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An account of a case of obsessional neurosis and perversion during the analysis of which a peculiar form of homosexuality was manifested. A married man, aged 37, had a compulsion to stare at people in the street, and in the event of their returning his scrutiny experienced fainting seizures. As a youth he had homosexual inclinations which he sometimes gratified. At the age of four he had inspected his mother's buttocks, and as a child was given to sucking the noses of animals and of other people. His homosexual phantasies were active in nature and exhibited a marked component of oral gratification: sucking the noses and penes of companions provided him with sexual satisfaction. After puberty there had been a gradual increase in heterosexual inclination, but he had had no intercourse until his marriage at thirty-two. It transpired that at the age of five he had played with a warehouse hand who had allowed him to suck her nipples. Anal coitus was accompanied with murder phantasies and other sadistic ideas.
Analysis showed that the penis was a surrogate for the nipple and that he equated masturbation with the milking of cows: an equation of mammæ