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Rh “The change of my feeling originated in this, that, in Pesth, dressed as a man, I had an opportunity to observe my cousin. I saw that I had wholly deceived myself in him. That gave me terrible heart-pangs. I knew that I could never love another man; that I belonged to those who love but once. Of similar effect was the fact that, in the society of my companions at the railway, I was compelled to hear the most offensive language and visit the most disreputable houses. As a result of the insight into men’s motives, gained in this way, I took an unconquerable dislike to them. However, since I am of a very passionate nature and need to have some loving person on whom to depend, and to whom I can wholly surrender myself, I felt myself more and more powerfully drawn toward intelligent women and girls who were in sympathy with me.”

The contrary sexual instinct of this patient, which was clearly acquired, expressed itself in a stormy and decidedly sensual way, and was further augmented by masturbation; because constant oversight in hospitals made sexual satisfaction with the same sex impossible. Character and occupation remained feminine. There were no manifestations of viraginity. According to information lately received by the author, this patient, after two years of treatment in an asylum, was entirely freed from her neurosis and sexual perversion, and discharged cured.

Case 96. X., aged 19; mother nervous; two sisters of mother’s father were insane. Patient of nervous temperament; well endowed mentally; well developed; normally formed. When he was twelve years old, he was seduced into mutual onanism by an elder brother.

After this, the patient continued the vice alone. In the last three years, during the act of masturbation, he had had peculiar fancies in the sense of “contrary sexual instinct.”

He fancies himself a female; as, for example, a ballet-dancer in the act of coitus with an officer or circus rider. These perverse fancies have accompanied the act of masturbation since the patient became neurasthenic. He understands the harm of masturbation, fights desperately against it, but always gives up to the impulse.

If he is able to withstand the impulse for a few days, a normal desire for sexual intercourse with females is awakened; but a certain fear of infection holds these desires in check, and always drives him again to masturbation.

It is worthy of remark that this unfortunate’s lascivious dreams concerned only females.

In the course of the last few months, the patient had become very neurasthenic and hypochondriacal. He feared tabes.