th curable acute mania, was so erotic
during her attacks that she made advances toward all the doctors who
visited her. Her mind was full of such erotic images that after her
cure she was frightened of being pregnant, although she had passed the
whole of her time of detention under supervision by female attendants.
Women who in their normal state are most modest or sexually cold may
be most erotic when they become insane, and may even behave as
prostitutes. This is especially observed in periodic hypomania. It is
a well-known fact in the female divisions of lunatic asylums, that the
doctors are always surrounded by erotic patients, who catch hold of
their clothes and pinch them, and try and embrace or scratch them
according as they are amorous or jealous, so that they often have
trouble in escaping from these signs of violent love or furious
jealousy.

On the other hand, in the male divisions of asylums, one is astonished
at the indifference and profound sexual apathy of nearly all insane
men. Some practice masturbation and others attempt pederasty, but all
with a philosophical calmness due to their dementia. Young women may
even go among them without any fear of assaults or indecent language.
It is only a few of the most violent who are exceptions to this rule.

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 manifest