He himself was a robust, fine-looking man, above middle age, who was well educated and very intelligent, as he necessarily must have been, because of the prominent position he held with an important railway company.  I will state, as a matter of interest, that the lad in this case, who is now 23 years of age, has recently consulted me for impotentia coeundi, manifesting a frigidity for women, and, from the young man’s statements, I am convinced that he is well on the road to confirmed sexual perversion.

    An interesting point in this connection is that the young man’s
    sister, the actress already alluded to, has recently had an
    attack of acute mania.

I have had other unpublished cases that might be of interest, but these two are somewhat classical, and typify to a greater or less degree the majority of other cases.  I will, however, mention one other case, occurring in a woman.

CASE III.—­A married woman 40 years of age.  Has been deserted by her husband because of her perverted sexuality.  Neurotic history on both sides of the family, and several cases of insanity on mother’s side.  In this case affinity for the same sex and perverted desire for the opposite sex existed, a combination by no means infrequent.  Hypnotic suggestion tried, but without success.  Cause was evidently suggestion and example on the part of another female pervert with whom she associated before her marriage.  Marriage was late, at age of 35.  In all these cases there was an element of what may be called suggestion, but it was really much more than this; it was probably in each case active seduction by an elder person of a predisposed younger person.  It will be observed that in each case there was, at the least, an organic neurotic basis for suggestion and seduction to work on.  I cannot regard these cases as entitled to modify our attitude toward suggestion.

MASTURBATION.—­Moreau believed that masturbation was a cause of sexual inversion, and Krafft-Ebing looked upon it as leading to all sorts of sexual perversions; the same opinion was currently repeated by many writers.  It is not now accepted.  Moll emphatically rejected the idea that masturbation can be the cause of inversion; Naecke repeatedly denies that masturbation, any more than seduction, can ever produce true inversion; Hirschfeld attaches to it no etiological significance.  Many years ago I gave special attention to this point and reached a similar conclusion.  That masturbation, especially at an early age, may sometimes enfeeble the sexual activities, and aid the manifestations of inversion, I certainly believe.  But beyond this there is little in the history of my male cases to indicate masturbation as a cause of inversion.  It is true that 44 out of 51 admit that they have practised masturbation,—­at all events, occasionally, or at some period in their lives,—­and it is possible that this proportion is larger than