Keywords: anti-onanism discourse, Friedrich Nasse, Germany, John Marten, masturbation, psychiatry, sexual sciences, 19th century

published or not. The documents may come

'About confusions of the mind due to abnormal conditions of the sexual organs' by Hermann Joseph Löwenstein

Frightful Consequences, in both SEXES Considered, with Spiritual and Physical Advice to those who already injured themselves by this abominable practice. And seasonable Admonition to the Youth of the nation of Both SEXES (Laqueur, 2004: 13ff.). According to Laqueur (p. 32), the author was the 'surgeon and quack' John Marten. In Britain it was republished again and again during the following decades and became well known. In 1724 there was an edition in the American colonies, and four years later the word 'Onania' could be found in a large English encyclopaedia (Chambers, 1728: 301). It was further promoted by Tissot, one of the most influential and famous physicians of the eighteenth century. In 1760 he published the French edition of L'Onanisme; ou, Dissertation physique sur les malades produites par la masturbation, which was originally written in Latin. This work was translated into several languages. The dangers arising from onania were not only described by Tissot, but also became an important issue in literature, for example, in Rousseau`s Emile. In Germany, in particular, some teachers warned of this vice and its awful consequences. The Church preached against masturbation, as well, but relatively late. And, in the first decades of the nineteenth century, physicians took up the issue in order to explain the development of psychiatric disorders [START_REF] Gutmann | Zur Reifizierung des Sexuellen im 19. Jahrhundert. Der Beginn einer Scientia sexualis[END_REF].

As one of these physicians, Hermann Joseph Löwenstein, contributed to the discussion by publishing his dissertation, De mentis aberrationibus ex partium sexualium conditione abnormi oriundis (1823; see [START_REF] Gutmann | Hermann Joseph Löwenstein's dissertation: De mentis aberrationibus ex partium sexualium conditione abnormi oriundis (1823)[END_REF]. Three years later, another German psychiatrist, Joseph Häussler, published the text, Ueber die Beziehungen des Sexualsystemes zur Psyche überhaupt und zum Kretinismus ins Besondere (1826; see [START_REF] Gutmann | On the way to a scientia sexualis: 'On the relation of the sexual system to the psyche in general and to Cretinism in particular' (1826) by Joseph Häussler[END_REF]. The aim of both Löwenstein and Häussler was to investigate the relation between psychic disturbances and abnormal sexual behaviour (e.g., masturbation) and conditions. About twenty years later, Heinrich Kaan published his substantial work, Psychopathia sexualis (1844), which was, like Löwenstein's text, written in Latin. For Kaan, both 'psychopathia sexualis' and onania were the central points of the text. Richard von Krafft-Ebing, in his famous work of 1886, adopted the term Psychopathia sexualis coined by Kaan. The differences between Kaan's and Krafft-Ebing's works were significant: whereas Kaan emphasized the relevance of onania in the development of somatic and psychic diseases and criticized particular behaviour, Krafft-Ebing concentrated on the differentiation between several paraphilias, such as homosexuality and pederasty, and masturbation played only a marginal role. In the current versions of ICD-10 and DSM-IV, remarkable traces of Krafft-Ebing's findings can be seen, but onania is no longer mentioned because, since the beginning of the twentieth century, masturbation has not been held responsible for psychiatric disorders.

In order to comprehend why, in the eighteenth century, onania became a vice of such significance, one must venture outside of the realm of medicine. Clearly, there must have been cultural trends encouraging the rise of the anti-onania discourse, but none of these trends alone can provide an explanation for the phenomenon. It was a time when an explicit individualist culture had been established -a culture which presupposed that each human being had the capacity to make autonomous decisions. Authorities, for example Church leaders, no longer determined ethical and moralistic norms, as had been the case before; the relation between the individual and society changed. Masturbation possibly became the focus of debate because it is a secret activity: whereas sexual intercourse between individuals is 'naturally' restricted by the circumstances in which they live, the masturbator arouses himself by means of his own imagination and fantasies, which cannot be kept under surveillance. This fact must have been threatening for members of the up-and-coming bourgeoisie.

There are several reasons why masturbation lost its aura of dangerousness at the beginning of the twentieth century (Laqueur, 2004: 66ff.). There was much scientific work, for example, in anthropology and zoology, which showed that masturbation was a unique phenomenon. It was found to be quite natural and universal. It became a form of 'autoeroticism' -a term introduced by Havelock Ellis in 1899. Onania now became a type of sexuality, 'freed from the constraints of body and society' (Laqueur, 2004: 68). And, in the context of Freudian psychoanalysis, masturbation was seen as a basic form of sexuality that every person practises during his/her development towards becoming a sexually healthy adult. Finally, the Kinsey reports proved how widespread masturbation was, and showed that satisfaction from sexual intercourse and masturbation were connected.

Some remarks on medicine at the beginning of the nineteenth century

In looking at the theory of medicine at the beginning of the nineteenth century, several trends can be identified. Although the Enlightenment had considerable effects on medicine, some very old medical theories still had a strong influence. On the one hand, there was the vitalistic conviction that not only every living creature as a whole, but also every single organ possesses an inner force called 'vis vitalis' -in contrast to non-living objects which lacked this power. On the other hand, medical theory was still moulded by humorous pathology going back to Classical physicians, such as Hippocrates and Galen.

Nineteenth-century medicine evolved from the systems of the previous century by focusing on observation instead of theoretical considerations. And these observations were no longer based on only a few cases but were obtained in the growing number of hospitals built in the nineteenth century. Examination of sections became increasingly important to confirm diagnoses, although this development did not take place simultaneously in all countries (Ackerknecht, 1989: 135). Under the influence of the Romantic philosopher Friedrich Schelling, in particular, German physicians discussed exhaustively the nature of diseases and the polarities and analogies between microcosm and macrocosm. As a result, medicine in Germany was not as developed as in France or Britain.

German psychiatry in the early nineteenth century

Löwenstein wrote his thesis under the supervision of Friedrich Nasse (1778-1851). In addition to being one of the most important psychiatrists, Nasse was a disciple of Johann Christian Reil and was his successor at the University of Halle. He belonged to the so-called somatics (Somatiker), who held that the human soul is of a divine nature, inviolable and therefore unable to fall ill. This anthropological premise was shared by their opponents, the so-called psychics (Psychiker). For both sides, the theoretical foundation was much more important than empirical observations. While Nasse tried to establish psychiatry (Seelenheilkunde) as a medical discipline, emphasizing the relation between body and soul, the psychics (e.g., Heinroth) focused on the inner dynamics of the soul. In contrast to the somatics, the psychics postulated that psychic diseases arose from sins and the loss of freedom. But, notwithstanding these important differences, the psychics and the somatics had quite a lot in common, leading some authors to call this period the time of 'anthropological psychiatry' (Kutzer, 2003: 27ff.;Roelcke, 1999: 47ff.; see also Gutmann, 2006: 46-7).

Löwenstein's life

As mentioned in [START_REF] Gutmann | Hermann Joseph Löwenstein's dissertation: De mentis aberrationibus ex partium sexualium conditione abnormi oriundis (1823)[END_REF], few details are known, but at the end of Löwenstein's dissertation, there is a brief curriculum vitae. He was born in 1799 in Wahrendorf near Münster (Germany). In 1817 he enrolled at the University of Münster and studied law. After the winter term in 1819-20, he enrolled at the newly founded Rhenish University Bonn, where he studied medicine. The scientific teachers mentioned in his CV included Von Walther, Stein and Windischmann. He wrote his thesis under the supervision of his mentor, Nasse, who was one of the most famous physicians in Germany at that time and had started publishing the first German psychiatric journal for physicians (Zeitschrift für psychische Aerzte) in 1818. There can be no doubt that Nasse had a great influence on Löwenstein's beliefs. ago, with the help of a parallel he tried to establish between the somatic and the dynamic condition of the female sexual organs, what a large influence the subject matter has, so I venture to discuss it in detail, encouraged by the very famous and highly regarded Professor Nasse, in this minor inaugural work.

A man differs distinctly from a woman in terms of the inner structure of the body, as well as in terms of the features of the mind. The greater power originating from the type of the body and the stronger nervous system in men are connected to a greater mental power; on the other hand, the more sensitive nervous system and the more complicated constitution of the sexual organs, whose functions can be attacked in various ways, expose a woman to the most unpleasant experiences which a man is spared. The functioning of menstruation and the cycles of pregnancy and childbirth subject a woman to different harmful conditions, unknown to men. From all this, it becomes clear that men are much less affected by the inevitable difficulties of life and the violence of emotional shocks than women and are therefore much more seldom exposed to confusions of the mind than women. For this reason, the first part of my dissertation is necessarily shorter.

The quite limited scope of my considerations does not allow me to discuss psychic illnesses, in so far as they are connected with an abnormal condition of the sexual organs or originate from them, in an unbiased and critical way, as fully as possible with respect to today's state of the sciences; I have merely attempted, I hope not in vain, to fill the pages of the dissertation with a juxtaposition of the most striking and important symptoms of psychic confusions.

Finally, I beg the reader's benevolence, and furthermore, I beg that he might not forget that the author of this work is, so far, only a beginner in this science. I therefore claim, with justification, the dear reader's indulgence with respect to this courageous, and quite incomplete, work.

Chapter I -The Male Sex

A boy leads a happy life without worries; as he is, up to that point, physically immature, he wards off with indifference the influence of the rather insignificant effects of the sexual organs. His mind being still innocent, he chooses his friends without regard to their sex, but once the difficult years of puberty, with their important changes in the body and especially in the sexual organs, begin to challenge him more, his natural disposition, the capability of reasoning, perceiving and wanting are exposed to enormous changes. He is no longer unabashed in the presence of the other sex; as a truly virtuous boy who conscientiously follows the rules of decency, he blushes during conversations he would listen to without any stirring of the soul when he was still a boy, and the enticement from which the boy was exempt is felt by the adolescent. The formation of the system of the sexual organs as well as of the whole body becomes more and more complete. The widened larynx makes the voice deeper and hoarser. The thorax expands substantially, and as a result of this development of the thorax and its components, the male organism provides a condition, coming from the centre, which is the opposite of the developments of the female organism; whereas in women, the development of the breast, of the brain and the complete maturity of the sexual organs virtually seem to be the end of the period of puberty, in men they represent the beginning of this difficult phase because of the use of oxygen which is indeed better and more sophisticated. The entire system of the genitals is now being prepared to produce semen. The resorption of the semen, which sets in at the same time, doubtlessly endows the adolescent -however anyone may object -with the feeling of strength, courage and ambition typical of this period. Indeed, some authors argue that this resorption only extends to the more fluid part of the semen. What objection could be raised, though, against the theory that this could happen to the part of more solid consistency, too? Yes, even the living human being as a whole, including the bones and the joints, changes in a normal way. During this period, especially, many quite promising adolescents rush headlong to their own destruction while at a thriving age, and many are ruined by the frequent wasting of their semen. It often happens that, even before the secretion of the whole semen, adolescents, who are otherwise of a good disposition but have been seduced by depraved role models or other pernicious incidents, rush into this crime -onanism -which is all the more detrimental as it deprives the incompletely developed body of the substance necessary for its final formation. Gaubius has already presented the physical and psychic effects of wasting the semen so excellently that his own words are worth quoting in this work, especially the following short excerpt: "In the first place," he says, "the excessive squandering of the semen is not only harmful because of the loss of highly valuable humour, but also because of the frequently repeated convulsive movements with which it is ejected. Furthermore, the general weakening of one's strength excludes the highest lust which cannot be obtained without being noxious. Yet the more the humours are exhausted the more the 'Colatoria' of the body attract from elsewhere and, as the humours are diverted to the genitals, the remaining parts are depleted. Therefore excessive lust leads to fatigue, paralysis, progressive weakness of the loins, headaches, spasms, obtuseness of all senses, especially of the visual sense, blindness, stupidity, fever cycles, dehydration, leanness and pulmonary as well as dorsal tabes." The wasting of the semen, especially, seems to harm the functions of the stomach in such a way that it sometimes shows a great disinterest in food, sometimes a truly beastly gluttony. I found some examples of this kind myself. Instead of thriving strength, these miserable people experience satiety and decrepitude, increasing from day to day as in a decaying old man. A sluggishness of the soul to act in a determined way and fear of the future depress and vex them continually; voluptuous images hover before their eyes day and night; similar or strange and terrible dreams disturb their sleep. Like those suffering from pulmonary consumption, they covet new clothes and various pieces of jewellery; and the urge to steal has been observed many times in male adolescents during their years of puberty. As an example of such an inclination to steal, combined with the desire to obtain borrowed money, it is certainly worth mentioning how Moritz depicts a certain merchant. His features showed the effects of the secret crime, an immoderate misdemeanour in virtue of which so many young men, even thousands, have either suffered an untimely death or became feeble, lazy and useless members of mankind. The urge to commit a theft or to accumulate borrowed money makes the man who is already very much doomed to death request money from a friend with a hushed and trembling voice. Individuals of this kind become gradually less worth remembering, and finally, as a result, a despondent state of mind develops in them to such a degree that the diseased persons either despair and commit suicide or lapse into melancholy and finally mania. In the old penitentiary of Huefingen, according to a report by Johann Rehmann, there lived a certain masturbator who had killed his own sister on a field and talked about that crime in a sometimes strangely naïve way. Haindorf tells us that in Pforzheim you could see a man who was weakened by dissipations of all kinds and nearly driven to madness by his lechery: he spat incessantly all day long and, being forbidden to do so, immediately became most extremely terrified because he believed that, due to the amount of water, he would drown in it, and therefore he tried to maintain a balance by spitting whenever he was without a guard and unobserved. Furthermore, Haindorf reminds us of an obsession worth recalling, under the influence of which several of those people believed they were losing parts of their bodies, in most cases the nose, which they therefore fastened with ribbons, sometimes so tightly that they cut themselves.

For the forensic physician and the judge, the joy of and desire for fire and combustion, which occurs at the beginning of the years of puberty, are of the greatest importance. From the legislative yearbooks of Klein and the medicinalforensic examinations of E. Plattner, A. Henke adduces four cases of such an intentionally started fire. Here an observation taken from Niemann seems to me to be of some importance: it was made in a sixteen-year-old male adolescent who displayed an unconquerable drive for youthful boisterousness which finally ended in purposeful arson. I believe I have discovered that this desire for fire is connected to an evil care of the body; it is probable that the system of the sexual organs is especially affected. And likewise with demonomania, of which Eduard Quackley observed an extraordinary example of a man who roamed about greatly in his youth.

Another pathological expression of the ability to desire, which appears not only in adolescents but indeed also in old men, is a certain insatiable lustfulness that sometimes creates the opportunity for a wife to sue her husband in court. Jacob Schmid describes, as an example of this, a 70-yearold man. In two corpses of men of this kind, Salomon Albert and Johann Riolan found three swellings in the right kidney and, as a matter of fact, venae spermaticae branching off on both sides of the swellings. And, indeed, Phil. Salmuth discovered, when dissecting two corpses of this type, kidneys three and four times as large as in normal people. Because of all this, I. H. Meibom (the father) formed the opinion that this insatiable lustfulness originated from an abnormal condition of the kidneys, which was also maintained by I. Olhafius with reference to experience. Furthermore, Selle has already adduced a certain pungent smell of the urine as well as an extraordinary sensitiveness and inflammation of the uretha as causes of the increased extent of this evil. And the most famous teacher, Nasse, taught me that hysteria is often combined with an abnormal condition of the kidneys.

Sometimes, lustfulness increases to an awful extent, and is rightfully called Satyriarsis; Arataeus has already provided an especially satisfactory description of this illness: "In the face," he writes, "a flush and a certain perspiration similar to moist dew can be found; furthermore the diseased persons cringe and writhe; they are sad and despondent and do not talk as they are weighed down heavily by their misfortune. As soon as this evil finally overpowers human shyness, those people who are excessive talkers lapse into a terrible state. They are also immoderate in the evacuation of their bowels, inordinate when it comes to coition, vacillating in their mind in an indecorous way because they cannot restrain themselves; they suffer thirst, they spit out phlegm profusely, as foam it sits on their lips like in goats indulging in their lustfulness, and even their smell is not dissimilar to the odour of these animals."

It is established that gonorrhoea is usually accompanied by an increased lasciviousness.

Here I consider the sexual organs to be suitable to be related to the soul, and this is certainly, as I believe, sufficiently substantiated with reasons. I admit that Gall has presented evidence that is, one might think, contrary to my considerations; in reality, however, this is only apparently so. He maintains that the cerebellum is the organ of the reproductive drive, and the sexual organs are actually only the means for physical propagation; yet everything he adduces to prove his point does not prove it at all. One can agree with him in so far as the cerebellum is closely connected with the sexual functions, although much could be said to contradict this; nevertheless, that part is not yet the exclusive organ of the reproductive drive. As a matter of fact, though, Gall claims to have seen people who were endowed with completely mature sexual organs but did not have any sexual drive; the criticism can be made that in those persons only the external and not the internal organs were considered; what is the condition of the vital energy of those parts, though -was it as big as the organs themselves? And this is the basis of that erroneous physiological assumption, which can be traced throughout Gall's works: that this vital energy doubtlessly corresponds to the volume of the organ. Here it is obviously sufficient to say that Dr Gall has admitted in his own words that, by the destruction and removal of the genitals, the cerebellum and thus the reproductive instinct are harmed, and therefore a relationship must exist between the sexual organs and the soul. It could merely be asked whether this relationship is direct (constituted by the cerebellum) or indirect; but this can remain unanswered for our course of argumentation.

Now when it comes to the defect of certain sexual organs, their incomplete development, their pseudo-organization, as well as their double or multiple existence, the psychic physician finds this field of study totally unexplored. Baillie observed testicles in a middle-aged man which looked like the tip of a finger; Home found the same organs not larger than those of a foetus in a 13year-old boy and a 23-year-old man; Meckel discovered testicles only half the normal size, though otherwise normal, and remarkably, a larynx very much resembling that of a woman; all persons examined completely lacked any sexual desire. And James Wilson observed a case well worth remembering in this context. He depicts the following: "Several years ago, a gentleman consulted me who was about to get married; considering the rightness of his entering this stage, because his penis and testicles had scarcely increased in size compared with those of an eight-year-old boy. He was then 26 years of age but had never had any desire for sexual intercourse whatsoever before he met his future wife; since that time he had experienced repeated erections combined with nightly emissions. He got married, became the father of a family and those parts, which when he was 26 had been so much smaller than usual compared with those of grown-up man, had grown to a normal size at the age of 28."

Very many instances of men are reported who had more than two testicles. Fernel, Bartholin, Forest, Krahn, Blasius and Haller provide those of men who were endowed with three testicles (triorchids). Insfeld reports that having three testicles seems to be hereditary in certain families. And indeed, Viogtel believed he had observed such a case. Even an instance of five testicles is reported (pentorchids). Several people considered this abundance to be the cause of great physical strength and immoderate lustfulness; thus says Regnerus de Graaf: "It is established that some men have had three testicles and that this is particular in some families, as well as the cause of their unique desire. We also know that in the citizenry of Delphi, one citizen was endowed with three testicles and the father of many children." And Georg Hannaeus knew a man who was, according to reports, a triorchid and very famous and sexually excitable.

Instead of the described abundance, often the lack of one testicle can be observed (monorchids), e.g., J. Riolan and Peter Borell found only one testicle in each of two corpses, and later de Graaf and Hey, too, came across the corpse of a man with only one testicle who had produced four children with his wife, and no scar could be found in the groin or the scrotum which could have indicated a testicle removed by surgical methods. Salomon Braun reports that he encountered an administrator who was monorchine by nature and the father of many children of both sexes. M. F. Lochner depicts another instance of a man who was made monorchine by the clumsy hands of an extesticulator and who produced an anorchine son. The entire tribe of the Hottentots is described by travelling journalists as possessing only one testicle because it is a custom of the tribe to cut open the scrotum of a child immediately after birth and remove it; they believe that men with two testicles produce twins and that this is a great evil which needs to be guarded against as quickly as possible. From what has been said so far, it can be understood that the lack of only one testicle does not harm the sexual desire and the ability to reproduce.

At times either one or both testicles remain in the abdomen during the whole lifetime (crypsorchids). Corresponding descriptions are provided by Riolan, Franziskus de la Boe Silvius, de Graaf, Stoerk, Penchienati, Seger, Osiander, Soemmering, Haller and Meckel; but in other cases, observed by Ansiaux, Brugnone, Desgenette, Fabarrani, Boerhaave, Heuermann, Sonsis, Arnaud and Lepechin, the presence of the testicles in the abdomen was combined either with a subtlety of the sense of shame, characteristic of the Anulus inguinalis, or with a structure similar to a clitoris, sometimes also with a feminine habitus. On the other hand, J. Hunter observed a crypsorchid who was endowed with the physical and mental abilities of a man. In addition, Scheller was acquainted with two boys, one of them crypsorchine, the other with one twisted testicle, in whom sexual lasciviousness had already increased to an enormous degree in their fourth and fifth years because thrashing and other chastisements had been neglected. No less famous is T. Kerkering's observation of a young man who amazed his listeners by the magic of his voice and the charm of varying it, but in whose empty scrotum, which was only of minor size, not the faintest trace of testicles could be found. At the age of 18, he lapsed into a fever, was troubled especially around the genitals by a quite unbearable pain, and finally his testicles grew; the charm of his voice vanished completely. Last in this series of examples, there was a crypsorchid described by his observer, J. Wilson, in the following way: "He is a married man and has children. Before his marriage he describes himself as having great desire, and not being deficient in the power of performance." Aristotle also maintained that a rather great lustfulness originated from testicles located so remote in the body. He says: "Thus are all those who do not have testicles but only ducts, or who are not short of testicles but have them inwardly, especially willing and hurried when it comes to sexual intercourse", and later, "therefore those who carry their testicles inwardly mate more quickly". Haller seems to be of the same opinion; Faust as well as Rolfink, Bauhini, Diemerbroek, Paulini and Schurig, all knowledgeable through experience, testify unanimously to the extreme sexual excitability of such people.

Finally, when dissecting corpses testicles are hardly ever discovered, which can be seen from the examinations of Bartholomeus Cabrol ad Sennert. Cabrol reminds us of a man who in spite of having no testicles showed an extraordinary lustfulness and was actually hanged for rape. J. Wilson knew a person who retained his lust, although his testicles, crippled by cancer, had been removed by a surgeon, so sometimes when having sexual intercourse he emitted a fluid secretion from the solely remaining seminal vesicles. Wilson says, "I was assured by this person that, after the removal of the testicles, he had occasional erections not unaccompanied with desire, and when as a married man he indulged, these were attended with the usual paroxysm and emission of some fluid, and, from his descriptions of its colour, consistency and other properties, I could not doubt it came from the vesiculae seminales." The points Benedict Mojon made about the characterisitcs of people castrated by surgical methods can be applied to people castrated, as it were, by nature. Their voice resembles that of a woman, they do not grow beards, and their mental abilities are, as experience shows, restricted as a consequence of the castration. Nature endowed man with hunger so that he would be concerned about his own maintenance, it planted love in him to preserve his species. However, it is completely different in eunuchs, which will be proved here; he sees and thinks only of himself and therefore develops into a misanthrope. To him, death seems far more horrible than to the rest; whereas the upright family man, who recognizes an image of himself in his children, approaches death with indifference. Never is the holy feeling of friendship going to consolidate in a eunuch's heart. It is a definite, though hardly observed fact, that eunuchs are subject to attacks of periodical haemorrhages especially from the haemorrhagial vessels, which B. Osiander observed in several beardless men, and already Zacutus Lusitanus was "acquainted with such a beardless, effeminate man, without any hairs on his body, displaying the figure of an adult woman or a eunuch, in whom monthly menstrual bleedings emanated from the genitals for four or five days in not insignificant amounts, from his twentieth to his 45th year."

Chapter II -The Female Sex

As in men, for our purpose the sexual system of the woman is of minor importance until the girl reaches the years of puberty. In the same way, however, during that time the forming vitality becomes more effective, and this process of life progresses to greater dynamic ways, which shows in the fact that during this time the reproductive system becomes qualified for its actual functions. Orgasms, blood congestions, change of the colour of the face, exanthemas, hairs in several places as well as the formation and development of breasts occur. The brain and the soul are especially affected by the reproductive system. Just at this time, the difference between the sexes rises fully to the consciousness for the first time, and in animals the virtuous love to behold a body increases to a passion, a passion which has to be counteracted during the periodic efflux of blood now commencing, i.e., the menstruation, according to the opinion of the very famous Professor Stein. Up to the present day, experience has taught that a delayed menstruation is highly disadvantageous to the state of the health of body and soul. Among others, Adam Nietzki describes observations in women who never experienced menstruation "being completely healthy and fertile", "but these cases are rare", he adds. Fears, dizziness, headaches, mania and melancholy are often symptoms of delayed menstruation. Plenk advises us that in female suicides, sometimes signs of a delayed menstruation had been found. The mental confusions occurring in women during this time, although they should be considered exceptions to the rule, deserve special mention, as well as the pathological symptoms of the external and internal perception, excesses of fantasy, the urge to talk and to do the opposite, fanaticism, talking or walking in their sleep, nightmares, apathy, dementia, even the perception of external things unknown to the senses in a healthy state, and indeed the vision or perception in a remote place (rhabdomantia), the apperception of the future either only with a certain gloomy feeling (praesagium) or with a clear-sighted conscience (divination), auto-somnambulism, of which my former fellow-student Dr Gereke just recently observed a remarkable example. Nevertheless, it is not to be contended that these gloomy forebodings and quite certain suppositions can be found in a non-somnambulistic state, too, which can be proven by several observations with regard to the ability to forebode that were gathered by Osiander.

Especially relevant is the history of the Aurelianic Virgin, who was burnt as a witch at the age of nineteen in Rouen in 1431. She had never had a menstrual period; in spite of that she was a true and untouched virgin, which was found out in an examination carried out by the Queen of Sicily and two noble dames. At times, the efforts of menstruation, spurred on by only one circumstance, can produce a great desire for sexual intercourse and give rise to the most wondrous changes of the nerves of life which show in idiosyncrasies, spasms, epilepsy, St. Viti Chorea and somnambulism. The different anomalies of menstruation create the most varied psychic confusions. Occasionally, menstruation starts too early. There are observations that it has occurred in the seventh, fourth, third and even in the second year, and it is even reported that little babies have menstruated three, five and nine days after being born. A decrease of physical strength and body size, a loss of the healthy colour of the face and of the usual energy and cheerfulness, a restless and disrupted sleep and an early death are often consequences of these premature menstruations.

Almost the same also applies to extreme and frequent menstruations. Suppressed menstruation caused mania in a woman that Lieutaud considered to be due to a sealed haemorrhage of the uterus; a mania of the same origin, combined with convulsions, was observed by Cordat; a mania arising from amenorrhoea that resulted in death because of the involvement of a bronchus was recorded by Schenk; Bauzmann observed a fury that would always occur at the same point of time of menstruation; Schurig writes that amnesia originates from amenorrhoea, too; the same author remarked that mental illness, furor uterinus and dementia all have the same cause. Earlier, Hippocrates observed that a beard in a woman is caused by suppressed menstruation. In the same way, Zacutus Lucitanus reports a corresponding case of a certain woman that suffered from suppressed menstruation and declined the venesection he recommended: "On the advice of another physician, she swallowed the squeezed juice of the aloe three times; the day was not yet over when, flung down by a violent lumbar pain and masses of blood bubbling forth from near the Arteria Dorsi, she was seized by dizziness, muteness, an ignorance of all things, a stupor of the mind, oblivion and a delirium", and after two hours she died.

In addition to these psychic confusions originating from an anomaly of the menstruation, much has been said recently about pathological symptoms of the mind with regard to the physical and legal effects on human society in general, as well as with particular regard to the most aggravating effects concerning the individuals themselves. Above all, the desire for fire and arson, which very often occurs during the years of puberty in boys and girls, belongs here. Some of the girls had neither got fully mature sexual organs nor reached the state of a woman's regular periodic flow of blood; some of them were, according to their own confessions, obsessed with the idea of lighting a fire, which they could not get rid of until they had actually lit one, but after that they were seized by happiness as never before; some believed they saw a shadow hovering before their eyes or continually heard an inner voice that urged them or commanded them to light a fire and kill themselves or others; again and again they would, at the same time, vehemently desire to watch a great fire. Klein and E. Plattner alone provide 17 examples of girls of this kind. Here, one Maria Friedrich should be mentioned, whose story can be read in A. Meckel from a medicinal-forensic point of view, and whose last sentence shows us that the desire for fire and arson has originated like a developmental disease, partly from a delayed period of puberty, partly from an anomalous irritation of the genitals. How many other cases of this kind have gone completely unidentified and will remain thus! It is necessary for me to mention onanism especially and its effects that upset the mind and the body. It must be stated that the amount of confusions that can quickly result from this pernicious desire and sometimes really occur is nearly infinite. The virgin of that disposition lacks energy, her figure changes, her eyes become hollow and sad, her soul freezes and becomes sluggish, her imagination and memory get lost, her excessive sensitiveness becomes bothersome, and hysteria emerges. Bad or no digestion, irregular menstrual efflux, aversion to a legitimate marriage, different kinds of spasms, epilepsy, catalepsy, melancholy, mania, nymphomania, naïvity, etc. These and other ailments are derived from onanism. It is not unusual to find examples of this anomaly of the functions of the body and the mind listed in books of psychological practice. Among others, Haindorf observed such a case which is worth recalling. A 34-year-old woman had been acquainted with this crime since she was six years of age when the father rocked the girl when she was sitting on his knee. Since her twelfth year she had exercised onanism and also sexual intercourse for several years, seemingly without being harmed by this disgraceful life. Finally, being married for the second time and not getting along with her husband, she lapsed into melancholy and mania. In hospital in Wuerzburg, her mania subsided quickly; but her melancholy and a certain fixed idea that she had killed her first child remained. Often, terrible memories hovered before her eyes. She abandoned any hope of ever recovering her full health.

Among the developmental diseases in adolescent girls, B. Osiander identifies a corresponding pathological symptom, the doubtlessly mysterious melancholy, which sometimes originates from an amorous melancholy experienced in the years of puberty. "Never", this author says, "is a girl purer, more tender and more inclined to secret love, never more flourishing, more passionate and yet more desirous and lascivious than at the beginning of the years of puberty, most often before the monthly period commences or occurs regularly. During that time, many girls of sensitive emotion and a more susceptible soul develop an amorous melancholy which is judged to be of minor importance in Germany, but is rightfully believed to be a serious illness in Italy; it is neglected and often it develops from love either into chlorosis and consumption or into mania or leads to suicide. In the strange symptoms of a girl thus diseased, our ancestors firmly believed they were seeing the effects of a demon, and they believed that the ill girl was either innocently obsessed by him or that she had created the cause and opportunity of these symptoms herself through a punishable agreement with the best demon. Earlier, the physician Pope Innocentius X, the very famous Paulus Zacchias, said about people possessed by a demon, "Yet who will be the ones possessed by a demon is not what we will explain, because every reader is closely acquainted with this; however, the ones to be described as possessed by a demon in a characteristic way are those who are driven from the malady of melancholy into madness and who the devil uses as his tool. It is better to have mentioned straightaway that many people, but especially idiots and lewd females -mostly the virgins -, who do not have a justification because of their mature age, are considered to be possessed by a demon, though in reality they are not."

Sometimes the course of a pregnancy is accompanied by the greatest psychic confusions, too. After having had sexual intercourse, the woman is despondent and becomes indifferent, freezes, and gnaws her teeth, according to an observation of Hippocrates. The functions of the mind are significantly slowed down in pregnant women and do not measure up at all to tasks that demand some effort of the mental powers; subject to wrongly connecting ideas, a change of personality and strange fantasies, they are not equal to the tasks continually challenging the mind and are left to the mercies of sleep, wrath and melancholy in a high degree. At times, pregnant women, especially during the last critical days of their pregnancy, are vexed by insomnia, or they sleep a most restless sleep disrupted by different dreams. Furthermore, the symptoms of dizziness and a lack of wit which often develops into a completely asphyxic state, belong here. The appetite for food, especially for quite nutritious foods like meat, bread, etc., not only decreases but changes into a most significant disgust at food, or often into an odd appetite caused by the vivid desire for things formerly unpalatable like chalk, limestone, etc. A relevant example of such an odd appetite, a ravenous hunger, is provided by Langeans: "A certain pregnant woman felt such an appetite for her husband's flesh that she killed him and kept a certain part of his flesh in salt in order to be able to savour him longer." Sauvages gives a report of a certain woman who "desired so strongly to eat the upper arm of a baker that she urged her husband, with any reward imaginable, to detain the baker in order that the wife could be satisfied with two bites." At times, this ravenous hunger in pregnant women can become so powerful that the ill persons no longer act according to their own free will. Thus a woman from Amsterdam, about whom Unzer reports, according to Blancardus, "who, when she was pregnant, at certain moments felt a great desire to steal. She had stolen many times from a merchant, to whom she finally confessed, when he pressed her with harsh words, that she had committed one single theft while she was pregnant, and in a generous manner she reimbursed him." Not unusual are examples of women who lapsed into melancholy, dementia or mania once or many times during their pregnancy, and were only relieved through the act of giving birth. Wolfart mentions a woman who, every time she was pregnant with a boy, became totally mad from the third month of pregnancy until the birth of the child; after that, though, she immediately regained her healthy state of mind. A. Henke describes the observation in a woman who had already been pregnant nine times and each time was seized by melancholy, and who believed each time that she was doomed to death and killed and poisoned her two daughters with opium because of the fixed idea that they would be deeply unhappy after her death.

A long series of observations shows that the normal functions of the mind in women who are in childbirth are often most vehemently affected by the birth; Bonetus mentions a woman who lapsed into such an insanity when giving birth that she called herself a devilish fury in public and, jumping suddenly out of bed, cried with a gloomy expression, "I am the devilish Tisiphone, I am the burning soul!" and attacked her husband's face and eyes with her fingernails. Several observations of such women who lapsed into insanity during childbirth are provided by Esquirol, Chiarugi and others; Esquirol reports that of 119 women who were taken into the so-called hospital Salpetriere in a state of dementia during the years 1811, 1812, 1813 and 1814, 92 had lapsed into dementia shortly after giving birth.

Disgusting is the illness that scoffs at the female nature, which is firmly rooted in customs and bashfulness, and therefore makes for a very heinous sight, and it shows in a lust for the stronger sex that exceeds every reasonable measure and wins the upper hand over power of judgement and conscious thinking, and is then nymphomania or hysteromania, andromania or furor uterinus, etc. The ill women indulge incessantly in fantasies of love and lust, and everything, even the greatest pleasure, means little to them unless it can serve to increase their lustfulness. These women are not fit for work, despondent and lost in their own thoughts, and they talk either very little or to themselves in a gloomy and hushed voice. The diseased person feels that a part of her better self has succumbed to a rude and vehement stimulation, and lapses into a deep emotional affliction. The patients resort to the most disgraceful devices to achieve their ends. Gradually, they lose all their sense of shame, reason and power of judgement, and the confusion finally reaches the highest degree, as in mania, ranging from the most vehement fury to a taciturn melancholy; during a manic fit they roar and rave extremely violently; they address men from out of their windows, undress themselves, masturbate even with a large crowd of people present and attack those who object to their desire. During lucid times in between, they lapse into the deepest melancholy, then they sometimes remember their obscene actions, and in cases where they had, as young girls, been brought up to perfect virtuousness, their depression and melancholy increase to such an extent that they often kill themselves, as observation shows.

Examinations of this matter have not at all proven the essential or close to essential cause of this miserable illness sufficiently. The physicians of old times believed it to be the acrimony and effervescence of the female semen; Carus considered a chronic inflammation of the ovaries to be the origin of all these symptoms; and indeed, Reimann and others mention erethism or an inflammation of the genitals or of the uropoetica system as the cause of this disease.

In the dissection of corpses, a clitoris which was exceedingly big, hard and scratched and showed ulcers in several places, a portio vaginalis which was situated in an unusual way deeper in the vagina than in healthy and virtuous women, and swollen labiae of the mouth of the uterus that looked inflamed and purulent were found; the ovaries were in most cases very big and covered in a slimy liquid; the extremely reddened Fallopian tubes were totally or in parts destroyed by bloody pus.

In the psychic symptoms of nymphomania, a comparable illness is the inflammation of the ovaries or oophoritis. Clarus has described this disease distinctly, and I have therefore largely followed him in the present description of the ailment. The natural disposition preceding the outbreak of the disease shows at times in anxiety, roughness, being hard to satisfy and inclined to fury, at times in unusual mental energy and boisterous cheerfulness, at times both in turn, but always, at least in the cases Clarus had been able to observe from the start, an inclination of the imagination, sometimes more subtle, sometimes more obscene, to lascivious matters. Often, the illness commences suddenly without clearly defined indications, stirred by an incidental cause, with the most violent epileptic or cataleptic symptoms which sometimes recur in the course of the disease. Most patients have obtuse, anxiously rolling and widely opened eyes, as well as an expression apparently showing the knowledge of a guilty conscience, and this sometimes changes abruptly into a soft laughter distorted by pain. Suddenly they start crying loudly, while at the same time they portray the fantasies they turn over in their soul with lascivious talk and movements, or utter invectives and blasphemies, or recite or sing verses, or conceive cacophonous and absurd rhythms. Often, at the same time a certain continuous movement of the legs can be observed, which they draw near at great strength and speed and then push back toward the far end of the bed repeatedly, and this happens especially in a more advanced state of the disease. During his frequent clinical examinations, Clarus often observed that the symptoms of the disease grew worse at the sight of many handsome young men.

A very remarkable disease to be included among these is the so-called hysteric catalepsy, the strange symptoms of which were observed and described in detail for the first time by Petetin and about which Dr Renard recently contributed more significant material. Petetin observed without doubt "that in hysteric catalepsy, the sense organs have forfeited their power of perception, and that in this illness only the conscience and the movement in space up to the visual sense [sic] are suppressed, and that either all or some of the external senses are moved to the lacuna of the heart and the farthest limbs of hands and feet, while at most times the limbs are inclined to adopt and remain in all positions that we put them in." According to Renard's observations, it is more probable that this hysteric catalepsy can originate from an inflammable disposition of the ovaries or from an actual oophoritis.

One of women's diseases that is still quite obscure is hysteria. The psychic and physical symptoms of this illness are so manifold and some of them are so strange that they often caused our ancestors to believe they were sorceresses and possessed by an evil demon. Most hysteric women have a restless sleep, even a real insomnia, sometimes accompanied by upsetting, life-depicting dreams, talking or even walking in their sleep. In a waking state, their soul is exceedingly touchy, so extremely quickly do the different moods of their soul change, minor incidents enrage them violently, and lead to sadness and tears; the totally dominating melancholy of a woman thus diseased often changes from one moment to the next into cheerfulness, and therefore the adage is true of them, "With one eye they are laughing, with the other they are shedding tears at the same moment." Yet, hysteric individuals distinguish themselves especially by an extraordinary verbosity, from which often all the minor symptoms of the illness develop, sometimes to the most significant extent, and it is especially important to describe all the most violent, most dangerous and most unbearable symptoms of those hysterics; sometimes they even resort to lies they have to invent and feel offended when the physician does not judge their illness to be that serious; after all, the depressing mood of the soul is combined with it, as already described excellently by Joanne Purcell: "Lastly", he says, "we observe that those who have laboured long under this distemper are oppressed with a dreadful anguish of mind and a deep melancholy, always reflecting on what can perplex, terrify and disorder them most; so that in the end they think their recovery impossible, and are very angry with those who pretend there is any hope of it. The least contradiction to their will casts them into violent passions; they are fickle, wavering and inconstant, now deciding on one thing and immediately changing to something else, which they presently quit; and indulging their distemper, they decline all diversions." Authors of the past, among them Johann von Beverwyck, thought that the most probable cause for hysteria was the retention of the semen or the blood in the uterus as a result of which the uterus suffers an irritation: "This retaining of the semen and the blood", says this author, "which is always in need and gets poisoned, whereby the uterus suffers an irritation, has tried itself to compensate that." Authors of our time, among them Elias von Siebold, believed they had discovered the location and cause of this evil in a pathologically increased sensitiveness of the abdominal organs, especially the stomach, sometimes the uterus. Other scientific teachers of high rank, e.g., Fredericus Hoffmann, maintain in line with the physicians of the past that hysteria originates from the uterus, "we are indeed convinced, as the most ancient physicians were, that the first origin of hysterical symptoms has to be believed to lie in the uterus, its membranous and vasculous substance and the corresponding vessels, especially the spermatic ones." And the very well known Professor Nasse taught me that hysteria can originate from the heart and kidneys as well.

Yet the ways in which the anomalies of the other genitals affect the mind have in part been observed and reported only scarcely, in part not at all.

The hydrops of an ovary, which, according to the assertion of Curtius Sprengel, is always accompanied by a white secretion, causes especially grumpiness and melancholy as the disease advances. These patients detest sexual intercourse; they are stricken with a terrible pallor and coolness all over their body. The desire for food is gone, disgust or a perverted craving occurs, the soul is sluggish and lingering. In prostitutes, J. F. Meckel nearly always found bigger or smaller serous follicles, originating either from the ovaries, the tubes or the ligamentae lata of the uterus.

When a scirrhous uterus develops into a carcinoma, exhaustion and a grumpy manner occur, and those affected detest sexual intercourse and do not feel any lust when involved in it; the ill woman is tortured by continuous sleepless nights, constant fear and satiety of life.

At times, some part or another of the system of reproductive organs is completely missing. For instance, Baptisita Morgagni observed a lack of both ovaries, and Walter a lack of one of them, and J. F. Meckel found in a certain 30-year-old woman, who had given birth shortly before she died, that the left ovary was missing though the spermatic vessels were totally normal. A lack of both ovaries was also observed by Ch. Pears in a virgin, Anna Josepha from Radnorshire in North Wales. Although of a gentle nature, she could get furious and vengeful. Since her tenth year she had not grown any taller and had never menstruated, and no other mental or physical signs of puberty could be found either, not even at the age of 29; on the contrary, she always displayed a malevolent temper towards adolescents.

At times, the uterus is completely missing; these cases are mostly combined with a lack of all other genitals, however. Zacutus Lucitanus describes the observation of a certain woman whose prolabated uterus was removed by a surgeon when she was 22: "she healthily lived until her 52nd year, performing the domestic duties in a most proper manner; she had sexual intercourse, but without any feeling of lust." Observations of cases of the uterus missing from the beginning were made by Meyer, Engel, Seron, Morgagni, Theden, Oberteuffer, W. J. Schmitt and Professor Stein, whom I revere. The last named had the opportunity to make a strange observation in a young woman who had been married for about six years and, although she had a perfectly feminine body shape, had actually never menstruated. An observation provided by W. J. Schmitt, which is worth mentioning for our purpose, is the case of a girl of special moral insensitiveness who indulged in every possible exploration without being ashamed, even in the presence of the fiancé selected for her.

Morgagni observed in a 66-year-old woman, who had never conceived any children from her very strong husband during their marriage, that she had extremely small external genitals and her inner vulvas in particular were so small that their rudiments could hardly be discerned.

The smallness of the parts of the sexual organs must be contrasted with their abnormal size. An abnormal size especially of the clitoris was always considered to be a sign of increased sexual excitement. Zacutus Lucitanus describes such a case in a girl in whom he carried out the amputation of the superfluous part with the greatest success. Several observations of this kind are also provided by de Graaf. A bigger clitoris is not unusual, particularly in the warmer regions of the earth. Albucases had stated this about the inhabitants of Arabia.

APPENDIX

On the history of hermaphroditism

It is clear that, when properly discussing the psychic abnormalities originating from anomalies of the genitals, one must, without doubt, also take into account the psychic conditions caused by the ambiguity of the sexual system, so-called hermaphroditism. If we define a hermaphrodite, following J. D. Metzger, "a creature that possesses the sexual organs of both sexes equally developed and that can use both parts successfully, however they please", then hermaphrodites exist in reality only in the lower species of animals, e.g. Molluscis acephalis, and certainly in several families of the perch species, e.g., Percae Marinae, etc. In human beings, however, only approximations of hermaphroditism can be found. One of the first degrees of approximation is constituted by so-called feminine men and viragos. I have already given examples of the former; with regard to viragos, it is not unusual to see ageing women who changed after the function of menstruation was extinguished, and also after it had been suppressed in earlier life. J. F. Meckel, referring to Vaulevier, describes this in a girl who had always menstruated in a completely normal way, but the function of menstruation suddenly disappeared in her 20th year and who, when she no longer had menses, grew a thick black beard. All over her body she grew dense black hair, and at the same time a hoarse voice emerged. Vicatus reports on one girl who had fallen ill with consumption after having lost the function of menstruation, and grew a beard the length of a thumb in the months preceding her death, which grew much longer in the last days of her life. The changes occurring in animals of a maturer age also belong here, three examples of which are provided by J. Hunter, among others; he describes chickens that, when growing older, lost their female plumage as a result of their flying feathers and down falling out and subsequently developed male plumage as well as tail feathers particular to the male sex. Rumball observed a duck who laid and hatched eggs in a normal fashion until her eighth year, but after that changed her plumage until she displayed the twisted tail feathers characteristic of a drake, and she even performed sexual intercourse with ducks in the water like a drake.

Similarly, examples exist of antlered hinds. J. F. Meckel emphasized that the sexual drive was often very much in opposition to the shape of the genitals and the whole body; it seems to me, though, that this opinion is only ostensibly true. A normal shape and inner structure of the genitals also make for normal functions, and this goes for the whole body, and this normality of the functions of the body's organs seems to be connected solely to the functions of the mind which interact with them in a normal way. That is the reason why in women, for example, those hermaphrodite apparitions appear when the genitals have been subjected to a change of an unusual kind, as a result of which the normal flow of menstruation, etc., is disturbed.

After these introductory words, I will now add a case that is well worth mentioning and has not yet been described by another author.

All of the following refers to the 17-year-old Heinrich Bessenich from Seelingenthal near Siegburg. In his youth he was unique with regard to his susceptibility to and affability towards his peers -irrespective of their sex; in a sincere spirit he approached other people, stroked and kissed them. Playing with wooden horses, whips, dogs, real horses, etc., were most agreeable occupations to him, and he preferred to pretend to be a soldier, never playing with dolls or other girls' toys. His mother reports having repeatedly seen penile erections during his years of puberty, but never stains on his clothes or sheets. Shortly before his disease became apparent, the mother repeatedly discovered his most intimate intercourse with a female servant, and once it seemed to the mother that he had been seduced by a passion of the servant; the mother showed him her indignation at this. From that time he became sad, shy and ailing. The outbreak of the disease manifested itself in a yellow complexion, the skin looking dirty and impure, the vital energy decreasing more and more, etc., but without the young man complaining about impaired health or debilitation of his strength. After a while, certain abdominal ailments emerged which were attributed to the presence of worms, and an abdominal tumour in the umbilical region was diagnosed for the first time in July last year, which was nearly circular and elastic and, on palpating, turned out to be of the circumference of a washbowl. At about the end of July last year he was taken into the clinical-medicinal hospital managed by the famous Professor Nasse where I had the opportunity to see him myself. The abdominal tumour was spotted by the disorganization and induration of the peritoneum. The patient stubbornly resisted a closer examination of his genitals. In August he returned home. There, the abdominal tumour was joined by an ascites. Twice, the much revered Professor Nasse had to remove water with the help of a puncture incision of the abdomen. However, at the end of last year the ill man died. The anatomical examinations carried out by the famous professor and p.t. [praemissis titulis, with titles given in advance] Dean Mayer when Heinrich B. was still alive, and later on his corpse, produced the following, which the highly regarded dean gave me, on request, with his usual amiability. The external genitals all exhibited the shape of hypospadia with mainly male characteristics. In his entire physical appearance he displayed a mixture of the male and the female type. On the dissection of the corpse, a large tumour was found in the abdomen which occupied nearly its total space and very much resembled those scirrhous-hydropic tumours of the ovaries that are often equally enormous. His serous and hydatide follicles contained almost three jugs of water. After these had been empted, the tumour still held 22 3 /4 ounces. Mere traces of testiculi were found. A vas deferens seemed to be missing on both sides. Both seminal vesicles on both sides contained, as in a man of normal shape, a brownish liquid crystallizing as a result of dehydration to unequal rhomboids. Between the two there was a duct which was absolutely the same as an incomplete vagina and an incomplete uterus, both in shape and inner structure. In every way, a similar blending of male and female qualities in the shape of the internal genitals and even in the other intestines of the body can easily be recognized.

As the connection of the parts was been completely destroyed by those who dissected the corpse a long time ago, only a thorough and careful examination, to be done by the highly esteemed Professor Mayer himself, can explore the destroyed connection of the parts and shed more light on the case.

Judgements arising from the above

Finally, I want to talk about certain aspects of three sets of questions, the complete explication of which would be highly significant to the psychic physician:

1. What is the kind of psychic confusion that originates especially from the sexual organs? And what role does the mind play in this?

When we, like C. A. Eschenmayer, understand by "soul" the ability to feel an emotion, and want to judge the quoted observations accordingly, it becomes clear that especially the confusions of the soul originate from the sexual organs in general. These abnormalities of the soul refer to the perception of the pleasant and the unpleasant, which is sometimes increased, sometimes decreased, sometimes spoilt. Through the sexual organs, inclinations turn into desires, and virtue, though also dependent on instructions of the mind, is repressed and oppressed. In this way, for example, the inclination for the other sex, which hardly shows in a boy's soul until the period of puberty approaches, increases to yearning and desire because the influence of the sexual organs is gradually increasing and real semen is secreted; admonitions as to the moral sense are indeed discouraged because this inflames desire more, and thus onanism emerges. And the same goes for satyriarsis, nymphomania, the desire for fire and arson in boys and girls, the different ravenous hungers of pregnant women, etc. The conclusion from the observations cited therefore confirms the opinion of Maximilian Jacobus, "the soul (animus/Gemueth) or in general the so-called heart are [sic] the origin of every real confusion of the mind." And I agree with Hartmann who says, "through the livelier development of the sexual organs during adolescence, through their extensive power affecting the rest of the body and through the increased activity of the whole nervous system during that time, a larger number of new feelings are awoken, from which representations of an obscure, not yet clearly defined yearning gradually emerge, and consequently, through the thus arising desire, the studious effort to satisfy that desire." Therefore the system of the reproductive organs, because of its connection to the psyche, seems to me the counterpart of the heart; and, indeed, as the highly esteemed Professor Nasse shows, the illnesses of the heart mainly affect the ability of the soul to feel, whereas the illnesses of the sexual organs above all and especially affect the ability of the soul to desire, as becomes obvious through the observations mentioned in my dissertation.

2. In how far does the one sex differ from the other in this matter?

From the observations given above, it seems to emerge that the other sex is subject to psychic confusions caused by illnesses of the sexual organs to a higher degree than the male sex. In the introduction to this little work, I have spoken of a certain cause promoting this, which I need not repeat here.

However, this declaration which we can make, and even affirm, with regard to those confusions of the mind connected to, and having originated from, anomalies of the sexual organs, is modified in manifold ways when it comes to confusions of the mind in general. For instance, the disposition for an alienation of the mind is different in different tribes: in England there is a larger number of insane men, in France there are more insane women. The cause and origin of this fact are probably to be traced back, in addition to climatic conditions, to specific national and religious conditions which affect the soul more or less, to the general way of life particular to a tribe, etc. Furthermore, the two sexes differ in the following way: psychic illnesses in women tend to exhibit a disposition towards confusions of sensation, whereas those in men tend to exhibit a way of [sic] pathological ability to desire. A woman sheds tears and whines, painful sorrow gnaws away at her soul and throws her into a deep melancholy; a man courageously defies his fate caused by hostile gods, and, endeavouring to extricate himself by his own forces, lapses into mania. Although no stranger to pathological desires and mania, a woman experiences these illnesses in a way similar to a quickly passing flash of lightning, whereas a man's anomalous desires and mania can be compared with an ongoing storm involving thunder and lightning. In the former you will always see, sometimes more sometimes less, the distinctly excited faculty of sensation as a basis of abnormal desire and mania.

3. How far can illnesses of the genitals be inferred from psychic confusions?

The answer to this question would doubtlessly contribute enormously to the diagnosis of alienations of the mind, but the dice have been thrown in vain with regard to this answer. According to the observations quoted above, most psychic confusions originating from anomalies of the genitals are combined with an intention of the imagination towards lustful things which is sometimes subtle, sometimes obscene; in general, as has been stated before, in the majority of observations an anomaly of the ability to desire exceeds the other confused faculties of the soul; but although it does not yet allow us to be convinced of the existence of a certain disease of the genitals, it does provide us with the prime clue out of many to direct our attention towards the sexual organs. The lively faculty of sensation and desire which is in most cases firmly connected to the sexual function -a fact that is only rarely observed, however -can give us more lucidness than the others. When dissecting the corpses of women seized by mania, we very often find morbid ovaries. In 135 observations of mania combined with an anomaly of extracerebral parts, only four cases of an organic anomaly of the uterus were found, according to Scipio Pinel. In certain cases when an increased lustfulness had preceded, an exceedingly large clitoris was found; in other cases, when decreased or lacking sexual desire, or the strongest disgust at it preceded, several organs of the sexual system were discovered which completely lacked one or more parts, etc. From all this and the entire work, it now certainly becomes obvious that the influence of the genitals on the functions of the mind must be estimated as strong; nevertheless, an anomaly of a certain sexual organ cannot necessarily be deduced from confusions of the functions of the mind. An illness of one or more parts of the sexual system need not always be combined with confusions of the functions of the mind, and some anomalies of the genitals have been found in the corpses of people who did not show the slightest trace of any confusion of the mind in their whole lifetime. Therefore a certain disposition of the soul, a certain particular intention of the different faculties of the soul which can be aroused by the manner of education, and various disadvantageous circumstances which abound, seem to be necessary in order that the illnesses of the genitals simultaneously create an anomaly of the psychic abilities. However, it must not therefore be deduced that I agree with the theory of those authors who maintain "that the morbid conditions, which precede or accompany the development of insanity, e.g., suppressed menstruations, a suppressed flow of lochia as well as disorders of other organic tools, must be considered to be not causes but effects of the states of the brain." In order to substantiate this view, Georget has cited several cases in which he reports that he had predicted certain unfortunate developments even before the patients lapsed into the greatest fear; only after that had the function of menstruation been irregular and suppressed. I want to oppose this opinion with only one case out of many: "a youthful woman suffered a miscarriage in her second pregnancy, and consequently a most aggravating haemorrhage of the sexual organs, by which she was extremely upset, and after several days she had a terrible dream from which she awoke seized by the severest mania." And likewise, at this point I want to remind those who maintain that the dream must be attributed solely to the influence of the brain and thus mania emerges solely as a result of the influence of the brain, that the haemorrhage has at least created a favourable climate for the influence of the brain and the dream. Do they really want to maintain that the abundance, abnormal location, etc., of certain parts of the sexual system do not have any effects on and consequences for the state of the brain?

Certain authors believe with regard to lasciviousness, onanism, etc., that the cause of these evils could be exactly determined during the period of mania, but their opinion is wrong; there do exist maniacs who, before they lapsed into mania, had never sinned against chastity, but in the period of mania became highly lascivious people; and others, who had been lascivious before the time of mania, remained in that period innocent of any guilt in that area. If it were true that during the period of mania the origin of the evils of lasciviousness, onanism, etc., can be demonstrated, one could hardly understand how lasciviousness and onanism have been found to such a degree in amentia congenita and cretinism; it cannot possibly be shown here that cretinism has originated from lasciviousness and onanism.

Curriculum vitae et studiorum

I, Hermann Joseph Löwenstein, Westphalian, was born on 26 May in 1799 in Warendorf near Muenster. My very highly esteemed parents, Bernhard Joseph Löwenstein and Maria Catharina Muermann, gave their consent to my first preference for the sciences, and so, after completing the usual first years of school, I attended the lower classes of the gymnasia in Warendorf and Muenster for five years, and I had my first lessons in the vernacular language, Latin, and also Greek, and at the same time I collected the basics of the ancient history of the Romans and the Greeks, of mathematics, geography, etc. In order to pursue my scientific occupations, I arranged to be enrolled in the University of Muenster on 25 November 1817, and there I engaged in studying jurisprudence, and in the winter semester I attended the lectures of cl. [colleague?] Laymann on logic and psychology, cl. Rath on the theory of curves, cl. Sprickmann-Kerkering on the history of the German empire and cl. Schlueter on Tacitus' Annals; and during the summer semester the lectures of cl. Laymann on logic, cl. Waldeck on natural and international law and cl. Meyer on the institutions of Roman law. I spent the winter of 1819 at home where I was lovingly introduced to the art of medicine which will always make me happy more than all other sciences, and prepared myself as best I could for the new academic career. After the end of the semester I applied for the University of Bonn, attracted by the fame of the newly founded Rhenish University of the Prussian Empire and its most famous professors, and on 29 April that same year I was enlisted among the members of the most splendid university by the magnificent Rector Huellmann and the esteemed Dean Harless. For four years I benefited from the scientific erudition of the most illustrious professors of medicinal science, surgery, obstetrics and philosophy, namely, through Freudenfeld in his introduction to the subject of philosophy and to logic, through Professor Arndt to the Germany of Tacitus and of modern history; through Goldfuss to the natural history of mammals and birds, zoology and mineralogy; through Kastner to a short synopsis of all physical sciences, experimental physics, experimental chemistry and forensic chemistry; through Windischmann to the history of medicine, through Nees von Esenbeck the Elder to general botany, through Nees von Esenbeck the Younger to the botany of cultivation and cryptogamy, through cl. Mayer to general anatomy, pathological anatomy, osteology and syndesmology, special anatomy and special physiology, through cl. Nasse to special physiology, through Harless to general physiology, general pathology, the medicinal subjects connected to the general principles of therapy as well as to venereal diseases; through cl. Nasse to general therapy, the pathology and therapy of fevers and inflammations, diseases of the nerves, pathological formations, diseases of secretions, the introduction to the clinic, through cl. von Walther to the pathology and special therapy of surgery, the execution of surgical operations, the theory of bandages, fractures and luxations of the bones, the ophthalmic diseases; through cl. Stein to both parts of the art of obstetrics and to more unusual cases of obstetrics, through cl. Bischoff to forensic medicine and to the art of compiling medicinal prescriptions. Finally, I visited the surgical clinic and polyclinic under the illustrious Doctor Nasse regularly for a period of two semesters; and for one semester the surgical clinic and polyclinic under the illustrious Principal von Walther. My counsellors in medical practice were the illustrious Nasse for one year, in surgical practice the illustrious von Walther and in obstetric practice the illustrious Stein for one year, too.

Acknowledgement

Thanks to Leonie Gutmann (Detmold, Germany, and Perth, Australia) for her assistance in the translation of the text.