A young lady doctor, assistant medical officer to the asylum at Zurich, made her visits alone among all the males, even the most violent, without any inconvenience; while, in the female divisions, she was approached by the erotic patients as much as were the male assistants. I mention this fact because some people wrongly imagine that the sexual excitation of insane women is due to the visits of male doctors. These facts are very striking and furnish perhaps the best proof that the feminine sexual appetite is especially situated in the higher brain, while the masculine appetite is situated more in the lower cerebral centers, as we have shown above. Mental alienation is due to irritations of the higher brain, and this explains why in women it lets loose such violent sexual passions and images, and why there is so little of this in men. The sexual pathological symptoms of the insane are as follows: (1). _Erotomania_ (satyriasis and nymphomania), or abnormal exaltation of the sexual appetite. This is especially seen in acute mania, in the early stages of general paralysis and senile dementia, also temporarily or permanently in other psychoses. It is manifested by sexual excesses, obscene language or excessive masturbation. All these symptoms disappear after the attack of insanity. (2). _Sexual anæsthesia_ or _hypoæsthesia_ or even _impotence_ may occur in the later stages of general paralysis and senile dementia. At the commencement of general paralysis there is often violent sexual desire combined with more or less complete impotence. The same thing occurs, as we shall see, in alcoholism. (3). Subjects affected with systematic delirium of persecution and grandeur (paranoia) sometimes commit atrocious sexual excesses, and often tyrannize and torment in a terrible way the women who are their victims. It is especially in the religious forms of this delirium, combined with fanatic ecstasy, that the most repulsive sexual orgies occur. I have treated a patient with paranoia who, full of pious sayings, regarded himself as a kind of prophet. He made a poor girl and her mother sleep in his room and had connection with them alternately. Finally, he mixed his semen in coffee with the girl's menstrual blood and made her drink the mixture, pretending that this was a religious ceremony intended to produce a strong race. In the end he set fire to the house of these poor women.