every one's experience testifies; and a special morbid feeling with its particular sympathetic ideas, of which the phenomena of dreaming and insanity yield illustrations.

The slight shades of this kind of morbid influence we cannot venture to trace; but it is easy to recognize the most marked effects. Take, for example, the irritation of ovaries or uterus, which is sometimes the direct occasion of nympho- . mania a disease by which the most chaste and modest woman is transformed into a raging fury of lust. Some observers have, without sufficient reason I think, made of nymphomania a special variety, grouping under the term. cases in which it was a prominent symptom. But it certainly occurs in forms of mania that are quite distinct-in puerperal mania, for example, in epileptic mania, and in the mania sometimes met with in old women; and the cases in which it does occur have not such characteristic features as warrant the formation of a definite group. We have, indeed, to note and bear in mind how often sexual ideas and feelings arise and display themselves in all sorts of insanity; how they connect themselves with ideas which in a normal mental state have no known relation to them; so that it seems as inexplicable that a virtuous person should ever have learned, as it is distressing that she should manifest, so much obscenity of thought and feeling. Perhaps it is that such ideas are excited sympathetically in a morbidly active brain by unrelated ideas, just as, in other nervous disorders, sympathetic morbid sensations and movements occur in parts distant from the seat of the primary irritation. Considering, too, what an important agent in the evolution of mind the sexual feeling is, how much of thought, feeling, and energy it remotely inspires, there is less cause for wonder at the naked intervention of its simple impulses in the phenomena of mania, when coördination of function is abolished in the supreme centres, and the mind resolved, as it were, into its primitive animal elements. This should teach us to take care not to attribute too hastily the sexual feelings to a morbid irritation of the

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sexual organs. It is plain that they may have a purely central origin, just as the excitation of them in health may proceed from the mind. Here, in fact, as in other cases, we must bear in mind the reciprocal influence of mind on organ, and of organ on mind.

The great mental revolution which occurs at puberty may go beyond its physiological limits, in some instances, and become pathological. The vague feelings, blind longings, and obscure impulses, which then arise in the mind, attest the awakening of an impulse which knows not at first its aim or the means of its gratification; a kind of vague and yearning melancholy is engendered, which leads to an abandonment to poetry of a gloomy Byronic kind, or to indulgence in indefinite religious feelings and aspirations. There is a want of some object to fill the void in the feelings, to satisfy the undefined yearning-a need of something to adore; consequently, where there is no visible object of worship the invisible is adored. The time of this mental revolution is, at best, a trying period for youth; and, where there is an inherited infirmity of nervous organization, the natural disturbance of the mental balance may easily pass into actual destruction of it.

The form of derangement connected with this period of life I believe to be either a fanciful and quasi-hysterical melancholia, which is not very serious when it is properly treated; or an acute mania, which is apt to be recurrent, and is much more serious. The former occurs especially in girls, if it be not peculiar to them; there are periods of depression and paroxysms of apparently causeless weeping, alternating with times of undue excitability, more especially at the menstrual periods; a disinclination is evinced to work, to rational amusement, to exertion of any kind; the behavior is capricious, and soon becomes perverse and wilful; the natural ' affections seem to be blunted or abolished, the patient taking pleasure in distressing those whose feelings she would most consider when in health; and, although there are no fixed

delusions, there are unfounded suspicions or fears and changing morbid fancies. The anxious sympathies of those most dear are apt to foster the morbid self-feeling which craves them, and thus to aggravate the disease: what such patients need to learn is, not the indulgence but a forgetfulness of their feelings, not the observation but the renunciation of self, not introspection but useful action. In some of these cases, where the disease has become chronic, delusions of sexual origin occur, and the patient whose virginity is intact imagines that she is pregnant or has had a baby.

The morbid self-feeling that has its root in the sexual system is not unapt to take on a religious guise. We observe examples of this in certain members of those latter-day religious sects which profess to commingle religion and love, and which especially abound in America. No physiologist can well doubt that the holy kiss of love in such cases owes all its warmth to the sexual feeling which consciously or unconsciously inspires it, or that the mystical union of the sexes lies very close to a union that is nowise mystical, when it does not lead to madness. A similar intimate connection between fanatical religious exaltation and sexual excitement is exemplified by the lives of such religious enthusiasts as St. Theresa and St. Catherine de Sienne, whose nightly trances and visions, in which they believed themselves received as veritable spouses into the bosom of Christ and transported into an unspeakable ecstasy by the touch of His sacred lips, attested, though they knew it not, the influence of excited sexual organs on the mind. More extreme examples of a like pathological action are afforded by those insane women who believe themselves to be visited by lovers or ravished by persecutors during the night. Sexual hallucinations, betraying an ovarian or uterine excitement, might almost be described as the characteristic feature of the insanity of old maids; the false visions of unreal indulgence being engendered probably in the same way as visions of banquets occur in the dreams of a starving person, or as visions of cooling streams to one

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who is perishing of thirst. It seems to be the fact that, although women bear sexual excesses better than men, they suffer more than men do from the entire deprivation of sexual intercourse.

The development of puberty may lead indirectly to insanity by becoming the occasion of a vicious habit of self-abuse in men; and it is not always easy to say in such cases how much of the evil is due to pubescence and how much to self-abuse. But the form of mental derangement directly traceable to self-abuse has certainly characteristic features. There are

no acute symptoms, the onset of the disease being most gradual. The patient becomes offensively egotistic and impracticable; he is full of self-feeling and self-conceit; insensible to the claims of others upon him, and of his duties to them; interested only in hypochondriacally watching his morbid sensations, and attending to his morbid feelings. His mental energy is sapped; and though he has extravagant pretensions, and often speaks of great projects engendered by his conceit, he never works systematically for any aim, but exhibits an incredible vacillation of conduct, and spends his days in indolent and suspicious self-brooding. His relatives he thinks hostile to him, because they do not take the interest in his sufferings which he craves, nor yield sufficiently to his pretensions, but perhaps urge him to some kind of work; he is utterably incapable of conceiving that he has duties to them. As matters get worse, the general suspicion of the hostility of people takes more definite form, and delusions spring up that persons speak offensively of him, or watch him in the street, or comment on what passes in his mind, or play tricks upon him by electricity or mesmerism, or in some other mysterious way. His delusions are the objective explanation, by wrong imagination, of the perverted feelings. Messages may be received from Heaven by peculiar telegraphic signals; and there are occasionally quasi-cataleptic trances. It is strange what exalted feelings and high moral and religious aims these patients will often declare they have, who, incapa

ble of reforming themselves, are ready to reform the world. A later and worse stage is one of moody or vacant self-absorption, and of extreme loss of mental power. They are silent, or, if they converse, they discover delusions of a suspicious or obscene character, the perverted sexual passion still giving the color to their thoughts. They die miserable wrecks at the last. This is a form of insanity which certainly has its special exciting cause and its characteristic features; nevertheless, I think that self-abuse seldom, if ever, produces it without the coöperation of the insane neurosis.

The monthly activity of the ovaries which marks the advent of puberty in women has a notable effect upon the mind and body; wherefore it may become an important cause of mental and physical derangement. Most women at that time are susceptible, irritable, and capricious, any cause of vexation affecting them more seriously than usual; and some who have the insane neurosis exhibit a disturbance of mind which amounts almost to disease. A sudden suppression of the menses has produced a direct explosion of insanity; or, occurring some time before an outbreak, it may be an important link in its causation. It is a matter also of common experience in asylums, that exacerbations of insanity often take place at the menstrual periods; but whether there is a particular variety of mental derangement connected with disordered menstruation, and, if so, what are its special features, we are not yet in a position to say positively. There is certainly a recurrent mania, which seems sometimes to have, in regard to its origin and the times of its attacks, a relation to the menstrual function, suppression or irregularity of which often accompanies it; and it is an obvious presumption that the mania may be a sympathetic morbid effect of the ovarian and uterine excitement, and may represent an exaggeration of the mental irritability which is natural to women at that period. The patient becomes elated, hilarious, talkative, passing soon from that condition into a state of acute and noisy mania, which may last for two or three