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[60] 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,[61] 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.[62] 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