Transcriber’s Note:

The cover image was created by the transcriber and is placed in the public domain.

Psychopathia Sexualis,
WITH ESPECIAL REFERENCE TO
Contrary Sexual Instinct:
A MEDICO-LEGAL STUDY.

By Dr. R. von KRAFFT-EBING,

Professor of Psychiatry and Neurology, University of Vienna.

AUTHORIZED TRANSLATION

OF THE

SEVENTH ENLARGED AND REVISED GERMAN EDITION,

BY

CHARLES GILBERT CHADDOCK, M.D.,

Professor of Nervous and Mental Diseases, Marion-Sims College of Medicine, St. Louis; Fellow of the Chicago Academy of Medicine; Corresponding Member of the Detroit Academy of Medicine; Associate Member of the American Medico-Psychological Association, etc.

PHILADELPHIA AND LONDON:

THE F. A. DAVIS CO., PUBLISHERS.

1893.

Entered according to Act of Congress, in the year 1892, by

THE F. A. DAVIS COMPANY,

In the Office of the Librarian of Congress, at Washington, D. C., U. S. A.

All rights reserved.

Philadelphia, Pa., U. S. A.:

The Medical Bulletin Printing House,

1916 Cherry Street.

PREFACE TO THE FIRST EDITION.

Very few ever fully appreciate the powerful influence which sexuality exercises over feeling, thought, and conduct, both in the individual and in society. Schiller, in his poem, “Die Weltweisen,” recognizes it with the words:—

“Einstweilen bis den Bau der Welt

Philosophie zusammenhält,

Erhält sie das Getriebe

Durch Hunger und durch Liebe.”[^[1]]

It is remarkable that the sexual life has received but a very subordinate consideration on the part of philosophers.

Schopenhauer (“The World as Will and Idea”) thought it strange that love had been thus far a subject for the poet alone, and that, with the exception of superficial treatment by Plato, Rousseau, and Kant, it had been foreign to philosophers.

What Schopenhauer and, after him, the Philosopher of the Unconscious, E. v. Hartmann, philosophized concerning the sexual relations is so imperfect, and in its consequences so distasteful, that, aside from the treatment in the works of Michelet (“L’amour”) and Mantegazza (“Physiology of Love”), which are to be considered more as brilliant discussions than as scientific treatises, the empirical psychology and metaphysics of the sexual side of human existence rest upon a foundation which is scientifically almost puerile.

The poets may be better psychologists than the psychologists and philosophers; but they are men of feeling rather than of understanding, and at least one-sided in their consideration of the subject. They cannot see the deep shadow behind the light and sunny warmth of that from which they draw their inspiration. The poetry of all times and nations would furnish inexhaustible material for a monograph on the psychology of love; but the great problem can be solved only with the help of Science, and especially with the aid of Medicine, which studies the psychological subject at its anatomical and physiological source, and views it from all sides.

Perhaps it will be possible for medical science to gain a stand-point of philosophical knowledge midway between the despairing views of philosophers like Schopenhauer and Hartmann[^[2]] and the gay, näive views of the poets.

It is not the intention of the author to lay the foundation of a psychology of the sexual life, though without doubt psychopathology would furnish many important sources of knowledge to psychology.

The purpose of this treatise is a description of the pathological manifestations of the sexual life and an attempt to refer them to their underlying conditions. The task is a difficult one, and, in spite of years of experience as alienist and medical jurist, I am well aware that what I can offer must be incomplete.

The importance of the subject for the welfare of society, especially forensically, demands, however, that it should be examined scientifically. Only he who, as a medico-legal expert, has been in a position where he has been compelled to pass judgment upon his fellow-men, where life, freedom, and honor were at stake, and realized painfully the incompleteness of our knowledge concerning the pathology of the sexual life, can fully understand the significance of an attempt to gain definite views concerning it.

Even at the present time, in the domain of sexual criminality, the most erroneous opinions are expressed and the most unjust sentences pronounced, influencing laws and public opinion.

He who makes the psychopathology of sexual life the object of scientific study sees himself placed on a dark side of human life and misery, in the shadows of which the godlike creations of the poet become hideous masks, and morals and æsthetics seem out of place in the “image of God.”

It is the sad province of Medicine, and especially of Psychiatry, to constantly regard the reverse side of life,—human weakness and misery.

Perhaps in this difficult calling some consolation may be gained, and extended to the moralist, if it be possible to refer to morbid conditions much that offends ethical and æsthetic feeling. Thus Medicine undertakes to save the honor of mankind before the Court of Morality, and individuals from judges and their fellow-men. The duty and right of medical science in these studies belong to it by reason of the high aim of all human inquiry after truth.

The author would take to himself the words of Tardieu (“Des attentats aux moeurs”): “Aucune misère physique ou morale, aucune plaie, quelque corrompue qu’elle soit, ne doit effrayer celui qui s’est voué a la science de l’homme et le ministère sacré du médecin, en l’obligeant à tout voir, lui permet aussi de tout dire.”[^[3]]

The following pages are addressed to earnest investigators in the domain of natural science and jurisprudence. In order that unqualified persons should not become readers, the author saw himself compelled to choose a title understood only by the learned, and also, where possible, to express himself in terminis technicis. It seemed necessary also to give certain particularly revolting portions in Latin[^[4]] rather than in German.

It is hoped that this attempt to present to physician and jurist facts from an important sphere of life will receive kindly acceptance and fill an actual hiatus in literature; for, with the exception of certain single descriptions and cases, the literature presents only the writings of Moreau and Tarnowsky, which cover but a portion of the field.[^[5]]

TRANSLATOR’S PREFACE.

The distinguished author of “Psychopathia Sexualis” speaks for himself and his work in its preface; but there are not wanting others to speak for him.

Dr. A. von Schrenck-Notzing, of Munich, writes[^[6]]:—

“It may be questioned whether it is justifiable to discuss the anomalies of the sexual instinct apart, instead of treating of them in their proper place in psychiatry. As a rule, they are certainly only symptoms of a constitutional malady, or of a weakened state of the brain, which manifest themselves in the various forms of sexual perversion.

“Moreover, attention has been directed to the baneful influence possibly exerted by such publications as ‘Psychopathia Sexualis.’ To be sure, the appearance of seven editions of that work could not be accounted for were its circulation confined to scientific readers. Therefore, it cannot be denied that a pornographic interest on the part of the public is accountable for a part of the wide circulation of the book. But, in spite of this disadvantage, the injury done by implanting knowledge of sexual pathology in unqualified persons is not to be compared with the good accomplished. History shows that uranism was very wide-spread long before the appearance of ‘Psychopathia Sexualis.’ The courts have constantly to deal with sexual crimes in which the responsibility of the accused comes in question.

“For the physician himself, sexual anomalies, treated as they are in a distant manner in text-books on psychiatry, are in greater part a terra incognita. Exact knowledge of the causes and conditions of development of sexual aberrations, and of the influence on them of hereditary constitution, education, the impressions of every-day life, and modern refined civilization, is the prerequisite for a rational prophylaxis of sexual aberrations, and for a correct sexual education. Without careful study of the circumstances which attend the development of sexual anomalies, we should never be in a position to use effectual therapeusis. The majority of these unfortunates—Krafft-Ebing calls them Nature’s step-children—are devoid of insight into their malady; like insane patients destitute of understanding of the ethical development of man, they are happy in their abnormal instinctive tendency. For this reason, in spite of the great prevalence of uranism, very few of its subjects seek medical treatment. While the terminal forms of sexual aberrations end in asylums for the insane, the doubtful cases, in which incompleteness of development or apparent viciousness render correct diagnosis difficult, make up the majority. But a thorough knowledge of the aberrations of the sexual instinct is absolutely indispensable to the jurist. The reasons given are thus sufficiently important to demonstrate the need of a hand-book on ‘psychopathia sexualis.’”

These words also hold true for English-speaking physicians and jurists,—who can scarcely fail to welcome the translation of a work so systematic and comprehensive as “Psychopathia Sexualis”; a work conceived and executed in the highest scientific and humane spirit; a work which not only broadens and systematizes our knowledge of psycho-sexual phenomena, but also demonstrates, in the results of hypnotic suggestion, how important mental therapeusis must ultimately become in the hands of the physician; a work which is a trustworthy guide in the study of the concrete case of sexual crime, and a philosophical treatise on the inter-relations of sexual criminality, disease, and criminal anthropology.

The difficulties of translation have not been slight; but minor errors cannot destroy the author’s meaning.

For much encouragement in the work of translation my gratitude to Dr. James G. Kiernan and Dr. G. Frank Lydston, of Chicago, both well-known investigators in this domain of psychopathology, is here expressed; and to Dr. William A. Stone, Assistant Superintendent at the Michigan Asylum, Kalamazoo, I am greatly indebted for assistance in the preparation of the manuscript.

Charles Gilbert Chaddock.

St. Louis, Mo.,

November, 1892.

TABLE OF CONTENTS.

I. A FRAGMENT
OF A
PSYCHOLOGY OF THE SEXUAL LIFE.

The propagation of the human species is not committed to accident or to the caprice of the individual, but made secure in a natural instinct, which, with all-conquering force and might, demands fulfillment. In the gratification of this natural impulse are found not only sensual pleasure and sources of physical well-being, but also higher feelings of satisfaction in perpetuating the single, perishable existence, by the transmission of mental and physical attributes to a new being. In coarse, sensual love, in the lustful impulse to satisfy this natural instinct, man stands on a level with the animal; but it is given to him to raise himself to a height where this natural instinct no longer makes him a slave: higher, nobler feelings are awakened, which, notwithstanding their sensual origin, expand into a world of beauty, sublimity, and morality.

On this height man overcomes his natural instinct, and from an inexhaustible spring draws material and inspiration for higher enjoyment, for more earnest work, and the attainment of the ideal. Maudsley (Deutsche Klinik, 1873, 2, 3) rightly calls the sexual feeling the foundation for the development of the social feeling. “Were man to be robbed of the instinct of procreation and all that arises from it mentally, nearly all poetry and, perhaps, the entire moral sense as well, would be torn from his life.”

Sexuality is the most powerful factor in individual and social existence; the strongest incentive to the exertion of strength and acquisition of property, to the foundation of a home, and to the awakening of altruistic feelings, first for a person of the opposite sex, then for the offspring, and, in a wider sense, for all humanity.

Thus all ethics and, perhaps, a good part of æsthetics and religion depend upon the existence of sexual feeling.

Though the sexual life leads to the highest virtues, even to the sacrifice of the ego, yet in its sensual force lies also the danger that it may degenerate into powerful passions and develop the grossest vices.

Love as an unbridled passion is like a fire that burns and consumes everything; like an abyss that swallows all,—honor, fortune, well-being.

It seems of high psychological interest to trace the developmental phases through which, in the course of the evolution of human culture to the morality and civilization of to-day, the sexual life has passed.[^[7]] On primitive ground the satisfaction of the sexual appetite of man seems like that of the animal. Openness in the sexual act is not shunned; man and woman are not ashamed to go naked. To-day we see savages in this condition (comp. Ploss, “Das Weib,” p. 196, 1884); as, for example, the Australians, the Polynesians, and the Malays of the Philippines. The female is the common property of the males, the temporary booty of the strongest, who strive for the possession of the most beautiful of the opposite sex, thus carrying out instinctively a kind of sexual selection.

Woman is a movable thing, a ware, an object of bargain and sale and gift; a thing to satisfy lust and to work.

The appearance of a feeling of shame before others in the manifestation and satisfaction of the natural instinct, and modesty in the intercourse of the sexes, form the beginning of morality in the sexual life. From this arose the effort to conceal the genitals (“And they knew that they were naked”) and the secret performance of the sexual act.

The development of this degree of culture is favored by the rigors of climate and the necessity for complete protection of the body thus entailed. Thus in part the fact is explained that among northern races modesty may be proved anthropologically earlier than among southern races.

A further stage in the development of culture in sexual life is marked when the female ceases to be a movable thing. She becomes a person; and if still for a long time placed far below the male socially, yet the idea that the right of disposal of herself and her favors belongs to her is developed.

Thus she becomes the object of the male’s wooing. To the barbarous sensual feeling of sexual desire the beginnings of ethical feeling are added. The instinct is intellectualized. Property in women ceases to exist. Individuals of the opposite sexes feel themselves drawn toward each other by mental and physical qualities, and show love for each other only. At this stage woman has a feeling that her charms belong only to the man of her choice, and wishes to conceal them from others. Thus, by the side of modesty, the foundations of chastity and faithfulness—as long as the bond of love lasts—are laid.

Woman attains this degree of social elevation earlier when, at the transition from nomadic life to a state of fixed habitation, man obtains a house and home, and the necessity arises for him to possess in woman a companion for the household,—a housewife.

Among the nations of the East, the Egyptians, the Israelites, and the Greeks, and among those of the West, the Germans, early attained this stage of culture. Among all these races, at this stage of advancement, the esteem in which virginity, chastity, modesty, and sexual faithfulness are held is in marked contrast with other nations which offer the female of the house to the guest for his sexual enjoyment.[^[8]]

That this stage in the culture of sexual morality is quite high and makes its appearance much later than other developmental forms of culture—as, for example, æsthetics—is seen from the condition of the Japanese, with whom it is the custom to marry a woman only after she has lived for a year in the tea-houses (which correspond with European houses of prostitution), and to whom the nakedness of women is nothing shocking. At all events, among the Japanese every unmarried woman can prostitute herself without lessening her value as a future wife,—a proof that with this remarkable people woman possesses no ethical worth, but is valued in marriage only as a means of enjoyment, procreation, and work.

Christianity gave the most powerful impulse to the moral elevation of the sexual relations by raising woman to social equality with man and elevating the bond of love between man and woman to a religio-moral institution.[^[9]]

The fact that in higher civilization human love must be monogamous and rest on a lasting contract was thus recognized. If nature does no more than provide for procreation, a commonwealth (family or state) cannot exist without a guaranty that the offspring shall flourish physically, morally, and intellectually. Christendom gained both mental and material superiority over the polygamous races, especially Islam, through the equalization of woman and man, and by establishing monogamous marriage and securing it by legal, religious, and moral ties.

If Mohammed was actuated by a desire to raise woman from her place as a slave and means of sensual gratification to a higher social and matrimonial plane, nevertheless, in the Mohammedan world woman remained far below man, to whom alone divorce was allowed and also made very easy.

Islam kept woman from any participation in public life under all circumstances, and thus hindered her intellectual and moral development. In consequence of this the Mohammedan woman has ever remained essentially a means of sensual gratification and procreation; while, on the other hand, the virtues and capabilities of the Christian woman, as housewife, educator of children, and equal companion of man, have been allowed to unfold in all their beauty. Islam, with its polygamy and harem-life, is glaringly contrasted with the monogamy and family life of the Christian world.

The same contrast is apparent in a comparison of the two religions with reference to the conception of the hereafter. The picture of eternity seen by the faith of the Christian is that of a paradise freed from all earthly sensuality, promising the purest of intellectual happiness; the fancy of the Mussulman fills the future life with the delights of a harem full of houris.

In spite of all the aids which religion, law, education, and morality give civilized man in the bridling of his passions, he is always in danger of sinking from the clear height of pure, chaste love into the mire of common sensuality.

In order to maintain one’s self on such a height, a constant struggle between natural impulses and morals, between sensuality and morality, is required. Only characters endowed with strong wills are able to completely emancipate themselves from sensuality and share in that pure love from which spring the noblest joys of human life.

It is yet questionable whether, in the course of the later centuries, mankind has advanced in morality. It is certain, however, that the race has become more modest; and this phenomenon of civilization—this hiding of the animal propensities—is, at least, a concession that vice makes to virtue.

From a reading of Scherr’s works (“History of German Civilization”) one would certainly gain the impression that, in comparison with those of the Middle Ages, our own ideas of morals have become refined, even when it must also be allowed that in many instances finer manners, without greater morality, have taken the place of earlier obscenity and coarseness of expression.

When widely separated periods of history are compared, no doubt is left that public morality, in spite of occasional temporary retrogression, makes continuous progress, and that Christianity is one of the most powerful of the forces favoring moral progress.

To-day we are far beyond the sexual conditions which, as shown in the sodomitic worship of the gods, in the life of the people, and in the laws and religious practices, existed among the ancient Greeks,—to say nothing of the worship of Phallus and Priapus among the Athenians and Babylonians, of the bacchanals of ancient Rome, and the prominent place prostitutes took among these peoples. In the slow and often imperceptible progress which human morality makes there are variations or fluctuations, just as in the individual sexuality manifests an ebb and flow.

Periods of moral decadence in the life of a people are always contemporaneous with times of effeminacy, sensuality, and luxury. These conditions can only be conceived as occurring with increased demands upon the nervous system, which must meet these requirements. As a result of increase of nervousness, there is increase of sensuality, and, since this leads to excesses among the masses, it undermines the foundation of society,—the morality and purity of family life. When this is destroyed by excesses, unfaithfulness, and luxury, then the destruction of the state is inevitably compassed in material, moral, and political ruin. Warning examples of this character are presented by Rome, Greece, and France under Louis XIV and XV.[^[10]] In such times of political and moral destruction monstrous perversions of the sexual life were frequent, which, however, may in part be referred to psycho-pathological or, at least, neuro-pathological conditions existing in the people.

It is shown by the history of Babylon, Nineveh, Rome, and also by the “mysteries” of life in modern Capitals, that large cities are the breeding-places of nervousness and degenerate sensuality. The fact which may be learned from reading Ploss’s work is remarkable, viz., that perversion of the sexual instinct (save among the Aleutians, and in the form of masturbation among the females of the East and the Nama Hottentots) does not occur in uncivilized or half-civilized races.[^[11]]

The study of the sexual life in the individual must begin at its development at puberty, and follow it through its different phases to the extinction of sexual feelings. In his “Physiology of Love,” Mantegazza describes the longings and impulses of awakening sexual life, of which presentiments, indefinite feelings, and impulses have existed long before the epoch of puberty. This epoch is, physiologically, the most important. In the abundant increase of feelings and ideas which it engenders is manifested the significance of the sexual factor in mental life.

These impulses, at first vague and incomprehensible, arising from the sensations which are awakened by organs which were previously undeveloped, are accompanied by a powerful excitation of the emotions. The psychological reaction of the sexual impulse at puberty expresses itself in a multitude of manifestations which have in common only the mental condition of emotion and the impulse to express in some way, or render objective, the strange emotionality. Religion and poetry lie close to it, which, after the time of sexual development is past and these originally incomprehensible feelings and impulses have cleared up, receive powerful incentives from the sexual sphere. He who doubts this has only to think how often religious enthusiasm occurs at the time of puberty; how frequent sexual episodes are in the lives of the saints;[^[12]] how powerfully sensuality expresses itself in the histories of religious fanatics; and in what revolting scenes, true orgies, the religious festivals of antiquity, no less than the “meetings” of certain sects in modern times, express themselves,—to say nothing of the lustful mysteries which characterized the cults of the ancients. On the other hand, we see that unsatisfied sensuality very frequently finds an equivalent in religious enthusiasm.[^[13]]

This relation between religious and sexual feeling is also shown on the basis of unequivocal psycho-pathological states. It suffices to recall how intense sensuality makes itself manifest in the clinical histories of many religious maniacs; the motley mixture of religious and sexual delusions that is so frequently observed in psychoses (e.g., in maniacal women, who think they are or will be the Mother of God), but particularly in masturbatic insanity; and, finally, the sensual, cruel self-punishments, injuries, self-castrations, and even self-crucifixions resulting from abnormal sexual-religious feeling.

Any attempt to explain the relations between religion and love has difficulties to encounter. Many analogies present themselves. The feeling of sexual attraction and religious feeling (considered as a psychological fact) consist of two elements.

In religion the primary element is a feeling of dependence,—a fact which Schleiermacher recognized long before the later studies in anthropology and ethnography, founded on the observation of primitive conditions, had led to the same conclusion. It is only at a higher stage of culture that the second and essentially ethical element—love of God—enters into religious feeling. In the place of the evil spirits of the primitive peoples came the two-faced—now kind, now angry—creations of the more complicated mythologies, until, finally, the God of love, as the giver of eternal happiness, is reverenced, whether this be hoped for from Jehovah, as a blessing on earth; from Allah, as a physical blessing in Paradise; from Christ, as eternal bliss in heaven; or as the Nirvana of the Buddhists.

In sexual desire, love, the expectation of unbounded happiness is the primary element. The feeling of dependence is of secondary development. The nucleus of this feeling exists in both parties, but it may remain undeveloped in one. As a rule, owing to her passive part in procreation and social conditions, it is more pronounced in woman; but exceptionally this is true of men having minds that approach the feminine type.

In both the religious and sexual spheres love is mystical, transcendental. In sexual love the real purpose of the instinct, the propagation of the species, does not enter into consciousness; and the strength of the desire is greater than any that consciousness of purpose could create. In religion, however, the good sought and the object of devotion are of such nature that they cannot become a part of empirical knowledge. Therefore, both mental processes give unlimited range to the imagination.

But both have an immortal object, in as far as the bliss which the sexual sentiment creates in fancy seems incomparable and infinite in contrast with all other pleasurable feelings; and the same is true of the promised blessings of faith, which are conceived to be eternal and supreme.

From the correspondence between the two states of consciousness, with reference to the commanding importance of their objects, it follows that they both often attain an intensity that is irresistible, and which overcomes all opposing motives. Owing to their similarity in that their objects cannot be attained, it follows that both easily degenerate into silly enthusiasm, in which the intensity of feeling far surpasses the clearness and constancy of the ideas. In both cases, in this enthusiasm, with the expectation of a happiness that cannot be attained, the necessity of unconditional submission plays a part.

Owing to the correspondence in many points between these two emotional states, it is clear that when they are very intense the one may take the place of the other; or one may appear by the side of the other, since every intensification of one element of mental life also intensifies its associations. The constant emotion thus calls into consciousness now one and now the other of the two series of ideas with which it is connected. Either of these mental states may become transformed into the impulse to cruelty (actively exercised or passively suffered).

In the religious life this is expressed by sacrifice. Primarily this is done with the idea that the victim is materially enjoyed by the deity; then, in reverence, as a sign of submission, as a tribute; and, finally, with the belief that sins and transgressions against the deity are thus atoned for and blessing obtained. If, however, the offering consist of self-punishment, which occurs in all religions, in individuals of very excitable religious nature, it serves not only as a symbol of submission and as an equivalent in the exchange of present pain for future bliss, but everything that is thought to come from the deity, all that happens in obedience to divine mandate or to the honor of the godhead, is felt directly as pleasure. Thus religious enthusiasm leads to ecstasy, to a condition in which consciousness is so preoccupied with feelings of mental pleasure that the concept of suffering endured can only be apperceived without its painful quality.

The exaltation of religious enthusiasm may lead actively to pleasure in the sacrifice of another, if pity be overcompensated by feelings of religious pleasure.

Sadism, and particularly masochism (v. infra), show that in the sphere of the sexual life there may be similar phenomena. Thus the well-established relations between religion, lust, and cruelty[^[14]] may be comprehended in the following formula: States of religious and sexual excitement, at the acme of their development, may correspond in the amount and quality of excitement, and, therefore, under favoring circumstances, one may take the place of the other. Both, in pathological conditions, may become transformed into cruelty.

The sexual factor proves to be no less influential in awakening æsthetic feelings. What would poetry and art be without a sexual foundation? In (sensual) love is gained that warmth of fancy without which a true creation of art is impossible; and in the fire of sensual feelings its glow and warmth are preserved. It may thus be understood why great poets and artists have sensual natures.

This world of ideals reveals itself with the inception of the processes of sexual development. He who, at this period of life, cannot become enthusiastic for all that is great, noble, and beautiful, remains a Philistine all his life. At this epoch does not the least of natural poets forge verses?

At the limits of physiological reaction there are events which take place at the time of puberty in which these obscure feelings of longing express themselves in paroxysms of despair of self and the world, which may go on to tædium vitæ, and are often accompanied by a desire to do harm to others (weak analogies of a psychological connection between lust and cruelty).

Youthful love has a romantic, idealistic character. It elevates the beloved object to apotheosis. In its inception it is platonic, and turns to forms of poetry and romance. With the awakening of sensuality there is danger that this idealizing power may be brought to bear upon persons of the opposite sex who are mentally, physically, and socially of inferior station. Thus there may occur méssalliances, seductions, and errors, with the whole tragedy of a passionate love that comes in conflict with the dictates of social position and prospects, and sometimes terminates in suicide or double suicide.

Over-sensual love can never be lasting and true. For this reason the first love is, as a rule, very fleeting; because it is nothing else than the flare of a passion, the flame of a fire of straw.

Only the love that rests upon a recognition of the social qualities of the beloved person, only a love which is willing not only to enjoy present pleasures, but to bear suffering for the beloved object and sacrifice all, is true love. The love of a strongly constituted man shrinks before no difficulties or dangers in order to gain and keep possession of its object.

Love expresses itself in acts of heroism and daring. Such love is in danger, under certain circumstances, of becoming criminal, if moral principles be weak. Jealousy is an ugly spot in this love. The love of a weakly constituted man is sentimental. It sometimes leads to suicide when it is not returned or meets with obstacles, while, under like conditions, the strongly constituted man may become a criminal.

Sentimental love is in danger of becoming a caricature, i.e., when the sensual element is weak (the Knight of Toggenburg, Don Quixote, many minnesingers and troubadours of the Middle Ages).

Such love is flat and soft, and may be even silly; but the true expression of this powerful feeling awakens appropriate pity, respect, or sorrow in the hearts of others.

Frequently this weak love expresses itself in equivalents—in poetry, which, however, under such circumstances, is effeminate; in æsthetics which are overdrawn; in religion, in which it gives itself up to mysteries and religious enthusiasm; or, where there is a more powerful sensual foundation, founds sects or expresses itself in religious insanity. The immature love of the age of puberty has something of all this in it. Of all the poems and rhymes written at this time of life, they only are readable that are the product of poets divinely endowed.

Notwithstanding all the ethics which love requires in order to develop into its true and pure form, its strongest root is still sensuality. Platonic love is an impossibility, a self-deception, a false designation for related feelings.

In as far as love rests upon sensual desire, it is only conceivable in a normal way as existing between individuals of opposite sex and capable of sexual intercourse. If these conditions are wanting or destroyed, then, in the place of love, comes friendship.

The rôle which the retention of sexual functions plays in the case of a man, both in originating and retaining the feeling of self-respect, is remarkable. In the deterioration of manliness and self-confidence which the onanist, in his weakened nervous state, and the man that has become impotent, present, may be estimated the significance of this factor.

Gyurkovechky (männl. Impotenz. Vienna, 1889) says, very justly, that old and young men essentially differ mentally, on account of the condition of their virility, and that impotence has a detrimental effect upon the feeling of well-being, mental freshness, activity, self-confidence, and the play of fancy. This loss becomes the more important the younger a man is when he loses his virility and the more sensually he was constituted.

Under such circumstances a sudden loss of virility may induce severe melancholia, and even lead to suicide. For such natures life without love is unbearable.

But, also, in cases where the reaction is not so deep, the man bereft of his virility is morose and spiteful, egotistic, jealous, contrary, listless, has but little self-respect or sense of honor, and is cowardly. Analogies are seen in the Skopzens,[^[15]] who, after their castration, change for the worse.

The loss of virility is still more noticeable in certain weakly constituted individuals, where it expresses itself in formal effemination (v. infra).

In a woman who has become a matron the condition is of much less importance psychologically, though it is noticeable. If the past period of sexual life has been satisfactory, if children delight the heart of the aging mother, then she is scarcely conscious of the change of her personality.

The situation is different, however, where sterility or circumstances have kept a woman from the performance of her natural functions and denied her that happiness.

These facts place in a clear light the differences which exist between man and woman in the psychology of the sexual life, and in all the sexual functions and desires.

Undoubtedly man has a much more intense sexual appetite than woman. As a result of a powerful natural instinct, at a certain age, a man is drawn toward a woman. He loves sensually, and is influenced in his choice by physical beauty. In accordance with the nature of this powerful impulse, he is aggressive and violent in his wooing. At the same time, this demand of nature does not constitute all of his mental existence. When his longing is satisfied, love temporarily retreats behind other vital and social interests.

With a woman it is quite otherwise. If she is normally developed mentally, and well bred, her sexual desire is small. If this were not so the whole world would become a brothel and marriage and a family impossible. It is certain that the man that avoids women and the woman that seeks men are abnormal.

Woman is wooed for her favor. She remains passive. This lies in her sexual organization, and is not founded merely on the dictates of good breeding.

Nevertheless, the sexual sphere occupies a much larger place in the consciousness of woman than in that of man. The need of love in her is greater than in man, and is continual, not intermittent; but this love is rather more spiritual than sensual. While a man loves a woman first as wife and then as mother of his children, a woman is primarily conscious of a man as the father of her children and then as husband. In the choice of a life-companion a woman is influenced much more by the mental than the physical qualities of a man. When she has become a mother she divides her love between child and husband. Sensuality disappears in the mother’s love. Thereafter, in marital intercourse, the wife finds less sensual satisfaction than proof of the love of her husband.

A woman loves with her whole soul. To her love is life; to a man it is the joy of life. To him misfortune in love is a wound; but it costs a woman her life, or at least her happiness. A psychological question worthy of consideration is whether a woman can truly love twice in her life. Certainly the mental inclination of woman is monogamous, while in man it is polygamous.

The weakness of men in comparison with women lies in the great intensity of their sexual desires. Man becomes dependent upon woman, and the more, the weaker and more sensual he becomes; and this just in proportion as he becomes neuropathic. Thus may be understood the fact that, in times of effeminateness and luxury, sensuality flourishes luxuriantly. Then arises the danger to society that mistresses and their dependents may rule the state and compass its ruin (the mistresses of the courts of Louis XIV and XV; the prostitutes of ancient Greece).

The biographies of many statesmen of ancient and modern times show that they were the instruments of women, owing to their great sensuality, which had its foundation in their neuropathic constitutions. The fact that the Catholic Church enjoins celibacy upon its priests, in order to emancipate them from sensuality and preserve them entirely for the purpose of their calling, is an example of discerning psychological knowledge of mankind; but it is unfortunate that the priests, living in celibacy, lose the elevating effect which love and matrimony exert upon the development of character.

From the fact that man by nature plays the aggressive rôle in sexual life, he is in danger of overstepping the limits which morality and law have set. The unfaithfulness of a wife, in comparison with that of a husband, is morally much more weighty, and should be more severely punished legally. The unfaithful wife dishonors not only herself, but also her husband and her family, not to speak of the possibility of pater incertus. Natural instinct and social position favor unfaithfulness on the part of a husband, while the wife is afforded much protection. In the case of an unmarried woman, sexual intercourse is something quite different from what it is in an unmarried man. Of a single man society demands decency; of a woman, also chastity. In the cultivated social life of to-day, woman, occupying a sexual position and concerning herself in the interests of society, can only be thought of as a wife.

The aim and ideal of woman, even when she is sunken in the mire of vice, is, and remains, marriage. Woman, as Mantegazza justly remarks, desires not only satisfaction of her sexual feeling, but also protection and support for herself and her children. A man of right feeling, no matter how sensual he may be, demands a wife that has been, and is, chaste. The emblem and ornament of a woman seeking this, her only worthy purpose in life, is modesty. Mantegazza finely characterizes modesty as “one of the forms of psychical self-respect” in woman. This is not the place for anthropological and historical consideration of this, the most beautiful attribute of woman. Probably, feminine modesty is an hereditarily evolved product of the development of civilization.[^[16]]

In remarkable contrast with it, there is occasional exposition of physical charms, conventionally sanctioned by the law of fashion, in which even the most discreet maiden allows herself to indulge in the ball-room. The reasons which lead to this display are evident. Fortunately the modest girl is as little conscious of them as of the reason for the occasionally recurring mode of making certain portions of the body more prominent (panniers); to say nothing of corsets, etc.

In all times, and among all races, women show a desire to adorn themselves and be charming.[^[17]] In the animal kingdom nature has distinguished the male with the greater beauty. Men designate women as the beautiful sex. This gallantry clearly arises from the sensual desire of men. As long as this personal adornment has a purpose only in itself, or the true psychological reason of the desire to please remains unknown to the woman, nothing can be said against it. When it is done with knowledge, the effort is called flirting.

Under all circumstances a dandified man is ridiculous. We are accustomed to this slight weakness in a woman, and find no fault with it, so long as it is but a subordinate manifestation. When it has become the all-absorbing aim, the French apply to it the word coquetry.

Woman far surpasses man in the natural psychology of love, partly because, through heredity and education, her native element is love; and partly because she has finer feelings (Mantegazza). Even in a man of the very highest breeding, it cannot be found objectionable that he recognizes woman as a means of satisfying his natural instinct. But it becomes his duty to belong only to the woman of his choice. In a civilized state this becomes a binding social obligation,—marriage; and, inasmuch as the wife requires for herself and children protection and support, it becomes a marriage right.

It is of great importance psychologically, and, for certain pathological manifestations to be later described, indispensable, to examine the psychological events which draw a man and a woman together and unite them; so that, of all other persons of the same sex, only the beloved one seems desirable.

If one could demonstrate design in the processes of nature,—adaptation cannot be denied them,—the fact of fascination by a single person of the opposite sex, with indifference toward all others, as it occurs between true and happy lovers, would appear as a wonderful creative provision to insure monogamous unions for the promotion of their object.

To the scientific observer, however, this love, or “harmony of souls,” this “heart-bond,” does not, by any means, appear as a “soul-mystery;” but, in the majority of cases, it may be referred to certain physical or mental peculiarities, as the case may be, by which the attractiveness of the beloved person is exerted.

Thus we speak of what is called fetich and fetichism. In the term fetich we are wont to comprehend objects, or parts, or simply peculiarities of objects, which, by virtue of associative relations to an intense feeling, or to a personality or idea that awakens deep interest, exert a kind of charm (“fetisso,” Portuguese), or, at least, owing to peculiar individual coloring, produce a very deep impression which does not belong to the external sign (symbol, fetich) in itself.[^[18]]

The individual valuation of the fetich, which may go to the extent of an unreasoning enthusiasm in the individual affected, is called fetichism. This interesting psychological phenomenon is explicable by an empirical law of association,—the relation of a particular to a general concept,—in which, however, the essential thing is the pleasurable emotional coloring of the particular concept peculiar to the individual. It is most common in two related mental spheres,—those of religious and erotic feelings and ideas. Religious fetichism differs in relation and significance from sexual fetichism, for it found, and still finds, its original motive in the delusion that the object of the fetichism, or the idol, possesses divine attributes, and that it is not simply a symbol; or peculiar wonder-working (relics) or protective (amulet) virtues are superstitiously ascribed to the fetich.

It is otherwise with erotic fetichism, which finds its psychological motive in fetiches which consist of physical or mental qualities of a person, or even merely of objects which a person has used. These always awaken intense associative ideas of the personality as a whole, and, moreover, are always colored with a lively feeling of sexual pleasure. Analogies with religious fetichism are always discernible; for, under certain circumstances, in the latter, the most insignificant objects (bones, nails, hair, etc.) become fetiches, and are associated with pleasurable feelings which may reach the intensity of ecstasy.

With respect of the development of physiological love, it is probable that its nucleus is always to be found in an individual fetich (charm) which a person of one sex exercises over a person of the opposite sex.

The case is the simplest where the sight of a person of the opposite sex occurs simultaneously with sensual excitement, and the latter is thus increased.

Emotional and visual impressions are brought into associative connection, and this association is strengthened in proportion as the recurring emotion awakens the visual memory-picture, or the latter (another meeting) renews sexual excitement, which may possibly reach the intensity of orgasm and pollution (dream-picture). In this case the whole physical personality has the effect of a fetich.

As Binet and others show, merely parts of the whole, simply peculiarities, either physical or mental, may affect the person of the opposite sex as a fetich, when the perception of them is associated with (accidental) sexual excitement (or induces it).

It is well known from experience that accident determines this mental association, that the objects of the fetich may be individually very diverse, and that thus the most peculiar sympathies (and antipathies) arise.

These physiological facts of fetichism explain the individual sympathies between husband and wife; the preference of a certain person to all others of the same sex. Since the fetich represents a symbol that is purely individual, it is clear that its effect must be individual. Since it is colored by the most intense pleasurable feeling, it follows that possible faults in the beloved object are overlooked (“Love is blind”), and an exaltation of it is induced that to others is incomprehensible, and even silly under some circumstances. Thus it is clear why lovers are not understood by their unaffected fellow-men; and why they deify their idols, develop a true cult of devotion, and invests them with attributes which objectively they do not possess. Thus we may understand why love appears sometimes more like a passion, sometimes as a formal, exceptional mental state, in which the unattainable seems attainable, the ugly beautiful, the profane sacred, and every other interest, every duty, disappears.

Tarde (Archives de l’anthropologie criminelle, v year, No. 30) rightfully emphasizes the fact that the fetich may vary with nations as well as with individuals, but that the general ideal of beauty remains the same among civilized people of the same era.

Binet deserves great credit for having studied and analyzed in detail the fetichism of love. The particular sympathies all spring from it. Thus one is attracted to slender, another to plump beauties, to blondes or brunettes. For one a peculiar expression of the eyes; for another a peculiar tone of the voice, or a particular (even an artificial) odor (perfume); or the hand, the foot, the ear, etc., may be the individual fetich (charm),—the beginning of a complicated chain of mental processes which, as a whole, represent love, i.e., the longing to possess, physically and mentally, the beloved object.

This fact is important, as showing a condition for the origin of a fetichism that falls within physiological limits. The fetich may constantly retain its significance without being pathological; but this is possible only when the particular concept is developed to a general concept; when the resulting love comes to take as its object the whole mental and physical personality.

Normal love can be nothing but a synthesis, a generalization. Ludwig Brunn,[^[19]] under the heading, “The Fetichism of Love,” cleverly says:—

“Thus normal love appears to us as a symphony of tones of all kinds. It results from the most various stimuli. It is likewise polytheistic. Fetichism recognizes only the tone of a single instrument; it results from a certain stimulus; it is monotheistic.”

On slight reflection any one will see that real love (this word is only too often abused) can be spoken of only when the whole person is both physically and mentally the object of adoration. Love must always have a sensual element, i.e., the desire to possess the beloved object, to be united with it and fulfill the laws of nature. But when merely the body of the person of the opposite sex is the object of love, when satisfaction of sensual pleasure is the sole object, without desire to possess the soul and enjoy mutual communion, love is not genuine, no more than that of platonic lovers, who love only the soul and avoid sensual pleasure (many cases of contrary sexuality). For the former merely the body, for the latter simply the soul, is a fetich, and the love fetichism. Such cases certainly represent transitions to pathological fetichism. This assumption is even more justified when, as a further criterion of real love, mental[^[20]] satisfaction must be given by the sexual act.

There remains to be mentioned, within the physiological phenomena of fetichism, the fact that among the many things that may become fetiches there are certain ones that gain such significance for a majority of persons.

As such for a man may be mentioned the hair, the hand, the foot of a woman, the expression of her eyes. Certain ones of these gain a remarkable significance in the pathology of fetichism. These facts clearly play a rôle in the feminine mind, either consciously or unconsciously.

One of the greatest cares of women is the cultivation of the hair, to which often an unreasonable amount of time and money is devoted. How a mother cares for her little daughter’s hair! What a part the hair-dresser plays! Falling of the hair would cause despair in a young lady. I recall a proud lady who became insane over it, and died by suicide. Young ladies like to talk of coiffures, and are envious of beautiful hair.[^[21]]

Beautiful hair is a powerful fetich with many men. In the legend of the Loreley, who lured men to destruction, the golden hair, which she combs with a golden comb, appears as a fetich. Frequently the hand and foot possess an attractiveness no less powerful, when, indeed, often (though by no means invariably) masochistic and sadistic feelings aid in determining the peculiar kind of fetich.

By a transference through association of ideas, the gloves or shoes may obtain the significance of a fetich.

Brunn (op. cit.) justly points out that among the customs of the Middle Ages drinking from the shoe of a beautiful woman (still to be found in Poland) played a remarkable part in gallantry and homage. The shoe also plays an important rôle in the legend of Aschenbrödel.

The expression of the eyes is particularly important as a means of kindling the sparks of love. A neuropathic eye frequently affects persons of both sexes as a fetich. “Madame, vos beaux yeux me font mourir d’amour” (Molière).

There is superfluity of examples showing that odors of the body may become fetiches.

This fact is also taken advantage of in the ars amandi of woman, either consciously or unconsciously. Ruth sought to attract Boaz by perfuming herself. The demi-monde of ancient and modern times is noted for its use of perfume. Jäger, in his “Discovery of the Soul,” calls attention to many olfactory sympathies.

Cases are known where men have married ugly women simply because their personal odors were exceedingly pleasing.

Binet makes it probable that the voice may also become a fetich. He relates a case in point of Dumas, who used it in his novel, “La Maison du Vent.” It was the case of a wife who fell in love with a tenor’s voice, and thus became untrue to her husband. Belot’s romance, “Les Baigneuses de Trouville,” speaks in favor of this assumption. Binet thinks that many marriages with singers are due to the fetich of their voices. He also calls attention to the interesting fact that among singing-birds the voice has the same sexual significance as odors among quadrupeds. The birds allure by their song, and the male that sings most beautifully flies at night to his charmed mate.

The pathological facts of masochism and sadism show that mental peculiarities may also act as fetiches in a wider sense.

Thus the fact of idiosyncrasies is explained, and the old saying, “De gustibus non est disputandum,” retains its force.

II. PHYSIOLOGY.

During the time of the physiological processes in the reproductive glands, desires arise in the consciousness of the individual which have for their purpose the perpetuation of the species (sexual instinct).

Sexual desire during the years of sexual maturity is a physiological law. The duration of the physiological processes in the sexual organs, as well as the strength of the sexual desire manifested, vary, both in individuals and in races. Race, climate, heredity, and social circumstances have a very decided influence upon it. The greater sensuality of southern races as compared with the sexual needs of those of the North is well known. Sexual development in the inhabitants of tropical climes takes place much earlier than in those of more northern regions. In women of northern countries ovulation, recognizable in the development of the body and the occurrence of a periodical flow of blood from the genitals (menstruation), usually begins about the thirteenth or fifteenth year; in men puberty, recognizable in the deepening of the voice, the appearance of hair on the face and the mons veneris, and the occasional occurrence of pollutions, etc., takes place about the fifteenth year. In the inhabitants of tropical countries, however, sexual development takes place several years earlier in women,—sometimes as early as the eighth year.

It is worthy of remark that girls who live in cities develop about a year earlier than girls living in the country, and that the larger the town the earlier, ceteris paribus, the development takes place.

Heredity, however, has no small influence on libido and sexual power. Thus there are families in which, with great physical strength and longevity, great libido and virility are preserved until a great age, while in other families the vita sexualis develops late and is early extinguished.

In women the time of the activity of the reproductive glands is shorter than in men, in whom the sexual function may last until a great age. Ovulation ceases about thirty years after puberty. This period of cessation of activity of the ovaries is called the change of life (climacterium). This biological phase does not represent merely a cessation of function and final atrophy of the reproductive organs, but also a transformation of the whole organism. In Middle Europe the sexual maturity of men begins about the eighteenth year, and their virility reaches its acme at forty. After that age it slowly declines.

The potentia generandi ceases usually at the age of sixty-two, but potentia cœundi may be present even in old age. The existence of the sexual instinct is continuous during the time of sexual life, but it varies in intensity. Under physiological conditions it is never intermittent (periodical), as in animals. In men it manifests an organic variation of intensity in consonance with the collection and expenditure of semen; in women the increase of sexual desire coincides with the process of ovulation, and in such a way that libido sexualis is greater after the menstrual period.

Sexual instinct—as emotion, idea, and impulse—is a function of the cerebral cortex. Thus far no definite region of the cortex has been proved to be exclusively the seat of sexual sensations and impulses.[^[22]]

Owing to the close relations which exist between the sexual instinct and the olfactory sense, it is to be presumed that the sexual and olfactory centres lie close together in the cerebral cortex. The development of the sexual life has its beginning in the organic sensations which arise from the developing reproductive glands. These excite the attention of the individual. Readings and the experiences of every-day life (which, unfortunately, to-day are too early and too frequently suggestive) convert these notions into clear ideas. These become accentuated by organic sensations which are pleasurable. With this accentuation of erotic ideas by lustful feelings, an impulse to induce these (sexual desire) is developed.

Thus there is established a mutual dependence between the cerebral cortex (as the place of origin of sensations and ideas) and the reproductive organs. The latter, by reason of physiological processes (hyperæmia, secretion of semen, ovulation), give rise to sexual ideas, images, and impulses.

The cerebral cortex, by means of apperceived or reproduced sensual ideas, reacts on the reproductive organs, inducing hyperæmia, secretion of semen, erection, ejaculation. This results by means of centres for vasomotor innervation and ejaculation, which are situated in the lumbar portion of the cord and lie close together. Both are reflex centres.

The erection-centre (Goltz, Eckhard) is an intermediate station placed between the brain and the genital apparatus. The nervous paths which connect it with the brain probably run through the pedunculi cerebri and the pons. This centre may be excited by central (psychical and organic) stimuli, by direct irritation of the nerve-tract in the pedunculis cerebri, pons, or cervical portion of the cord, as well as by peripheral irritation of the sensory nerves (penis, clitoris, and annexa). It is not directly subordinated to the will.

The excitation of this centre is conveyed to the corpora cavernosa by means of nerves (nervi erigentes—Eckhard) running in the first three sacral nerves.

The action of the nervi erigentes, which renders erection possible, is an inhibitory one. They inhibit the ganglionic nervous mechanism in the corpora cavernosa upon the action of which the smooth muscle-fibres of the corpora cavernosa are dependent (Kölliker and Kohlrausch). Under the influence of the action of the nervi erigentes these fibres of the corpora cavernosa become relaxed and their spaces fill with blood. Simultaneously, as a result of the dilatation of the capillary net-work of the corpora cavernosa, pressure is exerted upon the veins of the penis and the return of blood is impeded. This effect is aided by contraction of the bulbo cavernosus and ischio cavernosus muscles, which are inserted by means of an aponeurosis on the dorsal surface of the penis.

The erection-centre is under the influence of both exciting and inhibitory innervation arising in the cerebrum. Ideas and sense-perceptions of sexual content have an exciting effect. Also, according to observations made on men that have been hung, it is evident that the erection-centre may be excited by excitation of the tract in the spinal cord. Observations on the insane and those suffering with cerebral disease show that this is also possible as a result of organic irritation in the cerebral cortex (psycho-sexual centre?). Spinal diseases (tabes, especially myelitis) affecting the lumbar portion of the cord, in their earlier stages, may directly excite the erection-centre.

Reflex excitation of the centre is possible and frequent in the following ways: by irritation of the (peripheral) sensory nerves of the genitals and surrounding parts by friction; by irritation of the urethra (gonorrhœa), of the rectum (hæmorrhoids, oxyuris), of the bladder (distension with urine, especially in the morning, irritation of calculi); by distension of the vesicular seminales with semen; by hyperæmia of the genitals, occasioned by lying on the back, and thus inducing pressure of the intestines upon the blood-vessels of the pelvis.

The erection-centre may also be excited by irritation of the nervous ganglia which are so abundant in the prostatic tissue (prostatitis, introduction of catheter, etc.).

The experiment of Goltz, according to whom, when (in dogs) the lumbar portion of the cord is severed, erection is more easily induced, shows that the erection-centre is also subject to inhibitory influences from the brain.

In men the fact that the will and emotions (fear of unsuccessful coitus, surprise inter actum sexualem, etc.) may inhibit the occurrence of erection, and cause it, when present, to disappear, also indicates this.

The duration of erection is dependent upon the duration of its exciting causes (sensory stimuli), the absence of inhibitory influences, the nervous energy of the centre, and the early or late occurrence of ejaculation (v. infra).

The central and highest portion of the sexual mechanism is the cerebral cortex. It is justifiable to presume that there is a definite region of the cortex (cerebral centre) which gives rise to sexual feelings, ideas, and impulses, and is the place of origin of the psycho-somatic processes which we designate as sexual life, sexual instinct, and sexual desire. This centre is excitable to both central and peripheral stimuli.

Central stimuli, in the form of organic excitation, may be due to diseases of the cerebral cortex. Physiologically they consist of psychical stimuli (memory and sensory perceptions).

Under physiological conditions these stimuli are essentially visual perceptions and memory-pictures (i.e., lascivious stories) and also tactile impressions (touch, pressure of the hand, kiss, etc.).

Within physiological limits auditory and olfactory perceptions certainly play but a very subordinate rôle. Under pathological conditions (v. infra) the latter have a very decided influence in inducing sexual excitement.

Among animals the influence of olfactory perceptions on the sexual sense is unmistakable. Althaus (“Beiträge zur Physiol. und Pathol. des Olfactorius.” Archiv für Psych., xii, H 1) declares that the sense of smell is important with reference to the reproduction of the species. He shows that animals of opposite sexes are drawn to each other by means of olfactory perceptions, and that almost all animals, at the time of rutting, emit a very strong odor from their genitals. An experiment by Schiff is confirmatory of this. He extirpated the olfactory nerves in puppies, and found that, as the animals grew, the male was unable to distinguish the female. On the other hand, an experiment by Mantegazza (“Hygiene of Love”), who removed the eyes of rabbits and found that the defect constituted no obstacle to procreation, shows how important in animals the olfactory sense is for the vita sexualis.

It is also remarkable that many animals (musk-ox, civet-cat, beaver) possess glands on their sexual organs, which secrete materials having a very strong odor.

Althaus also shows that in man there are certain relations existing between the olfactory and sexual senses. He mentions Cloquet (“Osphrésiologie,” Paris, 1826), who calls attention to the sensual pleasure excited by the odors of flowers, and tells how Richelieu lived in an atmosphere loaded with the heaviest perfumes, in order to excite his sexual functions.

Zippe (Wien. Med. Wochenschrift, 1879, Nr. 24), in connection with a case of kleptomania in an onanist, likewise establishes such relations, and cites Hildebrand as authority, who in his popular physiology says: “It cannot be doubted that the olfactory sense stands in remote connection with the sexual apparatus. Odors of flowers often occasion pleasurable sensual feelings, and when one remembers the passage in the ‘Song of Solomon,’ ‘And my hands dropped with myrrh and my fingers with sweet-smelling myrrh upon the handles of the lock,’ one finds that it did not escape Solomon’s observation. In the Orient the pleasant perfumes are esteemed for their relation to the sexual organs, and the women’s apartments of the Sultan are filled with the perfumes of flowers.”

Most, professor in Rostock (comp. Zippe), relates: “I learned from a sensual young peasant that he had excited many a chaste girl sexually, and easily gained his end, by carrying his handkerchief in his axilla for a time, while dancing, and then wiping his partner’s perspiring face with it.”

The case of Henry III shows that contact with a person’s perspiration may be the exciting cause of passionate love. At the betrothal feast of the King of Navarre and Margaret of Valois, he accidentally dried his face with a garment of Maria of Cleves, which was moist with her perspiration. Although she was the bride of the Prince of Condé, Henry conceived immediately such a passionate love for her that he could not resist it, and made her, as history shows, very unhappy. An analogous instance is related of Henry IV, whose passion for the beautiful Gabriel is said to have originated at the instant when, at a ball, he wiped his brow with her handkerchief.

Professor Jäger, the “discoverer of the soul,” refers to the same thing in his well-known book (2d ed., 1880, chap. xv, p. 173); for he regards the sweat as important in the production of sexual effects and as being especially seductive.

One learns from reading the work of Ploss (“Das Weib”) that attempts to attract a person of the opposite sex by means of the perspiration may be discerned in many forms in popular psychology.

In reference to this, a custom which holds among the natives of the Philippine Islands when they become engaged, as reported by Jäger, is remarkable. When it becomes necessary for the engaged pair to separate, they exchange articles of wearing-apparel, by means of which each becomes assured of faithfulness. These objects are carefully preserved, covered with kisses, and smelled.

The love of certain libertines and sensual women for perfumes[^[23]] indicates a relation between the olfactory and sexual senses.

A case mentioned by Heschl (Wiener Zeitschrift f. pract. Heilkunde, March 22, 1861) is remarkable, where the absence of both olfactory lobes was accompanied by imperfectly developed genitals. It was the case of a man aged 45, in all respects well developed, with the exception of the testicles, which were not larger than beans and contained no seminal canals, and the larynx, which seemed to be of feminine dimensions. Every trace of olfactory nerves was wanting, and the trigona olfactoria and the furrow on the under surface of the anterior lobes were absent. The perforations of the ethmoid plate were sparingly present, and occupied by nerveless processes of the dura instead of by nerves. In the mucous membrane of the nose there was also an absence of nerves. Finally, the clearly-defined relation of the olfactory and sexual senses in mental diseases is worthy of notice, in that in the psychoses of both sexes dependent on masturbation, as well as in insanity due to disease of the sexual organs of the female, or during the climacteric[^[24]], olfactory hallucinations are especially frequent, while in cases where a sexual cause is wanting they are very infrequent.

I am inclined to doubt[^[25]] that olfactory impressions in man, under normal conditions, as in animals, play an important rôle in the excitation of the sexual centre. On account of the importance of this consensus for the understanding of pathological cases, it is necessary here to thoroughly consider the relations existing between the olfactory and sexual senses.

The sexual sphere of the cerebral cortex may be excited, in the sense of an excitation of sexual concepts and impulses, by processes in the generative organs. This is possible as a result of all conditions which also excite the erection-centre by means of centripetal influence (stimulus resulting from distension of the seminal vesicles; enlarged Graafian follicle; any sensory stimulus, however produced, about the genitals; hyperæmia and turgescence of the genitals, especially of the erectile tissue of the corpus cavernosum of the penis and clitoris, as a result of luxurious, sedentary life; plethora abdominalis, high external temperature, warm beds, clothing; taking of cantharides, pepper, and other spices).

Libido sexualis may also be induced by stimulation of the gluteal region (castigation, whipping).[^[26]]

This fact is not unimportant for the understanding of certain pathological manifestations. It sometimes happens that in boys the first excitation of the sexual instinct is caused by a spanking, and they are thus incited to masturbation. This should be remembered by those who have the care of children.

On account of the dangers to which this form of punishment of children gives rise, it would be better if parents, teachers, and nurses were to avoid it entirely.

Passive flagellation may excite sensuality, as is shown by the sects of flagellants, so wide-spread in the thirteenth and fifteenth centuries. They were accustomed to whip themselves, partly as atonement and partly to kill the flesh (in accordance with the principle of chastity promulgated by the Church,—i.e., the emancipation of the soul from sensuality).

These sects were at first favored by the Church; but, since sensuality was only excited the more by flagellation, and the fact became apparent in unpleasant occurrences, the Church was finally compelled to oppose it. The following facts from the lives of the two heroines of flagellation, Maria Magdalena of Pazzi and Elizabeth of Genton, clearly show the significance of flagellation as a sexual excitant. The former, a child of distinguished parents, was a Carmelite nun in Florence (about 1580), and, by her flagellations, and, still more, through the results of them, she became quite celebrated, and is mentioned in the Annals. It was her greatest delight to have the prioress bind her hands behind her and have her whipped on the naked loins in the presence of the assembled sisters.

But the whippings, continued from her earliest youth, quite destroyed her nervous system, and perhaps no other heroine of flagellation had so many hallucinations (“Entzückungen”). While being whipped her thoughts were of love. The inner fire threatened to consume her, and she frequently cried, “Enough! Fan no longer the flame that consumes me. This is not the death I long for; it comes with all too much pleasure and delight.” Thus it continued. But the spirit of impurity wove the most sensual, lascivious fancies, and she was several times near losing her chastity.

It was the same with Elizabeth of Genton. As a result of whipping she actually passed into a state of bacchanalian madness. As a rule, she rested when, excited by unusual flagellation, she believed herself united with her “ideal.” This condition was so exquisitely pleasant to her that she would frequently cry out, “O love, O eternal love, O love, O you creatures! cry out with me, love, love!”

It is known, on the authority of Taxil (op. cit., p. 175), that rakes sometimes have themselves flagellated, or pricked until blood flows, just before the sexual act, in order to stimulate their diminished sexual power.

These facts find an interesting confirmation in the following experiences, taken from Paullini’s “Flagellum Salutis” (1st ed., 1698; reproduction, Stuttgart, 1847):—

“There are some nations, viz., the Persians and Russians, where the women regard blows as a peculiar sign of love and favor. Strangely enough, the Russian women are never more pleased and delighted than when they receive hard blows from their husbands, as John Barclay relates in a remarkable narrative. A German, named Jordan, went to Russia, and, pleased with the country, he settled there and took a Russian wife, whom he loved dearly and to whom he was always kind in everything. But she always wore an expression of dissatisfaction, and went about with sighs and downcast eyes. The husband asked the reason, for he could not understand what was wrong. ‘Aye,’ she said, ‘though you love me you do not show me any sign of it.’ He embraced her and begged to be told what he had carelessly and unconsciously done to hurt her feelings, and to be forgiven, for he would never do it again. ‘I want nothing,’ was the answer, ‘but what is customary in our country,—the whip, the real sign of love.’ Jordan observed the custom and accustomed himself to it, and then his wife began to love him dearly. Similar stories are told by Peter Petrius, of Erlesund, with the addition that the husbands, immediately after the wedding, among other indispensable household articles, provide themselves with whips.”

On page 73 of this remarkable book, the author says further: “The celebrated Count of Mirindula, John Picus, relates of one of his intimate acquaintances that he was an insatiable fellow, but so lazy and incapable of love that he was practically impotent until he had been roughly handled. The more he tried to satisfy his desire, the heavier the blows he needed, and he could not attain his desire until he had been whipped until the blood came. For this purpose he had a suitable whip made, which was placed in vinegar the day before using it. He would give this to his companion and on bended knees beg her not to spare him, but to strike blows with it, the heavier the better. The good count thought this singular man found the pleasure of love in this punishment. While in other respects he was not a bad man, he understood and hated his weakness. Coelius Rhodigin relates a similar story, as does also the celebrated jurist, Andreas Tiraquell. In the time of the skillful physician, Otten Brunfelsen, there lived in Munich, then the Capital of the Bavarian Electorate, a debauchee who could never perform his [sexual] duties without a severe preparatory beating. Thomas Barthelin also knew a Venetian who had to be beaten and driven before he could have intercourse,—just as Cupid himself moved reluctantly driven by his followers with sprays of hyacinth. A few years ago there was in Lübeck a cheesemonger, living on Mill Street, who, on a complaint to the authorities of unfaithfulness, was ordered to leave the city. The prostitute with whom he had been went to the judges and begged in his behalf, telling how difficult all intercourse had become for him. He could do nothing until he had been mercilessly beaten. At first the fellow, from shame and to avoid disgrace, would not confess, but after earnest questioning he could not deny it. There is said to have been a man in the Netherlands who was similarly incapable, and could do nothing without blows. On the decree of the authorities, however, he was not only removed from his position, but also properly punished. A credible friend, a physician in an important city of the kingdom, told me, on July 14th, last year, how a woman of bad character had told a companion, who had been in the hospital a short time before, that she, with another woman of like character, had been sent to the woods by a man who followed them there, cut rods for them, and then exposed his nates, commanding them to belabor him well. This they did. It is easy to conclude what he then did with them. Not only men have been excited and inflamed to lasciviousness, but also women, that they too might experience greater intensity of pleasure. For this reason the Roman woman had herself whipped and beaten by the lupercis. Thus Juvenal writes:—

“‘Steriles moriuntur, et illis

Turgida non prodest condita psycido Lyde:

Nec prodest agili palmas præbere Luperco.’”

In men, as well as in women, erection and orgasm, or even ejaculation, may be induced by irritation of various other regions of the skin and mucous membrane. These “erogenous” zones in woman are, while she is a virgin, the clitoris, and, after defloration, the vagina and cervix uteri.

In woman the nipple particularly seems to possess this quality. Titillatio hujus regionis plays an important part in the ars erotica. In his “Topographical Anatomy,” 1865, Bd. i, p. 552, Hyrtl cites Val. Hildebrandt, who observed a peculiar anomaly of the sexual instinct in a girl, which he called suctusstupratio. She had her mammæ sucked by her lover, and finally, by gradually drawing on her nipples, she became able to suck them herself,—an act that gave her most intense pleasure. Hyrtl also calls attention to the fact that cows sometimes suck the milk from their own udders. L. Brunn (Zeitg. f. Literatur, etc., d. Hamburg. Correspondent, 1889, Nr. 21), in an interesting article on “Sensuality and Love of Kin,” points out how zealously the nursing mother gives herself to nursing the babe, “for love of the weak, undeveloped, helpless being.”

It is easy to assume that, by the side of the ethical motives, the fact that the sucking may be attended by feelings of physical pleasure plays a part. The remark of Brunn, which is correct in itself, but one-sided, that, according to Houzeau’s experience, among the majority of animals it is only during the time of nursing that the relations between mother and offspring are close, and thereafter indifferent, also speaks in favor of this assumption.

Bastian found the same thing (blunting of the feeling for the offspring after weaning) among savages.

Under pathological conditions, as is shown by Chambard, among others, in his thesis for the doctorate, other portions of the body (in hysterical persons) about the mammæ and genitals may attain the significance of “erogenous” zones.

In man, physiologically, the only “erogenous” zone is the glans penis, and, perhaps, the skin of the external genitals.

Under pathological conditions the anus may become an “erogenous” area. Thus anal auto-masturbation, which seems to be only too frequent, and passive pederasty would be explained. (Comp. Gamier, “Anomalies sexuelles,” Paris, p. 514; F. Moll, “Conträre Sexualempfindung,” p. 163.)

The psycho-physiological process comprehended in the idea of sexual instinct is composed of (1) concepts awakened centrally or peripherally; (2) the pleasurable feelings associated with them.

The longing for sexual satisfaction (libido sexualis) arises from them. This desire grows stronger constantly, in proportion as the excitation of the cerebral sphere accentuates the feeling of pleasure by appropriate concepts and activity of the imagination; and the pleasurable sensations are increased to lustful feeling by excitation of the erection centre and the consequent hyperæmia of the genitals (entrance of liquor prostaticus into the urethra, etc.).

If circumstances are favorable for the performance of the sexual act satisfactorily, the constantly-increasing desire is complied with; if, however, conditions are unfavorable, inhibitory concepts occur, overcome the sexual longing, and prevent the sexual act.

To civilized man cultivation of a readiness with ideas which inhibit sexual desire is necessary and distinctive. The moral freedom of the individual, and the decision whether, under certain circumstances, excess, and even crime, be committed or not, depend, on the one hand, upon the strength of the instinctive concepts and the accompanying organic sensations; on the other, upon the power of the inhibitory concepts. Constitution and, especially, organic influences have a marked effect upon the instinctive impulses; education and cultivation of self-control have a decisive influence on the opposing concepts.

The exciting and inhibitory powers are variable quantities. Over-indulgence in alcohol in this respect is very fatal, since it awakens and increases libido sexualis, while at the same time it reduces moral resistance.

The Act of Cohabitation.[^[27]]

The essential condition for the man is sufficient erection. Anjel (Arch. für Psych., viii, H. 2) calls attention to the fact that in sexual excitement the erection centre is not alone influenced,—the nervous excitement is distributed to the entire vasomotor system of nerves. The proof of this is the turgescence of the organs in the sexual act, injection of the conjunctiva, prominence of the eyes, dilatation of the pupils, and cardiac palpitation (resulting from paralysis of the vasomotor nerves of the heart, which arise from the cervical sympathetic, and the consequent dilatation of the cardiac arteries, and the increased stimulation of the cardiac ganglia induced by the consequent hyperæmia of the cardiac walls). The sexual act is accompanied by a pleasurable feeling, which, in the male, is conditioned by the passage of semen through the ductus ejaculatorii to the urethra, caused by sensory stimulation of the genitals. The pleasurable sensation occurs earlier in the male than in the female, grows rapidly in intensity until the moment of commencement of ejaculation, reaching its height in the instant of free emission, and disappears quickly post ejaculationem.

In the female the pleasurable feeling occurs later and comes on more slowly, and generally outlasts the act of ejaculation.

The distinctive event in coitus is ejaculation. This function is dependent on a centre (genito-spinal), which Budge has shown to be situated at the level of the fourth lumbar vertebra. It is a reflex centre. The stimulus that excites it is the ejection of sperma from the vesiculæ seminales into the pars membranacea urethræ, which follows reflexly from stimulation of the glans penis. As soon as the collection of semen, with ever-increasing pleasurable sensation, has reached a sufficient amount to be effectual as a stimulus of the ejaculation-centre, the centre acts. The reflex motor path lies in the fourth and fifth lumbar nerves. The action consists of a convulsive excitation of the bulbo-cavernosus muscle (innervated by the third and fourth sacral nerves), which forces the semen out.

In the female as well, at the height of sexual and pleasurable excitement, a reflex movement occurs. It is induced by stimulation of the sensory genital nerves, and consists of a peristaltic movement in the tubes and uterus as far down as the portio vaginalis, which presses out the mucous secretions of the tubes and uterus. Inhibition of the ejaculation centre is possible as a result of cortical influence (want of desire in coitus, emotions in general; influence of the will, in a measure).

Under normal conditions, with the completion of the sexual act, libido sexualis and erection disappear, and the psychical and sexual excitement gives place to a comfortable feeling of lassitude.

III. GENERAL PATHOLOGY.[^[28]]

(NEUROLOGICAL AND PSYCHOLOGICAL.)

Abnormality of the sexual functions proves to be especially frequent in civilized races. This fact is explained in part by the frequent abuse of the sexual organs, and in part by the circumstance that such functional anomalies are often the signs of an abnormal constitution of the central nervous system, which is, for the most part, hereditary (“functional signs of degeneration”).

Since the generative organs stand in important functional connection with the entire nervous system, and especially with its psychical and somatic functions, it is easy to understand the frequency of general neuroses and psychoses arising in sexual (functional or organic) disturbances.

II. SPINAL NEUROSES.

1. Affections of the Erection Centre.

(a) Irritation (priapism) arises reflexly from peripheral sensory irritants (e.g., gonorrhœa); directly, from organic irritation of the nerve-tracts from the brain to the erection centre (spinal disease in the lower cervical and upper dorsal regions), or of the centre itself (certain poisons); or from psychical irritation. In the latter case satyriasis exists, i.e., abnormal duration of erection, with libido sexualis. In simply reflex or direct organic irritation, libido sexualis may be wanting, and the priapism be accompanied by unpleasant feelings.

(b) Paralysis from destruction of the centre or of the nerve-tracts (nervi erigentes), in diseases of the spinal cord (paralytic impotence). A milder form is that of lessened excitability of the centre, resulting from overstimulation (in sexual excesses, especially in onanism), or from alcoholic intoxication, abuse of bromides, etc. It may be accompanied by cerebral anæsthesia, and often with anæsthesia of the external genitals. Cerebral hyperæsthesia is here more frequent (increased libido sexualis, lust). A peculiar form of diminished excitability is shown in those cases where the centre responds only to certain stimuli. Thus there are men for whom sexual contact with their virtuous wives does not supply the necessary stimulus for the excitation of an erection, but in whom it occurs when the act is attempted with a prostitute, or in the form of some unnatural sexual act. As far as psychical stimuli are here concerned, they may be inadequate (v. infra, paræsthesia and perversion of sexual instinct).

(c) Inhibition. The erection centre may become functionally incapable as a result of cerebral influence. This inhibitory influence is an emotion (disgust, fear of contagion), or an idea[^[30]] of impotence. There are many men in the first condition who have an unconquerable loathing for their wives, or fear of infection, or are suffering with perverse sexual feelings. In the latter condition are neuropathic individuals (neurasthenics, hypochondriacs), frequently weakened sexually (masturbators), who have reason, or think they have, to mistrust their sexual power. This idea acts as an inhibitory concept, and makes the act with the person concerned of the opposite sex temporarily or absolutely impossible.

(d) Irritable weakness. In this condition there is abnormal impressionability of the centre, but accompanied by rapid diminution of its energy. There may be functional disturbance of the centre itself, or weakness of the innervation through the nervi erigentes; or there may be weakness of the ischio-cavernosus muscle. Cases in which the erection is ineffectual, on account of abnormally early ejaculation, form a transition to the following anomalies:—

2. Affections of the Ejaculation Centre.

(a) Abnormally easy ejaculation from absence of cerebral inhibition, resulting from excessive psychical excitement or irritable weakness of the centre. In this case, under certain circumstances, the simple conception of a lascivious situation is sufficient to set the centre in action (high degree of spinal neurasthenia, usually resulting from sexual abuse). A third possibility is hyperæsthesia of the urethra, by virtue of which, when the semen enters it, an immediate and excessive reflex action of the ejaculation centre is induced. In such a case, simple proximity to the female genitals may be sufficient to induce ejaculation (ante portam).

In case of hyperæsthesia of the urethra as a cause, the ejaculation may be accompanied by painful, instead of pleasurable, sensations. Usually, in cases where there is hyperæsthesia of the urethra, there is, at the same time, irritable weakness of the centre. Both functional disturbances are important in the production of pollutio nimia and diurna.

The accompanying pleasurable feeling may be pathologically absent. This occurs in defective men and women (anæsthesia, aspermia?), and, further, as a result of disease (neurasthenia, hysteria); or (in prostitutes) it follows overstimulation and the blunting thus induced. The intensity of the pleasurable feeling depends on the degree of psychical and motor excitement accompanying the sexual act. Under pathological conditions this may become so pronounced that the movements of coitus take on the character of involuntary convulsive movements, and even pass into general convulsions.

(b) Abnormally difficult ejaculation. It is occasioned by inexcitability of the centre (absence of libido, paralysis of the centre: organic, from disease of brain or spinal cord; functional, from sexual abuses, marasmus, diabetes, morphinism), and, in this case, for the most part, in connection with anæsthesia of the genitals and paralysis of the erection centre. Or it is the result of a lesion of the reflex arc, or of peripheral anæsthesia (urethra), or of aspermia. The ejaculation occurs not at all, or tardily, in the course of the sexual act, or only afterward, in the form of a pollution.

III. CEREBRAL NEUROSES.

1. Paradoxia, i.e., sexual excitement occurring independently of the period of the physiological processes in the generative organs.

2. Anæsthesia (absence of sexual instinct). Here all organic impulses arising in the sexual organs, as well as all concepts, and visual, auditory, and olfactory sense-impressions, fail to excite the individual sexually. This is physiological in childhood and old age.

3. Hyperæsthesia (increased desire, satyriasis). In this state there is an abnormally increased impressionability of the vita sexualis to organic, psychical, and sensory stimuli (abnormally intense libido, lustfulness, lasciviousness). The stimulus may be central (nymphomania, satyriasis) or peripheral, functional or organic.

4. Paræsthesia, (perversion of the sexual instinct, i.e., excitability of the sexual functions to inadequate stimuli).

These cerebral anomalies fall within the domain of psychopathology. The spinal and peripheral anomalies may occur in combination with them, but these affect persons, as a rule, that are free from mental disease. They may occur in various combinations, and become the cause of sexual crimes. For this reason, they demand consideration in the following description. However, the cerebral anomalies claim the principal interest, since they very frequently lead to the commission of perverse and even criminal acts.

A. Paradoxia. Sexual Instinct Manifesting itself Independently of Physiological Processes.

1. Sexual Instinct Manifested in Childhood.

Every physician conversant with nervous affections and diseases incident to childhood is aware of the fact that manifestation of sexual instinct may occur in very young children. The observations of Ultzmann concerning masturbation in childhood[^[31]] are worthy of attention in relation to it. It is necessary here to differentiate between the numerous cases where, as a result of phimosis, balanitis, or oxyuris in rectum or vagina, young children have itching of the genitals, and experience a kind of pleasurable sensation from manipulations thus induced, and thus come to practice masturbation; and those cases in which sexual ideas and impulses occur in the child as a result of cerebral processes without peripheral causes. It is only in this latter class of cases that we have to do with the early manifestation of sexual instinct. In such cases it may always be regarded as an accompanying symptom of a neuro-psychopathic constitutional condition. A case of Marc’s (“Die Geisteskrankheiten,” etc., von Ideler, i, p. 66) illustrates very well these conditions. The subject was a girl of eight years, of respectable family, who was devoid of all child-like and moral feelings, and had masturbated from her fourth year; at the same time she consorted with boys of the age of ten or twelve. She had thought of killing her parents, that she might become her own mistress and give herself up to pleasure with men. In these cases of early manifestation of libido the children come also to masturbate; and, since they are greatly predisposed constitutionally, they frequently sink into dementia, or become subjects of severe degenerative neuroses or psychoses.

Lombroso (Archiv di Psichiatria, iv, p. 22) has collected a number of cases of children affected with very decided hereditary taint, which belong in this category. One was that of a girl who masturbated shamelessly and almost constantly at the age of three. Another girl began at the age of eight, and continued to practice masturbation when married, and even during pregnancy. She was pregnant twelve times. Five of the children died early, four were hydrocephalic, and two boys began to masturbate,—one at the age of seven, the other at the age of four.

Zambaco (L’Encéphale, 1882, Nr. 1, 2) tells the disgusting story of two sisters affected with premature and perverse sexual desire. The elder, R., masturbated at the age of seven, practiced lewdness with boys, stole wherever she could, seduced her four-year-old sister into masturbation, and at the age of ten was given up to the practice of the most revolting vices. Even ferrum candens ad clitoridem had no effect in overcoming the practice, and she masturbated with the cassock of a priest while he was exhorting her to reformation.

2. Re-awakening of Sexual Instinct in Old Age.[^[32]]

There are infrequent cases in which the sexual instinct persists until a great age. “Senectus non quidem annis sed viribus magis æstimatur” (Zittmann). Oesterlen (Maschka, Handb., iii, p. 18) mentions the case of a man aged 83, who was sentenced to three years’ imprisonment by a Wurtemberg court on account of sexual misdemeanors. Unfortunately nothing is said of the nature of the crime or of the mental condition of the criminal.[^[33]]

The manifestation of sexual instinct in old age is not in itself pathological; but presumption of pathological conditions must necessarily be entertained when the individual is decrepit and his sexual life has already long become extinct; and when the impulse, in a man whose sexual needs were in his early life, perhaps, not very marked, manifests itself with greater strength, and strives for even perverse satisfaction in a shameless and impulsive manner. In such cases there is at once suggested a presumption of pathological conditions. Medical science recognizes the fact that such an impulse depends upon the morbid alterations of the brain which lead to senile dementia. This abnormal manifestation of sexual life may be the precursor of senile dementia, and make its appearance even long before there are any well-defined manifestations of intellectual weakness. The attentive and experienced observer will always be able to detect in this prodromal stage an alteration of character in pejus, and a deterioration of the moral sense accompanying the peculiar sexual manifestation.

The libido of those passing into senile dementia is at first expressed in lascivious speech and gesture. The next objects of the attempts of these senile subjects of brain atrophy and psychical degeneration are children. This sad and dangerous fact is explained by the better opportunity they have of falling in with children, but more especially by a feeling of imperfect sexual power. Defective sexual power and greatly diminished moral sense explain the additional fact of the perversity of the sexual acts of these aged men. They are the equivalents of the impossible physiological act.

The annals of legal medicine distinguish, as such, exhibition of the genitals,[^[34]] lustful handling of the genitals of children,[^[35]] inducing them to perform manustupration of the seducer, and performing masturbation[^[36]] or flagellation on the victim.

In this stage the intellect may still be sufficiently intact to allow avoidance of publicity and discovery, while the moral sense is too far gone to allow consideration of the moral significance of the act and resistance to the impulse. With the progress of dementia, these acts are more and more shamelessly committed. Then care on account of defective sexual power disappears, and adults also become the objects of the senile passion; but the defective sexual power necessitates equivalents for coitus. Not infrequently sodomy results, and, as Tarnowsky (op. cit., p. 77) points out, in the sexual act performed with geese, chickens, etc., the sight of the dying animal and its death-struggles at the time of coitus afford complete satisfaction. The perverse sexual acts with adults are quite as horrible, and may be explained psychologically in the same way.

Case 49, in the author’s “Text-Book of Legal Psychopathology,” second ed., p. 161, demonstrates how enormously increased sexual lust may be during the course of senile dementia. Quum senex libidinosus germanam suam filiam æmulatione motus necaret et adspectu pectoris sciosi puellæ moribundæ delectaretur.

Erotic delirium and states of satyriasis may occur, in the course of the malady, with or without maniacal episodes, as the following case shows:—

Case 1. J. René, always given to indulgence in sensuality and sexual pleasures, but always with regard for decorum, has shown, since his seventy-sixth year, a progressive loss of intelligence and increasing perversion of his moral sense. Previously bright and outwardly moral, he now wasted his property in concourse with prostitutes, frequented brothels only, asked every woman on the street to marry him or allow coitus, and thus became so publicly obnoxious that it was necessary to place him in an asylum. There the sexual excitement increased to a veritable satyriasis, which lasted until he died. He masturbated continuously, even before others; took delight only in obscene ideas; thought the men about him were women, and followed them with indecent proposals (Legrand du Saulle, “La Folie,” p. 533).

Moreover, women previously moral, when affected with senile dementia, may manifest similar conditions of great sexual excitement (nymphomania, furor uterinus).

It may be seen from a reading of Schopenhauer,[^[37]] that, as a result of senile dementia, the abnormally excited and perverse instinct may be directed exclusively to persons of the same sex (v. infra). The manner of the satisfaction is here passive pederasty, or, as I ascertained in the following case, mutual masturbation:—

Case 2. Mr. X., aged 80, of high social position, from a family having hereditary taint. He was always very sensual and a cynic, of uncontrollable temper, and, according to his own confession, as a young man, preferred masturbation to coitus. However, he never showed signs of contrary sexual instinct, and kept mistresses, raising a child by one. At the age of forty-eight he married, out of inclination, and begat six children, and never gave his wife cause for complaint. I could obtain but an incomplete history of his family. It was certain that his brother was suspected of love for men, and that a nephew became insane as a result of excessive masturbation.

The patient, always peculiar and quick-tempered, for years has been growing more extreme in character. He has become exceedingly suspicious, and slight opposition to his wishes induces attacks of anger which may become actual raving, and in which he may raise his hand against his wife. For a year there have been unmistakable signs of incipient senile dementia. The patient has become forgetful, localizes past events incorrectly, and has false ideas of time. For fourteen months it has been noticed that he manifests affection for certain male servants, especially for a gardener’s boy. Otherwise rude and overbearing to servants, he surfeits his favorite with favors and presents, and commands his family and his house officials to treat the boy with the greatest respect. The aged patient awaits the hour of rendezvous in true sexual excitement. He sends his family away, that he may be with his favorite undisturbed, and remains shut up with him for hours; and when the doors are opened again, he is found lying on the bed exhausted. Besides this object of his passion, the patient had intercourse episodically with other servants. It is certain that he enticed them, asked them for kisses, exhibited himself, allowed manipulation ad genitalia, and practiced mutual masturbation. By these practices absolute demoralization was brought about. The family was powerless; for any opposition caused violent outbreaks of anger and even threats against his relatives. The patient was completely without appreciation of his perverse sexual acts; and therefore the only course left to the afflicted family was to remove all authority from his hands and place him in an asylum. No erotic inclination toward the opposite sex was observed, though the patient occupied a sleeping-apartment with his wife. With reference to the perverse sexuality and the defective moral sense of this unfortunate man, it is worthy of note that he questioned the servants of his daughter-in-law as to whether she had a lover.

B. Anæsthesia Sexualis (Absence of Sexual Feeling).

1. As a Congenital Anomaly.

Only those cases can be regarded as unquestionable examples of absence of sexual instinct dependent on cerebral causes, in which, in spite of generative organs normally developed and the performance of their functions (secretion of semen, menstruation), the corresponding emotions of sexual life are absolutely wanting. These functionally sexless individuals are seldom seen, and are, indeed, always persons having degenerative defects, and in whom other functional cerebral disturbances, states of psychical degeneration, and even anatomical signs of degeneration, are observed. Legrand du Saulle describes a classical case that falls under this head (Annales médico-psychol., May, 1876).

Case 3. D., aged 33, had a mother who suffered with insanity of persecution. The mother’s father also suffered with persecutory insanity, and committed suicide. Her mother was insane, and this woman’s mother became insane in the puerperal state. Three of her mother’s children died in babyhood, and those that lived longer had an abnormal character. As early as his thirteenth year, D. was troubled with the thought of becoming insane. At fourteen he attempted suicide. Later, vagabondage, and, as a soldier, repeated insubordination and crazy pranks. His intelligence was very limited; no sign of degeneration, genitals normal. At seventeen or eighteen he had emissions of semen, had never masturbated or had sexual feeling, and never had sought intercourse with women.

Case 4. P., aged 36, common laborer, was received at my clinic in the beginning of November on account of spastic spinal paralysis. He declares he comes of a healthy family. A stutterer from his youth. Cranium microcephalic (cf. 53 cm.). Patient somewhat imbecile. He was never sociable, never had a sexual emotion. The sight of a woman never had anything enticing for him. He never had a desire to masturbate. Erections frequent, but only on waking in the morning with a full bladder, and without a trace of sexual feeling. Pollutions very infrequent,—about once a year, in sleep,—and usually while dreaming that he is concerned with a female. These dreams, however, as his dreams in general, are not markedly erotic. He says the act of pollution is not accompanied by any pleasurable sensation. Patient does not feel this absence of sexual sensations. He gives the assurance that his brother, aged 34, is in exactly the same sexual condition as himself, and he makes it seem probable that a sister, aged 21, is in a similar state. A younger brother, he says, is normal sexually. The examination of his genitals reveals nothing abnormal besides phimosis.

Hammond (“Sexual Impotence”), even with his wide experience, reports only the following three cases of anæsthesia sexualis:—

Case 5. Mr. W., aged 33; strong, healthy, with normal genitals. He had never experienced libido, and had vainly sought to awaken his defective sexual instinct by means of obscene stories and intercourse with prostitutes. On the occasion of such attempts he experienced only disgust, with even a feeling of nausea, and became nervously and mentally exhausted. Only once, when he forced the situation, did he have a transitory erection. W. had never masturbated, and had had pollutions about once every two months from his seventeenth year. Important interests demanded that he marry. He had no horror feminæ, and longed for a home and a wife, but felt that he was incapable of the sexual act. He died, unmarried, in the American civil war.

Case 6. X., aged 27; genitals normal; never felt libido. Mechanical or thermic stimuli easily induced erection, but instead of libido sexualis there was regularly a desire for alcoholic indulgence. Such excesses also induced erections, and he then sometimes masturbated. He had a disinclination for women and a loathing of coitus. If, with an erection, he made an attempt at coitus, it disappeared at once. Death in coma during an attack of cerebral hyperæmia.

Case 7. Mrs. O., normally developed, healthy, menstruated regularly; aged 35, fifteen years married. She never experienced libido, and never had any erotic excitement in sexual intercourse with her husband. She was not averse to coitus, and sometimes seemed to experience pleasure in it, but she never had a wish for repetition of cohabitation.

In connection with such pure cases of anæsthesia there should be considered other cases in which the mental side of the vita sexualis is a blank leaf in the life of the individual, but where elementary sexual sensations manifest themselves at least in masturbation (comp. the transitional Case 6). According to Magnan’s ingenious classification, which, however, is not strictly correct and somewhat too dogmatic, in such cases the sexual life is so limited as to be designated spinal. Possibly in some such cases there exists virtually a mental side of the vita sexualis, but it is very weak, and undermined by masturbation before it attains development. These represent the transitional cases from the congenital to the acquired (psychical) anæsthesia sexualis. This danger threatens many masturbators of vicious constitution. It is psychologically interesting that when the sexual element is early vitiated, then an ethical defect is manifested.

The two following cases, previously published by me in the Archiv für Psychiatrie, vii, are given here as illustrations worthy of consideration:—

Case 8. F. J., aged 19, student; mother was nervous, sister epileptic. At the age of four, acute brain affection, lasting two weeks. As a child he was not affectionate, and was cold toward his parents; as a student he was peculiar, retiring, preoccupied with self, and given to much reading. Well endowed mentally. Masturbation from fifteenth year. Eccentric after puberty, with continual alternation between religious enthusiasm and materialism,—now studying theology, now natural sciences. At the university his fellow-students took him for a fool. He read Jean Paul almost exclusively, and wasted his time. Absolute absence of sexual feeling toward the opposite sex. Once he indulged in intercourse, experienced no sexual feeling in the act, found coitus absurd, and did not repeat it. Without any emotional cause whatever, he often had a thought of suicide. He made it the subject of a philosophical dissertation, in which he contended that it was, like masturbation, a justifiable act. After repeated experiments, which he made on himself with various poisons, he attempted suicide with fifty-seven grains of opium; but he was saved, and sent to an asylum.

Patient is destitute of moral and social feelings. His writings disclose incredible frivolity and vulgarity. His knowledge is of a wide range, but his logic is peculiarly distorted. There is no trace of emotionality. He treats everything (even the sublime) with incomparable cynicism and irony. He pleads for the justification of suicide with false philosophical premises and conclusions, and, as one would speak of the most indifferent affair, he declares that he intends to accomplish it. He regrets that his penknife has been taken from him. If he had it he would open his veins as Seneca did,—in the bath. A short time before a friend had given him, instead of a poison as he supposed, a cathartic. Instead of having been a means to send him to the other world, it had sent him to the water-closet. Only the Great Operator could eradicate his foolish and fatal idea by removing his senses, etc.

The patient has a large, rhombic, distorted skull, the left half of the forehead being flatter than the right. The occiput is very straight. Ears far back, widely projecting, and the external meatus forms a narrow slit. Genitals very lax; testicles unusually soft and small.

Now and then the patient suffers with onomatomania. He is compelled to think of the most useless problems and give up to an interminable distressing and worrying thought; and is so fatigued after it that he is no longer capable of any rational thought. After some months the patient was sent home unimproved. There he spent his time in reading and frivolities, and busied himself with the thought of founding a new Christianity, because Christ had been subject to grand delusions and had deceived the world with wonders (!). After remaining at home some years the sudden occurrence of a maniacal outbreak brought him again to the asylum. He presented a mixture of primordial delirium of persecution (devil, anti-christ, persecution, poisoning, persecutory voices) and delusions of grandeur (Christ, redemption of the world), with impulsive, incoherent actions. After five months there was a remission of this intercurrent acute mental disease, and the patient returned to the level of his original intellectual peculiarity and moral defect.

Case 9. E., aged 30, journeyman-painter, was arrested while trying to cut off the scrotum of a boy he had caught in the woods. He gave as a motive for this act that he wished to cut into it in order that the world should not multiply. Often in his youth, with like purpose, he had cut into his own genitals.

It is impossible to learn anything of his ancestry. From his childhood he was mentally abnormal, violent, never lively, very irritable, irascible, selfish, and weak-minded. He hated women, loved solitude, and read much. He sometimes laughed to himself and did silly things. Of late years his hatred of women had increased, especially of those that were pregnant, they being responsible for the misery of the world. He also hated children, and cursed his father. He entertained communistic ideas, and berated the rich and the ministry, and God, who had allowed him to come into the world so poor. He declared that it would be better to castrate all children than to allow others to come into the world that could only be fated to endure poverty and misery. He had always had the intention, from his fifteenth year, to castrate himself, in order to have no part in increasing unhappiness and adding to the number of men. He hated the female sex because it was a means of procreation. Only twice in his life had he allowed women to practice manustupration on him, and, with the exception of this, he had never had anything to do with them. Occasionally he had sexual desire, but never for a natural satisfaction of it. When nature did not help him, he occasionally helped himself by means of masturbation.

He is a powerful, muscular man. The formation of the genitals presents no abnormality. On the scrotum and penis are numerous scars, which resulted from his attempts at self-emasculation, but which, he asserts, were not carried out on account of pain. Genu valgum of right limb. No evidence of onanism could be discovered. He is moody, defiant, irritable. Social feelings are absolutely foreign to him. With the exception of imperfect sleep and frequent headaches, there are no functional disturbances.

From cases of this kind, depending on cerebral causes, there must be distinguished others where the absence of function arises from an absence or malformation of the generative organs, as in certain hermaphrodites, idiots, and cretins. A case belonging here is found in Maschka’s hand-book.

Case 10. Complainant pleads for divorce on account of impotence of her husband, who has never had intercourse with her. She is thirty-one years old, and a virgin. The husband is somewhat weak mentally, physically strong; the genitals well developed. He declares that he has never had a complete erection or a flow of semen, and says that he is totally indifferent about intercourse with women.

Ultzmann’s[^[38]] observations show that anæsthesia sexualis is not caused by aspermia simply. He shows that even in congenital aspermia the vita sexualis and sexual power may be entirely satisfying; an additional proof that defective libido ab origine is to be sought for in cerebral conditions.

The naturæ frigidas of Zacchias are examples of a milder form of anæsthesia. They are met more frequently among women than among men. The characteristic signs of this anomaly are: slight inclination to sexual intercourse, or pronounced disinclination to coitus without sexual equivalent, and failure of corresponding psychical, pleasurable excitation during coitus, which is indulged in simply from sense of duty. I have often had occasion to hear complaints from husbands about this. In such cases the wives have always proved to be neuropathic ab origine. Some were at the same time hysterical.

2. Acquired Anæsthesia.

Acquired diminution of sexual instinct, extending through all degrees to extinction, may depend on various causes. These may be organic and functional, psychical and somatic, central and peripheral. The diminution of libido, as age advances, and its temporary disappearance after the sexual act, are physiological. The variations with reference to the duration of the sexual instinct are dependent upon individual factors. Education and manner of life have a great influence upon the intensity of the vita sexualis. Intense mental activity (hard study), physical exertion, emotional depression, and sexual continence decidedly diminish sexual inclination. Continence at first induces increase, but sooner or later, according to constitutional conditions, the activity of the generative organs decreases, and with it libido. At all events, in a person sexually mature, a close connection exists between the activity of the generative glands and the degree of libido. That this relation is not determinate is shown by the cases of sensual women, who, after the climacterium, continue to have sexual intercourse, and may manifest states of sexual excitement (cerebral). Also in eunuchs it is seen that libido may long outlast the production of semen.

On the other hand, however, experience teaches that libido is essentially conditioned by the function of the generative glands, and that the facts mentioned are exceptional manifestations. As peripheral causes of diminution or extinction of libido, may be mentioned castration, degeneration of the sexual glands, marasmus, sexual excesses in the form of coitus and masturbation, and alcoholism [cocainism]. In the same way, the disappearance of libido in general disturbances of nutrition (diabetes, morphinism, etc.) may be explained. Finally, the atrophy of the testicles should be remembered, which has sometimes been observed to follow focal lesions of the brain (cerebellum).

A diminution of the vita sexualis, from degeneration of the tracts of the cord and genito-spinal centre, occurs in diseases of the spinal cord and brain. A central interference with the sexual instinct may be organically induced by cortical disease (dementia paralytica in its advanced stages); functionally, by hysteria (central anæsthesia?) and emotional insanity (melancholia, hypochondria).

C. Hyperæsthesia (Abnormally Increased Sexual Desire).

Pathology has no easy task, in the single case, when it has to decide whether the impulse to sexual satisfaction has reached a pathological degree. Emminghaus (“Psychopathologie,” p. 225) declares that the immediate re-awakening of desire after satisfaction, with its occupation of the entire attention, and no less the excitation of libido by the sight of persons and things which in themselves should have but an indifferent sexual effect, are decidedly abnormal. In general, sexual instinct and its corresponding needs are in proportion to physical strength and age. Sexual desire rapidly increases after puberty, until it reaches a marked degree; is strongest from the twentieth to the fortieth year, and then slowly decreases. Married life seems to preserve and control the instinct. Sexual intercourse with many persons increases the desire.