attracted the attention of Kulischer many years ago, and he showed how the dances of the men, among savages, excite the women, who watch them intently though unobtrusively, and are thus influenced in choosing their lovers. He was probably the first to insist that in man sexual selection has taken place mainly through the agency of dances, games, and festivals.[47] It is now clear, therefore, why the evacuation theory of the sexual impulse must necessarily be partial and inadequate. It leaves out of account the whole of the phenomena connected with tumescence, and those phenomena constitute the most prolonged, the most important, the most significant stage of the sexual process. It is during tumescence that the whole psychology of the sexual impulse is built up; it is as an incident arising during tumescence and influencing its course that we must probably regard nearly every sexual aberration. It is with the second stage of the sexual process, when the instinct of detumescence arises, that the analogy of evacuation can alone be called in. Even here, that analogy, though real, is not complete, the nervous element involved in detumescence being out of all proportion to the extent of the evacuation. The typical act of evacuation, however, is a nervous process, and when we bear this in mind we may see whatever truth the evacuation theory possesses. Beaunis classes the sexual impulse with the "needs of activity," but under this head he coordinates it with the "need of urination." That is to say, that both alike are nervous explosions. Micturition, like detumescence, is a convulsive act, and, like detumescence also, it is certainly connected with cerebral processes; thus in epilepsy the passage of urine which may occur (as in a girl described by Gowers with minor attacks during which it was emitted consciously, but involuntarily) is really a part of the process.[48] There appears, indeed, to be a special and intimate connection between the explosion of sexual detumescence and the explosive energy of the bladder; so that they may reinforce each other and to a limited extent act vicariously in relieving each other's tension. It is noteworthy that nocturnal and diurnal incontinence of urine, as well as "stammering" of the bladder, are all specially liable to begin or to cease at puberty. In men and even infants, distention of the bladder favors tumescence by producing venous congestion, though at the same time it acts as a physical hindrance to sexual detumescence[49]; in women--probably not from pressure alone, but from reflex nervous action--a full bladder increases both sexual excitement and pleasure, and I have been informed by several women that they have independently discovered this fact for themselves and acted in accordance with it. Conversely, sexual excitement increases the explosive force of the bladder, the desire to urinate is aroused, and in women the sexual orgasm, when very acute and occurring with a full bladder, is occasionally accompanied, alike in savage and civilized life, by an involuntary and sometimes full and forcible expulsion of urine.[50] The desire to urinate may possibly be, as has been said, the normal accompaniment of sexual excitement in women (just as it is said to be in mares; so that the Arabs judge that the mare is ready for the stallion when she urinates immediately on hearing him neigh). The association may even form the basis of sexual obsessions.[51] I have elsewhere shown that, of all the influences which increase the expulsive force of the bladder, sexual excitement is the most powerful.[52] It may also have a reverse influence and inhibit contraction of the bladder, sometimes in association with shyness, but also independently of shyness. There is also reason to suppose that the nervous energy expended in an explosion of the tension of the sexual organs may sometimes relieve the bladder; it is well recognized that a full bladder is a factor in producing sexual emissions during sleep, the explosive energy of the bladder being inhibited and passing over into the sexual sphere. Conversely, it appears that explosion of the bladder relieves sexual tension. An explosion of the nervous centers connected with the contraction of the bladder will relieve nervous tension generally; there are forms of epilepsy in which the act of urination constitutes the climax, and Gowers, in dealing with minor epilepsy, emphasizes the frequency of micturition, which "may occur with spasmodic energy when there is only the slightest general stiffness," especially in women. He adds the significant remark that it "sometimes seems to relieve the cerebral tension,"[53] and gives the case of a girl in whom the aura consisted mainly of a desire to urinate; if she could satisfy this the fit was arrested; if not she lost consciousness and a severe fit followed.
If micturition may thus relieve nervous tension generally, it is not surprising that it should relieve the tension of the centers with which it is most intimately connected. Sérieux records the case of a girl of 12, possessed by an impulse to masturbation which she was unable to control, although anxious to conquer it, who only found relief in the act of urination; this soothed her and to some extent satisfied the sexual excitement; when the impulse to masturbate was restrained the impulse to urinate became imperative; she would rise four or five times in the night for this purpose, and even urinate in bed or in her clothes to obtain the desired sexual relief.[54] I am acquainted with a lady who had a similar, but less intense, experience during childhood. Sometimes, especially in children, the act of urination becomes an act of gratification at the climax of sexual pleasure, the imitative symbol of detumescence. Thus Schultze-Malkowsky describes a little girl of 7 who would bribe her girl companions with little presents to play the part of horses on all fours while she would ride on their necks with naked thighs in order to obtain the pleasurable sensation of close contact. With one special friend she would ride facing backward, and leaning forward to embrace her body impulsively, and at the same time pressing the neck closely between her thighs, would urinate.[55] Féré has recorded the interesting case of a man who, having all his life after puberty been subject to monthly attacks of sexual excitement, after the age of 45 completely lost the liability to these manifestations, but found himself subject, in place of them, to monthly attacks of frequent and copious urination, accompanied by sexual day-dreams, but by no genital excitement.[56] Such a case admirably illustrates the compensatory relation of sexual and vesical excitation. This mutual interaction is easily comprehensible when we recall the very close nervous connection which exists between the mechanisms of the sexual organs and the bladder.
Nor are such relationships found to be confined to these two centers; in a lesser degree the more remote explosive centers are also affected; all motor influences may spread to related muscles; the convulsion of laughter, for instance, seems to be often in relation with the sexual center, and Groos has suggested that the laughter which, especially in the sexually minded, often follows allusions to the genital sphere is merely an effort to dispel nascent sexual excitement by liberating an explosion of nervous energy in another direction.[57] Nervous discharges tend to spread, or to act vicariously, because the motor centers are more or less connected.[58] Of all the physiological motor explosions, the sexual orgasm, or detumescence, is the most massive, powerful, and overwhelming. So volcanic is it that to the ancient Greek philosophers it seemed to be a minor kind of epilepsy. The relief of detumescence is not merely the relief of an evacuation; it is the discharge, by the most powerful apparatus for nervous explosion in the body, of the energy accumulated and stored up in the slow process of tumescence, and that discharge reverberates through all the nervous centers in the organism.
"The sophist of Abdera said that coitus is a slight fit of epilepsy, judging it to be an incurable disease." (Clement of Alexandria, _Pædagogus_, bk. ii, chapter x.) And Coelius Aurelianus, one of the chief physicians of antiquity, said that "coitus is a brief epilepsy." Féré has pointed out that both these forms of nervous storm are sometimes accompanied by similar phenomena, by subjective sensations of sight or smell, for example; and that the two kinds of discharge may even be combined. (Féré, _Les Epileptiques_, pp. 283-84; also "Exces Vénériens et Epilepsie," _Comptes-rendus de la Société de Biologie_, April 3, 1897, and the same author's _Instinct Sexuel_, pp. 209, 221, and his "Priapisme Epileptique," _La Médecine Moderne_, February 4, 1899.) The epileptic convulsion in some cases involves the sexual mechanism, and it is noteworthy that epilepsy tends to appear at puberty. In modern times even so great a physician as Boerhaave said that coitus is a "true epilepsy," and more recently Roubaud, Hammond, and Kowalevsky have emphasized the resemblance between coitus and epilepsy, though without identifying the two states. Some authorities have considered that coitus is a cause of epilepsy, but this is denied by Christian, Strümpell, and Löwenfeld. (Löwenfeld, _Sexualleben und Nervenleiden_, 1899, p. 68.) Féré has recorded the case of a youth in whom the adoption of the practice of masturbation, several times a day, was followed by epileptic attacks which ceased when masturbation was abandoned. (Féré, _Comptes-rendus de la Socitété de Biologie_, April 3, 1897.)
It seems unprofitable at present to attempt any more fundamental analysis of the sexual impulse. Beaunis, in the work already quoted, vaguely suggests that we ought possibly to connect the sexual excitation which leads the male to seek the female with chemical action, either exercised directly on the protoplasm of the organism or indirectly by the intermediary of the nervous system, and especially by smell in the higher animals. Clevenger, Spitzka, Kiernan, and others have also regarded the sexual impulse as protoplasmic hunger, tracing it back to the presexual times when one protozoal form absorbed another. In the same way Joanny Roux, insisting that the sexual need is a need of the whole organism, and that "we love with the whole of our body," compares the sexual instinct to hunger, and distinguishes between "sexual hunger" affecting the whole system and "sexual appetite" as a more localized desire; he concludes that the sexual need is an aspect of the nutritive need.[59] Useful as these views are as a protest against too crude and narrow a conception of the part played by the sexual impulse, they carry us into a speculative region where proof is difficult.
We are now, however, at all events, in a better position to define the contents of the sexual impulse. We see that there are certainly, as Moll has indicated, two constituents in that impulse; but, instead of being unrelated, or only distantly related, we see that they are really so intimately connected as to form two distinct stages in the same process: a first stage, in which--usually under the parallel influence of internal and external stimuli--images, desires, and ideals grow up within the mind, while the organism generally is charged with energy and the sexual apparatus congested with blood; and a second stage, in which the sexual apparatus is discharged amid profound sexual excitement, followed by deep organic relief. By the first process is constituted the tension which the second process relieves. It seems best to call the first impulse the _process of tumescence_; the second the _process of detumescence_.[60] The first, taking on usually a more active form in the male, has the double object of bringing the male himself into the condition in which discharge becomes imperative, and at the same time arousing in the female a similar ardent state of emotional excitement and sexual turgescence. The second process has the object, directly, of discharging the tension thus produced and, indirectly, of effecting the act by which the race is propagated.
It seems to me that this is at present the most satisfactory way in which we can attempt to define the sexual impulse.
FOOTNOTES: [1] C. Lloyd Morgan, "Instinct and Intelligence in Animals," _Nature_, February 3, 1898.
[2] _Essais_, livre iii, ch. v.
[3] Féré, "La Prédisposition dans l'étiologie des perversions sexuelles," _Revue de médecine_, 1898. In his more recent work on the evolution and dissolution of the sexual instinct Féré perhaps slightly modified his position by stating that "the sexual appetite is, above all, a general need of the organism based on a sensation of fullness, a sort of need of evacuation," _L'Instinct sexuel_, 1899, p. 6. Löwenfeld (_Ueber die Sexuelle Konstitution_, p. 30) gives a qualified acceptance to the excretory theory, as also Rohleder (_Die Zeugung beim Menschen_, p. 25).
[4] Goltz, _Centralblatt für die med. Wissenschaften_, 1865, No. 19, and 1866, No. 18; also _Beiträge zur Lehre von den Funktionen des Frosches_, Berlin, 1869, p. 20.
[5] J. Tarchanoff, "Zur Physiologie des Geschlechtsapparatus des Frosches," _Archiv für die Gesammte Physiologie_, 1887, vol. xl, p. 330.
[6] E. Steinach, "Untersuchungen zur vergleichenden Physiologie der männlicher Geschlechtsorgane insbesondere der accessorischen Geschlechtsdrüsen," _Archiv für die Gesammte Physiologie_, vol. lvi, 1894, pp. 304-338.
[7] See, e.g., Shattock and Seligmann, "The Acquirement of Secondary Sexual Characters," _Proceedings of the Royal Society_, vol. lxxiii, 1904, p. 49.
[8] For facts bearing on this point, see Guinard, art. "Castration," Richet's _Dictionnaire de Physiologie_. The general results of castration are summarized by Robert Müller in ch. vii of his _Sexualbiologie_; also by F.H.A. Marshall, _The Physiology of Reproduction_, ch, ix; see also E. Pittard, "Les Skoptzy," _L'Anthropologie_, 1903, p. 463.
[9] For an ancient discussion of this point, see Schurig, _Spermatologia_, 1720, cap. ix.
[10] J.J. Matignon, _Superstition, Crime, et Misère en Chine_, "Les Eunuques du Palais Impérial de Pékin," 1901.
[11] P. Marie, "Eunuchisme et Erotisme," _Nouvelle Iconographie de la Salpêtrière_, 1906, No. 5, and _Progrès médical_, Jan. 26, 1907.
[13] See, for instance, the case reported in another volume of these _Studies_ ("Sexual Inversion"), in which castration was performed on a sexual invert without effecting any change.
[14] Guinard, art. "Castration," _Dictionnaire de Physiologie_.
[16] See Swale Vincent, _Internal Secretion and the Ductless Glands_, 1912; F.H.A. Marshall, _The Physiology of Reproduction_, 1910, ch. ix; Munzer, _Berliner klinische Wochenschrift_, Nov., 1910; C. Sajous, _The Internal Secretions_, vol. i, 1911. The adrenal glands have been fully and interestingly studied by Glynn, _Quarterly Journal of Medicine_, Jan., 1912; the thyroid, by Ewan Waller, _Practitioner_, Aug., 1912; the internal secretion of the ovary, by A. Louise McIlroy, _Proceedings Royal Society Medicine_, July, 1912. For a discussion at the Neurology Section of the British Medical Association Meeting, 1912, see _British Medical Journal_, Nov. 16, 1912.
[17] Since this was written I have come across a passage in _Hampa_ (p. 228), by Rafael Salillas, the Spanish sociologist, which shows that the analogy has been detected by the popular mind and been embodied in popular language: "A significant anatomico-physiological concordance supposes a resemblance between the mouth and the sexual organs of a woman, between coitus and the ingestion of food, and between foods which do not require mastication and the spermatic ejaculation; these representations find expression in the popular name _papo_ given to women's genital organs. 'Papo' is the crop of birds, and is derived from 'papar' (Latin, _papare_), to eat soft food such as we call pap. With this representation of infantile food is connected the term _leche_ [milk] as applied to the ejaculated genital fluid." Cleland, it may be added, in the most remarkable of English erotic novels, _The Memoirs of Fanny Hill_, refers to "the compressive exsuction with which the sensitive mechanism of that part [the vagina] thirstily draws and drains the nipple of Love," and proceeds to compare it to the action of the child at the breast. It appears that, in some parts of the animal world at least, there is a real analogy of formation between the oral and vaginal ends of the trunk. This is notably the case in some insects, and the point has been elaborately discussed by Walter Wesché, "The Genitalia of Both the Sexes in Diptera, and their Relation to the Armature of the Mouth," _Transactions of the Linnean Society_, second series, vol. ix, Zoölogy, 1906.
[18] Näcke now expresses himself very dubiously on the point; see, e.g., _Archiv für Kriminal-Anthropologie_, 1905, p. 186.
[19] _Untersuchungen über die Libido Sexualis_, Berlin, 1897-98.
[20] Moll adopts the term "impulse of detumescence" (_Detumescenztrieb_) instead of "impulse of ejaculation," because in women there is either no ejaculation or it cannot be regarded as essential.
[21] I quote from the second edition, as issued in 1881.
[22] This is the theory which by many has alone been seen in Darwin's _Descent of Man_. Thus even his friend Wallace states unconditionally (_Tropical Nature_, p. 193) that Darwin accepted a "voluntary or conscious sexual selection," and seems to repeat the same statement in _Darwinism_ (1889), p. 283. Lloyd Morgan, in his discussion of the pairing instinct in _Habit and Instinct_ (1896), seems also only to see this side of Darwin's statement.
[23] In his _Variation of Animals and Plants under Domestication_, Darwin was puzzled by the fact that, in captivity, animals often copulate without conceiving and failed to connect that fact with the processes behind his own theory of sexual selection.
[24] Beaunis, _Sensations Internes_, ch. v, "Besoins Sexuels," 1889. It may be noted that many years earlier Burdach (in his _Physiologie als Erfahrungswissenschaft_, 1826) had recognized that the activity of the male favored procreation, and that mental and physical excitement seemed to have the same effect in the female also.
[25] It is scarcely necessary to point out that this is too extreme a position. As J.G. Millais remarks of ducks (_Natural History of British Ducks_, p. 45), in courtship "success in winning the admiration of the female is rather a matter of persistent and active attention than physical force," though the males occasionally fight over the female. The ruff (_Machetes pugnax_) is a pugnacious bird, as his name indicates. Yet, the reeve, the female of this species, is, as E. Selous shows ("Sexual Selection in Birds," _Zoölogist_, Feb. and May, 1907), completely mistress of the situation. "She seems the plain and unconcerned little mistress of a numerous and handsome seraglio, each member of which, however he flounce and bounce, can only wait to be chosen." Any fighting among the males is only incidental and is not a factor in selection. Moreover, as R. Müller points out (loc. cit., p. 290), fighting would not usually attain the end desired, for if the males expend their time and strength in a serious combat they merely afford a third less pugnacious male a better opportunity of running off with the prize.
[27] K. Groos, _Die Spiele der Thiere_, 1896; _Die Spiele der Menschen_, 1899; both are translated into English.
[28] Prof. H.E. Ziegler, in a private letter to Professor Groos, _Spiele der Thiere_, p. 202.
[29] _Die Spiele der Thiere_, p. 244. This had been briefly pointed out by earlier writers. Thus, Haeckel (_Gen. Morph._, ii, p. 244) remarked that fighting for females is a special or modified kind of struggle for existence, and that it acts on both sexes.
[30] It may be added that in the human species, as Bray remarks ("Le Beau dans la Nature," _Revue Philosophique_, October, 1901, p. 403), "the hymen would seem to tend to the same end, as if nature had wished to reinforce by a natural obstacle the moral restraint of modesty, so that only the vigorous male could insure his reproduction." There can be no doubt that among many animals pairing is delayed so far as possible until maturity is reached. "It is a strict rule amongst birds," remarks J.G. Millais (op. cit., p. 46), "that they do not breed until both sexes have attained the perfect adult plumage." Until that happens, it seems probable, the conditions for sexual excitation are not fully established. We know little, says Howard (_Zoölogist_, 1903, p. 407), of the age at which birds begin to breed, but it is known that "there are yearly great numbers of individuals who do not breed, and the evidence seems to show that such individuals are immature."
[32] Lloyd Morgan, _Animal Behavior_, 1900, pp. 264-5. It may be added that, on the esthetic side, Hirn, in his study (_The Origins of Art_, 1900), reaches conclusions which likewise, in the main, concord with those of Groos.
[33] It may be noted that the marriage ceremony itself is often of the nature of a courtship, a symbolic courtship, embodying a method of attaining tumescence. As Crawley, who has brought out this point, puts it, "Marriage-rites of union are essentially identical with love charms," and he refers in illustration to the custom of the Australian Arunta, among whom the man or woman by making music on the bull-roarer compels a person of the opposite sex to court him or her, the marriage being thus completed. (E. Crawley, _The Mystic Rose_, p. 318.)
[34] The more carefully animals are observed, the more often this is found to be the case, even with respect to species which possess no obvious and elaborate process for obtaining tumescence. See, for instance, the detailed and very instructive account--too long to quote here--given by E. Selous of the preliminaries to intercourse practised by a pair of great crested grebes, while nest-building. Intercourse only took place with much difficulty, after many fruitless invitations, more usually given by the female. ("Observational Diary of the Habits of the Great Crested Grebe," _Zöologist_, September, 1901.) It is exactly the same with savages. The observation of Foley (_Bulletin de la Société d'Anthropologie de Paris_, November 6, 1879) that in savages "sexual erethism is very difficult" is of great significance and certainly in accordance with the facts. This difficulty of erethism is the real cause of many savage practices which to the civilized person often seem perverse; the women of the Caroline Islands, for instance, as described by Finsch, require the tongue or even the teeth to be applied to the clitoris, or a great ant to be applied to bite the parts, in order to stimulate orgasm. Westermarck, after quoting a remark of Mariner's concerning the women of Tonga,--"it must not be supposed that these women are always easily won; the greatest attentions and the most fervent solicitations are sometimes requisite, even though there be no other lover in the way,"--adds that these words "hold true for a great many, not to say all, savage and barbarous races now existing." (_Human Marriage_, p. 163.) The old notions, however, as to the sexual licentiousness of peoples living in natural conditions have scarcely yet disappeared. See Appendix A; "The Sexual Instinct in Savages."
[35] In men a certain degree of tumescence is essential before coitus can be effected at all; in women, though tumescence is not essential to coitus, it is essential to orgasm and the accompanying physical and psychic relief. The preference which women often experience for prolonged coitus is not, as might possibly be imagined, due to sensuality, but has a profound physiological basis.
[37] See Lagrange's _Physiology of Bodily Exercise_, especially chapter ii. It is a significant fact that, as Sergi remarks (_Les Emotions_, p. 330), the physiological results of dancing are identical with the physiological results of pleasure.
[38] Groos, _Spiele der Menschen_, p. 112. Zmigrodzki (_Die Mutter bei den Volkern des Arischen Stammes_, p. 414 et seq.) has an interesting passage describing the dance--especially the Russian dance--in its orgiastic aspects.
[39] Féré, "L'Influence sur le Travail Volontaire d'un muscle de l'activité d'autres muscles," _Nouvelles Iconographie de la Salpêtrière_, 1901.
[40] "The sensation of motion," Kline remarks ("The Migratory Impulse," _American Journal of Psychology_, October, 1898, p. 62), "as yet but little studied from a pleasure-pain standpoint, is undoubtedly a pleasure-giving sensation. For Aristippus the end of life is pleasure, which he defines as gentle motion. Motherhood long ago discovered its virtue as furnished by the cradle. Galloping to town on the parental knee is a pleasing pastime in every nursery. The several varieties of swings, the hammock, see-saw, flying-jenny, merry-go-round, shooting the chutes, sailing, coasting, rowing, and skating, together with the fondness of children for rotating rapidly in one spot until dizzy and for jumping from high places, are all devices and sports for stimulating the sense of motion. In most of these modes of motion the body is passive or semipassive, save in such motions as skating and rotating on the feet. The passiveness of the body precludes any important contribution of stimuli from kinesthetic sources. The stimuli are probably furnished, as Dr. Hall and others have suggested, by a redistribution of fluid pressure (due to the unusual motions and positions of the body) to the inner walls of the several vascular systems of the body."
[41] _Anatomy of Melancholy_, part iii., sect. ii, mem. ii, subs. iv.
[43] Marro (_Pubertà_, p. 367 et seq.) has some observations on this point. It was an insight into this action of dancing which led the Spanish clergy of the eighteenth century to encourage the national enthusiasm for dancing (as Baretti informs us) in the interests of morality.
[44] It is scarcely necessary to remark that a primitive dance, even when associated with courtship, is not necessarily a sexual pantomime; as Wallaschek, in his comprehensive survey of primitive dances, observes, it is more usually an animal pantomime, but nonetheless connected with the sexual instinct, separation of the sexes, also, being no proof to the contrary. (Wallaschek, _Primitive Music_, pp. 211-13.) Grosse (_Anfänge der Kunst_, English translation, p. 228) has pointed out that the best dancer would be the best fighter and hunter, and that sexual selection and natural selection would thus work in harmony.
[45] Féré, "Le plaisir de la vue du Mouvement," _Comptes-rendus de la Société de Biologie_, November 2, 1901; also _Travail et Plaisir_, ch. xxix.
[46] Groos repeatedly emphasizes the significance of this fact (_Spiele der Menschen_, pp. 81-9, 460 et seq.); Grosse (_Anfänge der Kunst_, p. 215) had previously made some remarks on this point.
[47] M. Kulischer, "Die Geschlechtliche Zuchtwahl bei den Menschen in der Urzeit," _Zeitschrift für Ethnologie_, 1876, p. 140 _et seq._ [49] Guyon, _Leçons Cliniques sur les Maladies des Voies Urinaires_, 3d ed., 1896, vol. ii, p. 397.
[50] See, e.g., Féré, _L'Instinct Sexuel_, pp. 222-23: Brantôme was probably the first writer in modern times who referred to this phenomenon. MacGillicuddy (_Functional Disorders of the Nervous System in Women_, p. 110) refers to the case of a lady who always had sudden and uncontrollable expulsion of urine whenever her husband even began to perform the marital act, on which account he finally ceased intercourse with her. Kubary states that in Ponape (Western Carolines) the men are accustomed to titillate the vulva of their women with the tongue until the excitement is so intense that involuntary emission of urine takes place; this is regarded as the proper moment for intercourse.
[51] Thus Pitres and Régis (_Transactions of the International Medical Congress, Moscow_, vol. iv, p. 19) record the case of a young girl whose life was for some years tormented by a groundless fear of experiencing an irresistible desire to urinate. This obsession arose from once seeing at a theater a man whom she liked, and being overcome by sexual feeling accompanied by so strong a desire to urinate that she had to leave the theater. An exactly similar case in a young woman of erotic temperament, but prudish, has been recorded by Freud (_Zur Neurosenlehre_, Bd. i, p. 54). Morbid obsessions of modesty involving the urinary sphere and appearing at puberty are evidently based on transformed sexual emotion. Such a case has been recorded by Marandon de Montyel (_Archives de Neurologie_, vol. xii, 1901, p. 36); this lady, who was of somewhat neuropathic temperament, from puberty onward, in order to be able to urinate found it necessary not only to be absolutely alone, but to feel assured that no one even knew what was taking place.
[52] H. Ellis, "The Bladder as a Dynamometer," _American Journal of Dermatology_, May, 1902.
[53] Sir W. Gowers, "Minor Epilepsy," _British Medical Journal_, January 6, 1900; ib., _Epilepsy_, 2d ed., 1901, p. 106; see also H. Ellis, art. "Urinary Bladder, Influence of the Mind on the," in Tuke's _Dictionary of Psychological Medicine_.
[54] Sérieux, _Recherches Cliniques sur les Anomalies de l'Instinct Sexuel_, p. 22.