Three years after the death of her second husband, the patient discovered the fact that her nine-year-old daughter, by her first husband, was given to masturbation, and that she was failing in physical health. The patient read of this vice, and could not overcome the impulse to indulge in the practice, becoming, in consequence, an onanist. She is unable to bring herself to give the details of this period of her life. She says that she was frightfully excited sexually, and had to send her daughters from home to save them from terrible consequences; but the two boys she was able to keep at home. Patient became neurasthenic ex masturbatione (spinal irritation, feeling of pressure in head, weariness, lack of mental control), and, at times, had dysthymia and painful tædium vitæ. Her sexual feeling would be directed at one time to women, at another to men. She was able to restrain herself, and suffered much from abstinence, especially because, on account of her neurasthenic troubles, she sought to obtain relief in masturbation, though only in case of great necessity. At the present time, though forty-four years old, and menstruating regularly, she suffers intensely with a passion for a young man whose presence she cannot avoid on account of the exigencies of occupation. Patient presents nothing remarkable in external appearance. She is gracefully formed, but the muscular system is not strongly developed. Pelvis is, in all respects, that of a female, but the arms and legs are decidedly large and of masculine form. Ladies’ shoes do not fit her, but, being opposed to exciting attention, she forces her feet into female shoes, and they are, therefore, much deformed. Genitals normally developed, and present no other abnormality than descent of the uterus, with hypertrophy of the vaginal portion. On thorough examination it is seen that the patient is essentially homo-sexual, and that the desire for the opposite sex is but episodical and sensual. Thus, at present, she suffers intensely with sexual desires for every man with whom she comes in contact, but it is a more refined and higher pleasure for her to imprint a kiss on the soft, round cheek of a maiden. This pleasure is one she often enjoys, because she is much beloved as the “dear aunt” by all the “sweet creatures”; for she voluntarily does them the most various chivalrous favors, always feeling herself at such times as a man.