all inclination for men, and feels attracted by women exclusively. It must be mentioned, however, that, though L. has a decided inclination for the female sex, he presents an abnormal phenomenon. The essential thing in woman that excites him is the sight of her beautiful hands; L. is by far more impressed when he touches a beautiful female hand than he would be were he to see its possessor in a state of complete nudity. The extent to which L.’s preference for beautiful female hands goes is shown by the following incident:— L. knew a beautiful young lady possessed of every charm, but her hands were quite large and not beautifully formed, and often they were not as clean as L. could wish. For this reason it was not only impossible for L. to conceive a deeper interest in the lady, but he was not able even to touch her. L. believes that there is nothing more disgusting to him than dirty finger-nails; this alone would make it impossible for him to touch a woman who in all other respects was most beautiful. L. formerly, as a substitute for coitus, had the puella perform genital manipulation with her hand until ejaculation took place. To the question as to what there was about a woman’s hand that attracted him in particular, whether he saw in it a symbol of power, and whether it gave him pleasure to be directly humiliated by a woman, the patient answered that only the _beautiful form_ of the hand charmed him; that it afforded him no gratification to be humiliated by a woman; and that he had never had any thought to regard the hand as the symbol or instrument of a woman’s power. The preference for the hand is still so great that the patient has greater pleasure when his genitals are touched by it than when he performs coitus in vaginam. Yet, the patient prefers to perform the latter, because it seems to him to be natural, while the former seems abnormal. The touch of a beautiful female hand on his body immediately causes him to have erection; he thinks that kissing and other contacts do not exert nearly so strong an influence. It is only of late years that the patient has performed coitus frequently, but it has always been very difficult for him to determine to do it. Too, in coitus, he did not find the complete satisfaction he sought. However, when he finds himself near a woman whom he would like to possess, sometimes, at mere sight of her, his sexual excitement becomes so intense that ejaculation results. L. says expressly that during this he does not intentionally touch or press his genitals; ejaculation under such circumstances affords him much more pleasure than he experiences in actual coitus.[91]