Exhibitionism-Illustrative Cases-A Symbolic Perversion of Courtship-The Impulse to Defile-The Exhibitionist’s Psychic Attitude-The Sexual Organs as Fetichs-Phallus Worship-Adolescent Pride in Sexual Development-Exhibitionism of the Nates-The Classification of the Forms of Exhibitionism-Nature of the Relationship of Exhibitionism to Epilepsy.

There is a remarkable form of erotic symbolism-very definite and standing clearly apart from all other forms-in which sexual gratification is experienced in the simple act of exhibiting the sexual organ to persons of the opposite sex, usually by preference to young and presumably innocent persons, very often children. This is termed exhibitionism. It would appear to be a not very infrequent phenomenon, and most women, once or more in their lives, especially when young, have encountered a man who has thus deliberately exposed himself before them.

The exhibitionist, though often a young and apparently vigorous man, is always satisfied with the mere act of self-exhibition and the emotional reaction which that act produces; he makes no demands on the woman to whom he exposes himself; he seldom speaks, he makes no effort to approach her; as a rule, he fails even to display the signs of sexual excitation. His desires are completely gratified by the act of exhibition and by the emotional reaction it arouses in the woman. He departs satisfied and relieved.

A case recorded by Schrenck-Notzing very well represents both the nature of the impulse felt by the exhibitionist and the way in which it may originate. It is the case of a business man of 49, of neurotic heredity, an affectionate husband and father of a family, who, to his own grief and shame, is compelled from time to time to exhibit his sexual organs to women in the street. As a boy of 10 a girl of 12 tried to induce him to coitus; both had their sexual parts exposed. From that time sexual contacts, as of his own naked nates against those of a girl, became attractive, as well as games in which the boys and girls in turn marched before each other with their sexual parts exposed, and also imitation of the copulation of animals. Coitus was first practiced about the age of 20, but sight and touch of the woman’s sexual parts were always necessary to produce sexual excitement. It was also necessary-and this consideration is highly important as regards the development of the tendency to exhibition-that the woman should be excited by the sight of his organs. Even when he saw or touched a woman’s parts orgasm often occurred. It was the naked sexual organs in an otherwise clothed body which chiefly excited him. He was not possessed of a high degree of potency. Girls between the ages of 10 and 17 chiefly excited him, and especially if he felt that they were quite ignorant of sexual matters. His self-exhibition was a sort of psychic defloration, and it was accompanied by the idea that other people felt as he did about the sexual effects of the naked organs, that he was shocking but at the same time sexually exciting a young girl. He was thus gratifying himself through the belief that he was causing sexual gratification to an innocent girl. This man was convicted several times, and was finally declared to be suffering from impulsive insanity. (Schrenck-Notzing, Kriminal-psychologische und Psycho-pathologische Studien, 1902, pp. 50-57.) In another case of Schrenck-Notzing’s, an actor and portrait painter, aged 31, in youth masturbated and was fond of contemplating the images of the sexual organs of both sexes, finding little pleasure in coitus. At the age of 24, at a bathing establishment, he happened to occupy a compartment next to that occupied by a lady, and when naked he became aware that his neighbor was watching him through a chink in the partition. This caused him powerful excitement and he was obliged to masturbate. Ever since he has had an impulse to exhibit his organs and to masturbate in the presence of women. He believes that the sight of his organs excites the woman (Ib., pp. 57-68). The presence of masturbation in this case renders it untypical as a case of exhibitionism. Moll at one time went so far as to assert that when masturbation takes place we are not entitled to admit exhibitionism, (Untersuchungen ueber die Libido Sexualis, bd. i, , but now accepts exhibitionism with masturbation ("Perverse Sexualempfindung,” Krankheiten und Ehe). The act of exhibition itself gratifies the sexual impulse, and usually it suffices to replace both tumescence and detumescence.

A fairly typical case, recorded by Krafft-Ebing, is that of a German factory worker of 37, a good, sober and intelligent workman. His parents were healthy, but one of his mother’s and also one of his father’s sisters were insane; some of his relatives are eccentric in religion. He has a languishing expression and a smile of self-complacency. He never had any severe illness, but has always been eccentric and imaginative, much absorbed in romances (such as Dumas’s novels) and fond of identifying himself with their heroes. No signs of epilepsy. In youth moderate masturbation, later moderate coitus. He lives a retired life, but is fond of elegant dress and of ornament. Though not a drinker, he sometimes makes himself a kind of punch which has a sexually exciting effect on him. The impulse to exhibitionism has only developed in recent years. When the impulse is upon him he becomes hot, his heart beats violently, the blood rushes to his head, and he is oblivious of everything around him that is not connected with his own act. Afterwards he regards himself as a fool and makes vain resolutions never to repeat the act. In exhibition the penis is only half erect and ejaculation never occurs. (He is only capable of coitus with a woman who shows great attraction to him.) He is satisfied with self-exhibition, and believes that he thus gives pleasure to the woman, since he himself receives pleasure in contemplating a woman’s sexual parts. His erotic dreams are of self-exhibition to young and voluptuous women. He had been previously punished for an offense of this kind; medico-legal opinion now recognized the incriminated man’s psychopathic condition. (Krafft-Ebing, Op. cit., pp. 492-494.)

Trochon has reported the case of a married man of 33, a worker in a factory, who for several years had exhibited himself at intervals to shop-girls, etc., in a state of erection, but without speaking or making other advances. He was a hard-working, honest, sober man of quiet habits, a good father to his family and happy at home. He showed not the slightest sign of insanity. But he was taciturn, melancholic and nervous; a sister was an idiot. He was arrested, but on the report of the experts that he committed these acts from a morbid impulse he could not control he was released. (Trochon, Archives de l’Anthropologie Criminelle, 1888, .)

In a case of Freyer’s (Zeitschrift fuer Medizinalbeamte, third year, N the occasional connection of exhibitionism with epilepsy is well illustrated by a barber’s assistant, aged 35, whose father suffered from chronic alcoholism and was also said to have committed the same kind of offense as his son. The mother and a sister suffered nervously. From ages of 7 to 18 the subject had epileptic convulsions. From 16 to 21 he indulged in normal sexual intercourse. At about that time he had often to pass a playground and at times would urinate there; it happened that the children watched him with curiosity. He noticed that when thus watched sexual excitement was caused, inducing erection and even ejaculation. He gradually found pleasure in this kind of sexual gratification; finally he became indifferent to coitus. His erotic dreams, though still usually about normal coitus, were now sometimes concerned with exhibition before little girls. When overcome by the impulse he could see and hear nothing around him, though he did not lose consciousness. After the act was over he was troubled by his deed. In all other respects he was entirely reasonable. He was imprisoned many times for exhibiting himself to young schoolgirls, sometimes vaunting the beauty of his organs and inviting inspection. On one occasion he underwent mental examination, but was considered to be mentally sound. He was finally held to be a hereditarily tainted individual with neuropathic constitution. The head was abnormally broad, penis small, patellar reflex absent, and there were many signs of neurasthenia. (Krafft-Ebing, Op. cit., pp. 490-492.)

The prevalence of epilepsy among exhibitionists is shown by the observations of Pelanda in Verona. He has recorded six cases of this perversion, all of which eventually reached the asylum and were either epileptics or with epileptic relations. One had a brother who was also an exhibitionist. In some cases the penis was abnormally large, in others abnormally small. Several had very weak sexual impulse; one, at the age of 62, had never effected coitus, and was proud of the fact that he was still a virgin, considering, he would say, the epoch of demoralization in which we live. (Pelanda, “Pornopatici,” Archivio di Psichiatria, fasc. ii-iv, 1889.)

In a very typical case of exhibitionism which Garnier has recorded, a certain X., a gentleman engaged in business in Paris, had a predilection for exhibiting himself in churches, more especially in Saint-Roch. He was arrested several times for exposing his sexual organs here before ladies in prayer. In this way he finally ruined his commercial position in Paris and was obliged to establish himself in a small provincial town. Here again he soon exposed himself in a church and was again sent to prison, but on his liberation immediately performed the same act in the same church in what was described as a most imperturbable manner. Compelled to leave the town, he returned to Paris, and in a few weeks’ time was again arrested for repeating his old offense in Saint Roch. When examined by Garnier, the information he supplied was vague and incomplete, and he was very embarrassed in the attempt to explain himself. He was unable to say why he chose a church, but he felt that it was to a church that he must go. He had, however, no thought of profanation and no wish to give offense. “Quite the contrary!” he declared. He had the sad and tired air of a man who is dominated by a force stronger than his will. “I know,” he added, “what repulsion my conduct must inspire. Why am I made thus? Who will cure me?” (P. Garnier, “Perversions Sexuelles,” Comptes Rendus, International Congress of Medicine at Paris in 1900, Section de Psychiatrie, pp. 433-435.)

In some cases, it would appear, the impulse to exhibitionism may be overcome or may pass away. This result is the more likely to come about in those cases in which exhibitionism has been largely conditioned by chronic alcoholism or other influences tending to destroy the inhibiting and restraining action of the higher centers, which may be overcome by hygiene and treatment. In this connection I may bring forward a case which has been communicated to me by a medical correspondent in London. It is that of an actor, of high standing in his profession and extremely intelligent, 49 years of age, married and father of a large family. He is sexually vigorous and of erotic temperament. His general health has always been good, but he is a high-strung, neurotic man, with quick mental reactions. His habits had for a long time been decidedly alcoholic, but two years ago, a small quantity of albumen being found in the urine, he was persuaded to leave off alcohol, and has since been a teetotaller. Though ordinarily very reticent about sexual matters, he began four or five years ago to commit acts of exhibitionism, exposing himself to servants in the house and occasionally to women in the country. This continued after the alcohol had been abandoned and lasted for several years, though the attention of the police was never attracted to the matter, and so far as possible he was quietly supervised by his friends. Nine months after, the acts of exhibitionism ceased, apparently in a spontaneous manner, and there has so far been no relapse.

Exhibitionism is an act which, on the face of it, seems nonsensical and meaningless, and as such, as an inexplicable act of madness, it has frequently been treated both by writers on insanity and on sexual perversion. “These acts are so lacking in common sense and intelligent reflection that no other reason than insanity can be offered for the patient,” Ball concluded. Moll, also, who defines exhibitionism somewhat too narrowly as a condition in which “the charm of the exhibition lies for the subject in the display itself,” not sufficiently taking into consideration the imagined effect on the spectator, concludes that “the psychological basis of exhibitionism is at present by no means cleared up."

We may probably best approach exhibitionism by regarding it as fundamentally a symbolic act based on a perversion of courtship. The exhibitionist displays the organ of sex to a feminine witness, and in the shock of modest sexual shame by which she reacts to that spectacle, he finds a gratifying similitude of the normal emotions of coitus. He feels that he has effected a psychic defloration.

Exhibitionism is thus analogous, and, indeed, related, to the impulse felt by many persons to perform indecorous acts or tell indecent stories before young and innocent persons of the opposite sex. This is a kind of psychic exhibitionism, the gratification it causes lying exactly, as in physical exhibitionism, in the emotional confusion which it is felt to arouse. The two kinds of exhibitionism may be combined in the same person: Thus, in a case reported by Hoche , the exhibitionist an intellectual and highly educated man, with a doctor’s degree, also found pleasure in sending indecent poems and pictures to women, whom, however, he made no attempt to seduce; he was content with the thought of the emotions he aroused or believed that he aroused.

It is possible that within this group should come the agent in the following incident which was lately observed by a lady, a friend of my own. An elderly man in an overcoat was seen standing outside a large and well-known draper’s shop in the outskirts of London; when able to attract the attention of any of the shop-girls or of any girl in the street he would fling back his coat and reveal that he was wearing over his own clothes a woman’s chemise (or possibly bodice) and a woman’s drawers; there was no exposure. The only intelligible explanation of this action would seem to be that pleasure was experienced in the mild shock of interested surprise and injured modesty which this vision was imagined to cause to a young girl. It would thus be a comparatively innocent form of psychic defloration.

It is of interest to point out that the sexual symbolism of active flagellation is very closely analogous to this symbolism of exhibitionism. The flagellant approaches a woman with the rod (itself a symbol of the penis and in some countries bearing names which are also applied to that organ) and inflicts on an intimate part of her body the signs of blushing and the spasmodic movements which are associated with sexual excitement, while at the same time she feels, or the flagellant imagines that she feels, the corresponding emotions of delicious shame. This is an even closer mimicry of the sexual act than the exhibitionist attains, for the latter fails to secure the consent of the woman nor does he enjoy any intimate contact with her naked body. The difference is connected with the fact that the active flagellant is usually a more virile and normal person than the exhibitionist. In the majority of cases the exhibitionist’s sexual impulse is very feeble, and as a rule he is either to some degree a degenerate, or else a person who is suffering from an early stage of general paralysis, dementia, or some other highly enfeebling cause of mental disorganization, such as chronic alcoholism. Sexual feebleness is further indicated by the fact that the individuals selected as witnesses are frequently mere children.

It seems probable that a form of erotic symbolism somewhat similar to exhibitionism is to be found in the rare cases in which sexual gratification is derived from throwing ink, acid or other defiling liquids on women’s dresses. Thoinot has recorded a case of this kind (Attentats aux Moeurs, 1898, pp. 484, et seq.). An instructive case has been presented by Moll. In this case a young man of somewhat neuropathic heredity had as a youth of 16 or 17, when romping with his young sister’s playfellows, experienced sexual sensations on chancing to see their white underlinen. From that time white underlinen and white dresses became to him a fetich and he was only attracted to women so attired. One day, at the age of 25, when crossing the street in wet weather with a young lady in a white dress, a passing vehicle splashed the dress with mud. This incident caused him strong sexual excitement, and from that time he had the impulse to throw ink, perchloride of iron, etc., on to ladies’ white dresses, and sometimes to cut and tear them, sexual excitement and ejaculation taking place every time he effected this. (Moll, “Gutachten ueber einem Sexual Perversen [Besudelungstrieb],” Zeitschrift fuer Medizinalbeamte, Heft XIII, 1900). Such a case is of considerable psychological interest. Thoinot considers that in these cases the fleck is a fetich. That is an incorrect account of the matter. In this case the white garments constituted the primary fetich, but that fetich becomes more acutely realized, and at the same time both parties are thrown into an emotional state which to the fetichist becomes a mimicry of coitus, by the act of defilement. We may perhaps connect with this phenomenon the attraction which muddy shoes often exert over the shoe-fetichist, and the curious way in which, as we have seen , Restif de la Bretonne associates his love of neatness in women with his attraction to the feet, the part, he remarks, least easy to keep clean.

Garnier applied the term sadi-fetichism to active flagellation and many similar manifestations such as we are here concerned with, on the grounds that they are hybrids which combine the morbid adoration for a definite object with the impulse to exercise a more or less degree of violence. From the standpoint of the conception of erotic symbolism I have adopted there is no need for this term. There is here no hybrid combination of two unlike mental states. We are simply concerned with states of erotic symbolism, more or less complete, more or less complex.

The conception of exhibitionism as a process of erotic symbolism, involves a conscious or unconscious attitude of attention in the exhibitionist’s mind to the psychic reaction of the woman toward whom his display is directed. He seeks to cause an emotion which, probably in most cases, he desires should be pleasurable. But from one cause or another his finer sensibilities are always inhibited or in abeyance, and he is unable to estimate accurately either the impression he is likely to produce or the general results of his action, or else he is moved by a strong impulsive obsession which overpowers his judgment. In many cases he has good reason for believing that his act will be pleasurable, and frequently he finds complacent witnesses among the low-class servant girls, etc.

It may be pointed out here that we are quite justified in speaking of a penis-fetichism and also of a vulva-fetichism. This might be questioned. We are obviously justified in recognizing a fetichism which attaches itself to the pubic hair, or, as in a case with which I am acquainted, to the clitoris, but it may seem that we cannot regard the central sexual organs as symbols of sex, symbols, as it were, of themselves. Properly regarded, however, it is the sexual act rather than the sexual organ which is craved in normal sexual desire; the organ is regarded merely as the means and not as the end. Regarded as a means the organ is indeed an object of desire, but it only becomes a fetich when it arrests and fixes the attention. An attention thus pleasurably fixed, a vulva-fetichism or a penis-fetichism, is within the normal range of sexual emotion (this point has been mentioned in the previous volume when discussing the part played by the primary sexual organs in sexual selection), and in coarse-grained natures of either sex it is a normal allurement in its generalized shape, apart from any attraction to the person to whom the organs belong. In some morbid cases, however, this penis-fetichism may become a fully developed sexual perversion. A typical case of this kind has been recorded by Howard in the United States. Mrs. W., aged 39, was married at 20 to a strong, healthy man, but derived no pleasure from coitus, though she received great pleasure from masturbation practiced immediately after coitus, and nine years after marriage she ceased actual coitus, compelling her husband to adopt mutual masturbation. She would introduce men into the house at all times of the day or night, and after persuading them to expose their persons would retire to her room to masturbate. The same man never aroused desire more than once. This desire became so violent and persistent that she would seek out men in all sorts of public places and, having induced them to expose themselves, rapidly retreat to the nearest convenient spot for self-gratification. She once abstracted a pair of trousers she had seen a man wear and after fondling them experienced the orgasm. Her husband finally left her, after vainly attempting to have her confined in an asylum. She was often arrested for her actions, but through the intervention of friends set free again. She was a highly intelligent woman, and apart from this perversion entirely normal. (W.L. Howard, “Sexual Perversion,” Alienist and Neurologist, January, 1896.) It is on the existence of a more or less developed penis-fetichism of this kind that the exhibitionist, mostly by an ignorant instinct, relies for the effects he desires to produce.

The exhibitionist is not usually content to produce a mere titillated amusement; he seeks to produce a more powerful effect which must be emotional whether or not it is pleasurable. A professional man in Strassburg (in a case reported by Hoche) would walk about in the evening in a long cloak, and when he met ladies would suddenly throw his cloak back under a street lamp, or igniting a red-fire match, and thus exhibit his organs. There was an evident effort-on the part of a weak, vain, and effeminate man-to produce a maximum of emotional effect. The attempt to heighten the emotional shock is also seen in the fact that the exhibitionist frequently chooses a church as the scene of his exploits, not during service, for he always avoids a concourse of people, but perhaps toward evening when there are only a few kneeling women scattered through the edifice. The church is chosen, often instinctively rather than deliberately, from no impulse to commit a sacrilegious outrage-which, as a rule, the exhibitionist does not feel his act to be-but because it really presents the conditions most favorable to the act and the effects desired. The exhibitionist’s attitude of mind is well illustrated by one of Garnier’s patients who declared that he never wished to be seen by more than two women at once, “just what is necessary,” he added, “for an exchange of impressions.” After each exhibition he would ask himself anxiously: “Did they see me? What are they thinking? What do they say to each other about me? Oh! how I should like to know!” Another patient of Garnier’s, who haunted churches for this purpose, made this very significant statement: “Why do I like going to churches? I can scarcely say. But I know that it is only there that my act has its full importance. The woman is in a devout frame of mind, and she must see that such an act in such a place is not a joke in bad taste or a disgusting obscenity; that if I go there it is not to amuse myself; it is more serious than that! I watch the effect produced on the faces of the ladies to whom I show my organs. I wish to see them express a profound joy. I wish, in fact, that they may be forced to say to themselves: How impressive Nature is when thus seen!”

Here we trace the presence of a feeling which recalls the phenomena of the ancient and world-wide phallic worship, still liable to reappear sporadically. Women sometimes took part in these rites, and the osculation of the male sexual organ or its emblematic representation by women is easily traceable in the phallic rites of India and many other lands, not excluding Europe even in comparatively recent times. (Dulaure in his Divinités Generatices brings together much bearing on these points; cf.: Ploss and Bartels, Das Weib, vol. i, Chapter XVII, and Bloch, Beitraege zur Psychopathia Sexualis, Teil I, pp. 115-117. Colin Scott has some interesting remarks on phallic worship and the part it has played in aiding human evolution, “Sex and Art,” American Journal of Psychology, vol. vii, N, pp. 191-197. Irving Rosse describes some modern phallic rites in which both men and women took part, similar to those practiced in vaudouism, “Sexual Hypochondriasis,” Virginia Medical Monthly, October, 1892.)

Putting aside any question of phallic worship, a certain pride and more or less private feeling of ostentation in the new expansion and development of the organs of virility seems to be almost normal at adolescence. “We have much reason to assume,” Stanley Hall remarks, “that in a state of nature there is a certain instinctive pride and ostentation that accompanies the new local development. I think it will be found that exhibitionists are usually those who have excessive growth here, and that much that modern society stigmatizes as obscene is at bottom more or less spontaneous and perhaps in some cases not abnormal. Dr. Seerley tells me he has never examined a young man largely developed who had the usual strong instinctive tendency of modesty to cover himself with his hands, but he finds this instinct general with those whose development is less than the average.” (G. Stanley Hall, Adolescence, vol. ii, .) This instinct of ostentation, however, so far as it is normal, is held in check by other considerations, and is not, in the strict sense, exhibitionism. I have observed a full-grown telegraph boy walking across Hampstead Heath with his sexual organs exposed, but immediately he realized that he was seen he concealed them. The solemnity of exhibitionism at this age finds expression in the climax of the sonnet, “Oraison du Soir,” written at 16 by Rimbaud, whose verse generally is a splendid and insolent manifestation of rank adolescence:-

“Doux comme lé Seigneur du cèdre et des hysopes, Je pisse vers les cieux bruns très haut et très loin, Avec l’assentiment des grands héliotropes.”

(J.A. Rimbaud, Oeuvres, .)

In women, also, there would appear to be traceable a somewhat similar ostentation, though in them it is complicated and largely inhibited by modesty, and at the same time diffused over the body owing to the absence of external sexual organs. “Primitive woman,” remarks Madame Renooz, “proud of her womanhood, for a long time defended her nakedness which ancient art has always represented. And in the actual life of the young girl to-day there is a moment when by a secret atavism she feels the pride of her sex, the intuition of her moral superiority, and cannot understand why she must hide its cause. At this moment, wavering between the laws of Nature and social conventions, she scarcely knows if nakedness should or should not affright her. A sort of confused atavistic memory recalls to her a period before clothing was known, and reveals to her as a paradisaical ideal the customs of that human epoch.” (Celine Renooz, Psychologie Comparee de l’Homme et de la Femme, .) It may be added that among primitive peoples, and even among some remote European populations to-day, the exhibition of feminine nudity has sometimes been regarded as a spectacle with religious or magic operation. (Ploss, Das Weib, seventh edition, vol. ii, pp. 663-680; Havelock Ellis, Man and Woman, fourth edition, .) It is stated by Gopcevic that in the long struggle between the Albanians and the Montenegrians the women of the former people would stand in the front rank and expose themselves by raising their skirts, believing that they would thus insure victory. As, however, they were shot down, and as, moreover, victory usually fell to the Montenegrians, this custom became discredited. (Quoted by Bloch, Op. cit., Teil II, .)

With regard to the association, suggested by Stanley Hall, between exhibitionism and an unusual degree of development of the sexual organs, it must be remarked that both extremes-a very large and a very small penis-are specially common in exhibitionists. The prevalence of the small organ is due to an association of exhibitionism with sexual feebleness. The prevalence of the large organ may be due to the cause suggested by Hall. Among Mahommedans the sexual organs are sometimes habitually exposed by religious penitents, and I note that Bernhard Stern, in his book on the medical and sexual aspects of life in Turkey, referring to a penitent of this sort whom he saw on the Stamboul bridge at Constantinople, remarks that the organ was very largely developed. It may well be in such a case that the penitent’s religious attitude is reinforced by some lingering relic of a more fleshly ostentation.

It is by a pseudo-atavism that this phallicism is evoked in the exhibitionist. There is no true emergence of an ancestrally inherited instinct, but by the paralysis or inhibition of the finer and higher feelings current in civilization, the exhibitionist is placed on the same mental level as the man of a more primitive age, and he thus presents the basis on which the impulses belonging to a higher culture may naturally take root and develop.

Reference may here be made to a form of primitive exhibitionism, almost confined to women, which, although certainly symbolic, is absolutely non-sexual, and must not, therefore, be confused with the phenomena we are here occupied with. I refer to the exhibition of the buttocks as a mark of contempt. In its most primitive form, no doubt, this exhibitionism is a kind of exorcism, a method of putting evil spirits, primarily, and secondarily evil-disposed persons, to flight. It is the most effective way for a woman to display sexual centers, and it shares in the magical virtues which all unveiling of the sexual centers is believed by primitive peoples to possess. It is recorded that the women of some peoples in the Balkan peninsula formerly used this gesture against enemies in battle. In the sixteenth century so distinguished a theologian as Luther when assailed by the Evil One at night was able to put the adversary to flight by protruding his uncovered buttocks from the bed. But the spiritual significance of this attitude is lost with the decay of primitive beliefs. It survives, but merely as a gesture of insult. The symbolism comes to have reference to the nates as the excretory focus, the seat of the anus. In any case it ignores any sexual attractiveness in this part of the body. Exhibitionism of this kind, therefore, can scarcely arise in persons of any sensitiveness or aesthetic perception, even putting aside the question of modesty, and there seems to be little trace of it in classic antiquity when the nates were regarded as objects of beauty. Among the Egyptians, however, we gather from Herodotus (Bk. II, Chapter LX) that at a certain popular religious festival men and women would go in boats on the Nile, singing and playing, and when they approached a town the women on the boats would insult the women of the town by injurious language and by exposing themselves. Among the Arabs, however, the specific gesture we are concerned with is noted, and a man to whom vengeance is forbidden would express his feelings by exposing his posterior and strewing earth on his head (Wellhausen, Rests Arabischen Heidentums, 1897, . It is in Europe and in mediaeval and later times that this emphatic gesture seems to have flourished as a violent method of expressing contempt. It was by no means confined to the lower classes, and Kleinpaul, in discussing this form of “speech without words,” quotes examples of various noble persons, even princesses, who are recorded thus to have expressed their feelings. (Kleinpaul, Sprache ohne Worte, pp. 271-273.) In more recent times the gesture has become merely a rare and extreme expression of unrestrained feeling in coarse-grained peasants. Zola, in the figure of Mouquette in Germinal, may be said to have given a kind of classic expression to the gesture. In the more remote parts of Europe it appears to be still not altogether uncommon. This seems to be notably the case among the South Slavs, and Krauss states that “when a South Slav woman wishes to express her deepest contempt for anyone she bends forward, with left hand raising her skirts, and with the right slapping her posterior, at the same time exclaiming: ‘This for you!’” (Kryptadia, vol. vi, .)

A verbal survival of this gesture, consisting in the contemptuous invitation to kiss this region, still exists among us in remote parts of the country, especially as an insult offered by an angry woman who forgets herself. It is said to be commonly used in Wales. ("Welsh AEdoelogy,” Kryptadia, vol. ii, pp. 358, et seq.) In Cornwall, when addressed by a woman to a man it is sometimes regarded as a deadly insult, even if the woman is young and attractive, and may cause a life-long enmity between related families. From this point of view the nates are a symbol of contempt, and any sexual significance is excluded. (The distinction is brought out by Diderot in Le Neveu de Rameau: “Lui:-Il y a d’autres jours où il ne m’en couterait rien pour être vil tant qu’on voudrait; ces jours-la, pour un liard, je baiserais lé cul a la petite Hus. Moi:-Eh! maïs, l’ami, elle est blanche, jolie, douce, potelée, et c’est un acte d’humilite auquel un plus delicat que vous pourrait quelquefois s’abaisser. Lui:-Entendons-nous; c’est qu’il y a baiser lé cul au simple, et baiser lé cul au figure.”)

It must be added that a sexual form of exhibitionism of the nates must still be recognized. It occurs in masochism and expresses the desire for passive flagellation. Rousseau, whose emotional life was profoundly affected by the castigations which as a child he received from Mlle Lambercier, has in his Confessions told us how, when a youth, he would sometimes expose himself in this way in the presence of young women. Such masochistic exhibitionism seems, however, to be rare.

While the manifestations of exhibitionism are substantially the same in all cases, there are many degrees and varieties of the condition. We may find among exhibitionists, as Garnier remarks, dementia, states of unconsciousness, epilepsy, general paralysis, alcoholism, but the most typical cases, he adds, if not indeed the cases to which the term properly belongs, are those in which it is an impulsive obsession. Krafft-Ebing divides exhibitionists into four clinical groups: (1) acquired states of mental weakness, with cerebral or spinal disease clouding consciousness and at the same time causing impotence; (2) epileptics, in whom the act is an abnormal organic impulse performed in a state of imperfect consciousness; (3) a somewhat allied group of neurasthenic cases; (4) periodical impulsive cases with deep hereditary taint. This classification is not altogether satisfactory. Garnier’s classification, placing the group of obsessional cases in the foreground and leaving the other more vaguely defined groups in the background, is probably better. I am inclined to consider that most of the cases fall into one or other of two mixed groups. The first class includes cases in which there is more or less congenital abnormality, but otherwise a fair or even complete degree of mental integrity; they are usually young adults, they are more or less precisely conscious of the end they wish to attain, and it is often only with a severe struggle that they yield to their impulses. In the second class the beginnings of mental or nervous disease have diminished the sensibility of the higher centers; the subjects are usually old men whose lives have been absolutely correct; they are often only vaguely aware of the nature of the satisfaction they are seeking, and frequently no struggle precedes the manifestation; such was the case of the overworked clergyman described by Hughes, who, after much study, became morose and absent-minded, and committed acts of exhibitionism which he could not explain but made no attempt to deny; with rest and restorative treatment his health improved and the acts ceased. It is in the first class of cases alone that there is a developed sexual perversion. In the cases of the second class there is a more or less definite sexual intention, but it is only just conscious, and the emergence of the impulse is due not to its strength but to the weakness, temporary or permanent, of the higher inhibiting centers.

Epileptic cases, with loss of consciousness during the act, can only be regarded as presenting a pseudo-exhibitionism. They should be excluded altogether. It is undoubtedly true that many cases of real or apparent exhibitionism occur in epileptics. We must not, however, too hastily conclude that because these acts occur in epileptics they are necessarily unconscious acts. Epilepsy frequently occurs on a basis of hereditary degeneration, and the exhibitionism may be, and not infrequently is, a stigma of the degeneracy and not an indication of the occurrence of a minor epileptic fit. When the act of pseudo-exhibitionism is truly epileptic, it will usually have no psychic sexual content, and it will certainly be liable to occur under all sorts of circumstances, when the patient is alone or in a miscellaneous concourse of people. It will be on a level with the acts of the highly respectable young woman who, at the conclusion of an attack of petit mal, consisting chiefly of a sudden desire to pass urine, on one occasion lifted up her clothes and urinated at a public entertainment, so that it was with difficulty her friends prevented her from being handed over to the police. Such an act is automatic, unconscious, and involuntary; the spectators are not even perceived; it cannot be an act of exhibitionism. Whenever, on the other hand, the place and the time are evidently chosen deliberately,-a quiet spot, the presence of only one or two young women or children,-it is difficult to admit that we are in the presence of a fit of epileptic unconsciousness, even when the subject is known to be epileptic.

Even, however, when we exclude those epileptic pseudo-exhibitionists who, from the legal point of view, are clearly irresponsible, it must still be remembered that in every case of exhibitionism there is a high degree of either mental abnormality on a neuropathic basis, or else of actual disease. This is true to a greater extent in exhibitionism than in almost any other form of sexual perversion. No subject of exhibitionism should be sent to prison without expert medical examination.