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38 thus induced, and thus come to practice masturbation; and those cases in which sexual ideas and impulses occur in the child as a result of cerebral processes without peripheral causes. It is only in this latter class of cases that we have to do with the early manifestation of sexual instinct. In such cases it may always be regarded as an accompanying symptom of a neuropsychopathic constitutional condition. A case of Marc’s (“Die Geisteskrankheiten,” etc., von Ideler, i, p. 66) illustrates very well these conditions. The subject was a girl of eight years, of respectable family, who was devoid of all child-like and moral feelings, and had masturbated from her fourth year; at the same time she consorted with boys of the age of ten or twelve. She had thought of killing her parents, that she might become her own mistress and give herself up to pleasure with men. In these cases of early manifestation of libido the children come also to masturbate; and, since they are greatly predisposed constitutionally, they frequently sink into dementia, or become subjects of severe degenerative neuroses or psychoses.

Lombroso (Archiv di Psichiatria, iv, p. 22) has collected a number of cases of children affected with very decided hereditary taint, which belong in this category. One was that of a girl who masturbated shamelessly and almost constantly at the age of three. Another girl began at the age of eight, and continued to practice masturbation when married, and even during pregnancy. She was pregnant twelve times. Five of the children died early, four were hydrocephalic, and two boys began to masturbate,—one at the age of seven, the other at the age of four.

Zambaco (L’Encéphale, 1882, Nr. 1, 2) tells the disgusting story of two sisters affected with premature and perverse sexual desire. The elder, R., masturbated at the age of seven, practiced lewdness with boys, stole wherever she could, seduced her four-year-old sister into masturbation, and at the age of ten was given up to the practice of the most revolting vices. Even ferrum candens ad clitoridem had no effect in overcoming the practice, and she masturbated with the cassock of a priest while he was exhorting her to reformation.

There are infrequent cases in which the sexual instinct persists until a great age. “Senectus non quidem annis sed viribus