The sexual acts, by means of which male urnings seek and find satisfaction, are multifarious. There are individuals, of fine feeling and strength of will, who sometimes satisfy themselves with platonic love, with the risk, however, of becoming nervous (neurasthenic) and insane, as a result of this enforced abstinence. In other instances, for the same reasons which may lead normal individuals to avoid coitus, onanism, _faut de mieux_, is indulged in. In urnings with nervous systems congenitally irritable, or injured by onanism (irritable weakness of the ejaculation centre), simple embraces or caresses, with or without contact of the genitals, are sufficient to induce ejaculation and consequent satisfaction. In less irritable individuals, the sexual act consists of manustupration by the loved person, or mutual onanism, or imitation of coitus between the thighs. In urnings morally perverse and potent, quoad erectionem, the sexual desire is satisfied by pederasty,—an act, however, which is repugnant to perverted individuals that are not defective morally, much in the same way as it is to normal men. The statement of urnings is remarkable, that the sexual act with persons of the same sex, which is adequate for them, gives them a feeling of great satisfaction and accession of strength, while satisfaction by solitary onanism, or by enforced coitus with a woman, affects them in an unfavorable way, making them miserable and increasing their neurasthenic symptoms. The manner of satisfaction of the female urning is little known. In one of my cases, the girl masturbated, and during the act felt herself to be a man; and her fancy created a beloved female person. In another case, the act consisted of practicing onanism on the person loved, and fondling her genitals. _Amor lesbicus_ is presumably not infrequent here, for which an enlarged clitoris or an artificial priapus may be used. As to the frequency[111] of the occurrence of the anomaly, it is difficult to reach a just conclusion, since those affected with it break from their reserve only very infrequently; and in criminal cases the urning with perversion of sexual instinct is usually classed with the person given to pederasty for simply vicious reasons. According to Casper’s and Tardieu’s, as well as my own, experience, this anomaly is much more frequent than reported cases would lead us to presume.