Ulrichs (“Kritische Pfeile,” p. 2, 1880) declares that, on an average, there is one person affected with contrary sexual instinct to every two hundred mature men, or to every eight hundred of the population; and that the percentage among the Magyars and South Slavs is still greater,—statements which may be regarded as untrustworthy. The subject of one of my cases knows personally, at his home (13,000 inhabitants), fourteen urnings. He further declares that he is acquainted with at least eighty in a city of 60,000 inhabitants. It is to be presumed that this man, otherwise worthy of belief, makes no distinction between the congenital and the acquired anomaly. 1. _Psychical Hermaphroditism._[112]—The characteristic mark of this degree of inversion of the sexual instinct is that, by the side of the pronounced sexual instinct and desire for the same sex, a desire toward the opposite sex is present; but the latter is much weaker and is manifested episodically only, while the homo-sexuality is primary, and, in time and intensity, forms the most striking feature of the vita sexualis. The hetero-sexual instinct may be but rudimentary, manifesting itself simply in unconscious (dream) life; or (episodically, at least) it may be powerfully exhibited. The sexual instinct toward the opposite sex may be strengthened by the exercise of will and self-control; by moral treatment, and possibly by hypnotic suggestion; by improvement of the constitution and the removal of neuroses (neurasthenia); but especially by abstinence from masturbation. However, there is always the danger that homo-sexual feelings, in that they are the most powerful, may become permanent, and lead to enduring and exclusive contrary sexual instinct. This is especially to be feared as a result of the influences of masturbation (just as in acquired inversion of the sexual instinct) and its neurasthenia and consequent exacerbations; and, further, it is to be found as a consequence of unfavorable experiences in sexual intercourse with persons of the opposite sex (defective feeling of pleasure in coitus, failure in coitus on account of weakness of erection and premature ejaculation, infection). On the other hand, it is possible that æsthetic and ethical sympathy with persons of the opposite sex may favor the development of hetero-sexual desires. Thus it happens that the individual, according to the predominance of favorable or unfavorable influences, experiences now hetero-sexual, now homo-sexual, feeling.