The patient’s exterior—his plagiocephalic head; his large, prominent ears; the deficient innervation of the right facialis about the mouth; the neuropathic expression of the eyes—indicates a degenerate, neuropathic individual. Z. is tall, of powerful frame, and, in all respects, of masculine appearance. Pelvis masculine; testicles well developed; penis remarkably large; mons veneris with abundant hair. The right testicle hangs much lower than the left; the cremasteric reflex is weak on both sides. The patient is below the average intellectually. He feels his deficiency, complains of his indolence, and asks to have his will strengthened. His awkward, embarrassed manner, timid glances, and relaxed attitude, point to masturbation. The patient confesses that from his seventh year, until a year and a half ago, he practiced it, years at a time, from eight to ten times daily. Until a few years ago, when he became neurasthenic (cephalic pressure, loss of mental power, spinal irritation, etc.), he says he always found great sensual pleasure in it. Since then this had been lost, and the desire to masturbate had disappeared. He had constantly grown more bashful and indolent, less energetic, and more cowardly and apprehensive. He had lost interest in everything, and did his business only from a sense of duty, feeling very low-spirited. He had never thought of coitus, and, from his stand-point as an onanist, he could not understand how others could find pleasure in it. Investigations in the direction of contrary sexual instinct gave a negative result. He says he never was drawn toward persons of his own sex; he rather thinks that he has now and then had a weak inclination for females. He asserts that he came to masturbate independently. In his thirteenth year he first noticed ejaculations as a result of masturbatic manipulations. It was only after long persuasion that Z. consented to entirely unveil his vita sexualis. As his statements, which follow, show, he may be classified as a case of ideal masochism, with rudimentary sadism. The patient distinctly remembers that, at the age of six, without any cause, he had “ideas of violence.” He was compelled to imagine that a servant-girl spread his legs apart and showed his genitals to another; that she tried to throw him into cold or hot water, in order to cause him pain. These “ideas of violence” were attended with lustful feeling, and became the cause of masturbatic manipulations. Later the patient called them up voluntarily, in order to incite himself to masturbation. They also played a part in his dreams; but they never induced pollution, apparently because the patient masturbated excessively during the day.