The great practical importance which attaches to the facts of fetichism, in accordance with what has been said, lies in two factors. First, pathological fetichism is not infrequently a cause of _psychical impotence_.[89] Since the object upon which the sexual interest of the fetichist is concentrated stands, in itself, in no immediate relation to the normal sexual act, it often happens that the fetichist diminishes his excitability to normal stimuli by his perversion, or, at least is capable of coitus only by means of concentration of his fancy upon his fetich. In this perversion, and in the difficulty of its adequate satisfaction, just as in the other perversions of the sexual instinct, lie conditions favoring psychical and physical onanism, which again reacts deleteriously on the constitution and sexual power. This is especially true in the case of youthful individuals, and particularly in the case of those who, on account of opposing ethical and æsthetic motives, shrink from the realization of their perverse desires. Secondly, fetichism is of great forensic importance. Just as sadism may extend to murder and the infliction of bodily injury, fetichism may lead to theft and even to robbery for the possession of the desired articles. Erotic fetichism has for its object either a certain portion of the body of a person of the opposite sex, or a certain article or material of wearing-apparel of the opposite sex. (Only cases of pathological fetichism in men have thus far been observed, and therefore only portions of the female person and attire are spoken of here.) In accordance with this, fetichists fall into three groups. (a) _The Fetich is a Part of the Female Body._—Just as, in physiological fetichism, the eyes, the hand, the foot, and the hair of woman very frequently become fetiches, so, in the pathological domain, the same portions of the body become the sole objects of sexual interest. This exclusive concentration of interest on these parts, by the side of which everything else feminine fades, and all other sexual value of woman may sink to _nil_, so that, instead of coitus, strange manipulations of the fetich become the object of desire,—this it is that makes these cases pathological. Case 74. (Binet, _op. cit._) X., aged 34, teacher in a Gymnasium. In childhood he suffered with convulsions. At the age of ten he began to masturbate, with lustful feelings, which were connected with very strange ideas. He was particularly partial to women’s eyes; but since he wished to imagine some form of coitus, and was absolutely innocent in sexual matters, to avoid too great a separation from the eyes, he evolved the idea of making the nostrils the seat of the female sexual organs. Then his lively sexual desires were connected with this idea. He sketched drawings representing correct Greek profiles of female heads, but the nostrils were so large that immissio penis would have been possible.