case of an invert of English origin who had been castrated.  The inverted impulse remained unchanged, as well as sexual desire and the aptitude for erection; but neurasthenic symptoms, which had existed before, were aggravated; he felt less capable to resist his impulses, became migratory in his habits of life, and addicted to the use of laudanum.  In a case recorded by C.H.  Hughes (Alienist and Neurologist, Aug., 1914) the results were less unsatisfactory; in this case the dorsal nerve of the penis was first excised, without any result (see also Alienist and Neurologist, Feb., 1904, p. 70, as regards worse than useless results of cutting the pudic nerve), and a year or so later the testes were removed and the patient gained tranquillity and satisfaction; his homosexual inclinations appeared to go, and he began to show inclination for asexualized women, being specially anxious to meet with a woman whose ovaries had been removed on account of inversion. (Reference may also be made to Naecke, “Die Ersten Kastrationen aus sozialen Grunden auf europaeischen Boden,” Neurologisches Centralblatt, 1909, No. 5, and E. Wilhelm in Juristisch-psychiatrische Grenzfragen, vol. viii, Heft 6 and 7, 1911.)

More trust has usually been placed in the psychotherapeutical than the surgical treatment of homosexuality.  At one time hypnotic suggestion was carried out very energetically on homosexual subjects.  Krafft-Ebing seems to have been the first distinguished advocate of hypnotism for application to the homosexual.  Dr. von Schrenck-Notzing displayed special zeal and persistency in this treatment.  He undertook to treat even the most pronounced cases of inversion by courses lasting more than a year, and involving, in at least one case, nearly one hundred and fifty hypnotic sittings; he prescribed frequent visits to the brothel, previous to which the patient took large doses of alcohol; by prolonged manipulations a prostitute endeavored to excite erection, a process attended with varying results.  It appears that in some cases this course of treatment was attended by a certain sort of success, to which an unlimited good will on the part of the patient, it is needless to say, largely contributed.  The treatment was, however, usually interrupted by continual backsliding to homosexual practices, and sometimes, naturally, the cure involved a venereal disorder.  The patient was enabled to marry and to beget children.[248] It is a method of treatment which seems to have found few imitators.  This we need not regret.  The histories I have recorded in previous chapters show that it is not uncommon for even a pronounced invert to be able sometimes to effect coitus.  It often becomes easy if at the time he fixes his thoughts on images connected with his own sex.  But the perversion remains unaffected; the subject is merely (as one of Moll’s inverts expressed it) practising masturbation per vaginam.  Such treatment is a training in vice, and, as Raffalovich points out, the invert is simply perverted and brought down to the vicious level which necessarily accompanies perversity.[249]