Fere, whose attention was called to this point, from time to time noted the existence of sexual periodicity.  Thus, in a case of general paralysis, attacks of continuous sexual excitement, with sleeplessness, occurred every twenty-eight days; at other times, the patient, a man of 42, in the stage of dementia, slept well, and showed no signs of sexual excitation (Societe de Biologie, October 6, 1900).  In another case, of a man of sound heredity and good health till middle life, periodic sexual manifestations began from puberty, with localized genital congestion, erotic ideas, and copious urination, lasting for two or three days.  These manifestations became menstrual, with a period of intermenstrual excitement appearing regularly, but never became intense.  Between the age of 36 and 42, the intermenstrual crises gradually ceased; at about 45, the menstrual crises ceased; the periodic crises continued, however, with the sole manifestation of increased frequency of urination (Societe de Biologie, July 23, 1904).  In a third case, of sexual neurasthenia, Fere found that from puberty, onwards to middle life, there appeared, every twenty-five to twenty-eight days, tenderness and swelling below the nipple, accompanied by slight sexual excitation and erotic dreams, lasting for one or two days (Revue de Medecine, March, 1905).

It is in the domain of disease that the most strenuous and, on the whole, the most successful efforts have been made to discover a menstrual cycle in men.  Such a field seems promising at the outset, for many morbid exaggerations or defects of the nervous system might be expected to emphasize, or to free from inhibition, fundamental rhythmical processes of the organism which in health, and under the varying conditions of social existence, are overlaid by the higher mental activities and the pressure of external stimuli.  In the eighteenth century Erasmus Darwin wrote a remarkable and interesting chapter on “The Periods of Disease,” dealing with solar and lunar influence on biological processes.[121] Since then, many writers have brought forward evidence, especially in the domain of nervous and mental disease, which seems to justify a belief that, under pathological conditions, a tendency to a male menstrual rhythm may be clearly laid bare.

We should expect an organ so primitive in character as the heart, and with so powerful a rhythm already stamped upon its nervous organization, to be peculiarly apt to display a menstrual rhythm under the stress of abnormal conditions.  This expectation might be strengthened by the menstrual rhythm which Mr. Perry-Coste has found reason to suspect in pulse-frequency during health.  I am able to present a case in which such a periodicity seems to be indicated.  It is that of a gentleman who suffered severely for some years before his death from valvular disease of