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218 artist, but almost at the same time (September, 1865) he fell ill with paranoia persecutoria (ideas of enemies, derision in the street, poison in food; obstacles were placed on the bridges to keep him from going to his inamorata). On account of increasing excitement and conflicts with those about him that he considered inimical to him, he was taken to the asylum. At first he presented the picture of a typical paranoia persecutoria with symptoms of sexual, and later general, neurasthenia, though the delusions of persecution did not rest upon this neurotic foundation. It was only occasionally that the patient heard such sentences as this: “Now the semen will be drawn out of him. Now the bladder will be cut out.”

In the course of the years 1866–68, the delusions of persecution became less and less apparent, and were for the most part replaced by erotic ideas. The somatic and mental basis was a lasting and powerful excitation of the sexual sphere. The patient fell in love with every woman he saw, heard voices which told him to approach her, and begged to be allowed to marry, declaring that, if he was not given a wife, he would waste away. With continuance of masturbation, in 1869, signs of future effemination made themselves manifest. “He would, if he should get a wife, love her only platonically.” The patient grows more and more peculiar, lives in a circle of erotic ideas, sees prostitution practiced in the asylum, and now and then hears voices which impute immoral conduct with women to him. For this reason he avoids the society of women, and only associates with them for the sake of music when two witnesses are with him.

In the course of the year 1872, the neurasthenic condition became markedly increased. Now paranoia persecutoria again comes into the foreground, and takes on a clinical coloring from the neurotic basis. Olfactory hallucinations occur. Magnetic influences are at work on him (false interpretation of sensations due to spinal asthenia). With continued and intense sexual excitement and excess in masturbation, the process of effemination constantly progresses. Only episodically is he a man and inclined toward a woman, complaining that the shameless prostitution of the men in the house makes it impossible for a lady to come to him. He is dying of magnetically poisoned air and unsatisfied love. Without love he cannot live. He is poisoned by lewd poison that affects his sexual desire. The lady that he loves is sunk in the lowest vice. The prostitutes in the house have fortune-chains; that is, chains in which, without moving, a man can indulge in lustful pleasure. He is ready now to satisfy himself with prostitutes. He is possessed of a wonderful ray of thought that emanates from his eyes, which is worth twenty millions. His compositions are worth 500,000 francs. With these indications of delusions of grandeur, there are also those of persecution—the food is poisoned by venereal excrement; he tastes and smells poison, hears infamous accusations, and asks for instruments to close his ears. From