Chapter XIII.) In every case of this kind all the circumstances must

be carefully weighed. I repeat here, that in the future more attention should be paid to social interests, instead of always requiring the preservation of an embryo for the sole reason that the state of the mother does not contra-indicate pregnancy or accouchement. The question is whether a miserable abortion or an idiot should be allowed to come into the world. If we allow children who are born monsters, idiots or invalids to live, we should at least do what we can to prevent them being born. It will no doubt be objected that it is much easier to recognize the quality of a child after birth than before, and this objection is quite legitimate. But so long as the laws protect the lives of the most miserable monsters we must get out of the difficulty as best we can. =Treatment of Sexual Disorders.=--We cannot enter here into all the details of a purely medical question, and shall only touch on certain special points. Patients with venereal disease are often treated in a very defective manner, because many of them are ashamed to submit to rational treatment. The treatment of venereal diseases should be carried out with more regard for the feelings of the patients; there should be special hospitals for each sex, with separate divisions, so that patients can be treated without betraying their identity. The fear of being recognized prevents many better-class women from applying for treatment. The idea of being placed in the venereal divisions of a hospital along with common prostitutes is unbearable to them. For this reason I maintain that anonymous treatment should be instituted at hospitals in all the chief localities. This humanitarian work would benefit not only the patients, but society in general, by diminishing the number of venereal infections. Treatment by private practitioners is too costly for poor people and does not easily remain anonymous. Therefore, the creation of hospitals for venereal disease is very necessary in the public interest, and would benefit public health much more than the regulation of prostitution. The treatment of sexual perversions is also very important. These disorders are either hereditary, or acquired by auto-suggestion or evil example. By provoking suggestion and good habits in the opposite direction, hypnotic suggestion is alone capable of acting directly against the evil. Other remedies, such as distraction of the mind by work or fatigue, by marriage, electricity, etc., have only an indirect suggestive action. When a perversion has been acquired by auto-suggestion or by habit, especially in the case of onanism, hypnotic suggestion should always be employed. In compensatory masturbation, where normal sexual appetite exists, and where it is only the opportunity of satisfying it that is wanting, marriage or normal sexual intercourse are sufficient to cure the bad habit. We must not, however, too easily admit the existence of acquired perversions. Apart from compensatory masturbation, which is not a perversion, but only an outlet to a pent-up natural want, true acquired perversions are rather rare, and as we have seen generally auto-suggestive. Pederasts, sodomists, and others, whose perverse habits are truly acquired, have usually taken to them for want of something better, and prefer normal coitus if they have the opportunity and the means of procuring it. It is true, however, that some debauchees contract these perverse habits from desire for change, or from fear of infection or conception, but these individuals seldom consult the doctor. Thus the individuals who consult a doctor are nearly always more or less pathological, and belong to the domain of hereditary or auto-suggestive perversions. For the first, at least, we avoid recommending marriage. Von Schrenck-Notzing has sometimes succeeded in transforming hereditary inversion into normal sexual appetite for women, by hypnotic suggestion. I have also succeeded myself, two or three times. After a cure of long duration, confirmed by frequent visits to prostitutes, Von Schrenck-Notzing has ventured to recommend marriage; but I have never done this, as I do not consider a cure sufficient to guarantee definite success, in the case of disorders so deeply rooted in the constitution. In such cases I have endeavored, as far as possible, to weaken the sexual appetite and induce the patient to be contented with nocturnal emissions. I have always debarred inverts from marriage, impressing them with the fact that to marry would be a crime, and that they had a hundred times better masturbate; or, if they wish to attempt intercourse with women, to be contented with a mistress, avoiding the procreation of children. Unfortunately, our present laws and customs prevent us from recommending or even allowing inverts to "marry" their fellows, as they so strongly desire to do. This would be very innocent from the social point of view, and the poor wretches would be content, and would cease to be a menace to normal individuals. I am, therefore, of the same opinion as those who demand the suppression of all laws which punish or prosecute sexual inversion and pederasty committed between adults and in common agreement. So long as pederasts do not harm normal individuals, and so long as they do not seduce minors, they should be left alone, the same as all other sexually perverted individuals who are not dangerous. But when a patient of this kind wishes to be treated, through shame or nervous excitement, the doctor should hypnotize him and suggest distraction of mind by useful occupations. Psychic treatment is always the most efficacious. It is only in cases where it is certain that the perversion is purely acquired and easily curable that marriage can be allowed, or the procreation of children. I am not referring here to sterile marriages between perverts or psychopaths, which we have mentioned above, and which can always be allowed when the two parties are fully enlightened on the subject. Frequent emissions, masturbation, sexual hyperæsthesia and impotence may often be improved or even cured by suggestion. In such cases, if the sexual appetite is otherwise normal, marriage need not always be prohibited. Each case must be judged on its merits. In sexual anæsthesia marriage is an error based on a grave misconception. Even in partial anæsthesia it may have deplorable effects. We are now only speaking of anæsthesia in man. Most young virgins are anæsthetic in the sense that they are not acquainted with the venereal orgasm and cannot tell how far their hitherto dormant sexual appetite will develop. The sexual instruction which we have recommended for young girls would have the advantage of making those who are absolutely sexually frigid disgusted with marriage and coitus, as soon as they know all about it. The consequences of sexual anæsthesia are much more innocent in woman than in man, because this anæsthesia neither prevents coitus nor fecundation. A woman who is sexually anæsthetic may marry a man who is affected with the same condition, when both parties are aware of the fact and desire to contract a union which is hardly sexual, but rather a union of minds with a common ideal. This is the true platonic love which is admitted in theory. It is not very common and must not be confounded with homosexual inclinations. It has its object of existence, for those affected with anæsthesia may feel the want of affection and of home, as well as sentimental communion. If they desire children they can adopt them. Unfortunately for themselves, the subjects of sexual anæsthesia have as little idea of sexual sensations as a blind man has of colours; this causes them to commit great blunders, because they do not comprehend the nature of the sexual appetite in others, and often marry an erotic individual without knowing what they are doing. The special treatment of diseases of the male and female sexual organs is beyond the scope of this book. I may, however, remark that specialists are often wrong in treating the genital organs locally for pathological symptoms which depend on cerebral disorder, which can only yield to psychic treatment and suggestion. This is the case with many disorders of menstruation in women, psychic impotence and frequent seminal emissions in men, masturbation, etc., (except cases due to phimosis, or local irritation caused by worms, etc.) I hasten to add that this remark in no way excuses errors in the opposite direction, viz, neglect of local treatment, when this is indicated after careful examination.