a fourth form of masturbation the cases of paradoxy
which we have mentioned previously. In this case onanism is produced
spontaneously as the result of psycho-sexual precocity or hereditary
pathological satyriasis.

With the exception of the last paradoxical form which is based on
incurable satyriasis, all the kinds of onanism which we have mentioned
hitherto can only be successfully treated by kindness and confidence,
combined with work and direction of the mind to wholesome and
attractive subjects; not by threats or punishment. The new reformatory
schools called _Landerziehungsheime_ (Vide Chapter XVII) are an
excellent remedy for onanism, for they keep the child occupied from
morning to night and hardly leave him any time for bad habits; when he
goes to bed he is too tired to do anything but sleep. However, great
prudence and active supervision is required in these cases.

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 po