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278 brothers and sisters are excitable people. Pulmonary phthisis has been frequent in her family. When only a girl of thirteen, with signs of great sexual excitement, she attracted attention by enthusiastic love for a female friend of her own age. Her education was strict, though the patient secretly read many novels, and wrote innumerable poems. She married at eighteen to free herself from unpleasant circumstances at home.

She says she has always been indifferent toward men. In fact, she avoided balls. Female statues pleased her. Her greatest happiness was to think of marriage with a beloved woman. She was not aware of her sexual peculiarity until marriage, and the thing had remained inexplicable to her. Patient did her marital duty, and bore three children, two of whom were subject to convulsions. She lived pleasantly with her husband, but she esteemed him only for his moral qualities. She gladly avoided coitus. “I should have preferred intercourse with a woman.”

Until 1878 she had been neurasthenic. On the occasion of a sojourn at a watering-place, she made the acquaintance of a female urning, whose history I have reported as Case 6, in the Irrenfreund, No. 1, 1884.

The patient came home a changed person. Her husband says: “She was no longer a woman, no longer had any love for me and the children, and would have no more of marital approaches. She was inflamed with passionate love for her female friend, and had taste for nothing else.” After the husband forbade her lover the house, there was interchange of letters with such expressions in them as “My dove! I live only for you, my soul.” There were meetings and frightful excitement when an expected letter did not come. The relation was in nowise platonic. From certain indications it is presumable that mutual masturbation was the means of sensual satisfaction. This relation lasted until 1882, and made the patient decidedly neurasthenic.

She absolutely neglected the house, and her husband hired a woman of sixty years as a house-keeper, and also a governess for the children. The patient fell in love with both, who, at least, allowed caresses, and profited materially through the love of their mistress.

In the latter part of 1883, on account of developing pulmonary tuberculosis, she had to go south. There she became acquainted with a Russian lady of forty years, and fell passionately in love with her; but she did not meet with a return of love in her sense. One day insanity became manifest. She thought the Russian lady a nihilist; that she was magnetized by her; and she presented formal persecutory delusions. She fled, and was caught in an Italian city, and placed in a hospital, where she soon became quiet. Again she followed the lady with her love, felt herself very unhappy, and planned suicide.

When she returned home, she was greatly depressed because she did not have the lady, and was contrary toward her family. A delusive, erotic state of excitement came on about the end of May, 1884. She danced,