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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.
 Lasege first drew attention to this sexual perversion and gave it its
generally accepted name, "Les Exhibitionistes," _L'Union Medicale_, May,
1877. Magnan, on various occasions (for example, "Les Exhibitionistes,"
_Archives de l'Anthropologie Criminelle_, vol. v, 1890, p. 456), has given
further development and precision to the clinical picture of the
 B. Ball. _La Folie Erotique_, p. 86.
 Moll, _Untersuchungen ueber die Libido Sexualis_, bd. i, p. 661.
 "Exhibitionism in its most typical form is," Garnier truly says, "a
_systematic act_, manifesting itself as the _strange equivalent of a
sexual connection_, or its _substitution_." The brief account of
exhibitionism (pp. 433-437) in Garnier's discussion of "Perversions
Sexuelles" at the International Medical Congress at Paris in 1900
(_Section de Psychiatrie: Comptes-Rendus_) is the most satisfactory
statement of the psychological aspects of this perversion with which I am
acquainted. Garnier's unrivalled clinical knowledge of these
manifestations, due to his position during many years as physician at the
Depot of the Prefecture of Police in Paris, adds great weight to his
 The symbolism of coitus involved in flagellation has been touched on
by Eulenburg (_Sexuale Neuropathie_, p. 121), and is more fully developed
by Duehren (_Geschlechtsleben in England_, bd. ii, pp. 366, _et seq._).
 A. Hoche, _Neurologische Centralblatt_, 1896, No. 2.
 _Op. cit._, pp. 478, et seq.
 C.H. Hughes, "Morbid Exhibitionism," _Alienist and Neurologist_,
August, 1904. Another somewhat similar American case, also preceded by
overwork, and eventually adjudged insane by the courts, is recorded by
D.S. Booth, _Alienist and Neurologist_, February, 1905.
 Exhibitionism in epilepsy is briefly discussed by Fere, _L'Instinct
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