3. I feel an inclination toward women; for woman is lovely and

desirable, and created for man. During the sittings the patient always repeats these suggestions. After the fourth sitting it was noticeable that, when taken into society, he paid court to ladies. Shortly after that, when a famous prima-donna sang, he was all enthusiasm for her. Some days later the patient sought the address of a brothel. At the same time, he preferred the society of young gentlemen; but the most careful watching failed to reveal anything suspicious. February 17th. Patient asks to be allowed to indulge in coitus, and is very well satisfied with his experience with one of the _demi-monde_. March 16th. Up to this time, hypnosis twice a week. The patient always passes into deep somnambulism by simply being looked at, and, at request, repeats the suggestions. He is obnoxious to all kinds of post-hypnotic suggestion, and, in the waking state, knows not the least of the influences exerted on him in the hypnotic state. In the hypnotic condition he always gives the assurance that he is free from onanism and sexual feeling for men. Since he gives the same answers in hypnosis,—_e.g._, that on such and such a date he practiced onanism for the last time, and that he is too much under the will of the physician to be able to lie,—his assertions deserve belief; the more, since he looks well and is free from all neurasthenic symptoms, and, in the society of men, not the slightest suspicion rests on him. An open, free, and manly bearing is developed. Moreover, since, of his own will, he now and then indulges in coitus with pleasure, and occasional pollutions are induced by lascivious dreams which concern women, there can be no doubt of the favorable change of his vita sexualis; and it is presumable that the hypnotic suggestions have developed into auto-suggestive inclinations, which direct his feelings, thoughts, and will. Probably the patient will always remain a natura frigida; but he more often speaks of marriage, and of his intention to win a wife as soon as he has become acquainted with a sympathetic lady. In July, 1889, I received a letter from his father, which told me of his good health and conduct. On May 24, 1890, by chance, I met my former patient, while on a journey. His bright, healthful appearance allowed the most favorable opinion of his condition. He told me that he still had sympathetic feeling for some men, but never anything like love. He occasionally had pleasurable coitus with women, and now thought of marriage. I hypnotized him, in the former manner, to try him, and asked for the commands I had given him. In a deep condition of somnambulism, and in the same tone of voice as formerly, the patient repeated the suggestions he had received in December, 1888,—an excellent example of the possible duration and power of post-hypnotic suggestion. Case 140. _Psychical Hermaphroditism; Improvement with Hypnotic Treatment._—Mr. von K., aged 23; of distinguished family; well endowed mentally; scrofulous as a child. His father is said to have been dissipated. His father’s brother is said to have been subject to contrary sexuality. The patient states that, when only seven years old, he had a peculiar inclination for male persons. It was particularly coachmen and servants having moustaches for whom he showed partiality at that time. He experienced a peculiar delightful sensation when he pressed himself against such persons. The patient entered the cadet corps early, and there he was seduced into mutual onanism, and also learned imitatio coitus inter femora viri. At the age of seventeen he had coitus with a prostitute for the first time. He performed the act perfectly, but had not the slightest pleasure in it; and he learned that this kind of gratification amounted to nothing, or that he must be different from other young men. Nevertheless, he often had coitus, and contracted gonorrhœa. After this he experienced an increasing aversion for the female sex, and indulged in coitus less and less frequently; in fact, only when, with intense libido, he could not gain opportunity for intercourse with men. His inclination for men predominated more and more, and he was attracted exclusively by those handsomely formed, and having as little beard as possible. He descended to the most revolting practices,—coitus buccalis, active and passive pederasty. The patient was deeply ashamed of such depravity, and was constantly endeavoring to get into better ways by means of coitus with women. But he came to the despairing conclusion that his moral strength was insufficient, that he was indifferent about intercourse with women, or that it was repugnant to him; and that he was created for sexual intercourse with persons of his own sex. In fact, he had never dreamed of women, but always of men; and that at a time, too, when he had no suspicion of the difference between the sexes. The patient comes for consultation, because he sees that he is jeopardizing the happiness of his whole life, and recognizes the unnaturalness and immorality of his sexual life. He does not regard his condition as hopeless; for he has no horror of women, and three weeks ago he had successful coitus with one, though it was devoid of all pleasure and mental satisfaction. He has no doubt that he was really created to love men; but, owing to acquired neurasthenia, in the sexual act with a man he experiences no such pleasure as formerly. He had given up his position as an officer, because the soldiers excited him so sexually that he feared he might compromise himself. The patient is devoid of degenerative signs. His appearance is perfectly masculine, and his genitals are normal. Examination of the semen revealed abundance of spermatozoa. The penis is large and well developed; the growth of hair ad genitalia, as well as on the rest of the body, is abundant. The patient has masculine tastes, but has never been partial to drinking and smoking. A neuropathic eye is all that points to a nervous constitution. In his sexual acts with men, he states that, as a rule, he has felt as a man, only now and then as a woman. An attempt at hypnosis leads to lethargy, with cataleptic condition of the muscles, and the opportunity is used to impart suitable suggestions. After the fourth sitting he expressed himself as satisfied, and wondered that men made no impression on him. He wished to try his fortune with women, but was afraid that he was impotent. After the sixth sitting, without advice, he attempted coitus cum muliere. His libido was very great, but inter actum this and erection left him. After the ninth sitting the patient was forced to discontinue treatment, owing to business that called him home. He was satisfied, in that he felt indifferent and capable of resistance to men. He felt sure that he would not relapse into his former vices. At the same time, he had not the slightest interest in the female sex. Case 141. Mr. X., aged 31, chemist, comes of a neuropathic family, and from childhood has been nervous, emotional, and apprehensive, and afflicted with migraine. He remembers distinctly that, when a very small boy, he had a lustful feeling at the sight of the half-naked persons in the work-shop at his father’s house, and felt drawn to them. When he began school, he felt in the same way toward his companions. At the age of eleven, without teaching, he began to masturbate, during which he thought of his comrades. Later there were enthusiastic friendships. His vita sexualis gained the upper hand. As he grew up, women also interested him, but his chief interest was in men of the higher circles of society. He felt that this inclination was abnormal, and sought the acquaintance of puellis; he often had coitus, but never with any real pleasure. Thus he became more and more given to contrary sexuality, practiced mutual masturbation and coitus inter femora viri, and occasionally gave himself up to passive pederasty; but he soon abandoned this, on account of the pain it caused him. He asserts that he feels perfectly masculine, and has never had female inclinations. Skeleton and attitude perfectly masculine; strabismus; abundant beard; genitals entirely normal. No aversion to the female sex. Occasional coitus with puellis, but without satisfaction. The patient feels exceedingly unhappy, and clearly recognizes his abnormal position; at any price, he wishes to be freed from his homo-sexual inclination, and made capable of marriage. “It is terrible to have to act a farce constantly.” At the first attempt at hypnosis, after Bernheim’s method, the patient passes into a state of deep lethargy. He proves to be very susceptible to suggestion, and suitable suggestions are imparted. After the fourth sitting, he states, with gratitude, that men become indifferent, and he begins to have pleasure in coitus; but he did not feel mentally satisfied, owing to the fact that he was limited to puellæ publicæ. After the fourteenth sitting he declared that he required no more treatment. He was in love with a young lady, and thought of marrying her. He asked for her hand, and was refused. Soon after, while he was on a journey in Italy, men interested him again. He had a relapse, and asked for further treatment. A few sittings re-established the _status quo ante_. Case 142. _Psychical Hermaphroditism; Successful Treatment by Hypnotic Suggestion._—Mr. von Z., aged 29. He asserts that he comes of healthy grandparents; of a healthy father, but of a nervous mother. He is an only child, and was petted by his mother. At the age of eight he was powerfully excited sexually by a male servant, who showed him pornographic pictures and his penis. When twelve years old, Z. fell in love with his tutor. On going to sleep, the naked form of this man appeared before him. He thought of himself as in a female _rôle_ in relation to him, and thought to marry him some time. At the age of thirteen, at a private ball, his fancy was excited by a young governess, and, at fifteen, he fell in love with a young lady. He remained very excitable sensually; but, thereafter, exclusively so to men pleasing to him. Masturbation was not practiced. At the age of twenty the patient became neurasthenic (ex abstinentia?). He now attempted coitus, but was not successful. On the other hand, he had intense desire on an occasion when he saw a naked man in a steam-bath. The latter noticed his excitement, approached him, and performed masturbation on him, giving the patient intense delight. He felt powerfully attracted to this man, and, thereafter, allowed him to repeat the act. In the meantime, there were attempts at coitus with females, which always ended in a fiasco. The patient was much troubled by this, and consulted physicians, who explained his impotence as due to nervousness, and thought that it would soon pass off. Until his twenty-fifth year his sexual indulgence consisted of masturbation by the beloved man about once a month. At this time he last felt attracted to a woman. It was to a young peasant-girl. She would not accede to his wishes. Since his lover was also unattainable, the patient began to masturbate alone. With this, his neurasthenia increased. For this reason he was unable to finish his studies; he became shy, dysthymic, abulic, and now vainly tried cures at various hydropathic establishments. On account of continued severe (cerebro-spinal) neurasthenia, the patient came to me for advice, in the latter part of February, 1890. A tall, slim man, of aristocratic and decidedly masculine manners. Neuropathic appearance; large ears, the lobes of which run into and lose themselves in the skin of the cheeks. Genitals perfectly normal. The usual picture of cerebro-spinal neurasthenia of moderate degree. Great depression; complaint of being dissatisfied with life, even to tædium vitæ; he is pained by his sexual anomaly, especially because he is urged by his family to marry. He is interested in women only mentally, not physically. Sexually, his only interest is in men of distinction. His dreams have never been about persons of the opposite sex, but of those of his own sex. In these lascivious dreams he has always seen himself in the _rôle_ of a woman. The most refined woman has never been able to induce erection or even libido in him. His sexual intercourse with men has consisted of passive or mutual masturbation. He had practiced solitary onanism only infrequently and _faute de mieux_. During the last five months he had abstained, and had had no male intercourse since August, 1889. An attempt at hypnosis, after Bernheim’s method, failed; prolonged stroking of the brow induced deep lethargy, with catalepsy. This method is used, in order to carry out suggestive treatment of this patient, who is so worthy of compassion. The hypnotic state is always the same; he cannot be brought into a state of somnambulism. At the third sitting the patient is given the suggestions: ever despise onanism and male love; find women beautiful, and dream of them. After the sixth sitting (March 10th) a moral transformation takes place in his mind. The patient becomes quieter, feels more free, and dreams now and then of women, and no longer of men, finding that the latter have become indifferent to him. He gratefully states that he has no more inclination to masturbation. He approaches women, but he notices that they have not the least attraction for him. On March 19th, business called the patient home; so that the treatment had to be discontinued. On May 17, 1890, the patient returned for treatment. He asserted that he had not masturbated in the interval, and that he had resisted his inclination to men. Too, he had not dreamed of men, but twice of women, though only platonically. His cerebral asthenia (ex abstinentia?) had increased. He apparently suffers for the want of mental and sensual satisfaction of his vita sexualis; for homo-sexual love and masturbation have become impossible for him, and intercourse with women is denied him. The patient is thus painfully depressed to the extent of tædium vitæ. He is now subjected to anti-neurasthenic treatment (hydro-therapeutic and electro-therapeutic), and the treatment by hypnosis is resumed. Only after ten weeks of painstaking treatment did the neurasthenic symptoms disappear. Progressing parallel with this, there was a change of his mental personality. The patient was gratified to note that he grew stronger; that his sexual life no longer played a dominating part. Though he felt more drawn toward men than women, yet he easily resisted homo-sexual desires. His former _boudoir_ became a work-room; instead of to adornment and frivolous reading, he gave himself to walks in the mountains and forests. On account of the danger of a fiasco, the initiative in hetero-sexual attempts was left to the patient. It was not until the fourteenth week of treatment that the patient made an attempt. It was perfectly successful. The patient became happy, and sound in body and mind, and expressed the best hope of his future, even having thoughts of marriage. He experienced increasing pleasure in normal sexual intercourse; he occasionally had lascivious dreams of women, and no longer dreamed of men. The patient stopped treatment at the end of September. He felt perfectly normal in hetero-sexual intercourse, devoid of neurasthenia, and had thoughts of marriage. Yet he freely confessed that he still always had erections at the sight of a naked, handsome man; though he could easily resist the desires that arose, and in dreams had exclusively “_relations avec la femme_.” In April, 1891, I again saw the patient, and he was in the best of health. He regarded his vita sexualis as perfectly normal; for he had coitus regularly with pleasure and full virility, dreamed only of women, and had no inclination to masturbation. Yet he made the interesting confession that frequently, post coitum, he still had a temporary “_gout pour l’homme_,” which he could easily control. He thought he was lastingly cured, and was occupied with thoughts of marriage. Case 143. _Congenital Contrary Sexual Feeling. Successful Removal of Homo-Sexual Feelings by Suggestions._—L., doctor of philosophy, aged 34, German, consulted me, in the spring of 1888, on account of perversion of his vita sexualis, and asked whether he could not be freed from it by means of hypnotic treatment. Patient came of a healthy mother, in whose family, for generations, there had been neither insanity nor nervous disease. He, like his only brother, is much like his father mentally. His brother is very sensual, and also psychically abnormal, and given to over-indulgence in drink. His father was a neuropathic, eccentric man. Nothing is known of any abnormal sexual manifestations in him, though, like all his brothers, he had a tendency to over-indulgence in alcohol. This vice seems to have been inherited from his mother (grandmother of patient), who was a notorious drinker. The father of this woman (great-grandfather of patient) was also a great drinker. No other ancestral history was obtainable. Patient states that from childhood he was nervous and easily excited. He learned very easily, and had a talent for languages. He was always interested in art, particularly in music and poetry. His education was excellent, and given at home. When he was thirteen, his father told him that he should never touch his genitals, for it was wrong to do so, and to do it might bring unhappiness. Occasionally his father showed him pictures of syphilitic diseased conditions, etc., in an anatomical museum, and the patient was disgusted and frightened. He believed that his later fear of sexual intercourse with women was partly nourished by this early erroneous teaching. However, the patient seeks the principal cause of his sexual perversion in a defect of organization. When a small boy, he had a silly enthusiasm for companions. He also remembers that, at that time, he had a desire only for girlish games, and preferred the society of girls. When a boy, he had a passion for crocheting and embroidering. At fourteen he was still without any sexual knowledge, and fell into the hands of a pederast. He ran away, frightened, when he learned what was to be done with him. When fifteen, a sympathetic companion was accustomed to lay his head in the patient’s lap. This gave the patient a peculiar pleasurable feeling, but he knew no explanation of it. At sixteen he had the first erections—at the sight of men. At twenty he first learned that his sexual condition was perverse, and recognized the fact that what he had taken for friendship was love. He was much frightened at the discovery, and much pained. His sympathies were directed toward young men of the upper class that were handsomely formed and of pleasing appearance. The society of ladies had no effect on him. He was never attracted by the charms of the opposite sex. In his fifteenth year he had a sensual dream, in which he thought a girl of elegant figure sat opposite him, on a sofa. In the theatre it was only the art of the actresses that he admired; the actors excited his real interest. Drinking and smoking had always been very repugnant to him. Hunting and gymnastics, and other masculine occupations, had no interest for him. He did not enter the army, because his general physical weakness precluded it. The patient has but little sexual desire. He has never had any impulse to satisfy himself with persons of his own sex. Some years ago, when he first tried to embrace a man lovingly, he had powerful erection and became greatly excited; but he was able to control himself and to repel his lover. Thereafter he always avoided such attempts. It was only seldom that he became powerfully excited sexually, and even then he was not driven to satisfy himself. He was never given to onanism. During the establishment of puberty, the patient had frequent dreams with pollutions, but these were not induced by erotic fancies of any kind. Some years ago, for a long time, ejaculation was always induced by the embrace of a sympathetic man, but this condition of irritable weakness disappeared. As years passed, the patient, who had always had a desire for marriage and a family, became anxious on account of the conviction that the inclination toward females, for which he had hoped, would never come. It became more and more clear to him that he was abnormal, and he began to have fears about his virility and his future happiness in life. In order to test the matter, he sought a brothel. He found a prostitute of beautiful form; he had the best will to satisfy himself that he was virile; the woman did all she could, but in vain. There was no erection, and he withdrew, ashamed. New attempts, under the most favorable circumstances, were likewise failures, though the patient brought his imagination to his aid, and thought himself to be embracing a man instead of a woman. He now realized that his ideal—to consummate marriage—was impossible. He felt himself very unfortunate, and dissatisfied with life. Besides, it forced itself upon him that morally he was lowered, because he could not overcome his inclination for his own sex, and his friendship for respectable men of his circle was degraded by sexual feelings. In his consultation with me, the patient was unending in the description of his painful situation. His ideal was marriage. He longed for it, for purely ethical reasons. He thought of it as something holy; but the begetting of children, the sexual act, was very repugnant to him. At the same time, he saw that he could not really marry without being potent. Would not hypnotic suggestion exercise a favorable influence on his sexual life? He had not the energy of a man of normal sexual condition. He seemed to himself to be all wrong. He would endure all—to be poor and miserable—if he could but have a normal sexual inclination. When the patient was gently told of the congenital and deep constitutional significance of his sexual anomaly, and shown that, therefore, the creation of a normal sexual condition was doubtful, he thought that he would be satisfied to remain in his condition. But he wished to know whether it were not possible to eradicate his inclination for men, without attempting to create an equivalent for women; and if, in hypnosis, it could not be suggested to him that, in the future, men be a matter of indifference to him, and that, in intercourse with his friends, he no longer be excited sexually. Such a result would elevate very much his moral feeling, and make him satisfied and unembarrassed in social relations with his friends. The possibility of such suggestive removal of feelings by hypnosis could not be gainsaid, though he was in doubt as to whether he could be hypnotized or not, since the hypnoscope had proved to have no effect upon him. Out of pity and scientific interest, I decided to make an immediate attempt at hypnosis, after Bernheim’s method. The patient passed easily into a condition of deep lethargy, and, in a drawling voice, repeated the following suggestion: “I feel that, from this time, I am sexually indifferent to men; and, that a man is as sexually indifferent to me as a woman.” When I counted three,—having suggested previously that he awake at three,—the patient came to himself, as if out of a deep sleep, and performed immediately the post-hypnotic suggestion to open the door of the stove. He said that he had not lost consciousness entirely, that he had felt as one paralyzed and without will, and that he had felt a peculiar creeping sensation in all his limbs. After five days the patient came again. In manner he was a different person, and he said, joyfully, that he felt like another man. Energy and will-power—the loss of which he had felt so keenly—had returned. He felt, now, entirely unembarrassed toward men, and had a new joy in living. The following seven days he was hypnotized. Hypnosis is no longer as deep as at first, though the suggestion is always accepted and repeated. However, he is quite profoundly influenced; for, the suggestion given, he sleeps on, in a state of lethargy, for ten minutes, and has to be awakened by suggestion. This always occurs as if from a deep sleep,—slowly, and through a stage of somnolence. After the eighth sitting the patient found himself well and happy, and in possession of full self-confidence. He had the feeling and the evidence that men had no influence on him. He thought he could dispense with hypnotic treatment, and gratefully took his leave, with the promise that, should the influence of the suggestion fade, he would come again. Since then, I have heard nothing more of this interesting patient, and I have reason to hope that he remains improved. The patient is, in all respects, of masculine appearance; beard abundant. Physically, with the exception of slight neurasthenic symptoms, he presents nothing remarkable. Genitals normal. (Personal case. _Internat. Centralblatt_, etc., Bd. i, Heft 1.) Case 144. X., aged 33; single; tall. Mentally, of small endowment; comes of tainted family. Paternal grandfather died at thirty-four with a mental disease, which is said to have developed as a result of onanism and spermatorrhœa. His father and brother suffered with disturbances of the sexual functions. There was insanity in the mother’s family; other branches of the family were noted for their irritable and eccentric character. The patient has too small a head, a retreating brow, abnormal ears, sparse growth of hair, and a hernia, which is probably congenital. Genitals large, and normally developed. Great impressionability; neuropathic constitution; occasional tædium vitæ. For several years, peculiar, imperative ideas: that he is a locomotive; a horse; a velocipede; and, that he must act accordingly. From his earliest youth, contrary sexual feeling (congenital). Horror feminæ; sexual inclination toward boys; satisfaction by sensual contact, and, _faute de mieux_, masturbation. One day he had an affair with a boy dressed in gray, which made a deep impression on him. Since then, while masturbating, the image of the boy comes into his mind; and he cannot see gray clothes without having powerful erections. On the advice of physicians whom he consulted, he attempted coitus with women, but was cold and impotent, notwithstanding the assistance of memory-pictures of the boy dressed in gray; and he finally gave up the efforts. March 27th, first hypnotic sitting. Small result. He resists, and says his fancy keeps him from going to sleep. In a further series of sittings he declares that he experiences unfavorable effects,—is more excited, and troubled by imperative ideas and the desire to masturbate. He makes fun of the physician and hypnotism, and offers much resistance, with the expression that hypnotism is good for nothing, and only makes people crazy. However, gradually it became possible to induce somnambulism. After twenty-five sittings the patient confessed that he was better, and that he was less troubled with imperative ideas and onanism. The sittings were repeated every week or two. The patient felt mentally and morally well, ceased to masturbate, but, at the end of treatment, was indifferent toward the opposite sex (Dr. Ladame, _Revue de l’hypnotisme_, September 1, 1889). In the two foregoing cases there was successful suggestive removal of homo-sexual feelings,—a result which, as Case 143 shows, means a great improvement for such unfortunate individuals, in that it protects them from shame and the law. An entirely different and phenomenal result is presented by the following case, reported by Dr. v. Schrenk-Notzing in the _Wiener internat. klin. Rundschau_, October 6, 1889, No. 40, which is a case of effemination. It discloses a new method of treatment of urnings; but it is necessary to guard against illusions. Only where hypnosis can be deepened to somnambulism, are decided and lasting results to be expected:— Case 145. _Congenital Contrary Sexual Instinct Improved by Hypnotic Suggestion._—R., official, aged 28. January 20, 1888, he sought medical advice. He is the brother of the patient who is the subject of Case 135, and, therefore, of a badly tainted family (_v. supra_). Toward the end of treatment, he confessed that he was the author of the autobiography which was published as Case 83 in the fifth edition of this work, and it is here reproduced:— “In brief, my abnormality consists of this, that in sexual relations I feel myself to be completely feminine. Since my earliest youth, in my sexual acts and fancies, I have always had before my eyes only images of masculine beings and masculine genitals. “Until I went to the University, I found nothing in this (I had never spoken with others about my fancies, but rather, while at the Gymnasium, lived a silent and retired life). “While at the University, it struck me that female persons made not the slightest impression on me. Since then, in houses of prostitution, etc., I have attempted coitus, or only to obtain an erection, with women, but always in vain. “Erection ceased immediately, as soon as I was in a room alone with a woman. At first I considered it impotence, though, at the same time, I was so excited sexually that I had to masturbate several times during the day in order to sleep. “Quite different, however, has been the development of my feelings toward the masculine sex, and it has grown stronger every year. At first they expressed themselves in extraordinary, enthusiastic friendship for certain persons, under whose windows at night I would wait for hours; whom in all possible ways I would try to meet on the streets, and with whom I sought to come in contact. I wrote such persons the most passionate letters, in which, however, I was shy in expressing my feelings too plainly. Later, after my twentieth year, I came to understand the essential nature of my inclinations, particularly from the sensual pleasure I experienced as soon as I came in direct contact with any of these friends. These persons were all finely built men, with dark hair and eyes. I have never had my feelings excited by boys. Real pederasty is absolutely incomprehensible to me. About this time (twenty-second to twenty-third year) the circle of my beloved friends grew more and more extensive. Now I can scarcely see a handsome man on the street without having the wish to possess him excited in me. The fact is, I especially love persons of the lower classes, whose powerful forms attract me,—soldiers, policemen, car-drivers, etc.,—_i.e._, all that wear uniforms. If one of these returns my look, I feel a kind of thrill go through my whole body. I am especially excitable in the evening, and merely the heavy tread of a soldier is alone sufficient to induce the most powerful erections. I take a very peculiar pleasure in following such persons and looking at them. As soon as I learn that they are married, or that they consort with girls, my excitement very frequently ceases. “A few months ago I became able to control my inclinations to such an extent that they were not directly noticeable. About this time I followed a soldier who seemed likely to acquiesce in my desire, and spoke to him. For money he was ready for anything. At once I was filled with a most violent longing to embrace and kiss him, and the danger of being noticed did not deter me from doing it. He had scarcely grasped my genitals when ejaculation followed. With this meeting, I had finally attained the long-desired goal of my life. I knew that my whole nature would find its happiness and satisfaction in it, and from this time I gave myself up entirely to the effort to find a person whom I could love, and from whom I should never part. For my acts I do not experience the slightest twinge of conscience. “To be sure, in quiet moments, I very well appreciate the difference between my way of thinking and the way of the world; as a lawyer, too, I naturally recognize the dangers of a relation of the kind I desire; but, as long as my entire nature does not change, I shall not be able to give up the opportunities offered me. Nevertheless, I should be willing to undergo any cure to be freed from my abnormal condition. “I recognize my feminine feeling, among other things, in the fact that any sensual idea in connection with a woman must be forced, and seems unnatural to me. I am also sure that my respect for a woman—I move much in the society of ladies, and enjoy it—would change immediately to repugnance, were I to notice any sensual inclination in her toward me. In my dreams and sensual fancies of men, I always think of myself in such positions with them that their faces are always toward mine. My greatest delight would be to have a powerful man, undressed, take me in his arms with a force I could not resist. In such situations I always think of myself in a passive _rôle_, and have to force my feelings, in order to think of myself in any other position. In this, I am truly feminine. Great as my desire may be to approach certain persons, my struggle is as great not to allow this to be noticed. Moustaches, abundance of hair, and even dirt, seem to be especially enticing. It is hardly necessary to say that, to me, my condition, with reference to society, is absolutely desperate; and, if I had not the hope of finding a being that would understand me, life would be scarcely endurable. I feel that sexual commerce with a man is the only means of successfully combating my impulse to onanism. Though this has a very bad effect on me, I cannot keep myself from it constantly, because, as I have often found, I will be even more weakened by pollutions at night and persistent erections during the day. “Up to this time I have truly loved but two men. Both were officers, remarkably endowed mentally, handsomely and gracefully formed, and of dark skin and eyes. I became acquainted with the first at the University. I was madly in love with him, and suffered unspeakably on account of his indifference. I spent nights under his window, simply to be near him. When he was officially transferred, I was in despair. “Soon after, I became acquainted with an officer that resembled him, who likewise enchained me at first sight. I sought every opportunity to meet him, spent the day in the streets, and at places where I hoped to get a sight of him. I knew how the blood came into my face when, unsuspected, I saw him. When I saw him friendly with others, I could scarcely contain myself for jealousy. When I sat near him, I was impelled to touch him. I could scarcely conceal my excitement when I touched his knee or thigh. I never ventured, however, to express my feelings to him; for, from his conduct, I was convinced that he would not understand them or share them. “I am twenty-seven years old, of medium height, and well-developed, and would be considered handsome. My chest is somewhat narrow, hands and feet small, and voice weak. Mentally, I think I am well endowed; for I passed the State examination with distinction, speak several languages, and am a good painter. “In my calling I pass for one that is industrious and conscientious. My acquaintances think me cold and peculiar. I do not smoke, do not play games, and cannot sing or whistle. My gait, like my voice, is somewhat affected. I have much taste for elegance, love adornment, sweetmeats, and perfumes, and prefer the society of ladies.” From Dr. von Schrenk’s notes of the case, it is learned, further, that social and criminal deterrents, on the one hand, and uncontrollable desire for his own sex, on the other, caused violent mental struggles, and made life unendurable. For this reason the patient confided in the physician. January 22, 1889, hypnotic treatment, with suggestion, after the method of Nancy, was begun with the patient. Gradually it became possible to induce somnambulism. The suggestions were made with reference to indifference to men, and ability to resist them, and to increase of interest in women; masturbation was thus forbidden, and women substituted for men in lascivious dreams. After a few sittings pleasure at sight of women was induced. At the seventh sitting successful coitus was suggested; this was fulfilled. During the next three months the patient remained, under the influence of occasional hypnotic suggestions, in the full possession of normal sexual functions. April 22, 1889, there was a relapse, induced by a companion. At the next sitting, remorse and shame. As expiation, coitus with a woman in the presence of his seducer. The patient complained that coitus with women below him in station did not satisfy his æsthetic feelings. He hoped to find satisfaction in a happy marriage. After forty-five sittings (May 2, 1889) the patient considered himself cured. Treatment ceased. He became engaged to a young lady some weeks later, and presented himself again, after six months, as a happy bridegroom. He thought that, in his happiness with his wife, he had a sure preventive against relapse. The author emphasizes the fact that the hypnotic treatment had no injurious collateral effect, and leaves undecided the question as to whether the cure is permanent or not, with R.’s very bad heredity. But he expresses the conviction that, in case of relapse, renewed hypnotic treatment would not be contra-indicated. Since the incredible result of this case interested me exceedingly, as did its further course, I wrote to the author, requesting information concerning his patient. Dr. v. Schrenk very kindly placed at my disposal the following letter, which he had received from the patient in January, 1890:— “By means of suggestive treatment given me by Baron Schrenk, for the first time I became possessed of the psychical condition that permitted me to have intercourse with a woman, which, up to that time, in spite of repeated efforts, I had been unable to do successfully. “Since my æsthetic needs were unsatisfied by intercourse with prostitutes, I thought to find my real salvation in matrimony. The earlier friendly inclination toward a lady known in my youth offered me the opportunity, the more because I believed that she, of all others, would be in a position to awaken feelings for the opposite sex which were absolutely foreign to me. Her character,—_i.e._, our harmony,—is in such accord with my inclinations that I am fully convinced that I shall also find complete psychical satisfaction. This conviction has not changed during the eight months of my engagement. “I intend to be married in about four weeks. “As far as my position with respect of my own sex is concerned, my power of resistance—and this is the lasting positive result of this treatment—is absolutely changed in degree. While previously it was impossible for me to overcome an intense sexual excitation when I saw a finely formed car-driver, to-day, in the company of my former lovers, I am without sexual excitement. At the same time, I must add that now, as formerly, their society has a certain attraction for me, though it is not to be compared with my earlier passion. “On the other hand, I have refused repeated persuasions to indulge in sexual intercourse with men, without expending much force in resistance,—persuasions which formerly I should have been unable to resist. I may say, indeed, that it is a feeling of compassion for my former lovers, that have proved their passionate devotion to me, which keeps me from directly repulsing them. My action seems to be due to a feeling of duty, rather than to inner need. “Since the conclusion of treatment, I have not consorted with prostitutes. This circumstance, and the numerous letters and persuasions from my former lover, may well be the reason why, in the eight months that have elapsed, I have allowed him to persuade me to sexual intercourse on three or four occasions. At these times I have always been conscious of being completely master of myself, as compared with my earlier passionate condition in like situations, as the violent reproaches of my friend convinced me. _I always feel a certain unconquerable repugnance, which cannot be based on moral grounds, but which, I believe, must be attributed to the treatment._ I no longer feel a love for him in the former sense. Besides, since the treatment, I have sought no opportunities for sexual intercourse with men, and I feel no need of it. But, formerly, not a day passed on which I did not feel impelled to it, so that at times I was unable to think of anything else. Awake or dreaming, ideas of sexual content are very infrequent. “I may express the belief that my marriage, that is to take place in a few weeks, and the much desired change of place that is bound to it, will entirely remove the residuum of my earlier condition. I conclude these lines with the honest assurance that, subjectively, I am another man, and that this change has restored the mental equilibrium that was previously wanting.” The foregoing words, which Dr. v. Schrenk completes with the verbal statement of the patient that he had not practiced onanism again, are a brilliant proof of the lasting effect of post-hypnotic suggestion. I consider the hetero-sexual instinct of the patient to be the artificial creation of his excellent physician; and the patient himself seems to recognize this, in that he speaks of a repugnance which “does not rest on moral grounds, but which depends on the treatment.” The further fate of this interesting patient may be learned from the following letter, kindly submitted by Dr. v. Schrenk:— “Honored Sir: Having been home some days from my wedding-journey, I wish to send you a short report of my present condition. During the week before my wedding I was in great excitement, because I feared that I should be unable to perform certain duties. The impelling thoughts of my friend, who wished another meeting with me, at any price, had no effect on me. We had not seen each other since I heard from you last. [Receipt of the professor’s letter.] However, I was much troubled with the thought that my marriage must be unhappy. Now, however, I have no anxiety. To be sure, on the first night, success was difficult,—to induce sexual excitation in myself,—but on the following night, and since, the influences needed for a normal man, I believe, would have been sufficient for me. I am also convinced that the harmony between us, which, of course, is mentally of long standing, will become more and more complete. A relapse to the former condition seems impossible. It is, perhaps, significant for my present condition, that I one night dreamed of my former lover, and that the dream was not sensual, and did not excite me sensually. “I am satisfied with my present circumstances. I am, of course, well aware that my present inclinations are far from being of a degree equal to what they formerly were. I believe, however, that they will daily grow stronger. Already my former life is incomprehensible, and I cannot understand why I did not earlier think to overcome the abnormal sexual instinct by normal sexual indulgence. A relapse would now be possible only with an entire change of my mental life; and, in a word, it seems impossible. “Your obedient servant, ——d.” From a letter of Dr. v. Schrenk’s, of December 7th, I extract the following:— “In this case the cure seems to be of longer duration than I expected; for, on speaking with the patient, some months ago, he said that he was perfectly happy in marriage, and, as I hear, he expects soon the happiness of a father.” Dr. v. Schrenk has reported in the _Wiener internationalen klinischen Rundschau_, 1891, No. 26, later and very interesting facts concerning his patient, which, therapeutically, are very satisfactory. IV. SPECIAL PATHOLOGY. THE MANIFESTATIONS OF ABNORMAL SEXUAL LIFE IN THE VARIOUS FORMS AND STATES OF MENTAL DISTURBANCE. ARREST OF MENTAL DEVELOPMENT. Sexual life in idiots is, in general, but slightly developed. It is wanting entirely in idiots of high grade. In such instances the genitals are frequently small and deformed, and menstruation is late or does not occur at all. There is impotence, or sterility, as the case may be. Even in idiots of low grade, sexuality is not prominent. In infrequent cases it is manifested with a certain periodicity, and then with greater intensity. It may then be expressed impulsively, and be violently satisfied. Perversions of the sexual instinct do not occur at the lowest levels of mental development. When the desire for sexual satisfaction is opposed in these cases, great passion is excited, with danger of murderous assault on the persons attacked. It is to be expected that idiots should not exercise choice, and they attempt to satisfy the sexual instinct on their nearest relatives. Thus Marc-Ideler reports the case of an idiot who attempted to rape his sister, and had almost strangled her when he was discovered. Friedreich reports an analogous case (_Friedreich’s Blätter_, 1858, p. 50). I have repeatedly had occasion to give opinions in cases of attempts to rape little girls. Giraud (_Annal. méd. psych._, 1885, Nr. 1) also reports a case of this kind. Consciousness of the significance of the act is always wanting; an instinctive knowledge that such obscene acts are not publicly permitted is often present, and causes the attempted sexual act to be undertaken in a deserted place. In imbeciles the sexual instinct is usually developed as in normal individuals. The moral inhibitory ideas are cloudy, and, therefore, the sexual impulse is more or less openly manifested. For this reason imbeciles are sources of disturbance in society. Abnormal intensity and perversion of the sexual instinct are infrequent. The most frequent manner of satisfaction of the sexual desire is onanism. The weak-minded seldom make sexual attacks on adults of the opposite sex. Sexual satisfaction with animals is frequently attempted. The great majority of cases of injury (sexual) to animals must be attributed to imbeciles. Children are quite often their victims. Emminghaus (Maschka’s Handb. iv., p. 234) draws attention to the frequency of open manifestation of sexual instinct, which comprises open masturbation, exhibition of the genitals, attacks on children and those of the same sex, and sodomy. Giraud (_Annal. méd. psychol._, 1855, Nr. 1) has reported a whole series of immoral attacks on children:—