The Sexual Life of the Child/Chapter 5

In the previous chapters I have from time to time mentioned some phenomenon of comparatively rare occurrence; but for the most part I have described those processes only which are regularly met with, which cannot be regarded as exceptional peculiarities, and therefore must not be considered to be pathological manifestations. It is true that much that has been described comes within the province of the pathological; for example, many of the active manifestations of the sexual impulse occurring during the first period of childhood, such as the case quoted from Féré on page #. For practical reasons, however, such cases as this cannot always be dealt with as members of a distinct pathological group. On the other hand, it is necessary to give a separate consideration to the pathological aspect of our subject. Many of the cases which must be grouped as pathological occur in girls. Thus, we meet with cases in which menstruation becomes established at the age of eight, five, two, or even earlier.[53] Carus reports the case of a woman whose medical history showed that she had begun to menstruate at the age of two years, and that she became pregnant for the first time when eight years old. In girls from ten to twelve years of age, pregnancy has many times been observed. A French physician had under observation a girl who when only three months old had well-developed breasts, and in whom only a little later the pubic and axillary hair grew and menstruation began. When twenty-seven months old, the child was again seen by the same physician, and at this time menstruation was proceeding regularly; the features had now lost the infantile type, and the body as a whole exhibited all the signs of premature development. A collection of cases made by Gebhard[54] contains one case in which menstruation was established at birth; in quite a number of the cases menstruation began during the first year of life.

A case was reported from New Orleans in which menstruation began at the age of three months and continued regularly thereafter. This was a case of premature general growth; at the age of four years the girl was over 4 feet high, and her breasts were the size of a large orange. As a general rule, in these cases of premature development of the reproductive organs in girls, the great size of the breasts attracts especial attention. According to Kisch (op. cit., p. 78), these girls with precocious menstruation and premature sexual development very commonly exhibit also a comparatively high body-weight, great development of fat, and early dentition; they look older than their years, and their genital organs also develop very early, with hair on the pubes and in the axillae; the labia majora and the breasts resemble those of full-grown women, and the pelvis also has the adult form. Commonly also the sexual impulse develops early, whilst in other respects the mental development lags behind the physical.

In the post-mortem room, corresponding conditions are occasionally found in the ovaries; and some writers express the opinion that such premature sexual development is commoner than would appear from the comparative rarity of reports on the subject. Unquestionably, examination of the ovaries of young girls not infrequently leads to the discovery of ripe ovarian follicles; in one case this happened in the body of a female infant born prematurely. In a girl five years of age, fifteen follicles were counted in the ovaries. Liégeois,[55] in post-mortem examinations, twice found mature ova in girls two years of age.

Similar cases of premature sexual development are occasionally seen also in boys. For example, Breschet, in the year 1820, reported the case of a boy three years of age who exhibited all the signs of puberty. His voice resembled that of a young man of sixteen to eighteen. The length of the flaccid penis was 9.6 cm. (33/4 inches), its diameter at the root was 7.2 cm. (23/4 inches); the length of the organ when erect was 13.5 cm. (51/4 inches). In the presence of girls or women the boy's penis became erect, his whole manner became more vivacious, and his hands were directed towards the genital organs of these females. Masturbation was never observed. The boy showed many additional signs of premature development. For instance, the central incisors of the upper jaw were cut at the age of three months. Breschet also quotes a case published by Mead, in which a boy had undergone the puberal development before the end of the first year of his life; when five years of age, he died of pulmonary consumption, attended with all the signs of old age. The same writer records another case, that of a boy five years of age, whose genital organs were fully developed, who had a well-grown beard, and exhibited, in short, all the (physical) characteristics of complete sexual maturity. In accordance with the theoretical views of that day, more especially as a result of the wide acceptance of the phrenological doctrines of Gall, it was generally believed that an exceptional development of the cerebellum (which was supposed by Gall to be the seat of the sexual impulse) was the determining cause of such premature awakening of the sexual impulse.

Contrasted with the cases just described, are those in which there is a retardation of the whole course of sexual development, so that the signs of sexual maturity are not manifested until an age greatly exceeding the average "age of puberty." In respect of one symptom or several, many individuals may remain throughout life in an infantile condition. This is occasionally seen, for example, in dwarfs. It would be of great interest, from this point of view, to make a careful study of the sexual behaviour of dwarfs. In this respect, dwarfs appear to vary greatly. These differences depend, in part, at least, upon the fact that many persons are classified as dwarfs who do not, strictly speaking, belong to this category. This statement applies more especially to those whose growth has been impaired by rickets; for, properly speaking, those only should be designated dwarfs who are, though small, generally well-proportioned; and the term should not be applied to those in whom the defective stature is consequent on rachitis or some similar disease. It appears doubtful, however, if the confusion of terms just mentioned explains all the observed differences in the sexuality of those commonly spoken of as "dwarfs." From data communicated to me concerning a fairly large community of dwarfs, living in a single place, and in whom the dwarfing appears to have no connexion with rickets, it would seem that in the case of true dwarfs there is considerable variation in sexual behaviour. This particular group of dwarfs constitute a society of persons living and working together. Although they are all living in close association, there seems to be a striking lack of warmth in their sexual relationships. Notwithstanding the fact that they have been living together for ten years, they still address one another formally as "Mr." and "Miss." In the case of the male dwarfs, with one exception all had fully developed genital organs; the exceptional instance was that of a member of the community then thirty years of age, in whom the genitals were rudimentary. All were endowed with normal sexual impulse, but this was directed towards persons of normal stature. In one of these dwarfs, an Italian, the genital organs remained undeveloped and hairless until he attained the age of twenty-eight; then these organs underwent the normal degree of growth, and at the same time pubic hair appeared. As already mentioned, the sexual inclinations of dwarfs appear as a rule to be directed towards fully grown persons, and I knew one dwarf twenty years of age who never missed an opportunity of pressing up against a certain very pretty young lady. These observations of my own regarding the sexual inclinations in dwarfs are confirmed by other cases recorded in the literature of the subject, although in isolated instances sexual attraction between a male and a female dwarf has been observed to eventuate in the birth of a child.

This is the place in which to refer to those cases of which a brief mention was made in the first chapter, to which von Krafft-Ebing has given the name of sexual paradoxy. Activity of the sexual impulse is sometimes observed at an age as which this impulse is normally quiescent. The term applies alike to cases in which the sexual impulse becomes active in early childhood, and to cases in which the impulse persists to an advanced age. Whilst the cases in which the phenomena of contrectation alone occurred have commonly been overlooked, considerable attention has been paid to those cases in which the sexual impulse manifests itself by peripheral changes, more especially by premature impulse towards masturbation or towards actual sexual congress with one of the other sex. It was shown, however, in the last chapter, that active manifestations of the sexual impulse during childhood are not always paradoxical. If we examine cases which have been published as coming under this latter category (I limit myself here to cases occurring in childhood, and am not speaking of sexual paradoxy in old age), we find that they are characterised more particularly by the strength with which the peripheral sexual impulse manifests itself. There is, in fact, a marked distinction between cases, according as we have to do with an occasional general sensation in the genital organs, or with masturbation to excess and with sexual assaults upon others. But we must not describe as sexual paradoxy all manifestations of the sexual life occurring in early childhood. A reference to the last chapter will show that the cases of sexual paradoxy, when accurately studied, differ from the normal rather quantitatively than qualitatively. During the first period of childhood, and more especially during the first few years of life, a case in which sexual activity in a child threatens the well-being of members of that child's social environment is so sharply differentiated from the normal that there can hardly arise even momentary hesitation regarding the paradoxical nature of the manifestation. On the other hand, we shall do well to follow von Krafft-Ebing in excluding from the category of sexual paradoxy those cases in which sexual excitement is caused solely by peripheral inflammatory stimuli, balanitis (inflammation of the glans penis), threadworms, and the like. These are not instances of sexual paradoxy, because the essential characteristic of the latter is that it originates centrally, even though its manifestations take a peripheral form.

I will now recount three cases which I regard as pathological in nature, and as examples of a paradoxical sexual impulse.

Case 7.--The girl X., six years of age, stated by the mother to be free from all morbid inheritance, produces the general impression of being a nervous subject. She is affected with facial muscular spasms, especially affecting the corners of the mouth, the eyelids, and the neck. Her mental development, as far as can be judged from my own observations and from the account given by the parents, is perfectly normal; but attention is at once attracted by the appearance of premature development. The mother states that in the second year of life, owing to the carelessness of a nursemaid, the child fell out of her cradle, without, however, sustaining any manifest injury. The mother does not think there is any reason to suppose that the child has ever been led astray in sexual matters. For the past two years or more, the mother has noticed that the child likes to press up against articles of furniture in such a way that her genital organs come into contact with narrow edges or corners; for example, the back of a chair, and especially a small portfolio-stand in the room. At first the child did this very often. Then the mother forbade it, and the father whipped her several times for doing it; since then it has been done more furtively, but the mother has none the less often seen it done. When the child is in bed she plays with the genital organs with her fingers. A definite orgasm occurs: there are spastic twitchings of the whole body, the eyes brighten, the respiratory rhythm changes; all these changes, occurring as they do in association with the artificial stimulation of the genital organs, combine to prove that we have not to do here with a simple spasmodic neurosis, but with the artificial induction of the sexual orgasm. The process is, moreover, confined to peripheral manifestations. The most careful observation failed to show the existence, in association with the sexual excitement, of any especially tender sentiments towards other individuals.

Case 8.--The boy Y. was brought to see me when he was eight and a half years of age. From the second year of life he had been noticed to be subject to masturbatory impulses, attended from the first with erection of the penis. The practice of masturbation increased to such a degree that before the boy was four years of age it was found necessary to keep him separate, as far as possible, from his brothers and sisters to save these latter from being corrupted by him. But notwithstanding this precaution, by the time he was five years old he had begun to make sexual attacks on a sister one year older than himself. He was cunning enough to arrange matters in such a way that he was alone with his sister, at times when the usual safeguards to keep him separate from the other children were suspended--for example, when his parents were away, and when his governess (who had been made fully acquainted with the circumstances) was keeping some assignation of her own. (All this was fully elucidated at a later date. The distressed parents were foolish enough to imagine that a child with inherited morbid predispositions of this character could be adequately safeguarded by means of hired help; they were painfully disillusioned when it appeared that the hired assistant, instead of watching the child, was pursuing her own pleasures--a point in which she merely imitated the parents, themselves earnest pleasure-seekers, deluding themselves with the belief that everything possible was being done for their child.) Although the parents had known all about the boy's habit of masturbation for many years past, it was only through a fortunate accident, and after the sexual malpractices with the sister had been going on for a long time, that these at length came to light. It appears that the boy had from time to time made sexual advances to other girls than his sister. One day, while playing with the little daughter belonging to a neighbouring family, he endeavoured to lead this child sexually astray. The little girl told her parents what had happened, and these latter consequently refused to allow her to play with Y. any more. This prohibition led Y.'s parents to inquire into the whole matter with great care. It was then discovered that for years past Y. had been engaged in sexual, misconduct with his sister, his usual method being to play with her genital organs with his hands. In the girl, the frequent repetition of this act had given rise to abrasions and local inflammations.

The following case, the leading features of which are the early age at which seminal ejaculation occurred, and the marked hyperaesthesia of the sexual impulse, may also be regarded as an example of sexual paradoxy. This patient exhibits a number of different perverse modes of sexual sensibility, some of which have persisted to the present day.

Case 9.--Z., now thirty years of age, admits prolonged sexual excesses, and divides his sexual history into two periods: the first period extends from the age of seven to the age of twelve, before he had learned the use of alcohol; during the second period, from the age of thirteen to the age of thirty years, his sexual excesses occurred under the influence of alcohol. He gives his own history in the following terms:--

"In very early childhood my imagination began to exercise itself pleasurably in the pictured contemplation of the bodies of naked girls. I can also remember distinctly that my dreams were chiefly concerned with images of this character. In the later years of childhood (nine to twelve years) I masturbated to great excess, often five to ten times daily, sometimes actually while in class at school. Seminal emission had already begun--I remember this quite distinctly at the age of ten, and perhaps even at the age of nine years--but the quantity of semen was very small. I found several schoolmates with similar inclinations to my own, and with these I practised mutual masturbation. When I was eleven years old I became acquainted with a boy somewhat younger than myself, and in this case the proposal for mutual masturbation came from his side. At that time the thought that there was anything wrong in the practice had never entered my mind; on the contrary, I was always on the lookout for boys who would join with me in mutual masturbation. Such were my sexual habits, until as a boy of thirteen I for the first time had complete sexual intercourse with a woman, a prostitute. Thenceforward, for a time, I had intercourse at intervals of from four to six weeks, continuing in the meanwhile daily masturbation. Subsequently I sought and found opportunities for intercourse with women, married and unmarried, about once a week, for money. These almost daily venereal excesses appeared to have no bad effects on my physical health; my diet was at the time abundant, if not superabundant. On the other hand, I lacked effective will-power to make a successful stand against the promptings of my bodily lusts; nor was I able, though not devoid of talent, to perform any arduous or enduring mental work. There ensued also at this early stage a great infirmity of purpose, from which I still suffer to this day. I would take up now one thing, now another, at first with fiery zeal, soon to cast it aside in favour of some new undertaking, to be abandoned with the like precipitation.

"Having command of abundant means, I now, at the age of fifteen, became enabled to gratify my sexual desires without restraint with dependents of the other sex; nor did any untoward physical consequences arise to impose limitations. After a time, ordinary sexual intercourse ceased to furnish adequate gratification; and I began to excite myself sexually by contact with special parts of the body, most often the breasts. But the woman must not, as had formerly been my desire, strip herself completely nude; for I found the most powerful sexual stimulus was now exerted by her white drawers. The display, intentional or unintentional, of this article of feminine attire sufficed to arouse in me sexual feelings. For this reason I now came to frequent the skating rink, in order to obtain a sexual stimulus from the glimpse of a woman's drawers when putting on her skates. But even when a girl was physically beautiful and elegantly dressed, if her drawers were not white but coloured, she produced in me no sexual appetite whatever.

"As a result of long-continued excesses, attempts at ordinary intercourse no longer evoked an adequate sexual stimulus, so that I now began the practice of cunnilinctus. It was when the woman herself became excited through the cunnilinctus, that I experienced the highest sexual gratification. In the intervals, when I had no opportunity for sexual intercourse, I would endeavour to secure sexual gratification by exposing my genital organs in the presence of females, or when passing them in the street--especially female children. I also sought every possible opportunity of watching female dependents engaged in the act of urination. This gave me especially great gratification if, when they were urinating, I could see their white underlinen. I also procured pornographic literature, and masturbated frequently while reading it."

The next period in this patient's history now begins. But I shall not recount his case further, since the subsequent episodes have no bearing on the questions with which we are especially concerned. It will suffice to remark that Z. now exhibits numerous neuropathic and psychopathic characteristics. But the various psychopathic symptoms, some of which are very severe, lie altogether outside our chosen field of study.

Paradoxical sexual impulse is observed also in the lower animals. Weston reports the case of a colt which when only six weeks old attempted to serve its mother; when three months old this animal became so troublesome, owing to its attempts to cover other foals and even calves, that castration was necessary.[56] The same author describes a case of masturbation in a foal only two months old; the animal masturbated by arching the back to an extreme degree, and pushing the hind feet forward along the surface of the belly on either side of the penis.

Several allusions have been made in passing to the subject of sexual perversions. A detailed consideration of these manifestations is now necessary, owing to the fact that perversions exhibit peculiar relationships to the sexual life of the child, such relationships being of two distinct kinds. In the first place, perverse modes of sexual sensibility are very common during childhood; and since erroneous views on the subject are widely prevalent, the true significance of such perversions demands very careful study. In the second place, it is maintained that certain influences affecting the sexual life during childhood are competent to give rise to permanent sexual perversions. We will discuss these two questions in the order here stated.

Adult sexual perverts frequently declare that their first experience of perverse sexual sensibility dates from the eighth year, or even earlier. Thus, by homosexuals we are told that the homosexual inclination was felt in very early childhood, in one case directed towards a schoolfellow, in another towards some near relative, or towards a resident tutor--or in the case of female homosexuals, towards a girl-companion or a governess. Moreover, homosexuals often assure us that the homosexual inclination has been persistent, and that it has never been interrupted by any manifestation of heterosexual desire. The assumption that in homosexuals the sexual impulse becomes active earlier in life than is normal, was one of several considerations by which von Krafft-Ebing was led to regard homosexuality as a degenerative phenomenon, consequent upon neuropathic or psychopathic hereditary taint; and this author held the same view regarding other sexual perversions--sadism, for instance. In opposition to this opinion, attention may be drawn to the fact, which was fully considered in the last chapter, that very commonly indeed the activity of the normal sexual life can also be traced back into the early days of childhood. This fact has hitherto to a large extent been overlooked simply for the reason that recent investigations dealing with the sexual impulse have in most cases dealt exclusively with morbid manifestations; whilst the psychologists by profession, whose province it was to study the normal sexual life, have with few exceptions (Max Dessoir, Binet, Jodl, and Ribot) completely ignored this field of inquiry. For this reason many phenomena, e.g., early activity of the sexual impulse, and hyperaesthesia of that impulse, have been assumed to be characteristic of the perverse modes of sexual sensibility, whereas the like phenomena may readily be observed in association with a qualitatively normal mode of sexual sensibility.

The theory of the congenital nature of homosexuality was based for the most part on the common assumption that the condition is primary and premature in its occurrence, and that it is exclusive of the opposite mode of sexual sensibility. But for several reasons the inference is not justified. For, first of all, for many cases it is incorrect to assume that the homosexual inclinations are thus exclusive in their character; as I have previously explained, the adult homosexual's belief that from early childhood he has never experienced any other than homosexual inclinations, depends in many instances on an illusion of memory. Owing to the fact that in consequence of the fuller development of homosexuality he is no longer interested in the heterosexual, he is apt to forget any early heterosexual inclinations. Secondly, the primary appearance of homosexual inclinations does not prove that these inclinations are congenital; for in homosexuals, as in heterosexuals, the specialised mode of sexual sensibility is preceded by a period in which the sexual impulse is undifferentiated; and, in homosexuals and heterosexuals alike, chance plays a great part in determining which mode of sexual sensibility first manifests itself. The congenital nature of heterosexuality is not disproved by the fact that one who in adult life possesses a normal mode of sexual sensibility, may as a schoolboy have first experienced sexual desire towards a schoolfellow; just as little, then, does a similar early history in one who in adult life is homosexual in his inclinations, prove that his homosexuality is congenital. In the animal world also, before the occurrence of sexual maturity, the love-games occasionally display a similar confusion of rôles, so that the sexually immature female animal may attempt to cover the youthful male. The congenital nature of homosexuality is displayed, not by the primary appearance of this mode of sensibility, but by the fact that when the puberal development takes place, the homosexual sentiments persist, and are not replaced by heterosexuality.

The congenital nature of homosexuality has been assumed more particularly in those cases which are described respectively as effemination and viraginity. The former name is given by von Krafft-Ebing to cases in which in homosexual men the entire system of feelings and inclinations is influenced by the abnormal mode of sexual sensibility. Such a male homosexual has a strong dislike for smoking and drinking, and for all masculine sports; on the other hand, he delights in self-adornment, in art and belles-lettres and even in literary affectations. The corresponding condition in women was by von Krafft-Ebing termed viraginity. Such female homosexuals do not merely experience sexual attraction towards members of their own sex, but they also exhibit other peculiarities usually characteristic of the male, such as dislike of ordinary feminine occupations, a neglect of the arts of the toilet, and a rough and masculine mode of behaviour. They exhibit inclinations for science rather than for art. They sometimes attempt to drink and smoke in a masculine manner. Von Krafft-Ebing and many other writers have assumed that the characteristics of effemination and of viraginity are displayed in early childhood. We are told that a boy with these tendencies prefers the society of little girls to that of boys, that he likes to play with dolls, and to help his mother in her housework. He takes naturally to cooking, sewing, and darning; and becomes clever in the selection of feminine dress, so that he can help his sisters in the choice of their clothes. Contrariwise, the girl who is destined in later life to display the characteristics of viraginity will be found frequenting the playground of the boys. Such a girl will have nothing to do with dolls, but exhibits a passion for the rocking horse, and for playing at soldiers and robbers. It is indisputable that these descriptions apply to many cases. But it is necessary here to repeat my previous warning against over-ready generalisation; for we find that there is quite a number of boys and girls who exhibit during childhood such contrary sexual qualities and inclinations, and yet subsequently undergo a perfectly normal, or at any rate a non-homosexual, development of the sexual life. During the period of the puberal development, the normal heterosexual characteristics come to predominate. The non-differentiated character of the sexual life during childhood forbids us, from the mere existence at this period of life of such contrary sexual tendencies, to infer that these tendencies will necessarily persist, and that the subsequent sexual development will also be of an inverted character. We must point out, in addition, that from childhood onwards many women and many men fail to exhibit the psychical tendencies appropriate to average members of their respective sexes, without this justifying the conclusion that we have to do with homosexuality. There are heterosexual men who are fond of needlework; and there are heterosexual women in whom housework and the care of children, and even in many cases the details of their own toilet, arouse no interest whatever. Because we observe, in any individual, certain contrary sexual tendencies of this character, to draw the inference that in such a case we necessarily have to do with homosexuality, would be a most disastrous error.

Apart from these considerations, we have, when there is a history of such tendencies in childhood, to take into account the possibility of illusions of memory just as much as we have in the cases in which adult homosexuals assure us that in childhood they never experienced any other than homosexual inclinations--a matter discussed in the first chapter (see pp. # and #). A homosexual man, recalling his memories of childhood, lays especial stress on all that appears to be connected with homosexuality; he is apt to remember those instances only in which his conduct exhibited girlish characteristics, and to forget all instances of an opposite kind. Finally, we have to take into consideration the various interpretations which are tenable of occurrences during childhood. An adult homosexual who as a child once did some needlework for a joke, sees in this later a characteristic of effemination. A girl who, for lack of companions of her own sex, was accustomed to join in her brother's sports, comes to believe, when subsequently she has developed into a homosexual woman, that her conduct in childhood resulted from congenital perversion, whereas in reality this conduct was the purely accidental result of her childish environment. On the other hand, the withdrawal during childhood from the companionship of members of the same sex is explicable in a converse fashion. Homosexual adults often tell us that even in boyhood they shunned the company of other boys, and sought girl companions, to join in the games of these latter--and they endeavour to explain this conduct on their part as determined by contrary sexual inclinations in early childhood. Yet, in many cases, boys avoid those of their own sex, and seek the companionship of girls, not for the reason just alleged, but solely because these boys thus early experience erotic stimulation when associating with girls. In any case, we must carefully avoid over-estimating the importance of what may appear to be contrary sexual phenomena during childhood, and we must not be too ready to accept the occurrence of such phenomena as a proof that sexual perversion had manifested itself already during childhood. The general possibility of this occurrence is, of course, not disputed; but the far too common exaggerations of the matter cannot be too decisively rejected.

The case I have now to describe is that of a woman whose characteristics during childhood were thoroughly boyish, and who at this time experienced homosexual inclinations; during the period of the puberal development, however, the homosexual tendencies disappeared, never to return.

Case 10.--Mrs. X., twenty-six years of age, happily married for five years past, enjoys excellent health, with the exception of pains during menstruation, has normal intercourse with her husband, experiencing sexual impulse of full intensity, and a normal voluptuous sensation. The family history is healthy on the whole: some of the mother's relatives are described as "nervous"; but in so large a family, otherwise healthy, this is of trifling significance. Most of her blood-relations are, so far as inheritable morbid conditions are concerned, thoroughly healthy. As a girl, X. (whose statements, in so far as I was able to inquire, were in all important respects substantiated by her mother) was at first accustomed to seek the companionship of boys only. She was continually playing with her brothers and their friends, and was always the leader in their wildest games including war-games, and playing at Indians. During childhood she was almost always regarded as "the baby," although she had a sister two years younger than herself, this sister being altogether girlish in her ways. Very seldom did X. play with anyone but the boys; when she did on rare occasions seek other companionship, it was always that of the sister of one of her boy friends. The two girls had obviously great sympathy each for the other, manifested when they were as yet only nine years of age, and increasing as the years went on. The closer her association became with this girl, the more did X. withdraw from the companionship of the boys, to devote herself to her girl friend. The association became more and more intimate; and when they were both thirteen years old their endearments passed from kisses and embraces to manipulation of the genital organs. In these latter, X. always played a passive part, not herself touching her own genital organs nor those of her friend. Occasionally X. would feel drawn towards some other girl, but such errant inclinations never lasted long. At about the time when her fondness for the other girl began, that is to say, during her tenth year, X., who was then accustomed to compassionate herself for not having been born a boy, began to assume a more definitely boyish behaviour. Under the pretence of "dressing up," she used to wear her brother's clothes; occasionally she smoked, although in her home, and in the circle to which her family belonged, smoking was disapproved of even in grown women. At the age of fourteen, X. began to menstruate. The friendship between the two girls continued until the seventeenth year of life. Then X. gradually "came out," her homosexual tendencies disappeared, and at the same time her feminine nature became apparent. The desire to dress up as a man and the desire to smoke passed away, and have never returned, although X. now moves in circles in which many women smoke. And, most important fact of all, the homosexual relations were now completely broken off. The two girls remained on friendly terms; but alike in X. and in her friend the homosexual inclinations disappeared, and the improper sexual practices were entirely discontinued. X. began to flirt, now with one man, now with another, until when nineteen years old she fell in love with her present husband, and married him after a two years' engagement.

This case shown that neither the existence of homosexual inclinations during childhood, nor the simultaneous exhibition of other contrary sexual mental qualities, necessarily foreshadows the development of permanent homosexuality. On the other hand, we must not from the subsequent appearance of heterosexuality draw the conclusion that this was first acquired intra vitam, for it very often happens that congenital heterosexuality first manifests itself during the period of the puberal development. In an analogous case, in which the homosexual and other contrary sexual tendencies and inclinations of childhood have persisted during the adult sexual life, it would be equally erroneous in the absence of further evidence to conclude that the homosexuality was congenital. I recognise the existence of congenital homosexuality, but I consider that the reality of this condition is established by other grounds than those just mentioned. This question has been fully discussed by me elsewhere,[57] and cannot here be further considered.

Many investigators regard homosexuality as an acquired manifestation. In cases in which the existence of homosexuality can be traced back into childhood, they explain this on the ground that at a time when the individual concerned was in a state of sexual excitement, some other person of the same sex must have made a marked impression upon his imagination. In this way, they suggest, is effected an association whose influence endures throughout life. I will here say no more than this, that this association theory does not suffice to account for the facts. The deficiencies of the association theory will to some extent become apparent from the account I am about to give of the other sexual perversions.

For the dispute to what extent sexual perversions are congenital and to what extent they are acquired, prevails not only concerning homosexuality, but also concerning sadism, masochism, sexual fetichism, &c. In the case also of these latter perversions, some maintain that in those instances in which the perversion began in childhood, some early association was the originating cause; whilst others, from the very fact that the perversion appeared very early in life and was apparently primary, infer that it must be of a congenital character. For instance, a man experiences sexual excitement whenever he sees a cook or other woman kill a fowl; and when revived in memory, the corresponding ideas exercise a similar exciting influence. On inquiry, we learn that when he was eight years old he by chance saw a fowl killed, and then immediately felt strong sexual excitement. Similarly, many masochists and sadists assure us that their first experience of their peculiarly tinged sexual excitement occurred during childhood; e.g., in the case of the masochist, when being punished with a whipping, and so on.

Beyond question, the impressions of childhood may result in the formation of enduring associations. From experiences during childhood may originate terrors and feelings of disgust which are never subsequently overcome. A child who for any reason has several times felt a strong loathing towards some particular article of food, will retain throughout life a dislike to this same substance. Felix Platter relates his own experience as follows. When a child, he once saw his sister slicing rings of "boiled gorge" (see note, page #), and sticking these rings on her finger. The sight was so unpleasant to him that he had to go away. The disagreeable memory has been so persistent, that ever since he has been unable to bear the sight, not merely of such "rings of flesh," but rings of gold, silver, or any other material. A child who has once been frightened by a dog, may ever after be terrified of all dogs. An individual may also, by a kind of moral contagion, be affected by the experiences of others. A child who has seen another child frightened by a cat, may for this reason acquire an antipathy to cats lasting for the whole of life. It is upon the undoubted fact of such experiences as these, that those build their case who maintain that sexual perversions originate in chance impressions during childhood or early youth. But weighty reasons can be alleged against any such generalisation.

To return to the instance of the man who is sexually excited by the sight of fowls being killed, it is true that on superficial consideration the case may appear to support the theory that we have here to do with an acquired perversion. We cannot assume that in this child the complicated image of the killing of a fowl was inborn, and the first inference will therefore be that his perversion is purely an acquired one. But on closer examination we perceive that the matter is less simple than appeared at first sight. First of all we have to inquire why it is that in this particular instance the sight of the killing of a fowl induced such a perversion, when in hundreds of other cases no such result follows the same stimulus. The assumption that in the particular case there chanced to occur sexual excitement simultaneously with the sight of the fowl-killing, is altogether inadequate as an explanation. For, first, this assumption of the simultaneous occurrence of sexual excitement is in most cases a pure supposition, quite unsupported by proof. Secondly, even when the two processes, the sight of the killing, and the sexual excitement, do occur simultaneously, it is still open to question whether the latter may not have been determined by the former; that is to say, it may be that the perverse mode of sexual sensibility previously existed, at least as a predisposition, and that the connexion between the phenomena is the reverse of what is supposed. Thirdly, moreover, the chance view of some occurrence in association with sexual excitement does not suffice to explain the enduring association of sexual excitement with such an occurrence throughout the whole of life. Think of persons who have masturbated during childhood. When they were masturbating, their eyes have rested on various indifferent objects: underlinen, articles of furniture, pictures, books, &c.; but this does not induce the association throughout life of sexual excitement with the sight of any of these articles.

Apart from these considerations, the fact that some external process, such as the killing of a fowl, has important relationships with the content of a subsequent perversion, does not prove that this perversion is an acquired one. We may rather suppose that in the case of one endowed with a congenital predisposition to the excitement of the sexual impulse by the sight of cruelty, the particular cruel act which will prove the determinant in a particular case, must depend upon the chance circumstances of the individual's life. On this view, if, in the case under consideration, the fowl-killing had not happened, at the appropriate time, to awaken the sexual impulse, it must be assumed that some other but similar process would have been competent to effect this. In any case, the association theory alone will not suffice to account for these cases; and the possibility cannot be excluded that in cases of sadism there is a specific abnormal disposition of the sexual impulse, and that the experiences during childhood influence the matter only in so far as they may determine the special manner in which the sadistic tendency will subsequently manifest itself. It is, in fact, very remarkable how often some particular act of cruelty will, in a certain individual, exercise throughout life a sexually exciting influence: in one person the desire to strike may be associated with sexual excitement; in another it may be the desire to stab or to cut; in one individual sexual excitement results from the sight of a fowl being killed; in another, when the victim is a fish, and so on. Although we encounter some in whom the particular cruel act associated with sexual excitement changes many times during life; yet, on the other hand, we find that there are many persons in whom sexual excitement is aroused by some special sadistic practice, and by that alone; and on careful inquiry we ascertain that even in childhood such an act was associated with voluptuous excitement.

I will take this opportunity of explaining very briefly that there is still another possible way of explaining these enduring associations as being based upon impressions received during childhood, without the supposition that these impressions of childhood are the exclusive determinants; this is the assumption that there exists a congenital weakness of the rudiment of the normal sexual impulse, and that it is owing to this primary defect that the paths of nervous conduction involved in the activity of the normal sexual impulse so readily become impassable.

No further discussion of such disputed problems of the sexual life can now be attempted. What has been said should suffice, on the one hand, to prove that the experiences of childhood have important relationships to the occurrence of sexual perversions; and, on the other, to put the reader on his guard against numerous exaggerations. I will merely add that whilst the examples I have given concern only homosexuality and sadism, similar considerations will be found to apply, mutatis mutandis, to other sexual perversions.

Notes of a few cases will now be given in which more or less perverse tendencies can be traced back into the days of childhood, at least in so far as the memories of those concerned can be regarded as trustworthy.

Case 11.--X., thirty-one years of age, is a foot-fetichist. He believes that his preference for feet dates from the age of six years, when he began to regard with extraordinary interest the feet of a servant girl in his father's house when she was engaged in washing the floor. From the age of six to the age of eleven years, X.'s memories are somewhat confused. Thenceforward, however, in the matter of his fondness for feet, his memories are distinct enough. When he was twelve years old he saw in his parents' house a young girl standing bare-footed before the kitchen fire; he seized the opportunity of crouching down on the ground quite close to the girl's feet, giving as his excuse that he wanted to bask in the heat of the fire. While doing this, he yearned to touch or to kiss the girl's feet. Between the ages of thirteen and sixteen he was crazy about the naked feet of girls and women. He took every opportunity of seeing the servants' feet when they were scrubbing the floors, and this sight sufficed to induce in him erection of the penis. This foot fetichism has persisted, directed sometimes towards the feet of women, sometimes towards the feet of men. Since he grew up, X. has from time to time had normal heterosexual intercourse.

Case 12.--Y., twenty-five years of age, homosexual, with a special preference for soldiers. In early childhood he noticed in himself a great fondness for handsome men. When walking in the streets of the town as a small boy, it was the soldiers, in especial, from among the men he met, who made a strong impression upon him. He remembers that when he was seven years of age, he allowed a soldier to take him on his knees, and that it gave him great pleasure to stroke the man's cheeks. The roughness of the cheeks gave him an extremely agreeable sensation, and he sought every opportunity of renewing this sensation. He found cavalry soldiers especially stimulating. From the age of eleven dates his peculiar delight in the well-rounded nates of a cavalry soldier. As he himself puts it, with the lapse of time, this has become to him a genuine fetich. Subsequently, young men-servants also aroused his interest, but never to the same degree as cavalry soldiers. The homosexual tendency has persisted into adult life.

Case 13.--Z, twenty-seven years of age, has several times been prosecuted, on account of his attempts to spy upon women in public lavatories. It is his custom, when in such a place he can observe the genital organs of a woman in the act of defaecation, to masturbate. He states that this tendency was well marked in him at the age of thirteen years. He believes, indeed, that at this time he was inspired mainly by curiosity--by a desire to see what the genital organs of a female were like. But he recalls that when a child, at about the age of eight or nine years, he experienced sexual stimulation when a girl cousin of six sat on his face; and he thinks that when only five or six years old he crawled under the petticoats of a servant girl, in order to lay his face against her nates. Even as early as this he experienced great pleasure in the act.

Case 14.--X., is now twenty years of age. He always experiences sexual excitement when he thinks of the act of whipping. It is unnecessary for him to play any active part in this himself; and it is a matter of indifference to him whether a man beats a woman, a woman beats a man, or an adult of either sex beats a child. In all cases alike the sight induces sexual excitement; and the imaginative reproduction of such a scene is his customary stimulus during masturbation--this being a fairly frequent occurrence. He traces back to childhood the stimulus exercised on him by a whipping seen or imagined. When from seven to nine years of age, he began to find such experiences sexually stimulating; by the age of ten, he was quite clear as to the existence of this peculiarity in himself. At this early age he struck himself with a stick, under the influence of an obscure impulse to arouse voluptuous sensations by means of the blows; he did this fairly frequently.

As regards his sexual sensibilities in general, he is by no means indifferent to members of the opposite sex. He gladly seeks social intercourse with females, and likes to kiss them; but he does not experience any definite sexual impulse towards them, such as might culminate in sexual intercourse. Three times he has had actual intercourse, but on each occasion he has been able to effect erection and ejaculation only by means of all kinds of artificial stimulation. It is a noteworthy fact that when he was fifteen or sixteen years of age he became intimate with the members of a homosexual circle, and only by considerable effort was he able to free himself from these associations.

In autobiographical literature we from time to time come across accounts of such perverse modes of sexual sensibility. Ulrich von Lichtenstein, in whom masochistic inclinations were unmistakably present, relates that when he was barely twelve years of age he became the devoted slave of a grown woman; and he describes his sentiments, at this early age and subsequently, towards this woman, who was well born, good and beautiful, chaste in mind and body, and in every respect virtuous. Well known, too, is the case of Rousseau, of which I shall have to speak again later; this writer traces his masochistic perversion back to the seventh year of his life. I may allude also to Rétif de la Bretonne, who was born in 1734, and certainly experienced sexual sentiments in very early childhood. In his Monsieur Nicolas,[58] which must be regarded as an autobiographical work, Rétif relates the beginnings, in the years 1743-44, of his fetichistic fondness (which endured throughout his life) for women's feet and women's shoes. In purely fictional works, analogous cases are also described. Thus, in his Pour une Nuit d'Amour, Zola depicts a sadistic-masochistic relationship between two children:--

"From earliest childhood Thérèse von Morsanne used Colombel as the scapegoat and the sport of her caprices. He was about six months older than she. Thérèse was a dreadful child. Not that she was wild and uncontrolled, like the ordinary unruly child; on the contrary, she was extraordinarily serious, with the outward aspect of a well-brought-up young lady. But she had most remarkable whims and caprices. When she was alone, she would from time to time utter inarticulate cries or angry howls.

"From the age of six she began to torment little Colombel. He was small and weakly. She would lead him to the back of the park, to a place where the chestnut-trees formed an arbour; here she would spring on his back and make him carry her about, riding sometimes round and round for hours. She compressed his neck, and thrust her heels into his sides, so that he could hardly breathe. He was the horse, she was the lady on horseback. When he was tired out, and ready to drop from exhaustion, she would bite him till the blood flowed, and would cling to her seat so tightly that her nails sank into his flesh. And the ride would thus start once more. The cruel queen of six years old, borne on the back of the little boy who served her as beast of burden, hunted thus on horseback with her hair streaming in the wind. Afterwards, when they were with their parents, she would pinch him secretly, and by repeated threats would prevent him from crying or complaining. Thus in secret they led a life of their own, very different from that which was apparent to the eyes of others. When they were alone, she treated him as a toy, to be broken to fragments at her pleasure, simply to see what might be inside. Was she not the Marquise? Were not people on their knees before her? And when she was tired of tyrannising over Colombel in private, she would take a peculiar pleasure, when a number of others were present, in tripping him up, or in running a pin into his arm or leg, whilst at the same time she forbade him with a fierce glance of her black eyes to show even by the movement of an eyelid that she was to blame.

"Colombel bore his martyrdom with a dull resentment. Trembling, he kept his eyes on the ground, to escape the temptation to strangle his young mistress. And yet he did not dislike being beaten; it gave him a bitter delight. Sometimes, even, he actually sought for a blow, awaiting the pain with a peculiar thrill, and feeling a certain satisfaction in the smart when she pricked him with a pin."

I have now recounted a number of cases in which the perversions observed in adults can be traced back to early childhood. I have shown that it remains doubtful, when the specific perversion first makes its appearance, whether it results from a congenital predisposition which is merely aroused to activity by an outward stimulus, or whether the outward stimulus is also the true determinant. A further point has now to be considered, and it is one which, as far as I know, has hitherto been completely ignored in the literature of the subject. The majority of sexual perverts trace back the origin of their perversion to a time at which the detumescence impulse had not yet been awakened. Thus, the homosexual tells us of a peculiar impulse he felt in childhood to kiss his tutor; we learn from the hair-fetichist that when still a child he loved to play with girls' hair; and so on. And we are told that these impulses, voluptuously tinged, occurred at a time when erection and ejaculation had not yet taken place, and that there was not as yet any of that peripheral voluptuous sensation which can be clearly differentiated from the purely psychical voluptuous sensation. The question then arises, was this voluptuous sensation excited during childhood of a truly sexual nature at this early age? Was the boy's impulsive desire to kiss his tutor a sexual impulse? From the fact that later in life such an impulse is unmistakably sexual, the conclusion is often drawn that the earlier inclinations, and the pleasurable sensations associated with the corresponding mental processes, were also sexual. The inference is an obvious one, and is doubtless justified in many instances. But the following point must be taken into consideration. It is a fact that the psychosexual processes of the child are less sharply differentiated from other psychical processes than is the case in the adult; and it is therefore possible that the specific sexual perversions, and the specific sexual sensibility, develop out of a corresponding sensibility in the child which is not yet of a sexual character. The observation of Stanley Hall[59] that children display a peculiar interest, not only in their own feet, but also in the feet of other persons, would appear to confirm this view. He writes: "Quite small children often display a marked fondness for stroking the feet of others, especially when these feet are well formed; and many adults testify to the persistence of such an impulse, whose gratification gives them a peculiar pleasure." It may readily be supposed, in many cases of foot-fetichism, that this unmistakably sexual phenomenon has originally developed out of such a non-sexual fondness for feet.

Unquestionably, many of the processes of childhood are not to be regarded as sexual, although they are closely related to the sexual life. This statement applies to many of the friendships between boys or between girls, such as are formed during the period in which the sexual impulse is still undifferentiated, or after its differentiation has occurred--and such friendships must not be identified with sexual feelings. At this period of life, we occasionally observe a desire in boys to form romantic friendships with others of their own sex; and the same is true also of girls. In many cases of this kind, there is no question of the presence of any sexual element, and we have no right, therefore, to regard as manifestations of the sexual impulse such instances of enthusiastic friendship during the period of undifferentiated sexual impulse. Each case must be separately analysed, in order to determine its nature. On the other hand, the sexual character of an inclination may sometimes be recognised in the early years of childhood, even in cases in which the boy's own genital organs are in no way involved. It may happen that a boy of eight will display a marked interest in the genital organs of youths or of men, and will seize every opportunity of peeping at them; and in such a case we are as a rule justified in assuming the existence of a homosexual tendency, even when there is no reflection of sexual disturbance to the boy's own genital organs. But we must guard against the mistake of seeing a sexual element in every friendship between boys.

As with human beings, so also with the lower animals, it is not always possible to differentiate friendship from the sexual impulse. Robert Müller has collected a number of interesting observations bearing on this matter.[60] He states that the so-called animal friendships, friendships between animals of different species, are in many cases determined by sexual feelings. He mentions the case of a dog ten months old, which made sexual attacks on hens, and thereby killed them; in another instance, a thorough-bred dog, two years old, exhibited a similar perversion, and had a lasting sexual relationship with a hen. He also quotes a case of which a man named P. Momsen was the witness, in which a gander attempted to pair with a bitch. These examples show that in the cases of animal friendship so often reported in the newspapers, the existence of an element of perverse sexuality is at least possible. But it does not, of course, follow that every strange animal friendship is of a sexual nature.

This is true, also, of other perversions--of sadism, for instance. The tendency to cruelty appears in early childhood, and it is only subsequently that this tendency becomes definitely associated with the sexual life. But even though this association (of cruelty with the sexual life) is demonstrable in so many instances, we are not for this reason justified in regarding every brutal act, all deliberate cruelty, as manifestations of sadism; and this reservation applies no less to adults than to children. Thus, delight in the sufferings of others, though it may be regarded as analogous with sadism, has no necessary connexion with the sexual impulse. Just as little can we assume that the deliberate ill-treatment of animals, whether on the part of children or on that of adults, is necessarily the outcome of sadism.

Felix Platter relates in his autobiography that when as a boy verging on maturity he had already chosen his future profession as a medical man, he came to the conclusion that he ought to accustom himself to the sight of disagreeable things; with this end in view, to habituate himself to see without emotion the heart and other viscera, he frequented the slaughter-house. Subsequently he experimented on a little bird, to ascertain if it had blood-vessels, and if it could be "bled"; he opened a vein with a penknife, and the little bird died. He did the same thing with various insects--stag-beetles, cook-chafers, and the like. Actions of this kind performed by children have, of course, no connexion with the sexual life. When a child tears off the feet of an insect, or mutilates any other animal, the motive is often simply that with which the same child will pull a watch to pieces. The same act may result from various motives; and for this reason we must guard against the misconception which might lead us, from every cruel act performed by a child, to diagnose the existence of sadism, or the certainty of a subsequent sadistic development.

In a case of rose-fetichism, which I have published elsewhere, the subject was a philologist, thirty years of age, who had never masturbated during his school days, and until he was nineteen or twenty had remained sexually neutral, experiencing sexual inclination neither towards females nor towards members of his own sex. But he had from an early age exhibited a very great interest in flowers, and while still a child used to kiss them. He is unable, however, to recall the existence in this connexion of any sexual excitement. When about twenty-one years old he was introduced to a young lady who at the time was wearing a large rose fastened into the front of her jacket. Henceforward, in his sexual sensibility, the rose assumed extraordinary importance. Whenever he was able, he bought roses, kissed them, and took them to bed with him. The act of kissing a rose induced an erection of the penis. In his seminal dreams, the image of the rose always played a leading part.

This case is extremely instructive. A great love for flowers, leading to the act of kissing, occurs in many children without any subsequent association, when these children have grown up, of sexual sentiments with flowers. Such persons will lay little stress on their memories of such occurrences in childhood--indeed, in adult life these incidents are for the most part forgotten. But to X., who when grown-up became affected with rose-fetichism as a sequel of a specific experience, it seems that his sexual fetichism is causally dependent upon his childish love of flowers--and probably he is right in so thinking. But we must not for this reason assume that his childish preference had any sexual character. It is more likely that the abnormally great fondness for flowers, beginning in childhood, was a favouring factor of the subsequent development of the rose-fetichism. What applies here to a pathological instance, may also be assumed to be true of the normal sexual life. That is to say, the experiences of childhood, which have not as yet any relationship with sexual life, are nevertheless of great significance in relation to the subsequent upbuilding of the sexual life, and above all in relation to the development of the psychosexual sentiments.

For the sake of completeness I must allude here to two additional processes which are also related to the sexual life of the child, viz., exhibitionism and skatophilia. As regards exhibitionism, Lasègue[61] describes as exhibitionists those persons who display their genital organs to others from a certain distance, without attempting any other improper manipulations, and above all without making any endeavour to effect sexual intercourse. Kovalevsky[62] contends that the tendency to exhibitionism is observed in the male sex especially during childhood at the approach of puberty, and in old age. He records the following case: "The headmistress of a boarding-school one day brought to see me a boy fourteen years of age, very well behaved and intelligent, who experienced from time to time an irresistible impulse, when he met one of the little girls of the school, to expose his penis. As a rule he was able to withstand this terrible impulse, but occasionally he yielded to it. He then experienced a sense of confusion in his head and his vision, and his whole body seemed to become tense, whilst at the same time he experienced a voluptuous sensation in the penis and in the body generally. This state lasted for one or two minutes, and was succeeded by a moderate sense of weakness and a very distressing sense of shame. The acts of exhibition were never accompanied with seminal emission, although he sometimes had such emissions during the night." I have myself hardly over observed this form of exhibitionism in children. Somewhat commoner, however, is the mutual and perfectly voluntary exhibition of their genital organs by children, generally boys and girls together; in these cases, as previously explained (page #), the acts are determined rather by curiosity than by the sexual impulse. It is necessary to insist upon this fact, as distinguishing exhibitionism in children from exhibitionism in adults. A like question arises regarding the skatological inclinations and interests of children, which are assumed by Havelock Ellis[63] to be intimately connected with the sexual life. It is an undoubted fact that many children before puberty are greatly interested in the excretions from the bladder and the intestine. Stanley Hall,[64] to whom Havelock Ellis refers, is of opinion that "micturitional obscenities, which our returns show to be so common before adolescence, culminate at ten or twelve, and seem to retreat into the background as sex-phenomena appear." He distinguishes between two classes of cases: "fouling persons or things, secretly from adults, but openly with each other," and, less often, "ceremonial acts, connected with the act or the product, that almost suggest the skatological rites of savages." I can myself, as a result of numerous inquiries, confirm the existence of skatophilia in children. But I have not yet been able to satisfy myself that these processes always, or even usually, have any connexion with the sexual life. Such a connexion unquestionably exists in some cases, but no less certainly it is not an invariable one. Skatological acts--those, that is to say, in which the more disgusting excreta play a part--arise in some instances out of a masochistic mode of sensibility. In cases in which adult masochists have such inclinations, it is often impossible to trace their existence back into childhood. It rather appears, in most of the instances of skatological inclinations which have come under my own observation, that these inclinations have been superimposed upon other masochistic tendencies, and these latter may sometimes be traced back to the days of childhood. But in a few cases I have found skatological perversions to have originated very early in life. A man with a university education, with an inclination to the practice of cunnilinctus, assured me that this inclination began in childhood. Another man, whose interest in the female nates and anus was unquestionably not the result of any excesses, stated positively that he was able to refer the origin of this inclination to a definite experience of his childhood. When only seven years of age, he experienced the impulse to look at the nates of a servant-maid; and he believes that this inclination, which in his case was certainly generalised at a very early age, arose from a still earlier experience, viz., the chance sight of his mother's nates, when she urinated in his presence. His whole account of the matter suggests the existence of a fetichism directed to the nates, impelling him to the most disgusting acts, which he has several times performed. A similar case, but on a homosexual basis, will be found recorded an Case 20 in my work on Sexual Inversion.[65]

No detailed account of other pathological manifestations of the sexual life will now be attempted, since this work professes to deal only with subjects of a wide and general significance. We cannot consider those cases, for instance, in which there is developmental defect of the reproductive organs; those, for example, in which there is no discoverable development of the reproductive glands. But some reference may be made to hermaphroditism. In the human species true hermaphroditism is a very rare occurrence, whereas apparent hermaphroditism, the so-called pseudo-hermaphroditism, is comparatively frequent. The sexual life of pseudo-hermaphrodites has in some instances been very carefully studied, more especially with reference to the relationship of pseudo-hermaphroditism to the direction of the sexual impulse. It appears that in a number of cases of pseudo-hermaphroditism, not only did the secondary sexual characters exhibit an inverted or contrary sexual development, but the sexual impulse was also inverted--was directed, that is to say, towards individuals of the same sex as that to which the pseudo-hermaphrodite really belonged. Beyond question, cases have been observed in which pseudo-hermaphrodites with testicles have had sexual inclination towards males; and pseudo-hermaphrodites with ovaries, sexual inclination towards females. In many of these cases, such contrary sexual tendencies could be traced back into childhood. We have, of course, to reckon with the fact that in the case of pseudo-hermaphrodites the diagnosis of the sex is usually based upon the formation of the external genital organs, and without any expert examination of the reproductive glands; thus they are often brought up as members of a sex to which they do not really belong, and in consequence of this their education is sexually inverted. In such cues it may reasonably be suggested that the homosexuality is the result, not so much of a congenital inversion of the sexual impulse, as of the contrary sexual education.

For a detailed treatment of the subject of hermaphroditism, reference should be made to the special literature of the subject, and above all to the exhaustive and laborious work of Neugebauer.[66]

Note to p. #, on the expression "Boiled Gorge."--This is a literal translation of the German gesottne Gurgeln, an apparently forgotten article of diet. Finding no account of it in any German dictionary, I applied to Dr. Moll, who writes as follows:--"Gurgel denotes a particular part of the neck, in human beings the front part, comprising the hyoid bone, the larynx and trachea, the pharynx and the upper part of the oesophagus, the thyroid body, and the adjoining muscles. As far as I am aware, this part of the animal body is not now used for food. Presumably it was so used in Felix Platter's time, but I cannot say if the 'rings' of which he speaks were cut from the trachea, the oesophagus, or perhaps the great blood-vessels."--Translator's Note.