370 INTERNAL SECRETIONS 



have been repeated by several doctors. Successful results 

 are ' described by Miihsani (1922), Pfeiffer and others, 

 whereas Kr enter (1922) and Stahel (1922) deny any success. 

 Stabel is even of the opinion that it is impossible to change 

 the psycho-sexual behaviour of the homosexual individual 

 by implantation, as this behaviour is already definitely fixed 

 in the central nervous system after puberty is attained. 

 Stabel's view does not agree with the statements of Miihsam 

 and Kreuter, who described cases in which the homosexual 

 behaviour disappeared after castration. One is inclined to 

 explain the negative results partly by castration not having 

 been performed previously to transplantation. It may be said 

 that in three of his successful cases Miihsam previously re- 

 moved one of the testicles of the patient. But according to Stabel 

 a successful treatment of homosexuality by transplantation 

 is impossible even when both testicles are previously removed. 



The divergent results of the different surgeons may be partly 

 due to the fact that in some cases of homosexuality the sex 

 gland is not the direct cause of the abnormal behaviour, 

 some other organ of internal secretion being primarily involved 

 and influencing the hormonic activity of the testicle. In such 

 cases no transplantation of a normal testicle could help or 

 be successful even when castration is previously performed. 

 In such cases really nothing is changed by castration if followed 

 by testicular homoiotransplantation, whereas castration alone 

 will "cure" this homosexual individual in the sense that he 

 will become an ordinary " castrate," as in the cases of Miihsam 

 and of Kreuter. 



There is still another possible explanation of some cases 

 of homosexuality. It seems to me likely that certain forms 

 of this sexual perversion are nothing else than special cases 

 of fetishism on the basis of a more or less pronounced eunu- 

 choidism. Lately Weil (1921, 1922) having measured a great 

 number of homosexual individuals came to the conclusion 

 that the bodily proportions of male and female patients are 

 on the average like those of eunuchoids, but Weil's statements 

 have been contradicted by other authors. The success attained 

 by Steinach and Lichtenstern with the above-mentioned 

 homosexual individual could be explained, on the basis of 

 my assumption, as a cure of eunuchoidism by means of 

 transplantation. 



