Case 95. Ilma S.,[102] aged 29; single; merchant’s daughter. She comes of a family having bad nervous taint. Father was a drinker and died by suicide, as also did the patient’s brother and sister. A sister suffers with convulsive hysteria. Mother’s father shot himself while insane. Mother was sickly, and died paralyzed after apoplexy. The patient never had any severe illness. She is bright, enthusiastic, and dreamy. Menses at the age of eighteen without difficulty; but thereafter they were very irregular. At fourteen, chlorosis and catalepsy from fright. Later, hysteria gravis and an attack of hysterical insanity. At eighteen, relations with a young man which were not platonic. This man’s love was passionately returned. From statements of the patient, it seems that she was very sensual, and after separation from her lover practiced masturbation. After this she led a romantic life. In order to earn a living, she put on male clothing, and became a tutor; but she gave up her place because her mistress, not knowing her sex, fell in love with her and courted her. Then she became a railway-employé. In the company of her companions, in order to conceal her sex, she was compelled to visit brothels with them, and hear the most vulgar stories. This became so distasteful to her that she gave up her place, resumed the garments of a female, and again sought to earn her living. She was arrested for a theft, and on account of severe hystero-epilepsy was sent to the hospital. There, inclination and impulse toward the same sex were discovered. The patient became troublesome on account of passionate love for female nurses and patients. Her sexual perversion was considered congenital. With regard to this the patient made some interesting statements:— “I am judged incorrectly, if it is thought that I feel myself a man toward the female sex. In my whole thought and feeling I am much more a woman. I loved my cousin as only a woman can love a man. “The change of my feeling originated in this, that, in Pesth, dressed as a man, I had an opportunity to observe my cousin. I saw that I had wholly deceived myself in him. That gave me terrible heart-pangs. I knew that I could never love another man; that I belonged to those who love but once. Of similar effect was the fact that, in the society of my companions at the railway, I was compelled to hear the most offensive language and visit the most disreputable houses. As a result of the insight into men’s motives, gained in this way, I took an unconquerable dislike to them. However, since I am of a very passionate nature and need to have some loving person on whom to depend, and to whom I can wholly surrender myself, I felt myself more and more powerfully drawn toward intelligent women and girls who were in sympathy with me.”