The irresistible potency of the inner impulse is well illustrated in a case presented by Hirschfeld and Burchard:  “My daughter Erna,” said the subject’s mother, “showed boyish inclinations at the age of 3, and they increased from year to year.  She never played with dolls, only with tin soldiers, guns, and castles.  She would climb trees and jump ditches; she made friends with the drivers of all the carts that came to our house and they would place her on the horse’s back.  The annual circus was a joy to her for all the year.  Even as a child of 4 she was so fearless on horseback that lookers-on shouted Bravo! and all declared she was a born horsewoman.  It was her greatest wish to be a boy.  She would wear her elder brother’s clothes all day, notwithstanding her grandmother’s indignation.  Cycling, gymnastics, boating, swimming, were her passion, and she showed skill in them.  As she grew older she hated prettily adorned hats and clothes.  I had much trouble with her for she would not wear pretty things.  The older she grew the more her masculine and decided ways developed.  This excited much outcry and offence.  People found my daughter unfeminine and disagreeable, but all my trouble and exhortations availed nothing to change her.”  Now this young woman whom all the influences of a normal feminine environment failed to render feminine was not physiologically a woman at all; the case proved to be the unique instance of an individual possessing all the external characteristics of a woman combined with internal testicular tissue capable of emitting true masculine semen through the feminine urethra.  No suggestions of the environment could suffice to overcome this fundamental fact of internal constitution. (Hirschfeld and Burchard, “Spermasekretion aus einer weiblichen Harnroehre,” Deutsche medizinische Wochenschrift, No. 52, 1911.)

I may here quote three American cases (not previously published), for which I am indebted to Prof.  G. Frank Lydston, of Chicago.  They seem to me to illustrate the only kind of suggestions which play much part in the evolution of inversion.  I give them in Dr. Lydston’s words:—­

CASE I.—­A man, 45 years of age, attracted by the allusion to my essay on “Social Perversion” contained in the English translation of Krafft-Ebing’s Psychopathia Sexualis, consulted me regarding the possible cure of his condition.  This individual was a finely educated, very intelligent man, who was an excellent linguist, had considerable musical ability, and was in the employ of a firm whose business was such as to demand on the part of its employes considerable legal acumen, clerical ability, and knowledge of real-estate transactions.  This man stated that at the age of puberty, without any knowledge of perversity of sexual feeling, he was thrown intimately in contact with males of more advanced years, who took various means to excite his sexual passions, the result being that perverted sexual practices were