58 CASE HISTORIES 



masturbated excessively. At sixteen piles became more or less 

 chronic. At seventeen, when he moved to the city, he had coitus 

 with a prostitute. He had had five or six in all, and once was 

 impotent, but on returning home he masturbated and obtained 

 an orgasm. Coitus was unnecessary he explained, because he 

 could masturbate at home, which he did nearly every night. He 

 had felt "good, hearty, healthy and enjoyed life." At that time 

 he used cows and mares. 



In the hospital he continued the masturbation and committed 

 fellatio with other patients a few times. He consented once to 

 allow pederasty, but it hurt so much that he made the other man 

 stop. He also masturbated on the bodies of other patients. He 

 remarked with wonder on the hardness of other patients' penises 

 and said his own was half flabby. These incidents he related 

 with some shame, but said he had repented and felt forgiven. 

 He had rationalized masturbation as being necessary ("a man 

 must do enough to live"), and there was no mental conflict in 

 connection with it. Day masturbation he had given up, but if he 

 couldn't go to sleep at night he masturbated and then slept well. 

 This occurred on the average of every other night. He had 

 had only two night orgasms in his life, one without a dream ; in 

 the other he dreamed of heterosexual intercourse and awoke to 

 find himself in the sexual position on the farmhand he was sleep- 

 ing with. 



Fantasies: The only waking fantasies he had were of hetero- 

 sexual intercourse while masturbating. As a boy he dreamt of 

 being chased and caught by the police, and waked up out of 

 breath; of building a fire; and of seeing his father butcher a 

 cow upstairs and hang up the quarters. The quarters frightened 

 him very much. He had always been timid at night. 



More recent dreams were of being home again ; of seeing the 

 face of a handsome negro girl who worked in the hospital 

 kitchen ; of a nurse who sat down on his bed and, when he put 

 his arms around her, fainted; and of his half-brother hacking 

 at his goiter with a knife. This last was " terrible." 



General observations: Physically he was a thin, nervous, 

 quick-moving man with large goiter and protruding eyes. Ex- 



