24. It was discovered that she was of masculine sex. E. had worn female

clothing from her fourteenth year, and also been an actress. The hair was worn long after the manner of females, and parted in the middle. The form of the face was feminine, but otherwise the body was masculine. The beard was carefully pulled out. The masculine, well-developed genitals were fixed in an upward position by an artful bandage. The condition of the anus indicated passive pederasty. Case 127. An official of middle age, who for some years had been happy in family life, and was married to a virtuous woman, presented a peculiar manifestation of contrary sexual feeling. One day, through the indiscretion of a prostitute, the following scandal became public: About once a week X. would appear in a house of prostitution, and there dress himself up as a woman, always requiring, as a part of his costume, a coiffure. When his toilet was completed, he would lie down on the bed, and have the prostitute perform manustupration. But he very much preferred to have a male person (a servant of the house). This man’s father was hereditarily tainted, had been insane several times, and was afflicted with hyperæsthesia and paræsthesia sexualis. Case 128. C. R., maid-servant, aged 26, suffered from the time of her development with original paranoia and hysteria. As a result of her delusions, her life had been somewhat romantic, and in 1884, in Switzerland, where she had gone as a result of delusions of persecution, she came under the observation of the authorities. On this occasion, it was ascertained that R. was affected with contrary sexual instinct. Concerning her parents and relatives there is no information at hand. R. asserted that, with the exception of an inflammation of the lungs at the age of sixteen, she had never been severely ill. First menstruation at fifteen, without any difficulties; thereafter it was very often irregular and abnormally excessive. The patient declared that she never had had inclinations toward the opposite sex, and had never allowed the approach of a man. She never could understand how her friends could describe the beauty and amiability of men. But it was charming and inspiring for her to imprint a kiss on the lips of a beloved female friend. She had a love for girls that was incomprehensible to her. She had passionately loved and kissed some of her female friends, and she would have given up her life for them. Her greatest delight would have been to have constantly lived with such a friend and absolutely possessed her. In this she felt toward the beloved girl like a man. Even as a little child, she had an inclination only for the play of boys, and she loved to hear shooting and military music, was always much excited by them, and would gladly have gone as a soldier. The chase and war have been her ideals. In the theatre only feminine performers interested her. She knew very well that the whole of this inclination was unwomanly, but she could not help it. It had always been a great pleasure for her to go about in male clothing, and in the same way she had always preferred masculine work, and had shown unusual skill in it; while with reference to feminine occupations, especially handiwork, she had to say the contrary. The patient had also a weakness for smoking and spirits. On account of persecutory delusions, in order to rid herself of her persecutions, the patient had often gone about in male attire, and played the part of a man. She did this with such (congenital) skill that, as a rule, she was able to deceive people concerning her sex. It is authoritatively established that in 1884, for a long time, the patient went about in male attire, now in the garments of a civilian, now in the uniform of a lieutenant; and in August of the same year, dressed as a male servant, she fled to Switzerland as a result of delusions of persecution. There she found service in a merchant’s family, and fell in love with the daughter of the house, “the beautiful Anna,” who, on her side, not recognizing the sex of R., fell in love with the handsome young man. Concerning this episode the patient makes the following characteristic statement: “I was madly in love with Anna. I don’t know how it came about, and I cannot put myself right concerning this impulse. In this fatal love lies the reason why I played the _rôle_ of a man so long. I have never yet felt any love for a man, and I believe that my love is for the female and not the male sex. I can in nowise understand my condition.” From Switzerland R. wrote letters home to her friend, Amelia, which were produced at the examination. They are letters showing passionate love, which goes beyond the bounds of friendship. She apostrophizes her friend, “My flower, sun of my heart, longing of my soul.” She was her greatest happiness on earth; her heart was hers. And in her letters to her friend’s parents she wrote: “You, too, should watch your flower, for, if she should die, you also would be unable to endure life.” For the purpose of investigating her mental condition, R. remained for some time in an asylum. On one occasion, when Anna was allowed to pay R. a visit, there was no end of passionate embraces and kisses. The visitor acknowledged freely that they had before secretly embraced and kissed in the same way. R. is a tall, slim, stately person, of feminine form in all respects, but with masculine features. Cranium regular; no anatomical signs of degeneration. Genitals normal and indicative of virginity. All the circumstances indicate that she has only indulged in platonic love. Glance and appearance are indicative of a neuropathic person. Severe hysteria, occasional cataleptoid attacks, with visionary and delirious states. The patient is very easily brought into a state of somnambulism by hypnotic influence, and in this condition is susceptible to all possible suggestions. (Personal case. _Friedreich’s Blätter_, 1886, Heft 1.)