that inhibit it are inevitably very powerful.
Occasionally it becomes more clearly manifest, and this may happen early
in life. Fere records the case of a man of Anglo-Saxon origin, of sound
heredity so far as could be ascertained and presenting no obvious stigmata
of degeneration, who first experienced sexual manifestations at the age of
5 when a boy cousin was attacked by bleeding at the nose. It was the first
time he had seen such a thing and he experienced erection and much
pleasure at the sight. This was repeated the next time the cousin's nose
bled and also whenever he witnessed any injuries or wounds, especially
when occurring in males. A few years later he began to find pleasure in
pinching and otherwise inflicting slight suffering. This sadism was not,
however, further developed, although a tendency to inversion
persisted.[103]

Somewhat similar may have been the origin of the attraction of
blood in a case which has been reported to me of a youth of 17,
the youngest of a large family who are all very strong and
entirely normal. He is himself, however, delicate, overgrown,
with a narrow chest, a small head, and babyish features, while
mentally he is backward, with very defective memory and scant
powers of assimilation. He is intensely nervous, peevish, and
subject to fits of childish rage. He takes violent fancies to
persons of his own sex. But he appears to have only one way of
obtaining sexual excitement and gratification. It is his custom
to get into a hot bath and there to produce erection and
emission, not by masturbation, but by thinking of flowing blood.
He does not associate himself with the causation of this
imaginary flow of blood; he is merely the passive but pleased
spectator. He is aware of his peculiarity and endeavors to shake
it off, but his efforts to obtain normal pleasure by thinking of
a girl are vain.

I may here narrate a case which has been communicated to me of
algolagnia in a woman, combined with sexual hyperesthesia.

R.D., aged 25, married, and of good social position; she is a
small and dark woman, restless and alert in manner. She has one
child.

She has practised masturbation from an early age--ever since she
can remember--by the method of external friction and pressure.
From the age of 17 she was able (and is still) to produce the
orgasm almost without effort, by calling up