Case 11. On the afternoon of July 7, 1874, Clemens, engineer, being on his way, on business, from Trieste to Vienna, left the train at the town of Bruck, and, passing through the town to the neighboring village of St. Ruprecht, attempted a rape on an old woman, aged 70, whom he found alone in a house. He was seized by the neighbors and arrested by the local police. At his hearing he declared that he had tried to find the pound, in order to satisfy his sexual desire with a bitch. He said that he often suffered with such sexual excitement. He did not deny his act, but excused it as the result of disease. The heat, the motion of the cars, and anxiety about his family, to which he wished to go, had confused him and made him ill. Shame and remorse were not shown. His conduct was open, his mien gay; eyes red and bright, head hot, tongue coated; pulse full, soft, beating over 100; fingers somewhat tremulous. The statements of the accused were precise, but hurried; his glance uncertain, and with an unmistakable expression of lasciviousness. To the medical expert summoned to examine him, he gave the impression of one suffering with disease,—as if he were in the beginning of alcoholic insanity. C. is forty-five years old, married, father of one child. He does not know what diseases his parents or other members of his family have had. In childhood he was weak and neuropathic. At the age of five his head was injured by a blow with a hoe. A scar one-half cm. broad by one cm. long, situated on the right parietal and frontal bones, dates from that injury. The bone is here somewhat depressed. The overlying skin is united to the bone. Pressure at this point causes pain, which radiates along the lower branch of the trigeminus. This spot is also frequently spontaneously painful. In his youth he had frequent attacks of “fainting”; before puberty, pneumonia, rheumatism, and intestinal catarrh. At the age of seven he experienced a peculiar inclination for men,—_i.e._, for a certain superior. Whenever he saw this man he had a peculiar feeling in his heart; kissed the ground he walked on. At ten he fell in love with a certain deputy. Later he had an enthusiasm for men, though it was entirely platonic. He began to masturbate at the age of fourteen; first intercourse at seventeen. Then the earlier manifestations of contrary sexual feeling disappeared entirely. At that time he passed through a peculiar acute psychopathic condition, which he described as a kind of clairvoyance. From fifteen, hæmorrhoids, with symptoms of plethora abdominalis. When he had profuse hæmorrhoidal hæmorrhage, which occurred usually every three or four weeks, he was better. At other times he was constantly in a condition of painful sexual excitement, which he satisfied partly by means of onanism and partly by coitus. Every woman he met excited him;