The fifth class is constituted by the onanism of sexual inverts, and may be called _essential onanism_. This concerns men whose sexual appetite is directed toward their own sex instead of the other. They are called _homosexual_, and mutual onanism is, so to speak, the normal satisfaction of their inverted appetite. We shall refer to this again later on. While normal sexual intercourse is the best and most rational remedy for compensatory masturbation, there is no question of it here. Marriage is the worst and most scandalous remedy in such cases. It is therefore of the greatest importance in order to judge of the nature of the masturbation, to inquire into the kind of erotic images with which it is associated. If, in the case of a man, the images are those of women, it is simply a case of compensatory masturbation; but if the images are masculine, it is a case of sexual inversion. If masturbation is not accompanied by any images, the question remains doubtful. In young children this is explained by the fact that the psycho-sexual irradiations are not yet developed; but after puberty the absence of images as an object of eroticism suggests a certain anomaly and sometimes depends on a latent tendency to inversion. =Relation of Masturbation to Hypochondriasis.=--Some onanists become much distressed, and reproach themselves for having spoilt their lives by their bad habit. They give way to lamentations before their doctor and their acquaintances, wring their hands with despair, and beg every one to come to their aid. They look upon themselves as poor sinners whose lives have been ruined, either by their own fault or by others. They have read Lamert's "Personal Preservation," or other sensational books which excite both the fear and the sexual desire of weak characters, whom they are intended to exploit. These poor devils believe themselves lost, and are truly pitiable objects. These form the types which are paraded as terrible examples in books on onanism which make timid persons' hair stand on end. When these unfortunate onanists are questioned on all the circumstances of the act of which they accuse themselves, we generally arrive at the following results: We recognize that we have to deal with psychopathic or neurotic subjects more or less tainted by heredity, timid and shunning their fellows, easily impressed by imagination, possessed of unhealthy sentiments and ideas; in fact, hypochondriacs, predisposed to look upon every sensation or slight indisposition as a grave disorder threatening their health or life. They thus live in perpetual anxiety. This mental anomaly has for a long time preceded the onanism, even if they have masturbated, which is often even not the case.