False interpretations of sensation, due to spinal asthenia, are so powerful and real as to produce the sexual climax from purely psychical causes; and, since nature is not always kind to many of these subjects of delusional eviration, they pad their breasts and hips, wear tight shoes, use vast quantities of "tonic," to make their hair grow, and modulate their voices so as to conform as nearly as possible to the female falsetto.

The cases, however, of psychic inversion reaching this extreme development are comparatively rare. Krafft-Ebing cites only three, in his peculiarly extended experience;1 Seriéux, one; Esquirol, two; Aradt, one; I, myself, have known only two; and in the number of cases recorded by Mr. Ellis, in volume three of his admirable work, we find the delusional features so undeveloped as to bring the cases where he properly places them, within the category of simple sexual inversion.