long voyages, in prisons, in baths, etc. It is highly probable 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 _roues_ 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 temporarily renew their power, that has been psychically and physically 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, occasionally, 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.

In reference to this, the experiences of Tarnowsky (_op. cit._, p. 53 _et seq._), gathered from the society of St. Petersburg, are terrible. The places where pederasty is cultivated are Institutes. Old _roués_ and urnings play the _rôle_ of seducers. At first it is difficult for the person to carry out the disgusting act. Fancy is made to assist by calling up the image of a woman. Gradually, with practice, the unnatural act becomes easy, and at last the individual, like one injured by masturbation, becomes relatively impotent for women, and lustful enough to find pleasure 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 found 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 facts concerning the social life and practice of pederasts:—

Coffignon, “La Corruption à Paris,” p. 327, divides active pederasts into “_amateurs_,” “_entreteneurs_,” and “_souteneurs_.”

The “_amateurs_” (“_rivettes_”) are debauched persons, but also frequently 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. 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 “_petits jesus_,” “_jesus_,” 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-walkers, with or without “_souteneurs_.”

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 “_petit jesus_” to make the latter appear young, as long as possible, by means of all the arts of the toilet.

The limit of age is about twenty-five years; then they all become “_jesus_” and “_femmes entretenues_” and are then sustained by several “_souteneurs_.” The “_jesus_” fall into three categories: “_filles gallantes_,” _i.e._, those that have fallen again into the hands of a “_souteneur_”; “_pierreuses_” (ordinary 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 “_domestics_” is formed by such of them as enter the service of “_petits 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 “_aunts_,”—_i.e._, the “_souteneurs_” of (male) prostitutes,—who, though normal sexually, 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 they know how to lend to their appearance something indicative of their calling, by means of style of dress, etc. They entice by means of gesture, peculiar movements of the hands, etc., and lead their victims to hotels, baths, or brothels.

What the author says of blackmail is generally known. There are cases where pederasts have allowed their entire fortune to be wrung from them.

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 _décolleté_ ‘angel’ in _tricots_, who stands there, with bare arms folded behind her, likewise smoking. The two voices are masculine, and the conversation is likewise very masculine; 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 ‘genuineness,’ 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!

“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 carefully trained moustache. The well-curled hair; the powdered and painted face with the blackened eyebrows; the golden ear-rings; the bouquet of flowers 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 toys with the fan! How he dances and turns, and trips and lisps! And yet kindly Nature made this doll a man. He is a salesman in a great millinery 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 _décolleté_ ladies, who 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 widely-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 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 practice, 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 _rôle_ that he appears on the street in female attire almost exclusively, 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: my shoemaker, 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 accustomed 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 Bacchus, 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-monde_ of the German Capital, and do all they can to suppress blackmail among pederasts,—a practice which often does not stop short of murder.

The foregoing facts justify the wish that the law-maker of the future may, for reasons of utility, at least, abandon the prosecution of pederasty.

With reference to this point, it is worthy 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 pathological 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 exceptionally, 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, had normal inclinations, and occasionally has intercourse with the opposite 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 pederasty only to please another; for money, in the _rôle_ of a male prostitute; or as a means, when virility is declining, to make active pederasty still occasionally possible.

A horrible act, that must be alluded to, in conclusion, is pædicatio mulierum,[145] 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. Occasionally 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._ _Résumé_ 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 lawyer, 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 gonorrhœa 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 gonorrhœa. 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).

Opposed to this statement of Dr. S.’s must be mentioned the facts that were brought out in court, and which 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 subjects 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 gonorrhœa, 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 returned. 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 scarcely 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 physical 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, R. St. G. B., seemed to be covered. In passing sentence, there was consideration of S.’s education, which made him appear to be G.’s seducer; in G.’s case, this fact and his youth 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 distinguished 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 examination and observation of Dr. S. and G.

_Results of the Personal Examination, from December 11 to 13, 1888, in Graz._—Dr. S., aged 37; two years 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 apoplectic attack in his fifty-seventh year, and died, at the age of sixty-seven, of another attack of apoplexy. His mother is living, and is described as a strong person, who has been nervous for years. 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 grandfather 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 suffered with rheumatic pains, palpitation, and shortness of breath. These symptoms gradually disappeared with sea-bathing. Seven years ago he had gonorrhœa. 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 condition 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 semesters at the University, serving, in the war of 1870, as a voluntary hospital assistant. Since he had no certificate of graduation from the Gymnasium, he gave up the study of medicine, and obtained the degree of doctor of philosophy. Then he 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-stuffs, and five years 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. He first had coitus at eighteen, and thereafter indulged moderately. His sensual desire had never been very great, but, until lately, the sexual act had been normal in every way, and accompanied by gratifying 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 feeling 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 frequently been with her parents; and thus it had happened 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 society.

He had had two such close friendships previously: when he was yet a student, with a corps-brother, a Dr. A. whom 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 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 examination 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 jealousy, S. explained as due merely to his sentimental temperament and his inordinate friendship. G. was still as dear to him as if he were his son.

It is worthy 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 never felt hurt himself by 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 anything suspicious in the intercourse between her husband and G., though the most simple wife would instinctively notice anything 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. lay 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 he 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 perfectly 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 way.

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 carefully examined.

G. is a young man, aged 20, of delicate build, whose development corresponds with his years; 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 prolonged association with G., one gets the impression that he is a harmless, 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, feeling 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 unhappiness. 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 school-mates. 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 normally 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 general 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.

Dr. S. is physically strong, somewhat corpulent, with a symmetrical, brachycephalic cranium. The genitals are well developed; the penis somewhat bellied; the prepuce somewhat hypertrophied.

_Opinion._—Pederasty is, unfortunately, not infrequent among mankind 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 psychical conditions from which this aberration of the sexual instinct arises; and in the concrete and doubtful case it seems requisite to ascertain whether these empirical, subjective conditions necessary for pederasty 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 virility, 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 incapability 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.g._, coitus inter femora); and he resorts to pederasty only very exceptionally, 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.

(_b_) 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 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 remuneration to another for having allowed active pederasty.

II. As a _pathological_ phenomenon:—

1. In individuals affected with contrary sexual instinct, with endurance 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 feminæ and 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 congenitally 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 effemination; 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 antecedents 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 psychological 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 suffices to recall the friendship of school-girls, the self-sacrificing friendship of sentimental young persons 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 conclusion 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 7, 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 testified 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.[146]

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 anthropological 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 temporary manual gratification is not the only purpose of such friendships. They are made to be enduring,—entered into systematically, so to speak,—and intense jealousy and a passion for love are 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 with the prison-regulations, she says ‘she has had a child by her friend.’”

We are indebted to Parent-Duchatelet (“De la prostitution,” 1857, vol. i, p. 159) for interesting communications concerning Lesbian love.

According to this experienced author, repugnance for the most disgusting and perverse acts (coitus in axilla, inter mammæ, 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. culturhistorische Studien,” p. 97) also finds that sexual intercourse between women has especially the significance of a vice which arises on the basis of unsatisfied hyperæsthesia 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 correspondence with the lover was quite as sentimental and exaggerated in tone as it is between lovers of the opposite sex; unfaithfulness and separation broke the heart of the one abandoned; jealousy was unbridled, and led to bloody revenge. The following cases of Lesbian love, by Mantegazza, 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 different women. She was recognized as a woman, and sentenced to imprisonment for six months.

2. In 1773, another woman, dressed as a man, courted a girl, and asked for her hand; but the trick 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 sewing-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 ornament themselves alike, etc. They are then called “_petites sœurs_” (little sisters).

7. NECROPHILIA.[147]

(Austrian Statutes, § 306.)

This horrible kind of sexual indulgence is so monstrous that the presumption of a psychopathic state is, under all circumstances, justified; and Maschka’s recommendation, that the mental condition of the perpetrator should always be investigated, is well founded. In any case, an abnormal and decidedly perverse sensuality is required to overcome the natural repugnance which man has for a corpse, and permit a feeling of pleasure to be experienced in sexual congress with a cadaver.

Unfortunately, in the 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.

8. INCEST.

(Austrian Statutes, § 132; Abridgment, § 189; German Statutes, § 174.)

The preservation of the moral purity of family life is a product of civilization;[148] 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-mindedness 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 facilitate 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 weakness, and infrequently in cases of epilepsy and paranoia.

In many of the cases, probably a majority, it is not possible, 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 literature, to the honor of humanity, the presumption of a psychopathic basis is possible.

In the Feldtmann case (Marc-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, besides, probably subject to periodical mental disease. In another case of incest between father and daughter (_loc. cit._, p. 247), the latter, at least, was weak-minded. Lombroso (_Archiv. di Psichiatria_, 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 predisposition, intellectual and moral imbecility, and alcoholism.

There was no mental examination in the case reported by Schürmeyer (_Deutsche Zeitschr. für Staatsarzneikunde_, xxii, H. 1), in which a mother laid her son of five and a half years on herself, and practiced abuse with him; and in that given by Lafarque (_Journ. Méd. 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. méd.-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. méd.-psych._, May, 1876) mentions a girl, aged 15, who seduced her brother into all manner of sexual excesses on her person; and when, after two years 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 know 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 debauchees. 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

Æsthetics and sexuality, 10

Amor lesbicus, 428

Anæsthesia 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

Cæsars, 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

Diagnosis of contrary sexuality, 319

Durga, 57

Effemination, 279

Ejaculation centre, 31 affections of, 36

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 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

Hyperæsthesia 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

Masoch, 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

Necrophilia, 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

Paræsthesia 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 atavistic, 152 cases of, 62–67 in women, 87 physiological relations of, 59 symbolic, 81 with animals, 84 with other objects, 82

Satyriasis, 373

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, 23 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

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 _rôle_ of, 13

Woman-haters’ ball, 417

Women, defilement of, 79 injury of, 70 masochism in, 137

Zones, erogenous, 31

Footnote 1:

“Meanwhile, until Philosophy shall at last unite and maintain the world, Hunger and Love impel it onward.”

Footnote 2:

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 be 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. ff.).

Footnote 3:

“No physical or moral misery, no suffering, 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.”

Footnote 4:

The Latin is left untranslated.

Footnote 5:

The works of Moll and von Schrenck-Notzing have since appeared.—TRANS.

Footnote 6:

Die Suggestions-Therapie, etc., F. Enke, Stuttgart, 1892.

Footnote 7:

Comp. Lombroso, “The Criminal.”

Footnote 8:

Comp. Westermarck, “History of Human Marriage.” McMillan & Co., 1891.

Footnote 9:

This generally entertained idea, also held by many historians, requires some limitation, 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 churchteachings, 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 affect 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, 3–12; Ephes. v, 22: “Wives, submit yourselves unto your husbands;” and 33, “And the wife _see_ that she reverence her husband”).

Passages in Tertullian 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! Thou hast brought man to the ground!” St. Hieronymus has 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!”

The Provincial Council of Macon, in the sixth century, earnestly debated the question 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, 1862). 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. xxi, 15), is nowhere explicitly interdicted in the New Testament. Christian princes (_e.g._, the 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 deutschen Frauen im Mittelalter,” ii, p. 15). Comp. also Unger, “Die Ehe,” etc., and the excellent work by Louis Bridel, “La femme et le droit,” Paris, 1884.

Footnote 10:

Comp. Friedländer “Sittengeschichte Roms.” Wiedemeister, “Der Cäsarenwahnsinn.” Suetonius. Moreau, “Des aberrations du sens génésique.”

Footnote 11:

These statements, however, are opposed to Friedreich (“Hdb. d. gerichtsärztl Praxis,” i, p. 271, 1843), and also Lombroso (_op. cit._, p. 42), according to whom pederasty is very frequent among the uncivilized Americans.

Footnote 12:

Comp. Friedreich, “gerichtl. Psychologie,” 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 fire that, in order to cool herself, she would lie down on the ground and cry “Love, love, I can endure it no longer!” 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 which 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 had thee in my bed to bring delight to body and soul. Come and be mine, and my heart shall be thy resting-place.”

Footnote 13:

Comp. Friedreich, “Diagnostik der psych. Krankheiten,” p. 347 _u. ff._; Neumann, “Lehrb. d. Psychiatrie,” p. 80.

Footnote 14:

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” (Lübke).

Footnote 15:

A Russian religious sect.

Footnote 16:

Westermarck (_op. cit._, p. 211), after a careful review of the evidence, says: “These 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.

Footnote 17:

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. 182) says that “it is a common notion that women are by nature vainer and more addicted to dressing and decorating themselves than men. This certainly does not hold good for savage and barbarous peoples in general.”—TRANS.

Footnote 18:

Comp. Max Müller, who derives the word fetich etymologically from _factitious_ (artificial, an insignificant thing).

Footnote 19:

Deutsches Montagsblatt, Berlin, August 20, 1888.

Footnote 20:

Magnan’s “spinal cérébral postérieur,” who finds pleasure in every woman, and on whom every woman looks with favor, has only desire to satisfy his lust. Purchased 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 are 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.

Footnote 21:

“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 Radàma’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 sexes that civilization has gradually reversed. While in civilized society woman exercises 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 the risk of being 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 has the greatest difficulty in getting married, and she is also the vainer of the two.”—TRANS.

Footnote 22:

The olfactory centre is presumed by Ferrier (“Functions of the Brain”) to be in the region of the _gyrus uncinatus_. Zuckerkandl (“Ueber das Riechcentrum,” 1887), from researches in comparative anatomy, concludes that the olfactory centre has its seat in Ammon’s horn.

Footnote 23:

Comp. Laycock, who (“Nervous Diseases of Women,” 1840) found that in women the love for musk and similar perfumes was related to sexual excitement.

Footnote 24:

Also in the insanity of gestation.—TRANS.

Footnote 25:

The 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.

Footnote 26:

Meibomius, “De flagiorum usu in re medica,” London, 1765; Boileau, “The History of the Flagellants,” London, 1783.

Footnote 27:

Comp. Roubaud, “Traité de l’impuissance et de la stérilité.” Paris, 1878.

Footnote 28:

Literature: Parent-Duchatelet, Prostitution dans la ville de Paris, 1837.—Rosenbaum, Entstehung der Syphilis, Halle, 1839; also, Die Lustseuche im Alterthum, Halle, 1839.—Descuret, La médecine des passions, Paris, 1860.—Casper, Klin. Novellen, 1863.—Bastian, Der Mensch in der Geschichte.—Friedländer, Sittengeschichte Roms.—Wiedemeister, Cäsarenwahnsinn.—Scherr, Deutsche Cultur- und Sittenge- schichte, Bd. i, Cap. 9.—Tardieu, Des attentats aux mœurs., 7 édit., 1878.—Emminghaus, Psychopathol., pp. 98, 225, 230, 232.—Schüle, Handbuch der Geisteskrankheiten, p. 114.—Marc, Die Geisteskrankheiten, übers v. Ideler, ii, p. 128.—v. Krafft, Lehrb. der Psychiatrie, 4 Aufl., i, p. 90; Lehrb. d. ger. Psychopathol., 2 Aufl., p. 234; Archiv f. Psychiatrie, vii, 2.—Moreau, Des aberrations du sens génésique, Paris, 1880.—Kirn, Allg. Zeitschr. f. Psychiatrie, xxxix, Heft 2 u. 3.—Lombroso, Geschlechtstrieb u. Verbrechen in ihren gegenseitigen Beziehungen (Goltdammer’s Archiv, Bd. xxx.).—Tarnowsky, Die krankhaften Erscheinungen des Geschlechtssinns, Berlin, 1886.—Ball, La Folie érotique, Paris, 1888.—Serieux, Recherches cliniques sur les anomalies de l’instinct sexuel, Paris, 1888.—Hammond, Sexual Impotence.

Footnote 29:

_Vide_ Ultzmann, Genito-Urinary Neuroses in the Male (published by The F. A. Davis Co., Philadelphia), for discussion of peripheral neuroses.

Footnote 30:

An interesting example of how an imperative conception of non-sexual content can exert an influence is related by Magnan (_Ann. méd. psych._, 1885): Student, aged 21, strongly predisposed hereditarily, previously a masturbator, 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.

Footnote 31:

Louyer-Villermay speaks of masturbation in a girl of 3 or 4 years, and Moreau (“Aberrations du sens génésique,” 2 édit., p. 209) of the same in one of 2 years. See, further, Maudsley, “Physiology and Pathology of Mind;” Hirschsprung (Kopenhagen), Berlin, klin. Wochenschr., 1866, Nr. 38; Lombroso, “The Criminal,” Cases 10, 19, and 21.

Footnote 32:

Comp. Kirn, Zeitschr. f. Psych., Bd. xxxix. Legrand du Saulle, Annal. d’hyg., 1868, Oct.

Footnote 33:

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 circumstances, made an unsuccessful sexual assault on a girl aged 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 lightest 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!

Footnote 34:

Cases, _vide_ Laségue: “Les exhibitionistes,” Union médicale, 1877, May 1st.

Footnote 35:

Legrand du Saulle, La folie devant les tribunaux, p. 530.

Footnote 36:

Kirn, Maschka’s Handb. d. ger. Med., pp. 373, 374; Allg. Zeitschrift f. Psychiatrie, Bd. xxxix, p. 220.

Footnote 37:

Die Welt als Wille und Vorstellung, 1859, B. ii, p. 461 _et seq._

Footnote 38:

“Ueber männliche Sterilität,” Wiener med. Presse, 1878, Nr. 1. “Ueber Potentia generandi et coeundi,” Wiener Klinik, 1885, Heft 1, S. 5. Translated under the title of Genito-Urinary Neuroses, etc. The F. A. Davis Company, Philadelphia.

Footnote 39:

In individuals in whom intense sexual hyperæsthesia is associated with acquired irritable weakness of the sexual apparatus, it is possible that simply at the 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-coupé 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.

Footnote 40:

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.

Footnote 41:

U. A. Novalis, in his “Fragments”; Görres, “Christliche Mystik,” Bd. iii, p. 460.

Footnote 42:

Comp. also Alfred deMusset’s famous verses to the Andalusian girl:—

“Qu’elle est superbe en son désordre—quand elle tombe les seins nus— Qu’on la voit, béante, se tordre—dans un baiser de rage et mordre— En hurlant des mots inconnus!”

Footnote 43:

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!—here, there, the murderous steel slays enemy, friend. Given and taken—death and life—with wavering change—wildly raging in frenzy.”

Footnote 44:

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.

Footnote 45:

Concerning analogous acts in rutting animals, _vide_ Lombroso, “The Criminal.”

Footnote 46:

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.

Footnote 47:

The conquest of woman takes place to-day in the social form of courting, in seduction 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, where 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.

Footnote 48:

In the Jahrbücher für Psychologie, ii, p. 128, Schäfer (Jena) refers to the reports of two cases by A. Payer. In the first case states of great sexual excitement were induced by the sight 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 predominantly 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 incomprehensible 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.”

Footnote 49:

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.

Footnote 50:

Comp. Metzger’s ger. Arzneiw., herausgegeben von Remer, p. 539; Klein’s Annalen, x, p. 176, xviii, p. 311; Heinroth, System der psych, ger. Med., p. 270; Neuer Pitaval, 1855, 23, Th. (Fall Blaize Ferrage).

Footnote 51:

Comp. Spitzka, The Journal of Nervous and Mental Disease, December, 1888; Kiernan, The Medical Standard, November, December, 1888.

Footnote 52:

Simon (Crimes et Délits, p. 209) mentions an experience of Lacassagne’s, to whom a respectable man said that he was never intensely excited sexually except when a spectator at a funeral.

Footnote 53:

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 invited 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 Charenton. 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 destroyed, and the author committed to Charenton again, where he died, at the age of sixty-four.

Footnote 54:

Comp. Krauss, Psychologie des Verbrechens, 1884, p. 188; Dr. Hofer, Annalen der Staatsarzneikunde, 6 Jahrgang, Heft 2; Schmidt’s Jahrbücher, Bd. lix, p. 94.

Footnote 55:

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.

Footnote 56:

Leo Taxil (La Corruption, Paris, Noiret, p. 223) makes the same statements. There are also men who demand introductio linguæ meretricis in anum.

Footnote 57:

Leo Taxil (_op. cit._, p. 234) 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.

Footnote 58:

The legend is especially spread throughout the Balkan peninsula. Among the Greeks it has its origin in the myth of the _lamiæ_ and _marmolykes_,—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.

Footnote 59:

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.

Footnote 60:

So named from the writer, Sacher-Masoch, whose romances and novels have as their particular object the description of this perversion.

Footnote 61:

Comp., _supra_, Introduction, p. 28.

Footnote 62:

The author’s “Neue Forschungen auf d. Gebiet d. Psychopathia Sexualis,” Stuttgart, 1891, which is, for the most part, incorporated in this edition of “Psychopathia Sexualis.”

Footnote 63:

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 44), even though it is the only indication of effemination mentioned in this case.

Footnote 64:

Transactions of the Colorado State Medical Society, quoted in the Alienist and Neurologist, 1883, p. 345.

Footnote 65:

“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.”

Footnote 66:

“Never daring to express my desire, I at least gave it rein under circumstances that served to preserve in me the idea of it.”

Footnote 67:

“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.”

Footnote 68:

However, the domain of masochism must be sharply differentiated from the principal subject of that work, which is, that love contains an element of suffering. Unrequited 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 Hamerling (“Amor und Psyche,” iv, Gesang) uses perfect masochistic pictures, flagellation, etc., to express this feeling.

Footnote 69:

The desire to be trod upon also occurs in religious enthusiasts (comp. Turgenjew, “Sonderbare Geschichten”).

Footnote 70:

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.

Footnote 71:

In Continental hotels the guests are accustomed to put their shoes in the corridors at night, to be cleaned.

Footnote 72:

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 unexplained 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 æsthetic qualities in his fetich (comp. Case 90).

Footnote 73:

There is apparently a connection between foot-fetichism 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.

Footnote 74:

Analogy with the excesses of religious enthusiasm is found even here. The religious enthusiast, Antoinette Bouvignon de la Porte, mixed her food with fæces to punish herself (Zimmermann, _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.

Footnote 75:

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. The latter right was used freely, even by those of high standing (comp. Schultze, Das höfische Leben zur Zeit des Minnesangs, Bd. i, p. 163 _et seq._). Yet, by the side of this, the paradoxical chivalry of the Middle Ages stands unexplained.

Footnote 76:

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 us!”

Footnote 77:

Anthony and Cleopatra, v. 2.

Footnote 78:

Comp. the author’s article, “über geschlechtliche Hörigkeit und Masochismus,” in the Psychiatrischen Jahrbücher, Bd. x, p. 169 _et seq._, where this subject is treated in detail, and particularly from the forensic stand-point.

Footnote 79:

The expressions “slave” and “slavery,” though often used metaphorically under such circumstances, are avoided here because they are the favorite expressions of masochism, 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.

Footnote 80:

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 beyond the threshold of consciousness; and it may be used by the dominant individual like an inanimate instrument.

Footnote 81:

Sexual bondage, of course, plays a _rôle_ 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 Abbé Prévost, “Mano Lescault.” An excellent description of feminine “bondage” is that of “Leone Leoni,” by George Sand. But first of all comes Kleist’s “Käthchen von Heilbronn,” who himself called it the counterpart of (sadistic) “Penthesilea.” Halm’s “Griseldis” and many other similar poems also belong here.

Footnote 82:

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 latter suffer for love, without, however, having a desire for blows, we have a pseudo form of bondage that may simulate masochism.

Footnote 83:

It is very interesting, and dependent upon the nature of bondage and masochism, which essentially correspond in external effects, that to illustrate the former certain playful, metaphorical expressions are in general use; such 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 similes, _he proceeds exactly as does the masochist_, 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” (_e.g._, Horace, Od. iv, 11). From antiquity through all the centuries to our own times (comp. Grillparzer, “Ottokar,” Act v: “To rule is sweet, almost as sweet as to obey”), the poetry of love is filled with similar phrases and similes. The history 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 vassalage 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 systematic, poetical development of the “bondage” of love. Certain extreme manifestations, like the deeds and suffering 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 transformation of one phenomenon into the other.

Footnote 84:

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 inheritance 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 effemination, 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 present 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 _rôle_ of succubus, as shown by statements referring to this.

It must, however, be emphasized that “bondage” also plays no unimportant _rôle_ in the masculine 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 masochism, as well as its counterpart, sadism, occurs in irregular combination with contrary sexual instinct.

Footnote 85:

Of course, both have to contend with opposing ethical and æsthetic motives _in foro interno_. After these have been overcome and sadism appears, it immediately comes in 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 the realization of the latter. The practical significance of masochism lies only in its relations to psychical impotence; while that of sadism lies beyond that, and is principally forensic.

Footnote 86:

Every attempt to explain the facts of either sadism or masochism, owing to the close connection of the two phenomena demonstrated here, must also be suited to explain the other perversion. An attempt to offer an explanation of sadism, by J. G. Kiernan (Chicago) (_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, Cleukowsky) 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 connection with this the well-known facts that at the time of sexual union crabs tear limbs from their bodies and spiders bite off the heads of the males, and other sadistic acts performed by rutting animals with 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 survival 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 process 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 individual by another (comp. Weismann, Die Bedeutung der Sexuellen Fortpflanzung für die Selectionstheorie, p. 51, Jena, 1886).

Footnote 87:

In Zola’s “Therese Raquin,” where the lover repeatedly kisses his mistress’s boot, the case is quite different 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.

Footnote 88:

Though Binet (_op. cit._) declares that every sexual perversion, without exception, depends upon such an “accident acting on a predisposed subject” (where, under predisposition, only hyperæsthesia in general is understood), yet such an assumption for other perversions than fetichism is neither 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.

Footnote 89:

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 condition 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 accustomed 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.

Footnote 90:

A kind of rudimentary sadism in L. and masochism in N.

Footnote 91:

Great sexual hyperæsthesia. Comp. note on p. 50.

Footnote 92:

This is also sexual hyperæsthesia. Any intense excitement affects the sexual sphere (Binet’s “dynamogénie générale”). 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 nervous impotence.”

Footnote 93:

Phila. Med. and Surg. Rep., Sept. 7, 1889.

Footnote 94:

This case was originally reported by Dr. A. R. Reynolds, Chicago (Western Med. Reporter, Nov., 1888).

Footnote 95:

Moll (_op. cit._ p. 131) reports: “A man, X., becomes intensely excited sexually whenever he sees a woman with the hair in a braid; loose hair, no matter how beautiful, cannot produce this effect.”

Of course, it is not justifiable to consider all hair-despoilers fetichists, for in a few cases such acts are done for the purpose of gain,—_i.e._, the stolen hair is not a fetich.

Footnote 96:

Magnan (Arch, de Neurologie, vol. xxxiii, No. 69, 1892) gives the details of a case of sexual perversion in a degenerate individual, where the elements of fetichism and sadism were combined, and _faute 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 was 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.

Footnote 97:

The frequent changes of style of dress which fashion dictates may be referred to a physiological law. The reaction of the nervous system to a constant stimulus 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 self-mutilation, such as half-castration and circumcision (comp. Westermarck, _op. cit._, p. 205). Finally, mutilation is replaced by movable appendages, upon which ornaments are worn; and thus there is afforded opportunity for _change_, in obedience to the unconscious physiological requirement, which is called a “_taste_ for change.” Undoubtedly, woman’s desire for changes of fashion is primarily dependent upon man’s desire to be pleased; and her function in this direction has certainly been transferred from him to her by civilization (comp. p. 16).—TRANS.

Footnote 98:

Comp: Goethe’s remarks about his adventure in Geneva (“Briefe aus der Schweiz,” 1. Abtheil., Schluss).

Footnote 99:

The fact that the partly-veiled form is often more charming than when it is perfectly nude, is, as far as object goes, similar, but quite different psychically. This depends upon the effect of contrast and expectation, which are common phenomena, and in no sense pathological.

Footnote 100:

On page 124 (_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 him 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 gentleman 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.’”

Footnote 101:

Garnier (Anomalies Sexuelles, Paris, pp. 508, 509) reports two cases (Cases 222 and 223) that are apparently opposed to this assumption, particularly the first, in which 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 homo-sexual acts. In Case 223, the individual was effeminated _ab origine_, 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 the 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 are quite different in which, _faute de mieux_, with great sensuality and a defective æsthetic 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 importance of original predisposition in contrast with exciting causes (comp. _op. cit._, pp. 156–175). 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.”

Footnote 102:

Comp, author’s Experimental Study in the Domain of Hypnotism, 1889. G. P. Putnam’s Sons, New York.

Footnote 103:

Comp. Sprengel, “Apologie des Hippokrates,” Leipzig, 1792, p. 611; Friedreich, “Literärgeschichte der psych. Krankheiten,” 1830, p. 31; Lallemand, “Des pertes séminales,” Paris, 1836, i, p. 581; Nysten, “Dictionn. de médecine,” xi édit., Paris, 1858, Art. “éviration et Maladie des Scythes”; Marandon, “De la maladie des Scythes”; “Annal. médico-psychol.,” 1877, Mars, p. 161; Hammond, American Journal of Neurology and Psychiatry, August, 1882.

Footnote 104:

The following description of the “bote” is taken from Dr. J. G. Kiernan’s article on “Responsibility in Sexual Perversion,” read before the Chicago Medical Society, March 7, 1892: “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 disposition. By offering 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, consisting 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’ _negligée_ 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 tribes 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 significance, as male and female Indians are both free from hair on these parts of the body. The mammæ 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 successful 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 Scythians of Caucasus, called by the Greeks anandreis, a word strikingly similar in meaning to ‘bote.’”—TRANS.

Footnote 105:

Bibliography (besides works mentioned hereafter): Tardieu, Des attentats aux moeurs, 7 édit., 1878, p. 210.—Hofmann, Lehrb. d. ger. Med., 3 Aufl., pp. 172, 850.—Gley, Revue philosophique, 1884, Nr. 1.—Magnan, Annal. med.-psychol., 1885, p. 458.—Shaw and Ferris, Journal of Nervous and Mental Disease, 1883, April.—Bernhardi, Der Uranismus, Berlin (Volksbuchhandlung), 1882.—Chevalier, De l’inversion de l’instinct sexual, Paris, 1885.—Ritti, Gaz. hebdom. de médecine 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 conträre Sexualempfindung, Berlin, 1891 (numerous bibliographic references).—Chevalier, Archives de l’anthropologie criminelle, vol. v, No 27; vol. vi, No. 31.—Reuss, “Aberrations du sens générique,” Annales d’hygiène publique, 1886.—Saury, Étude clinique sur la folie héréditaire, 1886.—Brouardel, Gaz. des hôpiteaux, 1886 and 1887.—Tilier, L’instinct sexuel chez l’homme et chez les animaux, 1889.—Carlier, Les deux prostitutions, 1887.—Lacassagne, art. “Pédérastie,” in the Diction. encyclopédique.—Vibert, art. “Pédérastie,” in the Diction. méd. et de chirurgie.

Footnote 106:

Dr. Moll, of Berlin, called my attention to the fact that in Moritz’s Magazin f. Erfahrungsseelenkunde, 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 persons 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 opposite sex, in me, 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 viraginity, historically and legally interesting, derived from the legal proceedings, which took place early in the eighteenth century, is reported by Dr. Müller (Alexandersbad), in Friedrich’s Blätter f. ger. Medicin, 1891, part iv.

Footnote 107:

“Vindex, Inclusa, Vindicta, Formatrix, Ara spei, Gladius furens, kritische Pfeile,” Leipzig (Otto u. Kadler), 1864–1880.

Footnote 108:

In male individuals: (1) Casper, Klin. Novellen, p. 36 (Lehrb. d. ger. Med., 7 Aufl., p. 176); (2) Westphal, Archiv f. Psych., ii. p. 73; (3) Schminke, _id._, iii, p. 225; (4) Scholz, Vierteljahrsschr. f. ger. Med., xix; (5) Gock, Arch. f. Psych., v., p. 564; (6) Servaes, _id._, vi, p. 484; (7) Westphal, _id._, vi, 620; (8, 9, 10) Stark, Zeitsch. f. Psychiatrie, Bd. 31; (11) Liman (Casper’s Lehrb. der ger. Med., 6 Aufl., p. 509), p. 291; (12) Legrand du Saulle, Annal. méd.-psychol., 1876, May; (13) Sterz, Jahrb. f. Psychiatrie, iii, Heft 3; (14) Krueg, Brain, 1884, Oct.; (15) Charcot et Magnan, Arch. de neurolog., 1882, Nr. 9; (16, 17, 18) Kirn, Zeitschr. f. Psych., Bd. 39, p. 216; (19) Rabow, Erlenmeyer’s Centralb., 1883, Nr. 8; (20) Blumer, 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. méd. psychol., 1885, p. 461; (24) Chevalier, De l’inversion de l’instinct sexuel, Paris, 1885, p. 129; (25) Morselli, La Riforma medica, iv, March; (26) Leonpacher, Friedreich’s Blätter, 1888, H. 4; (27) Holländer, Allg. Wiener Med. Zeitg., 1882; (28) Kreise, Erlenmeyer’s Centralblatt, 1888, Nr. 19; (29, 30, 31, 32) v. Krafft, Psychopathia sexualis, 3 Aufl., Beob. 32, 36, 42, 43; (33) Golenko, Russ. Archiv f. Psychiatrie, Bd. ix, H. 3 (v. Rothe, Zeitschr. f. Psychiatrie); (34) v. Krafft, Internationales Centralblatt f. d. Physiol, u. Pathologie der Harn-u. Sexualorgane, Bd. 1, H. 1; (35) Cantarano, La Psichiatria, 1887, v., p. 195; (36) Sérieux, Recherches cliniques sur les anomalies de l’instinct sexuel, Paris, 1888, obs. 13; (37–42) Kiernan, The Medical Standard, 1888, 7 cases; (43–46) Rabow, Zeitschr. f. klin. Medicin, 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) Garnier, Anomalies sexuelles, 1889, Obs. 227, 228, 229, 230; (72) Müller, Friedreich’s Blätter, 1891; (73–87) 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) Sérieux, _op. cit._, obs. 14; (6) Kiernan, _op. cit._

Footnote 109:

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 in causal relation with an arrest of psychical development, caused by traumatism.

Footnote 110:

This supposition is overthrown by the result of the post-mortem of my case (118), where the brain-weight was 1150 grammes, and of Case 130, where it was 1175 grammes.

Footnote 111:

That inversion of the sexual instinct is not infrequent is proved, among other things, by the circumstance that it is frequently a subject in novels. Chevalier (_op. cit._) points out in French literature, besides the novels of Balzac, like “La Passion au Desert” (treating of bestiality) and “Sarrazine” (treating of the love of a woman for a eunuch), Diderot’s “La Religieuse” (a story of one given to _amor lesbicus_); Balzac’s “La Fille aux Yeux d’Or” (_amor lesbicus_); 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 mentioned (now translated into English). It is interesting that the heroines of these (Lesbian) novels appear in the character and _rôle_ of the husband of a lover of the same sex, and that their love is extremely passionate. Moreover, the neuropathic foundation of this sexual perversion does not escape the writers. This theme is treated, in German literature, in “Fridolin’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 the Empire, under the title Satyricon.

Footnote 112:

Comp. author’s work, “Ueber psychosexuales Zwitterthum,” in the internationalen Centralblatt f. d. Physiologie u. Pathologie der Harn und Sexualorgane, Bd. i, Heft 2.

Footnote 113:

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 acquaintance, in which married men at the same time had “relations” with men.

Footnote 114:

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.

Footnote 115:

“Thou art like any flower, so sweet, so beautiful, so pure,” etc.

Footnote 116:

“Lowering like the heavens, frowns the world on me, Yet blest or cursed will be the fate I meet. With trusting heart, dear friend, I think of thee! God keep thee, dear! it would have been too sweet! God keep thee, dear! such happiness was not to be!”

Footnote 117:

Comp. the expert medical opinion of this case, by Dr. Birnbacher, in Friedreich’s Blätter f. ger. Med., 1891, H. 1.

Footnote 118:

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.”

Footnote 119:

For numerous cases, _v._ Henke’s Zeitschr., xxiii.—Ergänzungsheft, p. 147.—Combes, Annal. méd. psychol., 1866.—Liman, Zweifelh. Geisteszustände, p. 389.—Casper-Liman, Lehrb., 7. Auflage, Fall 295.—Bartels, Friedreich’s Blätter f. gerichtl. Med., 1890, Heft 1.

Footnote 120:

Other cases of pederasty, _v._ Casper, Klin. Novellen, Fall 5; Combes, Annal. méd. psychol.

Footnote 121:

V. Sander, Vierteljahrsschr. f. ger. M., xviii, p. 31.—Casper, Klin. Novellen, Fall 27.

Footnote 122:

Arndt (Lehrb. d. Psych., 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 on the part of fathers, concerning sexual intercourse with the mothers.” But when Arndt declares that, wherever there is a peculiarity of the sexual life, thought of an epileptic element should come into consideration, he is in error.

Footnote 123:

Comp. also Liman, Zweifelhafte Geisteszustände, Fall 6.—Lasègue, Exhibitionists, Union méd., 1877.—Ball and Chambert, Art. Somnambulisme (Dict. des scienc. méd., 1881).

Footnote 124:

Comp. the interesting cases of Marc-Ideler, ii, p. 137.—Ideler, “Grundriss der Seelenheilkunde,” ii, pp. 488–492.

Footnote 125:

_Vide_ Fall Merlac, in the author’s Lehrb. d. ger. Psychopathol., 2 Aufl., p. 322.—Morel, Traité des malad. mentales, p. 687.—Legrand, La folie, p. 337.—Process La Roncière, in Annal. d’hyg., 1. Serie, iv; 3. Serie, xxii.

Footnote 126:

The incubus in the witch-trials of the Middle Ages depended on them.

Footnote 127:

Comp. Casper, Klin. Novellen.—Lombroso, Goltdammer’s Archiv, Bd. xxx.—Oettingen, Moralstatistik, p. 494.

Footnote 128:

Lasègue, Union Médicale, 1877, May.—Laugier, Annal d’hygiène publ., 1878, No. 106.—Pelanda, “Pornopaths,” Archivio di Psichiatria, viii.—Schuchardt, Zeitschr. f. Medicinalbeamte, 1890, Heft 6.

Footnote 129:

Comp. v. Krafft, “Ueber transitorisches Irresein bei Neurasthenischen,” Irrenfreund, 1883, No. 8.

Footnote 130:

Dr. Moll calls this perversion (?) mixoscopia (from μιξις, cohabitation; and σκεπτειν, 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 conträre Sexualempfindung,” p. 137.

Footnote 131:

Annal. médico-psychol., 1849, p. 515; 1863, p. 57; 1864, p. 215; 1866, p. 253.

Footnote 132:

Comp. the cases of Tardieu, Attentats, p. 182–192.

Footnote 133:

Comp. Haltzendorff, Psychologie des Mords.

Footnote 134:

Tardieu, Attentats, Case 51, p. 188.

Footnote 135:

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. österr. Strafrechts., Wien, 1878, p. 72) remarks, there are, nevertheless, crimes conditioned by the absence of assent on the part of the injured individual, 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 different and much milder punishment is inflicted under such circumstances (§ 216); and it is the same in Austrian law (Austrian Abridgment, § 222). 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.

Footnote 136:

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).

Footnote 137:

Cases, _vide_ Friedreich’s Blätter f. ger. Anthropologie, iii, p. 77.

Footnote 138:

Cases, Maschka, Handb., iii, p. 175.—Casper, Vierteljahrsschr., 1852, Bd. i.—Tardieu, Attentats.

Footnote 139:

Comp. Kirn, Allg. Zeitschr. f. Psych., 39, p. 217.

Footnote 140:

I follow the usual terminology in describing bestiality and pederasty under the general term sodomy. In Genesis (chap. xix), whence this word comes, it signifies exclusively 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 distinguished correctly, _i.e._, in the sense of Genesis, between sodomia, _i.e._, concubitus cum persona ejusdem sexus, and bestialitas, _i.e._, concubitus cum bestia (comp. Olfus, Pastoralmedicin, p. 78).

The jurists brought confusion into the terminology by establishing a “Sodomia ratione sexus” and a “S. ratione generis.” Science, however, should assert itself as _ansilla theologiæ_, and return to the correct usage.

Footnote 141:

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.

Footnote 142:

How difficult, unpleasant, and dangerous for the jurist judgment of these “coitus-like” acts for the establishment of the objective fact of the crime may be is well shown by an article on the punishableness of male intercourse, in the Zeitschr. f. d. gesammte Strafrechtswissenschaft., Bd. vii, Heft 1, as well as by a similar one in Friedreich’s Blätter f. ger. Medicin, 1891, Heft 6. _Vide_, further, Moll, Conträre Sexualempfindung, p. 223 _et seq._, and Bernhardi, Der Uranismus, Berlin, 1882.

Footnote 143:

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. Tarnowsky _et al._)

Footnote 144:

Lombroso (Der Verbrecher, p. 20 _et seq._) shows that also, in case of animals, intercourse with the same sex occurs where normal indulgence is impossible.

Footnote 145:

Comp. Tardieu, Attentats, p. 198.—Martineau, Deutsche Med. Zeitung, 1882, p. 9.—Virchow’s Jahrb., 1881, i, p. 533.—Coutagne, Lyon Médical, Nos. 35, 36.

Footnote 146:

Comp. Mayer, Friedreich’s Blätter, 1875, p. 41.—Kraussold, Melancholie und Schuld, 1884, p. 20.—Andronico, Archiv di psich. scienze penali ed anthropol. crim., vol. iii, p. 145.

Footnote 147:

Comp. Maschka, Hdb., iii, p. 191 (good historical notes).—Legrand, La folie, p. 521.

Footnote 148:

_Vide_ Westermarck, History of Human Marriage, chap. xiv. McMillan & Co., 1891.

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Hand-Book of Materia Medica, 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 in its 366 pages about as much sound and valuable information on the subjects indicated in its title as could well be crowded into the compass.—_St. Louis Medical and Surgical Journal._

_BURET_

SYPHILIS In 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 the 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._ 230 pages. 12mo. 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 complete history of Syphilis from prehistoric times up to the Christian Era.

The subject throughout is treated in a clear, concise manner, and readers will find many things which are historically new.

In order to give some idea of the contents of this first volume, the following are cited as among the subjects treated:—

In What does Syphilis 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. _Upadansa._—Syphilis Among the Hindoos, 1000 B.C. _Sukon._—Syphilis Among the Greeks. _Ficus._—Syphilis at Rome under the Cæsars. Conclusion: Rational Treatment of Syphilis in the Nineteenth Century.

_CAPP_

The Daughter: Her Health, Education, and Wedlock.

HOMELY SUGGESTIONS TO MOTHERS AND DAUGHTERS.

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 information sought.

It is complete in one beautifully printed (large, clear type) 12mo volume of 150 pages.

Handsomely bound in Extra Cloth, price, post-paid, in the United States and Canada, $1.00, net; Great Britain, 5s. 6d; France, 6 fr. 20.

In Paper Cover (Unabridged), 50 cts., net.

In the 144 pages allotted to him he has compressed an amount of homely wisdom on the physical, 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 offense in expression or ideas that it can safely be recommended for all whose minds are sufficiently developed to appreciate its teachings.—_Philadelphia Public Ledger._

Many delicate subjects are treated with skill and in a manner which cannot strike any one as improper or bold. The absolute ignorance in which most young girls are allowed to exist, even until adult life, is often productive of much misery, both mental and physical. Quite a number of books written by physicians for popular use have been prepared in such a way that the professional man can read between the lines strong bids for popular favor, etc. These objectionable features will not be found in Dr. Capp’s _brochure_, and for this reason it is worthy the confidence of physicians.—_Medical News._

_CATHELL_

Book on the Physician Himself

AND THINGS THAT CONCERN HIS REPUTATION AND SUCCESS. A NEW (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 charming 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 far as human effort can achieve, and though enlarged to 350 _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, 11s. 6d.; in France, 12 fr. 40.

“The Physician Himself” interested me so much that I actually read it through at one sitting. It is brimful of the very best advice possible for medical men. I, for one, shall try to profit by it.—_Prof. William Goodell, Philadelphia._

It is marked with good common sense and replete with excellent maxims and suggestions for the guidance of medical men.—_The British Medical Journal._

We advise our readers to buy it. It will give them food for thought and show them how to and how not to achieve reputation and success.—_The Medical Age._

We cannot too strongly commend it to the attention of every young doctor. Many a lesson is pleasantly and gently taught in its pages which cannot otherwise be learned unless 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 physician’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, carefully studied, the pages of this book will be of great benefit to the young and old.—_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 and feel the value of its practical points. How I wish I could have read such a guide at the outset of my career!—_Prof. James Nevins Hyde, Chicago, Ill._

“The Physician Himself” is useful alike to the tyro and the sage—the neophyte and the veteran. It is a _headlight_ in the splendor of whose beams a multitude of our profession shall find their way to success.—_Prof. 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 medical literature more profitable for perusal and possession.—_Denver Medical Times._

This book will do a world of good, a good that will be far-reaching and constant, and the fact that it has reached its tenth edition proves toward a higher and yet higher teaching, that “the elevation of the profession” is a consistent and timely aim.—_Chicago Clinical Review._

_CLEVENGER_

Spinal Concussion.

SURGICALLY CONSIDERED AS A CAUSE OF SPINAL INJURY, AND NEUROLOGICALLY RESTRICTED TO A CERTAIN SYMPTOM GROUP, FOR WHICH IS SUGGESTED THE DESIGNATION ERICHSEN’S DISEASE, AS ONE FORM OF 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 diagnosis by Electricity, a discussion of the controversy concerning hysteria, and the author’s original pathological view that the lesion is one involving the spinal sympathetic nervous system.

_Every Physician and Lawyer should own this work._

In one handsome Royal Octavo Volume of nearly 400 pages, with thirty Wood-Engravings.

Price, post-paid, in United States and Canada, $2.50, net; in Great Britain, 14s.; in France, 15 fr.

This work really does, if we may be permitted to use a trite and hackneyed expression, “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.—_Medical Weekly Review._

_COLTMAN_

THE CHINESE: Their Present and Future; Medical, Political, and Social.

By ROBERT COLTMAN, JR., M.D., Surgeon in Charge of the Presbyterian Hospital and Dispensary at Teng Chow Fu; Consulting Physician of the American Southern Baptist Mission Society, etc.

Beautifully printed in large, clear type, 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. Handsomely 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 curiosity to the American, and anything in regard to his 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 photographs taken by himself.—_Boston Med. and Surg. Journal._

Attached to a number of hospitals and dispensaries, he has had ample opportunity to observe the medical aspect of the Chinese. The most prevalent diseases are such as affect the alimentary 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 common, and the author states that it cannot be contagious, as is supposed by many, or it would assume a terrible 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. The political situation is very intelligently handled in its various bearings. The photo-engravings are handsome and well-executed, the book in general being gotten up in a very artistic manner. We can heartily commend this work not only to physicians, but to intelligent lay readers.—_St. Louis Medical Review._

_DAVIS_

CONSUMPTION: How to Prevent it and How to Live with it.

ITS NATURE, CAUSES, PREVENTION, 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 different climates and the important part they play in the treatment 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 consumption 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 discussion 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 Same Author_

Diseases of the Lungs, Heart, and Kidneys.

By N. S. DAVIS, JR., A.M., M.D.

_The Nature, Pathological Anatomy, Symptoms, Causes, Diagnosis, and Treatment_ 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. 14 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.; France, 7 fr. 75.

The author evidently knows how to put “multum in parvo” without omitting anything essential to a clear understanding of the subject discussed.—_St. Louis Medical Era._

It requires close thought, carefully and judiciously applied, to write a book as this one is written. A systematic treatise on the Diseases of the Lungs, Heart, and Kidneys, and their co-ordinate relation and sympathy, presenting 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 study.—_Medical Free Press._

_DEMARQUAY_

On Oxygen. A Practical Investigation of the Clinical and Therapeutic Value of the Gases in Medical and Surgical Practice,

WITH ESPECIAL REFERENCE TO THE VALUE AND AVAILABILITY OF OXYGEN, NITROGEN, HYDROGEN, AND NITROGEN MONOXIDE.

By J. N. DEMARQUAY, Surgeon to the Municipal Hospital, Paris, and of the Council of State; Member of the Imperial Society of Surgery, etc. Translated, with notes, additions, 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-Russia, $3.00, net. In Great Britain, Cloth, 11s. 6d.; Half-Russia, 17s. 6d. In France, Cloth, 12 fr. 40; Half-Russia, 18 fr. 60.

This is a handsome volume of 300 pages, in large print, on good paper, and nicely illustrated. Although nominally pleading for the use of oxygen inhalations, the author shows in a philosophical manner how much greater good physicians might do if they more fully appreciated the value of fresh-air exercise and water, especially in diseases of the lungs, kidneys, and skin. We commend its perusal to our readers.—_The Canada Medical Record._

_EISENBERG_

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, Ill.

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 reagents, with formulæ for same; the methods of microscopic examination of bacteria, etc., etc., etc.

_EDINGER_

Twelve Lectures on the Structure of the Central Nervous System.

FOR PHYSICIANS AND STUDENTS.

By DR. LUDWIG EDINGER, Frankfort-on-the-Main. Second Revised Edition. 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 Neurological 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 satisfactory 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 valuable 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 subject of the general and minute anatomy of the central nervous system so complete and exhaustive as this work of Dr. Ludwig Edinger. Being himself an original worker, and having the benefits of such masters as Stilling, Weigeit, Geilach, Meynert, and others, he has succeeded in transforming the mazy wilderness 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 anatomical bugbear.—_The Southern Medical Record._

Every point is clearly dwelt upon in the text, and where description alone might leave a subject obscure clever drawings and diagrams are introduced to render misconception of the author’s meaning impossible. 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 explicitly or so concisely.—_Northwestern Lancet._

_GOODELL_

LESSONS IN GYNECOLOGY.

By WILLIAM GOODELL, A.M., M.D., etc., Professor of Clinical Gynecology 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 women. 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, $4.00; Sheep, $4.80. Postage, 27 cents extra. Great Britain, Cloth, 22s. 6d.; Sheep, 28s., post-paid. France, 30 fr. 80.

It is too good a book to have been allowed to remain out of print, and it has unquestionably 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 by the insertion of six new lessons.—_Amer. Jour. of Obstet._

Extended mention of the contents of the book is unnecessary; suffice it to say that every important disease found in the female sex is taken up and discussed in a common-sense kind of a way. We wish every physician in America could read and carry out the suggestions of the chapter on “the sexual relations as causes of uterine disorders—conjugal onanism and kindred sins.” The department treating of nervous counterfeits of uterine diseases is a most valuable one.—_Kansas City Medical Index._

_GUERNSEY_

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 Guernsey’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. Introductory. II. The Infant. III. Childhood. IV. Adolescence of the Male. V. Adolescence of the Female. VI. Marriage: The Husband. VII. The Wife. VIII. 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, 6 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 7 x 3¾ inches, and can be conveniently carried in the pocket.

U. S. and Great Canada. Britain. France. 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, net 6s. 6 fr. 20

_HARE_

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 AMORY HARE, M.D., B.Sc., Professor of Materia Medica 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 the Physicians’ 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.

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 literature 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 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._

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 libraries, should get this work.—_The Sanitarian._

_By the Same Author_

Fever: Its Pathology and Treatment.

BEING THE BOYLSTON PRIZE ESSAY OF HARVARD UNIVERSITY FOR 1890. CONTAINING DIRECTIONS AND THE LATEST INFORMATION CONCERNING THE USE OF THE SO-CALLED ANTIPYRETICS IN FEVER AND PAIN.

By HOBART AMORY HARE, M.D., B.Sc., etc., etc.

_No. 10 in the Physicians’ and Students’ Ready-Reference Series._ 12mo. Neatly bound in Dark-Blue Cloth.

Illustrated with more than 25 new plates of tracings of various fever cases, showing beautifully and accurately the action of the Antipyretics. The work also contains 35 carefully 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, antifebrin, phenacetin, thallin, and salicylic acid. The reader will certainly find the work one of the most interesting of its excellent group, the _Physicians’ and Students’ Ready-Reference Series_.—_The Dosimetric Medical Review._

_IVINS_

Diseases of the Nose and Throat.

A TEXT-BOOK FOR STUDENTS AND PRACTITIONERS.

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 Homœopathy, of the Homœopathic Medical Society of the State of Pennsylvania, etc.

ROYAL OCTAVO, 507 PAGES. WITH 129 ILLUSTRATIONS, CHIEFLY ORIGINAL, including Eighteen (18) colored figures from Drawings and Photographs of Anatomical Dissections, etc.

Price, in United States, Extra Cloth, $4.00, net; Half-Russia, $5.00, net. Canada (duty paid), Cloth, $4.40, net; Half-Russia, $5.50, net. Great Britain, Cloth, 22s. 6d.; Sheep or Half-Russia, 28s. France, Cloth, 24 fr. 60; Half-Russia, 30 fr. 30.

_HUIDEKOPER_

Age of the Domestic Animals.

BEING A COMPLETE TREATISE ON THE DENTITION OF THE HORSE, OX, SHEEP, HOG, AND DOG, AND ON THE VARIOUS OTHER MEANS OF DETERMINING THE AGE OF THESE ANIMALS.

By RUSH SHIPPEN HUIDEKOPER, M.D., Veterinarian (Alfort, France); Professor of Sanitary Medicine and Veterinary Jurisprudence, 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 drawn 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 English), 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 by the incisive arches during the different stages of life. Illustrations do not always illustrate; these do.—_Amer. Vet. Review._

Although written primarily for the veterinarian, this book will be of interest to the dentist, physiologist, anatomist, and physician. Its wealth of illustration and careful preparation are alike commendable.—_Chicago Med. Recorder._

It is profusely illustrated with 200 engravings, 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 Medical Association; Fellow of the British Gynæcological Society; Fellow of the American Electro-Therapeutic Association; Member of the Philadelphia Obstetrical Society; Member of the Société d’Electro-Thérapie; Author of “Gynæcological 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 ABOUT 900 PAGES.

Price, in United States, Extra Cloth, $5.50, net; Sheep, $6.50, net; Half-Russia, $7.00, net. In Canada (duty paid), Cloth, $6.00, net; Sheep, $7.25, net; Half-Russia, $7.75, 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 PUBLISHED IN OCTOBER, 1893.

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. NORRIS WOLFENDEN, of London, and DR. JOHN MACINTYRE, 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 correspondents 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, 1s. 3d. (30 Cents). Sample Copy, 25 Cents.

_KEATING and EDWARDS_

Diseases of the Heart and Circulation

IN INFANCY AND ADOLESCENCE. WITH AN APPENDIX ENTITLED “CLINICAL STUDIES ON THE PULSE IN CHILDHOOD.”

By JOHN M. KEATING, M.D., Obstetrician to the Philadelphia Hospital, and Lecturer on Diseases of Women and Children; Surgeon to the Maternity Hospital; Physician to St. Joseph’s Hospital; Fellow of the College of Physicians of Philadelphia, etc.; and WILLIAM A. EDWARDS, M.D., Instructor in Clinical Medicine and Physician to the Medical Dispensary in the University of Pennsylvania; Fellow of the College of Physicians: formerly Assistant Pathologist to the Philadelphia Hospital, etc.

Illustrated by Photographs and Wood-Engravings. About 225 pages. Octavo. Bound in Cloth.

Price, post-paid, in the United States and Canada, $1.50, net; in Great Britain, 8s. 6d.; in France, 9 fr. 35.

Drs. Keating 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 novelties 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 regurgitation; there are also a number of wood-cuts.—_Cleveland Medical Gazette._

_LIEBIG and ROHÉ_

Practical Electricity in Medicine and 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. ROHÉ, M.D., Professor of Obstetrics and Hygiene, College of Physicians and Surgeons, Baltimore; Visiting Physician to Bay View and City Hospitals; Director of the Maryland Maternité; 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, 11s. 6d.; in France, 12 fr. 40.

Any physician, especially if he be a beginner in electro-therapeutics, will be well repaid by a careful study of this work by Liebig and Rohé. For a work on a special subject the price is low, and no one can give a good excuse for remaining in ignorance of so important a subject 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 application of electricity in the practice of medicine and surgery.”—_New 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 intended to cover the same field.—_Pharmaceutical Era._

_MASSEY_

Electricity in the Diseases of Women.

WITH SPECIAL REFERENCE TO THE APPLICATION OF STRONG CURRENTS.

By G. BETTON MASSEY, M.D., Physician to the Gynæcological Department of the Howard Hospital; late Electro-therapeutist to the Philadelphia Orthopædic Hospital and Infirmary for Nervous Diseases, etc. SECOND EDITION. Revised and Enlarged. With New and Original Wood-Engravings. Handsomely bound in Dark-Blue Cloth. 240 pages. 12mo. _No. 5 in the Physicians’ and Students’ Ready-Reference 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 this practical manual attests the utility of its existence and the recognition 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 experience.—_Journal of Nervous 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._

Physicians’ 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 communicating intelligibly with patients of those nationalities and languages unfamiliar 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, 5 × 2¾ inches. 206 pages.

Price, post-paid, in the United States and Canada, $1.00, net; in Great Britain, 6s.; in France, 6 fr. 20.

Many other books of the same sort, with more extensive vocabularies, have been published, but, from their size, and from their being usually devoted to equivalents in English and one other language only, they have not had the advantage which is pre-eminent 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 in one’s hip-pocket, and would insure its bearer against any ordinary conversational difficulty in dealing with foreign-speaking people, who are constantly coming into our city hospitals.—_New York Medical Journal._

This little volume is one of the most ingenious aids to the physician which we have seen. We heartily commend the 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. Louis Courier of Medicine._

The Medical Bulletin Visiting-List or Physicians’ Call Record.

ARRANGED 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 that the names of patients need be written but ONCE a month instead of FOUR times a month, as in the old-style lists. By means of a new feature, a simple device consisting of STUB OR HALF LEAVES IN THE FORM OF 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 understood process is repeated until the month is ended and the record 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 in 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 different 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 month 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 Recording of Visits in” have been made into removable sections. These sections are very thin, and are made up so as to answer in full the demand of the largest practice, each section providing ample space for the DAILY RECORD OF 210 DIFFERENT NAMES for two months; or 105 different names daily each month for four months; or seventy different names daily each month for six months. 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 permanently in the back of the book. The addition of a removable 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 least inconvenience or trouble. _Extra or additional sections will be furnished at any time for 15 cents each or $1.75 per dozen._ This Visiting-List contains calendars, 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 convenient for carrying in the pocket. Size, 4 × 6⅞ inches.

IN THREE STYLES. NET PRICES. No. 1. Regular size, to accommodate 70 patients daily each month for one year, $1.25 No. 2. Large size, to accommodate 105 patients daily each month for one year, $1.50 No. 3. In which the “Blanks for Recording Visits in” are in removable sections, $1.75 Special Edition for Great Britain, without printed matter, 4s. 6d.

_N. B.—The Recording of Visits in this List may be Commenced at any time during the Year._

_MICHENER_

Hand-Book of Eclampsia; OR, NOTES AND CASES OF PUERPERAL CONVULSIONS.

By E. MICHENER, M.D.; J. H. STUBBS, M.D.; R. B. EWING, M.D.; B. THOMPSON, M.D.; S. STEBBINS, M.D. 16mo. Cloth.

Price, 60 cents, net; in Great Britain, 4s. 6d.; in France, 4 fr. 20.

_NISSEN_

A MANUAL OF INSTRUCTION FOR GIVING

Swedish Movement _and_ Massage Treatment

By PROF. HARTVIG NISSEN, late Director of the Swedish Health Institute, Washington, 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 Summer 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 the 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 29 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 understood in this country.... The book is got up very creditably.—_N. Y. Med. Journal._

_SAJOUS_

HAY FEVER And Its Successful Treatment by Superficial Organic Alteration of the Nasal Mucous Membrane.

By CHARLES E. SAJOUS, M.D., formerly Lecturer on Rhinology and Laryngology in Jefferson 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.

_STRAUB_

Symptom Register and Case Record.

Designed by D. W. Straub, M.D.

Giving in plain view, on one side of the sheet 7½ × 10½ inches, the Clinical Record of the sick, including Date, Name, Residence, Occupation, Symptoms, Inspection (Auscultation and Percussion), History, Respiration, Pulse, Temperature, Diagnosis, Prognosis, Treatment (special and general), and Remarks, all conveniently arranged, and with ample room for recording, at each call, for four different calls, each item named above, the whole forming a clinical history of individual cases of great value to every Practitioner.

Published in stiff Board Tablets of 50 sheets each, at 50 cts. net per tablet, and in Book-form, flexible binding, with Alphabetical Marginal Index, at 75 cts., net.

Physician’s All-Requisite Time- and Labor-Saving Account-Book.

BEING A LEDGER AND ACCOUNT-BOOK FOR PHYSICIANS’ USE, MEETING 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 physicians. 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. We 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 sacrificing 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 accounts in any similar book; the 300–page book contains space for 900 accounts, and the 600–page book contains space for 1800 accounts.

=_Ninth_=—There are no smaller spaces.

=_Tenth_=—Compact without sacrificing completeness; every account complete on same page—a decided advantage and recommendation.

=_Eleventh_=—Uniform size of leaves.

=_Twelfth_=—The statement of the most complicated account is at once before you 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._ Canada Great In U.S. (duty paid). Britain. France.

No. 1. 300 Pages, for 900 Accounts per Year, Size 10×12, Bound in ¾-Russia, Raised Back Bands, Cloth Sides, $5.00 $5.50 28s. 30 fr. 30.

No. 2. 600 Pages, for 1800 Accounts per Year, Size 10×12, Bound in ¾-Russia, Raised Back-Bands, Cloth Sides, 8.00 8.80 42s. 49 fr. 40

_PRICE and EAGLETON_

Three Charts of the Nervo-Vascular System.