1868. The families of both my parents are healthy; at any rate, mental

disease has never occurred in them. My father was a merchant; he is now sixty-five years old, and for years has been nervous and especially inclined to be melancholic. Before his marriage, my father is said to have lived fast. My mother is healthy, though not very strong. There are two other healthy children. “I was very early developed sexually, and in my fourteenth year was so much troubled by pollutions that I was frightened. Under what circumstances they occurred, particularly the nature of the dreams that were connected with them, I am no longer able to state. The fact is, that for years I have only felt myself drawn toward men sexually; and, with every effort and a terrible struggle, I am still unable to overcome this unnatural impulse that is so repugnant to me. It is said that I had many severe illnesses in my childhood, and that my life was often despaired of. To this was probably due the fact that I was spoiled and made very delicate. I was always much in the house, preferred to play with dolls rather than with soldiers, and I liked to play quietly in the house better than to play noisily in the streets. I entered the Gymnasium at the age of ten. Though I was lazy, I was among the best scholars; for I learned very easily, and was the favorite of my teacher. From my earliest childhood (seventh year), I took pleasure in little girls. I remember that, even until my thirteenth year, I had formal love-affairs with them, and was jealous of those who associated with them; that I took pleasure in looking under the petticoats of my sister’s friends and the servants; and that I had erections when touching the persons of my female playmates. I can, however, recall with certainty that boys attracted and excited me sexually just as early and powerfully. I always took great delight in reading and in the theatre. I had a doll-theatre, with which I played by preference. I knew whole pieces by heart, and copied the actors I saw, taking especially the female parts, in which I was delighted to put on female attire. “As my sexual life became more pronounced, my inclination for boys won the upper hand. I fell completely in love with my companions, and had lustful feeling if one of them who pleased me touched my body. I became very shy, and refused to take gymnastic and swimming lessons. I thought I was different from my comrades, and did not like to undress before them. I liked to look at the penes of my companions, and easily had erections. I masturbated but once, and that in my youth. When a friend told me that one could have pleasure without women, I likewise tried it; but I found no pleasure in it. At that time, also, a book fell in my hands which warned against the effects of onanism. After that one trial I never did it again. In my fourteenth or fifteenth year, I made the acquaintance of two younger boys who excited me sexually to the highest degree. I was especially in love with one of them. I became sexually excited in his presence, and was restless when I did not have him near me. I was jealous of those who associated with him, and embarrassed in his presence. He had no suspicion of my condition. I felt very unhappy, and often wept gladly, feeling then relieved. Yet I could not understand this feeling, and always felt its irregularity. I was also especially unhappy because my ability to work disappeared all at once. I, who before had learned with ease, suddenly had difficulty; my thoughts were never on the subject. Only by straining every nerve could I get anything through my head. I always had to study aloud, in order to keep my attention on the matter in hand. My memory, which was previously excellent, often left me in the lurch. Nevertheless, I continued to be a good scholar, and I still pass for a talented man; but I have terrible difficulty in learning anything. I exerted all my energy to free myself from this sad condition. Daily I went swimming; I practiced turning, rode much, and practiced fencing, in all of which I enjoyed myself very much. I still like to be on a horse’s back, though I know nothing about horses, and have no particular talent for physical exercises. I was never absent from a drinking-party, and I smoked. I was much liked. In _cafés_ I associated much with waitresses, and liked to amuse myself with them, without, however, being sexually excited by them. Among my friends and teachers, I passed for a man who was much with women, and spoiled by them. Unfortunately, this was not true. “At the age of nineteen I went to the University. My first semester was spent at the University of B., and it is still terrible to recall it. My sexual appetite powerfully excited me, and at night, for hours at a time, I ran about looking for men, especially when I was intoxicated. The next morning I would be crazy about myself. Fortunately, I found no one. In the second semester, I went to M. This was my happiest time. I had pleasant friends, and, for a wonder, took pleasure in women, and was very happy about it. I had a love-affair with a young girl of spoiled character, with whom I spent wild nights. I was extraordinarily virile. I, who had formerly been chaste, also associated with other women, as never before. I felt fresh and well after coitus. I was not charmed so much by the female figure, which was never beautiful to me, as by—I know not what. In short, I knew women whose touch immediately induced erection. This joy and state of delight did not last long. I was so foolish as to take rooms with a friend. We had one sleeping-room. My friend was very talented and amiable, and a favorite with women; and it was by these characteristics that he at first so strongly attracted me. In fact, I love only highly-educated men; uneducated, powerful persons are able to excite me intensely only for the moment, and cannot retain my affections. I soon fell in love with my friend. Then came the terrible time that destroyed my health. I slept in the same room with my friend, and had to see him undress daily; so that it required all my strength to keep from betraying myself. I became nervous, cried easily, and was jealous of those who associated with my friend. I still associated with women; but it was only with difficulty that I could perform coitus, which, like woman, was repugnant to me. The same women who had excited me intensely, no longer had any effect on me. I followed my friend to W., where he met an earlier friend, with whom he associated. I became jealous and sick with love and longing. At the same time, I associated with women again, but seldom, and only with difficulty, indulged in coitus. I became terribly depressed and almost insane. Work was out of the question. I led a foolish, wild life, and spent a great amount of money, almost throwing it away. Then, after six weeks of it, I broke down, and had to visit a water-cure, where I spent many months. There I came to myself again, and soon became much liked; for I can be very gay, and I take great pleasure in the society of educated ladies. In conversation, I prefer married women to younger girls; I am also very gay in the society of gentlemen at the beer-table and bowling-alley. “At this sanitarium I met a man of twenty-nine, who was apparently constituted like myself. The fellow forced himself upon me, and wanted to embrace and kiss me; but he was very repugnant to me, though he excited me, and his touch caused erection, and even ejaculation. One evening he got me to perform mutual onanism. After it I spent a most frightful, sleepless night; I was terribly disgusted with the whole affair, and thought I should never do such a thing with a man again. All day long I could get no rest. It was terrible to me that, in spite of this, and against my will, this man so excited me sexually; yet, on the other hand, it gave me satisfaction that he was in love with me, and apparently had to go through struggles similar to my earlier ones. From that time I was successful in keeping him away from me. “I again went to various Universities, and also visited many water-cures, with temporary, but never permanent, benefit. I fell in love, too, with many friends, but never so deeply as with the friend at M. I no longer had sexual intercourse, neither with women—I was incapable of it—nor with men; for I had no opportunity for it with the latter, and I forced myself to avoid it. I still often met my friend of M.; we are as good friends as ever, and, much to my delight, he no longer excites me. It is usually so; when for a long time I have not seen a person who excites me, the sexual influence disappears. “I passed my examinations with distinction. During the last year before they took place,—when I was twenty-three,—I began to practice masturbation; for I could find no other way in which to gratify my burdensome sexual appetite. Still, I did it very infrequently; for after it I was always disgusted, and spent a sleepless night. But when I have drunk much, I lose all strength; and then I run about for hours, seeking men, and finally come to onanism, to awake the next day with a dull head and a horror of myself, and go about all day in a melancholy state. As long as I have control of myself, I use all my strength to combat my nature. It is terrible when one can have no pleasure in associating with friends, and every erect soldier or butcher-boy makes one tremble and throb. It is frightful when night comes, and I watch at the window for some one to urinate against a wall across the way, and give me an opportunity to see his genitals. These thoughts are terrible; and besides, there is the consciousness of the immorality and criminality of my state of mind and my longing. I have a repugnance for myself that I cannot describe. I consider my condition abnormal; I cannot think that it is congenital, but I believe that the impulse was bred in me by faulty education. My suffering makes me reckless and egotistical; it takes away all kindness of disposition, and makes me careless about my family. I am moody, and often almost insane; often I am so depressed that I know not what to do, and then am easily moved to tears. And yet I have a horror of sexual intercourse with men. One evening when I came from a drinking-party, drunk and excited and in a half-conscious state, and, full of desire, was wandering about, I met a young man, who got me to perform mutual masturbation. Though he excited me, after the act I was beside myself. To-day, when I go by the place, I am overcome with horror; and lately, when riding by it, without any cause, I fell from my gentle horse, that I know so well,—I was so overcome by the memory of my unworthy deed. “I love family life and children, and social intercourse; and, with my position in society, I am suited to have a family. But I must give up all that; and yet, I cannot abandon hope of cure. And so I vacillate between hopeful gaiety and frightful hopelessness, and neglect business and family. Indeed, I do not ask that I may marry and found a family; I wish only to overcome the terrible inclination for the male sex; only to associate quietly with my friends, and to learn to respect myself again. “No one has any suspicion of my condition; I pass rather for a great _roué_,—a reputation I try to maintain. I often try to have relations with girls, for which I often have opportunity. I have known many who loved me, and who would have sacrificed their honor for me; but I have no love to offer them, and nothing sexual to give. And yet I can love a man. I am excited only by young men,—_i.e._, aged from seventeen to twenty-five, without full beards, and preferably with no beards at all. I can love only those that are educated, respectable, and amiable. I am, in short, very proud, and quick; I am also enthusiastic, and easily led by persons who please me. These I try to imitate, but I am very sensitive with them, and easily hurt. I put much value on appearances, love beautiful furniture and dress, and assume a distinguished manner and elegant address. I am unhappy in that my neurasthenic condition keeps me from doing and learning what I should like.” Last fall I made the patient’s acquaintance. He is destitute of degenerative signs, and of perfectly masculine appearance, even though he is delicately formed and slender. Genitals perfectly normal. Appearance distinguished, with nothing striking. He is much troubled about his sexual perversion, and wishes to be freed from it at any price. In spite of the greatest effort on the part of both physician and patient, only a slight degree of hypnosis, insufficient for suggestive treatment, could be induced. Case 110. _Psychical Hermaphroditism—Mouth-fetichism._—“I am thirty-one years old, and an official in a manufactory. My parents are healthy, and have nothing abnormal about them. My paternal grandfather is said to have had brain disease; my maternal grandmother died melancholic; a cousin of my mother was given to drink; several other blood-relations are abnormal mentally. “I was four years old when my sexual appetite awoke. A man between twenty and thirty years old, who played with us children, and took us in his arms, excited in me the desire to embrace and kiss him passionately. This desire for sensual kissing on the mouth is characteristic of me, and it still forms the chief charm of my sexual gratification. “I experienced a similar excitation in about my ninth year. A man who was ugly and dirty, and had a red beard, likewise excited in me this desire for him. Here was manifested, for the first time, a characteristic peculiar to me, which is still present,—_i.e._, the peculiar stimulus which coarseness—the filthiness of a person in dress and conduct—is to my senses at times. “While in the Gymnasium, from my eleventh to my fifteenth year, I was affected with a passion for a comrade. In this case, it was also my greatest pleasure to embrace him, and kiss him on the mouth. I was often seized with a desire for him as intense as that I now have for persons I love. I think, however, that I first had erections in my thirteenth year. During these years, as I have said, I had only the desire to embrace and kiss; cupiditas videndi vel tangendi aliorum genitalia mihi plane deerat. I was a perfectly innocent, _näive_ boy, and, until my fifteenth year, did not know the meaning of an erection; indeed, I never once ventured to kiss the beloved person; for I felt that it would be doing something strange. I felt no desire to masturbate, and also had the good fortune not to be seduced to it by older comrades. I have never yet masturbated; I feel a certain repugnance for it. “In my fourteenth and fifteenth years I was seized with a passion for several young persons, some of whom still attract me. Thus I was very much in love with a boy with whom I had never spoken. It was even a delight to meet him on the street. “That my passions were of a sensual nature is shown by the fact that, when I pressed and caressed the hands of those I loved, I had powerful erections. But it has always been my greatest pleasure amplecti et os osculari; I desired nothing else. “I did not know that what I experienced was sexual love; I only said to myself that it was impossible that I alone felt such stimuli. “Until my fifteenth year a woman had never excited me; but one evening, when I was alone with our servant-girl in a room, I experienced the same desire that I had for many boys. At first I played with her; and, when I found that she liked to be kissed, I covered her with kisses. I felt such sensual pleasure in it as I now seldom experience. Mouth to mouth, we kissed each other, and after about ten minutes ejaculation occurred. Thus I gratified myself two or three times a week. I soon began a similar relation with our cook, and with other servant-girls. Ejaculation always took place after kissing for about ten minutes. “In the meantime, I had taken dancing-lessons. There I was first charmed by a nice girl; but this love soon disappeared, and I fell in love with another girl, with whom I never became acquainted, but at the sight of whom I felt an attraction like that of boys, and unlike the purely brutal passion I felt for other girls. At this time my impulse for girls was at its acme; I was pleased by about an equal number of girls and boys. As mentioned above, I gratified my sensuality by kissing the servant-girl and inducing ejaculation. Thus I spent the time from my sixteenth to my eighteenth year. The departure of the servant deprived me of opportunity. “Then came two or three years during which I had to give up sexual pleasure. In general, girls pleased me less; and, too, now that I had grown older, I was ashamed to surrender myself to the servant-girls. “It was not possible for me to obtain a mistress; for, notwithstanding my years, I was carefully watched by my parents, and associated but little with young men, and thus had but little independence. With the diminution in the desire for women, the attractiveness of youths increased. “Since I had had, since my sixteenth year, frequent pollutions at night with dreams,—in part of women and in part of men,—which weakened and depressed me exceedingly, I desired to make an end of them by means of normal coitus. But scruples and the belief that prostitutes would have no effect on me, kept me from the brothel until my twenty-first year. For two or three years I went through a daily struggle (if there had been male houses of prostitution, no scruples would have hindered me). Finally I visited a brothel. I could not even induce erection; for one reason because the girl, though she was unusually fresh and pretty for a prostitute, did not affect me; but really because she would not kiss me on the mouth. I was very much depressed, and thought I was impotent. Three weeks afterward I visited another prostitute, and she immediately induced erection by her kiss. She was erect and had thick lips, and was much more sensual than the first one. After only three minutes of simple kissing, mouth to mouth, ejaculation was induced,—of course, ante portam. Thus it was only after I had visited prostitutes about seven times that I was successful in coitus. “At one time I would have no erection at all, because the girl made no impression on me; again I would ejaculate prematurely. The first times I was reluctant penem introducere; and, too, even after I was successful in normal coitus, I found no pleasure in it. Sensual satisfaction comes with kissing on the mouth; for me this is the principal thing, coitus serving only as something secondary to embracing. Coitus, no matter how much the woman might charm me, would be an indifferent matter without kissing; indeed, erection disappears, or does not occur at all, when the woman will not kiss on the mouth. Yet, I cannot kiss every woman, but only such as have faces pleasing to me; a prostitute, the sight of whom is repugnant to me, with any amount of kissing, which then only disgusts me, cannot excite me. “Thus, during the last four years, I have visited brothels about every ten days or two weeks. Only seldom does coitus fail; for I have learned my peculiarities, and in the choice of a prostitute know immediately whether she will excite me or have no effect. Of late, however, it has again happened that I thought the woman would stimulate me, and yet no erection occurred. This happened when, the day before, I had to repress too forcibly the desire for men. “At first, when I went to brothels, the sensual pleasure was very slight; only a very few times did I have true lustful feeling (as in kissing previously). Now, on the contrary, for the most part I experience sensual pleasure. The lower houses have a particular charm for me; for of late the coarseness of the women, the dark entrance, the yellow light of the lamps, and all the surroundings, have a peculiar charm for me; probably because my sensuality is unconsciously excited by meeting soldiers, who frequent such places, and who at the same time lend a certain charm to the women. If I but find a woman whose face attracts me, I can have intense lustful pleasure. Besides by prostitutes, my desire can be excited by peasant-girls, servant-girls, working-women, and girls of the lower classes,—in general, by those in common dress. Red cheeks, thick lips, and erect forms please me particularly. I am absolutely indifferent to respectable women and young ladies. “My pollutions are usually without lustful pleasure, and often occur with dreams of men, but very seldom—almost never—with dreams of women. As is shown by the last circumstance, in spite of regular coitus, my desire is still for young men. Indeed, I may say that it has only increased, and that very markedly. Though immediately after coitus the girls have no charm for me, yet the kiss of a pleasing woman could immediately induce erection again. For the first few days after coitus, young men seem the most attractive to me. “Sexual congress with women does not satisfy all my sensual desire. I have days when I frequently have erections with an intense desire for young men; then come quieter days, with moments of complete indifference for women and latent desire for men. On the other hand, too great sensual rest makes me melancholy; viz., when such rest follows moments of repressed excitement. Only, then, when the thought of beloved youths again causes erection, do I feel light-hearted again. Then the rest changes to intense nervousness; I feel depressed, and sometimes have headache (after repressed erection). This nervousness often increases to ungovernable restlessness, which I then seek to overcome by coitus. “Last year an essential change took place in my sexual life, when I dared to enjoy male love for the first time. In spite of pleasurable coitus with women (more correctly, pleasurable kissing with resultant ejaculation), my desire for young men gave me no peace. I determined to go to a brothel much frequented by soldiers, and, in extremity, to buy a soldier for myself. I had the good luck to meet immediately one like myself, who, notwithstanding his much lower station, in character and behavior was not unworthy of me. What I experienced (and still experience) with this young man is something different from what I feel with women. The sensual pleasure is not greater than with prostitutes, whose kisses and embraces excite me extraordinarily; but I can experience lustful pleasure with him at any time, and for him I have a feeling that is wanting for women. Unfortunately, I have been able to embrace and kiss him only about eight times. “Though we have been separated many months, he having been sent to a garrison in Hungary, we have not forgotten each other, and keep up a regular correspondence. In order to possess him, I dared to go to a brothel and there embrace him, being in danger of being betrayed. “Early in our acquaintance there came a time when I heard nothing more of him; for he did not think he could trust me. During these weeks I endured anxiety and pain that brought me into a state of depression and anxious restlessness, such as I had never before experienced. Scarcely to have found a lover and then to be compelled to lose him, seemed the greatest misfortune to me. When, thanks to my efforts, we met again, my joy was unbounded; indeed, I was so excited that, in his embrace again for the first time, in spite of my sensual lust, I could not induce ejaculation. “Usus sexualis in osculis et amplexionibus solis constitit, pene meo ludere ei licebat (while the touch on it of a woman’s hand is unendurable to me, and I never allow it). It is also to be noted that, in the company of my lover, I immediately have an erection; the pressure of his hand, or even his look, is sufficient. Evenings, for hours at a time, I have gone about with him, never tiring of his society for a moment, despite his inferior station. With him I feel happy, and the sexual satisfaction is merely the crowning of our love. Although I had finally found the man like myself, whom I had so long sought, and I could at last enjoy male love, yet I have not become insensitive to women; and I visit brothels when I am too sorely troubled by desire. I had hoped to be able to spend this winter in the city where my lover is; but this is, unfortunately, impossible, and I am now forced to be separated from him for an indefinite period. Nevertheless, we shall try to see each other, if only for a short time, and only once or twice a year; at least, I hope that in the future we may again be together for a longer time. Thus, for this winter, I am again compelled to be without a friend like myself. I had, indeed, resolved, on account of the danger of discovery, never to try to find another urning; but this is impossible. Sexual intercourse with women does not satisfy me, and my desire for young men constantly increases. I am often afraid of myself; afraid that, in asking all prostitutes, as I do, whether they know others like me, I might be discovered. Yet I cannot keep from seeking a youth like myself; indeed, I know that in case of necessity I shall buy a soldier, though I know perfectly well the penalty meted out to one caught in such circumstances. “I can no longer do without male love; without it I should always be out of harmony with myself. My ideal would be to be associated with a number like myself; but I should be satisfied if I could have unrestrained intercourse with one lover. I could easily dispense with women, if I had regular male satisfaction; but I think that at long intervals I should embrace a woman for the sake of variety, as my nature is absolutely hermaphroditic in a psycho-sexual sense (women I can only desire sensually, but I can love and sensually desire young men). If there were marriage between men, I think I should not avoid a life-long union; while marriage with a woman seems to me something impossible. For, in the first place, though the woman charmed me, the charm would soon be lost in regular intercourse, and then all sexual indulgence, if not impossible, would certainly be devoid of pleasure for me; and, in the second place, true love for the wife would be wanting—the attraction that I feel with young men I love, and which makes the intercourse that is not simply sensual seem desirable to me. The constant association with a youth physically pleasing and in mental harmony with me, and who could understand all my feelings and share my intellectual opinions and desires, would, it seems to me, be the greatest happiness. “The young men who please me must be between eighteen and twenty-eight. As I have grown older, the limit of age in those pleasing to me has increased; otherwise, I am pleased with the most various forms. The principal _rôle_, if not the exclusive one, is played by the face. Blondes excite me more than dark persons; they must have no beard, but merely a small moustache that is not too thick, or none at all. As for the rest, the only thing I can say is, that certain kinds of faces please me. Faces with large, straight noses are excluded, as are also pale cheeks; but there are exceptions. I regard soldiers with favor, and many please me when in uniform who do not affect me when in civil dress. Just as in women certain ordinary articles of dress (like light-colored jackets) please me, so the military costume attracts me. To go to dance-halls—usually beer-halls—where there are many soldiers, and mix with the crowd of soldiers and boys that please me, and try to get a kiss and embrace,—this mingling with them would, of course, be an excitant only of sensuality; intellectually and socially, everything common in speech and conduct is repugnant to me. “With young men of higher position, my sensual desire is less prominent. “What I have said of the attractiveness of certain kinds of dress is not to be understood in the sense that they attract me in themselves. This charm only means that the dress may help to strengthen or make prominent the attraction exerted by the face, when, perhaps, the same face in itself would not attract me to the same extent. I may say the same thing, though with a different meaning, of the odor of lighted cigars. In indifferent persons the odor of cigars is rather repugnant than pleasing to me, but exciting in those sexually attractive. The kiss of a prostitute smelling of cigar-smoke, affords greater pleasure (because, even though in part unconsciously, I am reminded of the kiss of a man). Therefore, I took pleasure in kissing my lover just after he had smoked. (It is to be noted that I myself have never smoked a cigar or cigarette, and have never even tried to smoke.) I am tall and thin; my face is masculine; my eyes are restless; and in my whole form I often have something girlish. My health leaves much to be desired. It is much influenced by my sexual anomaly. As previously mentioned, I am very nervous, and I often have paroxysms of onomatomania. At times, I also have terrible depression and melancholia, when I see the difficulty of gratification corresponding with my male-loving nature; and when I am greatly excited sexually, and have overcome the desire, owing to impossibility of male gratification. In such conditions, often the depression is associated with absolute lack of sexual desire. In work I am industrious, but often too quick; for I am inclined to work too rapidly and violently. I have a lively interest in art and literature. Among poets and writers of fiction, I prefer, for the most part, those who describe refined feelings, peculiar passions, and far-fetched impressions; an artificial or hyper-artificial style pleases me. Likewise in music, it is the nervous, exciting music of a Chopin, a Schumann, a Schubert, or a Wagner, etc., that is in most perfect harmony with me. Everything in art that is not only original, but _bizarre_, attracts me. “I do not like physical exercise, and do not practice it. “In character I am kind and compassionate; and, though I have much to suffer with my anomaly, I am not unhappy because I love young men, but because the satisfaction of such love is considered improper, and because I cannot gratify it without restraint. I cannot regard male love as a vice, though I can well understand why it is considered vicious. But, since this love is regarded as criminal, in gratifying it I am in harmony with myself, but not with our age of the world; and, therefore, I must, necessarily, be somewhat depressed; the more, since I have a frank character that hates a lie. The pain of having always to hide it all in myself has induced me to confess my anomaly to a few friends, of whose silence and appreciation I am confident. Nevertheless, my situation often seems sad. On account of the difficulty of gratification and the general abhorrence of male love, I am often a little proud that I have such anomalous feelings. Of course, I shall never marry. This does not seem any misfortune, even though I love family life, and have thus far lived only with my parents. I live in the hope that later I shall have a lover; I must have one; without one, the future seems dark and barren, and all the ambitions usually cherished—honor, position, etc.—seem empty and unattractive. If I should not have this hope fulfilled, I know I shall be unable to long devote myself to my business with pleasure, and I shall soon be in a condition to sacrifice everything to obtain male love. I no longer have any moral scruples on account of my anomalous inclination; I have, in fact, never been troubled because I felt attracted to boys. I am much more inclined to judge morality and immorality in accordance with my feelings than in accordance with fixed principles; for I have always been given to skepticism, and have never yet studied out a fixed belief for myself. As yet, only what injures others seems to me to be evil and immoral, and that that I would not have inflicted on myself; and, in this direction, I may say that I try to infringe on the rights of others as little as possible, and that I am capable of great indignation at injustice inflicted on another. But, why love of men should be something immoral, I cannot understand; purposeless activity of the sexual instinct (if the immoral is to be seen in all that is useless and unnatural) is also found in intercourse with prostitutes, and even in marriage where means to prevent conception are used; and it seems to me that the sexual intercourse of men must be placed on the same level with all sexual congress that has not procreation as an end. But that only sexual gratification that has this purpose is moral, seems to me to be questionable. Certainly, sexual satisfaction that is not directed to procreation is not contrary to nature; and, whether it has not other purposes unknown to us, is uncertain; and, even if it were purposeless, it would not necessarily be despicable (it is not certain that the measure of a moral act is its usefulness). “I am very certain that present prejudice will disappear, and that when once such individuals experience male-love, the right of unrestricted love will be acknowledged. For the possibility of such recognition one need but recall the Greeks and their friendships, which were nothing but sexual love; and one has only to think that, despite such unnatural vice, practiced by their greatest men in intellectual and æsthetic matters, the Greeks are still regarded as an unattainable example, and held up for imitation. “I have already thought of having my anomaly cured by hypnotism. If it were to be of any use, which I doubt, yet I should certainly desire to be assured of a lasting love for women. For even though I cannot satisfy myself with men, yet I prefer to feel this capability of inordinate lust and love, even ungratified, to being absolutely without feeling. Thus I still have the hope that I shall find opportunity to satisfy the love I desire, the love that would make me happy; and I should not prefer the suggestive removal of homo-sexual feelings, without the simultaneous substitution of a hetero-sexual equivalent, to my present condition. Finally, I should like to add, in contrast with the statements of urnings in the published biographies, that I, at least, find it very difficult to recognize those like myself. Though I have described my sexual anomaly somewhat in detail, it seems to me that the following notes are important for a better understanding of my condition:— “Of late I have given up immissio penis, and confined myself to coitus inter femoræ puellæ. Ejaculation occurs earlier than with conjunctio membrorum, and I experience a certain lustful feeling in the penis itself. If this manner of sexual intercourse is quite pleasant to me, it is, perhaps, in part to be referred to the fact that in this kind of sexual indulgence the sex is quite indifferent, and I am, perhaps, unconsciously reminded of masculine embrace. But this memory is absolutely unconscious, and but obscurely felt; for I am not indebted to my imagination for my pleasure, but it is due immediately to kissing the woman’s mouth. I feel that the charm which the brothel and prostitutes have for me also begins to fade; but I am sure certain women will always be able to excite me by their kisses. Still, no woman is, or ever will be, so attractive as to induce me to overcome obstacles in winning her; but even the danger of discovery and disgrace could only with difficulty restrain me from seeking a man’s embraces. “Thus I lately allowed myself to be induced to buy a soldier at a prostitute’s house. The lustful pleasure was very great, but the subsequent feeling of satisfaction was especially very exhilarating. The next day I felt similarly strengthened (capable of erection at any moment); and though I have not yet been able to meet the soldier again, the thought that I shall venture to purchase another gives me peace. But I could be perfectly satisfied only in finding one feeling like myself, of my own position and education. “I have not yet mentioned that the female form (with the exception of the face) and genitals have no attraction for me (to touch the latter with my hand would be disgusting to me); but membrum virile me tangere dum os meum os ejus osculatur, mihi exoptatum esse; indeed, to kiss that of a very pleasing man would not be disgusting to me. Onanism, as has been said, would be quite impossible for me.” Case 111. _Psychical Hermaphroditism._-Hetero-sexual feeling early interfered with by masturbation, but episodically very intense. Homo-sexual feeling _ab origine_ perverse (sexual excitation by men’s boots). Mr. X., of high social position, Russian, aged 28, came to me in September, 1887, in a despairing mood, to consult me on account of a perversion of his vita sexualis, which made life seem almost unbearable to him, and which had repeatedly brought him near to suicide. The patient comes of a family in which neuroses and psychoses have been of frequent occurrence. In the father’s family there had been consanguineous marriages for three generations. The father is said to have been a healthy man, and to have lived morally in marriage. However, his father’s preference for fine-looking servants seems remarkable to the son. The mother’s family is described as eccentric. The mother’s grandfather and great-grandfather died melancholic; her sister was insane; a daughter of the grandfather’s brother was hysterical, and had nymphomania. Only three of the mother’s twelve brothers and sisters married. Of these, one brother was homo-sexual, and always nervous as a result of excessive masturbation. The patient’s mother is said to be a bigot, and of small mental endowment, nervous, irritable, and inclined to melancholia. Patient has a sister and a brother. The brother is frequently melancholy, and, though mature, has never shown the slightest trace of sexual inclinations. The sister is an acknowledged beauty, and much sought by gentlemen. This lady is married, but childless, as reported, owing to the impotence of her husband. She has always been indifferent to the attentions shown her by men, but is charmed by female beauty, and actually in love with some of her female friends. With respect of himself, the patient asserts that, when four years old, he dreamed of handsome jockeys wearing shining boots. Too, he never dreamed of women when he grew older. His nightly pollutions were always induced by “boot-dreams.” From his fourth year he had a peculiar partiality for men, or, more correctly, for lackeys wearing shining boots. At first they only excited his interest, but, with development of his sexual functions, the sight of them caused powerful erections and lustful pleasure. It was only servants’ boots that affected him; the same kind of boots on persons of like social station were without effect on him. In a homo-sexual sense, there was no sexual impulse connected with these situations. Even the thought of such a possibility was disgusting to him. At times, however, he had sensually-colored ideas,—like being his servant’s servant, and drawing off his boots; but the idea of being stepped on by him, or of having to blacken his boots, was most pleasing. The pride of the aristocrat rose up against such thoughts. In general, these notions about boots were disgusting and painful to him. Sexual instinct was early and powerfully developed. It first found expression in indulgence in sensual thoughts about boots, and, after puberty, in dreams accompanied by pollutions; otherwise, the mental and physical development was undisturbed. Patient was well endowed mentally,—learned easily, finished his studies, and became an officer. On account of his distinguished, manly appearance and his high position, he was much sought in society. He characterizes himself as a clever, quiet, strong-willed, but superficial man. He asserts that he is a passionate hunter and rider, and that he has never had any inclination for feminine pursuits. In the society of ladies he has always been reserved; dancing always tired him. He had never had any interest in a lady of high social position. As for women, only the buxom peasant girls, such as are the models of painters in Rome, had interested him. He had, however, never felt any sexual interest in such representatives of the female sex. In the theatre and circus only male performers had excited his interest; but, at the same time, they had caused him no sensual feelings. As for men, only their boots excited him, and, indeed, only when the wearers belonged to the servant class and were handsome men. Men of his own position, wearing never so fine boots, were absolutely indifferent to him. With reference to his sexual inclinations, the patient is still uncertain whether he feels more inclination toward the opposite sex or toward his own sex. He is inclined to think that originally he had more inclination for women, but that this sympathy was, in any case, very weak. He states with certainty that the sight of a naked man made no impression on him, and that the sight of male genitals was even repugnant to him. In the case of women, this was not exactly the case, but he was not excited sexually even by the most beautiful feminine form. When a young officer, he was now and then compelled to accompany his comrades to brothels. He was the more easily persuaded to this, since he hoped by this means to be rid of his vile partiality for boots; but he was impotent unless he brought the thought of boots to his aid. Under such circumstances, the act of cohabitation was normally performed, but without pleasurable feeling. Patient felt no impulse to intercourse with women, always requiring some external cause,—_i.e._, persuasion. Left to himself, his vita sexualis consisted in reveling in ideas about boots, and in corresponding dreams with pollutions. Since more and more there became connected with them the impulse to kiss his servant’s boots, to draw them off, etc., the patient determined to use every means to rid himself of this disgusting desire, which deeply wounded his pride. At that time, being in his twentieth year, and in Paris, he recalled a very beautiful peasant girl, who lived in his distant home. He hoped, with her assistance, to free himself of his perverse sexual inclination. He went directly home, and tried to win the girl’s favor. It seems that the patient was not naturally homo-sexual. He asserts that at that time he was actually in love with this person, and that her glance, or the touch of her dress, gave him sensual pleasure; and, when she once kissed him, he had a powerful erection. After about a year and a half, the patient succeeded in gaining his desires with this person. He was potent, but ejaculated tardily (ten to twenty minutes), and never had a pleasurable feeling in the act. After about a year and a half of sexual intercourse with this girl, his love for her grew cold, because he did not find her so “fine and pure” as he wished. From this time it was necessary for him to call upon ideas about boots for help, which had been latent, in order to be potent in sexual intercourse with her. In proportion as his power failed, these ideas arose spontaneously. Thereafter he had coitus with other women. Now and then, especially when the woman was in sympathy with him, the act took place without any assistance of imagination. It once happened that the patient committed a rape. It is remarkable that on this single occasion he had a pleasurable feeling in the (forced) act. Immediately after the deed he had a feeling of disgust. When, an hour after the forced indulgence, he had coitus with the same woman, with her consent, he experienced no feeling of pleasure. With decrease of virility,—_i.e._, when it was preserved only in connection with ideas about boots,—libido for the opposite sex decreased. The patient’s slight libido and weak inclination for women are evidenced by the fact that, while he still sustained sexual relations with the peasant girl, he began to masturbate. He learned the vice from “Rousseau’s Confessions,” the book accidentally falling into his hands. The boot-fancies immediately linked themselves with corresponding impulses. He then had violent erections, masturbated, and ejaculation afforded him a lively feeling of pleasure, which was denied to him in coitus; and at first he felt himself fresher and brighter, as a result of the masturbation. In time, however, symptoms of sexual, and, later, of general, neurasthenia, with spinal irritation, appeared. He then at first gave up masturbation, and sought his first love; but she was now more than ever indifferent to him. Since he finally became impotent, even when he called ideas of boots to his assistance, he gave up women entirely, and again practiced masturbation; by which he felt himself protected from the impulse to kiss and blacken servants’ boots. At the same time, he continued to feel that his sexual position was a painful one. He again occasionally attempted coitus, and was successful in it as soon as he thought of blackened boots. Too, after continued abstinence from masturbation, he was sometimes successful in coitus without any artificial aid. The patient says that his sexual needs are intense. If he has not had an ejaculation in a long time, he becomes congestive and psychically much excited, and tormented by repugnant images of boots, so that he is forced to have coitus, or, preferably, to masturbate. For some time his moral position has been complicated most painfully by the fact that, as the last of a wealthy line of high position, and at the importunate desire of his parents, he must marry. The bride is of rare beauty, and mentally in perfect sympathy with him; but, as a woman, she is as indifferent to him as any other. Æsthetically she satisfies him “as a work of art;” in his eyes, she is an ideal. To honor her in a platonic way would be happiness worth striving for; but to possess her as a wife is a painful thought. He is certain beforehand that with her he will be impotent, save with the help of ideas of boots. To use such means, however, is in opposition to his respect and his moral and æsthetic feeling for the lady. Were he to soil her with such thoughts, she would lose, in his eyes, all her æsthetic value; and then he would become impotent for her, and she would become repugnant to him. The patient considers his position one of despair, and confesses that he has lately been repeatedly near suicide. He is a man of much intelligence, and decidedly of masculine appearance, with abundant growth of beard, deep voice, and normal genitals. The eye has a neuropathic expression. No signs of degeneration. Symptoms of spinal neurasthenia. It was possible to reassure the patient, and give him hope of his future. The medical advice consisted in means for combating the neurasthenia, and the interdiction of masturbation and indulgence of the fancy in images of boots, in the hope that, with the removal of the neurasthenia, cohabitation without ideas of boots would become possible; and that, in time, the patient would become morally and physically capable of marriage. In the latter part of October, 1888, the patient wrote me that he had resolutely resisted masturbation and his imagination. In the interval he had had but one dream about boots, and scarcely a pollution. He had been free from homo-sexual inclinations, but, in spite of this, there was often considerable sexual excitement, without anything like adequate libido for women. In this deplorable situation, he was compelled, by circumstances, to marry in three months. _2. Homo-Sexual Individuals, or Urnings._—In distinction from the preceding group of psycho-sexual hermaphrodites, there are here, _ab origine_, sexual desires and inclinations for persons of the same sex exclusively; but, in contrast with the following group, the anomaly is limited to the vita sexualis, and does not more deeply and seriously affect the character and mental personality. The vita sexualis of these urnings, _mutatis mutandis_, is entirely like that in normal hetero-sexual love; but, since it is the exact opposite of the natural feeling, it becomes a caricature, and this the more, since these individuals, at the same time, as a rule, are subject to hyperæsthesia sexualis, and, therefore, their love for their own sex is emotional and passionate. The urning loves and deifies the male object of his affections, just as a man idealizes the woman he loves. He is capable of the greatest sacrifice for him, and experiences the pangs of unfortunate, often unrequited, love; suffers from the unfaithfulness of the beloved object, and is subject to jealousy, etc. The attention of the male-loving man is given only to male dancers, actors, athletes, statues, etc. The sight of female charms is indifferent to him, if not repulsive. A naked woman is disgusting to him, while the sight of male genitals, hips, etc., affords him infinite pleasure. The bodily contact of a sympathetic man induces a thrill of delight; and, since such individuals are mostly sexually neurasthenic, congenitally or from onanism or enforced abstinence from sexual intercourse, under such circumstances ejaculation is very easily induced, which, in the most intimate intercourse with women, cannot be induced at all, or only by mechanical means. The sexual act with a man, in many instances, affords pleasure, and leaves behind a feeling of well-being. Should the urning be able to force himself to coitus, in which, as a rule, disgust has the effect of an inhibitory concept, and makes the act impossible, then his feeling is something like that of a man compelled to take disgusting food or drink. However, experience teaches that not infrequently urnings falling in this group marry, either out of ethical or social considerations. Such unfortunates are relatively potent, in that in marital intercourse they incite their imagination, and, instead of thinking of their wives, they call up the image of some loved male person. But for them coitus is a great sacrifice, and no pleasure; and it makes them, for days after, nervous and miserable. If such urnings, by means of powerful excitation of their imagination, or under the influence of alcoholic drinks, or by erections induced by an overfilled bladder, etc., are enabled to overcome the inhibitory feelings and ideas, then they are still entirely impotent; while simply the touch of a man may induce powerful erection, and even ejaculation. Dancing with a woman is unpleasant to an urning, but to dance with a man, especially one with an attractive form, seems to him the greatest of pleasures. The male urning, in so far as he possesses higher culture, is not opposed to non-sexual intercourse with women, when by mind and refinement they make conversation pleasant. It is only of woman in her sexual _rôle_ that he has a horror. The homo-sexual woman offers the same manifestations, _mutatis mutandis_. In this degree of sexual degeneration, character and occupation correspond with the sex which the individual represents. The sexual perversion remains isolated, but an anomaly of the mental being of the individual which deeply affects the social existence. In accordance with this, many of these individuals, in the sexual act, feel themselves in the _rôle_ which would naturally belong to them in hetero-sexual intercourse. However, transitions to group 3 occur, in as much as sometimes the passive _rôle_ which corresponds with the homo-sexual manner of feeling, is thought of or desired, or at least forms the subject of dreams. Moreover, inclinations for occupations and tendencies of taste are manifested, which do not correspond with the sex of the individual. In many cases, one gets the impression that such symptoms are artificial, the result of educational influences; in other cases, that they represent deeper acquired degenerations of the original anomaly, induced by the perverse sexual activity (masturbation), analogous to the signs of progressive degeneration observed in acquired inversion of the sexual instinct. With regard to the manner of sexual satisfaction, it must be stated that with many male urnings simple embraces are sufficient to induce ejaculation, since they are subject to irritable weakness of the sexual apparatus. In case of sexual hyperæsthesia, and where there is paræsthesia of the moral sense, great pleasure is afforded by intercourse with persons of the lowest condition. On the same basis, desires to commit pederasty (active, of course) and other similar acts occur, though it is but seldom, and apparently only in cases of moral defect, and by reason of libido nimia in individuals especially passionate, that pederasty is indulged in. The sensual desire of mature urnings, _in contradistinction from old and decrepit debauchees, who prefer boys (and indulge in pederasty by preference), seems never to be directed to immature males_. Only for want of better material, and in case of violent passion, does the urning become dangerous to boys. The manner of sexual satisfaction in female urnings may be mutual and passive masturbation. To them coitus is quite as disgusting, wearisome, and inadequate as it is to the male urning. Case 112. The following is an extract from a very circumstantial autobiography which a physician affected with contrary sexual instinct has put at my disposal:— “I am now forty years old, of healthy family,[114] and have always been healthy and considered a model of physical and mental strength and energy. I am of powerful build, but have only a moderate beard, and, with the exception of hair in the axillæ and on the mons veneris, my body is hairless. The penis, even soon after birth unusually large, measures, in statu erectionis, 24 centimetres long by 11 centimetres in circumference. I am a skillful rider, athlete, and swimmer, and have passed through two great campaigns as a military surgeon. I never experienced any taste for female attire and vocation. Up to the time of puberty I was shy toward the female sex, and I am yet shy with new acquaintances. “I have always had a distaste for dancing. In my eighth year an inclination for my own sex made its appearance. I next experienced pleasure in regarding my brother’s genitals. I induced my brother to indulge with me in mutual fondling of the genitals, as a result of which I had an erection. Later, in bathing with the school-children, the boys excited a lively interest in me; the girls, none at all. I had so little interest in them that, as late as my fifteenth year, I believed that they also had a penis. In company with boys like myself, I took pleasure in mutual manustupration. At eleven and a half years I was given a strict tutor, and thereafter could steal to my friends but seldom. I learned very easily, but could not get along with my teacher; and when one day he made it too hard for me, I became furious and struck at him with a knife, and would have gladly stabbed him, if he had not fallen into my arms. In my thirteenth year, for a similar cause, I escaped from the teacher, and wandered about for six weeks in the neighboring country. “I now entered the Gymnasium. At that time I was already sexually developed, and amused myself while bathing with my comrades in the way above mentioned, and later by imitatio coitus between the thighs. I was then thirteen years old. I took absolutely no pleasure with girls. Violent erections caused me to play with my genitals, and I came to take my penis in my mouth, which I succeeded in doing by bending over. This induced ejaculation. I thus learned masturbation. I was much frightened, looked upon myself as a criminal, and confessed to a companion of sixteen. He encouraged and quieted me, and entered into a love-bond with me. We were happy, and satisfied ourselves by mutual onanism. At the same time, I masturbated. After two years the bond was broken; but to this day, when we occasionally meet,—my friend is a high official,—the old fire lights up anew. “That time with my friend H. was a happy one, the return of which I would gladly buy with my heart’s blood. Then life was a pleasure, learning was mere play, and I had a feeling for everything beautiful. “During this time a physician, a friend of my father’s, seduced me by caressing me and practicing masturbation on me on the occasion of a visit, and by explaining the sexual act to me. He advised me never to practice manustupration, since it was injurious to health. He then practiced mutual onanism with me, and explained that this was the only way in which he could perform the sexual function. He had a horror of women, and, therefore, had lived unhappily with his deceased wife. He gave me a pressing invitation to visit him as often as possible. The physician was a pompous man, and the father of two sons aged fourteen and fifteen respectively, with whom in the following year I entered into love-relations similar to those I had with my friend H. “I was ashamed of my unfaithfulness to him, but at the same time continued my relations with the physician. He practiced mutual masturbation with me, showed me our spermatozoa under the microscope, and pornographic works and pictures, which, however, did not please me, because I had interest only for male forms. On the occasion of later visits, he asked me to do him a favor which he had never yet enjoyed, and which he very much desired. Since I loved him, I acquiesced in everything. He dilated my anus with instruments, and practiced pederasty on me, and at the same time performed masturbation, so that I experienced pleasure and pain at once. After this discovery I went immediately to my friend H., with the thought that this beloved man would be able to give me still greater pleasure. We practiced pederasty on each other, but were both deceived, and did not repeat it; for passively I had only pain, and actively no pleasure, while mutual onanism gave us both the greatest enjoyment. Thereafter, out of gratitude, I was still frequently at the disposal of the physician only. Up to my fifteenth year I practiced passive or mutual onanism with my friend. Now I was quite grown, and had all kinds of signs made to me by women and girls; but I fled from them as Joseph did from Potiphar’s wife. At fifteen I came to the Capital. I had but infrequent opportunity for the satisfaction of my sexual inclination. I reveled in the sight of pictures and statues of male forms, and could not keep from kissing the beloved statues. The fig-leaves on the genitals were my principal annoyance. “At seventeen I went to the University. There, again, I lived two years with my friend H. “When I was in my eighteenth year, while in a state of mild intoxication, I was set on to have coitus with a woman. I forced myself to it, but immediately afterward I fled the house, overcome with disgust. Just as after the first active manustupration, I had a feeling as if I had committed a crime. On the occasion of another attempt, while in a sober condition, in spite of every effort of a beautiful naked girl, I could not get an erection; though the mere sight of a boy or the touch of a man’s hand on my thigh, would always throw my penis into violent erection. A short time before, my friend H. had had a similar experience. In vain we racked our brains to discover the reason for it. Now I let women alone, and found enjoyment with friends in passive and mutual onanism, among others with both the sons of the physician, who had used them for pederasty after my departure. “When nineteen years old, I made the acquaintance of two genuine urnings:— “A., aged 56, of effeminate appearance, beardless, of small endowment mentally, possessing a powerful sexual desire that had been manifested abnormally early, had indulged in urnings’ love since his sixth year. Once a month he visited the Capital. I had to sleep with him. He was insatiable in mutual onanism, and made me take part in active and passive pederasty, which was an unpleasant part of the bargain for me.” “B., a merchant, aged 36, of masculine appearance, was as passionate as I was. He knew how to make his manipulations on me such a stimulus that I had to serve him passively in pederasty. He was the only one with whom I ever had any pleasure in passive pederasty. He confessed to me that when he but knew that I was near, he had the most painful erections; and that when I could not serve him, he was compelled to satisfy himself by masturbation. “While pursuing these love-affairs, I was clinical assistant in hospital, and was considered ambitious and skillful in my work. I naturally sought throughout literature for an explanation of my sexual peculiarity. I found it in part as a crime deserving punishment, while for myself I could only recognize in it the natural satisfaction of my sexual desire. I was aware that this was congenital with me. But feeling myself in opposition to the whole world, often near insanity and suicide, I again sought to satisfy my powerful sexual desire with women. The result was always the same,—either want of sufficient erection, or, when it became possible, to force myself to the act, disgust and horror of its repetition. As a military surgeon, I suffered terribly from the sight and touch of thousands of naked male forms. Fortunately, I formed a love-bond with a lieutenant affected similarly, and passed again a time of happiness. For love of him I consented to pederasty, for which he longed. We loved each other until he lost his life at Sedan. From that time I never gave myself to active or passive pederasty, although I had many love-affairs, and was a person much sought. “At twenty-three I went to the country as a physician, and was sought and esteemed. I satisfied myself with boys over fourteen. I interested myself in political affairs, and made an enemy of the clergyman, and, being betrayed by one of my lovers, was denounced and compelled to flee. The legal investigation, fortunately, did me no harm. I was able to return, but I was greatly shaken; and I went to the war (1870) as a soldier, in the hope of meeting my death. I returned, however, with many distinctions, much matured; and I found still more pleasure in earnest work in my profession. I hoped that the extinction of my excessive sexual desire was near at hand, exhausted by the great hardships of the campaign. “Scarcely had I recovered, when the old unbounded desire again appeared, and led to new unbridled satisfaction. Of course, I often thought of it; but my inclination, so revolting to the world, did not seem so to me. “For a year, by means of the greatest exercise of my will, I abstained; then I went to the Capital to force myself to cohabit with a woman. I, who at the sight of the dirtiest ragamuffin had painful erections, could scarcely induce one with the most beautiful woman. Overcome, I returned home and obtained a young man-servant for my personal service and satisfaction. “The solitude of life as a country physician, and the longing for children, drove me to marriage; besides, I wished to make an end to gossip, and I hoped finally to triumph over my fatal desire. “I knew a young girl, of whose respect and love for me I was convinced. Through my esteem and honor for my wife, I was enabled to perform the conjugal duties, and begat four boys. The boyish appearance of my wife was of effectual assistance. I called her my ‘Raphael.’ I forced into my fancy images of boys, in order to induce erection. If my fancy ceased for a moment, the erection failed. I was unable to sleep with my wife. Within the last few years coitus has become constantly more difficult to attain, and for two years we have given up all attempts. My wife knows my mental condition, and her esteem and love for me may become estranged. “My sexual inclination for my own sex is unchanged, and, unfortunately, too often forces me to become untrue to my wife. To this day, the sight of a youth of sixteen puts me into violent sexual excitement with painful erections, so that occasionally I am compelled to help myself with manustupration of him and onanism on myself. “The sufferings I endure are indescribable. _Faute de mieux_, I have my wife practice manustupration on me; but what my wife’s hand accomplishes with great effort in half an hour is produced by the hand of a boy in a few seconds. Thus I live, miserable, a slave of the law and of my duty to my wife! I never had pleasure in active or passive pederasty. If I ever practiced or suffered it, it was only from gratitude or desire to please.” The physician to whom I owe the preceding autobiography assures me that he, up to this time, has had sexual intercourse with at least six hundred urnings. There were, indeed, many among them who to-day occupy high and respected positions. Only about ten per cent. of them came later to love women. Another portion did not avoid women, but were more inclined to their own sex; the remainder were exclusively and lastingly urnings. This physician asserted that among the six hundred he never found abnormal formation of the genitals; but there were, however, frequent approaches to the female form, as well as incomplete growth of hair, delicate complexion, and higher voice. Development of the mammæ was not infrequent. He asserted that from his thirteenth to his fifteenth year he had milk in his mammæ, which his friend H. sucked out. Only about ten per cent. of this number showed inclination for female occupations, etc. All his acquaintances were affected with a sexual desire that was abnormally powerful, and made its appearance abnormally early. The vast majority felt themselves as the man in their relations with the other, and satisfied themselves by mutual onanism, or by manustupration on the person of the lover, or by masturbation at his hands. The majority were inclined to active pederasty; but very frequently the law and æsthetic feeling were reasons for the non-performance of the act. Those feeling themselves toward the others as women were few, and the inclination to passive pederasty was very infrequent. In the beginning of 1887, this physician was arrested for having commuted acts of indecency on the persons of two boys under fourteen years. The crime consisted in his having first rubbed mentulam propriam inter femora viri until ejaculatio, and the same procedure cum mentula propria inter femora pueri. At the examination it was recognized that an abnormal instinct was in play, though, at the same time, it was shown that the culprit was not mentally unsound, and not deprived of free will; at least, he had not acted in obedience to an uncontrollable impulse. Therefore, he was sentenced to prison for one year, the mildest possible punishment. Case 113. Mr. X., Hungarian, merchant, consulted me on account of neurasthenia and sleeplessness, which had existed for years. The investigation of the cause of his trouble led the patient to confess that he had an abnormal sexual instinct for his own sex, that he was very passionate, and that his nervous trouble might well come from that. The following, taken from the history of this intelligent patient, possesses scientific interest:— “My abnormal sexual instinct reaches back to my childhood. When three years old, I got hold of a journal of fashions. The beautiful pictures of the men I kissed until the paper was torn to tatters, but I paid no attention to the female figures. I did not like to play with boys. I preferred to play with girls, because they always had dolls. I especially liked to cut out dolls’ clothes; and to-day, in spite of my thirty-three years, dolls still possess an interest for me. When a boy, for hours I would lurk about available places, in order to get a sight of male genitals. When I succeeded, a strange, dizzy feeling came over me. Weak, unattractive men or boys made no impression on me. At thirteen I began to masturbate. From my thirteenth till my fifteenth year, I slept with a handsome young man. That was happiness. Hours at a time at night, with erections, I would wait for his return. If in bed he chanced to touch my genitals, it gave me delight. At fourteen I had a school-mate whose instincts were like my own. For hours at a time, during school-hours, we held each other’s genitals. Ah, those were happy hours! As often as I could, I lingered in bath-houses. That was always a feast for me. The sight of male genitals induced violent erections. At sixteen I came to the metropolis. Seeing so many handsome men charmed me. In my eighteenth year I attempted coitus with a prostitute, but disgust and fear made it impossible. Other attempts were failures, until my nineteenth year, when I tried again with success; but the act afforded me no pleasure, rather inducing a feeling of disgust. I conquered myself, and was proud of my success at being a man, which I had gradually begun to doubt. “Subsequent attempts were no longer successful. The disgust was too great. When the woman was undressing, it became necessary, on account of my feeling of repugnance, to put out the light. I now considered myself impotent, consulted physicians, and visited baths and sanitariums to cure my supposed impotence; for I still did not know what to think of it. I took pleasure in the society of ladies, perhaps out of conceit; for I impressed most ladies as being sympathetic and amiable; but I valued in them nothing more than mental and æsthetic qualities. I liked to dance with them; but if one pressed against me in dancing, I experienced a feeling of repugnance, and even disgust, and felt like striking her. If in joke I happened to dance with a gentleman, I always took the part of the lady. I would press and rub against him, and take a perfect delight in it. When I was eighteen, a gentleman who came into the office, said, ‘That is a fine youth; in the East he would bring a pound sterling every time!’ I puzzled my head over that. Another gentleman liked to joke with me, and steal kisses of me as he was going away, which I would have given him only too gladly. He afterward became my lover. These circumstances excited my attention, and I waited for an opportunity. “When I was twenty-five years old, it happened that a man who was formerly a Capucine monk became attracted to me. For me he was like a Mephistopheles. Finally he spoke to me. To this day I can almost feel the beating of my heart that he caused me; I almost fainted. He made a rendezvous for that evening at a public house. I went, but at the threshold I turned back, afraid. On the next evening he met me again. He overcame my scruples, and took me to his room. I was scarcely able to walk for excitement. My seducer made me sit on his sofa, and, smiling at me, he fixed his wonderful black eyes on me, and I lost consciousness. This delight, this ideal, divine sense of pleasure that filled my whole being,—I could write too much about it. I think only an innocent youth, over head and ears in love, who for the first time has his love’s longing fulfilled, could be as happy as I was that night. My seducer demanded my life, in joke; but I at first thought him in earnest. I begged him to let me be happy for a time, and then, united to him, I would end my life. It would have been entirely in accordance with the high-flown ideas I entertained at that time. For five years after that, I kept up a relation with the man, who is still so dear to me. Oh, how happy, and yet, often, how unhappy, I was during those years! If I but saw him speak to a handsome young man, I became wildly jealous. “When twenty-seven, I became engaged to a young lady. Her mind and æsthetic feeling, as well as financial considerations, induced me to think of marriage. At the same time, I am very fond of children, and, whenever I meet even the commonest day-laborer and his wife and a pretty child, I envy the man his good fortune. Thus I made a fool of myself. I managed to get through the time of courtship; when kissing my bride I felt more anxiety and fear than pleasure. On one or two occasions, however, after luxurious dinners, while kissing her passionately, I had erections. How happy I was at that! I saw myself already a father. I twice came near breaking off the engagement. On my marriage-day, when all the guests had assembled, I locked myself in a room, cried like a child, and felt that I could not proceed with the ceremony. At the persuasion of all the relatives, to whom I made the best excuses that occurred to me, I allowed myself to be taken, in ordinary street-costume, to the altar. “As great good fortune would have it, at the time of the marriage, my wife was menstruating. Oh, how thankful I was for this excuse! I am now convinced that this circumstance is all that made later cohabitation possible. How it later became possible for me to cohabit with my wife, and have a lovely boy, I do not know. He is the comfort of my ruined life. I can only thank God for the happiness of having a child. I was a cheat, so to speak, in the marriage-bed. My wife, whom I respect for her high qualities of character, has no suspicion of my condition, but she often complains of my coldness. With her goodness of heart and simplicity, it was possible for me to make her think that the conjugal duty should be performed but once a month. Since she is in nowise sensual, and I can find excuse in my nervousness, I am successful in keeping up the swindle. Cohabitation is the greatest sacrifice for me. By taking considerable wine, and by making use of the erections which occur in the morning, as the result of an overfilled bladder, it is possible for me to perform coitus once a month; but it affords me no pleasurable feeling, and I am worried and experience an increase of my nervous difficulties all day long after it. The consciousness of having fulfilled my duty toward my wife, whom in all other respects I love, affords me moral consolation and satisfaction. With a man, it is otherwise. With him I can perform the act several times in a night, always taking the sexual _rôle_ of a man. In this, I experience the greatest pleasure, the purest happiness. I feel myself refreshed and invigorated by it. Of late, my desire for men has somewhat decreased; in fact, I have courage even to avoid a handsome young man that approaches me. Will it last? I fear not. I am absolutely unable to do without male love; if I am compelled to forego it, I become depressed, feel weary and miserable, and have pain and pressure in my head. I have always regarded my pitiable peculiarity as something congenital, and I would feel happy if I had only not married. I pity my good wife. Often the fear seizes me that I cannot endure it with her longer; then thoughts about divorce, suicide, and flight to America come to me.” No one seeing the patient to whom I owe this communication would suspect his condition. His outward appearance is, in all respects, masculine; he has a well-developed, full beard, strong and deep voice, and normal genitals. The cranium is normally formed; signs of degeneration are absolutely wanting, and only an exquisitely nervous eye makes one suspect a neuropathic condition. The vegetative organs perform their functions normally. The patient presents the usual symptoms of a neurasthenia, which may, in all essentials, be ascribed to sexual excesses with persons of his own sex, in a man abnormally passionate; and to the injurious influences of forced, though infrequent, coitus with the wife where horror feminæ exists. The patient declares that he comes from healthy parents, and that he knows of no neuroses or mental disease in his ancestry. His elder brother was married three years. There was a separation, because the husband never had sexual intercourse with his wife. He married a second time. The second wife also complained of neglect on the part of the husband; but she had four children, concerning whose legitimacy no doubt was ever raised. A sister is hysteropathic. The patient says that, when a young man, he suffered with momentary attacks of dizziness, during which it seemed to him as if he were about to die. He says that he has always been very excitable and emotional, and an enthusiast for the arts, especially poetry and music. He himself designates his character as enigmatical, abnormal, nervous, restless, extravagant, and undecided. He is often exalted without real reason, and then again depressed, even to thoughts of suicide. He may pass through quick and sudden changes,—“religious and frivolous, optimistic and cynical, cowardly and brave, credulous, amiable, and suspicious; inclined to do others harm, and sorrowful to tears over the misfortunes of others; and with this, generous to excess, and then again miserly _à la Harpagon_.” The patient is certainly a tainted individual. He seems to be very well endowed intellectually, and, as he says, to have learned easily, and been among the first at school. The marriage of this man was not happy. Notwithstanding the fact that it was but very infrequently that he performed the inadequate and injurious sexual act with his wife, and that he sought and found a substitute in male lovers, he remained neurasthenic. His disease, at times, presents marked exacerbations, even manifesting itself in despairing depression about his matrimonial, sexual, and mental condition, which even extends to violent tædium vitæ. His wife became hysteropathic and anæmic, and the patient attributed this to sexual abstinence. Try as he would to force himself, of late years he has not been able to perform coitus, erection failing completely; while, in intercourse with male lovers, he is very potent. The son of these unfortunate parents, who is now over nine years old, develops well. The patient adds that formerly, in coitus with his wife, he was potent only when he thought of a beloved man. (From the author’s “Lehrb. der Psychiatrie.”) Case 114. _Autobiography._ “The writer of this is a congenital urning. If I have not consorted with other urnings, nevertheless, I am fully informed of my condition; for it has been my lot to see almost all literature on the subject. A short time ago, your work, ‘Psychopathia Sexualis,’ was sent to me. I saw in it that you were working and studying without prejudice in the interest of science and humanity. “If I cannot tell you much that is new, yet I will speak of a few things which I trust you will receive as one more stone to be used by you in your work; which, I am confident, will, in your hands, aid in saving us. “When you presume that there is often an hereditary tainted condition, perhaps you are right. My father was subject to spinal disease before my birth; later, he became mentally unsound, and took his own life. “Another point, which I am inclined to doubt, is the one mentioned by you in another place,—_i.e._, that onanism practiced from youth may lead to perverse instinct. “I (merchant, owner of a small business, unmarried) am in the beginning of my thirtieth year. I am apparently healthy, and show scarcely a deviation from the normal masculine type. The first sexual impulses were immediately and exclusively directed to the male sex, and I experienced them from my tenth year. I have masturbated since my twelfth year. Since, in spite of all attempts, coitus with women was always absolutely impossible for me; and since I have never had desire for women—on the contrary, rather aversion; and since my attempts have never resulted in the slightest erection, I have been compelled to satisfy myself by onanism. “If now I am to confess the manner of my sexual satisfaction, I may say that in my earlier years my fellow-pupils and companions excited me sexually. Now my impulse consists in a desire for boys of about ten, but mostly for youths of from fifteen to twenty years. “For a long time, strong and healthy cadets, of fine form, have had a particular charm for me; and by their handsome uniforms and fine presence they especially excite my desire. I have no opportunity to approach them, or even to enter into distant social intercourse with them; but I am compelled to satisfy myself with following them in the streets and squares; or in restaurants, horse-cars or railways, by sitting near them, and, when it is possible to do it unnoticed, under such circumstances, by practicing onanism. My most ardent wish has often been to become the friend, servant, or slave of such a young man. “I have never even dreamed of direct pederasty; my desire has always been bodily contact, embrace, manustupration of my genitals by my lover, and, on my part, a kiss on his genitals or podex. “I often have the desire, however, to represent Sacher-Masoch in his ‘Venus in Furs.’ There a man makes himself the voluntary slave of a woman, and feels an intense thrill of lustful pleasure, if he is only chastised and humiliated by her. But I naturally feel that I could, under no circumstances, become the slave of a woman, but only of a man; more correctly, of a young man; one, however, for whom I should have such an infinite love that I could give myself up entirely to his mercy or cruelty. “The lustful images that float before my mind in masturbation are those of this or that young man that I have just seen. As a sad and incomplete substitute, I practice this onanism constantly. “I pass into a lustful dream in this way (and I say all here, because I wish to write only the truth and the whole truth): I choose a young man that pleases me by his form, and in imagination give myself up to involuntary obedience to him. I imagine that he wishes to humiliate me, and that he commands me, for example, to kiss his feet; or compels me to smell his socks. For want of the desired actuality, I take my own socks, smell of them, take them into my mouth, rub them over my genitals, and immediately erection and ejaculation, with sensual pleasure, take place. “Yes, I am so dominated by this mental imagery that I imagine that the young man is my confessor, and, in order to humiliate me, orders me to eat of his excrement. Here again, in want of actuality, I eat of my own excrement, but only in small quantity. Then, with an imperfect feeling of disgust and violent palpitation of the heart, erection and ejaculation take place. “However, I come to this vile, feverish imagery and the performance of these acts, only when it has not been possible for me for a long time to satisfy myself by onanism in the immediate vicinity of a young man. “This is for me more natural, because I then have more pleasure, and experience a more perfect physical and mental benefit, even though my ideal of actual and direct satisfaction in mutual understanding were never to be accorded me. “I almost believe that the above-mentioned disgusting imagery is only the evil result of constant want of normal satisfaction,—_i.e._, of my normal satisfaction as an urning; and that with a regular satisfaction, body to body, the imagery that becomes almost insane would be less intense, and certainly would not go to such extravagance. Or it is the ultimate result of an attempt at abstinence; for these idiotic, sensual images only come after a long period of it. “I believe, indeed, that, under other social conditions, I should be capable of great and noble love and self-sacrifice. My thoughts are in no way exclusively carnal or diseased. How often, at the sight of a handsome young man, a deep feeling of impatience seizes me, and I breathe at once the sweet words of Heine:— “‘Du bist wie eine Blume, so hold, so schön, so rein,’ etc.[115] “And once, when I was compelled to part with a young man who had honored and valued me as his friend and protector, though my love had remained unknown to him, those fine verses by Scheffel kept passing through my mind, especially the last,—_mutatis mutandis_:— “‘Grau wie der Himmel, steht vor mir die Welt, Doch wend’ es sich zum Guten oder Bösen, Du, lieber Freund, in Treuen denk’ ich Dein! Behüt Dich Gott! es wär’ zu schön gewesen, Behüt Dich Gott, es hat nicht sollen sein!’[116] “I have never independently revealed my love to a young man, and have never spoiled or injured one morally; but I have, now and then, made the way easy for many. Under such circumstances, nothing is too much trouble, and I obtain victims as only I can. “When I have an opportunity to have such a beloved friend about me, to educate, protect, and help, if my recognized love find a (natural, unsexual) return, then all my disgusting mental imagery grows less and less intense; then my love becomes almost platonic and ennobled, to sink again into the mire when this worthy satisfaction is removed. “As for the rest, and without over-estimating myself, I may say that I am not one of the worst of men. Brighter mentally than the average man, I take interest in all that moves humanity. I am amiable, and easily moved to pity, and am incapable of doing any animal, much less a man, an injury; but, on the contrary, do good wherever I can. “When I have nothing to reproach myself with in my own conscience, and must, at the same time, set myself in opposition to the judgment of the world, I suffer very much. Indeed, I have done no one harm, and I consider my love, in its noblest activity, to be quite as holy as that of a normal man; but, with the unhappy lot which impatience and ignorance cast upon us, I suffer even to the extent of tædium vitæ. “No pen, no tongue can describe all the misery, all the unhappy situations, the constant fear of having this peculiarity recognized, and of being cast from society. The one thought that, as soon as recognized, one’s existence would be lost, and he would be cast away from all, is as terrible as any thought can be. Then all the good that one had ever done would be forgotten; then, in the pride of his great morality, every normal man would be moved to scorn, even though he himself had been never so frivolous in his own love. “Then what does our misery amount to? We may, cursing man, end our unhappy lives. Truly, I often long for the quiet of an asylum. My life may end when it will, the quicker the better; I am ready. “To refer to one more point: I also believe, like the others that have written to you, that our nervousness is first acquired as a result of our unhappy, unspeakably miserable life among our fellow-creatures. “And still another: You write, at the conclusion of your work, concerning the repeal of the legal enactments concerned. Indeed, humanity would not be destroyed if they were repealed. In Italy there is no such law, as far as I know; and Italy is not a wilderness, but a cultivated nation. “As for myself, compelled as I am to undermine my life by onanism, the law could not touch me; for I have never sinned against it in a letter. But, at the same time, I suffer under the accursed scorn to which we are subjected. How can the ideas of society be changed, so long as there is a law which strengthens it in its immorality? The law must, of course, correspond with public opinion; but it should not be in harmony with the erroneous opinion of ignorance, but only in accord with the ideas of the best and most scientific thinkers,—not with the wish and prejudice of the vulgar. True thinking minds cannot much longer be satisfied with the old idea. “Pardon me, Professor, if I close without a signature. Do not try to find me. I could tell you nothing more. I give you these lines in the interest of future sufferers. Publish from them, in the interest of science, truth, and justice, what seems to you to be necessary.” Case 115. On a summer evening, at twilight, X. Y., a physician of a city in North Germany, was detected by a watchman while committing a misdemeanor with a countryman in a field. He was practicing masturbation on him, and then mentulam alius in os suum immisit. X. escaped legal prosecution by flight. The authorities dismissed the complaint, because there had been no publicity, and because immissio membri in anum had not taken place. Among X.’s effects was found an extensive correspondence of a perverse sexual character, which showed that he had had perverse intercourse for years with all classes of people. X. came of a neurotic family. His paternal grandfather died by suicide while insane. His father was a weak, peculiar man. One brother masturbated at the age of two. A cousin was sexually perverse, and practiced perverse acts, similar to those of X., while a youth; he became weak-minded, and died of spinal disease. A paternal great-uncle was an hermaphrodite. His mother’s sister was insane. His mother is said to have been healthy. X.’s brother is nervous and irascible. X., likewise, was nervous as a child. The mewing of a cat would create great fear in him; and if one but imitated the voice of a cat, he would cry bitterly, and run to others for protection. Slight physical disturbance caused violent fever. He was a quiet, dreamy child, of excitable imagination, but of slight mental capabilities. He did not indulge much in boyish games; he preferred feminine pursuits. It gave him especial pleasure to curl the hair of the house-maid or of his brother. At thirteen X. went to an Institute. There he practiced mutual masturbation, seduced his comrades, and, by his cynical conduct, made them unmanageable; so that he had to be taken home. At that time the parents found love-letters with lascivious contents, showing perverse sexuality. From the age of seventeen he studied under the strict surveillance of a professor in a Gymnasium. He made but sad progress in learning. He had only a talent for music. After finishing his studies, the patient entered the University, at the age of nineteen. There he attracted attention by his cynical character and his association with young persons who were thought to be given to masculine love. He began to be dandified; wore striking cravats, and shirts that were low cut; he forced his feet into narrow shoes, and curled his hair in a remarkable way. This peculiarity disappeared when he left the school, and had returned home. At the age of twenty-four he was for a long time neurasthenic. From that time until his twenty-ninth year, he was earnest and skillful in his profession; but he avoided the society of the opposite sex, and constantly associated with men of doubtful character. The patient would not allow a personal examination. In writing, he made the excuse for this that it would be of no use, because his impulse to his own sex had existed from his earliest childhood, and was congenital. He had always had horror feminæ, and had never been inclined to avail himself of the charms of women. Toward men he felt himself in the _rôle_ of a man. He recognized his impulse toward his own sex as abnormal, and excused his sexual indulgence as being the result of an abnormal natural condition. Since his flight X. lives out of Germany, in Southern Italy, and, as I learned from a letter, now, as before, he indulges in perverse love. X. is an earnest, stately man, of masculine features, well-grown beard, and normally developed genitals. Dr. X. furnished me, a short time ago, with his autobiography, of which the following is worthy of mention:— “When, at the age of seven, I entered the private school, I felt very uncomfortable, and found very little sympathy with my companions. Only toward one of them, who was a very handsome child, did I feel attracted, and I loved him wildly. In childish games I always knew how to arrange it so that I could appear in feminine attire; and my greatest pleasure was to form intricate coiffures for our servant-girls. I often regretted that I was not a girl. “My sexual instinct awakened when I was thirteen, and from the moment of its appearance was directed toward youthful, strong men. At first I was not really certain that this was abnormal, but consciousness of it came when I saw and heard how my companions were characterized sexually. I began to masturbate at the age of thirteen. At seventeen I left home and went to the Gymnasium of a large Capital, where I was put to board with a married professor of the Gymnasium, with whose son I afterward had sexual relations. It was with him that I first had sexual satisfaction. Thereafter I made the acquaintance of a young artist, who very soon noticed that I was abnormal, and confessed to me that he was in the same condition. I learned from him that this abnormality was very frequent; and this knowledge overcame the trouble that I had had in supposing that I was alone in my abnormality. This young man had an extensive acquaintance with persons in like condition, to which he introduced me. There I became the object of general attention, for on all sides I was declared to be very attractive physically. I soon became insanely loved by an old gentleman; but, not finding him to my taste, I endured him but a short time, and then gave ear to a young and handsome officer who lay at my feet. He was really my first love. “After passing my final examination, at the age of nineteen, free from the discipline of school, I made the acquaintance of a great number of people like myself, and among them Karl Ulrichs (Numa Numantinus). “When, later, I took up the study of medicine, and associated with many normal youths, I was often in a position where I was compelled to visit public prostitutes. After having consorted to no purpose with various prostitutes, some of whom were very beautiful, the opinion was spread among my acquaintances that I was impotent, and I strengthened this by telling of previous sexual excesses. At that time I had numerous external relations with persons who prized my physical peculiarities, which were considered very beautiful. The result of this was, that I was exciting somebody all the time; and I received such a mass of love-letters that I was often in embarrassment. The acme of this was reached later, when, as a physician, I lived in the hospital. There I moved about like a celebrated person, and the scenes of jealousy that took place, on my account, almost led to the discovery of the whole thing. Shortly after this, I fell ill with an inflammation of my shoulder-joint, from which I recovered after three months. During this illness I received subcutaneous injections of morphine several times daily, which were suddenly discontinued, and which I practiced thereafter secretly after my recovery. For the purpose of special study, I spent some months in Vienna, before entering into private practice, and there, by means of some recommendations, I gained entrance to various circles of people like myself. I there learned that the abnormality in question, in its various forms, is spread through the lower classes as well as the higher, and that those who are approachable for money are not infrequently met among the higher classes. “When I established myself in the country, I hoped to cure myself of the morphine habit by means of cocaine; and then I became a victim of cocaine, which, only after three relapses, I was able to rid myself of (about two years ago). In my position, it was impossible for me to find sexual satisfaction, and I noticed with pleasure that the use of cocaine had overcome my desire. When, on the first occasion, at the urgent request of my aunt, I had emancipated myself from cocaine, I traveled for a few weeks, in order to improve my health, the perverse impulses were again awakened in their old strength, and, one evening, while out in the fields by the city amusing myself with a man, I noticed that I had been detected by the authorities and advertised; but that the act of which I was accused was not punishable, in accordance with the opinion expressed by the highest court of the German kingdom. I had, therefore, to be careful; for already the announcement of the crime had been heralded on all sides. I saw that, after this, I would be compelled to leave Germany, and find a new home where neither the law nor public opinion would be opposed to that impulse, which, like all abnormal instincts, could not be overcome by the will. Since I was never deceived for a moment about the matter, in recognizing my impulses as opposed to social usages, I repeatedly attempted to become master of them; but by these efforts they were increased in power. This same observation has been communicated to me by acquaintances. Since I was exclusively drawn toward strong, youthful, and masculine individuals, and they were very seldom inclined to yield to my wishes, I was compelled to buy them. Since my desire was limited to persons of the lower classes, I was always able to find such as were purchasable with money. I hope that the following statements will not awaken your repugnance. At first I intended to omit them; but, for the completeness of this communication, I may include them, since they serve to enrich the clinical material. I am compelled to perform the sexual act in the following way:— “Pene juvenis in os recepto, ita ut commovendo ore meo effecerim, ut is quem cupio, semen ejaculaverit, sperma in perinæum exspuo, femora comprimi jubeo et penem meum ad versus et intra femora compressa immitto. Dum hæc fiunt, necesse est, ut juvenis me, quantum potest, amplectatur. Quæ prius me fecisse narravi, eandem mihi afferunt voluptatem, acsi ipse ejaculo. Ejaculationem pene in anum immittendo vel manu terendo assequi, mihi nequaquam amœnum est. “Sed inveni, qui penem meum receperint atque ea facientes, quæ supra exposui, effecerint, ut libidines meæ plane sint saturatæ. “Concerning my person, I must still mention the following: I am 186 centimetres tall, of masculine appearance, and, with the exception of abnormal irritability of the skin, healthy. My hair and beard are black and thick. My genitals are of medium size and normally formed. I am able, without any trace of fatigue, to perform the sexual act from four to six times in twenty-four hours. My life is very regular. I use alcohol and tobacco very sparingly. I play the piano quite well, and some of my unpretentious compositions have been much applauded. I have lately finished a novel, which, as my first work, has been very favorably criticised by my friends. The story has several problems taken from the life of urnings in the subject-matter. “Among the large number of fellow-sufferers that are personally known to me, I have naturally been in a position to make observations concerning the condition and the degrees of abnormality; and, perhaps, the following communications may be of service to you:— “The most abnormal thing that I am acquainted with, was the impulse of a gentleman who lived in Berlin. He preferred, above all others, young fellows with unwashed feet, which he would lick passionately. A gentleman in Leipzig was similar to him; who, where it was possible, would linguam in anum immittere, preferring the parts to be uncleaned. Several have assured me that the sight of riding-boots or of parts of military uniforms, induced such excitement in them that ejaculation resulted. A man in Paris compelled a friend ut in os ei mingat. “With reference to the degree in which many feel themselves as women, which is with me not the case, two persons in Vienna are examples. They bore feminine names. One is a barber who calls himself ‘French Laura’; the other was formerly a butcher, who calls himself ‘Selcher-Fanny.’ Both of them never missed an opportunity, during the carnival time, to show themselves in very fantastic feminine masks. In Hamburg there is a person that many people believe to be a woman, because he always goes about the house in feminine attire, and only occasionally leaves the house, and always in such clothing. This man wished to stand as godmother at a christening, and, as a result of it, gave rise to great scandal. “Feminine timidity, frivolity, obstinacy, and weakness of character, are the rule in such individuals. “Several cases of perverse sexuality are known to me where epilepsy and psychoses are present. Hernias are remarkably frequent. In practice many persons come to me to be treated for diseases of the anus, because of recommendation by friends. I saw two syphilitic and one local chancre, and several fissures; and at present I am treating a gentleman for condylomata of the anus, which form a rounded tumor as large as a fist. One case of primary affection of the soft palate I saw in Vienna, in a young man who was accustomed to frequent mask-balls dressed as a girl, and entice young men; he would then pretend that he was menstruating, and thus induce the others to use him per os. The assertion was made that in this way he had deceived fourteen men in one evening. Since, in none of the publications concerning contrary sexuality that I have seen, I have found anything concerning the intercourse of pederasts among themselves, I venture to communicate something concerning it in conclusion:— “As soon as individuals that are affected with contrary sexuality become acquainted, there is a detailed narration of their experiences, loves, and seductions, as far as the social difference between them allows such entertainment. Only in very few cases is this amusement uncommon with new acquaintances. Among themselves, they call themselves ‘aunts’; in Vienna, ‘sisters’; and two very masculine public prostitutes in Vienna, whom I accidentally became acquainted with, and who lived in a perverse sexual relation with each other, told me that for the corresponding condition in women the name ‘uncle’ was used. Since becoming conscious of my abnormal instinct, I have met thousands of such individuals. “Almost every large city has some meeting-place, as well as a so-called promenade. In smaller cities there are relatively few ‘aunts,’ though in a small town of 2300 inhabitants I found eight, and in one of 7000 eighteen of whom I was absolutely sure,—to say nothing of those whom I suspected. In my own town of 30,000 inhabitants, I personally know about one hundred and twenty ‘aunts.’ The greater number of them, and I especially, possess the capability of judging another immediately as to whether they are alike or not, which, in the language of the ‘aunts,’ is called ‘reasonable’ or ‘unreasonable.’ My acquaintances are often astounded at the certainty of my judgment. Individuals that are apparently absolutely masculine I recognize as ‘aunts’ at the first sight. On the other hand, I am able to behave myself in such a masculine way that, in circles to which I have been introduced by acquaintances, there is a doubt as to my genuineness. When I am in the mood, I can act exactly like a girl. “Since the majority of ‘aunts,’ like myself, in no way regret their abnormality, but would be sorry if the condition were to be changed; and, moreover, since the congenital condition, according to my own and all other experience, cannot be influenced; therefore, all our hope rests upon the possibility of a change of the laws with reference to it, so that only rape or the commission of public offense, when this can be proved at the same time, shall be punishable.” Case 116. _Contrary Sexual Instinct in a Woman._—S. J., aged 38, governess, came to me for advice about a nervous trouble. Her father was temporarily insane, and died of a brain disease. The patient is an only child, and even when quite young she suffered with feelings of anxiety and painful ideas. She thought, for example, that she would awake in her coffin after it had been closed; that at confession she might forget something, and make a sinful confession. She suffered much with headache. She was always very much excited and apprehensive, but yet she had to see horrible things, like corpses, etc. Even in her earliest childhood, the patient was excited sexually, and began to masturbate without any teaching. The menses began at fourteen, and were always accompanied by colicky pains, violent sexual excitement, migraine, and depression. After her eighteenth year she learned to repress her impulse to masturbate. The patient has never felt any inclination toward persons of the opposite sex. If she thought of marriage, it was only because she sought in matrimony a means of being supported. On the other hand, she felt powerfully attracted by girls. At first she regarded this inclination as friendship; but in the depth of her attachment to female friends, and in the longing she constantly felt for them, she recognized that the feeling was something more than friendship. The patient cannot understand how a girl can love a man, but she can easily see how a man might love a girl. She always has a lively interest in beautiful women and girls, and is powerfully excited at sight of them. Her longing had always been to kiss and embrace such dear creatures. She had never dreamed of a man, but only of girls. Her delight had been to revel in the sight of them. Separation from such female friends had always made her desperate. The patient, whose appearance is perfectly feminine and very respectable, states that she has never felt herself in any particular _rôle_ with her friends, not even in dreams. Female pelvis; large mammæ; no sign of beard. Case 117. Mrs. R., Russian, aged 35, of high social position, was brought to me, in 1886, by her husband for advice. Father was a physician, and very neuropathic. Paternal grandfather was healthy and normal, and reached the age of ninety-six. Facts concerning paternal grandmother are wanting. All the children of father’s family are said to have been nervous. The patient’s mother was nervous, and suffered with asthma. The mother’s parents were healthy. One of the mother’s sisters had melancholia. From her tenth year patient has been subject to habitual headache. With the exception of measles, she has had no illness. She was capable, and enjoyed the best of training, having especial talent for music and languages. It became necessary for her to prepare herself for the work of a governess, and during her earlier years she was mentally overworked. She passed through an attack of melancholia _sine delirio_, of some months’ duration, at seventeen. The patient asserts that she has always had sympathy only for her own sex, and found only an æsthetic interest in men. She never had any taste for female work. As a little girl, she preferred to play with boys. She says she remained well until her twenty-seventh year. Then, without external cause, she became depressed and considered herself a bad, sinful person, had no pleasure in anything, and was sleepless. During this time of illness she was also troubled with imperative conceptions: that she must think of the death of herself and her relatives. Recovery after about five months. She then became a governess, was overworked, but remained well, except for occasional neurasthenic symptoms and spinal irritation. At twenty-eight she made the acquaintance of a lady five years younger than herself. She fell in love with her, and her love was returned. The love was very sensual, and satisfied by mutual masturbation. “I loved her as a god; her’s is a noble soul,” she said, when she mentioned this love-bond. It lasted four years, and was ended by the (unfortunate) marriage of her friend. In 1885, after much emotional strain, the patient became ill with symptoms of hystero-neurasthenia (dyspepsia, spinal irritation, and tonic spasmodic attacks; attacks of hemiopia with migraine and transitory aphasia; pruritus pudendi et ani). In February, 1886, these symptoms disappeared. In March she became acquainted with her present husband, and married him without taking much time for reflection; for he was rich, much in love with her, and his character was in sympathy with her own. On April 6th, she read the sentence, “Death misses no one.” Like a flash of lightning in a clear sky, the former imperative conceptions of death returned. She was forced to meditate on the most horrible manner of death for herself and those about her, and constantly imagine death-scenes. She lost rest and sleep, and took no pleasure in anything. Her condition improved. Late in May, 1886, she was married, but was still troubled by painful thoughts at that time: that she would bring misfortune on her husband and those about her. First coitus on June 6, 1886. She was deeply depressed morally by it. She had had no such conception of matrimony. The husband, who really loved his wife, did all he could to quiet her. He consulted physicians, who thought all would be well after pregnancy. The husband was unable to explain the peculiar behavior of his wife. She was friendly toward him, and suffered his caresses. In coitus, which was actually carried out, she was entirely passive, and after the act she was tired, exhausted all day long, nervous, and troubled with spinal irritation. A bridal tour brought about a meeting with her old friend, who had lived in an unhappy marriage for three years. The two ladies trembled with joy and excitement as they sank into each other’s arms, and became inseparable. The husband saw that this friendly relation was a peculiar one, and hastened their departure. He had an opportunity to ascertain, through the correspondence of his wife with this friend, that the letters interchanged were like those of two lovers. Mrs. R. became pregnant. During pregnancy the remains of depression and imperative ideas disappeared. In September, during about the ninth week of pregnancy, abortion took place. After that, renewed symptoms of hystero-neurasthenia. In addition to this, there were anteflexio et latero-positio dextra uteri, anæmia, and atonia ventriculi. At the consultation the patient gave the impression of a very neuropathic, tainted person. The neuropathic expression of the eyes cannot be described. Appearance entirely feminine. With the exception of a very narrow, arched palate, there was no skeletal abnormality. With difficulty the patient could be brought to give the details of her sexual abnormality. She complained that she had married without knowing what marriage between men and women was. She loved her husband dearly for his mental qualities, but marital intercourse was a pain to her; she did it unwillingly, without ever finding any satisfaction in it. Post actum, all day long she was weary and exhausted. Since the abortion and the interdiction of sexual intercourse by the physicians, she had been better; but she thought of the future with horror. She esteemed her husband, and loved him mentally; but she would do anything for him, if he would but avoid her sexually in the future. She hoped to have sensual feeling for him in time. When he played the violin, she seemed to feel the beginning of an inclination for him that was something more than friendship; but it was only transitory, and she could get no assurance for the future in it. Her greatest happiness was in correspondence with her former lover. She felt that this was wrong, but she could not give it up; for to do so made her miserable. It is remarkable that the anomaly may be long limited to mere perversion of the sexual instinct, and that the impulse to perverse indulgence may make its appearance after some accidental cause,—_e.g._, seduction, or some neurosis. Such cases might easily be mistaken for acquired contrary sexual instinct (_v. supra_), if, with reference to the sexual feeling, they should not be demonstrated by the history to be original and congenital. Case 118. Mrs. C., aged 32, wife of an official, a large, not uncomely woman, feminine in appearance, comes of a neuropathic and emotional mother. A brother was psychopathic, and died of drink. Patient was always peculiar, obstinate, silent, quick-tempered, and eccentric. The brothers and sisters are excitable people. Pulmonary phthisis has been frequent in her family. When only a girl of thirteen, with signs of great sexual excitement, she attracted attention by enthusiastic love for a female friend of her own age. Her education was strict, though the patient secretly read many novels, and wrote innumerable poems. She married at eighteen to free herself from unpleasant circumstances at home. She says she has always been indifferent toward men. In fact, she avoided balls. Female statues pleased her. Her greatest happiness was to think of marriage with a beloved woman. She was not aware of her sexual peculiarity until marriage, and the thing had remained inexplicable to her. Patient did her marital duty, and bore three children, two of whom were subject to convulsions. She lived pleasantly with her husband, but she esteemed him only for his moral qualities. She gladly avoided coitus. “I should have preferred intercourse with a woman.” Until 1878 she had been neurasthenic. On the occasion of a sojourn at a watering-place, she made the acquaintance of a female urning, whose history I have reported as Case 6, in the _Irrenfreund_, No. 1, 1884. The patient came home a changed person. Her husband says: “She was no longer a woman, no longer had any love for me and the children, and would have no more of marital approaches. She was inflamed with passionate love for her female friend, and had taste for nothing else.” After the husband forbade her lover the house, there was interchange of letters with such expressions in them as “My dove! I live only for you, my soul.” There were meetings and frightful excitement when an expected letter did not come. The relation was in nowise platonic. From certain indications it is presumable that mutual masturbation was the means of sensual satisfaction. This relation lasted until 1882, and made the patient decidedly neurasthenic. She absolutely neglected the house, and her husband hired a woman of sixty years as a house-keeper, and also a governess for the children. The patient fell in love with both, who, at least, allowed caresses, and profited materially through the love of their mistress. In the latter part of 1883, on account of developing pulmonary tuberculosis, she had to go south. There she became acquainted with a Russian lady of forty years, and fell passionately in love with her; but she did not meet with a return of love in her sense. One day insanity became manifest. She thought the Russian lady a nihilist; that she was magnetized by her; and she presented formal persecutory delusions. She fled, and was caught in an Italian city, and placed in a hospital, where she soon became quiet. Again she followed the lady with her love, felt herself very unhappy, and planned suicide. When she returned home, she was greatly depressed because she did not have the lady, and was contrary toward her family. A delusive, erotic state of excitement came on about the end of May, 1884. She danced, shouted, and called herself a man; demanded her former lovers, and said she was of royal blood. She escaped from the house in male attire, and was taken to the asylum in a state of eroto-maniacal excitement. After a few days the exaltation disappeared. The patient became quiet, and made a despairing attempt at suicide; and after it she was in great anguish of mind with tædium vitæ. The perverse sexual feeling grew less and less noticeable, and the tuberculosis progressed. The patient died of phthisis in the beginning of 1885. The examination of the brain presented nothing unusual as far as architecture and arrangement of convolutions were concerned. Weight of brain 1150 grammes. Skull slightly asymmetrical. No anatomical signs of degeneration. External and internal genitals without anomaly.