He married a pretty young lady. In spite of lively erections when he thought of his wife’s shoes, in attempts at cohabitation he was absolutely impotent; for his distaste for coitus, and for close intercourse in general, was far more powerful than the influence of the shoe-idea, which induced sexual excitement. On account of his impotence, the patient applied to Dr. Hammond, who treated his epilepsy with bromides, and advised him to hang a shoe up over his bed, and look at it fixedly during coitus, at the same time imagining his wife to be a shoe. The patient became free from epileptic attacks, and potent so that he could have coitus about once a week. Too, his sexual excitation by women’s shoes grew less and less. (Hammond, “Sexual Impotence.”) Following these two cases of shoe-fetichism, which apparently depend merely upon accidental association, and are not favored by any inner relation between the things themselves, is given the very strange case of a fetichist who was excited sexually only by the idea of a night-cap on the head of an ugly old woman; also a case arising apparently from merely accidental association:— Case 89. L., aged 37, clerk, from tainted family, had his first erection at five years, when he saw his bed-fellow—an aged relative—put on a night-cap. The same thing occurred later, when he saw an old servant put on her night-cap. Later, simply the idea of an old, ugly woman’s head, covered with a night-cap, was sufficient to cause an erection. Simply the sight of a cap, or of a naked woman or man, made no impression, but the mere touch of a night-cap induced erection, and sometimes even ejaculation. L. was not a masturbator, and had never been sexually active until his thirty-second year, when he married a young girl with whom he had fallen in love. On his marriage-night he remained cold until, from necessity, he brought to his aid the memory-picture of an ugly woman’s head with a night-cap. Coitus was immediately successful. Thereafter it was always necessary for him to use this means. Since childhood he had been subject to occasional attacks of depression, with tendency to suicide, and now and then to frightful hallucinations at night. When looking out of windows, he became dizzy and anxious. He was a perverse, peculiar, and easily embarrassed man, of bad mental constitution. (Charcot and Magnan, _Arch. de neurol._, 1882, No. 12.) In this very peculiar case, the simultaneous coincidence of the first sexual excitation and an absolutely heterogeneous impression seems to have determined the association.